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3. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Author

Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, A. Tarasconi, M. Sella, S. Auriemma, G. Paternò, G. Faggian, C. Lucarelli, N. De Grazia, C. Alberto, A. Margola, L. Porcella, I. Nardiello, E. Chimenti, M. Zeni, A. Giani, S. Famularo, E. Romairone, C. Minaglia, C. Ceccotti, G. Guerra, G. Mantovani, F. Monacelli, T. Candiani, A. Ballestrero, F. Santolini, M. Rosso, V. Bono, S. Sibilla, P. Dal Santo, M. Ceci, P. Barone, T. Schirinzi, A. Formenti, G. Nastasi, G. Isaia, D. Gonella, A. Battuello, S. Casson, D. Calvani, F. Boni, A. Ciaccio, R. Rosa, G. Sanna, S. Manfredini, L. Cortese, M. Rizzo, R. Prestano, A. Greco, M. Lauriola, G. Gelosa, V. Piras, M. Arena, D. Cosenza, A. Bellomo, M. LaMontagna, L. Gabbani, L. Lambertucci, S. Perego, G. Parati, G. Basile, V. Gallina, G. Pilone, C. Giudice, F. De, L. Pietrogrande, B. De, M. Mosca, I. Corazzin, P. Rossi, V. Nunziata, F. D'Amico, A. Grippa, S. Giardini, R. Barucci, A. Cossu, L. Fiorin, M. Distefano, M. Lunardelli, M. Brunori, I. Ruffini, E. Abraham, A. Varutti, E. Fabbro, A. Catalano, G. Martino, D. Leotta, A. Marchet, G. Dell'Aquila, A. Scrimieri, M. Davoli, M. Casella, A. Cartei, G. Polidori, D. Brischetto, S. Motta, R. Saponara, P. Perrone, G. Russo, D. Del, C. Car, T. Pirina, S. Franzoni, A. Cotroneo, F. Ghiggia, G. Volpi, C. Menichetti, M. Bo, A. Panico, P. Calogero, G. Corvalli, M. Mauri, E. Lupia, R. Manfredini, F. Fabbian, A. March, M. Pedrotti, M. Veronesi, E. Strocchi, C. Borghi, A. Bianchetti, A. Crucitti, V. DiFrancesco, G. Fontana, L. Bonanni, F. Barbone, C. Serrati, G. Ballardini, M. Simoncelli, G. Ceschia, C. Scarpa, R. Brugiolo, S. Fusco, T. Ciarambino, C. Biagini, E. Tonon, M. Porta, D. Venuti, M. DelSette, M. Poeta, G. Barbagallo, G. Trovato, A. Delitala, P. Arosio, F. Reggiani, G. Zuliani, B. Ortolani, E. Mussio, A. Girardi, A. Coin, G. Ruotolo, A. Castagna, M. Masina, R. Cimino, A. Pinciaroli, G. Tripodi, U. Cannistrà, F. Cassadonte, M. Vatrano, L. Scaglione, P. Fogliacco, C. Muzzuilini, F. Romano, A. Padovani, L. Rozzini, A. Cagnin, F. Fragiacomo, G. Desideri, E. Liberatore, A. Bruni, G. Orsitto, M. Franco, L. Bonfrate, M. Bonetto, N. Pizio, G. Magnani, G. Cecchetti, A. Longo, V. Bubba, L. Marinan, M. Cotelli, M. Turla, M. Sessa, L. Abruzzi, G. Castoldi, D. LoVetere, C. Musacchio, M. Novello, A. Cavarape, A. Bini, A. Leonardi, F. Seneci, W. Grimaldi, F. Fimognari, V. Bambara, A. Saitta, F. Corica, M. Braga, E. Ettorre, C. Camellini, G. Bellelli, G. Annoni, A. Marengoni, A. Crescenzo, G. Noro, R. Turco, M. Ponzetto, L. Giuseppe, B. Mazzei, G. Maiuri, D. Costaggiu, R. Damato, M. Formilan, G. Patrizia, M. Gallucci, M. Paragona, P. Bini, D. Modica, C. Abati, M. Clerici, I. Barbera, F. NigroImperiale, A. Manni, C. Votino, C. Castiglioni, M. Di, M. Degl'Innocenti, G. Moscatelli, S. Guerini, C. Casini, D. Dini, E. D'Imporzano, S. DeNotariis, F. Bonometti, C. Paolillo, A. Riccardi, A. Tiozzo, M. DiBari, S. Vanni, A. Scarpa, D. Zara, P. Ranieri, M. Alessandro, F. Di, D. Pezzoni, C. Platto, V. D'Ambrosio, C. Ivaldi, P. Milia, F. DeSalvo, C. Solaro, M. Strazzacappa, M. Cazzadori, S. Confente, M. Grasso, E. Troisi, V. Guerini, B. Bernardini, C. Corsini, S. Boffelli, A. Filippi, K. Delpin, B. Faraci, E. Bertoletti, M. Vannucci, F. Tesi, P. Crippa, A. Malighetti, D. Bettini, F. Maltese, G. Abruzzese, D. Cosimo, M. Azzini, M. Colombo, G. Procino, S. Fascendini, F. Barocco, P. Del, A. Mazzone, E. Riva, D. Dell'Acqua, M. Cottino, G. Vezzadini, S. Avanzi, C. Brambilla, S. Orini, F. Sgrilli, A. Mello, L. Lombardi, E. Muti, B. Dijk, S. Fenu, C. Pes, P. Gareri, M. Passamonte, R. Rigo, L. Locusta, L. Caser, G. Rosso, S. Cesarini, R. Cozzi, C. Santini, P. Carbone, I. Cazzaniga, R. Lovati, A. Cantoni, P. Ranzani, D. Barra, G. Pompilio, S. Dimori, S. Cernesi, C. Riccò, F. Piazzolla, E. Capittini, C. Rota, F. Gottardi, L. Merla, A. Barelli, A. Millul, G. De, G. Morrone, M. Bigolari, M. Macchi, F. Zambon, C. Pizzorni, G. DiCasaleto, G. Menculini, M. Marcacci, G. Catanese, D. Sprini, T. DiCasalet, M. Bocci, S. Borga, P. Caironi, C. Cat, E. Cingolani, L. Avalli, G. Greco, G. Citerio, L. Gandini, G. Cornara, R. Lerda, L. Brazzi, F. Simeone, M. Caciorgna, D. Alampi, S. Francesconi, E. Beck, B. Antonini, K. Vettoretto, M. Meggiolaro, E. Garofalo, S. Notaro, R. Varutti, F. Bassi, G. Mistraletti, A. Marino, R. Rona, E. Rondelli, I. Riva, A. Scapigliati, A. Cortegiani, F. Vitale, L. Pistidda, R. D'Andrea, L. Querci, P. Gnesin, M. Todeschini, M. Lugano, G. Castelli, M. Ortolani, A. Cotoia, S. Maggiore, L. DiTizio, R. Graziani, I. Testa, E. Ferretti, C. Castioni, F. Lombardi, R. Caserta, M. Pasqua, S. Simoncini, F. Baccarini, M. Rispoli, F. Grossi, L. Cancelliere, M. Carnelli, F. Puccini, G. Biancofiore, A. Siniscalchi, C. Laici, E. Mossello, M. Torrini, G. Pasetti, S. Palmese, R. Oggioni, V. Mangani, S. Pini, M. Martelli, E. Rigo, F. Zuccalà, A. Cherri, R. Spina, I. Calamai, N. Petrucci, A. Caicedo, F. Ferri, P. Gritti, N. Brienza, R. Fonnesu, M. Dessena, G. Fullin, D. Saggioro, Morandi, A, Inzitari, M, Udina, C, Gual, N, Mota, M, Tassistro, E, Andreano, A, Cherubini, A, Gentile, S, Mossello, E, Marengoni, A, Olivé, A, Riba, F, Ruiz, D, de Jaime, E, Bellelli, G, Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, Italian Study Group of Delirium, Claudio Borghi, Morandi, Alessandro, Inzitari, Marco, Udina, Cristina, Gual, Neu, Mota, Miriam, Tassistro, Elena, Andreano, Anita, Cherubini, Antonio, Gentile, Simona, Mossello, Enrico, Marengoni, Alessandra, Olivé, Anna, Riba, Francesc, Ruiz, Domingo, de Jaime, Elisabet, Bellelli, Giuseppe, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, G Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, E D'Imporzano, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D'Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
medicine.medical_specialty, Activities of daily living, Cross-sectional study, Hearing loss, medicine.medical_treatment, Visual impairment, Psychological intervention, visual impairment, Socio-culturale, behavioral disciplines and activities, Hearing impairment, delirium, older, sensory deficits, visual impairment, sensory deficit, Hearing impairment, 03 medical and health sciences, delirium, older, sensory deficits, 0302 clinical medicine, Risk Factors, Activities of Daily Living, mental disorders, medicine, Humans, Dementia, 030212 general & internal medicine, LS4_4, Hearing Loss, General Nursing, Rehabilitation, business.industry, Health Policy, General Medicine, medicine.disease, nervous system diseases, Cross-Sectional Studies, Italy, Emergency medicine, Delirium, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

Published
2021

4. Persistence of Central Venous Oxygen Desaturation During Early Sepsis Is Associated With Higher Mortality

Author

Pietro Caironi, Serge Masson, Roberto Latini, G. Pasetti, Gianni Tognoni, Marilena Romero, Luciano Gattinoni, Carla Pessina, Alessandro Protti, Antonio Pesenti, and Roberto Fumagalli

Subjects
Pulmonary and Respiratory Medicine, Resuscitation, medicine.medical_specialty, Oxygen desaturation, business.industry, 030208 emergency & critical care medicine, Early goal-directed therapy, Critical Care and Intensive Care Medicine, medicine.disease, Logistic regression, 3. Good health, Persistence (computer science), Cardiac dysfunction, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, Simplified Acute Physiology Score, Cardiology and Cardiovascular Medicine, business
Abstract

Background Relevance of low ( Methods Regardless of treatment assignment (to receive albumin or not), all subjects enrolled in the ALBIOS trial received early goal-directed therapy aiming for Scvo2 ≥ 70% at 6 h. Using multivariable logistic regression analyses, we tested the association between Scvo2 Results Scvo2 Conclusions In the ALBIOS trial, persistence of low Scvo2 was associated with higher 90-day mortality, possibly because it reflected underlying cardiac dysfunction. Subjects with Scvo2 Trial Registry ClinicalTrials.gov; No. NCT00707122; URL: www.clinicaltrials.gov.

Published
2018

5. A startup circuit for even-stage differential ring oscillators

Author

F. Tinfena, Luca Fanucci, A. Maccioni, Paolo Bruschi, G. Pasetti, and Lorenzo Benvenuti

Subjects
Ring (mathematics), Computer science, business.industry, Oscillation, Electrical engineering, 020206 networking & telecommunications, Biasing, startup circuit, 02 engineering and technology, Dissipation, differential ring oscillator, even-stage, VCO, 020202 computer hardware & architecture, Phase-locked loop, Voltage-controlled oscillator, 0202 electrical engineering, electronic engineering, information engineering, Differential (infinitesimal), Spurious relationship, business
Abstract

If not properly initiated, even-stage ring oscillators may resonate in undesirable ways. When this occurs, their output frequency can be higher than expected and they can no longer be employed as VCOs in PLL designs. In this paper, we analyze this issue and then we propose a novel startup circuit that can be used in differential, even-stage ring oscillators. This design is produced using a 0.30 µm CMOS process. Measurements performed on test chips show that our circuit always prevents spurious oscillation modes from arising. On the contrary, if the proper startup is disabled, unwanted modes may occur, especially at low temperatures or with little bias current. Moreover, consisting of just two MOSFETs per oscillator stage, the proposed circuit is also very simple and efficient in terms of area and power dissipation.

Published
2020

6. Efficient Substrate Noise Coupling Verification and Failure Analysis Methodology for Smart Power ICs in Automotive Applications

Author

Yasser Moursy, Dieu-My Ton, Pierre Tisserand, Hao Zou, G. Pasetti, Marie-Minerve Louerat, Raouf Khalil, Ramy Iskander, Circuits Intégrés Numériques et Analogiques (CIAN), Laboratoire d'Informatique de Paris 6 (LIP6), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Valeo Electrical Systems, VALEO, and AMS - Austria Mikro Systeme Int. AG

Subjects
Failure analysis, Engineering, Semiconductor device modeling, Hardware_PERFORMANCEANDRELIABILITY, 02 engineering and technology, Integrated circuit, 7. Clean energy, law.invention, Power FET switches, law, Robustness (computer science), Hardware_INTEGRATEDCIRCUITS, 0202 electrical engineering, electronic engineering, information engineering, Electronic engineering, Electrical and Electronic Engineering, Electronic circuit, Substrate coupling, business.industry, Buck converter, 020208 electrical & electronic engineering, Electrical engineering, Chip, [SPI.TRON]Engineering Sciences [physics]/Electronics, 020202 computer hardware & architecture, DC-DC power conversion, Direct coupling, Semiconductor device noise, business
Abstract

This paper presents a methodology to analyze the substrate noise coupling and reduce their effects in smart power integrated circuits. This methodology considers the propagation of minority carriers in the substrate. Hence, it models the lateral bipolar junction transistors that are layout dependent and are not modeled in conventional substrate extraction tools. It allows the designer to simulate substrate currents and check their effects on circuits functionality. The proposed methodology employs a dedicated tool for substrate network generation referred to as AUTOMICS. We applied the methodology on two test cases. The first case is a dc–dc buck converter chip fabricated with a 0.35 $\mu\text{m}$ high-voltage-CMOS technology. The dc coupling current between the switches and the bandgap circuit is simulated and verified with measurements. The second test case is an automotive industrial chip that has a latch-up failure due to substrate coupling. In transient simulations, the failure has been reproduced as in measurements. This highlights the stronghold of the methodology since it can be used to prevent this type of failures before fabrication. The proposed methodology can reduce the number of redesigns in the automotive industry. Hence, it shortens the time-to-market, improves the robustness of the design, and reduces the cost.

Published
2017

7. A Case Study in Learning Factories for Real-Time Reconfiguration of Assembly Systems Through Computational Design and Cyber-Physical Systems

Author

Dominik T. Matt, Erwin Rauch, M. A. Ruiz Garcia, G. Pasetti Monizza, Rafael A. Rojas, Free University of Bozen-Bolzano, Fraunhofer Italia Research, Fraunhofer (Fraunhofer-Gesellschaft), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Paolo Chiabert, Abdelaziz Bouras, Frédéric Noël, José Ríos, TC 5, and WG 5.1

Subjects
Information management, 0209 industrial biotechnology, Computational design, business.industry, Business process, Computer science, Data management, Mass customization, 05 social sciences, Cyber-physical system, 02 engineering and technology, Manufacturing engineering, Personalization, Learning factory, 020901 industrial engineering & automation, 8. Economic growth, 0502 economics and business, Factory (object-oriented programming), Reconfigurable Manufacturing System, [INFO]Computer Science [cs], Visual recognition, business, 050203 business & management
Abstract

Part 3: PLM for Digital Factories and Cyber Physical Systems; International audience; Digitalization in manufacturing, also known as Industry 4.0, and Cyber Physical Systems (CPS) may turn ordinary manufacturing systems, usually designed for mass-production, into highly flexible and reconfigurable manufacturing system for mass customization purposes. The huge potential of the digital information management and real-time data management introduced by Industry 4.0 will be a key enabler for further developments in mass customization manufacturing. Increasing customization capabilities means increasing product variability and producing small quantities in a highly flexible way; this impacts the production process and the business process as well. Such reconfigurable CPS promise improvements of the production processes efficiency. In order to disseminate this production strategy to students and industry, the authors created a simple case study in order to introduce these aspects in a learning factory environment. This paper presents a pilot case study implemented in the Smart-Mini Factory laboratory at the Free University of Bolzano for educational and research purposes. The pilot case study aims at introducing a digital information management since the early first steps of the business process, combining Computational Design techniques and CPS. The authors discuss a simple pilot case that will be used mainly for dissemination purposes towards people not addicted to CPS and digital environments such as students and SME’s entrepreneurs. In the upcoming academic year, the demonstrator will be tested for the first time in the course Production Systems and Industrial Logistics with engineering students. In addition, the use of the demonstrator in industry seminars on mass customization and computational design is planned.

Published
2018

8. Design of Self-assessment Tools to Measure Industry 4.0 Readiness. A Methodological Approach for Craftsmanship SMEs

Author

Dominik T. Matt, R. D. D'Amico, Riccardo Brozzi, Michael Riedl, Carmen Marcher, G. Pasetti Monizza, Fraunhofer Italia Research, Fraunhofer (Fraunhofer-Gesellschaft), Free University of Bozen-Bolzano, Paolo Chiabert, Abdelaziz Bouras, Frédéric Noël, José Ríos, TC 5, and WG 5.1

Subjects
Self-assessment, 0209 industrial biotechnology, Measure (data warehouse), Process management, Industry 4.0, 9. Industry and infrastructure, business.industry, Scale (chemistry), 05 social sciences, SMEs, Context (language use), 02 engineering and technology, Automation, Craftsmanship, Self-assessment tool, 020901 industrial engineering & automation, Market segmentation, 8. Economic growth, 0502 economics and business, Production (economics), [INFO]Computer Science [cs], Business, 050203 business & management
Abstract

Part 8: Knowledge Management and Information Sharing; International audience; The ongoing transition to digitalization will inevitably require companies to shift their manufacturing processes towards the Industry 4.0 paradigm, to remain competitive on the market. An increasing number of companies worldwide are initiating integrated 4.0 solutions, catching up with this revolution in the very concept of production processes and the dynamics among producers, suppliers and end-users. SMEs will be particularly challenged to integrate IT and automation to gain market segments in an increasingly globalised playing-field. SMEs will either seize it by identifying opportunities and risks or succumb it. Against the background that there is no such a thing as a one-size-fits-all solution on the way to Industry 4.0, the self-assessment of firm-specific starting circumstances is an essential step prior to any digital implementation. However, the analysis of a diverse pool of existing online self-assessment tools demonstrated main application fields in the context of large companies. This paper will present a methodology developed to design self-assessment tools for Industry 4.0 readiness level, in the framework of two publicly funded EU projects, targeting small-scale craftsmanship companies in the manufacturing and construction sector. The results indicate the importance to scale existing tools to the specific framework conditions of SMEs as well as valuable approaches and concrete recommendations to consider during the conceptual and design phase.

Published
2018

9. Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial

Author

Roberto Bernasconi, Serge Masson, Marilena Romero, Pietro Caironi, Caterina Fanizza, R Thomae, Andrea Noto, G. Pasetti, Luciano Gattinoni, Gianni Tognoni, Roberto Oggioni, and Roberto Latini

Subjects
Male, medicine.medical_specialty, CD14, Lipopolysaccharide Receptors, Critical Care and Intensive Care Medicine, law.invention, Randomized controlled trial, law, Septic shock, Albumins, Sepsis, Anesthesiology, Humans, Medicine, Pathogen, Aged, Innate immune system, business.industry, Presepsin, Crystalloid Solutions, Middle Aged, Prognosis, medicine.disease, Shock, Septic, Severe sepsis, Peptide Fragments, Anti-Bacterial Agents, Clinical trial, Intensive Care Units, Treatment Outcome, Italy, Shock (circulatory), Immunology, Female, Isotonic Solutions, medicine.symptom, business, Biomarkers
Abstract

Presepsin is a soluble fragment of the cluster-of-differentiation marker protein 14 (CD14) involved in pathogen recognition by innate immunity. We evaluated the relation between its circulating concentration, host response, appropriateness of antibiotic therapy, and mortality in patients with severe sepsis.Plasma presepsin was measured 1, 2, and 7 days after enrollment of 997 patients with severe sepsis or septic shock in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. They were randomized to albumin or crystalloids. We tested with univariate and adjusted models the association of single measurements of presepsin or changes over time with clinical events, organ dysfunctions, appropriateness of antibiotic therapy, and ICU or 90-day mortality.Presepsin concentration at baseline (946 [492-1,887] ng/L) increased with the SOFA score, the number of prevalent organ dysfunctions or failures, and the incidence of new failures of the respiratory, coagulation, liver, and kidney systems. The concentration decreased in ICU over 7 days in patients with negative blood cultures, and in those with positive blood cultures and appropriate antibiotic therapy; it increased with inappropriate antibiotic therapy (p = 0.0009). Baseline presepsin was independently associated with, and correctly reclassified, the risk of ICU and 90-day mortality. Increasing concentrations of presepsin from day 1 to day 2 predicted higher ICU and 90-day mortality (adjusted p0.0001 and 0.01, respectively). Albumin had no effect on presepsin concentration.Presepsin is an early predictor of host response and mortality in septic patients. Changes in concentrations over time seem to reflect the appropriateness of antibiotic therapy.

Published
2014

10. Towards Automatic Diagnosis of Minority Carriers Propagation Problems in HV/HT Automotive Smart Power ICs

Author

Thomas Gneiting, G. Pasetti, Heidrun Alius, Hao Zou, Ramy Iskander, Alexander Steinmair, Dieu-My Ton, Pierre Tisserand, E. Seebacher, Yasser Moursy, Circuits Intégrés Numériques et Analogiques (CIAN), Laboratoire d'Informatique de Paris 6 (LIP6), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Valeo Electrical Systems, VALEO, AMS - Austria Mikro Systeme Int. AG, AdMOS GmbH Advanced Modeling Solutions (AdMOS), European Project: 314135,EC:FP7:ICT,FP7-2012-ICT-GC,AUTOMICS(2012), Moursy, Yasser, and Pragmatic solution for parasitic-immune design of electronics ICs for automotive - AUTOMICS - - EC:FP7:ICT2012-07-01 - 2015-08-31 - 314135 - VALID

Subjects
010302 applied physics, Engineering, Substrate coupling, business.industry, 020208 electrical & electronic engineering, Automotive industry, 02 engineering and technology, Integrated circuit, Hardware_PERFORMANCEANDRELIABILITY, Chip, 01 natural sciences, [SPI.TRON] Engineering Sciences [physics]/Electronics, law.invention, [SPI.TRON]Engineering Sciences [physics]/Electronics, Smart power, law, Robustness (computer science), 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Electronic engineering, Hardware_INTEGRATEDCIRCUITS, Resistor, business, Diode
Abstract

International audience; In this paper, a proposed methodology to identify the substrate coupling effects in smart power integrated circuits is presented. This methodology is based on a tool called AUTOMICS to extract substrate parasitic network. This network comprises diodes and resistors that are able to maintain the continuity of minority carrier concentration. The contribution of minority carriers in the substrate noise is significant in high-voltage and high temperature applications. The proposed methodology along with conventional latch-up problem identification for a test case automotive chip AUTOCHIP1 are presented. The time of the proposed methodology is significantly shorter than the conventional one. The proposed methodology could significantly shorten the time-to-market and ameliorate the robustness of the design.

Published
2016

11. Fully integrated multi-channel inductive load driver for harsh automotive applications

Author

Luca Fanucci, Riccardo Serventi, Sergio Saponara, and G. Pasetti

Subjects
Engineering, Automotive industry, 02 engineering and technology, Inductive load, 7. Clean energy, Coatings and Films, Hardware_INTEGRATEDCIRCUITS, 0202 electrical engineering, electronic engineering, information engineering, High voltage (HV) circuits, Multi channel, Block (data storage), Inductive load drivers, business.industry, 020208 electrical & electronic engineering, Automotive electronics, Integrated circuits (ICs), Signal Processing, Hardware and Architecture, Surfaces, Coatings and Films, Electrical engineering, Digital circuitry, 020202 computer hardware & architecture, Surfaces, business, Energy (signal processing), Communication channel
Abstract

The paper addresses the problem of inductive load drivers for automotive applications. The design integrates single-chip in a 0.35 μm low-cost HVMOS technology both the digital circuitry for control and communication with SPI/CAN vehicle networks and the multi-channel drivers optimized for inductive loads. To face ISO26262 requirements also a diagnostic block is embedded. As proved by experimental measurements on fabricated test-chip each channel can sustain up to 650 mA DC current, 1.1 A pulsed current with clamped energy up to 100 mJ, being compliant with automotive harsh operating conditions of ESD up to 4 kV and temperature range from ź40 to 150 °C.

Published
2016

12. A Flexible LED Driver for Automotive Lighting Applications: IC Design and Experimental Characterization

Author

Sergio Saponara, N Costantino, G. Pasetti, F. Tinfena, Luca Fanucci, and P. D'Abramo

Subjects
Engineering, Interfacing, business.industry, Linear regulator, Electrical engineering, Automotive industry, Motor soft starter, Power semiconductor device, Integrated circuit design, Electrical and Electronic Engineering, business, Electrical efficiency, Automotive electronics
Abstract

This letter presents a smart driver for LEDs, particularly for automotive lighting applications, which avoid ringing and overshoot phenomena. To this aim, advanced Soft Start and Current Slope Control techniques are integrated on-chip. This letter discusses the driver design integrating in high voltage CMOS technology, the digital circuitry for programming and electronic control units interfacing, and the power devices up to 10 W. Experimental characterizations with LEDs of different power levels and with different types of connections are showed. The smart driver sustains automotive temperature and voltage requirements; moreover it has high power efficiency, it is programmable, and can be configured to work as a linear regulator (for low current LEDs) or in switch mode (for higher power LEDs).

Published
2012

13. HV-CMOS design and characterization of a smart rotor coil driver for automotive alternators

Author

F. Tinfena, Sergio Saponara, Luca Fanucci, G. Pasetti, and P. D'Abramo

Subjects
Engineering, Rotor (electric), business.industry, 020208 electrical & electronic engineering, Electrical engineering, Automotive industry, 02 engineering and technology, Integrated circuit design, Mechatronics, 7. Clean energy, Automotive electronics, 020202 computer hardware & architecture, law.invention, CMOS, Control and Systems Engineering, law, Electromagnetic coil, 0202 electrical engineering, electronic engineering, information engineering, Electrical and Electronic Engineering, business, Polarity (mutual inductance)
Abstract

The work presents a single-chip integrated rotor coil driver (RCD) that can be used in automotive alternators. It integrates the power switch with the control circuitry and the diagnostics; with respect to the state of the art, new functionalities are integrated such as full reverse polarity protection and programmable output slope control against in-rush currents and current spike transients. The paper will discuss the driver IC design from the choice of the architecture to the real silicon implementation. The proposed innovative RCD has been implemented in a 0.35 μm HV-CMOS technology and has been embedded in a mechatronic brush-holder regulator system-on-chip for an automotive alternator. The simulation results and experimental measurements prove the effectiveness of the proposed RCD facing the harshest automotive conditions.

Published
2013
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14. L'usage de l'insuline comme agent anabolisant doit-il être préconisé chez le sujet dénutri ou agressé?

Author

Gaetano Iapichino, S. Marzorati, G. Pasetti, A Noto, Danilo Radrizzani, A. Pezzi, and Giancarlo Zanforlih

Subjects
Gynecology, medicine.medical_specialty, Nutrition and Dietetics, business.industry, Critically ill, Endocrinology, Diabetes and Metabolism, Internal Medicine, Medicine, Nutritional status, business
Abstract

Resume Cette mise au point a pour objet de montrer le role positif de l'insuline sur l'anabolisme proteique chez le sujet denutri ou catabolique. De nombreux travaux chez l'homme sont disponibles : - etudes, avec temoins controles, chez des sujets pouvant supporter une charge de glucose avec et sans administration d'insuline, - etudes, avec temoins controles, faisant varier a la fois la charge d'insuline et de glucose tout en maintenant un apport energetique constant, - etudes avec differents niveaux d'apport en insuline et en glucose, - etudes sur la reponse a l'insuline et son role dans l'anabolisme induit par la nutrition. La seconde partie de cet article passe en revue les differentes etudes cliniques concernant les effets metaboliques de la nutrition chez le patient agresse. Celles-ci permettent, selon le concept de l'entrainement anabolique lie aux nutriments ou anabolic drive , d'essayer de definir une composition optimale de l'apport calorique non proteique. Les etudes retenues portaient a la fois sur des sujets moderement agresses et avec des degres de malnutrition variables et sur des sujets en etat de stress severe. Par ailleurs, si l'on considere les 42 groupes retenus de patients cataboliques, des resultats cliniquement satisfaisants (c'est-a-dire avec un bilan d'azote au pire faiblement negatif) ont ete obtenus pour 13 groupes sur 22 recevant un systeme mixte glucose/lipide et pour 18 groupes sur 20 recevant uniquement du glucose. Ainsi, l'effet anabolique de l'insuline est egalement demontre chez le sujet catabolique.

Published
1996

15. Parametric and Generative Design Techniques for Digitalization in Building Industry: the Case Study of Glued- Laminated-Timber Industry

Author

Cristina Benedetti, Dominik T. Matt, and G. Pasetti Monizza

Subjects
Engineering, business.industry, Final product, 0211 other engineering and technologies, Mechanical engineering, 020101 civil engineering, 02 engineering and technology, Work in process, Manufacturing engineering, 0201 civil engineering, Order (exchange), 021105 building & construction, Glued laminated timber, Generative Design, business, Building industry, Overall efficiency, Parametric statistics
Abstract

According to Wortmann classification, the Building Industry (BI) can be defined as engineer-to-order (ETO) industry: the engineering-process starts only when an order is acquired. This definition implies that every final product (building) is almost unique' and processes cannot be easily standardized or automated. Because of this, BI is one of the less efficient industries today' mostly leaded by craftsmanship. In the last years' several improvements in process efficiency have been made focusing on manufacturing and installation processes only. In order to improve the efficiency of design and engineering processes as well, the scientific community agrees that the most fruitful strategy should be Front-End Design (FED). Nevertheless, effective techniques and tools are missing. This paper discusses outcomes of a research activity that aims at highlighting whether Parametric and Generative Design techniques allow reducing wastes of resources and improving the overall efficiency of the BI, by pushing the Digitalization of design and engineering processes of products. Focusing on the Glued-Laminated-Timber industry, authors will show how Parametric and Generative Design techniques can be introduced in a standard supply-chain system, highlighting potentials and criticism on the supply-chain system as a whole.

Published
2016

16. Kinetic of body nitrogen loss during a whole day infusion and withdrawal of glucose and insulin in injured patients

Author

G. Iapichino, D. Radrizzani, M. Cambisano, C. Cambisano, G. Bonetti, D. Codazzi, G. Pasetti, and M. Savioli

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, Nitrogen, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Blood Urea Nitrogen, Excretion, Intensive care, Internal medicine, medicine, Humans, Insulin, Urea, Weaning, Infusions, Intravenous, Pancreatic hormone, Aged, business.industry, Fasting, Middle Aged, Methylhistidines, Pathophysiology, Protein catabolism, Glucose, Endocrinology, Wounds and Injuries, Female, Energy Metabolism, business, Perfusion
Abstract

To investigate the kinetics of body nitrogen (N) excretion during 24 h glucose infusion (relating glycemia with insulin supply) and during subsequent 24 h saline infusion in injured patients during a full blown stress reaction. To define the lag time between the start of the withdrawal of glucose and insulin infusion, and the modification in the N loss from the body, and the time span to reach the maximum effect and its size. The knowledge of these variables is mandatory to plan short term studies in critically ill patients, while assuring the stability of the metabolic condition during the study period, and also to assess the possible weaning of the effect on protein breakdown during prolonged glucose and insulin infusion.24-36 h after injury, patients were fasted (100 g glucose) for 24 h (basal day). Thereafter, a 24 h glucose infusion in amount corresponding to measured fasting energy production rate (EPR), clamping glycemia at normal level with insulin supply followed by 24 h saline infusion, was performed. Total N, urea and 3-methyl-histidine (3-MH) in urine were measures on 4 h samples starting from 20th h of the basal day.Multipurpose ICU in University Hospital.6 consecutive patients who underwent accidental and/or surgical injury, immediately admitted for respiratory assistance (FIO20.04). Excluded patients were those with abnormal nutritional status, cardiovascular compromise and organ failures.Patients showed a 33% increase in measured versus predicted fasting EPR and a consistent increase in N and 3-MH urinary loss. An infusion of glucose at 5.95 +/- 0.53 mg/kg x min (97.20 +/- 0.03% of the fasting measured EPR) with 1.22 +/- 0.18 mU/kg x min insulin infusion reduced N and 3-MH loss after a time lag of 12 h. The peak decrease in body N (-36%) and 3-MH loss (-38%) was reached during the first 12 h of glucose withdrawal period. Thereafter, during the following 12 h, the effect completely vanished confirming that it is therapy-dependent and that the metabolic environment of the patients did not change during the three days study period.24 h glucose withdrawal reduces N and 3-MH loss injured patients, the drug-like effect is maintained during the first 12 h of withdrawal and thereafter disappears. The study suggests that at least a 24 h study period is necessary when planning studies exploring energy-protein metabolism relationship in injured patients, and, again 24 h before changing protocol in a crossover study.

Published
1995

17. A High Voltage High Power high frequency Boost/Flyback DC-DC converter for automotive applications

Author

Riccardo Serventi, F. Tinfena, G. Pasetti, Edoardo Biagi, and Luca Fanucci

Subjects
Engineering, CMOS, business.industry, Flyback converter, Flyback transformer, Gate driver, Electronic engineering, Buck–boost converter, Electrical engineering, High voltage, business, Electromagnetic interference, Voltage
Abstract

This work aims to present an High Voltage High Power and High Frequency CMOS DC-DC converter able to work in both Flyback and Boost configurations, designed for automotive applications. The system, implemented in Austriamicrosystems 0.35um HVCMOS technology, is able to manage input voltages from 2.5V up to 36V and generates a programmable output voltage from 6 to 36V with an output current up to 900mA. To improve EMC/EMI system performances, dithering of switching frequency and slope controlling of the gate driver have been implemented.

Published
2012

18. An integrated smart driver for inductive loads with self-monitoring/diagnostic capability

Author

Luca Fanucci, F. Tinfena, G. Pasetti, Sergio Saponara, P. D'Abramo, and Riccardo Serventi

Subjects
Engineering, business.industry, Capacitive sensing, Electrical engineering, Control unit, Hardware_PERFORMANCEANDRELIABILITY, Integrated circuit, Automotive electronics, law.invention, law, Logic gate, Power electronics, Hardware_INTEGRATEDCIRCUITS, Electronic engineering, Zener diode, business, Actuator
Abstract

This work presents a single-chip integrated Smart Driver, especially suited for inductive loads, although it can be used also for capacitive or resistive loads. The proposed smart driver has been realized in a 0.35 µm HVMOS technology. Besides the power MOS device and the relevant gate driving circuitry, the smart driver has integrated self-monitoring/diagnostic capability, it can sustain the large temperature and battery voltage variations of automotive applications, and can be directly connected through a CAN or LIN interface to a vehicle network or to a control host, thus realizing a single-chip actuator control unit. With respect to the state of the art the proposed circuit topology avoids integrating power diodes, occupying large chip area, or zener diodes. The latter are not available in low-cost HVMOS technology typically used for large volume market applications.

Published
2012

19. Characterization of an Intelligent Power Switch for LED driving with control of wiring parasitics effects

Author

Riccardo Serventi, Luca Fanucci, F. Tinfena, G. Pasetti, P. D'Abramo, Sergio Saponara, and N. Costantino

Subjects
Engineering, Incandescent light bulb, business.industry, Electrical engineering, Control reconfiguration, Hardware_PERFORMANCEANDRELIABILITY, Ringing, Automotive electronics, Power (physics), law.invention, EMI, law, Hardware_INTEGRATEDCIRCUITS, Electronic engineering, Parasitic extraction, business, Hardware_LOGICDESIGN, Voltage
Abstract

The flexibility of an Intelligent Power Switch (IPS) designed in HV-CMOS technology for incandescent lamp in automotive scenarios has been evaluated for the driving of a LED in presence of wiring parasitics. The paper presents how it is possible, through proper reconfiguration of the flexible IPS, to reduce the undesired ringing phenomenon when driving a LED with wiring parasitics thus reducing Electromagnetic Interferences (EMI) and spikes on supply voltage. Electrical simulation and experimental measurements prove the effectiveness of the proposed IPS.

Published
2011

22. Erratum to: Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial

Author

Luciano Gattinoni, Roberto Oggioni, Andrea Noto, Roberto Latini, Pietro Caironi, Gianni Tognoni, R Thomae, Marilena Romero, G. Pasetti, Roberto Bernasconi, Serge Masson, and Caterina Fanizza

Subjects
medicine.medical_specialty, Septic shock, business.industry, Intensive care, CD14, medicine, Host response, In patient, Critical Care and Intensive Care Medicine, medicine.disease, Intensive care medicine, business, Severe sepsis
Published
2015

24. [Retrospective study of Mycobacterium avium complex infection in the acquired immunodeficiency syndrome]

Author

C, Calzetti, G, Magnani, G, Elia, M, Avanzi, G, Pasetti, and F, Fiaccadori

Subjects
Adult, Male, AIDS-Related Opportunistic Infections, Humans, Drug Therapy, Combination, Female, Middle Aged, Mycobacterium avium-intracellulare Infection, Retrospective Studies
Abstract

We discuss here our experience with Mycobacterium avium complex (MAC) infection in 446 HIV-positive patients. MAC was found in 13 cases (2.9%): 10 males, 3 females, age range 21-47 years. Infection was disseminated in 10 cases and limited to the lung in 3. CD4+ cells were, on average, 48 per microliters. At clinical onset, all patients suffered from fever and weight loss, 10 from anemia, and 5 from diarrhea. MAC was found in its disseminated form in cultures of blood (10 patients), stool (5 patients) and urine (1 patient). Broncho-alveolar lavage seemed to be the most specific diagnostic method for lung infection. Twelve patients were treated with a multi-drug regimen consisting of an association of 4 or 5 antibiotics, selected on the basis of antibiogram, from the following: clofazimine, rifabutin, ciprofloxacin, ethambutol, isoniazid, amikacin and piazofolin. Mean survival of patients was 91.7%, 83.4%, 71.8% and 58.4% at 4, 5, 6 and 7 months of treatment respectively. Although the mean survival of the treated group is similar to that of untreated patients, multi-drug therapy seems to improve quality of life inasmuch as it brings temperature to normal and enables weight gain. Dissemination was never observed after treatment in patients with pulmonary infection only.

Published
1993

25. [Body, muscle, and visceral nitrogen balance in catabolic patients. Modification with metabolic treatment]

Author

G, Iapichino, D, Radrizzani, G, Veschi, A, Biondi, M, Cambisano, L, Cavallone, A, Colombo, G, Pasetti, D, Codazzi, and R, Russo

Subjects
Adult, Male, Parenteral Nutrition, Viscera, Adolescent, Nitrogen, Critical Illness, Muscles, Humans, Female, Middle Aged
Abstract

In sixteen severely catabolic patients, two different nutritional treatments with the same nitrogen input (0.30 gN.kg-1.die-1) but with a different caloric support: 30 kcal.kg-1.die-1 foe group A and 15 kcal.kg-1.die-1 for group B were infused. Body nitrogen balance (BN), muscle nitrogen balance (BNm) and, calculated as a difference of the two, visceral nitrogen balance were measured in every patient on basal day and on the second day of total parenteral nutrition. Both nutritional treatment reduced the catabolic state in the same amount: this was confirmed by a less negative body BN and by the reduced excretion of 3-MEH and amino acidic catabolic markers. Otherwise in the other compartments the treatments showed different effects: the metabolic support was more reduced by treatment A than it was by B, supplying to visceral compartment a lower nitrogen amount: the nitrogen dismission from muscle compartment, available for visceral tissues, is greater with treatment B than with treatment A. In conclusion, even if both treatments show the same effect on body nitrogen balance, they penalize either one of the examined compartment or the other. To avoid this problem, the study and the use of tissue-specific nutrients are desiderable. Tissue-specific solutions may warrant the balance among body compartment without any further increase of the nitrogen rate.

Published
1993

26. [Optimal dose of amino acids administered in total parenteral nutrition (TPN) of malnourished patients]

Author

A, Colombo, D, Radrizzani, G, Bonetti, G, Pasetti, A, Rigoli, G, Ronzoni, and G, Iapichino

Subjects
Humans, Parenteral Nutrition, Total, Amino Acids, Nutrition Disorders
Abstract

A plasmatic concentration for each aminoacid, between 1 and 1.5 times the normal value in fasting healthy subjects, is considered as an optimal target during total parenteral nutrition (TPN) in malnourished patients. We have analyzed the correlation between the aminoacid input and the aminoacid plasmatic concentration during TPN at different aminoacid composition. By exponential regression curves we then calculated the input required to keep each aminoacid plasma concentration in the optimal range.

Published
1992

27. [Determination of the best amino acid input after orthotopic liver transplantation]

Author

G, Iapichino, G, Ronzoni, G, Bonetti, M, Corti, L, Grugni, C, Guarnerio, A, Palandi, G, Pasetti, S, Rotelli, and M, Savioli

Subjects
Adult, Male, Postoperative Care, Enteral Nutrition, Adolescent, Humans, Female, Parenteral Nutrition, Total, Amino Acids, Middle Aged, Liver Transplantation
Abstract

Ten-three patients were investigated during the early postoperative phase after orthotopic liver transplantation to assess the adequacy of the amino acid (AA) supply during both parenteral (days 1-5) and enteral (days 6-9) nutrition. Plasma AA profile was determined preoperatively, on day 4 and 5 during TPN and on day 8 and 9 during EN, urea production rate was measured every day. Calories input was 28 kcal.kg-.day as glucose, nitrogen intake was 0.25 g.kg- day, supplying individual AA on the basis of previous studies. Urea nitrogen production during TPN (9-11 gN/m2.day) outlines the ability of the transplanted liver to manage the overall nitrogen load. Individual AA plasma profile was considered the expression of an adequate input when comprised between 1 and 1.5 times the normal value, in this respect we obtained adequate levels of all essential AAs. Particularly phenylalanine, methionine and branched chain AA, critical during liver failure, were kept in this range by supplying 68, 48 and 500 mg.kg-1.day. According to AA profile the supply of cystine and tyrosine (conditionally essential AAs), and of histidine, taurine, proline and serine could be safely increased. Not given dispensable AAs (glutamine, asparagine, citrulline and alfa amino butyric) showed a plasma level below the norm and should be added to the diet.

Published
1992

28. [Changes in the plasma amino acid profile in critically ill patients during total parenteral therapy]

Author

G, Iapichino, D, Radrizzani, G, Pasetti, A, Colombo, L, Grugni, C, Guarnerio, A, Palandi, G, Ronzoni, M, Savioli, and G, Veschi

Subjects
Adult, Male, Adolescent, Critical Illness, Homeostasis, Humans, Female, Parenteral Nutrition, Total, Amino Acids, Middle Aged
Abstract

The aim of this study was to evaluate the kinetics of arterial plasma amino acid profile during the first 48 h of clinical TPN in order to assess the time necessary to reach the steady-state condition during infusion. Each patient was treated with one of three different amino acid solutions yielding, in the same nitrogen intake, different intakes of individual amino acids. We found four different kinetics for the administered amino acids: an increase of plasma levels immediately after the start of the TPN with no variations during the steady period; the same trend with the steady-state obtained after 6-24 h of TPN infusion; no influence at all; a decrease of fasting plasma levels with the steady-state attained variably during the study period. Each given amino acid showed a different trend partly depending on the supply, suggesting that the steady-state was reached sooner for most amino acids, when the supply was larger. With lower intakes, plasma levels were unaffected or decreased. We conclude that in critically ill patients at least 24 h are needed to obtain stable arterial plasma amino acid concentration during TPN with adequate intakes of amino acid. Knowledge offers the possibility for a quick and accurate assessment of the adequacy of a given preparation (tailored for critically ill patients), it reduces the time span of the study and, as a consequence, the influence of varied metabolic conditions.

Published
1992

29. Plasma amino acid concentration changes during total parental nutrition in critically ill patients

Author

G. Pasetti, G. Ronzoni, G. Bonetti, Danilo Radrizzani, Angelo Colombo, G. Iapichino, and C. Corbetta

Subjects
chemistry.chemical_classification, medicine.medical_specialty, Resuscitation, Nutrition and Dietetics, business.industry, Critically ill, Arterial plasma, Clinical state, Plasma levels, Critical Care and Intensive Care Medicine, Amino acid, Endocrinology, Parenteral nutrition, chemistry, Biochemistry, Internal medicine, medicine, Steady state (chemistry), business
Abstract

In 16 critically ill patients with full-blown stress reaction and without severe organ failure, we studied the kinetics of the arterial plasma amino acid (aa) profile during the first 48 h of total parenteral nutrition (TPN) in order to assess the time necessary to reach the steady-state condition during infusion. Each patient was treated with one of three different amino acid solutions giving, with the same nitrogen load, different intakes of individual amino acids. We found four different responses to the administered amino acids. 1. (a) An increase in plasma levels within 1 h from the start of the TPN, with no further variation during the study period. 2. (b) The same trend with a steady-state obtained after 6–24 h of TPN infusion. 3. (c) No influence at all. 4. (d) A decrease from fasting plasma levels with a steady-state attained at various times during the study period. Some amino acids showed a different trend depending on the dose given. At lower doses a steady state was achieved sooner. Plasma levels of amino acids not supplied in the TPN were unaffected or decreased, achieving a steady state at various times during the study period. We conclude that, in critically ill patients, stable arterial plasma amino acid concentrations are obtained within 24 h of starting TPN. In such patients, valid studies of the effect of amino acid solutions may therefore be carried out over short periods of time, thereby minimizing errors due to a fluctuating and unstable clinical state.

Published
1992

32. Authors' reply

Author

A. Pezzi, G. Pasetti, F. Lombardi, C. Fiorentini, and G. Iapichino

Subjects
Critical Care and Intensive Care Medicine
Published
2000

33. Liver rupture after cardiopulmonary resuscitation (CPR) and thrombolysis

Author

G. Pasetti, A. Pezzi, C. Fiorentini, G. Iapichino, and F. Lombardi

Subjects
medicine.medical_specialty, Fatal outcome, business.industry, medicine.medical_treatment, Pain medicine, Thrombolysis, Critical Care and Intensive Care Medicine, medicine.disease, Internal medicine, Anesthesiology, Emergency medicine, medicine, Cardiology, Liver rupture, Myocardial infarction, Cardiopulmonary resuscitation, business
Published
1999

34. Comparison of Long-term Prognosis of Patients With AIDS Treated and Not Treated With Zidovudine

Author

S. Hawkes, Bruno Ledergerber, Tenna Ruest Haarmark Nielsen, F. Giannelli, A. Cargnel, Rui Proença, Dénes Bánhegyi, T. Gouzia, M. Arlotti, A. Chiesi, A. Ferlini, M. Soranzo, E. Buira, I. Gjprup, B. Hirschel, A. Bertaggia, P. Berlureau, B. Sommereijns, F. Antunes, N. Piersantelli, F. DeLalla, S. Pauluzzi, Antonios Papadopoulos, A. Colomba, Michel P. Glauser, B. Roscioli, G. Calonghi, B. Clotet, K. Bentsen, B. Ledergerber, A. Ranki, F. Fiaccadori, I. Yust, P. Ricciardiello, P. Skinhoj, Jens D Lundgren, R. Ciammarughi, Jose M. Gatell, Stefano Vella, G. Jensen, A. Pinching, Jens O. Nielsen, D. Coleman, E. Mignani, Court Pedersen, J. Kosmidis, P. Fassio, C.B. Pedersen, G. Stergiou, Sheila J. Barton, C. Nieport, J. Gerstoft, A. Thornval, S. Vella, L. Teglbjaerg, F. Ancarani, E. Francavilla, S. Maayan, A. Nunnari, A. Phillips, Nathan Clumeck, L. Martinez-Blanco, Z. Bentwich, Adriano Lazzarin, S. Danner, G. Pasetti, Reggio Emilia, J. González-Lahoz, J. Morcinek, S. DeWit, S.-L. Valle, P. Pehrson, F. Mulcahy, S. Schwander, Andrew D. Johnson, D. Bloemkolk, José M. Gatell, G. Scalise, Z. Ben-Ishai, Jonas B. Nielsen, J. O. Nielsen, J. Miró, T. Sacks, W. Grillone, Andrew N. Phillips, C. Katlama, F.-D. Goebel, Anne M Johnson, G. Panichi, M. Dietrich, Arcispedale S. Maria Nuova, L. Ortona, R. Hemmer, R. Lüthy, K. Olsson, Mads Melbye, A. D'Arminio Monforte, S. Ranieri, and J. Lundgren

Subjects
medicine.medical_specialty, Pediatrics, Chemotherapy, biology, business.industry, medicine.medical_treatment, Mortality rate, Placebo-controlled study, General Medicine, medicine.disease, biology.organism_classification, Confidence interval, Surgery, Zidovudine, Acquired immunodeficiency syndrome (AIDS), Medicine, Viral disease, business, Sida, medicine.drug
Abstract

Objective. —To determine the association between elapsed time since starting zidovudine and survival in patients with acquired immunodeficiency syndrome (AIDS). Design. —Inception cohort and observational study of patients treated and not treated with zidovudine. Setting. —Fifty-one centers in 17 European countries. Patients. —A total of 4484 patients diagnosed as having AIDS from 1979 to 1989 who survived their initial AIDS-defining event and who had not started zidovudine before AIDS diagnosis. Main Outcome Measures. —Use of zidovudine and mortality. Results. —Among patients who did not receive zidovudine, the death rate was approximately constant for the first 5 years after AIDS diagnosis. For patients treated with zidovudine, the death rate within the first year since starting zidovudine was markedly lower than for untreated patients who had developed AIDS at the same time (relative rate, 0.47; 95% confidence interval [CI] 0.42 to 0.51). For longer times since starting zidovudine, the association with reduced mortality rate was diminished, and for patients surviving more than 2 years since starting zidovudine, the death rate was greater than for untreated patients who had developed AIDS at the same time (relative rate, 1.35; 95% CI, 1.15 to 1.58). Adjustment for other prognostic factors failed to substantially affect this observation. Conclusions. —When initiated after the time of AIDS diagnosis, zidovudine was associated with improved prognosis but for no more than 2 years after starting therapy. ( JAMA . 1994;271:1088-1092)

Published
1994

36. Epidemiological aspects of delta (HDV) infection in a northern Italy district

Author

G, Magnani, C, Calzetti, A, Degli Antoni, P, Perinotto, and G, Pasetti

Subjects
Adult, Liver Cirrhosis, Male, Hepatitis B Surface Antigens, Adolescent, Substance-Related Disorders, Hepatitis B, Hepatitis D, Italy, Acute Disease, Carrier State, Humans, Female, Hepatitis Antibodies, Hepatitis Delta Virus, Hepatitis, Chronic
Published
1987

37. Clinical features of hepatitis delta virus infection in a northern Italian area

Author

Amalia Penna, G Pasetti, Franco Fiaccadori, Carlo Ferrari, A. Degli Antoni, and Calzetti C

Subjects
Microbiology (medical), HBsAg, Substance-Related Disorders, viruses, medicine.disease_cause, Virus, medicine, Humans, Antigens, Viral, Hepatitis, Chronic, Hepatitis, Hepatitis B virus, Hepatitis delta Antigens, business.industry, virus diseases, General Medicine, biochemical phenomena, metabolism, and nutrition, medicine.disease, Hepatitis B, Virology, Hepatitis D, Infectious Diseases, Italy, Superinfection, Immunology, Acute Disease, Carrier State, Coinfection, Viral disease, Hepatitis Delta Virus, business
Abstract

Expression of hepatitis delta virus (HDV) markers was investigated in sera from 310 patients with acute hepatitis, 63 chronic hepatitis B surface antigen (HBsAg) carriers and 76 drug addicts positive for at least one serological hepatitis B virus (HBV) marker. Acute HDV infection occurred in 17.1% of the patients with acute hepatitis. Among 40 cases of coinfection, hepatitis was severe in ten and fulminant in three. Only two of the 13 superinfected patients showed a severe hepatitis, but a high percentage (78%) of them developed chronic hepatitis one year after HDV infection. Also in our area parenteral drug addiction represents the main factor of risk for HDV infection. The high prevalence of HDV infection in our area points to the necessity for serological screening for HDV markers in patients with acute and chronic hepatitis.

Published
1988

39. Autopresentation of hepatitis B virus envelope antigens by T cells

Author

A Valli, Amalia Penna, Antonio Bertoletti, A. Cavalli, Carlo Ferrari, Massimo Pilli, G Pasetti, and Franco Fiaccadori

Subjects
Hepatitis B virus, Immunology, Antigen presentation, Antigen-Presenting Cells, Streptamer, Human leukocyte antigen, Biology, medicine.disease_cause, Microbiology, Viral envelope, Antigen, T-Lymphocyte Subsets, Virology, medicine, Humans, Cytotoxic T cell, Hepatitis B e Antigens, Antigen-presenting cell, food and beverages, Hepatitis B, Insect Science, CD4 Antigens, Receptors, Virus, Research Article
Abstract

Processing and presentation by T cells appear to be limited to antigens that can directly interact with the T-cell surface, thereby overcoming the T-cell inefficiency in antigen capture and internalization. Our study provides evidence that the hepatitis B virus (HBV) envelope proteins can also be efficiently processed and presented by CD4+ and CD8+ T cells to other T cells in a human leukocyte antigen class II-restricted fashion. This phenomenon suggests a receptor-mediated interaction between T cells and the HBV envelope and defines a system that can, we hope, be exploited for the identification of the receptor binding site within the HBV envelope and for the characterization of the putative cellular HBV receptor.

41. Prevalence and features of delirium in older patients admitted to rehabilitation facilities

Author

Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, Tarasconi, A, Sella, M, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D’Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell’Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Null, Ettorre, E, Camellini Bellelli, C G, Annoni, G, Marengoni, A, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl’Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D’Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D’Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, A Tarasconi, M Sella, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, L Porcella, I Nardiello, E Chimenti, M Zeni, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, L Pietrogrande, M Mosca, I Corazzin, P Rossi, V Nunziata, F D’Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena , M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell’Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, A Geriatria, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta , D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambar, A Saitta, F Corica, M Braga, Servi, E Ettorre , C G Camellini Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, L Santuar , M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl’Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D’Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D’Amico, A Grippa , A Mazzone, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L E Lombardi Muti, B Dijk , S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul , G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D’Amico, F D’Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Cortegiani, L Pistidda, R D’Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà , A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin & D Saggioro, VU University medical center, Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, and Saggioro, D

Subjects
Aging, Disability, Rehabilitation, Delirium, Dementia, Physical restraint, Cross-Sectional Studies, Activities of Daily Living, mental disorders, Prevalence, Humans, Geriatrics and Gerontology, Aged
Abstract

Background: Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. Aim: We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”. Methods: We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. Results: Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36, p value < 0.0001). Conclusion: This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.

Published
2022

42. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017

Author

Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Margola, A, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, De, F, Pietrogrande, L, De, B, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Bianchetti, A, Crucitti, A, Di Francesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Pezzoni, D, Gentile, S, Platto, C, D'Ambrosio, V, Faraci, B, Brambilla, C, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, C Boffelli S, Corsini, Filippi, A, Delpin, K, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, A Millul A, Barelli, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Scapigliati, A, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, M, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Citerio, G, Zucchelli, Alberto, Valsecchi, M G, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, A Bianchetti, A Crucitti, V Di Francesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, F Cassandonte, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, G Patrizia, L Santuari, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, P Calogero, G Corvalli, D Pezzoni, S Gentile, A Morandi, C Platto, V D'Ambrosio, B Faraci, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
Male, Aging, medicine.medical_specialty, Sarcopenia, medicine.medical_treatment, Socio-culturale, Older person, Logistic regression, Delirium, Older persons, Sarcopenia, Internal medicine, mental disorders, Delirium, Older persons, medicine, Dementia, Humans, LS4_4, Muscle, Skeletal, Pathological, Aged, Rehabilitation, business.industry, Area under the curve, Settore MED/23 - Chirurgia Cardiaca, Skeletal, medicine.disease, Skeletal muscle mass, Cross-Sectional Studies, Italy, Muscle, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium.

Published
2022

44. Sustainable manufacturing through application of reconfigurable and intelligent systems in production processes: a system perspective.

Author

Todescato M, Braholli O, Chaltsev D, Di Blasio I, Don D, Egger G, Emig J, Pasetti Monizza G, Sacco P, Siegele D, Steiner D, Terzer M, Riedl M, Giusti A, and Matt D

Abstract

Sustainable production aims at creating products from processes that minimize environmental impact, energy consumption and natural resources. Customers and markets are ever more leaning towards digital, custom, and flexible solutions with lower environmental impact. Hence, Industry 4.0 (I4.0) solutions are increasingly including social and environmental sustainability aspects. We focus on the realization of an infrastructure integrating industrially relevant application modules by combining system reconfigurability and artificial intelligence, towards sustainable production. To meet the final goal of sustainable production, we address four challenges considering flexibility and sustainability in production in a holistic way: (1) developing infrastructural and methodological tools to support companies to explore the potential of I4.0 towards sustainable production; (2) managing the configurability and customization possibilities of products; (3) effectively handling the flexibility provided by a production system with rapid reconfiguration capabilities; (4) integrating hardware and software flexibility by using reconfigurable robotics and machine learning methods. By developing and connecting different application modules, we obtain a physical demonstrator which represents on the one hand an exemplary scenario of reconfigurable and flexible production system; on the other, it enables new research activities and insights with a see, touch & feel approach for industrial and research realities., (© 2023. The Author(s).)

Published
2023
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45. Persistence of Central Venous Oxygen Desaturation During Early Sepsis Is Associated With Higher Mortality: A Retrospective Analysis of the ALBIOS Trial.

Author

Protti A, Masson S, Latini R, Fumagalli R, Romero M, Pessina C, Pasetti G, Tognoni G, Pesenti A, Gattinoni L, and Caironi P

Subjects
Aged, Catheterization, Central Venous methods, Correlation of Data, Early Diagnosis, Female, Humans, Male, Middle Aged, Mortality, Prognosis, Pulmonary Gas Exchange, Time-to-Treatment, Albumins administration & dosage, Heart Failure blood, Heart Failure diagnosis, Heart Failure etiology, Hypoxia diagnosis, Hypoxia etiology, Hypoxia physiopathology, Oxygen Consumption, Sepsis blood, Sepsis diagnosis, Sepsis mortality, Sepsis therapy
Abstract

Background: Relevance of low (< 70%) central venous oxygen saturation (Scvo 2 ) during early sepsis has been recently questioned by three negative trials (Protocol-Based Care for Early Septic Shock, Australasian Resuscitation in Sepsis Evaluation, and Protocolized Management in Sepsis) on early goal-directed therapy; however, subjects included in those trials had Scvo 2 at enrollment as high as 71 ± 13%, 73 ± 11%, and 70 ± 12%. Here we assess the association between Scvo 2  < 70% at 6 h and 90-day mortality in subjects enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial, focusing on those with initial Scvo 2  < 70%., Methods: Regardless of treatment assignment (to receive albumin or not), all subjects enrolled in the ALBIOS trial received early goal-directed therapy aiming for Scvo 2  ≥ 70% at 6 h. Using multivariable logistic regression analyses, we tested the association between Scvo 2  < 70% at 6 h and 90-day mortality in those with initial Scvo 2  < 70% (n = 514) or ≥ 70% (n = 961)., Results: Scvo 2  < 70% at 6 h was independently associated with higher 90-day mortality in subjects with initial Scvo 2  < 70% (OR, 1.84; 95% CI, 1.19-2.85; P = .007) but not in those with initial Scvo 2  ≥ 70% (OR, 1.25; 95% CI, 0.79-1.95; P = .357). Scvo 2  < 70% at enrollment and at 6 h was associated with history and/or signs of cardiac dysfunction but not with greater severity of disease or more aggressive resuscitation (required per protocol)., Conclusions: In the ALBIOS trial, persistence of low Scvo 2 was associated with higher 90-day mortality, possibly because it reflected underlying cardiac dysfunction. Subjects with Scvo 2  < 70% may benefit most from individually tailored interventions aimed at normalizing the balance between systemic oxygen delivery and consumption., Trial Registry: ClinicalTrials.gov; No. NCT00707122; URL: www.clinicaltrials.gov., (Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Published
2018
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46. Pharmacogenetic study of seven polymorphisms in three nicotinic acetylcholine receptor subunits in smoking-cessation therapies.

Author

Pintarelli G, Galvan A, Pozzi P, Noci S, Pasetti G, Sala F, Pastorino U, Boffi R, and Colombo F

Subjects
5' Untranslated Regions, Adult, Aged, Bupropion administration & dosage, Bupropion pharmacology, Carbon Monoxide analysis, Exhalation, Female, Humans, Male, Middle Aged, Pharmacogenomic Variants, Polymorphism, Single Nucleotide, Smoking genetics, Tobacco Use Cessation Devices, Tobacco Use Disorder therapy, Varenicline administration & dosage, Varenicline pharmacology, Young Adult, Nerve Tissue Proteins genetics, Receptors, Nicotinic genetics, Smoking therapy, Smoking Cessation Agents administration & dosage, Tobacco Use Disorder genetics
Abstract

Smoking-cessation therapy reduces the risk of smoking-related diseases, but is successful only in a fraction of smokers. There is growing evidence that genetic variations in nicotinic acetylcholine receptor (nAChR) subunits influence the risk of nicotine dependence and the ability to quit smoking. To investigate the role of polymorphisms in nAChR genes on smoking quantity and the outcome of smoking-cessation therapies, we carried out an association study on 337 smokers who underwent pharmacotherapy with varenicline, bupropion, nicotine replacement therapy (NRT) alone, or NRT plus bupropion. Smoking habit and abstention were assessed from the number of cigarettes smoked per day (CPD) and the exhaled CO (eCO), at baseline and up to 12 months. We genotyped seven polymorphisms in genes encoding the nAChR subunits CHRNA4, CHRNA5, and CHRNB2. At baseline, both CPD and eCO were associated with polymorphisms in the CHRNA5 locus (rs503464, rs55853698, rs55781567 and rs16969968; P < 0.01). rs503464, a variant in the 5'-UTR of CHRNA5, was also associated with short-, mid- and long-term responses to therapy (P = 0.011, P = 0.0043, P = 0.020, respectively), although after correction for multiple testing only the association at the mid-term assessment remained significant (FDR = 0.03). These data support the role of individual genetic makeup in the ability to quit smoking.

Published
2017
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47. Daily classification of the level of care. A method to describe clinical course of illness, use of resources and quality of intensive care assistance.

Author

Iapichino G, Radrizzani D, Bertolini G, Ferla L, Pasetti G, Pezzi A, Porta F, and Miranda DR

Subjects
Analysis of Variance, Cost-Benefit Analysis, Diagnosis-Related Groups, Europe epidemiology, Hospital Mortality, Humans, Least-Squares Analysis, Middle Aged, Nursing Staff, Hospital organization & administration, Retrospective Studies, Workload, Critical Care classification, Health Care Rationing methods, Intensive Care Units organization & administration, Intensive Care Units statistics & numerical data, Quality Assurance, Health Care methods, Risk Adjustment methods
Abstract

Objective: To develop a simple and comparable clinical method able to distinguish between higher and lower complexities of care in the ICU., Design: Retrospective analysis., Setting: Database of European ICUs Study I (Euricus-I: including 12,615 patients and 55,464 patient/days), prospectively collected in 89 ICUs of 12 European countries., Methods and Results: A panel of experts developed the classification of the complexity of care. Six (in addition to monitoring, two levels of respiratory support--R and r--two levels of circulatory support--C and c--and dialysis) out of the nine items of Nine Equivalents of Nursing Manpower use Score (NEMS), a therapeutic index, were utilised. Two levels of care (LOCs) were defined according to a more (HT) and a less complex (LT) combination of common activities of care. The two LOCs were significantly related to mortality: higher in HT and they rose with increasing cumulative number of HT days. HT accounted for 31,976 NEMS days (57.7%) while 23,488 (42.3 %) were LT. Major respiratory and cardiovascular support accounted for about 80 % of the HT days. Respiratory assistance and monitoring were responsible for an equivalent percentage of LT days. The distribution of the clinical classification of LOCs coincided with that of the managerial scores of LOCs in the literature., Conclusions: The managerial instrument described uses simple and reliable clinical data. It is able to distinguish between patients with different severity and outcome, and shows that every additional consecutive day spent in ICU as HT increases the probability of death. Moreover, (1) it suggests the possibility of describing the clinical course of illness by relating the complexity/level of medical care to the available technology and staff; (2) using relevant markers of clinical activity, it might be useful to include in quality control programmes.

Published
2001
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49. Which metabolic strategies in the early phase of injury?

Author

Iapichino G, Assi E, Minuto A, Pasetti G, and Zaniboni M

Subjects
Energy Metabolism, Food, Formulated, Humans, Respiratory Distress Syndrome metabolism, Respiratory Distress Syndrome therapy, Enteral Nutrition, Wounds and Injuries metabolism, Wounds and Injuries therapy
Published
1999

50. Kinetic of body nitrogen loss during a whole day infusion and withdrawal of glucose and insulin in injured patients.

Author

Iapichino G, Radrizzani D, Cambisano M, Bonetti G, Codazzi D, Pasetti G, and Savioli M

Subjects
Adolescent, Adult, Aged, Blood Urea Nitrogen, Energy Metabolism, Female, Humans, Infusions, Intravenous, Male, Methylhistidines urine, Middle Aged, Time Factors, Urea urine, Wounds and Injuries drug therapy, Fasting metabolism, Glucose therapeutic use, Insulin therapeutic use, Nitrogen metabolism, Wounds and Injuries metabolism
Abstract

Objective: To investigate the kinetics of body nitrogen (N) excretion during 24 h glucose infusion (relating glycemia with insulin supply) and during subsequent 24 h saline infusion in injured patients during a full blown stress reaction. To define the lag time between the start of the withdrawal of glucose and insulin infusion, and the modification in the N loss from the body, and the time span to reach the maximum effect and its size. The knowledge of these variables is mandatory to plan short term studies in critically ill patients, while assuring the stability of the metabolic condition during the study period, and also to assess the possible weaning of the effect on protein breakdown during prolonged glucose and insulin infusion., Design: 24-36 h after injury, patients were fasted ( < 100 g glucose) for 24 h (basal day). Thereafter, a 24 h glucose infusion in amount corresponding to measured fasting energy production rate (EPR), clamping glycemia at normal level with insulin supply followed by 24 h saline infusion, was performed. Total N, urea and 3-methyl-histidine (3-MH) in urine were measures on 4 h samples starting from 20th h of the basal day., Setting: Multipurpose ICU in University Hospital., Patients: 6 consecutive patients who underwent accidental and/or surgical injury, immediately admitted for respiratory assistance (FIO2 < 0.04). Excluded patients were those with abnormal nutritional status, cardiovascular compromise and organ failures., Main Results: Patients showed a 33% increase in measured versus predicted fasting EPR and a consistent increase in N and 3-MH urinary loss. An infusion of glucose at 5.95 +/- 0.53 mg/kg x min (97.20 +/- 0.03% of the fasting measured EPR) with 1.22 +/- 0.18 mU/kg x min insulin infusion reduced N and 3-MH loss after a time lag of 12 h. The peak decrease in body N (-36%) and 3-MH loss (-38%) was reached during the first 12 h of glucose withdrawal period. Thereafter, during the following 12 h, the effect completely vanished confirming that it is therapy-dependent and that the metabolic environment of the patients did not change during the three days study period., Conclusion: 24 h glucose withdrawal reduces N and 3-MH loss injured patients, the drug-like effect is maintained during the first 12 h of withdrawal and thereafter disappears. The study suggests that at least a 24 h study period is necessary when planning studies exploring energy-protein metabolism relationship in injured patients, and, again 24 h before changing protocol in a crossover study.

Published
1995
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