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2. Aneurismal subarachnoid hemorrhage during the COVID-19 outbreak in a Hub and Spoke system: observational multicenter cohort study in Lombardy, Italy

Author

Fiorindi, A, Vezzoli, M, Doglietto, F, Zanin, L, Saraceno, G, Agosti, E, Barbieri, A, Bellocchi, S, Bernucci, C, Bongetta, D, Cardia, A, Costi, E, Egidi, M, Fioravanti, A, Gasparotti, R, Giussani, C, Grimod, G, Latronico, N, Locatelli, D, Mardighian, D, Nodari, G, Poli, J, Rasulo, F, Roca, E, Sicuri, G, Spena, G, Stefini, R, Vivaldi, O, Zoia, C, Calza, S, Fontanella, M, Cenzato, M, Fiorindi A., Vezzoli M., Doglietto F., Zanin L., Saraceno G., Agosti E., Barbieri A., Bellocchi S., Bernucci C., Bongetta D., Cardia A., Costi E., Egidi M., Fioravanti A., Gasparotti R., Giussani C., Grimod G., Latronico N., Locatelli D., Mardighian D., Nodari G., Poli J. C., Rasulo F., Roca E., Sicuri G. M., Spena G., Stefini R., Vivaldi O., Zoia C., Calza S., Fontanella M. M., Cenzato M., Fiorindi, A, Vezzoli, M, Doglietto, F, Zanin, L, Saraceno, G, Agosti, E, Barbieri, A, Bellocchi, S, Bernucci, C, Bongetta, D, Cardia, A, Costi, E, Egidi, M, Fioravanti, A, Gasparotti, R, Giussani, C, Grimod, G, Latronico, N, Locatelli, D, Mardighian, D, Nodari, G, Poli, J, Rasulo, F, Roca, E, Sicuri, G, Spena, G, Stefini, R, Vivaldi, O, Zoia, C, Calza, S, Fontanella, M, Cenzato, M, Fiorindi A., Vezzoli M., Doglietto F., Zanin L., Saraceno G., Agosti E., Barbieri A., Bellocchi S., Bernucci C., Bongetta D., Cardia A., Costi E., Egidi M., Fioravanti A., Gasparotti R., Giussani C., Grimod G., Latronico N., Locatelli D., Mardighian D., Nodari G., Poli J. C., Rasulo F., Roca E., Sicuri G. M., Spena G., Stefini R., Vivaldi O., Zoia C., Calza S., Fontanella M. M., and Cenzato M.

Abstract

Background: Lombardy was the most affected Italian region by the first phase of the COVID-19 pandemic and underwent urgent reorganization for the management of emergencies, including subarachnoid hemorrhage from a ruptured cerebral aneurysm (aSAH). The aim of the study was to define demographics, clinical, and therapeutic features of aSAH during the COVID-19 outbreak and compare these with a historical cohort. Methods: In this observational multicenter cohort study, patients aged 18 years or older, who were diagnosed with aSAH at the participating centers in Lombardy from March 9 to May 10, 2020, were included (COVID-19 group). In order to minimize bias related to possible SAH seasonality, the control group was composed of patients diagnosed with aSAH from March 9 to May 10 of the three previous years, 2017–2018-2019 (pre-pandemic group). Twenty-three demographic, clinical, and therapeutic features were collected. Statistical analysis was performed. Results: Seventy-two patients during the COVID-19 period and 179 in the control group were enrolled at 14 centers. Only 4 patients were positive for SARS-CoV-2. The “diagnostic delay” was significantly increased (+ 68%) in the COVID-19 group vs. pre-pandemic (1.06 vs. 0.63 days, respectively, p-value = 0.030), while “therapeutic delay” did not differ significantly between the two periods (0.89 vs. 0.74 days, p-value = 0.183). Patients with poor outcome (GOS at discharge from 1 to 3) were higher during the COVID-19 period (54.2%) compared to pre-pandemic (40.2%, p = 0.044). In logistic regression analysis, in which outcome was the dichotomized Glasgow Outcome Scale (GOS), five variables showed p-values < 0.05: age at admission, WFNS grade, treatment (none), days in ICU, and ischemia. Conclusions: We documented a significantly increased “diagnostic delay” for subarachnoid hemorrhages during the first COVID-19 outbreak in Lombardy. However, despite the dramatic situation that the healthcare system was expe

Published
2022

3. Posterior fossa syndrome in a population of children and young adults with medulloblastoma: a retrospective, multicenter Italian study on incidence and pathophysiology in a histologically homogeneous and consecutive series of 136 patients

Author

de Laurentis, C, Cristaldi, P, Rebora, P, Valsecchi, M, Biassoni, V, Schiavello, E, Carrabba, G, Trezza, A, Dimeco, F, Ferroli, P, Cinalli, G, Locatelli, M, Cenzato, M, Talamonti, G, Fontanella, M, Spena, G, Stefini, R, Bernucci, C, Bellocchi, S, Locatelli, D, Massimino, M, Giussani, C, de Laurentis C., Cristaldi P. M. F., Rebora P., Valsecchi M. G., Biassoni V., Schiavello E., Carrabba G. G., Trezza A., DiMeco F., Ferroli P., Cinalli G., Locatelli M., Cenzato M., Talamonti G., Fontanella M. M., Spena G., Stefini R., Bernucci C., Bellocchi S., Locatelli D., Massimino M., Giussani C., de Laurentis, C, Cristaldi, P, Rebora, P, Valsecchi, M, Biassoni, V, Schiavello, E, Carrabba, G, Trezza, A, Dimeco, F, Ferroli, P, Cinalli, G, Locatelli, M, Cenzato, M, Talamonti, G, Fontanella, M, Spena, G, Stefini, R, Bernucci, C, Bellocchi, S, Locatelli, D, Massimino, M, Giussani, C, de Laurentis C., Cristaldi P. M. F., Rebora P., Valsecchi M. G., Biassoni V., Schiavello E., Carrabba G. G., Trezza A., DiMeco F., Ferroli P., Cinalli G., Locatelli M., Cenzato M., Talamonti G., Fontanella M. M., Spena G., Stefini R., Bernucci C., Bellocchi S., Locatelli D., Massimino M., and Giussani C.

Abstract

Introduction: Posterior fossa syndrome (PFS) is a set of debilitating complications that can occur after surgery for posterior fossa tumors. This study aimed to assess the preoperative radiological and surgical risk factors for the onset of PFS in a histologically homogeneous population of children with medulloblastoma and compare it to a similar population of young adults. Methods: Included patients underwent posterior fossa surgery for medulloblastoma at 11 Italian neurosurgical wards (2003–2019) and were referred to Fondazione IRCCS Istituto Nazionale dei Tumori in Milan (INT) for postoperative treatments. We collected patients’ pre- and post-operative clinical, surgical and radiological data from the INT charts. To compare the distribution of variables, we used the Mann–Whitney and Fisher tests for continuous and categorical variables, respectively. Results: 136 patients (109 children and 27 young adults) were included in the study. Among children, 29 (27%) developed PFS, and all of them had tumors at midline site with invasion of the fourth ventricle. Radiological evidence of involvement of the right superior (39% versus 12%; p = 0.011) or middle cerebellar peduncles (52% versus 18%; p = 0.002) seemed more common in children who developed PFS. Young adults showed an expected lower incidence of PFS (4 out of 27; 15%), that may be due to anatomical, physiological and oncological elements. Conclusions: This study confirmed some factors known to be associated with PFS onset and shed light on other debated issues. Our findings enhance an already hypothesized role of cerebellar language lateralization. The analysis of a population of young adults may shed more light on the often-neglected existence of PFS in non-pediatric patients.

Published
2022

4. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

Author

Ferroli, P, Schiavolin, S, Mariniello, A, Acerbi, F, Restelli, F, Schiariti, M, LA Corte, E, Falco, J, Levi, V, Dimeco, F, Assietti, R, Bongetta, D, Colombo, E, Bellocchi, S, Sangiorgi, S, Bistazzoni, S, Polosa, M, Orru, M, Spena, G, Bernucci, C, Sicignano, A, Fanti, A, Brembilla, C, Resmini, B, Costi, E, Cenzato, M, Talamonti, G, Bottini, G, Scarpa, P, Bollani, A, Querzola, M, Palmas, G, DE Gonda, F, Bosio, L, Egidi, M, Tardivo, V, Fioravanti, A, Subacchi, S, Fontanella, M, Biroli, A, Cereda, C, Panciani, P, Bergomi, R, Pertichetti, M, Tancioni, F, Bona, A, Tartara, F, Fornari, M, Pessina, F, Lasio, G, Cardia, A, Servadei, F, Riva, M, Casarotti, A, Giussani, C, Fiori, L, Mazzoleni, F, Vaiani, S, Carrabba, G, DI Cristofori, A, Sganzerla, E, Vimercati, A, Isella, V, Mauri, I, Incerti, M, Sicuri, G, Miramonti, V, Stefini, R, Spagnoli, D, Piparo, M, Grimod, G, Regazzoni, R, Vismara, D, Mazzeo, L, Monti, E, Franzin, A, Vivaldi, O, Maietti, A, Pini, E, Servello, D, Zekaj, E, DE Michele, S, Locatelli, M, Borsa, S, Grimoldi, N, Caroli, M, Tariciotti, L, Abete-Fornara, G, Vitale, M, Leonardi, M, Broggi, M, Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, Colombo, Elena V, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, Orru, Maria I, Spena, Giannantonio, Bernucci, Claudio, Sicignano, Angelo M, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Panciani, Pier Paolo, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, Tartara, Fulvio A, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, Sganzerla, Erik P, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, Broggi, Morgan, Ferroli, P, Schiavolin, S, Mariniello, A, Acerbi, F, Restelli, F, Schiariti, M, LA Corte, E, Falco, J, Levi, V, Dimeco, F, Assietti, R, Bongetta, D, Colombo, E, Bellocchi, S, Sangiorgi, S, Bistazzoni, S, Polosa, M, Orru, M, Spena, G, Bernucci, C, Sicignano, A, Fanti, A, Brembilla, C, Resmini, B, Costi, E, Cenzato, M, Talamonti, G, Bottini, G, Scarpa, P, Bollani, A, Querzola, M, Palmas, G, DE Gonda, F, Bosio, L, Egidi, M, Tardivo, V, Fioravanti, A, Subacchi, S, Fontanella, M, Biroli, A, Cereda, C, Panciani, P, Bergomi, R, Pertichetti, M, Tancioni, F, Bona, A, Tartara, F, Fornari, M, Pessina, F, Lasio, G, Cardia, A, Servadei, F, Riva, M, Casarotti, A, Giussani, C, Fiori, L, Mazzoleni, F, Vaiani, S, Carrabba, G, DI Cristofori, A, Sganzerla, E, Vimercati, A, Isella, V, Mauri, I, Incerti, M, Sicuri, G, Miramonti, V, Stefini, R, Spagnoli, D, Piparo, M, Grimod, G, Regazzoni, R, Vismara, D, Mazzeo, L, Monti, E, Franzin, A, Vivaldi, O, Maietti, A, Pini, E, Servello, D, Zekaj, E, DE Michele, S, Locatelli, M, Borsa, S, Grimoldi, N, Caroli, M, Tariciotti, L, Abete-Fornara, G, Vitale, M, Leonardi, M, Broggi, M, Ferroli, Paolo, Schiavolin, Silvia, Mariniello, Arianna, Acerbi, Francesco, Restelli, Francesco, Schiariti, Marco, LA Corte, Emanuele, Falco, Jacopo, Levi, Vincenzo, Dimeco, Francesco, Assietti, Roberto, Bongetta, Daniele, Colombo, Elena V, Bellocchi, Silvio, Sangiorgi, Simone, Bistazzoni, Simona, Polosa, Maria, Orru, Maria I, Spena, Giannantonio, Bernucci, Claudio, Sicignano, Angelo M, Fanti, Andrea, Brembilla, Carlo, Resmini, Bruno, Costi, Emanuele, Cenzato, Marco, Talamonti, Giuseppe, Bottini, Gabriella, Scarpa, Pina, Bollani, Alessandra, Querzola, Matteo, Palmas, Giulio, DE Gonda, Federico, Bosio, Lorenzo, Egidi, Marcello, Tardivo, Valentina, Fioravanti, Antonio, Subacchi, Sara, Fontanella, Marco, Biroli, Antonio, Cereda, Claudio, Panciani, Pier Paolo, Bergomi, Riccardo, Pertichetti, Marta, Tancioni, Flavio, Bona, Alberto, Tartara, Fulvio A, Fornari, Maurizio, Pessina, Federico, Lasio, Giovanni, Cardia, Andrea, Servadei, Franco, Riva, Marco, Casarotti, Alessandra, Giussani, Carlo, Fiori, Leonardo, Mazzoleni, Fabio, Vaiani, Simona, Carrabba, Giorgio, DI Cristofori, Andrea, Sganzerla, Erik P, Vimercati, Alberto, Isella, Valeria, Mauri, Ilaria, Incerti, Michele, Sicuri, Giovanni, Miramonti, Valentina, Stefini, Roberto, Spagnoli, Diego, Piparo, Maurizio, Grimod, Gianluca, Regazzoni, Rossana, Vismara, Daniela, Mazzeo, Lucio, Monti, Emanuele, Franzin, Alberto, Vivaldi, Oscar, Maietti, Alessandra, Pini, Elisa, Servello, Domenico, Zekaj, Edvin, DE Michele, Sara, Locatelli, Marco, Borsa, Stefano, Grimoldi, Nadia, Caroli, Manuela, Tariciotti, Leonardo, Abete-Fornara, Giorgia, Vitale, Mario, Leonardi, Matilde, and Broggi, Morgan

Abstract

Background: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment. Methods: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts' clinical practice and the existing literature. Results: A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected. Conclusions: A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level.

Published
2023

5. Management of intracranial hypertension following traumatic brain injury: a best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy. Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Author

Iaccarino C., Lippa L., Munari M., Castioni C. A., Robba C., Caricato A., Pompucci A., Signoretti S., Zona G., Rasulo F. A., Aimar E., Amato S., Angileri F. F., Anile C., Assietti R., Baratto V., Barbanera A., Basile L., Battaglia R., Bellocchi S., Bertuccio A., Blanco S., Bolognini A., Boniferro B., Bordi L., Bortolotti C., Brandini V., Broger M., Brollo M., Caffarella D. D., Caggiano C., Cantisani P. L., Capone C., Cappelletto B., Capuano C., Carangelo B., Caruselli G., Chessa M. A., Chiara M., Chibbaro S., Cioffi V., Ciprianocecchi P., Colistra D., Conti C., Contratti F., Costella G. B., Cuoci A., D'Avella D., D'Ercole M., Deangelis M., Defalco R., de Luca G., de Marinis P., Del Vecchio C., Delfinis C., Denaro L., Deodato F., Desogus N., Disomma A., Domenicucci M., Dones F., Fina M., Fiori L., Fricia M., Gaetani P., Gazzeri R., Gentile M., Germano A., Ghadirpour R., Gianfreda C. D., Gigante N., Gigli R., Giorgetti J., Giusa M., Gravina U. G., Grippi L., Guida F., Guizzardi G., Iannuzzo G., Kropp M., Lattanzi L., Lucantoni D., Maffei L., Magliulo M., Marconi F., Marruzzo D., Martellotta N., Marton E., Maugeri R., Mauro G., Meli F., Menniti A., Merciadri P., Milanese L., Nardacci B., Nasi D., Orvieto P., Pacca P., Pansini G., Panzarasa G., Passanisi M., Pavesi G., Pizzoni C., Pulera F., Rapana A., Ricci A., Rispoli R., Rotondo M., Russo N., Santilli S., Scarano E., Schwarz A., Servadei F., Simonetti G., Stefini R., Talamonti G., Turrisi A., Valente V. M., Villa A., Vindigni M., Visocchi M., Vitali M., Wierzbicki V., Zambon G., Zanotti B., Zenga F., Alampi D., Alessandri F., Aloj F., Amigoni A., Aspide R., Bertuetti R., Betti V., Bilotta F., Bonato V., Bosco E., Brita M., Buscema G., Cafiero T., Cappuccio D., Caradonna M., Caria C. G., Casartelliliviero M., Ciritella P., Cirrincione S., Citerio G., Colelli S., Coletta F., Concordia L., Congedo E., Covotta M., Crimella F., Dall'Acqua G., De Cassai A., Defulviis S., Deperi E., Deana C., Delgaudio A., Denittis N., Dicolandrea S., Divezza F., Ferri F., Flocco R., Fontana C., Forastierimolinari A., Frangiosa A., Fumagalli P., Fuselli E., Garbarino M. M., Gelormini D., Geraci C., Geraldini F., Giacomucci A., Giampaoli V., Giorgetti D., Gritti P., Gualdani S., Iacovazzo C., Iermano C., Latronico N., Lugari S., Lusenti F., Maglione C., Magnoni S., Maiarota F., Malla M., Marchesi M., Martino C., Matteotti I., Mazzeo A. T., Morello G., Nardiello I., Paticchio F., Pegoli M., Perotti V., Piazzolla M., Picciafuochi F., Rachedi N., Radolovich D. K., Recchia A., Riccardi S., Romagnoli S., Sala S., Scafuro M. A., Sgarlata P., Soragni A., Stefani F., Stival E., Stofella G., Terranova F., Tinturini R., Togni T., Toto R., Trapani D., Tringali E., Tullo L., Valente A., Valeo T., Varelli G., Villani R., Zamacavicchi F., Zanello M., Zarrillo N., Zugni N., Iaccarino, C, Lippa, L, Munari, M, Castioni, C, Robba, C, Caricato, A, Pompucci, A, Signoretti, S, Zona, G, Rasulo, F, Aimar, E, Amato, S, Angileri, F, Anile, C, Assietti, R, Baratto, V, Barbanera, A, Basile, L, Battaglia, R, Bellocchi, S, Bertuccio, A, Blanco, S, Bolognini, A, Boniferro, B, Bordi, L, Bortolotti, C, Brandini, V, Broger, M, Brollo, M, Caffarella, D, Caggiano, C, Cantisani, P, Capone, C, Cappelletto, B, Capuano, C, Carangelo, B, Caruselli, G, Chessa, M, Chiara, M, Chibbaro, S, Cioffi, V, Ciprianocecchi, P, Colistra, D, Conti, C, Contratti, F, Costella, G, Cuoci, A, D'Avella, D, D'Ercole, M, Deangelis, M, Defalco, R, de Luca, G, de Marinis, P, Del Vecchio, C, Delfinis, C, Denaro, L, Deodato, F, Desogus, N, Disomma, A, Domenicucci, M, Dones, F, Fina, M, Fiori, L, Fricia, M, Gaetani, P, Gazzeri, R, Gentile, M, Germano, A, Ghadirpour, R, Gianfreda, C, Gigante, N, Gigli, R, Giorgetti, J, Giusa, M, Gravina, U, Grippi, L, Guida, F, Guizzardi, G, Iannuzzo, G, Kropp, M, Lattanzi, L, Lucantoni, D, Maffei, L, Magliulo, M, Marconi, F, Marruzzo, D, Martellotta, N, Marton, E, Maugeri, R, Mauro, G, Meli, F, Menniti, A, Merciadri, P, Milanese, L, Nardacci, B, Nasi, D, Orvieto, P, Pacca, P, Pansini, G, Panzarasa, G, Passanisi, M, Pavesi, G, Pizzoni, C, Pulera, F, Rapana, A, Ricci, A, Rispoli, R, Rotondo, M, Russo, N, Santilli, S, Scarano, E, Schwarz, A, Servadei, F, Simonetti, G, Stefini, R, Talamonti, G, Turrisi, A, Valente, V, Villa, A, Vindigni, M, Visocchi, M, Vitali, M, Wierzbicki, V, Zambon, G, Zanotti, B, Zenga, F, Alampi, D, Alessandri, F, Aloj, F, Amigoni, A, Aspide, R, Bertuetti, R, Betti, V, Bilotta, F, Bonato, V, Bosco, E, Brita, M, Buscema, G, Cafiero, T, Cappuccio, D, Caradonna, M, Caria, C, Casartelliliviero, M, Ciritella, P, Cirrincione, S, Citerio, G, Colelli, S, Coletta, F, Concordia, L, Congedo, E, Covotta, M, Crimella, F, Dall'Acqua, G, De Cassai, A, Defulviis, S, Deperi, E, Deana, C, Delgaudio, A, Denittis, N, Dicolandrea, S, Divezza, F, Ferri, F, Flocco, R, Fontana, C, Forastierimolinari, A, Frangiosa, A, Fumagalli, P, Fuselli, E, Garbarino, M, Gelormini, D, Geraci, C, Geraldini, F, Giacomucci, A, Giampaoli, V, Giorgetti, D, Gritti, P, Gualdani, S, Iacovazzo, C, Iermano, C, Latronico, N, Lugari, S, Lusenti, F, Maglione, C, Magnoni, S, Maiarota, F, Malla, M, Marchesi, M, Martino, C, Matteotti, I, Mazzeo, A, Morello, G, Nardiello, I, Paticchio, F, Pegoli, M, Perotti, V, Piazzolla, M, Picciafuochi, F, Rachedi, N, Radolovich, D, Recchia, A, Riccardi, S, Romagnoli, S, Sala, S, Scafuro, M, Sgarlata, P, Soragni, A, Stefani, F, Stival, E, Stofella, G, Terranova, F, Tinturini, R, Togni, T, Toto, R, Trapani, D, Tringali, E, Tullo, L, Valente, A, Valeo, T, Varelli, G, Villani, R, Zamacavicchi, F, Zanello, M, Zarrillo, N, Zugni, N, Iaccarino, C., Lippa, L., Munari, M., Castioni, C. A., Robba, C., Caricato, A., Pompucci, A., Signoretti, S., Zona, G., Rasulo, F. A., Aimar, E., Amato, S., Angileri, F. F., Anile, C., Assietti, R., Baratto, V., Barbanera, A., Basile, L., Battaglia, R., Bellocchi, S., Bertuccio, A., Blanco, S., Bolognini, A., Boniferro, B., Bordi, L., Bortolotti, C., Brandini, V., Broger, M., Brollo, M., Caffarella, D. D., Caggiano, C., Cantisani, P. L., Capone, C., Cappelletto, B., Capuano, C., Carangelo, B., Caruselli, G., Chessa, M. A., Chiara, M., Chibbaro, S., Cioffi, V., Ciprianocecchi, P., Colistra, D., Conti, C., Contratti, F., Costella, G. B., Cuoci, A., D'Avella, D., D'Ercole, M., Deangelis, M., Defalco, R., de Luca, G., de Marinis, P., Del Vecchio, C., Delfinis, C., Denaro, L., Deodato, F., Desogus, N., Disomma, A., Domenicucci, M., Dones, F., Fina, M., Fiori, L., Fricia, M., Gaetani, P., Gazzeri, R., Gentile, M., Germano, A., Ghadirpour, R., Gianfreda, C. D., Gigante, N., Gigli, R., Giorgetti, J., Giusa, M., Gravina, U. G., Grippi, L., Guida, F., Guizzardi, G., Iannuzzo, G., Kropp, M., Lattanzi, L., Lucantoni, D., Maffei, L., Magliulo, M., Marconi, F., Marruzzo, D., Martellotta, N., Marton, E., Maugeri, R., Mauro, G., Meli, F., Menniti, A., Merciadri, P., Milanese, L., Nardacci, B., Nasi, D., Orvieto, P., Pacca, P., Pansini, G., Panzarasa, G., Passanisi, M., Pavesi, G., Pizzoni, C., Pulera, F., Rapana, A., Ricci, A., Rispoli, R., Rotondo, M., Russo, N., Santilli, S., Scarano, E., Schwarz, A., Servadei, F., Simonetti, G., Stefini, R., Talamonti, G., Turrisi, A., Valente, V. M., Villa, A., Vindigni, M., Visocchi, M., Vitali, M., Wierzbicki, V., Zambon, G., Zanotti, B., Zenga, F., Alampi, D., Alessandri, F., Aloj, F., Amigoni, A., Aspide, R., Bertuetti, R., Betti, V., Bilotta, F., Bonato, V., Bosco, E., Brita, M., Buscema, G., Cafiero, T., Cappuccio, D., Caradonna, M., Caria, C. G., Casartelliliviero, M., Ciritella, P., Cirrincione, S., Citerio, G., Colelli, S., Coletta, F., Concordia, L., Congedo, E., Covotta, M., Crimella, F., Dall'Acqua, G., De Cassai, A., Defulviis, S., Deperi, E., Deana, C., Delgaudio, A., Denittis, N., Dicolandrea, S., Divezza, F., Ferri, F., Flocco, R., Fontana, C., Forastierimolinari, A., Frangiosa, A., Fumagalli, P., Fuselli, E., Garbarino, M. M., Gelormini, D., Geraci, C., Geraldini, F., Giacomucci, A., Giampaoli, V., Giorgetti, D., Gritti, P., Gualdani, S., Iacovazzo, C., Iermano, C., Latronico, N., Lugari, S., Lusenti, F., Maglione, C., Magnoni, S., Maiarota, F., Malla, M., Marchesi, M., Martino, C., Matteotti, I., Mazzeo, A. T., Morello, G., Nardiello, I., Paticchio, F., Pegoli, M., Perotti, V., Piazzolla, M., Picciafuochi, F., Rachedi, N., Radolovich, D. K., Recchia, A., Riccardi, S., Romagnoli, S., Sala, S., Scafuro, M. A., Sgarlata, P., Soragni, A., Stefani, F., Stival, E., Stofella, G., Terranova, F., Tinturini, R., Togni, T., Toto, R., Trapani, D., Tringali, E., Tullo, L., Valente, A., Valeo, T., Varelli, G., Villani, R., Zamacavicchi, F., Zanello, M., Zarrillo, N., and Zugni, N.

Subjects
medicine.medical_specialty, Decompressive Craniectomy, Consensus development conference, Decompressive craniectomy, Guideline, Traumatic brain injuries, Critical Care, Intracranial Pressure, medicine.medical_treatment, MEDLINE, Neurosurgery, Traumatic brain injurie, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intensive care, Settore MED/41 - ANESTESIOLOGIA, Brain Injuries, Traumatic, medicine, Humans, Anesthesia, Intensive care medicine, Randomized Controlled Trials as Topic, business.industry, Neurointensive care, Evidence-based medicine, Italy, 030220 oncology & carcinogenesis, Intracranial pressure monitoring, Surgery, Neurology (clinical), Analgesia, Intracranial Hypertension, business, 030217 neurology & neurosurgery, Human
Abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from "TBI Section" of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the "TBI Section" of the SINch and the 111 members of the Neuroanesthesia and Neurocritical Care Study Group of the SIAARTI. The aim of the survey was to test a preliminary evaluation of the grade of predictable future adherence of the recommendations following this intersociety proposal. The following recommendations are suggested as representing best clinical practice, nevertheless, adoption of local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management and perioperative care of decompressed patients is strongly recommended to improve treatment efficiency, to increase the quality of data collection and to provide more powerful evidence with future studies. Thus, for this future perspective a rapid overview of the role of the multimodal neuromonitoring in the optimal severe TBI management is also provided in this document. It is reasonable to assume that the recommendations reported in this paper will in future be updated by new observations arising from future trials. They are not binding, and this document should be offered as a guidance for clinical practice through an intersociety agreement, taking in consideration the low level of evidence.

Published
2021

6. Converted neurosurgeons in a converted coronavirus hospital: sharing the experience of a metamorphosis

Author

Giussani, C, Sganzerla, E, Spena, G, Spagnoli, D, Assietti, R, Bellocchi, S, Oscarvivaldi, Bernucci, C, Magrassi, L, Zoia, C, Egidi, M, de Gonda, F, Locatelli, M, Bello, L, Incerti, M, Servello, D, Vitale, M, Nicolosi, F, Fioravanti, A, Fontanella, M, Stefini, R, Giussani C., Sganzerla E., Spena G., Spagnoli D., Assietti R., Bellocchi S., Bernucci C., Magrassi L., Zoia C., Egidi M., de Gonda F., Locatelli M., Bello L., Incerti M., Servello D., Vitale M., Nicolosi F., Fioravanti A., Fontanella M., Stefini R., Giussani, C, Sganzerla, E, Spena, G, Spagnoli, D, Assietti, R, Bellocchi, S, Oscarvivaldi, Bernucci, C, Magrassi, L, Zoia, C, Egidi, M, de Gonda, F, Locatelli, M, Bello, L, Incerti, M, Servello, D, Vitale, M, Nicolosi, F, Fioravanti, A, Fontanella, M, Stefini, R, Giussani C., Sganzerla E., Spena G., Spagnoli D., Assietti R., Bellocchi S., Bernucci C., Magrassi L., Zoia C., Egidi M., de Gonda F., Locatelli M., Bello L., Incerti M., Servello D., Vitale M., Nicolosi F., Fioravanti A., Fontanella M., and Stefini R.

Published
2021

7. Management of intracranial hypertension following traumatic brain injury: A best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy: Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Author

Iaccarino, C, Lippa, L, Munari, M, Castioni, C, Robba, C, Caricato, A, Pompucci, A, Signoretti, S, Zona, G, Rasulo, F, Aimar, E, Amato, S, Angileri, F, Anile, C, Assietti, R, Baratto, V, Barbanera, A, Basile, L, Battaglia, R, Bellocchi, S, Bertuccio, A, Blanco, S, Bolognini, A, Boniferro, B, Bordi, L, Bortolotti, C, Brandini, V, Broger, M, Brollo, M, Caffarella, D, Caggiano, C, Cantisani, P, Capone, C, Cappelletto, B, Capuano, C, Carangelo, B, Caruselli, G, Chessa, M, Chiara, M, Chibbaro, S, Cioffi, V, Ciprianocecchi, P, Colistra, D, Conti, C, Contratti, F, Costella, G, Cuoci, A, D'Avella, D, D'Ercole, M, Deangelis, M, Defalco, R, de Luca, G, de Marinis, P, Del Vecchio, C, Delfinis, C, Denaro, L, Deodato, F, Desogus, N, Disomma, A, Domenicucci, M, Dones, F, Fina, M, Fiori, L, Fricia, M, Gaetani, P, Gazzeri, R, Gentile, M, Germano, A, Ghadirpour, R, Gianfreda, C, Gigante, N, Gigli, R, Giorgetti, J, Giusa, M, Gravina, U, Grippi, L, Guida, F, Guizzardi, G, Iannuzzo, G, Kropp, M, Lattanzi, L, Lucantoni, D, Maffei, L, Magliulo, M, Marconi, F, Marruzzo, D, Martellotta, N, Marton, E, Maugeri, R, Mauro, G, Meli, F, Menniti, A, Merciadri, P, Milanese, L, Nardacci, B, Nasi, D, Orvieto, P, Pacca, P, Pansini, G, Panzarasa, G, Passanisi, M, Pavesi, G, Pizzoni, C, Pulera, F, Rapana, A, Ricci, A, Rispoli, R, Rotondo, M, Russo, N, Santilli, S, Scarano, E, Schwarz, A, Servadei, F, Simonetti, G, Stefini, R, Talamonti, G, Turrisi, A, Valente, V, Villa, A, Vindigni, M, Visocchi, M, Vitali, M, Wierzbicki, V, Zambon, G, Zanotti, B, Zenga, F, Alampi, D, Alessandri, F, Aloj, F, Amigoni, A, Aspide, R, Bertuetti, R, Betti, V, Bilotta, F, Bonato, V, Bosco, E, Brita, M, Buscema, G, Cafiero, T, Cappuccio, D, Caradonna, M, Caria, C, Casartelliliviero, M, Ciritella, P, Cirrincione, S, Citerio, G, Colelli, S, Coletta, F, Concordia, L, Congedo, E, Covotta, M, Crimella, F, Dall'Acqua, G, De Cassai, A, Defulviis, S, Deperi, E, Deana, C, Delgaudio, A, Denittis, N, Dicolandrea, S, Divezza, F, Ferri, F, Flocco, R, Fontana, C, Forastierimolinari, A, Frangiosa, A, Fumagalli, P, Fuselli, E, Garbarino, M, Gelormini, D, Geraci, C, Geraldini, F, Giacomucci, A, Giampaoli, V, Giorgetti, D, Gritti, P, Gualdani, S, Iacovazzo, C, Iermano, C, Latronico, N, Lugari, S, Lusenti, F, Maglione, C, Magnoni, S, Maiarota, F, Malla, M, Marchesi, M, Martino, C, Matteotti, I, Mazzeo, A, Morello, G, Nardiello, I, Paticchio, F, Pegoli, M, Perotti, V, Piazzolla, M, Picciafuochi, F, Rachedi, N, Radolovich, D, Recchia, A, Riccardi, S, Romagnoli, S, Sala, S, Scafuro, M, Sgarlata, P, Soragni, A, Stefani, F, Stival, E, Stofella, G, Terranova, F, Tinturini, R, Togni, T, Toto, R, Trapani, D, Tringali, E, Tullo, L, Valente, A, Valeo, T, Varelli, G, Villani, R, Zamacavicchi, F, Zanello, M, Zarrillo, N, Zugni, N, Iaccarino C., Lippa L., Munari M., Castioni C. A., Robba C., Caricato A., Pompucci A., Signoretti S., Zona G., Rasulo F. A., Aimar E., Amato S., Angileri F. F., Anile C., Assietti R., Baratto V., Barbanera A., Basile L., Battaglia R., Bellocchi S., Bertuccio A., Blanco S., Bolognini A., Boniferro B., Bordi L., Bortolotti C., Brandini V., Broger M., Brollo M., Caffarella D. D., Caggiano C., Cantisani P. L., Capone C., Cappelletto B., Capuano C., Carangelo B., Caruselli G., Chessa M. A., Chiara M., Chibbaro S., Cioffi V., Ciprianocecchi P., Colistra D., Conti C., Contratti F., Costella G. B., Cuoci A., D'Avella D., D'Ercole M., Deangelis M., Defalco R., de Luca G., de Marinis P., Del Vecchio C., Delfinis C., Denaro L., Deodato F., Desogus N., Disomma A., Domenicucci M., Dones F., Fina M., Fiori L., Fricia M., Gaetani P., Gazzeri R., Gentile M., Germano A., Ghadirpour R., Gianfreda C. D., Gigante N., Gigli R., Giorgetti J., Giusa M., Gravina U. G., Grippi L., Guida F., Guizzardi G., Iannuzzo G., Kropp M., Lattanzi L., Lucantoni D., Maffei L., Magliulo M., Marconi F., Marruzzo D., Martellotta N., Marton E., Maugeri R., Mauro G., Meli F., Menniti A., Merciadri P., Milanese L., Nardacci B., Nasi D., Orvieto P., Pacca P., Pansini G., Panzarasa G., Passanisi M., Pavesi G., Pizzoni C., Pulera F., Rapana A., Ricci A., Rispoli R., Rotondo M., Russo N., Santilli S., Scarano E., Schwarz A., Servadei F., Simonetti G., Stefini R., Talamonti G., Turrisi A., Valente V. M., Villa A., Vindigni M., Visocchi M., Vitali M., Wierzbicki V., Zambon G., Zanotti B., Zenga F., Alampi D., Alessandri F., Aloj F., Amigoni A., Aspide R., Bertuetti R., Betti V., Bilotta F., Bonato V., Bosco E., Brita M., Buscema G., Cafiero T., Cappuccio D., Caradonna M., Caria C. G., Casartelliliviero M., Ciritella P., Cirrincione S., Citerio G., Colelli S., Coletta F., Concordia L., Congedo E., Covotta M., Crimella F., Dall'Acqua G., De Cassai A., Defulviis S., Deperi E., Deana C., Delgaudio A., Denittis N., Dicolandrea S., Divezza F., Ferri F., Flocco R., Fontana C., Forastierimolinari A., Frangiosa A., Fumagalli P., Fuselli E., Garbarino M. M., Gelormini D., Geraci C., Geraldini F., Giacomucci A., Giampaoli V., Giorgetti D., Gritti P., Gualdani S., Iacovazzo C., Iermano C., Latronico N., Lugari S., Lusenti F., Maglione C., Magnoni S., Maiarota F., Malla M., Marchesi M., Martino C., Matteotti I., Mazzeo A. T., Morello G., Nardiello I., Paticchio F., Pegoli M., Perotti V., Piazzolla M., Picciafuochi F., Rachedi N., Radolovich D. K., Recchia A., Riccardi S., Romagnoli S., Sala S., Scafuro M. A., Sgarlata P., Soragni A., Stefani F., Stival E., Stofella G., Terranova F., Tinturini R., Togni T., Toto R., Trapani D., Tringali E., Tullo L., Valente A., Valeo T., Varelli G., Villani R., Zamacavicchi F., Zanello M., Zarrillo N., Zugni N., Iaccarino, C, Lippa, L, Munari, M, Castioni, C, Robba, C, Caricato, A, Pompucci, A, Signoretti, S, Zona, G, Rasulo, F, Aimar, E, Amato, S, Angileri, F, Anile, C, Assietti, R, Baratto, V, Barbanera, A, Basile, L, Battaglia, R, Bellocchi, S, Bertuccio, A, Blanco, S, Bolognini, A, Boniferro, B, Bordi, L, Bortolotti, C, Brandini, V, Broger, M, Brollo, M, Caffarella, D, Caggiano, C, Cantisani, P, Capone, C, Cappelletto, B, Capuano, C, Carangelo, B, Caruselli, G, Chessa, M, Chiara, M, Chibbaro, S, Cioffi, V, Ciprianocecchi, P, Colistra, D, Conti, C, Contratti, F, Costella, G, Cuoci, A, D'Avella, D, D'Ercole, M, Deangelis, M, Defalco, R, de Luca, G, de Marinis, P, Del Vecchio, C, Delfinis, C, Denaro, L, Deodato, F, Desogus, N, Disomma, A, Domenicucci, M, Dones, F, Fina, M, Fiori, L, Fricia, M, Gaetani, P, Gazzeri, R, Gentile, M, Germano, A, Ghadirpour, R, Gianfreda, C, Gigante, N, Gigli, R, Giorgetti, J, Giusa, M, Gravina, U, Grippi, L, Guida, F, Guizzardi, G, Iannuzzo, G, Kropp, M, Lattanzi, L, Lucantoni, D, Maffei, L, Magliulo, M, Marconi, F, Marruzzo, D, Martellotta, N, Marton, E, Maugeri, R, Mauro, G, Meli, F, Menniti, A, Merciadri, P, Milanese, L, Nardacci, B, Nasi, D, Orvieto, P, Pacca, P, Pansini, G, Panzarasa, G, Passanisi, M, Pavesi, G, Pizzoni, C, Pulera, F, Rapana, A, Ricci, A, Rispoli, R, Rotondo, M, Russo, N, Santilli, S, Scarano, E, Schwarz, A, Servadei, F, Simonetti, G, Stefini, R, Talamonti, G, Turrisi, A, Valente, V, Villa, A, Vindigni, M, Visocchi, M, Vitali, M, Wierzbicki, V, Zambon, G, Zanotti, B, Zenga, F, Alampi, D, Alessandri, F, Aloj, F, Amigoni, A, Aspide, R, Bertuetti, R, Betti, V, Bilotta, F, Bonato, V, Bosco, E, Brita, M, Buscema, G, Cafiero, T, Cappuccio, D, Caradonna, M, Caria, C, Casartelliliviero, M, Ciritella, P, Cirrincione, S, Citerio, G, Colelli, S, Coletta, F, Concordia, L, Congedo, E, Covotta, M, Crimella, F, Dall'Acqua, G, De Cassai, A, Defulviis, S, Deperi, E, Deana, C, Delgaudio, A, Denittis, N, Dicolandrea, S, Divezza, F, Ferri, F, Flocco, R, Fontana, C, Forastierimolinari, A, Frangiosa, A, Fumagalli, P, Fuselli, E, Garbarino, M, Gelormini, D, Geraci, C, Geraldini, F, Giacomucci, A, Giampaoli, V, Giorgetti, D, Gritti, P, Gualdani, S, Iacovazzo, C, Iermano, C, Latronico, N, Lugari, S, Lusenti, F, Maglione, C, Magnoni, S, Maiarota, F, Malla, M, Marchesi, M, Martino, C, Matteotti, I, Mazzeo, A, Morello, G, Nardiello, I, Paticchio, F, Pegoli, M, Perotti, V, Piazzolla, M, Picciafuochi, F, Rachedi, N, Radolovich, D, Recchia, A, Riccardi, S, Romagnoli, S, Sala, S, Scafuro, M, Sgarlata, P, Soragni, A, Stefani, F, Stival, E, Stofella, G, Terranova, F, Tinturini, R, Togni, T, Toto, R, Trapani, D, Tringali, E, Tullo, L, Valente, A, Valeo, T, Varelli, G, Villani, R, Zamacavicchi, F, Zanello, M, Zarrillo, N, Zugni, N, Iaccarino C., Lippa L., Munari M., Castioni C. A., Robba C., Caricato A., Pompucci A., Signoretti S., Zona G., Rasulo F. A., Aimar E., Amato S., Angileri F. F., Anile C., Assietti R., Baratto V., Barbanera A., Basile L., Battaglia R., Bellocchi S., Bertuccio A., Blanco S., Bolognini A., Boniferro B., Bordi L., Bortolotti C., Brandini V., Broger M., Brollo M., Caffarella D. D., Caggiano C., Cantisani P. L., Capone C., Cappelletto B., Capuano C., Carangelo B., Caruselli G., Chessa M. A., Chiara M., Chibbaro S., Cioffi V., Ciprianocecchi P., Colistra D., Conti C., Contratti F., Costella G. B., Cuoci A., D'Avella D., D'Ercole M., Deangelis M., Defalco R., de Luca G., de Marinis P., Del Vecchio C., Delfinis C., Denaro L., Deodato F., Desogus N., Disomma A., Domenicucci M., Dones F., Fina M., Fiori L., Fricia M., Gaetani P., Gazzeri R., Gentile M., Germano A., Ghadirpour R., Gianfreda C. D., Gigante N., Gigli R., Giorgetti J., Giusa M., Gravina U. G., Grippi L., Guida F., Guizzardi G., Iannuzzo G., Kropp M., Lattanzi L., Lucantoni D., Maffei L., Magliulo M., Marconi F., Marruzzo D., Martellotta N., Marton E., Maugeri R., Mauro G., Meli F., Menniti A., Merciadri P., Milanese L., Nardacci B., Nasi D., Orvieto P., Pacca P., Pansini G., Panzarasa G., Passanisi M., Pavesi G., Pizzoni C., Pulera F., Rapana A., Ricci A., Rispoli R., Rotondo M., Russo N., Santilli S., Scarano E., Schwarz A., Servadei F., Simonetti G., Stefini R., Talamonti G., Turrisi A., Valente V. M., Villa A., Vindigni M., Visocchi M., Vitali M., Wierzbicki V., Zambon G., Zanotti B., Zenga F., Alampi D., Alessandri F., Aloj F., Amigoni A., Aspide R., Bertuetti R., Betti V., Bilotta F., Bonato V., Bosco E., Brita M., Buscema G., Cafiero T., Cappuccio D., Caradonna M., Caria C. G., Casartelliliviero M., Ciritella P., Cirrincione S., Citerio G., Colelli S., Coletta F., Concordia L., Congedo E., Covotta M., Crimella F., Dall'Acqua G., De Cassai A., Defulviis S., Deperi E., Deana C., Delgaudio A., Denittis N., Dicolandrea S., Divezza F., Ferri F., Flocco R., Fontana C., Forastierimolinari A., Frangiosa A., Fumagalli P., Fuselli E., Garbarino M. M., Gelormini D., Geraci C., Geraldini F., Giacomucci A., Giampaoli V., Giorgetti D., Gritti P., Gualdani S., Iacovazzo C., Iermano C., Latronico N., Lugari S., Lusenti F., Maglione C., Magnoni S., Maiarota F., Malla M., Marchesi M., Martino C., Matteotti I., Mazzeo A. T., Morello G., Nardiello I., Paticchio F., Pegoli M., Perotti V., Piazzolla M., Picciafuochi F., Rachedi N., Radolovich D. K., Recchia A., Riccardi S., Romagnoli S., Sala S., Scafuro M. A., Sgarlata P., Soragni A., Stefani F., Stival E., Stofella G., Terranova F., Tinturini R., Togni T., Toto R., Trapani D., Tringali E., Tullo L., Valente A., Valeo T., Varelli G., Villani R., Zamacavicchi F., Zanello M., Zarrillo N., and Zugni N.

Abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from “TBI Section” of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the “T

Published
2021

8. Aneurismal subarachnoid hemorrhage during the COVID-19 outbreak in a Hub and Spoke system: observational multicenter cohort study in Lombardy, Italy

Author

Fiorindi, A., Vezzoli, M., Doglietto, Francesco, Zanin, L., Saraceno, G., Agosti, E., Barbieri, A., Bellocchi, S., Bernucci, C., Bongetta, D., Cardia, A., Costi, E., Egidi, M., Fioravanti, A., Gasparotti, R., Giussani, C., Grimod, G., Latronico, N., Locatelli, D., Mardighian, D., Nodari, G., Poli, J. C., Rasulo, F., Roca, E., Sicuri, G. M., Spena, G., Stefini, R., Vivaldi, O., Zoia, C., Calza, S., Fontanella, Marco Maria, Cenzato, M., Doglietto F. (ORCID:0000-0002-7438-0734), Fontanella M. M., Fiorindi, A., Vezzoli, M., Doglietto, Francesco, Zanin, L., Saraceno, G., Agosti, E., Barbieri, A., Bellocchi, S., Bernucci, C., Bongetta, D., Cardia, A., Costi, E., Egidi, M., Fioravanti, A., Gasparotti, R., Giussani, C., Grimod, G., Latronico, N., Locatelli, D., Mardighian, D., Nodari, G., Poli, J. C., Rasulo, F., Roca, E., Sicuri, G. M., Spena, G., Stefini, R., Vivaldi, O., Zoia, C., Calza, S., Fontanella, Marco Maria, Cenzato, M., Doglietto F. (ORCID:0000-0002-7438-0734), and Fontanella M. M.

Abstract

Background: Lombardy was the most affected Italian region by the first phase of the COVID-19 pandemic and underwent urgent reorganization for the management of emergencies, including subarachnoid hemorrhage from a ruptured cerebral aneurysm (aSAH). The aim of the study was to define demographics, clinical, and therapeutic features of aSAH during the COVID-19 outbreak and compare these with a historical cohort. Methods: In this observational multicenter cohort study, patients aged 18 years or older, who were diagnosed with aSAH at the participating centers in Lombardy from March 9 to May 10, 2020, were included (COVID-19 group). In order to minimize bias related to possible SAH seasonality, the control group was composed of patients diagnosed with aSAH from March 9 to May 10 of the three previous years, 2017–2018-2019 (pre-pandemic group). Twenty-three demographic, clinical, and therapeutic features were collected. Statistical analysis was performed. Results: Seventy-two patients during the COVID-19 period and 179 in the control group were enrolled at 14 centers. Only 4 patients were positive for SARS-CoV-2. The “diagnostic delay” was significantly increased (+ 68%) in the COVID-19 group vs. pre-pandemic (1.06 vs. 0.63 days, respectively, p-value = 0.030), while “therapeutic delay” did not differ significantly between the two periods (0.89 vs. 0.74 days, p-value = 0.183). Patients with poor outcome (GOS at discharge from 1 to 3) were higher during the COVID-19 period (54.2%) compared to pre-pandemic (40.2%, p = 0.044). In logistic regression analysis, in which outcome was the dichotomized Glasgow Outcome Scale (GOS), five variables showed p-values < 0.05: age at admission, WFNS grade, treatment (none), days in ICU, and ischemia. Conclusions: We documented a significantly increased “diagnostic delay” for subarachnoid hemorrhages during the first COVID-19 outbreak in Lombardy. However, despite the dramatic situation that the healthcare system was expe

Published
2022

9. May we deliver neuro-oncology in difficult times (e.g. COVID-19)?

Author

Perin, A, Servadei, F, Dimeco, F, Locatelli, M, Benazzo, M, Spena, G, Bernucci, C, Sganzerla, E, Egidi, M, Spagnoli, D, Giussani, C, Incerti, M, Lorusso, G, Stefini, R, Assietti, R, Bellocchi, S, Fornari, M, Skrap, M, Tartara, F, Vitale, M, Ferroli, P, Franzini, A, Silvani, A, Fontanella, M, Cenzato, M, Perin A., Servadei F., DiMeco F., Locatelli M., Benazzo M., Spena G., Bernucci C., Sganzerla E., Egidi M., Spagnoli D., Giussani C., Incerti M., Lorusso G., Stefini R., Assietti R., Bellocchi S., Fornari M., Skrap M., Tartara F., Vitale M., Ferroli P., Franzini A., Silvani A., Fontanella M., Cenzato M., Perin, A, Servadei, F, Dimeco, F, Locatelli, M, Benazzo, M, Spena, G, Bernucci, C, Sganzerla, E, Egidi, M, Spagnoli, D, Giussani, C, Incerti, M, Lorusso, G, Stefini, R, Assietti, R, Bellocchi, S, Fornari, M, Skrap, M, Tartara, F, Vitale, M, Ferroli, P, Franzini, A, Silvani, A, Fontanella, M, Cenzato, M, Perin A., Servadei F., DiMeco F., Locatelli M., Benazzo M., Spena G., Bernucci C., Sganzerla E., Egidi M., Spagnoli D., Giussani C., Incerti M., Lorusso G., Stefini R., Assietti R., Bellocchi S., Fornari M., Skrap M., Tartara F., Vitale M., Ferroli P., Franzini A., Silvani A., Fontanella M., and Cenzato M.

Published
2020

10. May we deliver neuro-oncology in difficult times (e.g. COVID-19)?

Author

Perin, A., Servadei, F., Dimeco, F., Locatelli, M., Benazzo, M., Spena, G., Bernucci, C., Sganzerla, E., Egidi, M., Spagnoli, D., Giussani, C., Incerti, M., Lorusso, G., Stefini, R., Assietti, R., Bellocchi, S., Fornari, M., Skrap, M., Tartara, F., Vitale, M., Ferroli, P., Franzini, A., Silvani, A., Fontanella, M., Cenzato, M., Perin, A, Servadei, F, Dimeco, F, Locatelli, M, Benazzo, M, Spena, G, Bernucci, C, Sganzerla, E, Egidi, M, Spagnoli, D, Giussani, C, Incerti, M, Lorusso, G, Stefini, R, Assietti, R, Bellocchi, S, Fornari, M, Skrap, M, Tartara, F, Vitale, M, Ferroli, P, Franzini, A, Silvani, A, Fontanella, M, and Cenzato, M

Subjects
medicine.medical_specialty, 2019-20 coronavirus outbreak, Cancer Research, Coronavirus disease 2019 (COVID-19), Neuro oncology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Viral transmission, Clinical Neurology, Medical Oncology, Brain Neoplasm, Betacoronavirus, medicine, Disease Transmission, Infectious, Humans, Medical physics, Pandemics, Betacoronaviru, Pandemic, business.industry, Brain Neoplasms, Coronavirus Infection, SARS-CoV-2, COVID-19, Oncology, Disease Transmission, Infectiou, Neurology, Neurology (clinical), business, Coronavirus Infections, Disease transmission, Delivery of Health Care, Human
Published
2020

11. Exploring potential synergies among energy sectors in alpine regions: the case of Valle d’Aosta

Author

Bellocchi, S., Iulio, R., Manno, M., Noussan, M., Roberta Roberto, Bellocchi, S., de Iulio, R., Manno, M., Noussan, M., and Roberto, R.

Subjects
Heat pumps, Smart Energy System, Large-scale RES, Hydroelectric power, Electric vehicles, EnergyPLAN, CO2 emissions reduction, Electric vehicles, emissions reduction2 emissions reduction., EnergyPLAN, Heat pumps, Hydroelectric power, Large-scale RES, Smart Energy System, Settore ING-IND/09 - Sistemi per l'Energia e L'Ambiente, emissions reduction2 emissions reduction
Abstract

Renewable energy sources could play a key role in curbing carbon dioxide emissions worldwide, provided their successful integration in the electricity generation sector. With this respect, a Smart Energy System approach allows to accommodate ever-larger shares of renewables benefiting from a synergic interaction among the different energy sectors, with a view to shifting final consumption from fossil fuels to electricity. In this perspective, opportunities for a carbon-free sustainable future are investigated in this work for an Italian alpine region, Valle d’Aosta, characterised by an abundance of hydroelectric power that currently exceeds electricity demand. Future energy scenarios are simulated with the help of EnergyPLAN software assuming the electrification of both transportation and heating sectors, which are currently heavily relying on oil-based fuels. Moreover, considering buildings heat demand, some areas of the region are not reached by the natural gas network. Proper energy efficiency measures are evaluated along with the possibility of optimizing the use of other renewable resources, such as local wood biomass for space heating and solar thermal for domestic hot water production. Results show that the enhanced management and usage of renewable power can lead to a significant reduction of CO2 emissions and helps pave the way for an optimal use of local available renewable energy sources for Valle d’Aosta Region, thanks to an increase in electricity penetration. At the same time, the benefits of electricity usage vary for different sectors, due to the specific features of the energy demand (e.g. industries, remote areas). Electricity penetration should therefore be tailored to the proper final uses, to fully exploit local resources and promote the sustainability of the entire energy system. © ECOS 2019 - Proceedings of the 32nd International Conference on Efficiency, Cost, Optimization, Simulation and Environmental Impact of Energy Systems.

Published
2019

12. Management of intracranial hypertension following traumatic brain injury: A best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy: Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Author

Iaccarino, C., Lippa, L., Munari, M., Castioni, C. A., Robba, C., Caricato, Anselmo, Pompucci, Angelo, Signoretti, S., Zona, G., Rasulo, F. A., Aimar, E., Amato, S., Angileri, F. F., Anile, Carmelo, Assietti, R., Baratto, V., Barbanera, A., Basile, L., Battaglia, R., Bellocchi, S., Bertuccio, A., Blanco, S., Bolognini, A., Boniferro, B., Bordi, L., Bortolotti, C., Brandini, V., Broger, Maximilian, Brollo, M., Caffarella, D. D., Caggiano, Cinzia, Cantisani, P. L., Capone, C., Cappelletto, B., Capuano, C., Carangelo, B., Caruselli, G., Chessa, M. A., Chiara, M., Chibbaro, S., Cioffi, V., Ciprianocecchi, P., Colistra, D., Conti, C., Contratti, F., Costella, G. B., Cuoci, A., D'Avella, D., D'Ercole, Manuela, Deangelis, M., Defalco, R., de Luca, G., de Marinis, P., Del Vecchio, C., Delfinis, C., Denaro, Luca, Deodato, F., Desogus, N., Disomma, A., Domenicucci, M., Dones, F., Fina, M., Fiori, L., Fricia, M., Gaetani, P., Gazzeri, R., Gentile, M., Germano, A., Ghadirpour, R., Gianfreda, C. D., Gigante, N., Gigli, R., Giorgetti, J., Giusa, M., Gravina, U. G., Grippi, L., Guida, F., Guizzardi, G., Iannuzzo, G., Kropp, M., Lattanzi, L., Lucantoni, D., Maffei, L., Magliulo, M., Marconi, F., Marruzzo, D., Martellotta, N., Marton, E., Maugeri, R., Mauro, G., Meli, F., Menniti, A., Merciadri, P., Milanese, L., Nardacci, B., Nasi, D., Orvieto, P., Pacca, P., Pansini, G., Panzarasa, G., Passanisi, M., Pavesi, G., Pizzoni, C., Pulera, F., Rapana, A., Ricci, A., Rispoli, R., Rotondo, M., Russo, N., Santilli, S., Scarano, E., Schwarz, A., Servadei, Franco, Simonetti, G., Stefini, R., Talamonti, G., Turrisi, A., Valente, V. M., Villa, A., Vindigni, M., Visocchi, Massimiliano, Vitali, M., Wierzbicki, V., Zambon, G., Zanotti, B., Zenga, F., Alampi, D., Alessandri, F., Aloj, F., Amigoni, A., Aspide, R., Bertuetti, R., Betti, V., Bilotta, F., Bonato, V., Bosco, E., Brita, M., Buscema, G., Cafiero, T., Cappuccio, D., Caradonna, M., Caria, C. G., Casartelliliviero, M., Ciritella, P., Cirrincione, S., Citerio, G., Colelli, S., Coletta, F., Concordia, L., Congedo, E., Covotta, M., Crimella, F., Dall'Acqua, G., De Cassai, A., Defulviis, S., Deperi, E., Deana, C., Delgaudio, A., Denittis, N., Dicolandrea, S., Divezza, F., Ferri, F., Flocco, R., Fontana, C., Forastierimolinari, A., Frangiosa, A., Fumagalli, P., Fuselli, E., Garbarino, M. M., Gelormini, D., Geraci, C., Geraldini, F., Giacomucci, A., Giampaoli, V., Giorgetti, D., Gritti, P., Gualdani, S., Iacovazzo, C., Iermano, C., Latronico, N., Lugari, S., Lusenti, F., Maglione, C., Magnoni, S., Maiarota, F., Malla, M., Marchesi, M., Martino, C., Matteotti, I., Mazzeo, A. T., Morello, G., Nardiello, I., Paticchio, F., Pegoli, M., Perotti, Valerio, Piazzolla, M., Picciafuochi, F., Rachedi, N., Radolovich, D. K., Recchia, A., Riccardi, S., Romagnoli, S., Sala, S., Scafuro, M. A., Sgarlata, P., Soragni, A., Stefani, F., Stival, Eleonora, Stofella, G., Terranova, F., Tinturini, R., Togni, T., Toto, R., Trapani, D., Tringali, E., Tullo, L., Valente, A., Valeo, T., Varelli, G., Villani, R., Zamacavicchi, F., Zanello, M., Zarrillo, N., Zugni, N., Caricato A. (ORCID:0000-0001-5929-120X), Pompucci A. (ORCID:0000-0002-5427-9719), Anile C. (ORCID:0000-0002-0481-9713), Broger M., Caggiano C., D'Ercole M., Denaro L., Servadei F., Visocchi M. (ORCID:0000-0003-1087-0491), Perotti V. (ORCID:0000-0001-9461-2101), Stival E., Iaccarino, C., Lippa, L., Munari, M., Castioni, C. A., Robba, C., Caricato, Anselmo, Pompucci, Angelo, Signoretti, S., Zona, G., Rasulo, F. A., Aimar, E., Amato, S., Angileri, F. F., Anile, Carmelo, Assietti, R., Baratto, V., Barbanera, A., Basile, L., Battaglia, R., Bellocchi, S., Bertuccio, A., Blanco, S., Bolognini, A., Boniferro, B., Bordi, L., Bortolotti, C., Brandini, V., Broger, Maximilian, Brollo, M., Caffarella, D. D., Caggiano, Cinzia, Cantisani, P. L., Capone, C., Cappelletto, B., Capuano, C., Carangelo, B., Caruselli, G., Chessa, M. A., Chiara, M., Chibbaro, S., Cioffi, V., Ciprianocecchi, P., Colistra, D., Conti, C., Contratti, F., Costella, G. B., Cuoci, A., D'Avella, D., D'Ercole, Manuela, Deangelis, M., Defalco, R., de Luca, G., de Marinis, P., Del Vecchio, C., Delfinis, C., Denaro, Luca, Deodato, F., Desogus, N., Disomma, A., Domenicucci, M., Dones, F., Fina, M., Fiori, L., Fricia, M., Gaetani, P., Gazzeri, R., Gentile, M., Germano, A., Ghadirpour, R., Gianfreda, C. D., Gigante, N., Gigli, R., Giorgetti, J., Giusa, M., Gravina, U. G., Grippi, L., Guida, F., Guizzardi, G., Iannuzzo, G., Kropp, M., Lattanzi, L., Lucantoni, D., Maffei, L., Magliulo, M., Marconi, F., Marruzzo, D., Martellotta, N., Marton, E., Maugeri, R., Mauro, G., Meli, F., Menniti, A., Merciadri, P., Milanese, L., Nardacci, B., Nasi, D., Orvieto, P., Pacca, P., Pansini, G., Panzarasa, G., Passanisi, M., Pavesi, G., Pizzoni, C., Pulera, F., Rapana, A., Ricci, A., Rispoli, R., Rotondo, M., Russo, N., Santilli, S., Scarano, E., Schwarz, A., Servadei, Franco, Simonetti, G., Stefini, R., Talamonti, G., Turrisi, A., Valente, V. M., Villa, A., Vindigni, M., Visocchi, Massimiliano, Vitali, M., Wierzbicki, V., Zambon, G., Zanotti, B., Zenga, F., Alampi, D., Alessandri, F., Aloj, F., Amigoni, A., Aspide, R., Bertuetti, R., Betti, V., Bilotta, F., Bonato, V., Bosco, E., Brita, M., Buscema, G., Cafiero, T., Cappuccio, D., Caradonna, M., Caria, C. G., Casartelliliviero, M., Ciritella, P., Cirrincione, S., Citerio, G., Colelli, S., Coletta, F., Concordia, L., Congedo, E., Covotta, M., Crimella, F., Dall'Acqua, G., De Cassai, A., Defulviis, S., Deperi, E., Deana, C., Delgaudio, A., Denittis, N., Dicolandrea, S., Divezza, F., Ferri, F., Flocco, R., Fontana, C., Forastierimolinari, A., Frangiosa, A., Fumagalli, P., Fuselli, E., Garbarino, M. M., Gelormini, D., Geraci, C., Geraldini, F., Giacomucci, A., Giampaoli, V., Giorgetti, D., Gritti, P., Gualdani, S., Iacovazzo, C., Iermano, C., Latronico, N., Lugari, S., Lusenti, F., Maglione, C., Magnoni, S., Maiarota, F., Malla, M., Marchesi, M., Martino, C., Matteotti, I., Mazzeo, A. T., Morello, G., Nardiello, I., Paticchio, F., Pegoli, M., Perotti, Valerio, Piazzolla, M., Picciafuochi, F., Rachedi, N., Radolovich, D. K., Recchia, A., Riccardi, S., Romagnoli, S., Sala, S., Scafuro, M. A., Sgarlata, P., Soragni, A., Stefani, F., Stival, Eleonora, Stofella, G., Terranova, F., Tinturini, R., Togni, T., Toto, R., Trapani, D., Tringali, E., Tullo, L., Valente, A., Valeo, T., Varelli, G., Villani, R., Zamacavicchi, F., Zanello, M., Zarrillo, N., Zugni, N., Caricato A. (ORCID:0000-0001-5929-120X), Pompucci A. (ORCID:0000-0002-5427-9719), Anile C. (ORCID:0000-0002-0481-9713), Broger M., Caggiano C., D'Ercole M., Denaro L., Servadei F., Visocchi M. (ORCID:0000-0003-1087-0491), Perotti V. (ORCID:0000-0001-9461-2101), and Stival E.

Abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from “TBI Section” of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the “T

Published
2021

15. Anxiety in neurosurgical patients undergoing nonurgent surgery during the COVID-19 pandemic

Author

Doglietto, Francesco, Vezzoli, Marika, Biroli, A., Saraceno, G., Zanin, L., Pertichetti, M., Calza, S., Agosti, E., Arias, J. M. A., Assietti, R., Bellocchi, S., Bernucci, C., Bistazzoni, S., Bongetta, D., Fanti, A., Fioravanti, A., Fiorindi, A., Franzin, A., Locatelli, D., Pugliese, R., Roca, E., Sicuri, G. M., Stefini, R., Venturini, M., Vivaldi, O., Zattra, C., Zoia, C., Fontanella, Marco Maria, Doglietto F. (ORCID:0000-0002-7438-0734), Vezzoli M., Fontanella M. M., Doglietto, Francesco, Vezzoli, Marika, Biroli, A., Saraceno, G., Zanin, L., Pertichetti, M., Calza, S., Agosti, E., Arias, J. M. A., Assietti, R., Bellocchi, S., Bernucci, C., Bistazzoni, S., Bongetta, D., Fanti, A., Fioravanti, A., Fiorindi, A., Franzin, A., Locatelli, D., Pugliese, R., Roca, E., Sicuri, G. M., Stefini, R., Venturini, M., Vivaldi, O., Zattra, C., Zoia, C., Fontanella, Marco Maria, Doglietto F. (ORCID:0000-0002-7438-0734), Vezzoli M., and Fontanella M. M.

Abstract

OBJECTIVE The COVID-19 pandemic has forced many countries into lockdown and has led to the postponement of nonurgent neurosurgical procedures. Although stress has been investigated during this pandemic, there are no reports on anxiety in neurosurgical patients undergoing nonurgent surgical procedures. METHODS Neurosurgical patients admitted to hospitals in eastern Lombardy for nonurgent surgery after the lockdown prospectively completed a pre- and postoperative structured questionnaire. Recorded data included demographics, pathology, time on surgical waiting list, anxiety related to COVID-19, primary pathology and surgery, safety perception during hospital admission before and after surgery, and surgical outcomes. Anxiety was measured with the State-Trait Anxiety Inventory. Descriptive statistics were computed on the different variables and data were stratified according to pathology (oncological vs nononcological). Three different models were used to investigate which variables had the greatest impact on anxiety, oncological patients, and safety perception, respectively. Because the variables (Xs) were of a different nature (qualitative and quantitative), mostly asymmetrical, and related to outcome (Y) by nonlinear relationships, a machine learning approach composed of three steps (1, random forest growing; 2, relative variable importance measure; and 3, partial dependence plots) was chosen. RESULTS One hundred twenty-three patients from 10 different hospitals were included in the study. None of the patients developed COVID-19 after surgery. State and trait anxiety were reported by 30.3% and 18.9% of patients, respectively. Higher values of state anxiety were documented in oncological compared to nononcological patients (46.7% vs 25%; p = 0.055). Anxiety was strongly associated with worry about primary pathology, surgery, disease worsening, and with stress during waiting time, as expected. Worry about positivity to SARS-CoV-2, however, was the strongest factor asso

Published
2020

19. Predictors of reading and comprehension abilities in bilingual and monolingual children: a longitudinal study on a transparent language

Author

Bellocchi, S, Tobia, V, Bonifacci, P, Bonifacci, P., TOBIA, VALENTINA ANTONIA, Bellocchi, S, Tobia, V, Bonifacci, P, Bonifacci, P., and TOBIA, VALENTINA ANTONIA

Abstract

Many studies have shown that learning to read in a second language (L2) is similar, in many ways, to learning to read in a first language (L1). Nevertheless, reading development also relies upon oral language proficiency and is greatly influenced by orthographic consistency. This longitudinal study aimed to analyze the role of linguistic predictors (phonological awareness, letter knowledge, pseudoword repetition, morphosyntactic comprehension, lexical knowledge and rapid naming) in reading outcomes (fluency, accuracy and comprehension) in a group of bilingual children (n = 30) reading Italian as an L2, compared to a group of monolingual children (n = 56). We ran a multi-group structural equation model. Our findings showed that rapid automatized naming was a significant predictor of reading speed in both groups. However, the study revealed different patterns of predictors for reading accuracy, predictors for monolinguals being LK, phonological awareness and lexical knowledge, while pseudoword repetition was a predictor for bilinguals. Morphosyntactic comprehension was the most significant predictor of comprehension skills in bilingual children. Implications for clinical and educational settings are discussed

Published
2017

26. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

Author

Paolo FERROLI, Silvia SCHIAVOLIN, Arianna MARINIELLO, Francesco ACERBI, Francesco RESTELLI, Marco SCHIARITI, Emanuele LA CORTE, Jacopo FALCO, Vincenzo LEVI, Francesco DIMECO, Roberto ASSIETTI, Daniele BONGETTA, Elena V. COLOMBO, Silvio BELLOCCHI, Simone SANGIORGI, Simona BISTAZZONI, Maria POLOSA, Maria I. ORRU, Giannantonio SPENA, Claudio BERNUCCI, Angelo M. SICIGNANO, Andrea FANTI, Carlo BREMBILLA, Bruno RESMINI, Emanuele COSTI, Marco CENZATO, Giuseppe TALAMONTI, Gabriella BOTTINI, Pina SCARPA, Alessandra BOLLANI, Matteo QUERZOLA, Giulio PALMAS, Federico DE GONDA, Lorenzo BOSIO, Marcello EGIDI, Valentina TARDIVO, Antonio FIORAVANTI, Sara SUBACCHI, Marco FONTANELLA, Antonio BIROLI, Claudio CEREDA, Pier Paolo PANCIANI, Riccardo BERGOMI, Marta PERTICHETTI, Flavio TANCIONI, Alberto BONA, Fulvio A. TARTARA, Maurizio FORNARI, Federico PESSINA, Giovanni LASIO, Andrea CARDIA, Franco SERVADEI, Marco RIVA, Alessandra CASAROTTI, Carlo GIUSSANI, Leonardo FIORI, Fabio MAZZOLENI, Simona VAIANI, Giorgio CARRABBA, Andrea DI CRISTOFORI, Erik P. SGANZERLA, Alberto VIMERCATI, Valeria ISELLA, Ilaria MAURI, Michele INCERTI, Giovanni SICURI, Valentina MIRAMONTI, Roberto STEFINI, Diego SPAGNOLI, Maurizio PIPARO, Gianluca GRIMOD, Rossana REGAZZONI, Daniela VISMARA, Lucio MAZZEO, Emanuele MONTI, Alberto FRANZIN, Oscar VIVALDI, Alessandra MAIETTI, Elisa PINI, Domenico SERVELLO, Edvin ZEKAJ, Sara DE MICHELE, Marco LOCATELLI, Stefano BORSA, Nadia GRIMOLDI, Manuela CAROLI, Leonardo TARICIOTTI, Giorgia ABETE-FORNARA, Mario VITALE, Matilde LEONARDI, Morgan BROGGI, Ferroli, P, Schiavolin, S, Mariniello, A, Acerbi, F, Restelli, F, Schiariti, M, LA Corte, E, Falco, J, Levi, V, Dimeco, F, Assietti, R, Bongetta, D, Colombo, E, Bellocchi, S, Sangiorgi, S, Bistazzoni, S, Polosa, M, Orru, M, Spena, G, Bernucci, C, Sicignano, A, Fanti, A, Brembilla, C, Resmini, B, Costi, E, Cenzato, M, Talamonti, G, Bottini, G, Scarpa, P, Bollani, A, Querzola, M, Palmas, G, DE Gonda, F, Bosio, L, Egidi, M, Tardivo, V, Fioravanti, A, Subacchi, S, Fontanella, M, Biroli, A, Cereda, C, Panciani, P, Bergomi, R, Pertichetti, M, Tancioni, F, Bona, A, Tartara, F, Fornari, M, Pessina, F, Lasio, G, Cardia, A, Servadei, F, Riva, M, Casarotti, A, Giussani, C, Fiori, L, Mazzoleni, F, Vaiani, S, Carrabba, G, DI Cristofori, A, Sganzerla, E, Vimercati, A, Isella, V, Mauri, I, Incerti, M, Sicuri, G, Miramonti, V, Stefini, R, Spagnoli, D, Piparo, M, Grimod, G, Regazzoni, R, Vismara, D, Mazzeo, L, Monti, E, Franzin, A, Vivaldi, O, Maietti, A, Pini, E, Servello, D, Zekaj, E, DE Michele, S, Locatelli, M, Borsa, S, Grimoldi, N, Caroli, M, Tariciotti, L, Abete-Fornara, G, Vitale, M, Leonardi, M, and Broggi, M

Subjects
predictors, Consensus, assessment, Settore MED/27 - NEUROCHIRURGIA, Neurosurgery, Surgery, neurosurgery, outcomes, consensus, Neurology (clinical), Treatment outcome, Outcome assessment, health care
Abstract

Background: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment. Methods: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts' clinical practice and the existing literature. Results: A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected. Conclusions: A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level.

Published
2023

27. Converted neurosurgeons in a converted coronavirus hospital: sharing the experience of a metamorphosis

Author

Federico Nicolosi, Roberto Stefini, Carlo Giussani, Michele Incerti, M. Egidi, Erik P. Sganzerla, R. Assietti, A. Fioravanti, Lorenzo Magrassi, Silvio Bellocchi, Domenico Servello, Giannantonio Spena, Federico De Gonda, Cesare Zoia, Marco Maria Fontanella, Diego Spagnoli, Claudio Bernucci, Oscar Vivaldi, Lorenzo Bello, Mario Vitale, Marco Locatelli, Giussani, C, Sganzerla, E, Spena, G, Spagnoli, D, Assietti, R, Bellocchi, S, Oscarvivaldi, Bernucci, C, Magrassi, L, Zoia, C, Egidi, M, de Gonda, F, Locatelli, M, Bello, L, Incerti, M, Servello, D, Vitale, M, Nicolosi, F, Fioravanti, A, Fontanella, M, and Stefini, R

Subjects
2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), media_common.quotation_subject, medicine.disease_cause, Hospital planning, Hospital, medicine, Internal Medicine, Humans, Bed Conversion, Metamorphosis, Pandemics, Neurosurgeon, Blood gas analysis, Coronavirus, media_common, Settore MED/27 - Neurochirurgia, business.industry, COVID-19, medicine.disease, Hospitals, Neurosurgeons, Italy, Surgery, Neurology (clinical), Medical emergency, business, Human
Published
2020

28. Analysis of smart energy system approach in local alpine regions - A case study in Northern Italy

Author

Matteo Giacomo Prina, R. de Iulio, Michele Manno, Michel Noussan, Giambattista Guidi, Sara Bellocchi, R. Roberto, Benedetto Nastasi, Bellocchi, S., De Iulio, R., Guidi, G., Manno, M., Nastasi, B., Noussan, M., Prina, M. G., and Roberto, R.

Subjects
Truck, Energy systems, Renewable energy sources, End-use electrification, Sector coupling, Decarbonization, Energy Efficiency, 020209 energy, 02 engineering and technology, Settore ING-IND/09, Industrial and Manufacturing Engineering, Energy storage, Variable cost, Local Energy Planning, Smart Energy Systems, Renewable Energy Sources, Electrification, 020401 chemical engineering, Natural gas, 0202 electrical engineering, electronic engineering, information engineering, 0204 chemical engineering, Electrical and Electronic Engineering, Civil and Structural Engineering, business.industry, Mechanical Engineering, Photovoltaic system, Building and Construction, Environmental economics, Pollution, Renewable energy, General Energy, Electricity generation, Settore ING-IND/09 - Sistemi per l'Energia e L'Ambiente, Environmental science, business
Abstract

Increasing electrification of final uses can be a viable solution towards low-carbon energy systems, when coupled with local renewable power generation. Mountain areas can already benefit from high shares of hydro-power generation, but, at the same time, rely on oil products for transport and for the heating sector in remote areas where natural gas infrastructures are not available. This research work evaluates potential scenarios for the electrification of transport and heating sectors, by coupling the simulation tool EnergyPLAN with a multi-objective optimization algorithm to analyse economic and environmental aspects. Results show that the largest benefits are expected from the electrification of the heating sector. Indeed, a CO2 emissions reduction up to 30% can be reached by acting on the transport sector alone, while up to 65% combining it with measures on heating, industry and agriculture sectors and additional electricity generation from photovoltaic systems. Moreover, the use of heat pumps can lead to significant CO2 emissions decrease with only to a slight increase in the overall annual costs thanks to lower variable costs that partly compensate the higher required initial investment and electricity storage deployment. The optimization analyses also highlight the effect of progressive penetration of electric vehicles in the private cars fleet and hydrogen trucks in the light-duty vehicles one.

Published
2020

30. Predictors of reading and comprehension abilities in bilingual and monolingual children: a longitudinal study on a transparent language

Author

Stéphanie Bellocchi, Valentina Tobia, Paola Bonifacci, Bellocchi, S, Tobia, V, Bonifacci, P, Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université de Montpellier (UM)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université Montpellier 1 (UM1), Bellocchi, Stéphanie, Tobia, Valentina, and Bonifacci, Paola

Subjects
Linguistics and Language, Bilingualism, media_common.quotation_subject, First language, [SHS.PSY]Humanities and Social Sciences/Psychology, 050105 experimental psychology, Education, Speech and Hearing, Fluency, Simple view of reading, Phonological awareness, M-PSI/04 - PSICOLOGIA DELLO SVILUPPO E PSICOLOGIA DELL'EDUCAZIONE, Reading (process), Learning to read, Linguistic predictor, 0501 psychology and cognitive sciences, Language proficiency, Rapid automatized naming, Second language learners, media_common, 05 social sciences, 050301 education, Linguistics, Neuropsychology and Physiological Psychology, Second language learner, Reading comprehension, Reading, Psychology, 0503 education, Cognitive psychology
Abstract

International audience; Many studies have shown that learning to read in a second language (L2) is similar, in many ways, to learning to read in a first language (L1). Nevertheless, reading development also relies upon oral language proficiency and is greatly influenced by orthographic consistency. This longitudinal study aimed to analyze the role of linguistic predictors (phonological awareness, letter knowledge, pseudoword repetition, morphosyntactic comprehension, lexical knowledge and rapid naming) in reading outcomes (fluency, accuracy and comprehension) in a group of bilingual children (n = 30) reading Italian as an L2, compared to a group of monolingual children (n = 56). We ran a multi-group structural equation model. Our findings showed that rapid automatized naming was a significant predictor of reading speed in both groups. However, the study revealed different patterns of predictors for reading accuracy, predictors for monolinguals being LK, phonological awareness and lexical knowledge, while pseudoword repetition was a predictor for bilinguals. Morphosyntactic comprehension was the most significant predictor of comprehension skills in bilingual children. Implications for clinical and educational settings are discussed.

Published
2017
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31. Speed of processing, anticipation, inhibition and working memory in bilinguals

Author

BONIFACCI, PAOLA, BELLOCCHI, STEPHANIE, CONTENTO, SILVANA GRAZIA, Giombini L., Bonifacci P., Giombini L., Bellocchi S., and Contento S.

Subjects
Male, INHIBITION, BILINGUALISM, Multilingualism, Anticipation, Psychological, Cognition, Memory, Short-Term, Reaction Time, Humans, Female, WORKING MEMORY, ANTICIPATION, COGNITIVE FUNCTIONING, Child, Language
Abstract

Literature on the so-called bilingual advantage is directed towards the investigation of whether the mastering of two languages fosters cognitive skills in the non-verbal domain. The present study aimed to evaluate whether the bilingual advantage in non-verbal skills could be best defined as domain-general or domain-specific, and, in the latter case, at identifying the basic cognitive skills involved. Bilingual and monolingual participants were divided into two different age groups (children, youths) and were tested on a battery of elementary cognitive tasks which included a choice reaction time task, a go/no-go task, two working memory tasks (numbers and symbols) and an anticipation task. Bilingual and monolingual children did not differ from each other except for the anticipation task, where bilinguals were found to be faster and more accurate than monolinguals. These findings suggest that anticipation, which has received little attention to date, is an important cognitive domain which needs to be evaluated to a greater extent both in bilingual and monolingual participants.

Published
2012

33. La valutazione delle difficoltà di letto scrittura attuali e pregresse nel primo biennio della scuola superiore: uno studio nella provincia di Forlì-Cesena

Author

BONIFACCI, PAOLA, BELLOCCHI, STEPHANIE, DESIDERI, LORENZO, CONTENTO, SILVANA GRAZIA, GALLANI A., PERINI N., TENCATI C., Bonifacci P., Bellocchi S., Desideri L., and Contento S.

Subjects
APPRENDIMENTO, DISTURBI DI APPRENDIMENTO, METACOGNIZIONE, ORIENTAMENTO, ADOLESCENTI
Abstract

L’attenzione per la diagnosi precoce del DSA è oramai consolidata nel panorama scientifico Italiano. Tuttavia, solo negli ultimi anni è iniziato l’interesse per la valutazione di difficoltà attuali e pregresse di lettura in popolazioni di giovani adulti (Hatcher, Snowling, Griffiths, 2002). Nel presente studio sono stati valutati 966 alunni, tra i 14 e i 16 anni, frequentanti 11 istituti della scuola secondaria di secondo grado. Obiettivo della ricerca era di valutare l’eventuale relazione fra difficoltà di apprendimento pregresse e orientamento alla scelta scolastica e testare una batteria per la valutazione delle attuali competenze di letto scrittura. Il protocollo prevedeva un questionario composto da 24 item suddivisi in quattro sottoscale (difficoltà attuali, difficoltà pregresse, metacognizione, rischio abbandono) e quattro prove oggettive (segmentazione, correzione di bozze, fluenza verbale e semantica, dettato). I risultati mettono in evidenza una relazione tra competenze di lettura attuali e pregresse e orientamento scolastico.

Published
2010

34. Ritorno al futuro: il pensiero episodico futuro nei bambini

Author

Nigro G., Cosenza M, Senese V. P., Sergi I., CICOGNA, PIERA CARLA, OTTAVIANI C., BOZZI S., BELLOCCHI S., NORI R., BONIFACCI P., Nigro G., Cicogna P.C., Cosenza M, Senese V.P., and Sergi I.

Subjects
MEMORIA PROSPETTICA, PENSIERO EPISODICO FUTURO, MEMORIA RETROSPETTIVA
Published
2010

35. L’evoluzione del profilo di bilinguismo in un gruppo di bilingui tardivi

Author

BELLOCCHI, STEPHANIE, BONIFACCI, PAOLA, Montuschi M., GALLANI A, PERINI N., TENCATI C., Bellocchi S., Bonifacci P., and Montuschi M.

Subjects
APPRENDIMENTO, BILINGUISMO, SCOLARIZZAZIONE
Abstract

Alcuni studi indicano come lo sviluppo di capacità scolastiche (es. lettura) in L2 sembri essere determinato dalla competenza verbale in entrambe le lingue (es. Carlisle, Beeman, Davis & Spharim, 1999). Tale dato è stato confermato anche da ricerche che hanno indagato gli effetti dell’educazione bilingue in studenti con L1 minoritaria (Lindholm-Leary & Borsato, 2006). Sono state valutate le competenze verbali in L1 e L2 di un piccolo gruppo di bilingui tardivi (n=10), in due momenti diversi: fine prima e fine seconda elementare. Inoltre è stato valutato lo sviluppo delle capacità di lettoscrittura. I risultati evidenziano, mediamente, uno spostamento da un profilo di dominanza in L1 ad uno in cui sembra dominare la lingua di scolarizzazione (Anderson, 2004). Da sottolineare, però, che nella maggior parte dei casi anche la competenza in L1 migliora. In relazione a ciò, emergono pattern differenti nelle prestazioni in letto-scrittura. Tali dati sembrerebbero dunque confermare quelli presenti in letteratura che sostengono l’importanza di considerare il livello di competenze verbali in entrambe le lingue come indice di sviluppo di capacità scolastiche.

Published
2010

38. E’ rori e sba glli: Bilinguismo e tipologia di errori nell’apprendimento della scrittura

Author

BELLOCCHI, STEPHANIE, PERRETTA, PAOLA, CONTENTO, SILVANA GRAZIA, Crisci G., Salvato M., NN, Bellocchi S., Crisci G., Perretta P., Salvato M., and Contento S.

Abstract

Gli errori di tipo ortografico individuati in un programma di screening dei DSA in un gruppo di soggetti non italiani L1 vengono analizzati in relazione alle caratteristiche fonologiche di L1

Published
2008

39. L'evoluzione delle capacotà di apprendimento: una analisi delle componenti cognitive verbali e non verbali

Author

BELLOCCHI, STEPHANIE, CONTENTO, SILVANA GRAZIA, Giombini L., Bellocchi S., Giombini L., and Contento S.

Subjects
APPRENDIMENTO, PROCESSI COGNITIVI, CAPACITÀ NON VERBALI, CAPACITÀ LINGUISTICHE, SVILUPPO
Abstract

Il lavoro analizza lo sviluppo longitudinale delle capacità verbali e non verbali in un gruppo di soggetti di età scolare. I risultati dimostrano che la correlazione tra le due componenti è variabile nel tempo, che le capacità non verbali, essendo meno sensibili a variazioni, risultano predittive di un buone potenzialità di apprendimento

Published
2008

41. Oral language predictors of word reading and spelling: A cross-linguistic comparison in bilingual and monolingual children.

Author

Bonifacci P, Cangelosi M, and Bellocchi S

Subjects
Humans, Male, Female, Child, Italy, Linguistics, Language, Multilingualism, Reading, Comprehension
Abstract

The current study investigated linguistic predictors of word reading and spelling skills in a cross-linguistic comparison (French vs. Italian) in heritage bilinguals (HBs) and their monolingual peers. The sample included 265 children (French: n = 113; 67 monolinguals and 46 HBs; Italian: n = 152; 82 monolinguals and 70 HBs) attending Grades 3, 4, and 5 while performing oral language, reading, and spelling tasks. The battery included verbal knowledge, morphosyntactic comprehension, nonword repetition, word reading (speed and accuracy), and spelling tasks. Results showed that for reading speed, there were no main effects of single predictors, but a significant interaction of morphosyntactic comprehension by language of schooling emerged. For reading accuracy, there was a main effect of verbal knowledge and syntactic comprehension, with a significant interaction of verbal knowledge and language of schooling. Finally, spelling accuracy was predicted only by linguistic status. The results suggest different pathways for word reading and spelling, with oral language skills' main role in reading accuracy and linguistic status's main role in spelling skills, possibly hindered by linguistic exposure and lexical access. Discussions are focused on potential implications for multilingual settings and cross-linguistic research., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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42. Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal.

Author

Ferroli P, Schiavolin S, Mariniello A, Acerbi F, Restelli F, Schiariti M, LA Corte E, Falco J, Levi V, Dimeco F, Assietti R, Bongetta D, Colombo EV, Bellocchi S, Sangiorgi S, Bistazzoni S, Polosa M, Orru MI, Spena G, Bernucci C, Sicignano AM, Fanti A, Brembilla C, Resmini B, Costi E, Cenzato M, Talamonti G, Bottini G, Scarpa P, Bollani A, Querzola M, Palmas G, DE Gonda F, Bosio L, Egidi M, Tardivo V, Fioravanti A, Subacchi S, Fontanella M, Biroli A, Cereda C, Panciani PP, Bergomi R, Pertichetti M, Tancioni F, Bona A, Tartara FA, Fornari M, Pessina F, Lasio G, Cardia A, Servadei F, Riva M, Casarotti A, Giussani C, Fiori L, Mazzoleni F, Vaiani S, Carrabba G, DI Cristofori A, Sganzerla EP, Vimercati A, Isella V, Mauri I, Incerti M, Sicuri G, Miramonti V, Stefini R, Spagnoli D, Piparo M, Grimod G, Regazzoni R, Vismara D, Mazzeo L, Monti E, Franzin A, Vivaldi O, Maietti A, Pini E, Servello D, Zekaj E, DE Michele S, Locatelli M, Borsa S, Grimoldi N, Caroli M, Tariciotti L, Abete-Fornara G, Vitale M, Leonardi M, and Broggi M

Subjects
Humans, Neon, Italy, Neurosurgeons, Outcome Assessment, Health Care
Abstract

Background: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment., Methods: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts' clinical practice and the existing literature., Results: A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected., Conclusions: A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level.

Published
2023
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43. The determinants of saccade targeting strategy in neurodevelopmental disorders: The influence of suboptimal reading experience.

Author

Vernet M, Bellocchi S, Danna J, Massendari D, Jover M, Chaix Y, and Ducrot S

Subjects
Child, Humans, Saccades, Eye Movements, Visual Fields, Dyslexia, Neurodevelopmental Disorders
Abstract

Whether eye-movements deficits are causal in reading disorders (RD) or rather a consequence of linguistic processing difficulty experienced by disabled readers has been extensively debated.Since RD are frequently comorbid with the Neurofibromatosis type1 (NF1), children with NF1 were used as a comparison group for children with dyslexia in this study.Eye movements were recorded while 21 dyslexic, 20 NF1, and 20 typically developing children performed an oculomotor lateralized bisection task. In this experiment, we manipulated the type of stimulus - discrete (words and strings of hashes) versus continuous (solid lines) - and the visual field where the stimulus was displayed (left vs right). The results showed that (1) only proficient readers (TD and NF1 without RD) showed fully developed oculomotor mechanisms for efficient reading, with a clear preferred viewing location located to the left of the word's centre in both visual fields, and fine-tuned saccade targeting guided by the between-character space information and (2) NF1 poor readers mirrored the dyslexic eye movement behaviour, with less accuracy and more variability in saccadic programming, no sensitivity to the discreteness of the stimuli, particularly in the left visual field. We concluded that disruption to oculomotor behaviour reflectsthe fact that many of the processes involved in reading are not yet automatized for children with RD, independently of NF1. This suggests that the differences in saccade targeting strategy between children with and without RD would be secondary consequences of their reduced reading experience., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Published
2023
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44. Posterior fossa syndrome in a population of children and young adults with medulloblastoma: a retrospective, multicenter Italian study on incidence and pathophysiology in a histologically homogeneous and consecutive series of 136 patients.

Author

de Laurentis C, Cristaldi PMF, Rebora P, Valsecchi MG, Biassoni V, Schiavello E, Carrabba GG, Trezza A, DiMeco F, Ferroli P, Cinalli G, Locatelli M, Cenzato M, Talamonti G, Fontanella MM, Spena G, Stefini R, Bernucci C, Bellocchi S, Locatelli D, Massimino M, and Giussani C

Subjects
Child, Humans, Incidence, Language, Postoperative Complications, Retrospective Studies, Syndrome, Young Adult, Cerebellar Neoplasms, Infratentorial Neoplasms, Medulloblastoma, Mutism
Abstract

Introduction: Posterior fossa syndrome (PFS) is a set of debilitating complications that can occur after surgery for posterior fossa tumors. This study aimed to assess the preoperative radiological and surgical risk factors for the onset of PFS in a histologically homogeneous population of children with medulloblastoma and compare it to a similar population of young adults., Methods: Included patients underwent posterior fossa surgery for medulloblastoma at 11 Italian neurosurgical wards (2003-2019) and were referred to Fondazione IRCCS Istituto Nazionale dei Tumori in Milan (INT) for postoperative treatments. We collected patients' pre- and post-operative clinical, surgical and radiological data from the INT charts. To compare the distribution of variables, we used the Mann-Whitney and Fisher tests for continuous and categorical variables, respectively., Results: 136 patients (109 children and 27 young adults) were included in the study. Among children, 29 (27%) developed PFS, and all of them had tumors at midline site with invasion of the fourth ventricle. Radiological evidence of involvement of the right superior (39% versus 12%; p = 0.011) or middle cerebellar peduncles (52% versus 18%; p = 0.002) seemed more common in children who developed PFS. Young adults showed an expected lower incidence of PFS (4 out of 27; 15%), that may be due to anatomical, physiological and oncological elements., Conclusions: This study confirmed some factors known to be associated with PFS onset and shed light on other debated issues. Our findings enhance an already hypothesized role of cerebellar language lateralization. The analysis of a population of young adults may shed more light on the often-neglected existence of PFS in non-pediatric patients., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2022
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45. Predicting future poor readers from pre-reading visual skills: A longitudinal study.

Author

Vernet M, Bellocchi S, Leibnitz L, Chaix Y, and Ducrot S

Subjects
Academic Success, Child, Humans, Learning, Longitudinal Studies, Prospective Studies, Forecasting, Reading, Visual Perception
Abstract

Reading is essential for learning, from literature to physics, from paper to screens on e-readers and smart phones. Even if it is well known that learning to read implies good language skills, children also need to develop good oculomotor and visual-perception skills. Thereby, any deficits in visual processing may affect learning. The possible impact of visual deficits is rarely considered, especially with regard to eye movements and visual perception. Hence, these deficits are usually discovered much later or remain undiagnosed. The present study aimed at assessing the usefulness of visual processing related measures in the early detection of reading difficulties. Visual skill differences that are apparent early in kindergarten might provide predictive insights into risk for learning difficulties at school entry. We used a prospective, longitudinal approach where visual processes (assessed with the Developmental Eye Movement (DEM) test) were measured in 51 preschoolers, and the impact of these processes on future reading development was explored one year later, in Grade 1. Results showed that (1) 31% of our sample of preschoolers showed visual processing impairments (without any clinical complaints) and (2) reading accuracy and speed in first graders were significantly correlated with visual skills assessed in kindergarten, thus confirming the significant role of oculomotor and visual-perception processes in the acquisition of reading skills. These suggests the potential for these measures to be used clinically for identifying children at risk for low academic achievement, enabling appropriate targeting of early interventions.

Published
2022
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46. Visual-processing deficits in children with neurofibromatosis type 1: A clinical marker of reading difficulties.

Author

Vernet M, Jover M, Bellocchi S, Maziero S, Jucla M, Tallet J, Danna J, Chaix Y, and Ducrot S

Subjects
Biomarkers, Child, Cognition, Humans, Dyslexia diagnosis, Dyslexia etiology, Learning Disabilities diagnosis, Learning Disabilities epidemiology, Neurofibromatosis 1 complications
Abstract

Today's estimates indicate that nearly 50% of children with Neurofibromatosis type 1 (NF1) suffer from reading disabilities, with a high impact on their academic achievement. In addition to the well-documented importance of phonological skills in reading acquisition and neurodevelopmental disorders, visual-attention processes also appear as important factors in learning to read. The present study aimed at assessing the role of visual-processing dysfunction in the high prevalence of reading disabilities in NF1 children and providing a useful tool for clinician in the early detection of reading impairment in this neurogenetic disorder. Forty-two children with NF1 and 42 typically developing children (TD) participated in the study. All were right-handed and did not present intellectual disability or attention deficit hyperactivity disorder. Visual-attention processes were assessed with the Developmental Eye Movement (DEM) test, together with the NF1 children's reading level. NF1 children with and without reading disabilities were then compared. The results showed that visual-processing deficits were highly present among the NF1 children included in our study. Furthermore, poor readers with NF1 presented an increased risk of visual-processing deficits compared to peers. This finding supports the role of visual-processing deficits in the reading difficulties encountered in nearly half of children with NF1. Finally, in NF1 children without intellectual or attention disability, visual-processing deficits emerge as one of the clinical markers of reading disabilities. The study holds important clinical implications both for the identification, by providing a useful screening tool, and the management of reading disabilities in NF1 children., (© 2022 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.)

Published
2022
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47. Exploring the role of electric vehicles in Africa's energy transition: A Nigerian case study.

Author

Dioha MO, Duan L, Ruggles TH, Bellocchi S, and Caldeira K

Abstract

We employed a bottom-up modeling framework to examine a set of scenarios to generate insights on the techno-economic and environmental implications of increasing levels of electric vehicle (EV) penetration using Nigeria as a case study. Results indicate that, despite Nigeria having a natural gas-dominated electricity system, the deployment of EVs can support the decarbonization of the transportation and power sectors but at a relatively high cost. The cost of EVs would need to drop by ∼40% to become cost-competitive. However, if variable renewable energy sources deliver the EVs power requirement with a bidirectional vehicle-to-grid (V2G) charging strategy, then the cost of EVs would need to decline by only ∼30%. Not all EVs need to participate in a V2G charging strategy in order to realize the full benefits of the strategy. Expanding renewables capacity leads to additional reduction in CO 2 emission and decarbonization cost but at different magnitudes based on the charging strategy., Competing Interests: The authors declare no competing interests., (© 2022 The Authors.)

Published
2022
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48. Aneurismal subarachnoid hemorrhage during the COVID-19 outbreak in a Hub and Spoke system: observational multicenter cohort study in Lombardy, Italy.

Author

Fiorindi A, Vezzoli M, Doglietto F, Zanin L, Saraceno G, Agosti E, Barbieri A, Bellocchi S, Bernucci C, Bongetta D, Cardia A, Costi E, Egidi M, Fioravanti A, Gasparotti R, Giussani C, Grimod G, Latronico N, Locatelli D, Mardighian D, Nodari G, Poli JC, Rasulo F, Roca E, Sicuri GM, Spena G, Stefini R, Vivaldi O, Zoia C, Calza S, Fontanella MM, and Cenzato M

Subjects
Cohort Studies, Humans, Pandemics, SARS-CoV-2, Treatment Outcome, COVID-19, Subarachnoid Hemorrhage epidemiology
Abstract

Background: Lombardy was the most affected Italian region by the first phase of the COVID-19 pandemic and underwent urgent reorganization for the management of emergencies, including subarachnoid hemorrhage from a ruptured cerebral aneurysm (aSAH). The aim of the study was to define demographics, clinical, and therapeutic features of aSAH during the COVID-19 outbreak and compare these with a historical cohort., Methods: In this observational multicenter cohort study, patients aged 18 years or older, who were diagnosed with aSAH at the participating centers in Lombardy from March 9 to May 10, 2020, were included (COVID-19 group). In order to minimize bias related to possible SAH seasonality, the control group was composed of patients diagnosed with aSAH from March 9 to May 10 of the three previous years, 2017-2018-2019 (pre-pandemic group). Twenty-three demographic, clinical, and therapeutic features were collected. Statistical analysis was performed., Results: Seventy-two patients during the COVID-19 period and 179 in the control group were enrolled at 14 centers. Only 4 patients were positive for SARS-CoV-2. The "diagnostic delay" was significantly increased (+ 68%) in the COVID-19 group vs. pre-pandemic (1.06 vs. 0.63 days, respectively, p-value = 0.030), while "therapeutic delay" did not differ significantly between the two periods (0.89 vs. 0.74 days, p-value = 0.183). Patients with poor outcome (GOS at discharge from 1 to 3) were higher during the COVID-19 period (54.2%) compared to pre-pandemic (40.2%, p = 0.044). In logistic regression analysis, in which outcome was the dichotomized Glasgow Outcome Scale (GOS), five variables showed p-values < 0.05: age at admission, WFNS grade, treatment (none), days in ICU, and ischemia., Conclusions: We documented a significantly increased "diagnostic delay" for subarachnoid hemorrhages during the first COVID-19 outbreak in Lombardy. However, despite the dramatic situation that the healthcare system was experiencing, the Lombardy regional reorganization model, which allowed centralization of neurosurgical emergencies such as SAHs, avoided a "therapeutic delay" and led to results overall comparable to the control period., (© 2021. The Author(s).)

Published
2022
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49. Solitary Calvarial Metastasis As the First Presentation of Urothelial Bladder Cancer.

Author

Bistazzoni S, Bonetto S, and Domenico Bellocchi S

Abstract

The most common sites of metastasis from urothelial carcinoma of the bladder include the lymph nodes, bones, lungs, liver, and peritoneum. Bladder carcinoma metastases of the head are uncommon. In the English literature, only a few cases of bladder carcinoma metastasis to the skull base have been reported, and no cases of metastasis to the calvaria have been reported previously. We present the first case of calvarial metastasis from bladder carcinoma that preceded the diagnosis of the primary tumor. Bladder calvarial metastasis as the first evidence of a primary tumor is a rare event and a sign of an advanced stage of the disease. Therefore, adequate staging is essential to ensure appropriate treatment. Surgical treatment of calvarial injuries is usually secure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bistazzoni et al.)

Published
2021
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50. "Same, same but different": The optimal viewing position effect in developmental dyslexia, developmental coordination disorder and comorbid disorders.

Author

Bellocchi S and Ducrot S

Subjects
Adult, Attention, Child, Comorbidity, Humans, Language, Dyslexia epidemiology, Motor Skills Disorders epidemiology
Abstract

The optimal viewing position (OVP) effect indicates that words are identified most quickly when the eyes fixate near the word centre in alphabetic languages. In two studies, we tested OVP in typically developing readers and children with developmental dyslexia (DD), developmental coordination disorder (DCD) and with both disorders (DD + DCD), using a variable-viewing-position technique. Study 1 showed that typically developing readers had developed highly automatized procedures of left-to-right attentional scanning resulting in an inverted J-shape VP curve comparable to what is observed in adult readers and that dyslexics showed non-prototypical one. In Study 2, we observed more typical procedures of left-to-right attentional scanning in children with DCD, isolated or comorbid, compared to DD. Moreover, given the absence of significant group differences between children with DD + DCD and children with isolated DD or DCD, our results reinforce the idea that the comorbid condition does not add to the severity of OVP anomalies. We then concluded that OVP atypicalities are specific to children with DD. Finally, we discussed the usefulness of the OVP effect as a clinical tool to identify possible OVP atypicalities that could be specific of some neurodevelopmental disorders (i.e., DD, DCD or DCD + DD)., (© 2021 John Wiley & Sons Ltd.)

Published
2021
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