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1. Comparative Life Cycle Assessment Between Single-Use and Reprocessed IPC Sleeves [Response to Letter]

Author

Lichtnegger S, Meissner M, Paolini F, Veloz A, and Saunders R

Subjects
Public aspects of medicine, RA1-1270
Abstract

Sabrina Lichtnegger,1 Markus Meissner,2 Francesca Paolini,3 Alex Veloz,4 Rhodri Saunders3 1ECOFIDES Consulting GmbH, Vienna, VIE, Austria; 2Austrian Institute of Ecology and Pulswerk GmbH, Vienna, VIE, Austria; 3Coreva Scientific GmbH & Co. KG, Koenigswinter, NRW, Germany; 4HEOR Pro, LLC, Elmhurst, IL, USACorrespondence: Rhodri Saunders, Coreva Scientific GmbH & Co. KG, Im Muehlenbruch 1, Koenigswinter, 53639, Germany, Fax +49 761 76 999 421, Email ourpublications@coreva-scientific.com

Published
2024

2. Comparative Life Cycle Assessment Between Single-Use and Reprocessed IPC Sleeves

Author

Lichtnegger S, Meissner M, Paolini F, Veloz A, and Saunders R

Subjects
circular economy, resource efficiency, equipment reuse, recycling, waste management, environmental footprint, Public aspects of medicine, RA1-1270
Abstract

Sabrina Lichtnegger,1 Markus Meissner,2 Francesca Paolini,3 Alex Veloz,4 Rhodri Saunders3 1ECOFIDES Consulting GmbH, Vienna, VIE, Austria; 2Austrian Institute of Ecology and Pulswerk GmbH, Vienna, VIE, Austria; 3Coreva Scientific GmbH & Co. KG, Koenigswinter, NRW, Germany; 4HEOR Pro, LLC, Elmhurst, IL, USACorrespondence: Rhodri Saunders, Coreva Scientific GmbH & Co. KG, Im Muehlenbruch 1, Koenigswinter, 53639, Germany, Fax +49 761 76 999 421, Email ourpublications@coreva-scientific.comPurpose: Healthcare has a large environmental footprint, not least due to the wide use of single-use supplies. Reprocessing of medical devices is a well-established, regulated process, and can reduce its environmental impact. This life cycle assessment (LCA) compares the environmental footprint of a single-use and a reprocessed version of otherwise identical intermittent pneumatic compression (IPC) sleeves.Materials and Methods: The LCA was performed in accordance with the international standard ISO 14044 using the Environmental Footprint 3.0 (EF) method for the assessment. Data were obtained in cooperation with IPC sleeve manufacturers. Where no primary data were available, ecoinvent database records were used. The functional unit is five hospital treatments applying IPC. The robustness of the results was interrogated in sensitivity analyses of the energy mix, the ethylene oxide emissions during reprocessing, and the transport distances. The impact of waste reduction on hospital disposal costs was calculated.Results: The environmental footprint of reprocessed IPC sleeves was found to be reduced in all categories compared to single-use devices, leading to a weighted normalized reduction of 43% across all categories. In a breakdown of the LCA results, reprocessed IPC sleeves were found to reduce the carbon footprint by 40%, with the treatment of five patients with single-use IPC sleeves creating 7 kg CO2eq, compared to 4.2 kg CO2eq from reprocessed sleeves. Waste disposal costs were also reduced by 90%.Conclusion: Reprocessing of IPC sleeves provides an environmental and economic benefit in comparison to single-use devices.Keywords: circular economy, resource efficiency, equipment reuse, recycling, waste management, environmental footprint

Published
2023

3. A first assessment of the safe brain initiative care bundle for addressing postoperative delirium in the postanesthesia care unit.

Author

Meco, BC, Jakobsen, K, De Robertis, E, Buhre, W, Alkış, N, Kirkegaard, PR, Hägi-Pedersen, D, Bubser, F, Koch, S, Evered, LA, Saunders, SJ, Caterino, M, Paolini, F, Berger-Estilita, J, Radtke, FM, Meco, BC, Jakobsen, K, De Robertis, E, Buhre, W, Alkış, N, Kirkegaard, PR, Hägi-Pedersen, D, Bubser, F, Koch, S, Evered, LA, Saunders, SJ, Caterino, M, Paolini, F, Berger-Estilita, J, and Radtke, FM

Abstract

BACKGROUND: Postoperative delirium (POD) following surgery is a prevalent and distressing condition associated with adverse patient outcomes and an increased healthcare burden. OBJECTIVES: To assess the effectiveness of the Safe Brain Initiative care bundle (SBI-CB) in reducing POD in the postanesthesia care unit (PACU). DESIGN: A multicenter, quality-improvement initiative with retrospective analysis of collected data. SETTING: The study was conducted in the operating rooms and postanesthesia care units (PACUs) of four hospitals across Denmark and Turkey. PATIENTS: The convenience sample of patients were aged ≥18 years, scheduled for surgery, and could communicate verbally. Age, sex, preoperative delirium, and the American Society for Anesthesiology physical status classification were used in statistical methods to control for potential confounding influences. INTERVENTION: The SBI-CB, 18 delirium-reducing recommendations aligned with international guidelines. The intervention included patient education, staff training, coordination meetings across centers, and a dashboard for the monitoring of outcomes in the PACU. MAIN OUTCOME MEASURES: The primary outcome was the POD trend in the PACU during implementation months, assessed through Nu-DESC screening at up to three time points in the PACU. We also examined the length of hospital stay. RESULTS: Data were collected from 18,697 adult patients across four hospitals. Initial POD incidence in the PACU after the first three months was 16.36% across all sites (n = 1021). POD in the PACU was observed across all age groups, with peak incidence in younger (18-35 years) and older (>75 years) patients. General anesthesia and longer surgical duration (>1 h) were identified as significant risk factors for POD in the PACU. Matched patients who experienced POD in the PACU had longer stays in hospital, with a mean increase from 35 to 69 h (p < 0.001). Implementation of the SBI-CB was associated with a decreased risk of POD in the P

Published
2024

5. Left-ventricular non-compaction and ventricular arrhythmias

Author

Principi, S, primary, Alfieri, M, additional, Barbarossa, A, additional, Ciliberti, G, additional, Coretti, F, additional, Coraducci, F, additional, Belleggia, S, additional, Torselletti, L, additional, Paolini, F, additional, Stronati, G, additional, Dello Russo, A, additional, and Guerra, F, additional

Published
2023
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9. Long-term prognosis in left ventricular non-compaction cardiomyopathy

Author

Guerra, F, primary, Barbarossa, A, additional, Alfieri, M, additional, Paolini, F, additional, Stronati, G, additional, Ciliberti, G, additional, Torselletti, L, additional, Coretti, F, additional, Coraducci, F, additional, Belleggia, S, additional, Principi, S, additional, Silenzi, M, additional, Manfredi, R, additional, Falanga, U, additional, and Dello Russo, A, additional

Published
2022
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25. HEART FAILURE WITH PRESERVED EJECTION FRACTION (HFPEF) IN A PATIENT WITH RECENT TAVI AND NUMEROUS CORONARY FISTULAS OF THE LEFT CORONARY ARTERY DRAINING INTO THE VENTRICULAR CAVITY

Author

Maffei, S, Tarsi, G, and Paolini, F

Abstract

Coronary fistula is a rare form of congenital heart disease and is defined as an abnormal connection between a coronary branch and a cardiac chamber or a large intrathoracic vessel without the interposition of the capillary circulation. The right coronary artery is the most common site of origin for coronary fistula. Other sites include the left anterior descending artery and left circumflex artery. The clinical presentation and the natural history can be extremely variable depending on the patient‘s age, fistula size, and anatomy. Small to medium–sized coronary fistulas may be asymptomatic. Large fistulas can manifest with angina pectoris due to myocardial ischemia secondary to the coronary steal phenomenon. Shunting through large fistulas can have hemodynamic consequences secondary to volume overload in the pulmonary or systemic circulation, leading to symptoms and signs of heart failure. We describe the case of an 83–year–old woman recently undergoing TAVI and suffering from primary myelofibrosis requiring periodic transfusions. Pre–TAVI coronary angiography showed coronary vessels free from significant hemodynamic lesions and multiple coronary–ventricular fistulas draining into the left ventricle. Total body aortic CT angiography did not reveal other abnormal vascular connections. One month after the aortic valve correction procedure, the patient presented with heart failure (HfpEF). At a recent follow–up visit, diuretic therapy was discontinued due to the successful correction of aortic valve disease and normal ejection fraction. Due to further anemization from the underlying hematologic condition, the patient underwent blood transfusion with worsening of dyspnea despite correction of hemoglobin levels. Discontinuation of diuretic therapy and transfusion of red blood cell units resulted in volume overload with worsening clinical condition. The presence of multiple coronary fistulas precluded an interventional approach, but therapeutic optimization and reintroduction of diuretic therapy restored the patient‘s hemodynamic compensation. Usually fistulas drain into the low–pressure venous circulation like right ventricle and right atrium. This case represents a rare instance of multiple left coronary fistulas draining into the left ventricle (only 3% of cases). Aortic valve correction may have further reduced left ventricular telediastolic pressures, worsening the shunt of coronary fistulas resulting in heart failure due to volume overload.

Published
2024
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26. Adherence issues related to sublingual immunotherapy as perceived by allergists

Author

Scurati, S., Frati, F., Passalacqua, G., Puccinelli, P., Hilaire, C., Incorvaia, C., D Avino, G., Comi, R., Lo Schiavo, M., Pezzuto, F., Montera, C., Pio, A., Teresa Ielpo, M., Cellini, F., Vicentini, L., Pecorari, R., Aresu, T., Capra, L., Benedictis, E., Bombi, C., Zauli, D., Vanzi, A., Alberto Paltrinieri, C., Bondioli, A., Paletta, I., Ventura, D., Mei, F., Paolini, F., Colangelo, C., Cavallucci, E., Cucinelli, F., Tinari, R., Ermini, G., Beltrami, V., Novembre, E., Begliomini, C., Marchese, E., Solito, E., Ammannati, V., Molino, G., Galli, E., Baldassini, M., Di Michele, L., Calvani, M., Gidaro, M., Venuti, A., Li Bianchi, E., Benassi, F., Pocobelli, D., Zangari, P., Rocco, M. G., Lo Vecchio, A., Pingitore, G., Grimaldi, O., Schiavino, D., Perrone, N., Antonietta Frieri, M., Di Rienzo, V., Tripodi, S., Scarpa, A., Tomsic, M., Bonaguro, R., Enrico Senna, G., Sirena, A., Turatello, F., Crescioli, S., Favero, E., Billeri, L., Chieco Bianchi, F., Gemignani, C., Zanforlin, M., Angiola Crivellaro, M., Hendrick, B., Maltauro, A., Masieri, S., Elisabetta Conte, M., Fama, M., Pozzan, M., Bonadonna, P., Casanova, S., Vallerani, E., Schiappoli, M., Borghesan, F., Giro, G., Casotto, S., Berardino, L., Zanoni, G., Ariano, R., Aquilina, R., Pellegrino, R., Marsico, P., Del Giudice, A., Narzisi, G., Tomaselli, V., Fornaca, G., Favro, M., Loperfido, B., Gallo, C., Buffoni, S., Gani, F., Raviolo, P., Faggionato, S., Truffelli, T., Vivalda, L., Albano, M., Enzo Rossi, R., Lattuada, G., Bona, F., Quaglio, L., Chiesa, A., Trapani, M., Seminara, R., Cucchi, B., Oderda, S., Borio, G., Galeasso, G., Garbaccio, P., Marco, A., Marengo, F., Cadario, G., Manzoni, S., Vinay, C., Curcio, A., Silvestri, A., Peduto, A., Riario-Sforza, G. G., Maria Forgnone, A., Barocelli, P., Tartaglia, N., Feyles, G., Giacone, A., Ricca, V., Guida, G., Nebiolo, F., Bommarito, L., Heffler, E., Vietti, F., Galimberti, M., Savi, E., Pappacoda, A., Bottero, P., Porcu, S., Felice, G., Berra, D., Francesca Spina, M., Pravettoni, V., Calamari, A. M., Varin, E., Iemoli, E., Lietti, D., Ghiglioni, D., Alessandro Fiocchi, Tosi, A., Poppa, M., Caviglia, A., Restuccia, M., Russello, M., Alciato, P., Manzotti, G., Ranghino, E., Luraschi, G., Rapetti, A., Rivolta, F., Allegri, F., Terracciano, L., Agostinis, F., Paolo Piras, P., Ronchi, G., Gaspardini, G., Caria, V., Tolu, F., Fantasia, D., Carta, P., Moraschini, A., Quilleri, R., Santelli, A., Prandini, P., Del Giudice, G., Apollonio, A., Bonazza, L., Teresa Franzini, M., Branchi, S., Zanca, M., Rinaldi, S., Catelli, L., Zanoletti, T., Cosentino, C., Della Torre, F., Cremonte, L., Musazzi, D., Suli, C., Rivolta, L., Ottolenghi, A., Marino, G., Sterza, G., Sambugaro, R., Orlandini, A., Minale, P., Voltolini, S., Bignardi, D., Omodeo, P., Tiri, A., Milani, S., Ronchi, B., Licardi, G., Bruni, P., Scibilia, J., Schroeder, J., Crosti, F., Maltagliati, A., Alesina, M. R., Mosca, M., Leone, G., Napolitano, G., Di Gruttola, G., Scala, G., Mascio, S., Valente, A., Marchetiello, I., Catello, R., Gazulli, A., Del Prete, A., Varricchio, A. M., Carbone, A., Forestieri, A., Stillitano, M., Leonetti, L., Tirroni, E., Castellano, F., Abbagnara, F., Romano, F., Levanti, C., Cilia, M., Longo, R., Ferrari, A., Merenda, R., Di Ponti, A., Guercio, E., Surace, L., Ammendola, G., Tansella, F., Peccarisi, L., Stragapede, L., Minenna, M., Granato, M., Fuiano, N., Pannofino, A., Ciuffreda, S., Giannotta, A., Morero, G., D Oronzio, L., Taddeo, G., Nettis, E., Cinquepalmi, G., Lamanna, C., Mastrandrea, F., Minelli, M., Salamino, F., Muratore, L., Latorre, F., Quarta, C., Ventura, M., D Ippolito, G., Giannoccaro, F., Dambra, P., Pinto, L., Triggiani, M., Munno, G., Manfredi, G., Lonero, G., Damiano, V., Errico, G., Di Leo, E., Manzari, F., Spagna, V., Arsieni, A., Matarrese, A., Mazzarella, G., Scarcia, G., Scarano, R., Ferrannini, A., Pastore, A., Maionchi, P., Filannino, L., Tria, M., Giuliano, G., Damiani, E., Scichilone, N., Marchese, M., Lucania, A., Marino, M., Strazzeri, L., Tumminello, S., Vitale, G. I., Gulotta, S., Gragotto, G., Zambito, M., Greco, D., Valenti, G., Licitra, G., Cannata, E., Filpi, R., Contraffatto, M., Sichili, S., Randazzo, S., Scarantino, G., Lo Porto, B., Pavone, F., Di Bartolo, C., Paternò, A., Rapisarda, F., Laudani, E., Leonardi, S., Padua, V., Cabibbo, G., Marino Guzzardi, G., Deluca, F., Agozzino, C., Pettinato, R., Ghini, M., Scurati S., Frati F., Passalacqua G., Puccinelli P., Hilaire C., Incorvaia C., D'Avino G., Comi R., Lo Schiavo M., Pezzuto F., Montera C., Pio A., Teresa Ielpo M., Cellini F., Vicentini L., Pecorari R., Aresu T., Capra L., De Benedictis E., Bombi C., Zauli D., Vanzi A., Alberto Paltrinieri C., Bondioli A., Paletta I., Ventura D., Mei F., Paolini F., Colangelo C., Cavallucci E., Cucinelli F., Tinari R., Ermini G., Beltrami V., Novembre E., Begliomini C., Marchese E., Solito E., Ammannati V., Molino G., Galli E., Baldassini M., Di Michele L., Calvani M., Gidaro M., Venuti A., Li Bianchi E., Benassi F., Pocobelli D., Zangari P., De Rocco M.G., Lo Vecchio A., Pingitore G., Grimaldi O., Schiavino D., Perrone N., Antonietta Frieri M., Di Rienzo V., Tripodi S., Scarpa A., Tomsic M., Bonaguro R., Enrico Senna G., Sirena A., Turatello F., Crescioli S., Favero E., Billeri L., Chieco Bianchi F., Gemignani C., Zanforlin M., Angiola Crivellaro M., Hendrick B., Maltauro A., Masieri S., Elisabetta Conte M., Fama M., Pozzan M., Bonadonna P., Casanova S., Vallerani E., Schiappoli M., Borghesan F., Giro G., Casotto S., Berardino L., Zanoni G., Ariano R., Aquilina R., Pellegrino R., Marsico P., Del Giudice A., Narzisi G., Tomaselli V., Fornaca G., Favro M., Loperfido B., Gallo C., Buffoni S., Gani F., Raviolo P., Faggionato S., Truffelli T., Vivalda L., Albano M., Enzo Rossi R., Lattuada G., Bona F., Quaglio L., Chiesa A., Trapani M., Seminara R., Cucchi B., Oderda S., Borio G., Galeasso G., Garbaccio P., De Marco A., Marengo F., Cadario G., Manzoni S., Vinay C., Curcio A., Silvestri A., Peduto A., Riario-Sforza G.G., Maria Forgnone A., Barocelli P., Tartaglia N., Feyles G., Giacone A., Ricca V., Guida G., Nebiolo F., Bommarito L., Heffler E., Vietti F., Galimberti M., Savi E., Pappacoda A., Bottero P., Porcu S., Felice G., Berra D., Francesca Spina M., Pravettoni V., Calamari A.M., Varin E., Iemoli E., Lietti D., Ghiglioni D., Fiocchi A., Tosi A., Poppa M., Caviglia A., Restuccia M., Russello M., Alciato P., Manzotti G., Ranghino E., Luraschi G., Rapetti A., Rivolta F., Allegri F., Terracciano L., Agostinis F., Paolo Piras P., Ronchi G., Gaspardini G., Caria V., Tolu F., Fantasia D., Carta P., Moraschini A., Quilleri R., Santelli A., Prandini P., Del Giudice G., Apollonio A., Bonazza L., Teresa Franzini M., Branchi S., Zanca M., Rinaldi S., Catelli L., Zanoletti T., Cosentino C., Della Torre F., Cremonte L., Musazzi D., Suli C., Rivolta L., Ottolenghi A., Marino G., Sterza G., Sambugaro R., Orlandini A., Minale P., Voltolini S., Bignardi D., Omodeo P., Tiri A., Milani S., Ronchi B., Licardi G., Bruni P., Scibilia J., Schroeder J., Crosti F., Maltagliati A., Alesina M.R., Mosca M., Leone G., Napolitano G., Di Gruttola G., Scala G., Mascio S., Valente A., Marchetiello I., Catello R., Gazulli A., Del Prete A., Varricchio A.M., Carbone A., Forestieri A., Stillitano M., Leonetti L., Tirroni E., Castellano F., Abbagnara F., Romano F., Levanti C., Cilia M., Longo R., Ferrari A., Merenda R., Di Ponti A., Guercio E., Surace L., Ammendola G., Tansella F., Peccarisi L., Stragapede L., Minenna M., Granato M., Fuiano N., Pannofino A., Ciuffreda S., Giannotta A., Morero G., D'Oronzio L., Taddeo G., Nettis E., Cinquepalmi G., Lamanna C., Mastrandrea F., Minelli M., Salamino F., Muratore L., Latorre F., Quarta C., Ventura M., D'Ippolito G., Giannoccaro F., Dambra P., Pinto L., Triggiani M., Munno G., Manfredi G., Lonero G., Damiano V., Errico G., Di Leo E., Manzari F., Spagna V., Arsieni A., Matarrese A., Mazzarella G., Scarcia G., Scarano R., Ferrannini A., Pastore A., Maionchi P., Filannino L., Tria M., Giuliano G., Damiani E., Scichilone N., Marchese M., Lucania A., Marino M., Strazzeri L., Tumminello S., Vitale G.I., Gulotta S., Gragotto G., Zambito M., Greco D., Valenti G., Licitra G., Cannata E., Filpi R., Contraffatto M., Sichili S., Randazzo S., Scarantino G., Lo Porto B., Pavone F., Di Bartolo C., Paterno A., Rapisarda F., Laudani E., Leonardi S., Padua V., Cabibbo G., Marino Guzzardi G., Deluca F., Agozzino C., Pettinato R., Ghini M., Scurati S, Frati F, Passalacqua G, Puccinelli P, Hilaire C, Incorvaia I, D'Avino G, Comi R, Lo Schiavio M, Pezzuto F, Montera C, Pio A, Ielpo MT, Cellini F, Vicentini L, Pecorari R, Aresu T, Capra L, De Benedictis E, Bombi C, Zauli D, and et al

Subjects
medicine.medical_specialty, Pathology, genetic structures, efficacy, Alternative medicine, Medicine (miscellaneous), Adherence, Cost, Efficacy, Side effects, Sublingual immunotherapy, Settore MED/10 - Malattie Dell'Apparato Respiratorio, sublingual immunotherapy, ALLERGEN, cost, medicine, Subcutaneous immunotherapy, Sublingual immunotherapy, adherence, Clinical efficacy, Intensive care medicine, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), sublingual immunoterapy, Original Research, Asthma, AEROALLERGENS, side effects, business.industry, Health Policy, medicine.disease, Slit, eye diseases, Clinical trial, Patient Preference and Adherence, immunotherapy, sense organs, Allergists, ADHERENCE TO TREATMENT, business, Social Sciences (miscellaneous)
Abstract

Silvia Scurati1, Franco Frati1, Gianni Passalacqua2, Paola Puccinelli1, Cecile Hilaire1, Cristoforo Incorvaia3, Italian Study Group on SLIT Compliance 1Scientific and Medical Department, Stallergenes, Milan, Italy; 2Allergy and Respiratory Diseases, Department of Internal Medicine, Genoa; 3Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, ItalyObjectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists.Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.Keywords: adherence, sublingual immunotherapy, efficacy, cost, side effects

Published
2010

27. Targeting immune response with therapeutic vaccines in premalignant lesions and cervical cancer: hope or reality from clinical studies

Author

Vici, P., Pizzuti, L., Mariani, L., Zampa, G., Santini, D., Di Lauro, L., Gamucci, Teresa, Natoli, C., Marchetti, P., Barba, M., Maugeri-Saccà, M., Sergi, Daniele, Tomao, F., Vizza, E., Di Filippo, S., Paolini, F., Curzio, G., Corrado, G., Michelotti, A., Sanguineti, G., De Maria Marchiano, Ruggero, Venuti, A., Giordano, A., Gamucci, T., Sergi, D., De Maria Marchiano, R. (ORCID:0000-0003-2255-0583), Vici, P., Pizzuti, L., Mariani, L., Zampa, G., Santini, D., Di Lauro, L., Gamucci, Teresa, Natoli, C., Marchetti, P., Barba, M., Maugeri-Saccà, M., Sergi, Daniele, Tomao, F., Vizza, E., Di Filippo, S., Paolini, F., Curzio, G., Corrado, G., Michelotti, A., Sanguineti, G., De Maria Marchiano, Ruggero, Venuti, A., Giordano, A., Gamucci, T., Sergi, D., and De Maria Marchiano, R. (ORCID:0000-0003-2255-0583)

Abstract

Human papillomavirus (HPV) is widely known as a cause of cervical cancer (CC) and cervical intraepithelial neoplasia (CIN). HPVs related to cancer express two main oncogenes, i.e. E6 and E7, considered as tumorigenic genes; their integration into the host genome results in the abnormal regulation of cell cycle control. Due to their peculiarities, these oncogenes represent an excellent target for cancer immunotherapy. In this work the authors highlight the potential use of therapeutic vaccines as safe and effective pharmacological tools in cervical disease, focusing on vaccines that have reached the clinical trial phase. Many therapeutic HPV vaccines have been tested in clinical trials with promising results. Adoptive T-cell therapy showed clinical activity in a phase II trial involving advanced CC patients. A phase II randomized trial showed clinical activity of a nucleic acid-based vaccine in HPV16 or HPV18 positive CIN. Several trials involving peptide-protein-based vaccines and live-vector based vaccines demonstrated that these approaches are effective in CIN as well as in advanced CC patients. HPV therapeutic vaccines must be regarded as a therapeutic option in cervical disease. The synergic combination of HPV therapeutic vaccines with radiotherapy, chemotherapy, immunomodulators or immune checkpoint inhibitors opens a new and interesting scenario in this disease.

Published
2016

28. Traumatic Brain Injury in Children: Role of CDRs-PECARN as a Clinical Predictive Resource for Evaluation of Intracranical Lesions and Neuropsychiatric Outcomes.

Author

Ferrara, Pietro, Basile, Mc, Dell'Aquila, L, Vena, F, Coppo, E, Chiaretti, Antonio, Verrotti, A, Paolini, F, Caldarelli, Massimo, Ferrara, Pietro (ORCID:0000-0001-9449-3464), Chiaretti, Antonio (ORCID:0000-0002-9971-1640), Caldarelli, Massimo (ORCID:0000-0002-2111-3800), Ferrara, Pietro, Basile, Mc, Dell'Aquila, L, Vena, F, Coppo, E, Chiaretti, Antonio, Verrotti, A, Paolini, F, Caldarelli, Massimo, Ferrara, Pietro (ORCID:0000-0001-9449-3464), Chiaretti, Antonio (ORCID:0000-0002-9971-1640), and Caldarelli, Massimo (ORCID:0000-0002-2111-3800)

Abstract

Cranial computed tomography (CT) is considered the gold standard for the diagnosis of traumatic brain injury (TBI). The aim of this study was to evaluate if the clinical decision rules proposed by the Pediatric Emergency Care Applied Research Network (CDRs-PECARN) are really able to identify the patients who do not need cranial CT. This study investigates the neuropsychiatric outcome after TBI according to a pediatric version of the Glasgow Outcome Scale-Extended (GOS-E Peds). We calculated the sensitivity, specificity, negative predictive value (NPV) and positive predictive value of the CDRs-PECARN in 2 age groups. Sensitivity was very high in both groups, and the NPV was very useful for predicting which subjects, of those who presented without CDRs- PECARN, would have a negative cranial CT. We also evaluated the correlations between the GOS-E Peds and Glasgow Coma Scale and between the GOS-E Peds and cranial CT scan. Our study confirms the validation of the PECARN TBI prediction rules as a clinical instrument which can play a significant role in CT decision-making for children with TBI. It also demonstrates that the GOS-E Peds is a valid pediatric outcome scale for children with TBI, despite some important limitations.

Published
2016

29. Targeting immune response with therapeutic vaccines in premalignant lesions and cervical cancer: hope or reality from clinical studies

Author

Vici, P, primary, Pizzuti, L, additional, Mariani, L, additional, Zampa, G, additional, Santini, D, additional, Di Lauro, L, additional, Gamucci, T, additional, Natoli, C, additional, Marchetti, P, additional, Barba, M, additional, Maugeri-Saccà, M, additional, Sergi, D, additional, Tomao, F, additional, Vizza, E, additional, Di Filippo, S, additional, Paolini, F, additional, Curzio, G, additional, Corrado, G, additional, Michelotti, A, additional, Sanguineti, G, additional, Giordano, A, additional, De Maria, R, additional, and Venuti, A, additional

Published
2016
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30. Problematiche per l'ascolto della musica in soggetti portatori di apparecchi acustici

Author

Bertini G., Paolini F., Magrini M., and Bedini L.

Subjects
Hearing Aids, Real Time Systems
Abstract

The need to increase the volume when listening to music in cars or through low-cost audio players has arisen in the mid-80s for several reasons: one is to overcome the ambient noise and the other, not secondary, is to enhance the sound of private radio stations with respect to competitors. The method used consists in greatly reducing the dynamic range of the signal amplitude, by overcompressing it. This process has been gradually applied also in the production of audio CDs for many kinds of light music, except classical and jazz, of course. Listening to this music by using HiFi audio systems or low-quality devices makes the sound to be perceived as flat, hard and annoying. This work proposes some solutions, found with also the contribution of the Signals & Images Lab of ISTI-CNR, for the enhancement of the dynamic transients of overcompressed music, by means of HW devices and/or SW plug-in to be included in the audio chain. In particular, it is addressed the problem of the estimation of the dynamic content of a music track, for which some indices of loudness, such as those defined by the EBU standards, are proposed. The hypothesis of a possible hearing damage in prolonged listening to overcompressed songs and how this can be highlighted are also taken into consideration.

Published
2014

36. Bach1 overexpression in Down syndrome correlates with the alteration of the HO-1/BVR-a system: insights for transition to Alzheimer's disease

Author

Di Domenico, F, Pupo, G, Mancuso, Cesare, Barone, Eugenio, Paolini, F, Arena, A, Blarzino, C, Schmitt, Fa, Head, E, Butterfield, Da, Perluigi, M., Mancuso, Cesare (ORCID:0000-0001-6532-483X), Di Domenico, F, Pupo, G, Mancuso, Cesare, Barone, Eugenio, Paolini, F, Arena, A, Blarzino, C, Schmitt, Fa, Head, E, Butterfield, Da, Perluigi, M., and Mancuso, Cesare (ORCID:0000-0001-6532-483X)

Abstract

Bach1, among the genes encoded on chromosome 21, is a transcription repressor, which binds to antioxidant response elements of DNA thus inhibiting the transcription of specific genes involved in the cell stress response including heme oxygenase-1 (HO-1). HO-1 and its partner, biliverdin reductase-A (BVR-A), are upregulated in response to oxidative stress in order to protect cells against further damage. Since oxidative stress is an early event in Down syndrome (DS) and might contribute to the development of multiple deleterious DS phenotypes, including Alzheimer's disease (AD) pathology, we investigated the status of the Bach1/HO-1/BVR-A axis in DS and its possible implications for the development of AD. In the present study, we showed increased total Bach1 protein levels in the brain of all DS cases coupled with reduced induction of brain HO-1. Furthermore, increased oxidative stress could, on one hand, overcome the inhibitory effects of Bach1 and, on the other hand, promote BVR-A impairment. Our data show that the development of AD in DS subjects is characterized by (i) increased Bach1 total and poly-ubiquitination; (ii) increased HO-1 protein levels; and (iii) increased nitration of BVR-A followed by reduced activity. To corroborate our findings, we analyzed Bach1, HO-1, and BVR-A status in the Ts65Dn mouse model at 3 (young) and 15 (old) months of age. The above data support the hypothesis that the dysregulation of HO-1/BVR-A system contributes to the early increase of oxidative stress in DS and provide potential mechanistic paths involved in the neurodegenerative process and AD development.

Published
2015

39. A portable DSP-based device improves music quality for hearing-impaired subjects

Author

Bertini G., Magrini M., and Paolini F.

Subjects
Sound and Music Computing, Body worn device, Hearing aid system, Digital signal processing, User Interfaces
Abstract

The paper describes our preliminary results and progress in the design of a portable device, that offers better quality than the usual miniaturized hearing aids for hearing-impaired subjects who listen to music. This can be by achieved employing wideband and high dynamic gain compensation curves obtained with a DSP processor and apply the signal with normal headphones. The first part of the paper refers to the performance of commercial hearing aids and their area of use in reference to the characteristics of human auditory apparatus. Next there is a brief summary of experiments carried out at the Signal&Image Lab of the ISTI-CNR, during which broadband curves (30-16000 Hz) were implemented with a IIR filter bank using a DSP laboratory equipment. We also report preliminary results obtained in tests conducted on some individuals with mild/medium hearing loss. We then describe the current device under development based on a low power, multi-core DSP board by which one can create special gain compensation curves using a single FIR filter. Finally, we describe some of the HW/SW parts required to perform the other system functions.

Published
2010

42. Dispositivo di ausilio a soggetti ipoacusici per il migliore ascolto della musica

Author

Bertini G., Magrini M., and Paolini F.

Subjects
Hearing aids, Sound and Music Computing, Special-Purpose and Application-Based Systems, Applications, Digital signal processing
Abstract

This paper describes the work of the training carried out c/o the ISTI-CNR S&I Lab. by Filippo Paolini, regarding the design of portable devices based on DSP, in order to allow the improvement the listen of music from ipoacousic subjects, not obtainable with commercial hearing aids. The activity has been born from an idea of the colleague Giotto Fiorio + since 2000, in spite of the argument was not considered of interest. The activity has been developed irregularly in the time, for the difficulties to find founds, mainly from Graziano Bertini like free research, with the collaboration of Massimo Magrini, Luigi Bedini and of students of the Pisa University. The topic is only recently dealt in bibliography, that is to improve the hearing aids response to "high frequency", to specifying that for the experts this term mean 5 kHz to 8 kHz. This range is the maximum limit considered by the commercial HW/SW instrumentation, while in our proposal the term "high frequency" refers to the entire audio range till 16 kHz, required for a good listening of music.

Published
2009

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