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2. STAR HE-Linac Complete Detailed Design Report

Author

Bacci, A., Faillace, L., Pellegrino, L., Alesini, D., Bini, S., Cardelli, F., Catuscelli, G., Chiarelli, F., Drebot, I., Esposito, A., Gallo, A., Ghigo, A., Giannotti, D., Petrillo, V., Piersanti, L., Puppin, E., Conti, M. Rossetti, Serafini, L., Stella, A., Vannozzi, A., and Vescovi, S.

Subjects
Physics - Accelerator Physics
Abstract

This Document contains a complete technical description of the system devoted to the upgrade of the STAR Linear Accelerator (STAR Linac). According to the Contract signed between Universita della Calabria (UniCal) and Istituto Nazionale di Fisica Nucleare (INFN) on May 7th, 2021, INFN is committed to install, test and commission the upgrade of the STAR Linac denominated STAR-HE-Linac (STAR High Energy Linac), hereafter STAR-HEL. The technical components as well as the installation / test procedures and the ancillary equipment involved in such an upgrade are the object of this Document, named Complete Detailed Design Report. A technical offer was submitted by INFN in the frame of its participation to the tender issued by UniCal, describing a possible energy upgrade of the STAR Linac, with an electron beam energy boosted from 65 MeV up to 150 MeV by means of Radiofrequency (RF) accelerating sections and power stations based on S-band technology (ie, 2856 MHz RF frequency). Following the Contract signature, INFN conceived and conceptually designed a technology change that offers several advantages both on performances and on operational reliability of STAR-HEL, based on adopting C-band technology (ie, 5712 MHz RF frequency) for accelerating sections and RF power stations. Such a technology change was illustrated in a dedicated document named "improvement option for STAR-2 HE-Linac", addressed to UniCal STAR Management Board and tender R.U.P. for approval on June 9th, 2021. INFN received a formal letter of approval on June 16th, 2021.

Published
2021

6. Progress in the energy upgrade of the Southern European Thomson back-scattering source (STAR)

Author

Samsam, S., primary, Serafini, L., additional, Ruijter, M., additional, Prelz, F., additional, Rossetti Conti, M., additional, Bacci, A., additional, Olivieri, A., additional, Esposito, A., additional, Faillace, L., additional, Gallo, A., additional, Vannozzi, A., additional, Ghigo, A., additional, Liedl, A., additional, Stella, A., additional, Giannotti, D., additional, Puppin, E., additional, Chiarelli, F., additional, Catuscelli, G., additional, Pellegrino, L., additional, Vescovi, S., additional, and Bini, S., additional

Published
2023
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7. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., Bellettato M., Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

Published
2022

8. Effect of peritoneal dialysis fluid containing osmo-metabolic agents on human endothelial cells

Author

Bonomini M, Di Silvestre S, Di Tomo P, Di Pietro N, Mandatori D, Di Liberato L, Sirolli V, Chiarelli F, Indiveri C, Pandolfi A, and Arduini A

Subjects
carnitine, peritoneal dialysis solution, inflammation, nitro-oxidative stress, endothelial cells, xylitol., Therapeutics. Pharmacology, RM1-950
Abstract

Mario Bonomini,1,2 Sara Di Silvestre,3,4 Pamela Di Tomo,3,4 Natalia Di Pietro,2,4 Domitilla Mandatori,3,4 Lorenzo Di Liberato,1 Vittorio Sirolli,1,2 Francesco Chiarelli,2,4 Cesare Indiveri,5 Assunta Pandolfi,3,4 Arduino Arduini6 1Unit of Nephrology and Dialysis, 2Department of Medicine and Aging Sciences, 3Department of Medical, Oral and Biotechnological Sciences, 4Aging Research Center and Translational Medicine, CeSI-MeT, University “G. d’Annunzio”, Chieti-Pescara, 5Department DiBEST (Biologia, Ecologia, Scienze della Terra), Unit of Biochemistry and Molecular Biotechnology, University of Calabria, Arcavacata di Rende CS, Italy; 6CoreQuest, Manno, Switzerland Background: The use of glucose as the only osmotic agent in peritoneal dialysis (PD) solutions (PDSs) is believed to exert local (peritoneal) and systemic detrimental actions, particularly in diabetic PD patients. To improve peritoneal biocompatibility, we have developed more biocompatible PDSs containing xylitol and carnitine along with significantly less amounts of glucose and have tested them in cultured Human Vein Endothelial Cells (HUVECs) obtained from the umbilical cords of healthy (C) and gestational diabetic (GD) mothers. Methods: Primary C- and GD-HUVECs were treated for 72 hours with our PDSs (xylitol 0.7% and 1.5%, whereas carnitine and glucose were fixed at 0.02% and 0.5%, respectively) and two glucose-based PDSs (glucose 1.36% or 2.27%). We examined their effects on endothelial cell proliferation (cell count), viability (3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide assay), intracellular nitro-oxidative stress (peroxynitrite levels), Vascular Cell Adhesion Molecule-1 and Intercellular Adhesion Molecule-1 membrane exposure (flow cytometry), and HUVEC-monocyte interactions (U937 adhesion assay). Results: Compared to glucose-based PDSs, our in vitro studies demonstrated that the tested PDSs did not change the proliferative potential both in C- and GD-HUVECs. Moreover, our PDSs significantly improved endothelial cell viability, compared to glucose-based PDSs and basal condition. Notably, glucose-based PDSs significantly increased the intracellular peroxynitrite levels, Vascular Cell Adhesion Molecule-1 and Intercellular Adhesion Molecule-1 membrane exposure, and endothelial cell–monocyte interactions in both C- and GD-HUVECs, as compared with our experimental PDSs. Conclusion: Present results show that in control and diabetic human endothelial cell models, xylitol–carnitine-based PDSs do not cause cytotoxicity, nitro-oxidative stress, and inflammation as caused by hypertonic glucose-based PDSs. Since xylitol and carnitine are also known to favorably affect glucose homeostasis, these findings suggest that our PDSs may represent a desirable hypertonic solution even for diabetic patients in PD. Keywords: carnitine, peritoneal dialysis solution, inflammation, nitro-oxidative stress, endothelial cells, xylitol

Published
2016

9. Perinatal diagnosis of congenital urogenital sinus abnormality

Author

Fiorentino, R., primary, Cauzzo, C., additional, Chiavaroli, V., additional, Sabatini, L., additional, Topazio, T., additional, Cognigni, R., additional, Di Credico, S., additional, Valzano, E., additional, Del Torto, M., additional, Miscia, M.E., additional, Lisi, G., additional, Chiarelli, F., additional, and Di Valerio, S., additional

Published
2023
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10. A neonatal report of iliac artery aneurysm

Author

Neri, C.R., primary, Torresi, S., additional, Chiavaroli, V., additional, Cicioni, P., additional, Carinci, S., additional, Coclite, E., additional, Sebastiani, M., additional, Pellegrino, N., additional, Di Donato, G., additional, Galasso, D., additional, Brancaccio, G., additional, Fusaro, F., additional, Chiarelli, F., additional, and Di Valerio, S., additional

Published
2023
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11. Michelin Tire Baby (MTB) Syndrome: a case report

Author

Cauzzo, C., primary, Fiorentino, R., additional, Chiavaroli, V., additional, Palka, C., additional, Petrucci, A., additional, Coclite, E., additional, Sebastiani, M., additional, Topazio, T., additional, Chiarelli, F., additional, and Di Valerio, S., additional

Published
2023
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13. Critical appraisal of Timothy grass pollen extract GRAZAX® in the management of allergic rhinitis

Author

Scaparrotta A, Attanasi M, Petrosino MI, Di Filippo P, Di Pillo S, and Chiarelli F

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

Alessandra Scaparrotta, Marina Attanasi, Marianna I Petrosino, Paola Di Filippo, Sabrina Di Pillo, Francesco Chiarelli Department of Pediatrics, University of Chieti, Chieti, Italy Abstract: Allergic rhinitis is one of the most common diseases of adult and pediatric age, associated with grass pollen (GP) allergy in >50% cases, with a consistent impact on quality of life of affected patients. A grass allergen tablet, containing standardized extract derived from Timothy grass (Phleum pratense) pollen and ~15 µg major allergen P. pratense (rPhl p 5), may be the future of allergen-specific immunotherapy (IT) for GP allergy. The aim of this review was to critically evaluate the role of Timothy GP extract IT for the management of allergic rhinitis. For this purpose, we have tried to analyze potential mechanisms of action at the basis of Timothy GP extract, we have reviewed efficacy studies to establish potential benefits and clinical response, and we have also evaluated safety and tolerability profiles and patient focus perspective, such as quality of life, satisfaction and acceptability, and compliance to this IT. Keywords: Timothy grass pollen extract, allergic rhinitis, Grazax, efficacy, safety, compliance

Published
2015

18. Corrigendum: The silent epidemic of diabetic ketoacidosis at diagnosis of type 1 diabetes in children and adolescents in italy during the covid-19 pandemic in 2020(Front. Endocrinol., (2022), 13, (878634), 10.3389/fendo.2022.878634)

Author

Cherubini, V., Marino, M., Scaramuzza, A. E., Tiberi, V., Bobbio, A., Delvecchio, M., Piccinno, E., Ortolani, F., Innaurato, S., Felappi, B., Gallo, F., Ripoli, C., Ricciardi, M. R., Pascarella, F., Stamati, F. A., Citriniti, F., Arnaldi, C., Monti, S., Graziani, V., De Berardinis, F., Giannini, C., Chiarelli, F., Zampolli, M., De Marco, R., Bracciolini, G. P., Grosso, C., De Donno, V., Piccini, B., Toni, S., Coccioli, S., Cardinale, G., Bassi, M., Minuto, N., D?annunzio, G., Maffeis, C., Marigliano, M., Zanfardino, A., Iafusco, D., Rollato, A. S., Piscopo, A., Curto, S., Lombardo, F., Bombaci, B., Sordelli, S., Mameli, C., Macedoni, M., Rigamonti, A., Bonfanti, R., Frontino, G., Predieri, B., Bruzzi, P., Mozzillo, E., Rosanio, F., Franzese, A., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, M. G., Lasagni, A., Pampanini, V., Patera, P. I., Schiaffini, R., Rutigliano, I., Meloni, G., De Sanctis, L., Tinti, D., Trada, M., Guerraggio, L. P., Franceschi, R., Cauvin, V., Tornese, G., Franco, F., Musolino, G., Maltoni, G., Talarico, V., Iannilli, A., Lenzi, L., Matteoli, M. C., Pozzi, E., Moretti, C., Zucchini, S., Rabbone, I., Gesuita, R., Cherubini, V., Marino, M., Scaramuzza, A. E., Tiberi, V., Bobbio, A., Delvecchio, M., Piccinno, E., Ortolani, F., Innaurato, S., Felappi, B., Gallo, F., Ripoli, C., Ricciardi, M. R., Pascarella, F., Stamati, F. A., Citriniti, F., Arnaldi, C., Monti, S., Graziani, V., De Berardinis, F., Giannini, C., Chiarelli, F., Zampolli, M., De Marco, R., Bracciolini, G. P., Grosso, C., De Donno, V., Piccini, B., Toni, S., Coccioli, S., Cardinale, G., Bassi, M., Minuto, N., D'Annunzio, G., Maffeis, C., Marigliano, M., Zanfardino, A., Iafusco, D., Rollato, A. S., Piscopo, A., Curto, S., Lombardo, F., Bombaci, B., Sordelli, S., Mameli, C., Macedoni, M., Rigamonti, A., Bonfanti, R., Frontino, G., Predieri, B., Bruzzi, P., Mozzillo, E., Rosanio, F., Franzese, A., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, M. G., Lasagni, A., Pampanini, V., Patera, P. I., Schiaffini, R., Rutigliano, I., Meloni, G., De Sanctis, L., Tinti, D., Trada, M., Guerraggio, L. P., Franceschi, R., Cauvin, V., Tornese, G., Franco, F., Musolino, G., Maltoni, G., Talarico, V., Iannilli, A., Lenzi, L., Matteoli, M. C., Pozzi, E., Moretti, C., Zucchini, S., Rabbone, I., and Gesuita, R.

Subjects
socioeconomic status, COVID - 19, type 1 diabetes, DKA, socioeconomic statu, diabetes onset
Abstract

In the published article, there was an error in affiliation(s) 29. Instead of “Departement of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele, Milano, Italy”, it should be “Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy”. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.

Published
2022

19. INNODIA Master Protocol for the evaluation of investigational medicinal products in children, adolescents and adults with newly diagnosed type 1 diabetes

Author

Dunger, David B., Bruggraber, Sylvaine F. A., Mander, Adrian P., Marcovecchio, M. Loredana, Tree, Timothy, Chmura, Piotr Jaroslaw, Knip, Mikael, Schulte, Anke M., Mathieu, Chantal, Mathieu, C., Gillard, P., Casteels, K., Overbergh, L., Dunger, D., Wallace, C., Evans, M., Thankamony, A., Hendriks, E., Bruggraber, S., Peakman, M., Tree, T., Morgan, N., Richardson, S., Todd, J., Wicker, L., Mander, A., Dayan, C., Alhadj Ali, M., Pieber, T., Eizirik, D., Cnop, M., Brunak, S., Pociot, F., Johannesen, J., Rossing, P., Legido Quigley, C., Mallone, R., Scharfmann, R., Boitard, C., Knip, M., Otonkoski, T., Veijola, R., Lahesmaa, R., Oresic, M., Toppari, J., Danne, T., Ziegler, A. G., Achenbach, P., Rodriguez-Calvo, T., Solimena, M., Bonifacio, E., Speier, S., Holl, R., Dotta, F., Chiarelli, F., Marchetti, P., Bosi, E., Cianfarani, S., Ciampalini, P., de Beaufort, C., Dahl-Jørgensen, K., Skrivarhaug, T., Joner, G., Krogvold, L., Jarosz-Chobot, P., Battelino, T., Thorens, B., Gotthardt, M., Roep, B., Nikolic, T., Zaldumbide, A., Lernmark, A., Lundgren, M., Costecalde, G., Strube, T., Schulte, A., Nitsche, A., von Herrath, M., Wesley, J., Napolitano-Rosen, A., Thomas, M., Schloot, N., Goldfine, A., Waldron-Lynch, F., Kompa, J., Vedala, A., Hartmann, N., Nicolas, G., van Rampelbergh, J., Bovy, N., Dutta, S., Soderberg, J., Ahmed, S., Martin, F., Agiostratidou, G., Koralova, A., Willemsen, R., Smith, A., Anand, B., Puthi, V., Zac-Varghese, S., Datta, V., Dias, R., Sundaram, P., Vaidya, B., Patterson, C., Owen, K., Piel, B., Heller, S., Randell, T., Gazis, T., Bismuth Reismen, E., Carel, J-C, Riveline, J-P, Gautier, J-F, Andreelli, F., Travert, F., Cosson, E., Penfornis, A., Petit, C., Feve, B., Lucidarme, N., Beressi, J-P, Ajzenman, C., Radu, A., Greteau-Hamoumou, S., Bibal, C., Meissner, T., Heidtmann, B., Toni, S., Rami-Merhar, B., Eeckhout, B., Peene, B., Vantongerloo, N., Maes, T., Gommers, L., Marcovecchio, M.L., Vela, J., Latres, E., Children's Hospital, and HUS Children and Adolescents

Subjects
Trials, Adult, Adolescent, SARS-CoV-2, Prevention, Beta-cell function, COVID-19, Medicine (miscellaneous), Beta-cell Function, C-peptide, Master Protocol, Phase 2, Type 1 Diabetes, Type 1 diabetes, Diabetes Mellitus, Type 1, Treatment Outcome, 3121 General medicine, internal medicine and other clinical medicine, Diabetes Mellitus, Type 1/diagnosis, Master protocol, Humans, Pharmacology (medical), Child, Biomarkers
Abstract

Background The INNODIA consortium has established a pan-European infrastructure using validated centres to prospectively evaluate clinical data from individuals with newly diagnosed type 1 diabetes combined with centralised collection of clinical samples to determine rates of decline in beta-cell function and identify novel biomarkers, which could be used for future stratification of phase 2 clinical trials. Methods In this context, we have developed a Master Protocol, based on the “backbone” of the INNODIA natural history study, which we believe could improve the delivery of phase 2 studies exploring the use of single or combinations of Investigational Medicinal Products (IMPs), designed to prevent or reverse declines in beta-cell function in individuals with newly diagnosed type 1 diabetes. Although many IMPs have demonstrated potential efficacy in phase 2 studies, few subsequent phase 3 studies have confirmed these benefits. Currently, phase 2 drug development for this indication is limited by poor evaluation of drug dosage and lack of mechanistic data to understand variable responses to the IMPs. Identification of biomarkers which might permit more robust stratification of participants at baseline has been slow. Discussion The Master Protocol provides (1) standardised assessment of efficacy and safety, (2) comparable collection of mechanistic data, (3) the opportunity to include adaptive designs and the use of shared control groups in the evaluation of combination therapies, and (4) benefits of greater understanding of endpoint variation to ensure more robust sample size calculations and future baseline stratification using existing and novel biomarkers.

Published
2022

23. Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

Author

Cianci, P., D'Apolito, V., Moretti, A., Barbagallo, M., Paci, S., Carbone, M. T., Lubrano, R., Urbino, A., Dionisi Vici, C., Memo, L., Zampino, G., La Marca, G., Villani, A., Corsello, G., Selicorni, A., Campania, A., Geremia, C., Castagno, E., Masi, S., Poggi, G., Vestri, M., Fossali, E., Rocchi, A., Dadalt, L., Arrighini, A., Chiappa, S., Renna, S., Piccotti, E., Borgna, C., Govoni, M. R., Biondi, A., Fossati, C., Iughetti, L., Bertolani, P., Salvatoni, A., Agosti, M., Fuca, F., Ilardi, A., Giuffrida, S., Diguardo, V., Boni, S., D'Antiga, L., Ruggeri, M., Chiaretti, A., Amarri, S., Peduto, A., Bernardi, F., Corsini, I., Deangelis, G. L., Ruberto, C., Zuccotti, G. V., Stringhi, C., Lombardi, G., Salladini, C., Dimichele, S., Parola, L., Porta, A., Biasucci, G., Bellini, M., Ortisi, M. T., Apuril, E., Midulla, F., Tarani, L., Parlapiano, G., Lietti, D., Sforzini, C., Marseglia, G. L., Savasta, S., Falsaperla, R., Vitaliti, M. C., Chiarelli, F., Rossi, N., Banderali, G., Giacchero, R., Bernardo, L., Pinto, F., Fabiani, E., Ficcadenti, A., Pellegrini, G., Giacoma, S., Biban, P., Spada, S., Tipo, V., Ghitti, C., Bolognini, S., Mariani, G., Russo, A., Colella, M. G., Verrico, A., Bruni, P., Poddighe, D., Cagnoli, G., Morandi, F., Gadaleta, A., Barbi, E., Bruno, I. I., Graziano, R., Sgaramella, P., Catalani, M. P., Baldoni, I., Colarusso, G., Galvagno, G., Barone, A. P., Longo, A., Nardella, G., Portale, G., Garigali, G., Bona, G., Erbela, M., Agostiniani, R., Nanni, L., Schieven, E., Dona, M., Varisco, T., Russo, F., Distefano, V. A., Dipietro, F., Tarallo, L., Imperato, L., Parisi, G., Salzano, R., Raiola, G., Talarico, V., Bellu, R., Cannone, A., Ferrante, P., Cianci, P, D'Apolito, V, Moretti, A, Barbagallo, M, Paci, S, Carbone, M, Lubrano, R, Urbino, A, Dionisi Vici, C, Memo, L, Zampino, G, La Marca, G, Villani, A, Corsello, G, Selicorni, A, Campania, A, Geremia, C, Castagno, E, Masi, S, Poggi, G, Vestri, M, Fossali, E, Rocchi, A, Dadalt, L, Arrighini, A, Chiappa, S, Renna, S, Piccotti, E, Borgna, C, Govoni, M, Biondi, A, Fossati, C, Iughetti, L, Bertolani, P, Salvatoni, A, Agosti, M, Fuca, F, Ilardi, A, Giuffrida, S, Diguardo, V, Boni, S, D'Antiga, L, Ruggeri, M, Chiaretti, A, Amarri, S, Peduto, A, Bernardi, F, Corsini, I, Deangelis, G, Ruberto, C, Zuccotti, G, Stringhi, C, Lombardi, G, Salladini, C, Dimichele, S, Parola, L, Porta, A, Biasucci, G, Bellini, M, Ortisi, M, Apuril, E, Midulla, F, Tarani, L, Parlapiano, G, Lietti, D, Sforzini, C, Marseglia, G, Savasta, S, Falsaperla, R, Vitaliti, M, Chiarelli, F, Rossi, N, Banderali, G, Giacchero, R, Bernardo, L, Pinto, F, Fabiani, E, Ficcadenti, A, Pellegrini, G, Giacoma, S, Biban, P, Spada, S, Tipo, V, Ghitti, C, Bolognini, S, Mariani, G, Russo, A, Colella, M, Verrico, A, Bruni, P, Poddighe, D, Cagnoli, G, Morandi, F, Gadaleta, A, Barbi, E, Bruno, I, Graziano, R, Sgaramella, P, Catalani, M, Baldoni, I, Colarusso, G, Galvagno, G, Barone, A, Longo, A, Nardella, G, Portale, G, Garigali, G, Bona, G, Erbela, M, Agostiniani, R, Nanni, L, Schieven, E, Dona, M, Varisco, T, Russo, F, Distefano, V, Dipietro, F, Tarallo, L, Imperato, L, Parisi, G, Salzano, R, Raiola, G, Talarico, V, Bellu, R, Cannone, A, Ferrante, P, Paola Cianci, Valeria D'Apolito, Alex Moretti, Massimo Barbagallo, Sabrina Paci, Maria Teresa Carbone, Riccardo Lubrano, Antonio Urbino, Carlo Dionisi Vici, Luigi Memo, Giuseppe Zampino, Giancarlo La Marca, Alberto Villani, Giovanni Corsello, Angelo Selicorni, Cianci, P., D'Apolito, V., Moretti, A., Barbagallo, M., Paci, S., Carbone, M. T., Lubrano, R., Urbino, A., Dionisi Vici, C., Memo, L., Zampino, G., La Marca, G., Villani, A., Corsello, G., Selicorni, A., Campania, A., Geremia, C., Castagno, E., Masi, S., Poggi, G., Vestri, M., Fossali, E., Rocchi, A., Dadalt, L., Arrighini, A., Chiappa, S., Renna, S., Piccotti, E., Borgna, C., Govoni, M. R., Biondi, A., Fossati, C., Iughetti, L., Bertolani, P., Salvatoni, A., Agosti, M., Fuca, F., Ilardi, A., Giuffrida, S., Diguardo, V., Boni, S., D'Antiga, L., Ruggeri, M., Chiaretti, A., Amarri, S., Peduto, A., Bernardi, F., Corsini, I., Deangelis, G. L., Ruberto, C., Zuccotti, G. V., Stringhi, C., Lombardi, G., Salladini, C., Dimichele, S., Parola, L., Porta, A., Biasucci, G., Bellini, M., Ortisi, M. T., Apuril, E., Midulla, F., Tarani, L., Parlapiano, G., Lietti, D., Sforzini, C., Marseglia, G. L., Savasta, S., Falsaperla, R., Vitaliti, M. C., Chiarelli, F., Rossi, N., Banderali, G., Giacchero, R., Bernardo, L., Pinto, F., Fabiani, E., Ficcadenti, A., Pellegrini, G., Giacoma, S., Biban, P., Spada, S., Tipo, V., Ghitti, C., Bolognini, S., Mariani, G., Russo, A., Colella, M. G., Verrico, A., Bruni, P., Poddighe, D., Cagnoli, G., Morandi, F., Gadaleta, A., Barbi, E., Bruno, I. I., Graziano, R., Sgaramella, P., Catalani, M. P., Baldoni, I., Colarusso, G., Galvagno, G., Barone, A. P., Longo, A., Nardella, G., Portale, G., Garigali, G., Bona, G., Erbela, M., Agostiniani, R., Nanni, L., Schieven, E., Dona, M., Varisco, T., Russo, F., Distefano, V. A., Dipietro, F., Tarallo, L., Imperato, L., Parisi, G., Salzano, R., Raiola, G., Talarico, V., Bellu, R., Cannone, A., and Ferrante, P.

Subjects
Male, Metabolic disease, Hospitalization rate, Congenital skeletal condition, Children with special health care needs, Emergency department, Isolated CNS malformation, Metabolic diseases, Multiple AED therapy, Neuromuscular diseases, Syndromic disorders, True isolated microcephaly, 0302 clinical medicine, Clinical history, Medicine, Child, education.field_of_study, Neuromuscular disease, Settore MED/38, Disabled Children, Hospitalization, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, Child, Preschool, Female, Children with special health care need, Emergency Service, Hospital, medicine.medical_specialty, Adolescent, Population, Triage Code, 03 medical and health sciences, Pharmacotherapy, 030225 pediatrics, Humans, Medical prescription, education, Retrospective Studies, Health Services Needs and Demand, Syndromic disorder, business.industry, Research, Infant, Newborn, Infant, 030208 emergency & critical care medicine, Children with special health care needs, Congenital skeletal conditions,Emergency department, Hospitalization rate, Isolated CNS malformation, Metabolic diseases, Multiple AED therapy, Neuromuscular diseases, Syndromic disorders, True isolated microcephaly, Family medicine, Chronic Disease, business, Facilities and Services Utilization
Abstract

Background Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements. Methods Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results Seventy-two percent of patients admitted to ED were affected by a previously defined medical condition. Most of the ED admissions were children with syndromic conditions (54%). 44.2% of the ED admissions were registered during the night-time and/or at the weekends. The hospitalization rate was of 45.6% among patients admitted to the ED. The most common reason for admission to the ED was the presence of respiratory symptoms (26.6%), followed by gastrointestinal problems (21.3%) and neurological disorders (18.2%). 51.4% of the access were classified as ‘urgent’, with a red/yellow triage code. Considering the type of ED, 61.9% of the visits were conducted at the Pediatric EDs (PedEDs), 33.5% at the Functional EDs (FunEDs) and 4.6% at the Dedicated EDs (DedEDs). Patients with more complex clinical presentation were more likely to be evaluated at the PedEDs. CSHCN underwent to a higher number of medical procedures at the PedEDs, more in comparison to other EDs. Children with medical devices were directed to a PedED quite exclusively when in need for medical attention. Subjects under multiple anti-epileptic drug therapy attended to PedEDs or FunEDs generally. Patients affected by metabolic diseases were more likely to look for medical attention at FunEDs. Syndromic patients mostly required medical attention at the DedEDs. Conclusions Access of CSHCN to an ED is not infrequent. For this reason, it is fundamental for pediatricians working in any kind of ED to increase their general knowledge about CHSCN and to gain expertise in the management of such patients and their related medical complexity.

Published
2020

24. Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

Author

Cianci, P, D'Apolito, V, Moretti, A, Barbagallo, M, Paci, S, Carbone, M, Lubrano, R, Urbino, A, Dionisi Vici, C, Memo, L, Zampino, G, La Marca, G, Villani, A, Corsello, G, Selicorni, A, Campania, A, Geremia, C, Castagno, E, Masi, S, Poggi, G, Vestri, M, Fossali, E, Rocchi, A, Dadalt, L, Arrighini, A, Chiappa, S, Renna, S, Piccotti, E, Borgna, C, Govoni, M, Biondi, A, Fossati, C, Iughetti, L, Bertolani, P, Salvatoni, A, Agosti, M, Fuca, F, Ilardi, A, Giuffrida, S, Diguardo, V, Boni, S, D'Antiga, L, Ruggeri, M, Chiaretti, A, Amarri, S, Peduto, A, Bernardi, F, Corsini, I, Deangelis, G, Ruberto, C, Zuccotti, G, Stringhi, C, Lombardi, G, Salladini, C, Dimichele, S, Parola, L, Porta, A, Biasucci, G, Bellini, M, Ortisi, M, Apuril, E, Midulla, F, Tarani, L, Parlapiano, G, Lietti, D, Sforzini, C, Marseglia, G, Savasta, S, Falsaperla, R, Vitaliti, M, Chiarelli, F, Rossi, N, Banderali, G, Giacchero, R, Bernardo, L, Pinto, F, Fabiani, E, Ficcadenti, A, Pellegrini, G, Giacoma, S, Biban, P, Spada, S, Tipo, V, Ghitti, C, Bolognini, S, Mariani, G, Russo, A, Colella, M, Verrico, A, Bruni, P, Poddighe, D, Cagnoli, G, Morandi, F, Gadaleta, A, Barbi, E, Bruno, I, Graziano, R, Sgaramella, P, Catalani, M, Baldoni, I, Colarusso, G, Galvagno, G, Barone, A, Longo, A, Nardella, G, Portale, G, Garigali, G, Bona, G, Erbela, M, Agostiniani, R, Nanni, L, Schieven, E, Dona, M, Varisco, T, Russo, F, Distefano, V, Dipietro, F, Tarallo, L, Imperato, L, Parisi, G, Salzano, R, Raiola, G, Talarico, V, Bellu, R, Cannone, A, Ferrante, P, Cianci P., D'Apolito V., Moretti A., Barbagallo M., Paci S., Carbone M. T., Lubrano R., Urbino A., Dionisi Vici C., Memo L., Zampino G., La Marca G., Villani A., Corsello G., Selicorni A., Campania A., Geremia C., Castagno E., Masi S., Poggi G., Vestri M., Fossali E., Rocchi A., DaDalt L., Arrighini A., Chiappa S., Renna S., Piccotti E., Borgna C., Govoni M. R., Biondi A., Fossati C., Iughetti L., Bertolani P., Salvatoni A., Agosti M., Fuca F., Ilardi A., Giuffrida S., DiGuardo V., Boni S., D'Antiga L., Ruggeri M., Chiaretti A., Amarri S., Peduto A., Bernardi F., Corsini I., DeAngelis G. L., Ruberto C., Zuccotti G. V., Stringhi C., Lombardi G., Salladini C., DiMichele S., Parola L., Porta A., Biasucci G., Bellini M., Ortisi M. T., Apuril E., Midulla F., Tarani L., Parlapiano G., Lietti D., Sforzini C., Marseglia G. L., Savasta S., Falsaperla R., Vitaliti M. C., Chiarelli F., Rossi N., Banderali G., Giacchero R., Bernardo L., Pinto F., Fabiani E., Ficcadenti A., Pellegrini G., Giacoma S., Biban P., Spada S., Tipo V., Ghitti C., Bolognini S., Mariani G., Russo A., Colella M. G., Verrico A., Bruni P., Poddighe D., Cagnoli G., Morandi F., Gadaleta A., Barbi E., Bruno I. I., Graziano R., Sgaramella P., Catalani M. P., Baldoni I., Colarusso G., Galvagno G., Barone A. P., Longo A., Nardella G., Portale G., Garigali G., Bona G., Erbela M., Agostiniani R., Nanni L., Schieven E., Dona M., Varisco T., Russo F., DiStefano V. A., DiPietro F., Tarallo L., Imperato L., Parisi G., Salzano R., Raiola G., Talarico V., Bellu R., Cannone A., Ferrante P., Cianci, P, D'Apolito, V, Moretti, A, Barbagallo, M, Paci, S, Carbone, M, Lubrano, R, Urbino, A, Dionisi Vici, C, Memo, L, Zampino, G, La Marca, G, Villani, A, Corsello, G, Selicorni, A, Campania, A, Geremia, C, Castagno, E, Masi, S, Poggi, G, Vestri, M, Fossali, E, Rocchi, A, Dadalt, L, Arrighini, A, Chiappa, S, Renna, S, Piccotti, E, Borgna, C, Govoni, M, Biondi, A, Fossati, C, Iughetti, L, Bertolani, P, Salvatoni, A, Agosti, M, Fuca, F, Ilardi, A, Giuffrida, S, Diguardo, V, Boni, S, D'Antiga, L, Ruggeri, M, Chiaretti, A, Amarri, S, Peduto, A, Bernardi, F, Corsini, I, Deangelis, G, Ruberto, C, Zuccotti, G, Stringhi, C, Lombardi, G, Salladini, C, Dimichele, S, Parola, L, Porta, A, Biasucci, G, Bellini, M, Ortisi, M, Apuril, E, Midulla, F, Tarani, L, Parlapiano, G, Lietti, D, Sforzini, C, Marseglia, G, Savasta, S, Falsaperla, R, Vitaliti, M, Chiarelli, F, Rossi, N, Banderali, G, Giacchero, R, Bernardo, L, Pinto, F, Fabiani, E, Ficcadenti, A, Pellegrini, G, Giacoma, S, Biban, P, Spada, S, Tipo, V, Ghitti, C, Bolognini, S, Mariani, G, Russo, A, Colella, M, Verrico, A, Bruni, P, Poddighe, D, Cagnoli, G, Morandi, F, Gadaleta, A, Barbi, E, Bruno, I, Graziano, R, Sgaramella, P, Catalani, M, Baldoni, I, Colarusso, G, Galvagno, G, Barone, A, Longo, A, Nardella, G, Portale, G, Garigali, G, Bona, G, Erbela, M, Agostiniani, R, Nanni, L, Schieven, E, Dona, M, Varisco, T, Russo, F, Distefano, V, Dipietro, F, Tarallo, L, Imperato, L, Parisi, G, Salzano, R, Raiola, G, Talarico, V, Bellu, R, Cannone, A, Ferrante, P, Cianci P., D'Apolito V., Moretti A., Barbagallo M., Paci S., Carbone M. T., Lubrano R., Urbino A., Dionisi Vici C., Memo L., Zampino G., La Marca G., Villani A., Corsello G., Selicorni A., Campania A., Geremia C., Castagno E., Masi S., Poggi G., Vestri M., Fossali E., Rocchi A., DaDalt L., Arrighini A., Chiappa S., Renna S., Piccotti E., Borgna C., Govoni M. R., Biondi A., Fossati C., Iughetti L., Bertolani P., Salvatoni A., Agosti M., Fuca F., Ilardi A., Giuffrida S., DiGuardo V., Boni S., D'Antiga L., Ruggeri M., Chiaretti A., Amarri S., Peduto A., Bernardi F., Corsini I., DeAngelis G. L., Ruberto C., Zuccotti G. V., Stringhi C., Lombardi G., Salladini C., DiMichele S., Parola L., Porta A., Biasucci G., Bellini M., Ortisi M. T., Apuril E., Midulla F., Tarani L., Parlapiano G., Lietti D., Sforzini C., Marseglia G. L., Savasta S., Falsaperla R., Vitaliti M. C., Chiarelli F., Rossi N., Banderali G., Giacchero R., Bernardo L., Pinto F., Fabiani E., Ficcadenti A., Pellegrini G., Giacoma S., Biban P., Spada S., Tipo V., Ghitti C., Bolognini S., Mariani G., Russo A., Colella M. G., Verrico A., Bruni P., Poddighe D., Cagnoli G., Morandi F., Gadaleta A., Barbi E., Bruno I. I., Graziano R., Sgaramella P., Catalani M. P., Baldoni I., Colarusso G., Galvagno G., Barone A. P., Longo A., Nardella G., Portale G., Garigali G., Bona G., Erbela M., Agostiniani R., Nanni L., Schieven E., Dona M., Varisco T., Russo F., DiStefano V. A., DiPietro F., Tarallo L., Imperato L., Parisi G., Salzano R., Raiola G., Talarico V., Bellu R., Cannone A., and Ferrante P.

Abstract

Background: Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements. Methods: Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results: Seventy-two percent of patients admitted to ED were affected by a previously defined medical condition. Most of the ED admissions were children with syndromic conditions (54%). 44.2% of the ED admissions were registered during the night-time and/or at the weekends. The hospitalization rate was of 45.6% among patients admitted to the ED. The most common reason for admission to the ED was the presence of respiratory symptoms (26.6%), followed by gastrointestinal problems (21.3%) and neurological disorders (18.2%). 51.4% of the access were classified as ‘urgent’, with a red/yellow triage code. Considering the type of ED, 61.9% of the visits were conducted at the Pediatric EDs (PedEDs), 33.5% at the Functional EDs (FunEDs) and 4.6% at the Dedicated EDs (DedEDs). Patients with more complex clinical presentation were more likely to be evaluated at the PedEDs. CSHCN underwent to a higher number of medical procedures at the PedEDs, more in comparison to other EDs. Children with medical devices were directed to a PedED quite exclusively when in need for medical attention. Subjects under multiple anti-epileptic drug therapy attended to PedEDs or FunEDs generally. Patients affected by metabolic diseases were more likely to look for medical attention at FunEDs. Syndromic patients mostly required medical attention at the DedEDs. Conclusions

Published
2020

26. Pre- and postnatal brain hemodynamics in pregnancies at term: correlation with Doppler ultrasound, birthweight, and adverse perinatal outcome

Author

Buca, D., Liberati, M., Rizzo, G., Gazzolo, D., Chiarelli, F., Giannini, C., Tizio, L. D., D'Adamo, E., Nappi, L., Scambia, G., D'Antonio, F., Scambia G. (ORCID:0000-0003-2758-1063), D'Antonio F., Buca, D., Liberati, M., Rizzo, G., Gazzolo, D., Chiarelli, F., Giannini, C., Tizio, L. D., D'Adamo, E., Nappi, L., Scambia, G., D'Antonio, F., Scambia G. (ORCID:0000-0003-2758-1063), and D'Antonio F.

Abstract

Purpose: To elucidate the correlation between pre- and postnatal cerebral Doppler in pregnancies close to term and to explore whether they are associated with perinatal outcome. Materials and methods: Prospective study on singleton pregnancies at 36–37 weeks of gestation. The primary outcome was a composite score of perinatal morbidity, while secondary outcomes were adverse intra-partum outcome and abnormal acid–base status. All pregnancies underwent ultrasound assessment of umbilical artery (UA), middle cerebral artery (MCA), uterine arteries (UtAs) pulsatility index (PI), and cerebroplacental ratio (CPR). At birth, neonatal MCA PI was measured 72 h from delivery and correlated with prenatal Doppler, primary and secondary outcomes. Fisher’s test and multivariate logistic regression analysis were used to analyze the data. Results: One hundred and sixty-six fetuses with both pre- and postnatal Doppler assessment of the MCA were included in the study. The risk of composite perinatal morbidity was higher in fetuses (OR: 5.7, 95% CI 2.2–14.6) and newborns (OR: 4.1, 95% CI 1.8–9.6) with fetal MCA PI < 10th centile. Likewise, the incidence of abnormal acid–base status was higher both in fetuses (20 versus 4.2%, p =.026) and newborns (17.1 versus 3.2%, p =.001) with a low MCA PI before and at birth, respectively. At logistic regression analysis, fetal and neonatal MCAPI were independently associated with composite perinatal morbidity and abnormal acid–base status, but not with adverse intra-partum outcome. In small for gestational age (SGA) fetuses, the incidence of composite perinatal morbidity was higher in fetuses and new-borns presenting compared to those not presenting with an MCA PI < 10th centile (61.5 versus 20%, p =.003 and 52.6% versus 7.1%, p =.008, respectively), while such association was lost when considering non-SGA fetuses. Conclusion: A low MCA PI is associated with adverse perinatal outcome in pregnancies at term and tends to persist after birt

Published
2022

39. Microvascular Complications of Type 1 Diabetes Mellitus Screening in Children, Adolescents and Young Adults: Report from a Small Center in a Limited Resource Setting, Brazzaville - Congo

Author

Babela Jr Mabiala, Mandilou Missambou, Villiers F De, Ngabou F Nganga, Ikobo Lc Ollandzobo, Ngwiri T, Chiarelli F, and Bouénizabila É

Subjects
Pediatrics, medicine.medical_specialty, Type 1 diabetes, endocrine system diseases, business.industry, Disease duration, General Engineering, nutritional and metabolic diseases, medicine.disease, Medicine, Early adolescents, Young adult, business, Limited resources
Abstract

The aim of this study was to assess the prevalence of microvascular complications of type 1 diabetes mellitus, to define the relationship between the disease duration and the onset of these complications among Congolese children, adolescents and young adults with type 1 diabetes mellitus.

Published
2020

41. Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians

Author

Attanasi, M, Pasini, S, Caronni, A, Michela Pellegrino, G, Faverio, P, Di Pillo, S, Maria Cimino, M, Cipolla, G, Chiarelli, F, Centanni, S, Francesco Sferrazza Papa, G, Marina Attanasi, Simone Pasini, Antonio Caronni, Giulia Michela Pellegrino, Paola Faverio, Sabrina Di Pillo, Matteo Maria Cimino, Giuseppe Cipolla, Francesco Chiarelli, Stefano Centanni, Giuseppe Francesco Sferrazza Papa, Attanasi, M, Pasini, S, Caronni, A, Michela Pellegrino, G, Faverio, P, Di Pillo, S, Maria Cimino, M, Cipolla, G, Chiarelli, F, Centanni, S, Francesco Sferrazza Papa, G, Marina Attanasi, Simone Pasini, Antonio Caronni, Giulia Michela Pellegrino, Paola Faverio, Sabrina Di Pillo, Matteo Maria Cimino, Giuseppe Cipolla, Francesco Chiarelli, Stefano Centanni, and Giuseppe Francesco Sferrazza Papa

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern. Objective: We explored the clinical management of inpatients with COVID-19 in Italy. Methods: A self-administered survey was sent by email to Italian physicians caring for adult patients with COVID-19. A panel of experts was selected according to their clinical curricula and their responses were analyzed. Results: A total of 1,215 physicians completed the survey questionnaire (17.4% response rate). Of these, 188 (15.5%) were COVID-19 experts. Chest computed tomography was the most used method to detect and monitor COVID-19 pneumonia. Most of the experts managed acute respiratory failure with CPAP (56.4%), high flow nasal cannula (18.6%), and non-invasive mechanical ventilation (8%), while an intensivist referral for early intubation was requested in 17% of the cases. Hydroxychloroquine was prescribed as an antiviral in 90% of cases, both as monotherapy (11.7%), and combined with protease inhibitors (43.6%) or azithromycin (36.2%). The experts unanimously prescribed low-molecular-weight heparin to patients with severe COVID-19 pneumonia, and half of them (51.6%) used a dose higher than standard. The respiratory burden in patients who survived the acute phase was estimated as relevant in 28.2% of the cases, modest in 39.4%, and negligible in 9%. Conclusions: In our survey some major topics, such as the role of non-invasive respiratory support and drug treatments, show disagreement between experts, likely reflecting the absence of high-quality evidence studies. Considering the significant respiratory sequelae reported following COVID-19, proper respiratory and physical therapy programs should be promptly made available.

Published
2020

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