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Lucchini A, Villa M, Fumagalli L, Carra A, Magri D, Mariconti I, Napoli S, Elli S, Giani M, Bambi S. Patients' recollections of helmet-CPAP treatment during COVID-19 pandemic: A qualitative study. Nurs Crit Care 2024; 29:49-57. [PMID: 37487593 DOI: 10.1111/nicc.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/08/2023] [Revised: 06/16/2023] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID-19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet-CPAP. Few reports are available on the experiences of patients undergoing this treatment. AIM This qualitative study aimed to explore the views and recollections of COVID-19 patients undergoing helmet-CPAP. STUDY DESIGN We conducted semi-structured interviews with thematic analysis. Participants were recruited from the follow-up programme for COVID-19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach. FINDINGS We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet-CPAP. Twenty-four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet-CPAP as a life-saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet-CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common. CONCLUSIONS The application of helmet-CPAP treatment generated positive and negative memories and feelings in COVID-19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success. RELEVANCE TO CLINICAL PRACTICE This study has provided an insight into the patient's recollections about helmet-CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet-CPAP and may foster a care focused on patient-centred outcomes.
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Affiliation(s)
- Alberto Lucchini
- General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy
| | - Marta Villa
- General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy
| | - Letizia Fumagalli
- General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy
| | - Agnese Carra
- Critical care nursing master degree student, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Denise Magri
- Critical care nursing master degree student, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ilenia Mariconti
- Critical care nursing master degree student, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Stefania Napoli
- Critical care nursing master degree student, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Stefano Elli
- General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy
| | - Marco Giani
- General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, Florence, Italy
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Tirelli U, Veronesi A, Galligioni E, Trovò MG, Magri D, Frustaci S, Crivellari D, Roncadin M, Tumolo S, Grigoletto E. Clinical and Immunological Evaluation of 5 Cases of Mycosis Fungoides in Advanced Stages. Tumori 2018; 65:447-53. [PMID: 315125 DOI: 10.1177/030089167906500404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Five patients with mycosis fungoides, hospitalized in the Division of Radiotherapy and Medical Oncology of the Ospedale Civile, Pordenone, from January 1975 to December 1978, were studied and treated as non-Hodgkin lymphomas. All patients had evidence of disseminated disease: 3 with bone marrow infiltration, 1 with splenic involvement and 1 with lymph node involvement. Three patients were treated with CVP, resulting in 2 complete remissions that lasted 18 months and 1 PR > 50% maintained for 7 months. One patient was treated with ABVD with a PR > 50% maintained for 10 months. The last patient was treated with prednisone and then with CV, but expired from pulmonary embolism after 1 cycle. Lymphocyte function, using E and EAC rosette and PHA, was evaluated before therapy in all patients: in the 2 patients who obtained a CR, an improvement in T-lymphocyte function was noted after therapy. The chromosome pattern of peripheral blood lymphocytes was altered before therapy in only one patient. Even if the follow-up period is still relatively brief, the duration of the 2 complete remissions must be stressed. In addition, a strict correlation between T-lymphocyte function and response to therapy was revealed in our study.
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Magri D, Mifsud R, Debono J. 1119 The management of breast cancer patients from first contact to surgery in Malta: Are there any delays in the system? Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30501-9] [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: 10/22/2022]
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Agostoni P, Banfi C, Brioschi M, Magri D, Sciomer S, Berna G, Brambillasca C, Marenzi G, Sisillo E. Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study. Eur Respir J 2010; 37:841-7. [DOI: 10.1183/09031936.00045910] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bagnoli F, Vendramin GG, Buonamici A, Doulis AG, González-Martínez SC, La Porta N, Magri D, Raddi P, Sebastiani F, Fineschi S. Is Cupressus sempervirens native in Italy? An answer from genetic and palaeobotanical data. Mol Ecol 2009; 18:2276-86. [PMID: 19389173 DOI: 10.1111/j.1365-294x.2009.04182.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study represents the first large-scale analysis using nuclear molecular markers to assess genetic diversity and structure of Cupressus sempervirens L.. Genetic and fossil data were combined to infer the possible role of human activity and evolutionary history in shaping the diversity of cypress populations. We analysed 30 populations with six polymorphic nuclear microsatellite markers. Dramatic reductions in heterozygosity and allelic richness were observed from east to west across the species range. Structure analysis assigned individuals to two main groups separating central Mediterranean and eastern populations. The two main groups could be further divided into five subgroups which showed the following geographical distributions: Turkey with the Greek islands Rhodes and Samos, Greece (Crete), Southern Italy, Northern Italy, Tunisia with Central Italy. This pattern of genetic structure is also supported by SAMOVA and Barrier analyses. Palaeobotanical data indicated that Cupressus was present in Italy in the Pliocene, Pleistocene and Holocene. Furthermore, our molecular survey showed that Italian cypress populations experienced bottlenecks that resulted in reduced genetic diversity and allelic richness and greater genetic differentiation. Recent colonization or introduction may also have influenced levels of diversity detected in the Italian populations, as most individuals found in this range today have multilocus genotypes that are also present in the eastern range of the species. The data reveal a new interpretation of the history of cypress distribution characterized by ancient eastern populations (Turkey and Greek islands) and a mosaic of recently introduced trees and remnants of ancient, depauperate populations in the central Mediterranean range.
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Affiliation(s)
- F Bagnoli
- CNR Istituto per la Protezione delle Piante, Sesto Fiorentino, Firenze, Italy
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Fancher T, Muto A, Fitzgerald T, Magri D, Dudrick S, Dardik A. QS247. EPH-B4 Stimulates Endothelial Cell Migration by an AKT1-Dependent Mechanism. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.550] [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: 10/21/2022]
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Agostoni P, Emdin M, Corra U, Veglia F, Magri D, Tedesco CC, Berton E, Passino C, Bertella E, Re F, Mezzani A, Belardinelli R, Colombo C, La Gioia R, Vicenzi M, Giannoni A, Scrutinio D, Giannuzzi P, Tondo C, Di Lenarda A, Sinagra G, Piepoli MF, Guazzi M. Permanent atrial fibrillation affects exercise capacity in chronic heart failure patients. Eur Heart J 2008; 29:2367-72. [DOI: 10.1093/eurheartj/ehn361] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Robieux I, Aita P, Sorio R, Lucenti A, Freschi A, Magri D, Colussi A, Vitali V, Monfardini S. 957 Bioavailability and pharmacokinetics of oral etoposide (VP16) in elderly patients. Eur J Cancer 1995. [DOI: 10.1016/0959-8049(95)96206-s] [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: 11/28/2022]
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Ardizzoni A, Pennucci MC, Castagneto B, Mariani GL, Cinquegrana A, Magri D, Verna A, Salvati F, Rosso R. Recombinant interferon alpha-2b in the treatment of diffuse malignant pleural mesothelioma. Am J Clin Oncol 1994; 17:80-2. [PMID: 8311014 DOI: 10.1097/00000421-199402000-00018] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [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: 01/29/2023]
Abstract
Fourteen patients with diffuse malignant pleural mesothelioma (DMPM) were enrolled in a Phase II study to assess activity and toxicity of the systemic administration of recombinant (r)-alpha-interferon (IFN)-2b. The IFN schedule was: 3 x 10(6) IU i.m. days 1-4, 6 x 10(6) IU days 5-8, 10 x 10(6) IU days 9-12; then IFN was administered at 10 x 10(6) IU 3 days/week. If grades II-III toxicity occurred, IFN dose was reduced and drug continued at the previous dose level. All patients were evaluated by CT scan. Only one patient was not evaluable for response and toxicity because of inadequate follow-up. Of 13 evaluable patients, we observed 1 objective response, 6 stable disease, and 6 failures (3 progressive disease and 3 early interruptions due to subjective toxicity). The median time to progression was 19 weeks, and the median overall survival was 62 weeks. Toxicity was mild: of 13 patients evaluable for toxicity we observed fever (9 patients), flu-like syndrome (3 patients), fatigue (4 patients), anorexia (2 patients), myelosuppression (3 patients), and muscle pain (1 patient). The results of this study indicate only marginal activity of r-alpha-IFN in the treatment of DMPM.
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Affiliation(s)
- A Ardizzoni
- Department of Medical Oncology, Ospedale S. Spirito of Casale Monferrato, Italy
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Magri D, Sadori L. Late-Quaternary History of Vegetation at Lago Di Vico (Central Italy). ACTA ACUST UNITED AC 1994. [DOI: 10.1080/11263509409437244] [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: 10/20/2022]
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De Cicco M, Fracasso A, Magri D, Barzan L, Testa V. [Morphine in the inferior cerebellar cisterna for oncologic pain in the ORL area]. Minerva Anestesiol 1990; 56:1401-8. [PMID: 2084588] [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: 12/30/2022]
Abstract
The study aimed to assess whether the infusion of microdoses of morphine in the cisterna magna, close to the sensitive nuclei of the cranial nerves (V-VII-IX-X) involved in painful syndromes of the head and neck, is able to control severe oncological pain in this region which does not respond to traditional pain killing treatment or neurolesive practices. Cisternal catheters were inserted in eight patients with cancer of the head and neck. The intensity of pain was assessed using VAS and the quality of analgesia obtained using cisternal morphine was judged to be: excellent, good, inadequate or null. Treatment lasted a mean of 121 days. Good or excellent analgesia was achieved in 7 patients using a mean daily dose of 1.5 mg morphine during the initial stage and 4.8 mg during the final stage; in one patient with a large component of "deafferent pain", good pain relief was obtained by associating cisternal morphine with chlorimipramin per os. The side-effects observed were almost always short-term and easily resolved. Morphine treatment was begun in the hospital and in all cases continued at home. This efficacious pain killing method should be given adequate attention in the global strategies used to treat oncological pain in the head and neck region.
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Affiliation(s)
- M De Cicco
- Servizio di Anestesia, Rianimazione e Terapia Antalgica, Centro Regionale di Riferimento Oncologico, Aviano, Pordenone
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Barzan L, Veronesi A, Caruso G, Serraino D, Magri D, Zagonel V, Tirelli U, Comoretto R, Monfardini S. Head and neck cancer and ageing: a retrospective study in 438 patients. J Laryngol Otol 1990; 104:634-40. [PMID: 2230561 DOI: 10.1017/s0022215100113453] [Citation(s) in RCA: 54] [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] [Indexed: 12/30/2022]
Abstract
To evaluate whether age over 70 years represents a prognostic factor in head and neck cancer, we reviewed all cases observed between 1981 and 1984. Four hundred and thirty-eight (438) patients were considered in relation to three age groups (less than or equal to 59, 60-69, and greater than or equal to 70 years, defined as non-elderly, mid-elderly and elderly respectively). The main parameters analyzed included histological diagnosis (no difference emerged among the three age groups); anatomical site (hypopharyngeal carcinoma was most frequent in non-elderly patients); TNM stage (an higher incidence of early stages was seen in the elderly); performance status (better in the non-elderly); previous illnesses (life-style related diseases were more frequent in the non-elderly); contraindications to surgery (more frequent in the elderly); surgical treatment ('en bloc' resections were more often employed in the non-elderly); post-operative complications and local control (no difference between the three groups); multiple primary malignancies (head and neck, oesophagus and lung were more frequent in non-elderly patients) and survival (no difference). Although age affects several features of head and neck cancer patients, it does not appear from the present study to be an independent prognostic factor for local control and survival. With regard to survival, stage appeared to be the most important prognostic factor.
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Affiliation(s)
- L Barzan
- Division of Otolaryngology, General Hospital of Pordenone, Italy
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