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Your search keyword '"Pace, M. C."' showing total 103 results
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103 results on '"Pace, M. C."'

1. Is intrathecal bupivacaine plus dexmedetomidine superior to bupivacaine in spinal anesthesia for a cesarean section? A systematic review and meta-analysis.

Author

GIACCARI, L. G., COPPOLINO, F., AURILIO, C., PACE, M. C., PASSAVANTI, M. B., POTA, V., and SANSONE, P.

Abstract

OBJECTIVE: This study aimed to investigate whether the administration of intrathecal dexmedetomidine as a bupivacaine adjuvant for caesarean section can prolong the duration of analgesia compared with bupivacaine alone. Secondary outcomes included postoperative pain, the time interval to the first analgesic request, the level of sedation, the incidence of adverse effects, and the fetal outcomes. MATERIALS AND METHODS: A systematic review and meta-analysis were conducted. The study compared the intrathecal administration of bupivacaine plus dexmedetomidine (group BD) to the intrathecal administration of bupivacaine alone (group B) for cesarean sections. RESULTS: Fourteen publications were included. Among patients who underwent spinal anesthesia for a cesarean section, 514 patients received intrathecal bupivacaine alone, and 533 patients received intrathecal bupivacaine plus dexmedetomidine. The onset of sensory and motor block was essentially the same in both groups; the time for sensory and motor block regression was significantly longer in the BD group. Postoperative Visual Analogue Scale (VAS) values were similar in group BD when compared to group B. Postoperative VAS scores remained consistently low in Group BD compared to Group B, starting from 1 hour after surgery. The level of sedation measured at the end of the cesarean section in both groups was almost similar. No difference in terms of safety, adverse events, and neonatal outcomes was found between the two groups. CONCLUSIONS: Use of intrathecal dexmedetomidine for spinal anesthesia in cesarean section significantly prolongs sensory and motor block compared to using bupivacaine alone as an adjuvant. It also improves analgesia after 1 hour with no difference in the incidence of maternal and neonatal adverse effects compared to bupivacaine alone. The optimal dose of dexmedetomidine to use remains to be ingested. [ABSTRACT FROM AUTHOR]

Published
2024

5. Lidocaine 700 mg medicated plaster for post-herpetic neuralgia: focus on Quality of Life, effectiveness and safety - a retrospective observational study

Author

Giaccari, L G, Aurilio, C, Coppolino, F, Pace, M C, Passavanti, M B, Pota, V, Sansone, P, Giaccari, L G, Aurilio, C, Coppolino, F, Pace, M C, Passavanti, M B, Pota, V, and Sansone, P

Subjects
Treatment Outcome, Quality of Life, Humans, Lidocaine, Neuralgia, Postherpetic, Neuropathic pain, Localized, Chronic Pain, Postherpetic Neuralgia, Lidocaine, Plaster, Patch, Retrospective Studies
Abstract

Objective: Postherpetic neuralgia (PHN) is a neuropathic pain syndrome following herpes zoster (HZ) infection, characterized by pain that persists for months to years after the resolution of the HZ rash. Therapeutic management remains challenging for every clinician. We report the follow-up of patients diagnosed with PHN and treated with lidocaine 700 mg medicated plaster (LMP), focusing on effectiveness, safety, and Quality of Life (QoL). Materials and methods: This study is a retrospective observational investigation of patients with PHN treated with LMP. Patients were regularly followed for pain intensity, co-analgesic consumption, adverse effects, QoL using the EQ-5D, and patient satisfaction for 8 weeks. Results: A total of 31 patients were evaluated. At enrollment, 18 patients (58.1%) were treated with at least one PHN concomitant medication, for which the number and dosing remained constant during the study. Patients had a mean average pain intensity of 6.5±1.0 at baseline, which decreased to 3.6±1.1 at week 4 and 2.8±0.9 at week 8. Four patients reported erythema, and one complained of vesicles eruption associated with pruritus. EQ-5D at weeks 4 and 8 of treatment showed persisting improvements in all domains except for the "anxiety/depression" domain. At week 8

Published
2022

6. Correction to: Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus (Aging Clinical and Experimental Research, (2020), 32, 9, (1647-1673), 10.1007/s40520-020-01624-x)

Author

Aceto, Paola, Antonelli Incalzi, R., Bettelli, G., Carron, M., Chiumiento, F., Corcione, A., Crucitti, Antonio, Maggi, S., Montorsi, M., Pace, M. C., Petrini, F., Tommasino, C., Trabucchi, Marta, Volpato, S., Aceto, P., Antonelli Incalzi, R., Bettelli, G., Carron, M., Chiumiento, F., Corcione, A., Crucitti, A., Maggi, S., Montorsi, M., Pace, M. C., Petrini, F., Tommasino, C., Trabucchi, M., and Volpato, S.

Subjects
Settore MED/18 - CHIRURGIA GENERALE, health care facilities, manpower, and services, perioperative management, social sciences, elderly patients, humanities
Abstract

The article Perioperative Management of Elderly patients (PriME).

Published
2020

7. Clinical applications of palmitoylethanolamide in pain management: Protocol for a scoping review 11 Medical and Health Sciences 1115 Pharmacology and Pharmaceutical Sciences

Author

Passavanti M. B., Alfieri A., Pace M. C., Pota V., Sansone P., Piccinno G., Barbarisi M., Aurilio C., Fiore M., Passavanti, M. B., Alfieri, A., Pace, M. C., Pota, V., Sansone, P., Piccinno, G., Barbarisi, M., Aurilio, C., and Fiore, M.

Subjects
Amide, Anti-Inflammatory Agents, Non-Steroidal, Palmitic Acid, PEA, Pain, Palmitic acids, Pain management, Treatment Outcome, Ethanolamines, Systematic review, Humans, Ethanolamine, Palmidrol, Chronic Pain, Palmitoylethanolamide, Endocannabinoid, Human, Endocannabinoids
Abstract

Background: Palmitoylethanolamide (PEA) belong to endocannabinoid family, a group of fatty acid amides. PEA has been proven to have analgesic and anti-inflammatory activity and has been used in several controlled studies focused on the management of chronic pain among adult patients with different underlying clinical conditions. Methods/design: A literature search will be performed using PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The population will be patients who have chronic pain, the intervention will be the administration of PEA alone or in combination with other drugs for the pain management; the comparison will be the standard therapy in accordance with the current guidelines for the treatment of pain. The Outcomes will be the reduction of pain not restricted to specific scales laying out the pain outcome data described in the included studies. Discussion: This scoping review aims to describe the clinical applications of the PEA in chronic pain management and its outcome. Scoping review registration: Open Science Framework https://osf.io/74tmx/. Background: Palmitoylethanolamide (PEA) belong to endocannabinoid family, a group of fatty acid amides. PEA has been proven to have analgesic and anti-inflammatory activity and has been used in several controlled studies focused on the management of chronic pain among adult patients with different underlying clinical conditions. Methods/design: A literature search will be performed using PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The population will be patients who have chronic pain, the intervention will be the administration of PEA alone or in combination with other drugs for the pain management; the comparison will be the standard therapy in accordance with the current guidelines for the treatment of pain. The Outcomes will be the reduction of pain not restricted to specific scales laying out the pain outcome data described in the included studies. Discussion: This scoping review aims to describe the clinical applications of the PEA in chronic pain management and its outcome. Scoping review registration: Open Science Framework https://osf.io/74tmx/.

Published
2019

14. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes 11 Medical and Health Sciences 1103 Clinical Sciences

Author

Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, C. B., Ceriello, Antonio, Russo, Giuspina T., Guida, Pietro, Pontremoli, Roberto, De Cosmo, S., Cimino, Antonino, Fava, Danila, Meloncelli, Illidio, Nicolucci, Antonio, Pellegrini, Fabio, Rossi, Maria Chiara, Turco, Salvatore, Vespasiani, Giacomo, Graziano, G., Lucisano, G., Memmo, R., Pellicciotta, E., Paciotti, V., Pupillo, M., Armentano, G., Giovannini, C., Armentano, V., Laudato, M., Acquati, S., Ciardullo, A. V., Laffi, G., Felace, G., Taboga, C., Tortul, C., Santantonio, G., Suraci, C., Ghisoni, G., Raffa, M., Genovese, S., Lovagnini-Scher, C. A., Rampini, P., Rocca, A., Ruggeri, P., Tortato, E., Cotti, L., Cristofaro, M. R., Tagliaferri, M., Comoglio, M., Fornengo, R., Gentile, F. M., Gigante, Antonio, Mastinu, F., Di Benedetto, A., Pata, P., Arcangeli, A., Orsini, P., Acler, P., De Blasi, G., Cicioni, G., Pocciati, S., Marangoni, A., Nogara, A., Lanero, M., Bertero, M. G., Damassino, R., Bergonzini, C., Schumtz, L., Seksich, L., Pipitone, A., Boaretto, M., Manfroi, I., Parmesan, L., Conte, B., Soccol, F., Pagano, A., Papini, E., Rinaldi, R., Petrucci, L., Graziano, F., Chianelli, M., Silvagni, S., Rosco, M., Ansaldi, E., Malvicino, F., Battezzati, M., Maresca, P., Palenzona, C., Boemi, M., Rabini, R. A., Brandoni, G., Lanari, L., Gatti, C., Testa, I., Cherubini, V., Doveri, G., Pecorelli, L., Ciccarelli, A., Gallardini, M. B., Courthoud, R., Sara Bredy, S., Ricciardi, G. P., Vitalone, G., Setti, D., Contrini, P., Corsi, A., Ghigliotti, V., Oddone, G., Ponzani, P., Valbonesi, G., Mazzini, V., Di Berardino, P., Colleluori, P., Montani, V., Trosini, V., Velussi, M., Alfidi, P., Verdecchia, B., Baliva, L., Di Pietro, A., Franchi, G., Luce, R. P., Pianta, A., Ferrari, M., Balzano, S., Beltranello, G., Dal Fabbro, S., Aricò, C. N., Cervo, L., Zanon, R., Rossa, S., Di Pace, M. C., Ciavarella, A., Giangiulio, S., Grimaldi, M., Mustacchio, A., Fattor, B., Monauni, T., Cristini, M., Orion, G., Crazzolara, D., Amor, F., Eisath, J. E., Lintner, S., Garavelli, S., Calari, T., Marini, P., Sandri, O., Scala, M., Stroppa, C., Trentin, A., Carlin, R., Carli, B., Sandonà, M., Zortea, C., Bonet, L., Pradel, L., Reato, S., Buschini, M., Bonfiglioli, D., Mones, D., Beldì, F., Morea, A., Bondesan, L., Perbellini, S., Valentini, U., Agosti, B., Corsini, R., Girelli, A., Zarra, E., Rocca, L., Bergmann, M., Pradi, I., Unterkircher, S., Piok, M., Pichler, M., Trinchera, A., Palamà, G., Palma, P., Carboni, L., Murtas, M. G., Mudadu, T., Turco, M. P., Floris, M., Delogu, A., Farris, L., Songini, M., Piras, G., Seguro, R., Floris, R., Corona, G., Lai, M., Piras, E., Contini, P. P., Cocco, S., Pilosu, R. M., Sannia, M. C., Spanu, F., Busciantella Ricci, N., Cartechini, M. G., Agostinelli, G., Fiorelli, C., Nuzzi, A., Ballauri, C., Lesina, A., Romeo, F., Giudici, G., Maciejewska, E. G., Deroma, A., Paduano, M., Rossi, L., Vagnini, C., Dolci, M., Mori, M., Baccetti, F., Gregori, G., Straface, E., Pozzuoli, G., Barone, M., Stasio, G. B., Tondini, S., Borgoni, F., Grosso, J., Scarsellato, C., Sciulli, A., De Marco, F., Confortin, L., Marin, N., Lamonica, M., Gialdino, S., Borzì, V., Gatta, C., Rapisard, R., Strano, S., Calabrò, M., Puccio, L., Zolli, M., Coracina, A., Starnone, V., Del Buono, A., Terracciano, A. M., Monda, M. V., Castro, F., Guaglianone, A., Maccari, V., Corsi, L., Versari, G., Falivene, M. R., Boletto, N., Corsi, S., Marafetti, L., Vitacolonna, E., Capani, F., Caputo, L., Di Nisio, L., Simonetti, F., Boscolo Bariga, A., Ballarin, G., De Boni, S., Di Benedetto, S., Chiambretti, A. M., Di Vito, L., Pascuzzo, M. D., Urli, P., Rumi, P., Balzarini, B., Galli, P., Castellan, M., Giannetti, A., Russotti, C., De Blasi, A., Perna, A., Campanelli, C., Ranchelli, A., Biccheri, D., Dadi, G., Massa, L., Baldi, G. P., Sciacca, F., Costanzo, E., Spada, M., Paolini, G., Ziller, P., Portolan, F., Pasolini, G., Ghilardi, G., Fiorina, P., Grata, M. L., Capretti, L., Speroni, G., Fugazza, L., Massafra, C., Lovagnini Scher, A., Cimicchi, M. C., Percudani, C., Risolo, T., Saccò, P., Gidoni Guarnieri, G. L., Piccolo, D., Bravin, C., De Noni, E., Scarpel, M., Marcon, M., Giacon, F., Panebianco, G., Tadiotto, F., Da Tos, V., D'Ambrosio, M., Pellizzola, D., Zampini, M. A., Frezzati, E., Mari, E., Raminelli, E., Gaiti, D., Bosi, E. A., Chierici, G., Pilla, S., Copelli, M., Zanichelli, P., Bertelli, L., Caretta, P., Vezzani, V., Bodecchi, S., Longobucco, A., Di Lembo, S., Spotti, E., Carrai, E., Degli Innocenti, A., Manini, L., Persico, R., Rossi, C., Magro, G., Marelli, G., Vilei, V., Andrioli, M., Bellato, L., Fedeli, M., Merlini, A., Pinelli, G., Marin, G., Contin, M. L., Gallo, A., Parlato, P., Pecchielan, W., Jacovacci, J., Placentino, G., Richini, D., Molinari, S., Strazzeri, R., Fabbri, T., Di Bartolo, P., Garrapa, G., D'Incau, F., Lagomanzini, P., Conte, P., Todesco, F., Foglini, P., Pantanetti, P., Bedetta, C., Maricotti, R., Tomasi, F., Monesi, M., Graziani, R., Beretta, F., Penna, L., Guberti, A., Dazzi, D., Forte, E., Gasbarrone, A., Marrocco, T., Moschetta, R., Tuccinardi, F., De Meo, F., Coppola, A., Pirolozzi, P., Placitelli, E., Vallefuoco, R., Catone, B., Ceschia, S., Urban, M., Fabbri, F., Torresani, M., Crovetto, R., Battistini, M., Carosia, P., Viviani, G. L., Durante, A., Pais, F., Lilliu, V., Quieto, C., D'Ugo, E., Squadrone, M., Amenduni, T., Iovannisci, M. M., Della Penna, L., Potente, F., Delle Donne, T., Massa, C., Ulisse, M. A., De Berardinis, F., Guarnieri, I., Pace, S., Splendiani, M., Di Giuseppe, R., Brunato, B., Assaloni, R., Muraro, R., Loro, R., Bucciol, S., Lavacca, C., Rossi, M., Sabbatini, G., Quadri, F., Sambuco, L., Santacroce, C., Paola Caretta, D., Marino, C., Micheletti, A., Petrelli, A., Corda, A., Pisano, L., Guaita, G., Deias, C., Trevisan, G., Coletti, I., Iannarelli, R., De Luca, A., Minnucci, A., Antenucci, D., Di Florio, C., Angelicola, G., Bosco, A., Fresco, R., Di Marco, G., Ugolotti, D., Cadossi, T., Di Caro, P., Mazzocchetti, M., Buzzetti, R., Leto, G., Gnessi, C., Cipolloni, L., Foffi, C., Moretti, C., Venditti, C., Meniconi, R., Bertoli, S., Cosimi, S., Di Cianni, G., Turco, A., Richini, A., Marconi, S., Sannino, C., Lemmi, P., Giuntoli, S., Manfrè, N., Giannini, F., Di Carlo, A., Casadidio, I., Melandri, P., Maolo, G., Polenta, B., Piccinini, N., Vincenti, C., Pastore, N., Mega, P., Magurano, E., Cananiello, A., Francescutto, C. A., Brussa Toi, E., Gaspardo, G., Angeli, L., Ronchese, L., Sciangula, L., Ciucci, A., Contartese, A., Banfi, E., Castelli, E., Tatti, P., Bloise, D., Di Mauro, P., Masselli, L., Lo Presti, A., Scarpitta, A. M., Gambina, F., Venezia, A., Morea, R., Lagonigro, G., Copeta, G., Iannucci, V., Milano, V., Trupo, M., Lochmann, A., Marchetto, P. E., Incelli, G., De Paola, G., Steiger, M. M., Gamper, M. A., Breitenberger, S., Holzner, M., Frischmann, J., Lambiase, C., Di Vece, T., D'Aniello, M., Fezza, M., Giordano, C., Leo, F., Saitta, G., Cucinotta, D., Di Vieste, G., Pintaudi, B., Mancuso, T., Musacchio, N., Giancaterini, A., Pessina, L., Salis, G., Schivalocchi, F., Testori, G., Cerutti, N., Morpugo, P. S., Cavaletto, M. L., Bonino, G., Morreale, F., Mariani, G., Ragonesi, P. D., Bollati, P., Colapinto, P., Falqui, L., Bortolato, L., Cosma, A., Pistolato, P., Centenaro, B., Ceccato, A., Campobasso, G., Zaurino, F., Mazzotta, G., Manti, R., Da Ros, R., Carlucci, S., Narduzzi, L., Bortolotto, D., D'Acunto, L., Stanic, L., Volpi, A., Cospite, A. M., Manicardi, V., Michelini, M., Finardi, L., Borghi, F., Manicardi, E., Lombardi, S., Tommasi, C., Iaccarino, M., Cozza, S., Binotto, M., Marini, F., Mecenero, I., Massignani, S., Stecco, P., Urbani, E., Massariol, W., Parolin, R., Gatti, A., Bonavita, M., Creso, E., Giannettino, R., Gobbo, M., Turco, S., Iovine, C., Riccardi, G., Iazzetta, N., Giannattasio, C., Egione, O., Galdieri, S., Velotti, A., Azzolina, A., Annicelli, G., Sorrentino, T., Gaeta, I., Zenari, L., Bertolini, L., Sorgato, C., Grippaldi, F., Stroppiana, M., Popolizio, R., Carbone, N., Grasso, S., Abate, S., Gaggero, G. C., Strazzabosco, M., Brun, E., Carlesi, G. P., Garrone, S., Cicalò, A. M., Clausi, C., Cau, R., Manconi, A., Carboni, A., Angius, M. F., Pinna, A. A., Caria, S., Filigheddu, G. D., Tonolo, G., Carta, I., Calebich, S., Burlotti, C., Saglietti, G., Schellino, A., Madau, G., Cossu, M., Mulas, F., Zoccheddu, S., Balsanelli, M., Fetonti, M., Rotolo, A., Sambo, P., Secchi, E., Angotzi, M. A., Loddoni, S., Brundu, I., Careddu, F., Becciu, A., Gabriella Piras, G., Novara, F., Cipro, F., Torchio, G., Palumbo, P., Bianchi, A., Colucci, G., La Motta, G., Tiengo, A., Avogaro, A., Bruttomesso, D., Crepaldi, C., Fadini, G., Guarnieri, G., Lavagnini, M. T., Maran, A., Vedovato, M., De Kreutzenberg, V., Fedele, D., Lapolla, A., Sartore, G., Bax, G., Cardone, C., Dalfrà, M. G., Masin, M., Toniato, R., Piarulli, Francesco, Mattina, G., Fulantelli, M. A., Gioia, D., Conti, M., Ridola, G., D'Agati, F., Grossi, G., Zavaroni, I., Dei Cas, A., Franzini, L., Usberti, E., Antonimi, M., Anelli, N., Poli, R., Ridolfi, V., Michela, M., Haddoub, S., Prampolini, G., Muoio, A., Filippi, D., Bucci, F., Tardio, S. M., Calderini, M. C., Magotti, M. G., Quarantelli, C., Vernazza, M. A., Carolfi, A., Saracca, R., Picchio, E., Del Sindaco, P., Spalluto, A., Maggiulli, L., Torreggiani, V., Rastelletti, S., Ugolini, C., Pucci, N., Magi, S., Muratori, S., La Penna, G., Consoli, A., Galeone, F., Magiar, A. V., Gherardini, V., Moretti, L., Bientinesi, M., Landi, L., Bernardi, A., Del Prato, S., Miccoli, R., Bianchi, C., Penno, G., Venditti, F., Anichini, R., De Bellis, A., Bruschi, T., Butelli, L., Gioffredi, M., Gori, R., Picciafuochi, R., Malagoli, R., Bernini, A., Gelisio, R., Zanon, M., Del Bianco, A., Bamiston, A., Signorato, M., Citro, G., Calabrese, M., Ianni, L., Lorenzetti, M., Marsocci, A., Guizzotti, S., Memoli, G., Cabasino, F., Farci, F., Atzori, A., Sanna, A., Ghiani, M., Siotto, I., Sedda, M., Manis, A., Loddo, C., Loddo, I., Seguro, P., Cuomo, A., Orlando, L., Olanda, G. B., Pucci, A., Massenzo, M., Sardu, C., Perrone, G., Corazziere, F., La Puzza, I., Tripodi, P. F., Riggio, S., Giampaolo, A., Mannino, D., Aleandri, A. R., Guidi, M. V., Battisti, B., Faraglia, M. R., Lilli, V., Leotta, S., Visalli, N., Gagliardi, A., Fontana, L., Altomare, M., Carletti, S., Abbruzzese, S., Chiaramonte, F., Giordano, R., Rossini, M., Migneco, G., Cappelloni, D., Urbani, A., Piergiovanni, F., Simonetta, A., Massimiani, F., Bulzomì, R., Giuliano, M., Pennafina, M. G., Di Perna, P., D'Accinni, M. P., Paolucci, D., D'Ubaldi, A., D'Angelo, M. T., Masaro, G., Pietrantoni, M., Fratini, M., La Rosa, R., Poggi, M., Piccirilli, F., Pisano, R., Saponara, C., Conforti, I., Penza, A., Scalpone, R., Lo Pinto, S., Iacovella, L., Caccamo, C., Sposito, S., Teodonio, C., Restuccia, M. G., Mirto, G., Girardello, R., Gennaro, R., De Moliner, L., Bettini, E., Mattuzzi, A., Speese, K., Frisinghelli, F., Locatelli, F., Nicoletti, M., Trojan, N., Centis, R., L Volsi, P., Levis, E., Zanette, G., Comba, G., Ballatore, L., Cattaneo, A., Aglialoro, A., Guido, R., Patrone, M., Zecchini, M., Clementi, L., Galetta, M., Marconi, V., Bordin, P., Perale, L., Vinci, C., Sira Zanon, M., Geretto, L., Toffolo, C., Furlan, M. G., Mazzanti, G., Vinci, M., Sica, V., Armeni, M., Derai, R., Ennas, O., Mamusa, S., Pisano, M. A., Carreras, L., Rauseo, A., Cervone, S., Leggieri, A., Pontonio, M., Sturaro, R., Quattrocchi, F., Molinaro, M., Trasatti, M., Ferretti, B., Labarile, G., Baule, G. M., Gentilini, A., Spanu, M. A., Fancellu, A., Bianco, P., Lione, L., Massazza, G., Bocchio, G., Bosco, E., Monachesi, M., Carta, G., Boschetti, M., Ceresola, E., Venier, E., Calcaterra, F., Cataldi, F., Miola, M., Manfrini, S., Lai, A., Locci, B., Putzu, D., Tanganelli, I., Leonini, M., Egger, K., Marchiotto, W., Vincis, L., Orlandini, V., Pilloni, C., Farci, R., Pelligra, I., Renier, G., Mameli, M., Pala, A., Devigus, E., Fumagalli, I., Lalli, C., Leandri, M., Agliani, M., De Pascalis, L., Malci, F., De Ciocchis, A., Diodati, M. B., Macerola, B., Davì, S., Caccavale, A., Brocato, L., Pognant Gros, M., Borla, S., Lattanzi, E., Piersanti, C., Piersanti, A., Spinelli, I., Tuzzoli, L., Tulini, V., Quaranta, G., Iorio, V., Tirabovi, M., De Terlizi, Candia, Massarelli, M. G., Venturi, S., Travaglini, A., Draghi, P., Pomante, P., Richiardi, L., Clerico, A., Bruno, A., Cavallo Perin, P., Ghigo, E., Porta, M., Scuntero, P., Arcari, R., Bertaina, S., Bo, S., Broglio, F., Bruno, G., Degiovanni, M., Fornengo, P., Grassi, G., Inglese, V., Maccario, M., Maghenzani, G., Marena, S., Martina, V., Passera, P., Ruiu, G., Tagliabue, M., Zanone, M., Monge, M., Boffano, G. M., Macrì, K., Maio, P., Ozzello, A., Pergolizzi, E., Gaia, D., Gennari, P., Micali, G., Rossetto, E., Dalmazzo, C., Oreglia, M., Stefani, T., Dossena, C., Paglia, P., Bosoni, S., Romanelli, T., Inchiostro, S., Dauriz, M., Bossi, C. A., Meregalli, G., Balini, A., Berzi, D., Filippini, B., Crotto, G., Paccagnella, A., Orrasch, M., Sambataro, M., Citro, T., Kiwanuka, E., Bagolin, E., Almoto, B., Macchia, A., Branca, M. T., Filesi, M., Candido, R., Caroli, E., Manca, E., Petrucco, A., Tommasi, E., Jagodnik, G., Baskar, B., Daris, N., Dal Col, P., Pellegrini, M. A., Tonutti, L., Venturini, G., Andreani, M., Turchi, F., Fedrighelli, F., Martinelli, G., Rongioletti, R., Candidi, M., Pais, M., Moro, E., Cervellino, F., Sinisi, R., Zampino, A., Mingardi, R., Lora, L., Reitano, R., Stocchiero, C., Simoncini, M., Mesturino, C. 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Subjects
Albuminuria, Diabetic kidney disease, GFR, Albuminuria, Diabetic kidney disease, GFR, Nephrology
Abstract

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage ≥3 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening.

Published
2018

15. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Author

Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T., Guida, Pietro, Pontremoli, Roberto, De Cosmo, Salvatore, Cimino, Antonino, Fava, Danila, Giorda, Carlo Bruno, Meloncelli, Illidio, Nicolucci, Antonio, Pellegrini, Fabio, Rossi, Maria Chiara, Turco, Salvatore, Vespasiani, Giacomo, Pellegrini, F., Graziano, G., Lucisano, G., Memmo, R., Pellicciotta, E., Paciotti, V., Pupillo, M., Armentano, G., Giovannini, C., Armentano, V., Laudato, M., Turco, S., Acquati, S., Ciardullo, A. V., Laffi, G., Felace, G., Taboga, C., Tortul, C., Santantonio, G., Suraci, C., Ghisoni, G., Raffa, M., Genovese, S., Lovagnini-Scher, C. A., Rampini, P., Rocca, A., Ruggeri, P., Tortato, E., Cotti, L., Cristofaro, M. R., Tagliaferri, M., Comoglio, M., Fornengo, R., De Cosmo, S., Gentile, F. M., Gigante, A., Mastinu, F., Di Benedetto, A., Pata, P., Arcangeli, A., Orsini, P., Acler, P., De Blasi, G., Cicioni, G., Pocciati, S., Marangoni, A., Nogara, A., Lanero, M., Bertero, M. G., Damassino, R., Bergonzini, C., Schumtz, L., Seksich, L., Pipitone, A., Boaretto, M., Manfroi, I., Parmesan, L., Conte, B., Soccol, F., Pagano, A., Papini, E., Rinaldi, R., Petrucci, L., Graziano, F., Chianelli, M., Silvagni, S., Rosco, M., Ansaldi, E., Malvicino, F., Battezzati, M., Maresca, P., Palenzona, C., Boemi, M., Rabini, R. A., Brandoni, G., Lanari, L., Gatti, C., Testa, I., Cherubini, V., Doveri, G., Pecorelli, L., Ciccarelli, A., Gallardini, M. B., Courthoud, R., Sara Bredy, S., Ricciardi, G. P., Vitalone, G., Setti, D., Contrini, P., Corsi, A., Ghigliotti, V., Oddone, G., Ponzani, P., Valbonesi, G., Mazzini, V., Di Berardino, P., Colleluori, P., Montani, V., Trosini, V., Velussi, M., Alfidi, P., Verdecchia, B., Baliva, L., Di Pietro, A., Franchi, G., Luce, R. P., Pianta, A., Ferrari, M., Balzano, S., Beltranello, G., Dal Fabbro, S., Aricò, C. N., Cervo, L., Zanon, R., Rossa, S., Di Pace, M. C., Ciavarella, A., Giangiulio, S., Grimaldi, M., Mustacchio, A., Santacroce, G., Fattor, B., Monauni, T., Cristini, M., Orion, G., Crazzolara, D., Amor, F., Eisath, J. E., Lintner, S., Garavelli, S., Calari, T., Marini, P., Sandri, O., Scala, M., Stroppa, C., Trentin, A., Carlin, R., Carli, B., Sandonà, M., Zortea, C., Bonet, L., Pradel, L., Reato, S., Buschini, M., Bonfiglioli, D., Mones, D., Beldì, F., Morea, A., Bondesan, L., Perbellini, S., Cimino, A., Valentini, U., Agosti, B., Corsini, R., Girelli, A., Zarra, E., Rocca, L., Bergmann, M., Pradi, I., Unterkircher, S., Piok, M., Pichler, M., Trinchera, A., Palamà, G., Palma, P., Carboni, L., Murtas, M. G., Mudadu, T., Turco, M. P., Floris, M., Delogu, A., Farris, L., Songini, M., Piras, G., Seguro, R., Floris, R., Corona, G., Lai, M., Piras, E., Contini, P. P., Cocco, S., Pilosu, R. M., Sannia, M. 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A., Brussa Toi, E., Gaspardo, G., Angeli, L., Ronchese, L., Sciangula, L., Ciucci, A., Contartese, A., Banfi, E., Castelli, E., Tatti, P., Bloise, D., Di Mauro, P., Masselli, L., Lo Presti, A., Scarpitta, A. M., Gambina, F., Venezia, A., Morea, R., Lagonigro, G., Copeta, G., Iannucci, V., Milano, V., Trupo, M., Lochmann, A., Marchetto, P. E., Incelli, G., De Paola, G., Steiger, M. M., Gamper, M. A., Breitenberger, S., Holzner, M., Frischmann, J., Lambiase, C., Di Vece, T., D'Aniello, M., Fezza, M., Giordano, C., Leo, F., Saitta, G., Cucinotta, D., Di Vieste, G., Pintaudi, B., Mancuso, T., Musacchio, N., Giancaterini, A., Pessina, L., Salis, G., Schivalocchi, F., Testori, G., Rampini, P. A., Cerutti, N., Morpugo, P. S., Cavaletto, M. L., Bonino, G., Morreale, F., Mariani, G., Ragonesi, P. D., Bollati, P., Colapinto, P., Bosi, E., Falqui, L., Bortolato, L., Cosma, A., Pistolato, P., Centenaro, B., Ceccato, A., Campobasso, G., Zaurino, F., Mazzotta, G., Manti, R., Da Ros, R., Carlucci, S., Narduzzi, L., Bortolotto, D., D'Acunto, L., Stanic, L., Volpi, A., Cospite, A. M., Manicardi, V., Michelini, M., Finardi, L., Borghi, F., Manicardi, E., Lombardi, S., Tommasi, C., Iaccarino, M., Cozza, S., Binotto, M., Marini, F., Mecenero, I., Massignani, S., Stecco, P., Urbani, E., Massariol, W., Parolin, R., Gatti, A., Bonavita, M., Creso, E., Giannettino, R., Gobbo, M., Iovine, C., Turco, A. A., Riccardi, G., Iazzetta, N., Giannattasio, C., Egione, O., Galdieri, S., Velotti, A., Azzolina, A., Annicelli, G., Sorrentino, T., Gaeta, I., Zenari, L., Bertolini, L., Sorgato, C., Grippaldi, F., Stroppiana, M., Popolizio, R., Carbone, N., Grasso, S., Abate, S., Gaggero, G. C., Strazzabosco, M., Brun, E., Carlesi, G. P., Garrone, S., Cicalò, A. M., Clausi, C., Cau, R., Manconi, A., Carboni, A., Angius, M. F., Pinna, A. A., Caria, S., Filigheddu, G. D., Tonolo, G., Carta, I., Calebich, S., Burlotti, C., Saglietti, G., Schellino, A., Madau, G., Cossu, M., Mulas, F., Zoccheddu, S., Balsanelli, M., Fetonti, M., Rotolo, A., Sambo, P., Secchi, E., Angotzi, M. A., Loddoni, S., Brundu, I., Careddu, F., Becciu, A., Gabriella Piras, G., Novara, F., Cipro, F., Torchio, G., Palumbo, P., Bianchi, A., Colucci, G., La Motta, G., Tiengo, A., Avogaro, A., Bruttomesso, D., Crepaldi, C., Fadini, G., Guarnieri, G., Lavagnini, M. T., Maran, A., Vedovato, M., De Kreutzenberg, V., Fedele, D., Lapolla, A., Sartore, G., Bax, G., Cardone, C., Dalfrà, M. G., Masin, M., Toniato, R., Piarulli, Francesco, Mattina, G., Fulantelli, M. A., Gioia, D., Conti, M., Ridola, G., D'Agati, F., Grossi, G., De Berardinis, F., Zavaroni, I., Dei Cas, A., Franzini, L., Usberti, E., Antonimi, M., Anelli, N., Poli, R., Ridolfi, V., Michela, M., Haddoub, S., Prampolini, G., Muoio, A., Filippi, D., Bucci, F., Tardio, S. M., Calderini, M. C., Magotti, M. G., Quarantelli, C., Vernazza, M. A., Carolfi, A., Saracca, R., Picchio, E., Del Sindaco, P., Spalluto, A., Maggiulli, L., Torreggiani, V., Rastelletti, S., Ugolini, C., Pucci, N., Magi, S., Muratori, S., La Penna, G., Consoli, A., Galeone, F., Magiar, A. V., Gherardini, V., Moretti, L., Bientinesi, M., Landi, L., Bernardi, A., Del Prato, S., Miccoli, R., Bianchi, C., Penno, G., Venditti, F., Anichini, R., De Bellis, A., Bruschi, T., Butelli, L., Gioffredi, M., Gori, R., Picciafuochi, R., Malagoli, R., Bernini, A., Gelisio, R., Zanon, M., Del Bianco, A., Bamiston, A., Signorato, M., Citro, G., Calabrese, M., Ianni, L., Lorenzetti, M., Marsocci, A., Guizzotti, S., Memoli, G., Cabasino, F., Farci, F., Atzori, A., Sanna, A., Ghiani, M., Siotto, I., Sedda, M., Manis, A., Loddo, C., Loddo, I., Seguro, P., Cuomo, A., Orlando, L., Olanda, G. B., Pucci, A., Massenzo, M., Sardu, C., Perrone, G., Corazziere, F., La Puzza, I., Tripodi, P. F., Riggio, S., Giampaolo, A., Mannino, D., Aleandri, A. R., Guidi, M. V., Battisti, B., Faraglia, M. R., Lilli, V., Leotta, S., Visalli, N., Gagliardi, A., Fontana, L., Altomare, M., Carletti, S., Abbruzzese, S., Chiaramonte, F., Giordano, R., Rossini, M., Migneco, G., Cappelloni, D., Urbani, A., Piergiovanni, F., Fava, D., Simonetta, A., Massimiani, F., Bulzomì, R., Giuliano, M., Pennafina, M. G., Di Perna, P., D'Accinni, M. P., Paolucci, D., D'Ubaldi, A., D'Angelo, M. T., Masaro, G., Pietrantoni, M., Fratini, M., La Rosa, R., Poggi, M., Piccirilli, F., Pisano, R., Saponara, C., Conforti, I., Penza, A., Scalpone, R., Lo Pinto, S., Iacovella, L., Caccamo, C., Sposito, S., Teodonio, C., Restuccia, M. G., Mirto, G., Girardello, R., Gennaro, R., De Moliner, L., Bettini, E., Mattuzzi, A., Speese, K., Frisinghelli, F., Locatelli, F., Nicoletti, M., Trojan, N., Centis, R., L Volsi, P., Levis, E., Zanette, G., Comba, G., Ballatore, L., Cattaneo, A., Aglialoro, A., Guido, R., Patrone, M., Zecchini, M., Vespasiani, G., Meloncelli, I., Clementi, L., Galetta, M., Marconi, V., Bordin, P., Perale, L., Vinci, C., Sira Zanon, M., Geretto, L., Toffolo, C., Furlan, M. G., Mazzanti, G., Vinci, M., Sica, V., Armeni, M., Derai, R., Ennas, O., Mamusa, S., Pisano, M. A., Carreras, L., Rauseo, A., Cervone, S., Leggieri, A., Pontonio, M., Sturaro, R., Quattrocchi, F., Molinaro, M., Trasatti, M., Ferretti, B., Labarile, G., Baule, G. M., Gentilini, A., Spanu, M. A., Fancellu, A., Bianco, P., Lione, L., Massazza, G., Bocchio, G., Bosco, E., Monachesi, M., Carta, G., Boschetti, M., Ceresola, E., Venier, E., Calcaterra, F., Cataldi, F., Miola, M., Manfrini, S., Lai, A., Locci, B., Putzu, D., Tanganelli, I., Leonini, M., Egger, K., Marchiotto, W., Vincis, L., Orlandini, V., Pilloni, C., Farci, R., Pelligra, I., Renier, G., Mameli, M., Pala, A., Devigus, E., Fumagalli, I., Lalli, C., Leandri, M., Agliani, M., De Pascalis, L., Malci, F., De Ciocchis, A., Diodati, M. B., Macerola, B., Davì, S., Caccavale, A., Brocato, L., Pognant Gros, M., Borla, S., Lattanzi, E., Piersanti, C., Piersanti, A., Spinelli, I., Tuzzoli, L., Tulini, V., Quaranta, G., Iorio, V., Tirabovi, M., De Terlizi, Candia, Massarelli, M. G., Venturi, S., Travaglini, A., Draghi, P., Pomante, P., Richiardi, L., Clerico, A., Bruno, A., Cavallo Perin, P., Ghigo, E., Porta, M., Scuntero, P., Arcari, R., Bertaina, S., Bo, S., Broglio, F., Bruno, G., Degiovanni, M., Fornengo, P., Grassi, G., Inglese, V., Maccario, M., Maghenzani, G., Marena, S., Martina, V., Passera, P., Ruiu, G., Tagliabue, M., Zanone, M., Monge, M., Boffano, G. M., Macrì, K., Maio, P., Ozzello, A., Pergolizzi, E., Gaia, D., Gennari, P., Micali, G., Rossetto, E., Dalmazzo, C., Oreglia, M., Stefani, T., Dossena, C., Paglia, P., Bosoni, S., Romanelli, T., Inchiostro, S., Dauriz, M., Bossi, C. A., Meregalli, G., Balini, A., Berzi, D., Filippini, B., Crotto, G., Paccagnella, A., Orrasch, M., Sambataro, M., Citro, T., Kiwanuka, E., Bagolin, E., Almoto, B., Macchia, A., Branca, M. T., Filesi, M., Candido, R., Caroli, E., Manca, E., Petrucco, A., Tommasi, E., Jagodnik, G., Baskar, B., Daris, N., Dal Col, P., Pellegrini, M. A., Tonutti, L., Venturini, G., Andreani, M., Turchi, F., Fedrighelli, F., Martinelli, G., Rongioletti, R., Candidi, M., Pais, M., Moro, E., Cervellino, F., Sinisi, R., Zampino, A., Mingardi, R., Lora, L., Reitano, R., Stocchiero, C., Simoncini, M., Mesturino, C. A., Zen, F., Di Pietro, S., Scoponi, C., Tilaro, L., Pelliccioni, S., Slongo, R., Vita, E., Garofalo, A., Vitale, F., Campanella, B., Mastrilli, V., Borrelli, T., D'Avino, A., Perbellini, A., Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T, Guida, Pietro, Pontremoli, Roberto, and De Cosmo, Salvatore, Giordano, Carla

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, endocrine system diseases, Renal function, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, lcsh:RC870-923, Kidney, urologic and male genital diseases, GFR, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, Albuminuria, Diabetic kidney disease, Type 1 diabetes, urogenital system, business.industry, Incidence (epidemiology), Middle Aged, lcsh:Diseases of the genitourinary system. Urology, medicine.disease, female genital diseases and pregnancy complications, Albuminuria, Diabetic kidney disease, GFR, Nephrology, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Italy, Disease Progression, Female, medicine.symptom, business, Research Article, Follow-Up Studies, Glomerular Filtration Rate, Kidney disease
Abstract

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR 30% from baseline was evaluated. Results The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening. Electronic supplementary material The online version of this article (10.1186/s12882-018-1136-6) contains supplementary material, which is available to authorized users.

Published
2018

16. PEEP E CPAP POSSONO RIDURRE LʼINSORGENZA DI ATELETTASIA POSTOPERATORIA?

Author

SANSONE, Pasquale, CARBONE, Anna Giorgia, AURILIO, Caterina, Pace, M. C., Passavanti, M. B., Peluso, F., Pasquariello, M. R., Marco, G. P. De, Rienzo, A. Di, Vedova, M. La, ADI ESCLUSIVA EMC, Sansone, Pasquale, Pace, M. C., Passavanti, M. B., Peluso, F., Pasquariello, M. R., Marco, G. P. De, Carbone, Anna Giorgia, Rienzo, A. Di, Vedova, M. La, and Aurilio, Caterina

Published
2015

18. DO GONODAL HORMONES INFLUENCE PAIN PERCEPTION

Author

SANSONE, Pasquale, PASSAVANTI M. B, PACE M. C, PALAGIANO A, IANNOTTI M, POTA V, AURILIO, Caterina, Sansone, Pasquale, Passavanti, M. B., Pace, M. C., Palagiano, A, Iannotti, M, Pota, V, and Aurilio, Caterina

Published
2008

20. Antalgic ambulatory in telemedicina

Author

Pace M. C, Argenzio F, Gemini D, Mazzariello L, Aurilio R, Baccari M. E, Fittipaldi C, Di Costanzo E, Pota V, Aurilio C., PASSAVANTI, Maria Beatrice, Pace, M, Passavanti, M, Argenzio, F, Gemini, D, Mazzariello, L, Aurilio, R, Baccari, Me, Fittipaldi, C, Di Costanzo, E, Pota, V, Aurilio, Caterina, Pace, M. C., Passavanti, Maria Beatrice, Baccari, M. E., and Aurilio, C.

Published
2005

22. Buprenorfina TDS nel dolore vascolare

Author

Pace M. C, Mazzariello L, Maisto M, Iannotti M, Grella E, Aurilio C., PASSAVANTI, Maria Beatrice, Pace, M. C., Passavanti, Maria Beatrice, Mazzariello, L, Maisto, M, Iannotti, M, Grella, E, and Aurilio, C.

Published
2005

33. Opioids Switching with Transdermal Systems in Chronic Cancer Pain.

Author

Aurilio, C., Pace, M. C., Pota, V., Sansone, P., Barbarisi, M., Grella, E., and Passavanti, M. B.

Subjects
*DRUG side effects, *OPIOIDS, *CANCER pain, *CANCER patients, *ANALGESIA, *PAIN tolerance, *VOMITING, *CANCER research, *MEDICAL research
Abstract

Background: Due to tolerance development and adverse side effects, chronic pain patients frequently need to be switched to alternative opioid therapy Objective: To assess the efficacy and tolerability of an alternative transdermally applied (TDS) opioid in patients with chronic cancer pain receiving insufficient analgesia using their present treatment. Methods: A total of 32 patients received alternative opioid therapy, 16 were switched from buprenorphine to fentanyl and 16 were switched from fentanyl to buprenorphine. The dosage used was 50% of that indicated in equipotency conversion tables. Pain relief was assessed at weekly intervals for the next 3 weeks Results: Pain relief as assessed by VAS, PPI, and PRI significantly improved (p < 0.0001) in all patients at all 3 follow up visits. After 3 weeks of treatment, the reduction in the mean VAS, PPI, and PRI scores in the fentanyl and buprenorphine groups was 68, 77, 74, and 69, 79, and 62%, respectively. Over the same time period the use of oral morphine as rescue medication was reduced from 27.5 ± 20.5 (mean ± SD) to 3.75 ± 8.06, and 33.8 ± 18.9 to 3.75 ± 10.9 mg/day in the fentanyl and buprenorphine groups, respectively. There was no significant difference in either pain relief or rescue medication use between the two patient groups The number of patient with adverse events fell during the study. After the third week of the treatment the number of patients with constipation was reduced from 11 to 5, and 10 to 4 patients in the fentanyl and buprenorphine groups, respectively. There was a similar reduction in the incidence of nausea and vomiting. No sedation was seen in any patient after one week of treatment. Conclusion: Opioid switching at 50% of the calculated equianalgesic dose produced a significant reduction in pain levels and rescue medication. The incidence of side effects decreased and no new side effects were noted. Further studies are required to provide individualized treatment for patients according to their different types of cancer. [ABSTRACT FROM AUTHOR]

Published
2009
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34. Neurobiology of pain.

Author

Pace, M. C., Mazzariello, L., Passavanti, M. B., Sansone, P., Barbarisi, M., and Aurilio, C.

Subjects
*PAIN, *INFLAMMATION, *NOCICEPTORS, *NEUROBIOLOGY, *NEUROPLASTICITY, *CELL physiology
Abstract

The neurobiology of pain had a notable interest in research focused on the study of neuronal plasticity development, nociceptors, molecular identity, signaling mechanism, ionic channels involved in the generation, modulation and propagation of action potential in all type of excitable cells. All the findings open the possibility for developing new therapeutic treatment. Nociceptive/inflammatory pain and neuropathic pain represent two different kinds of persistent chronic pain. We have reviewed the different mechanism suggested for the maintenance of pain, like descending nociceptive mechanism and their changes after tissue damage, including suppression and facilitation of defence behavior during pain. The role of these changes in inducing NMDA and AMPA receptors gene expression, after prolonged inflammation is emphasized by several authors. Furthermore, a relation between a persistent pain and amygdale has been shown. Molecular biology is the new frontier in the study of neurobiology of pain. Since the entire genome has been studied, we will able to find new genes involved in specific condition such as pain, because an altered gene expression can regulate neuronal activity after inflammation or tissue damage. J. Cell. Physiol. 209: 8–12, 2006. © 2006 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Published
2006
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35. Molecular basis of cell-specific endothelial nitric-oxide synthase expression in airway epithelium.

Author

German, Z, Chambliss, K L, Pace, M C, Arnet, U A, Lowenstein, C J, and Shaul, P W

Abstract

Nitric oxide (NO) plays an important role in airway function, and endothelial NO synthase (eNOS) is expressed in airway epithelium. To determine the basis of cell-specific eNOS expression in airway epithelium, studies were performed in NCI-H441 human bronchiolar epithelial cells transfected with the human eNOS promoter fused to luciferase. Transfection with 1624 base pairs of sequence 5' to the initiation ATG (position -1624) yielded a 19-fold increase in promoter activity versus vector alone. No activity was found in lung fibroblasts, which do not express eNOS. 5' deletions from -1624 to -279 had modest effects on promoter activity in H441 cells. Further deletion to -248 reduced activity by 65%, and activity was lost with deletion to -79. Point mutations revealed that the GATA binding motif at -254 is mandatory for promoter activity and that the positive regulatory element between -248 and -79 is the Sp1 binding motif at -125. Electrophoretic mobility shift assays yielded two complexes with the GATA site and three with the Sp1 site. Immunodepletion with antiserum to GATA-2 prevented formation of the slowest migrating GATA complex, and antiserum to Sp1 supershifted the slowest migrating Sp1 complex. An electrophoretic mobility shift assay with H441 versus fibroblast nuclei revealed that the slowest migrating GATA complex is unique to airway epithelium. Thus, cell-specific eNOS expression in airway epithelium is dependent on the interaction of GATA-2 with the core eNOS promoter, and the proximal Sp1 binding site is also an important positive regulatory element.

Published
2000

36. Sedation in gynaecologic oncology day surgery

Author

Pace, M. C., Palagiano, A., Pace, L., Maria Beatrice Passavanti, Iannotti, M., Sorrentino, R., Aurilio, C., Pace, M. C, Palagiano, Antonio, Pace, L, Passavanti, M. B, Iannotti, M, Sorrentino, R, and Aurilio, Caterina

Subjects
Adult, Ambulatory Surgical Procedure, Ambulatory Surgical Procedures, Genital Neoplasms, Female, Conscious Sedation, Humans, Female, Middle Aged, Aged, Human
Abstract

Gynaecologic oncology day surgery deals primarily with the diagnosis of endometrial, cervical, vulvar and vaginal tumors. Conscious sedation is an important technique used in gynaecologic oncology day surgery. It is often associated with regional anaesthesia. The goals of conscious sedation are to provide effective pain control with complete safety, reduction of the recovery time, of the infection risk and cost. Since the consequences of the immunosuppressive effects of the opiates and the surgical stress could lead to an increased susceptibility to post-operative infections and a possible lack of immunological defence in the cancer patients, we investigated the possibility of eliminating the administration of opiates during minor operations in gynaecologic oncology day surgery. In this study, 400 patients, aged between 35 and 77 years, underwent surgery using sedation at the day hospital annexed to the Gynaecology and Obstetrics Department of the 2nd University of Naples, Italy. The patients were randomized into two equal study groups, according to a computer-generated randomised list. All patients were seen by the consultant anaesthetist three days before surgery. In all cases, during surgery, we monitored the main vital parameters such as ECG, HR and RR, BT, BP and SO. The drugs commonly used were: opioids, hypnotics and benzodiazepines, associated or not, with local anaesthetics. By using these drugs, pain and anxiety were reduced, sedation and amnesia were accomplished. In our experience, conscious sedation seems to be the best choice in gynaecologic oncology day surgery because it presents low toxicity, is short acting and readily reversible, has a low cost and, finally, because it is more comfortable for the patients. Moreover, it is possible to eliminate the administration of opiates during conscious sedation for less invasive surgical procedures.

39. Multimodal analgesia in neurosurgery: a narrative review

Author

Caterina Aurilio, Maria Caterina Pace, Pasquale Sansone, Luca Gregorio Giaccari, Francesco Coppolino, Vincenzo Pota, Manlio Barbarisi, Aurilio, C., Pace, M. C., Sansone, P., Giaccari, L. G., Coppolino, F., Pota, V., and Barbarisi, M.

Subjects
Adult, gabapentinoid, Pain, Postoperative, ketamine, Anti-Inflammatory Agents, Non-Steroidal, acetaminophen/non-steroidal anti-inflammatory drug, craniotomy, dexmedetomidine, Pain, General Medicine, Analgesics, Opioid, opioid, Humans, Pain Management, local anesthetic, multimodal analgesia, neurosurgery, Analgesia
Abstract

Pain following brain surgery can compromise the result of surgery. Several pharmacological interventions have been used to prevent postoperative pain in adults undergoing brain surgery. Pain following craniotomy is considered to be moderate to severe during the first two post-operative days. Opioids have been historically the mainstay and are the current prominent strategy for pain treatment. They produce analgesia but may alter respiratory, cardiovascular, gastrointestinal, and neuroendocrine functions. All these side effects may affect the normal postoperative course of craniotomy by affecting neurological function and increasing intracranial pressure. Therefore, their use in neurosurgery is limited, and opioids are used in case of strict necessity or as rescue medication. In addition to opioids, drugs with differing mechanisms of actions target pain pathways, resulting in additive and/or synergistic effects. Some of these agents include acetaminophen/non-steroidal anti-inflammatory drugs (NSAIDs), alpha-2 agonists, NMDA receptor antagonists, gabapentinoids, and local anesthesia techniques. Multimodal analgesia should be a balance between adequate analgesia and less drug-induced sedation, respiratory depression, hypercapnia, nausea, and vomiting, which may increase intracranial pressure. Non-opioid analgesics can be an useful pharmacological alternative in multimodal regimes to manage post-craniotomy pain. This narrative review aims to outline the current clinical evidence of multimodal analgesia for post craniotomy pain control.

Published
2021

40. The Feasibility and Applications of Non-invasive Cardiac Monitoring in Obese Patients Undergoing Day-case Surgery: Results of a Prospective Observational Study

Author

Umberto Colella, Maria Caterina Pace, Vincenzo Pota, Caterina Aurilio, Maria Beatrice Passavanti, Francesco Coppolino, Pasquale Sansone, Luca Gregorio Giaccari, Sansone, P., Giaccari, L. G., Colella, U., Coppolino, F., Pace, M. C., Passavanti, M. B., Pota, V., and Aurilio, C.

Subjects
Cardiac output (CO), medicine.medical_specialty, Day-case surgery, NICOM®, Total peripheral resistance index (TPRI), business.industry, medicine.medical_treatment, Non invasive, 030208 emergency & critical care medicine, Obese, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Cardiac index (CI), Emergency medicine, Stroke volume index (SVI), medicine, Observational study, 030212 general & internal medicine, Day case surgery, Cardiac monitoring, business, Non-invasive cardiac monitoring
Abstract

Aims: This prospective observational study evaluates the utility of non-invasive cardiac monitoring in obese patients in the day-surgery case, considering factors, such as Body Mass Index (BMI) and anaesthesia technique. Background: Obese patients are more likely to be admitted to hospital or to get hospitalized because they are more prone to concomitant diseases and obesity itself is not a contraindication to day surgery. Obese patients are a high-risk patient population that may particularly benefit from monitoring perioperative haemodynamic variations. Methods: In this observational study, we compared haemodynamic variations between overweight or obese and normal weight patients undergoing day-case surgery. We adopted NICOM® as a non-invasive cardiac output monitoring. Objective: The aim of the current study was to investigate the haemodynamic impact of BMI and anaesthesia technique during day-case surgery procedures. The other goal was to evaluate the feasibility and applications of non-invasive cardiac output monitoring among the obese population in day-surgery. Results: 74 patients were included in the study. 34 were overweight or obese (weight 84 ± 10 kg, height 160 ± 10 cm, BMI ≈ 30 kg/m2), 40 were normal weight (weight 63 ± 15 kg, height 160 ± 10 cm, BMI ≈ 22 kg/m2). Compared to normal-weight patients, obese patients show an increase in blood pressure with a return to baseline values at the end of surgery (p < 0.05). The Cardiac Output (CO) shows a similar trend, whereas the heart rate is normal. A decrease in the Cardiac Index (CI) during the operation was noticed in both groups, the one in obese patients (p = 0.24) being greater. In the same way, the Stroke Volume Index (SVI) was lower in obese patients during surgery (p < 0.05). In spinal anaesthesia, the Total Peripheral Resistance Index (TPRI) was not statistically different between the groups of study. As for the TPRI in obese patients, we reported values similar to the ones in non-obese patients in spinal anaesthesia. In local anesthesia, TPRI was higher in obese patients than in non-obese. Conclusion: Cardiovascular alterations in relation to obesity include an increase in blood pressure, CO and SV. An inadequate monitoring of haemodynamic parameters is a risk factor for perioperative complications. NICOM® provides a continuous, non-invasive haemodynamic measurement.

Published
2020

41. Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis

Author

Rosalynn R.Z. Conic, Kristen Fajgenbaum, Paolo D. Pigatto, Sebastiano Leone, Emilio Berti, Alessia Pacifico, Nicola Luigi Bragazzi, Maria Caterina Pace, Vincenzo Bettoli, P. P. Poli, Carlo Maiorana, Giovanni Damiani, Piergiorgio Malagoli, Marco Fiore, Damiani, G., Leone, S., Fajgenbaum, K., Bragazzi, N. L., Pacifico, A., Conic, R. R. Z., Pigatto, P. D. M., Maiorana, C., Poli, P., Berti, E., Pace, M. C., Malagoli, P., Bettoli, V., and Fiore, M.

Subjects
medicine.medical_specialty, End stage liver disease, Observational Study, digestive system, 03 medical and health sciences, 0302 clinical medicine, Non-alcoholic fatty liver, Internal medicine, Nonalcoholic fatty liver disease, medicine, Retrospective analysis, Hidradenitis suppurativa, Non-alcoholic steatohepatitis, Hepatology, business.industry, nutritional and metabolic diseases, medicine.disease, digestive system diseases, humanities, body regions, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, business, Non-alcoholic steatohepatiti
Abstract

BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease (ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern. Hidradenitis suppurativa (HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed. AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients. METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH. RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients (P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index (ADDI) was significantly higher among patients with HS/NASH (5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only (2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups. CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores.

Published
2019

42. Septic shock due to Escherichia coli meningoencephalitis treated with immunoglobulin-M-enriched immunoglobulin preparation as adjuvant therapy: a case report

Author

Vincenzo Pota, R. Esposito, Marco Fiore, F Di Zazzo, G S R C Mangoni di Santostefano, Caterina Aurilio, Maria Beatrice Passavanti, Pasquale Sansone, Francesco Coppolino, L. De Nardis, Maria Caterina Pace, Pota, V., Passavanti, M. B., Coppolino, F., Di Zazzo, F., De Nardis, L., Esposito, R., Fiore, M., Mangoni di Santostefano, G., Aurilio, C., Sansone, P., and Pace, M. C.

Subjects
Adult, lcsh:Medicine, Case Report, Enriched IgM immunoglobulin preparation, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Meningoencephalitis, Septic shock, Antimicrobial chemotherapy, Escherichia coli, medicine, Adjuvant therapy, Animals, Humans, 030212 general & internal medicine, Escherichia coli Infections, Extraintestinal Pathogenic Escherichia coli, business.industry, lcsh:R, General Medicine, Middle Aged, medicine.disease, Shock, Septic, Bacteremia, Immunology, Female, business, Meningitis, 030217 neurology & neurosurgery
Abstract

Background Gram-negative bacteria are an uncommon etiology of spontaneous community-acquired adult meningitis and meningoencephalitis. Escherichia coli is a Gram-negative bacterium that is normally present in the intestinal microbial pool. Some Escherichia coli strains can cause diseases in humans and animals, with both intestinal and extraintestinal manifestations (extraintestinal pathogenic Escherichia coli) such as urinary tract infections, bacteremia with sepsis, and, more rarely, meningitis. Meningitis continues to be an important cause of mortality throughout the world, despite progress in antimicrobial chemotherapy and supportive therapy. The mortality rate fluctuates between 15% and 40%, and about 50% of the survivors report neurological sequelae. The majority of Escherichia coli meningitis cases develop as a result of hematogenous spread, with higher degrees of bacteremia also being related to worse prognosis. Cases presenting with impaired consciousness (that is, coma) are also reported to have poorer outcomes. Case presentation We describe the case of a 48-year-old caucasian woman with meningoencephalitis, with a marked alteration of consciousness on admission, and septic shock secondary to pyelonephritis caused by Escherichia coli, treated with targeted antimicrobial therapy and immunoglobulin-M-enriched immunoglobulin (Pentaglobin) preparation as adjuvant therapy. Conclusion Despite the dramatic presentation of the patient on admission, the conflicting data on the use of immunoglobulins in septic shock, and the lack of evidence regarding their use in adult Escherichia coli meningoencephalitis, we obtained a remarkable improvement of her clinical condition, accompanied by partial resolution of her neurological deficits.

Published
2021

43. Ceftolozane-Tazobactam Combination Therapy Compared to Ceftolozane-Tazobactam Monotherapy for the Treatment of Severe Infections: A Systematic Review and Meta-Analysis

Author

Aniello Alfieri, Marco Fiore, Vittorio Simeon, Mariachiara Ippolito, Antonino Giarratano, Maria Caterina Pace, Andrea Cortegiani, Antonio Corrente, Fiore, Marco, Corrente, Antonio, Pace, Maria Caterina, Alfieri, Aniello, Simeon, Vittorio, Ippolito, Mariachiara, Giarratano, Antonino, Cortegiani, Andrea, Fiore, M., Corrente, A., Pace, M. C., Alfieri, A., Simeon, V., Ippolito, M., Giarratano, A., and Cortegiani, A.

Subjects
0301 basic medicine, pseudomonas aeruginosa, Biochemistry, sepsis, 0302 clinical medicine, systematic review, ceftolozane, polycyclic compounds, Pharmacology (medical), 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, ceftolozane-tazobactam, Anti-infective agent, Infectious Diseases, Meta-analysis, Ceftolozane, medicine.drug, Microbiology (medical), medicine.medical_specialty, Combination therapy, Sepsi, β-lactamase inhibitors, 030106 microbiology, Microbiology, Tazobactam, Article, Sepsis, 03 medical and health sciences, multidrug resistance, Internal medicine, medicine, Meta-analysi, bacteremia, business.industry, organic chemicals, lcsh:RM1-950, Retrospective cohort study, biochemical phenomena, metabolism, and nutrition, medicine.disease, bacterial infections and mycoses, infection, meta-analysis, Pneumonia, lcsh:Therapeutics. Pharmacology, ESBL, ESBLs, Bacteremia, bacteria, anti-infective agents, business
Abstract

Ceftolozane-tazobactam (C/T) is a combination of an advanced-generation cephalosporin (ceftolozane) with a &beta, lactamase inhibitor (tazobactam). It is approved for the treatment of complicated urinary-tract/intra-abdominal infections and hospital-acquired/ventilator-associated pneumonia. This systematic review and meta-analysis (registered prospectively on PROSPERO, no. CRD42019134099, on 20 January 2020) aimed to evaluate the effectiveness of C/T combination therapy compared to C/T monotherapy for the treatment of severe infections and to describe the prevalence of microorganisms in the included studies. We retrieved literature from PubMed, EMBASE, and CENTRAL, until 26 November 2020. Eligible studies were both randomised trials and nonrandomised studies with a control group, published in the English language and peer-reviewed journals. The primary outcome was all-cause mortality, secondary outcomes were (i) clinical improvement and (ii) microbiological cure. Eight nonrandomised studies were included in the qualitative synthesis: Seven retrospective cohort studies and one case-control study. The meta-analysis of the four studies evaluating all-cause mortality (in total 148 patients: 87 patients treated with C/T alone and 61 patients treated with C/T combination therapy) showed a significant reduction of mortality in patients receiving C/T combination therapy, OR: 0.31, 95% CI: 0.10&ndash, 0.97, p = 0.045. Conversely, the meta-analysis of the studies evaluating clinical improvement and microbiological cure showed no differences in C/T combination therapy compared to C/T monotherapy. The most consistent data come from the analysis of the clinical improvement, n = 391 patients, OR: 0.97, 95% CI: 0.54&ndash, 1.74, p = 0.909. In 238 of the 391 patients included (60.8%), C/T was used for the treatment of infections caused by Pseudomonas aeruginosa.

Published
2021

44. Capsaicin 8% patch and chronic postsurgical neuropathic pain

Author

Caterina Aurilio, Luca Gregorio Giaccari, Maria Beatrice Passsavanti, Francesco Coppolino, Maria Caterina Pace, Pasquale Sansone, Vincenzo Pota, Giaccari, L. G., Aurilio, C., Coppolino, F., Pace, M. C., Passavanti, M. B., Pota, V., and Sansone, P.

Subjects
Erythema, Medicine (miscellaneous), Review, law.invention, chemistry.chemical_compound, Qutenza®, Randomized controlled trial, law, Chronic post-surgical pain (CPSP), medicine, Capsaicin 8% patch, Adverse effect, Postherpetic neuralgia, business.industry, medicine.disease, Peripheral neuropathy, chemistry, Tolerability, Capsaicin, Anesthesia, Neuropathic pain, Medicine, medicine.symptom, business
Abstract

(1) Background: Surgery is a frequent cause of persistent pain, defined chronic post-surgical pain (CPSP). The capsaicin 8% patch (Qutenza®) is approved for the treatment of postherpetic neuralgia (PHN) and for diabetic peripheral neuropathy (DPN) of the feet. We propose a review of the literature on use of the capsaicin 8% patch to treat neuropathic pain associated with surgery; (2) Methods: We identified the articles by searching electronic databases using a combination of such terms as “capsaicin 8% patch”, “Qutenza®”, and “chronic postsurgical pain”; (3) Results: We identified 14 selected studies reporting on a total of 632 CPSP cases treated with capsaicin 8% patch. Treatment with the capsaicin 8% patch significantly reduced the average pain intensity. Only 5 studies reported adverse events (AEs) after the patch application. The most common AEs were erythema, burning sensation and pain; (4) Conclusions: Our review indicate that capsaicin 8% patch treatment for CPSP is effective, safe and well tolerated, but randomized controlled trials on efficacy, safety and tolerability should be conducted.

Published
2021

45. Local infiltration of tramadol as an effective strategy to reduce post-operative pain: a systematic review protocol and meta-analysis

Author

Maria Caterina Pace, Vincenzo Pota, Giuseppe Mangoni, Aniello Alfieri, Maria Beatrice Passavanti, Sveva Di Franco, Giacomo Piccinno, Pasquale Sansone, Marco Fiore, Caterina Aurilio, Passavanti, M. B., Piccinno, G., Alfieri, A., Di Franco, S., Sansone, P., Mangoni, G., Pota, V., Aurilio, C., Pace, M. C., and Fiore, M.

Subjects
medicine.medical_specialty, Visual analogue scale, Analgesic, MEDLINE, lcsh:Medicine, Medicine (miscellaneous), 03 medical and health sciences, 0302 clinical medicine, Meta-Analysis as Topic, Rating scale, Protocol, Humans, Medicine, Tramadol, Analgesics, Pain, Postoperative, business.industry, lcsh:R, 030206 dentistry, 030220 oncology & carcinogenesis, Meta-analysis, Local infiltration, Physical therapy, business, Post operative pain, Systematic Reviews as Topic, medicine.drug
Abstract

Objective The purpose of this review is to evaluate the use and effectiveness of the local administration of tramadol in reducing post-operative pain during surgical interventions. Methods The PubMed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases will be searched for this review. This systematic review will include studies evaluating the clinical efficacy of the local infiltration of tramadol, with no study design restrictions. Only studies that present clear descriptions of local tramadol administration are published in peer-reviewed journals in the English, Italian, Spanish, French, Portuguese or German language and are published in full will be taken into consideration. A meta-analysis will be performed when there is sufficient clinical homogeneity among the retrieved studies, and only randomized controlled studies and quasi-randomized controlled studies will be included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used to assess the certainty in the evidence. If a quantitative analysis cannot be conducted, a qualitative description of the results of the retrieved studies will be provided. Results A high-quality synthesis of the current evidence on the local administration of tramadol for managing post-surgical pain will be illustrated using subjective reports and objective measures of performance. The primary outcomes will include the magnitude of post-operative pain intensity improvement, with improvement being as defined by a reduction by at least 2 points in the visual analogue scale (VAS) score or numerical rating scale (NRS) score. The secondary outcomes will be the magnitude of reduction in tramadol rescue doses and in other analgesic drug doses. Conclusion This protocol will present evidence on the efficacy of tramadol in relieving post-surgical pain. Systemic review registration PROSPERO CRD42018087381

Published
2020

46. Changes in the relative prevalence of candidaemia due to non-albicans Candida species in adult in-patients: A systematic review, meta-analysis and meta-regression

Author

Vittorio Simeon, Paolo Chiodini, Malgorzata Mikulska, Alberto Enrico Maraolo, Matteo Bassetti, Daniele Roberto Giacobbe, Claudio Viscoli, Ivan Gentile, Marco Fiore, Federica Magnè, Maurizio Sanguinetti, Maria Caterina Pace, Giacobbe, D. R., Maraolo, A. E., Simeon, V., Magne, F., Pace, M. C., Gentile, I., Chiodini, P., Viscoli, C., Sanguinetti, M., Mikulska, M., Fiore, M., and Bassetti, M.

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, 030106 microbiology, Dermatology, meta-analysi, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, law.invention, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, non-albicans, Epidemiology, meta-regression, medicine, Prevalence, candidaemia, non-albican, Humans, In patient, Meta-regression, invasive candidiasi, Candida, Inpatients, business.industry, Incidence, Candidemia, General Medicine, invasive candidiasis, Intensive care unit, Confidence interval, Hospitals, meta-analysis, Intensive Care Units, Infectious Diseases, Non albicans candida, Meta-analysis, candidemia, prevalence, Observational study, business
Abstract

Background Candidaemia remains associated with high mortality and increased costs worldwide. Objective To assess the changes over time in the relative prevalence of non-albicans candidaemia (NAC). Methods A systematic review, meta-analysis and meta-regression were performed. Observational studies investigating the epidemiology of consecutive, non-selected, candidaemia episodes were included. Two separated analyses were conducted: (a) whole hospital analysis and (b) intensive care unit (ICU) analysis. Results Starting from an initial total of 7726 records, 220 studies fulfilled inclusion criteria. The pooled prevalence of NAC in whole hospital analysis was 49.5% (95% confidence intervals [CI] 48.0-51.1, I2 93.1%), while the pooled prevalence in ICU analysis was 50.6% (95% CI 46.6-54.6; I2 86.7%). In meta-regression, a progressive increase in NAC prevalence was observed in whole hospital analysis, although it explained only a small portion of between-study variance (estimated yearly prevalence change +0.3%, 95% CI from +0.1% to +0.5%, P = .003; adjusted R2 3.42%) and was observed only in some continents in subgroup analyses. No relevant changes over time were observed in NAC prevalence for ICU studies. Conclusions We registered an increasing trend in the relative prevalence of NAC, which, nonetheless, seems to be limited to some continents and to contribute only minimally to explain the observed differences in NAC prevalence across studies.

Published
2020

47. The role of an ultrasound-guided block of the deep plane of the serratus muscle in a modified eras protocol for cardiac surgery

Author

Pasquale Sansone, Maria Beatrice Passavanti, Giuseppe Sepolvere, Caterina Aurilio, Francesco Coppolino, Maria Caterina Pace, Coppolino, F., Sansone, P., Passavanti, M. B., Pace, M. C., Sepolvere, G., and Aurilio, C.

Subjects
medicine.medical_specialty, Plane (geometry), business.industry, 030204 cardiovascular system & hematology, Ultrasound guided, Cardiac surgery, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Block (telecommunications), medicine, 030212 general & internal medicine, business, Biomedical engineering
Abstract

To date, the use of multimodal techniques can allow substantial opioid-sparing and can reduce pain by using the local and systemic effects of different types of analgesics. Aims: This case report describes a modified ERAS protocol specific for cardiac surgery with the ultrasound-guided block of the deep plane of the serratus muscle (SAP deep block) in a multimodal opioid-sparing approach. \ Two male patients, aged 62 and 67, undergoing elective mini-invasive off-pump Cardiopulmonary Bypass Grafting (CPB), were treated with an opioid-sparing multimodal anesthesiological approach based on the continuous ultrasound-guided SAP deep block. The continuous ultrasound-guided SAP deep block alone can be used in the case of mini-left thoracotomy off-pump cardiopulmonary bypass grafting implementing a multi-modal opioid-sparing strategy. It seems effective in obtaining good (2 hours) weaning from mechanical ventilation, quick (36 hours) discharge from post-operative intensive care, and good post-operative pain control (NRS < 5) even in elderly and frail patients.

Published
2020

48. Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

Author

Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva, Paola Aceto, Stefania Maggi, Maria Caterina Pace, Gabriella Bettelli, Marco Montorsi, F. Petrini, Associazione Italiana di Psicogeriatria, Marco Trabucchi, Stefano Volpato, Fernando Chiumiento, Antonio Crucitti, Michele Carron, Antonio Corcione, Raffaele Antonelli Incalzi, Concezione Tommasino, Aceto, P., Antonelli Incalzi, R., Bettelli, G., Carron, M., Chiumiento, F., Corcione, A., Crucitti, A., Maggi, S., Montorsi, M., Pace, M. C., Petrini, F., Tommasino, C., Trabucchi, M., and Volpato, S.

Subjects
Aging, medicine.medical_specialty, Consensus, Settore MED/18 - CHIRURGIA GENERALE, Population, Consensu, Comorbidity, 030204 cardiovascular system & hematology, Comprehensive geriatric assessment, NO, Analgesia, Anesthesia, Frail older, Older patients, Perioperative care, Surgery, 03 medical and health sciences, Older patient, 0302 clinical medicine, Multidisciplinary approach, Settore MED/41 - ANESTESIOLOGIA, Health care, medicine, 80 and over, Humans, 030212 general & internal medicine, Elective surgery, Intensive care medicine, Cognitive impairment, education, Consensus Document, Geriatric Assessment, Aged, Aged, 80 and over, education.field_of_study, Perioperative management, business.industry, Geriatricians, Integrated care, Italy, Geriatrics and Gerontology, business, Human
Abstract

BackgroundSurgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue.AimsTo develop evidence-based recommendations for the integrated care of geriatric surgical patients.MethodsA 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria.ResultsA total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items).ConclusionsThese recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient’s conditions.

Published
2020

49. Spontaneous bacterial peritonitis due to carbapenemase-producing Enterobacteriaceae: Etiology and antibiotic treatment

Author

Marco Fiore, Stephen Petrou, Aniello Alfieri, Sveva Di Franco, Maria Beatrice Passavanti, Maria Caterina Pace, Sebastiano Leone, Francesca Martora, Fiore, M., Di Franco, S., Alfieri, A., Passavanti, M. B., Pace, M. C., Petrou, S., Martora, F., and Leone, S.

Subjects
Carbapenemase-Producing Enterobacteriaceae, Cirrhosi, Hepatology, biology, medicine.drug_class, business.industry, Antibiotics, Carbapenem-resistant enterobacteriaceae, medicine.disease, biology.organism_classification, Enterobacteriaceae, Microbiology, Carbapenem-resistant Enterobacteriaceae, Spontaneous bacterial peritonitis, Carbapenem Antibiotics, Carbapenem-resistant Klebsiella pneumoniae, medicine, Etiology, business, Bacteria
Abstract

Carbapenem antibiotics were first introduced in the 1980s and have long been considered the most active agents for the treatment of multidrug-resistant gram-negative bacteria. Over the last decade, carbapenem-resistant Enterobacteriaceae (CRE) have emerged as organisms causing spontaneous bacterial peritonitis. Infections caused by CRE have shown a higher mortality rate than those caused by bacteria sensitive to carbapenem antibiotics. Current antibiotic guidelines for the treatment of spontaneous bacterial peritonitis are insufficient, and rapid de-escalation of empiric antibiotic treatment is not widely recognized. This review summarizes the molecular characteristics, epidemiology and possible treatment of spontaneous bacterial peritonitis caused by CRE.

Published
2020

50. Ceftazidime-Avibactam Combination Therapy Compared to Ceftazidime-Avibactam Monotherapy for the Treatment of Severe Infections Due to Carbapenem-Resistant Pathogens: A Systematic Review and Network Meta-Analysis

Author

Andrea Cortegiani, Marco Fiore, Maria Caterina Pace, Giulia Ingoglia, Sveva Di Franco, Aniello Alfieri, Vittorio Simeon, Fiore, Marco, Alfieri, Aniello, Di Franco, Sveva, Pace, Maria Caterina, Simeon, Vittorio, Ingoglia, Giulia, Cortegiani, Andrea, Fiore, M., Alfieri, A., Di Franco, S., Pace, M. C., Simeon, V., Ingoglia, G., and Cortegiani, A.

Subjects
0301 basic medicine, Carbapenem-resistant enterobacteriaceae, Biochemistry, law.invention, sepsis, Ceftazidime‐avibactam, 0302 clinical medicine, Randomized controlled trial, systematic review, law, Pharmacology (medical), 030212 general & internal medicine, General Pharmacology, Toxicology and Pharmaceutics, network meta-analysis, ceftazidime-avibactam, Anti‐infective agent, network meta-analysi, Infectious Diseases, carbapenem-resistant Enterobacteriaceae, Meta-analysis, β-lactamase inhibitors, sepsi, medicine.drug, Microbiology (medical), medicine.medical_specialty, Combination therapy, 030106 microbiology, MEDLINE, β‐lactamase inhibitors, Microbiology, Article, 03 medical and health sciences, Carbapenem‐resistant Enterobacteriaceae, multidrug resistance, Internal medicine, medicine, anti-infective agent, bacteremia, business.industry, lcsh:RM1-950, Retrospective cohort study, Ceftazidime/avibactam, medicine.disease, infection, lcsh:Therapeutics. Pharmacology, Bacteremia, anti-infective agents, business, Network meta‐analysi
Abstract

Ceftazidime-avibactam (CZA) is a novel beta-lactam beta-lactamase inhibitor combination approved for the treatment of complicated urinary tract infections, complicated intra-abdominal infections, and for hospital-acquired/ventilator-associated pneumonia. The aim of this systematic review (PROSPERO registration number: CRD42019128927) was to evaluate the effectiveness of CZA combination therapy versus CZA monotherapy in the treatment of severe infections. The databases included in the search, until February 12th, 2020, were MEDLINE by PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials. We included both randomized controlled trials (RCTs) and non-randomized studies published in peer-reviewed journals and in the English language. The primary outcome was all-cause mortality (longest follow-up) evaluated in patients with the diagnosis of infection with at least one pathogen, secondary outcomes were clinical and microbiological improvement/cure. Thirteen studies were included in the qualitative synthesis: 7 RCTs and 6 retrospective studies All the six retrospective studies identified carbapenamase-producing Enterobacteriaceae (CRE) as the cause of infection and for this reason were included in the network meta-analysis (NMA), the quality of the studies, assessed using the New Castle-Ottawa Scale, was moderate-high. In all the six retrospective studies included in the NMA, CZA was used in large part for off-label indications (mostly blood stream infections: 80&ndash, 100% of patients included). No difference in mortality rate was observed in patients undergoing CZA combination therapy compared to CZA monotherapy [n = 503 patients, direct evidence OR: 0.96, 95% CI: 0.65&ndash, 1.41].

Published
2020

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