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73 results on '"Torelli, E."'

1. Oral vs. IV paracetamol for pain control in patients with femur fracture in the emergency department: a practical randomized controlled trial

Author

Franceschi, Francesco, Saviano, Angela, Covino, Marcello, Candelli, Marcello, Ojetti, Veronica, Cicchinelli, S., Petrucci, M., Sardeo, F., Torelli, E., Nicolo, R., Forte, Enrica, Maccauro, Giulio, Franceschi F. (ORCID:0000-0001-6266-445X), Saviano A. (ORCID:0000-0002-2820-7180), Covino M. (ORCID:0000-0002-6709-2531), Candelli M. (ORCID:0000-0001-8443-7880), Ojetti V. (ORCID:0000-0002-8953-0707), Forte E., Maccauro G. (ORCID:0000-0002-7359-268X), Franceschi, Francesco, Saviano, Angela, Covino, Marcello, Candelli, Marcello, Ojetti, Veronica, Cicchinelli, S., Petrucci, M., Sardeo, F., Torelli, E., Nicolo, R., Forte, Enrica, Maccauro, Giulio, Franceschi F. (ORCID:0000-0001-6266-445X), Saviano A. (ORCID:0000-0002-2820-7180), Covino M. (ORCID:0000-0002-6709-2531), Candelli M. (ORCID:0000-0001-8443-7880), Ojetti V. (ORCID:0000-0002-8953-0707), Forte E., and Maccauro G. (ORCID:0000-0002-7359-268X)

Abstract

Femur fracture (FF) is a common reason for admission to the Emergency Department (ED) and pain is a frequent symptom. Effective and timely pain control is essential for these patients, however, the most appropriate analgesic therapy for quick pain relief in the ED setting is not well established. This is a single-center pragmatic randomized controlled study. We have enrolled 171 consecutive patients with FF and severe pain. They were randomized 1:5 to receive treatment with paracetamol 1000 mg orally (OR) or with paracetamol 1000 mg intravenously (IV). The effect on pain relief was measured with the Visual Analogue Scale for Pain (VAS) at baseline (T0), after 1 hour (T1), 2 hours (T2), and 4 hours (T4). The primary endpoint was the reduction of pain of 1 point of the VAS at T1. This target was reached by 75% of patients treated with paracetamol IV and 44% treated with paracetamol OR (p = 0.001). The secondary endpoint was the reduction of pain of at least 2 points of the VAS at T4, the need for rescue therapy, and the number of adverse events. At T4 the efficacy of paracetamol IV and OR resulted in 89.5% and 88.9%, respectively (p = 0.914). The 17.5% of patients treated with paracetamol IV vs. the 3.7% treated with paracetamol OR required rescue therapy (p = 0.082), with prevalence among women (p = 0.057). No adverse effects were reported. The treatment with paracetamol 1000 mg IV and OR resulted effective and safe for patients with FF waiting for surgery. IV administration was faster in reducing pain in the first 2 hours compared to oral administration but the latter required less rescue therapy. Interestingly, our study highlighted gender differences in pain relief opening the way for a gender-tailored therapy.

Published
2023

2. Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO)

Author

Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, Zoppellari, R, Polverino F., Stern D. A., Ruocco G., Balestro E., Bassetti M., Candelli M., Cirillo B., Contoli M., Corsico A., D'Amico F., D'Elia E., Falco G., Gasparini S., Guerra S., Harari S., Kraft M., Mennella L., Papi A., Parrella R., Pelosi P., Poletti V., Polverino M., Tana C., Terribile R., Woods J. C., Di Marco F., Martinez F. D., Zhang S., Geelhoed B., Sinning C., Agarossi A., Agati S., Agosteo E., Ando' F., Andreoni M., Angelillo I. F., Arcoleo G., Arena C., Baiamonte P., Ball L., Banfi P., Bartoletti G., Bartolotta R., Battaglini D., Bellan M., Benzoni I., Bertolini R., Bevilacqua M., Bezzi M., Bianco A., Bisbano A., Bobbio F., Bocchialini G., Bonetti F., Boni F., Bonifazi M., Borgonovo G., Borre' S., Bosio M., Brachini G., Brunetti I., Calagna L., Calo F., Capuozzo A., Carr T., Castellani A., Catalano F., Catania G., Catena E., Cattaneo M., Cattelan A., Ceruti V., Chiumiento F., Cicchitto G., Confalonieri M., Confalonieri P., Coppola N., Cosentina R., Costantino R., Crimi C., Curra A., D'Abbraccio M., Dalbeni A., Daleffe F., Davide R., Del Donno M., Di Pastena F., Di Perna F., Di Rosa Z., Di Sabatino A., Elesbani O., Elia D., Esposito V., Fabiani L., Falo G., Fanelli C., Fantin A., Ferrigno F., Fiorentino G., Franceschi F., Fronza M., Gardenghi G. G., Giacobbe D. R., Giannotti C., Giannotti G., Gidari A., Giovanardi F., Gnerre P., Gonnelli F., Graziano M., Greco S., Grosso A., Guarino S., Iannarelli A., Imitazione P., Inglese F., Iodice V., Izzo A., La Greca C., Lax A., Legittimo F., Leo A., Leone S., Lepidini V., Leto M., Licata F., Locati F., Lorini L., Lucchetti B., Maida I., Macera M., Manzillo E., March A., Mascheroni D., Mastroianni A., Mauro I., Mazzitelli M., Mazzuca E., Micheletto C., Mingoli A., Minuz P., Moioli M., Monti L., Morgagni R., Mucci L., Muselli M., Negri S., Nobile C. G. A., Oldani S., Olivieri C., Parati G., Parodi L., Pastorelli E., Patruno V., Pellegrino F., Pengo M. F., Pepe D., Perotti A., Petrino R., Petrucci M., Piane R. M., Pignataro G., Pino M., Pirisi M., Porru F., Pugliese F., Punzi R., Ramaroli D. A., Robba C., Rostagno R., Sabatini U., Sainaghi P. P., Salton F., Salzano C., Sanduzzi A., Zamparelli S. S., Sangiovanni V., Santopuoli D., Sapienza P., Sarmati L., Schiaroli E., Scienza F., Senni M., Serchisu L., Sgherzi S., Soddu D., Soranna D., Sorino C., Spadaro S., Stirpe E., Tardivo S., Tartaglia S., Teopompi E., Tomchaney M., Torelli E., Torlasco C., Torti C., Tupputi E., Ugolinelli C., Vatrella A., Versace A. G., Villani M., Vincenzo L., Volta C. A., Voraphani N., Zekaj E., Zoppellari R., Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, Zoppellari, R, Polverino F., Stern D. A., Ruocco G., Balestro E., Bassetti M., Candelli M., Cirillo B., Contoli M., Corsico A., D'Amico F., D'Elia E., Falco G., Gasparini S., Guerra S., Harari S., Kraft M., Mennella L., Papi A., Parrella R., Pelosi P., Poletti V., Polverino M., Tana C., Terribile R., Woods J. C., Di Marco F., Martinez F. D., Zhang S., Geelhoed B., Sinning C., Agarossi A., Agati S., Agosteo E., Ando' F., Andreoni M., Angelillo I. F., Arcoleo G., Arena C., Baiamonte P., Ball L., Banfi P., Bartoletti G., Bartolotta R., Battaglini D., Bellan M., Benzoni I., Bertolini R., Bevilacqua M., Bezzi M., Bianco A., Bisbano A., Bobbio F., Bocchialini G., Bonetti F., Boni F., Bonifazi M., Borgonovo G., Borre' S., Bosio M., Brachini G., Brunetti I., Calagna L., Calo F., Capuozzo A., Carr T., Castellani A., Catalano F., Catania G., Catena E., Cattaneo M., Cattelan A., Ceruti V., Chiumiento F., Cicchitto G., Confalonieri M., Confalonieri P., Coppola N., Cosentina R., Costantino R., Crimi C., Curra A., D'Abbraccio M., Dalbeni A., Daleffe F., Davide R., Del Donno M., Di Pastena F., Di Perna F., Di Rosa Z., Di Sabatino A., Elesbani O., Elia D., Esposito V., Fabiani L., Falo G., Fanelli C., Fantin A., Ferrigno F., Fiorentino G., Franceschi F., Fronza M., Gardenghi G. G., Giacobbe D. R., Giannotti C., Giannotti G., Gidari A., Giovanardi F., Gnerre P., Gonnelli F., Graziano M., Greco S., Grosso A., Guarino S., Iannarelli A., Imitazione P., Inglese F., Iodice V., Izzo A., La Greca C., Lax A., Legittimo F., Leo A., Leone S., Lepidini V., Leto M., Licata F., Locati F., Lorini L., Lucchetti B., Maida I., Macera M., Manzillo E., March A., Mascheroni D., Mastroianni A., Mauro I., Mazzitelli M., Mazzuca E., Micheletto C., Mingoli A., Minuz P., Moioli M., Monti L., Morgagni R., Mucci L., Muselli M., Negri S., Nobile C. G. A., Oldani S., Olivieri C., Parati G., Parodi L., Pastorelli E., Patruno V., Pellegrino F., Pengo M. F., Pepe D., Perotti A., Petrino R., Petrucci M., Piane R. M., Pignataro G., Pino M., Pirisi M., Porru F., Pugliese F., Punzi R., Ramaroli D. A., Robba C., Rostagno R., Sabatini U., Sainaghi P. P., Salton F., Salzano C., Sanduzzi A., Zamparelli S. S., Sangiovanni V., Santopuoli D., Sapienza P., Sarmati L., Schiaroli E., Scienza F., Senni M., Serchisu L., Sgherzi S., Soddu D., Soranna D., Sorino C., Spadaro S., Stirpe E., Tardivo S., Tartaglia S., Teopompi E., Tomchaney M., Torelli E., Torlasco C., Torti C., Tupputi E., Ugolinelli C., Vatrella A., Versace A. G., Villani M., Vincenzo L., Volta C. A., Voraphani N., Zekaj E., and Zoppellari R.

Abstract

Background: Italy has one of the world’s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide.

Published
2020

3. Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO)

Author

Polverino, F., Phd, Md, Stern, D., Polverino, M., D'Amico, F., D'Elia, E., Agarossi, A., Agati, S., Agosteo, E., Ando', F., Andreoni, M., Angelillo, If., Dds, Mph, Arcoleo, G., Arena, C., Baiamonte, P., Balestro, E., Ball, L., Banfi, P., Bartoletti, G., Bartolotta, R., Bassetti, M., Battaglini, D., Bellan, M., Benzoni, I., Bertolini, R., Bevilacqua, M., Bezzi, M., Bianco, A., Bisbano, A., Bobbio, F., Bocchialini, G., Bonetti, F., Boni, F., Bonifazi, M., Borgonovo, G., Borre', S., Bosio, M., Brachini, G., Brunetti, I., Calagna, L., Calò, F., Candelli, M., Capuozzo, A., Carr, T., Castellani, A., Catalano, F., Catania, G., Catena, E., Cattaneo, M., Cattelan, A., Ceruti, V., Chiumiento, F., Cicchitto, G., Cirillo, B., Confalonieri, M., Confalonieri, P., Contoli, M., Coppola, N., Corsico, A., Cosentina, R., Costantino, R., Crimi, C., Currà, A., D'Abbraccio, M., Dalbeni, A., Daleffe, F., Davide, R., Del Donno, M., Di Marco, F., Di Pastena, F., Di Perna, F., Di Rosa, Z., Di Sabatino, A., Elesbani, O., Elia, D., Esposito, V., Fabiani, L., Falco, G., Falo, G., Fanelli, C., Fantin, A., Ferrigno, F., Fiorentino, G., Franceschi, F., Fronza, M., Gardini Gardenghi, G., Gasparini, S., Giacobbe, D. R., Giannotti, C., Giannotti, G., Gidari, A., Giovanardi, F., Gnerre, P., Gonnelli, F., Graziano, M., Greco, S., Grosso, A., Phd, Guarino, S., Guerra, S., Harari, S., Iannarelli, A., Imitazione, P., Inglese, F., Iodice, V., Izzo, A., La Greca, C., Kraft, M., Lax, A., Legittimo, F., Leo, A., Leone, S., Lepidini, V., Leto, M., Licata, F., Locati, F., Lorini, L., Lucchetti, B., Maida, I., Macera, M., Manzillo, E., March, A., Mascheroni, D., Mastroianni, A., Mauro, I., Mazzitelli, M., Mazzuca, E., Mennella, L., Micheletto, C., Mingoli, A., Minuz, P., Moioli, M., Monti, L., Morgagni, R., Mucci, L., Muselli, M., Negri, S., Nobile, C. G. A., Oldani, S., Olivieri, C., Papi, A., Parati, G., Parodi, L., Parrella, R., Pastorelli, E., Patruno, V., Pellegrino, F., Pelosi, P., Fers, Md, Pengo, M. F., Pepe, D., Perotti, A., Petrino, R., Petrucci, M., Piane, R. M., Pignataro, G., Pino, M., Pirisi, M., Poletti, V., Porru, F., Pugliese, F., Punzi, R., Ramaroli, D. A., Robba, C., Rostagno, R., Ruocco, G., Sabatini, U., Sainaghi, P. P., Salton, F., Salzano, C., Sanduzzi, A., Sanduzzi Zamparelli, S., Sangiovanni, V., Santopuoli, D., Sapienza, P., Sarmati, L., Schiaroli, E., Scienza, F., Senni, M., Serchisu, L., Sgherzi, S., Soddu, D., Soranna, D., Sorino, C., Spadaro, S., Stirpe, E., Tana, C., Tardivo, S., Tartaglia, S., Teopompi, E., Terribile, R., Tomchaney, M., Torelli, E., Torlasco, C., Torti, C., Tupputi, E., Ugolinelli, C., Vatrella, A., Versace, A. G., Villani, M., Vincenzo, L., Volta, C. A., Voraphani, N., Woods, J. C., Zekaj, E., Zoppellari, R., Martinez, and F. D., Polverino, Francesca, Stern, Debra A, Ruocco, Gaetano, Balestro, Elisabetta, Bassetti, Matteo, Candelli, Marcello, Cirillo, Bruno, Contoli, Marco, Corsico, Angelo, D'Amico, Filippo, D'Elia, Emilia, Falco, Giuseppe, Gasparini, Stefano, Guerra, Stefano, Harari, Sergio, Kraft, Monica, Mennella, Luigi, Papi, Alberto, Parrella, Roberto, Pelosi, Paolo, Poletti, Venerino, Polverino, Mario, Tana, Claudio, Terribile, Roberta, Woods, Jason C, Di Marco, Fabiano, Martinez, Fernando D, Angelillo, Italo Francesco, Stern, Debra A., C Woods, Jason, Martinez, Fernando D., Polverino, F., Stern, D., Polverino, M., D'Amico, F., D'Elia, E., Agarossi, A., Agati, S., Agosteo, E., Ando', F., Andreoni, M., Angelillo, If., Arcoleo, G., Arena, C., Baiamonte, P., Balestro, E., Ball, L., Banfi, P., Bartoletti, G., Bartolotta, R., Bassetti, M., Battaglini, D., Bellan, M., Benzoni, I., Bertolini, R., Bevilacqua, M., Bezzi, M., Bianco, A., Bisbano, A., Bobbio, F., Bocchialini, G., Bonetti, F., Boni, F., Bonifazi, M., Borgonovo, G., Borre', S., Bosio, M., Brachini, G., Brunetti, I., Calagna, L., Calò, F., Candelli, M., Capuozzo, A., Carr, T., Castellani, A., Catalano, F., Catania, G., Catena, E., Cattaneo, M., Cattelan, A., Ceruti, V., Chiumiento, F., Cicchitto, G., Cirillo, B., Confalonieri, M., Confalonieri, P., Contoli, M., Coppola, N., Corsico, A., Cosentina, R., Costantino, R., Crimi, C., Currà, A., D'Abbraccio, M., Dalbeni, A., Daleffe, F., Davide, R., Del Donno, M., Di Marco, F., Di Pastena, F., Di Perna, F., Di Rosa, Z., Di Sabatino, A., Elesbani, O., Elia, D., Esposito, V., Fabiani, L., Falco, G., Falo, G., Fanelli, C., Fantin, A., Ferrigno, F., Fiorentino, G., Franceschi, F., Fronza, M., Gardini Gardenghi, G., Gasparini, S., Giacobbe, D. R., Giannotti, C., Giannotti, G., Gidari, A., Giovanardi, F., Gnerre, P., Gonnelli, F., Graziano, M., Greco, S., Grosso, A., Guarino, S., Guerra, S., Harari, S., Iannarelli, A., Imitazione, P., Inglese, F., Iodice, V., Izzo, A., La Greca, C., Kraft, M., Lax, A., Legittimo, F., Leo, A., Leone, S., Lepidini, V., Leto, M., Licata, F., Locati, F., Lorini, L., Lucchetti, B., Maida, I., Macera, M., Manzillo, E., March, A., Mascheroni, D., Mastroianni, A., Mauro, I., Mazzitelli, M., Mazzuca, E., Mennella, L., Micheletto, C., Mingoli, A., Minuz, P., Moioli, M., Monti, L., Morgagni, R., Mucci, L., Muselli, M., Negri, S., Nobile, C. G. A., Oldani, S., Olivieri, C., Papi, A., Parati, G., Parodi, L., Parrella, R., Pastorelli, E., Patruno, V., Pellegrino, F., Pelosi, P., Pengo, M. F., Pepe, D., Perotti, A., Petrino, R., Petrucci, M., Piane, R. M., Pignataro, G., Pino, M., Pirisi, M., Poletti, V., Porru, F., Pugliese, F., Punzi, R., Ramaroli, D. A., Robba, C., Rostagno, R., Ruocco, G., Sabatini, U., Sainaghi, P. P., Salton, F., Salzano, C., Sanduzzi, A., Sanduzzi Zamparelli, S., Sangiovanni, V., Santopuoli, D., Sapienza, P., Sarmati, L., Schiaroli, E., Scienza, F., Senni, M., Serchisu, L., Sgherzi, S., Soddu, D., Soranna, D., Sorino, C., Spadaro, S., Stirpe, E., Tana, C., Tardivo, S., Tartaglia, S., Teopompi, E., Terribile, R., Tomchaney, M., Torelli, E., Torlasco, C., Torti, C., Tupputi, E., Ugolinelli, C., Vatrella, A., Versace, A. G., Villani, M., Vincenzo, L., Volta, C. A., Voraphani, N., Woods, J. C., Zekaj, E., Zoppellari, R., Martinez, F. D., Public Health, Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, and Zoppellari, R

Subjects
0301 basic medicine, COVID-19, comorbidities, ACE inhibitors, mortality, cohort study, medicine.medical_specialty, comorbiditie, lcsh:Diseases of the circulatory (Cardiovascular) system, ACE inhibitors, Coronavirus disease 2019 (COVID-19), COVID-19, cohort study, comorbidities, mortality, Cardiomyopathy, Socio-culturale, Disease, 030204 cardiovascular system & hematology, Cardiovascular Medicine, Logistic regression, Older population, Comorbidities, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Internal medicine, ACE inhibitor, medicine, Mortality, Original Research, business.industry, Cohort study, medicine.disease, Comorbidity, 030104 developmental biology, lcsh:RC666-701, Observational study, Erratum, Cardiology and Cardiovascular Medicine, business
Abstract

Background: Italy has one of the world’s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide.

Published
2020

6. Delayed intracranial hemorrhage after mild traumatic brain injury in patients on oral anticoagulants: Is the juice worth the squeeze?

Author

Covino, Marcello, Manno, Alberto, Della Pepa, Giuseppe Maria, Piccioni, Andrea, Tullo, Gianluca, Petrucci, Martina, Navarra, S., Sardeo, F., Torelli, E., Nicolo, R., Simeoni, B., Carbone, Luigi, Gaudino, Simona, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Manno A., della Pepa G. M. (ORCID:0000-0001-8698-3359), Piccioni A., Tullo G., Petrucci M., Carbone L., Gaudino S. (ORCID:0000-0003-1681-4343), Franceschi F. (ORCID:0000-0001-6266-445X), Covino, Marcello, Manno, Alberto, Della Pepa, Giuseppe Maria, Piccioni, Andrea, Tullo, Gianluca, Petrucci, Martina, Navarra, S., Sardeo, F., Torelli, E., Nicolo, R., Simeoni, B., Carbone, Luigi, Gaudino, Simona, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Manno A., della Pepa G. M. (ORCID:0000-0001-8698-3359), Piccioni A., Tullo G., Petrucci M., Carbone L., Gaudino S. (ORCID:0000-0003-1681-4343), and Franceschi F. (ORCID:0000-0001-6266-445X)

Abstract

OBJECTIVE: Mild Traumatic Brain Injury (MTBI) in anticoagulated patients is a common challenge for Emergency Department (ED) Physicians. Anticoagulation is considered a risk factor for developing delayed intracranial hemorrhage (ICH) after MTBI. The occurrence of this event in patients on Vitamin K Antagonists (VKA) or Direct Oral Anticoagulants (DOACs) remains unclear. Primary endpoint: to analyze the role of anticoagulants as risk factors for developing delayed ICH after MTBI and evaluate the indications to repeat a cranial computed tomography (CT) after a period of observation. Secondary endpoint: to assess the difference in the prevalence rate of delayed ICH in patients on VKA versus those on DOACs. PATIENTS AND METHODS: We evaluated all consecutive patients admitted to our ED for MTBI, which had a control CT for late ICH after a negative CT at admission. We used a propensity score match (PSM) on factors affecting the need for oral anticoagulation to adjust the comparison between anticoagulated vs. non-anticoagulated patients for the baseline clinical characteristics. RESULTS: Among 685 patients enrolled, 15 (2.2%) developed ICH at control CT. After PSM, the incidence of ICH, although slightly higher, was not statistically different in anticoagulated patients vs. non-anticoagulated (2.3% vs. 0.6%, p=0.371). Among the 111 patients on VKA, 5 (4.5%) had a late ICH, compared to 4 out of 99 (4.0%) on DOACs; the difference was not statistically significant (p=0.868). CONCLUSIONS: The risk of developing delayed ICH after MTBI in patients on anticoagulation therapy is low. After correction for baseline covariates, the risk does not appear higher compared to non-anticoagulated patients. Thus, a routine control CT scan seems advisable only for patients presenting a clinical deterioration. Larger, prospective trials are required to clarify the safety profile of DOACs vs. VKA in MTBI.

Published
2021

7. Exploring the Potential of Speech-based Virtual Assistants in Mixed Reality Applications for People with Cognitive Disabilities

Author

Vona, F, Torelli, E, Beccaluva, E, Garzotto, F, Vona, F, Torelli, E, Beccaluva, E, and Garzotto, F

Abstract

Mixed Reality (MR) has been receiving increasing interest in the rehabilitation of people with Cognitive Disabilities. The power of MR in the context of therapies is the possibility to maintain a physical and psychological relationship with the surrounding environment while experiencing customized multimedia content and tasks that are appropriate for the needs of these users. The purpose of this work is to explore the potential of MR applications integrated with interactive speech-based Virtual Assistants. We present HoloLearn, an application for Microsoft HoloLens, which aims to help people with Cognitive Disabilities to improve their autonomy and learn simple activities of their everyday life (e.g., setting the table). The paper discusses the design features of the Virtual Assistant created and the results of a controlled study. The participants involved were 15 subjects with Cognitive Disabilities who used HoloLearn in two experimental conditions - with and without a Virtual Assistant. The results, although preliminary, indicate that enriching a MR experience with the presence of a speech-based Virtual Assistant would improve the user performance in the execution of the MR activities.

Published
2020

8. Do You Speak Holo? A Mixed Reality Application for Foreign Language Learning in Children with Language Disorders

Author

Torelli, E, El Shemy, I, Silleresi, S, Moskwa, L, Cosentino, G, Garzotto, F, Torelli, Emanuele, El Shemy, Ibrahim, Silleresi, Silvia, Moskwa, Lukasz, Cosentino, Giulia, Garzotto, Franca, Torelli, E, El Shemy, I, Silleresi, S, Moskwa, L, Cosentino, G, Garzotto, F, Torelli, Emanuele, El Shemy, Ibrahim, Silleresi, Silvia, Moskwa, Lukasz, Cosentino, Giulia, and Garzotto, Franca

Abstract

In this paper we present Do You Speak Holo?, an application for Microsoft HoloLens co-designed with linguistics experts that aims to facilitate the learning process of a foreign language for children and adolescents with language disorders (LD). The application includes several educational activities, aimed at improving both vocabulary and morpho-syntactic aspects of the language through the interaction with virtual content immersed in the real world. The application includes a virtual assistant, which acts as a virtual teacher and guides the user step by step in the comprehension and execution of the activities.

Published
2020

9. Atypical presentation of acute pancreatitis: a single center case-match analysis of clinical outcomes

Author

Covino, Marcello, Quero, Giuseppe, Ojetti, Veronica, Cina, C, Galiandro, F, Longo, Fabio, Torelli, E, Fiorillo, Claudio, Menghi, Roberta, Simeoni, B, Franceschi, Francesco, Alfieri, Sergio, Covino M (ORCID:0000-0002-6709-2531), Quero G (ORCID:0000-0002-0001-9479), Ojetti V (ORCID:0000-0002-8953-0707), Longo F, Fiorillo C (ORCID:0000-0001-7681-3567), Menghi R, Franceschi F (ORCID:0000-0001-6266-445X), Alfieri S (ORCID:0000-0002-0404-724X), Covino, Marcello, Quero, Giuseppe, Ojetti, Veronica, Cina, C, Galiandro, F, Longo, Fabio, Torelli, E, Fiorillo, Claudio, Menghi, Roberta, Simeoni, B, Franceschi, Francesco, Alfieri, Sergio, Covino M (ORCID:0000-0002-6709-2531), Quero G (ORCID:0000-0002-0001-9479), Ojetti V (ORCID:0000-0002-8953-0707), Longo F, Fiorillo C (ORCID:0000-0001-7681-3567), Menghi R, Franceschi F (ORCID:0000-0001-6266-445X), and Alfieri S (ORCID:0000-0002-0404-724X)

Abstract

Objective: Acute pancreatitis (AP) may present an aspecific clinical picture without abdominal symptoms (atypical AP). We compared clinical outcomes between typical and atypical AP. Patients and methods: Thirty out of 1163 patients (2.6%) presented an atypical AP. Demographic, clinical data, laboratory and radiological findings, management type, length of hospital stay (LOS) and mortality rate were retrospectively reviewed. A case match analysis 2:1 was performed. The final groups comprised 50 typical APs (TAP group) and 25 atypical APs (AAP group). Results: The AAP patients presented fever (36%), syncope (32%) and dyspnea (16%) as the most frequent symptoms. Laboratory values showed similarity between the two groups. We noted a comparable edematous AP rate in both groups (p=0.36). Ten (20%) TAP and 3 (12%) AAP patients needed ERCP, respectively (p=0.38). Cholecystectomy was similarly performed in both cohorts (p=0.81). One TAP patient underwent a percutaneous drainage and subsequent surgical necrosectomy compared to none in the AAP cohort (p=0.47). LOS and mortality rate were comparable (p=0.76 and 0.3, respectively). Conclusions: Similar outcomes have been reached in the two groups. Routine evaluation of the serum amylase values fundamentally contributed to early diagnosis and appropriate treatment.

Published
2020

10. Rapid clinical management of leishmaniasis in emergency department: A case report with clinical review of recent literature

Author

Piccioni, Andrea, Valletta, Federico, Zanza, Christian, Longhitano, Y., Torelli, E., De Cunzo, Tommaso, Esperide, Alessandra, Brigida, M., Ojetti, Veronica, Covino, Marcello, Taurone, S., Ralli, M., Artico, M., Franceschi, Francesco, Piccioni A., Valletta F., Zanza C., de Cunzo T., Esperide A., Ojetti V. (ORCID:0000-0002-8953-0707), Covino M. (ORCID:0000-0002-6709-2531), Franceschi F. (ORCID:0000-0001-6266-445X), Piccioni, Andrea, Valletta, Federico, Zanza, Christian, Longhitano, Y., Torelli, E., De Cunzo, Tommaso, Esperide, Alessandra, Brigida, M., Ojetti, Veronica, Covino, Marcello, Taurone, S., Ralli, M., Artico, M., Franceschi, Francesco, Piccioni A., Valletta F., Zanza C., de Cunzo T., Esperide A., Ojetti V. (ORCID:0000-0002-8953-0707), Covino M. (ORCID:0000-0002-6709-2531), and Franceschi F. (ORCID:0000-0001-6266-445X)

Abstract

Systemic or localized lympho-adenomegaly is a common cause of access to the emergency department (ED), and differential diagnosis is often complicated. The combination of anamnesis, physical examination, laboratory tests, and instrumental diagnosis are extremely important to orientate toward a rapid and correct therapy, even if a prompt discrimination of the etiology of this lymphadenomegaly is not often possible. Our aim with this review is to improve the management of a differential diagnosis between hematological and infective diseases as leishmaniasis in ED and suggest quick diagnostic techniques that might be useful for early identification. Together in the review, we describe a case report of a young man affected from visceral leishmaniasis who presented to our ED and was incorrectly addressed to the wrong ward for the study of his condition. Subsequently, we focus on the clinical presentation of visceral leishmaniasis and compare it to the most common differential diagnoses that are usually taken into account in the management of such patients.

Published
2020

11. Blood Glucose Levels Combined with Triage Revised Trauma Score Improve the Outcome Prediction in Adults and in Elderly Patients with Trauma

Author

Covino, Marcello, Zaccaria, R., Bocci, Maria Grazia, Carbone, Luigi, Torelli, E., Fuorlo, M., Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Bocci M. G., Carbone L., Piccioni A., Santoro M., Sandroni C. (ORCID:0000-0002-8878-2611), Franceschi F. (ORCID:0000-0001-6266-445X), Covino, Marcello, Zaccaria, R., Bocci, Maria Grazia, Carbone, Luigi, Torelli, E., Fuorlo, M., Piccioni, Andrea, Santoro, Michele, Sandroni, Claudio, Franceschi, Francesco, Covino M. (ORCID:0000-0002-6709-2531), Bocci M. G., Carbone L., Piccioni A., Santoro M., Sandroni C. (ORCID:0000-0002-8878-2611), and Franceschi F. (ORCID:0000-0001-6266-445X)

Abstract

Introduction: This study was aimed to assess if combining the evaluation of blood glucose level (BGL) and the Triage Revised Trauma Score (T-RTS) may result in a more accurate prediction of the actual clinical outcome, both in general adult population and in elderly patients with trauma. Methods: This is a retrospective cohort study, conducted in the emergency department (ED) of an urban teaching hospital, with an average ED admission rate of 75,000 patients per year. Those excluded: known diagnosis of diabetes, age <18 years old, pregnancy, and mild trauma (classified as isolate trauma of upper or lower limb, in absence of exposed fractures). A combined Revised Trauma Score Glucose (RTS-G) score was obtained adding to T-RTS: two for BGL <160mg/dL (8.9mmol/L); one for BGL ≥160mg/dL and < 200mg/dL (11.1mmol/L); and zero for BGL ≥ 200mg/dL. The primary outcome was a composite of patient's death in ED or admission to intensive care unit (ICU). Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the overall performance of T-RTS and of the combined RTS-G score. Results: Among a total of 68,933 traumas, 9,436 patients (4,407 females) were enrolled, aged from 18 to 103 years; 4,288 were aged ≥65 years. A total of 577 (6.1%) met the primary endpoint: 38 patients died in ED (0.4%) and 539 patients were admitted to ICU. The T-RTS and BGL were independently associated to primary endpoint at multivariate analysis. The cumulative RTS-G score was significantly more accurate than T-RTS and reached the best accuracy in elderly patients. In general population, ROC area under curve (AUC) for T-RTS was 0.671 (95% CI, 0.661 - 0.680) compared to RTS-G ROC AUC 0.743 (95% CI, 0.734 - 0.752); P <.001. In patients ≥65 years, T-RTS ROC AUC was 0.671 (95% CI, 0.657 - 0.685) compared to RTS-G ROC AUC 0.780 (95% CI, 0.768 - 0.793); P <.001. Conclusions: Results showed RTS-G could be used effectively at ED triage for the risk stratification for death in ED

Published
2020

12. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)

Abstract

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

13. Magnesium sulphate in the Emergency Department: an old, new friend

Author

Gilardi, E., Marsiliani, D., Nicolò, R., Petrucci, M., Torelli, E., Racco, S., Di Maurizio, L., Saviano, L., Biscione, G., Giannuzzi, R., Covino, M., Merra, G., Franceschi, F., M. PETRUCCI, E. TORELLI, L. SAVIANO (ORCID:0000-0002-2820-7180), M. COVINO (ORCID:0000-0002-6709-2531), G. MERRA, F. FRANCESCHI (ORCID:0000-0001-6266-445X), Gilardi, E., Marsiliani, D., Nicolò, R., Petrucci, M., Torelli, E., Racco, S., Di Maurizio, L., Saviano, L., Biscione, G., Giannuzzi, R., Covino, M., Merra, G., Franceschi, F., M. PETRUCCI, E. TORELLI, L. SAVIANO (ORCID:0000-0002-2820-7180), M. COVINO (ORCID:0000-0002-6709-2531), G. MERRA, and F. FRANCESCHI (ORCID:0000-0001-6266-445X)

Abstract

With our study, we searched the medical literature to find magnesium (Mg) correlation with Emergency situations or its use in Emergency Medicine. Our aim is to fill the gap that we find in our daily routine between Mg studies on its role in Emergency and the real conception that doctors have of it in medical practice. We searched the literature for terms as magnesium or magnesium sulphate, magnesium in emergency, eclampsia, arrhythmias, acute asthma exacerbation, magnesium, and pediatric population. After a thorough research, we divided our discoveries into chapters to sort out a large amount often discordant articles.

Published
2019

14. Delayed intracranial hemorrhage after mild traumatic brain injury in patients on oral anticoagulants: is the juice worth the squeeze?

Author

COVINO, M., MANNO, A., PEPA, G. M. DELLA, PICCIONI, A., TULLO, G., PETRUCCI, M., NAVARRA, S., SARDEO, F., TORELLI, E., NICOLÒ, R., SIMEONI, B., CARBONE, L., GAUDINO, S., and FRANCESCHI, F.

Abstract

OBJECTIVE: Mild Traumatic Brain Injury (MTBI) in anticoagulated patients is a common challenge for Emergency Department (ED) Physicians. Anticoagulation is considered a risk factor for developing delayed intracranial hemorrhage (ICH) after MTBI. The occurrence of this event in patients on Vitamin K Antagonists (VKA) or Direct Oral Anticoagulants (DOACs) remains unclear. Primary endpoint: to analyze the role of anticoagulants as risk factors for developing delayed ICH after MTBI and evaluate the indications to repeat a cranial computed tomography (CT) after a period of observation. Secondary endpoint: to assess the difference in the prevalence rate of delayed ICH in patients on VKA versus those on DOACs. PATIENTS AND METHODS: We evaluated all consecutive patients admitted to our ED for MTBI, which had a control CT for late ICH after a negative CT at admission. We used a propensity score match (PSM) on factors affecting the need for oral anticoagulation to adjust the comparison between anticoagulated vs. non-anticoagulated patients for the baseline clinical characteristics. RESULTS: Among 685 patients enrolled, 15 (2.2%) developed ICH at control CT. After PSM, the incidence of ICH, although slightly higher, was not statistically different in anticoagulated patients vs. non-anticoagulated (2.3% vs. 0.6%, p=0.371). Among the 111 patients on VKA, 5 (4.5%) had a late ICH, compared to 4 out of 99 (4.0%) on DOACs; the difference was not statistically significant (p=0.868). CONCLUSIONS: The risk of developing delayed ICH after MTBI in patients on anticoagulation therapy is low. After correction for baseline covariates, the risk does not appear higher compared to non-anticoagulated patients. Thus, a routine control CT scan seems advisable only for patients presenting a clinical deterioration. Larger, prospective trials are required to clarify the safety profile of DOACs vs. VKA in MTBI. [ABSTRACT FROM AUTHOR]

Published
2021

15. Wellens Syndrome without chest pain, is it possible?

Author

TORELLI, E., SARDEO, F., NUZZO, E., CICCHINELLI, S., PETRUCCI, M., PIGNATARO, G., COVINO, M., FRANCESCHI, F., and CANDELLI, M.

Abstract

OBJECTIVE: Wellens syndrome is a typical electrocardiographic and clinical pattern that correlates with a severe proximal stenosis of the left anterior descending artery (LAD). It is associated with previous angina, no or slightly increased cardiac markers, and two ECG patterns: diphasic T wave in V2-V3 (Type A) or deep negative T waves from V1 to V4 (type B). In this paper, we described two cases with asymptomatic Wellens patterns. PATIENTS AND METHODS: We describe two cases of Wellens syndrome ECG pattern that we observed in our Emergency Department not accompanied by chest pain or angina equivalents. RESULTS: Both patients presented significant stenosis of LAD at the coronary angiography. CONCLUSIONS: Asymptomatic patients presenting with Wellens ECG pattern should perform a coronary arteriography cause of the risk of a severe LAD stenosis. We need further studies to confirm if all "silent" Wellens syndromes deserve angiographic study. [ABSTRACT FROM AUTHOR]

Published
2020

16. Atypical presentation of acute pancreatitis: a single center case-match analysis of clinical outcomes.

Author

COVINO, M., QUERO, G., OJETTI, V., CINA, C., GALIANDRO, F., LONGO, F., TORELLI, E., FIORILLO, C., MENGHI, R., SIMEONI, B., FRANCESCHI, F., and ALFIERI, S.

Abstract

OBJECTIVE: Acute pancreatitis (AP) may present an aspecific clinical picture without abdominal symptoms (atypical AP). We compared clinical outcomes between typical and atypical AP. PATIENTS AND METHODS: Thirty out of 1163 patients (2.6%) presented an atypical AP. Demographic, clinical data, laboratory and radiological findings, management type, length of hospital stay (LOS) and mortality rate were retrospectively reviewed. A case match analysis 2:1 was performed. The final groups comprised 50 typical APs (TAP group) and 25 atypical APs (AAP group). RESULTS: The AAP patients presented fever (36%), syncope (32%) and dyspnea (16%) as the most frequent symptoms. Laboratory values showed similarity between the two groups. We noted a comparable edematous AP rate in both groups (p=0.36). Ten (20%) TAP and 3 (12%) AAP patients needed ERCP, respectively (p=0.38). Cholecystectomy was similarly performed in both cohorts (p=0.81). One TAP patient underwent a percutaneous drainage and subsequent surgical necrosectomy compared to none in the AAP cohort (p=0.47). LOS and mortality rate were comparable (p=0.76 and 0.3, respectively). CONCLUSIONS: Similar outcomes have been reached in the two groups. Routine evaluation of the serum amylase values fundamentally contributed to early diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

Published
2020

17. Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study

Author

De Rai, Paolo, Zerbi, Alessandro, Castoldi, Laura, Bassi, Claudio, Frulloni, Luca, Uomo, Generoso, Gabbrielli, Armando, Pezzilli, Raffaele, Cavallini, Giorgio, Di Carlo, Valerio, Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazzoni, G., Bartolo, F., Della Papa, D., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Bugnano, L., Buonanno, G. M., Esposito, C., Cordovana, A., Cavina, E., Seccia, M., Lippolis, P., Musco, B., Barletta, M., Chilovi, E., De Guelfi, A., Chirletti, P., Caronna, R., Scozzafava, S., Cardi, M., Cirino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Casentini, A., Costamagna, G., Trincali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosiani, V., D'Ambrosio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, Daniele, Mariani, L., Morelli, F., Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacignola, S., Calandro, L., Mazzitelli, L., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salval, N., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Lecconi, L., Valeri, L., Presenti, L., Alessio, F., Ventrucci, M., Virzi, S., Cipolla, A., De Rai, P, Zerbi, A, Castoldi, L, Bassi, C, Frulloni, L, Uomo, G, Gabbrielli, A, Pezzilli, R, Cavallini, G, Di Carlo, V, Proinf, Aisp, and Testoni, PIER ALBERTO

Subjects
Male, Time Factors, Pancreatitis, Alcoholic, medicine.medical_treatment, Acute pancreatitis, Surgery, Aged, Biliary Tract Diseases, Chi-Square Distribution, Cholangiopancreatography, Endoscopic Retrograde, Cholecystectomy, Laparoscopic, Female, Guideline Adherence, Humans, Italy, Pancreatitis, Pancreatitis, Acute Necrotizing, Practice Guidelines as Topic, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Treatment Outcome, Cholecystectomy, Jejunostomy, Pancreatectomy, Practice Patterns, Physicians', Hepatology, Gastroenterology, Physician's Practice Patterns, Practice Patterns, surgery, Endoscopic Retrograde, Medicine, Cholangiopancreatography, Laparoscopic, Acute Necrotizing, Alcoholic, Prospective cohort study, health care economics and organizations, acute pancreatitis, Corrigendum, Risk assessment, medicine.medical_specialty, education, Severity of illness, Intensive care medicine, Physicians', business.industry, General surgery, Original Articles, medicine.disease, business
Abstract

OBJECTIVE: This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines. METHODS: A series of 1173 patients in 56 hospitals were prospectively enrolled and their data analysed. RESULTS: Twenty-nine patients with severe pancreatitis underwent surgical intervention. Necrosectomy was performed in 26 patients, associated with postoperative lavage in 70% of cases. A feeding jejunostomy was added in 37% of cases. Mortality was 21%. Of the patients with mild pancreatitis, 714 patients with a biliary aetiology were evaluated. Prophylactic treatment of relapses was carried out in 212 patients (36%) by cholecystectomy and in 161 using a laparoscopic approach. Preoperative endoscopic retrograde cholangiopancreatography was associated with cholecystectomy in 83 patients (39%). Forty-seven patients (22%) were treated at a second admission, with a median delay of 31 days from the onset of pancreatitis. Eighteen patients with severe pancreatitis underwent cholecystectomy 37.9 days after the first admission. There were no deaths. DISCUSSION: The results indicate poor compliance with published guidelines. In severe pancreatitis, early surgical intervention is frequently performed and enteral feeding is seldom used. Only a small number of patients with mild biliary pancreatitis undergo definitive treatment (i.e. cholecystectomy) within 4 weeks of the onset of pancreatitis.

Published
2010
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20. Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study

Author

DE RAI, P, Zerbi, A, Castoldi, L, Bassi, C, Frulloni, L, Uomo, G, Gabbrielli, A, Pezzilli, R, Cavallini, G, DI CARLO, V, PROINF AISP PROGETTO INFORMATIZZATO PANCREATITE ACUTA, ASSOCIAZIONE ITALIANA PER LO STUDIO DEL PANCREAS COMPUTERIZED PROJECT ON ACUTE PANCREATITIS, COLLABORATORS AGUGIARO S, ITALIAN ASSOCIATION FOR THE STUDY OF THE PANCREAS STUDY G. R. O. U. P., Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, Dd, Bassi, Nicolo', Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, Gm, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Lippolis, P, Musco, B, Barletta, M, Chilovi, E, DE GUELFI, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, Gb, Rocco, P, Franzãˆ, A, Bertelãˆ, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, Pc, Sbrana, F, Balestracci, T, Giulini, Sm, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Calandro, L, Mazzitelli, L, Costarella, Sm, Egidio, A, Teggia, Pm, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, DEL CHIARO, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, Pg, Romano, C, Gerardi, G, Troianello, B, Russello, D, DI STEFANO, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, Pa, Masci, E, Mariani, A, Torelli, E, Garcea, Mr, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, and Cipolla, A.

Published
2010

23. Diagnostic assessment and outcome of acute pancreatitis in Italy: results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II

Author

Uomo, G, Pezzilli, R., Gabbrielli, A., Castoldi, L., Zerbi, A., Frulloni, L., De Rai, P., Cavallini, G., Di Carlo, V., Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazoni, G., Bartolo, F., Della Papa, D., Bassi, C., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Brugnano, L., Buonanno, G. M., Esposito, C., Cardovana, A., Cavina, E., Seccia, M., Lipollis, P., Musco, B., Barletta, M., Chilovi, E., De Guelmi, A., Chirletti, P., Caronna, R., Scozzafava, S., Cardi, M., Cirrino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Cosentini, A., Costamagna, G., Tringali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosini, V., D'Amborsio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, Daniele, Mariani, L. M., Murelli, Federica, Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacitignola, S., Caliandro, L., Mazzitelli, R., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salvai, M., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Cecconi, L., Valeri, A., Presenti, L., Alessio, F., Ventrucci, M., Virzì, S., and Cipolla, A.

Subjects
Adult, Male, Pancreatic necrosis, Severity of Illness Index, Body Mass Index, Acute Pancreatitis, Clinical outcome, Computed tomography, Diagnosis, Pancreatitis, Prognosis, Ultrasonography, Aged, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Creatinine, Female, Humans, Italy, Middle Aged, Prospective Studies, Treatment Outcome, Hepatology, Gastroenterology, Endoscopic Retrograde, 80 and over, treatment, Medicine (all), Cholangiopancreatography, acute pancreatitis, diagnosis
Abstract

Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy.The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data.One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24%) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0+/-18.2 years (95% confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8%) were defined as mild and 167 (14.2%) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3%) while alcoholic forms only 6.6% (77 cases); the remaining aetiologies accounted for 7.1% (83 cases) while 200 cases (17.1%) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6%) whereas morphological sequelae were found in 121 patients (10.3%) and mortality in 36 patients (3.1%; 0.4% in mild and 19.2% in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85% of patients. Computer tomography scan was also widely used, with 66.7% of exams in mild and 33.3% in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p=0.004) and necrotizing forms (p=0.021). Mortality was significantly related (p0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p0.001).Association of creatinine serum level over 2mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequelae and mortality (p=0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.

Published
2007

24. A prospective multicentre survey on the treatment of acute pancreatitis in Italy

Author

Pezzilli, R, Uomo, G., Gabbrielli, A., Zerbi, A., Frulloni, L., De Rai, P., Castoldi, L., Cavallini, G., Di Carlo, V., Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazoni, G., Bartolo, F., Della Papa, D., Bassi, C., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Brugnano, L., Buonanno, G. M., Esposito, C., Cardovana, A., Cavina, E., Seccia, M., Lipollis, P., Musco, B., Barletta, M., Chilovi, E., De Guelmi, A., Chirletti, Piero, Caronna, Roberto, Scozzafava, S., Cardi, Maurizio, Cirino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Cosentini, A., Costamagna, G., Tringali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosini, V., D'Amborsio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, D., Mariani, L. M., Murelli, F., Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacitignola, S., Caliandro, L., Mazzitelli, R., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salvai, M., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Cecconi, L., Valeri, A., Presenti, L., Alessio, F., Ventrucci, M., Virzi, S., and Cipolla, A.

Subjects
Adult, Male, medicine.medical_specialty, ERCP, Pancreatitis, Pancreatitis acute necrotising, Aged, Aged, 80 and over, Analgesics, Anti-Bacterial Agents, Digestive System Surgical Procedures, Female, Histamine Antagonists, Humans, Italy, Middle Aged, Prospective Studies, Severity of Illness Index, Treatment Outcome, Medicine (all), Hepatology, Gastroenterology, Therapeutic approach, Internal medicine, Severity of illness, 80 and over, Medicine, Prospective cohort study, business.industry, medicine.disease, Surgery, medicine.anatomical_structure, Acute pancreatitis, Tramadol, business, Pancreas, medicine.drug
Abstract

The Italian Association for the Study of the Pancreas released a diagnostic and therapeutic algorithm for acute pancreatitis in 1999.This study focused on the analysis of the therapeutic approach for the treatment of acute pancreatitis in Italy.One thousand, one hundred and seventy-three patients were recruited: 1006 patients (85.8%) had mild acute pancreatitis (MAP) and 167 (14.2%) had the severe acute pancreatitis (SAP); 161 patients showed pancreatic necrosis at computed tomography; 121 patients (10.3%) had sequelae and 36 (3.1%) died.Non-steroidal anti-inflammatory drugs and tramadol were used more frequently in patients with the MAP whereas opioids and the association schedules were used more frequently in patients with the SAP (P0.001). Gabexate mesilate was utilised in 831 out of 1173 patients (70.8%); in particular, gabexate mesilate was used in 70.6% patients with MAP and in 73.1% of those with SAP (P=0.521). The duration of the drug administration was significantly shorter in those having MAP than in those having the SAP (P0.001). The antibiotics most frequently used for the prophylaxis against infection from pancreatic necrosis (43.1%) were carbapenems. Only a small number of patients received enteral nutrition (4.7%). Endoscopic retrograde cholangiopancreatography was carried out in 344 of the 1173 patients (29.3%). Surgery was performed in 48 with SAP (19 had elective biliary surgery and 29 had pancreatic surgery).The results of this survey indicate a lack of compliance with the guidelines which regard the indications mainly for interventional endoscopy and surgery.

Published
2007

26. Rabeprazole is equivalent to omeprazole in the treatment of erosive gastro-oesophageal reflux disease. A randomised, double-blind, comparative study of rabeprazole and omeprazole 20 mg in acute treatment of reflux oesophagitis, followed by a maintenance open-label, low-dose therapy with rabeprazole

Author

Pace, F., Annese, V., Prada, A., Zambelli, A., Casalini, S., Nardini, P., Bianchi Porro, G., Rossi, Z., Fenderico, P., Molinari, F., Molinari, A., Poletti, M., Benedetti, A., Bolognini, L., Cercamondi, P., Piergallini, S., Pieroni, N., Ridolfi, F., Palazzi, A., Agnolucci, A., Ceccatelli, P., Laurenzi, F., Grassini, M., Iaquinto, G., D'Onofrio, V., Giardullo, N., Pasquale, L., Sedici, A., Moschetta, R., Maurogiovanni, G., Costan, F., Germana, B., Lecis, P., Negrini, F., Signorelli, S., Landi, P., Malaguti, P., Roda, E., De, E., Gandolfi, L., Torresan, F., Chilovi, F., Benvenuti, S., Grasso, T., Adamo, S., Azzurro, M., Carrara, M., Rubbiani, C., P. V., Di, Di, M., Belvedere, F., Di, A., Giglio, A., De Medici, A., Rodino, S., Sacca, N., Neri, M., Carbone, F., Laterza, F., Trimboli, V., Accattatis, G. C., Rizzuti, L. F., Sabatino, A., Lupinacci, G., Faleo, D., De Francesco, V., Lombardi, L. P, Minenna, M., Nocchiero, M. C., Tonti, P., Bocchini, R., D'Imperio, N., Giaccari, S., Tronci, S., Dall'Acqua, S., Berrini, E., Garatti, S., Putignano, R., Sferrazzo, A., Giacosa, A., Blanchi, S., Munizzi, F., Morlando, L., Bruno, G., Guardascione, F., Benedetti, E., Orzes, N., Pincione, F., Dell'Amico, I., Vannucci, P., Maurano, A., Calabrese, A., Napoli, G., Quagliariello, G., Sabarese, G., Pracanica, G., Gullotti, G., Princiotta, A., Rando, L., Anderloni, A., Pallotta, S., Fesce, E., Abbiati, D., Crippa, C., Ideo, G. M., Mannucci, P. M., Abbiati, C., De Franchis, R., Fazzini, L., Rossi, A., Bini, M., Chahin, N. J., Testoni, P. A., Fossati, D., Frego, R., Passaretti, S., Catanzano, C., Siciliano, S., Sivero, L., Cattaneo, D., Di Martino, V., Inzirillo, A., Lavelli, M., Del Genio, A., Maffettone, V., Napolitano, V., Del Piano, M., Ballare, M., Garello, E., Orsello, M., Capezzuto, E., Amuso, M., Marino, M., Reina, G., Craxi, A., Arini, A., Di Pisa, M., Peralta, S., Ficano, L., Miceli, D., Tarantello, M., Orlando, A., Perego, M., Alvisi, C., Pozzi, L., Torello Viera, F., Marchi, S., Arpe, P., Bellini, M., Costa, F., Da Massa Carrara, P., Manghetti, M., Meletis, P., Romano, A., Torelli, E., Garcea, M. R., Lombardi, M., Tristaino, B., Farroni, F., Di Cicco, M., Proietti, M., Tanzilli, A., Benedetti, G., Guido, E., Lacchin, T., Sablich, R., Vitalba, A., Casetti, T., Cantoni, F., Salzetta, A., Polimeni, F., Bortoli, A., Buono, M., Gozzini, C., Barberani, F., Boschetto, S., Giovannone, M., Casale, V., Assisi, D., Grassi, A., Lapenta, R., Stigliano, V., Fedeli, G., Pirozzi, G. A., Pippa, G., Bazuro, M. E., Romano, M., Borgheresi, P., Andriulli, A., Fiorella, S., De Rocco, R., Greco, G., Meloni, M., Fina, G., Frosini, G., Macchiarelli, R., Virgilio, C., Borina, E., Lauria, M., Cappelletti, F., Puglisi, F., Ravizza, M., Emanuelli, G., Battaglia, E., Dughera, L., Navino, M., Ferrari, A., Martinoglio, P., Turco, D., Pera, A., Daperno, M., Lombardo, L., Gusmaroli, R., Milesi, F., Zilli, M., Brosolo, P., De, G., Zoratti, L., Curzio, M., Amato, A., Bisso, G., Feliziani, M., Gianfrate, L., Natale, C., Petillo, A., Spadaccini, A., Meddi, P., Sciampa, G., and Ubalducci, G. M.

Subjects
Adult, Male, Gastrointestinal, Time Factors, Severity of Illness Index, 2-Pyridinylmethylsulfinylbenzimidazoles, Endoscopy, Gastrointestinal, Helicobacter Infections, Dose-Response Relationship, Gastro-oesophageal reflux disease, Double-Blind Method, Heartburn, Esophagitis, Humans, Esophagitis, Peptic, Curative/maintenance therapy, Peptic, Hepatology, Dose-Response Relationship, Drug, Helicobacter pylori, Rabeprazole, Antacids, Anti-Ulcer Agents, Benzimidazoles, Female, Gastroesophageal Reflux, Middle Aged, Omeprazole, Patient Satisfaction, Treatment Outcome, Gastroenterology, Endoscopy, Drug
Abstract

Previous studies have shown similar effects of rabeprazole and omeprazole, when used at the same dose in the treatment of reflux oesophagitis. However, such studies have been conducted as superiority studies but interpreted as equivalence ones.To properly assess the comparative efficacy of rabeprazole and omeprazole in inducing complete endoscopic healing and symptom relief in patients with reflux oesophagitis.Patients (n=560) with Savary-Miller grade I-III reflux oesophagitis were randomised in a double-blind, double-dummy fashion to rabeprazole or omeprazole 20 mg once daily for 4-8 weeks. Then, patients endoscopically healed and symptomatically relieved were openly maintained with rabeprazole 10 mg or 2x10 mg once daily (in the event of clinical and/or endoscopic relapse) for a maximum of 48 weeks.After 4-8 weeks of treatment, healing (primary end-point) was observed in 228/233 (97.9%) patients in the rabeprazole group and in 231/237 (97.5%) in the omeprazole one (equivalence effect demonstrated by p0.0001 at Blackwelder test and an upper confidence limit at 97.5% of 0.023). However, rabeprazole was faster in inducing heartburn relief than omeprazole (2.8+/-0.2 versus 4.7+/-0.5 days of therapy to reach the first day with satisfactory heartburn relief, p=0.0045 at log-rank test). In the maintenance phase, 15.2% of patients had an endoscopic and/or clinical relapse.Rabeprazole is equivalent to omeprazole in healing reflux oesophagitis, but shows a faster activity on reflux symptoms in the early treatment phase.

Published
2005

27. Long term outcome of acute pancreatitis in Italy: Results of a multicentre study

Author

Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Musco, B, Barletta, M, Chilovi, E, De Guelfi, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, G, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, Del Chiaro, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, P, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., STRAZZABOSCO, MARIO, Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, Musco, B, Barletta, M, Chilovi, E, De Guelfi, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Casentini, A, Costamagna, G, Trincali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosiani, V, D'Ambrosio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, G, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, Del Chiaro, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, P, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., and STRAZZABOSCO, MARIO

Abstract

Background: In Italy, no long-term studies regarding the natural history of acute pancreatitis have been carried out. Aim: To report the results of a follow-up on a large series of patients hospitalised for pancreatitis. Methods: Data of 631 patients admitted to 35 Italian hospitals were retrospectively evaluated 51.7 ± 8.4 months after discharge. Results: The average recovery time after mild or severe pancreatitis was 28.2 and 53.4 days respectively. Fourteen sequelae were not resolved and 9 cases required late surgical intervention. Eighty patients (12.7%) had a second hospital admission. Of the patients with mild biliary pancreatitis, 67.9% underwent a cholecystectomy. The overall incidence of relapse was 12.7%. Mortality was 9.8% and no death was related to pancreatitis. Three patients died from carcinoma of the pancreas. Conclusion: Reported recovery time after an attack of pancreatitis was longer than expected in the mild forms. The treatment of sequelae was delayed beyond one year after discharge. The incidence of relapse of biliary pancreatitis in patients not undergoing a cholecystectomy was low, due to endoscopic treatment. Mortality from pancreatic-related causes is low, but there is an association with malignant pancreatic or ampullary tumours not diagnosed during the acute phase of the illness. © 2013 Editrice Gastroenterologica Italiana S.r.l

Published
2013

35. A rapid method for detection of fumonisins B1 and B2 in corn meal using Fourier transform near infrared (FT-NIR) spectroscopy implemented with integrating sphere

Author

Gaspardo, B., Del Zotto, S., Torelli, E., Cividino, S.R., Firrao, G., Della Riccia, G., and Stefanon, B.

Subjects
*CORN meal, *FUMONISINS, *FOOD composition, *NEAR infrared spectroscopy, *ORGANIC compounds, *PRINCIPAL components analysis
Abstract

Abstract: Fourier transform near infrared (FT-NIR) spectroscopy is an analytical procedure generally used to detect organic compounds in food. In this work the ability to predict fumonisin B1 +B2 contents in corn meal using an FT-NIR spectrophotometer, equipped with an integration sphere, was assessed. A total of 143 corn meal samples were collected in Friuli Venezia Giulia Region (Italy) and used to define a 15 principal components regression model, applying partial least square regression algorithm with full cross validation as internal validation. External validation was performed to 25 unknown samples. Coefficients of correlation, root mean square error and standard error of calibration were 0.964, 0.630 and 0.632, respectively and the external validation confirmed a fair potential of the model in predicting FB1 +FB2 concentration. Results suggest that FT-NIR analysis is a suitable method to detect FB1 +FB2 in corn meal and to discriminate safe meals from those contaminated. [Copyright &y& Elsevier]

Published
2012
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36. Do You Speak Holo? A Mixed Reality Application for Foreign Language Learning in Children with Language Disorders

Author

Giulia Cosentino, Lukasz Moskwa, Ibrahim El Shemy, Silvia Silleresi, Franca Garzotto, Emanuele Torelli, Torelli, E, El Shemy, I, Silleresi, S, Moskwa, L, Cosentino, G, and Garzotto, F

Subjects
Comprehension, Virtual Reality, Language, Vocabulary, Process (engineering), media_common.quotation_subject, Foreign language, Language acquisition, Psychology, Human-centered computing, Mixed reality, Linguistics, media_common, User interface design
Abstract

In this paper we present Do You Speak Holo?, an application for Microsoft HoloLens co-designed with linguistics experts that aims to facilitate the learning process of a foreign language for children and adolescents with language disorders (LD). The application includes several educational activities, aimed at improving both vocabulary and morpho-syntactic aspects of the language through the interaction with virtual content immersed in the real world. The application includes a virtual assistant, which acts as a virtual teacher and guides the user step by step in the comprehension and execution of the activities.

Published
2020

37. Exploring the Potential of Speech-based Virtual Assistants in Mixed Reality Applications for People with Cognitive Disabilities

Author

Eleonora Beccaluva, Emanuele Torelli, Franca Garzotto, Francesco Vona, Vona, F, Torelli, E, Beccaluva, E, and Garzotto, F

Subjects
ING-INF/06 - BIOINGEGNERIA ELETTRONICA E INFORMATICA, Rehabilitation, Computer science, medicine.medical_treatment, media_common.quotation_subject, 020207 software engineering, Context (language use), 02 engineering and technology, Remote assistance, Mixed reality, Virtual Assistant, Cognitive disabilities, Human–computer interaction, Mixed Reality, 0202 electrical engineering, electronic engineering, information engineering, medicine, Cognitive Disability, Table (database), 020201 artificial intelligence & image processing, Controlled Study, Everyday life, Autonomy, media_common
Abstract

Mixed Reality (MR) has been receiving increasing interest in the rehabilitation of people with Cognitive Disabilities. The power of MR in the context of therapies is the possibility to maintain a physical and psychological relationship with the surrounding environment while experiencing customized multimedia content and tasks that are appropriate for the needs of these users. The purpose of this work is to explore the potential of MR applications integrated with interactive speech-based Virtual Assistants. We present HoloLearn, an application for Microsoft HoloLens, which aims to help people with Cognitive Disabilities to improve their autonomy and learn simple activities of their everyday life (e.g., setting the table). The paper discusses the design features of the Virtual Assistant created and the results of a controlled study. The participants involved were 15 subjects with Cognitive Disabilities who used HoloLearn in two experimental conditions - with and without a Virtual Assistant. The results, although preliminary, indicate that enriching a MR experience with the presence of a speech-based Virtual Assistant would improve the user performance in the execution of the MR activities.

Published
2020

38. Yeasts volatile organic compounds (VOCs) as potential growth enhancers and molds biocontrol agents of mushrooms mycelia.

Author

Di Francesco A, Moret E, Cignola R, Garagozzo L, Torelli E, and Di Foggia M

Subjects
Antifungal Agents pharmacology, Antifungal Agents metabolism, Biological Control Agents pharmacology, Biological Control Agents chemistry, Metschnikowia growth & development, Metschnikowia drug effects, Metschnikowia metabolism, Antibiosis, Aureobasidium, Trichoderma growth & development, Trichoderma chemistry, Trichoderma metabolism, Solid Phase Microextraction, Volatile Organic Compounds pharmacology, Volatile Organic Compounds metabolism, Volatile Organic Compounds chemistry, Mycelium growth & development, Mycelium drug effects, Mycelium chemistry, Agaricales chemistry, Agaricales growth & development, Agaricales drug effects, Agaricales metabolism, Gas Chromatography-Mass Spectrometry
Abstract

Volatile organic compounds (VOCs) produced by yeasts can positively affect crops, acting as antifungals or biostimulants. In this study, Aureobasidium pullulans and Metschnikowia pulcherrima were evaluated as potential antagonists of Trichoderma spp., common fungal pathogen in mushroom cultivation. To assess the biocontrol ability and biostimulant properties of the selected yeast species, in vitro co-culture and VOCs exposure assays were conducted. In both assays, VOCs produced by Aureobasidium spp. showed the stronger antifungal activity with a growth inhibition up to 30 %. This result was further confirmed by the higher volatilome alcohol content revealed by solid phase microextraction-gas chromatography mass spectrometry (SPME/GC-MS). Overall, Aureobasidium strains can be potentially used as biocontrol agent in Pleorotus ostreatus and Cyclocybe cylindracea mycelial growth, without affecting their development as demonstrated by VOCs exposure assay and Fourier-transform infrared spectroscopy (FT-IR). Conversely, M. pulcherrima was characterized by a lower or absent antifungal properties and by a volatilome composition rich in isobutyl acetate, an ester often recognized as plant growth promoter. As confirmed by FT-IR, Lentinula mycelia exposed to M. pulcherrima VOCs showed a higher content of proteins and lipids, suggesting an improvement of some biochemical properties. Our study emphasizes that VOCs produced by specific yeast strains are potentially powerful alternative to synthetic fungicide in the vegetative growth of mushroom-forming fungi and also able to modify their biochemical composition., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 British Mycological Society. All rights reserved.)

Published
2024
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39. Reverse engineering DNA origami nanostructure designs from raw scaffold and staple sequence lists.

Author

Shirt-Ediss B, Connolly J, Elezgaray J, Torelli E, Navarro SA, Bacardit J, and Krasnogor N

Abstract

Designs for scaffolded DNA origami nanostructures are commonly and minimally published as the list of DNA staple and scaffold sequences required. In nearly all cases, high-level editable design files (e.g. caDNAno) which generated the low-level sequences are not made available. This de facto 'raw sequence' exchange format allows published origami designs to be re-attempted in the laboratory by other groups, but effectively stops designs from being significantly modified or re-purposed for new future applications. To make the raw sequence exchange format more accessible to further design and engineering, in this work we propose the first algorithmic solution to the inverse problem of converting staple/scaffold sequences back to a 'guide schematic' resembling the original origami schematic. The guide schematic can be used to aid the manual re-input of an origami into a CAD tool like caDNAno, hence recovering a high-level editable design file. Creation of a guide schematic can also be used to double check that a list of staple strand sequences does not have errors and indeed does assemble into a desired origami nanostructure prior to costly laboratory experimentation. We tested our reverse algorithm on 36 diverse origami designs from the literature and found that 29 origamis (81 %) had a good quality guide schematic recovered from raw sequences. Our software is made available at https://revnano.readthedocs.io., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Published
2023
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40. Detection of Listeria monocytogenes in foods with a textile organic electrochemical transistor biosensor.

Author

Vizzini P, Beltrame E, Coppedè N, Vurro F, Andreatta F, Torelli E, and Manzano M

Subjects
Electrodes, Food, Gold, Listeria monocytogenes genetics, Biosensing Techniques methods
Abstract

Foods contaminated by pathogens are responsible for foodborne diseases which have socioeconomic impacts. Many approaches have been extensively investigated to obtain specific and sensitive methods to detect pathogens in food, but they are often not easy to perform and require trained personnel. This work aims to propose a textile organic electrochemical transistor-based (OECT) biosensor to detect L. monocytogenes in food samples. The analyses were performed with culture-based methods, Listeria Precis™ method, PCR, and our textile OECT biosensor which used poly(3,4-ethylenedioxythiophene) (PEDOT):polystyrene sulfonate (PSS) (PEDOT:PSS) for doping the organic channel. Atomic force microscopy (AFM) was used to obtain topographic maps of the gold gate. The electrochemical activity on gate electrodes was measured and related to the concentration of DNA extracted from samples and hybridized to the specific capture probe immobilized onto the gold surface of the gate. This assay reached a limit of detection of 1.05 ng/μL, corresponding to 0.56 pM of L. monocytogenes ATCC 7644, and allowed the specific and rapid detection of L. monocytogenes in the analyzed samples. KEYPOINTS: • Textile organic electrochemical transistors functionalized with a specific DNA probe • AFM topographic and surface potential maps of a functionalized gold gate surface • Comparison between the Listeria monocytogenes Precis™ method and an OECT biosensor., (© 2023. The Author(s).)

Published
2023
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41. Light-Up Split Broccoli Aptamer as a Versatile Tool for RNA Assembly Monitoring in Cell-Free TX-TL Systems, Hybrid RNA/DNA Origami Tagging and DNA Biosensing.

Author

Torelli E, Shirt-Ediss B, Navarro SA, Manzano M, Vizzini P, and Krasnogor N

Subjects
RNA genetics, Escherichia coli genetics, DNA chemistry, Nucleic Acid Conformation, Brassica genetics, Aptamers, Nucleotide chemistry, Nanostructures chemistry
Abstract

Binary light-up aptamers are intriguing and emerging tools with potential in different fields. Herein, we demonstrate the versatility of a split Broccoli aptamer system able to turn on the fluorescence signal only in the presence of a complementary sequence. First, an RNA three-way junction harbouring the split system is assembled in an E. coli -based cell-free TX-TL system where the folding of the functional aptamer is demonstrated. Then, the same strategy is introduced into a 'bio-orthogonal' hybrid RNA/DNA rectangle origami characterized by atomic force microscopy: the activation of the split system through the origami self-assembly is demonstrated. Finally, our system is successfully used to detect the femtomoles of a Campylobacter spp. DNA target sequence. Potential applications of our system include the real-time monitoring of the self-assembly of nucleic-acid-based devices in vivo and of the intracellular delivery of therapeutic nanostructures, as well as the in vitro and in vivo detection of different DNA/RNA targets.

Published
2023
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42. Factors Associated with ICU Admission in Patients with COVID-19: The GOL2DS Score.

Author

Candelli M, Pignataro G, Ferrigno M, Cicchinelli S, Torelli E, Gullì A, Sacco Fernandez M, Piccioni A, Ojetti V, Covino M, Gasbarrini A, Antonelli M, and Franceschi F

Subjects
Hospitalization, Humans, Intensive Care Units, Oxygen Saturation, Pandemics, ROC Curve, Retrospective Studies, SARS-CoV-2, COVID-19
Abstract

Background and Objectives : The COVID-19 pandemic has been shaking lives around the world for nearly two years. The discovery of highly effective vaccines has not been able to stop the transmission of the virus. SARS-CoV-2 shows completely different clinical manifestations. A large percentage (about 40%) of admitted patients require treatment in an intensive care unit (ICU). This study investigates the factors associated with admission of COVID-19 patients to the ICU and whether it is possible to obtain a score that can help the emergency physician to select the hospital ward. Materials and Methods : We retrospectively recorded 313 consecutive patients who were presented to the emergency department (ED) of our hospital and had a diagnosis of COVID-19 confirmed by polymerase chain reaction (PCR) on an oropharyngeal swab. We used multiple logistic regression to evaluate demographic, clinical, and laboratory data statistically associated with ICU admission. These variables were used to create a prognostic score for ICU admission. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver-operating characteristic curve (ROC) of the score for predicting ICU admission during hospitalization were calculated. Results : Of the variables evaluated, only blood type A ( p = 0.003), PaO2/FiO2 ( p = 0.002), LDH ( p = 0.004), lactate ( p = 0.03), dyspnea ( p = 0.03) and SpO2 ( p = 0.0228) were significantly associated with ICU admission after adjusting for sex, age and comorbidity using multiple logistic regression analysis. We used these variables to create a prognostic score called GOL2DS (group A, PaO2/FiO2, LDH, lactate and dyspnea, and SpO2), which had high accuracy in predicting ICU admission (AUROC 0.830 [95% CI, 0.791-0.892). Conclusions : In our single-center experience, the GOL2DS score could be useful in identifying patients at high risk for ICU admission.

Published
2021
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43. Effect of influenza vaccine on COVID-19 mortality: a retrospective study.

Author

Candelli M, Pignataro G, Torelli E, Gullì A, Nista EC, Petrucci M, Saviano A, Marchesini D, Covino M, Ojetti V, Antonelli M, Gasbarrini A, and Franceschi F

Subjects
Adult, COVID-19 mortality, COVID-19 Testing statistics & numerical data, Child, Humans, Influenza, Human mortality, Prognosis, COVID-19 prevention & control, Influenza Vaccines therapeutic use, Influenza, Human prevention & control, Vaccination statistics & numerical data
Abstract

It has been proposed that vaccines may exert an unspecific protective effect against infectious agents, different than expected. Coronavirus disease 2019 (COVID-19) is a pandemic infection with high mortality in older patients due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high number of vaccinations may be one of the reasons why children show a lower susceptibility to SARS-CoV-2 infection and milder severity when compared to adults. We have designed a study aimed at investigating whether the influenza vaccine may reduce the susceptibility and severity of SARS-CoV-2 infection. We retrospectively enrolled 635 patients who accessed our Emergency Department from March 1st to June 30th, 2020, and were diagnosed with COVID-19 infection confirmed by an RT-PCR on an oropharyngeal swab. Clinical data, outcomes, and influenza vaccination status were collected from the electronic medical records of our Hospital. We also used data from the Italian Health Ministry to compare the prevalence of flu vaccination among the general population of the Lazio Region and our enrolled patients. We then compared clinical outcomes between vaccinated and non-vaccinated patients, by univariate and multivariate analysis. COVID-19-positive patients older than 65 years reported a lower prevalence of flu vaccination when compared to the general population residing in the Lazio (p = 0.004). After correction for gender, age, and comorbidities, we found a lower risk of death at 60 days in patients with flu vaccination than in not vaccinated patients (p = 0.001). Our study shows that flu vaccination could reduce the mortality of COVID-19. Prospective studies are needed to confirm this result., (© 2021. Società Italiana di Medicina Interna (SIMI).)

Published
2021
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44. A last-in first-out stack data structure implemented in DNA.

Author

Lopiccolo A, Shirt-Ediss B, Torelli E, Olulana AFA, Castronovo M, Fellermann H, and Krasnogor N

Subjects
Computational Biology, Information Storage and Retrieval, Nucleic Acid Hybridization, Polymers chemistry, Computers, Molecular, DNA chemistry
Abstract

DNA-based memory systems are being reported with increasing frequency. However, dynamic DNA data structures able to store and recall information in an ordered way, and able to be interfaced with external nucleic acid computing circuits, have so far received little attention. Here we present an in vitro implementation of a stack data structure using DNA polymers. The stack is able to record combinations of two different DNA signals, release the signals into solution in reverse order, and then re-record. We explore the accuracy limits of the stack data structure through a stochastic rule-based model of the underlying polymerisation chemistry. We derive how the performance of the stack increases with the efficiency of washing steps between successive reaction stages, and report how stack performance depends on the history of stack operations under inefficient washing. Finally, we discuss refinements to improve molecular synchronisation and future open problems in implementing an autonomous chemical data structure., (© 2021. The Author(s).)

Published
2021
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45. Predictors of in-hospital mortality AND death RISK STRATIFICATION among COVID-19 PATIENTS aged ≥ 80 YEARs OLD.

Author

Covino M, De Matteis G, Polla DAD, Santoro M, Burzo ML, Torelli E, Simeoni B, Russo A, Sandroni C, Gasbarrini A, and Franceschi F

Subjects
Activities of Daily Living, Aged, 80 and over, Female, Hospital Mortality, Humans, Italy epidemiology, Male, Prognosis, Prospective Studies, Retrospective Studies, Risk Assessment, Risk Factors, SARS-CoV-2, COVID-19
Abstract

Introduction: To date, mainly due to age-related vulnerability and to coexisting comorbidities, older patients often face a more severe COVID-19. This study aimed to identify at Emergency Department (ED) admission the predictors of in-hospital mortality and suitable scores for death risk stratification among COVID-19 patients ≥ 80 years old., Methods: Single-centre prospective study conducted in the ED of an university hospital, referral center for COVID-19 in central Italy. We included 239 consecutive patients ≥ 80 years old with laboratory-confirmed COVID-19. The primary study endpoint was all-cause in-hospital mortality. Multivariable Cox regression analysis was performed on significant variables at univariate analysis to identify independent risk factor for death. Overall performance in predicting mortality of WHO severity scale, APACHE II score, NEWS score, and CURB-65 was calculated., Results: Median age was 85 [82-89] and 112 were males (46.9%). Globally, 77 patients (32.2%) deceased. The presence of consolidations at chest x-ray and the hypoxemic respiratory failure were significant predictors of poor prognosis. Moreover, age ≥ 85 years, dependency in activities of daily living (ADL), and dementia were risk factors for death, even after adjusting for clinical covariates and disease severity. All the evaluated scores showed a fairly good predictive value in identifying patients who could experience a worse outcome., Conclusions: Among patients ≥ 80 years old hospitalized with COVID-19, not only a worse clinical and radiological presentation of the disease, but also the increasing age, dementia, and impairment in ADL were strong risk factors for in-hospital death, regardless of disease severity., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Published
2021
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46. Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance.

Author

Piccioni A, Franza L, Brigida M, Zanza C, Torelli E, Petrucci M, Nicolò R, Covino M, Candelli M, Saviano A, Ojetti V, and Franceschi F

Abstract

How can the knowledge of probiotics and their mechanisms of action be translated into clinical practice when treating patients with diverticular disease and acute diverticulitis? Changes in microbiota composition have been observed in patients who were developing acute diverticulitis, with a reduction of taxa with anti-inflammatory activity, such as Clostridium cluster IV, Lactobacilli and Bacteroides. Recent observations supported that a dysbiosis characterised by decreased presence of anti-inflammatory bacterial species might be linked to mucosal inflammation, and a vicious cycle results from a mucosal inflammation driving dysbiosis at the same time. An alteration in gut microbiota can lead to an altered activation of nerve fibres, and subsequent neuronal and muscular dysfunction, thus favoring abdominal symptoms' development. The possible role of dysbiosis and mucosal inflammation in leading to dysmotility is linked, in turn, to bacterial translocation from the lumen of the diverticulum to perivisceral area. There, a possible activation of Toll-like receptors has been described, with a subsequent inflammatory reaction at the level of the perivisceral tissues. Being aware that bacterial colonisation of diverticula is involved in the pathogenesis of acute diverticulitis, the rationale for the potential role of probiotics in the treatment of this disease becomes clearer. For this review, articles were identified using the electronic PubMed database through a comprehensive search conducted by combining key terms such as "gut microbiota", "probiotics and gut disease", "probiotics and acute diverticulitis", "probiotics and diverticular disease", "probiotics mechanism of action". However, the amount of data present on this matter is not sufficient to draw robust conclusions on the efficacy of probiotics for symptoms' management in diverticular disease.

Published
2021
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47. Blood Glucose Levels Combined with Triage Revised Trauma Score Improve the Outcome Prediction in Adults and in Elderly Patients with Trauma.

Author

Covino M, Zaccaria R, Bocci MG, Carbone L, Torelli E, Fuorlo M, Piccioni A, Santoro M, Sandroni C, and Franceschi F

Subjects
Adolescent, Adult, Aged, Emergency Service, Hospital, Female, Hospital Mortality, Humans, Predictive Value of Tests, Retrospective Studies, Trauma Severity Indices, Triage, Blood Glucose, Wounds and Injuries diagnosis
Abstract

Introduction: This study was aimed to assess if combining the evaluation of blood glucose level (BGL) and the Triage Revised Trauma Score (T-RTS) may result in a more accurate prediction of the actual clinical outcome, both in general adult population and in elderly patients with trauma., Methods: This is a retrospective cohort study, conducted in the emergency department (ED) of an urban teaching hospital, with an average ED admission rate of 75,000 patients per year. Those excluded: known diagnosis of diabetes, age <18 years old, pregnancy, and mild trauma (classified as isolate trauma of upper or lower limb, in absence of exposed fractures). A combined Revised Trauma Score Glucose (RTS-G) score was obtained adding to T-RTS: two for BGL <160mg/dL (8.9mmol/L); one for BGL ≥160mg/dL and < 200mg/dL (11.1mmol/L); and zero for BGL ≥ 200mg/dL. The primary outcome was a composite of patient's death in ED or admission to intensive care unit (ICU). Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the overall performance of T-RTS and of the combined RTS-G score., Results: Among a total of 68,933 traumas, 9,436 patients (4,407 females) were enrolled, aged from 18 to 103 years; 4,288 were aged ≥65 years. A total of 577 (6.1%) met the primary endpoint: 38 patients died in ED (0.4%) and 539 patients were admitted to ICU. The T-RTS and BGL were independently associated to primary endpoint at multivariate analysis. The cumulative RTS-G score was significantly more accurate than T-RTS and reached the best accuracy in elderly patients. In general population, ROC area under curve (AUC) for T-RTS was 0.671 (95% CI, 0.661 - 0.680) compared to RTS-G ROC AUC 0.743 (95% CI, 0.734 - 0.752); P <.001. In patients ≥65 years, T-RTS ROC AUC was 0.671 (95% CI, 0.657 - 0.685) compared to RTS-G ROC AUC 0.780 (95% CI, 0.768 - 0.793); P <.001., Conclusions: Results showed RTS-G could be used effectively at ED triage for the risk stratification for death in ED and ICU admission of trauma patients, and it could reduce under-triage of approximately 20% compared to T-RTS. Comparing ROC AUCs, the combined RTS-G score performs significantly better than T-RTS and gives best results in patients ≥65 years.

Published
2021
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48. Lung Ultrasound Findings Are Associated with Mortality and Need for Intensive Care Admission in COVID-19 Patients Evaluated in the Emergency Department.

Author

Bonadia N, Carnicelli A, Piano A, Buonsenso D, Gilardi E, Kadhim C, Torelli E, Petrucci M, Di Maurizio L, Biasucci DG, Fuorlo M, Forte E, Zaccaria R, and Franceschi F

Subjects
Betacoronavirus, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections diagnosis, Female, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Patient Admission, Pneumonia, Viral virology, Predictive Value of Tests, Prospective Studies, SARS-CoV-2, Coronavirus Infections diagnostic imaging, Coronavirus Infections mortality, Emergency Service, Hospital organization & administration, Intensive Care Units, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral mortality, Ultrasonography methods
Abstract

Lung ultrasound (LUS) has recently been advocated as an accurate tool to diagnose coronavirus disease 2019 (COVID-19) pneumonia. However, reports on its use are based mainly on hypothesis studies, case reports or small retrospective case series, while the prognostic role of LUS in COVID-19 patients has not yet been established. We conducted a prospective study aimed at assessing the ability of LUS to predict mortality and intensive care unit admission of COVID-19 patients evaluated in a tertiary level emergency department. Patients in our sample had a median of 6 lung areas with pathologic findings (inter-quartile range [IQR]: 6, range: 0-14), defined as a score different from 0. The median rate of lung areas involved was 71% (IQR: 64%, range: 0-100), while the median average score was 1.14 (IQR: 0.93, range: 0-3). A higher rate of pathologic lung areas and a higher average score were significantly associated with death, with an estimated difference of 40.5% (95% confidence interval [CI]: 4%-68%, p = 0.01) and of 0.47 (95% CI: 0.06-0.93, p = 0.02), respectively. Similarly, the same parameters were associated with a significantly higher risk of intensive care unit admission with estimated differences of 29% (95% CI: 8%-50%, p = 0.008) and 0.47 (95% CI: 0.05-0.93, p = 0.02), respectively. Our study indicates that LUS is able to detect COVID-19 pneumonia and to predict, during the first evaluation in the emergency department, patients at risk for intensive care unit admission and death., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Published
2020
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49. Rapid Clinical Management of Leishmaniasis in Emergency Department: A Case Report with Clinical Review of Recent Literature.

Author

Piccioni A, Valletta F, Zanza C, Longhitano Y, Torelli E, de Cunzo T, Esperide A, Brigida M, Ojetti V, Covino M, Taurone S, Ralli M, Artico M, and Franceschi F

Abstract

Systemic or localized lympho-adenomegaly is a common cause of access to the emergency department (ED), and differential diagnosis is often complicated. The combination of anamnesis, physical examination, laboratory tests, and instrumental diagnosis are extremely important to orientate toward a rapid and correct therapy, even if a prompt discrimination of the etiology of this lymphadenomegaly is not often possible. Our aim with this review is to improve the management of a differential diagnosis between hematological and infective diseases as leishmaniasis in ED and suggest quick diagnostic techniques that might be useful for early identification. Together in the review, we describe a case report of a young man affected from visceral leishmaniasis who presented to our ED and was incorrectly addressed to the wrong ward for the study of his condition. Subsequently, we focus on the clinical presentation of visceral leishmaniasis and compare it to the most common differential diagnoses that are usually taken into account in the management of such patients.

Published
2020
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50. Cotranscriptional Folding of a Bio-orthogonal Fluorescent Scaffolded RNA Origami.

Author

Torelli E, Kozyra J, Shirt-Ediss B, Piantanida L, Voïtchovsky K, and Krasnogor N

Subjects
DNA-Directed RNA Polymerases metabolism, Fluorescent Dyes chemistry, Microscopy, Atomic Force, Nucleic Acid Conformation, RNA chemistry, RNA Folding, Transcription, Genetic, Viral Proteins metabolism, Nanostructures chemistry, RNA metabolism
Abstract

The scaffolded origami technique is an attractive tool for engineering nucleic acid nanostructures. This paper demonstrates scaffolded RNA origami folding in vitro in which, for the first time, all components are transcribed simultaneously in a single-pot reaction. Double-stranded DNA sequences are transcribed by T7 RNA polymerase into scaffold and staple strands able to correctly fold in a high synthesis yield into the nanoribbon. Synthesis is successfully confirmed by atomic force microscopy, and the unpurified transcription reaction mixture is analyzed by an in gel-imaging assay where the transcribed RNA nanoribbons are able to capture the specific dye through the reconstituted split Broccoli aptamer showing a clear green fluorescent band. Finally, we simulate the RNA origami in silico using the nucleotide-level coarse-grained model oxRNA to investigate the thermodynamic stability of the assembled nanostructure in isothermal conditions over a period of time. Our work suggests that the scaffolded origami technique is a viable, and potentially more powerful, assembly alternative to the single-stranded origami technique for future in vivo applications.

Published
2020
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