97 results on '"Di Nino G"'
Search Results
2. Major Abdominal Surgery and Postoperative Pain Control: Are Protocols Enough?
- Author
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Samolsky Dekel, B.G., Melotti, R.M., Carosi, F., Spinelli, F.D., D'Andrea, R., and Di Nino, G.
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- 2008
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Catalog
3. The effect of transient intestinal ischemia on inflammatory parameters
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Lammers, K., Innocenti, G., Venturi, A., Rizzello, F., Helwig, U., Bianchi, G., Pedrini, L., Di Nino, G., Gionchetti, P., and Campieri, M.
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- 2003
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4. AGREEMENT PATTERNS BETWEEN INPATIENT SELF REPORTED PAIN AND CARE PROVIDER EVALUATION: 958
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Dekel, B.G. Samolsky, Melotti, R. M., Carosi, F., and Di Nino, G. F.
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- 2006
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5. Wernicke's encephalopathy and pancreatic encephalopathy after necrotic-hemorrhagic pancreatitis. A case report
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Zangheri, E., Pigna, A., Amanti, E., D Alessandro, R., Bova, F., RITA MARIA MELOTTI, Di Nino, G., Zangheri E., Pigna A., Amanti E., D'Alessandro R., Bova F., Melotti R.M., and Di Nino G.
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Adult ,Male ,Brain Diseases ,Pancreatitis, Acute Necrotizing ,Humans ,Electroencephalography ,Hemorrhage ,Wernicke Encephalopathy ,Tomography, X-Ray Computed - Abstract
This case report describes a case of acute necrotic-hemorrhagic pancreatitis complicated by Wernicke's encephalopathy (WE) and stresses the importance of a correct dietetic regimen. A 39-year-old Chinese male patient with negative remote pathological anamnesis was hospitalized in the Medical Department with a diagnosis of gallstones. The clinical course was complicated with the onset of acute pancreatitis. Enteral fasting was imposed with intravenous feeding without vitamin supplementation. The progressive worsening of the clinical, radiodiagnostic and laboratory profile combined with deterioration in the state of consciousness promoted, on the 36th day exploratory laparotomy revealed necrotic-hemorrhagic pancreatitis. The patient was, therefore, admitted to the Intensive Care Unit in a deep coma. The recent medical history, neurological examination, and encephalic computed tomography suggested a revealing diagnosis of WE combined with pancreatic encephalopathy. more...
- Published
- 2009
6. Proteolytic activity of bovine lactoferrin RID C-3677-2011 RID A-4573-2009
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Massucci MT, Giansanti F, Di Nino G, Turacchio M, Giardi MF, Botti D, Ippoliti R, De Giulio B, Siciliano R, Donnarumma G, Valenti P, Bocedi A, Ascenzi P, ANTONINI, GIOVANNI, POLTICELLI, Fabio, Massucci, Mt, Giansanti, F, Di Nino, G, Turacchio, M, Giardi, Mf, Botti, D, Ippoliti, R, De Giulio, B, Siciliano, R, Donnarumma, G, Valenti, P, Bocedi, A, Polticelli, Fabio, Ascenzi, P, and Antonini, Giovanni more...
- Abstract
Bovine lactoferrin catalyzes the hydrolysis of synthetic substrates (i.e., Z-aminoacyl-7-amido-4-methylcoumarin). Values of K-m and k(cat) for the bovine lactoferrin catalyzed hydrolysis of Z-Phe-Arg-7-amido-4-methylcoumarin are 50 muM and 0.03 s(-1), respectively, the optimum pH value is 7.5 at 25 degreesC. The bovine lactoferrin substrate specificity is similar to that of trypsin, while the hydrolysis rate is several orders of magnitude lower than that of trypsin. The bovine lactoferrin catalytic activity is irreversibly inhibited by the serine-protease inhibitors PMSF and Pefabloc. Moreover, both iron-saturation of the protein and LPS addition strongly inhibit the bovine lactoferrin activity. Interestingly, bovine lactoferrin undergoes partial auto-proteolytic cleavage at positions Arg415-Lys 416 and Lys440-Lys441.pK(a) shift calculations indicate that several Ser residues of bovine lactoferrin display the high nucleophilicity required to potentially catalyze substrate cleavage. However, a definitive identification of the active site awaits further studies. more...
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- 2004
7. Postoperative cognitive dysfunction: toward the Alzheimer disease: Pathomechanism Hypothesis
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Fodale, Federico Bilotta, Luca Titi, Elisabetta Stazi, Giovanni Rosa, Andrea Doronzio, Di Nino G, F. Bilotta, A. Doronzio, E. Stazi, L. Titi, V. Fodale, G. Di Nino, and G. Rosa
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Programmed cell death ,COGNITIVE DYSFUNCTION ,Disease ,Nervous System ,Postoperative Complications ,Alzheimer Disease ,medicine ,Aging brain ,Dementia ,Humans ,pathology/psychology ,Aged ,business.industry ,General Neuroscience ,Social impact ,Delirium ,Cognition ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Clinical Psychology ,Aged, Alzheimer Disease ,pathology/psychology, Anesthesia Recovery Period, Chronic Disease, Cognition Disorders ,pathology/psychology, Delirium ,pathology/psychology, Humans, Nervous System ,pathology, Postoperative Complications ,Clinical research ,ALZHEIMER'S DISEASE ,Anesthesia Recovery Period ,Chronic Disease ,pathology ,POSTOPERATIVE ,Geriatrics and Gerontology ,business ,Cognition Disorders ,Neuroscience ,Postoperative cognitive dysfunction - Abstract
Alzheimer's disease (AD), a chronic and progressive deterioration of memory and other cognitive domains, is the most common form of dementia. Because of related health and social impact, there is growing interest in assessing potential relationship between anesthesia and the onset and progression of chronic neurodegenerative disorders, including AD. Currently, preclinical and clinical research is addressed to identify underlying pathomechanisms, patient risk factors, and the use of the least provocative drugs and techniques, to minimize the incidence of chronic neurodegenerative disorders. Preclinical studies are providing an increasing body of evidences on some of the mechanisms that link anesthetics to neuronal programmed cell death (apoptosis) and accumulation of misfolded proteins in the aging brain. Therefore, risk factors and pathomechanisms of chronic neurodegenerative disorders, including AD, and persistent postoperative-postanesthesia cognitive dysfunction may overlap. more...
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- 2010
8. Catalytic activity of bovine-lactoperoxidase supported on poly-hydroxyethylmethacrylate-glycidilmethacrylate
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DI NINO, G., Turacchio, M., D'Archivio, ANGELO ANTONIO, Lora, Corain, B., and Antonini, G.
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- 2004
9. Catalytic activity of bovine-lactoperoxidase supported on macroporous poly(2-hydroxyethyl methacrylate-co-glycidyl methacrylate)
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Di Nino G., Muracchio M., DArchivio A., Lora S., Corain B., and Antonimi G.
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- 2004
10. Our Experience in the Endoscopic Treatment of Oesophageal Obstructions
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Cetrullo, C., primary, Di Nino, G. F., additional, and Martinelli, G., additional
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11. 'Ovotransferrin production by CEF and MDCC-MSB-1 cells after infection by Marek’s Disease Virus'
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Giansanti, Francesco, Giardi, M. F., Massucci, M. T., DI NINO, G, Turacchio, M, Valenti, P, and Antonini, G. AND BOTTI D.
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- 2003
12. Nanostructure and molecular accessibility of gel-type resins for supported bio-catalysis. Part I. Poly-hydroxyethylmethacrilate-hydroxypropylmethacrylate-trimethylolpropanetrimethacrylate
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Turacchio, M., DI NINO, G., D'Archivio, ANGELO ANTONIO, Jerabek, K., Lora, S., Antonini, G., and Corain, B.
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- 2003
13. Nanostructure and Molecular Accessibility of Gel-Type Resins for Supported Catalysis. Part I. Poly-Hydroxyethylmethacrylate-Hydroxypropylmethacrylate-Trimethylolpropane Trimethacrylate
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Turacchio M., Di Nino G., D'Archivio A.A., Jerabek K., Lora S., Antonini G., and Corain B.
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- 2003
14. Nanostructure and molecular accessibility of gel type resins for supported bio-catalysis. Part.I. Polyhydroxyethylmethacrylate-hydroxypropylmethacryla-trimethylolpropanetrymethacrylate
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M. Turacchio, G. Di Nino G., A. A. Archivio, K. Jerabeck, S. Lora, G. Antonini, and B. Corain
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- 2003
15. 'Attivita’ Citoprotettiva della Ovotransferrina'
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Giansanti, Francesco, Massucci, Mt, Di Nino, G, Turacchio, M, Giardi, Mf, Botti, D, Valenti, P, and ottobre 2002, Antonini G.
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- 2002
16. 'Anti-Invasive activity of bovine Lactoferrin and chicken Ovotransferrin towards Group A Streptococcus pyogenes'
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Giansanti, Francesco, Massucci, M. T., DI NINO, G, Turacchio, M, DALLEVA N, GIARDI M. F., Ippoliti, Rodolfo, and Botti, D. AND ANTONINI G.
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- 2002
17. 'Stabilizzazione di Enzimi all’interno di una Matrice Amfifilica'
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Turacchio, M, Di Nino, G, Giansanti, Francesco, Massucci, Mt, D'Archivio, ANGELO ANTONIO, Lora, S, Corain, B, and Antonini, G.
- Published
- 2002
18. S507 EPIDEMIOLOGIC FEATURES OF BREAKTHROUGH PAIN IN CANCER AND NON CANCER PATIENTS WITH CHRONIC PAIN
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Dekel, B.G. Samolsky, primary, Vasarri, A., additional, Tomasi, M., additional, Gori, A., additional, Braghittoni, A., additional, Remondini, F., additional, Di Nino, G., additional, and Melotti, R.M., additional more...
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- 2011
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19. Distensibility index of inferior vena cava diameter in ventilated septic and trauma patients with shock
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Parenti, N, primary, Sangiorgi, D, additional, Pigna, A, additional, Coniglio, C, additional, Cancellieri, F, additional, Gordini, G, additional, Melotti, R, additional, and Di Nino, G, additional
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- 2010
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20. Hypotension as an isolated factor may not be sufficient to provoke hearing impairment.
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Pirodda A, Ferri GG, Montana T, Riggio R, Innocenti G, and Di Nino G
- Abstract
OBJECTIVE: We investigated the possible role of hypotension and related autonomic phenomena in the pathogenic mechanism of sudden sensorineural hearing loss. METHODS: Forty-nine patients belonging to the ASA I-II classes of anaesthesiological risk and submitted to a non-otological surgical procedure were examined. Each operation was performed under general anaesthesia by controlled hypotension technique. Hearing function of the patients was evaluated before and after surgery by means of a pure tone audiometry recorded by the same clinician with the same instrument. RESULTS: No cases of bilateral hearing worsening were recorded after surgery. CONCLUSIONS: An induced and controlled steady hypotension under general anaesthesia did not affect the hearing function of any of the patients. It may be supposed, therefore, that an adverse effect on the cochlear oxygenation is more likely to be caused by the sympathetic changes induced by a consistent decrease of blood pressure rather than to hypotension itself. [ABSTRACT FROM AUTHOR] more...
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- 2004
21. CONDOTTA ANESTESIOLOGICA NELLA CHIRURGIADELL’ERNIA DIAFRAMMATICA NEONATALE
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Bachiocco, V., De Eccher, L., Paladini, R., Appignani, Antonino, and Di Nino, G. F.
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- 1984
22. The influence of medical evidence moderators on pain rating agreement between inpatients and nurses
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Boaz Samolsky Dekel, Gori A, Vasarri A, Sorella C, Di Nino G, and Rm, Melotti
23. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol
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Gagliardi Stefano, Franceschi Claudio, Di Nino Gianfranco, De Cataldis Angelo, Chattat Rabbih, Catena Fausto, Ansaloni Luca, Agnoletti Vanni, Melotti Rita, Potalivo Antonella, and Taffurelli Mario
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Surgery ,RD1-811 - Abstract
Abstract Background Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state) is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. Design All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium) and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium). Our exposures are the following: ASA, Pain (SVS; VAS), Blood gas analysis (pH; Hb; pO2; pCO2), Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates), Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma Scale (GCS), Cognitive state (SPMSQ), Functional state (ADL and IADL), Psychological Distress (HADS), Cumulative Illness Rating Scale (CIRS), Hypotension (classified in: light; moderate and severe and duration), Blood loss (classified in: < 2 lt and > 2 lt), Blood transfusions (< 2 lt and > 2 lt), Quantity of red cells and plasma transfusions, Visual VAS / SVS (timing: I-II-III post-operative day), Red cells and Plasma transfusions, Blood count evaluation and Saturation (O2%), Postoperative analgesia (Emilia-Romagna protocol), Presence of malignant tumoral disease, APACHE Score II. Moreover the presence of some relevant genetic polymorphisms will be studied in different genes such as IL-6, IL-10, TNF-alpha, and IL-1 cluster. more...
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- 2005
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24. Lasting Prolonged-Release Tapentadol for Moderate/Severe Non-Cancer Musculoskeletal Chronic Pain
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Rita Maria Melotti, Sivia Ghedini, Alessio Vasarri, Boaz Gedaliahu Samolsky Dekel, Gianfranco Di Nino, Alberto Gori, Samolsky Dekel BG, Ghedini S, Gori A, Vasarri A, Di Nino G, and Melotti RM
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Quality of life ,medicine.medical_specialty ,Pain medicine ,Analgesic ,Long-term opioids ,Chronic pain ,Prolonged release ,medicine ,Psychiatry ,Original Research ,business.industry ,medicine.disease ,Tapentadol ,Anesthesiology and Pain Medicine ,Tolerability ,Opioid ,Musculoskeletal ,Anesthesia ,Chronicity ,Chronicity, Chronic pain, Long-term opioids, Musculoskeletal, Quality of life, Tapentadol ,Neurology (clinical) ,business ,medicine.drug - Abstract
INTRODUCTION: Despite opioids' recognized role in the treatment of moderate/severe musculoskeletal chronic pain, their long-term benefits need investigation. We explored the lasting analgesic efficacy, tolerability, influence on life quality, and chronicity stage of the novel prolonged release (PR) opioid, tapentadol, in 30 outpatients. METHODS: We evaluated patients' pain intensity and relief (Numerical Rating Scale; NRS), adverse effects, sleep quality, treatment satisfaction, health status (12-questions Health-Survey; SF-12), chronicity stage (Italian Mainz Pain-Staging System; I-MPSS) at 10, 30, 60, and 90 days after tapentadol prescription. RESULTS: At follow-ups, the investigated outcomes showed an overall statistically significant (Wilcoxon signed-rank test) improvement and remained stable over time, as did the health status and chronicity stage. Adverse effects were limited, transitory, and tolerable. CONCLUSIONS: Twelve weeks of PR tapentadol in outpatients with moderate/severe chronic musculoskeletal pain showed satisfactory analgesic efficacy and tolerability, and had a positive influence on life quality and chronicity stage. The results are robust enough to warrant a subsequent study with a larger sample and a longer observation period. PMID:25558866 more...
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- 2015
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25. Hypotension as an isolated factor may not be sufficient to provoke hearing impairment
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Raffaella Riggio, Teresa Montana, Antonio Pirodda, Gian Gaetano Ferri, Grazia Innocenti, Gianfranco Di Nino, Pirodda A., Ferri G.G., Montana T., Riggio R., Innocenti G., and Di Nino G.
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Adult ,Male ,Hearing loss ,Hearing Loss, Sensorineural ,Anesthesia, General ,Hypotension, Controlled ,Postoperative Complications ,HYPOTENSION ,otorhinolaryngologic diseases ,Humans ,Medicine ,General anaesthesia ,Postoperative Period ,SENSORINEURAL HEARING LOSS ,Adverse effect ,Intraoperative Care ,medicine.diagnostic_test ,business.industry ,General Medicine ,Oxygenation ,Middle Aged ,Blood pressure ,Otorhinolaryngology ,Sensory Thresholds ,Anesthesia ,Audiometry, Pure-Tone ,Female ,Pure tone audiometry ,medicine.symptom ,business ,Hearing function ,Controlled hypotension ,ANAESTHESIA - Abstract
Objective: We investigated the possible role of hypotension and related autonomic phenomena in the pathogenic mechanism of sudden sensorineural hearing loss.Methods: Forty-nine patients belonging to the ASA I-II classes of anaesthesiological risk and submitted to a non-otological surgical procedure were examined. Each operation was performed under general anaesthesia by controlled hypotension technique. Hearing function of the patients was evaluated before and after surgery by means of a pure tone audiometry recorded by the same clinician with the same instrument.Results: No cases of bilateral hearing worsening were recorded after surgery.Conclusions: An induced and controlled steady hypotension under general anaesthesia did not affect the hearing function of any of the patients. It may be supposed, therefore, that an adverse effect on the cochlear oxygenation is more likely to be caused by the sympathetic changes induced by a consistent decrease of blood pressure rather than to hypotension itself. more...
- Published
- 2004
- Full Text
- View/download PDF
26. Psychometric properties and validation of the Italian version of the Mainz pain staging system as a tool for pain-patients referral selection
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, DI NINO, GIANFRANCO, MELOTTI, RITA MARIA, Gori A, Vasarri A, Adversi M, Samolsky Dekel BG, Gori A, Vasarri A, Adversi M, Di Nino G, and Melotti RM
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Adult ,Aged, 80 and over ,Male ,Principal Component Analysis ,Psychometrics ,construct validity ,stratified medicine ,psychometric validation ,Reproducibility of Results ,Content validity ,Middle Aged ,factorial validity ,Italy ,internal consistency ,Humans ,Female ,MPSS ,Prospective Studies ,Chronic Pain ,Aged ,Pain Measurement - Abstract
Rationale, aims and objectivesIndications are lacking on which patient to refer to pain facilities. Pain-chronicity stage and outcome prognosis may be used for such aims. The Mainz pain-staging system (MPSS) classifies pain patients in three chronicity stages that respectively require more extensive management. We explored the psychometric and validation properties of its Italian version towards its application as screening/referral tool. MethodsI-MPSS was administered to n=120 mixed non-cancer-pain outpatients. Psychometric analyses and formal validation included: content validity, by assessing the hypothesis of an existing relationship between the I-MPSS classes and criteria derived from an operational case definition of chronic pain; construct validity, by principle component analysis (PCA); the autonomous construct of the I-MPSS was assessed by the strength of the Spearman correlation between its classes and the brief pain inventory (BPI) items; and reliability, by applying Cronbach's alpha statistics. Associations between psychosocial moderators and the I-MPSS were assessed applying (2) analyses. ResultsQuantitative and qualitative analyses showed significant differences between I-MPSS classes for health care and drug utilization; BPI item scores significantly differed between the classes; Spearman correlation between I-MPSS classes and BPI items was mostly moderate or mild. PCA and scree test identified four components accounting for 63.7% of the variance. Cronbach's alpha was 0.842. ConclusionsThe I-MPSS showed satisfactory psychometric and validation properties. With adequate feasibility, it enabled the screening of mixed non-cancer-pain outpatients in three chronicity/prognostic stages. Results are sufficient to warrant its use for a subsequent impact study as a prognostic model and screening tool for referring pain patients. more...
- Published
- 2014
27. The analgesic efficacy of continuous elastomeric pump ropivacaine wound instillation after appendectomy
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Rita Maria Melotti, Stefano Gagliardi, Morena Calli, Vanni Agnoletti, Fausto Catena, Antonella Potalivo, Dario Bettini, Mario Taffurelli, Angelo De Cataldis, Emmanuel Gasperoni, Antonio Leone, Gabriella Simoncini, Antonio Caira, Gianfranco Di Nino, Miria Celotti, Luca Ansaloni, Ansaloni L, Agnoletti V, Bettini D, Caira A, Calli M, Catena F, Celotti M, De Cataldis A, Gagliardi S, Gasperoni E, Leone A, Melotti RM, Potalivo A, Simoncini G, Taffurelli M, and Di Nino G. more...
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Visual analogue scale ,medicine.medical_treatment ,Analgesic ,Placebo ,law.invention ,Randomized controlled trial ,Double-Blind Method ,law ,medicine ,Appendectomy ,Humans ,Ropivacaine ,Prospective Studies ,Anesthetics, Local ,Prospective cohort study ,Saline ,Infusion Pumps ,Pain, Postoperative ,Local anesthetic ,business.industry ,Amides ,Surgery ,Anesthesiology and Pain Medicine ,Anesthesia ,Wounds and Injuries ,Female ,business ,medicine.drug - Abstract
Study Objective To evaluate the analgesic efficacy and safety of ropivacaine 0.2% when administered continuously via elastomeric pump after appendectomy. Design Prospective, randomized, double-blinded study. Setting Surgical ward of a university hospital. Patients 96 ASA physical status I and II patients of at least 14 years of age, undergoing appendectomy through a McBurney incision. Interventions Patients were randomly assigned into two groups: 500 mg of ropivacaine in 48 hours (10 mL of 0.2% ropivacaine 20 mg, starter dose plus 5 mL/h continuous wound infusion via elastomeric pump device; n=48) in the experimental group and 250 mL of normal saline, as placebo, in the control group. Measurements Postappendectomy pain, measured either with a simple verbal scale or with a visual analog scale, parenteral analgesic consumption, and global satisfaction were all measured. Main Results A reduction in postoperative pain was observed in the ropivacaine group. Degree of pain, with a simple verbal scale measurement of severe and unbearable, was significantly lower in the ropivacaine group than in the normal saline group from time 0 to 24 hours at rest and from time 0 to 36 hours on coughing. A significant lower pain intensity (visual analog scale) was found in the ropivacaine group both at rest and on coughing, beginning at three hours and continuing to 36 hours postoperatively. The mean number of rescue analgesic doses was significantly lower in the ropivacaine group. There were no statistically significant differences in the frequency of adverse events between the two groups. Conclusions Wound instillation with ropivacaine 0.2% is a useful, practical, and safe method for management of postoperative pain after appendectomy. more...
- Published
- 2006
28. Distorted configuration of the epidural catheter in situ. A pilot study
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, CAROSI, FRANCESCA, RINALDELLI, GIAMPAOLO, DI NINO, GIANFRANCO, Bonazzi F., Calli M., Campi S., Dal Checco E., Franceschini E., Mosca L., Samolsky Dekel B.G., Bonazzi F., Calli M., Campi S., Carosi F., Dal Checco E., Franceschini E., Mosca L., Rinaldelli G., and Di Nino G. more...
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DISTORTED CONFIGURATION ,EPIDURAL CATHETER - Published
- 2005
29. Indication for post bariatric surgery ICU admission
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, AGNOLETTI, VANNI, VALENTINI, MARIA VIOLA, DI NINO, GIANFRANCO, Celotti M., Mordini F., Moretti C., SanGiorgi F., Simoncini G., Samolsky Dekel B.G., Agnoletti V., Celotti M., Mordini F., Moretti C., SanGiorgi F., Simoncini G., Valentini MV., and Di Nino G. more...
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ICU ADMISSION ,BARIATRIC SURGERY - Published
- 2005
30. Transdermal buprenorphine in the treatment of chronic pain due to ischemic peripheral arteriopathy
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, ALBARELLO, RAFFAELLA, CAVALLO, PIERGIORGIO, DELLA VECCHIA, FAUSTINO, MINGONE, FEDERICA, PARESCHI, SILVIA, PARLAPIANO, GIAN MARCO, POTENA, LINDA, STAGNI, GAETANO, TONINI, SIMONE, DI NINO, GIANFRANCO, Samolsky Dekel B.G, Albarello R., Cavallo P., Della Vecchia F., Mingone F., Pareschi S., Parlapiano G., Potena L., Stagni G., Tonini S., and Di Nino G. more...
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ISCHEMIC PERIPHERAL ARTERIOPATHY ,TRANSDERMAL PATCH ,CHRONIC PAIN ,BUPRENORPHINE - Published
- 2005
31. Pain prevalence and predictors among inpatients in a major Italian teaching hospital. A baseline survey towards a pain free hospital
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Gianfranco Di Nino, Ennio Ricchi, Paolo Chiari, Rita Maria Melotti, Ida Di Giacinto, Boaz Gedaliahu Samolsky-Dekel, Francesca Carosi, Melotti RM., Samolsky Dekel B.G., Ricchi E., Chiari P., Di Giacinto I., Carosi F., and Di Nino G. more...
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Population ,Psychological intervention ,Pain ,PAIN PREVALENCE ,Teaching hospital ,Sex Factors ,Rating scale ,Internal medicine ,Surveys and Questionnaires ,Health care ,medicine ,Prevalence ,Humans ,Pain Management ,INPATIENT PAIN ,Young adult ,education ,Child ,Hospitals, Teaching ,PAIN PREDICTORS ,Aged ,Pain Measurement ,Quality Indicators, Health Care ,Aged, 80 and over ,education.field_of_study ,Inpatients ,Marital Status ,business.industry ,Age Factors ,Length of Stay ,Middle Aged ,Health Surveys ,Causality ,Benchmarking ,PAIN UNDERTREATMENT ,Anesthesiology and Pain Medicine ,Cross-Sectional Studies ,Italy ,Physical therapy ,Marital status ,Female ,business - Abstract
Pain prevalence among inpatients is an important indicator of quality care; it may reach over 80% in various clinical settings. A cross-sectional survey was conducted in a teaching hospital to depict benchmark data regarding pain prevalence and predictors among the entire inpatient population. Overall 892 patients, 6 years old and hospitalized for at least 24 h in 57 hospital wards were interviewed using an internationally applied questionnaire. Patients self-reported their pain intensity at the time of the interview (T(0)) and worst pain perceived during the previous 24 h (T(-1)), using a numerical rating scale (NRS) and indicated current pain duration. Specific pain predictor data (hospital stay, gender, age and marital status) were obtained from patient medical charts. Pain prevalence at T(0) was 38% and 52% at T(-1). Pain was moderate to severe (NRS4) in approximately 25% of the patients at T(0) and in 40% at T(-1). High pain prevalence was found (at T(0) and T(-1), respectively) in Radiotherapy (63%;77%), Obstetrics (68%;54%), and Surgery (59%;45%) wards. Gender was a prominent determinant as pain was significantly associated with females. Pain prevalence was high among young adults or divorced/separated individuals and low among pediatric patients ( approximately 20%). Protracted hospitalization and prolonged pain duration were associated with major pain severity. Results yield Quality Assurance interventions to ameliorate pain undertreatment. Predictor analysis suggests that attention should be paid to pain management in young adults, socially vulnerable patients and those with protracted hospitalization and pain. more...
- Published
- 2004
32. Pain assessment concordance in a major italian teaching hospital
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, MELOTTI, RITA MARIA, AGNOLETTI, VANNI, DI NINO, GIANFRANCO, Samolsky Dekel B.G., Melotti R.M, Agnoletti V., and Di Nino G.
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PAIN ASSESSMENT ,PAIN RATING CONCORDANCE ,TEACHING HOSPITAL - Published
- 2004
33. Anaesthesiological management of patients undergoing laparoscopic procedures
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DI NINO, GIANFRANCO, SAMOLSKY DEKEL, BOAZ GEDALIAHU, AGNOLETTI, VANNI, Di Nino G., Samolsky Dekel B.G., and Agnoletti V.
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ANAESTHESIOLOGICAL MANAGEMENT ,LAPAROSCOPIC PROCEDURES - Published
- 2004
34. La congruenza nella valutazione del dolore nei pazienti ospedalizzati
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SAMOLSKY DEKEL, BOAZ GEDALIAHU, MELOTTI, RITA MARIA, CAROSI, FRANCESCA, DI NINO, GIANFRANCO, Di Giacinto I., Poggi P. P, Samolsky Dekel B.G., Melotti R.M, Carosi F., Di Giacinto I., Poggi P.P, and Di Nino G. more...
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PAZIENTI OSPEDALIZZATI ,CONGRUENZA ,INFERMIERI ,VALUTAZIONE DEL DOLORE ,SCALE DOLORE - Published
- 2004
35. La formazione in tema di dolore nelle scuole di specializzazione dell’Universita’ di Bologna
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CAROSI, FRANCESCA, MELOTTI, RITA MARIA, SAMOLSKY DEKEL, BOAZ GEDALIAHU, DI NINO, GIANFRANCO, Di Giacinto I., Carosi F., Melotti RM., Samolsky Dekel B.G., Di Giacinto I., and Di Nino G.
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FORMAZIONE ,DOLORE ,SCUOLE DI SPECIALIZZAZIONE - Published
- 2004
36. Proteolytic activity of bovine lactoferrin
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Maria Teresa, Massucci, Francesco, Giansanti, Giovanna, Di Nino, Manola, Turacchio, Maria Federica, Giardi, Dario, Botti, Rodolfo, Ippoliti, Beatrice, De Giulio, Barbara, De Giulio, Rosa Anna, Siciliano, Rosa, Siciliano, Giovanna, Donnarumma, Piera, Valenti, Alessio, Bocedi, Fabio, Polticelli, Paolo, Ascenzi, Giovanni, Antonini, Massucci, Mt, Giansanti, F, DI NINO, G, Turacchio, M, Giardi, Mf, Botti, D, Ippoliti, R, DE GIULIO, B, Siciliano, Ra, Donnarumma, G, Valenti, P, Bocedi, A, Polticelli, Fabio, Ascenzi, Paolo, Antonini, Giovanni, MARIA TERESA, Massucci, Francesco, Giansanti, GIOVANNA DI, Nino, Manola, Turacchio, MARIA FEDERICA, Giardi, Dario, Botti, Rodolfo, Ippoliti, BARBARA DE, Giulio, Rosa, Siciliano, Giovanna, Donnarumma, Piera, Valenti, Alessio, Bocedi, Siciliano, R, Donnarumma, Giovanna, Polticelli, F, Ascenzi, P, and Antonini, G. more...
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LPS ,Hydrolases ,Cleavage (embryo) ,autoproteolysis ,iron ,lactoferrin ,Chromatography, Affinity ,General Biochemistry, Genetics and Molecular Biology ,Biomaterials ,Hydrolysis ,chemistry.chemical_compound ,Bovine lactoferrin ,Serine ,medicine ,Animals ,Humans ,Enzyme kinetics ,biology ,Chemistry ,Lactoferrin ,Metals and Alloys ,Active site ,Substrate (chemistry) ,Trypsin ,Molecular Weight ,natural immunity ,Biochemistry ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,proteolytic activity ,biology.protein ,Cattle ,PMSF ,General Agricultural and Biological Sciences ,medicine.drug - Abstract
Bovine lactoferrin catalyzes the hydrolysis of synthetic substrates (i.e., Z-aminoacyl-7-amido-4-methylcoumarin). Values of Km and kcat for the bovine lactoferrin catalyzed hydrolysis of Z-Phe-Arg-7-amido-4-methylcoumarin are 50 microM and 0.03 s(-1), respectively, the optimum pH value is 7.5 at 25 degrees C. The bovine lactoferrin substrate specificity is similar to that of trypsin, while the hydrolysis rate is several orders of magnitude lower than that of trypsin. The bovine lactoferrin catalytic activity is irreversibly inhibited by the serine-protease inhibitors PMSF and Pefabloc. Moreover, both iron-saturation of the protein and LPS addition strongly inhibit the bovine lactoferrin activity. Interestingly, bovine lactoferrin undergoes partial auto-proteolytic cleavage at positions Arg415-Lys416 and Lys440-Lys441. pKa shift calculations indicate that several Ser residues of bovine lactoferrin display the high nucleophilicity required to potentially catalyze substrate cleavage. However, a definitive identification of the active site awaits further studies. more...
- Published
- 2004
37. Aneurismi toraco-addominali di IV tipo
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STELLA, ANDREA, PARAGONA, ORESTE, FREYRIE, ANTONIO, FAGGIOLI, GIANLUCA, KAPELJ, STEFANIA, DI NINO, GIANFRANCO, Spagnolo C., D’addato M., Stella A., Paragona O., Freyrie A., Faggioli G., Kapelj S., Spagnolo C., Di Nino G., and D’addato M. more...
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ANEURISMI TORACO-ADDOMINALI DI IV TIPO - Published
- 2004
38. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol
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Rabbih Chattat, Claudio Franceschi, Fausto Catena, Stefano Gagliardi, Luca Ansaloni, Vanni Agnoletti, Mario Taffurelli, Gianfranco Di Nino, Angelo De Cataldis, Rita Maria Melotti, Antonella Potalivo, Agnoletti V., Ansaloni L., Catena F., Chattat R., De Cataldis A., Di Nino G., Franceschi C., Gagliardi S., Melotti R.M, Potalivo A., and Taffurelli M. more...
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Research design ,medicine.medical_specialty ,lcsh:Surgery ,MEDLINE ,ELECTIVE SURGERY ,Study Protocol ,Cognition ,Postoperative Complications ,Clinical Protocols ,Risk Factors ,EMERGENCY SURGERY ,mental disorders ,medicine ,Humans ,Postoperative delirium ,Elective surgery ,POSTOPERATIVE DELIRIUM ,Intensive care medicine ,Aged ,Aged, 80 and over ,business.industry ,Incidence (epidemiology) ,Case-control study ,Delirium ,lcsh:RD1-811 ,General Medicine ,Surgery ,Research Design ,Case-Control Studies ,medicine.symptom ,business - Abstract
Background Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state) is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. Design All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium) and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium). Our exposures are the following: ASA, Pain (SVS; VAS), Blood gas analysis (pH; Hb; pO2; pCO2), Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates), Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma Scale (GCS), Cognitive state (SPMSQ), Functional state (ADL and IADL), Psychological Distress (HADS), Cumulative Illness Rating Scale (CIRS), Hypotension (classified in: light; moderate and severe and duration), Blood loss (classified in: < 2 lt and > 2 lt), Blood transfusions (< 2 lt and > 2 lt), Quantity of red cells and plasma transfusions, Visual VAS / SVS (timing: I-II-III post-operative day), Red cells and Plasma transfusions, Blood count evaluation and Saturation (O2%), Postoperative analgesia (Emilia-Romagna protocol), Presence of malignant tumoral disease, APACHE Score II. Moreover the presence of some relevant genetic polymorphisms will be studied in different genes such as IL-6, IL-10, TNF-alpha, and IL-1 cluster. more...
- Published
- 2005
39. Dialyzability of Oxycodone and Its Metabolites in Chronic Noncancer Pain Patients with End-Stage Renal Disease.
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Samolsky Dekel BG, Donati G, Vasarri A, Croci Chiocchini AL, Gori A, Cavallari G, Di Nino G, Mercolini L, Protti M, Mandrioli R, Melotti RM, and La Manna G
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- Adult, Analgesics, Opioid therapeutic use, Chronic Disease, Chronic Pain drug therapy, Female, Humans, Kidney Failure, Chronic complications, Kidney Failure, Chronic drug therapy, Male, Middle Aged, Morphinans blood, Oxycodone therapeutic use, Oxymorphone blood, Analgesics, Opioid blood, Oxycodone blood, Renal Dialysis
- Abstract
Objectives: Opioids are the preferred analgesic drugs to treat severe chronic pain conditions among dialysis patients; however, knowledge about their dialyzability features is limited. Oxycodone is increasingly used for the treatment of chronic pain conditions as oral controlled release (CR) tablets; however, evidence about this drug and its metabolites' dialyzability is lacking., Methods: We assessed, during 4-hour dialysis sessions, the effect of standard hemodialysis (HD) and online hemodiafiltration (HDF) methods on the plasma concentration of oxycodone and its metabolites in n = 20 chronic pain patients with end-stage renal disease who were stably treated with oral CR oxycodone. Chromatographic techniques were used to evaluate the studied compounds' plasma concentrations at three different time points during dialysis., Results: Mean plasma concentrations of oxycodone and noroxycodone in the sample showed an overall reduction trend over time, but it was less enhanced for noroxycodone. Mean reduction in oxycodone and noroxycodone arterial concentrations was significant and higher with HDF (54% and 27%, respectively) than with HD (22% and 17%, respectively). Analysis of the regression of these compounds' clearance on their increasing arterial concentration showed a more stable and linear clearance prediction with HDF (roughly 85 mL/min); with HD, for increasing arterial concentration, clearance of oxycodone decreased while noroxycodone clearance increased., Discussion: While no oxymorphone or noroxymorphone metabolites were detected, limited dialyzability of oxycodone and noroxycodone was documented along with insignificant postdialysis pain increment. This evidence will contribute toward considerations as to the safety of the use of oxycodone in dialysis patients in the future., (© 2016 World Institute of Pain.) more...
- Published
- 2017
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40. Development, validation and psychometric properties of a diagnostic/prognostic tool for breakthrough pain in mixed chronic-pain patients.
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Samolsky Dekel BG, Remondini F, Gori A, Vasarri A, Di Nino G, and Melotti RM
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- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Principal Component Analysis methods, Prognosis, Prospective Studies, Psychometrics, Reproducibility of Results, Surveys and Questionnaires standards, Young Adult, Breakthrough Pain diagnosis, Breakthrough Pain epidemiology, Chronic Pain diagnosis, Chronic Pain epidemiology, Pain Measurement methods, Pain Measurement standards
- Abstract
Background/objective: Breakthrough pain (BTP) shows variable prevalence in different clinical contexts of cancer and non-cancer patients. BTP diagnostic tools with demonstrated reliability, validation and prognostic capability are lacking. We report the development, psychometric and validation properties of a diagnostic/prognostic tool, the IQ-BTP, for BTP recognition, its likelihood and clinical features among chronic-pain (CP) patients., Patients: n=120 consecutive mixed cancer/non-cancer CP in/outpatients. Development, psychometric analyses and formal validation included: Face/Content validity (by 'experts' opinion and assessing the relationship between the IQ-BTP classes and criteria derived from BTP operational-case-definition); Construct validity, by Principle Component Analysis (PCA); and the strength of Spearman correlation between IQ-BTP classes and the Brief Pain Inventory (BPI) items; Reliability, by Cronbach's alpha statistics. Associations with clinical/demographic moderators were assessed applying χ(2) analysis., Results: Potential-BTP was found in 36.7% of patients (38.4% of non-cancer and 32.4% of cancer patients). Among these the likelihood for BTP diagnosis was 'high' in 25%, 'intermediate' in 41% and, 'low' 34% of patients. Analyses showed significant differences between IQ-BTP classes and between the latter BPI pain-item scores. Correlation between IQ-BTP classes and BPI items was moderate. PCA and scree test identified 3 components accounting for 62.3% of the variance. Cronbach's alpha was 0.71., Conclusions: The IQ-BTP showed satisfactory psychometric and validation properties. With adequate feasibility it enabled the allocating of cancer/non-cancer CP patients in three prognostic classes. Results are sufficient to warrant a subsequent impact study of the IQ-BTP as prognostic model and screening tool for BTP in both CP populations., (Copyright © 2016 Elsevier B.V. All rights reserved.) more...
- Published
- 2016
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41. Medical Evidence Influence on Inpatients and Nurses Pain Ratings Agreement.
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Samolsky Dekel BG, Gori A, Vasarri A, Sorella MC, Di Nino G, and Melotti RM
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- Analgesics classification, Analgesics therapeutic use, Awareness, Female, Humans, Male, Nurse-Patient Relations, Pain drug therapy, Pain etiology, Time Factors, Inpatients, Nurses psychology, Nursing Diagnosis, Pain diagnosis, Pain Measurement methods, Self Report
- Abstract
Biased pain evaluation due to automated heuristics driven by symptom uncertainty may undermine pain treatment; medical evidence moderators are thought to play a role in such circumstances. We explored, in this cross-sectional survey, the effect of such moderators (e.g., nurse awareness of patients' pain experience and treatment) on the agreement between n = 862 inpatients' self-reported pain and n = 115 nurses' pain ratings using a numerical rating scale. We assessed the mean of absolute difference, agreement (κ-statistics), and correlation (Spearman rank) of inpatients and nurses' pain ratings and analyzed congruence categories' (CCs: underestimation, congruence, and overestimation) proportions and dependence upon pain categories for each medical evidence moderator (χ (2) analysis). Pain ratings agreement and correlation were limited; the CCs proportions were further modulated by the studied moderators. Medical evidence promoted in nurses overestimation of low and underestimation of high inpatients' self-reported pain. Knowledge of the negative influence of automated heuristics driven by symptoms uncertainty and medical-evidence moderators on pain evaluation may render pain assessment more accurate. more...
- Published
- 2016
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42. The influence of medical evidence moderators on pain rating agreement between inpatients and nurses.
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Samolsky Dekel BG, Gori A, Vasarri A, Sorella C, Di Nino G, and Melotti RM
- Published
- 2015
43. Pre-Operative, High-IL-6 Blood Level is a Risk Factor of Post-Operative Delirium Onset in Old Patients.
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Capri M, Yani SL, Chattat R, Fortuna D, Bucci L, Lanzarini C, Morsiani C, Catena F, Ansaloni L, Adversi M, Melotti MR, Di Nino G, and Franceschi C
- Abstract
Background: Post-operative delirium (POD) is a common complication in elderly patients undergoing surgery, but the underpinning causes are not clear. We hypothesized that inflammaging, the subclinical low and chronic grade inflammation characteristic of old people, can contribute to POD onset. Accordingly, we investigated the association of pre-operative and circulating cytokines in elderly patients (>65 years), admitted for elective and emergency surgery., Methods: This is a secondary analysis of a sub-cohort of patients belonging to a previous large case-control study, where 351 patients were clinically and cognitively thoroughly characterized, together with the assessment of POD (47 patients) by confusion assessment method and delirium rating scale. Seventy-four pre-operative plasma samples were selected from a larger bio-bank and they included 37 subjects with POD and 37 without POD. Inflammaging related cytokines, i.e., IL-1β, IL-2, IL-6, IL-8, IL-10, and TNF-α, were assayed by ELISA in pre-operative blood samples; univariate and multivariable analyses have been applied to identify cytokines independently associated to POD. Associations of cytokine levels with functional status, cognitive decline, intra-hospital mortality, and comorbidity were also analyzed independently of POD onset., Results: High IL-6 and low-IL-2 levels were significantly associated with POD. After adjustment for potential confounders in multivariate analysis, high level of pre-operative IL-6 was confirmed to be significantly associated with risk of POD onset. High level of IL-6 was also associated with several baseline features (including poor functional status, cognitive impairment, emergency admission, and higher comorbidity burden) and intra-hospital mortality., Conclusion: Pre-operative, high-plasma level of IL-6 (≥9 pg/mL) was significantly associated with POD onset. We propose IL-6 as an additional risk factor of POD onset together with the previously identified factors. Discovery of all risk factors contributing to POD onset will permit to improve hospitalized patient management and the decrease of healthcare cost. more...
- Published
- 2014
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44. Opioid titration with sustained-release oxycodone and immediate-release morphine for moderate/severe cancer pain: a pilot assessment of the CoDem protocol.
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Samolsky Dekel BG, Tomasi M, Vasarri A, Gori A, Adversi M, Castagnoli A, Di Nino G, and Melotti RM
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- Adult, Aged, Chemistry, Pharmaceutical, Delayed-Action Preparations, Female, Humans, Male, Middle Aged, Morphine adverse effects, Oxycodone adverse effects, Pilot Projects, Retrospective Studies, Analgesics, Opioid administration & dosage, Morphine administration & dosage, Neoplasms physiopathology, Oxycodone administration & dosage, Pain, Intractable drug therapy
- Abstract
Objectives: Opioid titration is the first challenging stage for rapid control of moderate/severe cancer pain. Evidence shows that sustained-release formulations may be used for opioid titration. We set a pilot assessment of the efficacy and tolerability of our in-house protocol (continuous and on demand opioids [CoDem]) of the association of sustained-release oxycodone and immediate-release morphine as rescue dose for opioid titration/rotation in opioid-naïve (NAOP, n = 13), tolerant to weak (WOP, n = 20), or strong opioids (STOP, n = 44) in-patients with moderate/severe cancer pain., Methods: Observational and retrospective analysis of cancer in-patients treated for ≥7 days with the CoDem protocol., Outcome Measures: Pain intensity (patients self-reported pain with numerical rating scale [NRS] under static [NRSs] and dynamic [NRSd] conditions), amount of drug consumption, opioid adverse effects, and patient satisfaction., Efficacy Endpoints: In more than 50 percent of the patients and in <72 hours, steady NRSs and NRSd score reduction of at least two points, NRSs ≤ 3 and NRSd ≤4; and mean daily morphine consumption < mean of one rescue dose and t1:t6 ratio of mean oxycodone daily dose < 1:2., Results: Endpoints were reached within 24 hours both within the sample and subgroups. Only NAOP patients reached NRSd ≤ 4 endpoint within 48 hours. Against moderate and transient adverse effects, most patients (84.4 percent) found pain treatment to be good or excellent., Conclusions: The CoDem protocol was shown to be effective and reasonably tolerated for titration for moderate/severe cancer pain relief in both opioid-naïve or opioid-tolerant cancer in-patients. This pilot assessment warrants prospective and comparative studies with larger samples for more generalized results. more...
- Published
- 2014
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45. Time course of proadrenomedullin in the early phase of septic shock. A comparative study with other proinflammatory proteins.
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Pezzilli R, Barassi A, Pigna A, Morselli-Labate AM, Imbrogno A, Fabbri D, Di Nino G, Corinaldesi R, and Melzi D'Eril G
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- Acute-Phase Proteins metabolism, Adrenomedullin blood, Adult, Aged, Aged, 80 and over, Area Under Curve, C-Reactive Protein biosynthesis, Calcitonin blood, Calcitonin Gene-Related Peptide, Female, Ferritins blood, Humans, Inflammation, Interleukin-6 blood, Male, Middle Aged, Prognosis, Protein Precursors blood, Sensitivity and Specificity, Time Factors, Adrenomedullin biosynthesis, Protein Precursors biosynthesis, Shock, Septic metabolism
- Abstract
Aim: It has been shown that pro-adrenomedullin is a good marker of the severity of septic shock but there are no data on the early changes in serum pro-adrenomedullin concentrations in patients with shock., Methods: Twenty-one patients with septic shock and 21 healthy subjects studied as controls. Serum concentrations of pro-adrenomedullin, procalcitonin, ferritin, CRP and IL-6 were determined in all subjects at the initial observation. Patients with septic shock were also studied after 24 and 48 hours., Results: The concentrations of the acute phase proteins were significantly higher in patients with septic shock than in the control subjects during the entire study period (P<0.001). Only procalcitonin significantly decreased on the third day of observation with respect to both the first day (P=0.002) and the second day (P=0.006). Proadrenomedullin (P=0.017) and IL-6 (P=0.001) showed an AUC significantly different from the null hypothesis in differentiating the patients who survived and those who did not. The sensitivity and specificity of pro-adrenomedullin in the assessment of death were 71.4% and 72.7%, respectively, while IL-6 had a sensitivity of 92.9% and a specificity of 60.6%., Conclusion: Proadrenomedullin is a reliable prognostic marker in patients with shock; further studies on a more consistent number of septic patients will definitively assess whether proadrenomedullin may replace the current prognostic markers in critically ill patients with shock due to sepsis. more...
- Published
- 2012
46. Peri-operative risk management in patients with Alzheimer's disease.
- Author
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Di Nino G, Adversi M, Samolsky Dekel BG, Fodale V, Rosa G, and Melotti RM
- Subjects
- Aged, Alzheimer Disease psychology, Amyloid beta-Peptides biosynthesis, Anesthesia, Anesthetics adverse effects, Animals, Cognition Disorders diagnosis, Cognition Disorders psychology, Delirium diagnosis, Delirium psychology, Guidelines as Topic, Humans, Hypothermia prevention & control, Intraoperative Care, Neuropsychological Tests, Nutritional Status, Personal Autonomy, Postoperative Care, Postoperative Complications psychology, Respiration, Artificial, Alzheimer Disease complications, Perioperative Care methods, Risk Management methods
- Abstract
The aim of this review is to identify an evidence-based perioperative management for patients affected by Alzheimer's disease (AD) that are scheduled to undergo surgery. This will minimize the negative effects of anesthesia and postoperative sedation and correct those perioperative variables possibly responsible for a decline in cognitive status and a worsening of AD. We here gather evidence on the importance of correct preoperative assessment regarding cognitive and functional status and the presence of preoperative delirium. The potential role of anesthesia, surgery, and postoperative analgosedation as risk factors for development of delirium are herein outlined. Finally, pain assessment instruments, as well as principles of management strategies for postoperative delirium in subjects with AD, are suggested. more...
- Published
- 2010
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47. Cholinergic central system, Alzheimer's disease, and anesthetics liaison: a vicious circle?
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Schifilliti D, Santamaria LB, Rosa G, Di Nino G, Mandal PK, and Fodale V
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- Aged, Anesthesia adverse effects, Autonomic Nervous System Diseases chemically induced, Autonomic Nervous System Diseases pathology, Humans, Alzheimer Disease pathology, Anesthetics adverse effects, Parasympathetic Nervous System drug effects, Parasympathetic Nervous System pathology
- Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the accumulation and aggregation of amyloid-β peptide and loss of forebrain cholinergic neurons, resulting in progressive loss of memory and irreversible impairment of higher cognitive functions. Several studies have accounted for the close relationship between AD and the central cholinergic system, suggesting that a dysfunction of acetylcholine containing neurons in the brain contributes significantly to the cognitive deficit of individuals with AD. The aim of the present review is to survey current literature on this topic in order to provide a clear understanding of the role of the cholinergic system in the development and neurodegenerative process of AD. The implications for anesthesia are also discussed. This knowledge could be valuable to improve anesthesia performance and patient safety. more...
- Published
- 2010
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48. Postoperative cognitive dysfunction: toward the Alzheimer's disease pathomechanism hypothesis.
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Bilotta F, Doronzio A, Stazi E, Titi L, Fodale V, Di Nino G, and Rosa G
- Subjects
- Aged, Alzheimer Disease pathology, Anesthesia Recovery Period, Chronic Disease, Cognition Disorders pathology, Delirium pathology, Delirium psychology, Humans, Nervous System pathology, Postoperative Complications pathology, Alzheimer Disease psychology, Cognition Disorders psychology, Postoperative Complications psychology
- Abstract
Alzheimer's disease (AD), a chronic and progressive deterioration of memory and other cognitive domains, is the most common form of dementia. Because of related health and social impact, there is growing interest in assessing potential relationship between anesthesia and the onset and progression of chronic neurodegenerative disorders, including AD. Currently, preclinical and clinical research is addressed to identify underlying pathomechanisms, patient risk factors, and the use of the least provocative drugs and techniques, to minimize the incidence of chronic neurodegenerative disorders. Preclinical studies are providing an increasing body of evidences on some of the mechanisms that link anesthetics to neuronal programmed cell death (apoptosis) and accumulation of misfolded proteins in the aging brain. Therefore, risk factors and pathomechanisms of chronic neurodegenerative disorders, including AD, and persistent postoperative-postanesthesia cognitive dysfunction may overlap. more...
- Published
- 2010
- Full Text
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49. Categories of congruence between inpatient self-reported pain and nurses evaluation.
- Author
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Melotti RM, Samolsky Dekel BG, Carosi F, Ricchi E, Chiari P, D'Andrea R, and Di Nino G
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Attitude of Health Personnel, Child, Cross-Sectional Studies, Female, Health Surveys, Humans, Italy, Length of Stay, Male, Middle Aged, Models, Nursing, Nursing Assessment, Nursing Diagnosis, Nursing Evaluation Research, Nursing Staff, Hospital, Observer Variation, Outcome Assessment, Health Care, Pain diagnosis, Patient Satisfaction, Psychiatric Status Rating Scales, Severity of Illness Index, Sex Distribution, Surveys and Questionnaires, Young Adult, Nurse-Patient Relations, Pain nursing, Pain psychology, Pain Measurement nursing, Pain Measurement psychology, Self-Assessment
- Abstract
Objective: To enhance the awareness that biased pain estimation may undermine its treatment, we sought to determine the congruence categories (CCs) between inpatient self-reported pain (PSRP) and nurse pain-evaluation (NEP) and to look for associations between CCs and inpatient and situational moderators., Design: A point cross-sectional survey., Subjects: The inpatient population [(n=869), > or = 6 years old and hospitalised for at least 24h] and n=115 nurses of the University of Bologna's teaching hospital, Italy., Measures: Using numerical rating scale, inpatients self-reported their pain while nurses indirectly rated these patients' pain using information acquired during their professional activity prior to the study and by reviewing patients' medical charts., Outcome Measures: Congruence moderator data were: gender, age, marital status, clinical area and length of hospital stay. The study was set to assess: PSRP-NEP mean of absolute difference (MAD), agreement and correlation; and to analyse the CCs dependence upon the PSRP and the congruence moderator variables., Results: PSRP-NEP agreement and correlation were mild and moderate, respectively, while their MAD=2.0 (95% CI 1.8-2.2). Congruence was found in 50% of the cases. Under-estimation (21%) was directly proportional to the PSRP severity, while congruence and over-estimation (29%) were inversely proportional to it. The 'PSRP effect' on the CCs detected was further modulated by the moderators studied., Conclusions: PSRP-NEP congruence was limited while CCs were associated with PSRP, inpatient and situational moderators. Further prospective studies are needed to verify generalization and whether the studied moderators operate through patient stereotyping mechanisms. Awareness of the influence of such mechanisms on pain evaluation may ameliorate pain assessment. more...
- Published
- 2009
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50. Wernicke's encephalopathy and pancreatic encephalopathy after necrotic-hemorrhagic pancreatitis. A case report.
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Zangheri E, Pigna A, Amanti E, D'Alessandro R, Bova F, Melotti RM, and Di Nino G
- Subjects
- Adult, Electroencephalography, Hemorrhage complications, Humans, Male, Tomography, X-Ray Computed, Brain Diseases etiology, Pancreatitis, Acute Necrotizing complications, Wernicke Encephalopathy etiology
- Abstract
This case report describes a case of acute necrotic-hemorrhagic pancreatitis complicated by Wernicke's encephalopathy (WE) and stresses the importance of a correct dietetic regimen. A 39-year-old Chinese male patient with negative remote pathological anamnesis was hospitalized in the Medical Department with a diagnosis of gallstones. The clinical course was complicated with the onset of acute pancreatitis. Enteral fasting was imposed with intravenous feeding without vitamin supplementation. The progressive worsening of the clinical, radiodiagnostic and laboratory profile combined with deterioration in the state of consciousness promoted, on the 36th day exploratory laparotomy revealed necrotic-hemorrhagic pancreatitis. The patient was, therefore, admitted to the Intensive Care Unit in a deep coma. The recent medical history, neurological examination, and encephalic computed tomography suggested a revealing diagnosis of WE combined with pancreatic encephalopathy. more...
- Published
- 2009
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