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1. Survival of Hospitalized COVID-19 Patients in Northern Italy: A Population-Based Cohort Study by the ITA-COVID-19 Network

Author: Ferroni E, Giorgi Rossi P, Spila Alegiani S, Trifirò G, Pitter G, Leoni O, Cereda D, Marino M, Pellizzari M, Fabiani M, Riccardo F, Sultana J, and Massari M
Subjects: covid-19, survival, cohort study, hospitalized patients, italy, Infectious and parasitic diseases, RC109-216
Abstract: Eliana Ferroni,1 Paolo Giorgi Rossi,2 Stefania Spila Alegiani,3 Gianluca Trifirò,4 Gisella Pitter,1 Olivia Leoni,5 Danilo Cereda,5 Massimiliano Marino,2 Michele Pellizzari,1 Massimo Fabiani,6 Flavia Riccardo,6 Janet Sultana,4 Marco Massari3 On behalf of The ITA-COVID Working Group1Azienda Zero of the Veneto Region, Padua, Italy; 2Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy; 3National Center for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy; 4Department of Biomedical and Dental Sciences and Morphofunctional Imaging – University of Messina, Messina, Italy; 5Department of Health of Lombardy Region, Milan, Italy; 6Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, ItalyCorrespondence: Stefania Spila AlegianiIstituto Superiore Di Sanità, Viale Regina Elena, 299, Rome 00161, ItalyTel +39 0649904249Fax +39 0649904248Email stefania.spila@iss.itPaolo Giorgi RossiAzienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, via Amendola 2, Reggio Emilia 42122, ItalyTel +39 0522335490Email paolo.giorgirossi@ausl.re.itIntroduction: COVID-19 case fatality rate in hospitalized patients varies across countries and studies. Reliable estimates, specific for age, sex, and comorbidities, are needed to monitor the epidemic, to compare the outcome in different settings, and to correctly design trials for COVID-19 interventions. The aim of this study was to provide population-based survival curves of hospitalized COVID-19 patients.Materials and Methods: A cohort study was conducted in three areas of Northern Italy, heavily affected by SARS-CoV-2 infection (Lombardy and Veneto Regions, and Reggio Emilia province), using a loco-regional COVID-19 surveillance system, linked to hospital discharge databases. We included all patients testing positive for SARS-CoV-2 RNA by RT-PCR on nasopharyngeal/throat swab samples who were hospitalized from 21 February to 21 April 2020. Kaplan–Meier survival estimates were calculated at 14 and 30 days for death in any setting, stratifying by age, sex, and the Charlson Index.Results: Overall, 42,926 hospitalized COVID-19 patients were identified. Patients’ median age was 69 years (IQR: 57– 79), 62.6% were males, and 6.0% had a Charlson Index ≥ 3. Survival curves showed that 22.0% (95% CI 21.6– 22.4) of patients died within 14 days and 27.6% (95% CI 27.2– 28.1) within 30 days from hospitalization. Survival was higher in younger patients and in females. The negative impact of comorbidities on survival was more pronounced in younger age groups.Conclusion: The high fatality rate observed in the study (28% at 30 days) suggests that studies should focus on death as primary endpoint during a follow-up of at least one month.Keywords: COVID-19, survival, cohort study, hospitalized patients, Italy
Published: 2020

2. Real-time investigation of an influenza A(H3N2) virus outbreak in a refugee community, November 2022

Author: Galli, C., Mazzola, G., Arosio, M., Pellegrinelli, L., Boldrini, A., Guarneri, D., Lombarda, E., Farina, C., Cereda, D., and Pariani, E.
Published: 2024
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3. The early phase of the COVID-19 outbreak in Lombardy, Italy

Author: Cereda, D, Tirani, M, Rovida, F, Demicheli, V, Ajelli, M, Poletti, P, Trentini, F, Guzzetta, G, Marziano, V, Barone, A, Magoni, M, Deandrea, S, Diurno, G, Lombardo, M, Faccini, M, Pan, A, Bruno, R, Pariani, E, Grasselli, G, Piatti, A, Gramegna, M, Baldanti, F, Melegaro, A, and Merler, S
Subjects: Quantitative Biology - Populations and Evolution
Abstract: In the night of February 20, 2020, the first case of novel coronavirus disease (COVID-19) was confirmed in the Lombardy Region, Italy. In the week that followed, Lombardy experienced a very rapid increase in the number of cases. We analyzed the first 5,830 laboratory-confirmed cases to provide the first epidemiological characterization of a COVID-19 outbreak in a Western Country. Epidemiological data were collected through standardized interviews of confirmed cases and their close contacts. We collected demographic backgrounds, dates of symptom onset, clinical features, respiratory tract specimen results, hospitalization, contact tracing. We provide estimates of the reproduction number and serial interval. The epidemic in Italy started much earlier than February 20, 2020. At the time of detection of the first COVID-19 case, the epidemic had already spread in most municipalities of Southern-Lombardy. The median age for of cases is 69 years (range, 1 month to 101 years). 47% of positive subjects were hospitalized. Among these, 18% required intensive care. The mean serial interval is estimated to be 6.6 days (95% CI, 0.7 to 19). We estimate the basic reproduction number at 3.1 (95% CI, 2.9 to 3.2). We estimated a decreasing trend in the net reproduction number starting around February 20, 2020. We did not observe significantly different viral loads in nasal swabs between symptomatic and asymptomatic. The transmission potential of COVID-19 is very high and the number of critical cases may become largely unsustainable for the healthcare system in a very short-time horizon. We observed a slight decrease of the reproduction number, possibly connected with an increased population awareness and early effect of interventions. Aggressive containment strategies are required to control COVID-19 spread and catastrophic outcomes for the healthcare system.
Published: 2020

4. Estimating All-Cause Deaths Averted in the First Two Years of the COVID-19 Vaccination Campaign in Italy

Author: Corrao, G, Porcu, G, Tratsevich, A, Cereda, D, Pavesi, G, Bertolaso, G, Franchi, M, Corrao G., Porcu G., Tratsevich A., Cereda D., Pavesi G., Bertolaso G., Franchi M., Corrao, G, Porcu, G, Tratsevich, A, Cereda, D, Pavesi, G, Bertolaso, G, Franchi, M, Corrao G., Porcu G., Tratsevich A., Cereda D., Pavesi G., Bertolaso G., and Franchi M.
Abstract: Comparing deaths averted by vaccination campaigns is a crucial public health endeavour. Excess all-cause deaths better reflect the impact of the pandemic than COVID-19 deaths. We used a seasonal autoregressive integrated moving average with exogenous factors model to regress daily all-cause deaths on annual trend, seasonality, and environmental temperature in three Italian regions (Lombardy, Marche and Sicily) from 2015 to 2019. The model was used to forecast excess deaths during the vaccinal period (December 2020–October 2022). We used the prevented fraction to estimate excess deaths observed during the vaccinal campaigns, those which would have occurred without vaccination, and those averted by the campaigns. At the end of the vaccinal period, the Lombardy region proceeded with a more intensive COVID-19 vaccination campaign than other regions (on average, 1.82 doses per resident, versus 1.67 and 1.56 in Marche and Sicily, respectively). A higher prevented fraction of all-cause deaths was consistently found in Lombardy (65% avoided deaths, as opposed to 60% and 58% in Marche and Sicily). Nevertheless, because of a lower excess mortality rate found in Lombardy compared to Marche and Sicily (12, 24 and 23 per 10,000 person-years, respectively), a lower rate of averted deaths was observed (22 avoided deaths per 10,000 person-years, versus 36 and 32 in Marche and Sicily). In Lombardy, early and full implementation of adult COVID-19 vaccination was associated with the largest reduction in all-cause deaths compared to Marche and Sicily.
Published: 2024

5. Corticosteroid treatment for acute hydrocephalus in neurosarcoidosis: a case report

Author: Schilke, E, Remoli, G, Cutellé, C, Balducci, C, Cereda, D, Fusco, M, Tremolizzo, L, Ferrarese, C, Appollonio, I, Frigo, M, Schilke, ED, Fusco, ML, Schilke, E, Remoli, G, Cutellé, C, Balducci, C, Cereda, D, Fusco, M, Tremolizzo, L, Ferrarese, C, Appollonio, I, Frigo, M, Schilke, ED, and Fusco, ML
Abstract: Background: Neurosarcoidosis occurs symptomatically in 5–10% of patients with sarcoidosis, and hydrocephalus is a rare complication of neurosarcoidosis, with either acute or subacute onset and presenting symptoms related to increased intracranial pressure. It represents a potentially fatal manifestation with a mortality rate of 22% (increased to 75% in case of coexistence of seizures) that requires a prompt initiation of treatment. High-dose intravenous corticosteroid treatment and neurosurgical treatment must be considered in all cases of neurosarcoidosis hydrocephalus. Case presentation: Here we present a case of hydrocephalus in neurosarcoidosis, complicated by generalized seizures, in a 29-year-old Caucasian male patient treated with medical treatment only, with optimal response. Conclusion: Since neurosurgery treatment can lead to severe complications, this case report underlines the possibility to undergo only medical treatment in selected cases. Further studies are needed to stratify patients and better identify those eligible for only medical approach.
Published: 2024

6. Surge of Mpox cases in Lombardy region, Italy, October 2023 - January 2024

Author: Moschese, D, Raccagni, A, Giacomelli, A, Piralla, A, Rossotti, R, Raimondi, A, Tesoro, D, Vezzosi, L, Gulletta, M, Clementi, N, Venturelli, S, Benardon, S, Ricaboni, D, Bernacchia, D, Mancon, A, Rovida, F, Attanasi, F, Cereda, D, Gismondo, M, Gori, A, Rizzardini, G, Antinori, S, Baldanti, F, Marzano, A, Marchetti, G, Castelli, F, Castagna, A, Nozza, S, Mileto, D, Bonfanti, P, Biasioli, L, Bruno, R, Vittoria Cossu, M, Fusetti, C, Lazzarin, S, Locatelli, M, Morosi, M, Piscaglia, M, Pusterla, L, Pozza, G, Ramoni, S, Rusconi, S, Rizzi, M, Rizzo, A, Sabaini, F, Salari, F, Sampaolo, M, Puoti, M, Tirani, M, Rachele Tomasoni, L, Null, N, Moschese, Davide, Raccagni, Angelo Roberto, Giacomelli, Andrea, Piralla, Antonio, Rossotti, Roberto, Raimondi, Alessandro, Tesoro, Daniele, Vezzosi, Luigi, Gulletta, Maurizio, Clementi, Nicola, Venturelli, Serena, Benardon, Susanna, Ricaboni, Davide, Bernacchia, Dario, Mancon, Alessandro, Rovida, Francesca, Attanasi, Federica, Cereda, Danilo, Gismondo, Maria Rita, Gori, Andrea, Rizzardini, Giuliano, Antinori, Spinello, Baldanti, Fausto, Marzano, Angelo Valerio, Marchetti, Giulia, Castelli, Francesco, Castagna, Antonella, Nozza, Silvia, Mileto, Davide, Bonfanti, Paolo, Biasioli, Lorenzo, Bruno, Raffaele, Vittoria Cossu, Maria, Fusetti, Chiara, Lazzarin, Samuel, Locatelli, Massimo, Morosi, Manuela, Piscaglia, Marco, Pusterla, Luigi, Pozza, Giacomo, Ramoni, Stefano, Rusconi, Stefano, Rizzi, Marco, Rizzo, Alberto, Sabaini, Federico, Salari, Federica, Sampaolo, Michela, Puoti, Massimo, Tirani, Marcello, Rachele Tomasoni, Lina, null, null, Moschese, D, Raccagni, A, Giacomelli, A, Piralla, A, Rossotti, R, Raimondi, A, Tesoro, D, Vezzosi, L, Gulletta, M, Clementi, N, Venturelli, S, Benardon, S, Ricaboni, D, Bernacchia, D, Mancon, A, Rovida, F, Attanasi, F, Cereda, D, Gismondo, M, Gori, A, Rizzardini, G, Antinori, S, Baldanti, F, Marzano, A, Marchetti, G, Castelli, F, Castagna, A, Nozza, S, Mileto, D, Bonfanti, P, Biasioli, L, Bruno, R, Vittoria Cossu, M, Fusetti, C, Lazzarin, S, Locatelli, M, Morosi, M, Piscaglia, M, Pusterla, L, Pozza, G, Ramoni, S, Rusconi, S, Rizzi, M, Rizzo, A, Sabaini, F, Salari, F, Sampaolo, M, Puoti, M, Tirani, M, Rachele Tomasoni, L, Null, N, Moschese, Davide, Raccagni, Angelo Roberto, Giacomelli, Andrea, Piralla, Antonio, Rossotti, Roberto, Raimondi, Alessandro, Tesoro, Daniele, Vezzosi, Luigi, Gulletta, Maurizio, Clementi, Nicola, Venturelli, Serena, Benardon, Susanna, Ricaboni, Davide, Bernacchia, Dario, Mancon, Alessandro, Rovida, Francesca, Attanasi, Federica, Cereda, Danilo, Gismondo, Maria Rita, Gori, Andrea, Rizzardini, Giuliano, Antinori, Spinello, Baldanti, Fausto, Marzano, Angelo Valerio, Marchetti, Giulia, Castelli, Francesco, Castagna, Antonella, Nozza, Silvia, Mileto, Davide, Bonfanti, Paolo, Biasioli, Lorenzo, Bruno, Raffaele, Vittoria Cossu, Maria, Fusetti, Chiara, Lazzarin, Samuel, Locatelli, Massimo, Morosi, Manuela, Piscaglia, Marco, Pusterla, Luigi, Pozza, Giacomo, Ramoni, Stefano, Rusconi, Stefano, Rizzi, Marco, Rizzo, Alberto, Sabaini, Federico, Salari, Federica, Sampaolo, Michela, Puoti, Massimo, Tirani, Marcello, Rachele Tomasoni, Lina, and null, null
Published: 2024

7. Dynamics of viral DNA shedding and culture viral DNA positivity in different clinical samples collected during the 2022 mpox outbreak in Lombardy, Italy

Author: Piralla, A, Mileto, D, Rizzo, A, Ferrari, G, Giardina, F, Gaiarsa, S, Petazzoni, G, Bianchi, M, Salari, F, Bracchitta, F, Sammartino, J, Ferrari, A, Gagliardi, G, Mancon, A, Fenizia, C, Biasin, M, Rovida, F, Paolucci, S, Percivalle, E, Lombardi, A, Micheli, V, Nozza, S, Castagna, A, Moschese, D, Antinori, S, Gori, A, Bonfanti, P, Rossotti, R, Monforte, A, Attanasi, F, Tirani, M, Cereda, D, Baldanti, F, Gismondo, M, Cutrera, M, Cuomo, M, De Poli, F, Campanini, G, Pitrolo, A, Iskandar, E, Cassaniti, I, Bruno, R, Rizzardini, G, Puoti, M, Castelli, F, Corsico, L, Giacomelli, A, Pozza, G, Casalini, G, Raccagni, A, Trentacapilli, B, Bertoni, C, Bruzzesi, E, Candela, C, Tesoro, D, Mule, G, Bandera, A, Bianca Mariani, A, Maffeo, M, Vecchio, R, Piccinelli, S, Piralla, Antonio, Mileto, Davide, Rizzo, Alberto, Ferrari, Guglielmo, Giardina, Federica, Gaiarsa, Stefano, Petazzoni, Greta, Bianchi, Micol, Salari, Federica, Bracchitta, Fiorenza, Sammartino, Josè Camilla, Ferrari, Alessandro, Gagliardi, Gloria, Mancon, Alessandro, Fenizia, Claudio, Biasin, Mara, Rovida, Francesca, Paolucci, Stefania, Percivalle, Elena, Lombardi, Alessandra, Micheli, Valeria, Nozza, Silvia, Castagna, Antonella, Moschese, Davide, Antinori, Spinello, Gori, Andrea, Bonfanti, Paolo, Rossotti, Roberto, Monforte, Antonella D'arminio, Attanasi, Federica, Tirani, Marcello, Cereda, Danilo, Baldanti, Fausto, Gismondo, Maria Rita, Cutrera, Miriam, Cuomo, Marianna, De Poli, Federica, Campanini, Giulia, Pitrolo, Antonino Maria Guglielmo, Iskandar, Elizabeth, Cassaniti, Irene, Bruno, Raffaele, Rizzardini, Giuliano, Puoti, Massimo, Castelli, Francesco, Corsico, Laura, Giacomelli, Andrea, Pozza, Giacomo, Casalini, Giacomo, Raccagni, Angelo, Trentacapilli, Bendetta, Bertoni, Costanza, Bruzzesi, Elena, Candela, Caterina, Tesoro, Daniele, Mule, Giovanni, Bandera, Alessandra, Bianca Mariani, Antonio Muscatello, Maffeo, Manuel, Vecchio, Riccardo, Piccinelli, Sara, Piralla, A, Mileto, D, Rizzo, A, Ferrari, G, Giardina, F, Gaiarsa, S, Petazzoni, G, Bianchi, M, Salari, F, Bracchitta, F, Sammartino, J, Ferrari, A, Gagliardi, G, Mancon, A, Fenizia, C, Biasin, M, Rovida, F, Paolucci, S, Percivalle, E, Lombardi, A, Micheli, V, Nozza, S, Castagna, A, Moschese, D, Antinori, S, Gori, A, Bonfanti, P, Rossotti, R, Monforte, A, Attanasi, F, Tirani, M, Cereda, D, Baldanti, F, Gismondo, M, Cutrera, M, Cuomo, M, De Poli, F, Campanini, G, Pitrolo, A, Iskandar, E, Cassaniti, I, Bruno, R, Rizzardini, G, Puoti, M, Castelli, F, Corsico, L, Giacomelli, A, Pozza, G, Casalini, G, Raccagni, A, Trentacapilli, B, Bertoni, C, Bruzzesi, E, Candela, C, Tesoro, D, Mule, G, Bandera, A, Bianca Mariani, A, Maffeo, M, Vecchio, R, Piccinelli, S, Piralla, Antonio, Mileto, Davide, Rizzo, Alberto, Ferrari, Guglielmo, Giardina, Federica, Gaiarsa, Stefano, Petazzoni, Greta, Bianchi, Micol, Salari, Federica, Bracchitta, Fiorenza, Sammartino, Josè Camilla, Ferrari, Alessandro, Gagliardi, Gloria, Mancon, Alessandro, Fenizia, Claudio, Biasin, Mara, Rovida, Francesca, Paolucci, Stefania, Percivalle, Elena, Lombardi, Alessandra, Micheli, Valeria, Nozza, Silvia, Castagna, Antonella, Moschese, Davide, Antinori, Spinello, Gori, Andrea, Bonfanti, Paolo, Rossotti, Roberto, Monforte, Antonella D'arminio, Attanasi, Federica, Tirani, Marcello, Cereda, Danilo, Baldanti, Fausto, Gismondo, Maria Rita, Cutrera, Miriam, Cuomo, Marianna, De Poli, Federica, Campanini, Giulia, Pitrolo, Antonino Maria Guglielmo, Iskandar, Elizabeth, Cassaniti, Irene, Bruno, Raffaele, Rizzardini, Giuliano, Puoti, Massimo, Castelli, Francesco, Corsico, Laura, Giacomelli, Andrea, Pozza, Giacomo, Casalini, Giacomo, Raccagni, Angelo, Trentacapilli, Bendetta, Bertoni, Costanza, Bruzzesi, Elena, Candela, Caterina, Tesoro, Daniele, Mule, Giovanni, Bandera, Alessandra, Bianca Mariani, Antonio Muscatello, Maffeo, Manuel, Vecchio, Riccardo, and Piccinelli, Sara
Abstract: Background: Mpox virus (MPXV) has recently spread outside of sub-Saharan Africa. This large multicentre study was conducted in Lombardy, the most densely populated Italian region accounting for more than 40% of Italian cases. The present study aims to: i) evaluate the presence and the shedding duration of MPXV DNA in different body compartments correlating the MPXV viability with the time to onset of symptoms; ii) provide evidence of MPXV persistence in different body compartment as a source of infection and iii) characterize the MPXV evolution by whole genome sequencing (WGS) during the outbreak occurred in Italy. Material and methods: The study included 353 patients with a laboratory-confirmed diagnosis of MPXV infection screened in several clinical specimens in the period May 24th - September 1st, 2022. Viral isolation was attempted from different biological matrices and complete genome sequencing was performed for 61 MPXV strains. Results: MPXV DNA detection was more frequent in the skin (94.4%) with the longest median time of viral clearance (16 days). The actively-replicating virus in cell culture was obtained for 123/377 (32.6%) samples with a significant higher viral quantity on isolation positive samples (20 vs 31, p < 0.001). The phylogenetic analysis highlighted the high genetic identity of the MPXV strains collected, both globally and within the Lombardy region. Conclusion: Skin lesion is gold standard material and the high viral load and the actively-replicating virus observed in genital sites confirms that sexual contact plays a key role in the viral transmission.
Published: 2024

8. Current use of fluid biomarkers as outcome measures in Multiple Sclerosis (MS): a review of ongoing pharmacological clinical trials

Author: Schilke, E, Remoli, G, Funelli, E, Galimberti, M, Fusco, M, Cereda, D, Balducci, C, Frigo, M, Cavaletti, G, Schilke E. D., Remoli G., Funelli E., Galimberti M., Fusco M. L., Cereda D., Balducci C., Frigo M., Cavaletti G., Schilke, E, Remoli, G, Funelli, E, Galimberti, M, Fusco, M, Cereda, D, Balducci, C, Frigo, M, Cavaletti, G, Schilke E. D., Remoli G., Funelli E., Galimberti M., Fusco M. L., Cereda D., Balducci C., Frigo M., and Cavaletti G.
Abstract: The present study aims to describe the state of the art of fluid biomarkers use in ongoing multiple sclerosis (MS) clinical trials. A review of 608 ongoing protocols in the clinicaltrials.gov and EudraCT databases was performed. The trials enrolled patients with a diagnosis of relapsing remitting MS, secondary progressive MS, and/or primary progressive MS according to Revised McDonald criteria or relapsing MS according to Lublin et al. (2014). The presence of fluid biomarkers among the primary and/or secondary study outcomes was assessed. Overall, 5% of ongoing interventional studies on MS adopted fluid biomarkers. They were mostly used as secondary outcomes in phase 3–4 clinical trials to support the potential disease-modifying properties of the intervention. Most studies evaluated neurofilament light chains (NfLs). A small number considered other novel fluid biomarkers of neuroinflammation and neurodegeneration such as glial fibrillary acid protein (GFAP). Considering the numerous ongoing clinical trials in MS, still a small number adopted fluid biomarkers as outcome measures, thus testifying the distance from clinical practice. In most protocols, fluid biomarkers were used to evaluate the effectiveness of approved second-line therapies, but also, new drugs (particularly Bruton kinase inhibitors). NfLs were also adopted to monitor disease progression after natalizumab suspension in stable patients, cladribine efficacy after anti-CD20 discontinuation, and the efficacy of autologous hematopoietic stem cell transplant (AHSCT) compared to medical treatment. Nevertheless, further validation studies are needed for all considered fluid biomarkers to access clinical practice, and cost-effectiveness in the “real word” remains to be clarified.
Published: 2023

9. A territory-wide opportunistic, hospital-based HCV screening in the general population from northern Italy: The 1969–1989 birth-cohort

Author: D'Ambrosio, R, Piccinelli, S, Beccalli, B, Spinetti, A, Puoti, M, Fagiuoli, S, Magni, C, Vavassori, A, Sacchi, P, Castaldi, S, Bombardieri, G, Farina, C, Buoro, S, Amorosi, A, Corradin, M, Cereda, D, Lampertico, P, D'Ambrosio R., Piccinelli S., Beccalli B., Spinetti A., Puoti M., Fagiuoli S., Magni C. F., Vavassori A., Sacchi P., Castaldi S., Bombardieri G., Farina C., Buoro S., Amorosi A., Corradin M., Cereda D., Lampertico P., D'Ambrosio, R, Piccinelli, S, Beccalli, B, Spinetti, A, Puoti, M, Fagiuoli, S, Magni, C, Vavassori, A, Sacchi, P, Castaldi, S, Bombardieri, G, Farina, C, Buoro, S, Amorosi, A, Corradin, M, Cereda, D, Lampertico, P, D'Ambrosio R., Piccinelli S., Beccalli B., Spinetti A., Puoti M., Fagiuoli S., Magni C. F., Vavassori A., Sacchi P., Castaldi S., Bombardieri G., Farina C., Buoro S., Amorosi A., Corradin M., Cereda D., and Lampertico P.
Abstract: Background and Aim: The World Health Organization (WHO) goal of Hepatitis C Virus (HCV) elimination by 2030 rose awareness about the need of screening plans, worldwide. In Italy, graduated screening starting from people born in 1969–1989 might be the most-effective strategy. We performed an opportunistic HCV screening study in the general population attending health facilities in Lombardy region, Northern Italy. Methods: This is a prospective, multicenter, territory-wide, opportunistic study supported by the Regional Government of Lombardy, Italy. Between June 2022 and December 2022, all subjects born in 1969–1989, hospitalized or accessing blood collection centres were offered anti-HCV and HCV–RNA tests. Patients with known anti-HCV positivity and/or previous anti-HCV treatment were excluded. Demographic features were uploaded into a regional web-based platform. Results: In total, 120 193 individuals were screened in 75 centres. Mean age was 44 (±6) years, 65.2% were females, 83.7% were tested at blood collection centres. Anti-HCV tested positive in 604 (0.50%) subjects: mean age 47 (±5), 51.1% females. HCV seroprevalence was higher in males (p < 0.00001), elderly (p < 0.00001) and in- vs. outpatients (p = 0.0009). HCV–RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects. Actively infected patients were 46 (±6) years old, mainly males (56.8%). The overall prevalence of active HCV infection was 0.10%, higher in elderly (p = 0.0003) and in in-patients (p = 0.0007). Among 93 HCV–RNA positive patients, the median age was 48 years, 58% males, 62% Italian born, median HCV–RNA levels were 6,1 log IU/mL, liver stiffness measurement (LSM) values 5.5 (3.1–29.9) kPa and ALT levels 48 U/L. Conclusions: The prevalence of active HCV infection in the 1969–1989 population attending health facilities in Lombardy was low. Most viremic patients were Italian-born, with mild liver disease but high-HCV–RNA levels. Due to the higher prevalence in the elderly, the
Published: 2023

10. Natural and vaccine-induced immunity are equivalent for the protection against SARS-CoV-2 infection

Author: Franchi, M, Pellegrini, G, Cereda, D, Bortolan, F, Leoni, O, Pavesi, G, Galli, M, Valenti, G, Corrao, G, Franchi M., Pellegrini G., Cereda D., Bortolan F., Leoni O., Pavesi G., Galli M., Valenti G., Corrao G., Franchi, M, Pellegrini, G, Cereda, D, Bortolan, F, Leoni, O, Pavesi, G, Galli, M, Valenti, G, Corrao, G, Franchi M., Pellegrini G., Cereda D., Bortolan F., Leoni O., Pavesi G., Galli M., Valenti G., and Corrao G.
Abstract: Objectives: To compare the long-term cumulative risk of SARS-CoV-2 infection associated with natural and vaccine-induced immunity. Methods: Retrospective population-based cohort study based on registry of COVID-19 vaccinations and SARS-CoV-2 infections among 9.1 million citizens of Lombardy, Italy, eligible for vaccination on 27th December 2020. Those who developed SARS-CoV-2 infection from 24th May to 14th September 2021, provided they did not yet receive the COVID-19 vaccine when infection was confirmed, and those who received the second mRNA vaccine dose, provided they had not yet developed the infection, were selected to be 1:1 matched for sex, age and index date. The latter corresponded to 90 days after confirmed infection or 14 days after vaccine administration. A control cohort including citizens who, on the index date, had neither developed infection nor received vaccination was also selected. Kaplan-Meier curves were used for comparing the cumulative incidence of new SARS-CoV-2 infection from the index date until 22nd June 2022. Results: Overall, 19,418 1:1:1 risk-sets were included. After 9 months of follow-up, the cumulative risk of new SARS-CoV-2 infection was 21.8%, 22.0%, and 25.9%, respectively, among exposed to natural immunity, vaccine-induced immunity and unexposed. Conclusions: Equivalent potential for protecting against new SARS-CoV-2 infection was observed.
Published: 2023

11. The role of the built environment in dementia: evolution and adaptation of an innovative care model through the SARS-CoV-2 pandemic

Author: Ferraguzzi, G, Zanetti, M, Mazzola, P, Sandrini, M, Sanvito, F, Gagliardo, R, Colaianni, A, Borriello, C, Cereda, D, Ferraguzzi G., Zanetti M., Mazzola P., Sandrini M., Sanvito F., Gagliardo R., Colaianni A., Borriello C., Cereda D., Ferraguzzi, G, Zanetti, M, Mazzola, P, Sandrini, M, Sanvito, F, Gagliardo, R, Colaianni, A, Borriello, C, Cereda, D, Ferraguzzi G., Zanetti M., Mazzola P., Sandrini M., Sanvito F., Gagliardo R., Colaianni A., Borriello C., and Cereda D.
Abstract: Introduction: The first Alzheimers village in Italy rises in Monza named “Il Paese Ritrovato”, an innovative long-term care facility dedicated to individuals with mild-to-moderate Alzheimers disease or other Dementias. The total area is 3, 360 m2 and it hosts up to 64 guests divided into 8 apartments (single rooms and private bathrooms). The village includes buildings with highly recognizable features thanks to the careful selection of colors and finishes with classic, almost stereotypical, but familiar and reassuring lines that limit adequately furnished spaces. Every space is designed to stimulate cognitive functions and provide a good quality of life for residents. Methods: The retrospective cohort study involved 60 subjects. Variables collected from June 2018 to December 2020 included demographic data, cognitive and functional statuses, comorbidities, engagement in activities through the Engagement Social Index, and psychoactive medication use. Follow-up was performed every 6 months from admission until the Tcovid (starting covid Time) period. Outcomes included any significant changes due to isolation compared with the pre-pandemic period. Results: The study population had a mean age of 82.5 years (76.7% female), with a predominant diagnosis of AD (65%). Assessment at Tcovid showed rather different data than those recorded in the first 18 months with accelerated worsening of MMSE and CDR scales, increased prescription of antipsychotics (+5%), antidepressants (+11.7%, p=0.045) and benzodiazepines (+1.7%), and increased number of falls delineating the worsening of functional status accelerated by the pandemic. Limitations of the study include observational design and small sample size. Conclusion: The pandemic resulted in an abrupt reorganization of the care model with an orientation predominantly toward the health needs by disrupting the use of shared spaces and any opportunity for cognitive stimulation. This showed how psychosocial activity and appropriate study
Published: 2023

12. Towards SDG30: Fighting HCV with a screening program in Lombardy

Author: Meloni, A, primary, Piccinelli, S, additional, Marrocu, C, additional, Odone, A, additional, and Cereda, D, additional
Published: 2023
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13. Evaluation of Pre‐Analytical and Analytical Methods for Detecting SARS‐CoV‐2 in Municipal Wastewater Samples in Northern Italy

Author: Pellegrinelli, L, Castiglioni, S, Cocuzza, C, Bertasi, B, Primache, V, Schiarea, S, Salmoiraghi, G, Franzetti, A, Musemeci, R, Tilola, M, Galuppini, E, Bertanza, G, Callegari, M, Stefani, F, Turolla, A, Ammoni, E, Cereda, D, Pariani, E, Binda, S, Pellegrinelli L., Castiglioni S., Cocuzza C. E., Bertasi B., Primache V., Schiarea S., Salmoiraghi G., Franzetti A., Musemeci R., Tilola M., Galuppini E., Bertanza G., Callegari M., Stefani F., Turolla A., Ammoni E., Cereda D., Pariani E., Binda S., Pellegrinelli, L, Castiglioni, S, Cocuzza, C, Bertasi, B, Primache, V, Schiarea, S, Salmoiraghi, G, Franzetti, A, Musemeci, R, Tilola, M, Galuppini, E, Bertanza, G, Callegari, M, Stefani, F, Turolla, A, Ammoni, E, Cereda, D, Pariani, E, Binda, S, Pellegrinelli L., Castiglioni S., Cocuzza C. E., Bertasi B., Primache V., Schiarea S., Salmoiraghi G., Franzetti A., Musemeci R., Tilola M., Galuppini E., Bertanza G., Callegari M., Stefani F., Turolla A., Ammoni E., Cereda D., Pariani E., and Binda S.
Abstract: (1) Background: The surveillance of SARS‐CoV‐2 RNA in urban wastewaters allows one to monitor the presence of the virus in a population, including asymptomatic and symptomatic individuals, capturing the real circulation of this pathogen. The aim of this study was to evaluate the performance of different pre‐analytical and analytical methods for identifying the presence of SARS‐CoV‐2 in untreated municipal wastewaters samples by conducting an inter‐laboratory proficiency test. (2) Methods: three methods of concentration, namely, (A) Dextran and PEG‐6000 two‐phase separation, (B) PEG‐8000 precipitation without a chloroform purification step and (C) PEG‐8000 precipitation with a chloroform purification step were combined with three different protocols of RNA extraction by using commercial kits and were tested by using two primers/probe sets in three different master mixes. (3) Results: PEG‐8000 precipitation without chloroform treatment showed the best performance in the SARS‐CoV‐2 recovery; no major differences were observed among the protocol of RNA extraction and the one‐step real‐time RT‐PCR master mix kits. The highest analytic sensitivity was observed by using primers/probe sets targeting the N1/N3 fragments of SARS‐CoV‐2. (4) Conclusions: PEG‐8000 precipitation in combination with real‐time RT‐PCR targeting the N gene (two fragments) was the best performing workflow for the detection of SARS‐CoV‐2 RNA in municipal wastewaters.
Published: 2022

14. Increased risk of myocarditis and pericarditis and reduced likelihood of severe clinical outcomes associated with COVID-19 vaccination: a cohort study in Lombardy, Italy

Author: Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Vignati, E, Pavesi, G, Gori, A, Corrao G., Franchi M., Cereda D., Bortolan F., Leoni O., Vignati E., Pavesi G., Gori A., Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Vignati, E, Pavesi, G, Gori, A, Corrao G., Franchi M., Cereda D., Bortolan F., Leoni O., Vignati E., Pavesi G., and Gori A.
Abstract: Introduction: We aimed to assess harms (post-vaccine myocarditis and pericarditis) and benefits (preventing severe disease) of COVID-19 vaccination. Methods: We conducted a population-based retrospective cohort study. Using the integrated platform of the vaccination campaign of Lombardy Region (Italy), after the exclusion of 24,188 individuals not beneficiaries of the Regional Health Service, 9,184,146 citizens candidates to vaccine at December 27, 2020 were followed until November 30, 2021 (the loss to follow-up rate was 0.5%). From the date of administration of each vaccine dose to day 28 post-administration, three periods that covered exposure to the first, second, and third dose were defined. The benefit–risk profile of vaccines was performed by comparing the number needed to harm (NNH) and number needed to treat (NNT) by sex, age, and vaccine type. Results: Incidence rates of myocarditis were 9.9 and 5.2 per million person-months during the exposure and no-exposure periods, respectively, and the incidence rates of pericarditis were 19.5 and 15.9 per million person-months, respectively. The risk of myocarditis was highest following exposure to the second dose of the Moderna vaccine (adjusted HR: 5.5, 95% CI: 3.7 to 8.1). Exposure to the Moderna vaccine was also associated with an increased risk of pericarditis (adjusted HR 2.2, 1.5 to 3.1). NNT was higher than NNH (9471 vs. 7213) for 16 to 19-year-old men who received the Moderna vaccine, while all other sex, age, and vaccine subgroups had a favourable harm-benefit profile. Conclusions: Men 16 to 19 years of age has the highest rates of myocarditis within a few days after receiving the Moderna vaccines. The balance between harms and benefits was almost always in favour of vaccination.
Published: 2022

15. Balancing Benefits and Harms of COVID-19 Vaccines: Lessons from the Ongoing Mass Vaccination Campaign in Lombardy, Italy

Author: Corrao, G, Rea, F, Franchi, M, Cereda, D, Barone, A, Borriello, C, Della Valle, G, Ercolanoni, M, Jara, J, Preziosi, G, Maffeo, M, Mazziotta, F, Pierini, E, Lecis, F, Sanchirico, P, Vignali, F, Leoni, O, Fortino, I, Galli, M, Pavesi, G, Bertolaso, G, Corrao G., Rea F., Franchi M., Cereda D., Barone A., Borriello C. R., Della Valle G. P., Ercolanoni M., Jara J., Preziosi G., Maffeo M., Mazziotta F., Pierini E., Lecis F., Sanchirico P., Vignali F., Leoni O., Fortino I., Galli M., Pavesi G., Bertolaso G., Corrao, G, Rea, F, Franchi, M, Cereda, D, Barone, A, Borriello, C, Della Valle, G, Ercolanoni, M, Jara, J, Preziosi, G, Maffeo, M, Mazziotta, F, Pierini, E, Lecis, F, Sanchirico, P, Vignali, F, Leoni, O, Fortino, I, Galli, M, Pavesi, G, Bertolaso, G, Corrao G., Rea F., Franchi M., Cereda D., Barone A., Borriello C. R., Della Valle G. P., Ercolanoni M., Jara J., Preziosi G., Maffeo M., Mazziotta F., Pierini E., Lecis F., Sanchirico P., Vignali F., Leoni O., Fortino I., Galli M., Pavesi G., and Bertolaso G.
Abstract: Background. Limited evidence exists on the balance between the benefits and harms of the COVID-19 vaccines. The aim of this study is to compare the benefits and safety of mRNA-based (Pfizer-BioNTech and Moderna) and adenovirus-vectored (Oxford-AstraZeneca) vaccines in subpopulations defined by age and sex. Methods. All citizens who are newly vaccinated from 27 December 2020 to 3 May 2021 are matched to unvaccinated controls according to age, sex, and vaccination date. Study outcomes include the events that are expected to be avoided by vaccination (i.e., hospitalization and death from COVID-19) and those that might be increased after vaccine inoculation (i.e., venous thromboembolism). The incidence rate ratios (IRR) of vaccinated and unvaccinated citizens are separately estimated within strata of sex, age category and vaccine type. When suitable, number needed to treat (NNT) and number needed to harm (NNH) are calculated to evaluate the balance between the benefits and harm of vaccines within each sex and age category. Results. In total, 2,351,883 citizens are included because they received at least one dose of vaccine (755,557 Oxford-AstraZeneca and 1,596,326 Pfizer/Moderna). A reduced incidence of COVID-19-related outcomes is observed with a lowered incidence rate ranging from 55% to 89% and NNT values ranging from 296 to 3977. Evidence of an augmented incidence of harm-related outcomes is observed only for women aged <50 years within 28 days after Oxford-AstraZeneca (being the corresponding adjusted IRR of 2.4, 95% CI 1.1–5.6, and NNH value of 23,207, 95% CI 10,274–89,707). Conclusions. A favourable balance between benefits and harms is observed in the current study, even among younger women who received Oxford-AstraZeneca.
Published: 2022

16. Vulnerability Predictors of Post-Vaccine SARS-CoV-2 Infection and Disease—Empirical Evidence from a Large Population-Based Italian Platform

Author: Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Borriello, C, Della Valle, P, Tirani, M, Pavesi, G, Barone, A, Ercolanoni, M, Jara, J, Galli, M, Bertolaso, G, Corrao G., Franchi M., Cereda D., Bortolan F., Leoni O., Borriello C. R., Della Valle P. G., Tirani M., Pavesi G., Barone A., Ercolanoni M., Jara J., Galli M., Bertolaso G., Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Borriello, C, Della Valle, P, Tirani, M, Pavesi, G, Barone, A, Ercolanoni, M, Jara, J, Galli, M, Bertolaso, G, Corrao G., Franchi M., Cereda D., Bortolan F., Leoni O., Borriello C. R., Della Valle P. G., Tirani M., Pavesi G., Barone A., Ercolanoni M., Jara J., Galli M., and Bertolaso G.
Abstract: We aimed to identify individual features associated with increased risk of post-vaccine SARS-CoV-2 infection and severe COVID-19 illness. We performed a nested case–control study based on 5,350,295 citizens from Lombardy, Italy, aged ≥ 12 years who received a complete anti-COVID-19 vaccination from 17 January 2021 to 31 July 2021, and followed from 14 days after vaccine completion to 11 November 2021. Overall, 17,996 infections and 3023 severe illness cases occurred. For each case, controls were 1:1 (infection cases) or 1:10 (severe illness cases) matched for municipality of residence and date of vaccination completion. The association between selected predictors (sex, age, previous occurrence of SARS-CoV-2 infection, type of vaccine received, number of previous contacts with the Regional Health Service (RHS), and the presence of 59 diseases) and outcomes was assessed by using multivariable conditional logistic regression models. Sex, age, previous SARS-CoV-2 infection, type of vaccine and number of contacts with the RHS were associated with the risk of infection and severe illness. Moreover, higher odds of infection and severe illness were significantly associated with 14 and 34 diseases, respectively, among those investigated. These results can be helpful to clinicians and policy makers for prioritizing interventions.
Published: 2022

17. The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

Author: La Rosa, G, Iaconelli, M, Veneri, C, Mancini, P, Bonanno Ferraro, G, Brandtner, D, Lucentini, L, Bonadonna, L, Rossi, M, Grigioni, M, Suffredini, E, Bucciarelli, G, Torlontano, P, Aprea, G, La Bianca, M, Cifarelli, R, Palma, A, La Vecchia, G, Lauria, G, Brienza, R, Montenegro, P, D'Argenzio, A, Cossentino, L, Olivares, R, Pizzolante, A, Fusco, G, Tosco, A, Porta, A, Pennino, F, Maria, T, Angelini, P, De Lellis, L, Nasci, D, Alborali, G, Formenti, N, Guarneri, F, Fontani, N, Nani, G, Palumbo, F, Borlone, G, Guercio, M, Gentili, L, Mariuz, M, Trani, G, Pariani, A, Ancona, C, Giorgi, D, Ferrante, I, Monfrinotti, M, Riosa, S, Capparuccini, V, Scicluna, M, Cersini, A, Arizzi, M, Cecchini, G, Ottaviano, C, Nicosia, E, Grasselli, E, Allaria, G, Izzotti, A, Rosatto, S, Ammoni, E, Cereda, D, Losio, M, Bertasi, B, Aliscioni, A, Oliva, D, Castiglioni, S, Schiarea, S, Zuccato, E, Antonelli, M, Azzellino, A, Malpei, F, Turolla, A, Binda, S, Laura, P, Primache, V, Cocuzza, C, Franzetti, A, Bertanza, G, Callegari, M, Bolognini, L, Filippetti, F, Paniccia', M, Ciuti, F, Briscolini, S, Magi, S, Colitti, M, Montanaro, C, Cerroni, M, Griglio, B, Berruti, R, Cravero, M, Costa, A, Bianchi, M, Decastelli, L, Romano, A, Zuccon, F, Carraro, E, Pignata, C, Bonetta, S, Di Vittorio, G, Mongelli, O, De Giglio, O, Apollonio, F, Triggiano, F, Montagna, M, Ungaro, N, Palermo, M, Maida, C, Mazzucco, W, De Grazia, S, Giammanco, G, Purpari, G, Ferrante, M, Agodi, A, Barchitta, M, Cala', P, Carducci, A, Verani, M, Federigi, I, Lauretani, G, Muzio, S, Ramazzotti, M, Antonelli, A, Ricci, E, Santoro, G, Federici, E, Petricciuolo, M, Barigelli, S, Ruffier, M, Borney, F, Grange, E, Damasco, F, Russo, F, Pitter, G, Groppi, V, Rigoli, F, Zampini, M, Baldovin, T, Amoruso, I, Mengon, E, Cadonna, M, Postinghel, M, Pizzo, F, Schiavuzzi, A, Cutrupi, F, Foladori, P, Manara, S, Zago, L, Stenico, A, Prast, A, La Rosa G., Iaconelli M., Veneri C., Mancini P., Bonanno Ferraro G., Brandtner D., Lucentini L., Bonadonna L., Rossi M., Grigioni M., Suffredini E., Bucciarelli G., Torlontano P., Aprea G., La Bianca M., Cifarelli R. A., Palma A., La Vecchia G., Lauria G., Brienza R., Montenegro P., D'Argenzio A., Cossentino L., Olivares R., Pizzolante A., Fusco G., Tosco A., Porta A., Pennino F., Maria T., Angelini P., De Lellis L., Nasci D., Alborali G., Formenti N., Guarneri F., Fontani N., Nani G., Palumbo F., Borlone G., Guercio M., Gentili L., Mariuz M., Trani G., Pariani A., Ancona C., Giorgi D. A., Ferrante I., Monfrinotti M., Riosa S., Capparuccini V., Scicluna M. T., Cersini A., Arizzi M., Cecchini G., Ottaviano C., Nicosia E., Grasselli E., Allaria G., Izzotti A., Rosatto S., Ammoni E., Cereda D., Losio M. N., Bertasi B., Aliscioni A., Oliva D., Castiglioni S., Schiarea S., Zuccato E., Antonelli M., Azzellino A., Malpei F., Turolla A., Binda S., Laura P., Primache V., Cocuzza C., Franzetti A., Bertanza G., Callegari M. L., Bolognini L., Filippetti F., Paniccia' M., Ciuti F., Briscolini S., Magi S., Colitti M., Montanaro C., Cerroni M. G., Griglio B., Berruti R., Cravero M., Costa A., Bianchi M., Decastelli L., Romano A., Zuccon F., Carraro E., Pignata C., Bonetta S., Di Vittorio G., Mongelli O., De Giglio O., Apollonio F., Triggiano F., Montagna M. T., Ungaro N., Palermo M., Maida C. M., Mazzucco W., De Grazia S., Giammanco G., Purpari G., Ferrante M., Agodi A., Barchitta M., Cala' P., Carducci A., Verani M., Federigi I., Lauretani G., Muzio S., Ramazzotti M., Antonelli A., Ricci E., Santoro G., Federici E., Petricciuolo M., Barigelli S., Ruffier M., Borney F., Grange E., Damasco F., Russo F., Pitter G., Groppi V., Rigoli F., Zampini M., Baldovin T., Amoruso I., Mengon E., Cadonna M., Postinghel M., Pizzo F., Schiavuzzi A., Cutrupi F., Foladori P., Manara S., Zago L., Stenico A., Prast A. -M., La Rosa, G, Iaconelli, M, Veneri, C, Mancini, P, Bonanno Ferraro, G, Brandtner, D, Lucentini, L, Bonadonna, L, Rossi, M, Grigioni, M, Suffredini, E, Bucciarelli, G, Torlontano, P, Aprea, G, La Bianca, M, Cifarelli, R, Palma, A, La Vecchia, G, Lauria, G, Brienza, R, Montenegro, P, D'Argenzio, A, Cossentino, L, Olivares, R, Pizzolante, A, Fusco, G, Tosco, A, Porta, A, Pennino, F, Maria, T, Angelini, P, De Lellis, L, Nasci, D, Alborali, G, Formenti, N, Guarneri, F, Fontani, N, Nani, G, Palumbo, F, Borlone, G, Guercio, M, Gentili, L, Mariuz, M, Trani, G, Pariani, A, Ancona, C, Giorgi, D, Ferrante, I, Monfrinotti, M, Riosa, S, Capparuccini, V, Scicluna, M, Cersini, A, Arizzi, M, Cecchini, G, Ottaviano, C, Nicosia, E, Grasselli, E, Allaria, G, Izzotti, A, Rosatto, S, Ammoni, E, Cereda, D, Losio, M, Bertasi, B, Aliscioni, A, Oliva, D, Castiglioni, S, Schiarea, S, Zuccato, E, Antonelli, M, Azzellino, A, Malpei, F, Turolla, A, Binda, S, Laura, P, Primache, V, Cocuzza, C, Franzetti, A, Bertanza, G, Callegari, M, Bolognini, L, Filippetti, F, Paniccia', M, Ciuti, F, Briscolini, S, Magi, S, Colitti, M, Montanaro, C, Cerroni, M, Griglio, B, Berruti, R, Cravero, M, Costa, A, Bianchi, M, Decastelli, L, Romano, A, Zuccon, F, Carraro, E, Pignata, C, Bonetta, S, Di Vittorio, G, Mongelli, O, De Giglio, O, Apollonio, F, Triggiano, F, Montagna, M, Ungaro, N, Palermo, M, Maida, C, Mazzucco, W, De Grazia, S, Giammanco, G, Purpari, G, Ferrante, M, Agodi, A, Barchitta, M, Cala', P, Carducci, A, Verani, M, Federigi, I, Lauretani, G, Muzio, S, Ramazzotti, M, Antonelli, A, Ricci, E, Santoro, G, Federici, E, Petricciuolo, M, Barigelli, S, Ruffier, M, Borney, F, Grange, E, Damasco, F, Russo, F, Pitter, G, Groppi, V, Rigoli, F, Zampini, M, Baldovin, T, Amoruso, I, Mengon, E, Cadonna, M, Postinghel, M, Pizzo, F, Schiavuzzi, A, Cutrupi, F, Foladori, P, Manara, S, Zago, L, Stenico, A, Prast, A, La Rosa G., Iaconelli M., Veneri C., Mancini P., Bonanno Ferraro G., Brandtner D., Lucentini L., Bonadonna L., Rossi M., Grigioni M., Suffredini E., Bucciarelli G., Torlontano P., Aprea G., La Bianca M., Cifarelli R. A., Palma A., La Vecchia G., Lauria G., Brienza R., Montenegro P., D'Argenzio A., Cossentino L., Olivares R., Pizzolante A., Fusco G., Tosco A., Porta A., Pennino F., Maria T., Angelini P., De Lellis L., Nasci D., Alborali G., Formenti N., Guarneri F., Fontani N., Nani G., Palumbo F., Borlone G., Guercio M., Gentili L., Mariuz M., Trani G., Pariani A., Ancona C., Giorgi D. A., Ferrante I., Monfrinotti M., Riosa S., Capparuccini V., Scicluna M. T., Cersini A., Arizzi M., Cecchini G., Ottaviano C., Nicosia E., Grasselli E., Allaria G., Izzotti A., Rosatto S., Ammoni E., Cereda D., Losio M. N., Bertasi B., Aliscioni A., Oliva D., Castiglioni S., Schiarea S., Zuccato E., Antonelli M., Azzellino A., Malpei F., Turolla A., Binda S., Laura P., Primache V., Cocuzza C., Franzetti A., Bertanza G., Callegari M. L., Bolognini L., Filippetti F., Paniccia' M., Ciuti F., Briscolini S., Magi S., Colitti M., Montanaro C., Cerroni M. G., Griglio B., Berruti R., Cravero M., Costa A., Bianchi M., Decastelli L., Romano A., Zuccon F., Carraro E., Pignata C., Bonetta S., Di Vittorio G., Mongelli O., De Giglio O., Apollonio F., Triggiano F., Montagna M. T., Ungaro N., Palermo M., Maida C. M., Mazzucco W., De Grazia S., Giammanco G., Purpari G., Ferrante M., Agodi A., Barchitta M., Cala' P., Carducci A., Verani M., Federigi I., Lauretani G., Muzio S., Ramazzotti M., Antonelli A., Ricci E., Santoro G., Federici E., Petricciuolo M., Barigelli S., Ruffier M., Borney F., Grange E., Damasco F., Russo F., Pitter G., Groppi V., Rigoli F., Zampini M., Baldovin T., Amoruso I., Mengon E., Cadonna M., Postinghel M., Pizzo F., Schiavuzzi A., Cutrupi F., Foladori P., Manara S., Zago L., Stenico A., and Prast A. -M.
Abstract: The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5–11 December, to 17.5% (25/143 samples) in the week 12–18, to 65.9% (89/135 samples) in the week 19–25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased from one in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons. In conclusion, we designed an RT-qPCR assay capable to detect the Omicron variant, which can be successfully used for the purpose of wastewater-based epidemiology. We also described the history of the introduction and diffusion of the Omicron variant in the Italian population and territory, confirming the effectiveness of sewage monitoring as a powerful surveillance tool.
Published: 2022

18. Protective action of natural and induced immunization against the occurrence of delta or alpha variants of SARS-CoV-2 infection: a test-negative case-control study

Author: Corrao, G, Franchi, M, Rea, F, Cereda, D, Barone, A, Borriello, C, Della Valle, P, Ercolanoni, M, Fortino, I, Jara, J, Leoni, O, Mazziotta, F, Pierini, E, Preziosi, G, Tirani, M, Galli, M, Bertolaso, G, Pavesi, G, Bortolan, F, Corrao G., Franchi M., Rea F., Cereda D., Barone A., Borriello C. R., Della Valle P. G., Ercolanoni M., Fortino I., Jara J., Leoni O., Mazziotta F., Pierini E., Preziosi G., Tirani M., Galli M., Bertolaso G., Pavesi G., Bortolan F., Corrao, G, Franchi, M, Rea, F, Cereda, D, Barone, A, Borriello, C, Della Valle, P, Ercolanoni, M, Fortino, I, Jara, J, Leoni, O, Mazziotta, F, Pierini, E, Preziosi, G, Tirani, M, Galli, M, Bertolaso, G, Pavesi, G, Bortolan, F, Corrao G., Franchi M., Rea F., Cereda D., Barone A., Borriello C. R., Della Valle P. G., Ercolanoni M., Fortino I., Jara J., Leoni O., Mazziotta F., Pierini E., Preziosi G., Tirani M., Galli M., Bertolaso G., Pavesi G., and Bortolan F.
Abstract: Background: The evolution of SARS-CoV-2 has led to the emergence of several new variants, and few data are available on the impact of vaccination on SARS-CoV-2 variants. We aimed to assess the association between natural (previous infection) and induced (partial or complete vaccination) exposure to SARS-CoV-2 and the onset of new infection supported by the delta variant, and of comparing it with that supported by alpha. Methods: We performed a test-negative case-control study, by linking population-based registries of confirmed diagnoses of infection with SARS-CoV-2, vaccinations against Covid-19 and healthcare utilization databases of the Italian Lombardy Region. Four hundred ninety-six persons who between 27 December 2020 and 16 July 2021 had an infection by the delta variant were 1:1 matched with citizens affected by alphavariant and 1:10 matched with persons who had a negative molecular test, according to gender, age and date of molecular ascertainment. We used a conditional logistic regression for estimating relative risk reduction of either variants associated with natural and/or induced immunization and corresponding 95% confidence interval (CI). Results: Previous infection was associated with 91% (95% CI 85% to 95%) reduced relative risk of reinfection, without evidence of significant differences between delta and alpha cases (p=0.547). Significant lower vaccinal protection against delta than alpha variant infection was observed with reduced relative risk associated with partial vaccination respectively of 29% (7% to 45%), and 62% (48% to 71%) (p=0.001), and with complete vaccination respectively of 75% (66% to 82%) and 90% (85% to 94%) (p=0.003). Conclusions: Lower protection towards infections caused by the delta variant with respect to alpha variant was noticed, even after the completion of the vaccination cycle. This finding would support efforts to maximize both vaccine uptake with two doses and fulfilment with individual protection measures, especially
Published: 2022

19. Detecting early signals of COVID-19 outbreaks in 2020 in small areas by monitoring healthcare utilisation databases: first lessons learned from the Italian Alert_CoV project

Author: Merlo, I, Crea, M, Berta, P, Ieva, F, Carle, F, Rea, F, Porcu, G, Savaré, L, De Maio, R, Villa, M, Cereda, D, Leoni, O, Bortolan, F, Sechi, G, Bella, A, Pezzotti, P, Brusaferro, S, Blangiardo, G, Fedeli, M, Corrao, G, Merlo, Ivan, Crea, Mariano, Berta, Paolo, Ieva, Francesca, Carle, Flavia, Rea, Federico, Porcu, Gloria, Savaré, Laura, De Maio, Raul, Villa, Marco, Cereda, Danilo, Leoni, Olivia, Bortolan, Francesco, Sechi, Giuseppe Maria, Bella, Antonino, Pezzotti, Patrizio, Brusaferro, Silvio, Blangiardo, Gian Carlo, Fedeli, Massimo, Corrao, Giovanni, Merlo, I, Crea, M, Berta, P, Ieva, F, Carle, F, Rea, F, Porcu, G, Savaré, L, De Maio, R, Villa, M, Cereda, D, Leoni, O, Bortolan, F, Sechi, G, Bella, A, Pezzotti, P, Brusaferro, S, Blangiardo, G, Fedeli, M, Corrao, G, Merlo, Ivan, Crea, Mariano, Berta, Paolo, Ieva, Francesca, Carle, Flavia, Rea, Federico, Porcu, Gloria, Savaré, Laura, De Maio, Raul, Villa, Marco, Cereda, Danilo, Leoni, Olivia, Bortolan, Francesco, Sechi, Giuseppe Maria, Bella, Antonino, Pezzotti, Patrizio, Brusaferro, Silvio, Blangiardo, Gian Carlo, Fedeli, Massimo, and Corrao, Giovanni
Abstract: BackgroundDuring the COVID-19 pandemic, large-scale diagnostic testing and contact tracing have proven insufficient to promptly monitor the spread of infections.AimTo develop and retrospectively evaluate a system identifying aberrations in the use of selected healthcare services to timely detect COVID-19 outbreaks in small areas.MethodsData were retrieved from the healthcare utilisation (HCU) databases of the Lombardy Region, Italy. We identified eight services suggesting a respiratory infection (syndromic proxies). Count time series reporting the weekly occurrence of each proxy from 2015 to 2020 were generated considering small administrative areas (i.e. census units of Cremona and Mantua provinces). The ability to uncover aberrations during 2020 was tested for two algorithms: the improved Farrington algorithm and the generalised likelihood ratio-based procedure for negative binomial counts. To evaluate these algorithms' performance in detecting outbreaks earlier than the standard surveillance, confirmed outbreaks, defined according to the weekly number of confirmed COVID-19 cases, were used as reference. Performances were assessed separately for the first and second semester of the year. Proxies positively impacting performance were identified.ResultsWe estimated that 70% of outbreaks could be detected early using the proposed approach, with a corresponding false positive rate of ca 20%. Performance did not substantially differ either between algorithms or semesters. The best proxies included emergency calls for respiratory or infectious disease causes and emergency room visits.ConclusionImplementing HCU-based monitoring systems in small areas deserves further investigations as it could facilitate the containment of COVID-19 and other unknown infectious diseases in the future.
Published: 2023

20. Web-based surveillance of respiratory infection outbreaks: retrospective analysis of Italian COVID-19 epidemic waves using Google Trends

Author: Porcu, G, Chen, Y, Bonaugurio, A, Villa, S, Riva, L, Messina, V, Bagarella, G, Maistrello, M, Leoni, O, Cereda, D, Matone, F, Gori, A, Corrao, G, Porcu, Gloria, Chen, Yu Xi, Bonaugurio, Andrea Stella, Villa, Simone, Riva, Leonardo, Messina, Vincenzina, Bagarella, Giorgio, Maistrello, Mauro, Leoni, Olivia, Cereda, Danilo, Matone, Fulvio, Gori, Andrea, Corrao, Giovanni, Porcu, G, Chen, Y, Bonaugurio, A, Villa, S, Riva, L, Messina, V, Bagarella, G, Maistrello, M, Leoni, O, Cereda, D, Matone, F, Gori, A, Corrao, G, Porcu, Gloria, Chen, Yu Xi, Bonaugurio, Andrea Stella, Villa, Simone, Riva, Leonardo, Messina, Vincenzina, Bagarella, Giorgio, Maistrello, Mauro, Leoni, Olivia, Cereda, Danilo, Matone, Fulvio, Gori, Andrea, and Corrao, Giovanni
Abstract: Introduction: Large-scale diagnostic testing has been proven insufficient to promptly monitor the spread of the Coronavirus disease 2019. Electronic resources may provide better insight into the early detection of epidemics. We aimed to retrospectively explore whether the Google search volume has been useful in detecting Severe Acute Respiratory Syndrome Coronavirus outbreaks early compared to the swab-based surveillance system. Methods: The Google Trends website was used by applying the research to three Italian regions (Lombardy, Marche, and Sicily), covering 16 million Italian citizens. An autoregressive-moving-average model was fitted, and residual charts were plotted to detect outliers in weekly searches of five keywords. Signals that occurred during periods labelled as free from epidemics were used to measure Positive Predictive Values and False Negative Rates in anticipating the epidemic wave occurrence. Results: Signals from “fever,” “cough,” and “sore throat” showed better performance than those from “loss of smell” and “loss of taste.” More than 80% of true epidemic waves were detected early by the occurrence of at least an outlier signal in Lombardy, although this implies a 20% false alarm signals. Performance was poorer for Sicily and Marche. Conclusion: Monitoring the volume of Google searches can be a valuable tool for early detection of respiratory infectious disease outbreaks, particularly in areas with high access to home internet. The inclusion of web-based syndromic keywords is promising as it could facilitate the containment of COVID-19 and perhaps other unknown infectious diseases in the future.
Published: 2023

21. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author: Tonetti T., Grasselli G., Zanella A., Pizzilli G., Fumagalli R., Piva S., Lorini L., Iotti G., Foti G., Colombo S., Vivona L., Rossi S., Girardis M., Agnoletti V., Campagna A., Gordini G., Navalesi P., Boscolo A., Graziano A., Valeri I., Vianello A., Cereda D., Filippini C., Cecconi M., Locatelli F., Bartoletti M., Giannella M., Viale P., Antonelli M., Nava S., Pesenti A., Ranieri V. M., Albano G., Alborghetti A., Aldegheri G., Antonini B., Belgiorno N., Bellani G., Beretta E., Bonazzi S., Borelli M., Cabrini L., Carnevale L., Carnevale S., Castelli G., Catena E., Chiumello D., Coluccello A., Coppini D., Covello D., DeFilippi G., DeiPoli M., Dughi P., Gallioli G., Gnesin P., Greco S., Guatteri L., Guzzon D., Keim R., Landoni G., Langer T., Lombardo A., Marino G., Merli G., Merlo D., Mojoli F., Muttini S., Natalini G., Petrucci N., Pezzi A., Radrizzani D., Raimondi M., Riccio M., Storti E., Tavola M., Vitale G., Bosco E., Calo M. A., Danzi V., DeRosa S., Farnia A., Lazzari F., Meggiolaro M., Munari M., Saia M., Sella N., Serra E., Tiberio I., Baiocchi M., Benedetto M., Bordini M., Caramelli F., Cilloni N., DellaGiovampaola M., Fanelli A., Frascaroli G., Fusari M., Maitan S., Martino C., Melotti R. M., Merola R., Minardi F., Moro F., Nardi G., Nolli M., Pierucci E., Potalivo A., Repetti F., Salsi P., Terzitta M., Tosi M., Venturi S., Volta C. A., Zani G., Zanoni A (COVID-19 Northern Italian ICU Network), Landoni G, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, F., Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A (COVID-19 Northern Italian ICU Network), and Landoni, G
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Respiratory rate, Socio-culturale, Critical Care and Intensive Care Medicine, Acute respiratory failure, acute respiratory failure, COVID-19, ICU, non-invasive ventilation, rationing, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Intensive care, Retrospective analysis, Medicine, 030212 general & internal medicine, Non-invasive ventilation, Rationing, Case report form, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Outbreak, lcsh:RC86-88.9, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, 030228 respiratory system, Emergency medicine, Base excess, business
Abstract: Background A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.
Published: 2020

22. Monkeypox epidemic in prisons: How to prevent it?

Author: Cocco, N., primary, Sebastiani, T., additional, Giuliani, R., additional, Cereda, D., additional, D'Arminio Monforte, A., additional, Tavoschi, L., additional, and Ranieri, R., additional
Published: 2022
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23. Underreporting of congenital rubella in Italy, 2010–2014

Author: Giambi, Cristina, Bella, Antonino, Filia, Antonietta, Del Manso, Martina, Nacca, Gloria, Declich, Silvia, Rota, Maria Cristina, Di Giacomo, M., Locuratolo, F., Cauzillo, G., Natter, B., Mignuoli, A., Pascucci, M. G., Frasca, G., Gallo, T., Braida, C., Vitagliano, A., Guerra, M., Scognamiglio, P., Cremonesi, I., Piatti, A., Cereda, D., Senatore, S., Fiacchini, D., Giuliani, S., Ponzio, G. V., Ferrara, L., Giovannetti, F., Prato, R., Cappelli, M. G., Palmas, M. A., Macis, F., Palermo, M., Balocchini, E., Pecori, L., Carraro, V., Zuccali, M. G., Ruffier, M., Russo, F., Zanella, F., Bano, M., Tosti, A., and Regional contact points for rubella
Published: 2017
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24. Who is really blind in the time of coronavirus: the patient or the doctor? A rare case of Balint’s syndrome

Author: Storti, B, Cereda, D, Balducci, C, Santangelo, F, Ferrarese, C, Appollonio, I, Storti B., Cereda D., Balducci C., Santangelo F., Ferrarese C., Appollonio I., Storti, B, Cereda, D, Balducci, C, Santangelo, F, Ferrarese, C, Appollonio, I, Storti B., Cereda D., Balducci C., Santangelo F., Ferrarese C., and Appollonio I.
Abstract: Background Selective bilateral lesions of the parietal-occipital lobes can lead to an uncommon and incompletely understood clinical entity, Balint' syndrome, which consists of simultanagnosia, oculomotor apraxia, optic ataxia and difficulty in perceiving distances between objects. Case presentation We herein report a rare presentation of Balint's syndrome in a 65-year-old woman suffering from stroke and SARS-CoV2 infection. Conclusion During SARS-CoV2 pandemic, Italian physicians were forced to work with less instrumental diagnostic resources, relying on their clinical knowledge mostly. The aim of this case report is to highlight the importance of performing a precise neurological evaluation, particularly during these challenging times: it might avoid incorrect diagnosis and favour the discovery of rare clinical diseases.
Published: 2021

25. Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome

Author: Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, Albanese, Y, Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., Albanese Y., Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, Albanese, Y, Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., and Albanese Y.
Abstract: Objective: To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10 years. Two pairs of raters independently reviewed patients’ records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsing-remitting course, and 4.8% of patients with sustained remission (p =.016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p =.013); for respiratory diseases were 3.6%,.3%, and.3% (p =.001), and for urogenital diseases were 3.6%,.7%, and 1.6% (p =.048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and clinical variables, with patients with these comorbidities showing a lower probability of achieving remission. Signifi
Published: 2021

26. Discontinuation of antiseizure medications in seizure-free patients with long-term follow-up: Patients’ profile, seizure recurrence, and risk factors

Author: Beghi, E, Beretta, S, Colombo, M, Bianchi, E, Carone, D, Zanchi, C, Tinti, L, Pirovano, M, Trentini, C, Padovano, G, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi E., Beretta S., Colombo M., Bianchi E., Carone D., Zanchi C., Tinti L., Pirovano M., Trentini C., Padovano G., Cereda D., Scanziani S., Giussani G., Gasparini S., Bogliun G., Ferrarese C., Beghi, E, Beretta, S, Colombo, M, Bianchi, E, Carone, D, Zanchi, C, Tinti, L, Pirovano, M, Trentini, C, Padovano, G, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi E., Beretta S., Colombo M., Bianchi E., Carone D., Zanchi C., Tinti L., Pirovano M., Trentini C., Padovano G., Cereda D., Scanziani S., Giussani G., Gasparini S., Bogliun G., and Ferrarese C.
Abstract: Objective: To compare withdrawal of antiseizure medications (ASM) to continued treatment in newly diagnosed individuals achieving seizure freedom, and assess the risk of relapse and factors associated with relapse. Methods: This is a multicenter retrospective cohort study with long-term follow-up. Patients with newly diagnosed epilepsy were identified from the medical records of 13 Italian epilepsy centers and followed up until the most recent visit or death. Seizure-free patients discontinuing treatment were compared to patients who maintained treatment for baseline characteristics. Treatment was stopped upon clinical judgment. The probability of relapse was calculated with the Kaplan–Meier method. Demographic, clinical, and instrumental variables associated with relapse were assessed with Cox proportional hazards models. Results: One thousand and six patients aged 1 month to 72 years at diagnosis were enrolled and followed up for 17,892 person-years (median follow-up, 9.9 years). Three hundred and twenty patients (31.8%) underwent one or more treatment discontinuations. Factors associated with ASM withdrawal were younger age at remission and normal psychiatric examination. The probability of relapse after the first withdrawal was 16% at six months, 24% at 12 months, and 36%, 45%, and 53% at three, five, and ten years, respectively. The probability of remission after the first relapse was 59% at one month, 67%, 72, and 76% at three, six, and 12 months, respectively. Variables associated with relapse were age 14+ years, structural etiology, abnormal neuroimaging, ASM initiation after a single seizure, and symptomatic/cryptogenic epilepsy. Conclusions: About one half of seizure-free patients stopping ASM relapse in 10 years. However, the possibility of remission after relapse is high, particularly in children and patients with idiopathic/cryptogenic epilepsy. Treatment deprescription might be encouraged at least in these patients.
Published: 2021

27. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Author: Morandi, A, Zambon, A, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Gabriele, A, Lenino, P, Andrea, T, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, M, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Claudio, P, Angelo, B, Flavio, C, Benedetta, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Fabio, S, De Filippi, F, Giudice, C, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Claudia Benati, H, Nesta, E, Tobaldini, C, Guerini, F, Elena, T, Mombelloni, P, Fontanini, F, Gabriella, L, Pizzorni, C, Oliverio, M, Del Grosso, L, Giavedoni, C, Bidoli, G, Mazzei, B, Corsonello, A, Fusco, S, Vena, S, De Vuono, T, Maiuri, G, Luca, F, Andrea, A, Giovanni, S, Rossella, N, Castegnaro, E, De Rosa, S, Sechi, R, Benvenuti, E, Del Lungo, I, Giardini, S, Giulietti, C, Mauro, D, Eleonora, B, Martina, P, Irene, F, Riccardo, B, Federica, S, Ilaria, D, Bertoletti, E, D'Amico, F, Caronzolo, F, Grippa, A, Lombardo, G, Pipicella, T, Antonino, S, Francesco, C, Valeria, P, Daniela, L, Domenico, C, Giorgio, B, March, A, Nitti, M, Felici, A, Pavan, S, Piazzani, F, Lunelli, A, Dimori, S, Margotta, A, Soglia, T, Postacchini, D, Brunelli, R, Santini, S, Francavilla, M, Macchiati, I, Sorvillo, F, Giuli, C, Mecocci, P, Longo, A, Perticone, F, Addesi, D, Rosa, P, Bencardino, G, Falbo, T, Grillo, N, Marco, F, Mirella, F, Fanto, F, Isaia, G, Pezzilli, S, Bergamo, D, Furno, E, Rrodhe, S, Lucarini, S, Dijk, B, Dall'Acqua, F, Cappelletto, F, Calvani, D, Becheri, D, Giuseppe, M, Costanza, M, Vito, A, Francesca, B, Magherini, L, Novella, M, Franca, B, Lucia Gambardella, P, Valente, C, Ilaria, B, Alice, F, Porrino, P, Ceci, G, Giuliana, B, Michela, T, Eleonora, C, Ettore, E, Camellini, C, Servello, A, Grassi, A, Rozzini, R, Tironi, S, Grassi, M, Troisi, E, Carlo, C, Simona Gabriella, D, Flaminia, F, Federica, R, Beatrice, P, Sofia, T, Gabutto, A, Quazzo, L, Rosatello, A, Suraci, D, Tagliabue, B, Perrone, C, Ferrara, L, Castagna, A, Tremolada, M, Giuseppe, C, Stefano, B, Davide, O, Piano, S, Serviddio, G, Lo Buglio, A, Gurrera, T, Merlo, V, Rovai, C, Cotroneo, A, Carlucci, R, Abbaldo, A, Monzani, F, Qasem, A, Bini, G, Tafuto, S, Galli, G, Bruni, A, Mancuso, G, Calipari, D, Giuseppe Massimiliano, D, Bernardini, B, Corsini, C, Michele, C, Sara, D, Cagnin, A, Fragiacomo, F, Pompanin, S, Piero, A, Marco, C, Zurlo, A, Guerra, G, Pala, M, Menozzi, L, Gatti, C, Magon, S, Roberto, M, Alfredo, D, Fabio, F, Ruana, T, Elisa, M, Christian, M, Marco, P, Massimo, G, Di Francesco, V, Faccioli, S, Pellizzari, L, Giorgia, F, Barbagallo, G, Lunardelli, M, Martini, E, Ferrari, E, Macchiarulo, M, Corneli, M, Bacci, M, Battaglia, G, Anastasio, L, Lo Storto, M, Seresin, C, Simonato, M, Loreggian, M, Cestonaro, F, Durando, M, Latella, R, Mazzoleni, M, Russo, G, Ponte, M, Valchera, A, Salustri, G, Petritola, D, Costa, A, Sinforiani, E, Cotta, M, Pizio, R, Cester, A, Formilan, M, Pietro, B, Carbone, P, Cazzaniga, I, Appollonio, I, Cereda, D, Stabile, A, Xhani, R, Acampora, R, Tremolizzo, L, Federico, P, Antonio, C, Valerio, P, Cesare, B, Zhirajr, M, Giovanni, V, Maria, A, Mariaelena, S, Bottacchi, E, Bucciantini, E, Di Giovanni, M, Franchi, F, Lucchetti, L, Mariani, C, Grande, G, Rapazzini, P, Marco, M, Romanelli, G, Franco, N, Alessio, M, Nicola, L, Laura, P, Nazario, P, Chiara, G, Soccorso, P, Andrea, S, Luca, B, Francesca, S, Roberto, A, Anna, C, Fugazza, L, Guerrini, C, De Paduanis, G, Iallonardo, L, Palumbo, P, Zuliani, G, Ortolani, B, Capatti, E, Soavi, C, Bianchi, L, Francesconi, D, Miselli, A, Gloria, B, Tommaso, R, Chiara, P, Agata, M, Marco, D, Luca, M, Gianluca, G, Suardi, T, Zaccarini, C, Manuela, R, Mirra, G, Muti, E, Bottura, R, Gianpaolo, M, Secreto, P, Bisio, E, Cecchettani, M, Naldi, T, Pallavicino, A, Pugliese, M, Iozzo, R, Grassi, G, Bombelli, M, Dell'Oro, R, Quarti Trevano, F, Giussani, G, Paternò, G, Contro, E, Mannironi, A, Giorli, E, Oberti, S, Fierro, B, Piccoli, T, Giacalone, F, Mandas, A, Serchisu, L, Costaggiu, D, Pinna, E, Orru, F, Mannai, M, Cordioli, Z, Pelizzari, L, Turcato, E, Arduini, P, Cacace, C, Chiloiro, R, Cimino, R, Ruberto, C, Giovanni, R, Pietro, G, Laura, G, Alberto, C, Carmen, R, Santo, P, Andriolli, A, Burattin, G, Rossi, L, Andreolli Antonino, C, Tezza, F, Maddalena, P, Laura, S, Crippa, P, Aloisio, P, Di Monda, T, Malighetti, A, Galbassini, G, Salutis, D, Ivaldi, C, Russo, A, Bennati, E, Pino, E, Zavarise, G, Pesci, A, Suigo, G, Faverio, P, Andrea, G, Sabrina, P, Zanasi, M, Moniello, G, Rostagno, C, Cartei, A, Polidori, G, Ungar, A, Melis, M, Martellini, E, Enrico, M, Monica, T, Antonella, G, Giovanna, L, Migliorini, M, Caramelli, F, Battiston, B, Berardino, M, Cavallo, S, Alessandro, M, Anna, S, Lombardi, B, D'Ippolito, P, Furini, A, Villani, D, Clara, R, Guarneri, M, Paolucci, S, Bassi, A, Coiro, P, De Angelis, D, Morone, G, Venturiero, V, Palleschi, L, Raganato, P, Di Niro, G, Rosa, C, Loredana, B, Imoscopi, A, Tibaldi, V, Bottignole G, G, Calvi, E, Clementi, C, Zanocchi, M, Agosta, L, Nortarelli, A, Provenzano, G, Mari, D, Romano, F, Rosini, F, Mansi, M, Rossi, S, Geriatria, A, Inzaghi, L, Bonini, G, Rossi, P, Potena, A, Lichii, M, Candiani, T, Grimaldi, W, Bertani, E, Alessandra, P, Calogero, P, Pinto, D, Bernardi, R, Nicolino, F, Galetti, C, Gianstefani, A, Giulia, C, Lorenzo, M, Odetti, P, Monacelli, F, Prefumo, M, Fiammetta, M, Canepa, M, Minaglia, C, Paolisso, G, Rizzo, M, Prestano, R, Dalise, A, Barra, D, Bosco, L, Asprinio, V, Dallape, L, Perina, E, Incalzi, R, Bartoli, I, Pluderi, A, Maina, A, Pecoraro, E, Sciarra, M, Prudente, A, Paola, M, Francesca, M, Manuel, V, Luisella, C, Maria, P, Tina, S, Benini, L, Levato, F, Mhiuta, V, Alius, F, Davidoaia, D, Giardini, V, Garancini, M, Bellamoli, C, Terranova, L, Bozzini, C, Tosoni, P, Provoli, E, Cascone, L, Dioli, A, Ferrarin, G, Bucci, A, Bua, G, Fenu, S, Bianchi, G, Casella, S, Romano, V, Maurizio, P, Mascherona, I, Belotti, G, Cavaliere, S, Cuni, E, Merciuc, N, Oberti, R, Veneziani, S, Capoferri, E, De Bernardi, E, Colombo, K, Bravi, M, Nicoletta, N, D'Arcangelo, P, Montenegro, N, Montanari, R, Lamanna, P, Gasperini, B, Isabella, M, Stefania, D, Gaia, A, Filippo, C, Palama, C, Di Emidio, C, Scarpini, E, Arighi, A, Fumagalli, G, Basilico, P, De Amicis Margherita, M, Marta, M, Diletta, M, Granata, A, Ranalli, C, Cammilli, A, Cavallini, M, Tricca, M, Natella, D, Gabbani, L, Tesi, F, Martella, L, Imbrici, R, Guerrini, G, Scotuzzi, A, Sozzi, F, Valenti, L, Chiarello, A, Monia, M, Pilotto, A, Prete, C, Senesi, B, Meta, A, Pendenza, E, Pasqualetti, G, Polini, A, Tognini, S, Ballino, E, Dell'Aquila, G, Gasparrini, P, Marotti, E, Migale, M, Scrimieri, A, Falsetti, L, Salvi, A, Toigo, G, Ceschia, G, Rosso, A, Tongiorgi, C, Scarpa, C, De Dominicis, L, Pucci, E, Renzi, S, Cartechini, E, Tomassini, P, Del Gobbo, M, Ugenti, F, Romeo, P, Nardelli, A, Lauretani, F, Visioli, S, Montanari, I, Ermini, F, Giordano, A, Pigato, G, Simeone, E, Barbujani, M, Giampieri, M, Amoruso, R, Piccinini, M, Ferrari, C, Gambetti, C, Sfrappini, M, Semeraro, L, Striuli, R, Pelliccioni, G, Marinelli, D, Fabi, K, Rossi, T, Pesallaccia, M, Sabbatini, D, Gobbi, B, Cerqua, R, Tagliani, G, Schlauser, E, Caser, L, Caramello, E, Sandigliano, F, Rosso, G, Ferrari, A, Bendini, C, Luisa, D, Casella, M, Prampolini, R, Scevola, M, Vitale, E, Roberto, B, Carlo, F, Sergio, F, Alberto, S, Daniela, Z, Giulia, B, Serena, G, Michele, B, Maugeri, D, Sorace, R, Anzaldi, M, De Gesu, R, Morrone, G, Davolio, F, Fabbo, A, Palmieri, M, Zoli, M, Forti, P, Pirazzoli, L, Fabbri, E, Terenzi, L, Bergolari, F, Wenter, C, Ruffini, I, Insam, M, Abraham, E, Kirchlechner, C, Cucinotta, D, Antonino, L, Basile, G, Grazia, A, Parise, P, Boccali, A, Amici, S, Gambacorta, M, Lasagni, A, Lovati, R, Giovinazzo, F, Kimak, E, Zappa, P, Medici, F, Lo Castro, M, Mauro, F, De Luca, A, Sancesario, G, Martorana, A, Scaricamazza, B, Toniolo, S, Di Lorenzo, F, Liguori, C, Lasco, A, Vita, N, Giomi, M, Forte, F, Padovani, A, Rozzini, L, Ceraso, A, Salvatore, C, Cottino, M, Vitali, S, Marelli, E, Tripi, G, Miceli, S, Urso, G, Grioni, G, Vezzadini, G, Misaggi, G, Forlani, C, Avanzi, S, Serena, S, Claudia, C, Marilena, V, Alberto, L, Diego, G, Alessandro, G, Iemolo, F, Sanzaro, E, D'Asta, G, Proietto, M, Carnemolla, A, Razza, G, Spadaro, D, Bertolotti, M, Mussi, C, Neviani, F, Roberto, C, Valentina, G, Linda, M, Francesca, V, Tarozzi, A, Balestri, F, Mannarino, G, Bigolari, M, Natale, A, Grassi, S, Bottaro, C, Stefanelli, S, Bovone, U, Tortorolo, U, Quadri, R, Leone, G, Ponzetto, M, Frasson, P, Annoni, G, Confalonieri, R, Corsi, M, Moretti, D, Teruzzi, F, Umidi, S, Mazzola, P, Perego, S, Persico, I, Olivieri, G, Bonfanti, A, Hajnalka, S, Galeazzi, M, Massariello, F, Anzuini, A, Caffarra, P, Barocco, F, Spallazzi, M, Paolo, C, Simonetta, M, Chioatto, P, Bortolamei, S, Soattin, L, Ruotolo, G, Beneamino, B, Giuseppe, B, Bertazzoli, M, Rota, E, Adobati, A, Scarpa, A, Granziera, S, Zuccher, P, Fabbro, A, Zara, D, Lo Nigro, A, Franchetti, L, Toniolo, M, Marcuzzo, C, Rollone, M, Guerriero, F, Sgarlata, C, Masse, A, Zatti, G, Piatti, M, Graci, J, Benati, G, Boschi, F, Biondi, M, Fiumi, N, Erika, T, Locatelli, S, Mauri, S, Beretta, M, Margheritis, L, Desideri, G, Liberatore, E, Carucci, A, Bonino, P, Caput, M, Antonietti, M, Polistena, G, De la Pierre, F, Mari, M, Massignani, P, Tombesi, F, Selvaggio, F, Verbo, B, Bodoni, P, Marchionni, N, Sabatini, T, Mussio, E, Magni, E, Bianchetti, A, Crucitti, A, Titoldini, G, Cossu, B, Fascendini, S, Licini, C, Tomasoni, A, Calderazzo, M, Daniela, T, Valentina, L, Melotti, R, Lilli, A, Buda, S, Adversi, M, Noro, G, Turco, R, Ubezio, M, Mantovani, A, Viola, M, Serrati, C, Pretta, S, Infante, M, Gentile, S, D'Ambrosio, V, Mazzanti, P, Brambilla, C, Sportelli, S, Platto, C, Faraci, B, Quattrocchi, D, Pernigotti, L, Pisu, C, Sicuro, F, Zagnoni, P, Ghiglia, S, Mosca, M, Corazzin, I, Deola, M, Biagini, C, Bencini, F, Cantini, C, Tonon, E, Pierinelli, S, Onofrj, M, Thomas, A, Filomena, B, Bonanni, L, Gabriella, C, Comi, G, Magnani, G, Santangelo, R, Mazzeo, S, Francesca, C, Giordano, C, Roberto, S, Barbieri, C, Giroldi, L, Bandini, F, Masina, M, Malservisi, S, Cicognani, A, Ricca, L, Piccininni, M, Tassinari, T, Brogi, D, Sugo, A, Alessandra, F, Sonia, M, Valerio, V, Andrea, U, Enrico, C, Vera, R, Assunta, S, Gianmaria, Z, Mauro, P, Barone, A, Razzano, M, Giuseppe, I, Angela, B, Francesco, S, Valeria, D, Federico, G, Lucia, P, Antonella, V, Elisabetta, D, Cristina, R, Nadia, C, Maria, S, Luciano, A, Chiara, C, Bini, P, Pignata, M, Enrico, B, Maria, V, Giovanni, C, Giorgio, C, Piera, R, Alberto, Z, Ceccon, A, Magrin, L, Marin, S, Barbara, S, Matteo, M, Caterina, P, Carla, R, Federica, G, Clara, T, Melania, C, Giampaolo, B, Stefano, G, Valeria, G, Lucia, M, Giovambattista, D, Ester, L, Cecilia, C, Maurizio, T, Nadia, B, Grillo, A, Arenare, F, Tonino, M, David, K, Giorgio, V, Ubaldo, B, Vincenzo, S, Stefano, M, Marino, F, Busonera Flavio, M, Paolo, A, Monica, M, Francesco, B, Roberto, F, Paolo, B, Durantemangoni, E, Testoni, M, Fabio, D, Loredana, S, Valeria, S, Fabiano, M, Annabella, D, Salvatore, D, Greco, A, Grazia, D, Daniele, S, Gianluca, R, Renzo, G, Sergio, M, Morena, B, Vitali, M, Marina, P, Paolo, D, Cristina, S, Orlandini, F, La Regina, M, Desiree, A, Mario, B, Paola, P, Padulo, F, Cristina, M, Dario, R, Giancarla, M, Guido, R, Elena, M, Marileda, N, Igor, B, Nicole, B, Elena, R, Paolillo, C, Riccardi, A, Claudia, B, Barbara, R, Silvia, V, Oliver, B, Mauro, C, Eleonora, M, Giuseppe, P, Rosaria, T, Maria, C, Davide, D, Stefania, C, Massimo, P, Luca, S, Martina, D, Paola, V, Lia, S, Sandro, C, Valentina, D, Erminia, B, Paola, C, Romina, R, Minisola, S, Luciano, C, Pasquale, A, Ilaria, L, Guglielmo, S, Marco, E, Sara, R, Paola, A, Claudio, A, Francesco, R, Alessandro, C, Simona, M, Lara, F, Paola, R, Simonetta, C, Antonella, C, Generoso, U, Fernando, G, Giuliano, C, Emanuela, S, Mariolina, S, Alessandro, D, Giulia, L, Famularo, S, Sandini, M, Pinotti, E, Gianotti, L, Antonella, B, Giulia, P, Sante, G, Rossi, A, Rubele, S, Sant, S, Marco, V, Danila, C, Fabio, R, Bandirali, M, Nicoletta, C, Laura, B, Paolo, T, Luciano, T, Leonello, A, Margherita, S, Pierluigi, D, Laura, R, Fabiana, T, Giovanna, C, Antonino, A, Felice, C, Danilo, F, Giovanna, D, Francesco, L, Salini, S, Giorgetta, C, Giovanni, G, Gerardo, B, Silvio, R, Letizia, S, Davide, B, Rosaria, R, Maria, D, Raffaele, P, Palmieri, V, Palasciano, G, Belfiore, A, Portincasa, P, Carlo, S, Alessia, D, Valiani, V, Carolina, B, Tiziana, C, Paola, T, Ugo, P, Giacomo, P, Castellano, M, Anna, G, Elisa, C, Federica, C, Antonietta, C, Luigi, M, Fabio, L, Salvatore, B, Gelosa, G, Viviana, A, Piras, V, Andrea, C, Alessandra, B, Coen, D, Magliola, R, Milanesio, D, Muzzulini, C, Paolo, F, Marinella, T, Sofia, C, Marta, B, Siano, P, Capo, G, Napoletano, R, Cecilia, P, Mancini, C, Del Buono, C, De Bartolomeo, G, Addolorata, M, Carmen, C, Moschettini, G, Franco, M, Daniela, R, D'Amico, G, Mirella, P, Endrizzi, C, Trotta, L, Ciarambino, T, Orazio, Z, Emanuela, T, Marta, S, Thomas, F, Giacomo, T, Ignazio, D, Andrea, B, Giuseppe, O, Emanuela, F, Serena, A, Elena, D, Serena, B, Erika, N, Elena, S, Manuela, P, Francesca, A, Angelo, T, Morandi A., Zambon A., Di Santo S. G., Mazzone A., Cherubini A., Mossello E., Bo M., Marengoni A., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Lupi G., Paonessa P., Fabbri A., Passuti M. T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Claudia Benati H. S., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L. L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F. F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Sechi R. B., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D. B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Ilaria D. L., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P. G., Daniela L., Domenico C., Giorgio B., March A., Nitti M. T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Perticone F., Addesi D., Rosa P. C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Cappelletto F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Lucia Gambardella P. M., Valente C., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M. G., Troisi E., Carlo C., Simona Gabriella D. S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M. L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A. M., Carlucci R., Abbaldo A., Monzani F., Qasem A. A., Bini G., Tafuto S., Galli G., Bruni A. C., Mancuso G., Calipari D., Giuseppe Massimiliano D. L., Bernardini B., Corsini C., Michele C., Sara D. F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Gatti C. D., Magon S., Roberto M., Alfredo D. G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M. L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M. S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M. R., Pizio R. N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M. M., Marco D. A., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R. C., Grassi G., Bombelli M., Dell'Oro R., Quarti Trevano F., Giussani G. C., Paternò G., Contro E., Mannironi A., Giorli E., Oberti S., Fierro B., Piccoli T., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Santo P. D., Andriolli A., Burattin G., Rossi L., Andreolli Antonino C. G., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Salutis D., Ivaldi C., Russo A. M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M. R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C. A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G G., Calvi E., Clementi C., Zanocchi M., Agosta L., Nortarelli A., Provenzano G., Mari D., Romano F. Y., Rosini F., Mansi M., Rossi S., Geriatria A. R., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M. R., Prestano R., Dalise A. M., Barra D., Bosco L. D., Asprinio V., Dallape L., Perina E., Incalzi R. A., Bartoli I. R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P. L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M. C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A. M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A. C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P. M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P. F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Barbujani M., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D. M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Michele B., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A. M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C. G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Fabbro A. D., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S. M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A. C., Bonino P., Caput M., Antonietti M. P., Polistena G., De la Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R. M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M. C., Mantovani A. R., Viola M. C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L. M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Biagini C. A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S. A., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U. C., Enrico C., Vera R. F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., Valeria D. A., Federico G., Lucia P., Antonella V., Elisabetta D. C., Cristina R., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P. M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C. A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V. P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Busonera Flavio M. T., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., DuranteMangoni E., Testoni M., Fabio D. S., Loredana S., Valeria S., Fabiano M., Annabella D. G., Salvatore D. C., Greco A., Grazia D. O., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., Paolo D. C., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Davide D. A., Stefania C., Massimo P., Luca S., Martina D. F., Paola V., Lia S., Sandro C., Valentina D. S., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M. P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., Stefania D. N., Pierluigi D. S., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Giovanna D. B., Francesco L., Salini S., Angela B. M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R. M., Maria D. A., Raffaele P., Palmieri V. O., Palasciano G., Belfiore A., Portincasa P., Carlo S., Alessia D., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C. M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A. T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C. L., Paolo F., Marinella T., Sofia C. M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V. A., Moschettini G., Franco M., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Ignazio D. F., Andrea B., Giuseppe O., Emanuela F., Serena A., Elena D. I., Serena B., Erika N., Roberto S., Elena S., Manuela P., Francesca A., Angelo T., Morandi, A, Zambon, A, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bo, M, Marengoni, A, Bellelli, G, Rispoli, V, Malara, A, Spadea, F, Di Cello, S, Ceravolo, F, Fabiano, F, Chiaradia, G, Gabriele, A, Lenino, P, Andrea, T, Settembrini, V, Capomolla, D, Citrino, A, Scriva, A, Bruno, I, Secchi, R, De Martino, E, Muccinelli, R, Lupi, G, Paonessa, P, Fabbri, A, Passuti, M, Castellari, S, Po, A, Gaggioli, G, Varesi, M, Moneti, P, Capurso, S, Latini, V, Ghidotti, S, Riccardelli, F, Macchi, M, Rigo, R, Claudio, P, Angelo, B, Flavio, C, Benedetta, B, Boffelli, S, Cassinadri, A, Franzoni, S, Spazzini, E, Andretto, D, Tonini, G, Andreani, L, Coralli, M, Balotta, A, Cancelliere, R, Ballardini, G, Simoncelli, M, Mancini, A, Strazzacapa, M, Fabio, S, De Filippi, F, Giudice, C, Dentizzi, C, Azzini, M, Cazzadori, M, Mastroeni, V, Bertassello, P, Claudia Benati, H, Nesta, E, Tobaldini, C, Guerini, F, Elena, T, Mombelloni, P, Fontanini, F, Gabriella, L, Pizzorni, C, Oliverio, M, Del Grosso, L, Giavedoni, C, Bidoli, G, Mazzei, B, Corsonello, A, Fusco, S, Vena, S, De Vuono, T, Maiuri, G, Luca, F, Andrea, A, Giovanni, S, Rossella, N, Castegnaro, E, De Rosa, S, Sechi, R, Benvenuti, E, Del Lungo, I, Giardini, S, Giulietti, C, Mauro, D, Eleonora, B, Martina, P, Irene, F, Riccardo, B, Federica, S, Ilaria, D, Bertoletti, E, D'Amico, F, Caronzolo, F, Grippa, A, Lombardo, G, Pipicella, T, Antonino, S, Francesco, C, Valeria, P, Daniela, L, Domenico, C, Giorgio, B, March, A, Nitti, M, Felici, A, Pavan, S, Piazzani, F, Lunelli, A, Dimori, S, Margotta, A, Soglia, T, Postacchini, D, Brunelli, R, Santini, S, Francavilla, M, Macchiati, I, Sorvillo, F, Giuli, C, Mecocci, P, Longo, A, Perticone, F, Addesi, D, Rosa, P, Bencardino, G, Falbo, T, Grillo, N, Marco, F, Mirella, F, Fanto, F, Isaia, G, Pezzilli, S, Bergamo, D, Furno, E, Rrodhe, S, Lucarini, S, Dijk, B, Dall'Acqua, F, Cappelletto, F, Calvani, D, Becheri, D, Giuseppe, M, Costanza, M, Vito, A, Francesca, B, Magherini, L, Novella, M, Franca, B, Lucia Gambardella, P, Valente, C, Ilaria, B, Alice, F, Porrino, P, Ceci, G, Giuliana, B, Michela, T, Eleonora, C, Ettore, E, Camellini, C, Servello, A, Grassi, A, Rozzini, R, Tironi, S, Grassi, M, Troisi, E, Carlo, C, Simona Gabriella, D, Flaminia, F, Federica, R, Beatrice, P, Sofia, T, Gabutto, A, Quazzo, L, Rosatello, A, Suraci, D, Tagliabue, B, Perrone, C, Ferrara, L, Castagna, A, Tremolada, M, Giuseppe, C, Stefano, B, Davide, O, Piano, S, Serviddio, G, Lo Buglio, A, Gurrera, T, Merlo, V, Rovai, C, Cotroneo, A, Carlucci, R, Abbaldo, A, Monzani, F, Qasem, A, Bini, G, Tafuto, S, Galli, G, Bruni, A, Mancuso, G, Calipari, D, Giuseppe Massimiliano, D, Bernardini, B, Corsini, C, Michele, C, Sara, D, Cagnin, A, Fragiacomo, F, Pompanin, S, Piero, A, Marco, C, Zurlo, A, Guerra, G, Pala, M, Menozzi, L, Gatti, C, Magon, S, Roberto, M, Alfredo, D, Fabio, F, Ruana, T, Elisa, M, Christian, M, Marco, P, Massimo, G, Di Francesco, V, Faccioli, S, Pellizzari, L, Giorgia, F, Barbagallo, G, Lunardelli, M, Martini, E, Ferrari, E, Macchiarulo, M, Corneli, M, Bacci, M, Battaglia, G, Anastasio, L, Lo Storto, M, Seresin, C, Simonato, M, Loreggian, M, Cestonaro, F, Durando, M, Latella, R, Mazzoleni, M, Russo, G, Ponte, M, Valchera, A, Salustri, G, Petritola, D, Costa, A, Sinforiani, E, Cotta, M, Pizio, R, Cester, A, Formilan, M, Pietro, B, Carbone, P, Cazzaniga, I, Appollonio, I, Cereda, D, Stabile, A, Xhani, R, Acampora, R, Tremolizzo, L, Federico, P, Antonio, C, Valerio, P, Cesare, B, Zhirajr, M, Giovanni, V, Maria, A, Mariaelena, S, Bottacchi, E, Bucciantini, E, Di Giovanni, M, Franchi, F, Lucchetti, L, Mariani, C, Grande, G, Rapazzini, P, Marco, M, Romanelli, G, Franco, N, Alessio, M, Nicola, L, Laura, P, Nazario, P, Chiara, G, Soccorso, P, Andrea, S, Luca, B, Francesca, S, Roberto, A, Anna, C, Fugazza, L, Guerrini, C, De Paduanis, G, Iallonardo, L, Palumbo, P, Zuliani, G, Ortolani, B, Capatti, E, Soavi, C, Bianchi, L, Francesconi, D, Miselli, A, Gloria, B, Tommaso, R, Chiara, P, Agata, M, Marco, D, Luca, M, Gianluca, G, Suardi, T, Zaccarini, C, Manuela, R, Mirra, G, Muti, E, Bottura, R, Gianpaolo, M, Secreto, P, Bisio, E, Cecchettani, M, Naldi, T, Pallavicino, A, Pugliese, M, Iozzo, R, Grassi, G, Bombelli, M, Dell'Oro, R, Quarti Trevano, F, Giussani, G, Paternò, G, Contro, E, Mannironi, A, Giorli, E, Oberti, S, Fierro, B, Piccoli, T, Giacalone, F, Mandas, A, Serchisu, L, Costaggiu, D, Pinna, E, Orru, F, Mannai, M, Cordioli, Z, Pelizzari, L, Turcato, E, Arduini, P, Cacace, C, Chiloiro, R, Cimino, R, Ruberto, C, Giovanni, R, Pietro, G, Laura, G, Alberto, C, Carmen, R, Santo, P, Andriolli, A, Burattin, G, Rossi, L, Andreolli Antonino, C, Tezza, F, Maddalena, P, Laura, S, Crippa, P, Aloisio, P, Di Monda, T, Malighetti, A, Galbassini, G, Salutis, D, Ivaldi, C, Russo, A, Bennati, E, Pino, E, Zavarise, G, Pesci, A, Suigo, G, Faverio, P, Andrea, G, Sabrina, P, Zanasi, M, Moniello, G, Rostagno, C, Cartei, A, Polidori, G, Ungar, A, Melis, M, Martellini, E, Enrico, M, Monica, T, Antonella, G, Giovanna, L, Migliorini, M, Caramelli, F, Battiston, B, Berardino, M, Cavallo, S, Alessandro, M, Anna, S, Lombardi, B, D'Ippolito, P, Furini, A, Villani, D, Clara, R, Guarneri, M, Paolucci, S, Bassi, A, Coiro, P, De Angelis, D, Morone, G, Venturiero, V, Palleschi, L, Raganato, P, Di Niro, G, Rosa, C, Loredana, B, Imoscopi, A, Tibaldi, V, Bottignole G, G, Calvi, E, Clementi, C, Zanocchi, M, Agosta, L, Nortarelli, A, Provenzano, G, Mari, D, Romano, F, Rosini, F, Mansi, M, Rossi, S, Geriatria, A, Inzaghi, L, Bonini, G, Rossi, P, Potena, A, Lichii, M, Candiani, T, Grimaldi, W, Bertani, E, Alessandra, P, Calogero, P, Pinto, D, Bernardi, R, Nicolino, F, Galetti, C, Gianstefani, A, Giulia, C, Lorenzo, M, Odetti, P, Monacelli, F, Prefumo, M, Fiammetta, M, Canepa, M, Minaglia, C, Paolisso, G, Rizzo, M, Prestano, R, Dalise, A, Barra, D, Bosco, L, Asprinio, V, Dallape, L, Perina, E, Incalzi, R, Bartoli, I, Pluderi, A, Maina, A, Pecoraro, E, Sciarra, M, Prudente, A, Paola, M, Francesca, M, Manuel, V, Luisella, C, Maria, P, Tina, S, Benini, L, Levato, F, Mhiuta, V, Alius, F, Davidoaia, D, Giardini, V, Garancini, M, Bellamoli, C, Terranova, L, Bozzini, C, Tosoni, P, Provoli, E, Cascone, L, Dioli, A, Ferrarin, G, Bucci, A, Bua, G, Fenu, S, Bianchi, G, Casella, S, Romano, V, Maurizio, P, Mascherona, I, Belotti, G, Cavaliere, S, Cuni, E, Merciuc, N, Oberti, R, Veneziani, S, Capoferri, E, De Bernardi, E, Colombo, K, Bravi, M, Nicoletta, N, D'Arcangelo, P, Montenegro, N, Montanari, R, Lamanna, P, Gasperini, B, Isabella, M, Stefania, D, Gaia, A, Filippo, C, Palama, C, Di Emidio, C, Scarpini, E, Arighi, A, Fumagalli, G, Basilico, P, De Amicis Margherita, M, Marta, M, Diletta, M, Granata, A, Ranalli, C, Cammilli, A, Cavallini, M, Tricca, M, Natella, D, Gabbani, L, Tesi, F, Martella, L, Imbrici, R, Guerrini, G, Scotuzzi, A, Sozzi, F, Valenti, L, Chiarello, A, Monia, M, Pilotto, A, Prete, C, Senesi, B, Meta, A, Pendenza, E, Pasqualetti, G, Polini, A, Tognini, S, Ballino, E, Dell'Aquila, G, Gasparrini, P, Marotti, E, Migale, M, Scrimieri, A, Falsetti, L, Salvi, A, Toigo, G, Ceschia, G, Rosso, A, Tongiorgi, C, Scarpa, C, De Dominicis, L, Pucci, E, Renzi, S, Cartechini, E, Tomassini, P, Del Gobbo, M, Ugenti, F, Romeo, P, Nardelli, A, Lauretani, F, Visioli, S, Montanari, I, Ermini, F, Giordano, A, Pigato, G, Simeone, E, Barbujani, M, Giampieri, M, Amoruso, R, Piccinini, M, Ferrari, C, Gambetti, C, Sfrappini, M, Semeraro, L, Striuli, R, Pelliccioni, G, Marinelli, D, Fabi, K, Rossi, T, Pesallaccia, M, Sabbatini, D, Gobbi, B, Cerqua, R, Tagliani, G, Schlauser, E, Caser, L, Caramello, E, Sandigliano, F, Rosso, G, Ferrari, A, Bendini, C, Luisa, D, Casella, M, Prampolini, R, Scevola, M, Vitale, E, Roberto, B, Carlo, F, Sergio, F, Alberto, S, Daniela, Z, Giulia, B, Serena, G, Michele, B, Maugeri, D, Sorace, R, Anzaldi, M, De Gesu, R, Morrone, G, Davolio, F, Fabbo, A, Palmieri, M, Zoli, M, Forti, P, Pirazzoli, L, Fabbri, E, Terenzi, L, Bergolari, F, Wenter, C, Ruffini, I, Insam, M, Abraham, E, Kirchlechner, C, Cucinotta, D, Antonino, L, Basile, G, Grazia, A, Parise, P, Boccali, A, Amici, S, Gambacorta, M, Lasagni, A, Lovati, R, Giovinazzo, F, Kimak, E, Zappa, P, Medici, F, Lo Castro, M, Mauro, F, De Luca, A, Sancesario, G, Martorana, A, Scaricamazza, B, Toniolo, S, Di Lorenzo, F, Liguori, C, Lasco, A, Vita, N, Giomi, M, Forte, F, Padovani, A, Rozzini, L, Ceraso, A, Salvatore, C, Cottino, M, Vitali, S, Marelli, E, Tripi, G, Miceli, S, Urso, G, Grioni, G, Vezzadini, G, Misaggi, G, Forlani, C, Avanzi, S, Serena, S, Claudia, C, Marilena, V, Alberto, L, Diego, G, Alessandro, G, Iemolo, F, Sanzaro, E, D'Asta, G, Proietto, M, Carnemolla, A, Razza, G, Spadaro, D, Bertolotti, M, Mussi, C, Neviani, F, Roberto, C, Valentina, G, Linda, M, Francesca, V, Tarozzi, A, Balestri, F, Mannarino, G, Bigolari, M, Natale, A, Grassi, S, Bottaro, C, Stefanelli, S, Bovone, U, Tortorolo, U, Quadri, R, Leone, G, Ponzetto, M, Frasson, P, Annoni, G, Confalonieri, R, Corsi, M, Moretti, D, Teruzzi, F, Umidi, S, Mazzola, P, Perego, S, Persico, I, Olivieri, G, Bonfanti, A, Hajnalka, S, Galeazzi, M, Massariello, F, Anzuini, A, Caffarra, P, Barocco, F, Spallazzi, M, Paolo, C, Simonetta, M, Chioatto, P, Bortolamei, S, Soattin, L, Ruotolo, G, Beneamino, B, Giuseppe, B, Bertazzoli, M, Rota, E, Adobati, A, Scarpa, A, Granziera, S, Zuccher, P, Fabbro, A, Zara, D, Lo Nigro, A, Franchetti, L, Toniolo, M, Marcuzzo, C, Rollone, M, Guerriero, F, Sgarlata, C, Masse, A, Zatti, G, Piatti, M, Graci, J, Benati, G, Boschi, F, Biondi, M, Fiumi, N, Erika, T, Locatelli, S, Mauri, S, Beretta, M, Margheritis, L, Desideri, G, Liberatore, E, Carucci, A, Bonino, P, Caput, M, Antonietti, M, Polistena, G, De la Pierre, F, Mari, M, Massignani, P, Tombesi, F, Selvaggio, F, Verbo, B, Bodoni, P, Marchionni, N, Sabatini, T, Mussio, E, Magni, E, Bianchetti, A, Crucitti, A, Titoldini, G, Cossu, B, Fascendini, S, Licini, C, Tomasoni, A, Calderazzo, M, Daniela, T, Valentina, L, Melotti, R, Lilli, A, Buda, S, Adversi, M, Noro, G, Turco, R, Ubezio, M, Mantovani, A, Viola, M, Serrati, C, Pretta, S, Infante, M, Gentile, S, D'Ambrosio, V, Mazzanti, P, Brambilla, C, Sportelli, S, Platto, C, Faraci, B, Quattrocchi, D, Pernigotti, L, Pisu, C, Sicuro, F, Zagnoni, P, Ghiglia, S, Mosca, M, Corazzin, I, Deola, M, Biagini, C, Bencini, F, Cantini, C, Tonon, E, Pierinelli, S, Onofrj, M, Thomas, A, Filomena, B, Bonanni, L, Gabriella, C, Comi, G, Magnani, G, Santangelo, R, Mazzeo, S, Francesca, C, Giordano, C, Roberto, S, Barbieri, C, Giroldi, L, Bandini, F, Masina, M, Malservisi, S, Cicognani, A, Ricca, L, Piccininni, M, Tassinari, T, Brogi, D, Sugo, A, Alessandra, F, Sonia, M, Valerio, V, Andrea, U, Enrico, C, Vera, R, Assunta, S, Gianmaria, Z, Mauro, P, Barone, A, Razzano, M, Giuseppe, I, Angela, B, Francesco, S, Valeria, D, Federico, G, Lucia, P, Antonella, V, Elisabetta, D, Cristina, R, Nadia, C, Maria, S, Luciano, A, Chiara, C, Bini, P, Pignata, M, Enrico, B, Maria, V, Giovanni, C, Giorgio, C, Piera, R, Alberto, Z, Ceccon, A, Magrin, L, Marin, S, Barbara, S, Matteo, M, Caterina, P, Carla, R, Federica, G, Clara, T, Melania, C, Giampaolo, B, Stefano, G, Valeria, G, Lucia, M, Giovambattista, D, Ester, L, Cecilia, C, Maurizio, T, Nadia, B, Grillo, A, Arenare, F, Tonino, M, David, K, Giorgio, V, Ubaldo, B, Vincenzo, S, Stefano, M, Marino, F, Busonera Flavio, M, Paolo, A, Monica, M, Francesco, B, Roberto, F, Paolo, B, Durantemangoni, E, Testoni, M, Fabio, D, Loredana, S, Valeria, S, Fabiano, M, Annabella, D, Salvatore, D, Greco, A, Grazia, D, Daniele, S, Gianluca, R, Renzo, G, Sergio, M, Morena, B, Vitali, M, Marina, P, Paolo, D, Cristina, S, Orlandini, F, La Regina, M, Desiree, A, Mario, B, Paola, P, Padulo, F, Cristina, M, Dario, R, Giancarla, M, Guido, R, Elena, M, Marileda, N, Igor, B, Nicole, B, Elena, R, Paolillo, C, Riccardi, A, Claudia, B, Barbara, R, Silvia, V, Oliver, B, Mauro, C, Eleonora, M, Giuseppe, P, Rosaria, T, Maria, C, Davide, D, Stefania, C, Massimo, P, Luca, S, Martina, D, Paola, V, Lia, S, Sandro, C, Valentina, D, Erminia, B, Paola, C, Romina, R, Minisola, S, Luciano, C, Pasquale, A, Ilaria, L, Guglielmo, S, Marco, E, Sara, R, Paola, A, Claudio, A, Francesco, R, Alessandro, C, Simona, M, Lara, F, Paola, R, Simonetta, C, Antonella, C, Generoso, U, Fernando, G, Giuliano, C, Emanuela, S, Mariolina, S, Alessandro, D, Giulia, L, Famularo, S, Sandini, M, Pinotti, E, Gianotti, L, Antonella, B, Giulia, P, Sante, G, Rossi, A, Rubele, S, Sant, S, Marco, V, Danila, C, Fabio, R, Bandirali, M, Nicoletta, C, Laura, B, Paolo, T, Luciano, T, Leonello, A, Margherita, S, Pierluigi, D, Laura, R, Fabiana, T, Giovanna, C, Antonino, A, Felice, C, Danilo, F, Giovanna, D, Francesco, L, Salini, S, Giorgetta, C, Giovanni, G, Gerardo, B, Silvio, R, Letizia, S, Davide, B, Rosaria, R, Maria, D, Raffaele, P, Palmieri, V, Palasciano, G, Belfiore, A, Portincasa, P, Carlo, S, Alessia, D, Valiani, V, Carolina, B, Tiziana, C, Paola, T, Ugo, P, Giacomo, P, Castellano, M, Anna, G, Elisa, C, Federica, C, Antonietta, C, Luigi, M, Fabio, L, Salvatore, B, Gelosa, G, Viviana, A, Piras, V, Andrea, C, Alessandra, B, Coen, D, Magliola, R, Milanesio, D, Muzzulini, C, Paolo, F, Marinella, T, Sofia, C, Marta, B, Siano, P, Capo, G, Napoletano, R, Cecilia, P, Mancini, C, Del Buono, C, De Bartolomeo, G, Addolorata, M, Carmen, C, Moschettini, G, Franco, M, Daniela, R, D'Amico, G, Mirella, P, Endrizzi, C, Trotta, L, Ciarambino, T, Orazio, Z, Emanuela, T, Marta, S, Thomas, F, Giacomo, T, Ignazio, D, Andrea, B, Giuseppe, O, Emanuela, F, Serena, A, Elena, D, Serena, B, Erika, N, Elena, S, Manuela, P, Francesca, A, Angelo, T, Morandi A., Zambon A., Di Santo S. G., Mazzone A., Cherubini A., Mossello E., Bo M., Marengoni A., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Lupi G., Paonessa P., Fabbri A., Passuti M. T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Claudia Benati H. S., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L. L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F. F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Sechi R. B., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D. B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Ilaria D. L., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P. G., Daniela L., Domenico C., Giorgio B., March A., Nitti M. T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Perticone F., Addesi D., Rosa P. C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Cappelletto F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Lucia Gambardella P. M., Valente C., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M. G., Troisi E., Carlo C., Simona Gabriella D. S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M. L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A. M., Carlucci R., Abbaldo A., Monzani F., Qasem A. A., Bini G., Tafuto S., Galli G., Bruni A. C., Mancuso G., Calipari D., Giuseppe Massimiliano D. L., Bernardini B., Corsini C., Michele C., Sara D. F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Gatti C. D., Magon S., Roberto M., Alfredo D. G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M. L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M. S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M. R., Pizio R. N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M. M., Marco D. A., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R. C., Grassi G., Bombelli M., Dell'Oro R., Quarti Trevano F., Giussani G. C., Paternò G., Contro E., Mannironi A., Giorli E., Oberti S., Fierro B., Piccoli T., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Santo P. D., Andriolli A., Burattin G., Rossi L., Andreolli Antonino C. G., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Salutis D., Ivaldi C., Russo A. M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M. R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C. A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G G., Calvi E., Clementi C., Zanocchi M., Agosta L., Nortarelli A., Provenzano G., Mari D., Romano F. Y., Rosini F., Mansi M., Rossi S., Geriatria A. R., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M. R., Prestano R., Dalise A. M., Barra D., Bosco L. D., Asprinio V., Dallape L., Perina E., Incalzi R. A., Bartoli I. R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P. L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M. C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A. M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A. C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P. M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P. F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Barbujani M., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D. M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Michele B., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A. M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C. G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Fabbro A. D., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S. M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A. C., Bonino P., Caput M., Antonietti M. P., Polistena G., De la Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R. M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M. C., Mantovani A. R., Viola M. C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L. M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Biagini C. A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S. A., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U. C., Enrico C., Vera R. F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., Valeria D. A., Federico G., Lucia P., Antonella V., Elisabetta D. C., Cristina R., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P. M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C. A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V. P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Busonera Flavio M. T., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., DuranteMangoni E., Testoni M., Fabio D. S., Loredana S., Valeria S., Fabiano M., Annabella D. G., Salvatore D. C., Greco A., Grazia D. O., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., Paolo D. C., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Davide D. A., Stefania C., Massimo P., Luca S., Martina D. F., Paola V., Lia S., Sandro C., Valentina D. S., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M. P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., Stefania D. N., Pierluigi D. S., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Giovanna D. B., Francesco L., Salini S., Angela B. M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R. M., Maria D. A., Raffaele P., Palmieri V. O., Palasciano G., Belfiore A., Portincasa P., Carlo S., Alessia D., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C. M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A. T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C. L., Paolo F., Marinella T., Sofia C. M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V. A., Moschettini G., Franco M., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Ignazio D. F., Andrea B., Giuseppe O., Emanuela F., Serena A., Elena D. I., Serena B., Erika N., Roberto S., Elena S., Manuela P., Francesca A., and Angelo T.
Abstract: Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the “Delirium Day” study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors.
Published: 2020

28. Factors associated with severe or fatal clinical manifestations of SARS-CoV-2 infection after receiving the third dose of vaccine

Author: Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Jara, J, Valenti, G, Pavesi, G, Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Leoni, O, Jara, J, Valenti, G, and Pavesi, G
Abstract: Background: Little is known about vulnerability to severe COVID-19 illness after vaccination completion with three doses of vaccine against COVID-19. Objectives: To identify individual features associated with increased risk of severe clinical manifestation of SARS-CoV-2 infections after receiving the third dose of vaccine against COVID-19. Methods: We performed a nested case-control study based on 3,360,116 citizens from Lombardy, Italy, aged 12 years or older who received the third dose of vaccine against COVID-19 from 20 September through 31 December 2021. Individuals were followed from 14 days after vaccination completion until the occurrence of severe COVID-19 illness, death unrelated to COVID-19, emigration or 15 March 2022. For each case, controls were randomly selected to be 1:10 matched for the date of vaccination completion and municipality of residence. The association between candidate predictors and outcome was assessed through multivariable conditional logistic regression models. Results: During 12,538,330 person-months of follow-up, 5171 cases of severe illness occurred. As age increased, a trend towards increasing odds of severe illness was observed. Male gender was a significant risk factor. As the number of contacts with the Regional Health Service increased, a trend towards increasing odds of severe illness was observed. Having had a previous SARS-CoV-2 infection was a significant protective factor. Having received the Moderna vaccine significantly decreased the odds of severe illness. Significant higher odds were associated with 42 diseases/conditions. Odds ratios ranged from 1.23 (diseases of the musculoskeletal system) to 5.00 (autoimmune disease). Conclusions: This study provides useful insights for establishing priority in fourth-dose vaccination programs.
Published: 2022

29. Association of COVID-19 Vaccinations With Intensive Care Unit Admissions and Outcome of Critically Ill Patients With COVID-19 Pneumonia in Lombardy, Italy

Author: Grasselli, G, Zanella, A, Carlesso, E, Florio, G, Canakoglu, A, Bellani, G, Bottino, N, Cabrini, L, Castelli, G, Catena, E, Cecconi, M, Cereda, D, Chiumello, D, Forastieri, A, Foti, G, Gemma, M, Giudici, R, Grazioli, L, Lombardo, A, Lorini, F, Madotto, F, Mantovani, A, Mistraletti, G, Mojoli, F, Mongodi, S, Monti, G, Muttini, S, Piva, S, Protti, A, Rasulo, F, Scandroglio, A, Severgnini, P, Storti, E, Fumagalli, R, Pesenti, A, Grasselli, Giacomo, Zanella, Alberto, Carlesso, Eleonora, Florio, Gaetano, Canakoglu, Arif, Bellani, Giacomo, Bottino, Nicola, Cabrini, Luca, Castelli, Gian Paolo, Catena, Emanuele, Cecconi, Maurizio, Cereda, Danilo, Chiumello, Davide, Forastieri, Andrea, Foti, Giuseppe, Gemma, Marco, Giudici, Riccardo, Grazioli, Lorenzo, Lombardo, Andrea, Lorini, Ferdinando Luca, Madotto, Fabiana, Mantovani, Alberto, Mistraletti, Giovanni, Mojoli, Francesco, Mongodi, Silvia, Monti, Gianpaola, Muttini, Stefano, Piva, Simone, Protti, Alessandro, Rasulo, Frank, Scandroglio, Anna Mara, Severgnini, Paolo, Storti, Enrico, Fumagalli, Roberto, Pesenti, Antonio, Grasselli, G, Zanella, A, Carlesso, E, Florio, G, Canakoglu, A, Bellani, G, Bottino, N, Cabrini, L, Castelli, G, Catena, E, Cecconi, M, Cereda, D, Chiumello, D, Forastieri, A, Foti, G, Gemma, M, Giudici, R, Grazioli, L, Lombardo, A, Lorini, F, Madotto, F, Mantovani, A, Mistraletti, G, Mojoli, F, Mongodi, S, Monti, G, Muttini, S, Piva, S, Protti, A, Rasulo, F, Scandroglio, A, Severgnini, P, Storti, E, Fumagalli, R, Pesenti, A, Grasselli, Giacomo, Zanella, Alberto, Carlesso, Eleonora, Florio, Gaetano, Canakoglu, Arif, Bellani, Giacomo, Bottino, Nicola, Cabrini, Luca, Castelli, Gian Paolo, Catena, Emanuele, Cecconi, Maurizio, Cereda, Danilo, Chiumello, Davide, Forastieri, Andrea, Foti, Giuseppe, Gemma, Marco, Giudici, Riccardo, Grazioli, Lorenzo, Lombardo, Andrea, Lorini, Ferdinando Luca, Madotto, Fabiana, Mantovani, Alberto, Mistraletti, Giovanni, Mojoli, Francesco, Mongodi, Silvia, Monti, Gianpaola, Muttini, Stefano, Piva, Simone, Protti, Alessandro, Rasulo, Frank, Scandroglio, Anna Mara, Severgnini, Paolo, Storti, Enrico, Fumagalli, Roberto, and Pesenti, Antonio
Abstract: Importance: Data on the association of COVID-19 vaccination with intensive care unit (ICU) admission and outcomes of patients with SARS-CoV-2-related pneumonia are scarce. Objective: To evaluate whether COVID-19 vaccination is associated with preventing ICU admission for COVID-19 pneumonia and to compare baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU. Design, Setting, and Participants: This retrospective cohort study on regional data sets reports: (1) daily number of administered vaccines and (2) data of all consecutive patients admitted to an ICU in Lombardy, Italy, from August 1 to December 15, 2021 (Delta variant predominant). Vaccinated patients received either mRNA vaccines (BNT162b2 or mRNA-1273) or adenoviral vector vaccines (ChAdOx1-S or Ad26.COV2). Incident rate ratios (IRRs) were computed from August 1, 2021, to January 31, 2022; ICU and baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU were analyzed from August 1 to December 15, 2021. Exposures: COVID-19 vaccination status (no vaccination, mRNA vaccine, adenoviral vector vaccine). Main Outcomes and Measures: The incidence IRR of ICU admission was evaluated, comparing vaccinated people with unvaccinated, adjusted for age and sex. The baseline characteristics at ICU admission of vaccinated and unvaccinated patients were investigated. The association between vaccination status at ICU admission and mortality at ICU and hospital discharge were also studied, adjusting for possible confounders. Results: Among the 10107674 inhabitants of Lombardy, Italy, at the time of this study, the median [IQR] age was 48 [28-64] years and 5154914 (51.0%) were female. Of the 7863417 individuals who were vaccinated (median [IQR] age: 53 [33-68] years; 4010343 [51.4%] female), 6251417 (79.5%) received an mRNA vaccine, 550439 (7.0%) received an adenoviral vector vaccine, and 1061561 (13.5%) received a mix of vaccines and 4497875 (57.2
Published: 2022

30. Persistence of protection against SARS-CoV-2 clinical outcomes up to 9 months since vaccine completion: a retrospective observational analysis in Lombardy, Italy

Author: Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Zoli, A, Leoni, O, Borriello, C, Valle, G, Tirani, M, Pavesi, G, Barone, A, Ercolanoni, M, Jara, J, Galli, M, Bertolaso, G, Mancia, G, Corrao, Giovanni, Franchi, Matteo, Cereda, Danilo, Bortolan, Francesco, Zoli, Alberto, Leoni, Olivia, Borriello, Catia Rosanna, Valle, Giulia Petra Della, Tirani, Marcello, Pavesi, Giovanni, Barone, Antonio, Ercolanoni, Michele, Jara, Jose, Galli, Massimo, Bertolaso, Guido, Mancia, Giuseppe, Corrao, G, Franchi, M, Cereda, D, Bortolan, F, Zoli, A, Leoni, O, Borriello, C, Valle, G, Tirani, M, Pavesi, G, Barone, A, Ercolanoni, M, Jara, J, Galli, M, Bertolaso, G, Mancia, G, Corrao, Giovanni, Franchi, Matteo, Cereda, Danilo, Bortolan, Francesco, Zoli, Alberto, Leoni, Olivia, Borriello, Catia Rosanna, Valle, Giulia Petra Della, Tirani, Marcello, Pavesi, Giovanni, Barone, Antonio, Ercolanoni, Michele, Jara, Jose, Galli, Massimo, Bertolaso, Guido, and Mancia, Giuseppe
Abstract: Background: Scarce information is available on the duration of the protective effect of COVID-19 vaccination against the risk of SARS-CoV-2 infection and its severe clinical consequences. We investigated the effect of time since vaccine completion on the SARS-CoV-2 infection and its severe forms. Methods: In this retrospective observational analysis using the vaccination campaign integrated platform of the Italian region of Lombardy, 5 351 085 individuals aged 12 years or older who received complete vaccination from Jan 17 to July 31, 2021, were followed up from 14 days after vaccine completion until Oct 20, 2021. Changes over time in outcome rates (ie, SARS-CoV-2 infection and severe illness among vaccinated individuals) were analysed with age-period-cohort models. Trends in vaccine effectiveness (ie, outcomes comparison in vaccinated and unvaccinated individuals) were also measured. Findings: Overall, 14 140 infections and 2450 severe illnesses were documented, corresponding to incidence rates of 6·7 (95% CI 6·6–6·8) and 1·2 (1·1–1·2) cases per 10 000 person-months, respectively. From the first to the ninth month since vaccine completion, rates increased from 4·6 to 10·2 infections, and from 1·0 to 1·7 severe illnesses every 10 000 person-months. These figures correspond to relative reduction of vaccine effectiveness of 54·9% (95% CI 48·3–60·6) for infection and of 40·0% (16·2–57·0) for severe illness. The increasing infection rate was greater for individuals aged 60 years or older who received adenovirus-vectored vaccines (from 4·0 to 23·5 cases every 10 000 person-months). The increasing severe illness rates were similar for individuals receiving mRNA-based vaccines (from 1·1 to 1·5 every 10 000 person-months) and adenovirus-vectored vaccines (from 0·5 to 0·9 every 10 000 person-months). Interpretation: Although the risk of infection after vaccination, and even more of severe illness, remains low, the gradual increase in clinical outcomes related to SARS-CoV-2 i
Published: 2022

31. Neurological soft signs are increased in migraine without aura: relationship with the affective status

Author: Tremolizzo, L, Selvatico, D, Pozzi, F, Cereda, D, Difrancesco, J, Fumagalli, L, Ferrarese, C, Appollonio, I, Tremolizzo, Lucio, Selvatico, Daniele, Pozzi, Federico Emanuele, Cereda, Diletta, DiFrancesco, Jacopo Cosimo, Fumagalli, Lorenzo, Ferrarese, Carlo, Appollonio, Ildebrando, Tremolizzo, L, Selvatico, D, Pozzi, F, Cereda, D, Difrancesco, J, Fumagalli, L, Ferrarese, C, Appollonio, I, Tremolizzo, Lucio, Selvatico, Daniele, Pozzi, Federico Emanuele, Cereda, Diletta, DiFrancesco, Jacopo Cosimo, Fumagalli, Lorenzo, Ferrarese, Carlo, and Appollonio, Ildebrando
Abstract: Introduction: Neurological soft signs (NSS) are subtle non-localizing sensorimotor abnormalities initially reported as increased in primary headache patients. The aims of this study were confirming with full power NSS increased expression in migraine and, collaterally, determining if psychiatric traits or white matter lesions at brain imaging could influence this result. Methods: Forty drug-free episodic migraine outpatients (MH) were recruited with 40 matched controls. NSS were determined by the 16-item Heidelberg scale; depression, anxiety and QoL by the HAM-D; the STAI-X1/X2; and the SF36, respectively. The Fazekas scale on brain MR studies was applied in n = 32 MH, unravelling deep white matter signal alterations (DWM). MH characteristics, including the headache disability inventory (HDI), were recorded. Results: NSS were 46% increased in MH vs. controls (p = 0.0001). HAM-D and STAI-X1/X2 were increased in MH, while SF36 was unchanged, but they all failed to influence NSS, just as MH characteristics. NSS scores were increased in MH-DWM + (n = 11, + 85%) vs. MH-DWM − (n = 21, + 27%) vs. controls (p < 0.0001). NSS increased expression in MH was influenced by DWM, while psychiatric traits and headache characteristics failed to do so. Discussion/conclusions: NSS are increased in MH and probably not influenced by the affective status, possibly marking a dysfunction within the cerebellar-thalamic-prefrontal circuit that may deserve further attention from the prognostic point of view.
Published: 2022

32. Tracking SARS-CoV-2 in urban wastewater samples during the first wave of COVID-19 epidemic in Lombardy (Italy)

Author: Pellegrinelli, L., primary, Schiarea, S., additional, Primache, V., additional, Galli, C., additional, Bubba, L., additional, Mancinelli, F., additional, Cereda, D., additional, Ammoni, E., additional, Pariani, E., additional, Castiglioni, S., additional, Zuccato, E., additional, and Binda, S., additional
Published: 2022
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33. Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long-term outcome

Author: Giussani G., Bianchi E., Beretta S., Carone D., DiFrancesco J. C., Stabile A., Zanchi C., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Tinti L., Scanziani S., Gasparini S., Bogliun G., Ferrarese C., Beghi E., Romeo A., Viri M., Specchio L., Trivisano M., Mecarelli O., Zarabla A., Capovilla G., Beccaria F., Sasanelli F., Galimberti C. A., Tartara E., Zamponi N., Cappanera S., Aguglia U., Ferlazzo E., La Neve A., Luisi C., Pontrelli G., Cantisani A. T., De Maria G., Albanese Y., Giussani, G, Bianchi, E, Beretta, S, Carone, D, Difrancesco, J, Stabile, A, Zanchi, C, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Tinti, L, Scanziani, S, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi, E, Romeo, A, Viri, M, Specchio, L, Trivisano, M, Mecarelli, O, Zarabla, A, Capovilla, G, Beccaria, F, Sasanelli, F, Galimberti, C, Tartara, E, Zamponi, N, Cappanera, S, Aguglia, U, Ferlazzo, E, La Neve, A, Luisi, C, Pontrelli, G, Cantisani, A, De Maria, G, and Albanese, Y
Subjects: Adult, medicine.medical_specialty, comorbiditie, mechanism, Comorbidity, Disease, Urogenital diseases, Cohort Studies, Epilepsy, Risk Factors, Internal medicine, cohort study, Humans, Endocrine system, Medicine, In patient, Child, business.industry, Mental Disorders, medicine.disease, Neurology, epilepsy, Neurology (clinical), Sustained remission, business, prognosi, Cohort study
Abstract: Objective: To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10years. Two pairs of raters independently reviewed patients’ records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsing-remitting course, and 4.8% of patients with sustained remission (p=.016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p=.013); for respiratory diseases were 3.6%,.3%, and.3% (p=.001), and for urogenital diseases were 3.6%,.7%, and 1.6% (p=.048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and clinical variables, with patients with these comorbidities showing a lower probability of achieving remission. Significance: Comorbidities in epilepsy are not uncommon and reflect differing underlying mechanisms. Psychiatric, endocrine/metabolic, and respiratory disorders are associated with a worse long-term epileptological outcome.
Published: 2021

34. Prognostic patterns and predictors in epilepsy: A multicentre study (PRO-LONG)

Author: Beghi, E, Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi E., Beretta S., Carone D., Zanchi C., Bianchi E., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Scanziani S., Giussani G., Gasparini S., Bogliun G., Ferrarese C., Beghi, E, Beretta, S, Carone, D, Zanchi, C, Bianchi, E, Pirovano, M, Trentini, C, Padovano, G, Colombo, M, Cereda, D, Scanziani, S, Giussani, G, Gasparini, S, Bogliun, G, Ferrarese, C, Beghi E., Beretta S., Carone D., Zanchi C., Bianchi E., Pirovano M., Trentini C., Padovano G., Colombo M., Cereda D., Scanziani S., Giussani G., Gasparini S., Bogliun G., and Ferrarese C.
Abstract: Objectives To describe the long-term prognosis of epilepsy and prognostic patterns in a large cohort of newly diagnosed patients and identify prognostic factors. Methods Study participants were 13 Italian epilepsy centres with accessible records dating back to 2005 or earlier, complete data on seizure outcome and treatments, precise epilepsy diagnosis, and follow-up of at least 10 years. Records were examined by trained neurology residents for demographics, seizure characteristics, neurological signs, psychiatric comorbidity, first electroencephalogram (EEG) and MRI/CT, epilepsy type and aetiology, antiepileptic drugs (AEDs), and 1-year, 2-year, 5-year and 10-year seizure remissions. Five predefined prognostic patterns were identified: early remission, late remission, relapsing-remitting course, worsening course and no remission. Prognostic factors were assessed using multinomial logistic regression models. Results 1006 children and adults were followed for 17 892 person-years (median 16 years; range 10-57). During follow-up, 923 patients (91.7%) experienced 1-year remission. 2-year, 5-year and 10-year remissions were present in 89.5%, 77.1% and 44.4% of cases. 5-year remission was associated with one to two seizures at diagnosis, generalised epilepsy, no psychiatric comorbidity, and treatment with one or two AEDs during follow-up. 10-year remission was associated with one or two AEDs. The most common prognostic pattern was relapsing-remitting (52.2%), followed by early remission (24.5%). 8.3% of cases experienced no remission. Predictors of a relapsing-remitting course were <6 seizures at diagnosis, (presumed) genetic aetiology and no psychiatric comorbidity. Conclusions Few seizures at diagnosis, generalised epilepsy and no psychiatric comorbidity predict early or late seizure freedom in epilepsy. Achieving remission at any time after the diagnosis does not exclude further relapses.
Published: 2019

35. ALS Cognitive Behavioral Screen (ALS-CBS): normative values for the Italian population and clinical usability

Author: Tremolizzo, L., Lizio, A., Santangelo, G., Diamanti, S., Lunetta, C., Gerardi, F., Messina, S., La Foresta, S., Riva, N., Falzone, Y., Filippi, M., Woolley, S. C., Sansone, V. A., Siciliano, M., Ferrarese, C., Appollonio, I., Aliprandi, A., Cereda, D., Conti, E., Gallone, A. M., Mantero, V., Marzorati, L., Mosca, L., Pellegrini, A., Perini, M., Rigamonti, A., Sala, G., Salmaggi, A., Spinazzola, L., Susani, E., Tarlarini, C., Trojsi, F., Zarcone, D., Tremolizzo, L., Lizio, A., Santangelo, G., Diamanti, S., Lunetta, C., Gerardi, F., Messina, S., La Foresta, S., Riva, N., Falzone, Y., Filippi, M., Woolley, S. C., Sansone, V. A., Siciliano, M., Ferrarese, C., Appollonio, I., Aliprandi, A., Cereda, D., Conti, E., Gallone, A. M., Mantero, V., Marzorati, L., Mosca, L., Pellegrini, A., Perini, M., Rigamonti, A., Sala, G., Salmaggi, A., Spinazzola, L., Susani, E., Tarlarini, C., Trojsi, F., Zarcone, D., Tremolizzo, L, Lizio, A, Santangelo, G, Diamanti, S, Lunetta, C, Gerardi, F, Messina, S, La Foresta, S, Riva, N, Falzone, Y, Filippi, M, Woolley, S, Sansone, V, Siciliano, M, Ferrarese, C, Appollonio, I, and Sala, G
Subjects: Adult, Male, medicine.medical_specialty, Neurology, Cognitive, Italian, Normative, Screening test, Dermatology, Disease, Behavioral Symptoms, Neuropsychological Tests, M-PSI/02 - PSICOBIOLOGIA E PSICOLOGIA FISIOLOGICA, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Reference Values, medicine, 80 and over, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Amyotrophic lateral sclerosis, Aged, MED/26 - NEUROLOGIA, Aged, 80 and over, business.industry, Amyotrophic Lateral Sclerosis, Cognition, Usability, General Medicine, Caregiver burden, Middle Aged, medicine.disease, Test (assessment), Psychiatry and Mental health, M-PSI/03 - PSICOMETRIA, Italy, ALS, ALS-CBS, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Clinical psychology
Abstract: Amyotrophic lateral sclerosis (ALS) patients often express cognitive and behavioral dysfunctions within the so-called “frontotemporal spectrum disorders.” Guidelines recommend screening of such dysfunctions, albeit only ALS dedicated tools are eventually suitable, due to the profound motor limitations induced by the disease. ALS Cognitive Behavioral Screen (ALS-CBS) is such a screening tool but normative data are not available, limiting its widespread implementation. Our aim consisted in producing normative data for the Italian version of the ALS-CBS. The scale was administered to n = 458 healthy controls with different age and education. Following translation and back translation of the original version of the test, normative data and correction scores for the ALS-CBS cognitive subtest (ALS-CBSci) were generated. Furthermore, n = 100 ALS consecutive outpatients with a wide range of cognitive and motor severity underwent to the ALS-CBS, besides FAB and Weigl sorting test (WST), in order to check its usability. Completion rate was 100% for ALS-CBS and WST, and 68% for the FAB. Corrected ALS-CBS scores showed 12% detection rate of significant cognitive dysfunction with a moderate kappa with FAB and WST. For the ALS-CBS behavioral subtest (ALS-CBSbi), a caregiver was available for n = 81 ALS patients and asked to complete the subset. The detection rate for behavioral dysfunction was 55.5%, and a mild correlation between with the Caregiver Burden Inventory was present (r = − 0.26, p = 0.04). In conclusion, we offer here normative data for the ALS-CBS, a handy tool for screening frontotemporal spectrum dysfunctions in ALS patients, and confirm its usability and validity in an outpatient setting.
Published: 2020

36. Infectious diseases other than Covid-19 in 2020, a report from Lombardy Region

Author: Maffeo, M, primary, Mazziotta, F, additional, Pierini, E, additional, Della Valle, PG, additional, Gramegna, M, additional, Tirani, M, additional, Crottogini, L, additional, Odone, A, additional, Castaldi, S, additional, and Cereda, D, additional
Published: 2021
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37. Case Report: Concomitant Massive Cerebral Venous Thrombosis and Internal Iliac Vein Thrombosis Related to Paucisymptomatic COVID-19 Infection

Author: Beretta, S, Da Re, F, Francioni, V, Remida, P, Storti, B, Fumagalli, L, Piatti, M, Santoro, P, Cereda, D, Cutellè, C, Pirro, F, Montisano, D, Beretta, F, Pasini, F, Cavallero, A, Appollonio, I, Ferrarese, C, Beretta, Simone, Da Re, Fulvio, Francioni, Valentina, Remida, Paolo, Storti, Benedetta, Fumagalli, Lorenzo, Piatti, Maria Luisa, Santoro, Patrizia, Cereda, Diletta, Cutellè, Claudia, Pirro, Fiammetta, Montisano, Danilo Antonio, Beretta, Francesca, Pasini, Francesco, Cavallero, Annalisa, Appollonio, Ildebrando, Ferrarese, Carlo, Beretta, S, Da Re, F, Francioni, V, Remida, P, Storti, B, Fumagalli, L, Piatti, M, Santoro, P, Cereda, D, Cutellè, C, Pirro, F, Montisano, D, Beretta, F, Pasini, F, Cavallero, A, Appollonio, I, Ferrarese, C, Beretta, Simone, Da Re, Fulvio, Francioni, Valentina, Remida, Paolo, Storti, Benedetta, Fumagalli, Lorenzo, Piatti, Maria Luisa, Santoro, Patrizia, Cereda, Diletta, Cutellè, Claudia, Pirro, Fiammetta, Montisano, Danilo Antonio, Beretta, Francesca, Pasini, Francesco, Cavallero, Annalisa, Appollonio, Ildebrando, and Ferrarese, Carlo
Abstract: Thrombotic complications are common in COVID-19 patients, but cerebral venous system involvement, timing after infection, optimal treatment, and long-term outcome are uncertain. We report a case of massive cerebral venous thrombosis and concomitant internal iliac vein thrombosis occurring in the late phase of paucisymptomatic COVID-19 infection. Mild respiratory symptoms, without fever, started 3 weeks before headache and acute neurological deficits. The patient had silent hypoxemia and typical COVID-19 associated interstitial pneumonia. Brain CT scan showed a left parietal hypodense lesion with associated sulcal subarachnoid hemorrhage. CT cerebral venography showed a massive cerebral venous thrombosis involving the right transverse sinus, the right jugular bulb, the superior sagittal sinus, the straight sinus, the vein of Galen, and both internal cerebral veins. Abdominal CT scan showed no malignancy but revealed an asymptomatic right internal iliac vein thrombosis. Both cerebral venous thrombosis and pelvic vein thrombosis were effectively treated with unfractionated heparin started on the day of admission, then shifted to low molecular weight heparin, with a favorable clinical course. Nasopharyngel swab, repeated twice, tested negative for SARS-CoV-2. Serological tests confirmed SARS-CoV-2 infection. Our case supports active surveillance and prevention of thrombotic complications associated with COVID-19, which may affect both peripheral and cerebral venous system. Early initiation of unfractionated heparin may lead to good neurologic outcome.
Published: 2021

38. Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy

Author: Bruno, R., Mondelli, M., Brunetti, E., Di Matteo, A., Seminari, E., Maiocchi, L., Zuccaro, V., Pagnucco, L., Mariani, B., Ludovisi, S., Lissandrin, R., Parisi, A., Sacchi, P., Patruno, S.F.A., Michelone, G., Gulminetti, R., Zanaboni, D., Novati, S., Maserati, R., Orsolini, P., Vecchia, M., Sciarra, M., Asperges, E., Colaneri, M., Di Filippo, A., Sambo, M., Biscarini, S., Lupi, M., Roda, S., Pieri, T.C., Gallazzi, I., Sachs, M., Valsecchi, P., Perlini, S., Alfano, C., Bonzano, M., Briganti, F., Crescenzi, G., Falchi, A.G., Guarnone, R., Guglielmana, B., Maggi, E., Martino, I., Pettenazza, P., Pioli di Marco, S., Quaglia, F., Sabena, A., Salinaro, F., Speciale, F., Zunino, I., De Lorenzo, M., Secco, G., Dimitry, L., Cappa, G., Maisak, I., Chiodi, B., Sciarrini, M., Barcella, B., Resta, F., Moroni, L., Vezzoni, G., Scattaglia, L., Boscolo, E., Zattera, C., Tassi, M.F., Capozza, V., Vignaroli, D., Bazzini, M., Iotti, G., Mojoli, F., Belliato, M., Perotti, L., Mongodi, S., Tavazzi, G., Marseglia, G., Licari, A., Brambilla, I., Barbarini, D., Bruno, A., Cambieri, P., Campanini, G., Comolli, G., Corbella, M., Daturi, R., Furione, M., Monzillo, E., Paolucci, S., Parea, M., Percivalle, E., Piralla, A., Rovida, F., Sarasini, A., Zavattoni, M., Adzasehoun, G., Bellotti, L., Cabano, E., Casali, G., Dossena, L., Frisco, G., Garbagnoli, G., Girello, A., Landini, V., Lucchelli, C., Maliardi, V., Pezzaia, S., Premoli, M., Bonetti, A., Caneva, G., Cassaniti, I., Corcione, A., Di Martino, R., Di Napoli, A., Ferrari, A., Ferrari, G., Fiorina, L., Giardina, F., Mercato, A., Novazzi, F., Ratano, G., Rossi, B., Sciabica, I.M., Tallarita, M., Vecchio Nepita, E., Calvi, M., Tizzoni, M., Nicora, C., Triarico, A., Petronella, V., Marena, C., Muzzi, A., Lago, P., Cereda, D., Marseglia, G.L., and Baldanti, F.
Published: 2020
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39. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author: Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., Locatelli F. (ORCID:0000-0002-7976-3654), Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., and Locatelli F. (ORCID:0000-0002-7976-3654)
Abstract: Background: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.
Published: 2020

40. Use of critical care resources during the first 2 weeks (February 24-March 8, 2020) of the Covid-19 outbreak in Italy

Author: Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, Langer, Thomas, Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, and Langer, Thomas
Abstract: Background: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24-March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.
Published: 2020

41. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Author: Grasselli, G, Zangrillo, A, Zanella, A, Antonelli, M, Cabrini, L, Castelli, A, Cereda, D, Coluccello, A, Foti, G, Fumagalli, R, Iotti, G, Latronico, N, Lorini, L, Merler, S, Natalini, G, Piatti, A, Ranieri, M, Scandroglio, A, Storti, E, Cecconi, M, Pesenti, A, Lorini, F, Ranieri, MV, Scandroglio, AM, LORINI, FERDINANDO LUCA, Grasselli, G, Zangrillo, A, Zanella, A, Antonelli, M, Cabrini, L, Castelli, A, Cereda, D, Coluccello, A, Foti, G, Fumagalli, R, Iotti, G, Latronico, N, Lorini, L, Merler, S, Natalini, G, Piatti, A, Ranieri, M, Scandroglio, A, Storti, E, Cecconi, M, Pesenti, A, Lorini, F, Ranieri, MV, Scandroglio, AM, and LORINI, FERDINANDO LUCA
Abstract: Question What are the baseline characteristics and outcomes of patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to intensive care units (ICUs) in Lombardy, Italy? Findings In this retrospective case series that involved 1591 critically ill patients admitted from February 20 to March 18, 2020, 99% (1287 of 1300 patients) required respiratory support, including endotracheal intubation in 88% and noninvasive ventilation in 11%; ICU mortality was 26%. Meaning In this case series of critically ill patients admitted to ICUs in Lombardy, Italy, with laboratory-confirmed coronavirus disease 2019 (COVID-19), a high proportion required mechanical ventilation and ICU mortality was 26% as of March 25, 2020.Importance In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited. Objective To characterize patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) in the Lombardy region of Italy. Design, Setting, and Participants Retrospective case series of 1591 consecutive patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinator center (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network and treated at one of the ICUs of the 72 hospitals in this network between February 20 and March 18, 2020. Date of final follow-up was March 25, 2020. Exposures SARS-CoV-2 infection confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swabs. Main Outcomes and Measures Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. Data were recorded by the coordinator center
Published: 2020

42. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy

Author: Grasselli, G, Greco, M, Zanella, A, Albano, G, Antonelli, M, Bellani, G, Bonanomi, E, Cabrini, L, Carlesso, E, Castelli, G, Cattaneo, S, Cereda, D, Colombo, S, Coluccello, A, Crescini, G, Forastieri Molinari, A, Foti, G, Fumagalli, R, Iotti, G, Langer, T, Latronico, N, Lorini, F, Mojoli, F, Natalini, G, Pessina, C, Ranieri, V, Rech, R, Scudeller, L, Rosano, A, Storti, E, Thompson, B, Tirani, M, Villani, P, Pesenti, A, Cecconi, M, Grasselli, Giacomo, Greco, Massimiliano, Zanella, Alberto, Albano, Giovanni, Antonelli, Massimo, Bellani, Giacomo, Bonanomi, Ezio, Cabrini, Luca, Carlesso, Eleonora, Castelli, Gianpaolo, Cattaneo, Sergio, Cereda, Danilo, Colombo, Sergio, Coluccello, Antonio, Crescini, Giuseppe, Forastieri Molinari, Andrea, Foti, Giuseppe, Fumagalli, Roberto, Iotti, Giorgio Antonio, Langer, Thomas, Latronico, Nicola, Lorini, Ferdinando Luca, Mojoli, Francesco, Natalini, Giuseppe, Pessina, Carla Maria, Ranieri, Vito Marco, Rech, Roberto, Scudeller, Luigia, Rosano, Antonio, Storti, Enrico, Thompson, B Taylor, Tirani, Marcello, Villani, Pier Giorgio, Pesenti, Antonio, Cecconi, Maurizio, Grasselli, G, Greco, M, Zanella, A, Albano, G, Antonelli, M, Bellani, G, Bonanomi, E, Cabrini, L, Carlesso, E, Castelli, G, Cattaneo, S, Cereda, D, Colombo, S, Coluccello, A, Crescini, G, Forastieri Molinari, A, Foti, G, Fumagalli, R, Iotti, G, Langer, T, Latronico, N, Lorini, F, Mojoli, F, Natalini, G, Pessina, C, Ranieri, V, Rech, R, Scudeller, L, Rosano, A, Storti, E, Thompson, B, Tirani, M, Villani, P, Pesenti, A, Cecconi, M, Grasselli, Giacomo, Greco, Massimiliano, Zanella, Alberto, Albano, Giovanni, Antonelli, Massimo, Bellani, Giacomo, Bonanomi, Ezio, Cabrini, Luca, Carlesso, Eleonora, Castelli, Gianpaolo, Cattaneo, Sergio, Cereda, Danilo, Colombo, Sergio, Coluccello, Antonio, Crescini, Giuseppe, Forastieri Molinari, Andrea, Foti, Giuseppe, Fumagalli, Roberto, Iotti, Giorgio Antonio, Langer, Thomas, Latronico, Nicola, Lorini, Ferdinando Luca, Mojoli, Francesco, Natalini, Giuseppe, Pessina, Carla Maria, Ranieri, Vito Marco, Rech, Roberto, Scudeller, Luigia, Rosano, Antonio, Storti, Enrico, Thompson, B Taylor, Tirani, Marcello, Villani, Pier Giorgio, Pesenti, Antonio, and Cecconi, Maurizio
Abstract: Importance: Many patients with coronavirus disease 2019 (COVID-19) are critically ill and require care in the intensive care unit (ICU). Objective: To evaluate the independent risk factors associated with mortality of patients with COVID-19 requiring treatment in ICUs in the Lombardy region of Italy. Design, setting, and participants: This retrospective, observational cohort study included 3988 consecutive critically ill patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinating center (Fondazione IRCCS [Istituto di Ricovero e Cura a Carattere Scientifico] Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network from February 20 to April 22, 2020. Infection with severe acute respiratory syndrome coronavirus 2 was confirmed by real-time reverse transcriptase-polymerase chain reaction assay of nasopharyngeal swabs. Follow-up was completed on May 30, 2020. Exposures: Baseline characteristics, comorbidities, long-term medications, and ventilatory support at ICU admission. Main outcomes and measures: Time to death in days from ICU admission to hospital discharge. The independent risk factors associated with mortality were evaluated with a multivariable Cox proportional hazards regression. Results: Of the 3988 patients included in this cohort study, the median age was 63 (interquartile range [IQR] 56-69) years; 3188 (79.9%; 95% CI, 78.7%-81.1%) were men, and 1998 of 3300 (60.5%; 95% CI, 58.9%-62.2%) had at least 1 comorbidity. At ICU admission, 2929 patients (87.3%; 95% CI, 86.1%-88.4%) required invasive mechanical ventilation (IMV). The median follow-up was 44 (95% CI, 40-47; IQR, 11-69; range, 0-100) days; median time from symptoms onset to ICU admission was 10 (95% CI, 9-10; IQR, 6-14) days; median length of ICU stay was 12 (95% CI, 12-13; IQR, 6-21) days; and median length of IMV was 10 (95% CI, 10-11; IQR, 6-17) days. Cumulative observation time was 164 305 patient-days. Hospital and ICU mortality ra
Published: 2020

43. Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

Author: Morandi, A., Zambon, A., Di Santo, S. G., Mazzone, A., Cherubini, A., Mossello, E., Bo, M., Marengoni, A., Bellelli, G., Rispoli, V., Malara, A., Spadea, F., Di Cello, S., Ceravolo, F., Fabiano, F., Chiaradia, G., Gabriele, A., Lenino, P., Andrea, T., Settembrini, V., Capomolla, D., Citrino, A., Scriva, A., Bruno, I., Secchi, R., De Martino, E., Muccinelli, R., Lupi, G., Paonessa, P., Fabbri, A., Passuti, M. T., Castellari, S., Po, A., Gaggioli, G., Varesi, M., Moneti, P., Capurso, S., Latini, V., Ghidotti, S., Riccardelli, F., Macchi, M., Rigo, R., Claudio, P., Angelo, B., Flavio, C., Benedetta, B., Boffelli, S., Cassinadri, A., Franzoni, S., Spazzini, E., Andretto, D., Tonini, G., Andreani, L., Coralli, M., Balotta, A., Cancelliere, R., Ballardini, G., Simoncelli, M., Mancini, A., Strazzacapa, M., Fabio, S., De Filippi, F., Giudice, C., Dentizzi, C., Azzini, M., Cazzadori, M., Mastroeni, V., Bertassello, P., Claudia Benati, H. S., Nesta, E., Tobaldini, C., Guerini, F., Elena, T., Mombelloni, P., Fontanini, F., Gabriella, L., Pizzorni, C., Oliverio, M., Del Grosso, L. L., Giavedoni, C., Bidoli, G., Mazzei, B., Corsonello, A., Fusco, S., Vena, S., De Vuono, T., Maiuri, G., Luca, F. F., Andrea, A., Giovanni, S., Rossella, N., Castegnaro, E., De Rosa, S., Sechi, R. B., Benvenuti, E., Del Lungo, I., Giardini, S., Giulietti, C., Mauro, D. B., Eleonora, B., Martina, P., Irene, F., Riccardo, B., Federica, S., Ilaria, D. L., Bertoletti, E., D'Amico, F., Caronzolo, F., Grippa, A., Lombardo, G., Pipicella, T., Antonino, S., Francesco, C., Valeria, P. G., Daniela, L., Domenico, C., Giorgio, B., March, A., Nitti, M. T., Felici, A., Pavan, S., Piazzani, F., Lunelli, A., Dimori, S., Margotta, A., Soglia, T., Postacchini, D., Brunelli, R., Santini, S., Francavilla, M., Macchiati, I., Sorvillo, F., Giuli, C., Mecocci, P., Longo, A., Perticone, F., Addesi, D., Rosa, P. C., Bencardino, G., Falbo, T., Grillo, N., Marco, F., Mirella, F., Fanto, F., Isaia, G., Pezzilli, S., Bergamo, D., Furno, E., Rrodhe, S., Lucarini, S., Dijk, B., Dall'Acqua, F., Cappelletto, F., Calvani, D., Becheri, D., Giuseppe, M., Costanza, M., Vito, A., Francesca, B., Magherini, L., Novella, M., Franca, B., Lucia Gambardella, P. M., Valente, C., Ilaria, B., Alice, F., Porrino, P., Ceci, G., Giuliana, B., Michela, T., Eleonora, C., Ettore, E., Camellini, C., Servello, A., Grassi, A., Rozzini, R., Tironi, S., Grassi, M. G., Troisi, E., Carlo, C., Simona Gabriella, D. S., Flaminia, F., Federica, R., Beatrice, P., Sofia, T., Gabutto, A., Quazzo, L., Rosatello, A., Suraci, D., Tagliabue, B., Perrone, C., Ferrara, L., Castagna, A., Tremolada, M. L., Giuseppe, C., Stefano, B., Davide, O., Piano, S., Serviddio, G., Lo Buglio, A., Gurrera, T., Merlo, V., Rovai, C., Cotroneo, A. M., Carlucci, R., Abbaldo, A., Monzani, F., Qasem, A. A., Bini, G., Tafuto, S., Galli, G., Bruni, A. C., Mancuso, G., Calipari, D., Giuseppe Massimiliano, D. L., Bernardini, B., Corsini, C., Michele, C., Sara, D. F., Cagnin, A., Fragiacomo, F., Pompanin, S., Piero, A., Marco, C., Zurlo, A., Guerra, G., Pala, M., Menozzi, L., Gatti, C. D., Magon, S., Roberto, M., Alfredo, D. G., Fabio, F., Ruana, T., Elisa, M., Christian, M., Marco, P., Massimo, G., Di Francesco, V., Faccioli, S., Pellizzari, L., Giorgia, F., Barbagallo, G., Lunardelli, M. L., Martini, E., Ferrari, E., Macchiarulo, M., Corneli, M., Bacci, M., Battaglia, G., Anastasio, L., Lo Storto, M. S., Seresin, C., Simonato, M., Loreggian, M., Cestonaro, F., Durando, M., Latella, R., Mazzoleni, M., Russo, G., Ponte, M., Valchera, A., Salustri, G., Petritola, D., Costa, A., Sinforiani, E., Cotta, M. R., Pizio, R. N., Cester, A., Formilan, M., Pietro, B., Carbone, P., Cazzaniga, I., Appollonio, I., Cereda, D., Stabile, A., Xhani, R., Acampora, R., Tremolizzo, L., Federico, P., Antonio, C., Valerio, P., Cesare, B., Zhirajr, M., Giovanni, V., Maria, A., Mariaelena, S., Bottacchi, E., Bucciantini, E., Di Giovanni, M., Franchi, F., Lucchetti, L., Mariani, C., Grande, G., Rapazzini, P., Marco, M., Romanelli, G., Franco, N., Alessio, M., Nicola, L., Laura, P., Nazario, P., Chiara, G., Soccorso, P., Andrea, S., Luca, B., Francesca, S., Roberto, A., Anna, C., Fugazza, L., Guerrini, C., De Paduanis, G., Iallonardo, L., Palumbo, P., Zuliani, G., Ortolani, B., Capatti, E., Soavi, C., Bianchi, L., Francesconi, D., Miselli, A., Gloria, B., Tommaso, R., Chiara, P., Agata, M. M., Marco, D. A., Luca, M., Gianluca, G., Suardi, T., Zaccarini, C., Manuela, R., Mirra, G., Muti, E., Bottura, R., Gianpaolo, M., Secreto, P., Bisio, E., Cecchettani, M., Naldi, T., Pallavicino, A., Pugliese, M., Iozzo, R. C., Grassi, G., Michele, B., Raffaella, D. O., Fosca, Q. T., Giorgio, G. C., Giovanni, P., Ernesto, C., Mannironi, A., Giorli, E., Oberti, S., Fierro, B., Piccoli, T., Giacalone, F., Mandas, A., Serchisu, L., Costaggiu, D., Pinna, E., Orru, F., Mannai, M., Cordioli, Z., Pelizzari, L., Turcato, E., Arduini, P., Cacace, C., Chiloiro, R., Cimino, R., Ruberto, C., Giovanni, R., Pietro, G., Laura, G., Alberto, C., Carmen, R., Santo, P. D., Andriolli, A., Burattin, G., Rossi, L., Andreolli Antonino, C. G., Tezza, F., Maddalena, P., Laura, S., Crippa, P., Aloisio, P., Di Monda, T., Malighetti, A., Galbassini, G., Salutis, D., Ivaldi, C., Russo, A. M., Bennati, E., Pino, E., Zavarise, G., Pesci, A., Suigo, G., Faverio, P., Andrea, G., Sabrina, P., Zanasi, M., Moniello, G., Rostagno, C., Cartei, A., Polidori, G., Ungar, A., Melis, M. R., Martellini, E., Enrico, M., Monica, T., Antonella, G., Giovanna, L., Migliorini, M., Caramelli, F., Battiston, B., Berardino, M., Cavallo, S., Alessandro, M., Anna, S., Lombardi, B., D'Ippolito, P., Furini, A., Villani, D., Clara, R., Guarneri, M., Paolucci, S., Bassi, A., Coiro, P., De Angelis, D., Morone, G., Venturiero, V., Palleschi, L., Raganato, P., Di Niro, G., Rosa, C. A., Loredana, B., Imoscopi, A., Tibaldi, V., Bottignole G, G., Calvi, E., Clementi, C., Zanocchi, M., Agosta, L., Nortarelli, A., Provenzano, G., Mari, D., Romano, F. Y., Rosini, F., Mansi, M., Rossi, S., Geriatria, A. R., Inzaghi, L., Bonini, G., Rossi, P., Potena, A., Lichii, M., Candiani, T., Grimaldi, W., Bertani, E., Alessandra, P., Calogero, P., Pinto, D., Bernardi, R., Nicolino, F., Galetti, C., Gianstefani, A., Giulia, C., Lorenzo, M., Odetti, P., Monacelli, F., Prefumo, M., Fiammetta, M., Canepa, M., Minaglia, C., Paolisso, G., Rizzo, M. R., Prestano, R., Dalise, A. M., Barra, D., Bosco, L. D., Asprinio, V., Dallape, L., Perina, E., Incalzi, R. A., Bartoli, I. R., Pluderi, A., Maina, A., Pecoraro, E., Sciarra, M., Prudente, A., Paola, M., Francesca, M., Manuel, V., Luisella, C., Maria, P. L., Tina, S., Benini, L., Levato, F., Mhiuta, V., Alius, F., Davidoaia, D., Giardini, V., Garancini, M., Bellamoli, C., Terranova, L., Bozzini, C., Tosoni, P., Provoli, E., Cascone, L., Dioli, A., Ferrarin, G., Bucci, A., Bua, G., Fenu, S., Bianchi, G., Casella, S., Romano, V., Maurizio, P., Mascherona, I., Belotti, G., Cavaliere, S., Cuni, E., Merciuc, N., Oberti, R., Veneziani, S., Capoferri, E., De Bernardi, E., Colombo, K., Bravi, M., Nicoletta, N., D'Arcangelo, P., Montenegro, N., Montanari, R., Lamanna, P., Gasperini, B., Isabella, M., Stefania, D., Gaia, A., Filippo, C., Palama, C., Di Emidio, C., Scarpini, E., Arighi, A., Fumagalli, G., Basilico, P., De Amicis Margherita, M., Marta, M., Diletta, M., Granata, A., Ranalli, C., Cammilli, A., Cavallini, M. C., Tricca, M., Natella, D., Gabbani, L., Tesi, F., Martella, L., Imbrici, R., Guerrini, G., Scotuzzi, A. M., Sozzi, F., Valenti, L., Chiarello, A., Monia, M., Pilotto, A., Prete, C., Senesi, B., Meta, A. C., Pendenza, E., Pasqualetti, G., Polini, A., Tognini, S., Ballino, E., Dell'Aquila, G., Gasparrini, P. M., Marotti, E., Migale, M., Scrimieri, A., Falsetti, L., Salvi, A., Toigo, G., Ceschia, G., Rosso, A., Tongiorgi, C., Scarpa, C., De Dominicis, L., Pucci, E., Renzi, S., Cartechini, E., Tomassini, P. F., Del Gobbo, M., Ugenti, F., Romeo, P., Nardelli, A., Lauretani, F., Visioli, S., Montanari, I., Ermini, F., Giordano, A., Pigato, G., Simeone, E., Barbujani, M., Giampieri, M., Amoruso, R., Piccinini, M., Ferrari, C., Gambetti, C., Sfrappini, M., Semeraro, L., Striuli, R., Pelliccioni, G., Marinelli, D., Fabi, K., Rossi, T., Pesallaccia, M., Sabbatini, D., Gobbi, B., Cerqua, R., Tagliani, G., Schlauser, E., Caser, L., Caramello, E., Sandigliano, F., Rosso, G., Ferrari, A., Bendini, C., Luisa, D. M., Casella, M., Prampolini, R., Scevola, M., Vitale, E., Roberto, B., Carlo, F., Sergio, F., Alberto, S., Daniela, Z., Giulia, B., Serena, G., Maugeri, D., Sorace, R., Anzaldi, M., De Gesu, R., Morrone, G., Davolio, F., Fabbo, A., Palmieri, M., Zoli, M., Forti, P., Pirazzoli, L., Fabbri, E., Terenzi, L., Bergolari, F., Wenter, C., Ruffini, I., Insam, M., Abraham, E., Kirchlechner, C., Cucinotta, D., Antonino, L., Basile, G., Grazia, A. M., Parise, P., Boccali, A., Amici, S., Gambacorta, M., Lasagni, A., Lovati, R., Giovinazzo, F., Kimak, E., Zappa, P., Medici, F., Lo Castro, M., Mauro, F., De Luca, A., Sancesario, G., Martorana, A., Scaricamazza, B., Toniolo, S., Di Lorenzo, F., Liguori, C., Lasco, A., Vita, N., Giomi, M., Forte, F., Padovani, A., Rozzini, L., Ceraso, A., Salvatore, C., Cottino, M., Vitali, S., Marelli, E., Tripi, G., Miceli, S., Urso, G., Grioni, G., Vezzadini, G., Misaggi, G., Forlani, C., Avanzi, S., Serena, S., Claudia, C., Marilena, V., Alberto, L., Diego, G., Alessandro, G., Iemolo, F., Sanzaro, E., D'Asta, G., Proietto, M., Carnemolla, A., Razza, G., Spadaro, D., Bertolotti, M., Mussi, C., Neviani, F., Roberto, C., Valentina, G., Linda, M., Francesca, V., Tarozzi, A., Balestri, F., Mannarino, G., Bigolari, M., Natale, A., Grassi, S., Bottaro, C., Stefanelli, S., Bovone, U., Tortorolo, U., Quadri, R., Leone, G., Ponzetto, M., Frasson, P., Annoni, G., Bruni, A., Confalonieri, R., Corsi, M., Moretti, D., Teruzzi, F., Umidi, S., Mazzola, P., Perego, S., Persico, I., Olivieri, G., Bonfanti, A., Hajnalka, S., Galeazzi, M., Massariello, F., Anzuini, A., Caffarra, P., Barocco, F., Spallazzi, M., Paolo, C. G., Simonetta, M., Chioatto, P., Bortolamei, S., Soattin, L., Ruotolo, G., Beneamino, B., Giuseppe, B., Bertazzoli, M., Rota, E., Adobati, A., Scarpa, A., Granziera, S., Zuccher, P., Fabbro, A. D., Zara, D., Lo Nigro, A., Franchetti, L., Toniolo, M., Marcuzzo, C., Rollone, M., Guerriero, F., Sgarlata, C., Masse, A., Zatti, G., Piatti, M., Graci, J., Benati, G., Boschi, F., Biondi, M., Fiumi, N., Erika, T., Locatelli, S. M., Mauri, S., Beretta, M., Margheritis, L., Desideri, G., Liberatore, E., Carucci, A. C., Bonino, P., Caput, M., Antonietti, M. P., Polistena, G., De la Pierre, F., Mari, M., Massignani, P., Tombesi, F., Selvaggio, F., Verbo, B., Bodoni, P., Marchionni, N., Sabatini, T., Mussio, E., Magni, Eugenio, Bianchetti, A., Crucitti, Antonio, Titoldini, G., Cossu, B., Fascendini, S., Licini, C., Tomasoni, A., Calderazzo, M., Daniela, T., Valentina, L., Melotti, R. M., Lilli, A., Buda, S., Adversi, M., Noro, G., Turco, R., Ubezio, M. C., Mantovani, A. R., Viola, M. C., Serrati, C., Pretta, S., Infante, M., Gentile, S., D'Ambrosio, V., Mazzanti, P., Brambilla, C., Sportelli, S., Platto, C., Faraci, B., Quattrocchi, D., Pernigotti, L. M., Pisu, C., Sicuro, F., Zagnoni, P., Ghiglia, S., Mosca, M., Corazzin, I., Deola, M., Biagini, C. A., Bencini, F., Cantini, C., Tonon, E., Pierinelli, S., Onofrj, M., Thomas, A., Filomena, B., Bonanni, L., Gabriella, C., Comi, G., Magnani, G., Santangelo, R., Mazzeo, S., Francesca, C., Giordano, C., Roberto, S. A., Barbieri, C., Giroldi, L., Bandini, F., Masina, M., Malservisi, S., Cicognani, A., Ricca, L., Piccininni, M., Tassinari, T., Brogi, D., Sugo, A., Alessandra, F., Sonia, M., Valerio, V., Andrea, U. C., Enrico, C., Vera, R. F., Assunta, S., Gianmaria, Z., Mauro, P., Barone, A., Razzano, M., Giuseppe, I., Angela, B., Francesco, S., Valeria, D. A., Federico, G., Lucia, P., Antonella, V., Elisabetta, D. C., Cristina, R., Nadia, C., Maria, S., Luciano, A., Chiara, C., Bini, P., Pignata, M., Enrico, B., Maria, V., Giovanni, C., Giorgio, C., Piera, R., Alberto, Z., Ceccon, A., Magrin, L., Marin, S., Barbara, S., Matteo, M., Caterina, P. M., Carla, R., Federica, G., Clara, T., Melania, C., Giampaolo, B., Stefano, G., Valeria, G., Lucia, M., Giovambattista, D., Ester, L., Cecilia, C. A., Maurizio, T., Nadia, B., Grillo, A., Arenare, F., Tonino, M., David, K., Giorgio, V. P., Ubaldo, B., Vincenzo, S., Stefano, M., Marino, F., Busonera Flavio, M. T., Paolo, A., Monica, M., Francesco, B., Roberto, F., Paolo, B., Durantemangoni, E., Testoni, M., Fabio, D. S., Loredana, S., Valeria, S., Fabiano, M., Annabella, D. G., Salvatore, D. C., Greco, A., Grazia, D. O., Daniele, S., Gianluca, R., Renzo, G., Sergio, M., Morena, B., Vitali, M., Marina, P., Paolo, D. C., Cristina, S., Orlandini, F., La Regina, M., Desiree, A., Mario, B., Paola, P., Padulo, F., Cristina, M., Dario, R., Giancarla, M., Guido, R., Elena, M., Marileda, N., Igor, B., Nicole, B., Elena, R., Paolillo, C., Riccardi, A., Claudia, B., Barbara, R., Silvia, V., Oliver, B., Mauro, C., Eleonora, M., Giuseppe, P., Rosaria, T., Maria, C., Davide, D. A., Stefania, C., Massimo, P., Luca, S., Martina, D. F., Paola, V., Lia, S., Sandro, C., Valentina, D. S., Erminia, B., Paola, C., Romina, R., Minisola, S., Luciano, C., Pasquale, A., Ilaria, L., Guglielmo, S., Marco, E., Sara, R., Paola, A., Claudio, A., Francesco, R., Alessandro, C., Simona, M., Lara, F., Paola, R., Simonetta, C., Antonella, C., Generoso, U., Fernando, G., Giuliano, C., Emanuela, S., Mariolina, S., Alessandro, D., Giulia, L., Famularo, S., Sandini, M., Pinotti, E., Gianotti, L., Antonella, B., Giulia, P., Sante, G., Rossi, A., Rubele, S., Sant, S., Marco, V., Danila, C., Fabio, R., Bandirali, M. P., Nicoletta, C., Laura, B., Paolo, T., Luciano, T., Leonello, A., Margherita, S., Stefania, D. N., Pierluigi, D. S., Laura, R., Fabiana, T., Giovanna, C., Antonino, A., Felice, C., Danilo, F., Giovanna, D. B., Francesco, L., Salini, S., Angela, B. M., Giorgetta, C., Giovanni, G., Gerardo, B., Silvio, R., Letizia, S., Davide, B., Rosaria, R. M., Maria, D. A., Raffaele, P., Palmieri, V. O., Palasciano, G., Belfiore, A., Portincasa, P., Carlo, S., Alessia, D., Valiani, V., Carolina, B., Tiziana, C., Paola, T., Ugo, P., Giacomo, P., Castellano, M., Anna, G., Elisa, C., Federica, C., Antonietta, C. M., Luigi, M., Fabio, L., Salvatore, B., Gelosa, G., Viviana, A. T., Piras, V., Andrea, C., Alessandra, B., Coen, D., Magliola, R., Milanesio, D., Muzzulini, C. L., Paolo, F., Marinella, T., Sofia, C. M., Marta, B., Siano, P., Capo, G., Napoletano, R., Cecilia, P., Mancini, C., Del Buono, C., De Bartolomeo, G., Addolorata, M., Carmen, C., Giovanni, V. A., Moschettini, G., Franco, M., Daniela, R., D'Amico, G., Mirella, P., Endrizzi, C., Trotta, L., Ciarambino, T., Orazio, Z., Emanuela, T., Marta, S., Thomas, F., Giacomo, T., Ignazio, D. F., Andrea, B., Giuseppe, O., Emanuela, F., Serena, A., Elena, D. I., Serena, B., Erika, N., Roberto, S., Elena, S., Manuela, P., Francesca, A., Angelo, T., Magni E. (ORCID:0000-0002-2235-2280), Crucitti A. (ORCID:0000-0003-3496-4185), Morandi, A., Zambon, A., Di Santo, S. G., Mazzone, A., Cherubini, A., Mossello, E., Bo, M., Marengoni, A., Bellelli, G., Rispoli, V., Malara, A., Spadea, F., Di Cello, S., Ceravolo, F., Fabiano, F., Chiaradia, G., Gabriele, A., Lenino, P., Andrea, T., Settembrini, V., Capomolla, D., Citrino, A., Scriva, A., Bruno, I., Secchi, R., De Martino, E., Muccinelli, R., Lupi, G., Paonessa, P., Fabbri, A., Passuti, M. T., Castellari, S., Po, A., Gaggioli, G., Varesi, M., Moneti, P., Capurso, S., Latini, V., Ghidotti, S., Riccardelli, F., Macchi, M., Rigo, R., Claudio, P., Angelo, B., Flavio, C., Benedetta, B., Boffelli, S., Cassinadri, A., Franzoni, S., Spazzini, E., Andretto, D., Tonini, G., Andreani, L., Coralli, M., Balotta, A., Cancelliere, R., Ballardini, G., Simoncelli, M., Mancini, A., Strazzacapa, M., Fabio, S., De Filippi, F., Giudice, C., Dentizzi, C., Azzini, M., Cazzadori, M., Mastroeni, V., Bertassello, P., Claudia Benati, H. S., Nesta, E., Tobaldini, C., Guerini, F., Elena, T., Mombelloni, P., Fontanini, F., Gabriella, L., Pizzorni, C., Oliverio, M., Del Grosso, L. L., Giavedoni, C., Bidoli, G., Mazzei, B., Corsonello, A., Fusco, S., Vena, S., De Vuono, T., Maiuri, G., Luca, F. F., Andrea, A., Giovanni, S., Rossella, N., Castegnaro, E., De Rosa, S., Sechi, R. B., Benvenuti, E., Del Lungo, I., Giardini, S., Giulietti, C., Mauro, D. B., Eleonora, B., Martina, P., Irene, F., Riccardo, B., Federica, S., Ilaria, D. L., Bertoletti, E., D'Amico, F., Caronzolo, F., Grippa, A., Lombardo, G., Pipicella, T., Antonino, S., Francesco, C., Valeria, P. G., Daniela, L., Domenico, C., Giorgio, B., March, A., Nitti, M. T., Felici, A., Pavan, S., Piazzani, F., Lunelli, A., Dimori, S., Margotta, A., Soglia, T., Postacchini, D., Brunelli, R., Santini, S., Francavilla, M., Macchiati, I., Sorvillo, F., Giuli, C., Mecocci, P., Longo, A., Perticone, F., Addesi, D., Rosa, P. C., Bencardino, G., Falbo, T., Grillo, N., Marco, F., Mirella, F., Fanto, F., Isaia, G., Pezzilli, S., Bergamo, D., Furno, E., Rrodhe, S., Lucarini, S., Dijk, B., Dall'Acqua, F., Cappelletto, F., Calvani, D., Becheri, D., Giuseppe, M., Costanza, M., Vito, A., Francesca, B., Magherini, L., Novella, M., Franca, B., Lucia Gambardella, P. M., Valente, C., Ilaria, B., Alice, F., Porrino, P., Ceci, G., Giuliana, B., Michela, T., Eleonora, C., Ettore, E., Camellini, C., Servello, A., Grassi, A., Rozzini, R., Tironi, S., Grassi, M. G., Troisi, E., Carlo, C., Simona Gabriella, D. S., Flaminia, F., Federica, R., Beatrice, P., Sofia, T., Gabutto, A., Quazzo, L., Rosatello, A., Suraci, D., Tagliabue, B., Perrone, C., Ferrara, L., Castagna, A., Tremolada, M. L., Giuseppe, C., Stefano, B., Davide, O., Piano, S., Serviddio, G., Lo Buglio, A., Gurrera, T., Merlo, V., Rovai, C., Cotroneo, A. M., Carlucci, R., Abbaldo, A., Monzani, F., Qasem, A. A., Bini, G., Tafuto, S., Galli, G., Bruni, A. C., Mancuso, G., Calipari, D., Giuseppe Massimiliano, D. L., Bernardini, B., Corsini, C., Michele, C., Sara, D. F., Cagnin, A., Fragiacomo, F., Pompanin, S., Piero, A., Marco, C., Zurlo, A., Guerra, G., Pala, M., Menozzi, L., Gatti, C. D., Magon, S., Roberto, M., Alfredo, D. G., Fabio, F., Ruana, T., Elisa, M., Christian, M., Marco, P., Massimo, G., Di Francesco, V., Faccioli, S., Pellizzari, L., Giorgia, F., Barbagallo, G., Lunardelli, M. L., Martini, E., Ferrari, E., Macchiarulo, M., Corneli, M., Bacci, M., Battaglia, G., Anastasio, L., Lo Storto, M. S., Seresin, C., Simonato, M., Loreggian, M., Cestonaro, F., Durando, M., Latella, R., Mazzoleni, M., Russo, G., Ponte, M., Valchera, A., Salustri, G., Petritola, D., Costa, A., Sinforiani, E., Cotta, M. R., Pizio, R. N., Cester, A., Formilan, M., Pietro, B., Carbone, P., Cazzaniga, I., Appollonio, I., Cereda, D., Stabile, A., Xhani, R., Acampora, R., Tremolizzo, L., Federico, P., Antonio, C., Valerio, P., Cesare, B., Zhirajr, M., Giovanni, V., Maria, A., Mariaelena, S., Bottacchi, E., Bucciantini, E., Di Giovanni, M., Franchi, F., Lucchetti, L., Mariani, C., Grande, G., Rapazzini, P., Marco, M., Romanelli, G., Franco, N., Alessio, M., Nicola, L., Laura, P., Nazario, P., Chiara, G., Soccorso, P., Andrea, S., Luca, B., Francesca, S., Roberto, A., Anna, C., Fugazza, L., Guerrini, C., De Paduanis, G., Iallonardo, L., Palumbo, P., Zuliani, G., Ortolani, B., Capatti, E., Soavi, C., Bianchi, L., Francesconi, D., Miselli, A., Gloria, B., Tommaso, R., Chiara, P., Agata, M. M., Marco, D. A., Luca, M., Gianluca, G., Suardi, T., Zaccarini, C., Manuela, R., Mirra, G., Muti, E., Bottura, R., Gianpaolo, M., Secreto, P., Bisio, E., Cecchettani, M., Naldi, T., Pallavicino, A., Pugliese, M., Iozzo, R. C., Grassi, G., Michele, B., Raffaella, D. O., Fosca, Q. T., Giorgio, G. C., Giovanni, P., Ernesto, C., Mannironi, A., Giorli, E., Oberti, S., Fierro, B., Piccoli, T., Giacalone, F., Mandas, A., Serchisu, L., Costaggiu, D., Pinna, E., Orru, F., Mannai, M., Cordioli, Z., Pelizzari, L., Turcato, E., Arduini, P., Cacace, C., Chiloiro, R., Cimino, R., Ruberto, C., Giovanni, R., Pietro, G., Laura, G., Alberto, C., Carmen, R., Santo, P. D., Andriolli, A., Burattin, G., Rossi, L., Andreolli Antonino, C. G., Tezza, F., Maddalena, P., Laura, S., Crippa, P., Aloisio, P., Di Monda, T., Malighetti, A., Galbassini, G., Salutis, D., Ivaldi, C., Russo, A. M., Bennati, E., Pino, E., Zavarise, G., Pesci, A., Suigo, G., Faverio, P., Andrea, G., Sabrina, P., Zanasi, M., Moniello, G., Rostagno, C., Cartei, A., Polidori, G., Ungar, A., Melis, M. R., Martellini, E., Enrico, M., Monica, T., Antonella, G., Giovanna, L., Migliorini, M., Caramelli, F., Battiston, B., Berardino, M., Cavallo, S., Alessandro, M., Anna, S., Lombardi, B., D'Ippolito, P., Furini, A., Villani, D., Clara, R., Guarneri, M., Paolucci, S., Bassi, A., Coiro, P., De Angelis, D., Morone, G., Venturiero, V., Palleschi, L., Raganato, P., Di Niro, G., Rosa, C. A., Loredana, B., Imoscopi, A., Tibaldi, V., Bottignole G, G., Calvi, E., Clementi, C., Zanocchi, M., Agosta, L., Nortarelli, A., Provenzano, G., Mari, D., Romano, F. Y., Rosini, F., Mansi, M., Rossi, S., Geriatria, A. R., Inzaghi, L., Bonini, G., Rossi, P., Potena, A., Lichii, M., Candiani, T., Grimaldi, W., Bertani, E., Alessandra, P., Calogero, P., Pinto, D., Bernardi, R., Nicolino, F., Galetti, C., Gianstefani, A., Giulia, C., Lorenzo, M., Odetti, P., Monacelli, F., Prefumo, M., Fiammetta, M., Canepa, M., Minaglia, C., Paolisso, G., Rizzo, M. R., Prestano, R., Dalise, A. M., Barra, D., Bosco, L. D., Asprinio, V., Dallape, L., Perina, E., Incalzi, R. A., Bartoli, I. R., Pluderi, A., Maina, A., Pecoraro, E., Sciarra, M., Prudente, A., Paola, M., Francesca, M., Manuel, V., Luisella, C., Maria, P. L., Tina, S., Benini, L., Levato, F., Mhiuta, V., Alius, F., Davidoaia, D., Giardini, V., Garancini, M., Bellamoli, C., Terranova, L., Bozzini, C., Tosoni, P., Provoli, E., Cascone, L., Dioli, A., Ferrarin, G., Bucci, A., Bua, G., Fenu, S., Bianchi, G., Casella, S., Romano, V., Maurizio, P., Mascherona, I., Belotti, G., Cavaliere, S., Cuni, E., Merciuc, N., Oberti, R., Veneziani, S., Capoferri, E., De Bernardi, E., Colombo, K., Bravi, M., Nicoletta, N., D'Arcangelo, P., Montenegro, N., Montanari, R., Lamanna, P., Gasperini, B., Isabella, M., Stefania, D., Gaia, A., Filippo, C., Palama, C., Di Emidio, C., Scarpini, E., Arighi, A., Fumagalli, G., Basilico, P., De Amicis Margherita, M., Marta, M., Diletta, M., Granata, A., Ranalli, C., Cammilli, A., Cavallini, M. C., Tricca, M., Natella, D., Gabbani, L., Tesi, F., Martella, L., Imbrici, R., Guerrini, G., Scotuzzi, A. M., Sozzi, F., Valenti, L., Chiarello, A., Monia, M., Pilotto, A., Prete, C., Senesi, B., Meta, A. C., Pendenza, E., Pasqualetti, G., Polini, A., Tognini, S., Ballino, E., Dell'Aquila, G., Gasparrini, P. M., Marotti, E., Migale, M., Scrimieri, A., Falsetti, L., Salvi, A., Toigo, G., Ceschia, G., Rosso, A., Tongiorgi, C., Scarpa, C., De Dominicis, L., Pucci, E., Renzi, S., Cartechini, E., Tomassini, P. F., Del Gobbo, M., Ugenti, F., Romeo, P., Nardelli, A., Lauretani, F., Visioli, S., Montanari, I., Ermini, F., Giordano, A., Pigato, G., Simeone, E., Barbujani, M., Giampieri, M., Amoruso, R., Piccinini, M., Ferrari, C., Gambetti, C., Sfrappini, M., Semeraro, L., Striuli, R., Pelliccioni, G., Marinelli, D., Fabi, K., Rossi, T., Pesallaccia, M., Sabbatini, D., Gobbi, B., Cerqua, R., Tagliani, G., Schlauser, E., Caser, L., Caramello, E., Sandigliano, F., Rosso, G., Ferrari, A., Bendini, C., Luisa, D. M., Casella, M., Prampolini, R., Scevola, M., Vitale, E., Roberto, B., Carlo, F., Sergio, F., Alberto, S., Daniela, Z., Giulia, B., Serena, G., Maugeri, D., Sorace, R., Anzaldi, M., De Gesu, R., Morrone, G., Davolio, F., Fabbo, A., Palmieri, M., Zoli, M., Forti, P., Pirazzoli, L., Fabbri, E., Terenzi, L., Bergolari, F., Wenter, C., Ruffini, I., Insam, M., Abraham, E., Kirchlechner, C., Cucinotta, D., Antonino, L., Basile, G., Grazia, A. M., Parise, P., Boccali, A., Amici, S., Gambacorta, M., Lasagni, A., Lovati, R., Giovinazzo, F., Kimak, E., Zappa, P., Medici, F., Lo Castro, M., Mauro, F., De Luca, A., Sancesario, G., Martorana, A., Scaricamazza, B., Toniolo, S., Di Lorenzo, F., Liguori, C., Lasco, A., Vita, N., Giomi, M., Forte, F., Padovani, A., Rozzini, L., Ceraso, A., Salvatore, C., Cottino, M., Vitali, S., Marelli, E., Tripi, G., Miceli, S., Urso, G., Grioni, G., Vezzadini, G., Misaggi, G., Forlani, C., Avanzi, S., Serena, S., Claudia, C., Marilena, V., Alberto, L., Diego, G., Alessandro, G., Iemolo, F., Sanzaro, E., D'Asta, G., Proietto, M., Carnemolla, A., Razza, G., Spadaro, D., Bertolotti, M., Mussi, C., Neviani, F., Roberto, C., Valentina, G., Linda, M., Francesca, V., Tarozzi, A., Balestri, F., Mannarino, G., Bigolari, M., Natale, A., Grassi, S., Bottaro, C., Stefanelli, S., Bovone, U., Tortorolo, U., Quadri, R., Leone, G., Ponzetto, M., Frasson, P., Annoni, G., Bruni, A., Confalonieri, R., Corsi, M., Moretti, D., Teruzzi, F., Umidi, S., Mazzola, P., Perego, S., Persico, I., Olivieri, G., Bonfanti, A., Hajnalka, S., Galeazzi, M., Massariello, F., Anzuini, A., Caffarra, P., Barocco, F., Spallazzi, M., Paolo, C. G., Simonetta, M., Chioatto, P., Bortolamei, S., Soattin, L., Ruotolo, G., Beneamino, B., Giuseppe, B., Bertazzoli, M., Rota, E., Adobati, A., Scarpa, A., Granziera, S., Zuccher, P., Fabbro, A. D., Zara, D., Lo Nigro, A., Franchetti, L., Toniolo, M., Marcuzzo, C., Rollone, M., Guerriero, F., Sgarlata, C., Masse, A., Zatti, G., Piatti, M., Graci, J., Benati, G., Boschi, F., Biondi, M., Fiumi, N., Erika, T., Locatelli, S. M., Mauri, S., Beretta, M., Margheritis, L., Desideri, G., Liberatore, E., Carucci, A. C., Bonino, P., Caput, M., Antonietti, M. P., Polistena, G., De la Pierre, F., Mari, M., Massignani, P., Tombesi, F., Selvaggio, F., Verbo, B., Bodoni, P., Marchionni, N., Sabatini, T., Mussio, E., Magni, Eugenio, Bianchetti, A., Crucitti, Antonio, Titoldini, G., Cossu, B., Fascendini, S., Licini, C., Tomasoni, A., Calderazzo, M., Daniela, T., Valentina, L., Melotti, R. M., Lilli, A., Buda, S., Adversi, M., Noro, G., Turco, R., Ubezio, M. C., Mantovani, A. R., Viola, M. C., Serrati, C., Pretta, S., Infante, M., Gentile, S., D'Ambrosio, V., Mazzanti, P., Brambilla, C., Sportelli, S., Platto, C., Faraci, B., Quattrocchi, D., Pernigotti, L. M., Pisu, C., Sicuro, F., Zagnoni, P., Ghiglia, S., Mosca, M., Corazzin, I., Deola, M., Biagini, C. A., Bencini, F., Cantini, C., Tonon, E., Pierinelli, S., Onofrj, M., Thomas, A., Filomena, B., Bonanni, L., Gabriella, C., Comi, G., Magnani, G., Santangelo, R., Mazzeo, S., Francesca, C., Giordano, C., Roberto, S. A., Barbieri, C., Giroldi, L., Bandini, F., Masina, M., Malservisi, S., Cicognani, A., Ricca, L., Piccininni, M., Tassinari, T., Brogi, D., Sugo, A., Alessandra, F., Sonia, M., Valerio, V., Andrea, U. C., Enrico, C., Vera, R. F., Assunta, S., Gianmaria, Z., Mauro, P., Barone, A., Razzano, M., Giuseppe, I., Angela, B., Francesco, S., Valeria, D. A., Federico, G., Lucia, P., Antonella, V., Elisabetta, D. C., Cristina, R., Nadia, C., Maria, S., Luciano, A., Chiara, C., Bini, P., Pignata, M., Enrico, B., Maria, V., Giovanni, C., Giorgio, C., Piera, R., Alberto, Z., Ceccon, A., Magrin, L., Marin, S., Barbara, S., Matteo, M., Caterina, P. M., Carla, R., Federica, G., Clara, T., Melania, C., Giampaolo, B., Stefano, G., Valeria, G., Lucia, M., Giovambattista, D., Ester, L., Cecilia, C. A., Maurizio, T., Nadia, B., Grillo, A., Arenare, F., Tonino, M., David, K., Giorgio, V. P., Ubaldo, B., Vincenzo, S., Stefano, M., Marino, F., Busonera Flavio, M. T., Paolo, A., Monica, M., Francesco, B., Roberto, F., Paolo, B., Durantemangoni, E., Testoni, M., Fabio, D. S., Loredana, S., Valeria, S., Fabiano, M., Annabella, D. G., Salvatore, D. C., Greco, A., Grazia, D. O., Daniele, S., Gianluca, R., Renzo, G., Sergio, M., Morena, B., Vitali, M., Marina, P., Paolo, D. C., Cristina, S., Orlandini, F., La Regina, M., Desiree, A., Mario, B., Paola, P., Padulo, F., Cristina, M., Dario, R., Giancarla, M., Guido, R., Elena, M., Marileda, N., Igor, B., Nicole, B., Elena, R., Paolillo, C., Riccardi, A., Claudia, B., Barbara, R., Silvia, V., Oliver, B., Mauro, C., Eleonora, M., Giuseppe, P., Rosaria, T., Maria, C., Davide, D. A., Stefania, C., Massimo, P., Luca, S., Martina, D. F., Paola, V., Lia, S., Sandro, C., Valentina, D. S., Erminia, B., Paola, C., Romina, R., Minisola, S., Luciano, C., Pasquale, A., Ilaria, L., Guglielmo, S., Marco, E., Sara, R., Paola, A., Claudio, A., Francesco, R., Alessandro, C., Simona, M., Lara, F., Paola, R., Simonetta, C., Antonella, C., Generoso, U., Fernando, G., Giuliano, C., Emanuela, S., Mariolina, S., Alessandro, D., Giulia, L., Famularo, S., Sandini, M., Pinotti, E., Gianotti, L., Antonella, B., Giulia, P., Sante, G., Rossi, A., Rubele, S., Sant, S., Marco, V., Danila, C., Fabio, R., Bandirali, M. P., Nicoletta, C., Laura, B., Paolo, T., Luciano, T., Leonello, A., Margherita, S., Stefania, D. N., Pierluigi, D. S., Laura, R., Fabiana, T., Giovanna, C., Antonino, A., Felice, C., Danilo, F., Giovanna, D. B., Francesco, L., Salini, S., Angela, B. M., Giorgetta, C., Giovanni, G., Gerardo, B., Silvio, R., Letizia, S., Davide, B., Rosaria, R. M., Maria, D. A., Raffaele, P., Palmieri, V. O., Palasciano, G., Belfiore, A., Portincasa, P., Carlo, S., Alessia, D., Valiani, V., Carolina, B., Tiziana, C., Paola, T., Ugo, P., Giacomo, P., Castellano, M., Anna, G., Elisa, C., Federica, C., Antonietta, C. M., Luigi, M., Fabio, L., Salvatore, B., Gelosa, G., Viviana, A. T., Piras, V., Andrea, C., Alessandra, B., Coen, D., Magliola, R., Milanesio, D., Muzzulini, C. L., Paolo, F., Marinella, T., Sofia, C. M., Marta, B., Siano, P., Capo, G., Napoletano, R., Cecilia, P., Mancini, C., Del Buono, C., De Bartolomeo, G., Addolorata, M., Carmen, C., Giovanni, V. A., Moschettini, G., Franco, M., Daniela, R., D'Amico, G., Mirella, P., Endrizzi, C., Trotta, L., Ciarambino, T., Orazio, Z., Emanuela, T., Marta, S., Thomas, F., Giacomo, T., Ignazio, D. F., Andrea, B., Giuseppe, O., Emanuela, F., Serena, A., Elena, D. I., Serena, B., Erika, N., Roberto, S., Elena, S., Manuela, P., Francesca, A., Angelo, T., Magni E. (ORCID:0000-0002-2235-2280), and Crucitti A. (ORCID:0000-0003-3496-4185)
Abstract: Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the “Delirium Day” study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors.
Published: 2020

44. Low risk for SARS-CoV2 symptomatic infection and early complications in paediatric patients during the ongoing CoVID19 epidemics in Lombardy

Author: Rovida, F., primary, Cereda, D., additional, Novati, S., additional, Licari, A., additional, Triarico, A., additional, Marseglia, G.L., additional, Bruno, R., additional, Baldanti, F., additional, Mondelli, M., additional, Brunetti, E., additional, Di Matteo, A., additional, Seminari, E., additional, Maiocchi, L., additional, Zuccaro, V., additional, Pagnucco, L., additional, Mariani, B., additional, Ludovisi, S., additional, Lissandrin, R., additional, Parisi, A., additional, Sacchi, P., additional, Patruno, S.F.A., additional, Michelone, G., additional, Gulminetti, R., additional, Zanaboni, D., additional, Maserati, R., additional, Orsolini, P., additional, Vecchia, M., additional, Sciarra, M., additional, Asperges, E., additional, Colaneri, M., additional, Di Filippo, A., additional, Sambo, M., additional, Biscarini, S., additional, Lupi, M., additional, Roda, S., additional, Pieri, T.C., additional, Gallazzi, I., additional, Sachs, M., additional, Valsecchi, P., additional, Perlini, S., additional, Alfano, C., additional, Bonzano, M., additional, Briganti, F., additional, Crescenzi, G., additional, Falchi, A.G., additional, Guarnone, R., additional, Guglielmana, B., additional, Maggi, E., additional, Martino, I., additional, Pettenazza, P., additional, Pioli di Marco, S., additional, Quaglia, F., additional, Sabena, A., additional, Salinaro, F., additional, Speciale, F., additional, Zunino, I., additional, De Lorenzo, M., additional, Secco, G., additional, Dimitry, L., additional, Cappa, G., additional, Maisak, I., additional, Chiodi, B., additional, Sciarrini, M., additional, Barcella, B., additional, Resta, F., additional, Moroni, L., additional, Vezzoni, G., additional, Scattaglia, L., additional, Boscolo, E., additional, Zattera, C., additional, Tassi, M.F., additional, Capozza, V., additional, Vignaroli, D., additional, Bazzini, M., additional, Iotti, G., additional, Mojoli, F., additional, Belliato, M., additional, Perotti, L., additional, Mongodi, S., additional, Tavazzi, G., additional, Marseglia, G., additional, Brambilla, I., additional, Barbarini, D., additional, Bruno, A., additional, Cambieri, P., additional, Campanini, G., additional, Comolli, G., additional, Corbella, M., additional, Daturi, R., additional, Furione, M., additional, Monzillo, E., additional, Paolucci, S., additional, Parea, M., additional, Percivalle, E., additional, Piralla, A., additional, Rovida, F., additional, Sarasini, A., additional, Zavattoni, M., additional, Adzasehoun, G., additional, Bellotti, L., additional, Cabano, E., additional, Casali, G., additional, Dossena, L., additional, Frisco, G., additional, Garbagnoli, G., additional, Girello, A., additional, Landini, V., additional, Lucchelli, C., additional, Maliardi, V., additional, Pezzaia, S., additional, Premoli, M., additional, Bonetti, A., additional, Caneva, G., additional, Cassaniti, I., additional, Corcione, A., additional, Di Martino, R., additional, Di Napoli, A., additional, Ferrari, A., additional, Ferrari, G., additional, Fiorina, L., additional, Giardina, F., additional, Mercato, A., additional, Novazzi, F., additional, Ratano, G., additional, Rossi, B., additional, Sciabica, I.M., additional, Tallarita, M., additional, Vecchio Nepita, E., additional, Calvi, M., additional, Tizzoni, M., additional, Nicora, C., additional, Petronella, V., additional, Marena, C., additional, Muzzi, A., additional, and Lago, P., additional
Published: 2020
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45. Outbreak of measles genotype H1 in Northern Italy originated from a case imported from Southeast Asia, 2017

Author: Rovida, F., Brianese, N., Piralla, A., Sarasini, A., Girello, A., Giardina, F., Cassaniti, I., Fornabaio, C., Seminari, E., Monteverdi, A., Piro, A., Baggieri, M., Cereda, D., Pan, A., Magurano, F., and Baldanti, F.
Published: 2019
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46. Influenza surveillance system and Covid-19

Author: Castrofino, A, primary, Del Castillo, G, additional, Grosso, F, additional, Barone, A, additional, Gramegna, M, additional, Galli, C, additional, Tirani, M, additional, Castaldi, S, additional, Pariani, E, additional, and Cereda, D, additional
Published: 2020
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47. COVID-19 serological testing for Healthcare Workers in Lombardy, Italy

Author: Del Castillo, G, primary, Castrofino, A, additional, Grosso, F, additional, Barone, A, additional, Crottogini, L, additional, Toso, C, additional, Pellegrinelli, L, additional, Pariani, E, additional, Castaldi, S, additional, and Cereda, D, additional
Published: 2020
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48. The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the 'Delirium Day 2015'

Author: Bo, M, Porrino, P, Di Santo SG, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, on behalf of the Italian Study Group on Delirium (ISGoD): Boffelli, S, Di Stefano, F, De Filippi, F, Guerini, F, Bertoletti, E, March, A, Margiotta, A, Mecocci, P, Ruggiero, C, Addesi, D, Fantò, F, Isaia, G, Dijik, B, Cotroneo, Am, Galli, G, Bruni, Ac, Bernardini, B, Corsini, C, Cagnin, A, Zurlo, G, Barbagallo, G, Lunardelli, Ml, Martini, E, Battaglia, G, Latella, R, Petritola, D, Sinforiani, E, Cester, A, Formilan, M, Carbone, P, Appollonio, I, Cereda, D, Tremolizzo, L, Bottacchi, E, Lucchetti, L, Mariani, C, Rapazzini, P, Romanelli, G, Marengoni, A, Zuliani, G, Bianchi, L, Suardi, T, Muti, E, Bottura, R, Sgrò, G, Mandas, A, Serchisu, L, Crippa, P, Ivaldi, C, Ungar, A, Villani, D, Raimondi, C, Mussi, C, Provenzano, G, Mari, D, Odetti, P, Monacelli, F, Antonelli Incalzi, R, Pluderi, A, Bellamoli, C, Terranova, L, Scarpini, E, D’Amico, F, Cavallini, Mc, Guerrini, G, Scotuzzi, Am, Chiarello, A, Pilotto, A, Tognini, S, Dell’Aquila, G, Toigo, G, Ceschia, G, Piccinini, M, Fabbo, A, Zoli, M, Forti, P, Wenter, C, Basile, G, Lasagni, A, Padovani, A, Rozzini, L, Cottino, M, Vitali, S, Tripi, G, Avanzi, S, Umidi, S, Moretti, D, Ruotolo, G, Boschi, F, Bonino, P, Marchionni, N, Fascendini, S, Noro, G, Turco, R, Ubezio, Mc, Serrati, C, Infante, M, Gentile, S, Pernigotti, Lm, Biagini, Ca, Canonico, E, Bonati, P, Gareri, P, Caffarra, P, Castagna, A, Ceretti, A, Castiglia, R, Gabelli, C, Lo Storto, M, Putzu, P, Di Santo, S, Rozzini, R, Zanetti, E, Trabucchi, M., Bo, M, Porrino, P, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, Bo, Mario, Porrino, Paola, Di Santo, Simona G., Mazzone, Andrea, Cherubini, Antonio, Mossello, Enrico, Bianchetti, Angelo, Musicco, Massimo, Ferrari, Alberto, Ferrara, Nicola, Filippini, Claudia, Trabucchi, Marco, Morandi, Alessandro, and Bellelli, Giuseppe
Subjects: Male, Aging, medicine.medical_specialty, 4AT test, Cognition, Delirium, Geriatric assessment, Aged, Aged, 80 and over, Catheters, Indwelling, Female, Humans, Logistic Models, Urinary Catheterization, Nursing Homes, Catheters, Hospitalized patients, medicine.medical_treatment, Logistic regression, behavioral disciplines and activities, Urinary catheterization, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Internal medicine, mental disorders, medicine, 80 and over, Dementia, 030212 general & internal medicine, Coma, business.industry, Geriatrics and Gerontology, medicine.disease, Indwelling, medicine.symptom, Nursing homes, business, 030217 neurology & neurosurgery
Abstract: Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score >= 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score >= 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.
Published: 2019

49. CALIS - CAncer Literacy and Information Seeking: a study in the setting of colorectal screening : Danilo Cereda

Author: Nobile, M., Cereda, D., Bastiampillai, AJ, Gabrielli, E., Germeni, E., Diviani, N., Beghi, G., Vitale, A., Antonioli, C., Gariani, L., Gullotta, R., Manes, G., Auxilia, F., Schulz, P., and Castaldi, S.
Published: 2017

50. Outbreak of acute hepatitis A involving young men in Lombardy Region, Italy: risk factors, clinical and virological characteristics

Author: Iavarone, M., primary, Viganò, M., additional, Orcese, C., additional, Coen, M., additional, Oggioni, C., additional, Spinetti, A., additional, Soria, A., additional, Galli, C., additional, Tagliacarne, C., additional, Scaramella, L., additional, Merli, M., additional, Rossotti, R., additional, Gubertini, G.A., additional, Merli, S., additional, Piscitelli, A., additional, Castelli, V., additional, Comelli, A., additional, Cereda, D., additional, Gramegna, M., additional, Puoti, M., additional, Gori, A., additional, Rumi, M.G., additional, Castelli, F., additional, Lampertico, P., additional, and Romanò, L., additional
Published: 2018
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