170 results on '"Besozzi, G."'
Search Results
2. Epidemiology and treatment outcome of MDR and pre-XDR TB in international migrants at two reference centers in the North of Italy: a cross-sectional study coordinated by Stop TB Italia Onlus
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Riccardi, N., Pontarelli, A., Alagna, R., Saderi, L., Ferrarese, M., Castellotti, P., Viggiani, P., Cirillo, D., Besozzi, G., Sotgiu, G., and Codecasa, L.
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- 2020
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3. Advantages and Challenges of Tailored Regimens for Drug-Resistant Tuberculosis: A StopTB Italia Look into the Future
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Riccardi N, Villa S, Alagna R, Giacomelli A, Saderi L, Cirillo DM, Besozzi G, Sotgiu G, and Codecasa L
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tuberculosis ,drug-resistance ,treatment ,tailored ,stoptb. ,Infectious and parasitic diseases ,RC109-216 - Abstract
Niccolò Riccardi,1,2,* Simone Villa,1,3,* Riccardo Alagna,1,4 Andrea Giacomelli,1,5 Laura Saderi,1,6 Daniela Maria Cirillo,1,4 Giorgio Besozzi,1 Giovanni Sotgiu,1,6 Luigi Codecasa1,7 1StopTB Italia Onlus, Milan 20159, Italy; 2Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona 37024, Italy; 3Centre for Multidisciplinary Research in Health Science, University of Milan, Milan 20122, Italy; 4IRCCS San Raffaele Scientific Institute, Milan 20132, Italy; 5III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Milan 20157, Italy; 6Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari 07100, Italy; 7Regional TB Reference Centre, Istituto Villa Marelli, Niguarda Hospital, Milan 20159, Italy*These authors contributed equally to this workCorrespondence: Niccolò RiccardiDepartment of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni N.5, 37024, Negrar di Valpolicella, Verona, ItalyTel +39 045 601 6420Email niccolo.riccardi@yahoo.itAbstract: The emerge of drug-resistant tuberculosis (TB) strain in recent decades is hampering the efforts of the international community to eliminate the disease worldwide. The World Health Organization (WHO) has drafted many strategies to achieve this ambitious goal. In the very beginning, the aim was to standardize inadequate regimens used in many countries and, thereafter, evolved to tackle the social determinants which hinder TB elimination. However, following the path of narrowing the clinical vision to deal with TB, there is an increased need to personalize the treatment considering both patients and pathogen unique characteristics. In our narrative review, we report the advantages and the backwards in developing a method to implement the concept of precision medicine to the treatment of TB. In this dissertation, we highlight the importance to address different aspects of the diseases encompassing the host and pathogen features, as well as the needs to further implement an adequate follow-up based on the available resources. Nevertheless, many things may hamper the vision of precision medicine in TB, such as the complexity and the costs to develop novel compounds and the costs related to global-scale implementation of patient-centered follow-up. To achieve the ambitious goal of TB elimination, a radical change in TB treatment is needed in order to give a more comprehensive approach based both on patients’ peculiarities and driven by drug susceptibility tests and whole-genome sequencing.Keywords: tuberculosis, drug-resistance, treatment, tailored, StopTB
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- 2020
4. Intracameral cefuroxime in combined pars plana vitrectomy and phacoemulsification: a study of safety
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Besozzi G, Di Salvatore A, Cardillo D, Finzi A, Pinackatt JS, Baldi A, Monfardini A, Forioli V, Frisina R, and Parolini B
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Antibiotics retinal toxicity Cefuroxime Combined surgery Endophthalmitis prevention Intracameral cefuroxime Pars plana vitrectomy Phacoemulsification ,Ophthalmology ,RE1-994 - Abstract
Gianluca Besozzi,1 Attilio Di Salvatore,2 Daniele Cardillo,2 Alessandro Finzi,2 Joseph Sajish Pinackatt,2 Andrea Baldi,2 Alessandro Monfardini,2 Valeria Forioli,2 Rino Frisina,3 Barbara Parolini2 1Department of Ophthalmology, Vito Fazzi Hospital, Lecce, Italy; 2Department of Ophthalmology, Sant’Anna Clinical Institute, Brescia, Italy; 3Department of Ophthalmology, Padova University Hospital, Padova, Italy Background: Postoperative endophthalmitis is a severe complication after intraocular surgery. The aim of this pilot study was to investigate the safety of intracameral cefuroxime in combined vitrectomy and phacoemulsification for cataract and various vitreoretinal disease.Methods: The charts of 152 patients who underwent combined phacoemulsification, intraocular lens implant and pars plana vitrectomy were reviewed. The final tamponade was chosen among fluid, air, gas or silicone oil, based on the requirement of each single case. Patients were operated on by four different surgeons. At the end of surgery, 1 mg/0.1 mL of intracameral cefuroxime (Aprokam) was administered.Results: The mean follow-up was 6.26±7.78 months (range 1–12). No retinal complication, such as retinal infarction or hemorrhages were observed. No acute macular serous detachment and no new intraretinal cysts were noted, in those patients who received optical coherence tomography within the fifth day after surgery. No endophthalmitis was recorded.Conclusion: Intracameral cefuroxime, at the end of combined phacoemulsification and pars plana vitrectomy, is safe as it has no toxicity on the retina and maybe could be considered effective in endophthalmitis prevention. Due to the relatively small number of patients, further studies are advisable.Summary statement: The standard dose of intracameral cefuroxime at the end of combined phacoemulsification and pars plana vitrectomy has no toxic effects on the retina. This paper/The abstract of this paper was presented at the European Vitreo Retinal Society Conference 2017 as a conference talk with interim findings. The poster’s abstract was not published. Keywords: antibiotics retinal toxicity, cefuroxime, combined surgery, endophthalmitis prevention, intracameral cefuroxime, pars plana vitrectomy, phacoemulsification
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- 2018
5. Microbiological Confirmation of Tuberculosis Cases at Diagnosis and at the End of Treatment in Italy
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Migliori, G. B., Ambrosetti, M., Besozzi, G., Farris, B., Nutini, S., Saini, L., Confalonieri, M., Bugiani, M., and Codecasa, L. R.
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- 2000
6. How to improve TB outpatient service in a TB low-endemic country during SARS-CoV-2 pandemic
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Riccardi, N., Rodari, P., Duranti, S., Villa, S., Assante, L. R., Castellotti, P., Ferrarese, M., Martini, M., Zuppini, T., Tessari, R., Calza, C., Codecasa, L., Besozzi, G., and Angheben, A.
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Ethics ,TB-care ,SARS-CoV-2 ,Antitubercular Agents ,COVID-19 ,Italy ,Medical ethics ,Outpatient care ,Tuberculosis ,Ambulatory Care ,Ethics, Medical ,Humans ,Outpatient Clinics, Hospital ,Pandemics ,Telemedicine ,Hospital ,Medical ,Outpatient Clinics ,Research Article - Abstract
Summary Despite notable progresses in the recent decades, tuberculosis (TB) continues to remain a public health concern even in Europe. TB prevention and care should be people-centred, improving ambulatory models across countries, in order to expand access to diagnosis and treatment for both TB infection and disease. Even more, during emergencies such as the current pandemic, when seeking of TB care has been replaced by the fear of coronavirus disease 2019 (COVID-19), TB patient’s care is fundamental. In this short communication, we document how was possible to implement a TB outpatient service meanwhile a local outbreak of SARS-CoV-2 transmission was ongoing.
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- 2021
7. Tuberculosis: an ancient disease that remains a medical, social, economical and ethical issue
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Martini, M., Riccardi, N., Giacomelli, A., Gazzaniga, V., and Besozzi, G.
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Population Density ,Ethics ,History ,Social Determinants of Health ,Malnutrition ,Urbanization ,History, 19th Century ,Hygiene ,Disease of poverty ,History, 20th Century ,History, 18th Century ,Risk Factors ,disease of poverty ,ethics ,history ,tuberculosis ,BCG Vaccine ,Humans ,Tuberculosis ,Tuberculosis Vaccines ,Poverty ,History, 15th Century ,Research Article - Abstract
Journal of Preventive Medicine and Hygiene, Vol. 61 No. 1s1 (2020): Tuberculosis. The Never Ending Story: past, present and Future Challeng (Parte I)
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- 2020
8. An international collaborative evaluation of central serous chorioretinopathy: different therapeutic approaches and review of literature. The European Vitreoretinal Society central serous chorioretinopathy study
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Romano, M. R., Parolini, B., Allegrini, D., Mickalewska, Z., Adelman, R., Bonovas, S., Bopp, S., Citirik, M., Tekin, K., Fiser, I., Boon, C. J. F., Van, D., Donvito, G., Gungel, H., Ozdogan Erkul, S., Unsal, E., Osmanbasoglu, O., Dincer, N., Ercalik, N. Y., Yenerel, N. M., Amar, J. -P., Ennemoser, A., Besozzi, G., Sallam, A. A. B., Ellabban, A. A., Chang, W., Eandi, C. M., Demir, M., Lee, J., Pak, K., Arrevola, L., Sloka, A., Morawski, K., Kulig - Stochmal, A., Romanowska - Dixon, B., Striebe, N. -A., Feltgen, N., Hoerauf, H., Inan, U. U., Tanev, I., Dyrda, A., Schuler, A., Lucke, K., Brix, A., Pape, S., Kusserow-Napp, C., Loo, P. A., Kanra, A. Y., Ardagil Akcakaya, A., Ari Yaylali, S., Bae, S. H., Kim, H. K., Kim, S. J., Han, J. R., Nam, W. H., Odrobina, D., Lavaque, E., Bertelli, E., Coser, S., Ziemssen, F., Forlini, M., Benatti, C., Cavallini, G. M., Stefanickova, J., Berrod, J. -P., Saksonov, S., Lytvinchuk, L., Moussa, M., Stefaniotou, M., Christodoulou, E., Zayed, M. A., Oz, O., Tassinari, P., Koch, P., Declercq, C., Johnston, R., Rusnak, S., Penas, S., Ozdek, S., Ucgul, Y., Cisiecki, S., Dziegielewski, K., Klimczak, D., Michalewska, Z., Michalewski, J., Nawrocka, Z., Nawrocki, J., Ornafel, K., Pikulski, Z., Maciej, M., Acar, N., Elshafei, M. M., Hamon, F., Soyeur, R., Badat, I., Brousseau, B., Hermouet, E., Peiretti, E., Lee, J. -H., Ferreira, N., Yoon, H. -S., Alkhars, W. I., Dudani, A., Minu, R., Telang, O., Morepatil, V. G., Furtado, M. J., Y. -J., Jo, Piccolino, F. C., Finzi, A., Ophthalmology, and Amsterdam Neuroscience - Complex Trait Genetics
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Pars plana ,medicine.medical_specialty ,Visual acuity ,medicine.medical_treatment ,Vitrectomy ,03 medical and health sciences ,0302 clinical medicine ,PDT ,Ophthalmology ,medicine ,central serous chorioretinopathy ,First episode ,Aspirin ,Univariate analysis ,medicine.diagnostic_test ,business.industry ,General Medicine ,Fluorescein angiography ,eye diseases ,laser ,Serous fluid ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,medicine.symptom ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose: To study and compare the efficacy of different therapeutic options for the treatment of central serous chorioretinopathy (CSCR). Methods: This is a nonrandomized, international multicentre study on 1719 patients (1861 eyes) diagnosed with CSCR, from 63 centres (24 countries). Reported data included different methods of treatment and both results of diagnostic examinations [fluorescein angiography and/or optical coherent tomography (OCT)] and best-corrected visual acuity (BCVA) before and after therapy. The duration of observation had a mean of 11 months but was extended in a minority of cases up to 7 years. The aim of this study is to evaluate the efficacy of the different therapeutic options of CSCR in terms of both visual (BCVA) and anatomic (OCT) improvement. Results: One thousand seven hundred nineteen patients (1861 eyes) diagnosed with CSCR were included. Treatments performed were nonsteroidal anti-inflammatory eye drops, laser photocoagulation, micropulse diode laser photocoagulation, photodynamic therapy (PDT; Standard PDT, Reduced-dose PDT, Reduced-fluence PDT), intravitreal (IVT) antivascular endothelial growth factor injection (VEGF), observation and other treatments. The list of the OTHERS included both combinations of the main proposed treatments or a variety of other treatments such as eplerenone, spironolactone, acetazolamide, beta-blockers, anti-anxiety drugs, aspirin, folic acid, methotrexate, statins, vitis vinifera extract medication and pars plana vitrectomy. The majority of the patients were men with a prevalence of 77%. The odds ratio (OR) showed a partial or complete resolution of fluid on OCT with any treatment as compared with observation. In univariate analysis, the anatomical result (improvement in subretinal fluid using OCT at 1 month) was favoured by age 500 μm (p = 0.03). The OR for obtaining partial or complete resolution showed that anti-VEGF and eyedrops were not statistically significant; whereas PDT (8.5), thermal laser (11.3) and micropulse laser (8.9) lead to better anatomical results with less variability. In univariate analysis, the functional result at 1 month was favoured by first episode (p = 0.04), height of subretinal fluid >500 μm (p
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- 2019
9. The evolution of a neglected disease: tuberculosis discoveries in the centuries
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RICCARDI, N., CANETTI, D., MARTINI, M., DIAW, M.M., DI BIAGIO, A., CODECASA, L., BARBERIS, I., BRAGAZZI, N.L., and BESOZZI, G.
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History ,Infectious disease ,Neglected Diseases ,History, 19th Century ,Mycobacterium tuberculosis ,History, 20th Century ,History, 18th Century ,humanities ,History, Medieval ,History, 17th Century ,Risk Factors ,Humans ,Tuberculosis ,Phthisis ,History, Ancient ,Research Article - Abstract
Summary Tuberculosis (TB) and humans have coexisted for more than 40,000 years. The word “tuberculosis” derives from “tubercle”, the histological lesion which appears in the organs, described by Pott in the late Eighteenth century and found, by molecular biology, in human skeletons dating back to 5000 BC. Early description of TB can be found in the writings of ancient India and China and in the Bible. In ancient Greece tuberculosis was not considered contagious, but Aristotle recognized the contagious nature of the pig’s and ox’s scrofula. The suspicion that phthisis is a contagious disease and that isolation can reduce the risk of transmission was expressed for the first time by the Arabian Avicenna, in his work “The canon of medicine”. In 1699, the Health Council of the Republic of Lucca founded the “sanatorium” concept as place of care and isolation. In 1865 Villemain inoculated tubercular material from a human lymph node into a rabbit, obtaining for the first time the typical tubercular lesions. Some years later, on March 24, 1882, Robert Koch announced to the Berlin Society of Physiology the discovery of Mycobacterium tuberculosis. In the same period Virchow improved awareness of risk factors and correct behaviours among the general population. In 1952 Waksman won the Nobel Prize for the discovery of the first active drug against TB: streptomycin. Nevertheless, drug resistance appeared rapidly some years later and it is still a great challenge in TB fight nowadays.
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- 2019
10. Three-port lens-sparing vitrectomy for aggressive posterior retinopathy of prematurity: Early surgery before tractional retinal detachment appearance
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FERRARI, T. MICELLI, FURINO, C., LORUSSO, V. V., DAMMACCO, R., SBORGIA, G., SBORGIA, L., and BESOZZI, G.
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- 2007
11. Intravitreal triamcinolone acetonide: Valuation of retinal thickness changes measured by optical coherence tomography in diffuse diabetic macular edema
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FERRARI, MICELLI T., SBORGIA, L., FURINO, C., CARDASCIA, N., FERRERI, P., BESOZZI, G., and SBORGIA, C.
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- 2004
12. Circulating, Mycobacterium tuberculosis-specific lymphocytes from PPD skin test-negative patients with tuberculosis do not secrete interferon-gamma (IFN-γ) and lack the cutaneous lymphocyte antigen skin-selective homing receptor
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MAGNANI, Z. I., CONFETTI, C., BESOZZI, G., CODECASA, L. R., PANINA-BORDIGNON, P., LANG, R., ROSSI, G. A., PARDI, R., and BURASTERO, S. E.
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- 2000
13. The Italian registry of pulmonary non-tuberculous mycobacteria - IRENE: The study protocol
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Aliberti, S., Codecasa, L. R., Gori, A., Sotgiu, G., Spotti, M., Di Biagio, A., Calcagno, A., Nardini, S., Assael, B. M., Tortoli, E., Besozzi, G., Ferrarese, M., Matteelli, A., Girardi, E., De Lorenzo, S., Seia, M., Gramegna, A., Del Prato, B., Terranova, L., Oriano, M., Sverzellati, N., Mirsaeidi, M., Chalmers, J. D., Haworth, C. S., Loebinger, M. R., Aksamit, T., Winthrop, K., Ringshausen, F. C., Previdi, G., Blasi, F., Fusetti, G., Martorana, M., Colella, G., Verga, G., Carbone, G., Damilano, I., Nava, F., Pancini, L., Pasat, A., and Vanoni, N.
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,M. Avium ,Atypical mycobacteria ,Bronchiectasis ,COPD ,Cystic fibrosis ,HIV ,Lung transplant ,M. Intracellulare ,NTM, NTM-PD ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Original Research Article ,030212 general & internal medicine ,Case report form ,lcsh:RC705-779 ,business.industry ,lcsh:Diseases of the respiratory system ,bacterial infections and mycoses ,medicine.disease ,Biobank ,030228 respiratory system ,Infectious disease (medical specialty) ,Emergency medicine ,NTM-PD ,Observational study ,NTM ,business ,Cohort study - Abstract
Background A substantial increase in pulmonary and extra-pulmonary diseases due to non-tuberculous mycobacteria (NTM) has been documented worldwide, especially among subjects suffering from chronic respiratory diseases and immunocompromised patients. Many questions remain regarding the epidemiology of pulmonary disease due to NTM (NTM-PD) mainly because reporting of NTM-PD to health authorities is not mandated in several countries, including Italy. This manuscript describes the protocol of the first Italian registry of adult patients with respiratory infections caused by NTM (IRENE). Methods IRENE is an observational, multicenter, prospective, cohort study enrolling consecutive adult patients with either a NTM respiratory isolate or those with NTM-PD. A total of 41 centers, including mainly pulmonary and infectious disease departments, joined the registry so far. Adult patients with all of the following are included in the registry: 1) at least one positive culture for any NTM species from any respiratory sample; 2) at least one positive culture for NTM isolated in the year prior the enrolment and/or prescribed NTM treatment in the year prior the enrolment; 3) given consent to inclusion in the study. No exclusion criteria are applied to the study. Patients are managed according to standard operating procedures implemented in each IRENE clinical center. An online case report form has been developed to collect patients’ demographics, comorbidities, microbiological, laboratory, functional, radiological, clinical, treatment and outcome data at baseline and on an annual basis. An IRENE biobank has also been developed within the network and linked to the clinical data of the registry. Conclusions IRENE has been developed to inform the clinical and scientific community on the current management of adult patients with NTM respiratory infections in Italy and acts as a national network to increase the disease’s awareness. Trial registration Clinicaltrial.gov: NCT03339063.
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- 2018
14. Resistance to second-line injectables and treatment outcomes in multidrug-resistant and extensively drug-resistant tuberculosis cases
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Migliori, G. B., Lange, C., Centis, R., Sotgiu, G., Mutterlein, R., Hoffmann, H., Kliiman, K., De Iaco, G., Lauria, F. N., Richardson, M. D., Spanevello, A., Cirillo, D. M., Ortmann, J., Kirsten, D., Ruesch Gerdes, S., Piana, F., Gori, A., Codecasa, L. R., Ferrarese, M., Toungoussova, O. S., Ferrara, Giovanni, Matteelli, A., De Lorenzo, S., Troupioti, P., Besozzi, G., Fattorini, L., Iona, E., Gualano, A., De Mori, P., Bevilacqua, N., Girardi, E., Danilovits, M., Hollo, V., and Mariandyshev, A.
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Estonia ,Pulmonary and Respiratory Medicine ,Drug ,medicine.medical_specialty ,Tuberculosis ,Settore MED/17 - Malattie Infettive ,Capreomycin ,FLUOROQUINOLONES ,Extensively Drug-Resistant Tuberculosis ,media_common.quotation_subject ,Drug Resistance ,Antitubercular Agents ,Drug resistance ,Injections ,Russia ,Mycobacterium tuberculosis ,Multidrug-resistant tuberculosis ,Drug Resistance, Multiple, Bacterial ,Germany ,Internal medicine ,tuberculosis MYCOBACTERIUM-TUBERCULOSIS ,Humans ,Medicine ,Registries ,Treatment Failure ,XDR-TB ,media_common ,biology ,business.industry ,Bacterial ,Extensively drug-resistant tuberculosis ,Odds ratio ,biology.organism_classification ,medicine.disease ,Survival Analysis ,Injectable second-line drugs ,Injections, Intravenous ,Italy ,Surgery ,Multiple drug resistance ,drug resistance, extensively drug-resistant tuberculosis, injectable second-line drugs, multidrug-resistant tuberculosis, tuberculosis MYCOBACTERIUM-TUBERCULOSIS, XDR-TB, FLUOROQUINOLONES ,Intravenous ,business ,Multiple ,medicine.drug - Abstract
No information is currently available on the influence of injectable second-line drugs on treatment outcomes of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) patients. To investigate this issue, a large series of MDR- and XDR-TB cases diagnosed in Estonia, Germany, Italy and the Russian Federation (Archangels Oblast) between 1999 and 2006 were analysed. All study sites performed drug susceptibility testing for first- and second-line anti-TB drugs, laboratory quality assurance and treatment delivery according to World Health Organization recommendations. Out of 4,583 culture-confirmed cases, 240 MDR- and 48 XDR-TB cases had a definitive outcome recorded (treatment success, death, failure). Among MDR- and XDR-TB cases, capreomycin resistance yielded a higher proportion of failure and death than capreomycin-susceptible cases. Resistance to capreomycin was independently associated with unfavourable outcome (logistic regression analysis: odds ratio 3.51). In the treatment of patients with multidrug-resistant and extensively drug-resistant tuberculosis, resistance to the injectable drug capreomycin was an independent predictor for therapy failure in this cohort. As Mycobacterium tuberculosis drug resistance is increasing worldwide, there is an urgent need for novel interventions in the fight against tuberculosis.
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- 2008
15. Monitoring the quality of laboratories and the prevalence of resistance to antituberculosis drugs: Italy, 1998–2000
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Migliori, G. B., Fattorini, L., Vaccarino, R., Besozzi, G., Saltini, C., Orefici, G., Iona, E., Matteelli, A., Fiorentini, F., Codecasa, L. R., Casali, Lucio, Cassone, A., De Santis, A., Giorgio, V., Vinciguerra, P., Angarano, G., Petrozzi, L., Costa, D., Gozzellino, F., Perboni, A., Marchetti, D., Pascali, A., Falcone, F., Mariano, V., Rizza, F., Pretto, P., Turano, A., Carosi, G. P., Farris, A. G., Ligia, G. P., Orani, G., Farris, B., Foschi, C., Trucco, G., Aiolfi, S., Ceruti, T., Parpanesi, M., Calabro, S., Felisatti, G., Tortoli, E., Nutini, S., Montini, G., D'Ambrosio, V., Ceraminiello, A., Bernorio, S., Buono, L., Montesano, P., Vinci, E., Sabato, E., Gamba, S., Crepaldi, P., Magliano, E., Penati, V., Vaccarino, P., Astolfi, A., Bertoli, G., Rupianesi, F., Losi, M., Richeldi, L., Ferrara, Giovanni, Minuccio, E., Napolitano, G., Molinari, G. L., Saini, L., Garzone, A., Vertuccio, C., Marcias, S., Menozzi, M., Marone, P., Peona, V., Nascimbene, C., Pasi, A., Cascina, A., Monaco, A., Penza, O., Pasticci, Maria Bruna, Bistoni, F., Sposini, T., Colorizio, V., Confalonieri, M., Bottrighi, P., Macor, G., Moretti, G., Fatigante, R., Barbaro, A., Agati, G., Zaccara, F., Viola, S., Le Donne, R., Farinelli, G., Mancini, D., Ermeti, M., Longi, R., Tronci, M., Bisetti, A., Altieri, A., and Fadda, G.
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Tuberculosis ,Prevalence of resistance ,Drug Resistance ,Antitubercular Agents ,Drug resistance ,Proficiency testing ,Drug ,Immigrant ,Susceptibility testing ,Emigration and Immigration ,Humans ,Italy ,Laboratories ,Prevalence ,Drug Resistance, Multiple, Bacterial ,Tuberculosis, Multidrug-Resistant ,Internal medicine ,medicine ,Ethambutol ,business.industry ,Public health ,Isoniazid ,Bacterial ,Multidrug-Resistant ,medicine.disease ,Surgery ,Streptomycin ,business ,Multiple ,Rifampicin ,medicine.drug - Abstract
In 1998 a network of 20 regional tuberculosis (TB) laboratories (the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) network) was established in Italy to implement proficiency testing and to monitor the prevalence of drug resistance nationwide. The network managed 30% of all TB cases reported in Italy each year. The aim of the present report is to describe: 1) the accuracy of drug-susceptibility testing in the network; 2) the prevalence of drug resistance for the period 1998-2000. Data were collected from the network laboratories. Sensitivity to streptomycin and ethambutol increased from the first survey (1998-1999) to the second survey (2000) from 87.7 to 91.9%. Specificity, predictive values for resistance and susceptibility, efficiency and reproducibility were consistent in both surveys. In previously untreated cases, the prevalence of multidrug-resistance was the same in both surveys (1.2%), while a slight decrease from the first to the second survey was observed for monoresistance to rifampicin (from 0.8 to 0.4%) and isoniazid (from 2.9 to 2%). The significant association found between isoniazid resistance and immigration is a useful indicator for both clinicians managing individual tuberculosis cases and public health services planning control strategies.
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- 2003
16. Cost-comparison of different management policies for tuberculosis patients in Italy
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Migliori, G.B., Ambrosetti, M., Besozzi, G., Farris, B., Nutini, S., Saini, L., Casali, L., Nardini, S., Bugiani, M., Neri, M., and Raviglioni, M.C.
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Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$ 186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$ 2.50 to US$ 11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$ 16 703 in scenario 1 and US$ 5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$ 1407 (scenario 1, smear-negative and extrapulmonary cases) to US$ 1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$ 1800 to US$ 4200. The possible savings at the national level were in the order of US$ 50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation., Introduction The competition of health programmes for limited economic resources within national health systems has spawned an abundance of studies on economic evaluation in health care. Economic evaluation is the [...]
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- 1999
17. Il punto di vista del tisiologo e del filosofo sul futuro della Tisiologia
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Emanuele, Pietro, Rossitto, S., and Besozzi, G.
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- 2014
18. New diagnostic tests for diagnosis of tuberculosis latent infection. Documento sull'utilizzo dei nuovi test immunologici per la diagnosi di infezione tubercolare latente
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Fiorentini, F, Bugiani, M, Besozzi, G, Casali, L, Codecasa, LR, Saltini, C, Richeldi, L, Ferrara, G, Piersimoni, C., BOCCHINO, MARIALUISA, Fiorentini, F, Bugiani, M, Besozzi, G, Casali, L, Codecasa, Lr, Saltini, C, Richeldi, L, Ferrara, G, Bocchino, Marialuisa, and Piersimoni, C.
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- 2007
19. Surveillance of anti-tuberculosis drug resistance: Results of the 1998/1999 proficiency testing in Italy
- Author
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Migliori GB, Ambrosetti M, Fattorini L, Penati V, Vaccarino P, Besozzi G, Ortona L, Saltini C, Orefici G, Moro ML, Iona E, Cassone A, De Santis A, Giorgio V, Vinciguerra P, Angarano G, Petrozzi L, Costa D, Gozzellino F, Perboni A, Marchetti D, Pascali A, Falcone F, Mariano V, Rizza F, Pretto P, Turano A, Matteelli A, Carosi GP, Tedoldi S, Pinsi G, Farris AG, Ligia GP, Orani G, Farris B, Foschi C, Trucco G, Aiolfi S, Ceruti T, Parpanesi M, Calabro S, Felisatti G, Tortoli E, Nutini S, Montini G, Fiorentini F, D'Ambrosio V, Ceraminiello A, Bernorio S, Buono L, Montesano P, Vinci E, Sabato E, Gamba S, Crepaldi P, Bertoli G, Rupianesi F, Losi M, Richeldi L, Ferrara G, Muccio E, Napolitano G, Molinari GL, Saini L, Garzone A, Vertuccio C, Marcias, Menozzi, Marone P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M.B., Bistoni, Sposini, Colorizio, Confalonieri M, Bottrighi P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Le Donne, Farinelli, Mancini, Ermeti, Migliori, Gb, Ambrosetti, M, Fattorini, L, Penati, V, Vaccarino, P, Besozzi, G, Ortona, L, Saltini, C, Orefici, G, Moro, Ml, Iona, E, Cassone, A, De Santis, A, Giorgio, V, Vinciguerra, P, Angarano, G, Petrozzi, L, Costa, D, Gozzellino, F, Perboni, A, Marchetti, D, Pascali, A, Falcone, F, Mariano, V, Rizza, F, Pretto, P, Turano, A, Matteelli, A, Carosi, Gp, Tedoldi, S, Pinsi, G, Farris, Ag, Ligia, Gp, Orani, G, Farris, B, Foschi, C, Trucco, G, Aiolfi, S, Ceruti, T, Parpanesi, M, Calabro, S, Felisatti, G, Tortoli, E, Nutini, S, Montini, G, Fiorentini, F, D'Ambrosio, V, Ceraminiello, A, Bernorio, S, Buono, L, Montesano, P, Vinci, E, Sabato, E, Gamba, S, Crepaldi, P, Bertoli, G, Rupianesi, F, Losi, M, Richeldi, L, Ferrara, G, Muccio, E, Napolitano, G, Molinari, Gl, Saini, L, Garzone, A, Vertuccio, C, Marcias, Menozzi, Marone, P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M., B., Bistoni, Sposini, Colorizio, Confalonieri, M, Bottrighi, P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Le, Donne, Farinelli, Mancini, and Ermeti
- Subjects
Tuberculosi ,Drug susceptibility testing ,Proficiency testing - Published
- 2000
20. PDT LOW DOSE, LOW FLUENCE RATE FOR CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
- Author
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Boscia, F, Reibaldi, M, Besozzi, G, Cardascia, N, Furino, C, Faro, S, Uva, Maurizio Giacinto, Sborgia, G, Reibaldi, A, and Sborgia, C.
- Published
- 2010
21. PDT Low-Dose, Low-Fluence Rate for Chronic Central Serous Chorioretinopathy
- Author
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Boscia, F., Reibaldi, Michele, Besozzi, G., Cardascia, N., Furino, C., Faro, S., Uva, Maurizio Giacinto, Sborgia, G., Reibaldi, A., and Sborgia, AND C.
- Published
- 2010
22. A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis
- Author
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Migliori, G. B., Eker, B., Richardson, M. D., Sotgiu, G., Zellweger, J. P., Skrahina, A., Ortmann, J., Girardi, E., Hoffmann, H., Besozzi, G., Bevilacqua, N., Kirsten, D., Centis, R., Lange, C., Hurevich, H, Skrahin, A, Muetterlein, R, Schaberg, T, Eberhardt, R, Flick, H, de Roux, A, Hamm, M, Hang, H, Hannemann, P, Hillemann, D, Kretz, B, Laumanns, C, Paulick, A, Pletz, Mw, Rau, M, Schaudt, C, Matteelli, A, Spanevello, Antonio, Toungoussova, O, D'Ambrosio, L, De Lorenzo, S, Troupioti, P, De Iaco, G, Gualano, A, De Mori, P, Lauria, Fn, Ferrara, G, Cirillo, D, and Janssens, J. P.
- Subjects
Pulmonary and Respiratory Medicine ,Male ,safety ,medicine.medical_specialty ,Efficacy ,Antitubercular Agents ,Drug resistance ,linezolid ,Cohort Studies ,chemistry.chemical_compound ,Anti-Infective Agents ,Internal medicine ,Acetamides ,Drug Resistance, Bacterial ,Tuberculosis, Multidrug-Resistant ,Odds Ratio ,Medicine ,Humans ,extensively drug-resistant tuberculosis ,Efficacy, extensively drug-resistant tuberculosis, linezolid, multidrug-resistant tuberculosis, safety, tolerability ,Dosing ,tolerability ,Oxazolidinones ,Antibacterial agent ,Retrospective Studies ,business.industry ,Extensively drug-resistant tuberculosis ,medicine.disease ,multidrug-resistant tuberculosis ,Surgery ,Discontinuation ,Europe ,Regimen ,Treatment Outcome ,Tolerability ,chemistry ,Linezolid ,Regression Analysis ,Female ,business - Abstract
Linezolid is used to treat patients with multidrug-resistant (MDR)/extensively drug-resistant (XDR)-tuberculosis (TB) cases, although clinical data on its safety, tolerability and efficacy are lacking. We performed a retrospective, nonrandomised, unblinded observational study evaluating the safety and tolerability of linezolid at 600 mg q.d. or b.i.d. in MDR/XDR-TB treatment in four European countries. Efficacy evaluation compared end-points of 45 linezolid-treated against 110 linezolid-nontreated cases. Out of 195 MDR/XDR-TB patients, 85 were treated with linezolid for a mean of 221 days. Of these, 35 (41.2%) out of 85 experienced major side-effects attributed to linezolid (anaemia, thrombocytopenia and/or polyneuropathy), requiring discontinuation in 27 (77%) cases. Most side-effects occurred after 60 days of treatment. Twice-daily administration produced more major side-effects than once-daily dosing (p = 0.0004), with no difference in efficacy found. Outcomes were similar in patients treated with/without linezolid (p = 0.8), although linezolid-treated cases had more first-line (p = 0.002) and second-line (p = 0.02) drug resistance and a higher number of previous treatment regimens (4.5 versus 2.3; p = 0.07). Linezolid 600 mg q.d. added to an individualised multidrug regimen may improve the chance of bacteriological conversion, providing a better chance of treatment success in only the most complicated MDR/XDR-TB cases. Its safety profile does not warrant use in cases for which there are other, safer, alternatives.
- Published
- 2009
23. Extensively drug-resistant tuberculosis is worse than multidrug-resistant tuberculosis: different methodology and settings, same results
- Author
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Migliori, G. B., Lange, C., Girardi, E., Centis, R., Besozzi, G., Kliiman, K., Ortmann, J., Matteelli, A., Spanevello, A., Cirillo, D. M., Kirsten, D., Codecasa, L. R., Gori, A., De Lorenzo, S., Troupioti, P., De Iaco, G., Gualano, G., De Mori, P., Fattorini, L., Iona, E., Ferrara, G., Sotgiu, G., Danilovits, M., Hollo, V., Mariandyshev, A., and Toungoussova, O.
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,Tuberculosis ,Extensively Drug-Resistant Tuberculosis ,Treatment outcome ,MEDLINE ,Antitubercular Agents ,Drug Resistance ,Drug resistance ,Microbial Sensitivity Tests ,Treatment failure ,Mycobacterium tuberculosis ,Internal medicine ,medicine ,Humans ,Treatment Failure ,biology ,business.industry ,Bacterial ,Extensively drug-resistant tuberculosis ,Multidrug-Resistant ,medicine.disease ,biology.organism_classification ,Multiple drug resistance ,Infectious Diseases ,Treatment Outcome ,Regression Analysis ,Drug Resistance, Multiple, Bacterial ,Tuberculosis, Multidrug-Resistant ,business ,Multiple - Published
- 2008
24. Extensively drug-resistant tuberculosis, Italy and Germany
- Author
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Migliori, G. B., Ortmann, J., Girardi, E., Besozzi, G., Lange, C., Cirillo, D. M., Ferrarese, M., De Iaco, G., Gori, A., Raviglione, M. C., Kirsten, D., Ruesch Gerdes, S., Piana, F., Codecasa, L. R., Lacchini, C., Matteelli, A., De Lorenzo, S., Troupioti, P., Gualano, G., De Mori, P., Fattorini, L., Iona, E., Ferrara, Giovanni, and Centis, R.
- Subjects
Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,Epidemiology ,Extensively Drug-Resistant Tuberculosis ,letter ,lcsh:Medicine ,Emigrants and Immigrants ,HIV Infections ,Drug resistance ,lcsh:Infectious and parasitic diseases ,Germany ,Culture conversion ,medicine ,Infection control ,Humans ,lcsh:RC109-216 ,Letters to the Editor ,drug resistance ,business.industry ,Mortality rate ,Incidence (epidemiology) ,lcsh:R ,Extensively drug-resistant tuberculosis ,medicine.disease ,multidrug-resistant tuberculosis ,Infectious Diseases ,Italy ,Sputum ,medicine.symptom ,business - Abstract
To the Editor: Twenty-three countries have reported >1 case of extensively drug-resistant tuberculosis (XDR TB) (1); however, information about XDR TB is still incomplete. In particular, the response of XDR TB to treatment in countries with low incidence is not known. We compared mortality rates from XDR TB with those from multidrug-resistant (MDR) TB. We analyzed data from all culture-confirmed TB cases diagnosed during 2003–2006 by the TB clinical reference centers in Italy (Sondalo, Milan, Rome) and Germany (Borstel, Grosshansdorf, Bad-Lippspringe) and reviewed original clinical records. Drug susceptibility testing for first- and second-line anti-TB drugs was performed according to World Health Organization (WHO) recommendations by quality-assured laboratories and retested at WHO Supranational Reference Laboratories (Rome/Milan; Borstel) (2–4). XDR TB was defined as resistance to at least rifampin and isoniazid (MDR TB definition) in addition to any fluoroquinolone and >1 of 3 injectable anti-TB drugs (capreomycin, kanamycin, amikacin) (3). Characteristics of MDR TB and XDR TB cases were compared by χ2 test (categorical variables), Student t test (admission days), and Kaplan-Maier curve (sputum smear, culture conversion), where appropriate. Of 2,888 culture-positive TB cases analyzed (Italy 2,140, Germany 748), 126 (4.4%) were MDR (Italy 83, Germany 43) and 11 (0.4%) were XDR (Italy 8, Germany 3). We estimate that the TB cases analyzed represent 24% of culture-positive cases reported in Italy (69.7% of MDR) and 4.2% of those reported in Germany (12.6% of MDR). XDR TB was diagnosed in each year of the study. All 11 XDR TB patients were receiving retreatment, and of the 126 MDR TB patients, 74 (58.7%) were receiving retreatment. All XDR TB patients were HIV seronegative; and of 109 MDR TB patients tested for HIV, 10 (9.2%) were HIV seropositive. Details about previous treatment regimens, drug resistance, and duration of treatment of XDR TB patients are summarized in the Appendix Table. XDR TB patients were significantly more likely than MDR TB patients to be resistant to all first-line drugs (8/11 vs. 36/126, p
- Published
- 2007
25. Ripped from the headlines: how can we harness communications to control TB?
- Author
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Migliori, G. B., Cirillo, D. M., Spanevello, A., Codecasa, L. R., Murabito, L., Besozzi, G., Bugiani, M., Gori, A., Matteelli, A., Toungossova, O., D'Arcy Richardson, M., De Iaco, G., and Centis, R.
- Subjects
Pulmonary and Respiratory Medicine ,Economic growth ,Health Knowledge, Attitudes, Practice ,Tuberculosis ,Communicable Disease Control ,Disease Outbreaks ,Global Health ,Humans ,Incidence ,Tuberculosis, Multidrug-Resistant ,Tuberculosis, Pulmonary ,Control (management) ,Human immunodeficiency virus (HIV) ,medicine.disease_cause ,Plague (disease) ,Politics ,Acquired immunodeficiency syndrome (AIDS) ,Global health ,MANAGEMENT ,Medicine ,Market share ,Practice ,business.industry ,Health Knowledge ,Pulmonary ,Multidrug-Resistant ,medicine.disease ,Attitudes ,business - Abstract
Even 125 yrs after Robert Koch discovered the tuberculosis (TB) bacillus and 63 yrs since the discovery of streptomycin, the first anti-TB drug, TB, the “white plague”, still causes ∼9 million incidents of illness and claims >1.6 million lives annually. Yet, little attention has been paid to TB by decision-makers, the media or the general public, contributing to a lack of political will and public action to solve this global health emergency. With the recent rekindling of media and popular interest in the emerging threat of extensively drug-resistant TB (XDR-TB), the health community has a critical opportunity to leverage more coordinated and purposeful communications as an important weapon in the fight against TB. Data gathered through the study described below are a starting point for developing a communications strategy and key messages to strengthen Europe's response to the TB epidemic. TB traditionally receives little media attention; coverage is often limited to large exposures ( e.g. cases in schools and workplaces) and dramatic events, such as the high-mortality XDR-TB outbreak among HIV-positive individuals in South Africa 1. At the start of 2007, Le Iene (the Ienas 2; a popular evening television broadcast with a high market share in Italy) reviewed coverage of various health issues and “discovered” that the media had in the past given priority and much more relevance to hot-button issues, such as severe acute respiratory syndrome, avian flu and HIV/AIDS (without mentioning its association with TB), than to TB. The Ienas journalists charged one of the Italian national television channels with having forgotten TB, with the effect of raising discussion on this previously neglected disease. At around the same time, the European Respiratory Journal published a paper describing the threat of XDR-TB 1. In March 2007, following the publication of a scientific report on 11 XDR-TB cases in Europe (three …
- Published
- 2007
26. Clinical and operational value of the XDR-TB definition
- Author
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Migliori, G., Besozzi, G., Kliiman, K., Lange, C., Toungoussova, O., Ferrara, Giovanni, Cirillo, D., Gori, A., Matteelli, A., Spanevello, A., Codecasa, L., and Raviglione, M.
- Published
- 2007
27. Clinical and operational value of the extensively drug-resistant tuberculosis definition
- Author
-
Migliori, G. B., Besozzi, G., Girardi, E., Kliiman, K., Lange, C., Toungoussova, O. S., Ferrara, G., Cirillo, D. M., Gori, A., Matteelli, A., Spanevello, A., Codecasa, L. R., Raviglione, M. C., Ortmann, J., Kirsten, D., Ruesch-Gerdes, S., Piana, F., Ferrarese, M., De Iaco, G., De Lorenzo, S., Troupioti, P., Fattorini, L., Iona, E., Gualano, A., De Mori, P., Centis, R., Danilovits, M., Hollo, V., and Mariandyshev, A.
- Subjects
Pulmonary and Respiratory Medicine ,Risk ,medicine.medical_specialty ,Tuberculosis ,Time Factors ,medicine.medical_treatment ,Extensively Drug-Resistant Tuberculosis ,Antitubercular Agents ,Drug Resistance ,Drug resistance ,Global Health ,Communicable Diseases ,Russia ,Multidrug-resistant tuberculosis ,Isoniazid ,Medicine ,tuberculosis MYCOBACTERIUM-TUBERCULOSIS ,Humans ,Clinical value ,Extensively drug-resistant tuberculosis ,Drug Resistance, Multiple ,Population Surveillance ,Public Health ,Rifampin ,Treatment Outcome ,Intensive care medicine ,Ethambutol ,business.industry ,Pyrazinamide ,medicine.disease ,Surgery ,clinical value, drug resistance, extensively drug-resistant tuberculosis, multidrug-resistant tuberculosis, tuberculosis MYCOBACTERIUM-TUBERCULOSIS ,Tuberculosis management ,business ,Multiple ,Rifampicin ,medicine.drug - Abstract
Currently, no information is available on the effect of resistance/susceptibility to first-line drugs different from isoniazid and rifampicin in determining the outcome of extensively drug-resistant tuberculosis (XDR-TB) patients, and whether being XDR-TB is a more accurate indicator of poor clinical outcome than being resistant to all first-line anti-tuberculosis (TB) drugs. To investigate this issue, a large series of multidrug-resistant TB (MDR-TB) and XDR-TB cases diagnosed in Estonia, Germany, Italy and the Russian Federation during the period 1999-2006 were analysed. Drug-susceptibility testing for first- and second-line anti-TB drugs, quality assurance and treatment delivery was performed according to World Health Organization recommendations in all study sites. Out of 4,583 culture-positive TB cases analysed, 361 (7.9%) were MDR and 64 (1.4%) were XDR. XDR-TB cases had a relative risk (RR) of 1.58 to have an unfavourable outcome compared with MDR-TB cases resistant to all first-line drugs (isoniazid, rifampicin ethambutol, streptomycin and, when tested, pyrazinamide), and an RR of 2.61 compared with "other" MDR-TB cases (those susceptible to at least one first-line anti-TB drug among ethambutol, pyrazinamide and streptomycin, regardless of resistance to the second-line drugs not defining XDR-TB). The emergence of extensively drug-resistant tuberculosis confirms that problems in tuberculosis management are still present in Europe. While waiting for new tools which will facilitate management of extensively drug-resistant tuberculosis, accessibility to quality diagnostic and treatment services should be urgently ensured and adequate public health policies should be rapidly implemented to prevent further development of drug resistance.
- Published
- 2007
28. Management of multidrug-resistant tuberculosis in Italy
- Author
-
Ferrara G, Richeldi L, Bugiani M, Cirillo D, Besozzi G, Nutini S, Casali L, Fiorentini F, luigi codecasa, and Gb, Migliori
- Subjects
Adult ,Male ,Emigration and Immigration ,Middle Aged ,Logistic Models ,Treatment Outcome ,tuberculosis ,MDR ,management ,Italy ,Risk Factors ,Multivariate Analysis ,Tuberculosis, Multidrug-Resistant ,Humans ,Female ,Tuberculosis, Pulmonary - Abstract
SMIRA (Italian Study on Anti-Tuberculosis Drug Resistance) network, 46 major clinical units and 22 laboratories nationwide in Italy.To determine the main features, adherence to WHO guidelines and the outcomes of multidrug-resistant tuberculosis (MDR-TB) patients enrolled from January 1995 to December 1999.Observational study, preceded by proficiency testing, according to WHO recommendations. Results were stratified by appropriate and inappropriate regimens (three active drugs). Analysis of the outcomes was performed according to adequacy of treatment. Analysis of risk factors and factors predicting treatment outcomes was performed using univariate and multivariate analysis (level of significance P0.05).One hundred and twenty-seven MDR patients were diagnosed. The overall success rate was low (39%). Seventy per cent of cases were treated with at least three active drugs. Factors predicting treatment success were new MDR-TB cases (OR 3.45; 95% CI 1.22-9.78; P0.05) and treatment foror = 12 months (OR 5.03; 95% CI 1.65-15. 31; P0.05). Immigration and HIV infection were the main risk factors among new MDR-TB cases.The best available treatment should be provided to all newly diagnosed MDR-TB patients, avoiding the use of poorly modified regimens. MDR-TB patients should be referred to highly specialised centres.
- Published
- 2005
29. Mas alla de la hiperactividad: Un detallado analisis retrospectivo de 30 casos estudiados en la Clinica de Psicologia de la Universidad de Lausanne
- Author
-
Gaillard, F., Quartier, V., and Besozzi, G.
- Published
- 2004
30. Monitoring the quality of laboratories and the prevalence of resistance to antituberculosis drugs: Italy, 1998-2000
- Author
-
Migliori, G, Centis, R, Fattorini, L, Besozzi, G, Saltini, C, Orefici, G, Piersimoni, C, Gori, A, and Cassone, A
- Subjects
proficiency testing ,GROWTH INDICATOR TUBE ,MYCOBACTERIUM-TUBERCULOSIS ,SUSCEPTIBILITY ,SURVEILLANCE ,RECOVERY ,Settore MED/10 - Malattie dell'Apparato Respiratorio ,drug ,immigrant ,susceptibility testing ,prevalence of resistance ,tuberculosis - Published
- 2003
31. Prevalence of resistance to anti-tuberculosis drugs: results of the 1998/99 national survey in Italy
- Author
-
Giovanni Battista Migliori, Fattorini, L., Vaccarino, P., Besozzi, G., Saltini, C., Orefici, G., Iona, E., Matteelli, A., Fiorentini, F., Codecasa, Lr, Casali, L., and Cassone, A.
- Subjects
prevalence of resistance ,tuberculosis ,drug susceptibility testing ,HIV ,immigrant - Published
- 2002
32. Management of MDR and rifampicin-resistant TB cases in Italy, 1995-1999
- Author
-
Ferrara, Giovanni, Richeldi, L., Centis, R., Nutini, S., Bugiani, M., Fiorentini, F., Casali, Lucio, Besozzi, G., and Migliori, G. B.
- Published
- 2001
33. The Italian AIPO study on tuberculosis treatment results, report 1997. National AIPO 'Tuberculosis' Study Group
- Author
-
Ambrosetti M, Besozzi G, luigi codecasa, Farris B, Nutini S, Saini L, Casali L, Nardini S, and Gb, Migliori
- Subjects
Adult ,Aged, 80 and over ,Male ,Adolescent ,Middle Aged ,Treatment Outcome ,Italy ,Risk Factors ,Child, Preschool ,Humans ,Female ,Child ,Tuberculosis, Pulmonary ,Aged - Abstract
In Italy no national data have been available on tuberculosis (TB) treatment results. In 1995 the AIPO (Italian Association of Hospital Pneumologists) TB Study Group, in collaboration with the Istituto Superiore di Sanità (technical branch of the Ministry of Health) started a prospective monitoring activity based on the recommendations of the World Health Organization and the International Union Against Tuberculosis and Lung Disease. The aim of this study was to analyse the case findings and treatment results during 1997. Data were collected from a representative network of TB units nation-wide, managing a significant proportion of all TB cases notified in Italy each year. A total of 715 TB cases were reported (56% males; 24% immigrants), of which 635 (89%) were new cases. Of these cases 493 (69%) were pulmonary, 187 (26%) extra-pulmonary cases and 35 (5%) both pulmonary and extrapulmonary. The main risk factors for TB were history of recent contact and diabetes among native Italians, human immunodeficiency virus-seropositive status and a history of recent contact among immigrants. The majority of immigrants came from Africa and Central and South America, and stayed in Italy for more than 24 months before the diagnosis of TB was made. Thirty-six per cent of patients had a positive direct sputum smear examination for alcohol acid-fast bacilli and 27% were resistant to any drug (monoresistance to isoniazid: 2.4%; multi-drug resistance: 7.5%). In 97% of cases the duration of treatment was12 months. The overall success rate (cured plus treatment completed) was 78.1%. A significantly higher percentage of deaths, which was age related, was found in native Italians, while immigrants had a higher default rate. In conclusion, case finding and treatment results in Italy in 1997 are similar to those described in 1995 and 1996.
- Published
- 2000
34. Surveillance of anti-tuberculosis drug resistance: Results of the 1998/1999 proficiency testing in Italy
- Author
-
Migliori, Gb, Ambrosetti, M, Fattorini, L, Penati, V, Vaccarino, P, Besozzi, G, Ortona, L, Saltini, C, Orefici, G, Moro, Ml, Iona, E, Cassone, A, De Santis, A, Giorgio, V, Vinciguerra, P, Angarano, G, Petrozzi, L, Costa, D, Gozzellino, F, Perboni, A, Marchetti, D, Pascali, A, Falcone, F, Mariano, V, Rizza, F, Pretto, P, Turano, A, Matteelli, A, Carosi, Gp, Tedoldi, S, Pinsi, G, Farris, Ag, Ligia, Gp, Orani, G, Farris, B, Foschi, C, Trucco, G, Aiolfi, S, Ceruti, T, Parpanesi, M, Calabro, S, Felisatti, G, Tortoli, E, Nutini, S, Montini, G, Fiorentini, F, D'Ambrosio, V, Ceraminiello, A, Bernorio, S, Buono, L, Montesano, P, Vinci, E, Sabato, E, Gamba, S, Crepaldi, P, Bertoli, G, Rupianesi, F, Losi, M, Richeldi, L, Ferrara, G, Muccio, E, Napolitano, G, Molinari, Gl, Saini, L, Garzone, A, Vertuccio, C, Marcias, Menozzi, Marone, P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M. B., Bistoni, Sposini, Colorizio, Confalonieri, M, Bottrighi, P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Donne, Le, Farinelli, Mancini, and Ermeti
- Subjects
Drug susceptibility testing ,Tuberculosis ,Proficiency testing - Published
- 2000
35. Hospital admission policy for tuberculosis in pulmonary centres in Italy: a national survey. AIPO Tuberculosis Study Group. Italian Association of Hospital Pulmonologists
- Author
-
Nutini S, Fiorenti F, luigi codecasa, Casali L, Besozzi G, Di Pisa G, Nardini S, and Gb, Migliori
- Subjects
Patient Admission ,Hospital Administration ,Italy ,Health Care Surveys ,Surveys and Questionnaires ,Humans ,Length of Stay ,Tuberculosis, Pulmonary ,Organizational Policy - Abstract
A national survey including 203 pulmonary centres (PCs) (144 hospital PCs with beds dedicated to TB patients and 59 out-patient PCs) managing tuberculosis cases in Italy during 1995.To evaluate: 1) hospitalisation practices (criteria for admission/discharge; duration of hospitalisation) as primary end-points; and 2) as secondary end-points the availability of beds, the preventive measures adopted to reduce the spread of infection, the sources of referral for hospitalisation and the procedures adopted to follow up TB patients after discharge.A 26-point questionnaire mailed to 203 PCs.Of 167 PCs that responded to the questionnaire (82.3%), 159 questionnaires were considered valid for the analysis (110 from hospitals PCs and 49 from out-patient PCs). The criteria adopted by PCs to admit TB patients were: all TB cases 47%, only smear-positive pulmonary TB 14%, TB cases with clinical problems 39%. Hospital PCs hospitalised significantly more cases of smear-negative, extra-pulmonary TB. On average 71.6% of all cases were hospitalised (88.2% by hospital and 28% by out-patient PCs). The median hospital stay was 34 days for sputum smear-positive, 20 for sputum smear-negative and 21.5 for extra-pulmonary TB cases. Sputum conversion was considered the mandatory criterion to allow discharge from 61% of hospital PCs.A switch from the present policy (majority of cases hospitalised for a long period) to an outpatient oriented policy needs the co-ordinated educational effort of scientific societies and health authorities.
- Published
- 1999
36. The Italian AIPO study on tuberculosis treatment results, report 1995. National AIPO 'Tuberculosis' Study Group
- Author
-
Ambrosetti M, Besozzi G, luigi codecasa, Farris B, Nutini S, Saini L, Casali L, Nardini S, and Gb, Migliori
- Subjects
Cohort Studies ,Male ,Treatment Outcome ,Italy ,Risk Factors ,Incidence ,Outcome Assessment, Health Care ,Antitubercular Agents ,Humans ,Drug Resistance, Microbial ,Female ,Emigration and Immigration ,Tuberculosis, Pulmonary - Abstract
In Italy, no national data on tuberculosis (TB) treatment results were available. In 1995, the AIPO (Italian Association of Hospital Pneumologists) TB Study Group, in collaboration with the Istituto Superiore di Sanità (technical branch of the Ministry of Health), started a prospective monitoring activity based on World Health Organization (WHO) and International Union against Tuberculosis and Lung Disease (IUATLD) recommendations. Data were collected from a nationwide network of 41 TB units, managing a significant proportion of all TB cases notified in Italy each year. The aim of this study was to analyse the case findings and treatment results for the year 1995. Seven hundred and seventy eight TB cases were reported (59% males; 21% immigrants), 640 (82%) being new cases. Of these cases, 517 (66%) were pulmonary, 239 (31%) extrapulmonary and 22 (3%) both pulmonary and extrapulmonary. The main risk factors for TB were a history of recent contact and alcohol abuse among native Italians and human immunodeficiency virus-seropositive status among immigrants. The majority of immigrants were from Africa and South America, and had been in Italy24 months before diagnosis of TB. Thirty-seven per cent of patients had a positive direct sputum smear examination for alcohol acid-fast bacilli; 20% were resistant to any drug (monoresistance to isoniazid 3.5%; multidrug resistance 5.2%). In 95% of cases, the duration of treatment was12 months. The overall success rate (cured plus treatment completed) was 81.1%. A significantly higher percentage of deaths was found in native Italians (being age-related), whereas immigrants had a higher default rate.
- Published
- 1999
37. Cost-comparison of different management policies for tuberculosis patients in Italy. AIPO TB Study Group
- Author
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Migliori, G. B., Ambrosetti, M., Besozzi, G., Farris, B., Nutini, S., Saini, L., Casali, L., Nardini, S., Bugiani, M., Neri, M., and Raviglione, M. C.
- Subjects
Treatment Outcome ,Cost Control ,Italy ,Cost-Benefit Analysis ,Health Policy ,Humans ,Tuberculosis ,Prospective Studies ,Research Article - Abstract
Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$2.50 to US$11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$16,703 in scenario 1 and US$5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$1407 (scenario 1, smear-negative and extrapulmonary cases) to US$1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$1800 to US$4200. The possible savings at the national level were in the order of US$50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation.
- Published
- 1999
38. Isoniazid preventive treatment: predictors of adverse events and treatment completion
- Author
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Codecasa, L. R., primary, Murgia, N., additional, Ferrarese, M., additional, Delmastro, M., additional, Repossi, A. C., additional, Casali, L., additional, Besozzi, G., additional, Ferrara, G., additional, and Raviglione, M. C., additional
- Published
- 2013
- Full Text
- View/download PDF
39. Evaluation of the impact of guidelines on tuberculosis control in Italy. National AIPO 'Tuberculosis' Study Group. Associazione Italiana Pneumologi Ospedalieri
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Migliori, Gb, Casali, L, Nardini, S, Spanevello, Antonio, Besozzi, G, and Faravelli, B.
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CONSENSUS - GUIDELINES - PREVENTION - REHABILITATION - TUBERCULOSIS - Published
- 1996
40. Safety, tolerability and efficacy of linezolid in the treatment of MDR- and XDR-TB. A TBNET survey
- Author
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Giovanni, BM, primary, Eker, B, additional, Richardson, M, additional, Sotgiu, G, additional, Zellweger, J, additional, Skrahina, A, additional, Ortmann, J, additional, Girardi, E, additional, Hoffmann, H, additional, Besozzi, G, additional, and Centis, R, additional
- Published
- 2009
- Full Text
- View/download PDF
41. First tuberculosis cases in Italy resistant to all tested drugs
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Migliori, G B, primary, De Iaco, G, additional, Besozzi, G, additional, Centis, R, additional, and Cirillo, D M, additional
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- 2007
- Full Text
- View/download PDF
42. Circulating,Mycobacterium tuberculosis-specific lymphocytes from PPD skin test-negative patients with tuberculosis do not secrete interferon-gamma (IFN-γ) and lack the cutaneous lymphocyte antigen skin-selective homing receptor
- Author
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Magnani, Z I, primary, Confetti, C, additional, Besozzi, G, additional, Codecasa, L R, additional, Panina-Bordignon, P, additional, Lang, R, additional, Rossi, G A, additional, Pardi, R, additional, and Burastero, S E, additional
- Published
- 2000
- Full Text
- View/download PDF
43. Pulmonary infection due to Mycobacterium szulgai, case report and review of the literature
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Tortoli, E, primary, Besozzi, G, additional, Lacchini, C, additional, Penati, V, additional, Simonetti, MT, additional, and Emler, S, additional
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- 1998
- Full Text
- View/download PDF
44. Clinical and epidemiological features of TB in 327 immigrants observed from 1989 to 1993
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Codecasa, L.R., primary, Besozzi, G., additional, Sarassi, A., additional, and Mantellini, P.V., additional
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- 1994
- Full Text
- View/download PDF
45. Daily and twice-weekly administered short-course anti-TB treatment with Rifampicin +isoniazid fixed combination: 10 years of follow-up
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Besozzi, G., primary, Codecasa, L.R., additional, and Mantellini, P.V., additional
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- 1994
- Full Text
- View/download PDF
46. Circulating, Mycobacterium tuberculosis-specific lymphocytes from PPD skin test-negative patients with tuberculosis do not secrete interferon-gamma (IFN-gamma) and lack the cutaneous lymphocyte antigen skin-selective homing receptor.
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Magnani, Z.I., Confetti, C., Besozzi, G., Codecasa, L.R., Panina-Bordignon, P., Lang, R., Rossi, G.A., Pardi, R., and Burastero, S.E.
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TUBERCULIN test ,MYCOBACTERIA ,INTERFERONS ,T cells ,INTERLEUKIN-12 - Abstract
Investigates the association of negative tuberculin reaction of patients exposed to mycobacteria with the production of interferon-gamma. Circulation of PPD-specific T-cells; Analysis of p70 interleukin-12 production by monocytes; Identification of PPD skin test-negative individuals.
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- 2000
- Full Text
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47. Disoccupazione involontaria e curva di Phillips G. Gagliani
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Besozzi, G.
- Published
- 1973
48. Wage Inflation J. Burton
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Besozzi, G.
- Published
- 1974
49. Characterization of an Isolate Belonging to the Newly Described Species Mycobacterium hassiacum
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Tortoli, E., Reischl, U., Besozzi, G., and Emler, S.
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- 1998
- Full Text
- View/download PDF
50. Mycobacterium tuberculosis Complex Drug Resistance in Italy [1]
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Giovanni Battista Migliori, Centis, R., Fattorini, L., Besozzi, G., Saltini, C., Scarparo, C., Cirillo, D., Gori, A., Cassone, A., and Piersimoni, C.
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