Search

Your search keyword '"Gennaro Vetrano"' showing total 4 results
Start Over Author "Gennaro Vetrano" Topic infant, premature
4 results on '"Gennaro Vetrano"'

1. Exposure to Gastric Acid Inhibitors Increases the Risk of Infection in Preterm Very Low Birth Weight Infants but Concomitant Administration of Lactoferrin Counteracts This Effect

Author

Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina, Amelia Di Comite, Alessandro Borghesi, Giovanni Agriesti, Riccardo Arisio, Caterina Franco, Roberta Guardione, Elena Boano, Alessia Catarinella, Cristina Romano, Cesare Monetti, Ugo Sala, Caterina Carbonara, Emmanuele Mastretta, Paola Del Sordo, Claudio Priolo, Paolo Galletto, Francesca Campagnoli, Mauro Vivalda, Giuseppina Bonfante, Giovanna Gomirato, Davide Montin, Roberta Camilla, Alessandro Messina, Marta Pieretto, Domenico Cipolla, Mario Giuffrè, Giovanni Corsello, Fabio Natale, Gennaro Vetrano, Elisabetta Tridapalli, Giacomo Faldella, Maria Grazia Capretti, PierMichele Paolillo, Simonetta Picone, Serafina Lacerenza, Giancarlo Gargano, Cristiana Magnani, Onofrio Sergio Saia, Elena Della Casa, Manzoni, Paolo, García Sánchez, Ruben, Meyer, Michael, Stolfi, Ilaria, Pugni, Lorenza, Messner, Hubert, Cattani, Silvia, Betta, Pasqua Maria, Memo, Luigi, Decembrino, Lidia, Bollani, Lina, Rinaldi, Matteo, Fioretti, Maria, Quercia, Michele, Maule, Milena, Tavella, Elena, Mussa, Alessandro, Tzialla, Chryssoula, Laforgia, Nicola, Mosca, Fabio, Magaldi, Rosario, Mostert, Michael, Farina, Daniele, Giuffrè, Mario, Corsello, Giovanni, Manzoni P, García Sánchez R, Meyer M, Stolfi I, Pugni L, Messner H, Cattani S, Betta PM, Memo L, Decembrino L, Bollani L, Rinaldi M, Fioretti M, Quercia M, Maule M, Tavella E, Mussa A, Tzialla C, Laforgia N, Mosca F, Magaldi R, Mostert M, Farina D, and Di Comite A, Borghesi A, Agriesti G, Arisio R, Franco C, Guardione R, Boano E, Catarinella A, Romano C, Monetti C, Sala U, Carbonara C, Mastretta E, Del Sordo P, Priolo C, Galletto P, Campagnoli F, Vivalda M, Bonfante G, Gomirato G, Montin D, Camilla R, Messina A, Pieretto M, Cipolla D, Giuffrè M, Corsello G, Natale F, Vetrano G, Tridapalli E, Faldella G, Capretti MG, Paolillo P, Picone S, Lacerenza S, Gargano G, Magnani C, Sergio Saia O, Della Casa E

Subjects
Colonization, Proton Pump Inhibitor, Neonatal intensive care unit, Administration, Oral, Histamine H2 Antagonist, Probiotic, Gastroenterology, Pediatrics, H2 blocker, 0302 clinical medicine, Risk Factors, Infant, Very Low Birth Weight, 030212 general & internal medicine, Candida, VLBW neonate, Lacticaseibacillus rhamnosus, Gestational age, Perinatology and Child Health, Histamine H2 Antagonists, Italy, Necrotizing enterocolitis, medicine.symptom, Infection, Infant, Premature, Human, medicine.medical_specialty, Birth weight, Gastric Acid, Sepsis, 03 medical and health sciences, Enterocolitis, Necrotizing, Intensive Care Units, Neonatal, 030225 pediatrics, Internal medicine, medicine, H2 blockers, Humans, Dietary Supplement, business.industry, Risk Factor, Probiotics, Infant, Newborn, Proton Pump Inhibitors, medicine.disease, Low birth weight, Lactoferrin, Concomitant, Dietary Supplements, Pediatrics, Perinatology and Child Health, VLBW neonates, Gastric acid, Lactobacillus rhamnosu, business, New Zealand
Abstract

Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. Study design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgment of attending physicians. The distribution of days of inhibitors of gastric acidity exposure between infants with and without LOS/NEC was assessed. The mutually adjusted effects of birth weight, gestational age, duration of inhibitors of gastric acidity treatment, and exposure to BLF were controlled through multivariable logistic regression. Interaction between inhibitors of gastric acidity and BLF was tested; the effects of any day of inhibitors of gastric acidity exposure were then computed for BLF-treated vs -untreated infants. Results: Two hundred thirty-five of 743 infants underwent treatment with inhibitors of gastric acidity, and 86 LOS episodes occurred. After multivariate analysis, exposure to inhibitors of gastric acidity remained significantly and independently associated with LOS (OR, 1.03; 95% CI, 1.008-1.067; P = .01); each day of inhibitors of gastric acidity exposure conferred an additional 3.7% odds of developing LOS. Risk was significant for Gram-negative (P < .001) and fungal (P = .001) pathogens, but not for Gram-positive pathogens (P = .97). On the test for interaction, 1 additional day of exposure to inhibitors of gastric acidity conferred an additional 7.7% risk for LOS (P = .003) in BLF-untreated infants, compared with 1.2% (P = .58) in BLF-treated infants. Conclusion: Exposure to inhibitors of gastric acidity is significantly associated with the occurrence of LOS in preterm VLBW infants. Concomitant administration of BLF counteracts this selective disadvantage. Trial registration: isrctn.org: ISRCTN53107700.

Published
2018

2. Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT

Author

Roberta Maragliano, P B Smith, Fabio Mosca, Gennaro Vetrano, Ilaria Stolfi, Luigi Memo, Paolo Manzoni, Florentia Kaguelidou, Claudio Priolo, Maria Agnese Latino, Daniele Farina, Lina Bollani, Chryssoula Tzialla, Ignazio Barberi, Giuseppina Corona, Michael Cohen-Wolkowiez, Daniel K. Benjamin, Elisabetta Tridapalli, Paolo Galletto, Stefano Rizzollo, C. Giovannozzi, Mauro Stronati, Lidia Decembrino, Giacomo Faldella, Onofrio Sergio Saia, Michael Mostert, Federica Vagnarelli, E. Gallo, Lorenza Pugni, Roberto Pedicino, Evelyne Jacqz-Aigrain, and Giulia Ruffinazzi

Subjects
Male, Pediatrics, medicine.medical_specialty, Antifungal Agents, Neonatal intensive care unit, medicine.medical_treatment, Population, Infant, Premature, Diseases, Biology, law.invention, Randomized controlled trial, law, Intensive Care Units, Neonatal, medicine, Humans, Infant, Very Low Birth Weight, Candidiasis, Invasive, education, Fluconazole, Candida, education.field_of_study, Colonisation, Infection, Preterm neonate, Infant, Newborn, Infant, Obstetrics and Gynecology, Infectious Disease Transmission, Vertical, Parenteral nutrition, Pediatrics, Perinatology and Child Health, Candida spp, Premature Birth, Female, Infant, Premature, Central venous catheter, medicine.drug
Abstract

Fungal colonisation by Candida spp. affects a high proportion of VLBW neonates in NICU. However, few data are available on the clinical characteristics of colonisation in preterm infants who are colonised at baseline via vertical transmission, compared to preterms who become colonised during their stay in NICU via horizontal transmission.We reviewed the database of a multicentre, randomised trial of prophylactic fluconazole in VLBW neonates conducted in 8 Italian NICUs in the years 2004 and 2005 (Manzoni et al., NEJM 2007;356(24):2483-95). Per the protocol, all enrolled infants underwent weekly surveillance cultures from birth till discharge. We investigated the frequency of the two different modalities of Candida colonisation in this population, as well as the clinical and outcome characteristics possibly related to them.Overall, Candida colonisation affected 54 of 336 infants (16.1%). Baseline (i.e., detected3(rd) day of life) colonisation affected 16 (4.7%), and acquired 38 (11.4%), of the 54 colonised preterms. Infants with baseline colonisation had significantly higher birth weight (1229 ± 28 g vs. 1047 g ± 29, p = 0.01) and gestational age (30.2 wks ± 2.7 vs. 28.5 wks ± 2.6, p = 0.01), and were significantly more likely to limit progression from colonisation to invasive Candida infection when fluconazole prophylaxis was instituted (21.6% vs. 42.7%, p = 0.009). Isolation of C. parapsilosis was significantly more frequent in infants with acquired colonisation.Infants with baseline and acquired colonisation differ for demographics characteristics and for their response to fluconazole prophylaxis. This information may be useful for targeting more accurate management strategies for these two different groups of colonised preterms in NICU.

Published
2012
Full Text
View/download PDF

3. Severe pulmonary arterial hypertension in a very premature baby with bronchopulmonary dysplasia: normalization with long-term sildenafil

Author

Bruno Villari, Luigi Maria Pilla, Gennaro Vetrano, Quirino Ciampi, Salvatore Caputo, Brigida Pasquariello, Alfredo De Simone, Raffaello Rabuano, Giuseppe Furcolo, and Angelo Maria Basilicata

Subjects
Male, medicine.medical_specialty, Time Factors, Sildenafil, Hypertension, Pulmonary, Vasodilator Agents, medicine.medical_treatment, Blood Pressure, Gestational Age, Severity of Illness Index, Asymptomatic, Drug Administration Schedule, Piperazines, Sildenafil Citrate, chemistry.chemical_compound, Oxygen therapy, Internal medicine, medicine.artery, Severity of illness, Humans, Medicine, Sulfones, Antihypertensive Agents, Bronchopulmonary Dysplasia, Ultrasonography, business.industry, Infant, Newborn, Gestational age, General Medicine, medicine.disease, Discontinuation, Treatment Outcome, Bronchopulmonary dysplasia, chemistry, Purines, Pulmonary artery, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Infant, Premature
Abstract

Bronchopulmonary dysplasia is a common adverse outcome of very premature babies treated with long-lasting ventilation and oxygen therapy. Infants with bronchopulmonary dysplasia may develop pulmonary arterial hypertension. We report on severe bronchopulmonary dysplasia in a preterm infant who developed secondary, symptomatic and progressively severe pulmonary arterial hypertension. He was treated with sildenafil for 12 months, with complete resolution of pulmonary arterial hypertension. Eighteen months after therapy discontinuation, the patient was asymptomatic, and his systolic pulmonary artery pressure was normal. Routine use of sildenafil in preterm infants with bronchopulmonary dysplasia and secondary pulmonary arterial hypertension could be the future; large studies should confirm this report.

Published
2010
Full Text
View/download PDF

4. A multicenter, randomized trial of prophylactic fluconazole in preterm neonates

Author

Lorenza Pugni, Giuseppina Corona, Franco Merletti, Lidia Decembrino, Gennaro Vetrano, Michael Mostert, Ilaria Stolfi, Paolo Manzoni, Daniele Farina, Milena Maule, C. Giovannozzi, Mauro Stronati, Elisabetta Tridapalli, Fabio Mosca, Riccardo Arisio, C Magnani, Giovanna Gomirato, and Roberto Pedicino

Subjects
Male, medicine.medical_specialty, Pediatrics, Randomization, Antifungal Agents, Infant, Premature, Diseases, Microbial Sensitivity Tests, law.invention, Randomized controlled trial, Double-Blind Method, law, Internal medicine, medicine, Humans, Infant, Very Low Birth Weight, Fluconazole, Candida, Pregnancy, Neonatal Candidiasis, Cholestasis, business.industry, Incidence (epidemiology), Incidence, Candidiasis, Infant, Newborn, General Medicine, medicine.disease, Clinical trial, Gestation, Female, business, Infant, Premature, medicine.drug
Abstract

Invasive candida infections are a major cause of morbidity and mortality in preterm infants. We performed a multicenter, randomized, double-blind, placebo-controlled trial of fluconazole for the prevention of fungal colonization and infection in very-low-birth-weight neonates.During a 15-month period, all neonates weighing less than 1500 g at birth from eight tertiary Italian neonatal intensive care units (322 infants) were randomly assigned to receive either fluconazole (at a dose of either 6 mg or 3 mg per kilogram of body weight) or placebo from birth until day 30 of life (day 45 for neonates weighing1000 g at birth). We performed weekly surveillance cultures and systematic fungal susceptibility testing.Among infants receiving fluconazole, fungal colonization occurred in 9.8% in the 6-mg group and 7.7% in the 3-mg group, as compared with 29.2% in the placebo group (P0.001 for both fluconazole groups vs. the placebo group). The incidence of invasive fungal infection was 2.7% in the 6-mg group and 3.8% in the 3-mg group, as compared with 13.2% in the placebo group (P=0.005 for the 6-mg group and P=0.02 for the 3-mg group vs. the placebo group). The use of fluconazole did not modify the relationship between colonization and the subsequent development of invasive fungal infection. Overall mortality was similar among groups, as was the incidence of cholestasis. No evidence for the emergence of resistant candida species was observed, but the study did not have substantial power to detect such an effect.Prophylactic fluconazole reduces the incidence of colonization and invasive candida infection in neonates weighing less than 1500 g at birth. The benefit of treating candida colonization is unclear. (Current Controlled Trials number, ISRCTN85753869 [controlled-trials.com]).

Catalog

Books, media, physical & digital resources
See catalog results