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6. Adherence issues related to sublingual immunotherapy as perceived by allergists

Author

Scurati, S., Frati, F., Passalacqua, G., Puccinelli, P., Hilaire, C., Incorvaia, C., D Avino, G., Comi, R., Lo Schiavo, M., Pezzuto, F., Montera, C., Pio, A., Teresa Ielpo, M., Cellini, F., Vicentini, L., Pecorari, R., Aresu, T., Capra, L., Benedictis, E., Bombi, C., Zauli, D., Vanzi, A., Alberto Paltrinieri, C., Bondioli, A., Paletta, I., Ventura, D., Mei, F., Paolini, F., Colangelo, C., Cavallucci, E., Cucinelli, F., Tinari, R., Ermini, G., Beltrami, V., Novembre, E., Begliomini, C., Marchese, E., Solito, E., Ammannati, V., Molino, G., Galli, E., Baldassini, M., Di Michele, L., Calvani, M., Gidaro, M., Venuti, A., Li Bianchi, E., Benassi, F., Pocobelli, D., Zangari, P., Rocco, M. G., Lo Vecchio, A., Pingitore, G., Grimaldi, O., Schiavino, D., Perrone, N., Antonietta Frieri, M., Di Rienzo, V., Tripodi, S., Scarpa, A., Tomsic, M., Bonaguro, R., Enrico Senna, G., Sirena, A., Turatello, F., Crescioli, S., Favero, E., Billeri, L., Chieco Bianchi, F., Gemignani, C., Zanforlin, M., Angiola Crivellaro, M., Hendrick, B., Maltauro, A., Masieri, S., Elisabetta Conte, M., Fama, M., Pozzan, M., Bonadonna, P., Casanova, S., Vallerani, E., Schiappoli, M., Borghesan, F., Giro, G., Casotto, S., Berardino, L., Zanoni, G., Ariano, R., Aquilina, R., Pellegrino, R., Marsico, P., Del Giudice, A., Narzisi, G., Tomaselli, V., Fornaca, G., Favro, M., Loperfido, B., Gallo, C., Buffoni, S., Gani, F., Raviolo, P., Faggionato, S., Truffelli, T., Vivalda, L., Albano, M., Enzo Rossi, R., Lattuada, G., Bona, F., Quaglio, L., Chiesa, A., Trapani, M., Seminara, R., Cucchi, B., Oderda, S., Borio, G., Galeasso, G., Garbaccio, P., Marco, A., Marengo, F., Cadario, G., Manzoni, S., Vinay, C., Curcio, A., Silvestri, A., Peduto, A., Riario-Sforza, G. G., Maria Forgnone, A., Barocelli, P., Tartaglia, N., Feyles, G., Giacone, A., Ricca, V., Guida, G., Nebiolo, F., Bommarito, L., Heffler, E., Vietti, F., Galimberti, M., Savi, E., Pappacoda, A., Bottero, P., Porcu, S., Felice, G., Berra, D., Francesca Spina, M., Pravettoni, V., Calamari, A. M., Varin, E., Iemoli, E., Lietti, D., Ghiglioni, D., Alessandro Fiocchi, Tosi, A., Poppa, M., Caviglia, A., Restuccia, M., Russello, M., Alciato, P., Manzotti, G., Ranghino, E., Luraschi, G., Rapetti, A., Rivolta, F., Allegri, F., Terracciano, L., Agostinis, F., Paolo Piras, P., Ronchi, G., Gaspardini, G., Caria, V., Tolu, F., Fantasia, D., Carta, P., Moraschini, A., Quilleri, R., Santelli, A., Prandini, P., Del Giudice, G., Apollonio, A., Bonazza, L., Teresa Franzini, M., Branchi, S., Zanca, M., Rinaldi, S., Catelli, L., Zanoletti, T., Cosentino, C., Della Torre, F., Cremonte, L., Musazzi, D., Suli, C., Rivolta, L., Ottolenghi, A., Marino, G., Sterza, G., Sambugaro, R., Orlandini, A., Minale, P., Voltolini, S., Bignardi, D., Omodeo, P., Tiri, A., Milani, S., Ronchi, B., Licardi, G., Bruni, P., Scibilia, J., Schroeder, J., Crosti, F., Maltagliati, A., Alesina, M. R., Mosca, M., Leone, G., Napolitano, G., Di Gruttola, G., Scala, G., Mascio, S., Valente, A., Marchetiello, I., Catello, R., Gazulli, A., Del Prete, A., Varricchio, A. M., Carbone, A., Forestieri, A., Stillitano, M., Leonetti, L., Tirroni, E., Castellano, F., Abbagnara, F., Romano, F., Levanti, C., Cilia, M., Longo, R., Ferrari, A., Merenda, R., Di Ponti, A., Guercio, E., Surace, L., Ammendola, G., Tansella, F., Peccarisi, L., Stragapede, L., Minenna, M., Granato, M., Fuiano, N., Pannofino, A., Ciuffreda, S., Giannotta, A., Morero, G., D Oronzio, L., Taddeo, G., Nettis, E., Cinquepalmi, G., Lamanna, C., Mastrandrea, F., Minelli, M., Salamino, F., Muratore, L., Latorre, F., Quarta, C., Ventura, M., D Ippolito, G., Giannoccaro, F., Dambra, P., Pinto, L., Triggiani, M., Munno, G., Manfredi, G., Lonero, G., Damiano, V., Errico, G., Di Leo, E., Manzari, F., Spagna, V., Arsieni, A., Matarrese, A., Mazzarella, G., Scarcia, G., Scarano, R., Ferrannini, A., Pastore, A., Maionchi, P., Filannino, L., Tria, M., Giuliano, G., Damiani, E., Scichilone, N., Marchese, M., Lucania, A., Marino, M., Strazzeri, L., Tumminello, S., Vitale, G. I., Gulotta, S., Gragotto, G., Zambito, M., Greco, D., Valenti, G., Licitra, G., Cannata, E., Filpi, R., Contraffatto, M., Sichili, S., Randazzo, S., Scarantino, G., Lo Porto, B., Pavone, F., Di Bartolo, C., Paternò, A., Rapisarda, F., Laudani, E., Leonardi, S., Padua, V., Cabibbo, G., Marino Guzzardi, G., Deluca, F., Agozzino, C., Pettinato, R., Ghini, M., Scurati S., Frati F., Passalacqua G., Puccinelli P., Hilaire C., Incorvaia C., D'Avino G., Comi R., Lo Schiavo M., Pezzuto F., Montera C., Pio A., Teresa Ielpo M., Cellini F., Vicentini L., Pecorari R., Aresu T., Capra L., De Benedictis E., Bombi C., Zauli D., Vanzi A., Alberto Paltrinieri C., Bondioli A., Paletta I., Ventura D., Mei F., Paolini F., Colangelo C., Cavallucci E., Cucinelli F., Tinari R., Ermini G., Beltrami V., Novembre E., Begliomini C., Marchese E., Solito E., Ammannati V., Molino G., Galli E., Baldassini M., Di Michele L., Calvani M., Gidaro M., Venuti A., Li Bianchi E., Benassi F., Pocobelli D., Zangari P., De Rocco M.G., Lo Vecchio A., Pingitore G., Grimaldi O., Schiavino D., Perrone N., Antonietta Frieri M., Di Rienzo V., Tripodi S., Scarpa A., Tomsic M., Bonaguro R., Enrico Senna G., Sirena A., Turatello F., Crescioli S., Favero E., Billeri L., Chieco Bianchi F., Gemignani C., Zanforlin M., Angiola Crivellaro M., Hendrick B., Maltauro A., Masieri S., Elisabetta Conte M., Fama M., Pozzan M., Bonadonna P., Casanova S., Vallerani E., Schiappoli M., Borghesan F., Giro G., Casotto S., Berardino L., Zanoni G., Ariano R., Aquilina R., Pellegrino R., Marsico P., Del Giudice A., Narzisi G., Tomaselli V., Fornaca G., Favro M., Loperfido B., Gallo C., Buffoni S., Gani F., Raviolo P., Faggionato S., Truffelli T., Vivalda L., Albano M., Enzo Rossi R., Lattuada G., Bona F., Quaglio L., Chiesa A., Trapani M., Seminara R., Cucchi B., Oderda S., Borio G., Galeasso G., Garbaccio P., De Marco A., Marengo F., Cadario G., Manzoni S., Vinay C., Curcio A., Silvestri A., Peduto A., Riario-Sforza G.G., Maria Forgnone A., Barocelli P., Tartaglia N., Feyles G., Giacone A., Ricca V., Guida G., Nebiolo F., Bommarito L., Heffler E., Vietti F., Galimberti M., Savi E., Pappacoda A., Bottero P., Porcu S., Felice G., Berra D., Francesca Spina M., Pravettoni V., Calamari A.M., Varin E., Iemoli E., Lietti D., Ghiglioni D., Fiocchi A., Tosi A., Poppa M., Caviglia A., Restuccia M., Russello M., Alciato P., Manzotti G., Ranghino E., Luraschi G., Rapetti A., Rivolta F., Allegri F., Terracciano L., Agostinis F., Paolo Piras P., Ronchi G., Gaspardini G., Caria V., Tolu F., Fantasia D., Carta P., Moraschini A., Quilleri R., Santelli A., Prandini P., Del Giudice G., Apollonio A., Bonazza L., Teresa Franzini M., Branchi S., Zanca M., Rinaldi S., Catelli L., Zanoletti T., Cosentino C., Della Torre F., Cremonte L., Musazzi D., Suli C., Rivolta L., Ottolenghi A., Marino G., Sterza G., Sambugaro R., Orlandini A., Minale P., Voltolini S., Bignardi D., Omodeo P., Tiri A., Milani S., Ronchi B., Licardi G., Bruni P., Scibilia J., Schroeder J., Crosti F., Maltagliati A., Alesina M.R., Mosca M., Leone G., Napolitano G., Di Gruttola G., Scala G., Mascio S., Valente A., Marchetiello I., Catello R., Gazulli A., Del Prete A., Varricchio A.M., Carbone A., Forestieri A., Stillitano M., Leonetti L., Tirroni E., Castellano F., Abbagnara F., Romano F., Levanti C., Cilia M., Longo R., Ferrari A., Merenda R., Di Ponti A., Guercio E., Surace L., Ammendola G., Tansella F., Peccarisi L., Stragapede L., Minenna M., Granato M., Fuiano N., Pannofino A., Ciuffreda S., Giannotta A., Morero G., D'Oronzio L., Taddeo G., Nettis E., Cinquepalmi G., Lamanna C., Mastrandrea F., Minelli M., Salamino F., Muratore L., Latorre F., Quarta C., Ventura M., D'Ippolito G., Giannoccaro F., Dambra P., Pinto L., Triggiani M., Munno G., Manfredi G., Lonero G., Damiano V., Errico G., Di Leo E., Manzari F., Spagna V., Arsieni A., Matarrese A., Mazzarella G., Scarcia G., Scarano R., Ferrannini A., Pastore A., Maionchi P., Filannino L., Tria M., Giuliano G., Damiani E., Scichilone N., Marchese M., Lucania A., Marino M., Strazzeri L., Tumminello S., Vitale G.I., Gulotta S., Gragotto G., Zambito M., Greco D., Valenti G., Licitra G., Cannata E., Filpi R., Contraffatto M., Sichili S., Randazzo S., Scarantino G., Lo Porto B., Pavone F., Di Bartolo C., Paterno A., Rapisarda F., Laudani E., Leonardi S., Padua V., Cabibbo G., Marino Guzzardi G., Deluca F., Agozzino C., Pettinato R., Ghini M., Scurati S, Frati F, Passalacqua G, Puccinelli P, Hilaire C, Incorvaia I, D'Avino G, Comi R, Lo Schiavio M, Pezzuto F, Montera C, Pio A, Ielpo MT, Cellini F, Vicentini L, Pecorari R, Aresu T, Capra L, De Benedictis E, Bombi C, Zauli D, and et al

Subjects
medicine.medical_specialty, Pathology, genetic structures, efficacy, Alternative medicine, Medicine (miscellaneous), Adherence, Cost, Efficacy, Side effects, Sublingual immunotherapy, Settore MED/10 - Malattie Dell'Apparato Respiratorio, sublingual immunotherapy, ALLERGEN, cost, medicine, Subcutaneous immunotherapy, Sublingual immunotherapy, adherence, Clinical efficacy, Intensive care medicine, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), sublingual immunoterapy, Original Research, Asthma, AEROALLERGENS, side effects, business.industry, Health Policy, medicine.disease, Slit, eye diseases, Clinical trial, Patient Preference and Adherence, immunotherapy, sense organs, Allergists, ADHERENCE TO TREATMENT, business, Social Sciences (miscellaneous)
Abstract

Silvia Scurati1, Franco Frati1, Gianni Passalacqua2, Paola Puccinelli1, Cecile Hilaire1, Cristoforo Incorvaia3, Italian Study Group on SLIT Compliance 1Scientific and Medical Department, Stallergenes, Milan, Italy; 2Allergy and Respiratory Diseases, Department of Internal Medicine, Genoa; 3Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, ItalyObjectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists.Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.Keywords: adherence, sublingual immunotherapy, efficacy, cost, side effects

Published
2010

8. Emergenze Toraciche

Author

Alamanni F, Ancona E, Anselmino M, Beltrami V, Bergami F, Biglioli P, Boglino C, Bonavina L, Brazzi L, Cappelletti M, Carretta A, Castagnone D, Chiesa G, Ciprandi G, Cortale M, Di Nuzzo D, Donin I, Fedriga E, Floriani M, Gattinoni L, Gherli T, Giulini SM, Grossi A, Guglielmi M, Inserra A, Leggeri A, Liguori G, Lovaria A, Lubatti L, Messineo A, Pelosi P, Peracchia A, Pouchè A, Pozzato C, Rossi P, Sottini A, Stipa S, Tiberio G, Tiberio GAM, Trazzi R, Volterrani F, Ziparo V., DOCIMO, Ludovico, Alamanni, F, Ancona, E, Anselmino, M, Beltrami, V, Bergami, F, Biglioli, P, Boglino, C, Bonavina, L, Brazzi, L, Cappelletti, M, Carretta, A, Castagnone, D, Chiesa, G, Ciprandi, G, Cortale, M, Di Nuzzo, D, Docimo, Ludovico, Donin, I, Fedriga, E, Floriani, M, Gattinoni, L, Gherli, T, Giulini, Sm, Grossi, A, Guglielmi, M, Inserra, A, Leggeri, A, Liguori, G, Lovaria, A, Lubatti, L, Messineo, A, Pelosi, P, Peracchia, A, Pouchè, A, Pozzato, C, Rossi, P, Sottini, A, Stipa, S, Tiberio, G, Tiberio, Gam, Trazzi, R, Volterrani, F, and Ziparo, V.

Published
2000

13. NM23 expression as prognostic factor in colorectal carcinoma

Author

Forte, A., Antonio D'URSO, Gallinaro, L. S., Lo Storto, G., Soda, G., Bosco, D., Bezzi, M., Vietri, F., and Beltrami, V.

Subjects
Carcinoma, NM23 Nucleoside Diphosphate Kinases, Prognosis, Gene Expression Regulation, Neoplastic, Antigens, Neoplasm, Predictive Value of Tests, Lymphatic Metastasis, Nucleoside-Diphosphate Kinase, Colonic Neoplasms, Biomarkers, Tumor, Humans, Monomeric GTP-Binding Proteins, Neoplasm Staging, Transcription Factors
Abstract

The current most important prognostic indicator in colorectal carcinoma is tumor stage at the moment of diagnosis. The role of NM23 gene as prognostic factor is controversial. The aim of this study was to investigate NM23 expression.The study population included 104 unselected patients who underwent surgery for colorectal carcinoma between 1992 and 1997. NM23 expression was quantified by estimating the percentage of tumor cells with unequivocal reactivity. The percentage was scored: 0 when no tumor cells showed immunoreactivity; 1 when less than 10% of cells showed immunoreactivity; 2 when 11-50% of cells were positive; 3 when more than 51% of cells were positive.Four cases belonged to group 0.21 to group 1.55 to group 2 and 24 to group 3.NM23 cannot be considered an independent prognostic variable.

Published
2002

15. REOPERATIONS IN LUNG SURGERY

Author

Angelici, Alberto Maria, Nasti, Ag, Bertagni, A, Palumbo, Piergaspare, Vietri, Francesco, and Beltrami, V.

Published
2002

18. [Pulmonary carcinoids. Analysis of 53 cases]

Author

Beltrami, V, Gallinaro, Ls, Bezzi, Marcello, and Angelici, Alberto Maria

Subjects
Adult, Male, Lung Neoplasms, Time Factors, Adolescent, Carcinoid Tumor, Middle Aged, Prognosis, Humans, Female, Pneumonectomy, Lung, Aged, Follow-Up Studies, Retrospective Studies
Abstract

We have performed a retrospective analysis of 53 cases of bronchial carcinoids using our own patient data from more than 4700 lung tumors and 1632 resections. The male/female ratio was 1:12 (28/25) and the age range 13 to 75 years (mean 52.2). Fifty-three tumors resections of varying extent were performed, including one radical pneumonectomy in a patient who had previously undergone a lobectomy, and one limited resection of the main left bronchus; there was no intraoperative mortality. After histological examination, 44 tumors (83%) were found to be typical carcinoids and nine (17%) atypical carcinoids. The median follow-up period was 4.56 years, with a range from 1 to 10 years. Only one patient with an atypical carcinoid tumor had a relapse and died three years after, while another patient underwent surgery of the contralateral lung for a second primary lung cancer (SPLC). On the basis of these observations we would like to underline the importance of an accurate histopathological classification for both therapeutic and prognostic purposes; given the higher aggressiveness of atypical carcinoids, these tumors would be eligible for a therapeutic approach analogous to that adopted for bronchogenic carcinoma.

Published
1999

20. Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases

Author

Pastorino, U, Buyse, M, Friedel, G, Ginsberg, R, Girard, P, Goldstraw, P, Johnston, M, Mccormack, P, Pass, H, Putnam, J, Cerrina, J, Chapelier, A, Dartevelle, P, Baldeyrou, P, Grunenwald, D, Bulzebruck, H, Schirren, J, Vogtmoykopf, I, Toomes, H, Vangeel, A, Cappello, M, Rocmans, P, Pietraszek, A, Sklodowska, M, Andreani, S, Incarbone, M, Ravasi, G, Tavecchio, L, Ambrogi, V, Ricci, C, Mineo, Tc, Maggi, G, Briccoli, A, Gelmini, R, Heidari, A, Guernelli, N, Beltrami, V, Bains, M, Burt, M, Martini, N, Rusch, V, Roth, J, Holmes, C, Temeck, B, and Marchand, P

Subjects
SOFT-TISSUE SARCOMAS, ADJUVANT CHEMOTHERAPY, RESECTION, PULMONARY METASTASES, SURGERY, TOMOGRAPHY, SURGICAL-MANAGEMENT, Settore MED/21 - Chirurgia Toracica, MEDIAN STERNOTOMY, OSTEOGENIC-SARCOMA
Published
1997

28. Resection and reconstruction of the sternum: case report.

Author

Beltrami, V and Gidaro, G

Abstract

The case history of a 67-year-old man who underwent a subtotal sternectomy for a tumour of the manubrium and left clavicle is reported. Histological examination revealed a highly undifferentiated metastatic carcinoma: the original tumour was not discovered but the patient was in good condition 10 months after operation. Adequate replacement and stabilization of the chest wall was obtained with autotransplantation of the tibia and muscle flaps. [ABSTRACT FROM AUTHOR]

Published
1976

29. Comparative pharmacokinetics of two urinary human follicle stimulating hormone preparations in healthy female and male volunteers.

Author

le Cotonnec, J Y, Porchet, H C, Beltrami, V, and Howles, C

Abstract

These studies were designed to compare the pharmacokinetic characteristics of a very highly purified urinary human follicle stimulating hormone (FSH-HP) preparation (sp. act. approximately 9000 IU FSH/mg of protein), Metrodin HP, with a standard urinary FSH preparation Metrodin (FSH). The two preparations were administered in a balanced, random-order, cross-over sequence as single doses of 150 IU, separated by 1 week of washout to 12 female volunteers by i.v. injection and to 12 male volunteers by i.m. and s.c. routes. FSH concentrations were measured by immunoradiometric assay and by an in-vitro rat granulosa cell aromatase bioassay. After an i.v. bolus, the pharmacokinetics of the two FSH preparations were identical. Total clearance was 0.5 and 0.15 l/h respectively for immunoassay and bioassay data. Immunoassay showed that the two preparations were similar for renal clearance (0.1 l/h), volumes of distribution at steady state (9 l), distribution and terminal half-lives (2 and 17 h, respectively). After parenteral administrations, the absorption half-life of FSH was approximately 3 h and the apparent terminal half-life was approximately 1.5 days. Both preparations had relative bioavailabilities close to 100% for i.m. and s.c. administrations. Immunopurification, which results in a very highly purified FSH-HP, does not modify the pharmacokinetic properties of FSH. This study also confirmed that s.c. and i.m. doses of FSH-HP are equivalent from the pharmacokinetic and pharmacodynamic points of view. [ABSTRACT FROM AUTHOR]

Published
1993

31. Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases

Author

Pastorino, U., Buyse, M., Friedel, G., Ginsberg, R., Girard, P., Goldstraw, P., Johnston, M., Mccormack, P., Pass, H., J. B. Putnam J. r., Cerrina, J., Chapelier, A., Dartevelle, P., Baldeyrou, P., Grunenwald, D., Bulzebruck, H., Schirren, J., Vogt Moykopf, I., Toomes, H., van Geel, A. N., Cappello, M., Rocmans, P., Pietraszek, A., Sklodowska, M., Andreani, S., Incarbone, M., Ravasi, G., Tavecchio, L., Ambrogi, V., Ricci, C., Mineo, T., Maggi, G., Briccoli, A., Gelmini, Roberta, Heidari, A., Guernelli, N., Beltrami, V., Bains, M. S., Burt, M. E., Martini, N., Mccormack, P. M., Rusch, V. W., Roth, J., Holmes, C., and Temeck, H. Pass B.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Lung Neoplasms, Adolescent, lung metastasis ssurgery, medicine, Humans, Child, Survival analysis, Aged, Proportional hazards model, business.industry, Middle Aged, medicine.disease, Primary tumor, Survival Analysis, Surgery, Cardiothoracic surgery, Child, Preschool, Complete Metastasectomy, Female, Sarcoma, Germ cell tumors, Metastasectomy, Neoplasm Recurrence, Local, Cardiology and Cardiovascular Medicine, business
Abstract

Objectives: The International Registry of Lung Metastases was established in 1991 to assess the long-term results of pulmonary metastasectomy. Methods: The Registry has accrued 5206 cases of lung metastasectomy, from 18 departments of thoracic surgery in Europe ( n = 13), the United States ( n = 4) and Canada ( n = 1). Of these patients, 4572 (88%) underwent complete surgical resection. The primary tumor was epithelial in 2260 cases, sarcoma in 2173, germ cell in 363, and melanoma in 328. The disease-free interval was 0 to 11 months in 2199 cases, 12 to 35 months in 1857, and more than 36 months in 1620. Single metastases accounted for 2383 cases and multiple lesions for 2726. Mean follow-up was 46 months. Analysis was performed by Kaplan-Meier estimates of survival, relative risks of death, and multivariate Cox model. Results: The actuarial survival after complete metastasectomy was 36% at 5 years, 26% at 10 years, and 22% at 15 years (median 35 months); the corresponding values for incomplete resection were 13% at 5 years and 7% at 10 years (median 15 months). Among complete resections, the 5-year survival was 33% for patients with a disease-free interval of 0 to 11 months and 45% for those with a disease-free interval of more than 36 months; 43% for single lesions and 27% for four or more lesions. Multivariate analysis showed a better prognosis for patients with germ cell tumors, disease-free intervals of 36 months or more, and single metastases. Conclusions: These results confirm that lung metastasectomy is a safe and potentially curative procedure. Resectability, disease-free interval, and number of metastases enabled us to design a simple system of classification valid for different tumor types. (J Thorac Cardiovasc Surg 1997;113:37-49)

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32. Diagnosis and First-Line Treatment of Patients with Lung Cancer in Italian General Hospitals

Author

Alexanian, Alexan, Apolone, Giovanni, Roberto Grilli, Roldano Fossati, Mosconi, Paola, Nicolucci, Antonio, Liberati, Alessandro, Di Biagio, G., Testore, F., Michetti, G., Beltrami, V., Iarussi, T., Bonati, P.L., Rossetti, A., Buccheri, G.F., Manichetti, C., Indelli, M., Malacarne, P., Ghiringhelli, P., Olivadoti, O., Cella, C., Lepore, S., Isa, L., Scapaticci, R., Sargenti, A., Sevieri, G.F., Lanzetti, V., Nascimben, O., Soresi, E., Mezzetti, M., Confalonieri, C., Pavia, G.F., Rizzi, A., Di Costanzo, F., Tagliaventi, M., Trotti, A. Boidi, Fracchia, F., Rovea, P., Verna, V., and Bian, A. Rosa

Abstract

The quality of diagnostic and therapeutic care was examined in a series of 380 consecutive newly diagnosed cases of primary lung cancer seen in 20 Italian general hospitals between January and June 1987. At diagnosis most patients (78%) had one or more symptoms related to the tumor, and in an additional 9 % symptoms were related to the presence of distant metastases. The median diagnostic time lag between first symptoms and final diagnosis was 50 days with a significantly longer delay in patients first seen by their general practitioner compared with those who sought first care in hospital outpatient departments. The diagnostic process was satisfactorily carried out in fewer than two-thirds of the patients leading to complete ascertainment of disease stage and histology in 58% cases with significantly better performance in more specialized institutions. Analysis of the first-line treatment profile indicated a rather aggressive therapeutic attitude In the case of patients with non-small cell lung cancer – 28% of them had chemotherapy despite the lack of any proof of efficacy in controlled clinical trials – and a failure to identify among the patients with small cell disease those amenable to more aggressive treatment. The lack of progress in the treatment of lung cancer over the last decades seems to have resulted in widely varying practice patterns where a mixture of aggressive and laissez-faire attitudes does not take into account that in the absence of effective therapies a more conservative attitude would at least have some advantage in terms of quality of remaining life for many patients.

Published
1989
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33. Surgical Transsternal Treatment of Bronchopleural Fistula Postpneumonectomy

Author

Beltrami, V.

Abstract

An original method of treatment for main bronchus fistula occurring after pneumonectomy was described in 1961. The operation is performed via a median sternotomy and the carinal region exposed. The main bronchi can then be divided in an area not involved with infection. We describe ten patients who underwent this procedure. The left bronchus was divided in seven patients and the right in three. Nine patients were long-term survivors, and one patient died in the early postoperative period from myocardial infarction. The transmediastinal approach for the control of bronchopleural fistula seems an effective means of managing this difficult postoperative problem.

Published
1989
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41. Multimedia presentation of lung sounds as a learning aid for medical students

Author

Piersante Sestini, Renzoni, E., Rossi, M., Beltrami, V., and Vagliasindi, M.

Subjects
Pulmonary and Respiratory Medicine, Undergraduate, Questionnaires, Students, Medical, Audiovisual Aids, Attitude of Health Personnel, Audiovisual Aids, Auscultation, Clinical Competence, Computer-Assisted Instruction, Education, Medical, methods, Humans, Questionnaires, Respiratory Sounds, diagnosis, Respiratory Tract Diseases, diagnosis, Students, psychology, Teaching, methods, Attitude of Health Personnel, diagnosis, Teaching, Respiratory Tract Diseases, psychology, Education, Auscultation, Surveys and Questionnaires, Humans, Clinical Competence, Students, Education, Medical, Undergraduate, Computer-Assisted Instruction, Respiratory Sounds
Abstract

New educational technologies might help to compensate for the decrease in time and emphasis dedicated to physical examination in medical training. This may, in particular, be applicable for improving the skills in auscultation of the chest. We investigated whether a multimedia presentation of acoustic and graphic characteristics of lung sounds could improve the learning of pulmonary auscultation by medical students, in comparison with conventional teaching methods. We studied 48 medical students without clinical experience, who had received conventional formal teaching on chest examination. Chest auscultation skills were evaluated using an inaccuracy score for the student's auscultation report on three patients, selected according to a standardized procedure. After a baseline evaluation, 27 students in groups of 5-10, participated in a multimedia seminar on lung sounds during which digitized lung sounds were played and the corresponding time-expanded waveform and frequency spectrum were commented on and displayed on a computer. The remaining 21 students received conventional bedside training, acting as control group. The following week, all the students underwent a second evaluation of chest auscultation skills. No differences in the inaccuracy score were observed between the two groups in the preliminary test. However, in the second postintervention assessment, the inaccuracy score of the students who had followed the seminar (11.2 +/- 1.3 points) was significantly lower than that of the controls (16.6 +/- 1.6 points). The answers to a feedback questionnaire confirmed that the great majority of the students found the association of the acoustic signals with their visual image to be useful for learning and understanding lung sounds.(ABSTRACT TRUNCATED AT 250 WORDS)

46. La riduzione reale del capitale sociale

Author

MARTORANO, FRANCESCO SAVERIO, P. Beltrami, V. Cariello, A Daccò, V. De Stasio, A. A. Dolmetta, C. Frigeni, E. Ginevra, U. Minneci, P.F. Mondini, A. Perrone, G. Presti, L. Purpura, M. Rescigno, A. Sciarrone Alibrandi, and Martorano, FRANCESCO SAVERIO

Published
2011

47. Konso Statues or Wooden Men Among Us

Author

PALMISANO, ANTONIO LUIGI, Bacchetti P., Beltrami V., Palmisano, Antonio Luigi, and Palmisano, ANTONIO LUIGI

Subjects
antropologia sociale, Konso, Bernardi, Africa, social anthropology, Ethiopia, Ethnography of Africa
Abstract

Eastern Africa and Ethiopia, unlike the rest of the African continent, are not particularly well-known for their production of sculptures. But the waga, the wooden poles of the Konso, are one of the few exceptions. This article analyses the art production in relation with the social and political structure of Konso society.

Published
2009

49. Burkholderia cenocepacia ST-250 in cystic fibrosis patients in Switzerland: Genomic investigation of transmission routes.

Author

Zbinden A, Seth-Smith HMB, Beltrami V, Mancini S, Droz S, Bürgi U, Melillo D, Schuurmans MM, Schwizer B, Schmid I, Casaulta C, Barben J, Mueller NJ, and Imkamp F

Subjects
Humans, Switzerland epidemiology, Male, Retrospective Studies, Female, Child, Adolescent, Genome, Bacterial genetics, Polymorphism, Single Nucleotide, Child, Preschool, Adult, Young Adult, Cystic Fibrosis microbiology, Cystic Fibrosis complications, Burkholderia Infections microbiology, Burkholderia Infections epidemiology, Burkholderia Infections transmission, Burkholderia cenocepacia genetics, Burkholderia cenocepacia classification, Whole Genome Sequencing
Abstract

This report describes the characterization of Burkholderia cenocepacia isolates belonging to sequence type (ST)-250, detected in eight patients with cystic fibrosis (CF) in Switzerland. We retrospectively analyzed 18 isolates of B. cenocepacia ST-250 isolated between 2003 and 2015 by whole-genome sequencing and evaluated clinical and epidemiological data. Single nucleotide polymorphism analysis of the B.°cenocepacia ST-250 lineage showed that the isolates from all patients cluster tightly, suggesting that this cluster has a recent common ancestor. Epidemiological investigations showed that six out of eight patients acquired B.°cenocepacia ST-250 in the years 2001-2006, where participation in CF summer camps was common. Two patients were siblings. Genomic relatedness of the B. cenocepacia ST-250 isolates supported transmission by close contact, however, a common source or nosocomial routes cannot be excluded. With respect to the fatal outcome in six patients, our study shows the importance of infection control measurements in CF patients with B.°cenocepacia., 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 © 2024. Published by Elsevier Inc.)

Published
2024
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50. Influenza and Covid-19 Vaccination in 2023: a descriptive analysis in two Italian Research and Teaching Hospitals. Is the On-Site strategy effective?

Author

Perrone PM, Villa S, Raciti GM, Clementoni L, Vegro V, Scovenna F, Altavilla A, Tomoiaga AM, Beltrami V, Bruno I, Vaccargiu M, Astorri E, Tiwana N, Letzgus M, Schulz PJ, Pregliasco FE, and Castaldi S

Subjects
Humans, Italy, Cross-Sectional Studies, Male, Female, Vaccination statistics & numerical data, Adult, Surveys and Questionnaires, Middle Aged, Health Personnel statistics & numerical data, Immunization Programs statistics & numerical data, Attitude of Health Personnel, Influenza Vaccines administration & dosage, COVID-19 prevention & control, COVID-19 epidemiology, Influenza, Human prevention & control, COVID-19 Vaccines administration & dosage, Hospitals, Teaching
Abstract

Introduction: Vaccinations represent an extremely effective tool for the prevention of certain infectious diseases - such as influenza and COVID-19 -, particularly for those categories at risk due to both their frail condition or professional exposure, such as healthcare workers. The aim of this study is to describe the course of the anti-influenza and anti-COVID-19 vaccination campaign at two Research Hospitals in Milan, Italy., Study Design: Multicentre, cross-sectional study., Methods: For the 2023-24 vaccination campaign, the two facilities opted for two different approaches. At the Hospital A, two dif-ferent strategies for vaccinating healthcare workers were implemented: a fixed-site vaccination clinic and two mobile vaccination groups run by Public Health residents of the University of Milan. At the Hospital B, on the other hand, a single fixed-site outpatient clinic run by Public Health residents of the University of Milan was used. On the occasion of the campaign, a survey was also carried out using anonymous online questionnaires to investigate healthcare workers attitudes towards vaccination., Results: A total of 1,937 healthcare workers were vaccinated: 756 were immunized against influenza only, 99 against COVID-19 only, and 1,082 against both. The results show a substantial difference in vaccination adherence among medical and nursing staff compared to other professional categories. In particular, the category with the highest vaccination adhesion turned out to be that of medical doctors with 55.7% adhesion while, on the contrary, the category with the lowest adhesion turned out to be that of auxiliary personnel characterized by 7.4% adhesion. At the same time, the comparison between the two hospital facilities showed a double adherence rate by the staff of Hospital A as regards both the flu vaccine (40.6% and 20.1%) and the anti-COVID-19 vaccine (26.4% and 12.3%). Finally, the survey showed that the attitude towards influenza vaccination is lower among auxiliary staff in terms of both knowledge and vaccination attitude., Conclusions: The results of the study show a vaccination adherence in line with that of previous years, although lower than the values recommended by the principal national and international Organizations. The analysis of the differences between the two facilities and the surveys carried out will allow for the implementation of targeted interventions to increase adherence in future campaigns.

Published
2024
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