35 results on '"La Fauci G"'
Search Results
2. The Arousal Disorders Questionnaire: a new and effective screening tool
- Author
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Loddo, G., primary, La Fauci, G., additional, Vignatelli, L., additional, Zenesini, C., additional, Cilea, R., additional, Mignani, F., additional, Cecere, A., additional, Mondini, S., additional, Baldelli, L., additional, Bisulli, F., additional, Licchetta, L., additional, Mostacci, B., additional, Guaraldi, P., additional, Giannini, G., additional, Tinuper, P., additional, and Provini, F., additional
- Published
- 2022
- Full Text
- View/download PDF
3. Children with covid-19 in pediatric emergency departments in Italy
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Parri, N, Lenge, M, Buonsenso, D, Cantoni, B, Arrighini, A, Romanengo, M, Urbino, A, Da Dalt, L, Verdoni, L, Limoli, G, Musolino, A, Pilotto, C, La Fauci, G, Chiossi, M, Agostiniani, R, Plebani, A, Barbieri, M, Lanari, M, Masi, S, Giacalone, M, Leo, M, Falconi, M, Indolfi, G, D'Antiga, L, Mazza, A, De Martiis, D, Bertolozzi, G, Marchisio, P, Chidini, G, Calderini, E, Agostoni, C, Gori, A, Bondone, C, Dona, D, Todeschini, M, Scilipoti, M, Cogo, P, Ginocchio, F, Russotto, V, Biban, P, Stera, G, Margherita, M, Maiandi, S, Tubino, B, Chiaretti, A, Zampogna, S, Mazzuca, A, Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A. M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M. A., Lanari M., Masi S., Giacalone M., Leo M. C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V. S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., Mazzuca A., Parri, N, Lenge, M, Buonsenso, D, Cantoni, B, Arrighini, A, Romanengo, M, Urbino, A, Da Dalt, L, Verdoni, L, Limoli, G, Musolino, A, Pilotto, C, La Fauci, G, Chiossi, M, Agostiniani, R, Plebani, A, Barbieri, M, Lanari, M, Masi, S, Giacalone, M, Leo, M, Falconi, M, Indolfi, G, D'Antiga, L, Mazza, A, De Martiis, D, Bertolozzi, G, Marchisio, P, Chidini, G, Calderini, E, Agostoni, C, Gori, A, Bondone, C, Dona, D, Todeschini, M, Scilipoti, M, Cogo, P, Ginocchio, F, Russotto, V, Biban, P, Stera, G, Margherita, M, Maiandi, S, Tubino, B, Chiaretti, A, Zampogna, S, Mazzuca, A, Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A. M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M. A., Lanari M., Masi S., Giacalone M., Leo M. C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V. S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., and Mazzuca A.
- Published
- 2020
4. Children with Covid-19 in Pediatric Emergency Departments in Italy
- Author
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Parri, N., Lenge, M., Buonsenso, D., Cantoni, B., Arrighini, A., Romanengo, M., Urbino, A., Da Dalt, L., Verdoni, L., Limoli, G., Musolino, A. M., Pilotto, C., La Fauci, G., Chiossi, M., Agostiniani, R., Plebani, A., Barbieri, M. A., Lanari, M., Masi, S., Giacalone, M., Leo, M. C., Falconi, M., Indolfi, G., D'Antiga, L., Mazza, A., De Martiis, D., Bertolozzi, G., Marchisio, P., Chidini, G., Calderini, E., Agostoni, C., Gori, A., Bondone, C., Dona', D., Todeschini, M., Scilipoti, M., Cogo, P., Ginocchio, F., Russotto, V. S., Biban, P., Stera, G., Margherita, M., Maiandi, S., Tubino, B., Chiaretti, A., Zampogna, S., Mazzuca, A., Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A.M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M.A., Lanari M., Masi S., Giacalone M., Leo M.C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V.S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., and Mazzuca A.
- Subjects
Pediatric emergency ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,China ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,030204 cardiovascular system & hematology ,Betacoronavirus ,COVID-19 ,Child ,Humans ,Italy ,SARS-CoV-2 ,Coronavirus Infections ,Emergency Service, Hospital ,Pandemics ,Hospital ,03 medical and health sciences ,0302 clinical medicine ,Correspondence ,Pandemic ,medicine ,Viral ,030212 general & internal medicine ,Emergency Service ,Betacoronaviru ,business.industry ,Coronavirus Infection ,Pneumonia ,General Medicine ,Family medicine ,Cohort ,business ,Human - Abstract
This letter describes a cohort of 100 children younger than 18 years of age with RT-PCR-confirmed Covid-19 who were assessed in 17 pediatric emergency departments in Italy. The descriptive results are compared with previously published results involving children in China and the United States.
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- 2020
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- View/download PDF
5. The development of a Consensus Conference on Pediatric Procedural Sedation in the Emergency Department in Italy: From here where to?
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Sforzi I., Bressan S., Saffirio C., De Masi S., Bussolin L., Da Dalt L., De Iaco F., Shavit I., Krauss B., Barbi E., Bergese I., Biermann K. P., Borrometi F., Calligaris L., Cantoni B., Fontanazza S., Fornasari D., Ghizzi C., Gregorini M., Guarino M., L'erario M., La Fauci G., Lai A., Lazzeri S., Leo M. C., Lucenteforte E., Macchiarini A., Maiandi S., Mando M., Mazza A., Montobbio G., Mugelli A., Parrino R., Sammartino M., Schleef J., Spotti A., Tomasello C., Di Francia M. T., Trapani C., Turini M., Vagnoli L., Vergna S., Virgili G., Rosati G. V., Zanon D., Sforzi, I., Bressan, S., Saffirio, C., De Masi, S., Bussolin, L., Da Dalt, L., De Iaco, F., Shavit, I., Krauss, B., Barbi, E., Bergese, I., Biermann, K. P., Borrometi, F., Calligaris, L., Cantoni, B., Fontanazza, S., Fornasari, D., Ghizzi, C., Gregorini, M., Guarino, M., L'Erario, M., La Fauci, G., Lai, A., Lazzeri, S., Leo, M. C., Lucenteforte, E., Macchiarini, A., Maiandi, S., Mando, M., Mazza, A., Montobbio, G., Mugelli, A., Parrino, R., Sammartino, M., Schleef, J., Spotti, A., Tomasello, C., Di Francia, M. T., Trapani, C., Turini, M., Vagnoli, L., Vergna, S., Virgili, G., Rosati, G. V., and Zanon, D.
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Consensus ,medicine.medical_treatment ,Training system ,MEDLINE ,Conscious Sedation ,Consensu ,Subspecialty ,Pediatrics ,Emergency department ,Pediatric ,Procedural sedation and analgesia ,03 medical and health sciences ,Hospital ,0302 clinical medicine ,Pediatric emergency medicine ,030202 anesthesiology ,Multidisciplinary approach ,030225 pediatrics ,Health care ,Medicine ,Humans ,Emergency Service ,business.industry ,Research ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,Italy ,Emergency Medicine ,Analgesia ,Emergency Service, Hospital ,Medical emergency ,business ,Human - Abstract
Background In Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard. We aimed to describe the procedures and results of the first multidisciplinary and multi-professional Consensus Conference in Italy on safe and effective pediatric PSA in Italian EDs. Methods The preparation, organization and conduct of the Consensus Conference, held in Florence in 2017, followed the recommended National methodological standards. Professionals from different specialties across the country were invited to participate. Results Overall 86 recommendations covering 8 themes (pre-sedation evaluation, pharmacologic agents, monitoring, equipment and discharge checklists, training, non-pharmacologic techniques, the adult ED setting, impact on hospitalizations) were developed, taking into account the Italian training system and healthcare organization characteristics. Conclusion The results of the first multidisciplinary and multi-professional Consensus Conference in Italy are meant to provide up-to-date national guidance to improve the standard of care of children undergoing painful and stressful procedures in the ED. The recommendations will be periodically updated as new relevant evidence is published.
- Published
- 2020
6. Menarcheal age in celiac disease may not be delayed and may be irrespective of age at diagnosis and dietary management
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Sferlazzas, C., Arrigo, T., Salzano, G., Pellegrino, S., La Fauci, G., Rulli, I., Magazzù, G., and De Luca, F.
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- 2008
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7. Two-Spot Modeling of Synoptic Light Curves of II Peg
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La Fauci, G., Rodonò, M., Byrne, Patrick B., editor, and Rodonò, Marcello, editor
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- 1983
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8. Epilessia con mioclonie palpebrali e assenze
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Marangio, Lucia, Fiumana, E., La Fauci, G., and Faggioli, Raffaella
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Tic ,Fotosensibilità ,Epilessia con mioclonie palpebrali e assenze ,Epilessia Idiopatica Generalizzata ,Video-EEG - Published
- 2010
9. La terapia farmacologica dell'obesità in adolescenza
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Tanas, R, Iughetti, Lorenzo, LA FAUCI, G, Zaghi, M, Berri, R, China, Mc, and DI MAIO, S.
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obesity ,fenfluramine ,orli - Published
- 2008
10. Convulsive status epilepticus in the emergency room,Lo stato di male epilettico in pronto soccorso
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La Fauci, G., Melodie Olivia Loredana Rosa Arico', Bonelli, A., Cattazzo, E., and Pagano, G.
11. Distribuzione del Nematodi del Suolo in Due Stazioni di Una Lecceta Della Etna
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Vinciguerra, M. T., primary and la Fauci, G., additional
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- 1978
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12. Distribuzione del Nematodi del Suolo in Due Stazioni di Una Lecceta Della Etna
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Vinciguerra, M. T. and la Fauci, G.
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- 1978
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13. ROCCA observational study: Early results on safety of Sputnik V vaccine (Gam-COVID-Vac) in the Republic of San Marino using active surveillance
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Rossella Messina, Giusy La Fauci, Marco Montalti, Edoardo Barvas, Elisabetta Poluzzi, Marcello Forcellini, Rossano Riccardi, Giorgia Solda, Emanuel Raschi, Jacopo Lenzi, Maria Pia Fantini, Zeno Di Valerio, Davide Gori, Aurelia Salussolia, Susanna Guttmann, Montalti M., Solda' G., Di Valerio Z., Salussolia A., Lenzi J., Forcellini M., Barvas E., Guttmann S., Messina R., Poluzzi E., Raschi E., Riccardi R., Fantini M.P., La Fauci G., and Gori D.
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Medicine (General) ,Pediatrics ,medicine.medical_specialty ,Population ,Active surveillance ,Sputnik V ,R5-920 ,Adverse events following immunisation ,San Marino ,Medicine ,Adverse effect ,education ,San Marino Republic ,Covid-19 vaccine ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Vaccination ,General Medicine ,Early results ,Tolerability ,Observational study ,Safety ,Gam-COVID-Vac ,business ,Research Paper - Abstract
Background: In August 2020, Sputnik V was registered as Gam-COVID-Vac by the Russian Ministry of Health, and since December 2020 it has been distributed in 61 countries worldwide. On 25 February 2021, the Republic of San Marino started its vaccination campaign, which includes Sputnik V. Our aim was to describe the adverse events following immunization (AEFIs) with this vaccine through participant-based active surveillance in the country. Methods: Beginning from 4 March to 8 April 2021, a nationwide study was conducted on San Marino's population aged 18–89 years who received one or two doses of Sputnik V. E-questionnaire dissemination occurred through e-mails, QR-codes or live/phone interviews ~7 days after the first and second vaccine dose. A descriptive analysis was conducted to quantify AEFI incidence on both occasions, stratifying results by type and severity of symptoms. Findings: Mean age of the 2558 vaccine recipients was 66±14 years. First-dose AEFI incidence was 53.3% (systemic reactions at 42.2%), while second-dose AEFI incidence was 66.8% (systemic reactions at 50.4%) (n = 1288). In general, 76.0% of two-dose recipients reported some AEFIs after either vaccine dose, and 2.1% suffered severe reactions; in 60- to 89-year-olds (n = 1021), AEFI incidence was 70.0%, with 53.0% of subjects describing systemic reactions and 0.8% reporting severe symptoms. The most frequent symptoms were local pain, asthenia, headache and joint pain. Interpretation: Our results, albeit preliminary, suggest that Sputnik V has a high tolerability profile in the population aged ≥60 years in terms of short-term AEFIs. Funding: None.
- Published
- 2021
14. Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department.
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Cozzi G, Chiappa S, La Fauci G, Calvi M, Castagno E, Tappi E, Villa G, Tommasi P, Milani GP, Cellai Rustici M, Casciana ML, Tovaglieri N, Masi S, Vezzoli C, Tilatti SZ, Giangreco M, Barbi E, and Benini F
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- Humans, Administration, Sublingual, Retrospective Studies, Child, Male, Female, Adolescent, Child, Preschool, Analgesia methods, Analgesics administration & dosage, Emergency Service, Hospital, Administration, Intranasal, Pain Management methods
- Abstract
Background: Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes., Methods: A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group. It included a survey and a retrospective data collection in which the medical records of all patients who received analgesia from 1 April 2022 to 31 May 2022 were collected., Results: 48 centres (91%) answered the survey. The intranasal and sublingual routes were used in 25 centres (52%). 13 centres (27%) used both routes, 9 centres (19%) used only the sublingual and 3 centres (6%) used only the intranasal route.12 centres (48%) participated in the retrospective study. Data about 3409 patients, median age 9 years (IQR 5-12), were collected. Among them, 337 patients (9.6%) received sublingual analgesia, and 87 patients (2.5%) received intranasal analgesia. The intranasal route was employed for injuries in 79 (90.8%) cases, and fentanyl was the drug delivered in 85 (97.7%) cases. The sublingual route was used mainly for injuries (57.3%), but also for abdominal pain (15.4%), musculoskeletal pain (14.5%) and headache (10.7%). Paracetamol, ketorolac and tramadol were administered through this route., Conclusions: The use of the intranasal and sublingual routes for analgesia in the paediatric ED is still limited., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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15. Herpes zoster (HZ) vaccine coverage and confidence in Italy: a Nationwide cross-sectional study, the OBVIOUS project.
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Salussolia A, Capodici A, Scognamiglio F, La Fauci G, Soldà G, Montalti M, Di Valerio Z, Fantini MP, Odone A, Costantino C, Larson HJ, Leask J, Lenzi J, and Gori D
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- Humans, Italy epidemiology, Cross-Sectional Studies, Male, Female, Middle Aged, Aged, Adult, Young Adult, Vaccination statistics & numerical data, Adolescent, Surveys and Questionnaires, Aged, 80 and over, Herpes Zoster prevention & control, Herpes Zoster epidemiology, Herpes Zoster Vaccine administration & dosage, Vaccination Coverage statistics & numerical data
- Abstract
Background: Herpes Zoster is an age dependent disease and as such it represents a problem in the Italian social context, where the demographic curve is characterized by an overrepresentation of the elderly population. Vaccines against Herpes Zoster are available, safe and effective, however coverage remains sub-optimal. This study was therefore conducted to examine the variations in Herpes Zoster vaccine uptake and confidence across different regions in Italy., Methods: This study utilized a cross-sectional computer-assisted web interview (CAWI) methodology. The survey was conducted by Dynata, an online panel provider, and involved 10,000 respondents recruited in Italy between April 11 and May 29, 2022. The sample was stratified based on geographic region, gender, and age group. Data management adhered to European Union data protection regulations, and the survey covered demographics, living conditions, and vaccination against herpes zoster (HZ), following the BeSD framework., Results: The findings indicate regional disparities in herpes zoster vaccine uptake across Italy. Notably, the Islands region exhibits a particularly low vaccination rate (2.9%), highlighting the need for targeted interventions. The multivariate regression analysis showed that sociodemographic factors, limited access to healthcare services, and inadequate awareness of vaccine eligibility contribute to the lower uptake observed in this region., Conclusion: In conclusion, this research emphasizes regional disparities in herpes zoster (HZ) vaccination uptake in Italy. Demographic, socioeconomic, and geographic factors impact individuals' willingness to receive the vaccine. The study highlights the importance of awareness of vaccine eligibility and accessible vaccination facilities in increasing uptake rates., (© 2024. The Author(s).)
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- 2024
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16. Influenza Vaccine Uptake in Italy-The 2022-2023 Seasonal Influenza Vaccination Campaign in Italy: An Update from the OBVIOUS Project.
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Capodici A, Salussolia A, La Fauci G, Di Valerio Z, Montalti M, Odone A, Costantino C, Larson HJ, Leask J, Lenzi J, Manzoli L, Gori D, and On Behalf Of The Obvious Board
- Abstract
Influenza is a significant public health concern, with Italy being profoundly impacted annually. Despite extensive vaccination campaigns and cooperative initiatives between the Public Health Departments of Local Healthcare Authorities and family physicians, low vaccine uptake rates persist. This study builds upon the OBVIOUS project, providing an updated picture of influenza vaccine uptake in Italy through a representative sample. A cross-sectional computer-assisted web interviewing (CAWI) survey of 10,001 Italian citizens was conducted between 31 March and 5 June 2023. Our findings underscore the negative impact of a lack of awareness that a person is in a priority group for influenza vaccination (-26.1 percentage points in vaccine uptake) and the profound influence of social circles on vaccination decisions (-5 percentage points when unfavorable). Medical professionals played a pivotal role, with recommendations from family doctors significantly promoting vaccine uptake (+20.2 percentage points). Age, chronic conditions, and socio-demographic factors also influenced vaccination behaviors. For children, parental negative perceptions regarding the flu (-10.4 percentage points) and vaccine safety (-23.4 percentage points) were crucial determinants. The present study emphasizes the need for a comprehensive approach addressing awareness, societal beliefs, and tailored medical advice to enhance vaccination rates and protect public health in Italy.
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- 2024
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17. Rates and determinants of Rotavirus vaccine uptake among children in Italy: a cross-sectional study within the 2022 OBVIOUS* project.
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La Fauci G, Soldà G, Di Valerio Z, Salussolia A, Montalti M, Scognamiglio F, Capodici A, Fantini MP, Larson HJ, Leask J, Gori D, and Lenzi J
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- Child, Female, Humans, Infant, Child, Preschool, Cross-Sectional Studies, Vaccination, Italy, Rotavirus Vaccines, Rotavirus Infections prevention & control, Rotavirus
- Abstract
Introduction: The World Health Organization defines rotavirus as among the most severe causes of viral gastroenteritis affecting children under 5 year old. Italy and other European countries do not release disaggregated data on rotavirus vaccination coverage. This study aimed to assess the uptake and drivers of rotavirus vaccination in Italy., Methods: We administered a survey to 10,000 Italian citizens recruited via an online panel and proportionate to key demographic strata. We examined rotavirus vaccine uptake among parents whose youngest child was aged 6 weeks to 4 years, their sociodemographic characteristics, their beliefs about vaccine administration, and who recommended the rotavirus vaccination., Results: A total of 711 respondents met the inclusion criteria for the rotavirus vaccine questionnaire. The uptake was estimated at 60.3% nationwide (66.4% among mothers and 50.2% among fathers). Being a mother and living in cities/suburbs was significantly associated with a higher likelihood of vaccine uptake, while fathers were more likely to be uncertain of their children's vaccine status. Living in Central Italy and having friends/relatives opposed to vaccination were found to be significantly associated with a lower likelihood of vaccine uptake, while parents' education level and children's demographics were not found to correlate with any outcomes. In 90.3% of cases, the rotavirus vaccination was recalled as being recommended by a paediatrician., Conclusions: Consistent collection of behavioural preferences and socioeconomic characteristics of recipients of rotavirus vaccine campaigns, their epidemiological information, cost-benefit, and national policy data are crucial for designing effective vaccination strategies in Italy and other European countries with similar social profiles to reach the target uptake., (© 2024. The Author(s).)
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- 2024
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18. Pneumococcal vaccine uptake among high-risk adults and children in Italy: results from the OBVIOUS project survey.
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Di Valerio Z, La Fauci G, Scognamiglio F, Salussolia A, Montalti M, Capodici A, Fantini MP, Odone A, Costantino C, Soldà G, Larson HJ, Leask J, Lenzi J, and Gori D
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- Child, Humans, Female, Aged, Adult, Middle Aged, Male, Pneumococcal Vaccines, Vaccination, Surveys and Questionnaires, Pneumococcal Infections prevention & control, Diabetes Mellitus
- Abstract
Background: Streptococcus pneumoniae infections, including Invasive Pneumococcal Diseases (IPDs), pose a substantial public health challenge, causing significant morbidity and mortality, especially among children and older adults. Vaccination campaigns have played a vital role in reducing pneumococcal-related deaths. However, obstacles related to accessibility and awareness might impede optimal vaccine adoption. This study aims to provide comprehensive data on pneumococcal vaccine coverage and attitudes within at-risk groups in Italy, with the goal of informing public health strategies and addressing vaccination barriers., Methods: Between April 11 and May 29, 2022, a questionnaire investigating vaccine uptake and attitudes toward several vaccinations was administered to 10,000 Italian adults, chosen through population-based sampling. Respondents who were targets of the campaign according to the 2017-2019 National Vaccination Plan, accessed questions regarding pneumococcal vaccination. Data on uptake, awareness of having the right to free vaccination, opinion on vaccine safety, concern with pneumococcal disease, and ease of access to vaccination services were summarized and presented based on statistical regions. Multinomial logistic regression analysis was used to explore factors influencing vaccine uptake., Results: Out of 2357 eligible adult respondents (42.6% women; mean age: 58.1 ± 15.7), 39.5% received pneumococcal vaccination. Uptake differed among at-risk groups: respondents aged ≥65 (33.7%), with lung disease (48.4%), cardiovascular disease (46.6%), and diabetes (53.7%). Predictors of not being vaccinated and unwilling to included female gender, residing in rural areas, lower education, low concern about pneumococcal disease, vaccine safety concerns, and associations with vaccine-opposed acquaintances. Health access issues predicted willingness to be vaccinated despite non-vaccination. Pneumopathy, heart disease, diabetes, and living in Northeastern or Central Italy were linked to higher uptake. Among the 1064 parents of eligible children, uptake was 79.1%. Parental unawareness of children's free vaccination eligibility was a predictor of non-vaccination. Vaccine safety concerns correlated with reluctance to vaccinate children, while perceived healthcare access challenges were associated with wanting but not having received vaccination., Conclusions: Pneumococcal vaccination uptake within prioritized groups and children in Italy remains inadequate. Scarce awareness of vaccine availability and obstacles in accessing vaccinations emerge as principal barriers influencing this scenario., (© 2024. The Author(s).)
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- 2024
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19. Human Papillomavirus (HPV) Vaccine Coverage and Confidence in Italy: A Nationwide Cross-Sectional Study, the OBVIOUS Project.
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Montalti M, Salussolia A, Capodici A, Scognamiglio F, Di Valerio Z, La Fauci G, Soldà G, Fantini MP, Odone A, Costantino C, Leask J, Larson HJ, Lenzi J, and Gori D
- Abstract
Background: Human Papillomavirus (HPV) vaccination rates are still below the target due to vaccine refusal or delay, lack of knowledge, and logistical challenges. Understanding these barriers is crucial for developing strategies to improve HPV vaccination rates., Methods: This cross-sectional study used a questionnaire to investigate social and behavioral factors influencing decision making about the HPV vaccine. The survey was conducted from 11 April to 29 May 2022 and involved 10,000 Italian citizens aged ≥ 18 years. The sample was stratified based on region of residence, gender, and age group., Results: 3160 participants were surveyed about themselves, while 1266 respondents were surveyed about their children's vaccine uptake. Among females aged ≥ 26 years, the national average HPV vaccine uptake was 21.7%, with variations across different regions. In the 18-25 age group, females had a vaccine uptake (80.8%) twice as much as males (38.1%), while vaccine uptake among male and female children aged 9-11 was similar., Conclusions: The OBVIOUS study in Italy reveals factors influencing low HPV vaccine uptake, suggesting targeted approaches, tailored information campaigns, heightened awareness of eligibility, promoting early vaccination, addressing low-risk perception among males, addressing safety concerns, and enhancing perceived accessibility to improve vaccine uptake and mitigate health risks.
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- 2024
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20. Influenza vaccination landscape in Italy: A comprehensive study through the OBVIOUS project lens.
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Capodici A, Montalti M, Soldà G, Salussolia A, La Fauci G, Di Valerio Z, Scognamiglio F, Fantini MP, Odone A, Costantino C, Larson HJ, Leask J, Lenzi J, and Gori D
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- Adult, Humans, Female, Patient Acceptance of Health Care, Health Knowledge, Attitudes, Practice, Vaccination, Italy, Influenza, Human prevention & control, Influenza Vaccines
- Abstract
Influenza annually claims an estimated 8,000 lives in Italy. Despite no-cost vaccinations for high-risk groups, hesitancy persists. This study aims to pinpoint social and behavioral vaccination determinants, forming strategies to bolster vaccine uptake. From April 11 to May 29, 2022, we surveyed a demographic-stratified sample of 10,000 Italian adults, employing the WHO's Behavioral and Social Drivers of Vaccination (BesD) framework. Of those, 4,613 (46.1%) were eligible for the influenza vaccine and included in the analysis. Roughly a third remained unvaccinated and unwilling. Central Italy showed the highest resistance, with significant percentages of seniors and professionals like teachers, law enforcement, and healthcare workers expressing noncompliance. A lack of awareness of being in a target group correlated significantly with vaccine refusal or delayed acceptance. Other refusal factors included female gender, being aged 45-54, rural residency, absence of higher education, perceived vaccine unsafety, and having vaccine-opposed acquaintances. Thus, addressing these perceptions and enhancing awareness can potentially increase vaccination rates and lessen disease impact.
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- 2023
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21. Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception.
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Poonai N, Cohen DM, MacDowell D, Mistry RD, Mintegi S, Craig S, Roland D, Miller M, Shavit I, Wang Y, Nager A, Heyming T, Burns R, Trehan I, Lipshaw M, Sulton C, Li J, Ojo A, Kelly S, Thornton M, Caperell K, Amoni I, Abrams A, Duong M, Wassem M, Davis A, Gravel J, Doyon Trottier E, Bar Am N, Thompson G, Sabhaney V, Meckler G, Jain R, Ali S, Bressan S, Zangardi T, Villa G, Giacalone M, Seiler M, Sahyoun C, Romano F, Bognar Z, Hajosi-Kalcakosz S, Amir L, Hachimi-Idrissi S, Pucuka Z, Zviedre A, Zeltina E, Phillips N, Borland M, O'Brien S, Marchant J, Kochar A, George S, Pennington V, Lyttle M, Browning J, McLoughlin A, Hartshorn S, Urooj C, Johnston L, Walton E, Subrahmanyam Puthucode D, Peacock P, Conroy J, Marañon R, Garcia S, Cahís N, Cámara-Otegui A, Gomez A, Carbonero M, Angelats-Romero C, Yock-Corrales A, Hualde G, Spigariol F, Donas A, Gübeli Linné C, Rocchi A, Pedrazzini A, Cozzi G, Barbi D, Baggio L, La Fauci G, Mauro A, Steimle M, Buonsenso D, Ugalde I, Nieva G, Harper C, Sforzi I, and Jain S
- Subjects
- Male, Child, Humans, Adolescent, Female, Analgesics, Opioid therapeutic use, Cross-Sectional Studies, Intussusception complications, Intestinal Perforation etiology, Analgesia adverse effects
- Abstract
Importance: Ileocolic intussusception is an important cause of intestinal obstruction in children. Reduction of ileocolic intussusception using air or fluid enema is the standard of care. This likely distressing procedure is usually performed without sedation or analgesia, but practice variation exists., Objective: To characterize the prevalence of opioid analgesia and sedation and assess their association with intestinal perforation and failed reduction., Design, Setting, and Participants: This cross-sectional study reviewed medical records of children aged 4 to 48 months with attempted reduction of ileocolic intussusception at 86 pediatric tertiary care institutions in 14 countries from January 2017 to December 2019. Of 3555 eligible medical records, 352 were excluded, and 3203 medical records were eligible. Data were analyzed in August 2022., Exposures: Reduction of ileocolic intussusception., Main Outcomes and Measures: The primary outcomes were opioid analgesia within 120 minutes of reduction based on the therapeutic window of IV morphine and sedation immediately before reduction of intussusception., Results: We included 3203 patients (median [IQR] age, 17 [9-27] months; 2054 of 3203 [64.1%] males). Opioid use was documented in 395 of 3134 patients (12.6%), sedation 334 of 3161 patients (10.6%), and opioids plus sedation in 178 of 3134 patients (5.7%). Perforation was uncommon and occurred in 13 of 3203 patients (0.4%). In the unadjusted analysis, opioids plus sedation (odds ratio [OR], 5.92; 95% CI, 1.28-27.42; P = .02) and a greater number of reduction attempts (OR, 1.48; 95% CI, 1.03-2.11; P = .03) were significantly associated with perforation. In the adjusted analysis, neither of these covariates remained significant. Reductions were successful in 2700 of 3184 attempts (84.8%). In the unadjusted analysis, younger age, no pain assessment at triage, opioids, longer duration of symptoms, hydrostatic enema, and gastrointestinal anomaly were significantly associated with failed reduction. In the adjusted analysis, only younger age (OR, 1.05 per month; 95% CI, 1.03-1.06 per month; P < .001), shorter duration of symptoms (OR, 0.96 per hour; 95% CI, 0.94-0.99 per hour; P = .002), and gastrointestinal anomaly (OR, 6.50; 95% CI, 2.04-20.64; P = .002) remained significant., Conclusions and Relevance: This cross-sectional study of pediatric ileocolic intussusception found that more than two-thirds of patients received neither analgesia nor sedation. Neither was associated with intestinal perforation or failed reduction, challenging the widespread practice of withholding analgesia and sedation for reduction of ileocolic intussusception in children.
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- 2023
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22. COVID-19 Vaccine Refusal and Delay among Adults in Italy: Evidence from the OBVIOUS Project, a National Survey in Italy.
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Gori D, Capodici A, La Fauci G, Montalti M, Salussolia A, Soldà G, Di Valerio Z, Scognamiglio F, Fantini MP, Leask J, Larson HJ, Profeti S, Toth F, Lenzi J, and On Behalf Of The Other Researchers Of The Obvious Board
- Abstract
Background: Vaccine hesitancy was defined by the World Health Organization (WHO) in 2019 as a major threat to global health. In Italy, reluctance to receive vaccines is a widespread phenomenon that was amplified during the COVID-19 pandemic by fear and mistrust in government. This study aims to depict different profiles and characteristics of people reluctant to vaccinate, focusing on the drivers of those who are in favor of and those who are opposed to receiving the COVID-19 vaccine., Methods: A sample of 10,000 Italian residents was collected. A survey on COVID-19 vaccination behavior and possible determinants of vaccine uptake, delay, and refusal was administered to participants through a computer-assisted web interviewing method., Results: In our sample, 83.2% stated that they were vaccinated as soon as possible ("vaccinators"), 8.0% delayed vaccination ("delayers"), and 6.7% refused to be vaccinated ("no-vaccinators"). In general, the results show that being female, aged between 25 and 64, with an education level less than a high school diploma or above a master's degree, and coming from a rural area were characteristics significantly associated with delaying or refusing COVID-19 vaccination. In addition, it was found that having minimal trust in science and/or government (i.e., 1 or 2 points on a scale from 1 to 10), using alternative medicine as the main source of treatment, and intention to vote for certain parties were characteristics associated with profiles of "delayers" or "no-vaccinators". Finally, the main reported motivation for delaying or not accepting vaccination was fear of vaccine side effects (55.0% among delayers, 55.6% among no-vaccinators)., Conclusion: In this study, three main profiles of those who chose to be vaccinated are described. Since those who are in favor of vaccines and those who are not usually cluster in similar sociodemographic categories, we argue that findings from this study might be useful to policy makers when shaping vaccine strategies and choosing policy instruments.
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- 2023
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23. Vial Sharing of High-Cost Drugs to Decrease Leftovers and Costs: A Retrospective Observational Study on Patisiran Administration in Bologna, Italy.
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Cozzio M, Melis A, La Fauci G, Guaraldi P, Caputo R, Lioi F, Cellini GS, Santilli G, Scarlattei D, Siravo P, Zuccheri P, Ziglio A, and Montalti M
- Abstract
Waste of high-cost medicines, such as orphan drugs, is a major problem in healthcare, which leads to excessive costs for treatments. The main objective of this study was to evaluate the impact of a vial-sharing strategy for patisiran, an orphan drug used for the treatment of hereditary transthyretin-mediated amyloidosis, in terms of a reduction in the discarded drug amount and cost savings. The retrospective observational study was conducted in a tertiary referral center (Emilia-Romagna, Italy), between February 2021 and November 2022. Data on drug waste were calculated as "(mg used-mg prescribed)/mg prescribed" for each session. We found a statistically significant (-9.14%, p < 0.001, 95% CI 5.87-12.41) absolute difference in mean discarded drug rates per session based on the study phase (before and after vial-sharing introduction) at the two-sample t-test. The absolute difference corresponded to a percentage decrease in the average reduction in the discarded drug rate with vial sharing of 82.96% per session. On an annual scale, the estimated cost savings was EUR 26,203.80/year for a patient with a standard body weight of 70 kg. In conclusion, we demonstrated that a patisiran vial-sharing program undoubtedly offsets some of the high costs associated with this treatment. We suggest that this easy-to-introduce and cost-effective approach can be applied to the administration of other high-cost drugs.
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- 2023
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24. ROCCA cohort study: Nationwide results on safety of Gam-COVID-Vac vaccine (Sputnik V) in the Republic of San Marino using active surveillance.
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Di Valerio Z, La Fauci G, Soldà G, Montalti M, Lenzi J, Forcellini M, Barvas E, Guttmann S, Poluzzi E, Raschi E, Riccardi R, Fantini MP, Salussolia A, and Gori D
- Abstract
Background: Gam-COVID-Vac is the world's first registered vector vaccine against COVID-19 based on a combination of two heterologous adenoviruses. It was chosen by the Republic of San Marino as the main tool in its vaccination campaign, which started on 25 February 2021. Our aim was to build up on the ROCCA study, focused on the older population, by describing adverse effects following immunisation (AEFIs) rates and characteristics in all age groups for the first time in a real-world context., Methods: An active surveillance study on recipients of at least one dose of the Gam-COVID-Vac vaccine was conducted. Participants were administered online questionnaires through live/phone interviews with physicians, by e-mail or by scanning a QR code at different points in time after the first dose: one week (Q1) one month (Q2), and three months (Q3) between March and August 2021., Findings: Overall, 6190 vaccine recipients were recruited. Mean age was 52·4 ± 18·2 years. After the first dose, systemic reactions were reported by 57·5% of the participants, while injection site reactions were reported by 46·7%. The most common AEFIs were pain at the injection site, fatigue and headache. Grade 3 or 4 AEFIs were reported by 0·8% and 0·3% of the participants, respectively. After the second dose, systemic reactions were reported by 63·1% of the participants, while injection site reactions by 54·7%. The most common AEFIs were malaise, pain at injection site and myalgia. Grade 3 or 4 AEFIs were reported by 2·7% and 1·1% of the participants, respectively. Multivariate analysis showed younger age, being a woman and food allergies are risk factors for more severe AEFIs., Interpretation: Our results confirm a good tolerability profile for the population aged 18 and over providing useful data for vaccination campaigns ongoing in countries planning to use Gam-COVID-Vac., Funding: None., Competing Interests: The authors have no conflicts of interest to declare., (© 2022 The Author(s).)
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- 2022
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25. Obesity and COVID-19 in Children and Adolescents: Reciprocal Detrimental Influence-Systematic Literature Review and Meta-Analysis.
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La Fauci G, Montalti M, Di Valerio Z, Gori D, Salomoni MG, Salussolia A, Soldà G, and Guaraldi F
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- Adolescent, Child, Communicable Disease Control, Exercise, Humans, Life Style, Weight Gain, COVID-19 epidemiology, Pediatric Obesity epidemiology
- Abstract
The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection. The PubMed database was searched to identify original studies assessing: (1) the extent and risk factors of lockdown-induced weight increase; and (2) the impact of obesity on the risk of hospital admission in children and adolescents. A systematic literature review and meta-analyses were performed. Twenty out of 13,986 identified records were included. A significant weight increase was reported in the majority of subjects, with no apparent gender or age differences. It was induced by a higher consumption of hypercaloric/hyperglycemic/junk food and/or the reduction of physical activity, often associated with an altered sleep-wake cycle. On the other hand, obesity increased the risk of hospitalization (OR = 4.38; 95% C.I. 1.46-13.19; p = 0.009; I
2 = 96%) as compared to the normal weight population. COVID-19 and obesity represent epidemic conditions with reciprocal detrimental impact. Urgent public health interventions, targeting the various age and social strata, and involving governmental authorities, health care personnel, teachers and families are warranted to increase awareness and actively promote healthy lifestyles to contrast pediatric obesity and its detrimental consequences at a global level.- Published
- 2022
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26. Vaccinations and Healthy Ageing: How to Rise to the Challenge Following a Life-Course Vaccination Approach.
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Scognamiglio F, Fantini MP, Reno C, Montalti M, Di Valerio Z, Soldà G, Salussolia A, La Fauci G, Capodici A, and Gori D
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In the context of an ageing population, one of the major Public Health goals is to promote healthy ageing. To rise to this challenge, rethinking conventional prevention paradigms and implementing them with vaccination at all stages of life is necessary. Indeed, vaccinations are able to both prevent pathogen specific diseases and all their downstream effects and to increase overall immune system plasticity and resilience. Our aim is to discuss the obstacles and opportunities in pursuing a "life-course vaccination approach" and to highlight the role of vaccines in healthy ageing. In doing so, we address the close connections between immunology and vaccinology advances and introduce the novel concept of immune fitness. Finally, we conclude that even though vaccinology is making giant steps towards tailored vaccination strategies, more studies are needed to investigate this topic.
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- 2022
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27. Gam-COVID-Vac (Sputnik V) and Pfizer-BioNTech Vaccines Adverse Events following Immunization in Patients Affected by Parkinson's Disease and Multiple Sclerosis: A Longitudinal Study.
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Soldà G, Barvas E, Lenzi J, Di Valerio Z, La Fauci G, Guttmann S, Riccardi R, Fantini MP, Salussolia A, Montalti M, and Gori D
- Abstract
The Republic of San Marino COVID-19 vaccination campaign used Gam-COVID-Vac and Pfizer-BioNTech vaccines. To assess adverse events following immunization (AEFIs), approximately 6000 vaccine recipients were monitored by the ROCCA study, including subgroups with Parkinson's Disease (PD) and Multiple Sclerosis (MS). The purpose of this study is to evaluate short-term AEFIs through a 1-month follow-up. We conducted a longitudinal study, using active surveillance to evaluate the safety profiles of COVID-19 vaccines in PD and MS patients. Participants were actively administered a standardized online questionnaire to collect information on AEFIs. Among all PD and MS assisted by the San Marino hospital, a total of 82 patients completed the questionnaires. One week after administration of the first dose, vaccine recipients reported AEFIs in 26% of cases in the PD group, 67% in the MS group, and 68% in the control group. Participants reported slightly higher rates of AEFIs after dose 2 compared with dose 1, being 29%, 75%, and 78% for PD, MS, control group, respectively. Most of the reported symptoms were mild. Patients with PD and MS reported few AEFIs after administration of the COVID-19 vaccines. The frequency of AEFIs in the PD population was significantly lower than in the control group.
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- 2022
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28. ROCCA observational study: Early results on safety of Sputnik V vaccine (Gam-COVID-Vac) in the Republic of San Marino using active surveillance.
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Montalti M, Soldà G, Di Valerio Z, Salussolia A, Lenzi J, Forcellini M, Barvas E, Guttmann S, Messina R, Poluzzi E, Raschi E, Riccardi R, Fantini MP, La Fauci G, and Gori D
- Abstract
Background: In August 2020, Sputnik V was registered as Gam-COVID-Vac by the Russian Ministry of Health, and since December 2020 it has been distributed in 61 countries worldwide. On 25 February 2021, the Republic of San Marino started its vaccination campaign, which includes Sputnik V. Our aim was to describe the adverse events following immunization (AEFIs) with this vaccine through participant-based active surveillance in the country., Methods: Beginning from 4 March to 8 April 2021, a nationwide study was conducted on San Marino's population aged 18-89 years who received one or two doses of Sputnik V. E-questionnaire dissemination occurred through e-mails, QR-codes or live/phone interviews ~7 days after the first and second vaccine dose. A descriptive analysis was conducted to quantify AEFI incidence on both occasions, stratifying results by type and severity of symptoms., Findings: Mean age of the 2558 vaccine recipients was 66±14 years. First-dose AEFI incidence was 53.3% (systemic reactions at 42.2%), while second-dose AEFI incidence was 66.8% (systemic reactions at 50.4%) ( n = 1288). In general, 76.0% of two-dose recipients reported some AEFIs after either vaccine dose, and 2.1% suffered severe reactions; in 60- to 89-year-olds ( n = 1021), AEFI incidence was 70.0%, with 53.0% of subjects describing systemic reactions and 0.8% reporting severe symptoms. The most frequent symptoms were local pain, asthenia, headache and joint pain., Interpretation: Our results, albeit preliminary, suggest that Sputnik V has a high tolerability profile in the population aged ≥60 years in terms of short-term AEFIs., Funding: None., Competing Interests: The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication. The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained., (© 2021 The Author(s).)
- Published
- 2021
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29. Neonatal and Pediatric Emergency Room Visits in a Tertiary Center during the COVID-19 Pandemic in Italy.
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Silvagni D, Baggio L, Lo Tartaro Meragliotta P, Soloni P, La Fauci G, Bovo C, Ielo S, and Biban P
- Abstract
The COVID-19 pandemic is affecting healthcare services worldwide. We investigated the impact of a strict lockdown policy on the characteristics of neonatal and pediatric attendances to our pediatric emergency department (PED). The clinical features of PED visits in March-April 2020 (COVID-19) and March-April 2019 (non-COVID-19) were analyzed. During the COVID-19 lockdown period, visits reduced by 67%, from 3159 to 1039. Neonatal access decreased from 78 to 59, mainly due to fewer pathological conditions, with a complete disappearance of respiratory infections. On the other hand, minor neonatal clinical conditions rose from 44 (56.4%) to 48 (81.4%), mostly due to feeding-related issues. Communicable diseases, particularly respiratory infections and gastroenteritis, dropped from 1552 (49.1%) to 288 (27.7%). Accident-related visits also decreased during COVID-19, from 535 (16.9%) to 309 (29.7%), becoming the most common cause of PED access. Hospital admissions reduced from 266 to 109, while PICU (pediatric intensive care unit) admissions decreased from 27 to 11, with a comparable rate of 10.1% in both periods. The lockdown due to COVID-19 had a substantial impact on our PED visits, which markedly decreased, mainly due to fewer respiratory infections. Unexpectedly, neonatal visits for minor conditions did not decline, but rather slightly increased. Among the children admitted to the PICU, none had respiratory disease.
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- 2021
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30. The Arousal Disorders Questionnaire: a new and effective screening tool for confusional arousals, Sleepwalking and Sleep Terrors in epilepsy and sleep disorders units.
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Loddo G, La Fauci G, Vignatelli L, Zenesini C, Cilea R, Mignani F, Cecere A, Mondini S, Baldelli L, Bisulli F, Licchetta L, Mostacci B, Guaraldi P, Giannini G, Tinuper P, and Provini F
- Subjects
- Adult, Arousal, Humans, Surveys and Questionnaires, Epilepsy diagnosis, Night Terrors diagnosis, Parasomnias diagnosis, Sleep Arousal Disorders diagnosis, Sleep Wake Disorders, Somnambulism diagnosis
- Abstract
Background: Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (ADQ) as a new diagnostic tool for DoA diagnosis. The objective of this study was to evaluate the diagnostic accuracy of the ADQ in a sleep and epilepsy center., Methods: One interviewer blinded to clinical and video-polysomnographic (VPSG) data administered the ADQ to 150 patients consecutively admitted to our Sleep and Epilepsy Centers for a follow-up visit. The final diagnosis, according to VPSG recordings of at least one major episode, classified patients either with DoA (DoA group) or with other sleep-related motor behaviors confounding for DoA (nDoA group)., Results: 47 patients (31%) composed the DoA group; 56 patients with REM sleep behavior disorder, 39 with sleep-hypermotor epilepsy, six with night eating syndrome, and two with drug-induced DoA composed the nDoA group. The ADQ had a sensitivity of 72% (95% CI: 60-82) and a specificity of 96% (95% CI: 89-98) for DoA diagnosis; excluding the items regarding consciousness and episode recall, sensitivity was 83% (95% CI: 71-90) and specificity 93% (95% CI: 86-97)., Conclusions: The ADQ showed good accuracy in screening patients with DoA in a sleep and epilepsy center setting. Diagnostic criteria related to cognition and episode recall reduced ADQ sensitivity, therefore a better definition of these criteria is required, especially in adults., (Copyright © 2021 Elsevier B.V. All rights reserved.)
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- 2021
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31. COVID-19 in 17 Italian Pediatric Emergency Departments.
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Parri N, Lenge M, Cantoni B, Arrighini A, Romanengo M, Urbino A, Da Dalt L, Verdoni L, Giacchero R, Lanari M, Musolino AM, Biban P, La Fauci G, Pilotto C, Buonsenso D, Chiossi M, Agostiniani R, Plebani A, Zampogna S, Barbieri MA, De Masi S, Agostoni C, and Masi S
- Subjects
- Asymptomatic Infections epidemiology, COVID-19 diagnosis, COVID-19 diagnostic imaging, COVID-19 Testing statistics & numerical data, Child, Child, Preschool, Female, Humans, Infant, Italy epidemiology, Male, Point-of-Care Testing statistics & numerical data, Radiography, Thoracic statistics & numerical data, Retrospective Studies, Symptom Assessment, Systemic Inflammatory Response Syndrome diagnosis, Systemic Inflammatory Response Syndrome epidemiology, Tomography, X-Ray Computed statistics & numerical data, Ultrasonography statistics & numerical data, COVID-19 epidemiology, Emergency Service, Hospital statistics & numerical data, SARS-CoV-2
- Abstract
Background: Variability in presentation of children with coronavirus disease 2019 (COVID-19) is a challenge in emergency departments (EDs) in terms of early recognition, which has an effect on disease control and prevention. We describe a cohort of 170 children with COVID-19 and differences with the published cohorts., Methods: Retrospective chart reviews on children (0-18 years) evaluated in 17 Italian pediatric EDs., Results: In our cohort (median age of 45 months; interquartile range of 4 months-10.7 years), we found a high number of patients <1 year with COVID-19 disease. The exposure happened mainly (59%) outside family clusters; 22% had comorbidities. Children were more frequently asymptomatic (17%) or with mild diseases (63%). Common symptoms were cough (43%) and difficulty feeding (35%). Chest computed tomography, chest radiograph, and point-of-care lung ultrasound were used in 2%, 36%, and 8% of cases, respectively. Forty-three percent of patients were admitted because of their clinical conditions. The minimal use of computed tomography and chest radiograph may have led to a reduced identification of moderate cases, which may have been clinically classified as mild cases., Conclusions: Italian children evaluated in the ED infrequently have notable disease symptoms. For pediatrics, COVID-19 may have rare but serious and life-threatening presentations but, in the majority of cases, represents an organizational burden for the ED. These data should not lower the attention to and preparedness for COVID-19 disease because children may represent a source of viral transmission. A clinically driven classification, instead of a radiologic, could be more valuable in predicting patient needs and better allocating resources., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)
- Published
- 2020
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32. The role of reduced expression of fragile X mental retardation protein in neurons and increased expression in astrocytes in idiopathic and syndromic autism (duplications 15q11.2-q13).
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Wegiel J, Brown WT, La Fauci G, Adayev T, Kascsak R, Kascsak R, Flory M, Kaczmarski W, Kuchna I, Nowicki K, Martinez-Cerdeno V, Wisniewski T, and Wegiel J
- Subjects
- Adolescent, Adult, Animals, Brain metabolism, Cerebral Cortex pathology, Child, Child, Preschool, Female, Humans, Immunohistochemistry, Male, Middle Aged, Young Adult, Astrocytes metabolism, Autistic Disorder genetics, Autistic Disorder metabolism, Fragile X Mental Retardation Protein genetics, Fragile X Mental Retardation Protein metabolism, Neurons metabolism
- Abstract
Fragile X syndrome (FXS), caused by lack of fragile X mental retardation protein (FMRP), is associated with a high prevalence of autism. The deficit of FMRP reported in idiopathic autism suggests a mechanistic overlap between FXS and autism. The overall goal of this study is to detect neuropathological commonalities of FMRP deficits in the brains of people with idiopathic autism and with syndromic autism caused by dup15q11.2-q13 (dup15). This study tests the hypothesis based on our preliminary data that both idiopathic and syndromic autism are associated with brain region-specific deficits of neuronal FMRP and structural changes of the affected neurons. This immunocytochemical study revealed neuronal FMRP deficits and shrinkage of deficient neurons in the cerebral cortex, subcortical structures, and cerebellum in subjects with idiopathic and dup(15)/autism. Neuronal FMRP deficit coexists with surprising infiltration of the brains of autistic children and adults with FMRP-positive astrocytes known to be typical only for the fetal and short postnatal periods. In the examined autistic subjects, these astrocytes selectively infiltrate the border between white and gray matter in the cerebral and cerebellar cortex, the molecular layer of the cortex, part of the amygdala and thalamus, central cerebellar white matter, and dentate nucleus. Astrocyte pathology results in an additional local loss of FMRP in neurons and their shrinkage. Neuronal deficit of FMRP and shrinkage of affected neurons in structures free of FMRP-positive astrocytes and regions infiltrated with FMRP-expressing astrocytes appear to reflect mechanistic, neuropathological, and functional commonalities of FMRP abnormalities in FXS and autism spectrum disorder. Autism Res 2018, 11: 1316-1331. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Immunocytochemistry reveals a deficit of fragile X mental retardation protein (FMRP) in neurons of cortical and subcortical brain structures but increased FMRP expression in astrocytes infiltrating gray and white matter. The detected shrinkage of FMRP-deficient neurons may provide a mechanistic explanation of reported neuronal structural and functional changes in autism. This study contributes to growing evidence of mechanistic commonalities between fragile X syndrome and autism spectrum disorder., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)
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- 2018
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33. Carbon monoxide poisoning in narghile (water pipe) tobacco smokers.
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La Fauci G, Weiser G, Steiner IP, and Shavit I
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- Adolescent, Carbon Monoxide Poisoning therapy, Emergency Service, Hospital, Female, Humans, Hyperbaric Oxygenation methods, Risk Assessment, Treatment Outcome, Water, Carbon Monoxide Poisoning diagnosis, Carbon Monoxide Poisoning etiology, Smoking adverse effects
- Abstract
Narghile (water pipe, hookah, shisha, goza, hubble bubble, argeela) is a traditional method of tobacco use. In recent years, its use has increased worldwide, especially among young people. Narghile smoking, compared to cigarette smoking, can result in more smoke exposure and greater levels of carbon monoxide (CO). We present an acutely confused adolescent patient who had CO poisoning after narghile tobacco smoking. She presented with syncope and a carboxyhemoglobin level of 24% and was treated with hyperbaric oxygen. Five additional cases of CO poisoning after narghile smoking were identified during a literature search, with carboxyhemoglobin levels of 20 to 30%. Each patient was treated with oxygen supplementation and did well clinically. In light of the increasing popularity of narghile smoking, young patients presenting with unexplained confusion or nonspecific neurologic symptoms should be asked specifically about this exposure, followed by carboxyhemoglobin measurement.
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- 2012
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34. Expression of the human cytomegalovirus 65K tegument phosphoprotein in insect cells by baculovirus vectors.
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La Fauci G, Sapienza VJ, Chen CJ, Wisniewski HM, and Kim KS
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- Animals, Antigens, Viral genetics, Baculoviridae genetics, Base Sequence, Genetic Vectors, Humans, Molecular Sequence Data, Moths, Phosphoproteins genetics, Recombinant Proteins biosynthesis, Viral Matrix Proteins genetics, Antigens, Viral biosynthesis, Baculoviridae metabolism, Cytomegalovirus genetics, Phosphoproteins biosynthesis, Viral Matrix Proteins biosynthesis
- Abstract
The gene encoding the 65K tegument phosphoprotein (pp65) of human cytomegalovirus (HCMV) was cloned into pAc373 to construct a recombinant baculovirus (Acpp65-3) expressing pp65 in insect Sf9 cells. A baculovirus that carried a fragment of the gene, corresponding to the first 442 amino acids of pp65, was also developed, using vector pVL941 (Acpp65-2). Recombinant proteins migrating in SDS-polyacrylamide gels with an M(r) of either 65K (Acpp65-3) or 56K (Acpp65-2) were detected in cytoplasmic and nuclear extracts of infected Sf9 cells. The 56K and 65K proteins were recognized in immunoblots by monoclonal antibodies (MAbs) 28-77 and 28-19, which are specific for pp65. The insect cell-expressed antigens were also analysed on Western blots using MAbs 4D11, 7D2, 8E3, 7B4 and 8E10, which recognize the HCMV antigen GP66 in immunoblots. The truncated pp65 antigen of Acpp65-2 was reactive with MAbs 4D11, 7D2, 8E10 and 7B4. The protein expressed by Acpp65-3 reacted only with MAb 4D11. The data proved that the epitopes recognized by MAbs 4D11, 7D2, 8E3 and 7B4 mapped in the region of pp65, comprising amino acids 1 to 442, and also that GP66 and pp65 represent the same HCMV antigen. Immunoblot analysis of human sera from individuals seropositive for HCMV showed that the recombinant pp65 products were as antigenic as the native 65K phosphoprotein produced in HCMV-infected human embryonic fibroblasts.
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- 1994
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35. Characterization of the 5'-end region and the first two exons of the beta-protein precursor gene.
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La Fauci G, Lahiri DK, Salton SR, and Robakis NK
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- Amino Acid Sequence, Amyloid beta-Protein Precursor, Animals, Base Sequence, Chromosomes, Human, Pair 21, DNA genetics, DNA Restriction Enzymes, Endonucleases, Gene Expression Regulation, Humans, Introns, Molecular Sequence Data, Nucleic Acid Conformation, Nucleic Acid Hybridization, Oligonucleotide Probes, Promoter Regions, Genetic, Rats, Single-Strand Specific DNA and RNA Endonucleases, Transcription Factors, Transcription, Genetic, Tumor Cells, Cultured, Amyloid genetics, Exons, Protein Precursors genetics
- Abstract
Human genomic clones encoding the promoter region and the first two exons of the beta-amyloid protein precursor (beta-APP) gene were isolated. The first exon is 205 base pairs (bp) long and encodes 19 amino acids. The second exon is 168 bp long and encodes 56 amino acids. The 5'-flanking sequence of the beta-APP gene was found to display promoter activity in several cell lines including PC12 cells where the highest activity was detected. The promoter region of this gene lacks the typical "TATAA" and "CAAT" boxes usually associated with eukaryotic promoters. Five copies of the GGGCGC sequence are located between positions -107 and -188 and one copy is located within the first exon of the beta-APP gene. Consensus sequences recognized by the transcription factors Sp1 and AP-1 are located upstream from the RNA start site. Palindromic sequences capable of forming stable hairpin-like structures are found around the main transcription initiation site. The structural characteristics of the beta-APP promoter indicate that multiple elements participate in the regulation of the expression of this gene.
- Published
- 1989
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