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1. Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

Author: Guadagni, S, Catarci, M, Masedu, F, Karim, M, Clementi, M, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Guadagni S., Catarci M., Masedu F., Karim M. E., Clementi M., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Guadagni, S, Catarci, M, Masedu, F, Karim, M, Clementi, M, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Guadagni S., Catarci M., Masedu F., Karim M. E., Clementi M., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Background: In Italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. The aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. Methods: A database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. The primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. The results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. Results: A total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). Group A versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51–0.70; P < 0.001). A mean postoperative duration of stay difference of 0.86 days was detected between groups. No difference was recorded between the two groups for all the other endpoints. Conclusion: This study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery.
Published: 2024

2. Mechanical bowel preparation in elective colorectal surgery: a propensity score-matched analysis of the Italian colorectal anastomotic leakage (iCral) study group prospective cohorts

Author: Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Patriti, A, Campagnacci, R, Sica, G, Caricato, M, Montemurro, L, Ciano, P, Benedetti, M, Guercioni, G, Scatizzi, M, De Luca, R, Ficari, F, Scabini, S, Liverani, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Cicconi, S, Marziali, I, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Sisti, V, Ricci, M, Maurizi, A, Sensi, B, Capolupo, G, Pandolfini, L, Falsetto, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Aprile, A, Soriero, D, Scarinci, A, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Pirozzi F., Delrio P., Garulli G., Marini P., Patriti A., Campagnacci R., Sica G., Caricato M., Montemurro L. A., Ciano P., Benedetti M., Guercioni G., Scatizzi M., De Luca R., Ficari F., Scabini S., Liverani A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Mattei M. S., Belloni E., Apa D., Di Carlo M., Cicconi S., Marziali I., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Sisti V., Ricci M. L., Maurizi A., Sensi B., Capolupo G. T., Pandolfini L., Falsetto A., Simone M., Giudici F., Cianchi F., Baldini G., Aprile A., Soriero D., Scarinci A., Sagnotta A., Molfino S., Amodio P., Cardinali A., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Patriti, A, Campagnacci, R, Sica, G, Caricato, M, Montemurro, L, Ciano, P, Benedetti, M, Guercioni, G, Scatizzi, M, De Luca, R, Ficari, F, Scabini, S, Liverani, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Cicconi, S, Marziali, I, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Sisti, V, Ricci, M, Maurizi, A, Sensi, B, Capolupo, G, Pandolfini, L, Falsetto, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Aprile, A, Soriero, D, Scarinci, A, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Pirozzi F., Delrio P., Garulli G., Marini P., Patriti A., Campagnacci R., Sica G., Caricato M., Montemurro L. A., Ciano P., Benedetti M., Guercioni G., Scatizzi M., De Luca R., Ficari F., Scabini S., Liverani A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Mattei M. S., Belloni E., Apa D., Di Carlo M., Cicconi S., Marziali I., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Sisti V., Ricci M. L., Maurizi A., Sensi B., Capolupo G. T., Pandolfini L., Falsetto A., Simone M., Giudici F., Cianchi F., Baldini G., Aprile A., Soriero D., Scarinci A., Sagnotta A., Molfino S., Amodio P., Cardinali A., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Retrospective evaluation of the effects of mechanical bowel preparation (MBP) on data derived from two prospective open-label observational multicenter studies in Italy regarding elective colorectal surgery. MBP for elective colorectal surgery remains a controversial issue with contrasting recommendations in current guidelines. The Italian ColoRectal Anastomotic Leakage (iCral) study group, therefore, decided to estimate the effects of no MBP (treatment variable) versus MBP for elective colorectal surgery. A total of 8359 patients who underwent colorectal resection with anastomosis were enrolled in two consecutive prospective studies in 78 surgical centers in Italy from January 2019 to September 2021. A retrospective PSMA was performed on 5455 (65.3%) cases after the application of explicit exclusion criteria to eliminate confounders. The primary endpoints were anastomotic leakage (AL) and surgical site infections (SSI) rates; the secondary endpoints included SSI subgroups, overall and major morbidity, reoperation, and mortality rates. Overall length of postoperative hospital stay (LOS) was also considered. Two well-balanced groups of 1125 patients each were generated: group A (No MBP, true population of interest), and group B (MBP, control population), performing a PSMA considering 21 covariates. Group A vs. group B resulted significantly associated with a lower risk of AL [42 (3.5%) vs. 73 (6.0%) events; OR 0.57; 95% CI 0.38–0.84; p = 0.005]. No difference was recorded between the two groups for SSI [73 (6.0%) vs. 85 (7.0%) events; OR 0.88; 95% CI 0.63–1.22; p = 0.441]. Regarding the secondary endpoints, no MBP resulted significantly associated with a lower risk of reoperation and LOS > 6 days. This study confirms that no MBP before elective colorectal surgery is significantly associated with a lower risk of AL, reoperation rate, and LOS < 6 days when compared with MBP.
Published: 2024

3. Three-row versus two-row circular staplers for left-sided colorectal anastomosis: a propensity score-matched analysis of the iCral 2 and 3 prospective cohorts

Author: Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Baldini G., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Baldini G., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Background: Since most anastomoses after left-sided colorectal resections are performed with a circular stapler, any technological change in stapling devices may influence the incidence of anastomotic adverse events. The aim of the present study was to analyze the effect of a three-row circular stapler on anastomotic leakage and related morbidity after left-sided colorectal resections. Materials and methods: A circular stapled anastomosis was performed in 4255 (50.9%) out of 8359 patients enrolled in two prospective multicenter studies in Italy, and, after exclusion criteria to reduce heterogeneity, 2799 (65.8%) cases were retrospectively analyzed through a 1:1 propensity score-matching model including 20 covariates relative to patient characteristics, to surgery and to perioperative management. Two well-balanced groups of 425 patients each were obtained: group (A) – true population of interest, anastomosis performed with a three-row circular stapler; group (B) – control population, anastomosis performed with a two-row circular stapler. The target of inferences was the average treatment effect in the treated (ATT). The primary endpoints were overall and major anastomotic leakage and overall anastomotic bleeding; the secondary endpoints were overall and major morbidity and mortality rates. The results of multiple logistic regression analyses for the outcomes, including the 20 covariates selected for matching, were presented as odds ratios (OR) and 95% confidence intervals (95% CI). Results: Group A versus group B showed a significantly lower risk of overall anastomotic leakage (2.1 vs. 6.1%; OR 0.33; 95% CI 0.15–0.73; P = 0.006), major anastomotic leakage (2.1 vs. 5.2%; OR 0.39; 95% CI 0.17–0.87; P = 0.022), and major morbidity (3.5 vs. 6.6% events; OR 0.47; 95% CI 0.24–0.91; P = 0.026). Conclusion: The use of three-row circular staplers independently reduced the risk of anastomotic leakage and related morbidity after left-sided colorectal resection. Twenty-five pati
Published: 2023

4. Women’s height in several African countries in the first half of the 20th century

Author: Danubio, M.E. and Masedu, F.
Published: 2018
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5. Biomechanical analysis following a single session of individualised whole-body vibration in young adults with autism spectrum disorders-ASD

Author: DI GIMINIANI, Riccardo, LA GRECA, Stefano, Masedu, F, Mazza, Monica, and Valenti, M
Published: 2023

6. OP0044 CYTOKINE PROFILE, HYPERFERRITINEMIA, AND MULTI-VISCERAL INVOLVEMENT CHARACTERISE MACROPHAGE ACTIVATION SYNDROME COMPLICATING ADULT ONSET STILL’S DISEASE. RESULTS FROM A MULTIDIMENSIONAL EVALUATION

Author: Ruscitti, P., primary, Ursini, F., additional, Berardicurti, O., additional, Masedu, F., additional, Bozzalla Cassione, E., additional, Naldi, S., additional, DI Cola, I., additional, DI Muzio, C., additional, De Stefano, L., additional, DI Nino, E., additional, Sensini, F., additional, Navarini, L., additional, Vomero, M., additional, Bugatti, S., additional, Valenti, M., additional, Mariani, E., additional, Iagnocco, A., additional, Montecucco, C., additional, Giacomelli, R., additional, and Cipriani, P., additional
Published: 2022
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7. Videolaringoscopy beyond Conventional Endotracheal Intubation in HEMS: A Real Flight Simulation

Author: Facchetti G, Gyra A, Angeletti C, Masedu F, Molineris E, Franchi D, Introzzi L, Lucchelli M, Molesi A, Marinangeli F, and Bucci V
Published: 2022
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8. Burnout among therapists working with persons with autism after the 2009 earthquake in LʼAquila, Italy: a longitudinal comparative study

Author: Valenti, M., La Malfa, G, Tomassini, A., Masedu, F., Tiberti, S., and Sorge, G.
Published: 2014
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9. Register-based cumulative prevalence of Autism Spectrum Disorders during childhood and adolescence in Central Italy

Author: Valenti, M., Vagnetti, R., Masedu, F., Pino, M. C., Rossi, A., Scattoni, M. L., Di Giovanni, C., Attanasio, M., Filocamo, A., Le Donne, I., Siracusano, M., and Mazza, M.
Subjects: Change over time, Register based, Autism Spectrum Disorder, Population, Cumulative Prevalence, Prevalence, 03 medical and health sciences, 0302 clinical medicine, Adolescence, Childhood, Epidemiologic Register, mental disorders, Medicine, 0501 psychology and cognitive sciences, education, education.field_of_study, lcsh:R5-920, business.industry, lcsh:Public aspects of medicine, 05 social sciences, lcsh:RA1-1270, Dsm criteria, medicine.disease, Settore MED/39, Population data, Autism, business, lcsh:Medicine (General), 030217 neurology & neurosurgery, 050104 developmental & child psychology, Demography, Calendar time
Abstract: Background: Studies have evaluated the prevalence of Autism Spectrum Disorders (ASD), focusing on different ages during childhood and adolescence. How cumulative prevalence increases before adulthood remains unclear. Methods: We used data from the Autism Register of the Regional Reference Centre for Autism in L’Aquila, Central Italy, to retrieve information on individuals born in 2001–2012 with any of the inclusion diagnoses of ASD (DSM criteria) for the period 2001 to 2018. Cumulative prevalence on L’Aquila district population data was calculated as percentages for three-year age strata. Results: All prevalence data were estimated at December 31st, 2018. The overall crude prevalence was 0.95% (352 cases over 36938 population). Cumulative prevalence was 1.19% among those born in 2001-2003 (15 to 17 years of follow up), 1.15% among those born in 2004-2006 (12 to 14 years of follow up), 1.04% among those born in 2007-2009 (9 to 11 years of follow up), 0.80% among those born in 2010-2012 (6 to 8 years of follow up), and 0.57% among those born in 2013-2015 (3 to 5 years of follow up). The proportion of ASD diagnoses until the age of 5 years, compared to the group diagnosed 6 to 8 years of age, showed a significant increasing trend over calendar time (53.6% for those born in 2001-2003, to 77.0% for those born in 2010-2012). Conclusions: Cumulative prevalence by time period provides a better understanding of ASD occurrence than a point prevalence. We did not find any difference in frequency of diagnosis comparing age strata and year of birth, suggesting that frequencies of ASD diagnosis remained roughly constant from 2001 to 2015. Results show that cumulative prevalence of autism diagnosis does not substantially change over time; instead, diagnosis of ASD is more likely at earliest ages over time, although new cases of ASD are also detected at later ages.
Published: 2020

10. Family and disease management in young type 1 diabetic patients

Author: Altobelli, E., Valenti, M., Verrotti, A., Masedu, F., Tiberti, S., Chiarelli, F., and Di Orio, F.
Published: 2000
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11. Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients

Author: Mercadante, S. Adile, C. Lanzetta, G. Mystakidou, K. Maltoni, M. Guilherme Soares, L. De Santis, S. Ferrera, P. Valenti, M. Rosati, M. Rossi, R. Cortegiani, A. Masedu, F. Marinangeli, F. Aielli, F.
Abstract: Background: The aim of this study was to assess the patients’ global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods: Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Results: Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71–2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. Conclusion: PSG and PGI seem to be relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Implications for Practice: Personalized symptom goals and global impression of change are relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. © AlphaMed Press 2018
Published: 2019

12. Expansion of permanent first molars with rapid maxillary expansion appliance anchored on primary second molars

Author: Tepedino, M, primary, Iancu-Potrubacz, M, additional, Ciavarella, D, additional, Masedu, F, additional, Marchione, L, additional, and Chimenti, C, additional
Published: 2018
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13. Average interradicular sites for miniscrew insertion: should dental crowding be considered?

Author: Tepedino, M, Cattaneo, PM, Masedu, F, Chimenti, C, Tepedino, M, Cattaneo, PM, Masedu, F, and Chimenti, C
Abstract: OBJECTIVE: To define a map of interradicular spaces where miniscrew can be likely placed at a level covered by attached gingiva, and to assess if a correlation between crowding and availability of space exists. METHODS: Panoramic radiographs and digital models of 40 patients were selected according to the inclusion criteria. Interradicular spaces were measured on panoramic radiographs, while tooth size-arch length discrepancy was assessed on digital models. Statistical analysis was performed to evaluate if interradicular spaces are influenced by the presence of crowding. RESULTS: In the mandible, the most convenient sites for miniscrew insertion were in the spaces comprised between second molars and first premolars; in the maxilla, between first molars and second premolars as well as between canines and lateral incisors and between the two central incisors. The interradicular spaces between the maxillary canines and lateral incisors, and between mandibular first and second premolars revealed to be influenced by the presence of dental crowding. CONCLUSIONS: The average interradicular sites map hereby proposed can be used as a general guide for miniscrew insertion at the very beginning of orthodontic treatment planning. Then, the clinician should consider the amount of crowding: if this is large, the actual interradicular space in some areas might be significantly different from what reported on average. Individualized radiographs for every patient are still recommended.
Published: 2017

14. RevitalVision Treatment in Patients affected by Nystagmus

Author: Sabetti, L., Bianchi, F., and Masedu, F.
Subjects: Nystagmus, RevitalVision, Visual impairment, Nystagmus, RevitalVision, Visual impairment
Published: 2016

15. 'Evalutation Model GIADA' for the Physical Activity in the Secondary School of I Grade

Author: Vinciguerra, M. G., Pellegrini, G., Cannas, A., and Masedu, F.
Published: 2016

16. SAT0489 Biologic Therapies and Infections in The Daily Practice: A Study on Historical Cohort from 3 Italian Rheumatologic Units

Author: Cipriani, P., primary, Berardicurti, O., additional, Masedu, F., additional, D'Onofrio, F., additional, Navarini, L., additional, Ruscitti, P., additional, Maruotti, N., additional, Margiotta, D.P.E., additional, Liakouli, V., additional, Di Benedetto, P., additional, Carubbi, F., additional, Valenti, M., additional, Cantatore, F.P., additional, Afeltra, A., additional, and Giacomelli, R., additional
Published: 2016
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17. FRI0504 Prognostic Factors of Adult Onset Still's Disease: Analysis of 100 Cases in 3 Tertiary Referral Centers

Author: Ruscitti, P., primary, Cipriani, P., additional, Ciccia, F., additional, Masedu, F., additional, Iacono, D., additional, Liakouli, V., additional, Guggino, G., additional, Carubbi, F., additional, Berardicurti, O., additional, Di Benedetto, P., additional, Valenti, M., additional, Triolo, G., additional, Valentini, G., additional, and Giacomelli, R., additional
Published: 2016
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18. Intravesical sequential BCG and electromotive mitomycin versus BCG alone for stage pT1 urothelial bladder cancer

Author: DI STASI, Sm, Verri, C, Liberati, E, Masedu, F, and Valenti, M
Subjects: Settore MED/24 - Urologia
Published: 2013

19. Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome

Author: FUSETTI, M., FIORETTI, A.B., VALENTI, M., MASEDU, F., LAURIELLO, M., and PAGLIARELLA, M.
Subjects: Sleep Medicine, Adult, Aged, 80 and over, Male, Arterial hypertension, Sleep Apnea, Obstructive, Adolescent, nutritional and metabolic diseases, Insulin resistance, Middle Aged, Severity of Illness Index, Metabolic syndrome, nervous system diseases, respiratory tract diseases, Young Adult, Diabetes mellitus, stomatognathic system, Obstructive sleep apnoea syndrome, Hypertension, Humans, Female, Aged
Abstract: The purpose of this study was to evaluate the correlation between severity of obstructive sleep apnoea syndrome (OSAS), cardiovascular disease and metabolic syndrome. We recruited 1185 patients with OSAS who underwent a complete ENT examination, including nasolaryngeal fibre optic endoscopy with Müller's manoeuvre, overnight cardio-respiratory monitoring, Epworth Sleepiness Scale (ESS) to measure daytime sleepiness, body mass index (BMI), measurement of blood pressure and blood tests.SUBSEQUENTLY, SUBJECTS WERE DIVIDED INTO THREE SUBGROUPS ACCORDING TO THE APNOEA HYPOPNOEA INDEX (AHI): mild OSAS (AHI 5-15), moderate OSAS (AHI 15-30) and severe OSAS (AHI30). In the sample collected, 347 (262 males and 85 females) of 1185 patients suffered from mild OSAS, 363 (269 males and 94 females) from moderate OSAS and 475 (330 males and 145 females) from severe OSAS. In the group suffering from mild OSAS, we found: 127 patients affected by hypertension, 48 with diabetes, 11 with dyslipidaemia and 32 with metabolic syndrome. In the group with moderate OSAS there were 157 patients with hypertension, 63 with diabetes, 72 with dyslipidaemia and 47 with metabolic syndrome. In the group suffering from severe OSAS there were 244 patients with hypertension, 138 with diabetes, 47 with dyslipidaemia and 90 with metabolic syndrome. For data analysis, we used the Spearman correlation test adjusted according to Sidak between the dependent variable AHI and the independent variables BMI, ESS, average SO2 (SO(2med)), hypertension, diabetes mellitus, dyslipidaemia and metabolic syndrome. The results show different patterns of correlation in terms of statistical significance: BMI ρ(s) = 0.26, SO(2med) ρ(s) = -0:51, hypertension ρ(s) = -0.05, dyslipidaemia ρ(s) = 0.22 for women, and BMI ρ(s) = 0.53, ESS ρ(s) = 0.28, SO(2med) ρ(s) = -0.50, hypertension ρ(s) = 0.17, diabetes mellitus ρ(s) = 0.28 and metabolic syndrome ρ(s) = 0.26 for men. The results of the study confirm the existence of a statistically significant correlation between the severity of OSAS and BMI, ESS, average SO2, hypertension, diabetes mellitus, dyslipidaemia and metabolic syndrome.RIASSUNTOLo scopo dello studio è stato valutare la correlazione tra gravità della sindrome delle apnee ostruttive del sonno (OSAS), patologia cardiovascolare e sindrome metabolica. Sono stati reclutati 1185 pazienti affetti da OSAS e sottoposti a visita otorinolaringoiatrica, scala di Epworth per la sonnolenza diurna (ESS), nasolaringofibroscopia con manovra di Mueller, monitoraggio cardio-respiratorio notturno, calcolo dell'indice di massa corporeo (BMI), misurazione della pressione arteriosa ed esami ematochimici. Successivamente la casistica è stata suddivisa in tre sottogruppi in base all' Apnea Hypopnea Index (AHI): OSAS lieve (AHI 5-15),OSAS moderato (AHI 15-30),OSAS severo (AHI30). Dei 1185 pazienti, 347 sono risultati affetti da OSAS di grado lieve, di cui 262 maschi e 85 femmine, 363 da OSAS di grado moderato, di cui 269 maschi e 94 femmine e 475 da OSAS di grado severo, di cui 330 maschi e 145 femmine. Nel gruppo affetto da OSAS lieve abbiamo riscontrato:127 pazienti ipertesi, 48 pazienti diabetici, 11 pazienti con dislipidemia e 32 pazienti affetti da sindrome metabolica. In quello con OSAS moderato: 157 pazienti ipertesi, 63 pazienti diabetici, 72 pazienti dislipidemici, 47 pazienti affetti da sindrome metabolica. Infine nel gruppo affetto da OSAS severo: 244 pazienti ipertesi, 138 pazienti diabetici, 47 pazienti dislipidemici e 90 pazienti affetti da sindrome metabolica. Per l'analisi dei dati è stato utilizzato il test di correlazione di Spearman adattato secondo Sidak tra la variabile dipendente AHI e le variabili indipendenti BMI, ESS, SO media, ipertensione arteriosa, diabete mellito, dislipidemia e sindrome metabolica. I risultati mostrano differenti pattern di correlazione in termini di significatività statistica: BMI ρ = 0,26, SO ρ = -0,51, ipertensione arteriosa ρ = -0,05, dislipidemia ρ = 0,22 per le donne, e BMI ρ = 0,53, ESS ρ = 0,28, SO ρ = -0,50, ipertensione arteriosa ρ = 0,17, diabete mellito ρ = 0,28 e sindrome metabolica ρ = 0,26 per gli uomini. I risultati dello studio confermano l'esistenza di una correlazione statisticamente significativa tra la gravità dell'OSAS ed i parametri BMI, ESS, SO media, ipertensione arteriosa, diabete mellito, dislipidemia e sindrome metabolica.
Published: 2012

20. INTRAVESICAL ADJUVANT ELECTROMOTIVE MITOMYCIN-C IN PATIENTS WITH INTERMEDIATE-RISK NON-MUSCLE INVASIVE BLADDER CANCER: A RANDOMIZED CONTROLLED TRIAL

Author: DI STASI, Sm, Verri, C, Liberati, E, Micali, F, Masedu, F, and Valenti, M
Subjects: Settore MED/24 - Urologia
Published: 2012

21. Somatosensory evoked responses and lead position for deep brain stimulation in the brainstem: their relationships are helpful in the precise targeting of the pedunculopontine tegmental nucleus

Author: Mazzone, P., primary, Scarnati, E., additional, Masedu, F., additional, Valeriani, M., additional, and Insola, A., additional
Published: 2015
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22. Burnout among therapists working with persons with autism after the 2009 earthquake in L'Aquila, Italy: a longitudinal comparative study

Author: Valenti, M., primary, La Malfa, G, additional, Tomassini, A., additional, Masedu, F., additional, Tiberti, S., additional, and Sorge, G., additional
Published: 2013
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23. 698 Intravesical sequential BCG and electromotive mitomycin versus BCG alone for stage pT1 urothelial bladder cancer

Author: Di Stasi, S.M., primary, Verri, C., additional, Liberati, E., additional, Masedu, F., additional, and Valenti, M., additional
Published: 2013
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24. 1045 Intravesical adjuvant electromotive drug administration (EMDA®) of mitomycin-C in patients with intermediate-risk non-muscle invasive bladder cancer: A randomized controlled trial

Author: Di Stasi, S.M., primary, Verri, C., additional, Liberati, E., additional, Micali, F., additional, Masedu, F., additional, Zampa, G., additional, and Valenti, M., additional
Published: 2012
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25. Burnout among therapists working with persons with autism after the 2009 earthquake in L' Aquila, Italy: a longitudinal comparative study.

Author: Valenti, M., La Malfa, G, Tomassini, A., Masedu, F., Tiberti, S., and Sorge, G.
Subjects: TREATMENT of autism, ANALYSIS of variance, PSYCHOLOGICAL burnout, LONGITUDINAL method, MULTIVARIATE analysis, NATURAL disasters, POST-traumatic stress disorder, MENTAL health personnel, SAMPLE size (Statistics), EVALUATION research, DESCRIPTIVE statistics, PSYCHOLOGY
Abstract: Accessible summary This study was the first attempt to evaluate burnout occurrence in mental health therapists working in a highly exposed setting, characterized by prolonged exposure to an autism-related work frame and a post-earthquake aftermath., Results strongly suggest that autism therapists exposed to a disruptive earthquake are at higher risk of burnout than caregivers working in typical conditions. In presence of high-risk exposures, burnout occurs rapidly (1 year) with respect to times to event described in the literature (4 years or later)., Efforts are required to help mental health workers, including psychiatric nurses, to cope with the devastating situation determined by an earthquake. Assuming that return to good work conditions, supervision support, and natural adaptation are plausible determinants in reducing burnout risk, a periodical monitoring of mental health status is recommended in mental health works., Abstract The aim of this study was to follow up the occurrence of burnout in therapists of children and adolescents with autism experiencing the 2009 earthquake in L' Aquila, and to discuss implications for burnout prevention after disasters. A longitudinal study was carried out, measuring burnout outcomes according to the Maslach Burnout Inventory in 11 exposed and 53 unexposed therapists. Staff in the exposed group appeared to report significantly higher levels of emotional exhaustion after 1 and 2 years of follow-up than the unexposed staff. As to lack of personal accomplishment, the exposed groups shows increasingly lower scores with respect to the unexposed group, with personal accomplishment ( PA) values falling from 41.0 [standard deviation (SD) 3.7] to 33.4 (SD 4.1) after 2 years, whereas PA values remain stable over time in the unexposed group. As to depersonalization, data show no significant difference between groups. Burnout occurrence is induced by the exceptional stressors related with natural disasters like earthquakes. Efforts are required to help mental health workers, including psychiatric nurses, to cope with the devastating situation determined by an earthquake. A periodical monitoring of mental health status is recommended in mental health works, especially with regard to help with post-traumatic stress disorder, coping with work and therapeutic relationships, family and social life and economic impact. [ABSTRACT FROM AUTHOR]
Published: 2014
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26. Validity of the Italian version of Khalfa's questionnaire on hyperacusis

Author: Alessandra Fioretti, Tortorella F, Masedu F, Valenti M, Fusetti M, and Pavaci S
Subjects: Adult, Aged, 80 and over, Male, Adolescent, Hyperacusis questionnaire, Audiology, Middle Aged, Hyperacusis, Tinnitus, Young Adult, Italy, Khalfa, Humans, Female, Self Report, Aged, Language, Uncomfortable loudness level (ULL)
Abstract: The present study aims to evaluate and validate the Italian version of Khalfa's questionnaire on hyperacusis (HQ). We recruited 117 patients (64 men, 53 women, mean age 53 years, range 14-88) with tinnitus for at least 3 months as a primary disorder. All patients completed the THI and the Italian version of the HQ and underwent audiometry, pitch and loudness tinnitus matching, otoacoustic emissions with distortion products (DPOAE) and uncomfortable loudness level (ULL). The overall performance of the tests was evaluated and compared using the area under the RO C curve (AUC) relative to the tests. The cut-off of the HQ was calculated. We also assessed the Cronbach's alpha (αC) for the HQ and its three major dimensions (attentional - αC1, emotional - αC2 and social - αC3). Statistical analysis showed no correlation between DPOAE, audiometry, ULL and gender. We observed a high correlation (p0.05) between hyperacusis and ULL described by the Spearman's ρ index (rs = 0.72). We found a cut-off of 16 indicative of hyperacusis comparing the area under the RO C curve (AUC) of HQ and audiometry, taken as a diagnostic reference, (sensitivity = 67.9% and specificity = 72.2%). The reliability of HQ was confirmed by a high αC = 0.89. The αC for the single dimensional scales were, respectively, αC1 = 0.73, αC2 = 0.72 and αC3 = 0.81. The Italian version of the HQ is recommended for proper and complete classification of patients with tinnitus and hyperacusis. From our study, we found a cut-off of 16 instead of the cut-off of 28 described as very high by other authors. Moreover, ULL was an important variable and can be discriminating in the evaluation of hyperacusis.Il presente studio ha come scopo quello di valutare e dimostrare la validità della versione italiana del questionario sull'iperacusia di Khalfa (HQ). Sono stati reclutati 117 pazienti (64 uomini, 53 donne; età: 14-88 anni, media 53 anni) con acufene da almeno 3 mesi come disturbo primario. Tutti i pazienti hanno compilato il THI e la versione italiana del HQ e sono stati sottoposti ad esame audiometrico, acufenometria, otoemissioni acustiche con prodotti di distorsione (DPOAE) e soglia del fastidio (ULL). La performance complessiva dei test è stata valutata e confrontata usando l'area sotto le curve ROC (AUC) relative ai test. Il cut-off del HQ è stato calcolato. Inoltre abbiamo valutato l'alfa di Cronbach's (αC) per il HQ e per le sue tre scale dimensionali: attenzionale (αC1), emotiva (αC2) e sociale (αC3). La nostra analisi statistica non ha evidenziato alcuna correlazione tra DPOAE, esame audiometrico, ULL e sesso. Inoltre è stata osservata una elevata correlazione tra l'iperacusia e l'ULL, descritto dall'indice ρ di Spearman (rs = 0,72). È stato calcolato un cut-off di 16 indicativo di iperacusia, comparando l'area sotto la curva ROC (AUC) del HQ e l'audiometria, presa come riferimento diagnostico, (sensibilità = 67.89% e specificità = 72.22%). L'affidabilità del HQ è stata confermata da un alto αC = 0,89. L'αC per le singole scale dimensionali sono risultate rispettivamente αC1 = 0.73, αC2 = 0.72 e αC3 = 0.81. La versione italiana del HQ è consigliata per una classificazione appropriata e completa dei pazienti con iperacusia. Dal nostro studio abbiamo trovato un cut-off di 16 invece del cut-off di 28, descritto come molto alto da differenti autori. Inoltre, l'ULL risulta una importante variabile e può essere discriminante nella valutazione dell'iperacusia.

27. Quality of health care services as perceived by the customers: issues of method or context?,La qualità del servizio sanitario come percepita dagli utenti: questioni di metodo o di contesto?

Author: Stefano NECOZIONE, Masedu, F., Cofini, V., and Di Orio, F.

28. Biologic therapies and infections in the daily practice of three Italian rheumatologic units: a prospective, observational study

Author: Cipriani P, Berardicurti O, Masedu F, D'Onofrio F, Luca Navarini, Ruscitti P, Maruotti N, Dp, Margiotta, Liakouli V, Di Benedetto P, Carubbi F, Valenti M, Fp, Cantatore, Afeltra A, and Giacomelli R

29. COPD: cross-sectional study of prevalence and screening program in a risk area of the Po River delta in Italy,BPCO: studio trasversale di prevalenza e programma di screening in un'area a rischio nel delta del Po

Author: Tiberti, S., Masedu, F., and Marco Valenti

30. Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome,Comorbiditá cardiovascolare e metabolica nei pazienti affetti da sindrome delle apnee ostruttive del sonno

Author: Fusetti, M., Fioretti, A. B., Valenti, M., Masedu, F., Maria Lauriello, and Pagliarella, M.

31. COPD: cross-sectional study of prevalence and screening program in a risk area of the Po River delta in Italy | BPCO: studio trasversale di prevalenza e programma di screening in un'area a rischio nel delta del Po

Author: Sergio Tiberti, Masedu, F., and Valenti, M.

32. Cervical pain and headache in patients with facial asymmetries: The effect of orthognathic surgical correction

Author: Corbacelli A, Cutilli T, Marinangeli F, Alessandra Ciccozzi, Corbacelli C, Necozione S, Masedu F, and Varrassi G
Subjects: Adult, Male, Fibromyalgia, Neck Pain, Adolescent, Headache, Pain, Orthodontics, Treatment Outcome, Facial Asymmetry, Humans, Female, Orthopedic Procedures, Tomography, X-Ray Computed, Myofascial Pain Syndromes, Orthodontic Surgery, Pain Measurement
Abstract: Facial asymmetries are often associated with cervicobrachial pain and headache. The aim of the study was to evaluate the influence of surgical orthognathic correction of facial asymmetries on the intensity of cervicobrachial pain and headache in the short and long term.Thirty-two patients affected by maxillomandibular asymmetries associated with pain referred to occipital, cervical, dorsal and scapulohumeral areas who were undergoing orthodontic surgical correction were enrolled in the study. The pain intensity at rest and on fibromyalgia trigger points was assessed using a 0-10 Visual Analogue Scale (VAS) preoperatively (T(0)) and 5 days (T(1)), 6 months (T(2)) and 12 months (T(3)) after surgery. Functional limitation was evaluated by the same method at T(0),T(2) and T(3).VAS scores at rest were significantly lower at T(1), T(2) and T(3) compared to T0 in every area to which pain was referred. After 12 months (T(3)), pain at rest was completely absent in 23 patients (71.8%) in the occipital region, in 23 patients (71.8%) in the cervical area, in 22 patients (68.7%) in the dorsal area, and in 28 patients (87.5%) in the scapulohumeral area. In the other patients, the pain scores in all areas were1 (0.77, 0.83, 0.95, 0.5 in the occipital, cervical, dorsal, and scapulohumeral areas respectively). The VAS at neck fibromyalgia points were significantly reduced at T(1), T(2), T(3) and functional limitation was improved at T(3) and T(4) (P=0.00).This study appears to demonstrate the utility of orthognathic surgery when facial asymmetry is associated with cranial-cervicobrachial pain syndrome, presumably through a new musculoskeletal rearrangement of stomatognathic apparatus. Indeed, the surgical correction has resulted in morphological, functional and symptomatic effects.

33. Intensive intervention for children and adolescents with autism in a community setting in Italy: a single-group longitudinal study

Author: Valenti Marco, Cerbo Renato, Masedu Francesco, De Caris Marco, and Sorge Germana
Subjects: Pediatrics, RJ1-570, Psychiatry, RC435-571
Abstract: Abstract Background Previous studies have shown favourable results with intensive behavioural treatment for children with autism: evidence has emerged that treatment can be successfully implemented in a community setting and in adolescent participants. The aim of this study was to describe the 2-year adaptive functioning outcome of children and adolescents with autism treated intensively within the context of special autism centres, as well as to evaluate family satisfaction with the activity of the centres. Methods Sixty participants with autism (20 females and 40 males, aged between 4 and 18 years) attending the semi-residential rehabilitation centres for autism located in the Abruzzo region (Central Italy) were followed up and their adaptive functioning was evaluated both at baseline and after one and two years using the Vineland Adaptive Behaviour Scales (VABS). Parents' satisfaction with the service was evaluated using the Orbetello Satisfaction Scale for Children and Adolescent Mental Health. Results The increase in VABS scores was significant on several domains in the different gender and age categories. It is worth noting that male children had improved a great deal (roughly, an effect size >0.20) in the domains of communication, daily living and motor skills (effect sizes 0.34, 0.45 and 0.27 respectively) whereas in male adolescents, a notable increase in VABS scores was recorded in the domain of socialization only (effect size 0.23). On the other hand, adaptive behaviour in female children increased in the domains of socialization and motor skills (effect sizes 0.27 and 0.42 respectively) whereas in female adolescents, good results were achieved in the domains of daily living, socialization and motor skills (effect sizes 0.22, 0.26 and 0.20 respectively). The level of satisfaction of users of the service over time was found to be substantial, even when they had recently started the program. Conclusions Our results support the implementation of special autism treatment community centres, based on a parent co-directed rehabilitative, intensive and early intervention. Further experimental research designed to document the effectiveness of services provided to children and adolescents with autism in the community is recommended.
Published: 2010
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34. Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients

Author: Luiz Guilherme L Soares, Marco Maltoni, Stefano De Santis, Kyriaki Mystakidou, Federica Aielli, Gaetano Lanzetta, Andrea Cortegiani, Francesco Masedu, Sebastiano Mercadante, Marco Valenti, Patrizia Ferrera, Romina Rossi, Franco Marinangeli, Claudio Adile, Marta Rosati, Mercadante S, Adile C, Lanzetta G, Mystakidou K, Maltoni M, Soares LG, De Santis S, Ferrera P, Valenti M, Rosati M, Rossi R, Cortegiani A, Masedu F, Marinangeli F, Aielli F, Mercadante S., Adile C., Lanzetta G., Mystakidou K., Maltoni M., Guilherme Soares L., De Santis S., Ferrera P., Valenti M., Rosati M., Rossi R., Cortegiani A., Masedu F., Marinangeli F., and Aielli F.
Subjects: Male, Cancer Research, medicine.medical_specialty, Multivariate analysis, Palliative care, Symptom assessment, Global impression of change, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Advanced cancer, Neoplasms, medicine, Odd ratio, Humans, 030212 general & internal medicine, Related factors, Symptom management, business.industry, Personalized symptom goal, Oncology, Symptom Management and Supportive Care, 030220 oncology & carcinogenesis, Physical therapy, Female, Symptom Assessment, business
Abstract: Background The aim of this study was to assess the patients’ global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Results Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71–2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. Conclusion PSG and PGI seem to be relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Implications for Practice Personalized symptom goals and global impression of change are relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response.
Published: 2017

35. Symptom expression in advanced cancer patients admitted to hospice or home care with and without delirium

Author: Domenico Russo, Daniela De Giovanni, Luigi Montanari, Raffaella Bertè, Federica Aielli, Cristina Pittureri, Laura Ursini, Marco Maltoni, Sebastiano Mercadante, Francesco Masedu, Franco Marinangeli, Mercadante S., Masedu F., Maltoni M., De Giovanni D., Montanari L., Pittureri C., Berte R., Russo D., Ursini L., Marinangeli F., and Aielli F.
Subjects: Male, medicine.medical_specialty, Weakness, Palliative care, Nausea, MEDLINE, 030204 cardiovascular system & hematology, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, Advanced cancer, Neoplasms, Internal medicine, mental disorders, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Depression (differential diagnoses), Edmonton Symptom Assessment Scale, Aged, Aged, 80 and over, Analysis of Variance, business.industry, Delirium, Memorial Delirium Assessment Scale, Syndrome, Middle Aged, Hospitalization, Hospice Care, Poor Appetite, Emergency Medicine, Female, medicine.symptom, business
Abstract: The aim of this study is to investigate the relationship between delirium and symptom expression in advanced cancer patients admitted to palliative care services. This is a secondary analysis of a consecutive sample of advanced cancer patients who were admitted to home care and hospices, and prospectively assessed for a period of 10months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after seven days of home care or hospice care (T7). Of the eight hundred and forty-eight patients screened in the period, 585 were not considered in the analysis for various reasons. The mean age was 72.1years (SD 13.7), and 146 patients were males (55.5%). The mean Karnofsky status recorded at T0 is 34.1 (SD = 6.69). The mean duration palliative care assistance is 38.4days (SD = 48, range 2–220). Of 263 patients who had a MDAS available at T0, 110 patients (41.8%) had a diagnosis of delirium. Of them, 167 patients had complete data regarding MDAS measurement, either at T0 and T7. A larger number of patients (n 167, 63.5%) had delirium after a week of palliative care. Patients with delirium are likely to be older, to have a lower Karnofsky level at T0, and to be home care patients. At T0, weakness, nausea, drowsiness, lack of appetite, and well-being are associated with delirium. At T7, weakness, poor appetite, and poor well-being are significantly associated with delirium. 27% of patients who had a normal cognitive status at T0 developed delirium at T7. In patients with delirium, an improvement in the cognitive status corresponds to a significant improvement in weakness, depression, and appetite. Conversely, the occurrence of delirium in patients who had a normal cognitive status at admission significantly increases the level depression, while the level of weakness and appetite decrease. Symptom expression is amplified in patients with delirium admitted to home care or hospices, while patients without delirium can be more responsive to palliative treatments with a significant decrease in intensity of ESAS items.
Published: 2018
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36. Prognostic factors of macrophage activation syndrome, at the time of diagnosis, in adult patients affected by autoimmune disease: Analysis of 41 cases collected in 2 rheumatologic centers

Author: Francesco Ciccia, Vasiliki Liakouli, Francesco Carubbi, Giovanni Triolo, Paola Di Benedetto, Paola Cipriani, Roberto Giacomelli, Onorina Berardicurti, Marco Valenti, Francesco Masedu, Piero Ruscitti, Giuliana Guggino, Salvatore Di Bartolomeo, Ruscitti, P., Cipriani, P., Ciccia, F., Masedu, F., Liakouli, V., Carubbi, F., Berardicurti, O., Guggino, G., Di Benedetto, P., Di Bartolomeo, S., Valenti, M., Triolo, G., Giacomelli, R., Ciccia, Francesco, and Guggino, Giuliana
Subjects: Adult, Male, musculoskeletal diseases, 0301 basic medicine, medicine.medical_specialty, Immunology, Adult onset Still's disease, Hyperferritinemic syndrome, Macrophage activation syndrome, Ambulatory Care Facilities, Autoimmune Diseases, Female, Humans, Immunosuppressive Agents, Macrophage Activation Syndrome, Middle Aged, Prognosis, Retrospective Studies, Treatment Outcome, Immunology and Allergy, Disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, 030203 arthritis & rheumatology, Autoimmune disease, Adult patients, business.industry, Mortality rate, fungi, Retrospective cohort study, medicine.disease, body regions, Settore MED/16 - Reumatologia, 030104 developmental biology, Cohort, lipids (amino acids, peptides, and proteins), business, Cytokine storm, hormones, hormone substitutes, and hormone antagonists
Abstract: Macrophage activation syndrome (MAS) is a rare, life-threatening disease in which early diagnosis and aggressive therapeutic strategy may improve the outcome. Due to its rarity, epidemiologic data are still lacking. Hyperferritinemia is frequently associated with MAS and might modulate the cytokine storm, which is involved in the development of multiple organ failure. In this paper, we investigated clinical data, treatments, and outcome of a homogeneous cohort of 41 adult MAS patients, complicating autoimmune rheumatic diseases. MAS-related death occurred in 17 patients (42.5%) during the follow-up, and older age and increased serum ferritin levels, at the time of diagnosis, were significantly associated with mortality. In conclusion, adult MAS is associated with high mortality rate. Some clinical features at diagnosis may be predictive of MAS-associated death.
Published: 2017
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37. Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients

Author: Sebastiano Mercadante, Paolo Marchetti, Arturo Cuomo, Augusto Caraceni, Rocco Domenico Mediati, Renato Vellucci, Massimo Mammucari, Silvia Natoli, Marzia Lazzari, Mario Dauri, Claudio Adile, Mario Airoldi, Giuseppe Azzarello, Mauro Bandera, Livio Blasi, Giacomo Cartenì, Bruno Chiurazzi, Benedetta Veruska Pierpaola Costanzo, Daniela Degiovanni, Flavio Fusco, Vittorio Guardamagna, Vincenzo Iaffaioli, Simeone Liguori, Loredana Palermo, Sergio Mameli, Francesco Masedu, Rodolfo Mattioli, Teresita Mazzei, Rita Maria Melotti, Valentino Menardo, Danilo Miotti, Stefano Moroso, Gaetano Pascoletti, Stefano De Santis, Remo Orsetti, Alfonso Papa, Sergio Ricci, Elvira Scelzi, Michele Sofia, Giuseppe Tonini, Alessandro Valle, Federica Aielli, on behalf of the IOPS-MS Study Group, Mercadante S., Marchetti P., Cuomo A., Caraceni A., Mediati R.D., Vellucci R., Mammucari M., Natoli S., Lazzari M., Dauri M., Adile C., Airoldi M., Azzarello G., Bandera M., Blasi L., Carteni G., Chiurazzi B., Costanzo B.V.P., Degiovanni D., Fusco F., Guardamagna V., Iaffaioli V., Liguori S., Palermo L., Mameli S., Masedu F., Mattioli R., Mazzei T., Melotti R.M., Menardo V., Miotti D., Moroso S., Pascoletti G., De Santis S., Orsetti R., Papa A., Ricci S., Scelzi E., Sofia M., Tonini G., Valle A., and Aielli F.
Subjects: medicine.medical_specialty, Cancer Research, Palliative care, Nausea, Settore MED/06 - Oncologia Medica, Settore MED/41 - Anestesiologia, lcsh:RC254-282, Article, 03 medical and health sciences, breakthrough pain, cancer, palliative care, supportive care, 0302 clinical medicine, Internal medicine, medicine, Breakthrough pain, Cancer, Supportive care, Oncology, business.industry, Hydromorphone, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 030220 oncology & carcinogenesis, Neuropathic pain, Tramadol, medicine.symptom, Cancer pain, business, Oxycodone, 030217 neurology & neurosurgery, medicine.drug, Buprenorphine
Abstract: Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics.
Published: 2018

38. The prevalence of constipation at admission and after 1 week of palliative care: a multi-center study

Author: Luigi Montanari, Daniela De Giovanni, Cristina Pittureri, Federica Aielli, Sebastiano Mercadante, Francesco Masedu, Raffaella Bertè, Marco Maltoni, Franco Marinangeli, Laura Ursini, Mercadante S., Masedu F., Maltoni M., Giovanni D.D., Montanari L., Pittureri C., Berte R., Ursini L., Marinangeli F., and Aielli F.
Subjects: Male, medicine.medical_specialty, advanced cancer, bowel function index, Constipation, opioids, palliative care, Medicine (all), Palliative care, 03 medical and health sciences, Benzodiazepines, 0302 clinical medicine, Neoplasms, medicine, Prevalence, Humans, 030212 general & internal medicine, Prospective Studies, Karnofsky Performance Status, Intensive care medicine, Aged, Neoplasm Staging, Dehydration, business.industry, Palliative Care, General Medicine, Middle Aged, Prognosis, Advanced cancer, Hospitalization, Italy, Laxatives, 030220 oncology & carcinogenesis, Multi center study, opioid, Disease Progression, Female, sense organs, medicine.symptom, Symptom Assessment, business
Abstract: Aim: To assess the prevalence and intensity of constipation in advanced-cancer patients referred to palliative care, and to assess changes after 1 week of specialist palliative care. Methods: This was a prospective multi-center study in advanced patients for a period of 1 year. At admission (T0), age, gender, primary tumor, concomitant diseases, Karnofsky status, Palliative prognostic score (PaP), Edmonton Symptom Assessment scale (ESAS), Memorial Delirium Assessment Scale (MDAS), and bowel function index (BFI) were collected. In BFI, high values represent severe constipation. The use of medication was also recorded, as well as possible causes of constipation. The same parameters were recorded 1 week after admission for palliative care (T7). Results: A total of 246 patients were screened for constipation. The mean BFI at T0 was 42.4 (SD = 26.92). One hundred and sixty-three patients (66.3%) had a BFI >28. The mean BFI at T7 was 35.7 (SD = 28.8), with a significant decrease from T0 to T7 (p =.000). A significant decrease of BFI in patients with a BFI >28 was reported (p =.000). In patients with a BFI ≤28 there was a significant worsening of constipation (p =.000). In patients with a BFI >28 at T0 there was a significant increase in the use of laxatives at T7 in comparison with patients having a BFI ≤28 (p =.002). In patients with a BFI ≤28 at T0, who had a significant worsening of BFI (Δ > 12), the use of laxatives was significantly lower in comparison to patients who had a BFI >28 (p =.000). In the multivariate analysis, dehydration and the use of benzodiazepines were independently associated with higher BFI scores. Conclusion: Constipation is present in approximately two-thirds of patients, and is principally associated with dehydration and the use of benzodiazepines. Patients with normal bowel function at initial assessment may see a worsening in their condition a week later due to lack of prevention or subsequent under-treatment.
Published: 2017

39. Adult-onset Still’s disease: evaluation of prognostic tools and validation of the systemic score by analysis of 100 cases from three centers

Author: Piero Ruscitti, Gabriele Valentini, Onorina Berardicurti, Francesco Carubbi, Giuliana Guggino, Francesco Masedu, Paola Di Benedetto, Vasiliki Liakouli, Paola Cipriani, Marco Valenti, Roberto Giacomelli, Daniela Iacono, Francesco Ciccia, Giovanni Triolo, Ruscitti P., Cipriani P., Masedu F., Iacono D., Ciccia F., Liakouli V., Guggino G., Carubbi F., Berardicurti O., Di Benedetto P., Valenti M., Triolo G., Valentini G., Giacomelli R., Ruscitti, Piero, Cipriani, Paola, Masedu, Francesco, Iacono, Daniela, Ciccia, Francesco, Liakouli, Vasiliki, Guggino, Giuliana, Carubbi, Francesco, Berardicurti, Onorina, Di Benedetto, Paola, Valenti, Marco, Triolo, Giovanni, Valentini, Gabriele, and Giacomelli, Roberto
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Prognosi, Hepatosplenomegaly, Arthritis, Disease, Adult-onset Still's disease, Young Adult, 03 medical and health sciences, Systemic score, 0302 clinical medicine, Retrospective Studie, Internal medicine, medicine, Humans, Young adult, Retrospective Studies, Adult-onset Still’s disease, Medicine(all), 030203 arthritis & rheumatology, Prognostic factor, business.industry, Medicine (all), Biomarker, General Medicine, Middle Aged, Prognosis, medicine.disease, Rash, Surgery, Settore MED/16 - Reumatologia, 030104 developmental biology, Macrophage activation syndrome, Etiology, Female, medicine.symptom, business, Still's Disease, Adult-Onset, Serositis, Biomarkers, Human, Research Article
Abstract: Background: Adult-onset Still's disease (AOSD) is rare inflammatory disease of unknown etiology that usually affects young adults. The more common clinical manifestations are spiking fevers, arthritis, evanescent rash, elevated liver enzymes, lymphadenopathy, hepatosplenomegaly, and serositis. The multi-visceral involvement of the disease and the different complications, such as macrophage activation syndrome, may strongly decrease the life expectancy of AOSD patients. Methods: This study aimed to identify the positive and negative features correlated with the outcome of patients. A retrospective analysis of AOSD patients prospectively admitted to three rheumatologic centers was performed to identify the clinical features present at the time of diagnosis and to predict the possible outcome. Furthermore, we investigated the as yet to be validated prognostic value of the systemic score previously proposed. Results: One hundred consecutive AOSD patients were enrolled. The mean systemic score showed that the majority of patients had a multi-organ involvement. Sixteen patients showed different complications, mainly the macrophage activation syndrome. A strong increase of inflammatory markers was observed. All patients received steroids at different dosages, 55 patients in association with immunosuppressive drugs and 32 in association with biologic agents. Sixteen patients died during the follow-up. Regression analysis showed that the higher values of the systemic score and the presence of AOSD-related complications, assessed at the time of diagnosis, were significantly correlated with patient mortality. A prognostic impact of the systemic score of ≥ 7.0 was reported. Conclusions: Our study showed that a higher systemic score and the presence of AOSD-related complications at the time of diagnosis were significantly associated with mortality. Of note, a cut-off at 7.0 of the systemic score showed a strong prognostic impact in identifying patients at risk of AOSD-related death.
Published: 2016
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40. Anti-interleukin-1 treatment in patients with rheumatoid arthritis and type 2 diabetes (TRACK): A multicentre, open-label, randomised controlled trial

Author: Immacolata Prevete, Paolo Airò, Francesco Paolo Cantatore, Virginia D'Abrosca, Saverio Alvaro, Bruno Frediani, Luigi Sinigaglia, Daniela Iacono, Norma Battafarano, Ombretta Viapiana, Ilenia Pantano, Micol Frassi, Francesco Masedu, Vasiliki Liakouli, Marco Valenti, Luca Cantarini, Piero Ruscitti, Roberta Maggio, Paola Cipriani, Rita Mulè, Roberto Giacomelli, Giorgio Carlino, Ruscitti, P., Masedu, F., Alvaro, S., Airo, P., Battafarano, N., Cantarini, L., Cantatore, F. P., Carlino, G., D'Abrosca, V., Frassi, M., Frediani, B., Iacono, D., Liakouli, V., Maggio, R., Mule, R., Pantano, I., Prevete, I., Sinigaglia, L., Valenti, M., Viapiana, O., Cipriani, P., and Giacomelli, R.
Subjects: Blood Glucose, Male, Glycated Hemoglobin A, Time Factors, Physiology, 030204 cardiovascular system & hematology, Pathology and Laboratory Medicine, Biochemistry, Etanercept, Arthritis, Rheumatoid, Endocrinology, 0302 clinical medicine, Drug Metabolism, Rheumatoid, Immune Physiology, Receptors, Medicine and Health Sciences, Diabetes diagnosis and management, Insulin, Medicine, 030212 general & internal medicine, Certolizumab pegol, Immune Response, Innate Immune System, Pharmaceutics, General Medicine, Middle Aged, Type 2 Diabetes, Treatment Outcome, Italy, Antirheumatic Agents, Rheumatoid arthritis, Number needed to treat, Cytokines, Female, Type 2, Research Article, medicine.drug, medicine.medical_specialty, HbA1c, Endocrine Disorders, Immunology, Rheumatoid Arthritis, Autoimmune Diseases, 03 medical and health sciences, Signs and Symptoms, Rheumatology, Drug Therapy, Internal medicine, Diabetes Mellitus, Adalimumab, Humans, Pharmacokinetics, Hemoglobin, Aged, Inflammation, Diabetic Endocrinology, Pharmacology, Glycated Hemoglobin, Anakinra, business.industry, Arthritis, Biology and Life Sciences, Proteins, Receptors, Interleukin-1, Molecular Development, medicine.disease, Diagnostic medicine, Hormones, Infliximab, Golimumab, Interleukin 1 Receptor Antagonist Protein, Diabetes Mellitus, Type 2, Metabolic Disorders, Immune System, Clinical Immunology, Tumor Necrosis Factor Inhibitors, Clinical Medicine, business, Biomarkers, Interleukin-1, Developmental Biology
Abstract: Background The inflammatory contribution to type 2 diabetes (T2D) has suggested new therapeutic targets using biologic drugs designed for rheumatoid arthritis (RA). On this basis, we aimed at investigating whether interleukin-1 (IL-1) inhibition with anakinra, a recombinant human IL-1 receptor antagonist, could improve both glycaemic and inflammatory parameters in participants with RA and T2D compared with tumour necrosis factor (TNF) inhibitors (TNFis). Methods and findings This study, designed as a multicentre, open-label, randomised controlled trial, enrolled participants, followed up for 6 months, with RA and T2D in 12 Italian rheumatologic units between 2013 and 2016. Participants were randomised to anakinra or to a TNFi (i.e., adalimumab, certolizumab pegol, etanercept, infliximab, or golimumab), and the primary end point was the change in percentage of glycated haemoglobin (HbA1c%) (EudraCT: 2012-005370-62 ClinicalTrial.gov: NCT02236481). In total, 41 participants with RA and T2D were randomised, and 39 eligible participants were treated (age 62.72 ± 9.97 years, 74.4% female sex). The majority of participants had seropositive RA disease (rheumatoid factor and/or anticyclic citrullinated peptide antibody [ACPA] 70.2%) with active disease (Disease Activity Score-28 [DAS28]: 5.54 ± 1.03; C-reactive protein 11.84 ± 9.67 mg/L, respectively). All participants had T2D (HbA1c%: 7.77 ± 0.70, fasting plasma glucose: 139.13 ± 42.17 mg). When all the enrolled participants reached 6 months of follow-up, the important crude difference in the main end point, confirmed by an unplanned ad interim analysis showing the significant effects of anakinra, which were not observed in the other group, led to the study being stopped for early benefit. Participants in the anakinra group had a significant reduction of HbA1c%, in an unadjusted linear mixed model, after 3 months (β: −0.85, p < 0.001, 95% CI −1.28 to −0.42) and 6 months (β: −1.05, p < 0.001, 95% CI −1.50 to −0.59). Similar results were observed adjusting the model for relevant RA and T2D clinical confounders (male sex, age, ACPA positivity, use of corticosteroids, RA duration, T2D duration, use of oral antidiabetic drug, body mass index [BMI]) after 3 months (β: −1.04, p < 0.001, 95% CI −1.52 to −0.55) and 6 months (β: −1.24, p < 0.001, 95% CI −1.75 to −0.72). Participants in the TNFi group had a nonsignificant slight decrease of HbA1c%. Assuming the success threshold to be HbA1c% ≤ 7, we considered an absolute risk reduction (ARR) = 0.42 (experimental event rate = 0.54, control event rate = 0.12); thus, we estimated, rounding up, a number needed to treat (NNT) = 3. Concerning RA, a progressive reduction of disease activity was observed in both groups. No severe adverse events, hypoglycaemic episodes, or deaths were observed. Urticarial lesions at the injection site led to discontinuation in 4 (18%) anakinra-treated participants. Additionally, we observed nonsevere infections, including influenza, nasopharyngitis, upper respiratory tract infection, urinary tract infection, and diarrhoea in both groups. Our study has some limitations, including open-label design and previously unplanned ad interim analysis, small size, lack of some laboratory evaluations, and ongoing use of other drugs. Conclusions In this study, we observed an apparent benefit of IL-1 inhibition in participants with RA and T2D, reaching the therapeutic targets of both diseases. Our results suggest the concept that IL-1 inhibition may be considered a targeted treatment for RA and T2D. Trial registration The trial is registered with EU Clinical Trials Register, EudraCT Number: 2012-005370-62 and with ClinicalTrial.gov, number NCT02236481., Roberto Giacomelli and co-authors study treatment of comorbid rheumatoid arthritis and type 2 diabetes via interleukin-1 blockade., Author summary Why was this study done? A growing body of evidence suggests the inflammatory contribution to type 2 diabetes (T2D) as observed in rheumatoid arthritis (RA). Interleukin-1 (IL-1) would be a common pathogenic mediator in T2D and RA, suggesting a possible common therapeutic target. We investigated whether IL-1 inhibition with anakinra, a human IL-1-receptor antagonist, could improve both glycaemic and inflammatory parameters in participants with RA and T2D compared with tumour necrosis factor (TNF) inhibitors (TNFis). What did the researchers do and find? In a multicentre, open-label, randomised controlled trial, 39 participants with RA and T2D (age 62.72 ± 9.97 years, 74.4% female sex) were randomised to anakinra or to TNFi in order to evaluate the efficacy of these drugs in controlling the metabolic alterations of T2D. Anakinra showed a significant improvement of metabolic alteration (reduction of percentage of glycated haemoglobin [HbA1c%]) after both 3 months and 6 months of therapy (crude difference of 0.93 HbA1c% between groups), whereas TNFi did not show any significant improvement on these features. No severe adverse events, hypoglycaemic episodes, or deaths were observed. What do these findings mean? Our results suggest the concept that IL-1 inhibition may be considered a targeted treatment for RA and T2D. Managing the inflammatory disease and the metabolic comorbidity by an agent inhibiting IL-1 may lead to a consequent beneficial impact on participants’ compliance, their overall cardiovascular (CV) risk, and the burden of healthcare costs. Our study has some limitations, mainly due to open-label design, and future studies are necessary to fully clarify this topic.
Published: 2019
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41. Sleep Disturbances in Patients with Advanced Cancer in Different Palliative Care Settings

Author: Claudio Adile, Amanda Caruselli, Sebastiano Mercadante, Corrado Ficorella, Claudio Cartoni, Federica Aielli, Alessandro Valle, Massimo Pizzuto, Marco Valenti, Giampiero Porzio, Renato Parsi, Francesco Masedu, Andrea Cortegiani, Patrizia Ferrera, Mercadante, S., Aielli, F., Adile, C., Ferrera, P., Valle, A., Cartoni, C., Pizzuto, M., Caruselli, A., Parsi, R., Cortegiani, A., Masedu, F., Valenti, M., Ficorella, C., and Porzio, G.
Subjects: medicine.medical_specialty, Pediatrics, Palliative care, Cross-sectional study, insomnia, Population, Sleep disturbance, advanced cancer, palliative care, Sleep disturbances, Anesthesiology and Pain Medicine, Neurology (clinical), Nursing (all)2901 Nursing (miscellaneous), Sleep Wake Disorders, Hospital Anxiety and Depression Scale, medicine, Insomnia, Athens insomnia scale, education, Prospective cohort study, General Nursing, education.field_of_study, business.industry, Physical therapy, medicine.symptom, business
Abstract: Context Information regarding sleep disturbances in the population with advanced cancer is meager. Objectives To assess the prevalence of sleep disturbances and possible correlations with associated factors in a large number of patients with advanced cancer admitted to different palliative care settings. Methods This was an observational study performed in different settings of palliative care. A consecutive sample of patients with advanced cancer was prospectively assessed for a period of six months. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System scores, and concomitant medical treatment were recorded. Patients were administered the Athens Insomnia Scale and the Hospital Anxiety and Depression Scale (HADS). Results A total of 820 patients were surveyed. Mean age was 69.7 years (SD 12.7), and 429 patients were males. Consistent sleep disturbances (moderate to maximum) were found in 60.8% of patients. Aged patients were less likely to have sleep disturbances, whereas a poor Karnofsky level was significantly associated with sleep problems. Breast, gastrointestinal, head and neck, lung, and prostate cancers were associated with sleep problems. Patients who had a secondary school or undergraduate education had less sleep disturbances. Hormone therapy and use of opioids and corticosteroids were positively associated with sleep disturbances, and there was a positive correlation of HADS-Anxiety and HADS-Depression scores with sleep disturbances. Conclusion More than 60% of palliative care patients have relevant sleep disturbances. Several factors associated with sleep disorders have been identified and should prompt physicians to make a careful examination and subsequent treatment of these disturbances.
Published: 2015

42. Epidemiology and Characteristics of Episodic Breathlessness in Advanced Cancer Patients. An Observational Study

Author: Andrea Cortegiani, Giuseppe Bellavia, Claudio Adile, Flavio Fusco, Paolo Marchetti, Claudio Cartoni, Marco Valenti, Alessandro Valle, Patrizia Ferrera, Federica Aielli, Amanda Caruselli, Francesco Masedu, Giampiero Porzio, Sebastiano Mercadante, Mercadante, S., Aielli, F., Adile, C., Valle, A., Fusco, F., Ferrera, P., Caruselli, A., Cartoni, C., Marchetti, P., Bellavia, G., Cortegiani, A., Masedu, F., Valenti, M., and Porzio, G.
Subjects: Male, Pediatrics, medicine.medical_specialty, Palliative care, Activities of daily living, Time Factors, Episodic breathlessne, Settore MED/41 - Anestesiologia, Context (language use), advanced cancer, dyspnea, Episodic breathlessness, opioids, palliative care, Anesthesiology and Pain Medicine, Neurology (clinical), Nursing (all)2901 Nursing (miscellaneous), Disease, Comorbidity, episodic breathlessness, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Neoplasms, Epidemiology, Activities of Daily Living, medicine, Prevalence, Humans, 030212 general & internal medicine, Karnofsky Performance Status, General Nursing, Aged, business.industry, Cardiovascular Agents, respiratory system, Middle Aged, medicine.disease, 030220 oncology & carcinogenesis, Cardiovascular agent, Multivariate Analysis, opioid, Observational study, Female, business
Abstract: Context Episodic breathlessness is a relevant aspect in patients with advanced cancer. Objectives The aim of this study was to assess the different aspects of this clinical phenomenon. Methods A consecutive sample of patients with advanced cancer admitted to different settings for a period of six months was surveyed. The presence of background breathlessness and episodic breathlessness, their intensity (numerical scale 0–10), and drugs used for treatment were collected. Factors inducing episodic breathlessness and its influence on daily activities were investigated. Results Of 921 patients, 29.3% ( n = 269) had breathlessness and 134 patients (49.8%) were receiving drugs for background breathlessness. In the multivariate analysis, the risk of breathlessness increased with chronic obstructive pulmonary disease, although it decreased in patients receiving disease-oriented therapy and patients with gastrointestinal tumors. The prevalence of episodic breathlessness was 70.9% ( n = 188), and its mean intensity was 7.1 (SD 1.6). The mean duration of untreated episodic breathlessness was 19.9 minutes (SD 35.3); 41% of these patients were receiving drugs for episodic breathlessness. The majority of episodic breathlessness events (88.2%) were triggered by activity. In the multivariate analysis, higher Karnofsky Performance Status levels were significantly related to episodic breathlessness, although patients receiving disease-oriented therapy were less likely to have episodic breathlessness. Conclusion This study showed that episodic breathlessness frequently occurs in patients with breathlessness in the advanced stage of disease, has a severe intensity, and is characterized by rapid onset and short duration, which require rapid measures.
Published: 2015

43. Does ChatGPT have a typical or atypical theory of mind?

Author: Attanasio M, Mazza M, Le Donne I, Masedu F, Greco MP, and Valenti M
Abstract: In recent years, the capabilities of Large Language Models (LLMs), such as ChatGPT, to imitate human behavioral patterns have been attracting growing interest from experimental psychology. Although ChatGPT can successfully generate accurate theoretical and inferential information in several fields, its ability to exhibit a Theory of Mind (ToM) is a topic of debate and interest in literature. Impairments in ToM are considered responsible for social difficulties in many clinical conditions, such as Autism Spectrum Disorder (ASD). Some studies showed that ChatGPT can successfully pass classical ToM tasks, however, the response style used by LLMs to solve advanced ToM tasks, comparing their abilities with those of typical development (TD) individuals and clinical populations, has not been explored. In this preliminary study, we administered the Advanced ToM Test and the Emotion Attribution Task to ChatGPT 3.5 and ChatGPT-4 and compared their responses with those of an ASD and TD group. Our results showed that the two LLMs had higher accuracy in understanding mental states, although ChatGPT-3.5 failed with more complex mental states. In understanding emotional states, ChatGPT-3.5 performed significantly worse than TDs but did not differ from ASDs, showing difficulty with negative emotions. ChatGPT-4 achieved higher accuracy, but difficulties with recognizing sadness and anger persisted. The style adopted by both LLMs appeared verbose, and repetitive, tending to violate Grice's maxims. This conversational style seems similar to that adopted by high-functioning ASDs. Clinical implications and potential applications are discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Attanasio, Mazza, Le Donne, Masedu, Greco and Valenti.)
Published: 2024
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44. Locomotion and Postural Control in Young Adults with Autism Spectrum Disorders: A Novel Kinesiological Assessment.

Author: Di Giminiani R, La Greca S, Marinelli S, Attanasio M, Masedu F, Mazza M, and Valenti M
Abstract: Background/Objectives : The purposes of the present study were to assess gait by using a novel approach that plots two adjacent joint angles and the postural control in individuals with autism (ASD) and individuals with typical neurodevelopmental (TD). Methods : The surface electromyography (sEMG) activity was measured synchronously with the other variables. Twenty young adult men, 10 with TD and 10 with a diagnosis of ASD, took part in this study. Results: There was a significant difference between ASD and TD groups in the area described by the knee-ankle diagram ( p < 0.05). The sEMG activity recorded from the lateral gastrocnemius (LG) during the contact phase of gait was significantly lower in the ASD group compared with the TD group ( p < 0.05). The sEMG activity recorded in the different postural conditions showed differences in LG and tibialis anterior (TA) between the ASD and TD groups ( p < 0.05). Conclusions : The knee-ankle diagram provided a sensitive and specific movement descriptor to differentiate individuals with ASD from individuals with TD. The reduced LG activation is responsible for the reduced area in the knee-ankle diagram and 'toe-walking' in individuals with ASD and represents the common denominator of an altered ankle strategy during locomotion and postural control.
Published: 2024
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45. Response to "Assessment of the integrity and perfusion of colorectal anastomoses: which tools do we need?"

Author: Catarci M, Guadagni S, and Masedu F
Published: 2024
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46. Intraoperative left-sided colorectal anastomotic testing in clinical practice: a multi-treatment machine-learning analysis of the iCral3 prospective cohort.

Author: Catarci M, Guadagni S, Masedu F, Guercioni G, Ruffo G, Viola MG, Borghi F, Scatizzi M, Patriti A, and Baiocchi GL
Subjects: Humans, Male, Female, Aged, Middle Aged, Prospective Studies, Rectum surgery, Retrospective Studies, Colon surgery, Fluorescein Angiography methods, Reoperation statistics & numerical data, Intraoperative Care methods, Cohort Studies, Anastomotic Leak, Anastomosis, Surgical methods, Anastomosis, Surgical adverse effects, Indocyanine Green administration & dosage, Machine Learning
Abstract: Background: Current evidence about intraoperative anastomotic testing after left-sided colorectal resections is still controversial. The aim of this study was to analyze the impact of Indocyanine Green fluorescent angiography (ICG-FA) and air-leak test (ALT) over standard assessment on anastomotic leakage (AL) rates according to surgeon's perception of anastomosis perfusion and/or integrity in clinical practice., Methods: A database of 2061 patients who underwent left-sided colorectal resections was selected from patients enrolled in a prospective multicenter study. It was retrospectively analyzed through a multi-treatment machine-learning model considering standard visual assessment (NW; No. = 899; 43.6%) as the reference treatment arm, compared to ICG-FA alone (WP; No. = 409; 19.8%), ALT alone (WI; No. = 420; 20.4%) or both (WPI; No. = 333; 16.2%). Twenty-four covariates potentially affecting the outcomes were included and balanced into the model within the subgroups. The primary endpoint was AL, the secondary endpoints were overall morbidity (OM), major morbidity (MM), reoperation for AL, and mortality. All the results were reported as odds ratio (OR) with 95% confidence intervals (95%CI)., Results: The WPI subgroup showed significantly higher AL risk (OR 1.91; 95% CI 1.02-3.59; p 0.043), MM risk (OR 2.35; 95% CI 1.39-3.97; p 0.001), and reoperation for AL risk (OR 2.44; 95% CI 1.12-5.31; p 0.025). No other significant differences were recorded., Conclusions: This study showed that the surgeons' perception of both anastomotic perfusion and integrity (WPI subgroup) was associated to a significantly higher risk of AL and related morbidity, notwithstanding the extensive use of both ICG-FA and ALT testing., (© 2024. Italian Society of Surgery (SIC).)
Published: 2024
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47. Bowel preparation before elective right colectomy: Multitreatment machine-learning analysis on 2,617 patients.

Author: Catarci M, Guadagni S, Masedu F, Ruffo G, Viola MG, and Scatizzi M
Subjects: Humans, Female, Male, Middle Aged, Aged, Cathartics administration & dosage, Surgical Wound Infection prevention & control, Surgical Wound Infection epidemiology, Surgical Wound Infection etiology, Propensity Score, Anti-Bacterial Agents administration & dosage, Anastomotic Leak prevention & control, Anastomotic Leak epidemiology, Anastomotic Leak etiology, Adult, Administration, Oral, Colectomy methods, Colectomy adverse effects, Machine Learning, Elective Surgical Procedures methods, Elective Surgical Procedures adverse effects, Preoperative Care methods, Antibiotic Prophylaxis methods
Abstract: Background: In the worldwide, real-life setting, some candidates for right colectomy still receive no bowel preparation, some receive oral antibiotics alone, some receive mechanical bowel preparation alone, and some receive mechanical bowel preparation with oral antibiotics, with varying degrees of compliance to preoperative intravenous antibiotic prophylaxis. Previous studies mainly focused on left-sided colorectal anastomoses while less attention has been devoted to right-sided ileocolic anastomoses. When high-level evidence from randomized clinical trials is lacking, multiple-treatment propensity score weighting analysis of prospective data on the basis of generalized boosted model is superior to a simple propensity score-matching analysis and to an inverse probability weighting in terms of external validity and bias reduction., Methods: This is an analysis on the basis of machine-learning procedures of 2,617 patients who underwent elective right colectomies., Results: The risk of surgical-site infections (5.0% after no bowel preparation) was significantly lower after mechanical bowel preparation with oral antibiotics (4.0%, P = .017), significantly greater after mechanical bowel preparation alone (8.6%, P = .019), and comparable after oral antibiotics alone (3.9%). The risk of anastomotic leakage (3.2% after no bowel preparation) was significantly greater after oral antibiotics alone (4.8%, P = .013). Concerning secondary outcomes, no significant differences were recorded for the risk of overall morbidity and reoperation. The risk of readmission (3.0% after no bowel preparation) was significantly reduced after mechanical bowel preparation with oral antibiotics (1.5%, P = .046), and the risk of major morbidity (5.1% after no bowel preparation) was significantly greater after oral antibiotics alone (6.7%, P = .007)., Conclusion: This multitreatment machine-learning analysis, despite some limitations, showed that mechanical bowel preparation with oral antibiotics is associated with a decrease in surgical-site infections after elective right colectomy compared with no bowel preparation., (Copyright © 2024 Elsevier Inc. All rights reserved.)
Published: 2024
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48. The Systemic Score May Identify Life-Threatening Evolution in Still Disease: Data from the GIRRCS AOSD-Study Group and the AIDA Network Still Disease Registry.

Author: Ruscitti P, Masedu F, Vitale A, Caggiano V, Di Cola I, Cipriani P, Valenti M, Mayrink Giardini HA, de Brito Antonelli IP, Dagostin MA, Lopalco G, Iannone F, Maria M, Almaghlouth IA, Asfina KN, Ali HH, Ciccia F, Iacono D, Pantano I, Mauro D, Sfikakis PP, Tektonidou M, Laskari K, Berardicurti O, Dagna L, Tomelleri A, Tufan A, Can Kardas R, Hinojosa-Azaola A, Martín-Nares E, Kawakami-Campos PA, Ragab G, Hegazy MT, Direskeneli H, Alibaz-Oner F, Fotis L, Sfriso P, Govoni M, La Torre F, Cristina Maggio M, Montecucco C, De Stefano L, Bugatti S, Rossi S, Makowska J, Del Giudice E, Emmi G, Bartoloni E, Hernández-Rodríguez J, Conti G, Nunzia Olivieri A, Lo Gullo A, Simonini G, Viapiana O, Wiesik-Szewczyk E, Erten S, Carubbi F, De Paulis A, Maier A, Tharwat S, Costi S, Iagnocco A, Sebastiani GD, Gidaro A, Brucato AL, Karamanakos A, Akkoç N, Caso F, Costa L, Prete M, Perosa F, Atzeni F, Guggino G, Fabiani C, Frediani B, Giacomelli R, and Cantarini L
Subjects: Humans, Male, Female, Adult, Prospective Studies, Middle Aged, Young Adult, Severity of Illness Index, Prognosis, Disease Progression, Macrophage Activation Syndrome diagnosis, Registries, Still's Disease, Adult-Onset diagnosis, Still's Disease, Adult-Onset complications
Abstract: Objective: We aimed to evaluate the clinical usefulness of the systemic score in the prediction of life-threatening evolution in Still disease. We also aimed to assess the clinical relevance of each component of the systemic score in predicting life-threatening evolution and to derive patient subsets accordingly., Methods: A multicenter, observational, prospective study was designed including patients included in the Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale Adult-Onset Still Disease Study Group and the Autoinflammatory Disease Alliance Network Still Disease Registry. Patients were assessed to see if the variables to derive the systemic score were available. The life-threatening evolution was defined as mortality, whatever the clinical course, and/or macrophage activation syndrome, a secondary hemophagocytic lymphohistiocytosis associated with a poor prognosis., Results: A total of 597 patients with Still disease were assessed (mean ± SD age 36.6 ± 17.3 years; male 44.4%). The systemic score, assessed as a continuous variable, significantly predicted the life-threatening evolution (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.07-1.42; P = 0.004). A systemic score ≥7 also significantly predicted the likelihood of a patient experiencing life-threatening evolution (OR 3.36; 95% CI 1.81-6.25; P < 0.001). Assessing the clinical relevance of each component of the systemic score, liver involvement (OR 1.68; 95% CI 1.48-2.67; P = 0.031) and lung disease (OR 2.12; 95% CI 1.14-4.49; P = 0.042) both significantly predicted life-threatening evolution. The clinical characteristics of patients with liver involvement and lung disease were derived, highlighting their relevance in multiorgan disease manifestations., Conclusion: The clinical utility of the systemic score was shown in identifying Still disease at a higher risk of life-threatening evolution in a large cohort. Furthermore, the clinical relevance of liver involvement and lung disease was highlighted., (© 2024 American College of Rheumatology.)
Published: 2024
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49. Bowel preparation for elective colorectal resection: multi-treatment machine learning analysis on 6241 cases from a prospective Italian cohort.

Author: Catarci M, Guadagni S, Masedu F, Ruffo G, Viola MG, Borghi F, Garulli G, Pirozzi F, Delrio P, De Luca R, Baldazzi G, and Scatizzi M
Subjects: Humans, Prospective Studies, Anastomosis, Surgical, Machine Learning, Italy epidemiology, Anastomotic Leak etiology, Colorectal Neoplasms surgery
Abstract: Background: Current evidence concerning bowel preparation before elective colorectal surgery is still controversial. This study aimed to compare the incidence of anastomotic leakage (AL), surgical site infections (SSIs), and overall morbidity (any adverse event, OM) after elective colorectal surgery using four different types of bowel preparation., Methods: A prospective database gathered among 78 Italian surgical centers in two prospective studies, including 6241 patients who underwent elective colorectal resection with anastomosis for malignant or benign disease, was re-analyzed through a multi-treatment machine-learning model considering no bowel preparation (NBP; No. = 3742; 60.0%) as the reference treatment arm, compared to oral antibiotics alone (oA; No. = 406; 6.5%), mechanical bowel preparation alone (MBP; No. = 1486; 23.8%), or in combination with oAB (MoABP; No. = 607; 9.7%). Twenty covariates related to biometric data, surgical procedures, perioperative management, and hospital/center data potentially affecting outcomes were included and balanced into the model. The primary endpoints were AL, SSIs, and OM. All the results were reported as odds ratio (OR) with 95% confidence intervals (95% CI)., Results: Compared to NBP, MBP showed significantly higher AL risk (OR 1.82; 95% CI 1.23-2.71; p = .003) and OM risk (OR 1.38; 95% CI 1.10-1.72; p = .005), no significant differences for all the endpoints were recorded in the oA group, whereas MoABP showed a significantly reduced SSI risk (OR 0.45; 95% CI 0.25-0.79; p = .008)., Conclusions: MoABP significantly reduced the SSI risk after elective colorectal surgery, therefore representing a valid alternative to NBP., (© 2024. The Author(s).)
Published: 2024
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50. Oral Antibiotics Alone versus Oral Antibiotics Combined with Mechanical Bowel Preparation for Elective Colorectal Surgery: A Propensity Score-Matching Re-Analysis of the iCral 2 and 3 Prospective Cohorts.

Author: Catarci M, Guadagni S, Masedu F, Sartelli M, Montemurro LA, Baiocchi GL, Tebala GD, Borghi F, Marini P, Scatizzi M, and The Italian ColoRectal Anastomotic Leakage iCral Study Group
Abstract: The evidence regarding the role of oral antibiotics alone (oA) or combined with mechanical bowel preparation (MoABP) for elective colorectal surgery remains controversial. A prospective database of 8359 colorectal resections gathered over a 32-month period from 78 Italian surgical units (the iCral 2 and 3 studies), reporting patient-, disease-, and procedure-related variables together with 60-day adverse events, was re-analyzed to identify a subgroup of 1013 cases (12.1%) that received either oA or MoABP. This dataset was analyzed using a 1:1 propensity score-matching model including 20 covariates. Two well-balanced groups of 243 patients each were obtained: group A (oA) and group B (MoABP). The primary endpoints were anastomotic leakage (AL) and surgical site infection (SSI) rates. Group A vs. group B showed a significantly higher AL risk [14 (5.8%) vs. 6 (2.5%) events; OR: 3.77; 95%CI: 1.22-11.67; p = 0.021], while no significant difference was recorded between the two groups regarding SSIs. These results strongly support the use of MoABP for elective colorectal resections.
Published: 2024
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