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1. The CRILIN calorimeter: gamma radiation resistance of crystals and SiPMs

Author

Cemmi, A., D'Orsi, B., Di Meco, E., Di Sarcina, I., Diociaiuti, E., Moulson, M., Paesani, D., Sarra, I., Scifo, J., and Verna, A.

Subjects
Physics - Instrumentation and Detectors, High Energy Physics - Experiment
Abstract

The Crilin calorimeter is a semi-homogeneous calorimetric system based on Lead Fluoride (PbF$_2$) crystals with UV-extended Silicon Photomultipliers (SiPMs) proposed for the Muon Collider. This study investigates the radiation resistance of crystals and SiPMs, subjected to 10 kGy gamma irradiation, equivalent to a 10-year service life in the Muon Collider. Our findings indicate that while PbF$_2$ crystals exhibit a decrease in transmittance post-irradiation with partial recovery over time, the alternative PbWO$_4$-Ultra Fast (PWO-UF) demonstrates exceptional radiation hardness, maintaining stable transmittance. SiPMs showed an increase in dark current and breakdown voltage post-irradiation, with less degradation observed in the SiPM biased during the exposure to radiation compared to the unbiased component. These results underscore the viability of PbF$_2$ for radiation-tolerant calorimeters, though improvements in production homogeneity are needed. The superior performance of PWO-UF crystals suggests they are a promising alternative for high-radiation applications, but their higher cost must be carefully considered., Comment: 11 pages, 7 figures, 1 table

Published
2024
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2. Interim report for the International Muon Collider Collaboration (IMCC)

Author

Accettura, C., Adrian, S., Agarwal, R., Ahdida, C., Aimé, C., Aksoy, A., Alberghi, G. L., Alden, S., Amapane, N., Amorim, D., Andreetto, P., Anulli, F., Appleby, R., Apresyan, A., Asadi, P., Mahmoud, M. Attia, Auchmann, B., Back, J., Badea, A., Bae, K. J., Bahng, E. J., Balconi, L., Balli, F., Bandiera, L., Barbagallo, C., Barlow, R., Bartoli, C., Bartosik, N., Barzi, E., Batsch, F., Bauce, M., Begel, M., Berg, J. S., Bersani, A., Bertarelli, A., Bertinelli, F., Bertolin, A., Bhat, P., Bianchi, C., Bianco, M., Bishop, W., Black, K., Boattini, F., Bogacz, A., Bonesini, M., Bordini, B., de Sousa, P. Borges, Bottaro, S., Bottura, L., Boyd, S., Breschi, M., Broggi, F., Brunoldi, M., Buffat, X., Buonincontri, L., Burrows, P. N., Burt, G. C., Buttazzo, D., Caiffi, B., Calatroni, S., Calviani, M., Calzaferri, S., Calzolari, D., Cantone, C., Capdevilla, R., Carli, C., Carrelli, C., Casaburo, F., Casarsa, M., Castelli, L., Catanesi, M. G., Cavallucci, L., Cavoto, G., Celiberto, F. G., Celona, L., Cemmi, A., Ceravolo, S., Cerri, A., Cerutti, F., Cesarini, G., Cesarotti, C., Chancé, A., Charitonidis, N., Chiesa, M., Chiggiato, P., Ciccarella, V. L., Puviani, P. Cioli, Colaleo, A., Colao, F., Collamati, F., Costa, M., Craig, N., Curtin, D., D'Angelo, L., Da Molin, G., Damerau, H., Dasu, S., de Blas, J., De Curtis, S., De Gersem, H., Del Moro, T., Delahaye, J. -P., Denisov, D., Denizli, H., Dermisek, R., Valdor, P. Desiré, Desponds, C., Di Luzio, L., Di Meco, E., Di Petrillo, K. F., Di Sarcina, I., Diociaiuti, E., Dorigo, T., Dreimanis, K., Pree, T. du, Edgecock, T., Fabbri, S., Fabbrichesi, M., Farinon, S., Ferrand, G., Somoza, J. A. Ferreira, Fieg, M., Filthaut, F., Fox, P., Franceschini, R., Ximenes, R. Franqueira, Gallinaro, M., Garcia-Sciveres, M., Garcia-Tabares, L., Gargiulo, R., Garion, C., Garzelli, M. V., Gast, M., Gerber, C. E., Giambastiani, L., Gianelle, A., Gianfelice-Wendt, E., Gibson, S., Gilardoni, S., Giove, D. A., Giovinco, V., Giraldin, C., Glioti, A., Gorzawski, A., Greco, M., Grojean, C., Grudiev, A., Gschwendtner, E., Gueli, E., Guilhaudin, N., Han, C., Han, T., Hauptman, J. M., Herndon, M., Hillier, A. D., Hillman, M., Holmes, T. R., Homiller, S., Jana, S., Jindariani, S., Johannesson, S., Johnson, B., Jones, O. R., Jurj, P. -B., Kahn, Y., Kamath, R., Kario, A., Karpov, I., Kelliher, D., Kilian, W., Kitano, R., Kling, F., Kolehmainen, A., Kong, K. C., Kosse, J., Krintiras, G., Krizka, K., Kumar, N., Kvikne, E., Kyle, R., Laface, E., Lane, K., Latina, A., Lechner, A., Lee, J., Lee, L., Lee, S. W., Lefevre, T., Leonardi, E., Lerner, G., Li, P., Li, Q., Li, T., Li, W., Voti, R. Li, Lindroos, M., Lipton, R., Liu, D., Liu, M., Liu, Z., Lombardi, A., Lomte, S., Long, K., Longo, L., Lorenzo, J., Losito, R., Low, I., Lu, X., Lucchesi, D., Luo, T., Lupato, A., Métral, E., Mękała, K., Ma, Y., Mańczak, J. M., Machida, S., Madlener, T., Magaletti, L., Maggi, M., Durand, H. Mainaud, Maltoni, F., Mandurrino, M., Marchand, C., Mariani, F., Marin, S., Mariotto, S., Martin-Haugh, S., Masullo, M. R., Mauro, G. S., Mazzolari, A., Mele, B., Meloni, F., Meng, X., Mentink, M., Miceli, R., Milas, N., Mohammadi, A., Moll, D., Montella, A., Morandin, M., Morrone, M., Mulder, T., Musenich, R., Nardecchia, M., Nardi, F., Neuffer, D., Newbold, D., Novelli, D., Olvegård, M., Onel, Y., Orestano, D., Osborne, J., Otten, S., Torres, Y. M. Oviedo, Paesani, D., Griso, S. Pagan, Pagani, D., Pal, K., Palmer, M., Pampaloni, A., Panci, P., Pani, P., Papaphilippou, Y., Paparella, R., Paradisi, P., Passeri, A., Pastrone, N., Pellecchia, A., Piccinini, F., Piekarz, H., Pieloni, T., Plouin, J., Portone, A., Potamianos, K., Potdevin, J., Prestemon, S., Puig, T., Qiang, J., Quettier, L., Rabemananjara, T. R., Radicioni, E., Radogna, R., Rago, I. C., Ratkus, A., Resseguie, E., Reuter, J., Ribani, P. L., Riccardi, C., Ricciardi, S., Robens, T., Robert, Y., Roger, C., Rojo, J., Romagnoni, M., Ronald, K., Rosser, B., Rossi, C., Rossi, L., Rozanov, L., Ruhdorfer, M., Ruiz, R., Queiroz, F. S., Saini, S., Sala, F., Salierno, C., Salmi, T., Salvini, P., Salvioni, E., Sammut, N., Santini, C., Saputi, A., Sarra, I., Scarantino, G., Schneider-Muntau, H., Schulte, D., Scifo, J., Sen, T., Senatore, C., Senol, A., Sertore, D., Sestini, L., Rêgo, R. C. Silva, Simone, F. M., Skoufaris, K., Sorbello, G., Sorbi, M., Sorti, S., Soubirou, L., Spataro, D., Stamerra, A., Stapnes, S., Stark, G., Statera, M., Stechauner, B. M., Su, S., Su, W., Sun, X., Sytov, A., Tang, J., Taylor, R., Kate, H. Ten, Testoni, P., Thiele, L. S., Garcia, R. Tomas, Mugglestone, M. Topp, Torims, T., Torre, R., Tortora, L. T., Trifinopoulos, S., Udongwo, S. -A., Vai, I., Valente, R. U., van Rienen, U., van Weelderen, R., Vanwelde, M., Velev, G., Venditti, R., Vendrasco, A., Verna, A., Verweij, A., Verwilligen, P., Villamzar, Y., Vittorio, L., Vitulo, P., Vojskovic, I., Wang, D., Wang, L. -T., Wang, X., Wendt, M., Widorski, M., Wozniak, M., Wu, Y., Wulzer, A., Xie, K., Yang, Y., Yap, Y. C., Yonehara, K., Yoo, H. D., You, Z., Zanetti, M., Zaza, A., Zhang, L., Zhu, R., Zlobin, A., Zuliani, D., and Zurita, J. F.

Subjects
Physics - Accelerator Physics, High Energy Physics - Experiment
Abstract

The International Muon Collider Collaboration (IMCC) [1] was established in 2020 following the recommendations of the European Strategy for Particle Physics (ESPP) and the implementation of the European Strategy for Particle Physics-Accelerator R&D Roadmap by the Laboratory Directors Group [2], hereinafter referred to as the the European LDG roadmap. The Muon Collider Study (MuC) covers the accelerator complex, detectors and physics for a future muon collider. In 2023, European Commission support was obtained for a design study of a muon collider (MuCol) [3]. This project started on 1st March 2023, with work-packages aligned with the overall muon collider studies. In preparation of and during the 2021-22 U.S. Snowmass process, the muon collider project parameters, technical studies and physics performance studies were performed and presented in great detail. Recently, the P5 panel [4] in the U.S. recommended a muon collider R&D, proposed to join the IMCC and envisages that the U.S. should prepare to host a muon collider, calling this their "muon shot". In the past, the U.S. Muon Accelerator Programme (MAP) [5] has been instrumental in studies of concepts and technologies for a muon collider., Comment: This document summarises the International Muon Collider Collaboration (IMCC) progress and status of the Muon Collider R&D programme

Published
2024

3. Development of nanocomposite scintillators for use in high-energy physics

Author

Antonelli, A., Auffray, E., Brovelli, S., Bruni, F., Campajola, M., Carsi, S., Carulli, F., De Nardo, G., Di Meco, E., Diociaiuti, E., Erroi, A., Francesconi, M., Frank, I., Kholodenko, S., Kratochwil, N., Leonardi, E., Lezzani, G., Mangiacavalli, S., Martellotti, S., Mirra, M., Monti-Guarnieri, P., Moulson, M., Paesani, D., Paoletti, E., Perna, L., Pierluigi, D., Prest, M., Romagnoni, M., Russo, A., Sarra, I., Selmi, A., Sgarbossa, F., Soldana, M., Tesauro, R., Tinti, G., and Vallazza, E.

Subjects
Physics - Instrumentation and Detectors, High Energy Physics - Experiment
Abstract

Semiconductor nanocrystals (quantum dots) are light emitters with high quantum yield that are relatively easy to manufacture. There is therefore much interest in their possible application for the development of high-performance scintillators for use in high-energy physics. However, few previous studies have focused on the response of these materials to high-energy particles. To evaluate the potential for the use of nanocomposite scintillators in calorimetry, we are performing side-by-side tests of fine-sampling shashlyk calorimeter prototypes with both conventional and nanocomposite scintillators using electron and minimum-ionizing particle beams, allowing direct comparison of the performance obtained., Comment: 3 pages, 2 figures, 1 table

Published
2024

4. Characterization of the PADME positron beam for the X17 measurement

Author

Bertelli, S., Bossi, F., Buonomo, B., De Sangro, R., Di Giulio, C., Di Meco, E., Dimitrova, K., Domenici, D., Ferrarotto, F., Finocchiaro, G., Foggetta, L. G., Frankenthal, A., Garattini, M., Georgiev, G., Gianotti, P., Ivanov, S., Ivanov, Sv., Kozhuharov, V., Leonardi, E., Long, E., Mancini, M., Organtini, G. C., Raggi, M., Sarra, I., Simeonov, R., Spadaro, T., Spiriti, E., Valente, P., Variola, A., and Vilucchi, E.

Subjects
High Energy Physics - Experiment, Physics - Instrumentation and Detectors
Abstract

This paper presents a detailed characterization of the positron beam delivered by the Beam Test Facility at Laboratori Nazionali of Frascati to the PADME experiment during Run III, which took place from October to December 2022. It showcases the methodology used to measure the main beam parameters such as the position in space, the absolute momentum scale, the beam energy spread, and its intensity through a combination of data analysis and Monte Carlo simulations. The results achieved include an absolute precision in the momentum of the beam to within $\sim$ 1-2 MeV$/c$, a relative beam energy spread below 0.25\%, and an absolute precision in the intensity of the beam at the level of 2\% percent.

Published
2024

5. Beam test, simulation, and performance evaluation of PbF$_2$ and PWO-UF crystals with SiPM readout for a semi-homogeneous calorimeter prototype with longitudinal segmentation

Author

Cantone, C., Carsi, S., Ceravolo, S., Di Meco, E., Diociaiuti, E., Frank, I., Kholodenko, S., Martellotti, S., Mirra, M., Monti-Guarnieri, P., Moulson, M., Paesani, D., Prest, M., Romagnoni, M., Sarra, I., Sgarbossa, F., Soldani, M., and Vallazza, E.

Subjects
Physics - Instrumentation and Detectors, High Energy Physics - Experiment
Abstract

Crilin (Crystal Calorimeter with Longitudinal Information) is a semi-homogeneous, longitudinally segmented electromagnetic calorimeter based on high-$Z$, ultra-fast crystals with UV-extended SiPM readout. The Crilin design has been proposed as a candidate solution for both a future Muon Collider barrel ECAL and for the Small Angle Calorimeter of the HIKE experiment. As a part of the Crilin development program, we have carried out beam tests of small ($10\times10\times40$~mm$^3$) lead fluoride (PbF$_2$) and ultra-fast lead tungstate (PbWO$_4$, PWO) crystals with 120~GeV electrons at the CERN SPS to study the light yield, timing response, and systematics of light collection with a proposed readout scheme. For a single crystal of PbF$_2$, corresponding to a single Crilin cell, a time resolution of better than 25~ps is obtained for $>$3 GeV of deposited energy. For a single cell of \pwo, a time resolution of better than 45~ps is obtained for the same range of deposited energy. This timing performance fully satisfies the design requirements for the Muon Collider and HIKE experiments. Further optimizations of the readout scheme and crystal surface preparation are expected to bring further improvements.

Published
2023

6. HIKE, High Intensity Kaon Experiments at the CERN SPS

Author

Gil, E. Cortina, Jerhot, J., Lurkin, N., Numao, T., Velghe, B., Wong, V. W. S., Bryman, D., Bician, L., Hives, Z., Husek, T., Kampf, K., Koval, M., Akmete, A. T., Aliberti, R., Büscher, V., Di Lella, L., Doble, N., Peruzzo, L., Schott, M., Wahl, H., Wanke, R., Döbrich, B., Montalto, L., Rinaldi, D., Dettori, F., Cardini, A., Lai, A., Bomben, L., Carsi, S., Prest, M., Selmi, A., Lezzani, G., Monti-Guarnieri, P., Perna, L., Dalpiaz, P., Guidi, V., Mazzolari, A., Neri, I., Petrucci, F., Soldani, M., Bandiera, L., Ramusino, A. Cotta, Gianoli, A., Romagnoni, M., Sytov, A., Lenti, M., Panichi, I., Ruggiero, G., Bizzeti, A., Bucci, F., Antonelli, A., Di Meco, E., Lanfranchi, G., Martellotti, S., Martini, M., Moulson, M., Paesani, D., Sarra, I., Spadaro, T., Tinti, G., Vallazza, E., Ambrosino, F., Giordano, R., Massarotti, P., Napolitano, M., Saracino, G., Di Donato, C., D'Ambrosio, G., D'Errico, M., Mirra, M., Neshatpour, S., Fiorenza, R., Rosa, I., De Salvador, D., Sgarbossa, F., Anzivino, G., Germani, S., Volpe, R., Cenci, P., Cutini, S., Duk, V., Lubrano, P., Pepe, M., Piccini, M., Costantini, F., Donati, S., Giorgi, M., Giudici, S., Lamanna, G., Pedreschi, E., Pinzino, J., Sozzi, M., Fantechi, R., Giusti, V., Spinella, F., Mannelli, I., Raggi, M., Biagioni, A., Cretaro, P., Frezza, O., Cicero, F. Lo, Lonardo, A., Turisini, M., Vicini, P., Ammendola, R., Bonaiuto, V., Fucci, A., Salamon, A., Sargeni, F., Arcidiacono, R., Bloch-Devaux, B., Menichetti, E., Migliore, E., Biino, C., Marchetto, F., Baigarashev, D., Kambar, Y., Kereibay, D., Mukhamejanov, Y., Sakhiyev, S., Olvera, A. Briano, Engelfried, J., Estrada-Tristan, N., Piandani, R., Santos, M. A. Reyes, Rivera, K. A. Rodriguez, Boboc, P. C., Bragadireanu, A. M., Ghinescu, S. A., Hutanu, O. E., Blazek, T., Cerny, V., Kleimenova, A., Kucerova, Z., Santos, D. Martinez, Prouve, C., Boretto, M., Brizioli, F., Ceccucci, A., Corvino, M., Danielsson, H., Duval, F., Gamberini, E., Guida, R., Holzer, E. B., Jenninger, B., Miotto, G. Lehmann, Lichard, P., Massri, K., Minucci, E., Perrin-Terrin, M., Ryjov, V., Swallow, J., Van Dijk, M., Zamkovsky, M., Marchevski, R., Gerbershagen, A., Fry, J. R., Gonnella, F., Goudzovski, E., Henshaw, J., Kenworthy, C., Lazzeroni, C., Parkinson, C., Romano, A., Sanders, J., Shaikhiev, A., Tomczak, A., Heath, H., Britton, D., Norton, A., Protopopescu, D., Dainton, J. B., Jones, R. W. L., De Santo, A., Salvatore, F., Cooper, P., Coward, D., and Rubin, P.

Subjects
High Energy Physics - Experiment, Physics - Instrumentation and Detectors
Abstract

A timely and long-term programme of kaon decay measurements at a new level of precision is presented, leveraging the capabilities of the CERN Super Proton Synchrotron (SPS). The proposed programme is firmly anchored on the experience built up studying kaon decays at the SPS over the past four decades, and includes rare processes, CP violation, dark sectors, symmetry tests and other tests of the Standard Model. The experimental programme is based on a staged approach involving experiments with charged and neutral kaon beams, as well as operation in beam-dump mode. The various phases will rely on a common infrastructure and set of detectors., Comment: Letter of Intent submitted to CERN SPSC. Address all correspondence to hike-eb@cern.ch

Published
2022

7. Crilin: A CRystal calorImeter with Longitudinal InformatioN for a future Muon Collider

Author

Ceravolo, S., Colao, F., Curatolo, C., Di Meco, E., Diociaiuti, E., Lucchesi, D., Paesani, D., Pastrone, N., Saputi, A., Sarra, I., Sestini, L., and Tagnani, D.

Subjects
Physics - Instrumentation and Detectors, High Energy Physics - Experiment
Abstract

The measurement of physics processes at new energy frontier experiments requires excellent spatial, time, and energy resolutions to resolve the structure of collimated high-energy jets. In a future Muon Collider, the beam-induced backgrounds (BIB) represent the main challenge in the design of the detectors and of the event reconstruction algorithms. The technology and the design of the calorimeters should be chosen to reduce the effect of the BIB, while keeping good physics performance. Several requirements can be inferred: i) high granularity to reduce the overlap of BIB particles in the same calorimeter cell; ii) excellent timing (of the order of 100 ps) to reduce the out-of-time component of the BIB; iii) longitudinal segmentation to distinguish the signal showers from the fake showers produced by the BIB; iv) good energy resolution (less than 10%/sqrt(E)) to obtain good physics performance, as has been already demonstrated for conceptual particle flow calorimeters. Our proposal consists of a semi-homogeneous electromagnetic calorimeter based on Lead Fluoride Crystals (PbF2) readout by surface-mount UV-extended Silicon Photomultipliers (SiPMs): the Crilin calorimeter. In this paper, the performances of the Crilin calorimeter in the Muon Collider framework for hadron jets reconstruction have been analyzed. We report the single components characterizations together with the development of a small-scale prototype, consisting of 2 layers of 3x3 crystals each.

Published
2022
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9. Readout studies for the HIKE main electromagnetic calorimeter

Author

Francesconi, M., Ambrosino, F., Antonelli, A., De Nardo, G., Di Donato, C., Di Meco, E., Diociaiuti, E., Fiorenza, R., Giordano, R., Massarotti, P., Merola, M., Mirra, M., Martellotti, S., Moulson, M., Napolitano, M., Paesani, D., Rosa, I., Saracino, G., Sarra, I., Soldani, M., Spadaro, T., and Tinti, G.

Published
2024
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11. R&D status for an innovative crystal calorimeter for the future Muon Collider

Author

Cantone C., Ceravolo S., Colao F., Di Meco E., Diociaiuti E., Gianotti P., Liedl A., Lucchesi D., Paesani D., Pastrone N., Pezzullo G., Saputi A., Sarra I., Sestini L., and Tagnani D.

Subjects
electromagnetic calorimeters, pbf2, sipm, crystals, high granularity, Physics, QC1-999
Abstract

The measurement of physics processes at new energy frontier experiments requires excellent spatial, time, and energy resolutions to resolve the structure of collimated high-energy jets. Calorimeters, as other detectors, must face this increasing performance demand. In a future TeV-scale Muon Collider, the beam-induced background (BIB) represents the main challenge in the design of the detectors and of the event reconstruction algorithms and can pose serious limitations to the physics performance. However, it is possible to reduce the BIB impact on the Muon Collider calorimeter by exploiting some of its characteristics and by ensuring high granularity, excellent timing, longitudinal segmentation and good energy resolution. The proposed R&D is an innovative semi-homogeneous electromagnetic calorimeter based on stackable modules of lead fluoride crystals (PbF2) readout by surface-mount UV-extended Silicon Photomultipliers (SiPMs): the Crilin calorimeter (CRystal calorImeter with Longitudinal INformation). The calorimeter should operate in a very harsh radiation environment, withstanding yearly a neutron flux of 1014 n1MeV /cm2 and a dose of 100 krad. In this paper, the radiation tolerance measured in several irradiation campaigns and the timing performances evaluated during a test beam at CERN-H2 with 120-GeV electron are discussed. A description of the latest prototype Proto-1, that will be shortly tested, is also provided.

Published
2023
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12. Beam test, simulation, and performance evaluation of PbF2 and PWO-UF crystals with SiPM readout for a semi-homogeneous calorimeter prototype with longitudinal segmentation

Author

Cantone, C., primary, Carsi, S., additional, Ceravolo, S., additional, Di Meco, E., additional, Diociaiuti, E., additional, Frank, I., additional, Kholodenko, S., additional, Martellotti, S., additional, Mirra, M., additional, Monti-Guarnieri, P., additional, Moulson, M., additional, Paesani, D., additional, Prest, M., additional, Romagnoni, M., additional, Sarra, I., additional, Sgarbossa, F., additional, Soldani, M., additional, and Vallazza, E., additional

Published
2023
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13. Research and Development Status for an Innovative Crystal Calorimeter for the Future Muon Collider

Author

Cantone, C., Ceravolo, S., Colao, F., Di Meco, E., Diociaiuti, E., Frank, I., Gianotti, P., Gargiulo, R., Leonardi, E., Lucchesi, D., Martellotti, S., Moulson, M., Paesani, D., Pastrone, N., Pezzullo, G., Saputi, A., Sarra, I., Sestini, L., and Tagnani, D.

Abstract

Accurate measurements of physical processes in high energy frontier experiments demand exceptional spatial, temporal, and energy precision to discern the physics behind high-energy particle jets. Calorimeters, like other detection systems, must be able to meet these increasingly challenging performance requirements. In the prospective TeV-scale Muon Collider, the primary hurdle in designing detectors and devising event reconstruction algorithms is the challenge posed by Beam-Induced Background (BIB). Nevertheless, it is conceivable to mitigate the impact of BIB on the Muon Collider’s calorimeter by capitalizing on certain characteristics and ensuring key features such as high granularity, precise timing, longitudinal segmentation, and superior energy resolution. This is what the here described Research and Development is trying to achieve with an innovative semi-homogeneous electromagnetic calorimeter constructed from stackable and interchangeable modules composed of lead fluoride crystals (PbF2). These modules are equipped with surface-mount UV-extended Silicon Photomultipliers (SiPMs) and are collectively referred to as the Crilin calorimeter (CRystal calorImeter with Longitudinal INformation). The challenge lies in making sure this calorimeter can operate effectively within an extremely harsh radiation environment, enduring an annual neutron flux of $10^{14}~n_{1\text {MeV}}/\text {cm}^{2}$ and a total ionizing dose (TID) of 10 kGy. In this article, the radiation tolerance measured in several irradiation campaigns is discussed, and the timing performances during a test beam at CERN-H2 with 120-GeV electrons. Additionally, a description of the latest prototype, Proto-1, is provided together with the results of the latest low-energy beam test at the LNF beam test facility (BTF) with 450 MeV electrons.

Published
2024
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14. HIKE, High Intensity Kaon Experiments at the CERN SPS: Letter of Intent

Author

Cortina Gil, E., Jerhot, J., Lurkin, N., Numao, T., Velghe, B., Wong, V.W.S., Bryman, D., Bician, L., Hives, Z., Husek, T., Kampf, K., Koval, M., Akmete, A.T., Aliberti, R., Büscher, V., Di Lella, L., Doble, N., Peruzzo, L., Schott, M., Wahl, H., Wanke, R., Döbrich, B., Montalto, L., Rinaldi, D., Dettori, F., Cardini, A., Lai, A., Bomben, L., Carsi, S., Prest, M., Selmi, A., Lezzani, G., Monti-Guarnieri, P., Perna, L., Dalpiaz, P., Guidi, V., Mazzolari, A., Neri, I., Petrucci, F., Soldani, M., Bandiera, L., Cotta Ramusino, A., Gianoli, A., Romagnoni, M., Sytov, A., Lenti, M., Panichi, I., Ruggiero, G., Bizzeti, A., Bucci, F., Antonelli, A., Di Meco, E., Lanfranchi, G., Martellotti, S., Martini, M., Moulson, M., Paesani, D., Sarra, I., Spadaro, T., Tinti, G., Vallazza, E., Ambrosino, F., Giordano, R., Massarotti, P., Napolitano, M., Saracino, G., Di Donato, C., D'Ambrosio, G., D'Errico, M., Mirra, M., Neshatpour, S., Fiorenza, R., Rosa, I., De Salvador, D., Sgarbossa, F., Anzivino, G., Germani, S., Volpe, R., Cenci, P., Cutini, S., Duk, V., Lubrano, P., Pepe, M., Piccini, M., Costantini, F., Donati, S., Giorgi, M., Giudici, S., Lamanna, G., Pedreschi, E., Pinzino, J., Sozzi, M., Fantechi, R., Giusti, V., Spinella, F., Mannelli, I., Raggi, M., Biagioni, A., Cretaro, P., Frezza, O., Lo Cicero, F., Lonardo, A., Turisini, M., Vicini, P., Ammendola, R., Bonaiuto, V., Fucci, A., Salamon, A., Sargeni, F., Arcidiacono, R., Bloch-Devaux, B., Menichetti, E., Migliore, E., Biino, C., Marchetto, F., Baigarashev, D., Kambar, Y., Kereibay, D., Mukhamejanov, Y., Sakhiyev, S., Olvera, A. Briano, Engelfried, J., Estrada-Tristan, N., Piandani, R., Santos, M.A. Reyes, Rivera, K.A. Rodriguez, Boboc, P.C., Bragadireanu, A.M., Ghinescu, S.A., Hutanu, O.E., Blazek, T., Cerny, V., Kleimenova, A., Kucerova, Z., Martinez Santos, D., Prouve, C., Boretto, M., Brizioli, F., Ceccucci, A., Corvino, M., Danielsson, H., Duval, F., Gamberini, E., Guida, R., Holzer, E.B., Jenninger, B., Lehmann Miotto, G., Lichard, P., Massri, K., Minucci, E., Perrin-Terrin, M., Ryjov, V., Swallow, J., Van Dijk, M., Zamkovsky, M., Marchevski, R., Gerbershagen, A., Fry, J.R., Gonnella, F., Goudzovski, E., Henshaw, J., Kenworthy, C., Lazzeroni, C., Parkinson, C., Romano, A., Sanders, J., Shaikhiev, A., Tomczak, A., Heath, H., Britton, D., Norton, A., Protopopescu, D., Dainton, J.B., Jones, R.W.L., De Santo, A., Salvatore, F., Cooper, P., Coward, D., and Rubin, P.

Subjects
Detectors and Experimental Techniques, Particle Physics - Experiment
Abstract

A timely and long-term programme of kaon decay measurements at a new level of precision is presented, leveraging the capabilities of the CERN Super Proton Synchrotron (SPS). The proposed programme is firmly anchored on the experience built up studying kaon decays at the SPS over the past four decades, and includes rare processes, CP violation, dark sectors, symmetry tests and other tests of the Standard Model. The experimental programme is based on a staged approach involving experiments with charged and neutral kaon beams, as well as operation in beam-dump mode. The various phases will rely on a common infrastructure and set of detectors.

Published
2022

16. Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study)

Author

Bai, F, Aldieri, C, Cattelan, A, Raumer, F, Di Meco, E, Moioli, M, Tordato, F, Morelli, P, Borghi, F, Rizzi, M, Van Hauwermeiren, E, Castelli, F, Migliorino, G, Menzaghi, B, Rizzardini, G, Saracino, A, Cascio, A, Puoti, M, d'Arminio Monforte, A, Marchetti, G, Bai F., Aldieri C., Cattelan A., Raumer F., Di Meco E., Moioli M. C., Tordato F., Morelli P., Borghi F., Rizzi M., Van Hauwermeiren E., Castelli F., Migliorino G., Menzaghi B., Rizzardini G., Saracino A., Cascio A., Puoti M., d'Arminio Monforte A., Marchetti G., Bai, F, Aldieri, C, Cattelan, A, Raumer, F, Di Meco, E, Moioli, M, Tordato, F, Morelli, P, Borghi, F, Rizzi, M, Van Hauwermeiren, E, Castelli, F, Migliorino, G, Menzaghi, B, Rizzardini, G, Saracino, A, Cascio, A, Puoti, M, d'Arminio Monforte, A, Marchetti, G, Bai F., Aldieri C., Cattelan A., Raumer F., Di Meco E., Moioli M. C., Tordato F., Morelli P., Borghi F., Rizzi M., Van Hauwermeiren E., Castelli F., Migliorino G., Menzaghi B., Rizzardini G., Saracino A., Cascio A., Puoti M., d'Arminio Monforte A., and Marchetti G.

Abstract

Objectives: We evaluated the efficacy and safety of dalbavancin in ABSSSI and ‘other sites’ infections’ (OTA). Methods: Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016–2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting. Results: 206 patients enrolled (males 50%, median age 62 [IQR 50–76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p = 0.003) and 46.3% ABSSSI vs 37.2% OTA (p = 0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure. Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hospitalization (13.5 days, 5.5–22 vs 3, 0–11.7; p<0.0001) and received longer previous (18 days, 9–30 vs 11, 7–19; p = 0.007)/concomitant antibiotic treatments (21 days, 14–52 vs 11, 8–14; p < 0.0001), compared to ABSSSI. ABSSSI and OTA showed similar efficacy (85.5% vs 75%, p = 0.459) and safety (no AE: 81.5% vs 64.3%, p = 0.258); efficacy was independent of previous/concomitant therapies. Conclusions: Dalbavancin demonstrated a success rate of >80%, with similar efficacy/safety in ABSSSI and off-label indications. The preferential use of dalbavancin as second-line or combination therapy would seem to suggest the need for in-depth studies focused on its off-label use.

Published
2020

17. Medical and surgical treatment of pyogenic spondylodiscitis

Author

Pola, E., Logroscino, C. A., Gentiempo, M., Colangelo, D., Mazzotta, V., Di Meco, E., Massimo FANTONI, Pola, E, Logroscino, Ca, Genitiempo, M, Colangelo, D, Mazzotta, V, DI MECO, E, and Fantoni, M

Subjects
Male, Discitis, medical surgical treatment, Osteomyelitis, Middle Aged, Anti-Bacterial Agents, Settore MED/33 - MALATTIE APPARATO LOCOMOTORE, Treatment Outcome, spondylodisciti, Humans, Orthopedic Procedures, spondylodiscitis, Intervertebral Disc, Aged
Abstract

BACKGROUND: Pyogenic vertebral osteomyelitis (PVO) represents approximately 2-7% of all cases of osteomyelitis. The approach to the treatment of PVO may be conservative, which includes antibiotic therapy and orthopaedic treatment, or surgical. AIM: To overview conservative and surigical approaches to PVO. METHODS: A literature review was performed using the Pubmed database to identify studies published in the last 20 years, addressing the treatment of PVO. RESULTS: Empirical antibiotic treatment of PVO, while waiting for the results of cultures or in culture-negative cases, should include broad spectrum agents in association with agents active on Staphylococcus (S.) aureus. Based on local epidemiological data, antibiotics active on methicillin resistant S. aureus (MRSA) should be included. Once an organism has been identified, antibiotics should be initially administered intravenously but the optimal duration of antimicrobial therapy is unclear. Studies have reported that the incidence of treatment failure was higher when i.v. therapy was administered for less than 4 weeks. Rifampin is widely used in the combination therapy of PVO, but no controlled trials are available to define weather this approach is beneficial. Many PVO need a surgical treatment and can represent a real challenge for the orthopaedic surgeon. Anterior and posterior cervical, thoracic, lumbar approaches and the relatives surgical strategies are reported in this review. Moreover, recently the mininvasive posterior stabilization have been proposed as a efficient alternative to open surgery in elderly with severe comorbidities. Possible advantages and limitations of this technique are also reported. CONCLUSIONS: Further research is needed in order to define the optimal duration of antibiotic therapy, and the benefits and limitations of open or mini-invasive surgical techniques.

Published
2012

18. Epidemiological and clinical features of pyogenic spondylodiscitis

Author

Fantoni M, ENRICO TRECARICHI, Rossi B, Mazzotta V, Di Giacomo G, La, Nasto, Di Meco E, Pola E, Fantoni, M, Trecarichi, Em, Rossi, B, Mazzotta, V, Nasto, L, DI MECO, E, and Pola, E

Subjects
Bacteriological Techniques, Discitis, Incidence, Osteomyelitis, Middle Aged, Prognosis, Settore MED/17 - MALATTIE INFETTIVE, Risk Assessment, Young Adult, Predictive Value of Tests, Risk Factors, Humans, Intervertebral Disc, SPONDYLODISCITIS, Aged
Abstract

Pyogenic spondylodiscitis (PS) is an uncommon but important infection, that represents 3-5% of all cases of osteomyelitis. The annual incidence in Europe has been estimated to be from 0.4 to 2.4/100,000. A has been reported, with peaks at age less than 20 years and in the group aged 50-70 years. The incidence of PS seems to be increasing in the last years as a result of the higher life expectancy of older patients with chronic debilitating diseases, the rise in the prevalence of immunosuppressed patients, intravenous drug abuse, and the increase in spinal instrumentation and surgery. PS is in most cases a hematogenous infection. Staphylococcus aureus is the most frequent causative microorganism, accounting for about one half of the cases of PS. Gram-negative rods are causative agents in 7-33% of PS cases. Coagulase-negative staphylococci (CoNS) have been reported in 5-16% of cases. Staphylococcus epidermidis is often related to post-operative infections and intracardiac device-related bacteremia. Unremitting back pain, characteristically worsening during the night, is the most common presenting symptom, followed by fever that is present in about one half of the cases. The mortality of PS ranges from 0 to 11%. In a significant number of cases, recrudescence, residual neurological defects or persistent pain may occur.

Published
2012

19. Procedura di assistenza ai pazienti diabetici nell’esperienza del Poliambulatorio Caritas di Roma; un approccio innovativo alla presa in carico della Cronicità in pazienti vulnerabili

Author

Mario Affronti, Manila Bonciani, Emanuela Forcella, Salvatore Geraci, Maurizio Marceca, Maria Laura Russo, Corsaro, Alice, Pettinicchio, V, Civitelli, G, Arrivi, F, Silvestrini, Giulia, Di Meco, Eugenia, Sciacca, S, Fratini, P, Geraci, S, Bruno, Stefania, Damiani, Gianfranco, Corsaro A, Silvestrini G, Di Meco E, Bruno S (ORCID:0000-0002-0362-4180), Damiani G (ORCID:0000-0003-3028-6188), Mario Affronti, Manila Bonciani, Emanuela Forcella, Salvatore Geraci, Maurizio Marceca, Maria Laura Russo, Corsaro, Alice, Pettinicchio, V, Civitelli, G, Arrivi, F, Silvestrini, Giulia, Di Meco, Eugenia, Sciacca, S, Fratini, P, Geraci, S, Bruno, Stefania, Damiani, Gianfranco, Corsaro A, Silvestrini G, Di Meco E, Bruno S (ORCID:0000-0002-0362-4180), and Damiani G (ORCID:0000-0003-3028-6188)

Published
2016

20. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome

Author

Trecarichi, E. M., Di Meco, E., Mazzotta, V., and Massimo FANTONI

Subjects
Adult, Male, Bacteriological Techniques, Discitis, Osteomyelitis, Mycobacterium tuberculosis, Middle Aged, Settore MED/17 - MALATTIE INFETTIVE, Anti-Bacterial Agents, Treatment Outcome, tuberculosis, Predictive Value of Tests, Humans, Female, Orthopedic Procedures, Tuberculosis, Spinal, spondylodiscitis, Intervertebral Disc, Aged
Abstract

Tuberculous spondylodiscitis (TS) is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications.To discuss certain aspects of the approach to TSs, focusing upon epidemiology, diagnosis, and treatment outcome.For the purpose of this review, a literature search was performed using the Pubmed database through to 19th October 2011 to identify studies published in the last 20 years, concerned in epidemiological, clinical, diagnostic, and therapeutical aspects of TS in adults. Only studies drafted in English language and reporting case series of more than 20 patients have been included.TS has been reported to accounts for 1-5% of all TB cases, and for about 50% of the cases of articulo-skeletal TB infections. Despite the actual availability of more effective diagnostic tools, early recognition of TS remains difficult and a high index of suspicion is needed due to the chronic nature of the disease and its insidious and variable clinical presentation. A prompt diagnosis is required to improve long term outcome, and a microbiological confirmation is recommended to enable appropriate choice of anti-mycobacterial agents. Surgery has an important role in alleviating pain, correcting deformities and neurological impairment, and restoring function.Further studies are required to assess the appropriate duration of anti-microbial treatment, also in regarding of a combined surgical approach.

Published
2012

22. Multidrug-resistant Proteus mirabilis bloodstream infections: risk factors and outcomes

Author

Tumbarello, Mario, Trecarichi, Enrico Maria, Fiori, Barbara, Losito, Angela Raffaella, D'Inzeo, Tiziana, Campana, Lara, Ruggeri, A, Di Meco, E, Liberto, E, Fadda, G, Cauda, R, Spanu, T., Tumbarello, Mario (ORCID:0000-0002-9519-8552), Fiori, Barbara (ORCID:0000-0003-3318-5809), D'Inzeo, Tiziana (ORCID:0000-0003-1508-3518), Cauda, R (ORCID:0000-0002-1498-4229), Spanu, T. (ORCID:0000-0003-1864-5184), Tumbarello, Mario, Trecarichi, Enrico Maria, Fiori, Barbara, Losito, Angela Raffaella, D'Inzeo, Tiziana, Campana, Lara, Ruggeri, A, Di Meco, E, Liberto, E, Fadda, G, Cauda, R, Spanu, T., Tumbarello, Mario (ORCID:0000-0002-9519-8552), Fiori, Barbara (ORCID:0000-0003-3318-5809), D'Inzeo, Tiziana (ORCID:0000-0003-1508-3518), Cauda, R (ORCID:0000-0002-1498-4229), and Spanu, T. (ORCID:0000-0003-1864-5184)

Abstract

Our aims were to identify (i) risk factors associated with the acquisition of multidrug-resistant (MDR, to 3 or more classes of antimicrobials) Proteus mirabilis isolates responsible for bloodstream infections (BSIs) and (ii) the impact on mortality of such infections. Risk factors for acquiring MDR P. mirabilis BSIs were investigated in a case-case-control study; those associated with mortality were assessed by comparing survivors and nonsurvivors in a cohort study. The population consisted of 99 adult inpatients with P. mirabilis BSIs identified by our laboratory over an 11-year period (1999 to 2009), 36 (33.3%) of which were caused by MDR strains, and the overall 21-day mortality rate was 30.3%. Acquisition of an MDR strain was independently associated with admission from a long-term care facility (odds ratio [OR], 9.78; 95% confidence interval [CI], 1.94 to 49.16), previous therapy with fluoroquinolones (OR, 5.52; 95% CI, 1.30 to 23.43) or oxyimino-cephalosporins (OR, 4.72; 95% CI, 1.31 to 16.99), urinary catheterization (OR, 3.89; 95% CI, 1.50 to 10.09), and previous hospitalization (OR, 2.68; 95% CI, 10.4 to 6.89). Patients with MDR P. mirabilis BSIs received inadequate initial antimicrobial therapy (IIAT, i.e., treatment with drugs to which the isolate displayed in vitro resistance) more frequently than those with non-MDR infections; they also had increased mortality and (for survivors) longer post-BSI-onset hospital stays. In multivariate regression analysis, 21-day mortality was associated with septic shock at BSI onset (OR, 12.97; 95% CI, 32.2 to 52.23), P. mirabilis isolates that were MDR (OR, 6.62; 95% CI, 16.4 to 26.68), and IIAT (OR, 9.85; 95% CI, 26.7 to 36.25), the only modifiable risk factor of the 3. These findings can potentially improve clinicians' ability to identify P. mirabilis BSIs likely to be MDR, thereby reducing the risk of IIAT--a major risk factor for mortality in these cases--and facilitating the prompt implementation of appropriate in

Published
2012

23. Epidemiological and clinical features of pyogenic spondylodiscitis.

Author

Fantoni, M., Trecarichi, E. M., Rossi, B., Mazzotta, V., Di Giacomo, G., Nasto, L. A., Di Meco, E., and Pola, E.

Abstract

Pyogenic spondylodiscitis (PS) is an uncommon but important infection, that represents 3-5% of all cases of osteomyelitis. The annual incidence in Europe has been estimated to be from 0.4 to 2.4/100,000. A has been reported, with peaks at age less than 20 years and in the group aged 50-70 years. The incidence of PS seems to be increasing in the last years as a result of the higher life expectancy of older patients with chronic debilitating diseases, the rise in the prevalence of immunosuppressed patients, intravenous drug abuse, and the increase in spinal instrumentation and surgery. PS is in most cases a hematogenous infection. Staphylococcus aureus is the most frequent causative microorganism, accounting for about one half of the cases of PS. Gram-negative rods are causative agents in 7-33% of PS cases. Coagulase-negative staphylococci (CoNS) have been reported in 5-16% of cases. Staphylococcus epidermidis is often related to post-operative infections and intracardiac device-related bacteremia. Unremitting back pain, characteristically worsening during the night, is the most common presenting symptom, followed by fever that is present in about one half of the cases. The mortality of PS ranges from 0 to 11%. In a significant number of cases, recrudescence, residual neurological defects or persistent pain may occur. [ABSTRACT FROM AUTHOR]

Published
2012

24. Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study)

Author

Eugenia Di Meco, Giuliano Rizzardini, Francesca Bai, Antonio Cascio, Anna Maria Cattelan, Federica Tordato, Evelyn Van Hauwermeiren, Massimo Puoti, Chiara Aldieri, Maria Cristina Moioli, Francesco Castelli, Giulia Marchetti, Guglielmo Migliorino, Paola Morelli, Barbara Menzaghi, Federica Borghi, Marco Rizzi, Antonella d'Arminio Monforte, Annalisa Saracino, Francesca Raumer, Bai F., Aldieri C., Cattelan A., Raumer F., Di Meco E., Moioli M.C., Tordato F., Morelli P., Borghi F., Rizzi M., Van Hauwermeiren E., Castelli F., Migliorino G., Menzaghi B., Rizzardini G., Saracino A., Cascio A., Puoti M., d'Arminio Monforte A., and Marchetti G.

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, Gram-positive infection, 030106 microbiology, Real life setting, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Virology, Internal medicine, Antibiotic therapy, medicine, antibiotic therapy, Humans, acute bacterial skin and skin structure infection, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Dalbavancin, Off-Label Use, Skin Diseases, Bacterial, Middle Aged, acute bacterial skin and skin structure infections, Anti-Bacterial Agents, second-generation lipoglycopeptide antibiotics, Hospitalization, dalbavancin, Gram-positive infections, Infectious Diseases, Italy, Acute Disease, Skin structure, Observational study, Female, Teicoplanin, business
Abstract

Objectives: We evaluated the efficacy and safety of dalbavancin in ABSSSI and ‘other sites’ infections’ (OTA). Methods: Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016–2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting. Results: 206 patients enrolled (males 50%, median age 62 [IQR 50–76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p=0.003) and 46.3% ABSSSI vs 37.2% OTA (p=0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure. Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hospitalization (13.5days, 5.5–22 vs 3, 0–11.7; p80%, with similar efficacy/safety in ABSSSI and off-label indications. The preferential use of dalbavancin as second-line or combination therapy would seem to suggest the need for in-depth studies focused on its off-label use.

Published
2020

26. Target regimen profiles for tuberculosis treatment.

Author

Lienhardt C, Dooley KE, Nahid P, Wells C, Ryckman TS, Kendall EA, Davies G, Brigden G, Churchyard G, Cirillo DM, Di Meco E, Gopinath R, Mitnick C, Scott C, Amanullah F, Bansbach C, Boeree M, Campbell M, Conradie F, Crook A, Daley CL, Dheda K, Diacon A, Gebhard A, Hanna D, Heinrich N, Hesseling A, Holtzman D, Jachym M, Kim P, Lange C, McKenna L, Meintjes G, Ndjeka N, Nhung NV, Nyang'wa BT, Paton NI, Rao R, Rich M, Savic R, Schoeman I, Makokotlela BS, Spigelman M, Sun E, Svensson E, Tisile P, Varaine F, Vernon A, Diul MY, Kasaeva T, Zignol M, Gegia M, Mirzayev F, and Schumacher SG

Subjects
Humans, Tuberculosis, Multidrug-Resistant drug therapy, Rifampin therapeutic use, Cost-Benefit Analysis, Medication Adherence, Antitubercular Agents therapeutic use, World Health Organization, Tuberculosis drug therapy
Abstract

Simpler, shorter, safer and more effective treatments for tuberculosis that are easily accessible to all people with tuberculosis are desperately needed. In 2016, the World Health Organization (WHO) developed target regimen profiles for the treatment of tuberculosis to make drug developers aware of both the important features of treatment regimens, and patient and programmatic needs at the country level. In view of recent ground-breaking advances in tuberculosis treatment, WHO has revised and updated these regimen profiles. We used a similar process as for the 2016 profiles, including a baseline treatment landscape analysis, an initial stakeholder survey, modelling studies estimating the impact and cost-effectiveness of novel tuberculosis treatment regimens, and an extensive stakeholder consultation. We developed target regimen profiles for the treatment of rifampicin-susceptible and rifampicin-resistant tuberculosis, as well as a pan-tuberculosis regimen that would be appropriate for patients with any type of tuberculosis. We describe the revised target regimen profile characteristics, with specific minimal and optimal targets to be met, rationale and justification, and aspects relevant to all target regimen profiles (drug susceptibility testing, adherence and forgiveness, treatment strategies, post-tuberculosis lung disease, and cost and access considerations). We discuss the trade-offs of proposed characteristics for decision-making at developmental or operational levels. We expect that, following these target regimen profile revisions, tuberculosis treatment developers will produce regimens that are quality-assured, affordable and widely available, and that meet the needs of affected populations., ((c) 2024 The authors; licensee World Health Organization.)

Published
2024
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28. Prolonged SARS-CoV-2-RNA Detection from Nasopharyngeal Swabs in an Oncologic Patient: What Impact on Cancer Treatment?

Author

Ferrari A, Trevenzoli M, Sasset L, Di Liso E, Tavian T, Rossi L, Di Meco E, and Cattelan AM

Subjects
Aged, Carrier State diagnosis, Female, Humans, Nasopharynx virology, RNA, Viral genetics, SARS-CoV-2 genetics, Time-to-Treatment, COVID-19 diagnosis, Carcinoma, Non-Small-Cell Lung virology, Lung Neoplasms virology, SARS-CoV-2 isolation & purification
Abstract

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient's infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.

Published
2021
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29. Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study.

Author

Cattelan AM, Di Meco E, Trevenzoli M, Frater A, Ferrari A, Villano M, Gomiero F, Carretta G, and Sasset L

Subjects
Aged, Aspartate Aminotransferases blood, Biomarkers blood, C-Reactive Protein analysis, COVID-19 epidemiology, COVID-19 virology, Comorbidity, Female, Follow-Up Studies, Humans, Intensive Care Units, Italy epidemiology, Leukocyte Count, Male, Middle Aged, Neutrophils immunology, Retrospective Studies, Risk Factors, Time Factors, COVID-19 blood, COVID-19 therapy, Critical Care methods, Patient Transfer, SARS-CoV-2 genetics
Abstract

Background: Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not., Methods: This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups., Results: 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01)., Conclusions: The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.

Published
2020
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30. Efficacy and safety of dalbavancin in the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and other infections in a real-life setting: data from an Italian observational multicentric study (DALBITA study).

Author

Bai F, Aldieri C, Cattelan A, Raumer F, Di Meco E, Moioli MC, Tordato F, Morelli P, Borghi F, Rizzi M, Van Hauwermeiren E, Castelli F, Migliorino G, Menzaghi B, Rizzardini G, Saracino A, Cascio A, Puoti M, d'Arminio Monforte A, and Marchetti G

Subjects
Acute Disease, Aged, Anti-Bacterial Agents adverse effects, Female, Humans, Italy, Male, Middle Aged, Off-Label Use, Retrospective Studies, Skin Diseases, Bacterial microbiology, Teicoplanin administration & dosage, Teicoplanin adverse effects, Anti-Bacterial Agents administration & dosage, Hospitalization statistics & numerical data, Skin Diseases, Bacterial drug therapy, Teicoplanin analogs & derivatives
Abstract

Objectives: We evaluated the efficacy and safety of dalbavancin in ABSSSI and 'other sites' infections' (OTA)., Methods: Observational study involving 11 Italian hospitals including patients that received ≥1 dose of dalbavancin in 2016-2019. The outcome was end-of-treatment efficacy and safety in ABSSSI and OTA in a real-life setting., Results: 206 patients enrolled (males 50%, median age 62 [IQR 50-76] years), 60.2% ABSSSI, 39.8% OTA. 69.7% ABSSSI vs 90.7% OTA (p = 0.003) and 46.3% ABSSSI vs 37.2% OTA (p = 0.786) received previous and concomitant antibiotics, respectively. 82.5% reached clinical cure . Eleven (5.4%) patients had non-serious adverse events (AE). OTA patients showed longer hospitalization (13.5 days, 5.5-22 vs 3, 0-11.7; p<0.0001) and received longer previous (18 days, 9-30 vs 11, 7-19; p = 0.007)/concomitant antibiotic treatments (21 days, 14-52 vs 11, 8-14; p < 0.0001), compared to ABSSSI. ABSSSI and OTA showed similar efficacy (85.5% vs 75%, p = 0.459) and safety (no AE: 81.5% vs 64.3%, p = 0.258); efficacy was independent of previous/concomitant therapies., Conclusions: Dalbavancin demonstrated a success rate of >80%, with similar efficacy/safety in ABSSSI and off-label indications. The preferential use of dalbavancin as second-line or combination therapy would seem to suggest the need for in-depth studies focused on its off-label use.

Published
2020
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31. SARS-CoV-2 and hepatitis.

Author

Trevenzoli M, Guarnaccia A, Alberici I, Fassan M, Di Meco E, Farinati F, and Cattelan AM

Subjects
Antiviral Agents administration & dosage, Antiviral Agents adverse effects, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques methods, Diagnosis, Differential, Drug Combinations, Humans, Liver pathology, Liver Function Tests methods, Male, Middle Aged, SARS-CoV-2, COVID-19 Drug Treatment, Alanine Transaminase blood, Aspartate Aminotransferases blood, Betacoronavirus isolation & purification, Betacoronavirus pathogenicity, Chemical and Drug Induced Liver Injury blood, Chemical and Drug Induced Liver Injury diagnosis, Chemical and Drug Induced Liver Injury etiology, Chloroquine administration & dosage, Chloroquine adverse effects, Coronavirus Infections complications, Coronavirus Infections diagnosis, Coronavirus Infections drug therapy, Coronavirus Infections physiopathology, Hepatitis, Viral, Human blood, Hepatitis, Viral, Human diagnosis, Hepatitis, Viral, Human etiology, Lopinavir administration & dosage, Lopinavir adverse effects, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral diagnosis, Pneumonia, Viral physiopathology, Ritonavir administration & dosage, Ritonavir adverse effects
Published
2020
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32. Coinfection of severe acute respiratory syndrome coronavirus 2 and HIV in a teaching hospital: still much to learn.

Author

Sasset L, Di Meco E, Cavinato S, and Cattelan AM

Subjects
Betacoronavirus, COVID-19, Coinfection virology, Coronavirus Infections virology, HIV Infections virology, Hospitals, Teaching, Humans, Italy, Male, Middle Aged, Pandemics, Pneumonia, Viral virology, SARS-CoV-2, Coronavirus Infections complications, HIV Infections complications, Pneumonia, Viral complications
Published
2020
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33. An Integrated Strategy for the Prevention of SARS-CoV-2 Infection in Healthcare Workers: A Prospective Observational Study.

Author

Cattelan AM, Sasset L, Di Meco E, Cocchio S, Barbaro F, Cavinato S, Gardin S, Carretta G, Donato D, Crisanti A, Trevenzoli M, and Baldo V

Subjects
Adult, Asymptomatic Infections epidemiology, Betacoronavirus, Body Temperature, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections diagnosis, Disease Outbreaks, Female, Health Personnel standards, Humans, Infection Control standards, Italy epidemiology, Male, Patient Care Team organization & administration, Personal Protective Equipment statistics & numerical data, Personal Protective Equipment supply & distribution, Prospective Studies, SARS-CoV-2, Triage organization & administration, Coronavirus Infections prevention & control, Health Personnel organization & administration, Infection Control organization & administration, Infectious Disease Transmission, Patient-to-Professional prevention & control, Pandemics prevention & control, Pneumonia, Viral prevention & control
Abstract

Background: Since the beginning of SARS-CoV-2 outbreak, a large number of infections have been reported among healthcare workers (HCWs). The aim of this study was to investigate the occurrence of SARS-CoV-2 infection among HCWs involved in the first management of infected patients and to describe the measures adopted to prevent the transmission in the hospital., Methods: This prospective observational study was conducted between February 21 and April 16, 2020, in the Padua University Hospital (north-east Italy). The infection control policy adopted consisted of the following: the creation of the "Advanced Triage" area for the evaluation of SARS-CoV-2 cases, and the implementation of an integrated infection control surveillance system directed to all the healthcare personnel involved in the Advance Triage area. HCWs were regularly tested with nasopharyngeal swabs for SARS-CoV-2; body temperature and suggestive symptoms were evaluated at each duty. Demographic and clinical data of both patients and HCWs were collected and analyzed; HCWs' personal protective equipment (PPE) consumption was also recorded. The efficiency of the control strategy among HCWs was evaluated identifying symptomatic infection (primary endpoint) and asymptomatic infection (secondary endpoint) with confirmed detection of SARS-CoV-2., Results: 7595 patients were evaluated in the Advanced Triage area: 5.2% resulted positive and 72.4% was symptomatic. The HCW team was composed of 60 members. A total of 361 nasopharyngeal swabs were performed on HCWs. All the swabs resulted negative and none of the HCWs reached the primary or the secondary endpoint., Conclusions: An integrated hospital infection control strategy, consisting of dedicated areas for infected patients, strict measures for PPE use and mass surveillance, is successful to prevent infection among HCWs.

Published
2020
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34. Infectious and dermatological diseases among arriving migrants on the Italian coasts.

Author

Di Meco E, Di Napoli A, Amato LM, Fortino A, Costanzo G, Rossi A, Mirisola C, and Petrelli A

Subjects
Adult, Cross-Sectional Studies, Female, Humans, Italy epidemiology, Male, Middle Aged, Socioeconomic Factors, Young Adult, Communicable Diseases epidemiology, Refugees statistics & numerical data, Skin Diseases epidemiology, Transients and Migrants statistics & numerical data
Abstract

Background: Since 2008 Italy has been the destination of the 'central Mediterranean route', used by migrants to reach Europe. The aim of this study is to describe demographic characteristics and health problems of migrants at the time of arrival on the Italian coasts, focussing on dermatological and infectious diseases., Methods: Cross-sectional study of data routinely collected (n = 6, 188) by the National Institute for Health Migration and Poverty (INMP) in the centres for migrants of Lampedusa and Trapani-Milo (2015-16). Logistic models were performed to identify factors associated with scabies, varicella and the occurrence of two or more not related diagnosis., Results: The average age was 21.6 years; 83.5% of the patients were males. The most frequent countries of origin were Eritrea, Nigeria, and Somalia. The most frequent diagnosis was scabies (58% of patients), skin infections, pediculosis and dermatitis; respiratory infections and varicella were the most represented infectious diseases. The diagnosis of scabies was more probable among Somalis (OR: 11.60) and Eritreans (OR: 10.05); the diagnosis of varicella was more probable among Ghanaians (OR: 13.58) and Nigerians (OR: 9.79). Somalis (OR: 4.10) and Eritreans (OR: 3.32) were the patients more likely to receive two or more diagnosis., Conclusions: The majority of the diseases affecting migrants is in most cases, related to the migration experience and is likely not to represent a major threat for public health. Up-to-date information regarding the burden of diseases is needed in order to identify the health needs of incoming migrants and to arrange the appropriate response in terms of health services provision.

Published
2018
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35. Is posterior percutaneous screw-rod instrumentation a safe and effective alternative approach to TLSO rigid bracing for single-level pyogenic spondylodiscitis? Results of a retrospective cohort analysis.

Author

Nasto LA, Colangelo D, Mazzotta V, Di Meco E, Neri V, Nasto RA, Fantoni M, and Pola E

Subjects
Adult, Aged, Anti-Bacterial Agents therapeutic use, Cohort Studies, Combined Modality Therapy, Discitis drug therapy, Female, Humans, Male, Middle Aged, Quality of Life, Retrospective Studies, Treatment Outcome, Bone Screws, Braces, Discitis surgery, Lumbar Vertebrae surgery, Spinal Fusion methods, Thoracic Vertebrae surgery
Abstract

Background Context: Currently, treatment for patients diagnosed with noncomplicated (ie, known infectious agent, no neurologic compromise, and preserved spinal stability) pyogenic spondylodiscitis (PS) is based on intravenous antibiotics and rigid brace immobilization. Since January 2010, we started offering our patients percutaneous posterior screw-rod instrumentation as an alternative approach to rigid bracing. Supposed benefits of posterior percutaneous instrumentation over rigid bracing are earlier free mobilization, increased comfort, and faster recovery., Purpose: To evaluate safety and effectiveness of posterior percutaneous spinal instrumentation for single-level PS and compare clinical and quality-of-life outcomes with standard thoracolumbosacral orthosis (TLSO) rigid bracing., Study Design/setting: Retrospective observational cohort study., Patient Sample: Twenty-seven patients consecutively diagnosed with single-level noncomplicated lower thoracic or lumbar PS from January 2010 to December 2011., Outcome Measures: Healing rate, healing time, and changes in segmental kyphosis Cobb angle were compared in the two treatment groups. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complete blood count at regular time points until complete healing were also obtained. Self-report measures included Visual Analog Scale (VAS), Short-Form 12 (SF-12), and EuroQol five-dimension (EQ-5D) questionnaires., Methods: At enrollment, patients were offered to choose between 24/7 TLSO rigid bracing for 3 to 4 months and bridging posterior percutaneous screw-rod instrumentation followed by soft bracing for 4 weeks after surgery. All patients underwent antibiotic therapy accordingly to isolated infectious agents. Patients were seen in the clinic at 1, 3, 6, and 9 months, and ESR, CRP, complete blood count, VAS, SF-12, and EQ-5D questionnaires were obtained. Segmental kyphosis was measured at diagnosis and at 9 months follow-up. Two-way repeated-measures analysis of variance was used to assess group and time differences across time points., Results: Fifteen patients chose conservative treatment, whereas 12 patients chose surgical treatment. Complete infection healing was achieved in all patients with no significant differences in healing time (p<.366). C-reactive protein and ESR levels decreased in both groups accordingly with positive response to therapy with no significant differences. Surgically treated patients had significantly lower VAS scores at 1 month (2.76±0.80 vs. 5.20±1.21, p<.001) and 3 months (2.31±0.54 vs. 2.85±0.54, p<.016) post-diagnosis over TLSO patients. Moreover, surgery patients also showed steeper and statistically significant improvements in SF-12 scores over TLSO patients at 1, 3, and 6 months post-diagnosis (p<.012); no significant differences were detected at the other time points. EuroQol five-dimension index was significantly higher in surgery patients at 1 month (0.764±0.043 vs. 0.458±0.197, p<.001) and 3 months (0.890±0.116 vs. 0.688±0.142, p<.001); no significant changes were observed in segmental pre- and posttreatment kyphosis between the two groups. No instrumentation-related complications were observed in any patient., Conclusions: Posterior percutaneous spinal instrumentation is a safe, feasible, and effective procedure in relieving pain, preventing deformity, and neurologic compromise in patients affected by noncomplicated lower thoracic (T9-T12) or lumbar PS. Posterior instrumentation did not offer any advantage in healing time over TLSO rigid bracing because infection clearance is strongly dependent on proper antibiotic therapy. Nevertheless, surgical stabilization was associated with faster recovery, lower pain scores, and improved quality of life compared with TLSO conservative treatment at 1, 3, and 6 months after treatment., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Published
2014
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36. Multidrug-resistant Proteus mirabilis bloodstream infections: risk factors and outcomes.

Author

Tumbarello M, Trecarichi EM, Fiori B, Losito AR, D'Inzeo T, Campana L, Ruggeri A, Di Meco E, Liberto E, Fadda G, Cauda R, and Spanu T

Subjects
Aged, Anti-Bacterial Agents therapeutic use, Case-Control Studies, Cephalosporins therapeutic use, Drug Resistance, Multiple, Bacterial drug effects, Fluoroquinolones therapeutic use, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Proteus Infections mortality, Retrospective Studies, Risk Factors, Proteus Infections drug therapy, Proteus mirabilis drug effects, Proteus mirabilis pathogenicity
Abstract

Our aims were to identify (i) risk factors associated with the acquisition of multidrug-resistant (MDR, to 3 or more classes of antimicrobials) Proteus mirabilis isolates responsible for bloodstream infections (BSIs) and (ii) the impact on mortality of such infections. Risk factors for acquiring MDR P. mirabilis BSIs were investigated in a case-case-control study; those associated with mortality were assessed by comparing survivors and nonsurvivors in a cohort study. The population consisted of 99 adult inpatients with P. mirabilis BSIs identified by our laboratory over an 11-year period (1999 to 2009), 36 (33.3%) of which were caused by MDR strains, and the overall 21-day mortality rate was 30.3%. Acquisition of an MDR strain was independently associated with admission from a long-term care facility (odds ratio [OR], 9.78; 95% confidence interval [CI], 1.94 to 49.16), previous therapy with fluoroquinolones (OR, 5.52; 95% CI, 1.30 to 23.43) or oxyimino-cephalosporins (OR, 4.72; 95% CI, 1.31 to 16.99), urinary catheterization (OR, 3.89; 95% CI, 1.50 to 10.09), and previous hospitalization (OR, 2.68; 95% CI, 10.4 to 6.89). Patients with MDR P. mirabilis BSIs received inadequate initial antimicrobial therapy (IIAT, i.e., treatment with drugs to which the isolate displayed in vitro resistance) more frequently than those with non-MDR infections; they also had increased mortality and (for survivors) longer post-BSI-onset hospital stays. In multivariate regression analysis, 21-day mortality was associated with septic shock at BSI onset (OR, 12.97; 95% CI, 32.2 to 52.23), P. mirabilis isolates that were MDR (OR, 6.62; 95% CI, 16.4 to 26.68), and IIAT (OR, 9.85; 95% CI, 26.7 to 36.25), the only modifiable risk factor of the 3. These findings can potentially improve clinicians' ability to identify P. mirabilis BSIs likely to be MDR, thereby reducing the risk of IIAT--a major risk factor for mortality in these cases--and facilitating the prompt implementation of appropriate infection control measures.

Published
2012
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37. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome.

Author

Trecarichi EM, Di Meco E, Mazzotta V, and Fantoni M

Subjects
Adult, Aged, Anti-Bacterial Agents therapeutic use, Bacteriological Techniques, Discitis diagnosis, Discitis epidemiology, Discitis therapy, Female, Humans, Intervertebral Disc surgery, Male, Middle Aged, Mycobacterium tuberculosis isolation & purification, Orthopedic Procedures, Osteomyelitis diagnosis, Osteomyelitis epidemiology, Osteomyelitis therapy, Predictive Value of Tests, Treatment Outcome, Tuberculosis, Spinal diagnosis, Tuberculosis, Spinal epidemiology, Tuberculosis, Spinal therapy, Discitis microbiology, Intervertebral Disc microbiology, Mycobacterium tuberculosis pathogenicity, Osteomyelitis microbiology, Tuberculosis, Spinal microbiology
Abstract

Background: Tuberculous spondylodiscitis (TS) is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications., Aim: To discuss certain aspects of the approach to TSs, focusing upon epidemiology, diagnosis, and treatment outcome., Materials and Methods: For the purpose of this review, a literature search was performed using the Pubmed database through to 19th October 2011 to identify studies published in the last 20 years, concerned in epidemiological, clinical, diagnostic, and therapeutical aspects of TS in adults. Only studies drafted in English language and reporting case series of more than 20 patients have been included., Results: TS has been reported to accounts for 1-5% of all TB cases, and for about 50% of the cases of articulo-skeletal TB infections. Despite the actual availability of more effective diagnostic tools, early recognition of TS remains difficult and a high index of suspicion is needed due to the chronic nature of the disease and its insidious and variable clinical presentation. A prompt diagnosis is required to improve long term outcome, and a microbiological confirmation is recommended to enable appropriate choice of anti-mycobacterial agents. Surgery has an important role in alleviating pain, correcting deformities and neurological impairment, and restoring function., Conclusions: Further studies are required to assess the appropriate duration of anti-microbial treatment, also in regarding of a combined surgical approach.

Published
2012

38. Medical and surgical treatment of pyogenic spondylodiscitis.

Author

Pola E, Logroscino CA, Gentiempo M, Colangelo D, Mazzotta V, Di Meco E, and Fantoni M

Subjects
Aged, Discitis diagnosis, Discitis microbiology, Discitis surgery, Humans, Intervertebral Disc microbiology, Male, Middle Aged, Osteomyelitis diagnosis, Osteomyelitis microbiology, Osteomyelitis surgery, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Discitis therapy, Intervertebral Disc surgery, Orthopedic Procedures, Osteomyelitis therapy
Abstract

Background: Pyogenic vertebral osteomyelitis (PVO) represents approximately 2-7% of all cases of osteomyelitis. The approach to the treatment of PVO may be conservative, which includes antibiotic therapy and orthopaedic treatment, or surgical., Aim: To overview conservative and surigical approaches to PVO., Methods: A literature review was performed using the Pubmed database to identify studies published in the last 20 years, addressing the treatment of PVO., Results: Empirical antibiotic treatment of PVO, while waiting for the results of cultures or in culture-negative cases, should include broad spectrum agents in association with agents active on Staphylococcus (S.) aureus. Based on local epidemiological data, antibiotics active on methicillin resistant S. aureus (MRSA) should be included. Once an organism has been identified, antibiotics should be initially administered intravenously but the optimal duration of antimicrobial therapy is unclear. Studies have reported that the incidence of treatment failure was higher when i.v. therapy was administered for less than 4 weeks. Rifampin is widely used in the combination therapy of PVO, but no controlled trials are available to define weather this approach is beneficial. Many PVO need a surgical treatment and can represent a real challenge for the orthopaedic surgeon. Anterior and posterior cervical, thoracic, lumbar approaches and the relatives surgical strategies are reported in this review. Moreover, recently the mininvasive posterior stabilization have been proposed as a efficient alternative to open surgery in elderly with severe comorbidities. Possible advantages and limitations of this technique are also reported., Conclusions: Further research is needed in order to define the optimal duration of antibiotic therapy, and the benefits and limitations of open or mini-invasive surgical techniques.

Published
2012

39. Identifying patients harboring extended-spectrum-beta-lactamase-producing Enterobacteriaceae on hospital admission: derivation and validation of a scoring system.

Author

Tumbarello M, Trecarichi EM, Bassetti M, De Rosa FG, Spanu T, Di Meco E, Losito AR, Parisini A, Pagani N, and Cauda R

Subjects
Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Community-Acquired Infections drug therapy, Community-Acquired Infections microbiology, Enterobacteriaceae drug effects, Enterobacteriaceae pathogenicity, Enterobacteriaceae Infections drug therapy, Enterobacteriaceae Infections microbiology, Female, Humans, Klebsiella drug effects, Klebsiella enzymology, Klebsiella pathogenicity, Male, Middle Aged, Proteus mirabilis drug effects, Proteus mirabilis enzymology, Proteus mirabilis pathogenicity, Retrospective Studies, Enterobacteriaceae enzymology, beta-Lactamases metabolism
Abstract

Increases in community-acquired infections caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae have important implications for hospital infection control and empirical antibiotic therapy protocols. We developed and validated a tool for identifying patients harboring these organisms at hospital admission. We retrospectively analyzed chart data for 849 adult inpatients. The derivation cohort included 339 patients admitted to a large hospital in Rome during 2008, with (n = 113) or without (n = 226) culture positivity for ESBL-producing Escherichia coli, Klebsiella spp., or Proteus mirabilis within 48 h after admission. Logistic-regression-based prediction scores were calculated based on variables independently associated with the outcome. The model was validated in a second cohort (n = 510) selected with identical criteria in hospitals in Genoa and Turin during 2009. Prediction scores were based on the following six variables (reported with odds ratio for study outcome and the 95% confidence intervals in brackets): recent (≤ 12 months before admission) hospitalization (5.69 [2.94 to 10.99]), transfer from another health care facility (5.61 [1.65 to 19.08]), Charlson comorbidity score ≥ 4 (3.80 [1.90 to 7.59]), recent (≤ 3 months before admission) β-lactam and/or fluoroquinolone treatment (3.68 [1.96 to 6.91]), recent urinary catheterization (3.52 [1.96 to 6.91]), and age ≥ 70 years (3.20 [1.79 to 5.70]). The model displayed good calibration and good-to-excellent discrimination in the derivation and validation sets (Hosmer-Lemshow χ(2) = 15.28 and 14.07; P = 0.17 and 0.23; areas under the receiver-operating characteristic curve, 0.83 and 0.92). It reliably identified patients likely to be harboring ESBL-producing Enterobacteriaceae at hospital admission who may need special infection control measures. Further study is needed to confirm this model's potential as a guide for prescribing empirical antibiotic therapy.

Published
2011
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