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1. Segmental Thoracic Spinal Anesthesia for Laparoscopic Cholecystectomy with the “Hypobaric” Technique: A Case Series

Author

Vincenzi P, Stronati M, Garelli P, Gaudenzi D, Boccoli G, and Starnari R

Subjects
thoracic spinal anesthesia, laparoscopic cholecystectomy, hypobaric ropivacaine, intratechal midazolam, intratechal ketamine, Anesthesiology, RD78.3-87.3
Abstract

Paolo Vincenzi,1 Massimo Stronati,2 Paolo Garelli,3 Diletta Gaudenzi,4 Gianfranco Boccoli,3 Roberto Starnari2 1Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy; 2Department of Anesthesiology, IRCSS-INRCA, Ancona, Italy; 3Department of General Surgery, IRCSS-INRCA, Ancona, Italy; 4Department of Perioperative Services, AOU “Ospedali Riuniti di Ancona”, Ancona, ItalyCorrespondence: Paolo Vincenzi, Department of General Surgery, Ospedali Riuniti Marche Nord, Piazzale Cinelli n 1, Pesaro, 61121, Italy, Tel +39 3394578495, Email paolo.vincenzi1981@gmail.comPurpose: Several studies have applied lumbar spinal anesthesia (SA) with isobaric/hyperbaric bupivacaine and opioids in elective laparoscopic cholecystectomy (LC), documenting a superiority of the methodic over general anesthesia (GA) in terms of perioperative pain, nausea, and vomiting, though with a notable incidence of intraoperative right shoulder pain, potentially responsible for conversion to GA. This case series presents an opioid-free scheme of segmental thoracic spinal anesthesia (STSA) with hypobaric ropivacaine, reporting its benefits mainly in terms of shoulder pain occurrence.Patients and Methods: Hypobaric STSA was performed in nine patients undergoing elective LC between May 1 and September 1, 2022. The level of the needle insertion was included between T8 and T9, via a median or a paramedian approach. Midazolam (0.03 mg/kg) and Ketamine (0.3 mg/kg) were used as adjuvants for intrathecal sedation, followed by the administration of hypobaric ropivacaine 0.25% at a dose of 5 mg and then isobaric ropivacaine at a dose of 10 mg. Patients were placed in anti-Trendelenburg position for the entire duration of surgery. LC was conducted through the standard 3 or 4 ports technique with pneumoperitoneum maintained at a pressure of 8– 10 mmHg.Results: Mean patient age was 75.7 (± 17.5) years, with a mean ASA score and Charlson comorbidity index (CCI) of 2.7 (± 0.7) and 4.9 (± 2.7), respectively. STSA was completed without complications in all patients, with no need for conversion to GA. Mean operative time and SA duration were 37.5 (± 8.7) and 145.2 (± 21.8) min, respectively. Intraoperatively, no shoulder or abdominal pain and nausea were reported, with only four and two patients requiring vasopressor and sedative intravenous drugs, respectively. Postoperatively, overall mean VAS pain score and within the first 12 hafter surgery were 3 (± 2) and 4 (± 2), respectively. Median length of stay was 2 (range = 1– 3) days.Conclusion: Hypobaric opioid-free STSA appears to be a promising approach for laparoscopic surgeries, with minimal to null occurrence of shoulder pain. Larger prospective studies are required to validate these findings.Keywords: thoracic spinal anesthesia, laparoscopic cholecystectomy, hypobaric ropivacaine, intrathecal midazolam, intrathecal ketamine

Published
2023

2. Incidence and risk factors of bacterial sepsis and invasive fungal infection in neonates and infants requiring major surgery: an Italian multicentre prospective study

Author

Auriti, C., De Rose, D.U., Santisi, A., Martini, L., Ronchetti, M.P., Ravà, L., Antenucci, V., Bernaschi, P., Serafini, L., Catarzi, S., Fiorini, P., Betta, P., Scuderi, M.G., Di Benedetto, V., Ferrari, S., Maino, M., Cavigioli, F., Cocchi, I., Giuffré, M., Bonanno, E., Tzialla, C., Bua, J., Pugni, L., Della Torre, B., Nardella, G., Mazzeo, D., Manzoni, P., Capolupo, I., Ciofi degli Atti, M., Dotta, A., Stronati, M., Raponi, M., Mosca, F., and Bagolan, P.

Published
2022
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3. Opioid-Free Segmental Thoracic Spinal Anesthesia with Intrathecal Sedation for Breast and Axillary Surgery: Report of Four Cases

Author

Vincenzi P, Stronati M, Isidori P, Iuorio S, Gaudenzi D, Boccoli G, and Starnari R

Subjects
spinal anesthesia, breast cancer surgery, axillary surgery, intrathecal midazolam, intrathecal ketamine, Anesthesiology, RD78.3-87.3
Abstract

Paolo Vincenzi,1 Massimo Stronati,2 Paolo Isidori,1 Salvatore Iuorio,2 Diletta Gaudenzi,3 Gianfranco Boccoli,1 Roberto Starnari2 1Department of General Surgery, IRCSS-INRCA, Ancona, Italy; 2Department of Anaesthesiology, IRCSS-INRCA, Ancona, Italy; 3Department of Perioperative Services, AOU “Ospedali Riuniti di Ancona”, Ancona, ItalyCorrespondence: Paolo Vincenzi, Department of General Surgery, IRCSS-INRCA, Via della Montagnola n 81, Ancona, 60127, Italy, Tel + 39 3394578495, Email paolo.vincenzi1981@gmail.comPurpose: Few studies have described segmental thoracic spinal anesthesia (STSA) as primary anesthesiologic method in breast and axillary surgery, documenting the association of intrathecal local anesthetics and opioids. This case series reports an opioid-free scheme of STSA in four elderly patients undergoing major breast and axillary oncological surgery.Patients and Methods: STSA was performed in three female patients undergoing unilateral mastectomy ± axillary lymph node dissection (ALND) or sentinel lymph node biopsy for invasive ductal carcinoma and in one male patient undergoing ALND for melanoma metastases. The level of needle insertion was included between T6-8, via a median or paramedian approach. Midazolam (2 mg) and ketamine (20 mg) were used as adjuvants for intrathecal sedation, followed by the administration of hypobaric ropivacaine 0.25% at a dose of 8 mg. The level of sensory blockade achieved was comprised between C2-3 and T11-12. Postoperative analgesia was maintained through continuous intravenous administration of Ketorolac by an elastomeric pump (90 mg over 24 hrs.).Results: Spinal anesthesia was completed without complications in all patients. Conversion to general anesthesia (GA) and perioperative intravenous sedation were not required. No major postoperative complications and no episodes of postoperative nausea and vomiting (PONV) were reported. No rescue analgesic was administered. All patients were discharged in postoperative day 2 and are alive at 30, 29, 27 and 13 months after surgery, respectively. High grade of satisfaction on the anesthesiologic method was expressed by all cases.Conclusion: STSA with local anesthetic plus midazolam and ketamine might be considered a safe and effective alternative to GA, even in surgeries involving the breast and axillary region, particularly in elderly and frail patients. Larger prospective studies are required to validate these findings.Keywords: spinal anesthesia, breast cancer surgery, axillary surgery, intrathecal midazolam, intrathecal ketamine

Published
2022

12. Erratum: Probiotics' efficacy in paediatric diseases: Which is the evidence? A critical review on behalf of the Italian Society of Pediatrics (Ital J Pediatr. (2020) 46 (104) DOI: 10.1186/s13052-020-00862-z)

Author

Martinelli M., Banderali G., Bobbio M., Civardi E., Chiara A., D'Elios S., Lo Vecchio A., Olivero M., Peroni D., Romano C., Stronati M., Turra R., Viola I., Staiano A., Villani A., Martinelli, M., Banderali, G., Bobbio, M., Civardi, E., Chiara, A., D'Elios, S., Lo Vecchio, A., Olivero, M., Peroni, D., Romano, C., Stronati, M., Turra, R., Viola, I., Staiano, A., and Villani, A.

Abstract

One of the studies included in this review [1] assessed a probiotic formulation known as VSL# 3. The probiotic formulation that was assessed in this tudy is now known by the generic name ‘De Simone Formulation’. The current product known as VSL# 3 is not the same formulation as the original product nvented by Professor De Simone. The authors would like to apologise for any inconvenience caused.

Published
2020

17. Neonatal Assessment Visual European Grid (NAVEG): Unveiling neurological risk

Author

Andrea, Rossi, Marco, Gnesi, Cristina, Montomoli, Gaetano, Chirico, Laura, Malerba, Merabet, Lotfi B., NAVEG Study Group, Alessandrini, A, D’Adda, N, Tansini, F, Micheletti, S, Galli, J, Accorsi, P, Martelli, P, Gritti, M, Mattei, P, Bettelli, S, Franzoni, A, Nascimbeni, G, Semeraro, F, Gasparoni, A, Ferrari, F, Della Casa, E, Orcesi, S, Stronati, M, Lebrun, F, Marcou, V, Haumont, D, Tackoen, M, and Fazzi, ELISA MARIA

Subjects
Visual function, Assessment, Brain lesion, Newborn, Preterm, Developmental and Educational Psychology, MEDLINE, Grid, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Brain lesions, Psychology, Neuroscience, 030217 neurology & neurosurgery
Published
2017
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29. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

30. Intersociety policy statement on the use of whole-exome sequencing in the critically ill newborn infant

Author

Borghesi, A, Mencarelli, Ma, Memo, L, Ferrero, Gb, Bartuli, A, Genuardi, M, Stronati, M, Villani, A, Renieri, A, Corsello, G, Their Respective Scientific Societies, Agostiniani, R, Staiano, A, Del Vecchio, A, Banderali, G, Peroni, D, Piazzolla, R, Turra, R, Bozzola, E, Vecchio, D, Rosati, Gv, Macrì, F, Romagnoli, C, De Curtis, M, Orfeo, L, Mangili, G, Mosca, F, Fanos, V, Paolillo, P, Raimondi, F, Rizzo, A, Chirico, G, Corvaglia, Lt, Cacace, Concetta, Poggiani, C, Zuppa, Aa, Pisano, D, Melis, D, Giuffrè, M, Carbone, Mt, Macchiaiolo, M, Tarani, L, Selicorni, A, Andria, G, Coviello, D, Gentile, M, Ghiorzo, P, Novelli, A, Ragusa, A, Scarano, G, Giardino, D., Borghesi A, Mencarelli MA, Memo L, Ferrero GB, Bartuli A, Genuardi M, Stronati M, Villani A, Renieri A, Corsello G, Borghesi, Alessandro, Mencarelli, Maria Antonietta, Memo, Luigi, Ferrero, Giovanni Battista, Bartuli, Andrea, Genuardi, Maurizio, Stronati, Mauro, Villani, Alberto, Renieri, Alessandra, Corsello, Giovanni, and Agostiniani R, Staiano A, Del Vecchio A, Banderali G, Peroni D, Piazzolla R, Turra R, Bozzola E, Vecchio D, Rosati GV, Macrì F, Romagnoli C, De Curtis M, Orfeo L, Mangili G, Mosca F, Fanos V, Paolillo P, Raimondi F, Rizzo A, Chirico G, Corvaglia LT, Cacace C, Poggiani C, Zuppa AA, Pisano D, Melis D, Giuffrè M, Carbone MT, Macchiaiolo M, Tarani L, Selicorni A, Andria G, Coviello D, Gentile M, Ghiorzo P, Novelli A, Ragusa A, Scarano G, Giardino D.

Subjects
0301 basic medicine, Male, Neonatal intensive care unit, Disease, Review, 030105 genetics & heredity, Pediatrics, Whole Exome Sequencing, Neonate, Neonatal, Outcome Assessment, Health Care, Diagnosis, Policy Making, Exome sequencing, Sanger sequencing, Genome, lcsh:RJ1-570, Perinatology and Child Health, Settore MED/38, Intensive Care Units, Italy, Whole-exome sequencing, Practice Guidelines as Topic, symbols, WES, Female, Human, Diagnosi, NICU, medicine.medical_specialty, Mendelian, 03 medical and health sciences, symbols.namesake, Outcome Assessment (Health Care), Neonatal Screening, Genetic, Intensive Care Units, Neonatal, Exome Sequencing, medicine, WGS, Pediatrics, Perinatology and Child Health, Humans, Genetic Testing, Intensive care medicine, Settore MED/06 - ONCOLOGIA MEDICA, Genetic heterogeneity, Critically ill, business.industry, Genome, Human, Infant, Newborn, Infant, lcsh:Pediatrics, Newborn, Infant newborn, 030104 developmental biology, Differential diagnosis, business
Abstract

The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system. Most genetic diseases may be already expressed during the neonatal age, but their identification may be complicated by nonspecific presentation, especially in the setting of critical clinical conditions. The differential diagnosis process in the neonatal intensive care unit (NICU) may be time-consuming, uncomfortable for the patient due to repeated sampling, and ineffective in reaching a molecular diagnosis during NICU stay. Serial gene sequencing (Sanger sequencing) may be successful only for conditions for which the clinical phenotype strongly suggests a diagnostic hypothesis and for genetically homogeneous diseases. Newborn screenings with Guthrie cards, which vary from country to country, are designed to only test for a few dozen genetic diseases out of the more than 6000 diseases for which a genetic characterization is available. The use of WES in selected cases in the NICU may overcome these issues. We present an intersociety document that aims to define the best indications for the use of WES in different clinical scenarios in the NICU. We propose that WES is used in the NICU for critically ill newborn infants when an early diagnosis is desirable to guide the clinical management during NICU stay, when a strong hypothesis cannot be formulated based on the clinical phenotype or the disease is genetically heterogeneous, and when specific non-genetic laboratory tests are not available. The use of WES may reduce the time for diagnosis in infants during NICU stay and may eventually result in cost-effectiveness.

Published
2017

31. Enteral Nutrition Tolerance and REspiratory Support (ENTARES) Study in preterm infants: Study protocol for a randomized controlled trial

Author

Cresi, F., Maggiora, E., Borgione, S. M., Spada, E., Coscia, Emanuele, Bertino, E., Meneghin, F., Corvaglia, L. T., Ventura, M. L., Lista, G., Mosca, F., Orsi, A., Mercadante, D., Martinelli, S., Ilardi, L., Proto, A., Gatto, S., Aceti, A., Sandri, F., Chakrokh, R., Laforgia, N., Di Mauro, A., Baldassarre, M. E., Del Vecchio, A., Petrillo, F., Spalierno, M. P., Raimondi, F., Capasso, L., Palma, M., Farina, D., Campagnoli, M. F., Boetti, T., Logrippo, F., Agosti, M., Morlacchi, L., Perniciaro, S., Dani, C., Elia, S., Vento, Giovanni, Maggio, Luca, Stronati, M., Civardi, E., Lidia, G., Angela, B., Coscia A., Vento G. (ORCID:0000-0002-8132-5127), Maggio L. (ORCID:0000-0001-6358-7775), Cresi, F., Maggiora, E., Borgione, S. M., Spada, E., Coscia, Emanuele, Bertino, E., Meneghin, F., Corvaglia, L. T., Ventura, M. L., Lista, G., Mosca, F., Orsi, A., Mercadante, D., Martinelli, S., Ilardi, L., Proto, A., Gatto, S., Aceti, A., Sandri, F., Chakrokh, R., Laforgia, N., Di Mauro, A., Baldassarre, M. E., Del Vecchio, A., Petrillo, F., Spalierno, M. P., Raimondi, F., Capasso, L., Palma, M., Farina, D., Campagnoli, M. F., Boetti, T., Logrippo, F., Agosti, M., Morlacchi, L., Perniciaro, S., Dani, C., Elia, S., Vento, Giovanni, Maggio, Luca, Stronati, M., Civardi, E., Lidia, G., Angela, B., Coscia A., Vento G. (ORCID:0000-0002-8132-5127), and Maggio L. (ORCID:0000-0001-6358-7775)

Abstract

Background: Respiratory distress syndrome (RDS) and feeding intolerance are common conditions in preterm infants and among the major causes of neonatal mortality and morbidity. For many years, preterm infants with RDS have been treated with mechanical ventilation, increasing risks of acute lung injury and bronchopulmonary dysplasia. In recent years non-invasive ventilation techniques have been developed. Showing similar efficacy and risk of bronchopulmonary dysplasia, nasal continuous positive airway pressure (NCPAP) and heated humidified high-flow nasal cannula (HHHFNC) have become the most widespread techniques in neonatal intensive care units. However, their impact on nutrition, particularly on feeding tolerance and risk of complications, is still unknown in preterm infants. The aim of the study is to evaluate the impact of NCPAP vs HHHFNC on enteral feeding and to identify the most suitable technique for preterm infants with RDS. Methods: A multicenter randomized single-blind controlled trial was designed. All preterm infants with a gestational age of 25-29 weeks treated with NCPAP or HHHFNC for RDS and demonstrating stability for at least 48 h along with the compliance with inclusion criteria (age less than 7 days, need for non-invasive respiratory support, suitability to start enteral feeding) will be enrolled in the study and randomized to the NCPAP or HHHFNC arm. All patients will be monitored until discharge, and data will be analyzed according to an intention-to-treat model. The primary outcome is the time to reach full enteral feeding, while parameters of respiratory support, feeding tolerance, and overall health status will be evaluated as secondary outcomes. The sample size was calculated at 141 patients per arm. Discussion: The identification of the most suitable technique (NCPAP vs HHHFNC) for preterm infants with feeding intolerance could reduce gastrointestinal complications, improve growth, and reduce hospital length of stay, thus improving clinica

Published
2019

33. Combined antiretroviral therapy reduces hyperimmunoglobulinemia in HIV-1 infected children

Author

Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, DI BARI, DANIELA COLOMBA, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, CAVALLINI, RAFFAELLA, D'ANASTASIO, ELISABETTA, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, CECCHI, MARIA TERESA, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, PINZANI, ROBERTO, VIGANO', ALDO, Giacomet, V, Bianchi, R, SALVINI, FRANCESCO, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, DE MARCO, GIUSEPPINA, Tarallo, L, TANCREDI, FERNANDO ANTONIO, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, SANFILIPPO, ALESSIA, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, PALMA, PASQUALE, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, Molesini, M, Chiappini, E, Galli, L, Tovo, PA, Gabiano, C, de Martino, M, Osimani, P, Cordiali, R, De Mattia, D, Manzioma, M, Di Bari, C, Ruggeri, M, Masi, M, Miniaci, A, Specchia, F, Ciccia, M, Lanari, M, Baldi, F, Battisti, L, Schumacher, R, Duse, M, Fiorino, C, Dessi, C, Pintor, C, Dedoni, M, Fenu, ML, Cavallini, R, Anastasio, E, Merolla, F, Sticca, M, Pomero, G, Bezzi, T, Fiumana, E, Paganelli, S, Vierucci, A, Vitucci, P, Cecchi, MT, Cosso, D, Timitilli, A, Stronati, M, Plebani, A, Pinzani, R, Vigano, A, Giacomet, V, Bianchi, R, Salvini, F, Zuccotti, GV, Giovannini, M, Ferraris, G, Lipreri, R, Moretti, C, Cellini, M, Cano, MC, Palazzi, G, Guarino, A, Bruzzese, E, De Marco, G, Tarallo, L, Tancredi, F, Giaquinto, C, D'Elia, R, Rampon, O, Nogare, EDR, Sanfilippo, A, Romano, A, Saitta, M, Dodi, I, Barone, A, Maccabruni, A, Consolini, R, Legitimo, A, Magnani, C, Falconieri, P, Fundaro, C, Genovese, O, Salvucci, S, Casadei, AM, Gattinara, GC, Bernardi, S, Palma, P, Anzidei, G, Anzidei, M, Cerilli, S, Catania, S, Ajassa, C, Ganau, A, Cristiano, L, Mazza, A, Di Palma, A, Garetto, S, Riva, C, Scolfaro, C, Portelli, V, Rabusin, M, Pellegatta, A, and Molesini, M

Subjects
Adult, medicine.medical_specialty, Adolescent, immunogiobulins, Immunology, immunoglobulins, combined antiretroviral therapy, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Gastroenterology, children, Hypergammaglobulinemia, Internal medicine, medicine, Humans, Immunology and Allergy, Child, Therapeutic regimen, biology, business.industry, Immunoglobulins, Intravenous, Infant, Normal population, hiv-1 infection, Settore MED/38, Antiretroviral therapy, HIV Reverse Transcriptase, Infectious Diseases, Child, Preschool, Intravenous IG, HIV-1, biology.protein, HIV-1 infection, Drug Evaluation, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Antibody, business, Viral load
Abstract

Objective: To evaluate the effect of combined antiretroviral therapy on serum immunoglobulin (Ig) levels in HIV-1 perinatally infected children.Methods: Data from 1250 children recorded by the Italian Register for HIV Infection in Children from 1985 to 2002 were analysed. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using means and standard deviations of normal population for each age period. Combined antiretroviral therapy has become widespread in Italy since 1996, thus differences in Ig z-scores between the periods 1985-1995 and 1996-2002 were analysed. Data according to type of therapeutic regimen were also analysed.Results: Between the two periods 1985-1995 and 1996-2002, significant (P < 0.0001) decreases in IgG (6.29 +/- 4.72 versus 4.44 +/- 4.33), IgM (9.25 +/- 13.32 versus 5.61 +/- 7.93), and IgA (10.25 +/- 15.68 versus 6.48 +/- 11.56) z-scores, together with a parallel significant (P < 0.0001) increase in CD4 T-lymphocyte percentages, were found. These decreases were confirmed regardless of whether the children were receiving intravenous Ig or not. Ig z-scores were significantly higher in children receiving mono-therapy than in those receiving double-combined therapy (IgG, P < 0.0001; IgM, P = 0.003; IgA, P = 0.031) and in the latter children than in those receiving three or more drugs (P < 0.0001 for all z-scores). Ig z-scores correlated inversely with CD4 T lymphocyte percentages and, directly, with viral loads.Conclusions: Our data show that in HIV-1 infected children combined antiretroviral therapy leads to reduction of hyperimmunoglobulinemia which parallels restoration of CD4 T-lymphocyte percentage and viral load decrease, which it turn probably reflects improved B-lymphocyte functions.(C) 2004 Lippincott Williams Wilkins.

Published
2004
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34. Robust Hyperproperty Preservation for Secure Compilation (Extended Abstract)

Author

Garg, D., Hritcu, C., Patrignani, M., Stronati, M., and Swasey, D.

Abstract

We map the space of soundness criteria for secure compilation based on the preservation of hyperproperties in arbitrary adversarial contexts, which we call robust hyperproperty preservation. For this, we study the preservation of several classes of hyperproperties and for each class we propose an equivalent "property-free" characterization of secure compilation that is generally better tailored for proofs. Even the strongest of our soundness criteria, the robust preservation of all hyperproperties, seems achievable for simple transformations and provable using context back-translation techniques previously developed for showing fully abstract compilation. While proving the robust preservation of hyperproperties that are not safety requires such powerful context back-translation techniques, for preserving safety hyperproperties robustly, translating each finite trace prefix back to a source context seems to suffice.

Published
2017

36. Congenital syphilis in Italy: a multicentre study

Author

Tridapalli, E., Capretti, M. G., Reggiani, M. L. B., Stronati, M., Faldella, G., Auriti, C., Balata, A., Barera, G., Bennato, E., Berardi, A., Bolognesi, S., Bonomi, A., Boulos, F., Brambilla, C., Branchi, M., Cabiati, G., Caddia, V., Calzetti, G., Campanile, A., Cataldo, P., Cavagna, R., Chiarolini, A., Ciccia, M., Ciccotti, R., Ciofalo, A., Contiero, R., Corona, G., Corso, G., Costa, L., Coviello, C., Cristofori, G., Crivellaro, C., Cucchi, G., Danese, G., Da Riol, R., Decembrino, L., Delogu, A., Del Vecchio, A., De Sanctis, L., Di Chiara, G., Di Comite, A., Di Grande, E. C., D'Onofrio, A. M., Faccia, P., Ferrari, D., Fortunati, P., Gabriella, T. L., Galimberti, D., Garzia, P., Giorgino, M., Gragnani, S., Gurrido, R., Lacaita, G., Leone, G., Lipari, A., Lorenzini, C., Lo Sciotto, P., Malagutti, L., Maschio, F., Matteucci, L., Migliozzi, L., Mileti, F., Murgia, M. R., Navone, M., Nosari, N., Notarmuzi, M. L., Pagliani, L., Paino, D., Papa, I., Papili, F., Parisi, G., Perocchi, F., Perona, A., Pirrami, R., Pitassi, I., Priore, Raponi, S., Rizzo, V., Robieux, I., Rossi, A., Ruffini, E., Russo, R., Salvi, G., Serra, L., Sferlazzo, S., Solimano, T., Spadaro, V., Stramare, D., Stroppiana, P., Tarquini, E., Taurino, L., Tedoldi, S., Tessariol, D., Travaglio, M. D., Vagnarelli, F., Valente, A., Valentini, P., Volta, A., Zaffaroni, M., Tridapalli E, Capretti MG, Reggiani ML, Stronati M, Faldella G, and Italian Neonatal Task Force of Congenital Syphilis for The Italian Society of Neonatology – Collaborative Group.

Subjects
medicine.medical_specialty, Pediatrics, Adolescent, Reproductive medicine, Infant, Premature, Diseases, Prenatal care, Young Adult, Foreign born, Pregnancy, Risk Factors, Seroepidemiologic Studies, Age Factors, Birth Weight, Female, Humans, Infant, Newborn, Infant, Premature, Italy, Maternal Age, Pregnancy Complications, Infectious, Prenatal Care, Prospective Studies, Syphilis, Syphilis, Congenital, medicine, CONGENITAL SYPHILIS, Seroprevalence, Reproductive health, business.industry, Obstetrics and Gynecology, General Medicine, medicine.disease, Congenital syphilis, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Pediatrics, Perinatology and Child Health, MULTICENTER STUDY, business
Abstract

OBJECTIVE: To study the prevalence of congenital syphilis and its risk factors in Italy. STUDY DESIGN: Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. RESULTS: Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age

Published
2010
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38. Canonical Transient Receptor Potential 3 channel triggers VEGF-induced intracellular Ca2+ oscillations in endothelial progenitor cells isolated from umbilical cord blood

Author

Dragoni, S, Laforenza, U, Bonetti, E, Lodola, F, Bottino, C, Guerra, G, Borghesi, A, Stronati, M, Rosti, V, Tanzi, F, Moccia, F, Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Guerra G, Borghesi A, Stronati M, Rosti V, Tanzi F, Moccia F, Dragoni, S, Laforenza, U, Bonetti, E, Lodola, F, Bottino, C, Guerra, G, Borghesi, A, Stronati, M, Rosti, V, Tanzi, F, Moccia, F, Dragoni S, Laforenza U, Bonetti E, Lodola F, Bottino C, Guerra G, Borghesi A, Stronati M, Rosti V, Tanzi F, and Moccia F

Abstract

Endothelial colony-forming cells (ECFCs) are the only endothelial progenitor cells (EPCs) that are capable of acquiring a mature endothelial phenotype. ECFCs are mainly mobilized from bone marrow to promote vascularization and represent a promising tool for cell-based therapy of severe ischemic diseases. Vascular endothelial growth factor (VEGF) stimulates the proliferation of peripheral blood-derived ECFCs (PB-ECFCs) through oscillations in intracellular Ca2+ concentration ([Ca2+]i). VEGF-induced Ca2+ spikes are driven by the interplay between inositol-1,4,5-trisphosphate (InsP3)-dependent Ca2+ release and store-operated Ca2+ entry (SOCE). The therapeutic potential of umbilical cord blood-derived ECFCs (UCB-ECFCs) has also been shown in recent studies. However, VEGF-induced proliferation of UCB-ECFCs is faster compared with their peripheral counterpart. Unlike PB-ECFCs, UCB-ECFCs express canonical transient receptor potential channel 3 (TRPC3) that mediates diacylglycerol-dependent Ca2+ entry. The present study aimed at investigating whether the higher proliferative potential of UCB-ECFCs was associated to any difference in the molecular underpinnings of their Ca 2+ response to VEGF. We found that VEGF induces oscillations in [Ca2+]i that are patterned by the interaction between InsP3-dependent Ca2+ release and SOCE. Unlike PB-ECFCs, VEGF-evoked Ca2+ oscillations do not arise in the absence of extracellular Ca2+ entry and after pharmacological (with Pyr3 and flufenamic acid) and genetic (by employing selective small interference RNA) suppression of TRPC3. VEGF-induced UCB-ECFC proliferation is abrogated on inhibition of the intracellular Ca2+ spikes. Therefore, the Ca 2+ response to VEGF in UCB-ECFCs is shaped by a different Ca 2+ machinery as compared with PB-ECFCs, and TRPC3 stands out as a promising target in EPC-based treatment of ischemic pathologies.

Published
2013

39. Patient-reported outcomes measure for children born preterm: validation of the SOLE VLBWI Questionnaire, a new quality of life self-assessment tool

Author

Olivieri, I., M Bova, S., Fazzi, E., Ricci, Daniela, Tinelli, F., Montomoli, C., Rezzani, C., Balottin, U., Orcesi, S., Ariaudo, G., Capone, L., Spairani, S., Stronati, M., Figar, T., Mastrangelo, Marica, Krachmalnicoff, A., Lista, G., Accorsi, P., Martelli, P., Rossi, A., Micheletti, S., Zaccagnino, M., Chirico, G., Mallardi, M., Quintiliani, Michela, Romeo, Domenico Marco, Gallini, Francesca, Battini, Roberta, and Comparini, A.

Subjects
Self-assessment, Male, Self-Assessment, Psychometrics, Neurology (clinical), Pediatrics, Perinatology and Child Health, Developmental Neuroscience, Pediatrics, Developmental psychology, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Cronbach's alpha, 030225 pediatrics, Surveys and Questionnaires, Humans, Infant, Very Low Birth Weight, Medical history, Patient Reported Outcome Measures, Child, Measure (data warehouse), Alpha Value, Very Low Birth Weight, Infant, Reproducibility of Results, Perinatology and Child Health, Focus group, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Quality of Life, Female, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Aim This study was conducted to develop and validate a new self-report questionnaire for measuring quality of life (QoL), at school age, in children with a very low birthweight (VLBW). Method Through a focus group approach, children were involved directly in defining the questionnaire items, which were presented as illustrations rather than written questions. This preliminary validation of the questionnaire was conducted in 152 participants with VLBW (aged 7–11y) randomly selected from the five participating Italian centres. The questionnaire was completed by children and parents separately; data on children's demographic and medical history, and intellectual, adaptive, and behavioural functioning were collected using standardized scales. All the children also completed the Paediatric Quality of Life Inventory (PedsQL), another Italian-language measure of QoL in children. Results Our questionnaire was readily accepted and understood, and quick to complete. The Cronbach's alpha value showed it to be a reliable instrument. The child-compiled version correlated well with the PedsQL, whereas no correlations emerged with the other scales used, IQ, or degree of impairment. Conversely, these variables correlated significantly with the parent-compiled version. Children's and parents’ answers were divergent on practically all the items. Interpretation The results confirm the validity of the new instrument and highlight a poor overlap between parents’ and children's perspectives.

Published
2016

40. [Update for the standard procedures of diagnosis and therapy in cases of congenital rubella]

Author

BUFFOLANO, WILMA, Filia A, Agnese M, Stronati M, Dicostanzo P., Buffolano, Wilma, Filia, A, Agnese, M, Stronati, M, and Dicostanzo, P.

Subjects
Incidence, Rubella Syndrome, Congenital, Vaccination, Diagnosis, Differential, Early Diagnosis, Immunoglobulin M, Italy, Pregnancy, Immunoglobulin G, Practice Guidelines as Topic, Humans, Immunologic Factors, Female, Rubella Vaccine, Pregnancy Complications, Infectious, Child, Biomarkers
Abstract

Congenital Rubella is the dramatic consequence of rubella during gestation. A combined strategy of Measles and Rubella universal vaccination on children and selective vaccination of susceptible women has been shown effective in the elimination of congenital rubella requiring an incidence of1 case of CRS per 100,000 live births. Verification processes of rubella elimination require that physicians early and appropriately diagnose all cases of congenital rubella, including those unpatent at birth. The paper highlights clinical and laboratory aspects channeling diagnosis of congenital rubella infection or syndrome even after the first year of life, and the short- and long-term management criteria.

Published
2013

41. Recommendations for pediatric tuberculosis vaccination in Italy

Author

Montagnani, C, Esposito, S, Galli, L, Chiappini, E, Principi, N, de Martino, M, Bosis, S, Tagliabue, C, Senatore, L, Ascolese, B, Villani, A, Lancella, L, Cursi, L, Grandin, A, Marabotto, C, Ciofi, D, Festini, F, Anziati, M, Becciani, S, Remaschi, G, Sollai, S, Tersigni, C, Venturini, E, Guarino, A, Lo Vecchio, A, Scotto, R, Gabiano, C, Garazzino, S, Le Serre, D, Raffaldi, I, Bernardi, F, Bertazzoni, E, Blasi, F, Bocchino, M, Assante, L, Castagnola, E, Losurdo, G, Codecasa, L, Di Mauro, G, Faccini, M, Marseglia, G, Mascolo, A, Di Comite, A, Stronati, M, Matteelli, A, Migliori, Gb, D’Ambrosio, L, Centis, R, Pasinato, Cirillo, Tortoli, Russo, Scaglione, F, Scala, E, and Tomà, P

Subjects
Pediatrics, medicine.medical_specialty, Tuberculosis, Immunology, Breastfeeding, Tuberculin, Reviews, Disease, Tuberculous meningitis, 03 medical and health sciences, 0302 clinical medicine, children, prevention, BCG, tuberculosis, vaccination, vaccine, 030225 pediatrics, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Immunization Schedule, Pharmacology, business.industry, medicine.disease, Settore MED/38, Pediatric tuberculosis, Vaccination, Italy, BCG Vaccine, business, BCG vaccine
Abstract

Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged

Published
2015

42. Effect of maternal psychopathology on neurodevelopmental outcome and quality of the dyadic relationship in preterm infants: an explorative study.

Author

Pisoni, C., Spairani, S., Fauci, F., Ariaudo, G., Tzialla, C., Tinelli, C., Politi, P., Balottin, U., Stronati, M., and Orcesi, S.

Subjects
PREMATURE infants, RELATIONSHIP quality, PARENT-child relationships, MOTHER-child relationship, MOTHER-infant relationship, CHILD psychopathology, BRAIN, SOCIAL support, INFANT care, CHILD development, PSYCHOLOGY of mothers, PARENTING, PSYCHOLOGICAL stress, LONGITUDINAL method, PSYCHOLOGICAL factors
Abstract

Background: The literature shows that parents of preterm infants are at risk of psychological distress and that this may impact on the quality of the parent-child relationship and on the child's development.Aim: This longitudinal study was conducted to examine in preterm infants relationships between maternal psychological variables, parental protective factors, perinatal infant variables, and neurodevelopmental outcome. Furthermore, we explored the impact of these variables on the quality of the mother-infant relationship (dyadic synchrony).Subjects and methods: A total of 29 preterm infants (GA < 34 weeks) and their mothers were evaluated twice: at t0, during the infant's hospitalization in the neonatal intensive care unit (NICU), and at 12 months of infant corrected age (t2).Results: With the exception of decreases in anxiety and perceived social support and an increase in the rate of severe depression at follow-up, there were no significant changes between t0 and t1 assessments. The infant's perinatal risk status was the variable that impacted most on maternal psychopathology. Furthermore, our data revealed that baseline maternal stress related to the appearance of the child and to the mother's perception of her parenting role represent a risk factor in relation to developmental outcome at 12 months of corrected age. Finally, no correlations emerged between dyadic synchrony and infant perinatal data, maternal psychological variables (at t0 and at t1), or child developmental outcome at t1.Conclusions: Our results underline the need to identify negative maternal affective states early in the mother-child relationship and to provide mothers with adequate support in the NICU, to enhance their parental role. [ABSTRACT FROM AUTHOR]

Published
2020
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43. Lactoferrin and prevention of late-onset sepsis in the pre-term neonates

Author

Manzoni, P, Decembrino, L, Stolfi, I, Pugni, L, Rinaldi, M, Cattani, Sara, Romeo, Mg, Messner, H, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, MILENA MARIA, Gallo, E, Mostert, Michael Martin, Magnani, Silvia Carla, Quercia, M, Bollani, Luigi, Pedicino, R, Renzullo, L, Betta, P, Ferrari, F, Magaldi, R, Mosca, F, Stronati, M, Farina, Davide, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Subjects
Infant, Premature, Diseases, Sepsis, chemistry.chemical_compound, Anti-Infective Agents, Lactoferricin, Intensive care, medicine, Animals, Humans, Age of Onset, biology, Lactoferrin, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Antimicrobial, Lactoferrin and prevention of late-onset sepsis, Low birth weight, chemistry, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Premature Birth, Colostrum, Cattle, medicine.symptom, business, Infant, Premature, Fluconazole, medicine.drug
Abstract

Late-onset sepsis (LOS) affects a large proportion of pre-term neonates in neonatal intensive care units (NICUs) worldwide, with high morbidity and related mortality, and frequent occurrence of severe late neurodevelopmental impairment. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. It is well known that feeding with fresh maternal milk, hygiene measures and the cautious use of H2-blockers are related with a decreased risk of developing sepsis. However, evidence from randomised clinical trials exists only for fluconazole in the prevention of fungal infections in the NICU. Lactoferrin is the main whey protein in mammalian milk, and is involved in innate immune host defences. Notably, human lactoferrin can be found at increased concentrations in colostrum and in milk from mothers of premature neonates. Human (hLF) and bovine lactoferrin (bLF) share a high (77%) amino-acid homology, and the same N-terminal peptide responsible for antimicrobial activity, called lactoferricin. In vitro, bLF shows potent direct antimicrobial activity against all types of pathogens, which occurs via anti-cell wall actions and leads to disintegration of the micro-organism's membranes. bLF is also synergistic with many antimicrobials and antifungals, and promotes growth and differentiation of the immature gut. Based on this background data, a randomised clinical trial was recently conducted in very low birth weight pre-term neonates given bLF alone or with the probiotic Lactobacillus GG. The aim of the trial was to assess the ability of bLF to prevent late-onset sepsis of any origin in the studied infants during their stay in the NICU. This article discusses the preliminary data from this study, along with the proposed mechanisms of action of bLF in pre-term infants.

Published
2010
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47. Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates

Author

Manzoni, P, Stolfi, I, Pedicino, R, Vagnarelli, F, Mosca, F, Pugni, L, Bollani, L, Pozzi, M, Gomez, K, Tzialla, C, Borghesi, A, Decembrino, L, Mostert, M, Latino, Ma, Priolo, C, Galletto, P, Gallo, E, Rizzollo, S, Tavella, E, Luparia, M, Corona, G, Barberi, Ignazio, Tridapalli, E, Faldella, G, Vetrano, G, Memo, L, Saia, Os, Bordignon, L, Messner, H, Cattani, S, Casa, Ed, Laforgia, N, Quercia, M, Romeo, M, Betta, Pm, Rinaldi, M, Magaldi, R, Maule, M, Stronati, M, Farina, D, Italian Task Force for the study, prevention of Neonatal Fungal Infections, and the Italian Society of Neonatology

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, Gestational Age, law.invention, Sepsis, Randomized controlled trial, law, Intensive Care Units, Neonatal, medicine, Humans, Infant, Very Low Birth Weight, Retinopathy of Prematurity, Human milk, Preterm neonates, Retinopathy of prematurity, Prevention, Univariate analysis, Milk, Human, business.industry, Incidence (epidemiology), Confounding, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Infant, retinopathy of prematurity, medicine.disease, Infant Formula, Italy, Pediatrics, Perinatology and Child Health, Female, business, Infant, Premature
Abstract

Retinopathy of prematurity (ROP) is a multifactorial disease, but little is known about its relationships with neonatal nutritional policies. Human, maternal milk is the best possible nutritional option for all premature infants, including those at high risk for severe complications of prematurity, such as ROP.This is a secondary analysis of data collected during two multicenter RCTs performed consecutively (years 2004 through 2008) by a network of eleven tertiary NICUs in Italy. The two trials aimed at assessing effectiveness of fluconazole prophylaxis (Manzoni et al., N Engl J Med 2007 Jun 14;356(24):2483-95), and of bovine lactoferrin supplementation (Manzoni et al., JAMA 2009 Oct 7;302(13):1421-8), in prevention of invasive fungal infection, and of late-onset sepsis in VLBW infants, respectively. We tested the hypothesis that exclusive feeding with fresh maternal milk may prevent ROP of any stage - as defined by the ETROP study - in VLBW neonates, compared to formula feeding.We analyzed the database from both trials. Systematic screening for detection of ROP was part of the protocol of both studies. The definition of threshold ROP was as defined by the ETROP study. Univariate analysis was performed to look for significant associations between ROP and several possible associated factors, and among them, the type of milk feeding (maternal milk or formula for preterms). When an association was indicated by p0.05, multiple logistic regression was used to determine the factors significantly associated with ROP.In both trials combined, 314 infants received exclusively human maternal milk (group A), and 184 a preterm formula because their mothers were not expected to breastfeed. The clinical, demographical and management characteristics of the neonates did not differ between the two groups, particularly related to the presence of the known risk factors for ROP. Overall, ROP incidence (any stage) was significantly lower in infants fed maternal milk (11 of 314; 3.5%) as compared to formula-fed neonates (29 of 184; 15.8%) (RR 0.14; 95% CI 0.12-0.62; p = 0.004). The same occurred for threshold ROP (1.3% vs. 12.3%, respectively; RR 0.19; 95% CI 0.05-0.69; p = 0.009). At multivariate logistic regression controlling for potentially confounding factors that were significantly associated to ROP (any stage) at univariate analysis (birth weight, gestational age, days on supplemental oxygen, systemic fungal infection, outborn, hyperglycaemia), type of milk feeding retained significance, human maternal milk being protective with p = 0.01.Exclusive human, maternal milk feeding since birth may prevent ROP of any stage in VLBW infants in the NICU.

Published
2013

48. Development and validation of an enzyme linked immunosorbent assay for palivizumab serum determination

Author

Iommiello, Livia Visai, Michela Montagna, Maria Antonietta Avanzini, Ragazzi M, Nora Bloise, Stronati M, and Di Comite A

Subjects
Palivizumab, medicine.drug_class, Immunology, Population, Enzyme-Linked Immunosorbent Assay, medicine.disease_cause, Monoclonal antibody, Antibodies, Monoclonal, Humanized, Antiviral Agents, Injections, Intramuscular, Sensitivity and Specificity, Epitope, Virus, Antigen, Limit of Detection, medicine, Immunology and Allergy, Humans, education, Pharmacology, Observer Variation, education.field_of_study, biology, business.industry, Infant, Reproducibility of Results, Reference Standards, Virology, Respiratory syncytial virus (RSV), Polyclonal antibodies, Calibration, biology.protein, Linear Models, Drug Monitoring, business, medicine.drug
Abstract

Palivizumab (Synagis®) is a humanized monoclonal antibody (IgG1K) composed of 95% human and 5% murine sequences. It is directed to an epitope in the A antigenic site of the F protein of respiratory syncytial virus (RSV). Palivizumab is used for prevention of serious lower respiratory tract disease caused by RSV in pediatric patients who are at increased risk of severe disease and is administered intramuscularly (IM) for a total of 5 monthly doses. Herein, we report on the development and validation of a very sensitive enzyme-linked immunosorbent assay (ELISA) to measure serum concentrations of palivizumab by a rabbit polyclonal antibody specifically produced against the murine sequence. The method was developed and validated according to the guidelines “Guidance for Industry” (1998) and has proved suitable for the determination of palivizumab serum levels in the target infant population. The ELISA assay was successfully applied to test the serum samples in an infant population who received palivizumab intramuscularly; thus, the assay could be used to determine serum levels in palivizumab-treated infants to optimize dosing and scheduling and to study the relationship between dose and clinical response.

Published
2013

49. Do differences in delivery room intubation explain different rates of bronchopulmonary dysplasia between hospitals?

Author

Gagliardi, Luigi, Bellù, Roberto, Lista, Gianluca, Zanini, Rinaldo, Compagnoni, G., Mosca, F., Martinelli, S., Chirico, G., Santucci, S., Caccamo, M. L., Maccabruni, M., Stronati, M., Rondini, G., Agosti, M., Magni, L. A., Moro, G., Tagliabue, P., Barera, G., Merazzi, D., Cavazza, A., Brunelli, A., Battaglioli, M., Tandoi, F., Cella, D., Perotti, G. F., Pelti, M., Stucchi, I., Frisone, F., Avanzini, A., Bastrenta, P., Iacono, G., Pontiggia, F., Cotta-Ramusino, A., Strano, F., Fontana, P., Franco, M., Rossi, L., Calciolari, G., Citterio, G., Rovelli, R., Poloniato, A., Gancia, G. P., Costato, C., Germani, R., Barp, S., Crossignani, R., Siliprandi, N., Borroni, C., Ventura, M. L., Abbiati, L., Giardinetti, S., Leva, L., Fusi, M., and Bellasio, M.

Subjects
Male, Birth weight, medicine.medical_treatment, Gestational Age, Pediatrics, law.invention, Case mix index, law, Risk Factors, mental disorders, Intubation, Intratracheal, Medicine, Intubation, Birth Weight, Humans, Infant, Very Low Birth Weight, Bronchopulmonary Dysplasia, Mechanical ventilation, business.industry, Pediatrics, Perinatology and Child Health, Obstetrics and Gynecology, Delivery Rooms, Infant, Newborn, Gestational age, General Medicine, Perinatology and Child Health, medicine.disease, Respiration, Artificial, Bronchopulmonary dysplasia, Italy, Anesthesia, Ventilation (architecture), Small for gestational age, Female, business, Infant, Premature
Abstract

To investigate whether the wide variation in the frequency of bronchopulmonary dysplasia (BPD) between hospitals is due to differences in delivery room intubation rates.Data on 1260 infants of birth weight1500 g and 23-31 weeks gestational age, born in 1999-2002 and surviving to 36 weeks, were collected; 196 (15.6%) developed BPD defined as oxygen need at 36 weeks postmenstrual age. Generalised estimating equations and conditional logistic models adjusting for centre, gestational age, propensity score for intubation, and other potential confounders were used.Rates of BPD, delivery room intubation and mechanical ventilation for24 h differed significantly between hospitals. Centres with high delivery room intubation rates had higher ventilation and BPD rates. Hospitals ventilating more often also did so for a longer time. Although delivery room intubation was associated with BPD in unadjusted analyses, neither delivery room intubation nor brief (24 h) mechanical ventilation were risk factors for BPD in multivariate analyses adjusting for gestational age, case mix and other pre- and perinatal factors, indicating no causal effect or unmeasured confounding. Significant risk factors for developing BPD were low gestational age, prolonged ventilation (24 h: adjusted OR (aOR) 2.4;7 days: aOR 14.9), male sex (aOR 1.7), being small for gestational age (SGA; aOR 4.3) and late-onset sepsis (aOR 2.2). After taking into account these variables/procedures, centre differences remained significant but explained only about 5% of variance.Differences in BPD frequency between hospitals are explained by differences in procedures, chiefly mechanical ventilation, rather than by differences in initial management or case mix. Delivery room intubation and brief mechanical ventilation did not increase BPD risk.

Published
2011

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