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3. International consensus on sleep problems in pediatric palliative care: Paving the way

Author

Li, Albert, Wolfson, Amy R., Marinetto, Anna, Santini, Anna, Zanin, Anna, Kuhn, Brett R., Angelhoff, Charlotte, Santos, Cristiane Fumo dos, Goh, Daniel Y.T., Verrillo, Elisabetta, Zhou, Eric S., Ferreira, Esther Angélica Luiz, Bergstraesser, Eva, Pizza, Fabio, Nilsson, Frans, Plazzi, Giuseppe, Wang, Guanghai, Traslaviña, Guillermo Andrey Ariza, Moreira, Gustavo Antonio, Siden, Hal, Hauch, Holger, Huijer, Huda Abu-Saad, Catalano, Igor, Narang, Indra, Avagnina, Irene, Lopez, Jaime Gutierrez Del Alamo, Wille, Joakim, Mindell, Jodi, Bogetz, Jori, Downing, Julia, Hauer, Julie, Streuli, Jürg, Baker, Justin, Spruyt, Karen, Chan, Kate Ching Ching, Soster, Leticia Azevedo, Oliveira, Lia, Ragsdale, Lindsay, Nobili, Lino, Matlen, Lisa, Nosetti, Luana, De Zen, Lucia, Strambi, Luigi Ferini, Stenmarker, Margaretha, Lopes, Maria Cecilia, Blankenburg, Markus, Rios, Marta, Bernadá, Mercedes, Farquhar, Michael, Frühwald, Michael, Gradisar, Michael, Simakajornboon, Narong, Lazzarin, Pierina, Chong, Poh-Heng, Ferri, Raffaele, Martino-Alba, Ricardo, Findling, Robert L., Ferreira, Rosário, Bin-Hasan, Saadoun, Kudchadkar, Sapna R., Mercadante, Sebastiano, Amarri, Sergio, Keenan, Sharon, Noce, Silvia, de Oliveira Iglesias, Simone Brasil, Fagondes, Simone, Suh, Sooyeon, Sheldon, Stephen H., Sejersen, Thomas, Ceranoglu, Tolga Atilla, Crabtree, Valerie, Castronovo, Vincenza, Mercante, Anna, Owens, Judith, Bruni, Oliviero, Nunes, Magda L., Gringras, Paul, Li, Shirley Xin, Papa, Simonetta, Kreicbergs, Ulrika, Wolfe, Joanne, Zernikow, Boris, Lacerda, Ana, and Benini, Franca

Published
2024
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5. Specialized pediatric palliative care in Italy: where are we going? The Palliped 2022–2023 study.

Author

Benini, Franca, Mercante, Anna, Di Nunzio, Sara, Papa, Simonetta, Amarri, Sergio, Barrocu, Laura, Bolognani, Marco, Calì, Monica, Catalano, Gaetano, Celentano, Loredana, De Zen, Lucia, Lazzarin, Pierina, Lijoi, Stefano, Manfredini, Luca, Molinaro, Grazia, Moliterni, Paola, Orofino, Rocco, Pellegatta, Federico, Pizzi, Simone, and Raspi, Marina

Abstract

Background: The PalliPed project is a nationwide, observational, cross-sectional study designed with the aim of providing a constantly updated national database for the census and monitoring of specialized pediatric palliative care (PPC) activities in Italy. This paper presents the results of the first monitoring phase of the PalliPed project, which was developed through the PalliPed 2022–2023 study, to update current knowledge on the provision of specialized PPC services in Italy. Methods: Italian specialized PPC centers/facilities were invited to participate and asked to complete a self-reporting, ad-hoc, online survey regarding their clinical activity in 2022–2023, in the revision of the data initially collected in the first PalliPed study of 2021. Results: 18 specialized PPC centers/facilities from 14 Italian regions and two autonomous provinces participated; 13 were identified as regional referral centers (72.2%), with the acquisition of three new centers in comparison to 2021. Full coverage of the regional territory was reported by 54% of them, compared with 45% in 2021, while a 24/7 service was offered by 23%, compared with 27% in 2021. Eight of 13 referral centers (61%) had a dedicated team, compared with 91% in 2021. Also, an overall increase in the number of followed patients was observed, rising from 1,209 (2019) to 2,734 (2023). In line with previous data, most PPC healthcare providers were nurses (n = 181) and physicians (n = 89), with an overall increased number of PPC providers from 2021. Conclusions: The nationwide PalliPed project established the first comprehensive overview and monitoring of the state of specialized PPC in Italy. Data reported within the PalliPed 2022–2023 monitoring study suggest a general improving trend in the availability of the specialized PPC service in Italy, compared with data collected in 2021. At the same time, the need for a greater effort to provide better care models and resources for specialized PPC remains, especially considering that the number of children needing PPC is constantly increasing. [ABSTRACT FROM AUTHOR]

Published
2025
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8. Characterization of a Nanoparticle Drug Delivery System for the Treatment of Inflammation in Spinal Cord Injury

Author

Papa, Simonetta Giulia

Subjects
617.4
Abstract

Spinal cord injury (SCI) results from a mechanical primary injury that is followed by a multifactorial secondary injury which worsens the clinical course. Persistent inflammation is a crucial event during the secondary injury. Indeed, microglia/macrophage respond to traumatic stimuli by adopting an activated phenotype, which has a dual role. An M1 phenotype, associated with harmful effects, is expressed very early and persists for a long time in the injured site, whereas M2, associated with a beneficial phenotype, has only a transient expression in a subacute phase of the trauma. This suggests that microglia/macrophage mediated inflammation is a crucial therapeutic target. Nanoparticles (NPs) are selectively engulfed by microglia/macrophage as part of their endocytic/phagocytic activity in removing foreign bodies. Microglia assume phagocytic activity after traumatic stimuli and this makes NPs an excellent tool for carrying drug to these cells. So, in order to counteract this deleterious pro-inflammatory response, we decided to maximize the efficacy of a well-known anti-inflammatory drug, minocycline, through a NPs delivery tool selectively targeted to microglia/macrophage. We developed and tested a new drug delivery nanocarrier (minocycline loaded in poly-ε-caprolactone NPs, PCL Mino) in vitro and in vivo. Specifically, we demonstrated a reduced activation of microglia/macrophage after PCL Mino treatment in vitro and a reduction of cells with phagocytic-like phenotype, up to 15 days tested in vivo. To clarify the involvement of the inflammatory response associated to microglia/macrophage in SCI progression, we treated SCI mice in acute and subacute phase. PCL Mino treatment, only when administered acutely after the damage, was able to ameliorate the locomotor activity up to 63 days post injury. Furthermore, we demonstrated that this treatment reduced M1 macrophages recruitment orchestrated by activated microglial cells via CCL2 chemokine in the damaged site, suggesting a deleterious effect in the early phase of the injury of these cells. In conclusion, this delivery tool represents a new hope for SCI treatment by showing several advantages compared to conventionally administered anti-inflammatory therapy, such as maximization of therapeutic efficiency and reduction of side effects. Furthermore, the potential of transfer to clinical practice is aided by the large clinical use of minocycline and the high biocompatibility of the proposed NPs.

Published
2017

9. A Nationwide Study to Evaluate Accessibility to Specialized Pediatric Palliative Care in Italy—Patients, Needs, and Critical Issues: The PalliPed Study.

Author

Benini, Franca, Mercante, Anna, Di Nunzio, Sara, and Papa, Simonetta

Subjects
HEALTH services accessibility, PALLIATIVE treatment, MEDICAL quality control, RESEARCH funding, MOTHERS, PATIENT-family relations, CANCER patients, DECISION making, DESCRIPTIVE statistics, PEDIATRICS, SURVEYS, MEDICAL needs assessment, FAMILY support, HEALTH care teams
Abstract

Background: PalliPed is the first Italian nationwide project aimed at describing the characteristics of patients accessing specialized pediatric palliative care (PPC) and their families, in the main care settings (hospice, home care, and hospital). The project's secondary aim is to assess the extent and quality of regional PPC networks/facilities and the number of dedicated resources. In this article, we present the results of the first part of the project. Methods: All Italian PPC centers/facilities were invited to participate in the project. Children and young adults in the care of the specialized PPC networks/structures as of 24 October, 2022, including prenatal care, were involved. Children's eligibility for specialized PPC was assessed according to the Assessment Form for Complex Clinical Needs in Pediatrics (ACCAPED Scale) and after a multidisciplinary assessment by the healthcare team. Data were collected through an online survey. Results: A total of 867 patients were described. The lack of adequate specialized PPC service emerged, according to the available estimate of specialized PPC needs, as well as the need for improved referral to PPC by pediatricians or territorial services, particularly for infants and oncological patients. More family support measures also seem necessary, particularly for the mothers. Healthcare providers' communication skills should be improved to ensure greater involvement of patients and families in care decisions. Conclusions: This analysis represents the first step toward defining a constantly updated database for the census and monitoring of specialized PPC activities at the national level. This research model can be extended to other realities in different countries, allowing comparison of different care models. [ABSTRACT FROM AUTHOR]

Published
2024
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10. International consensus on sleep problems in pediatric palliative care: paving the way

Author

MERCANTE, Anna, primary, OWENS, Judith, additional, BRUNI, Oliviero, additional, NUNES, Magda L., additional, GRINGRAS, Paul, additional, LI, Shirley Xin, additional, PAPA, Simonetta, additional, KREICBERGS, Ulrika, additional, WOLFE, Joanne, additional, ZERNIKOW, Boris, additional, LACERDA, Ana, additional, BENINI, Franca, additional, Li, Albert, additional, Wolfson, Amy R., additional, Marinetto, Anna, additional, Santini, Anna, additional, Zanin, Anna, additional, Kuhn, Brett R., additional, Angelhoff, Charlotte, additional, Santos, Cristiane Fumo dos, additional, Goh, Daniel YT., additional, Verrillo, Elisabetta, additional, Zhou, Eric S., additional, Ferreira, Esther Angélica Luiz, additional, Bergstraesser, Eva, additional, Pizza, Fabio, additional, Nilsson, Frans, additional, Plazzi, Giuseppe, additional, Wang, Guanghai, additional, Traslaviña, Guillermo Andrey Ariza, additional, Moreira, Gustavo Antonio, additional, Siden, Hal, additional, Hauch, Holger, additional, Huijer, Huda Abu-Saad, additional, Catalano, Igor, additional, Narang, Indra, additional, Avagnina, Irene, additional, Lopez, Jaime Gutierrez Del Alamo, additional, Wille, Joakim, additional, Mindell, Jodi, additional, Bogetz, Jori, additional, Downing, Julia, additional, Hauer, Julie, additional, Streuli, Jürg, additional, Baker, Justin, additional, Spruyt, Karen, additional, Chan, Kate Ching Ching, additional, Soster, Leticia Azevedo, additional, Oliveira, Lia, additional, Ragsdale, Lindsay, additional, Nobili, Lino, additional, Matlen, Lisa, additional, Nosetti, Luana, additional, De Zen, Lucia, additional, Strambi, Luigi Ferini, additional, Stenmarker, Margaretha, additional, Lopes, Maria Cecilia, additional, Blankenburg, Markus, additional, Rios, Marta, additional, Bernadá, Mercedes, additional, Farquhar, Michael, additional, Frühwald, Michael, additional, Gradisar, Michael, additional, Simakajornboon, Narong, additional, Lazzarin, Pierina, additional, Chong, Poh-Heng, additional, Ferri, Raffaele, additional, Martino-Alba, Ricardo, additional, Findling, Robert L., additional, Ferreira, Rosário, additional, Bin-Hasan, Saadoun, additional, Kudchadka, Sapna, additional, Mercadante, Sebastiano, additional, Amarri, Sergio, additional, Keenan, Sharon, additional, Noce, Silvia, additional, de Oliveira Iglesias, Simone Brasil, additional, Fagondes, Simone, additional, Suh, Sooyeon, additional, Sheldon, Stephen H., additional, Sejersen, Thomas, additional, Ceranoglu, Tolga Atilla, additional, Crabtree, Valerie, additional, and Castronovo, Vincenza, additional

Published
2024
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14. Contributors

Author

Assunção-Silva, Rita C., primary, Benech, Carlo Alberto, additional, Bergui, Mauro, additional, Boccaccini, Leonardo, additional, Boido, Beatrice, additional, Boniolo, Giovanni, additional, Carpanese, Fernando, additional, Casalini, Tommaso, additional, Cioffi, Armando, additional, Di Liberto, Alessandra, additional, Ferraris, Marilena, additional, Ferrero, Bruno, additional, Gimona, Mario, additional, Gomes, Eduardo D., additional, González-Cantalapiedra, Antonio, additional, Imaninezhad, Mozhdeh, additional, Kubinová, Šárka, additional, Lima, Rui, additional, López-Peña, Mónica, additional, Masi, Maurizio, additional, Mauri, Emanuele, additional, Molinaro, Fano, additional, Morbidoni, Giulia, additional, Muñoz Guzón, Fernando María, additional, Naddeo, Francesco, additional, Papa, Simonetta, additional, Perale, Giuseppe, additional, Perez, Rosa, additional, Permuy, María, additional, Pertici, Gianni, additional, Reinert, Michael, additional, Rinaldis, Andrea De, additional, Rocha, Luís A., additional, Rossi, Filippo, additional, Russo, Raúl E., additional, Salgado, António J., additional, Sanchini, Virginia, additional, Sheth, Saahil, additional, Silva, N.A., additional, Tomatis, Alberto, additional, Veglianese, Pietro, additional, Vismara, Irma, additional, Zaca’, Domenico, additional, Zazzera, Pier Luigi La, additional, and Zustiak, Silviya Petrova, additional

Published
2020
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17. Unravelling the role of mind–body therapies in paediatric palliative care: A narrative review.

Author

Giacomelli, Luca, Papa, Simonetta, Vecchi, Lara, Mercante, Anna, Benini, Franca, Romoli, Raffaella, Filomeno, Angela, Brugiolo, Alessandra, Vaccher, Silvia, Maccioni, Carla, Perrone, Barbara, Lucarelli, Annunziata, Cocciolo, Alessandro, and Paniccia, Patrizia

Subjects
*MIND & body therapies, *PALLIATIVE treatment, *MEDICAL personnel, *PEDIATRICS, *EXPRESSIVE arts therapy, *DRAMA therapy
Abstract

Aim: Given the multifaceted nature of paediatric palliative care (PPC), integrative medicine and mind–body therapies, in particular, are increasingly used in this setting. However, to our knowledge, their use in PPC has never been specifically reviewed. Therefore, this work aims to provide a comprehensive overview of the application and possible beneficial effects of mind–body therapies in the PPC setting. Methods: Papers about the use of meditation and mindfulness, biofeedback, hypnosis, yoga, tai chi and qi gong, imagery, creative outlets, and art therapy in PPC were identified by browsing PubMed and CINHAL. Results: We found that the harmless nature of mind–body therapies has been extensively described, and available studies consistently show some benefits on the anxiety, stress, and quality of life of parents/caregivers and healthcare providers. However, well‐grounded and robust evidence does not fully support the efficacy of mind–body therapies, especially in patients. Conclusion: Considering the peculiarity of the PPC setting, we suggest that mind–body therapies should be further considered and properly investigated through larger controlled studies and according to the different populations of PPC children, as well as for parents, caregivers, and healthcare professionals. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Early modulation of pro-inflammatory microglia by minocycline loaded nanoparticles confers long lasting protection after spinal cord injury

Author

Papa, Simonetta, Caron, Ilaria, Erba, Eugenio, Panini, Nicolò, De Paola, Massimiliano, Mariani, Alessandro, Colombo, Claudio, Ferrari, Raffaele, Pozzer, Diego, Zanier, Elisa R., Pischiutta, Francesca, Lucchetti, Jacopo, Bassi, Andrea, Valentini, Gianluca, Simonutti, Giulio, Rossi, Filippo, Moscatelli, Davide, Forloni, Gianluigi, and Veglianese, Pietro

Published
2016
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24. Role of Etiology in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Counterfactual Event-Based Mediation Analysis

Author

Sacco, Rodolfo, primary, Ramai, Daryl, additional, Tortora, Raffaella, additional, di Costanzo, Giovan Giuseppe, additional, Burlone, Michela Emma, additional, Pirisi, Mario, additional, Federico, Piera, additional, Daniele, Bruno, additional, Silletta, Marianna, additional, Gallo, Paolo, additional, Cocuzza, Caterina, additional, Russello, Maurizio, additional, Cabibbo, Giuseppe, additional, Rancatore, Gabriele, additional, Cesario, Silvia, additional, Masi, Gianluca, additional, Marzi, Luca, additional, Mega, Andrea, additional, Granito, Alessandro, additional, Pieri, Giulia, additional, Giannini, Edoardo G., additional, Paolillo, Rosa, additional, Gadaleta-Caldarola, Gennaro, additional, Dadduzio, Vincenzo, additional, Giordano, Guido, additional, Giacomelli, Luca, additional, Papa, Simonetta, additional, Renzulli, Matteo, additional, Maida, Marcello, additional, Ghidini, Michele, additional, Borzio, Mauro, additional, and Facciorusso, Antonio, additional

Published
2023
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26. Researching the level of agreement among experts on terms used to describe wounds: An international study.

Author

Greco, Alessandro, Mastronicola, Diego, Pacini, Francesco, Giacomelli, Luca, Papa, Simonetta, Fiorentini, Chiara, David, Valentina, Rowan, Sara, Mennini, Natascia, and Magnoni, Cristina

Subjects
SKIN disease treatment, EXCHANGE of persons programs, CONSENSUS (Social sciences), WOUND healing, CONFIDENCE intervals, MANAGEMENT information systems, DECISION support systems, COMMUNICATION, DECISION making, TERMS & phrases, DESCRIPTIVE statistics, DIGITAL diagnostic imaging
Abstract

Establishing a common language that allows univocal and objective communication in describing wounds and their healing is of utmost importance in defining the diagnostic hypothesis and proper wound management. To measure the level of agreement on the description of wounds, an international study was performed among experts of different professional backgrounds on several common terms used to describe ulcerative lesions. A panel of 27 wound care experts anonymously completed a multiple‐choice questionnaire on 100 images of 50 ulcerative lesions. The participants were asked to describe each image using a set of pre‐defined terms. An expert data analyst interpreted the questionnaires to map the level of agreement on the used terminology. Our findings show a very low level of agreement among experts in using the proposed terminology to describe the wound bed, the wound edge, and the surrounding skin conditions. Efforts should be planned to find a consensus on the correct use of terminology for wound description. To this aim, partnership, consensus, and agreement with educators in medicine and nursing are necessary. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Hospital Frailty Risk Score Is Independently Associated with Mortality and Encephalopathy in Hospitalized Patients with Hepatocellular Carcinoma

Author

Ramai, Daryl, primary, Dang-Ho, Khoi P., additional, Kewalramani, Anjali, additional, Bandaru, Praneeth, additional, Sacco, Rodolfo, additional, Giacomelli, Luca, additional, Shah, Aashni, additional, Papa, Simonetta, additional, Cappellini, Francesca, additional, Perversi, Fabio, additional, di Nunzio, Sara, additional, and Facciorusso, Antonio, additional

Published
2021
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34. Target therapies plus somatostatin analogs in NETs: a network meta-analysis

Author

Pusceddu, Sara, primary, Facciorusso, Antonio, additional, Giacomelli, Luca, additional, Prinzi, Natalie, additional, Corti, Francesca, additional, Niger, Monica, additional, Milione, Massimo, additional, Coppa, Jorgelina, additional, Cascella, Tommaso, additional, Pulice, Iolanda, additional, Biamonte, Lavinia, additional, Papa, Simonetta, additional, Di Bartolomeo, Maria, additional, Shah, Aashni, additional, Sacco, Rodolfo, additional, and de Braud, Filippo, additional

Published
2021
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38. The Experience of Oncology Healthcare Providers in the Central Italy during the COVID-19 Lockdown

Author

Fabi, Alessandra, primary, Pugliese, Patrizia, additional, Falbo, Pina Tiziana, additional, Corsi, Domenico, additional, Fabbri, Maria Agnese, additional, Vincenzi, Bruno, additional, Bria, Emilio, additional, Angelini, Francesco, additional, Bonucci, Alessandro, additional, Pellegrino, Arianna, additional, Falcicchio, Chiara, additional, Caruso, Anita, additional, Giacomelli, Luca, additional, Mirisola, Valentina, additional, Papa, Simonetta, additional, Cognetti, Francesco, additional, Ciliberto, Gennaro, additional, and Perrone, Maria, additional

Published
2020
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41. Selective Modulation of A1 Astrocytes by Drug-Loaded Nano-Structured Gel in Spinal Cord Injury

Author

Vismara, Irma, primary, Papa, Simonetta, additional, Veneruso, Valeria, additional, Mauri, Emanuele, additional, Mariani, Alessandro, additional, De Paola, Massimiliano, additional, Affatato, Roberta, additional, Rossetti, Arianna, additional, Sponchioni, Mattia, additional, Moscatelli, Davide, additional, Sacchetti, Alessandro, additional, Rossi, Filippo, additional, Forloni, Gianluigi, additional, and Veglianese, Pietro, additional

Published
2019
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43. A refinement approach in a mouse model of rehabilitation research. Analgesia strategy, reduction approach and infrared thermography in spinal cord injury

Author

Redaelli, Veronica, primary, Papa, Simonetta, additional, Marsella, Gerardo, additional, Grignaschi, Giuliano, additional, Bosi, Alice, additional, Ludwig, Nicola, additional, Luzi, Fabio, additional, Vismara, Irma, additional, Rimondo, Stefano, additional, Veglianese, Pietro, additional, Tepteva, Svetlana, additional, Mazzola, Silvia, additional, Zerbi, Pietro, additional, Porcu, Luca, additional, Roughan, John V., additional, Parati, Gianfranco, additional, and Calvillo, Laura, additional

Published
2019
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45. Microwave-assisted synthesis of TEMPO-labeled hydrogels traceable with MRI

Author

Mauri, Emanuele, primary, Micotti, Edoardo, additional, Rossetti, Arianna, additional, Melone, Lucio, additional, Papa, Simonetta, additional, Azzolini, Giulia, additional, Rimondo, Stefano, additional, Veglianese, Pietro, additional, Punta, Carlo, additional, Rossi, Filippo, additional, and Sacchetti, Alessandro, additional

Published
2018
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48. Double conjugated nanogels for selective intracellular drug delivery

Author

Mauri, Emanuele, primary, Veglianese, Pietro, additional, Papa, Simonetta, additional, Mariani, Alessandro, additional, De Paola, Massimiliano, additional, Rigamonti, Riccardo, additional, Chincarini, Giulia M. F., additional, Vismara, Irma, additional, Rimondo, Stefano, additional, Sacchetti, Alessandro, additional, and Rossi, Filippo, additional

Published
2017
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50. Selective Modulation of A1 Astrocytes by Drug-Loaded Nano-Structured Gel in Spinal Cord Injury

Author

Vismara, Irma, Papa, Simonetta, Veneruso, Valeria, Mauri, Emanuele, Mariani, Alessandro, De Paola, Massimiliano, Affatato, Roberta, Rossetti, Arianna, Sponchioni, Mattia, Moscatelli, Davide, Sacchetti, Alessandro, Rossi, Filippo, Forloni, Gianluigi, and Veglianese, Pietro

Abstract

Astrogliosis has a very dynamic response during the progression of spinal cord injury, with beneficial or detrimental effects on recovery. It is therefore important to develop strategies to target activated astrocytes and their harmful molecular mechanisms so as to promote a protective environment to counteract the progression of the secondary injury. The challenge is to formulate an effective therapy with maximum protective effects, but reduced side effects. In this study, a functionalized nanogel-based nanovector was selectively internalized in activated mouse or human astrocytes. Rolipram, an anti-inflammatory drug, when administered by these nanovectors limited the inflammatory response in A1 astrocytes, reducing iNOS and Lcn2, which in turn reverses the toxic effect of proinflammatory astrocytes on motor neurons in vitro, showing advantages over conventionally administered anti-inflammatory therapy. When tested acutely in a spinal cord injury mouse model, it improved motor performance, but only in the early stage after injury, reducing the astrocytosis and preserving neuronal cells.

Published
2020
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