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Scardina G, Ceccarelli L, Casigliani V, Mazzilli S, Padovan M, Petillo A, Tavoschi L, Foddis R, Privitera G, Baggiani A. Flu vaccination coverage in healthcare workers during a 3-year period in the context of the pandemic. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs and maintain essential healthcare services during influenza epidemics. With the present study we aimed to evaluate the efficacy of measures implemented during the three flu campaigns of 2018/19, 2019/20 and 2020/21 in a university hospital in Pisa, Italy, through the assessment of vaccination coverage (VC) in HCWs and to assess attitudes toward flu vaccination.
Methods
Flu VC was stratified according to sex, age, job and vaccination status for each season and the association between each variable and vaccination status was explored. In 2020, a survey collecting data on knowledge and attitudes on flu vaccination was distributed.
Results
Starting from the 2018/19 campaign, an increasing flu VC rate was registered: contained in 2019/20 (from 11.6% to 14.3%, Δ%=23.1) and significant (VC = 39.6%, Δ%=177.6) in 2020/21 as compared with the previous year. Physicians were the professionals most willing to get vaccinated during all seasons. Considering age the situation changed greatly over the study period, with VC rising in 2020/21 in those age groups marked by low VC in previous years (<30 and 41-50 years old, Δ%=293). Having been vaccinated in the previous year represented the most important variable to predict likelihood of accepting flu jab. However, while previously vaccinated HCWs were 13 times more likely to get the flu jab in 2019/20 compared with the others; in 2020/21 they were only 3 times. Only half of HCWS considered themselves at higher risk of contracting influenza compared to the general population, while 71% totally agreed that receiving the flu jab in 2020/21 was more important than the previous years due to COVID.
Conclusions
A significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years, due to the COVID pandemic that positively influenced vaccination uptake.
Key messages
• This study evaluates the impact of subsequent flu vaccination campaigns implemented in a large university hospital in Italy through the assessment of flu VC among HCWs.
• A significant increase in flu VC among HCWs was observed in 2020/21, especially in those categories characterized by lower VC rates in the previous years, more likely due to the COVID-19 pandemic.
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Affiliation(s)
- G Scardina
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - L Ceccarelli
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - V Casigliani
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | | | - M Padovan
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - A Petillo
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - L Tavoschi
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - R Foddis
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - G Privitera
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - A Baggiani
- Translational Research in Medicine, University of Pisa , Pisa, Italy
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Immediata V, Baggiani A, Cirillo F, Zanagnolo M, Ronchetti C, Morenghi E, Specchia C, Levi-Setti P. P-476 Why are they not coming back? A single-center follow-up study on oncological women oocyte's storing for fertility preservation. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Which is the return rate and which factors are responsible for the non-return in cancer patients who underwent oocyte cryopreservation for fertility preservation?
Summary answer
Return rate was 11.7%. Young age at freezing, lack of a partner and type of cancer were the main factors responsible for the non-return.
What is known already
Improvements in oncological early diagnoses and therapies have significantly increased the survival rates of patients, allowing clinicians to focus on long-term quality-of-life issues, such as access to motherhood. An extensive literature on the importance of fertility preservation (FP) has been produced thanks to the growing number of patients undergoing FP cycles over the years. Nevertheless, the rates of patients returning to use their cryopreserved material have shown to be considerably low, ranging from 5 to 8%. Significant data regarding the reasons that might explain such low return rates are still scarce.
Study design, size, duration
This is a single-center follow-up retrospective study that includes all women who underwent oocyte cryopreservation cycles for oncological purposes at referral University affiliated center, from January 2001 to December 2017.
Participants/materials, setting, methods
The database consists of 171 patients, among those 110 (64%) were diagnosed with breast cancer, 45 (26%) hematological cancer, 5 (3%) gynecologic cancer and 11 (7%) other cancers. Data about returned patients were retrieved from internal registries. Non-returned patients were assessed by standardized phone survey on health and marital status, family projects, spontaneous conceptions, and reasons why they had not returned to use their gametes. A univariate analysis between returned and non-returned patients was performed.
Main results and the role of chance
Among the 171 women who underwent oocyte cryopreservation, 9 (5%) died and 17 (10%) were lost at follow up. In the remaining 145-patient group, the mean age at freezing was 32.2±6.1 and at follow-up 38.2±6.7 years. A total of 20 patients (11.7%) returned to use their frozen material and 125 did not. In the non-returned group, 37 (29.6%) did not have a partner, 10 (8%) had a previous spontaneous conception and 15 (12%) had recurrent malignancy at the time of follow-up. In the univariate analysis, younger age at freezing (31.8±6.2 vs 35.2±4.7; p 0.018), lack of a partner (p 0.002), type of cancer (other than breast cancer; p 0.024) were the significant factors in the non-returned group. As for the personal reason for not coming back, patients mainly answered as follows: lack of a partner (29, 23.2%), desire of spontaneous motherhood (24, 19.2%), previous spontaneous pregnancies after FP procedures (16, 12.8%), and still ongoing hormonal therapy for breast cancer (13, 10.4%). Nonetheless all of them confirmed their will to keep the storage of their oocytes.
Limitations, reasons for caution
The study population consists of a limited number of patients from a single Italian Fertility Center. Since the Italian law limits ART access to heterosexual couples, this setting may limit any possible adaptation of the study to other countries, with different legislations.
Wider implications of the findings
The impact of a cancer diagnosis on a woman’s maternal desire, sentimental status and life priorities should be studied more thoroughly. Moreover, it is important to encourage studies investigating so long hormonal therapy suppression in breast cancer patients seeking pregnancy in order to reduce their time to pregnancy.
Trial registration number
na
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Affiliation(s)
- V Immediata
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - A Baggiani
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - F Cirillo
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - M.F Zanagnolo
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - C Ronchetti
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - E Morenghi
- Humanitas Research Hospital- IRCCS, Biostatistics Unit , Rozzano MI, Italy
| | - C Specchia
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
| | - P.E Levi-Setti
- Humanitas Research Hospital- IRCCS, Department of Gynecology- Division of Gynecology and Reproductive Medicine- Fertility Center , Rozzano MI, Italy
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Setti PEL, Cirillo F, Immediata V, Morenghi E, Canevisio V, Ronchetti C, Baggiani A, Albani E, Patrizio P. First trimester pregnancy outcomes in a large IVF center from the Lombardy County (Italy) during the peak COVID-19 pandemic. Sci Rep 2021; 11:16529. [PMID: 34400730 PMCID: PMC8368203 DOI: 10.1038/s41598-021-96134-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/05/2021] [Indexed: 01/02/2023] Open
Abstract
At the beginning of 2020, the Italian Lombardy region was hit by an "epidemic tsunami" which was, at that point in time, one of the worst pandemics ever. At that moment the effects of SARS-COV 2 were still unknown. To evaluate whether the pandemic has influenced ART (Assisted Reproduction Techniques) outcomes in an asymptomatic infertile population treated at one of the major COVID-19 epicentres during the weeks immediately preceding lockdown. All ART procedures performed during two time periods were compared: November 1st, 2018 to February 28th, 2019 (non-COVID-19 risk) and November 1st, 2019 to February 29th, 2020 (COVID-19 risk). In total 1749 fresh cycles (883 non-COVID-19 risk and 866 COVID-19 risk) and1166 embryos and 63 oocytes warming cycles (538 and 37 during non-COVID and 628 and 26 during COVID-19 risk, respectively) were analysed. Clinical pregnancies per cycle were not different: 370 (25.38%) in non-COVID versus 415 (27.30%) (p = 0.237) during COVID-19 risk. There were no differences in biochemical pregnancy rates 52 (3.57%) versus 38 (2.50%) (p = 0.089) nor in ectopic pregnancies 4 (1.08%) versus 3 (0.72%) (p = 0.594), spontaneous miscarriages 84 (22.70%) versus 103 (24.82%) p = 0.487, nor in intrauterine ongoing pregnancies 282 (76.22%) versus 309 (74.46%) p = 0.569. A multivariate analysis investigating differences in spontaneous miscarriage rate showed no differences between the two timeframes. Our results support no differences in asymptomatic infertile couples' ART outcomes between the pre COVID and COVID-19 periods in one of the earliest and most severe pandemic areas.
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Affiliation(s)
- P E Levi- Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
| | - F Cirillo
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - V Immediata
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - E Morenghi
- Biostatistics Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy
| | - V Canevisio
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - C Ronchetti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - A Baggiani
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - E Albani
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - P Patrizio
- Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Yale University, New Haven, CT, USA
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Levi Setti PE, Cirillo F, Morenghi E, Immediata V, Caccavari V, Baggiani A, Albani E, Patrizio P. One step further: randomised single-centre trial comparing the direct and afterload techniques of embryo transfer. Hum Reprod 2021; 36:2484-2492. [PMID: 34323282 DOI: 10.1093/humrep/deab178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What are the differences in ease of use between two different embryo transfer (ET) techniques: the preload direct approach and the afterload approach. SUMMARY ANSWER The afterload technique seems to reduce the rate of difficult ETs. WHAT IS KNOWN ALREADY Numerous published trials now document that the ET procedure has an impact on pregnancy and delivery rates after IVF. Difficult transfers should be avoided, as they reduce implantation and pregnancy rates. Preload direct ETs with soft catheters under ultrasound guidance is currently considered the best procedure. However, when using soft catheters, it is not known which technique is preferable or which one should be implemented to reduce the operator factor. STUDY DESIGN, SIZE, DURATION This prospective randomised unblinded controlled clinical trial, included 352 ultrasound-guided ETs assigned to either direct ET or afterload ET, between September 2017 and March 2019. The sample size was calculated based on the historical rate of difficult ETs encountered between 2014 and 2015 with a direct ET procedure. PARTICIPANTS/MATERIALS, SETTING, METHODS The inclusion criteria were women 18-38 years old, with BMI between 18 and 28, receiving a single-thawed blastocyst transfer. The exclusion criteria were use of testicular sperm and preimplantation genetic testing (PGT) cycles. The primary outcome was the rate of difficult or suboptimal transfers defined as: advancement of the outer sheath (specific for the direct transfer), multiple attempts, use of force, required manipulation, use of a stylet or tenaculum, dilatation, or use of a different catheter. The secondary outcome was clinical pregnancy rate. MAIN RESULTS AND THE ROLE OF CHANCE A total of 352 frozen ETs were randomised, with 176 patients in each group. The two arms were homogeneous for female and male age, female BMI, duration of infertility, secondary infertility, previous deliveries or miscarriages, myomas, previous surgery to the uterine cavity, cycle day at ovulation trigger, freeze all cycles, first transfers, indication for treatment, endometrial preparation protocol and duration, endometrial thickness, and blastocyst grade at vitrification. Across the entire population, 85 (24.1%) ETs were defined as difficult. The rate of difficult transfers was significantly higher in the direct ET group than in the afterload group: 68 (38.6%) versus 17 (9.7%), respectively (OR 0.17, 95% CI 0.09-0.30, P < 0.001). The mean percentage in the rate of difficult transfers per operator was 22.5% (SD ± 14.5%), of which 36.1% (SD ± 23.4%) were in the direct group compared with 8.6% (± 8.2%) in the afterload group (P < 0.001). The difficult transfer rate among operators varied from 0 to 43.8% (0-77.8% in the direct group and 0 to 25.0% in the afterload group). The clinical pregnancy rates (42.0% vs 48.3%, P = 0.239 in the direct and afterload groups, respectively) were not significantly different between the groups. LIMITATIONS, REASONS FOR CAUTION There were 18 experienced operators who participated in the trial. Conclusions about the pregnancy rate should not be generalised, since the sample analysis was not performed on this outcome and, although clinically relevant, the difference was not significantly different. WIDER IMPLICATIONS OF THE FINDINGS The rate of difficult transfers was significantly higher in the direct ET group compared with the afterload ET group, although a wide variation was observed among operators. Further studies regarding the association between transfer technique and ART outcomes are required. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was sought and there are no competing interests. TRIAL REGISTRATION NUMBER NCT03161119. TRIAL REGISTRATION DATE 5 April 2017. DATE OF FIRST PATIENT'S ENROLMENT 26 September 2017.
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Affiliation(s)
- P E Levi Setti
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy.,Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - F Cirillo
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - E Morenghi
- Biostatistics Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - V Immediata
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - V Caccavari
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy.,Division of Assisted Reproduction, Department of Gynecology, Istituto Clinico Città Studi, Milano, Italy
| | - A Baggiani
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - E Albani
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - P Patrizio
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA
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Milli C, Molinari L, Giannetti I, Frassi D, Totaro M, Pagliantini S, Luchini G, Briani S, Baggiani A. [Digitization and Virtual Healthcare in a teaching hospital (Pisa, Italy) during COVID-19 emergency]. Ig Sanita Pubbl 2021; 77:509-517. [PMID: 34342600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on tele-triage, tele-consultation and tele-visits procedures. This led, in the following months, the integration of virtual healthcare services applicable to the Azienda Ospedaliero Universitaria Pisa (AOUP). In particular, BCure system represents an important technological investment for the remote management of care protocols and the analysis of the complete use of health services. This is a unique system for sharing information between specialists, general practitioners and patients.
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Affiliation(s)
- C Milli
- Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa)
| | - L Molinari
- Ente di Supporto Tecnico-Amministrativo Regionale della Toscana (ESTAR, Pisa)
| | - I Giannetti
- Ente di Supporto Tecnico-Amministrativo Regionale della Toscana (ESTAR, Pisa)
| | - D Frassi
- Ente di Supporto Tecnico-Amministrativo Regionale della Toscana (ESTAR, Pisa)
| | - M Totaro
- Dipartimento di Ricerca Traslazionale e delle Nuova Tecnologie in Medicina e Chirurgia, Università di Pisa
| | - S Pagliantini
- Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa)
| | - G Luchini
- Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa)
| | - S Briani
- Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa)
| | - A Baggiani
- Azienda Ospedaliero Universitaria Pisana (AOUP, Pisa) Dipartimento di Ricerca Traslazionale e delle Nuova Tecnologie in Medicina e Chirurgia, Università di Pisa
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Cirillo F, Patrizio P, Baccini M, Morenghi E, Ronchetti C, Cafaro L, Zannoni E, Baggiani A, Levi-Setti PE. The human factor: does the operator performing the embryo transfer significantly impact the cycle outcome? Hum Reprod 2021; 35:275-282. [PMID: 32100020 PMCID: PMC7048715 DOI: 10.1093/humrep/dez290] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/02/2019] [Indexed: 11/17/2022] Open
Abstract
STUDY QUESTION Is Ongoing Pregnancy Rate (OPR) operator-dependent, and can experience improve embryo transfer efficiency? SUMMARY ANSWER OPR is influenced by the operators who perform the embryo transfer (ET), and experience does not assure proficiency for everyone. WHAT IS KNOWN ALREADY ET remains the critical step in assisted reproduction. Although many other factors such as embryo quality and uterine receptivity impact embryo implantation, the proper ET technique is clearly an operator-dependent variable and as such it should be objectively standardized. STUDY DESIGN, SIZE, DURATION Retrospective comparative analysis including all fresh ETs performed between January 1996 and December 2016 at the Humanitas Fertility Center after IVF—ICSI cycles. PARTICIPANTS/MATERIALS, SETTING, METHODS IVF/ICSI fresh ETs performed by 32 operators, 19 824 cycles in all, were analyzed. All transfers consisting of freehand insertion of a preloaded soft catheter into the uterine cavity under transabdominal ultrasound guidance were considered. Two different statistical analyses were performed. First, a logistic regression model with a random intercept for the operator was used to estimate the heterogeneity of the rate of success among operators, accounting for woman age, FSH, number of oocytes retrieved, fertilization rate, year of the procedure, number and stage of transferred embryos and operator’s experience. Second, the relationship between experience and pregnancy rate was estimated separately for each operator by logistic regression, and operator-specific results were combined and compared in a random-effects meta-analysis. In both analyses, the operator’s experience at time t was measured in terms of number of embryo transfers performed before t. MAIN RESULTS AND THE ROLE OF CHANCE The heterogeneity among operators was highly significant (P value <0.001) and explained 44.5% of the total variability. The odds ratio of success of the worst operator in respect to the mean was equal to 0.84. For the best operator, the odds ratio of success was equal to 1.13 in respect to the mean. Based on the meta-analysis of the relationship between operator’s experience and success rate, it resulted that, on average, the operators’ performance did not improve with additional transfers. LIMITATIONS, REASONS FOR CAUTION At our center, operators become independent for ET’s after performing between 30 and 50 transfers under supervision. It is also possible that other relevant factors, such as embryologists on duty for the ET, have not been included in the present analysis and this may represent a potential bias. Among these, it should be mentioned that the embryologists on duty for the ET were not taken into consideration. WIDER IMPLICATIONS OF THE FINDINGS Continued performance analysis and the use of a digital simulator could help operators to test their expertise over time and either correct poor performance or avoid doing transfers. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER NCT03561129.
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Affiliation(s)
- F Cirillo
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - P Patrizio
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CO 06520, USA
| | - M Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, 50134 Florence, Italic
| | - E Morenghi
- Biostatistics Unit, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - C Ronchetti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - L Cafaro
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - E Zannoni
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - A Baggiani
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - P E Levi-Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy
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Porfido E, Giuliani P, Dell'Acqua M, Passaretta M, Rabbufetti G, Salzillo A, Gelmi R, Tagliasacchi R, Francioli M, Colombai R, Totaro M, Baggiani A. [Skills tracing and activation of multi-professional teams in response to COVID-19 pandemic]. Ig Sanita Pubbl 2021; 77:447-458. [PMID: 34314406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The rapid spread of Covid-19 epidemic led to a change in the organizational strategies of all Italian healthcare facilities. From January 31, 2020 (starting date of the state of national health emergency) Asst Valle Olona has prepared a reorganization of the supply units passing from a traditional division system to a structure that foresees the presence of traditional wards and a set of areas dedicated exclusively to the of Covid 19 treatments.The study aims to represent the method used for the redistribution of human capital in the new areas for identified, mapped, evaluated and reordered skills. The method may guarantee assistance to Covid-19 patients with the greatest number of human resources available and adequately trained.
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Affiliation(s)
| | | | | | | | | | | | - R Gelmi
- ASST Valle Olona - Lombardia
| | | | - M Francioli
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum - Università di Bologna, Italia
| | - R Colombai
- Azienda Ospedaliero Universitaria Meyer (Firenze)
| | - M Totaro
- Dipartimento di Ricerca Traslazionale e delle Nuova Tecnologie in Medicina e Chirurgia, Università di Pisa
| | - A Baggiani
- Dipartimento di Ricerca Traslazionale e delle Nuova Tecnologie in Medicina e Chirurgia, Università di Pisa
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Tuvo B, Cristina ML, Spagnolo AM, Totaro M, Baggiani A, Privitera G, Casini B. Microbiological surveillance in reducing potential infection risk. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Failure in reprocessing of endoscopes has been reported as one of the top ten most important threats to patient health.
Materials/Methods
The study was conducted in two digestive endoscopy centres of a teaching hospital (29,000 endoscopies/year, of which 550 endoscopic retrograde cholangiopancreatography (ERCP). Following two cases of bacteremia due to KPC-producing Klebsiella pneumoniae temporally related to ERCP and 89% of non-compliance detected on endoscopes subjected to microbiological surveillance, the reprocessing activities were audited and implemented to ensure guideline compliance. Clinical and microbiological surveillance were reinforced and all responsibilities for each phase identified according to UNI/TR11662. Microbiological surveillance was performed according to the 'Duodenoscope Surveillance Sampling and Culturing Protocols' protocol, CDC, 2018.
Results
In the 11 months of surveillance, 47 endoscopes were sampled (13 colonoscopes, 9 gastroscopes, 23 duodenoscopes and 2 echoendoscopes), 19 washer-disinfector machines and 9 medical cabinets. 36% (17/47) of endoscope internal channels resulted non-compliant, 17% (4/23) in duodenoscopes. NDM-producing K. pneumoniae was isolated in 2 gastroscopes always associated with the use on a colonized patient. The inlet and final rinsing water of washer-disinfectors and medical cabinets resulted always conformed. Non-conformities were managed immediately in order to avoid infectious risks for patients.
Conclusions
Microbiological surveillance of endoscopes after reprocessing allowed to prevent infections in patients undergoing endoscopic procedures.
Key messages
Training of health workers followed by strict adherence to guidelines is the most appropriate tool in preventing and controlling infections related to the use of endoscopes. Endoscopy and reprocessing staff should follow a formal recognized endoscopy reprocessing training program, followed by regular practice and periodically updated training to maintain competency.
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Affiliation(s)
- B Tuvo
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - A M Spagnolo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Totaro
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research, University of Pisa, Pisa, Italy
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9
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Casini B, Tuvo B, Totaro M, Baggiani A, Privitera G. Surveillance and control of M. chimaera infections in the Tuscany Region, Italy. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Disseminated M. chimaera infections among patients who underwent open-chest surgery with cardiopulmonary bypass have been associated with the contamination of heater-cooler devices (HCDs). The Tuscany region in the Decree 3822/2019 issued recommendations for the surveillance and control of M. chimaera infections.
Methods
In three Tuscan cardiac surgery centers, the case finding was carried out through evaluation and testing of patients with a history of HCD exposure (past 6 years) was performed. Water and aerosol samples were analyzed from each HCDs to determine the microbiological parameters required by the Directive 98/83/CE and to assess the presence of non-tuberculous mycobacteria (NTMs), according to the regional protocol.
Results
M. chimaera infection was not found in any patient and all clinical specimens tested negative. 22 HCDs were sampled (n.12 LivaNova, n.1 Terumo and n.9 Maquet) for a total of 114 samples (45, 8, 2 and 59 respectively). All the microbiological parameters were compliant, excepted for total microbial count at 36 °C that exceeded 100 CFU/ml in 50% (57/114) of samples and for the presence of P.aeruginosa in 10% (12/114). NTMs were detected in 16% (18/114) of HCDs: M. chimaera was identified in 11% (13/114) of samples and in 4% (5/114) M. gordonae. All aerosol samples were negative for NTMs, but in the HCDs Maquet, B.cereus were detected in 7% (4/59) of the samples, K.oxytoca in 2% (1/59), B.ursincola in 2% (1/59) and S. paucimobilis in 3% (2/59). Only S. paucimobilis was isolated also in the same HCD water sample.
Conclusions
The implementation of maintenance and disinfection procedures of HCDs was able to reduce the risk of contamination and aerosolization by NTMs but not of other microorganisms.
Key messages
Further strategies should be put in place for the cases finding. Moreover, reliable decontamination and identification of agents that can disrupt biofilms and increase chlorine susceptibility of mycobacteria are required.
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Affiliation(s)
- B Casini
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - B Tuvo
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - M Totaro
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - A Baggiani
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - G Privitera
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
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10
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Montagna MT, Mascipinto S, Pousis C, Bianchi FP, Caggiano G, Carpagnano LF, De Giglio O, Barbuti G, Auxilia F, Destrebecq A, Castaldi S, Baldovin T, Bargellini A, Righi E, Boccia G, Santoro E, Casini B, Baggiani A, Novati R, Oriani R, Odone A, Mezzoiuso AG, Orsi GB, Napoli C, Pasquarella C, Veronesi L, Ripabelli G, Sammarco ML, Rossini A, Squeri R, Laganà P, Antonuccio GM, Genovese C, Tardivo S, Torre I, Alfano R, Pennino F, Torregrossa MV, Barchitta M, Agodi A. Knowledge, experiences, and attitudes toward Mantoux test among medical and health professional students in Italy: a cross-sectional study. Ann Ig 2019; 30:86-98. [PMID: 30374514 DOI: 10.7416/ai.2018.2253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The World Health Organization's Action Framework for tuberculosis elimination in low-tuberculosis incidence countries includes the screening for active and latent tuberculosis in selected high-risk groups, including health care workers. In this context, medical and health profession students, exposed to nosocomial tuberculosis transmission during training and clinical rotations, are target populations for tuberculosis screening. No updated data are available on tuberculosis screening practice and knowledge of medical and health profession students in Italy. METHODS Within the activities Italian Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health, we carried out a multicentre cross-sectional study to assess knowledge, attitude and practices on tuberculosis prevention and control among Medical, Dentistry, Nursing and other health professions' students. Students were enrolled in the study on a voluntary basis and were administered a previously piloted structured questionnaire. Logistic regression models were applied to explore knowledge on tuberculosis prevention by selected socio-demographic variables and University-based tuberculosis prevention practice. RESULTS Students of seventeen Universities across Italy participated in the study, and 58.2% of them received compulsory tuberculin skin test either at enrollment or while attending clinical practice. A total of 5,209 students filled the questionnaire. 37.7% were medicine and dentistry students (Group 1), 44.9% were nursing students (Group 2) and 17.4% were other health professions' students (Group 3). Age and gender had different distributions by groups, as well as knowledge and practice on tuberculin skin test. 84.4% of the study population (95% CI = 83.3-85.3) was aware of the existence of the tuberculin skin test, 74.4% (95% CI = 73.2-75.6) knew what is the first-level screening test for latent tuberculosis and only 22.5% (95% CI = 21.4-23.6) knew how to proceed after a positive tuberculin skin test result. Overall, knowledge on tuberculosis prevention was higher in Group 2 and lower Group 3, as compared to Group 1. CONCLUSION In Italy, the knowledge on tuberculosis screening among University students is generally good. To reduce some of the criticalities found among the different study courses, it would be appropriate to harmonize both the regulations on tuberculosis screening practices for admission to University courses, and the educational activities on the topic of tuberculosis, to be extended to all workers involved in health care setting.
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Affiliation(s)
- M T Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - S Mascipinto
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - C Pousis
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - F P Bianchi
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - G Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - L F Carpagnano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - O De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - G Barbuti
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - A Destrebecq
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - S Castaldi
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - T Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Hygiene and Public Health Unit, Padova, Italy
| | - A Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - E Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Boccia
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - E Santoro
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - B Casini
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Pisa, Italy
| | - R Novati
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - R Oriani
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - A Odone
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, Milan, Italy
| | - A G Mezzoiuso
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, Milan, Italy
| | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - M L Sammarco
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Rossini
- Fondazione Santa Lucia, Institute for Research and Health Care, IRCCS, University of Tor Vergata, Rome, Italy
| | - R Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - P Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - G M Antonuccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - C Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - S Tardivo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - I Torre
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - R Alfano
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - F Pennino
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
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11
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Totaro M, De Vita E, Mariotti T, Bisordi C, Giorgi S, Gallo A, Costa AL, Casini B, Valentini P, Privitera G, Baggiani A. Cost analysis for electron time-flow taps and point of use filters: a comparison of two methods for Legionnaires' disease prevention in hospital water networks. J Hosp Infect 2019; 103:231-232. [PMID: 31310790 DOI: 10.1016/j.jhin.2019.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - E De Vita
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - T Mariotti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - C Bisordi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Gallo
- Division of Public Health and Nutrition, Area of Pisa, Azienda USL Toscana Nord Ovest, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
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12
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Totaro M, Avella M, Giorgi S, Casini B, Tulipani A, Costa AL, Frendo L, Valentini P, Lopalco PL, Privitera G, Baggiani A. Survey on Energy Drinks consumption and related lifestyle among students of two Italian high schools. Ann Ig 2019; 30:509-516. [PMID: 30614500 DOI: 10.7416/ai.2018.2251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of side effects linked to energy drinks (EDs) consumption by young people. EDs consumption has been evaluated in a sample of students in Italy together with some aspects of their lifestyle. METHODS The survey was performed in two high schools from September 2016 to June 2017. 583 students between 14 to 18 years were recruited and a standard questionnaire (EFSA checklist) was used to collect information on responders characteristics, beverages consumption, EDs with alcohol, and EDs and sports. RESULTS Despite 350 out of 583 responders (60%) consumed EDs, only 146 out of 583 (25%) were EDs-alcohol consumers. Moreover, 208 out of 379 (55%) of all physically active adolescents reported frequent EDs consumption before sport trainings. CONCLUSIONS Study results highlight the need for primary prevention measures in communication campaigns and training delivered by school to limit potential health threats related to excess of EDs consumption.
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Affiliation(s)
- M Totaro
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - M Avella
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - S Giorgi
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - B Casini
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A Tulipani
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A L Costa
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - L Frendo
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - P Valentini
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - P L Lopalco
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - G Privitera
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A Baggiani
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
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Filippetti E, Baggiani A, Privitera G, Lopalco PL. Teaching children hygiene principles using a tailored version of e-Bug. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Filippetti
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - A Baggiani
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - G Privitera
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - PL Lopalco
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
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14
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Cirillo F, Patrizio P, Leggieri C, Canevisio V, De Cesare R, Bruno G, Baggiani A, Levi-Setti P. Frozen-thawed embryo transfers: a comparison between natural vs HCG-primed cycles. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Totaro M, Porretta A, Canale A, Filippetti E, Tulipani A, Quattrone F, Giorgi S, Costa AL, Valentini P, Casini B, Privitera G, Baggiani A. Preliminary study of the air quality in operating rooms: do textiles have a role? J Hosp Infect 2018; 99:306-308. [PMID: 29674114 DOI: 10.1016/j.jhin.2018.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/10/2018] [Indexed: 11/15/2022]
Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Canale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - E Filippetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Tulipani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Quattrone
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
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16
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Casini B, Baggiani A, Totaro M, Mansi A, Costa AL, Aquino F, Miccoli M, Valentini P, Bruschi F, Lopalco PL, Privitera G. Detection of viable but non-culturable legionella in hospital water network following monochloramine disinfection. J Hosp Infect 2017; 98:46-52. [PMID: 28917570 DOI: 10.1016/j.jhin.2017.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Prevention of legionellosis remains a critical issue in healthcare settings where monochloramine (MC) disinfection was recently introduced as an alternative to chlorine dioxide in controlling Legionella spp. contamination of the hospital water network. Continuous treatments with low MC doses in some instances have induced a viable but non-culturable state (VBNC) of Legionella spp. AIM To investigate the occurrence of such dormant cells during a long period of continuous MC treatment. METHODS Between November 2010 and April 2015, 162 water and biofilm samples were collected and Legionella spp. isolated in accordance with standard procedures. In sampling sites where MC was <1.5mg/L, VBNC cells were investigated by ethidium monoazide bromide (EMA)-real-time polymerase chain reaction (qPCR) and 'resuscitation' test into Acanthamoeba polyphaga CCAP 1501/18. According to the Health Protection Agency protocol, free-living protozoa were researched in 60 five-litre water samples. FINDINGS In all, 136 out of 156 (87.2%) of the samples taken from sites previously positive for L. pneumophila ST269 were negative by culture, but only 47 (34.5%) negative by qPCR. Although no positive results were obtained by EMA-qPCR, four out of 22 samples associated with MC concentration of 1.3 ± 0.5mg/L showed VBNC legionella resuscitation. The presence of the amoeba A. polyphaga in the hospital water network was demonstrated. CONCLUSION Our study is the first report evidencing the emergence of VNBC legionella during a long period of continuous MC treatment of a hospital water network, highlighting the importance of keeping an appropriate and uninterrupted MC dosage to ensure the control of legionella colonization in hospital water supplies.
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Affiliation(s)
- B Casini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy.
| | - A Baggiani
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M Totaro
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A Mansi
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone (Roma), Roma, Italy
| | - A L Costa
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - F Aquino
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - F Bruschi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P L Lopalco
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
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17
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Totaro M, Valentini P, Costa AL, Giorgi S, Casini B, Baggiani A. Rate of Legionella pneumophila colonization in hospital hot water network after time flow taps installation. J Hosp Infect 2017; 98:60-63. [PMID: 28890285 DOI: 10.1016/j.jhin.2017.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/30/2017] [Indexed: 11/17/2022]
Abstract
In hospital water systems legionellae may be resistant to disinfectants in pipework, which is a problem particularly in areas where there is low flow or stagnation of water. We evaluated legionella colonization of a water network of an Italian hospital after time flow taps (TFTs) installation in proximity to dead legs. The water volume flushed was 64 L/day from May 2016, and 192 L/day from December 2016. Before TFTs installation, Legionella pneumophila sg2-14 was detected in all points (4 × 104 ± 3.1 × 104 cfu/L). All sites remained positive (2.9 × 104 ± 1.9 × 104 cfu/L) through November 2016. From December 2016 legionella persisted in one point only (2 × 102 to 6.8 × 103 cfu/L). TFTs with chemical disinfection may reduce legionella colonization associated with dead legs.
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Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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18
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Totaro M, Casini B, Valentini P, Miccoli M, Giorgi S, Porretta A, Privitera G, Lopalco PL, Baggiani A. Evaluation and control of microbial and chemical contamination in dialysis water plants of Italian nephrology wards. J Hosp Infect 2017; 97:169-174. [PMID: 28546028 DOI: 10.1016/j.jhin.2017.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/16/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients receiving haemodialysis are exposed to a large volume of dialysis fluid. The Italian Society of Nephrology (ISN) has published guidelines and microbial quality standards on dialysis water (DW) and solutions to ensure patient safety. AIM To identify microbial and chemical hazards, and evaluate the quality of disinfection treatment in DW plants. METHODS In 2015 and 2016, water networks and DW plants (closed loop and online monitors) of nine dialysis wards of Italian hospitals, hosting 162 dialysis beds overall, were sampled on a monthly basis to determine the parameters provided by ISN guidelines. Chlorinated drinking water was desalinated by reverse osmosis and distributed to the closed loop which feeds all online monitors. Disinfection with peracetic acid was performed in all DW plants on a monthly basis. FINDINGS Over the 24-month study period, seven out of nine DW plants (78%) recorded negative results for all investigated parameters. Closed loop contamination with Burkholderia cepacia was detected in a DW plant from January 2015 to March 2015. Pseudomonas aeruginosa was isolated from March 2016 to May 2016 in the closed loop of another DW plant. These microbial contaminations were eradicated by shock disinfection with sodium hypochlorite and peracetic acid, followed by water flushing. CONCLUSION These results highlight the importance of chemical and physical methods of DW disinfection. The maintenance of control measures in water plants hosted in dialysis wards ensures a microbial risk reduction for all dialysis patients.
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Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P L Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Totaro M, Valentini P, Casini B, Miccoli M, Costa AL, Baggiani A. Experimental comparison of point-of-use filters for drinking water ultrafiltration. J Hosp Infect 2016; 96:172-176. [PMID: 28073586 DOI: 10.1016/j.jhin.2016.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/26/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Waterborne pathogens such as Pseudomonas spp. and Legionella spp. may persist in hospital water networks despite chemical disinfection. Point-of-use filtration represents a physical control measure that can be applied in high-risk areas to contain the exposure to such pathogens. New technologies have enabled an extension of filters' lifetimes and have made available faucet hollow-fibre filters for water ultrafiltration. AIM To compare point-of-use filters applied to cold water within their period of validity. METHODS Faucet hollow-fibre filters (filter A), shower hollow-fibre filters (filter B) and faucet membrane filters (filter C) were contaminated in two different sets of tests with standard bacterial strains (Pseudomonas aeruginosa DSM 939 and Brevundimonas diminuta ATCC 19146) and installed at points-of-use. Every day, from each faucet, 100 L of water was flushed. Before and after flushing, 250 mL of water was collected and analysed for microbiology. FINDINGS There was a high capacity of microbial retention from filter C; filter B released only low Brevundimonas spp. counts; filter A showed poor retention of both micro-organisms. CONCLUSION Hollow-fibre filters did not show good micro-organism retention. All point-of-use filters require an appropriate maintenance of structural parameters to ensure their efficiency.
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Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Casini B, Selvi C, Cristina ML, Totaro M, Costa AL, Valentini P, Barnini S, Baggiani A, Tagliaferri E, Privitera G. Evaluation of a modified cleaning procedure in the prevention of carbapenem-resistant Acinetobacter baumannii clonal spread in a burn intensive care unit using a high-sensitivity luminometer. J Hosp Infect 2016; 95:46-52. [PMID: 27939245 DOI: 10.1016/j.jhin.2016.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Enhanced environmental cleaning practices are among the most accepted measures for controlling the spread of carbapenem-resistant Acinetobacter baumannii (CR-Ab). AIM To evaluate the impact of heightened cleaning on an ongoing CR-Ab outbreak in a burn intensive care unit (BICU) of an Italian teaching hospital, where chlorhexidine-60% isopropyl alcohol was applied as a complementary disinfectant on high-touch surfaces. METHODS Compliance with the microbial limit proposed for the BICU by AFNOR-NF-S90-351 (20 colony-forming units/100cm2) was assessed by plate count, and compared with the results obtained with intracellular adenosine triphosphate (ATP) detection. Genotyping was performed using pulsed-field gel electrophoresis. FINDINGS During the standard cleaning regimen, three out of 23 samples (13%) gave results over the AFNOR limit and five (21.7%) showed unacceptable ATP levels with 100 relative light units/100cm2 as the benchmark limit (sensibility 86.4%, specificity 92.2%). Following improvement of the cleaning procedure, only two samples out of 50 (4%) did not satisfy the microbiological criteria and seven (14%) exceeded the ATP limit. In a successive phase, eight of 30 samples collected showed unacceptable results (27%). CONCLUSIONS Adding chlorhexidine-60% isopropyl alcohol as complementary disinfectant proved to be effective for reducing environmental microbial contamination, ATP levels and CR-Ab infection/colonization in patients admitted to the BICU. Real-time monitoring by ATP assay was useful for managing the cleaning schedule and reducing hospital infections, although the calculated values must be interpreted as cleanliness indicators rather than risk indicators.
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Affiliation(s)
- B Casini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy.
| | - C Selvi
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Totaro
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A L Costa
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - S Barnini
- Unit of Microbiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - E Tagliaferri
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
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Totaro M, Casini B, Costa AL, Valentini P, Petretti F, Giorgi S, Frendo L, Miccoli M, Privitera G, Baggiani A. Evaluation of the relationship between consumers and food labels in Tuscany (Italy). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Casini B, Zezza L, Totaro M, Giorgi S, Righi A, Bianchi G, Marini L, Valentini P, Tagliaferri E, Tascini C, Baggiani A, Privitera G. Risk of transmission of KPC-producing Klebsiella pneumoniae in digestive endoscopy. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Baggiani A, Casini B, Totaro M, Aquino F, Valentini P, Bruni B, Porretta A, Casalini F, Miccoli M, Privitera G. Colonization by Legionella spp. of water networks in residential buildings of the Province of Pisa, Italy. Ann Ig 2015; 27:718-25. [PMID: 26661913 DOI: 10.7416/ai.2015.2064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Despite the increase of community acquired cases of legionellosis in Italy over the last years, the Italian guidelines do not give indications for prevention and control of Legionella in the hot water networks (or centralized conditioning systems) of residential buildings. We performed a survey on eight medium sized apartment buildings in the Pisa district to assess the prevalence of Legionella spp. in the water network and the respondance to drinking water requisites at the point of use, according to the Italian norms. METHODS For each building two hot water and three cold water samples (located at water entrance from the aqueduct network into the building pipework, at the exit from pressure autoclave, and at a remote tap) were collected. RESULTS Legionella was detected in 20% of residential buildings, mostly in those with a central hot water production system. CONCLUSIONS The study highlights a condition of potential risk for susceptible population subgroups and supports the need for measures of risk assessment and control.
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Affiliation(s)
- A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Aquino
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Bruni
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Casalini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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Totaro M, Carnesecchi E, Valentini P, Porretta A, Bruni B, Privitera G, Casini B, Baggiani A. Presence of Legionella in water networks of italian residential buildings. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Casini B, Carnesecchi E, Totaro M, Privitera G, Baggiani A. Diffusion model applied to assessment of children health impact. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nisi M, La Ferla F, Karapetsa D, Gennai S, Miccoli M, Baggiani A, Graziani F, Gabriele M. Risk factors influencing BRONJ staging in patients receiving intravenous bisphosphonates: a multivariate analysis. Int J Oral Maxillofac Surg 2015; 44:586-91. [DOI: 10.1016/j.ijom.2015.01.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/10/2014] [Accepted: 01/19/2015] [Indexed: 01/23/2023]
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Marino M, Azzali F, Zanini R. The certification of Hospital Delivery Ward: the Italian Project to ensure Quality and Safety for Patients and Professionals. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Marino
- Department of Hygiene and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Azzali
- Pro.Ge.A.: innovazione e cambiamento al servizio del management, Milano, Italy
| | - R Zanini
- Mother-and-child Department, Azienda Ospedaliera Provinciale di Lecco, Ospedale A.Manzoni, Lecco, Italy
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Levi Setti P, Smeraldi A, Baggiani A, Zannoni E, Morreale G, Albani E. Blastocyst artificial shrinkage improves pregnancy outome. retrospective analysis of 573 warming cycles. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gandhi G, Allahbadia G, Kagalwala S, Allahbadia A, Ramesh S, Patel K, Hinduja R, Chipkar V, Madne M, Ramani R, Joo JK, Jeung JE, Go KR, Lee KS, Goto H, Hashimoto S, Amo A, Yamochi T, Iwata H, Morimoto Y, Koifman M, Lahav-Baratz S, Blais E, Megnazi-Wiener Z, Ishai D, Auslender R, Dirnfeld M, Zaletova V, Zakharova E, Krivokharchenko I, Zaletov S, Zhu L, Li Y, Zhang H, Ai J, Jin L, Zhang X, Rajan N, Kovacs A, Foley C, Flanagan J, O'Callaghan J, Waterstone J, Dineen T, Dahdouh EM, St-Michel P, Granger L, Carranza-Mamane B, Faruqi F, Kattygnarath TV, Gomes FLAF, Christoforidis N, Ioakimidou C, Papas C, Moisidou M, Chatziparasidou A, Klaver M, Tilleman K, De Sutter P, Lammers J, Freour T, Splingart C, Barriere P, Ikeno T, Nakajyo Y, Sato Y, Hirata K, Kyoya T, Kyono K, Campos FB, Meseguer M, Nogales M, Martinez E, Ariza M, Agudo D, Rodrigo L, Garcia-Velasco JA, Lopes AS, Frederickx V, Vankerkhoven G, Serneels A, Roziers P, Puttermans P, Campo R, Gordts S, Fragouli E, Alfarawati S, Spath K, Wells D, Liss J, Lukaszuk K, Glowacka J, Bruszczynska A, Gallego SC, Lopez LO, Vila EO, Garcia MG, Canas CL, Segovia AG, Ponce AG, Calonge RN, Peregrin PC, Hashimoto S, Amo A, Ito K, Nakaoka Y, Morimoto Y, Alcoba DD, Valerio EG, Conzatti M, Tornquist J, Kussler AP, Pimentel AM, Corleta HE, Brum IS, Boyer P, Montjean D, Tourame P, Gervoise-Boyer M, Cohen J, Lefevre B, Radio CI, Wolf JP, Ziyyat A, De Croo I, Tolpe A, Degheselle S, Van de Velde A, Tilleman K, De Sutter P, Van den Abbeel E, Kagalwala S, Gandhi G, Allahbadia G, Kuwayama M, Allahbadia A, Chipkar V, Khatoon A, Ramani R, Madne M, Alsule S, Inaba M, Ohgaki A, Ohtani A, Matsumoto H, Mizuno S, Mori R, Fukuda A, Morimoto Y, Umekawa Y, Yoshida A, Tanigiwa S, Seida K, Suzuki H, Tanaka M, Vahabi Z, Yazdi PE, Dalman A, Ebrahimi B, Mostafaei F, Niknam MR, Watanabe S, Kamihata M, Tanaka T, Matsunaga R, Yamanaka N, Kani C, Ishikawa T, Wada T, Morita H, Miyamura H, Nishio E, Ito M, Kuwahata A, Ochi M, Horiuchi T, Dal Canto M, Guglielmo MC, Fadini R, Renzini MM, Albertini DF, Novara P, Lain M, Brambillasca F, Turchi D, Sottocornola M, Coticchio G, Kato M, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Hasegawa N, Nakayama K, Takeuchi M, Ohno H, Aoyagi N, Kojima E, Itoi F, Hashiba Y, Asada Y, Kikuchi H, Iwasa Y, Kamono T, Suzuki A, Yamada K, Kanno H, Sasaki K, Murakawa H, Matsubara M, Yoshida H, Valdespin C, Elhelaly M, Chen P, Pangestu M, Catt S, Hojnik N, Kovacic B, Roglic P, Taborin M, Zafosnik M, Knez J, Vlaisavljevic V, Mori C, Yabuuchi A, Ezoe K, Takayama Y, Aono F, Kato K, Radwan P, Krasinski R, Chorobik K, Radwan M, Stoppa M, Maggiulli R, Capalbo A, Ievoli E, Dovere L, Scarica C, Albricci L, Romano S, Sanges F, Barnocchi N, Papini L, Vivarelli A, Ubaldi FM, Rienzi L, Rienzi L, Bono S, Capalbo A, Spizzichino L, Rubio C, Ubaldi FM, Fiorentino F, Ferris J, Favetta LA, MacLusky N, King WA, Madani T, Jahangiri N, Aflatoonian R, Cater E, Hulme D, Berrisford K, Jenner L, Campbell A, Fishel S, Zhang XY, Yilmaz A, Hananel H, Ao A, Vutyavanich T, Piromlertamorn W, Saenganan U, Samchimchom S, Wirleitner B, Lejeune B, Zech NH, Vanderzwalmen P, Albani E, Parini V, Smeraldi A, Menduni F, Antonacci R, Marras A, Levi S, Morreale G, Pisano B, Di Biase A, Di Rosa A, Setti PEL, Puard V, Cadoret V, Tranchant T, Gauthier C, Reiter E, Guerif F, Royere D, Yoon SY, Eum JH, Park EA, Kim TY, Yoon TK, Lee DR, Lee WS, Cabal AC, Vallejo B, Campos P, Sanchez E, Serrano J, Remohi J, Nagornyy V, Mazur P, Mykytenko D, Semeniuk L, Zukin V, Guilherme P, Madaschi C, Bonetti TCS, Fassolas G, Izzo CR, Santos MJDL, Beltran D, Garcia-Laez V, Escriba MJ, Grau N, Escrich L, Albert C, Zuzuarregui JL, Pellicer A, LU Y, Nikiforaki D, Meerschaut FV, Neupane J, De Vos WH, Lierman S, Deroo T, Heindryckx B, De Sutter P, Li J, Chen XY, Lin G, Huang GN, Sun ZY, Zhong Y, Zhang B, Li T, Zhang SP, Ye H, Han SB, Liu SY, Zhou J, Lu GX, Zhuang GL, Muela L, Roldan M, Gadea B, Martinez M, Perez I, Meseguer M, Munoz M, Castello C, Asensio M, Fernandez P, Farreras A, Rovira S, Capdevila JM, Velilla E, Lopez-Teijon M, Kovacs P, Matyas SZ, Forgacs V, Reichart A, Rarosi F, Bernard A, Torok A, Kaali SG, Sajgo A, Pribenszky CS, Sozen B, Ozturk S, Yaba-Ucar A, Demir N, Gelo N, Stanic P, Hlavati V, ogoric S, Pavicic-Baldani D, prem-Goldtajn M, Radakovic B, Kasum M, Strelec M, Canic T, imunic V, Vrcic H, Ajina M, Negra D, Ben-Ali H, Jallad S, Zidi I, Meddeb S, Bibi M, Khairi H, Saad A, Escrich L, Grau N, Meseguer M, Gamiz P, Viloria T, Escriba MJ, Lima ET, Fernandez MP, Prieto JAA, Varela MO, Kassa D, Munoz EM, Morita H, Watanabe S, Kamihata M, Matsunaga R, Wada T, Kani K, Ishikawa T, Miyamura H, Ito M, Kuwahata A, Ochi M, Horiuchi T, Nor-Ashikin MNK, Norhazlin JMY, Norita S, Wan-Hafizah WJ, Mohd-Fazirul M, Razif D, Hoh BP, Dale S, Cater E, Woodhead G, Jenner L, Fishel S, Andronikou S, Francis G, Tailor S, Vourliotis M, Almeida PA, Krivega M, Van de Velde H, Lee RK, Hwu YM, Lu CH, Li SH, Vaiarelli A, Antonacci R, Smeraldi A, Desgro M, Albani E, Baggiani A, Zannoni E, Setti PEL, Kermavner LB, Klun IV, Pinter B, Vrtacnik-Bokal E, De Paepe C, Cauffman G, Verheyen G, Stoop D, Liebaers I, Van de Velde H, Stecher A, Wirleitner B, Vanderzwalmen P, Zintz M, Neyer A, Bach M, Baramsai B, Schwerda D, Zech NH, Wiener-Megnazi Z, Fridman M, Koifman M, Lahav-Baratz S, Blais I, Auslender R, Dirnfeld M, Akerud H, Lindgren K, Karehed K, Wanggren K, Hreinsson J, Rovira S, Capdevila JM, Freijomil B, Castello C, Farreras A, Fernandez P, Asensio M, Lopez-Teijon M, Velilla E, Weiss A, Neril R, Geslevich J, Beck-Fruchter R, Lavee M, Golan J, Ermoshkin A, Shalev E, Shi W, Zhang S, Zhao W, Xue XIA, Wang MIN, Bai H, Shi J, Smith HL, Shaw L, Kimber S, Brison D, Boumela I, Assou S, Haouzi D, Ahmed OA, Dechaud H, Hamamah S, Dasiman R, Nor-Shahida AR, Wan-Hafizah WJ, Norhazlin JMY, Mohd-Fazirul M, Salina O, Gabriele RAF, Nor-Ashikin MNK, Ben-Yosef D, Shwartz T, Cohen T, Carmon A, Raz NM, Malcov M, Frumkin T, Almog B, Vagman I, Kapustiansky R, Reches A, Azem F, Amit A, Cetinkaya M, Pirkevi C, Yelke H, Kumtepe Y, Atayurt Z, Kahraman S, Risco R, Hebles M, Saa AM, Vilches-Ferron MA, Sanchez-Martin P, Lucena E, Lucena M, Heras MDL, Agirregoikoa JA, Martinez E, Barrenetxea G, De Pablo JL, Lehner A, Pribenszky C, Murber A, Rigo J, Urbancsek J, Fancsovits P, Bano DG, Sanchez-Leon A, Marcos J, Molla M, Amorocho B, Nicolas M, Fernandez L, Landeras J, Adeniyi OA, Ehbish SM, Brison DR, Egashira A, Murakami M, Nagafuchi E, Tanaka K, Tomohara A, Mine C, Otsubo H, Nakashima A, Otsuka M, Yoshioka N, Kuramoto T, Choi D, Yang H, Park JH, Jung JH, Hwang HG, Lee JH, Lee JE, Kang AS, Yoo JH, Kwon HC, Lee SJ, Bang S, Shin H, Lim HJ, Min SH, Yeon JY, Koo DB, Kuwayama M, Higo S, Ruvalcaba L, Kobayashi M, Takeuchi T, Yoshida A, Miwa A, Nagai Y, Momma Y, Takahashi K, Chuko M, Nagai A, Otsuki J, Kim SG, Lee JH, Kim YY, Kim HJ, Park IH, Sun HG, Lee KH, Song HJ, Costa-Borges N, Belles M, Herreros J, Teruel J, Ballesteros A, Pellicer A, Calderon G, Nikiforaki D, Vossaert L, Meerschaut FV, Qian C, Lu Y, Parys JB, De Vos WH, Deforce D, Deroo T, Van den Abbeel E, Leybaert L, Heindryckx B, De Sutter P, Surlan L, Otasevic V, Velickovic K, Golic I, Vucetic M, Stankovic V, Stojnic J, Radunovic N, Tulic I, Korac B, Korac A, Fancsovits P, Pribenszky C, Lehner A, Murber A, Rigo J, Urbancsek J, Elias R, Neri QV, Fields T, Schlegel PN, Rosenwaks Z, Palermo GD, Gilson A, Piront N, Heens B, Vastersaegher C, Vansteenbrugge A, Pauwels PCP, Abdel-Raheem MF, Abdel-Rahman MY, Abdel-Gaffar HM, Sabry M, Kasem H, Rasheed SM, Amin M, Abdelmonem A, Ait-Allah AS, VerMilyea M, Anthony J, Bucci J, Croly S, Coutifaris C, Maggiulli R, Rienzi L, Cimadomo D, Capalbo A, Dusi L, Colamaria S, Baroni E, Giuliani M, Vaiarelli A, Sapienza F, Buffo L, Ubaldi FM, Zivi E, Aizenman E, Barash D, Gibson D, Shufaro Y, Perez M, Aguilar J, Taboas E, Ojeda M, Suarez L, Munoz E, Casciani V, Minasi MG, Scarselli F, Terribile M, Zavaglia D, Colasante A, Franco G, Greco E, Hickman C, Cook C, Gwinnett D, Trew G, Carby A, Lavery S, Asgari L, Paouneskou D, Jayaprakasan K, Maalouf W, Campbell BK, Aguilar J, Taboas E, Perez M, Munoz E, Ojeda M, Remohi J, Rega E, Alteri A, Cotarelo RP, Rubino P, Colicchia A, Giannini P, Devjak R, Papler TB, Tacer KF, Verdenik I, Scarica C, Ubaldi FM, Stoppa M, Maggiulli R, Capalbo A, Ievoli E, Dovere L, Albricci L, Romano S, Sanges F, Vaiarelli A, Iussig B, Gala A, Ferrieres A, Assou S, Vincens C, Bringer-Deutsch S, Brunet C, Hamamah S, Conaghan J, Tan L, Gvakharia M, Ivani K, Chen A, Pera RR, Bowman N, Montgomery S, Best L, Campbell A, Duffy S, Fishel S, Hirata R, Aoi Y, Habara T, Hayashi N, Dinopoulou V, Partsinevelos GA, Bletsa R, Mavrogianni D, Anagnostou E, Stefanidis K, Drakakis P, Loutradis D, Hernandez J, Leon CL, Puopolo M, Palumbo A, Atig F, Kerkeni A, Saad A, Ajina M, D'Ommar G, Herrera AK, Lozano L, Majerfeld M, Ye Z, Zaninovic N, Clarke R, Bodine R, Rosenwaks Z, Mazur P, Nagorny V, Mykytenko D, Semeniuk L, Zukin V, Zabala A, Pessino T, Outeda S, Blanco L, Leocata F, Asch R, Wan-Hafizah WJ, Rajikin MH, Nuraliza AS, Mohd-Fazirul M, Norhazlin JMY, Razif D, Nor-Ashikin MNK, Machac S, Hubinka V, Larman M, Koudelka M, Budak TP, Membrado OO, Martinez ES, Wilson P, McClure A, Nargund G, Raso D, Insua MF, Lotti B, Giordana S, Baldi C, Barattini J, Cogorno M, Peri NF, Neuspiller F, Resta S, Filannino A, Maggi E, Cafueri G, Ferraretti AP, Magli MC, Gianaroli L, Sioga A, Oikonomou Z, Chatzimeletiou K, Oikonomou L, Kolibianakis E, Tarlatzis BC, Sarkar MR, Ray D, Bhattacharya J, Alises JM, Gumbao D, Sanchez-Leon A, Amorocho B, Molla M, Nicolas M, Fernandez L, Landeras J, Duffy S, Campbell A, Montgomery S, Hickman CFL, Fishel S, Fiorentino I, Gualtieri R, Barbato V, Braun S, Mollo V, Netti P, Talevi R, Bayram A, Findikli N, Serdarogullari M, Sahin O, Ulug U, Tosun SB, Bahceci M, Leon AS, Gumbao D, Marcos J, Molla M, Amorocho B, Nicolas M, Fernandez L, Landeras J, Cardoso MCA, Aguiar APS, Sartorio C, Evangelista A, Gallo-Sa P, Erthal-Martins MC, Mantikou E, Jonker MJ, de Jong M, Wong KM, van Montfoort APA, Breit TM, Repping S, Mastenbroek S, Power E, Montgomery S, Duffy S, Jordan K, Campbell A, Fishel S, Findikli N, Aksoy T, Gultomruk M, Aktan A, Goktas C, Ulug U, Bahceci M, Petracco R, Okada L, Azambuja R, Badalotti F, Michelon J, Reig V, Kvitko D, Tagliani-Ribeiro A, Badalotti M, Petracco A, Pirkevi C, Cetinkaya M, Yelke H, Kumtepe Y, Atayurt Z, Kahraman S, Aydin B, Cepni I, Serdarogullari M, Findikli N, Bayram A, Goktas C, Sahin O, Ulug U, Bahceci M, Rodriguez-Arnedo D, Ten J, Guerrero J, Ochando I, Perez M, Bernabeu R, Okada L, Petracco R, Azambuja R, Badalotti F, Michelon J, Reig V, Tagliani-Ribeiro A, Kvitko D, Badalotti M, Petracco A, Reig V, Kvitko D, Tagliani-Ribeiro A, Okada L, Azambuja R, Petracco R, Michelon J, Badalotti F, Petracco A, Badalotti M. Embryology. Hum Reprod 2013. [DOI: 10.1093/humrep/det210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bindi ML, Miccoli M, Marietta M, Meacci L, Esposito M, Bisà M, Mozzo R, Mazzoni A, Baggiani A, Scatena F, Filipponi F, Biancofiore G. Solvent detergent vs. fresh frozen plasma in cirrhotic patients undergoing liver transplant surgery: a prospective randomized control study. Vox Sang 2013; 105:137-43. [DOI: 10.1111/vox.12021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 12/05/2012] [Accepted: 12/08/2012] [Indexed: 02/01/2023]
Affiliation(s)
- M. L. Bindi
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - M. Miccoli
- Biostatistic Research Unit; University of Pisa; Pisa; Italy
| | - M. Marietta
- Haemostasis and Thrombosis Unit; Department of Haematology and Oncology; Azienda Ospedaliera Universitaria Modena; Modena; Italy
| | - L. Meacci
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - M. Esposito
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - M. Bisà
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - R. Mozzo
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - A. Mazzoni
- Immunohematology Unit; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - A. Baggiani
- Biostatistic Research Unit; University of Pisa; Pisa; Italy
| | - F. Scatena
- Immunohematology Unit; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
| | - F. Filipponi
- Liver Transplant Unit; University School of Medicine; Pisa; Italy
| | - G. Biancofiore
- Liver Transplant Anaesthesia and Critical Care Medicine; Azienda Ospedaliera Universitaria Pisana; Pisa; Italy
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Foddis R, Iuzzolini M, Pantani E, Ferraro A, Baggiani A, Cristaudo A. [Study on the efficacy of personal protective equipment for skin against nicotine absorption through the skin route in tobacco workers]. G Ital Med Lav Ergon 2012; 34:150-152. [PMID: 23405605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
During a previous assessment on the efficacy of some recently installed general dust extraction systems in a tuscan cigar manufacture line, both environmental and biologic monitoring were performed. Although the analysis of environmental samples supported the efficacy of the new general protection implant, these data did not parallel the results from the biologic monitoring, suggesting that nicotine skin absorption needed to be further investigated. We, therefore, carried out a study aimed at evaluating the efficacy of three different kind of PPE for skin (two nitrile gloves of different thickness and one latex glove), to be used by tobacco workers. The results of this study showed that the performance of these three materials in stopping nicotine transfer through the gloves was significantly different. The 0.22 mm thick nicotine gloves resulted, by far, the best gloves in protecting the workers' skin against nicotine exposure.
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Affiliation(s)
- R Foddis
- Dipartimento di Endocrinologia e metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro - Università di Pisa, Pisa, Italy
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Foddis R, Bonotti A, Sderci F, Pistelli A, Pantani E, Franzini M, Paolicchi A, Baggiani A, Cristaudo A. [Preliminary study to evaluate the meaning of GGT fractions analysis in a population of workers previously exposed to asbestos]. G Ital Med Lav Ergon 2012; 34:565-567. [PMID: 23405717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The GGT enzyme, considered for years only as a marker of liver disease and alcohol abuse, has now revealed a risk of death for many causes. Through a molecular exclusion chromatography on FPLC system (Fast Protein Liquid Chromatography), it is possible to discriminate four fractions of GGT, defined according to the molecular weight: big-GGT, medium-GGT, small-GGT and free-GGT. The objective was to study the preventing meaning of GGT fractions for asbestos-related diseases. This study was conducted on 129 workers previously exposed to asbestos, 22 patients affected by Malignant Pleural Mesothelioma and 107 healthy workers. Our data demonstrated a statistical significant correlation between the fraction free-GGT with the presence of MPM, suggesting a possible role for this molecule as a biomarker for MPM diagnosis. However, being a preliminary study, further studies are warranted to confirm our results.
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Affiliation(s)
- R Foddis
- Dipartimento di Endocrinologia e metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro - Università di Pisa, via Paradisa 2, Pisa.
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Lu JH, Materazzi G, Miccoli M, Baggiani A, Hu S, Miccoli P. Minimally invasive video assisted thyroidectomy versus endoscopic thyroidectomy via the areola approach: a retrospective analysis of safety, postoperative recovery, and patient satisfaction. MINERVA CHIR 2012; 67:31-37. [PMID: 22361674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM Minimally invasive video-assisted thyroidectomy (MIVAT) and endoscopic thyroidectomy through areola (ETA) access are among the endoscopic approaches for thyroidectomy that have been perfected, but reports comparing the two are lacking. This study evaluated the safety, postoperative recovery, and patient satisfaction of MIVAT compared with ETA. METHODS This study included 119 patients undergoing MIVAT and 42 patients undergoing ETA from January 2006 to October 2009. Operative time, complications, postoperative recovery, cosmetic result, and patient satisfaction were analyzed. RESULTS The ETA group had a higher percentage of women (100% vs. 78.2%, P<0.05) and was younger (33.5 vs. 39 years, P<0.05). Thyroid volume (24.5 vs. 14.5 mL, P<0.001) and nodular diameter (26 vs. 22 mm, P<0.05) were larger in ETA group. The MIVAT group had a shorter operative time (28.2 vs. 112.8 minutes) and a lower rate of intraoperative (7.2 vs. 21.2 mL) and postoperative (0 vs. 80 mL, P<0.0001) blood loss. Rates of conversion and complications were similar. Postoperative pain at 12 hours was 1.9 in MIVAT vs. 3.1 in ETA (P<0.0001). Hospitalization was 1 day in the MIVAT group vs. 3.5 days in ETA (P<0.0001). Patient satisfaction was similar. CONCLUSION MIVAT and ETA showed similar results for safety, although ETA might be considered more invasive than MIVAT. Patients of both groups were equally satisfied with the cosmetic result. Differently from ETA, MIVAT allows total thyroidectomy to be performed also for malignant diseases. Although different, the two approaches were safe and reliable and both are valid options. Choice might depend on the surgeon's preference, thyroid size, type of disease, and the patient's expectation about cosmesis.
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Affiliation(s)
- J H Lu
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
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Casini B, Buzzigoli A, Valentini P, Vecchione A, Torracca F, Baggiani A, Privitera G. Best practice approach to the risk management of Legionella infection in health care facilities. BMC Proc 2011. [PMCID: PMC3239739 DOI: 10.1186/1753-6561-5-s6-p305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Berrettini S, Arslan E, Baggiani A, Burdo S, Cassandro E, Cuda D, Dinelli E, Filipo R, Mancini P, Martini A, Quaranta A, Quaranta N, Turchetti G, Forli F. A registry for the collection of data in cochlear implant patients. Acta Otorhinolaryngol Ital 2011; 31:328-40. [PMID: 22287824 PMCID: PMC3262416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/25/2011] [Indexed: 11/03/2022]
Abstract
The need to optimize the use of all the information that modern technological tools have made available to the physician ENT/audiologist has increasingly emerged within the Italian scientific community. Towards this purpose, it is necessary to create a registry of the patients using cochlear implants (CIs). This registry will include a homogeneous summary of the information deriving from multiple sources related to daily clinical practice, in order to assess auditory benefits, safety and reliability in patients with cochlear implants, and organization over the national territory. The primary objectives relative to the above-mentioned analysis are to assess the impact of the use of cochlear implants on patient health, to ensure traceability of the devices currently used, monitoring their safety and reliability over time, to guarantee access of the technique in clinical and organizational conditions that can allow the best possible benefits. The aspects concerning implementation of the registry were discussed extensively during the first meetings of the Working Group (WG). In particular, owing to the complexity and high costs related mainly to the development of the technological aspects and the need to involve technological partners external to the WG, and to respect current privacy laws, the WG members decided that the project should be limited to proposal of a paper registry to be implemented at a later stage, possibly within the framework of successive research projects. During meetings, the WG members discussed various aspects of implementation of the registry, and in particular the scientific features connected to objectives, inclusion criteria, and structure of the forms needed for data collection and organizational aspects. A registry is proposed herein.
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Affiliation(s)
- S. Berrettini
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy;,Address for correspondence: Prof Stefano Berrettini, Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, via Paradisa 2, 56124 Pisa, Italy. E-mail:
| | - E. Arslan
- Audiology and Phoniatrics Unit, Treviso Hospital, University of Padova, Italy
| | - A. Baggiani
- General and Applied Hygiene, Department of Experimental Pathology, Medical Biotechnologies, Infectivology and Epidemiology, University of Pisa, Italy
| | - S. Burdo
- Operative Unit of Audiovestibology of the Hospital of the Circolo di Varese
| | - E. Cassandro
- Audiology and Phoniatrics Unit, University of “Magna Graecia”, Catanzaro, Italy
| | - D. Cuda
- Operative Unit of Otolaryngology, Hospital “G. da Saliceto”, Piacenza, Italy
| | - E. Dinelli
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy
| | - R. Filipo
- Department of Sense Organs, Faculty of Medicine and Odontoiatry, Sapienza University of Rome, Italy
| | - P. Mancini
- Department of Sense Organs, Faculty of Medicine and Odontoiatry, Sapienza University of Rome, Italy
| | - A. Martini
- Operative Unit of Otolaryngology and Otosurgery, University of Padova, Italy
| | - A. Quaranta
- Otorhinolaryngology Clinic “G. Lugli”, University of Bari, Otological and Otoneurological Microsurgery, Italy
| | - N. Quaranta
- Otorhinolaryngology Clinic “G. Lugli”, University of Bari, Otological and Otoneurological Microsurgery, Italy
| | - G. Turchetti
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - F. Forli
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy
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Berrettini S, Baggiani A, Bruschini L, Cassandro E, Cuda D, Filipo R, PALLA I, Quaranta N, Forli F. Systematic review of the literature on the clinical effectiveness of the cochlear implant procedure in adult patients. Acta Otorhinolaryngol Ital 2011; 31:299-310. [PMID: 22287821 PMCID: PMC3262411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/25/2011] [Indexed: 11/09/2022]
Abstract
The aim of this systematic review was to summarize the results of scientific publications on the clinical effectiveness of the cochlear implant (CI) procedure in adults. The members of the Working Group first examined existing research evidence from the national and international literature and main international guidelines. They considered as universally accepted the usefulness/effectiveness of unilateral cochlear implantation in severely-profoundly adult patients. Accordingly, they focused their attention on the systematic reviews addressing clinical effectiveness and cost/efficacy of CI procedures, with particular regard to the most controversial issues for which international consensus is still lacking. The following aspects were evaluated: monolateral CI in advanced-age adult patients; bilateral (simultaneous/sequential) CI vs. unilateral CI and vs. bimodal stimulation; benefits derived from the monolateral CI procedure in adult patients with prelingual deafness. With regard to CI in elderly patients, the selected studies document an improvement of the quality of life and perceptive abilities after CI, even if the benefits were found to be inferior in patients over 70 years at the time of surgery. Thus, from the results of the studies included in the review, advanced age is not a contraindication for the CI procedure. With respect to unilateral CI, bilateral CI offers advantages in hearing in noise, in sound localization and less during hearing in a silent environment. However, high interindividual variability is reported in terms of benefits from the second implant. With regard to CI in prelingually deaf adults, the selected studies document benefits deriving from the CI procedure in terms of improvement of perceptive abilities and in the quality of life after CI, as well as subjectively perceived benefits. However, there is high interindividual variability and the study sample is limited.
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Affiliation(s)
- S. Berrettini
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy;,Address for correspondence: Prof. Stefano Berrettini, Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, via Paradisa 2, 56124 Pisa, Italy. E-mail:
| | - A. Baggiani
- General and Applied Hygiene, Department of Experimental Pathology, Medical Biotechnologies, Infectology and Epidemiology, University of Pisa, Italy
| | - L. Bruschini
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy
| | - E. Cassandro
- Audiology and Phoniatrics Unit, University of “Magna Graecia”, Catanzaro, Italy
| | - D. Cuda
- Operative Unit of Otolaryngology, Hospital “G. da Saliceto”, Piacenza, Italy.
| | - R. Filipo
- Department of Sense Organs, , Faculty of Medicine and Odontoiatry, Sapienza University of Rome, Italy
| | - I. PALLA
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - N. Quaranta
- Otorhinolaryngology Clinic “G. Lugli”, University of Bari, Otological and Otoneurological Microsurgery, Italy
| | - F. Forli
- Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy
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Baggiani A, Ierardi AM, Caspani B, Motta F, Toniolo D, Belloni P, Setola E, Campagnoli E, Tempini S, Crocchiolo R, Bregni M, Belli L. Hypoxic liver perfusion with mitomycin-C for treating multifocal metastases and unresectable primary tumours: a single-centre series of 42 patients. Radiol Med 2011; 116:1239-49. [DOI: 10.1007/s11547-011-0724-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 12/15/2010] [Indexed: 01/02/2023]
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Levi Setti P, Baggiani A, Castelli S, Bracone G, Marras A, Albani E. Incidence of congenital anomalies in 2351 IVF/ICSI babies. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cristaudo A, Roselli MG, Parducci DA, Ugolini R, Ferraro A, Ficini G, Bonotti A, Baggiani A, Foddis R. [Assessment of urinary cotinine in a group occupationally exposed to nicotine]. G Ital Med Lav Ergon 2011; 33:254-256. [PMID: 23393849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In a Tobacco processing company, located in central Italy, both air nicotine and, one of its metabolites, the urinary cotinine were assessed, as part of the evaluation of the effectiveness of recently implemented technical preventive controls. Urinary cotinine measurements ranged from 9,63 to 234,09 microg/gr creat. in non-smokers and from 178,79 to 2476,19 microg/gr creat. in smokers. Urinary cotinine proved useful as an exposure biological index especially in terms of population monitoring. On the contrary, the meaning of the measured values were less clear in single workers, because of significant both intra- and inter-individual variability.
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Affiliation(s)
- A Cristaudo
- Dipartimento di Endocrinologia e metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro, Università di Pisa, Italy.
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Abstract
Thyroid surgery during the last century was characterized by a development of Kocher's concepts: through a relentless work of surgeons from all over the world thyroidectomy reached a standard of quality in terms of overall results which was unimaginable in the first half of the XX century. The flattering data collected in the literature until the 90's were all concordant in assuming that there would be little space for a real improvement in the quality standard of thyroid surgery. The introduction of laparoscopic surgery, though, changed very quickly the attitude of surgeons towards their operative behavior and countless new mini-invasive techniques were soon proposed for almost any field of surgery. In 1994, Gagner published the first series of laparoscopic adrenalectomies. Soon after, parathyroid adenomas seemed to offer an ideal field of application of these new surgical concepts. The first report of an endoscopic parathyroidectomy was in 1996. One year later other videoscopic procedures were described whose results seemed quite encouraging so as to push surgeons to try the same access and the same technique also for operations on thyroid. During the following decade several endoscopic or video-assisted approaches were proposed for the removal of thyroid gland. This paper aims to evaluate the results of minimally invasive thyroid and parathyroid surgery through an extensive review of the literature, in particular as far as minimally invasive video-assisted thyroidectomy is concerned.
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Affiliation(s)
- P Miccoli
- Department of Surgery, University of Pisa, Pisa, Italy.
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Dell'Amico MC, Vivani P, Miccoli M, Cecconi M, Baggiani A. Mutations in GDI1 and X-linked non-specific mental retardation. Ann Ig 2011; 23:71-79. [PMID: 21736009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Mental retardation (MR) is a complex phenotype characterized by suboptimal functioning of the central nervous system (CNS). It is estimated that from 1 to 3% of the general population is affected with MR. MR or "intellectual disability" can be caused by genetic as well as environmental causes that act on the development and functioning of the CNS prenatally, perinatally or postnatally. Genetic causes of MR include chromosome aneusomies, chromosome structural abnormalities, genomic disorders and monogenic diseases. Amongst children, acute MR (QI < 50) is estimated at 0.4% and faint MR is about 2.5-3%. To determine the etiology of the MR, many diagnostic studies have been conducted and they show that MR is very heterogeneous and its etiology is not yet known in 20-50% of the group of patients with severe MR. This percentage increases up to 75-80% in the group of individuals with mild or "borderline" forms of MR. In light of the literature results, we tried to carry out a screening of 41 subjects with nonspecific MR for the detection of mutations in the gene GDI1 using the DHPLC methodology. This technique has the following advantages: low cost, high sensitivity (> 95%), and it can be done quickly. We have found 3 nucleotide (nt) substitutions: an intronic polymorphism at nt 107877 A --> C, a polymorphism in exon 3 at nt 109259 T --> C (Asn73Asn), and an intronic polymorphism at nt 110314 G --> C. The mutations in this gene are common and do not seem to influence the gene expression so as to cause a change in phenotype. These results therefore do not encourage the research of a diagnostic protocol designed for mutational analysis of the GDI1 human gene as the only responsible factor for a complex disease as Mental Retardation X-linked (MRX).
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Piscitelli P, Brandi ML, Tarantino U, Baggiani A, Distante A, Muratore M, Grattagliano V, Migliore A, Granata M, Guglielmi G, Gimigliano R, Iolascon G. [Incidence and socioeconomic burden of hip fractures in Italy: extension study 2003-2005]. Reumatismo 2010; 62:113-8. [PMID: 20657888 DOI: 10.4081/reumatismo.2010.113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We aimed to analyze incidence and costs of hip fractures in Italy. METHODS We analyzed the Italian Ministry of Health national hospitalization and DRGs databases concerning fractures occurred in people > or =65 between 2003 and 2005. We have estimated incidence and direct costs sustained by the National Health Service for hospitalization and treatment of hip fractures on the basis of the value of the Diagnosis Related Groups (DRGs) referring to hip fractures. The expenses of rehabilitation and indirect costs were based on regional estimations. RESULTS Between 2003 and 2005 we registered almost 90,000 hospital admissions per year (corresponding to 75,000 patients) because of hip fractures in people aged > or =65. Women accounted for the majority of hospital admissions due to hip fractures (78.0%; n=214,519). Among women, 84.3% of fractures (n=180,861) occurred in patients > or =75, which is known to be the age group with the highest prevalence of osteoporosis. Hospitalizations of both men and women showed an increasing trend across all the examined period. Hospital costs increased up to 467 million euros in 2005, while rehabilitation costs rose up to 531 million in the same year. CONCLUSIONS Hip fractures in the Italian population are increasing and represent a major public health challenge.
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Cristofano M, Miccoli M, Furlan M, Torracca F, Costa A, Benvenuti D, Tomassini CR, Baggiani A. [Managing the hospitalizations for older patients in University Hospital of Pisa]. Ann Ig 2009; 21:555-563. [PMID: 20169827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We have analyzed hospitalizations of older people (> 64) from 2002 to 2005. Patients, discharges and stay in hospital have increased, the variation has been statistically significant. We have noticed the same trend about the rehospitalizations. Patients and discharges coming from ASL 5 and zone 4 have decreased in relation with all the elderly people. The reduction of stay in hospital and the decrease of rehospitalizations have been statistically significant.
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Casini B, Valentini P, Baggiani A, Torracca F, Frateschi S, Nelli LC, Privitera G. Molecular epidemiology of Legionella pneumophila serogroup 1 isolates following long-term chlorine dioxide treatment in a university hospital water system. J Hosp Infect 2008; 69:141-7. [DOI: 10.1016/j.jhin.2008.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 03/06/2008] [Indexed: 11/26/2022]
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Casini B, Valentini P, Baggiani A, Torracca F, Lorenzini C, Frateschi S, Matteoli B, Privitera G. Comparison of two molecular methods used for subtyping of Legionella pneumophila 1 strains isolated from a hospital water supply. Water Sci Technol 2008; 58:683-688. [PMID: 18725739 DOI: 10.2166/wst.2008.434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The results of the pulsed-field gel electrophoresis and the sequence-based typing (using the loci flaA, pilE, asd, mip, mompS and proA) were compared for subtyping of Legionella pneumophila 1 strains isolated from a hospital water supply. Molecular typing was carried out on 61 isolates (38% of the positive samples) selected on space and temporal criteria in order to follow the evolution of the water-system colonization. For all the 61 isolates, the sequence of the amplified mip gene fragment identified Legionella pneumophila strain Wadsworth. Genotype testing by PFGE analysis showed three different patterns, correspondent to three SBT types according to the allelic profiles. Both PFGE and SBT indicated the circulation and the persistence in the hospital potable water-system of three types randomly distributed in space and time. The two molecular methods adopted showed a 100% concordance, although a low degree of genetic heterogeneity characterized the isolates. The electrophoretic patterns were sufficiently unambiguous to consider PFGE a highly discriminatory typing method, but the SBT technique besides accurately characterizing isolates, was able to identify Legionella strains through analysis of the mip gene. A typing method with this level of discriminatory power has great potential for assisting in epidemiological studies.
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Affiliation(s)
- B Casini
- Department of Experimental Pathology, MBIE, University of Pisa, via S. Zeno 35-39, 56127 Pisa, Italy.
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Di Colo G, Baggiani A, Zambito Y, Mollica G, Geppi M, Serafini MF. A new hydrogel for the extended and complete prednisolone release in the GI tract. Int J Pharm 2006; 310:154-61. [PMID: 16414222 DOI: 10.1016/j.ijpharm.2005.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2005] [Revised: 11/25/2005] [Accepted: 12/04/2005] [Indexed: 11/16/2022]
Abstract
The issue of incomplete release of poorly soluble drugs from sustained-release oral formulations is addressed using prednisolone (PDS) as the model drug and a novel highly swelling hydrogel as the rate-controlling material. The hydrogel was formed by heating N-carboxymethylchitosan (CMC) to 80 degrees C for 24 h. Swelling, alkalimetry, FTIR, DSC, and solid-state NMR studies showed that the treatment produced physical crosslinking, i.e., polymer chain entanglement. A controlled-release system was prepared by coating an inert compacted support of ethylcellulose (50 mg; diameter, 6 mm) with a CMC layer containing dispersed PDS powder (10-50 microm). The system was heated to crosslink the CMC coating, then drug release to simulated GI fluids was studied in vitro. The drug release pattern and term were modulated via the layer mass (LM) (10 or 14 mg cm(-2)) and/or the drug-polymer wt ratio (D/P) (1:5 or 2:5). The rate parameter, K, and the time exponent, n, of the Peppas equation were: K=26.6+/-0.3 h(-n), n = 0.78+/-0.02 (LM, 10 mg cm(-2); D/P, 1:5); K = 24.7+/-0.7 h(-n), n = 0.56+/-0.02 (LM, 14 mg cm(-2); D/P, 1:5); K = 20.7+/-0.3 h(-n), n = 0.76+/-0.01 (LM, 10 mg cm(-2); D/P, 2:5). Hydrogel swelling was faster than drug release. This was controlled, in a first stage, by drug dissolution-diffusion in the swollen gel, and subsequently, by diffusion. The drug release rate was unaffected by the GI pH variations, and slightly affected by the environmental hydrodynamics. The system promises an extended and complete release of poorly soluble drugs in the GI tract.
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Affiliation(s)
- G Di Colo
- Department of Bioorganic Chemistry and Biopharmaceutics, University of Pisa, Via Bonanno 33, 56126 Pisa, Italy
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Celandroni F, Longo I, Tosoratti N, Giannessi F, Ghelardi E, Salvetti S, Baggiani A, Senesi S. Effect of microwave radiation on Bacillus subtilis spores. J Appl Microbiol 2005; 97:1220-7. [PMID: 15546413 DOI: 10.1111/j.1365-2672.2004.02406.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To compare the killing efficacy and the effects exerted by microwaves and conventional heating on structural and molecular components of Bacillus subtilis spores. METHODS AND RESULTS A microwave waveguide applicator was developed to generate a uniform and measurable distribution of the microwave electric-field amplitude. The applicator enabled the killing efficacy exerted by microwaves on B. subtilis spores to be evaluated in comparison with conventional heating at the same temperature value. The two treatments produced a similar kinetics of spore survival, while remarkably different effects on spore structures were seen. The cortex layer of the spores subjected to conductive heating was 10 times wider than that of the untreated spores; in contrast, the cortex of irradiated spores did not change. In addition, the heated spores were found to release appreciable amounts of dipicolinic acid (DPA) upon treatment, while extracellular DPA was completely undetectable in supernatants of the irradiated spores. These observations suggest that microwave radiation may promote the formation of stable complexes between DPA and other spore components (i.e. calcium ions); thus, making any release of DPA from irradiated spores undetectable. Indeed, while a decrease in measurable DPA concentrations was not produced by microwave radiation on pure DPA solutions, a significant lowering in DPA concentration was detected when this molecule was exposed to microwaves in the presence of either calcium ions or spore suspensions. CONCLUSIONS Microwaves are as effective as conductive heating in killing B. subtilis spores, but the microwave E-field induces changes in the structural and/or molecular components of spores that differ from those attributable only to heat. SIGNIFICANCE AND IMPACT OF THE STUDY This study provides information on the effect of microwaves on B. subtilis spore components.
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Affiliation(s)
- F Celandroni
- Dipartimento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia, Universita degli Studi di Pisa, Pisa, Italy
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Zambito Y, Baggiani A, Carelli V, Serafini MF, Di Colo G. Matrices for site-specific controlled-delivery of 5-fluorouracil to descending colon. J Control Release 2005; 102:669-77. [PMID: 15681088 DOI: 10.1016/j.jconrel.2004.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Accepted: 11/01/2004] [Indexed: 11/25/2022]
Abstract
Colon-specific controlled-delivery 5-fluorouracil (5-FU) matrices for the treatment of colorectal carcinoma were prepared and evaluated. Matrices are destined to be introduced into enteric-coated capsules and thereby carried to and liberated in the ileum. There, drug release should be prevented until matrices reach descending colon where release should occur. Matrices (50 mg, diameter 0.6 mm) were prepared by compression of powders or of granules prepared by melt granulation. The ingredients comprised 30-70% w/w 5-FU, glyceryl palmitostearate as rate-controlling material and 5% w/w Aerosil as glidant. Drug release was measured by the rotating basket method. The matrix containing 60% w/w drug, prepared by compression of powders, was appropriate to make the planned system, in virtue of its fairly high drug load and its nearly constant and reasonable release rate. This matrix was spray-coated with Eudragit S100 (EUD). Subsequently, an external layer of chitosan hydrochloride (CH-HCl) was applied by a dipping-drying technique. When transit of coated matrix through ileum (phosphate buffer (PB) pH 7.4), ascending colon (PB pH 6 containing rat cecal contents) and descending colon (PB pH 7.4) was simulated in vitro, the pH 4.7 of the CH-HCl gel layer and the pH 6 of the ascending colon prevented dissolution of the protective EUD film until descending colon was reached, then controlled release started. The present small matrices can enter size no. 00 capsules. Considering that each capsule contains 10 matrices, the maximal dose is 300 mg.
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Affiliation(s)
- Y Zambito
- Department of Bioorganic Chemistry and Biopharmaceutics, University of Pisa, Via Bonanno 33, 56126 Pisa, Italy
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Reali D, Deriu MG, Baldi P, Baggiani A, Pinto B. [Mycobacteria in swimming pool water and the meaning of microbiological conventional indicators]. Ann Ig 2004; 16:247-53. [PMID: 15554531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Monitoring program of hygienic quality water in twelve public swimming pools was performed. Legally required microbiological indicator parameters of safety for gastrointestinal illness were measured besides the analyses of Pseudomonas spp. and Staphylococcus spp. prevalence, frequency of recovery and number of nontuberculous mycobacteria. We detected positive samples for coliforms at lower rate (29.3%) than Pseudomonas (75.5%), Staphylococcus spp. (46%) and Mycobacteria (59.4%). We pointed out statistically significant correlation (r=0.67 p=0.0001) between Mycobacteria and Pseudomonas so we think that the latter might be a good predictive marker. As 82% of samples had free chlorine residual within the limits stated by Italian Laws, the efficacy of chlorination to prevent risk of infectious diseases transmission by route other than gastroenteric was discussed. A revision of both the sanitary significance of conventional microbial parameters and the related regulations appears necessary.
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Affiliation(s)
- D Reali
- Dipartimento Patologia Sperimentale, Biotecnologie Mediche, Infettivologia, Epidemiologia, Università degli Studi di Pisa.
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Abstract
AIMS Development of an agar-diffusion assay to measure vitamin B2 in biological samples and application of the method to determine the amount of vitamin B2 secreted by bacteria. METHODS AND RESULTS A riboflavin-auxotrophic mutant of Bacillus cereus was generated by mini-Tn10 insertion in the ribD gene. ribD mutant sensitivity to exogenous vitamin B2 was investigated by turbidimetric and agar-diffusion assays. In turbidimetric assays, the B. cereus mutant displayed a similar level of sensitivity to vitamin B2 to that of Lactobacillus casei ATCC 7469, the reference organism used for microbiological vitamin B2 quantification. However, only the ribD mutant could be used as an indicator organism in agar-diffusion assays. A total of eight probiotic strains, from five different probiotic formulations, were analysed by the ribD mutant-based assay on agar plates in order to determine their ability to secrete vitamin B2 during growth. CONCLUSION The agar diffusion method with the ribD mutant of B. cereus is highly reproducible, sensitive, rapid, inexpensive, and can be applied to measure the amount of vitamin B2 in different samples. SIGNIFICANCE AND IMPACT OF THE STUDY The method developed in this study appears to be a good candidate for the screening of vitamin B2 secretion by bacteria growing on solid media.
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Affiliation(s)
- S Salvetti
- Dipartimento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia, Sezione di Microbiologia e Virologia, Università di Pisa, Pisa, Italy
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