61 results on '"Cancelliere, A."'
Search Results
2. Hypertriglyceridemia in young adults with a 22q11.2 microdeletion
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Christina Blagojevic, Tracy Heung, Sarah Malecki, Shengjie Ying, Sabrina Cancelliere, Robert A Hegele, and Anne S Bassett
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Adult ,Cohort Studies ,Hypertriglyceridemia ,Male ,Young Adult ,Endocrinology ,Risk Factors ,Endocrinology, Diabetes and Metabolism ,Diabetes Mellitus ,Humans ,Obesity ,General Medicine - Abstract
Objective Mild to moderate hypertriglyceridemia is a condition often associated with obesity and diabetes, with as yet incomplete knowledge of underlying genetic architecture. The 22q11.2 microdeletion is associated with multimorbidity, including increased risk of obesity and diabetes. In this study, we sought to investigate whether the 22q11.2 microdeletion was associated with mild to moderate hypertriglyceridemia (1.7–10 mmol/L). Design This was a cohort study comparing 6793 population-based adults and 267 with a 22q11.2 microdeletion aged 17–69 years, excluding those with diabetes or on statins. Methods We used binomial logistic regression modeling to identify predictors of hypertriglyceridemia, accounting for the 22q11.2 microdeletion, male sex, BMI, ethnicity, age, and antipsychotic medications. Results The 22q11.2 microdeletion was a significant independent predictor of mild to moderate hypertriglyceridemia (odds ratio (OR): 2.35, 95% CI: 1.70–3.26). All other factors examined were also significant predictors (OR: 1.23–2.10), except for antipsychotic medication use. Within the 22q11.2 microdeletion subgroup, only male sex (OR: 3.10, 95% CI: 1.77–5.44) and BMI (OR: 1.63, 95% CI: 1.14–1.98) were significant predictors of hypertriglyceridemia, evident at mean age 31.2 years. Conclusions The 22q11.2 microdeletion is associated with hypertriglyceridemia even when accounting for other known risk factors for elevated triglycerides. This effect is seen in young adulthood (76.6% were
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- 2022
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3. The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory
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Nicole Mariantonia Cancelliere, Eric Hummel, Fred van Nijnatten, Peter van de Haar, Paul Withagen, Marijke van Vlimmeren, Bertan Hallacoglu, Ronit Agid, Patrick Nicholson, and Vitor Mendes Pereira
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundCone-beam computed tomography (CBCT) imaging of the brain can be performed in the angiography suite to support various neurovascular procedures. Relying on CBCT brain imaging solely, however, still lacks full diagnostic confidence due to the inferior image quality compared with CT and various imaging artifacts that persist even with modern CBCT.ObjectiveTo perform a detailed evaluation of image artifact improvement using a new CBCT protocol which implements a novel dual-axis ‘butterfly’ trajectory.MethodsOur study included 94 scans from 47 patients who received CBCT imaging for assessment of either ischemia or hemorrhage during a neurovascular procedure. Both a traditional uni-axis ‘circular’ and novel dual-axis ‘butterfly’ protocol were performed on each patient (same-patient control). Each brain scan was divided into six regions and scored out of 3 based on six artifacts originating from various physics-based and patient-based sources.ResultsThe dual-axis trajectory produces CBCT images with significantly fewer image artifacts than the traditional circular scan (whole brain average artifact score, AS: 0.20 vs 0.33), with the greatest improvement in bone beam hardening (AS: 0.13 vs 0.78) and cone-beam artifacts (AS: 0.04 vs 0.55).ConclusionsRecent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.
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- 2022
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4. Integrating computational fluid dynamics data into medical image visualization workflows via DICOM
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Lucas Temor, Nicole M. Cancelliere, Daniel E. MacDonald, Peter W. Coppin, Vitor M. Pereira, and David A. Steinman
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Biomedical Engineering ,Health Informatics ,Radiology, Nuclear Medicine and imaging ,Surgery ,General Medicine ,Computer Vision and Pattern Recognition ,Computer Graphics and Computer-Aided Design ,Computer Science Applications - Published
- 2022
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5. Venous balloon test occlusion for pulsatile tinnitus assessment: A clinical feasibility study
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Guillaume Charbonnier, Nicole Mariantonia Cancelliere, Arianna Rustici, André Araújo, Irene Vanek, John Rutka, Jose Danilo Bengzon Diestro, Tom Marotta, Julian Spears, and Vitor Mendes Pereira
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General Medicine - Abstract
Background Pulsatile tinnitus (PT) can have huge impact on the patients’ quality of life and can be associated with curable vascular anomalies. In the present study, we aim firstly to describe our protocol for venous BTO and secondly to report possible predictors for a positive BTO test. Methods All consecutive PT patients undergoing BTO for the purpose of determining eligibility for venous neuro-intervention were included. We recommend BTO for patients when there is uncertainty in the association of the venous pathology identified on non-invasive cross-sectional imaging (CTV or MRV) and the patient's symptoms. Results Between May 2016 and October 2022, we recorded 29 venous balloon test occlusions fulfilling our inclusions criteria. Over the 29 procedures scheduled, 8 finally did not lead to a successful balloon test occlusion. The main reason was that the patient did not hear the PT on the day the angiogram was performed. Two patients could not have the BTO due to difficulties in venous navigation. After BTO, only four patients of our cohort were scheduled for an endovascular treatment. Conclusion We describe a technique and present a single cohort of venous BTO in severe PT patients with unclear anatomical cause. This angiographic test was useful to exclude patients from endovascular surgery and discuss the most probable cause of the PT. Complexity of vascular PT should support a patient-based approach when discussing interventional treatment.
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- 2023
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6. Identifying ex vivo acute ischemic stroke thrombus composition using electrochemical impedance spectroscopy
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Jean Darcourt, Waleed Brinjikji, Olivier François, Alice Giraud, Collin R. Johnson, Smita Patil, Senna Staessens, Ramanathan Kadirvel, Mahmoud H Mohammaden, Leonardo Pisani, Gabriel Martins Rodrigues, Nicole M Cancelliere, Vitor Mendes Pereira, Franz Bozsak, Karen Doyle, Simon F De Meyer, Pierluca Messina, David Kallmes, Christophe Cognard, and Raul G Nogueira
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General Medicine - Abstract
Background Intra-procedural characterization of stroke thromboemboli might guide mechanical thrombectomy (MT) device choice to improve recanalization rates. Electrochemical impedance spectroscopy (EIS) has been used to characterize various biological tissues in real time but has not been used in thrombus. Objective To perform a feasibility study of EIS analysis of thrombi retrieved by MT to evaluate: (1) the ability of EIS and machine learning to predict red blood cell (RBC) percentage content of thrombi and (2) to classify the thrombi as “RBC-rich” or “RBC-poor” based on a range of cutoff values of RBC. Methods ClotbasePilot was a multicentric, international, prospective feasibility study. Retrieved thrombi underwent histological analysis to identify proportions of RBC and other components. EIS results were analyzed with machine learning. Linear regression was used to evaluate the correlation between the histology and EIS. Sensitivity and specificity of the model to classify the thrombus as RBC-rich or RBC-poor were also evaluated. Results Among 514 MT,179 thrombi were included for EIS and histological analysis. The mean composition in RBC of the thrombi was 36% ± 24. Good correlation between the impedance-based prediction and histology was achieved (slope of 0.9, R2 = 0.53, Pearson coefficient = 0.72). Depending on the chosen cutoff, ranging from 20 to 60% of RBC, the calculated sensitivity for classification of thrombi ranged from 77 to 85% and the specificity from 72 to 88%. Conclusion Combination of EIS and machine learning can reliably predict the RBC composition of retrieved ex vivo AIS thrombi and then classify them into groups according to their RBC composition with good sensitivity and specificity.
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- 2023
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7. Deep learning-based cerebral aneurysm segmentation and morphological analysis with three-dimensional rotational angiography
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Hidehisa Nishi, Nicole M Cancelliere, Ariana Rustici, Guillaume Charbonnier, Vanessa Chan, Julian Spears, Thomas R Marotta, and Vitor Mendes Pereira
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundThe morphological assessment of cerebral aneurysms based on cerebral angiography is an essential step when planning strategy and device selection in endovascular treatment, but manual evaluation by human raters only has moderate interrater/intrarater reliability.MethodsWe collected data for 889 cerebral angiograms from consecutive patients with suspected cerebral aneurysms at our institution from January 2017 to October 2021. The automatic morphological analysis model was developed on the derivation cohort dataset consisting of 388 scans with 437 aneurysms, and the performance of the model was tested on the validation cohort dataset consisting of 96 scans with 124 aneurysms. Five clinically important parameters were automatically calculated by the model: aneurysm volume, maximum aneurysm size, neck size, aneurysm height, and aspect ratio.ResultsOn the validation cohort dataset the average aneurysm size was 7.9±4.6 mm. The proposed model displayed high segmentation accuracy with a mean Dice similarity index of 0.87 (median 0.93). All the morphological parameters were significantly correlated with the reference standard (all PConclusionThe automatic aneurysm analysis model based on angiography data exhibited high accuracy for evaluating the morphological characteristics of cerebral aneurysms.
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- 2023
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8. Integrating Indigenous healing practices within collaborative care models in primary healthcare in Canada: a rapid scoping review
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Melissa Corso, Astrid DeSouza, Ginny Brunton, Hainan Yu, Carolina Cancelliere, Silvano Mior, Anne Taylor-Vaisey, Kathy MacLeod-Beaver, and Pierre Côté
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Canada ,British Columbia ,Population Groups ,Primary Health Care ,Humans ,General Medicine ,Indigenous Peoples ,Delivery of Health Care ,Aged - Abstract
ObjectivesIn November 2020, a series of reports, In Plain Sight, described widespread Indigenous-specific stereotyping, racism and discrimination limiting access to medical treatment and negatively impacting the health and wellness of Indigenous Peoples in British Columbia, Canada. To address the health inequalities experienced by Indigenous peoples, Indigenous healing practices must be integrated within the delivery of care. This rapid scoping review aimed to identify and synthesise strategies used to integrate Indigenous healing practices within collaborative care models available in community-based primary healthcare, delivered by regulated health professionals in Canada.Eligibility criteriaWe included quantitative, qualitative and mixed-methods studies conducted in community-based primary healthcare practices that used strategies to integrate Indigenous healing practices within collaborative care models.Sources of evidenceWe searched MEDLINE, Embase, Indigenous Studies Portal, Informit Indigenous Collection and Native Health Database for studies published from 2015 to 2021.Charting methodsOur data extraction used three frameworks to categorise the findings. These frameworks defined elements of integrated healthcare (ie, functional, organisational, normative and professional), culturally appropriate primary healthcare and the extent of community engagement. We narratively summarised the included study characteristics.ResultsWe identified 2573 citations and included 31 in our review. Thirty-nine per cent of reported strategies used functional integration (n=12), 26% organisational (n=8), 19% normative (n=6) and 16% professional (n=5). Eighteen studies (58%) integrated all characteristics of culturally appropriate Indigenous healing practices into primary healthcare. Twenty-four studies (77%) involved Indigenous leadership or collaboration at each phase of the study and, seven (23%) included consultation only or the level of engagement was unclear.ConclusionsWe found that collaborative and Indigenous-led strategies were more likely to facilitate and implement the integration of Indigenous healing practices. Commonalities across strategies included community engagement, elder support or Indigenous ceremony or traditions. However, we did not evaluate the effectiveness of these strategies.
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- 2022
9. Sap Beetles (Coleoptera: Nitidulidae) in Oak Forests of Two Northeastern States: A Comparison of Trapping Methods and Monitoring for Phoretic Fungi
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Marc F. DiGirolomo, Isabel A. Munck, Jessica Cancelliere, and Kevin J. Dodds
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0106 biological sciences ,Oak wilt ,Ecology ,biology ,Geographic area ,education ,Microascales ,Sap beetle ,General Medicine ,Fungus ,Forests ,biology.organism_classification ,010603 evolutionary biology ,01 natural sciences ,Pheromones ,Spore ,Trapping methods ,Coleoptera ,Quercus ,010602 entomology ,Ascomycota ,Insect Science ,Sex pheromone ,Botany ,Animals - Abstract
Oak wilt is slowly expanding in the northeastern United States. Several nitidulid beetle species are known vectors of the fungus [Bretziella fagacearum (Bretz) Z. W. De Beer, Marinc., T. A. Duong, and M. J. Wingf (Microascales: Ceratocystidaceae)] that causes this disease, acquiring spores from fungal mats on infected trees and transmitting them to uninfected trees. Survey and fungal isolation from captured nitidulid beetles could be an important tool for detecting the presence of this disease in a geographic area not previously known to have oak wilt. In preparation for monitoring activities in such areas, two trapping studies were conducted in the northeastern United States: 1) trap test comparing the efficacy of wind-oriented pipe, multiple-funnel, and modified pitfall traps for nitidulids and 2) wet and dry collection cup comparison. Lures were a combination of nitidulid pheromones and fermenting liquid. Results support the use of multiple-funnel traps over the other two trap types, for both targeted species-specific surveys and community sampling. More total nitidulids, Colopterus truncatus (Randall), and Glischrochilus fasciatus (Olivier) were captured in wet collection cups compared with dry cups. Twenty-seven fungal species were isolated, none of which were B. fagacearum. Many fungi isolated from beetles were plant pathogens, indicating that in addition to the oak wilt fungus, sap beetles may contribute to the spread of other plant diseases.
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- 2020
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10. Brief action planning targeting prognostic factors for an adult with persistent low back pain without radiculopathy: A case report
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Heather M. Shearer, Carol Cancelliere, Hainan Yu, Leslie Verville, Jessica J. Wong, and Gaelan Connell
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Medicine (General) ,medicine.medical_specialty ,Case Report ,Case Reports ,030204 cardiovascular system & hematology ,patient education ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Medicine ,behavioral medicine ,business.industry ,General Medicine ,Guideline ,Low back pain ,social care ,Clinical Practice ,Action planning ,030220 oncology & carcinogenesis ,Behavioral medicine ,Physical therapy ,Social care ,medicine.symptom ,business ,heath maintenance ,Psychosocial ,Patient education - Abstract
We describe the implementation of brief action planning in conjunction with evidence‐based clinical practice guideline recommendations to improve self‐efficacy in a patient with psychosocial barriers and persistent nonspecific low back pain.
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- 2020
11. Comparison of intra-aneurysmal flow modification using optical flow imaging to evaluate the performance of Evolve and Pipeline flow diverting stents
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Nicole M. Cancelliere, Emanuele Orru, Vitor Mendes Pereira, Ivan Radovanovic, Karla Mirella Silva Lobato Mendes, Patrick Nicholson, and Timo Krings
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medicine.medical_treatment ,Pipeline (computing) ,Optical flow ,Pulsatile flow ,Aneurysm ,Basic Science ,medicine ,blood flow ,Humans ,angiography ,cardiovascular diseases ,medicine.diagnostic_test ,business.industry ,Hemodynamics ,Stent ,flow diverter ,Angiography, Digital Subtraction ,Intracranial Aneurysm ,General Medicine ,Digital subtraction angiography ,Blood flow ,medicine.disease ,equipment and supplies ,Angiography ,aneurysm ,Surgery ,Stents ,Neurology (clinical) ,business ,Biomedical engineering - Abstract
BackgroundFlow diverting stent (FDS) devices have revolutionized the treatment of large and complex brain aneurysms, but there is still room for improvement, particularly on the flow diversion properties and technical challenges associated with stent deployment. In this study we compared flow diversion properties between the new generation Surpass Evolve (Stryker) and the Pipeline Flex (Medtronic) devices by quantitatively evaluating intra-aneurysmal flow modification.MethodsAn in vitro experimental set-up was used, consisting of four patient-specific silicone models with internal carotid aneurysms and a circulating hemodynamic simulation system with pulsatile flow. The Evolve and Pipeline stents were deployed across the neck of each aneurysm model, in a randomized fashion, for a total of eight device deployments. A 60 frames/s digital subtraction angiography run was acquired before and after placement of each FDS. An optical flow-analysis method was used to measure intra-aneurysmal flow modification induced by the stent by calculating a mean aneurysm flow amplitude (MAFA) before and after stent placement and computing a ratio.ResultsAverage MAFA ratio values calculated from pre- and post-stent placement were significantly lower after deployment of the Evolve (n=4, mean=0.62±0.09) compared with the Pipeline device (n=4, mean=0.71±0.06) (p=0.03).ConclusionsOur in vitro results show that the Evolve stent had a superior flow diversion effect compared with the Pipeline stent, which—based on clinical evidence—suggest it may promote faster aneurysm occlusion rates in patients.
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- 2020
12. Cost-effective and disposable label-free voltammetric immunosensor for sensitive detection of interleukin-6
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Rocco Cancelliere, Alessio Di Tinno, Andrea Maria Di Lellis, Giorgio Contini, Laura Micheli, and Emanuela Signori
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Immunoassay ,Interleukin-6 ,Cost-Benefit Analysis ,Biomedical Engineering ,Biophysics ,Reproducibility of Results ,General Medicine ,Biosensing Techniques ,Electrochemical Techniques ,Biochar ,Label-free immunosensor ,Settore CHIM/01 ,Limit of Detection ,Electrochemistry ,Point-of-care device ,Humans ,Electrochemical immunosensor ,Green-nanocarbon ,Electrodes ,Biotechnology - Abstract
IL-6 detection is highly desirable since can monitor many diseases in humans and assess the response to treatments. Herein, two novel label-free voltammetric immunosensors for rapid and accurate interleukin-6 (IL-6) detection in human serum are presented. The immunosensors are fabricated by immobilising two different IL-6 antibodies, identified as mAb-IL-6 clone-5 and clone-7, on in-house produced screen-printed electrodes modified with inexpensive recycling biochar (Bio-SPEs). To ensure high structural fidelity and performance, an in-depth electrochemical characterization of the layer-by-layer assembly of the immunosensor was conducted by cyclic voltammetry (CV) and sensing was performed using square wave voltammetry (SWV). The two immunosensors showed good analytical performances in human serum, exhibiting a wide linear range (LR) between 26-125 and 30-138 pg/mL, a good limit of detection (LOD) of 4.8 and 5.4 pg/mL and selectivity for IL-6 over other common cytokines, including IL-1β and TNF-α. Performance comparison of IL-6 immunosensors with those of a commercial spectrophotometric ELISA kit (LOD of 20 pg/mL, RSD% of 15%) denotes a better sensitivity and reproducibility of the proposed label-free devices, associated with a reduced detection time (30 min instead of more than 3 h for ELISA test). Furthermore, the proposed immunosensors were successfully applied in blood samples (with only a dilution of 1:100 v/v in PBS and without additional treatments) with good sensitivity (LOD of 14.3 pg/mL) and reproducibility (RSD% 11%), thus paving the way for their application as viable diagnostic and therapeutic point-of-care tools alternative to the IL-6 detection techniques routinely used (ELISA and Western Blot).
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- 2022
13. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review
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Carlo Ammendolia, Corey Hofkirchner, Joshua Plener, André Bussières, Michael J Schneider, James J Young, Andrea D Furlan, Kent Stuber, Aksa Ahmed, Carol Cancelliere, Aleisha Adeboyejo, and Joseph Ornelas
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clinical trials ,Leg ,Epidemiology ,back pain ,General Medicine ,spine ,Musculoskeletal Manipulations ,Exercise Therapy ,Spinal Stenosis ,pain management ,Humans ,Medicine ,epidemiology ,neurological pain ,Aged - Abstract
ObjectivesNeurogenic claudication due to lumbar spinal stenosis (LSS) is a growing health problem in older adults. We updated our previous Cochrane review (2013) to determine the effectiveness of non-operative treatment of LSS with neurogenic claudication.DesignA systematic review.Data sourcesCENTRAL, MEDLINE, EMBASE, CINAHL and Index to Chiropractic Literature databases were searched and updated up to 22 July 2020.Eligibility criteriaWe only included randomised controlled trials published in English where at least one arm provided data on non-operative treatment and included participants diagnosed with neurogenic claudication with imaging confirmed LSS.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias using the Cochrane Risk of Bias Tool 1. Grading of Recommendations Assessment, Development and Evaluation was used for evidence synthesis.ResultsOf 15 200 citations screened, 156 were assessed and 23 new trials were identified. There is moderate-quality evidence from three trials that: Manual therapy and exercise provides superior and clinically important short-term improvement in symptoms and function compared with medical care or community-based group exercise; manual therapy, education and exercise delivered using a cognitive-behavioural approach demonstrates superior and clinically important improvements in walking distance in the immediate to long term compared with self-directed home exercises and glucocorticoid plus lidocaine injection is more effective than lidocaine alone in improving statistical, but not clinically important improvements in pain and function in the short term. The remaining 20 new trials demonstrated low-quality or very low-quality evidence for all comparisons and outcomes, like the findings of our original review.ConclusionsThere is moderate-quality evidence that a multimodal approach which includes manual therapy and exercise, with or without education, is an effective treatment and that epidural steroids are not effective for the management of LSS with neurogenic claudication. All other non-operative interventions provided insufficient quality evidence to make conclusions on their effectiveness.PROSPERO registration numberCRD42020191860.
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- 2022
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14. Delirium and Clusters of Older Patients Affected by Multimorbidity in Acute Hospitals
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Monacelli, F, Signori, A, Marengoni, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Monacelli, F, Signori, A, Marengoni, A, Di Santo, S, Rossi, E, Valsecchi, M, Morandi, A, and Bellelli, G
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medicine.medical_specialty ,multimorbidity ,Delirium, multimorbidity ,Socio-culturale ,Older patients ,mental disorders ,Medicine ,Dementia ,Multimorbidity ,Humans ,Medical history ,LS4_4 ,General Nursing ,Aged ,Aged, 80 and over ,Routine screening ,business.industry ,Health Policy ,Delirium ,General Medicine ,Targeted interventions ,medicine.disease ,Hospitals ,Cross-Sectional Studies ,Charlson comorbidity index ,Emergency medicine ,Geriatrics and Gerontology ,medicine.symptom ,business - Abstract
Objectives Delirium is commonly seen in older adults with multimorbidity, during a hospitalization, resulting from the interplay between predisposing factors such as advanced age, frailty, and dementia, and a series of precipitating factors. The association between delirium and specific multimorbidity is largely unexplored so far although of potential key relevance for targeted interventions. The aim of the study was to check for a potential association of multimorbidity with delirium in a large cohort of older patients hospitalized for an acute medical or surgical condition. Design This is a cross-sectional study nested in the 2017 Delirium Day project. Setting and Participants The study includes 1829 hospitalized patients (age: 81.8, SD: 5.5). Of them, 419 (22.9%) had delirium. Methods Sociodemographic and medical history were collected. The 4AT was used to assess the presence of delirium. The Charlson Comorbidity index was used to assess multimorbidity. Results The results identified neurosensorial multimorbidity as the most prevalent, including patients with dementia, cerebrovascular diseases, and sensory impairments. In light of the highest co-occurrence of 3 neurosensorial chronic conditions, we could hypothesize that a baseline altered brain functional and neural connectivity might determine the vulnerability signature for incipient overall system disruption in presence of acute insults. Conclusions and Implications Eventually, our findings moved a step forward in supporting the key importance of routine screening for sensory impairments and cognitive status of older patients for the highest risk of in-hospital delirium. In fact, preventive interventions could be particularly relevant and effective in preventing delirium in such vulnerable populations and might help refining this early diagnosis.
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- 2022
15. Powerful electron-transfer screen-printed platforms as biosensing tools: the case of uric acid biosensor
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Rocco Cancelliere, Alessio Di Tinno, Antonino Cataldo, Stefano Bellucci, and Laura Micheli
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Nanotubes, Carbon ,nanomaterials ,screen-printed electrodes ,uric acid ,point-of-care device ,Clinical Biochemistry ,Reproducibility of Results ,Electrons ,General Medicine ,Biosensing Techniques ,Electrochemical Techniques ,Screen-printed electrodes ,Article ,Settore CHIM/01 ,Point-of-care device ,Electrodes ,Uric acid ,TP248.13-248.65 ,Biotechnology ,Nanomaterials - Abstract
The use of carbon nanomaterials (CNMs) in sensors and biosensor realization is one of the hottest topics today in analytical chemistry. In this work, a comparative in-depth study, exploiting different nanomaterial (MWNT-CO2H, -NH2, -OH and GNP) modified screen-printed electrodes (SPEs), is reported. In particular, the sensitivity, the heterogeneous electron transfer constant (k0), and the peak-to-peak separation (ΔE) have been calculated and analyzed. After which, an electrochemical amperometric sensor capable of determining uric acid (UA), based on the nano-modified platforms previously characterized, is presented. The disposable UA biosensor, fabricated modifying working electrode (WE) with Prussian Blue (PB), carbon nanotubes, and uricase enzyme, showed remarkable analytical performances toward UA with high sensitivity (CO2H 418 μA μM−1 cm−2 and bare SPE-based biosensor, 33 μA μM−1 cm−2), low detection limits (CO2H 0.5 nM and bare SPE-based biosensors, 280 nM), and good repeatability (CO2H and bare SPE-based biosensors, 5% and 10%, respectively). Moreover, the reproducibility (RSD%) of these platforms in tests conducted for UA determination in buffer and urine samples results are equal to 6% and 15%, respectively. These results demonstrate that the nanoengineered electrode exhibited good selectivity and sensitivity toward UA even in the presence of interfering species, thus paving the way for its application in other bio-fluids such as simple point-of-care (POC) devices.
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- 2022
16. Effectiveness of digitally delivered sleep interventions on sleep and mental health outcomes in postsecondary students: A systematic review
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M. Albrecht-Bisset, C. Cancelliere, K. Martin, G. Brunton, K. Velji, D. Southerst, L. Verville, A. Taylor-Vaisey, B. Ashtarieh, R. Larmour, P. Côté, and E.A. Papaconstantinou
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General Medicine - Published
- 2022
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17. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia
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Morandi, A, Zambon, A, Di Santo SG, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Amedeo, G, Peluso, L, Taristano, A, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, Mt, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Pascale, C, Bosio, A, Cerrato, F, Bardelli, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Cavallino, P, Fabio, S, De Filippi, F, Giudice, C, Floris, P, D’Elia, K, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Santana, H, Benati, C, Nesta, E, Tobaldini, C, Antonioli, A, Guerini, F, Tambare, E, Mombelloni, P, Fontanini, F, 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Salini, S, Brunetti, Ma, Cappa, G, Galvagno, G, Cena, P, Gerardo, B, Raspo, S, Pedrotti, S, Palmieri, Vo, Palasciano, G, Belfiore, A, Portincasa, P, Sabbà, C, Solfrizzi, V, D’Introno, A, Valiani, V, Bologna, C, Ciarambino, T, Turelli, P, Pazzaglia, U, Rodella, F, Piana, G, Castellano, M, Garelli, A, Casella, E, Campana, F, Coschignano, Ma, Marinangeli, L, Lorico, F, Bazzano, S, Menculini, G, Gelosa, G, Ambrogio, Tv, Piras, V, Ciricugno, A, Bollari, A, Coen, D, Magliola, R, Milanesio, D, Muzzulini, Cl, Fogliacco, P, Turla, M, Cotelli, Ms, Bianchi, M, Siano, P, Capo, G, Napoletano, R, Politi, C, Mancini, C, Del Buono, C, De Bartolomeo, G, Martinelli, A, Cefalogli, C, Cozzi, R, Virtuani, Ag, Moschettini, G, Mastroianni, F, Roglia, D, D’Amico, G, Palella, M, Endrizzi, C, Trotta, L, Zanetti, O, Terazzi, E, Sacchetti, M, Fleetwood, T, Tondo, G, Di Fazio, I, Orsitto, G, Fabbro, E, D’Imporzano, E, Casanova, A, Bertolio, S, Nervo, E, Silvestri, R, Semproni, E, Pintus, M, Aloe, F, Tagliaccica, A., Morandi A., Zambon A., Di Santo S.G., Mazzone A., Cherubini A., Mossello E., Bo M., Marengoni A., Piccoli T., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Lupi G., Paonessa P., Fabbri A., Passuti M.T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Claudia Benati H.S., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L.L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F.F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Sechi R.B., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D.B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Ilaria D.L., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P.G., Daniela L., Domenico C., Giorgio B., March A., Nitti M.T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Perticone F., Addesi D., Rosa P.C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Cappelletto F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Lucia Gambardella P.M., Valente C., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M.G., Troisi E., Carlo C., Simona Gabriella D.S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M.L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A.M., Carlucci R., Abbaldo A., Monzani F., Qasem A.A., Bini G., Tafuto S., Galli G., Bruni A.C., Mancuso G., Calipari D., Giuseppe Massimiliano D.L., Bernardini B., Corsini C., Michele C., Sara D.F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Gatti C.D., Magon S., Roberto M., Alfredo D.G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M.L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M.S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M.R., Pizio R.N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M.M., Marco D.A., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R.C., Grassi G., Michele B., Raffaella D.O., Fosca Q.T., Giorgio G.C., Giovanni P., Ernesto C., Mannironi A., Giorli E., Oberti S., Fierro B., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Santo P.D., Andriolli A., Burattin G., Rossi L., Andreolli Antonino C.G., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Salutis D., Ivaldi C., Russo A.M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M.R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C.A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G G., Calvi E., Clementi C., Zanocchi M., Agosta L., Nortarelli A., Provenzano G., Mari D., Romano F.Y., Rosini F., Mansi M., Rossi S., Geriatria A.R., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M.R., Prestano R., Dalise A.M., Barra D., Bosco L.D., Asprinio V., Dallape L., Perina E., Incalzi R.A., Bartoli I.R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P.L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M.C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A.M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A.C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P.M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P.F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Barbujani M., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D.M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A.M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C.G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Fabbro A.D., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S.M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A.C., Bonino P., Caput M., Antonietti M.P., Polistena G., De la Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R.M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M.C., Mantovani A.R., Viola M.C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L.M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Biagini C.A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S.A., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U.C., Enrico C., Vera R.F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., Valeria D.A., Federico G., Lucia P., Antonella V., Elisabetta D.C., Cristina R., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P.M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C.A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V.P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Busonera Flavio M.T., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., DuranteMangoni E., Testoni M., Fabio D.S., Loredana S., Valeria S., Fabiano M., Annabella D.G., Salvatore D.C., Greco A., Grazia D.O., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., Paolo D.C., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Davide D.A., Stefania C., Massimo P., Luca S., Martina D.F., Paola V., Lia S., Sandro C., Valentina D.S., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M.P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., Stefania D.N., Pierluigi D.S., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Giovanna D.B., Francesco L., Salini S., Angela B.M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R.M., Maria D.A., Raffaele P., Palmieri V.O., Palasciano G., Belfiore A., Portincasa P., Carlo S., Alessia D., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C.M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A.T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C.L., Paolo F., Marinella T., Sofia C.M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V.A., Moschettini G., Franco M., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Ignazio D.F., Andrea B., Giuseppe O., Emanuela F., Serena A., Elena D.I., Serena B., Erika N., Roberto S., Elena S., Manuela P., Francesca A., Angelo T., Morandi, A, Zambon, A, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Gabriele, A, Lenino, P, Andrea, T, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, M, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Claudio, P, Angelo, B, Flavio, C, Benedetta, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Fabio, S, De Filippi, F, Giudice, C, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Claudia Benati, H, Nesta, E, Tobaldini, C, Guerini, F, Elena, T, Mombelloni, P, Fontanini, F, Gabriella, L, Pizzorni, C, Oliverio, M, Del Grosso, L, Giavedoni, C, Bidoli, G, Mazzei, B, Corsonello, A, Fusco, S, 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Migale, M, Scrimieri, A, Falsetti, L, Salvi, A, Toigo, G, Ceschia, G, Rosso, A, Tongiorgi, C, Scarpa, C, De Dominicis, L, Pucci, E, Renzi, S, Cartechini, E, Tomassini, P, Del Gobbo, M, Ugenti, F, Romeo, P, Nardelli, A, Lauretani, F, Visioli, S, Montanari, I, Ermini, F, Giordano, A, Pigato, G, Simeone, E, Barbujani, M, Giampieri, M, Amoruso, R, Piccinini, M, Ferrari, C, Gambetti, C, Sfrappini, M, Semeraro, L, Striuli, R, Pelliccioni, G, Marinelli, D, Fabi, K, Rossi, T, Pesallaccia, M, Sabbatini, D, Gobbi, B, Cerqua, R, Tagliani, G, Schlauser, E, Caser, L, Caramello, E, Sandigliano, F, Rosso, G, Ferrari, A, Bendini, C, Luisa, D, Casella, M, Prampolini, R, Scevola, M, Vitale, E, Roberto, B, Carlo, F, Sergio, F, Alberto, S, Daniela, Z, Giulia, B, Serena, G, Michele, B, Maugeri, D, Sorace, R, Anzaldi, M, De Gesu, R, Morrone, G, Davolio, F, Fabbo, A, Palmieri, M, Zoli, M, Forti, P, Pirazzoli, L, Fabbri, E, Terenzi, L, Bergolari, F, Wenter, C, Ruffini, I, Insam, M, Abraham, E, Kirchlechner, C, Cucinotta, D, Antonino, L, Basile, G, Grazia, A, Parise, P, Boccali, A, Amici, S, Gambacorta, M, Lasagni, A, Lovati, R, Giovinazzo, F, Kimak, E, Zappa, P, Medici, F, Lo Castro, M, Mauro, F, De Luca, A, Sancesario, G, Martorana, A, Scaricamazza, B, Toniolo, S, Di Lorenzo, F, Liguori, C, Lasco, A, Vita, N, Giomi, M, Forte, F, Padovani, A, Rozzini, L, Ceraso, A, Salvatore, C, Cottino, M, Vitali, S, Marelli, E, Tripi, G, Miceli, S, Urso, G, Grioni, G, Vezzadini, G, Misaggi, G, Forlani, C, Avanzi, S, Serena, S, Claudia, C, Marilena, V, Alberto, L, Diego, G, Alessandro, G, Iemolo, F, Sanzaro, E, D'Asta, G, Proietto, M, Carnemolla, A, Razza, G, Spadaro, D, Bertolotti, M, Mussi, C, Neviani, F, Roberto, C, Valentina, G, Linda, M, Francesca, V, Tarozzi, A, Balestri, F, Mannarino, G, Bigolari, M, Natale, A, Grassi, S, Bottaro, C, Stefanelli, S, Bovone, U, Tortorolo, U, Quadri, R, Leone, G, Ponzetto, M, Frasson, P, Annoni, G, Confalonieri, R, Corsi, M, Moretti, D, Teruzzi, F, Umidi, S, Mazzola, P, Perego, S, Persico, I, Olivieri, G, Bonfanti, A, Hajnalka, S, Galeazzi, M, Massariello, F, Anzuini, A, Caffarra, P, Barocco, F, Spallazzi, M, Paolo, C, Simonetta, M, Chioatto, P, Bortolamei, S, Soattin, L, Ruotolo, G, Beneamino, B, Giuseppe, B, Bertazzoli, M, Rota, E, Adobati, A, Scarpa, A, Granziera, S, Zuccher, P, Fabbro, A, Zara, D, Lo Nigro, A, Franchetti, L, Toniolo, M, Marcuzzo, C, Rollone, M, Guerriero, F, Sgarlata, C, Masse, A, Zatti, G, Piatti, M, Graci, J, Benati, G, Boschi, F, Biondi, M, Fiumi, N, Erika, T, Locatelli, S, Mauri, S, Beretta, M, Margheritis, L, Desideri, G, Liberatore, E, Carucci, A, Bonino, P, Caput, M, Antonietti, M, Polistena, G, De la Pierre, F, Mari, M, Massignani, P, Tombesi, F, Selvaggio, F, Verbo, B, Bodoni, P, Marchionni, N, Sabatini, T, Mussio, E, Magni, E, Bianchetti, A, Crucitti, A, Titoldini, G, Cossu, B, Fascendini, S, Licini, C, Tomasoni, A, Calderazzo, M, Daniela, T, Valentina, L, Melotti, R, Lilli, A, Buda, S, Adversi, M, Noro, G, Turco, R, Ubezio, M, Mantovani, A, Viola, M, Serrati, C, Pretta, S, Infante, M, Gentile, S, D'Ambrosio, V, Mazzanti, P, Brambilla, C, Sportelli, S, Platto, C, Faraci, B, Quattrocchi, D, Pernigotti, L, Pisu, C, Sicuro, F, Zagnoni, P, Ghiglia, S, Mosca, M, Corazzin, I, Deola, M, Biagini, C, Bencini, F, Cantini, C, Tonon, E, Pierinelli, S, Onofrj, M, Thomas, A, Filomena, B, Bonanni, L, Gabriella, C, Comi, G, Magnani, G, Santangelo, R, Mazzeo, S, Francesca, C, Giordano, C, Roberto, S, Barbieri, C, Giroldi, L, Bandini, F, Masina, M, Malservisi, S, Cicognani, A, Ricca, L, Piccininni, M, Tassinari, T, Brogi, D, Sugo, A, Alessandra, F, Sonia, M, Valerio, V, Andrea, U, Enrico, C, Vera, R, Assunta, S, Gianmaria, Z, Mauro, P, Barone, A, Razzano, M, Giuseppe, I, Angela, B, Francesco, S, Valeria, D, Federico, G, Lucia, P, Antonella, V, Elisabetta, D, Cristina, R, Nadia, C, Maria, S, Luciano, A, Chiara, C, Bini, P, Pignata, M, Enrico, B, Maria, V, Giovanni, C, Giorgio, C, Piera, R, Alberto, Z, Ceccon, A, Magrin, L, Marin, S, Barbara, S, Matteo, M, Caterina, P, Carla, R, Federica, G, Clara, T, Melania, C, Giampaolo, B, Stefano, G, Valeria, G, Lucia, M, Giovambattista, D, Ester, L, Cecilia, C, Maurizio, T, Nadia, B, Grillo, A, Arenare, F, Tonino, M, David, K, Giorgio, V, Ubaldo, B, Vincenzo, S, Stefano, M, Marino, F, Busonera Flavio, M, Paolo, A, Monica, M, Francesco, B, Roberto, F, Paolo, B, Durantemangoni, E, Testoni, M, Fabio, D, Loredana, S, Valeria, S, Fabiano, M, Annabella, D, Salvatore, D, Greco, A, Grazia, D, Daniele, S, Gianluca, R, Renzo, G, Sergio, M, Morena, B, Vitali, M, Marina, P, Paolo, D, Cristina, S, Orlandini, F, La Regina, M, Desiree, A, Mario, B, Paola, P, Padulo, F, Cristina, M, Dario, R, Giancarla, M, Guido, R, Elena, M, Marileda, N, Igor, B, Nicole, B, Elena, R, Paolillo, C, Riccardi, A, Claudia, B, Barbara, R, Silvia, V, Oliver, B, Mauro, C, Eleonora, M, Giuseppe, P, Rosaria, T, Maria, C, Davide, D, Stefania, C, Massimo, P, Luca, S, Martina, D, Paola, V, Lia, S, Sandro, C, Valentina, D, Erminia, B, Paola, C, Romina, R, Minisola, S, Luciano, C, Pasquale, A, Ilaria, L, Guglielmo, S, Marco, E, Sara, R, Paola, A, Claudio, A, Francesco, R, Alessandro, C, Simona, M, Lara, F, Paola, R, Simonetta, C, Antonella, C, Generoso, U, Fernando, G, Giuliano, C, Emanuela, S, Mariolina, S, Alessandro, D, Giulia, L, Famularo, S, Sandini, M, Pinotti, E, Gianotti, L, Antonella, B, Giulia, P, Sante, G, Rossi, A, Rubele, S, Sant, S, Marco, V, Danila, C, Fabio, R, Bandirali, M, Nicoletta, C, Laura, B, Paolo, T, Luciano, T, Leonello, A, Margherita, S, Pierluigi, D, Laura, R, Fabiana, T, Giovanna, C, Antonino, A, Felice, C, Danilo, F, Giovanna, D, Francesco, L, Salini, S, Giorgetta, C, Giovanni, G, Gerardo, B, Silvio, R, Letizia, S, Davide, B, Rosaria, R, Maria, D, Raffaele, P, Palmieri, V, Palasciano, G, Belfiore, A, Portincasa, P, Carlo, S, Alessia, D, Valiani, V, Carolina, B, Tiziana, C, Paola, T, Ugo, P, Giacomo, P, Castellano, M, Anna, G, Elisa, C, Federica, C, Antonietta, C, Luigi, M, Fabio, L, Salvatore, B, Gelosa, G, Viviana, A, Piras, V, Andrea, C, Alessandra, B, Coen, D, Magliola, R, Milanesio, D, Muzzulini, C, Paolo, F, Marinella, T, Sofia, C, Marta, B, Siano, P, Capo, G, Napoletano, R, Cecilia, P, Mancini, C, Del Buono, C, De Bartolomeo, G, Addolorata, M, Carmen, C, Moschettini, G, Franco, M, Daniela, R, D'Amico, G, Mirella, P, Endrizzi, C, Trotta, L, Ciarambino, T, Orazio, Z, Emanuela, T, Marta, S, Thomas, F, Giacomo, T, Ignazio, D, Andrea, B, Giuseppe, O, Emanuela, F, Serena, A, Elena, D, Serena, B, Erika, N, Elena, S, Manuela, P, Francesca, A, Angelo, T, Di Santo SG, Rizzo, Maria Rosaria, Paolisso, Giuseppe, and Italian Study Group on Delirium, (ISGoD).
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Rehabilitation hospital ,medicine.medical_specialty ,Urinary system ,Socio-culturale ,dementia ,elderly ,Motor subtypes of delirium ,Aged ,Cross-Sectional Studies ,Humans ,Inpatients ,Italy ,Delirium ,Dementia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,mental disorders ,medicine ,Motor subtypes of delirium, dementia, elderly ,dementia, elderly, Motor subtypes of delirium ,030212 general & internal medicine ,LS4_4 ,Medical prescription ,General Nursing ,Psychomotor learning ,business.industry ,Health Policy ,Medical record ,Memantine ,General Medicine ,medicine.disease ,Settore MED/26 - NEUROLOGIA ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Objectives Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design This is a cross-sectional study nested in the "Delirium Day" study, a nationwide Italian point-prevalence study. Setting and participants Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and implications In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors.
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- 2020
18. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study
- Author
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Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, A. Tarasconi, M. Sella, S. Auriemma, G. Paternò, G. Faggian, C. Lucarelli, N. De Grazia, C. Alberto, A. Margola, L. Porcella, I. Nardiello, E. Chimenti, M. Zeni, A. Giani, S. Famularo, E. Romairone, C. Minaglia, C. Ceccotti, G. Guerra, G. Mantovani, F. Monacelli, T. Candiani, A. Ballestrero, F. Santolini, M. Rosso, V. Bono, S. Sibilla, P. Dal Santo, M. Ceci, P. Barone, T. Schirinzi, A. Formenti, G. Nastasi, G. Isaia, D. Gonella, A. Battuello, S. Casson, D. Calvani, F. Boni, A. Ciaccio, R. Rosa, G. Sanna, S. Manfredini, L. Cortese, M. Rizzo, R. Prestano, A. Greco, M. Lauriola, G. Gelosa, V. Piras, M. Arena, D. Cosenza, A. Bellomo, M. LaMontagna, L. Gabbani, L. Lambertucci, S. Perego, G. Parati, G. Basile, V. Gallina, G. Pilone, C. Giudice, F. De, L. Pietrogrande, B. De, M. Mosca, I. Corazzin, P. Rossi, V. Nunziata, F. D'Amico, A. Grippa, S. Giardini, R. Barucci, A. Cossu, L. Fiorin, M. Distefano, M. Lunardelli, M. Brunori, I. Ruffini, E. Abraham, A. Varutti, E. Fabbro, A. Catalano, G. Martino, D. Leotta, A. Marchet, G. Dell'Aquila, A. Scrimieri, M. Davoli, M. Casella, A. Cartei, G. Polidori, D. Brischetto, S. Motta, R. Saponara, P. Perrone, G. Russo, D. Del, C. Car, T. Pirina, S. Franzoni, A. Cotroneo, F. Ghiggia, G. Volpi, C. Menichetti, M. Bo, A. Panico, P. Calogero, G. Corvalli, M. Mauri, E. Lupia, R. Manfredini, F. Fabbian, A. March, M. Pedrotti, M. Veronesi, E. Strocchi, C. Borghi, A. Bianchetti, A. Crucitti, V. DiFrancesco, G. Fontana, L. Bonanni, F. Barbone, C. Serrati, G. Ballardini, M. Simoncelli, G. Ceschia, C. Scarpa, R. Brugiolo, S. Fusco, T. Ciarambino, C. Biagini, E. Tonon, M. Porta, D. Venuti, M. DelSette, M. Poeta, G. Barbagallo, G. Trovato, A. Delitala, P. Arosio, F. Reggiani, G. Zuliani, B. Ortolani, E. Mussio, A. Girardi, A. Coin, G. Ruotolo, A. Castagna, M. Masina, R. Cimino, A. Pinciaroli, G. Tripodi, U. Cannistrà, F. Cassadonte, M. Vatrano, L. Scaglione, P. Fogliacco, C. Muzzuilini, F. Romano, A. Padovani, L. Rozzini, A. Cagnin, F. Fragiacomo, G. Desideri, E. Liberatore, A. Bruni, G. Orsitto, M. Franco, L. Bonfrate, M. Bonetto, N. Pizio, G. Magnani, G. Cecchetti, A. Longo, V. Bubba, L. Marinan, M. Cotelli, M. Turla, M. Sessa, L. Abruzzi, G. Castoldi, D. LoVetere, C. Musacchio, M. Novello, A. Cavarape, A. Bini, A. Leonardi, F. Seneci, W. Grimaldi, F. Fimognari, V. Bambara, A. Saitta, F. Corica, M. Braga, E. Ettorre, C. Camellini, G. Bellelli, G. Annoni, A. Marengoni, A. Crescenzo, G. Noro, R. Turco, M. Ponzetto, L. Giuseppe, B. Mazzei, G. Maiuri, D. Costaggiu, R. Damato, M. Formilan, G. Patrizia, M. Gallucci, M. Paragona, P. Bini, D. Modica, C. Abati, M. Clerici, I. Barbera, F. NigroImperiale, A. Manni, C. Votino, C. Castiglioni, M. Di, M. Degl'Innocenti, G. Moscatelli, S. Guerini, C. Casini, D. Dini, E. D'Imporzano, S. DeNotariis, F. Bonometti, C. Paolillo, A. Riccardi, A. Tiozzo, M. DiBari, S. Vanni, A. Scarpa, D. Zara, P. Ranieri, M. Alessandro, F. Di, D. Pezzoni, C. Platto, V. D'Ambrosio, C. Ivaldi, P. Milia, F. DeSalvo, C. Solaro, M. Strazzacappa, M. Cazzadori, S. Confente, M. Grasso, E. Troisi, V. Guerini, B. Bernardini, C. Corsini, S. Boffelli, A. Filippi, K. Delpin, B. Faraci, E. Bertoletti, M. Vannucci, F. Tesi, P. Crippa, A. Malighetti, D. Bettini, F. Maltese, G. Abruzzese, D. Cosimo, M. Azzini, M. Colombo, G. Procino, S. Fascendini, F. Barocco, P. Del, A. Mazzone, E. Riva, D. Dell'Acqua, M. Cottino, G. Vezzadini, S. Avanzi, C. Brambilla, S. Orini, F. Sgrilli, A. Mello, L. Lombardi, E. Muti, B. Dijk, S. Fenu, C. Pes, P. Gareri, M. Passamonte, R. Rigo, L. Locusta, L. Caser, G. Rosso, S. Cesarini, R. Cozzi, C. Santini, P. Carbone, I. Cazzaniga, R. Lovati, A. Cantoni, P. Ranzani, D. Barra, G. Pompilio, S. Dimori, S. Cernesi, C. Riccò, F. Piazzolla, E. Capittini, C. Rota, F. Gottardi, L. Merla, A. Barelli, A. Millul, G. De, G. Morrone, M. Bigolari, M. Macchi, F. Zambon, C. Pizzorni, G. DiCasaleto, G. Menculini, M. Marcacci, G. Catanese, D. Sprini, T. DiCasalet, M. Bocci, S. Borga, P. Caironi, C. Cat, E. Cingolani, L. Avalli, G. Greco, G. Citerio, L. Gandini, G. Cornara, R. Lerda, L. Brazzi, F. Simeone, M. Caciorgna, D. Alampi, S. Francesconi, E. Beck, B. Antonini, K. Vettoretto, M. Meggiolaro, E. Garofalo, S. Notaro, R. Varutti, F. Bassi, G. Mistraletti, A. Marino, R. Rona, E. Rondelli, I. Riva, A. Scapigliati, A. Cortegiani, F. Vitale, L. Pistidda, R. D'Andrea, L. Querci, P. Gnesin, M. Todeschini, M. Lugano, G. Castelli, M. Ortolani, A. Cotoia, S. Maggiore, L. DiTizio, R. Graziani, I. Testa, E. Ferretti, C. Castioni, F. Lombardi, R. Caserta, M. Pasqua, S. Simoncini, F. Baccarini, M. Rispoli, F. Grossi, L. Cancelliere, M. Carnelli, F. Puccini, G. Biancofiore, A. Siniscalchi, C. Laici, E. Mossello, M. Torrini, G. Pasetti, S. Palmese, R. Oggioni, V. Mangani, S. Pini, M. Martelli, E. Rigo, F. Zuccalà, A. Cherri, R. Spina, I. Calamai, N. Petrucci, A. Caicedo, F. Ferri, P. Gritti, N. Brienza, R. Fonnesu, M. Dessena, G. Fullin, D. Saggioro, Morandi, A, Inzitari, M, Udina, C, Gual, N, Mota, M, Tassistro, E, Andreano, A, Cherubini, A, Gentile, S, Mossello, E, Marengoni, A, Olivé, A, Riba, F, Ruiz, D, de Jaime, E, Bellelli, G, Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, Italian Study Group of Delirium, Claudio Borghi, Morandi, Alessandro, Inzitari, Marco, Udina, Cristina, Gual, Neu, Mota, Miriam, Tassistro, Elena, Andreano, Anita, Cherubini, Antonio, Gentile, Simona, Mossello, Enrico, Marengoni, Alessandra, Olivé, Anna, Riba, Francesc, Ruiz, Domingo, de Jaime, Elisabet, Bellelli, Giuseppe, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, G Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, E D'Imporzano, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D'Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro
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medicine.medical_specialty ,Activities of daily living ,Cross-sectional study ,Hearing loss ,medicine.medical_treatment ,Visual impairment ,Psychological intervention ,visual impairment ,Socio-culturale ,behavioral disciplines and activities ,Hearing impairment, delirium, older, sensory deficits, visual impairment ,sensory deficit ,Hearing impairment ,03 medical and health sciences ,delirium ,older ,sensory deficits ,0302 clinical medicine ,Risk Factors ,Activities of Daily Living ,mental disorders ,medicine ,Humans ,Dementia ,030212 general & internal medicine ,LS4_4 ,Hearing Loss ,General Nursing ,Rehabilitation ,business.industry ,Health Policy ,General Medicine ,medicine.disease ,nervous system diseases ,Cross-Sectional Studies ,Italy ,Emergency medicine ,Delirium ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.
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- 2021
19. Motion artifact correction for cone beam CT stroke imaging: a prospective series
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Nicole M Cancelliere, Fred van Nijnatten, Eric Hummel, Paul Withagen, Peter van de Haar, Hidehisa Nishi, Ronit Agid, Patrick Nicholson, Bertan Hallacoglu, Marijke van Vlimmeren, and Vitor M Pereira
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundImaging assessment for acute ischemic stroke (AIS) patients in the angiosuite using cone beam CT (CBCT) has created increased interest since endovascular treatment became the first line therapy for proximal vessel occlusions. One of the main challenges of CBCT imaging in AIS patients is degraded image quality due to motion artifacts. This study aims to evaluate the prevalence of motion artifacts in CBCT stroke imaging and the effectiveness of a novel motion artifact correction algorithm for image quality improvement.MethodsPatients presenting with acute stroke symptoms and considered for endovascular treatment were included in the study. CBCT scans were performed using the angiosuite X-ray system. All CBCT scans were post-processed using a motion artifact correction algorithm. Motion artifacts were scored before and after processing using a 4-point scale.ResultsWe prospectively included 310 CBCT scans from acute stroke patients. 51% (n=159/310) of scans had motion artifacts, with 24% being moderate to severe. The post-processing algorithm improved motion artifacts in 91% of scans with motion (n=144/159), restoring clinical diagnostic capability in 34%. Overall, 76% of the scans were sufficient for clinical decision-making before correction, which improved to 93% (n=289/310) after post-processing with our algorithm.ConclusionsOur results demonstrate that CBCT motion artifacts are significantly reduced using a novel post-processing algorithm, which improved brain CBCT image quality and diagnostic assessment for stroke. This is an important step on the road towards a direct-to-angio approach for endovascular thrombectomy (EVT) treatment.
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- 2021
20. First-in-human, robotic-assisted neuroendovascular intervention
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Kaitlyn E Drake, Nicole M. Cancelliere, Ivan Radovanovic, Patrick Nicholson, Aquilla Turk, Timo Krings, John-Michael Sungur, and Vitor Mendes Pereira
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Technology ,medicine.medical_specialty ,Percutaneous ,Robotic assisted ,medicine.medical_treatment ,Coil ,030204 cardiovascular system & hematology ,Coronary Angiography ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Intervention (counseling) ,Stent ,medicine ,Milestone (project management) ,Humans ,Medical physics ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Brain ,Intracranial Aneurysm ,General Medicine ,First in human ,Middle Aged ,Neurovascular bundle ,Aneurysm ,Treatment Outcome ,New Devices and Techniques ,Fluoroscopy ,Female ,Stents ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Cerebral angiography - Abstract
Robotic-assisted technology has been used as a tool to enhance open and minimally invasive surgeries as well as percutaneous coronary and peripheral vascular interventions. It offers many potential benefits, including increased procedural and technical accuracy as well as reduced radiation dose during fluoroscopic procedures. It also offers the potential for truly “remote” procedures. Despite these benefits, robotic technology has not yet been used in the neuroendovascular field, aside from diagnostic cerebral angiography. Here, we report the first robotic-assisted, therapeutic, neuroendovascular intervention performed in a human. This was a stent-assisted coiling procedure to treat a large basilar aneurysm. All intracranial steps, including stent placement and coil deployment, were performed with assistance from the CorPath© GRX Robotic System (Corindus, a Siemens Healthineers Company, Waltham, MA, USA). This represents a major milestone in the treatment of neurovascular disease and opens the doors for the development of remote robotic neuroendovascular procedures.
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- 2020
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21. Evidence-based Claims Adjudication of Traffic Injury Claims in Ontario: Shifting the Focus from Cost to Care
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Robert Power, Keshini Moodley, Pierre Côté, and Carol Cancelliere
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Focus (computing) ,Actuarial science ,Evidence-based practice ,business.industry ,030503 health policy & services ,Automobile insurance ,Psychological intervention ,General Medicine ,Traffic injury ,03 medical and health sciences ,0302 clinical medicine ,Health care ,030212 general & internal medicine ,Business ,0305 other medical science ,Adjudication - Abstract
Background.— In the Ontario automobile insurance system, claims adjusters decide whether to approve, partially approve or deny funding for clinical interventions submitted by healthcare practitioners. Typically, these decisions are made based on cost, without considering the evidence on the effectiveness and safety of the interventions. Objective.— Develop an evidence-based claims adjudication framework, which can be used by automobile insurers to integrate clinical evidence into claims adjudication. Method.— We adapted the evidence-based medicine framework developed by Sackett et al1 to develop a framework for evidence-based claims adjudication. Conclusion.— An evidence-based claims adjudication framework may help insurers make claim decisions that will promote recovery of individuals injured in traffic collisions and reduce claims costs. The effectiveness and implementation of the framework needs to be evaluated.
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- 2020
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22. Analyse archéométrique des stucs et de la polychromie du temple C de Sélinonte en Sicile
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Carmelo Bennardo, Katia D’Ignoti, Lorenzo Lazzarini, Giovanni Alfano, and Stefano Cancelliere
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medicine.anatomical_structure ,Extant taxon ,Temple ,medicine ,Sampling (statistics) ,General Medicine ,Archaeology ,Geology - Abstract
The most recent restoration of the re-erected part of temple C of ancient Selinus (modern Selinunte, Sicily) made it possible to carry out direct observations and a sampling campaign on the very few extant ancient stuccoes and polychromy traces on the columns and capitals of the northern peristasis. The samples were submitted to laboratory analyses including XRD on powder, OM, as well as SEM-EDS, on polished and thin sections, providing a stratigraphic reconstruction of the various stuccoes applied over the biocalcarenite of the temple. The composition of the stuccoes, together with that of the remaining polychromy, has been determined archaeometrically, thus allowing new hypotheses about the decorative materials and techniques used during the main lifetime (6th-5th centuries B.C.) of the temple.
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- 2019
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23. 4D-CT angiography versus 3D-rotational angiography as the imaging modality for computational fluid dynamics of cerebral aneurysms
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Vitor Mendes Pereira, Olivier Brina, Timo Krings, Karl-Olof Lövblad, Mehdi Najafi, Nicole M. Cancelliere, Pierre Bouillot, Maria Vargas, and David A. Steinman
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Male ,Computed Tomography Angiography ,0206 medical engineering ,Hemodynamics ,ddc:500.2 ,02 engineering and technology ,Computational fluid dynamics ,ddc:616.0757 ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Aneurysm ,Blood Flow ,medicine ,Humans ,Four-Dimensional Computed Tomography ,Modality (human–computer interaction) ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Angiography ,Brain ,Intracranial Aneurysm ,Computational Fluid Dynamics ,General Medicine ,Blood flow ,Middle Aged ,medicine.disease ,020601 biomedical engineering ,Cerebral Angiography ,3d rotational angiography ,Rotational angiography ,Hydrodynamics ,Female ,Surgery ,CT Angiography ,Neurology (clinical) ,Nuclear medicine ,business ,030217 neurology & neurosurgery - Abstract
Background and purposeComputational fluid dynamics (CFD) can provide valuable information regarding intracranial hemodynamics. Patient-specific models can be segmented from various imaging modalities, which may influence the geometric output and thus hemodynamic results. This study aims to compare CFD results from aneurysm models segmented from three-dimensional rotational angiography (3D-RA) versus novel four-dimensional CT angiography (4D-CTA).MethodsFourteen patients with 16 cerebral aneurysms underwent novel 4D-CTA followed by 3D-RA. Endoluminal geometries were segmented from each modality using an identical workflow, blinded to the other modality, to produce 28 'original' models. Each was then minimally edited a second time to match length of branches, producing 28 additional 'matched' models. CFD simulations were performed using estimated flow rates for 'original' models (representing real-world experience) and patient-specific flow rates from 4D-CTA for 'matched' models (to control for influence of modality alone).ResultsOverall, geometric and hemodynamic results were consistent between models segmented from 3D-RA and 4D-CTA, with correlations improving after matching to control for operator-introduced variability. Despite smaller 4D-CTA parent artery diameters (3.49±0.97 mm vs 3.78±0.92 mm for 3D-RA; p=0.005) and sac volumes (157 (37–750 mm3) vs 173 (53–770 mm3) for 3D-RA; p=0.0002), sac averages of time-averaged wall shear stress (TAWSS), oscillatory shear (OSI), and high frequency fluctuations (measured by spectral power index, SPI) were well correlated between 3D-RA and 4D-CTA 'matched' control models (TAWSS, R2=0.91; OSI, R2=0.79; SPI, R2=0.90).ConclusionsOur study shows that CFD performed using 4D-CTA models produces reliable geometric and hemodynamic information in the intracranial circulation. 4D-CTA may be considered as a follow-up imaging tool for hemodynamic assessment of cerebral aneurysms.
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- 2019
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24. Implementation interventions for musculoskeletal programs of care in the active military and barriers, facilitators, and outcomes of implementation: a scoping review
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Silvano Mior, Pierre Côté, Deborah Sutton, Simon D. French, Anne Taylor-Vaisey, and Carol Cancelliere
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Scoping review ,Time Factors ,Military personnel ,Population ,Psychological intervention ,Health Informatics ,CINAHL ,Therapeutics ,Environment ,Efficiency, Organizational ,Social Environment ,Health informatics ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Patient-Centered Care ,Humans ,Medicine ,Musculoskeletal Diseases ,030212 general & internal medicine ,education ,Health policy ,education.field_of_study ,lcsh:R5-920 ,business.industry ,030503 health policy & services ,Health Policy ,Wounds and injuries ,Public Health, Environmental and Occupational Health ,Health services research ,General Medicine ,3. Good health ,Outcome and Process Assessment, Health Care ,Patient Satisfaction ,Evidence-Based Practice ,Implementation science ,Systematic Review ,Implementation research ,0305 other medical science ,business ,lcsh:Medicine (General) ,Delivery of Health Care - Abstract
Background Musculoskeletal disorders are common in the active military and are associated with significant lost duty days and disability. Implementing programs of care to manage musculoskeletal disorders can be challenging in complex healthcare systems such as in the military. Understanding how programs of care for musculoskeletal disorders have been implemented in the military and how they impact outcomes may help to inform future implementation interventions in this population. Methods We conducted a scoping review using the modified Arksey and O’Malley framework to identify literature on (1) implementation interventions of musculoskeletal programs of care in the active military, (2) barriers and facilitators of implementation, and (3) implementation outcomes. We identified studies published in English by searching MEDLINE, CINAHL, Embase, and CENTRAL (Cochrane) from inception to 1 June 2018 and hand searched reference lists of relevant studies. We included empirical studies. We synthesized study results according to three taxonomies: the Effective Practice and Organization of Care (EPOC) taxonomy to classify the implementation interventions; the capability, opportunity, motivation-behavior (COM-B) system to classify barriers and facilitators of implementation; and Proctor et al.’s taxonomy (Adm Policy Ment Health 38:65–76, 2011) to classify outcomes in implementation research. Results We identified 1785 studies and 16 were relevant. All but two of the relevant studies were conducted in the USA. Implementation interventions were primarily associated with delivery arrangements (e.g., multidisciplinary care). Most barriers or facilitators of implementation were environmental (physical or social). Service and client outcomes indicated improved efficiency of clinical care and improved function and symptomology. Studies reporting implementation outcomes indicated the programs were acceptable, appropriate, feasible, or sustainable. Conclusion Identification of evidence-based approaches for the management of musculoskeletal disorders is a priority for active-duty military. Our findings can be used by military health services to inform implementation strategies for musculoskeletal programs of care. Further research is needed to better understand (1) the components of implementation interventions, (2) how to overcome barriers to implementation, and (3) how to measure implementation outcomes to improve quality of care and recovery from musculoskeletal disorders.
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- 2019
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25. Robust cerebrovascular blood velocity and flow rate estimation from 4D‐<scp>CTA</scp>
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Christophe Chnafa, Ivan Radovanovic, Olivier Brina, Pierre Bouillot, Nicole M. Cancelliere, Vitor Mendes Pereira, Maria Vargas, David A. Steinman, and Timo Krings
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Adult ,Male ,Blood velocity ,Computed Tomography Angiography ,Pulsatile flow ,ddc:500.2 ,ddc:616.0757 ,Flow measurement ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,High spatial resolution ,medicine ,Humans ,In vivo measurements ,Prospective Studies ,Four-Dimensional Computed Tomography ,Cerebrovascular disease ,Vertebral Artery ,Aged ,Mathematics ,Computed tomography angiography ,CT angiogaphy ,medicine.diagnostic_test ,Models, Cardiovascular ,Intracranial Aneurysm ,Blood flow ,General Medicine ,Middle Aged ,Volumetric flow rate ,Carotid Arteries ,Cerebrovascular Circulation ,030220 oncology & carcinogenesis ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Blood Flow Velocity ,Biomedical engineering - Abstract
Purpose Blood velocity and flow rate information may be helpful for a wide variety of applications, but it often requires separate acquisitions. The dynamic information combined with the high spatial resolution of four-dimensional computed tomography angiography (4D-CTA) offers the possibility to quantify blood flow simultaneous to vascular anatomy. Methods A 4D-CTA clinical protocol with a novel dedicated postprocessing were validated in vitro in a patient-specific model, and tested in a pilot study of six patients. Blood flow was assessed in both internal carotid (ICAs) and vertebral (VAs) arteries by analyzing spatial displacement of contrast agent in the form of time-intensity curves (TICs). Unlike previous approaches, it does not require any a priori assumptions about TIC shape, but rather computes mean velocity and flow rates from the spatial displacement of the TICs along the automatically segmented vessels. Results In vitro experiments showed good agreement between 4D-CTA and flowmeter measurements under steady and pulsatile flow conditions. In vivo measurements exhibited large interpatient variability of the TIC shapes, from which blood flow rates could nevertheless be successfully measured in all patients and investigated vessels. On average, measured flow rates were 3.2 ± 0.7 ml/s (in ICAs) and 1.3 ± 0.8 ml/s (in VAs) consistent with previous reference standards. Contrary to our novel approach, which considered the full TIC shape, application of previous time-to-peak analyses based on idealized TIC shapes showed limited reliability. Conclusions We demonstrate the high potential of 4D-CTA for assessing blood velocity and flow rate in addition to anatomical evaluation. The wide variety of TIC shapes encountered in vivo highlights the importance of an adaptive TIC analysis as proposed in the present work.
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- 2019
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26. Robotic-assisted intracranial aneurysm treatment: 1 year follow-up imaging and clinical outcomes
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Nicole Mariantonia Cancelliere, Jeremy Lynch, Patrick Nicholson, Tomas Dobrocky, Saravana Kumar Swaminathan, Eef Jacobus Hendriks, Timo Krings, Ivan Radovanovic, Kaitlyn E Drake, Raymond Turner, John-Michael Sungur, and Vitor M Pereira
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Treatment Outcome ,Endovascular Procedures ,Humans ,Surgery ,Intracranial Aneurysm ,Stents ,Neurology (clinical) ,General Medicine ,Embolization, Therapeutic ,Follow-Up Studies ,Retrospective Studies ,Cerebral Angiography - Abstract
BackgroundThe use of robotics in medicine may enable increased technical accuracy, reduced procedural time and radiation exposure, and remote completion of procedures. We have previously described the first-in-human, robotic-assisted cerebral aneurysm treatment using the CorPath GRX Robotic System. In this report we discuss our early experiences and outcomes using this robotic device for endovascular treatment of intracranial aneurysms using stent-assisted coil embolization and flow diversion.MethodsThe patient and disease characteristics, procedural details, and follow-up imaging and clinical outcomes of consecutive patients undergoing robotically-assisted intracranial aneurysm embolization between November 2019 and February 2020 are presented.ResultsSix patients underwent robotically-assisted embolization of intracranial aneurysms. Four of the patients were treated with a neck-bridging stent (with or without coiling) and two patients were treated with a flow-diverting stent. Two patients were treated in the subacute period of subarachnoid hemorrhage and four patients were treated electively. All of the procedures could be completed robotically and there was no need for unplanned manual intervention. The technical success rate of the procedures was 100%. There was no morbidity or mortality associated with the procedures. One year follow-up imaging showed that four aneurysms were completely obliterated (Raymond-Roy Occlusion Classification (RROC) class I) and the remaining two were occluded with a residual neck (RROC class II).ConclusionsThe Corpath GRX Robotic System demonstrated a precise control over the microcatheter, wire and stent during aneurysm treatment. Robotic neuro-procedures seem to be safe and effective and demonstrate stable occlusion results in the midterm follow-up.
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- 2021
27. Improving visualization of three-dimensional aneurysm features via segmentation with upsampled resolution and gradient enhancement (SURGE)
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Daniel E MacDonald, Nicole M Cancelliere, Arianna Rustici, Vitor M Pereira, and David A Steinman
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
BackgroundIntracranial aneurysm neck width tends to be overestimated when measured with three-dimensional rotational angiography (3DRA) compared with two-dimensional digital subtraction angiography (2D-DSA), owing to high curvature at the neck. This may affect morphological and hemodynamic analysis in support of treatment planning. We present and validate a method for extracting high curvature features, such as aneurysm ostia, during segmentation of 3DRA images.MethodsIn our novel SURGE (segmentation with upsampled resolution and gradient enhancement) approach, the gradient of an upsampled image is sharpened before gradient-based watershed segmentation. Neck measurements were performed for both standard and SURGE segmentations of 3DRA for 60 consecutive patients and compared with those from 2D-DSA. Those segmentations were also qualitatively compared for surface topology and morphology.ResultsCompared with the standard watershed method, SURGE reduced neck measurement error relative to 2D-DSA by >60%: median error was 0.49 mm versus 0.17 mm for SURGE, which is less than the average pixel resolution (~0.33 mm) of the 3DRA dataset. SURGE reduced neck width overestimations >1 mm from 13/60 to 5/60 cases. Relative to 2D-DSA, standard segmentations were overestimated by 16% and 93% at median and 95th percentiles, respectively, compared with only 6% and 37%, respectively, for SURGE.ConclusionSURGE provides operators with high-level control of the image gradient, allowing recovery of high-curvature features such as aneurysm ostia from 3DRA where conventional algorithms may fail. Compared with standard segmentation and tedious manual editing, SURGE provides a faster, easier, and more objective method for assessing aneurysm ostia and morphology.
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- 2022
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28. The relationship between frailty and delirium: insights from the 2017 Delirium Day study
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Mazzola, P, Tassistro, E, Di Santo, S, Rossi, E, Andreano, A, Valsecchi, Mg, Cherubini, A, Marengoni, A, Mossello, E, Bo, M, Inzitari, M, Di Bari, M, Udina, C, Latronico, N, Paolillo, C, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Margola, A, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Del Sette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Scapigliati, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Mazzola, P, Tassistro, E, Di Santo, S, Rossi, E, Andreano, A, Valsecchi, M, Cherubini, A, Marengoni, A, Mossello, E, Bo, M, Inzitari, M, Di Bari, M, Udina, C, Latronico, N, Paolillo, C, Morandi, A, and Bellelli, G
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Aging ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Socio-culturale ,frailty ,Odds ,older people ,delirium ,Risk Factors ,Internal medicine ,80 and over ,Medicine ,Humans ,Prospective Studies ,LS4_4 ,education ,Prospective cohort study ,Geriatric Assessment ,Aged ,Aged, 80 and over ,education.field_of_study ,Rehabilitation ,business.industry ,Confounding ,Delirium Day ,Delirium Day, delirium, frailty, mortality, older people ,General Medicine ,Odds ratio ,mortality ,Delirium ,Observational study ,Geriatrics and Gerontology ,medicine.symptom ,business - Abstract
Background although frailty and delirium are among the most frequent and burdensome geriatric syndromes, little is known about their association and impact on short-term mortality. Objective to examine, in hospitalized older persons, whether frailty is associated with delirium, and whether these two conditions, alone or in combination, affect these patients’ 30-day survival. Design observational study nested in the Delirium Day project, with 30-day follow-up. Setting acute medical wards (n = 118) and rehabilitation wards (n = 46) in Italy. Subjects a total of 2,065 individuals aged 65+ years hospitalized in acute medical (1,484 patients, 71.9%) or rehabilitation (581 patients, 28.1%) wards. Methods a 25-item Frailty Index (FI) was created. Delirium was assessed using the 4AT test. Vital status was ascertained at 30 days. Results overall, 469 (22.7%) patients experienced delirium on the index day and 82 (4.0%) died during follow-up. After adjustment for potential confounders, each FI score increase of 0.1 significantly increased the odds of delirium (odds ratio, OR: 1.66 [95% CI: 1.45–1.90]), with no difference between the acute (OR: 1.65 [95% CI: 1.41–1.93]) and rehabilitation ward patients (OR: 1.71 [95% CI: 1.27–2.30]). The risk of dying during follow-up also increased significantly for every FI increase of 0.1 in the overall population (OR: 1.65 [95% CI: 1.33–2.05]) and in the acute medical ward patients (OR: 1.61 [95% CI: 1.28–2.04]), but not in the rehabilitation patients. Delirium was not significantly associated with 30-day mortality in either hospital setting. Conclusions in hospitalized older patients, frailty is associated with delirium and with an increased risk of short-term mortality.
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- 2021
29. Simple parameters from complete blood count predict in-hospital mortality in covid-19
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Bellan, M., Azzolina, D., Hayden, E., Gaidano, G., Pirisi, M., Acquaviva, A., Aimaretti, G., Valletti, P. A., Angilletta, R., Arioli, R., Avanzi, G. C., Avino, G., Balbo, P. E., Baldon, G., Baorda, F., Barbero, E., Baricich, A., Barini, M., Barone-Adesi, F., Battistini, S., Beltrame, M., Bertoli, M., Bertolin, S., Bertolotti, M., Betti, M., Bobbio, F., Boffano, P., Boglione, L., Borre, S., Brucoli, M., Calzaducca, E., Cammarata, E., Cantaluppi, V., Cantello, R., Capponi, A., Carriero, A., Casciaro, G. F., Castello, L. M., Ceruti, F., Chichino, G., Chirico, E., Cisari, C., Cittone, M. G., Colombo, C., Comi, C., Croce, E., Daffara, T., Danna, P., Corte, F. D., de Vecchi, S., Dianzani, U., Benedetto, D. D., Esposto, E., Faggiano, F., Falaschi, Z., Ferrante, D., Ferrero, A., Gagliardi, I., Galbiati, A., Gallo, S., Garavelli, P. L., Gardino, C. A., Garzaro, M., Gastaldello, M. L., Gavelli, F., Gennari, A., Giacomini, G. M., Giacone, I., Via, V. G., Giolitti, F., Gironi, L. C., Gramaglia, C., Grisafi, L., Inserra, I., Invernizzi, M., Krengli, M., Labella, E., Landi, I. C., Landi, R., Leone, I., Lio, V., Lorenzini, L., Maconi, A., Malerba, M., Manfredi, G. F., Martelli, M., Marzari, L., Marzullo, P., Mennuni, M., Montabone, C., Morosini, U., Mussa, M., Nerici, I., Nuzzo, A., Olivieri, C., Padelli, S. A., Panella, M., Parisini, A., Pasche, A., Patrucco, F., Patti, G., Pau, A., Pedrinelli, A. R., Percivale, I., Ragazzoni, L., Re, R., Rigamonti, C., Rizzi, E., Rognoni, A., Roveta, A., Salamina, L., Santagostino, M., Saraceno, M., Savoia, P., Sciarra, M., Schimmenti, A., Scotti, L., Spinoni, E., Smirne, C., Tarantino, V., Tillio, P. A., Tonello, S., Vaschetto, R., Vassia, V., Zagaria, D., Zavattaro, E., Zeppegno, P., Zottarelli, F., Sainaghi, P. P., Aiosa, G., Airoldi, A., Barco, A., Bargiacchi, O., Bazzano, S., Berni, P., Bianchi, B., Bianco, S., Biffi, S., Binda, V., Bolgeo, T., Bolla, C., Bonato, V., Bonizzoni, G., Bragantini, A., Brustia, D., Bullara, V., Burlone, M., Brustia, F., Caccia, S., Calareso, A., Cammarota, G., Cancelliere, L., Carbone, R., Cassinari, A., Ceriani, E., Cena, T., Clivati, E., Collimedaglia, L., Colombatto, A., Cornella, C., Costanzo, M., Croce, A., de Benedittis, C., Delorenzi, S., Dionisio, R., Donato, P., Esposito, M., Fangazio, S., Feggi, A., Ferrillo, S., Foci, V., Fra, G. P., Gaggino, C., Gambaro, E., Gattoni, E., Gattoni, L., Giacchero, F., Gianfreda, R., Giubertoni, A., Grecu, L., Grossi, F., Guglielmetti, G., Guido, S., Iannantuoni, G., Ingrao, S., Jona, A., Lazzarich, E., Lissandrin, R., Maduli, E., Magne, F., Mantia, E., Marangon, D., Massara, M., Matino, E., Mauri, M. G., Menegatti, M., Moglia, R., Molinari, R., Morelli, S., Morlino, P., Naldi, P., Nebbiolo, C., Omodeo, P., Palmieri, D., Panero, A., Parodi, M., Pedrazzoli, R., Pelazza, C., Penpa, S., Perucca, R., Pirovano, A., Pittau, S., Pochetti, P., Poletti, F., Polla, B., Prandi, P., Prodam, F., Prosperini, P., Puma, A., Quaglia, M., Raie, A., Rapetti, R., Ravera, S., Re, A., Reale, M., Rossati, A., Rossi, M., Rossi, P., Rostagno, R., Salomoni, G., Sama, M. T., Sarchi, E., Sarcoli, M., Sarda, C., Sguazzotti, I., Soddu, D., Sola, D., Stobbione, P., Todoerti, M., Vallese, G. C., Varrasi, C., Veia, A., Vignazia, G. L., Zanotti, I., Zecca, E., Zichittella, D., Zisa, G., and Zoppis, E.
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Adult ,Male ,medicine.medical_specialty ,Medicine (General) ,Multivariate analysis ,Article Subject ,Clinical Decision Rules, COVID-19, Prognosis, Blood Cell Count, Hospital Mortality, Severity of Illness Index ,Clinical Biochemistry ,Asymptomatic ,Severity of Illness Index ,NO ,R5-920 ,Internal medicine ,Clinical Decision Rules ,Severity of illness ,Genetics ,80 and over ,Medicine ,Humans ,Hospital Mortality ,Molecular Biology ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Biochemistry (medical) ,Complete blood count ,COVID-19 ,Retrospective cohort study ,Red blood cell distribution width ,General Medicine ,Odds ratio ,Middle Aged ,Prognosis ,Female ,Italy ,Multivariate Analysis ,Blood Cell Count ,Cohort ,medicine.symptom ,business ,Research Article - Abstract
Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.
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- 2021
30. Late-onset myocardial infarction and autoimmune haemolytic anaemia in a COVID-19 patient without respiratory symptoms, concomitant with a paradoxical increase in inflammatory markers: a case report
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Maria Chiara Pelle, Bruno Tassone, Marco Ricchio, Maria Mazzitelli, Chiara Davoli, Giada Procopio, Anna Cancelliere, Valentina La Gamba, Elena Lio, Giovanni Matera, Angela Quirino, Giorgio Settimo Barreca, Enrico Maria Trecarichi, Carlo Torti, and IDTM UMG COVID-19 Group
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medicine.medical_specialty ,Prednisolone ,lcsh:Medicine ,Case Report ,Anaemia ,Azithromycin ,medicine.disease_cause ,Gastroenterology ,Electrocardiography ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,AIHA ,Enzyme Inhibitors ,Stroke ,Asymptomatic Infections ,Glucocorticoids ,Coronavirus ,Inflammation ,Aged, 80 and over ,IL-6 ,business.industry ,Interleukin-6 ,SARS-CoV-2 ,Cardiogenic shock ,lcsh:R ,COVID-19 ,General Medicine ,medicine.disease ,Cardiovascular disease ,Anti-Bacterial Agents ,COVID-19 Drug Treatment ,Pneumonia ,Coombs Test ,C-Reactive Protein ,Heart failure ,Platelet aggregation inhibitor ,ST Elevation Myocardial Infarction ,Female ,Anemia, Hemolytic, Autoimmune ,business ,Platelet Aggregation Inhibitors ,medicine.drug ,Hydroxychloroquine - Abstract
Background In December 2019, a new coronavirus (named severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) spread from China, causing a pandemic in a very short time. The main clinical presentation of SARS-CoV-2 infection (COVID-19, coronavirus disease-2019) is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock). Direct or indirect mechanisms induced by SARS-CoV-2 could be implicated in the pathogenesis of these events. Case presentation We report herein the third case of COVID-19 autoimmune haemolytic anaemia (AIHA) reported so far, which occurredwithout any other possible explanations in a Caucasian patient. The patient also suffered from ST-elevation myocardial injury. Conclusions Both complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in inflammatory markers, including interleukin-6 (IL-6).
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- 2020
31. Feasibility of robot-assisted neuroendovascular procedures
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Ivan Radovanovic, Ronit Agid, Patrick Nicholson, Xiao Yu Eileen Liu, Nicole M. Cancelliere, Timo Krings, and Vitor Mendes Pereira
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medicine.medical_specialty ,Telemedicine ,Guide catheter ,business.industry ,Technical success ,Endovascular Procedures ,Intracranial Aneurysm ,General Medicine ,Robotics ,medicine.disease ,Saccular aneurysm ,Catheter ,Robotic systems ,Aneurysm ,Treatment Outcome ,Robotic Surgical Procedures ,medicine ,Robot ,Feasibility Studies ,Humans ,Medical physics ,Stents ,Prospective Studies ,business - Abstract
OBJECTIVE Geographic factors prevent equitable access to urgent advanced neuroendovascular treatments. Robotic technologies may enable remote endovascular procedures in the future. The authors performed a translational, benchtop-to-clinical study to evaluate the in vitro and clinical feasibility of the CorPath GRX Robotic System for robot-assisted endovascular neurointerventional procedures. METHODS A series of bench studies was conducted using patient-specific 3D-printed models to test the system’s compatibility with standard neurointerventional devices, including microcatheters, microwires, coils, intrasaccular devices, and stents. Optimal baseline setups for various procedures were determined. The models were further used to rehearse clinical cases. Subsequent to these investigations, a prospective series of 6 patients was treated using robotic assistance for complex, wide-necked intracranial saccular aneurysms between November 2019 and February 2020. The technical success, incidence of periprocedural complications, and need for conversion to manual procedures were evaluated. RESULTS The ideal robotic setup for treatment of both anterior and posterior circulation aneurysms was determined to consist of an 80-cm guide catheter with a 115-cm-long intermediate catheter, a microcatheter between 150 and 170 cm in length, and a microwire with a minimum length of 300 cm. All coils, intrasaccular devices, and stents tested were compatible with the system and could be advanced or retracted safely and placed accurately. All 6 clinical procedures were technically successful, with all intracranial steps being performed robotically with no conversions to manual intervention or failures of the robotic system. There were no procedure-related complications or adverse clinical outcomes. CONCLUSIONS This study demonstrates the feasibility of robot-assisted neurointerventional procedures. The authors’ results represent an important step toward enabling remote neuroendovascular care and geographic equalization of advanced endovascular treatments through so-called telestroke intervention.
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- 2020
32. Torrents of torment: turbulence as a mechanism of pulsatile tinnitus secondary to venous stenosis revealed by high-fidelity computational fluid dynamics
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David A. Steinman, John Rutka, Patrick Nicholson, Vitor Mendes Pereira, Thangam Natarajan, Timo Krings, Ivan Radovanovic, Dan MacDonald, Mehdi Najafi, and Nicole M. Cancelliere
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Pulsatile flow ,Arachnoid granulation ,Constriction, Pathologic ,03 medical and health sciences ,Tinnitus ,0302 clinical medicine ,Imaging, Three-Dimensional ,Basic Science ,Internal medicine ,medicine ,Humans ,blood flow ,Computer Simulation ,030223 otorhinolaryngology ,Sinus (anatomy) ,intervention ,Sound (medical instrument) ,Sigmoid sinus ,Transverse Sinuses ,business.industry ,Hemodynamics ,stenosis ,Stent ,General Medicine ,Blood flow ,Phlebography ,Middle Aged ,medicine.disease ,Stenosis ,Cerebrovascular Disorders ,medicine.anatomical_structure ,Treatment Outcome ,technology ,Cardiology ,Surgery ,Stents ,stent ,Neurology (clinical) ,business ,Vascular Surgical Procedures ,030217 neurology & neurosurgery ,Magnetic Resonance Angiography - Abstract
BackgroundPulsatile tinnitus (PT) is a debilitating condition that can be caused by a vascular abnormality, such as an arterial or venous lesion. Although treatment of PT-related venous lesions has been shown to successfully cure patients of the associated ‘tormenting’ rhythmical sound, much controversy still exists regarding their role in the etiology of PT.MethodsA patient presented with a history of worsening, unilateral PT. A partial venous sinus obstruction related to the large arachnoid granulation was detected on the right side, and subsequently stented at the right transverse sinus. High-fidelity computational fluid dynamics (CFD) was performed on a 3D model digitally segmented from the pre-stent venogram, with assumed pulsatile flow rates. A post-stent CFD model was also constructed from this. Data-driven sonification was performed on the CFD velocity data, blinded to the patient’s self-reported sounds.ResultsThe patient reported that the PT was completely resolved after stenting, and has had no recurrence of the symptoms after more than 2 years. CFD simulation revealed highly disturbed, turbulent-like flow at the sigmoid sinus close to auditory structures, producing a sonified audio signal that reproduced the subjective sonance of the patient’s PT. No turbulence or sounds were evident at the stenosis, or anywhere in the post-stent model.ConclusionsFor the first time, turbulence generated distal to a venous stenosis is shown to be a cause of PT. High-fidelity CFD may be useful for identifying patients with such ‘torrents’ of flow, to help guide treatment decision-making.
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- 2020
33. Cross‑reactivity between Parietaria judaica and Parietaria officinalis in immunotherapy extracts for the treatment of allergy to Parietaria
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Irene Iglesias, Ángel Ayuga, Ernesto Enrique Miranda, and Nataly Cancelliere
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0301 basic medicine ,Allergy ,Parietaria ,biology ,Traditional medicine ,General Neuroscience ,Parietaria officinalis ,General Medicine ,biology.organism_classification ,medicine.disease_cause ,medicine.disease ,Cross-reactivity ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Pollen ,Officinalis ,medicine ,Parietaria judaica ,General Pharmacology, Toxicology and Pharmaceutics ,Asthma - Abstract
Parietaria judaica and P. officinalis are the two most common subspecies of the Parietaria genus. P. judaica and P. officinalis have exhibited cross-reactivity in previous studies. P. judaica pollen is the main cause of allergy in the Mediterranean area. It has been shown that a high percentage of patients sensitized to P. judaica with allergic rhinitis (AR) have an increased risk of developing asthma. The present study aimed to confirm the cross-reactivity between P. judaica and P. officinalis and to evaluate the use of a single P. officinalis extract in patients allergic to both subspecies as a preferable option for the diagnosis and treatment of allergy in a highly pollinated area of the Spanish Mediterranean coast. The present study was a single centre, observational cross-sectional study of adult patients diagnosed with AR and/or bronchial asthma who were sensitized to Parietaria pollen. A total of 24 patients were enrolled in the study and included in the analysis. Allergovit® immunotherapy extracts were selected for the study based on the protein content (P. officinalis pollen extract). The results of an in vitro ELISA revealed that 79.1% (n=19) of the patient sera were reactive to immunotherapy extracts. ELISA inhibition assay of the IgE binding to P. officinalis demonstrated inhibition values >70% in the sera of highly reactive patients, confirming the cross-reactivity between the two Parietaria subspecies. In addition, all patients enrolled in the study exhibited double skin positivity against P. judaica and P. officinalis extracts, as assessed by the skin prick test, further supporting the in vivo reactivity between the two subspecies. The present study demonstrated that P. judaica and P. officinalis pollen extracts were highly cross-reactive, and that a unique P. officinalis pollen extract may be used for the diagnosis and immunotherapy of patients allergic to Parietaria.
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- 2020
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34. Biomodex patient-specific brain aneurysm models: the value of simulation for first in-human experiences using new devices and robotics
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Patrick Nicholson, Vitor Mendes Pereira, Timo Krings, John-Michael Sungur, Vitor Nagai Yamaki, Nicole M. Cancelliere, Ivan Radovanovic, and Marta Rodrigues
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Brain aneurysm ,Male ,medicine.medical_specialty ,Self Expandable Metallic Stents ,Aneurysm ,Robotic Surgical Procedures ,Basic Science ,medicine ,Humans ,Medical physics ,angiography ,intervention ,Flow diverter ,Aged ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Reproducibility of Results ,flow diverter ,Robotics ,Intracranial Aneurysm ,General Medicine ,First in human ,Equipment Design ,Patient specific ,Middle Aged ,medicine.disease ,Neurovascular bundle ,Treatment Outcome ,Angiography ,Printing, Three-Dimensional ,technology ,aneurysm ,Surgery ,Female ,Neurology (clinical) ,Artificial intelligence ,business - Abstract
BackgroundWith the recent advent of advanced technologies in the field, treatment of neurovascular diseases using endovascular techniques is rapidly evolving. Here we describe our experience with pre-surgical simulation using the Biomodex EVIAS patient-specific 3D-printed models to plan aneurysm treatment using endovascular robotics and novel flow diverter devices.MethodsPre-procedural rehearsals with 3D-printed patient-specific models of eight cases harboring brain aneurysms were performed before the first in-human experiences. To assess the reliability of the experimental model, the characteristics of the aneurysms were compared between the patient and 3D models. The rehearsals were used to define the patient treatment plan, including technique, device sizing, and operative working projections.ResultsThe study included eight patients with their respective EVIAS 3D aneurysm models. Pre-operative simulation was performed for the first in-human robotic-assisted neurovascular interventions (n=2) and new generation flow-diverter stents (n=6). Aneurysms were located in both the anterior (n=5) and posterior (n=3) circulation and were on average 11.0±6.5 mm in size. We found reliable reproduction of the aneurysm features and similar dimensions of the parent vessel anatomy between the 3D models and patient anatomy. Information learned from pre-surgical in vitro simulation are described in detail, including an improved patient treatment plan, which contributed to successful first in-world procedures with no intraprocedural complications.ConclusionsPre-procedural rehearsal using patient-specific 3D models provides precise procedure planning, which can potentially lead to greater operator confidence, decreased radiation dose and improvements in patient safety, particularly in first in-human experiences.
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- 2020
35. Predictors of asthma relapse in patients who attended an emergency department
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N. Cancelliere, Gemma Vilà-Nadal, Ana Entrala, Beatriz Pola-Bibian, Santiago Quirce, Pilar Barranco, Lourdes González-Cavero, Javier Domínguez-Ortega, and Mariana Díaz-Almirón
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Adult ,Male ,Pulmonary and Respiratory Medicine ,Emergency Medical Services ,medicine.medical_specialty ,Adolescent ,Population ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Recurrence ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Eosinophilia ,0601 history and archaeology ,Young adult ,education ,Aged ,Retrospective Studies ,Asthma ,Aged, 80 and over ,education.field_of_study ,060102 archaeology ,business.industry ,Retrospective cohort study ,06 humanities and the arts ,General Medicine ,Emergency department ,Middle Aged ,Prognosis ,medicine.disease ,Hospitalization ,030228 respiratory system ,Disease Progression ,Female ,Symptom Assessment ,medicine.symptom ,business ,Cohort study - Abstract
BACKGROUND Patients with asthma exacerbations and frequent relapses that require admission to the emergency department (ED) often have more severe disease, worse quality of life, and higher use of health care resources. OBJECTIVE The aim of this study was to identify potential predictors of relapse after patients are treated in an ED for an asthma exacerbation. METHODS A retrospective, noninterventional cohort study was conducted in adult patients who attended the ED of a tertiary hospital in 2014 for an asthma exacerbation. We analyzed the subpopulation who experienced at least one relapse (returned to the ED < 15 days after the previous event). RESULTS Fifty-two of 831 patients experienced 66 relapses after going to the ED (mean ± standard deviation [SD] age, 58.5 ± 23.4 years). The average ± SD probability of a relapse was 6 ± 0.8%. The frequency of episodes was higher in May and November. Twenty-four patients had ≥260 blood eosinophils/μL, including 17 who had ≥400 eosinophils/μL. Only 15% of the patients were referred to an asthma specialist at discharge. Factors related to a higher probability of relapse were the following: having multiple visits to the ED in 1 year, uncontrolled asthma, wheezing in the pulmonary auscultation, peripheral eosinophilia with ≥400 eosinophils/ μL, and being discharged in the first visit to the ED (p < 0.01 for all). CONCLUSION In this population, patients who had multiple ED visits in 1 year, those with uncontrolled asthma, wheezing, ≥400 blood eosinophils/μL, or who had been discharged at the first ED visit are at higher risk of relapse.
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- 2018
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36. Virtual stenting of intracranial aneurysms: A pilot study for the prediction of treatment success based on hemodynamic simulations
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Sylvia Saalfeld, Paolo Machi, Vitor Mendes Pereira, Philipp Berg, Nicole M. Cancelliere, Gábor Janiga, and Olivier Brina
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medicine.medical_specialty ,0206 medical engineering ,Biomedical Engineering ,Medicine (miscellaneous) ,Hemodynamics ,Pilot Projects ,Bioengineering ,02 engineering and technology ,Inflow ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,Internal medicine ,Occlusion ,medicine ,Shear stress ,Humans ,Computer Simulation ,cardiovascular diseases ,business.industry ,Models, Cardiovascular ,Intracranial Aneurysm ,General Medicine ,Blood flow ,medicine.disease ,020601 biomedical engineering ,Treatment Outcome ,Treatment success ,cardiovascular system ,Cardiology ,Stents ,Internal carotid artery ,business ,Carotid Artery, Internal ,030217 neurology & neurosurgery - Abstract
Endovascular treatment of intracranial aneurysms using flow-diverting devices has revolutionized the treatment of large and complex lesions due to its minimally invasive nature and potential clinical outcomes. However, incomplete or delayed occlusion and persistent intracranial aneurysm growth are still an issue for up to one-third of the patients. We evaluated two patients with intracranial aneurysm located at the internal carotid artery who were treated with flow-diverting devices and had opposite outcomes. Both patients presented with similar aneurysms and were treated with the same device, but after a 1-year follow-up, one case presented with complete occlusion (Case 1) and the other required further treatment (Case 2). To reproduce the interventions, virtual stents were deployed and blood flow simulations were carried out using the respective patient-specific geometries. Afterward, hemodynamic metrics such as aneurysmal inflow reduction, wall shear stresses, oscillatory shear, and inflow concentration indices were quantified. The hemodynamic simulations reveal that for both cases, the neck inflow was clearly reduced due to the therapy (Case 1: 19%, Case 2: 35%). In addition, relevant hemodynamic parameters such as time-averaged wall shear stress (Case 1: 35.6%, Case 2: 57%) and oscillatory shear (Case 1: 33.1%, Case 2: 26.7%) were decreased considerably. However, although stronger relative reductions occurred in the unsuccessful case, the absolute flow values in the successful case were approximately halved. The findings demonstrate that a high relative effect of endovascular devices is not necessarily associated with the desired treatment outcome. Instead, it appears that a successful intracranial aneurysm therapy requires a certain patient-specific inflow threshold.
- Published
- 2018
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37. Brain Drain: Psychosocial Factors Influence Recovery Following Mild Traumatic Brain Injury—3 Recommendations for Clinicians Assessing Psychosocial Factors
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Riaz J Mohammed and Carol Cancelliere
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medicine.medical_specialty ,Post-concussion syndrome ,Post-Concussion Syndrome ,Traumatic brain injury ,business.industry ,Public health ,Postconcussion syndrome ,Physical Therapy, Sports Therapy and Rehabilitation ,Brain drain ,Recovery of Function ,General Medicine ,Neuropsychological Tests ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,business ,Psychiatry ,Referral and Consultation ,Psychosocial ,Brain Concussion ,030217 neurology & neurosurgery - Abstract
Mild traumatic brain injury is a major global public health concern. While most people recover within days to months, 1 in 5 people with mild traumatic brain injury report persistent, disabling symptoms that interfere with participation in work, school, and sport. People with injuries to regions other than the head may report similar symptoms. The biopsychosocial model of health explains this phenomenon in terms of factors associated with recovery that are not biomedical. Important psychosocial factors include poor recovery expectations and pretraumatic and posttraumatic psychological symptoms. Recent clinical practice guidelines recommend that clinicians examine all relevant biopsychosocial factors that may contribute to persistent postconcussive symptoms and consider them when helping their patients make health-management decisions. However, because clinical training continues to prioritize biomedical symptoms, clinicians may not feel confident in the psychosocial domain. Our objective is to provide 3 recommendations for clinicians to assess psychosocial factors in patients after concussion, and to argue a case for clinicians to improve their skills in assessing psychosocial factors.
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- 2019
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38. A-116 Neuropsychological Support for Use of Russell Posttraumatic Amnesia Classification of Traumatic Brain Injury
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Melanie A Mascarenhas and Andy E Cancelliere
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Post-traumatic amnesia ,Traumatic brain injury ,business.industry ,Neuropsychology ,Glasgow Coma Scale ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Clinical Psychology ,Neuropsychology and Physiological Psychology ,nervous system ,English as a second language ,Private practice ,medicine ,business ,Clinical psychology ,Posttraumatic amnesia - Abstract
Objective To compare neurocognitive outcomes between 3 traumatic brain injury (TBI) groups (mild, moderate, severe) across 3 TBI classification systems: Glasgow Coma Scale (GCS) and Russell (mild 24 hours) and the modified (mild one week) posttraumatic amnesia (PTA) systems. Method Private practice archival data were reviewed for ambulance/hospital documentation of lowest GCS and PTA duration. Exclusion criteria included ESL and failed tests of engagement. Tests included WAIS, WMS, WRAT, Halstead Reitan etc. Results There were 91 patients (16 mild, 30 moderate and 45 severe); 45 were male. Mean age and education was 30.9 and 12.6. Russell PTA classification yielded significant differences (t-tests) between mild and moderate TBI on 8 of 46 tests/measures and 13 differences in moderate versus severe and 24 differences in mild versus severe TBI. Differences were always severe > moderate > mild impairment, with most in psychomotor speed, memory, working memory and executive/frontal functions consistent with TBI. The modified PTA classification yielded 2 significant differences between mild and moderate, 6 differences between moderate and severe and 22 differences between mild and severe TBI. GCS yielded 0 differences between mild and moderate, 7 differences between moderate and severe and 14 differences between mild and severe TBI. The modified PTA and GCS reduced moderate TBI numbers and some differences were opposite expectations. Conclusions Russell PTA was superior to the modified PTA system and GCS in separation/discrimination (without reversals) and maintenance of moderate TBI as a substantive category.
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- 2021
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39. How patient-specific do internal carotid artery inflow rates need to be for computational fluid dynamics of cerebral aneurysms?
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Mehdi Najafi, Maria Vargas, Pierre Bouillot, David A. Steinman, Olivier Brina, Bénédicte M. A. Delattre, Vitor Mendes Pereira, and Nicole M. Cancelliere
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Flow waveform ,Male ,medicine.medical_specialty ,0206 medical engineering ,Pulsatile flow ,Hemodynamics ,02 engineering and technology ,Inflow ,ddc:616.0757 ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Imaging, Three-Dimensional ,medicine.artery ,Internal medicine ,medicine ,Waveform ,Humans ,cardiovascular diseases ,business.industry ,Models, Cardiovascular ,Intracranial Aneurysm ,General Medicine ,Blood flow ,Middle Aged ,medicine.disease ,020601 biomedical engineering ,Magnetic Resonance Imaging ,Cerebral Angiography ,Cardiology ,Hydrodynamics ,cardiovascular system ,Surgery ,Female ,Neurology (clinical) ,Stress, Mechanical ,Internal carotid artery ,business ,CFD ,030217 neurology & neurosurgery ,Blood Flow Velocity ,Carotid Artery, Internal ,circulatory and respiratory physiology - Abstract
Background Computational fluid dynamics (CFD) has become a popular tool for studying ‘patient-specific’ blood flow dynamics in cerebral aneurysms; however, rarely are the inflow boundary conditions patient-specific. We aimed to test the impact of widespread reliance on generalized inflow rates. Methods Internal carotid artery (ICA) flow rates were measured via 2D cine phase-contrast MRI for 24 patients scheduled for endovascular therapy of an ICA aneurysm. CFD models were constructed from 3D rotational angiography, and pulsatile inflow rates imposed as measured by MRI or estimated using an average older-adult ICA flow waveform shape scaled by a cycle-average flow rate (Qavg) derived from the patient’s ICA cross-sectional area via an assumed inlet velocity. Results There was good overall qualitative agreement in the magnitudes and spatial distributions of time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and spectral power index (SPI) using generalized versus patient-specific inflows. Sac-averaged quantities showed moderate to good correlations: R2=0.54 (TAWSS), 0.80 (OSI), and 0.68 (SPI). Using patient-specific Qavg to scale the generalized waveform shape resulted in near-perfect agreement for TAWSS, and reduced bias, but not scatter, for SPI. Patient-specific waveform had an impact only on OSI correlations, which improved to R2=0.93. Conclusions Aneurysm CFD demonstrates the ability to stratify cases by nominal hemodynamic ‘risk’ factors when employing an age- and vascular-territory-specific recipe for generalized inflow rates. Qavg has a greater influence than waveform shape, suggesting some improvement could be achieved by including measurement of patient-specific Qavg into aneurysm imaging protocols.
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- 2020
40. Biochar from Brewers' Spent Grain: a green and low-cost smart material to modify screen-printed electrodes
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Katya Carbone, Mauro Pagano, Rocco Cancelliere, Ilaria Cacciotti, and Laura Micheli
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Working electrode ,Materials science ,Clinical Biochemistry ,Settore AGR/13 - Chimica Agraria ,screen-printed electrode ,Biosensing Techniques ,02 engineering and technology ,tyrosinase ,Electrochemistry ,biosensor ,01 natural sciences ,Article ,law.invention ,chemistry.chemical_compound ,Settore CHIM/01 ,law ,Biochar ,biochar ,brewers’ spent grain ,Electrodes ,Detection limit ,Graphene ,010401 analytical chemistry ,Electrochemical Techniques ,General Medicine ,021001 nanoscience & nanotechnology ,0104 chemical sciences ,Smart Materials ,chemistry ,Chemical engineering ,Charcoal ,Electrode ,Printing ,Ferricyanide ,Edible Grain ,0210 nano-technology ,Biosensor - Abstract
In the present study, biochar from brewers&rsquo, spent grain was used, for the first time, to develop screen-printed electrodes. After having investigated the dispersion behaviour of biochar in different organic solvents, a biochar-based screen-printed electrode was prepared with the drop-casting technique. In order to understand the electrochemical potentiality and performances of the biochar/sensor tool, different electroactive species, i.e., ferricyanide, benzoquinone, epinephrine, ascorbic, and uric acids, were used. The results were compared with those of the same electrodes that were modified with commercial graphene, confirming that the proposed electrode showed improved electrochemical behaviour in terms of resolution, peak-to-peak separation, current intensity, and resistance to charge transfer. Furthermore, a tyrosinase biosensor was developed by direct immobilisation of this enzyme on the biochar/screen printed electrode, as an example of the potential of biochar for disposable biosensor development. The efficiently occurred immobilisation of the biochar on the screen printed electrode&rsquo, s (SPE&rsquo, s) surface was demonstrated by the observation of the working electrode with a scanning electron microscope. The detection was performed by measuring the current due to the reduction of the corresponding quinone at low potential, equal to &minus, 0.310 V for epinephrine. The experimental conditions for the tyrosinase immobilization and the analytical parameters, such as applied potential and pH of buffer, were studied and optimized. Under these conditions, the electrochemical biosensors were characterized. A linear working range of epinephrine was obtained from 0.05 up to 0.5 mM. The detection limit was 2 ×, 10&minus, 4 mM for the biosensor.
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- 2019
41. Novel flat-panel cone-beam CT compared to multi-detector CT for assessment of acute ischemic stroke: A prospective study
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John Bracken, Erik Hummel, Marijke van Vlimmeren, Peter van de Haar, Timo Krings, Nicole M. Cancelliere, Bertan Hallacoglu, Paul Withagen, Vitor Mendes Pereira, Ronit Agid, Patrick Nicholson, and Fred van Nijnatten
- Subjects
Image quality ,Flat panel ,Brain Ischemia ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Occlusion ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Stroke ,Acute ischemic stroke ,Cone beam ct ,Ischemic Stroke ,Phantoms, Imaging ,business.industry ,General Medicine ,Gold standard (test) ,Cone-Beam Computed Tomography ,medicine.disease ,030220 oncology & carcinogenesis ,Nuclear medicine ,business - Abstract
Cone beam CT (CBCT) imaging assessment of acute ischemic stroke (AIS) patients with large-vessel occlusion (LVO) in the angiosuite may improve stroke workflow and decrease time to recanalization. In order for this workflow to gain widespread acceptance, current CBCT imaging needs further development to improve image quality. Our study aimed to compare the image quality of a new CBCT protocol performed directly in the angiosuite with imaging from multidetector CT as a gold standard.AIS patients with an LVO who were candidates for endovascular treatment were prospectively included in this study. Following conventional multidetector CT (MDCT), patients underwent unenhanced cone beam CT (XperCT, Philips) imaging in the angiosuite, using two different protocols: a standard 20.8 s XperCT and/or an improved 10.4 s XperCT protocol. Images were evaluated using both qualitative and quantitative methods.We included 65 patients in the study. Patients received CBCT imaging prior to endovascular treatment; 18 patients were assessed with a standard 20.8 s protocol scans and 47 with a newer 10.4 s scan. The quantitative analysis showed that the mean contrast-to-noise ratio (CNR) was significantly higher for the newer 10.4 s protocol compared with the 20.8 s protocol (2.08 +/- 0.64 vs. 1.15 +/- 0.27, p 0.004) and the mean image noise was significantly lower for the 10.4 s XperCTs when compared with the 20.8 s XperCTs (6.30 +/- 1.34 vs. 7.82 +/- 2.03, p=0.003). Qualitative analysis, including 6 measures of image quality, demonstrated that 74.1 % of the 10.4 s XperCT scans were ranked as 'Acceptable' for assessing parenchymal imaging in AIS patients(scoring 3-5 points on a 5-point Likert-scale), compared with 32.4 % of the standard 20.8 s XperCT and 100 % of the MDCT scans. Compared to the MDCT studies, 83 % of the 10.4 s XperCT scans were deemed sufficient image quality for a direct-to-angiosuite selection, compared to only 11 % for the standard 20.8 s scans. The largest image quality improvements included grey/white matter differentiation (59 % improvement), and reduction of image noise and artefacts (63 %50 % improvement, respectively).Continued advances in cone-beam CT allow marked improvements in image quality for the assessment of brain parenchyma, which supports a direct-to-angiosuite approach for AIS patients eligible for thrombectomy treatment.
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- 2021
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42. Assessment of Studies Evaluating Spinal Manipulative Therapy and Infectious Disease and Immune System Outcomes
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Anne Taylor-Vaisey, Silvano A. Mior, Carol Cancelliere, Ngai Chow, Pierre Côté, Sheilah Hogg-Johnson, Julita A. Teodorczyk-Injeyan, J. David Cassidy, and Stephen H Injeyan
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Manipulation, Spinal ,medicine.medical_specialty ,MEDLINE ,Communicable Diseases ,law.invention ,Complementary and Alternative Medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Intensive care medicine ,Physical Therapy Modalities ,Randomized Controlled Trials as Topic ,Original Investigation ,Manipulation, Chiropractic ,SARS-CoV-2 ,business.industry ,Research ,COVID-19 ,General Medicine ,Guideline ,Chiropractic ,Low back pain ,Online Only ,Treatment Outcome ,Infectious disease (medical specialty) ,Immune System ,medicine.symptom ,Manual therapy ,business ,Biomarkers ,Cohort study - Abstract
Key Points Question Is spinal manipulative therapy associated with changes in the immune system? Findings In this systematic review of 13 studies comprising 795 participants, no clinical studies investigated the efficacy or effectiveness of spinal manipulative therapy in preventing or improving disease-specific outcomes among patients with infectious disease. Preliminary laboratory experiments indicated that spinal manipulative therapy may, in the short term, be associated with levels of change in immunological biomarkers among asymptomatic participants. Meaning These findings suggest that, given the limitations of the evidence, claims that spinal manipulative therapy is associated with changes in the immune system are premature and further clinical studies should be completed., Importance Claims that spinal manipulative therapy (SMT) can improve immune function have increased substantially during the COVID-19 pandemic and may have contributed to the rapid spread of both accurate and inaccurate information (referred to as an infodemic by the World Health Organization). Objective To identify, appraise, and synthesize the scientific literature on the efficacy and effectiveness of SMT in preventing the development of infectious disease or improving disease-specific outcomes in patients with infectious disease and to examine the association between SMT and selected immunological, endocrine, and other physiological biomarkers. Evidence Review A literature search of MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Index to Chiropractic Literature, the Cochrane Central Register of Controlled Trials, and Embase was conducted from inception to April 15, 2020. Randomized clinical trials and cohort studies were included. Eligible studies were critically appraised, and evidence with high and acceptable quality was synthesized using the Synthesis Without Meta-Analysis guideline. Findings A total of 2593 records were retrieved; after exclusions, 50 full-text articles were screened, and 16 articles reporting the findings of 13 studies comprising 795 participants were critically appraised. The literature search found no clinical studies that investigated the efficacy or effectiveness of SMT in preventing the development of infectious disease or improving disease-specific outcomes among patients with infectious disease. Eight articles reporting the results of 6 high- and acceptable-quality RCTs comprising 529 participants investigated the effect of SMT on biomarkers. Spinal manipulative therapy was not associated with changes in lymphocyte levels or physiological markers among patients with low back pain or participants who were asymptomatic compared with sham manipulation, a lecture series, and venipuncture control groups. Spinal manipulative therapy was associated with short-term changes in selected immunological biomarkers among asymptomatic participants compared with sham manipulation, a lecture series, and venipuncture control groups. Conclusions and Relevance In this systematic review of 13 studies, no clinical evidence was found to support or refute claims that SMT was efficacious or effective in changing immune system outcomes. Although there were limited preliminary data from basic scientific studies suggesting that SMT may be associated with short-term changes in immunological and endocrine biomarkers, the clinical relevance of these findings is unknown. Given the lack of evidence that SMT is associated with the prevention of infectious diseases or improvements in immune function, further studies should be completed before claims of efficacy or effectiveness are made., This systematic review investigates the association of spinal manipulative therapy with the prevention of infectious disease, improvement of disease-specific outcomes, and changes in immune system function.
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- 2021
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43. Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study
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Giada Procopio, Enrico Maria Trecarichi, Rosaria Lionello, Paolo Fusco, Concetta Irace, Carlo Torti, Bruno Tassone, Elena Lio, Francesca Serapide, Marco Ricchio, Maria Chiara Pelle, Maria Mazzitelli, and Anna Cancelliere
- Subjects
Medicine (General) ,medicine.medical_specialty ,Pilot Projects ,Type 2 diabetes ,Article ,R5-920 ,Risk Factors ,Diabetes management ,Internal medicine ,Diabetes mellitus ,Health care ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,diabetes ,SARS-CoV-2 ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,mortality ,Confidence interval ,Ketoacidosis ,Hospitalization ,Diabetes Mellitus, Type 2 ,insulin therapy ,Covid-19 ,business - Abstract
Background and objectives: Diabetes may affect in-hospital mortality of patients with Coronavirus disease 2019 (COVID-19). We have retrospectively evaluated clinical characteristics, diabetes management, and outcomes in a sample of COVID-19 patients with diabetes admitted to our hospital. Materials and Methods: All patients admitted to the Infectious Diseases Unit from 28 March 2020, to 16 June 2020, were enrolled. Clinical information and biochemical parameters were collected at the time of admission. Patients were ranked according to diabetes and death. Results: Sixty-one patients with COVID-19 were analyzed. Most of them were from a long-term health care facility. Mean age was 77 ± 16 years, and 19 had type 2 diabetes (T2D). Eighteen patients died, including 8 with T2D and 10 without T2D (p = 0.15). Patients with diabetes were significantly older, had a higher prevalence of cardiovascular diseases, and a significantly lower lymphocyte count. No significant relationship was found between diabetes and in-hospital mortality (Odds Ratio OR 2.3, Confidence Interval CI 0.73–7.38, p = 0.15). Patients with diabetes were treated with insulin titration algorithm. Severe hypoglycemic events, ketoacidosis and hyperosmolar hyperglycemias did not occur during hospitalization. Mean pre-meal capillary blood glucose was 157 ± 45 mg/dL, and the coefficient of variation of glycaemia was 29%. Conclusions: Our study, albeit limited by the small number of subjects, did not describe any significant association between T2D diabetes and mortality. Clinical characteristics of patients, and acceptable glucose control prior and during hospitalization may have influenced the result. The use of an insulin titration algorithm should be pursued during hospitalization.
- Published
- 2021
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44. Adipose Tissue and Brain Metabolic Responses to Western Diet—Is There a Similarity between the Two?
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Susanna Iossa, Rosa Cancelliere, Arianna Mazzoli, Maria Stefania Spagnuolo, Martina Nazzaro, Luisa Cigliano, Raffaella Crescenzo, Cristina Gatto, Mazzoli, A, Spagnuolo, M, Gatto, C, Nazzaro, M, Cancelliere, R, Crescenzo, R, Iossa, S, and Cigliano, L
- Subjects
Male ,0301 basic medicine ,hippocampus ,Adipose tissue ,White adipose tissue ,lcsh:Chemistry ,0302 clinical medicine ,Adipocytes ,Insulin ,lcsh:QH301-705.5 ,Spectroscopy ,frontal cortex ,Brain ,General Medicine ,haptoglobin ,adipose tissue ,Computer Science Applications ,Organ Specificity ,Cytokines ,Inflammation Mediators ,lipocalin ,Signal Transduction ,synaptic proteins ,medicine.medical_specialty ,Adipokine ,Biology ,Models, Biological ,Article ,Catalysis ,Inorganic Chemistry ,03 medical and health sciences ,Internal medicine ,medicine ,Animals ,Receptor, trkB ,Physical and Theoretical Chemistry ,Molecular Biology ,Protein kinase B ,Brain-derived neurotrophic factor ,adiponectin ,Adiponectin ,hippocampu ,Organic Chemistry ,Rats ,IRS1 ,Insulin receptor ,BDNF ,030104 developmental biology ,Endocrinology ,lcsh:Biology (General) ,lcsh:QD1-999 ,Diet, Western ,biology.protein ,Energy Metabolism ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Dietary fats and sugars were identified as risk factors for overweight and neurodegeneration, especially in middle-age, an earlier stage of the aging process. Therefore, our aim was to study the metabolic response of both white adipose tissue and brain in middle aged rats fed a typical Western diet (high in saturated fats and fructose, HFF) and verify whether a similarity exists between the two tissues. Specific cyto/adipokines (tumor necrosis factor alpha (TNF-&alpha, ), adiponectin), critical obesity-inflammatory markers (haptoglobin, lipocalin), and insulin signaling or survival protein network (insulin receptor substrate 1 (IRS), Akt, Erk) were quantified in epididymal white adipose tissue (e-WAT), hippocampus, and frontal cortex. We found a significant increase of TNF-&alpha, in both e-WAT and hippocampus of HFF rats, while the expression of haptoglobin and lipocalin was differently affected in the various tissues. Interestingly, adiponectin amount was found significantly reduced in e-WAT, hippocampus, and frontal cortex of HFF rats. Insulin signaling was impaired by HFF diet in e-WAT but not in brain. The above changes were associated with the decrease in brain derived neurotrophic factor (BDNF) and synaptotagmin I and the increase in post-synaptic protein PSD-95 in HFF rats. Overall, our investigation supports for the first time similarities in the response of adipose tissue and brain to Western diet.
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- 2020
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45. A dangerous chase: severe neurocognitive impairment and death following smoked heroin
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Eike Blohm, Mark J. Neavyn, and Alessandro Cancelliere
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medicine.medical_specialty ,Neurotoxicity ,General Medicine ,Chasing the dragon ,Drug-induced encephalopathy ,Toxicology ,medicine.disease ,Heroin ,03 medical and health sciences ,0302 clinical medicine ,Tomography x ray computed ,X ray computed ,Heroin dependence ,medicine ,030211 gastroenterology & hepatology ,Psychiatry ,Psychology ,Neurocognitive ,030217 neurology & neurosurgery ,medicine.drug - Published
- 2017
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46. Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)-phase II: rupture risk assessment
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Anderson Chun On Tsang, Saba Elias, Sylvia Saalfeld, Hui Meng, Yu An Wu, György Paál, Oliver Beuing, Senol Piskin, Prasanth Velvaluri, Samuel Voß, Gábor Janiga, Mehdi Najafi, Leonid Goubergrits, S. V. Sindeev, Tin Lok Chiu, Felicitas J. Detmer, Masaaki Shojima, Hiroyuki Takao, Nikhil Paliwal, Bong Jae Chung, Sergey Frolov, Gábor Závodszky, Andreas Spuler, Gabriele Copelli, Philipp Berg, Sreenivas Venguru, David F. Kallmes, Nicole M. Cancelliere, Aslak W. Bergersen, Kent D. Carlson, Dan Dragomir-Daescu, Vitor Mendes Pereira, David A. Steinman, Santhosh Seshadhri, Juan R. Cebral, Kristian Valen-Sendstad, Hamidreza Rajabzadeh-Oghaz, Christof Karmonik, Soichiro Fujimura, Jan Bruening, Benjamin Csippa, Mariya S. Pravdivtseva, Ender A. Finol, Yi Qian, and Computational Science Lab (IVI, FNWI)
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Multivariate analysis ,Research groups ,Biomedical Engineering ,Hemodynamics ,Health Informatics ,Aneurysm, Ruptured ,Risk Assessment ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Risk Factors ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Rupture risk ,Multiple aneurysms ,Radiation treatment planning ,business.industry ,Models, Cardiovascular ,Computational Biology ,Intracranial Aneurysm ,General Medicine ,Blood flow ,Anatomy ,medicine.disease ,Computer Graphics and Computer-Aided Design ,Computer Science Applications ,Cerebral Angiography ,Cerebrovascular Circulation ,Surgery ,Computer Vision and Pattern Recognition ,business ,030217 neurology & neurosurgery - Abstract
PurposeAssessing the rupture probability of intracranial aneurysms (IAs) remains challenging. Therefore, hemodynamic simulations are increasingly applied toward supporting physicians during treatment planning. However, due to several assumptions, the clinical acceptance of these methods remains limited.MethodsTo provide an overview of state-of-the-art blood flow simulation capabilities, the Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH) was conducted. Seventeen research groups from all over the world performed segmentations and hemodynamic simulations to identify the ruptured aneurysm in a patient harboring five IAs. Although simulation setups revealed good similarity, clear differences exist with respect to the analysis of aneurysm shape and blood flow results. Most groups (12/71%) included morphological and hemodynamic parameters in their analysis, with aspect ratio and wall shear stress as the most popular candidates, respectively.ResultsThe majority of groups (7/41%) selected the largest aneurysm as being the ruptured one. Four (24%) of the participating groups were able to correctly select the ruptured aneurysm, while three groups (18%) ranked the ruptured aneurysm as the second most probable. Successful selections were based on the integration of clinically relevant information such as the aneurysm site, as well as advanced rupture probability models considering multiple parameters. Additionally, flow characteristics such as the quantification of inflow jets and the identification of multiple vortices led to correct predictions.ConclusionsMATCH compares state-of-the-art image-based blood flow simulation approaches to assess the rupture risk of IAs. Furthermore, this challenge highlights the importance of multivariate analyses by combining clinically relevant metadata with advanced morphological and hemodynamic quantification.
- Published
- 2019
47. Postsurgical rehabilitation for adults with low back pain with or without radiculopathy who were treated surgically: protocol for a mixed studies systematic review
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Ginny Brunton, Anne Taylor-Vaisey, Leslie Verville, Carol Cancelliere, Margareta Nordin, Jessica J. Wong, Pierre Côté, Gaelan Connell, Hainan Yu, Heather M. Shearer, Silvano Mior, and Paulo S. Pereira
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medicine.medical_specialty ,medicine.medical_treatment ,education ,MEDLINE ,Context (language use) ,CINAHL ,PsycINFO ,Rehabilitation Medicine ,Postoperative Complications ,systematic review ,Knowledge translation ,Humans ,Medicine ,lumbar radiculopathy ,Orthopedic Procedures ,Radiculopathy ,Rehabilitation ,business.industry ,post-surgical rehabilitation ,General Medicine ,Chiropractic ,Physical therapy ,business ,Low Back Pain ,Systematic Reviews as Topic ,Qualitative research - Abstract
IntroductionSurgical rates for low back pain (LBP) have been increasing in Europe, North America and Asia. Many patients treated surgically will require postsurgical rehabilitation. Little is known about the effectiveness of postsurgical rehabilitation interventions on health outcomes or about patients’ experiences with these interventions.ObjectivesTo conduct a mixed studies systematic review of quantitative and qualitative studies regarding: (1) the effectiveness and safety of postsurgical rehabilitation interventions for adults with LBP treated surgically and (2) the experiences of patients, healthcare providers, caregivers or others involved with the rehabilitation.Methods and analysisWe will search MEDLINE, Embase, PsycINFO, CINAHL, the Index to Chiropractic Literature, the Cochrane Controlled Register of Trials and the Rehabilitation & Sports Medicine Source for peer-reviewed empirical studies published from inception in any language. Studies using quantitative, qualitative and mixed methodologies will be included. We will also search reference lists of all eligible articles. Data extraction will include type of presurgical pathology, indication for surgery, surgical procedure, how the intervention was delivered and by whom, context and setting. We will conduct a quality assessment of each study and consider study quality in our evidence synthesis. We will use a sequential approach at the review level to synthesise and integrate data. First, we will synthesise the quantitative and qualitative studies independently, conducting a meta-analysis of the quantitative studies if appropriate and thematic synthesis of the qualitative studies. Then, we will integrate the quantitative and qualitative evidence by juxtaposing the findings in a matrix.Ethics and disseminationEthical approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) presentations at national and international conferences and scientific meetings; (2) presentations to local and international stakeholders; (3) publications in peer-reviewed journals and (4) posts on organisational websites.PROSPERO registration numberCRD42019134607.
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- 2020
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48. Towards the Clinical utility of CFD for assessment of intracranial aneurysm rupture - a systematic review and novel parameter-ranking tool
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Nicole M. Cancelliere, Olivier Brina, Li Liang, Christophe Chnafa, Vitor Mendes Pereira, and David A. Steinman
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Population ,Computational fluid dynamics ,Aneurysm, Ruptured ,computer.software_genre ,Risk Assessment ,030218 nuclear medicine & medical imaging ,Aneurysm rupture ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine ,Humans ,Rupture risk ,Prospective Studies ,education ,education.field_of_study ,business.industry ,Hemodynamics ,Intracranial Aneurysm ,General Medicine ,Solver ,medicine.disease ,Ranking ,Hydrodynamics ,Surgery ,Size ratio ,Neurology (clinical) ,Data mining ,Stress, Mechanical ,business ,computer ,030217 neurology & neurosurgery - Abstract
BackgroundIntracranial aneurysms (IAs) are vascular dilations on cerebral vessels that affect between 1%–5% of the general population, and can cause life-threatening intracranial hemorrhage when ruptured. Computational fluid dynamics (CFD) has emerged as a promising tool to study IAs in recent years, particularly for rupture risk assessment. However, despite dozens of studies, CFD is still far from clinical use due to large variations and frequent contradictions in hemodynamic results between studies.PurposeTo identify key gaps in the field of CFD for the study of IA rupture, and to devise a novel tool to rank parameters based on potential clinical utility.MethodsA Pubmed search identified 231 CFD studies for IAs. Forty-six studies fit our inclusion criteria, with a total of 2791 aneurysms. For included studies, study type, boundary conditions, solver resolutions, parameter definitions, geometric and hemodynamic parameters used, and results found were recorded.Data synthesisAspect ratio, aneurysm size, low wall shear stress area, average wall shear stress, and size ratio were the parameters that correlate most strongly with IA rupture.LimitationsSignificant differences in parameter definitions, solver spatial and temporal resolutions, number of cycles between studies as well as frequently missing information such as inlet flow rates were identified. A greater emphasis on prospective studies is also needed.ConclusionsOur recommendations will help increase standardization and bridge the gaps in the CFD community, and expedite the process of making CFD clinically useful in guiding the treatment of IAs.
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- 2018
49. 'Delirium Day': a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool
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Bellelli, Giuseppe, Morandi, Alessandro, Di Santo, Simona G., Mazzone, Andrea, Cherubini, Antonio, Mossello, Enrico, Mario, Bo, Bianchetti, Angelo, Rozzini, Renzo, Zanetti, Ermellina, Musicco, Massimo, Ferrari, Alberto, Ferrara, Nicola, Trabucchi, Marco, Boffelli, Stefano, Stefano, Fabio Di, Filippi, Francesco De, Guerini, Fabio, Bertoletti, Erik, March, Albert, Margiotta, Alessandro, Mecocci, Patrizia, Addesi, Desireè, Fantò, Fausto, Dijik, Babette, Porrino, Paola, Cotroneo, Antonino Maria, Galli, Giovanni, Bruni, Amalia Cecilia, Bernardini, Bruno, Corsini, Carla, Cagnin, Annachiara, Zurlo, Amedeo, Barbagallo, Giuseppe, Lunardelli, Maria Lia, Martini, Emilio, Battaglia, Giuseppe, Latella, Raffaele, Petritola, Donatella, Sinforiani, Elena, Cester, Alberto, Formilan, Marino, Carbone, Pasqualina, Appollonio, Ildebrando, Cereda, Diletta, Tremolizzo, Lucio, Bottacchi, Edo, Lucchetti, Lucio, Mariani, Claudio, Rapazzini, Piero, Romanelli, Giuseppe, Marengoni, Alessandra, Zuliani, Giovanni, Bianchi, Lara, Suardi, Teresa, Muti, Ettore, Bottura, Renato, Sgrò, Giovanni, Mandas, Antonella, Serchisu, Luca, Crippa, Patrizia, Ivaldi, Claudio, Ungar, Andrea, Villani, Daniele, Raimondi, Clara, Mussi, Chiara, Isaia, Giancarlo, Provenzano, Giuseppe, Mari, Daniela, Odetti, Patrizio, Monacelli, Fiammetta, Incalzi, Raffaele Antonelli, Pluderi, Alice, Bellamoli, Claudio, Terranova, Luciano, Scarpini, Elio, D'Amico, Ferdinando, Cavallini, Maria Chiara, Guerrini, Gianbattista, Scotuzzi, Anna Maria, Chiarello, Antonino, Pilotto, Alberto, Tognini, Sara, Dell'Aquila, Giuseppina, Toigo, Gabriele, Ceschia, Giuliano, Piccinini, Maristella, Fabbo, Andrea, Zoli, Marco, Forti, Paola, Wenter, Christian, Basile, Giorgio, Lasagni, Anna, Padovani, Alessandro, Rozzini, Luca, Cottino, Maria, Vitali, Silvia, Tripi, Gabriele, Avanzi, Stefano, Annoni, Giorgio, Ruotolo, Giovanni, Boschi, Federica, Bonino, Paolo, Marchionni, Niccolo, Fascendini, Sara, Noro, Gabriele, Turco, Renato, Ubezio, Maria C., Serrati, Carlo, Infante, Maria, Gentile, Simona, Pernigotti, Luigi M., Biagini, Carlo A., Canonico, Enzo, Bonati, Pietro, Gareri, Pietro, Caffarra, Paolo, Ceretti, Arcangelo, Castiglia, Rosanna, Gabelli, Carlo, Storto, Mario Lo, Putzu, Paolo, Santo, Simona Di, Malara, Alba, Spadea, Fausto, Di Cello, Serena, Ceravolo, Francesco, Fabiano, Francesco, Rispoli, Vincenzo, Chiaradia, Giuseppe, Gabriele, Amedeo, Settembrini, Vincenzo, Capomolla, Domenico, Citrino, Antonella, Scriva, Antonietta, Bruno, Irene, Secchi, Roberto, De Martino, Eugenio, Muccinelli, Roberto, Lupi, Gerardo, Paonessa, Patrizio, Fabbri, Andrea, Castellari, Sofia, Andrea, Po, Gaggioli, Guido, Varesi, Massimo, Moneti, Paolo, Capurso, Sebastiano, Latini, Vincenzo, Ghidotti, Stefano, Riccardelli, Francesco, Macchi, Maurizio, Cassinadri, Angela, Tonini, Gabriele, Andreani, Laura, Coralli, Mirco, Balotta, Antonio, Cancelliere, Roberto, Strazzacapa, Mara, Cavallino, Pierangela, Fabio, Stefano, De Filippi, Francesco, Giudice, Chiara, Floris, Patrizia, Dentizzi, Cosimo, D’Elia, Katia, Azzini, Margherita, Cazzadori, Marco, Benati, Claudia, Tobaldini, Chiara, Antonioli, Angela, Mombelloni, Paolo, Fontanini, Fulvio, Oliverio, Martina, Del Grosso, Luciano, Giavedoni, Cristina, Bidoli, Giuliano, Mazzei, Bruno, Corsonello, Andrea, Fusco, Sergio, Vena, Silvio, De Vuono, Tommaso, Maiuri, Giorgio, Castegnaro, Eugenio, De Rosa, Salvatore, Sechi, Rossella Bazzano, Benvenuti, Enrico, Del Lungo, Ilaria, Giardini, Sante, Giulietti, Chiara, D’Amico, Ferdinando, Caronzolo, Francesco, Grippa, Alessandro, Lombardo, Giuseppina, Pipicella, Tiziana, Nitti, Maria Teresa, Felici, Alessandro, Pavan, Silvia, Piazzani, Fabrizio, Lunelli, Alessandra, Dimori, Sergio, Magnani, Angelo, Soglia, Tiziano, Postacchini, Demetrio, Brunelli, Roberto, Santini, Silvia, Francavilla, Monia, Macchiati, Ilenia, Sorvillo, Francesca, Giuli, Cinzia, Perticone, Francesco, Rosa, Paola Cerra, Bencardino, Giuseppe, Falbo, Tania, Grillo, Nadia, Isaia, Gianluca, Pezzilli, Stella, Bergamo, Daniele, Furno, Elisabetta, Rrodhe, Sokol, Lucarini, Simonetta, Dall’Acqua, Francesca, Cappelletto, Francesco, Calvani, Donatella, Becheri, Dimitri, Gambardella, Lucia, Valente, Carlo, Ceci, Giacomo, Ettorre, Evaristo, Tironi, Sara, Grassi, Maria Grazia, Troisi, Elio, Gabutto, Anna, Baglietto, Nino, Quazzo, Loredana, Rosatello, Annalisa, Suraci, Domenico, Tagliabue, Benedetta, Perrone, Chiara, Ferrara, Lucia, Castagna, Alberto, Tremolada, Maria Luisa, Piano, Simonetta, Serviddio, Gaetano, Lo Buglio, Aurelio, Gurrera, Tiziana, Merlo, Valeria, Rovai, Carla, Carlucci, Rosaria, Abbaldo, Anna, Monzani, Fabio, Qasem, Ahmad Amedeo, Bini, Giacomo, Tafuto, Silvia, Mancuso, Giovanna, Fragiacomo, Federica, Pompanin, Sara, Guerra, Gianluca, Pala, Marco, Menozzi, Luca, Gatti, Chiara Delli, Magon, Stefania, Di Francesco, Vincenzo, Faccioli, Silvia, Pellizzari, Luca, Lia Lunardelli, Maria, Macchiarulo, Maria, Corneli, Maria, Bacci, Monica, Lo Storto, Mario, Seresin, Chiara, Simonato, Matteo, Loreggian, Michele, Cestonaro, Fausta, Durando, Mario, Mazzoleni, Marta, Russo, Giuseppe, Ponte, Martino, Valchera, Alessandro, Salustri, Giuseppe, Costa, Alfredo, Cotta, Matteo Ramusino, Pizio, Renato Nicola, Perego, Germana, Bucciantini, Elisabetta, Di Giovanni, Marco, Franchi, Fabrizio, Claudio Mariani, Sara Barbieri, Grande, Giulia, Fugazza, Luciano, Guerrini, Chiara, De Paduanis, Giovanna, Iallonardo, Lucia, Palumbo, Pasquale, Ortolani, Beatrice, Capatti, Eleonora, Soavi, Cecilia, Francesconi, Daniela, Miselli, Agata, Zaccarini, Cinzia, Mirra, Gianluca, Secreto, Piero, Bisio, Erika, Cecchettani, Marco, Naldi, Tamara, Pallavicino, Alessandra, Pugliese, Michela, Iozzo, Rosaria Cosima, Guido Grassi, Giovanni Sgrò, Dell’Oro, Raffaella, Mannironi, Antonio, Giorli, Elisa, Oberti, Sara, Fierro, Brigida, Piccoli, Tommaso, Giacalone, Fabio, Costaggiu, Diego, Pinna, Elisa, Orrù, Francesca, Mannai, Martina, Cordioli, Zeno, Pelizzari, Luca, Chiloiro, Roberta, Cimino, Rosella, Ruberto, Carmen, Dal Santo, Pierluigi, Andriolli, Antonino, Burattin, Giuseppe, Rossi, Laura, Tezza, Fabiana, Aloisio, Paola, Di Monda, Tiziana, Galbassini, Gloria, Russo, Anna Maria, Pesci, Alberto, Suigo, Giulia, Zanasi, Massimo, Moniello, Giovanni, Rostagno, Carlo, Cartei, Alessandro, Polidori, Gianluca, Melis, Maria Ramona, Martellini, Eleonora, Battiston, Bruno, Berardino, Maurizio, Cavallo, Simona, Lombardi, Bruna, D’Ippolito, Pierpaolo, Furini, Angela, Guarneri, Massimo, Paolucci, Stefano, Bassi, Andrea, Coiro, Paola, De Angelis, Domenico, Morone, Giovanni, Venturiero, Vincenzo, Palleschi, Lorenzo, Raganato, Paolo, Di Niro, Giuseppina, Imoscopi, Alessandra, Tibaldi, Vittoria, Bottignole, Giuliana, Calvi, Elisa, Clementi, Carlotta, Zanocchi, Mauro, Agosta, Luca, Criasia, Antonio, Spertino, Elena, Nortarelli, Antonella, Principato, Pietro, Rizzo, Anita, Cellura, Eleonora, Zanghierato, Angelo, Romano, Federica Y., Rosini, Francesca, Mansi, Marta, Rossi, Silvia, Riccardelli, Alex, Potena, Alfredo, Lichii, Mihaela, Candiani, Tiziana, Grimaldi, William, Bertani, Emiliano, Calogero, Pietro, Pinto, Daniela, Bernardi, Roberto, Nicolino, Francesco, Galetti, Caterina, Gianstefani, Alice, Prefumo, Matteo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Prestano, Raffaele, Dalise, Anna Maria, Barra, Davide, Dal Bosco, Livio, Asprinio, Vincenzo, Dallape, Luciana, Perina, Elisa, Bartoli, Isaura Rossi, Maina, Antonella, Pecoraro, Elisabetta, Sciarra, Michela, Prudente, Angela, Benini, Lucia, Levato, Francesco, Mhiuta, Victor, Alius, Florin, Davidoaia, Diana, Giardini, Vittorio, Garancini, Mattia, Bozzini, Claudia, Tosoni, Paolo, Provoli, Emma, Cascone, Luisa, Dioli, Andrea, Ferrarin, Gianfranco, Bucci, Adelmo, Bua, Guido, Fenu, Sara, Bianchi, Giovanna, Casella, Silvia, Romano, Valentina, Belotti, Gloria, Cavaliere, Sabina, Cuni, Estella, Merciuc, Nina, Oberti, Rosella, Colombo, Katia, D’Arcangelo, Paolo, Montenegro, Nicola, Montanari, Roberto, Lamanna, Pierpaolo, Gasperini, Beatrice, Arighi, Andrea, Granata, Antonino, Ranalli, Claudia, Cammilli, Alessandra, Tricca, Manola, Natella, Daniela, Sozzi, Ferdinando, Valenti, Luigi, Monia, Monella, Prete, Camilla, Senesi, Barbara, Meta, Anna Cristina, Pendenza, Enrico, Pasqualetti, Giuseppe, Polini, Antonio, Ballino, Elena, Dell’Aquila, Giuseppina, Gasparrini, Pina Maria, Marotti, Elisabetta, Migale, Monica, Scrimieri, Antonia, Rosso, Alessia, Tongiorgi, Chiara, Scarpa, Cristina, Pacchioni, Maurizio, De Dominicis, Luigino, Pucci, Eugenio, Renzi, Sara, Cartechini, Elisabetta, Barilaro, Giuseppe, Ugenti, Francesca, Romeo, Pasquale, Nardelli, Anna, Lauretani, Fulvio, Visioli, Sandra, Montanari, Ilaria, Ermini, Francesca, Giordano, Antonio, Pigato, Giorgio, Simeone, Emilio, Colameco, Franco, Cecamore, Antonella, Scurti, Rosa, Lupinetti, Maria Cristina, Barbujani, Mario, Perazzi, Beatrice, Giampieri, Marina, Amoruso, Raffaele, Ferrari, Camilla, Gambetti, Claudio, Sfrappini, Mario, Semeraro, Letizia, Striuli, Rinaldo, Mariani, Claudia, Pelliccioni, Giuseppe, Marinelli, Donatella, Rossi, Tommaso, Pesallaccia, Martina, Sabbatini, Debora, Gobbi, Beatrice, Cerqua, Raffaella, Tagliani, Giancarla, Schlauser, Elena, Caser, Luciano, Caramello, Elisa, Sandigliano, Franca, Rosso, Giorgio, Bendini, Chiara, Scevola, Moreno, Vitale, Enrico, Maugeri, Domenico, Sorace, Rosaria, Anzaldi, Massimiliano, De Gesu, Roberto, Morrone, Giuseppe, Davolio, Federica, Pirazzoli, Luca, Fabbri, Elisa, Ruffini, Ingrid, Insam, Miriam, Abraham, Elisabeth, Kirchlechner, Christine, Cucinotta, Domenico, Parise, Pasquale, Boccali, Andrea, Amici, Serena, Gambacorta, Maurizia, Lovati, Roberto, Giovinazzo, Francesca, Kimak, Elzbieta, Lo Castro, Marika, Mauro, Flavia, De Luca, Alessandro, Sancesario, Giuseppe, Martorana, Alessandro, Scaricamazza, Beatrice, Toniolo, Sofia, Di Lorenzo, Francesco, Liguori, Claudio, Lasco, Antonino, Vita, Natale, Giomi, Mirna, Forte, Floriana, Ceraso, Anna, Marelli, Eleonora, Miceli, Salvatore, Urso, Giovanni, Grioni, Giuseppe, Vezzadini, Giuliana, Misaggi, Giulia, Forlani, Chiara, Iemolo, Francesco, Giordano, Antonello, Sanzaro, Enzo, D’Asta, Gabriele, Proietto, Maria, Carnemolla, Anna, Razza, Grazia, Spadaro, Daniela, Bertolotti, Marco, Neviani, Francesca, Balestri, Francesca, Torrini, Monica, Mannarino, Giulio, Tesi, Francesca, Bigolari, Michela, Natale, Alessia, Grassi, Simona, Bottaro, Cinzia, Stefanelli, Sara, Bovone, Ugo, Tortorolo, Umberto, Quadri, Roberto, Leone, Giuseppe, Ponzetto, Maria, Frasson, Paola, Bruni, Adriana, Confalonieri, Roberto, Corsi, Maurizio, Moretti, Daniela, Teruzzi, Fabiola, Umidi, Simona, Barocco, Federica, Spallazzi, Marco, Chioatto, Paolo, Bortolamei, Sandra, Soattin, Lucia, Bertazzoli, Marco, Rota, Elisabetta, Adobati, Annamaria, Scarpa, Alberto, Granziera, Serena, Zuccher, Paola, Dal Fabbro, Angela, Zara, Daniela, Lo Nigro, Ambra, Franchetti, Lorena, Toniolo, Marika, Marcuzzo, Cinzia, Rollone, Marco, Guerriero, Fabio, Sgarlata, Carmelo, Massè, Alessandro, Zatti, Giovanni, Piatti, Massimiliano, Graci, Jole, Benati, Giuseppe, Biondi, Mario, Fiumi, Nicoletta, Locatelli, Sergio M., Mauri, Sabrina, Beretta, Mauro, Margheritis, Laura, Desideri, Giovanbattista, Liberatore, Ester, Carucci, Anna Cecilia, Caput, Margherita, Antonietti, Maria Paola, Polistena, Giuseppe, De la Pierre, Franz, Mari, Marcello, Massignani, Paola, Tombesi, Fabio, Selvaggio, Fabio, Verbo, Brunella, Bodoni, Paolo, Marchionni, Niccolò, Sabatini, Tony, Mussio, Eleonora, Titoldini, Giulia, Cossu, Beatrice, Licini, Cristina, Tomasoni, Angela, Calderazzo, Massimo, Prampolini, Raffaella, Melotti, Rita Maria, Lilli, Albina, Buda, Simona, Adversi, Marco, Mantovani, Anna Roberta, Viola, Maria C., D’Ambrosio, Viviana, Mazzanti, Paolo, Brambilla, Cristina, Sportelli, Silvia, Quattrocchi, Daniela, Pisu, Cristina, Sicuro, Francesca, Zagnoni, Piergiuseppe, Ghiglia, Stefania, Mosca, Massimiliano, Corazzin, Ileana, Deola, Mariangela, Biagini, Carlo Adriano, Bencini, Francesca, Cantini, Claudia, Tonon, Elisabetta, Pierinelli, Silvia, Onofrj, Marco, Thomas, Astrid, Bonanni, Laura, Cacchiò, Gabriella, Comi, Giancarlo, Magnani, Giuseppe, Santangelo, Roberto, Mazzeo, Salvatore, Barbieri, Cristina, Giroldi, Liviana, Bandini, Fabio, Masina, Marco, Malservisi, Simona, Cicognani, Annalena, Ricca, Laura, Tassinari, Tiziana, Brogi, Davide, Sugo, Annalisa, Bellelli G., Morandi A., Di Santo S.G., Mazzone A., Cherubini A., Mossello E., Bo M., Bianchetti A., Rozzini R., Zanetti E., Musicco M., Ferrari A., Ferrara N., Trabucchi M., Boffelli S., Stefano F.D., Filippi F.D., Guerini F., Bertoletti E., March A., Margiotta A., Mecocci P., Addesi D., Fanto F., Dijik B., Porrino P., Cotroneo A.M., Galli G., Bruni A.C., Bernardini B., Corsini C., Cagnin A., Zurlo A., Barbagallo G., Lunardelli M.L., Martini E., Battaglia G., Latella R., Petritola D., Sinforiani E., Cester A., Formilan M., Carbone P., Appollonio I., Cereda D., Tremolizzo L., Bottacchi E., Lucchetti L., Mariani C., Rapazzini P., Romanelli G., Marengoni A., Zuliani G., Bianchi L., Suardi T., Muti E., Bottura R., Sgro G., Mandas A., Serchisu L., Crippa P., Ivaldi C., Ungar A., Villani D., Raimondi C., Mussi C., Isaia G., Provenzano G., Mari D., Odetti P., Monacelli F., Incalzi R.A., Pluderi A., Bellamoli C., Terranova L., Scarpini E., D'Amico G., Cavallini M.C., Guerrini G., Scotuzzi A.M., Chiarello A., Pilotto A., Tognini S., Dell'Aquila G., Toigo G., Ceschia G., Piccinini M., Fabbo A., Zoli M., Forti P., Wenter C., Basile G., Lasagni A., Padovani A., Rozzini L., Cottino M., Vitali S., Tripi G., Avanzi S., Annoni G., Ruotolo G., Boschi F., Bonino P., Marchionni N., Fascendini S., Noro G., Turco R., Ubezio M.C., Serrati C., Infante M., Gentile S., Pernigotti L.M., Biagini C.A., Canonico E., Bonati P., Gareri P., Caffarra P., Ceretti A., Castiglia R., Gabelli C., Storto M.L., Putzu P., Santo S.D., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Rispoli V., Chiaradia G., Gabriele A., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Lupi G., Paonessa P., Fabbri A., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Cassinadri A., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Strazzacapa M., Cavallino P., Fabio S., De Filippi F., Giudice C., Floris P., Dentizzi C., D'Elia K., Azzini M., Cazzadori M., Benati C., Tobaldini C., Antonioli A., Mombelloni P., Fontanini F., Oliverio M., Del Grosso L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Castegnaro E., De Rosa S., Sechi R.B., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Nitti M.T., Felici A., Pavan S., Lunelli A., Dimori S., Magnani A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Perticone F., Rosa P.C., Bencardino G., Falbo T., Grillo N., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dall'Acqua F., Cappelletto F., Calvani D., Becheri D., Gambardella L., Valente C., Ceci G., Ettorre E., Tironi S., Grassi M.G., Troisi E., Gabutto A., Baglietto N., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Carlucci R., Abbaldo A., Monzani F., Qasem A., Bini G., Tafuto S., Mancuso G., Fragiacomo F., Pompanin S., Guerra G., Pala M., Menozzi L., Gatti C.D., Magon S., Di Francesco V., Faccioli S., Pellizzari L., Lia Lunardelli M., Macchiarulo M., Corneli M., Bacci M., Lo Storto M., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Costa A., Cotta M.R., Pizio R.N., Perego G., Bucciantini E., Di Giovanni M., Franchi F., Claudio Mariani S.B., Grande G., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Ortolani B., Capatti E., Soavi C., Francesconi D., Miselli A., Zaccarini C., Mirra G., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R., Guido Grassi G.S., Dell'Oro R., Mannironi A., Giorli E., Oberti S., Fierro B., Piccoli T., Giacalone F., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Chiloiro R., Cimino R., Ruberto C., Dal Santo P., Andriolli A., Burattin G., Rossi L., Tezza F., Aloisio P., Di Monda T., Galbassini G., Russo A., Pesci A., Suigo G., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Melis M., Martellini E., Battiston B., Berardino M., Cavallo S., Lombardi B., D'Ippolito P., Furini A., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Imoscopi A., Tibaldi V., Bottignole G., Calvi E., Clementi C., Zanocchi M., Agosta L., Criasia A., Spertino E., Nortarelli A., Principato P., Rizzo A., Cellura E., Zanghierato A., Romano F.Y., Rosini F., Mansi M., Rossi S., Riccardelli A., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Prefumo M., Paolisso G., Rizzo M.R., Prestano R., Dalise A.M., Barra D., Dal Bosco L., Asprinio V., Dallape L., Perina E., Bartoli I.R., Maina A., Pecoraro E., Sciarra M., Prudente A., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Colombo K., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Arighi A., Granata A., Ranalli C., Cammilli A., Tricca M., Natella D., Sozzi F., Valenti L., Monia M., Prete C., Senesi B., Meta A.C., Pendenza E., Pasqualetti G., Polini A., Ballino E., Gasparrini P., Marotti E., Migale M., Scrimieri A., Rosso A., Tongiorgi C., Scarpa C., Pacchioni M., De Dominicis L., Pucci E., Renzi S., Cartechini E., Barilaro G., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Colameco F., Cecamore A., Scurti R., Lupinetti M.C., Barbujani M., Perazzi B., Giampieri M., Amoruso R., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Bendini C., Scevola M., Vitale E., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Pirazzoli L., Fabbri E., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Parise P., Boccali A., Amici S., Gambacorta M., Lovati R., Giovinazzo F., Kimak E., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Ceraso A., Marelli E., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Neviani F., Balestri F., Torrini M., Mannarino G., Tesi F., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Barocco F., Spallazzi M., Chioatto P., Bortolamei S., Soattin L., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Dal Fabbro A., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Biondi M., Fiumi N., Locatelli S.M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A.C., Caput M., Antonietti M.P., Polistena G., De la Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Sabatini T., Mussio E., Titoldini G., Cossu B., Licini C., Tomasoni A., Calderazzo M., Prampolini R., Melotti R.M., Lilli A., Buda S., Adversi M., Mantovani A.R., Viola M.C., D'Ambrosio V.V., Mazzanti P., Brambilla C., Sportelli S., Quattrocchi D., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Bonanni L., Cacchio G., Comi G., Magnani G., Santangelo R., Mazzeo S., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Tassinari T., Brogi D., Sugo A., Bellelli, G, Morandi, A, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Bianchetti, A, Rozzini, R, Zanetti, E, Musicco, M, Ferrari, A, Ferrara, N, Trabucchi, M, Appollonio, I, Cereda, D, Tremolizzo, L, Annoni, G, Zatti, G, Bellelli, Giuseppe, Morandi, Alessandro, Di Santo, Simona G, Mazzone, Andrea, Cherubini, Antonio, Mossello, Enrico, Bo, Mario, Bianchetti, Angelo, Rozzini, Renzo, Zanetti, Ermellina, Musicco, Massimo, Ferrari, Alberto, Ferrara, Nicola, Trabucchi, Marco, Giuseppe Bellelli, Alessandro Morandi, Simona G. Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi, and on behalf of the Italian Study Group on Delirium (ISGoD), Stefano Boffelli, Fabio Di Stefano, Francesco De Filippi, Fabio Guerini, Erik Bertoletti, Albert March, Alessandro Margiotta, Patrizia Mecocci, Desireè Addesi, Fausto Fantò, Gianluca Isaia, Babette Dijik, Paola Porrino, Antonino Maria Cotroneo, Giovanni Galli, Amalia Cecilia Bruni, Bruno Bernardini, Carla Corsini, Annachiara Cagnin, Amedeo Zurlo, Giuseppe Barbagallo, Maria Lia Lunardelli, Emilio Martini, Giuseppe Battaglia, Raffaele Latella, Donatella Petritola, Elena Sinforiani, Alberto Cester, Marino Formilan, Pasqualina Carbone, Ildebrando Appollonio, Diletta Cereda, Lucio Tremolizzo, Edo Bottacchi, Lucio Lucchetti, Claudio Mariani, Piero Rapazzini, Giuseppe Romanelli, Alessandra Marengoni, Giovanni Zuliani, Lara Bianchi, Teresa Suardi, Ettore Muti, Renato Bottura, Giovanni Sgrò, Antonella Manda, Luca Serchisu, Patrizia Crippa, Claudio Ivaldi, Andrea Ungar, Daniele Villani, Clara Raimondi, Chiara Mussi, Giancarlo Isaia, Giuseppe Provenzano, Daniela Mari, Patrizio Odetti, Fiammetta Monacelli, Raffaele Antonelli Incalzi, Alice Pluderi, Claudio Bellamoli, Luciano Terranova, Elio Scarpini, Ferdinando D'Amico, Maria Chiara Cavallini, Gianbattista Guerrini, Anna Maria Scotuzzi, Antonino Chiarello, Alberto Pilotto, Sara Tognini, Giuseppina Dell’Aquila, Gabriele Toigo, Giuliano Ceschia, Maristella Piccinini, Andrea Fabbo, Marco Zoli, Paola Forti, Christian Wenter, Giorgio Basile, Anna Lasagni, Alessandro Padovani, Luca Rozzini, Maria Cottino, Silvia Vitali, Gabriele Tripi, Stefano Avanzi, Giorgio Annoni, Giovanni Ruotolo, Federica Boschi, Paolo Bonino, Niccolò Marchionni, Maria C. Cavallini, Sara Fascendini, Gabriele Noro, Renato Turco, Maria C. Ubezio, Carlo Serrati, Maria Infante, Simona Gentile, Luigi M. Pernigotti, Carlo A. Biagini, Enzo Canonico, Pietro Bonati, Pietro Gareri, Paolo Caffarra, Arcangelo Ceretti, Rosanna Castiglia, Carlo Gabelli, Mario Lo Storto, Paolo Putzu, Simona Di Santo, Andrea, Mazzone, and Rita Maria Melotti
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Male ,Cross-sectional study ,Hospitalized patients ,Prevalence ,0302 clinical medicine ,Surveys and Questionnaires ,80 and over ,Odds Ratio ,Medicine ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Multicenter ,Acute hospital ,2. Zero hunger ,Aged, 80 and over ,Medicine(all) ,Medicine (all) ,Settore BIO/14 ,General Medicine ,3. Good health ,4AT ,Delirium ,Hospital ,Aged ,Cross-Sectional Studies ,Female ,Humans ,Inpatients ,Italy ,Logistic Models ,medicine.symptom ,Research Article ,Rehabilitation hospital ,medicine.medical_specialty ,NO ,03 medical and health sciences ,4AT, Delirium, Hospital, Multicenter, Prevalence, Aged, Aged, 80 and over, Cross-Sectional Studies, Delirium, Female, Humans, Inpatients, Italy, Logistic Models, Male, Odds Ratio, Prevalence, Prospective Studies, Surveys and Questionnaires ,mental disorders ,Psychiatry ,business.industry ,Odds ratio ,Emergency medicine ,business ,030217 neurology & neurosurgery - Abstract
Background To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods This is a point prevalence study (called “Delirium Day”) including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01–1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12–1.27), dementia (OR 3.25, 95 % CI 2.41–4.38), malnutrition (OR 2.01, 95 % CI 1.29–3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45–2.82), feeding tubes (OR 2.51, 95 % CI 1.11–5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06–1.87), urinary catheters (OR 1.73, 95 % CI 1.30–2.29), and physical restraints (OR 1.84, 95 % CI 1.40–2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29–3.14), while admission to other settings was not. Conclusions Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The “Delirium Day” project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys. Electronic supplementary material The online version of this article (doi:10.1186/s12916-016-0649-8) contains supplementary material, which is available to authorized users.
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- 2016
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50. Diagnostic Ultrasound of the Soleal Sling
- Author
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Tyler Kelly, Pasquale Cancelliere, and Andrew J. Rader
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medicine.medical_specialty ,Sling (implant) ,medicine.diagnostic_test ,Diagnostic ultrasound ,business.industry ,Nerve Compression Syndromes ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,030218 nuclear medicine & medical imaging ,Nerve compression syndrome ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Nerve conduction study ,Humans ,Ultrasonography ,Tibial Nerve ,Tibial nerve ,business - Abstract
The soleal sling may be a site of tibial nerve entrapment. Objective diagnosis of this syndrome is difficult with current nerve conduction study techniques, magnetic resonance imaging, and neurosensory testing. Diagnostic ultrasound is ideally suited to visualize the tibial nerve statically and dynamically as it enters the soleal sling, thus making an objective diagnosis of soleal sling impingement much easier.
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- 2016
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