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Fortunato F, Campanozzi A, Maffei G, Arena F, Carri VD, Rollo T, Lopalco PL, Martinelli D. Respiratory syncytial virus-associated hospitalizations among children: an Italian retrospective observational study. Ital J Pediatr 2024; 50:45. [PMID: 38454523 PMCID: PMC10921699 DOI: 10.1186/s13052-024-01617-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/24/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV), a single-stranded RNA virus, is a leading cause of hospitalization in infants, especially ≤ 2 months of life. In the light new immunization strategies adoption, we described epidemiological and clinical characteristics of RSV-associated hospitalizations in pediatric and neonatal intensive care units of the Policlinico Foggia Hospital, Apulia Region, Italy. METHODS Hospitalized children with a laboratory-confirmed RSV infection from 2011 to 2023 were retrospectively evaluated. Clinical information was collected from Hospital Discharge Registry in the period 2011-2020. The proportion of the hospitalization for acute respiratory infections (ARIs) associated to RSV was calculated and the hospitalization cost was analyzed by using the diagnosis-related group reimbursement rate. The anticipated impact of immunization either with monoclonal antibodies or maternal immunization on the number of hospitalizations was estimated. All analyses and quality assessment were performed using STATA/SE15.0. RESULTS A total of 1,005 RSV-cases were included in the study, of which 86.3% occurred between December-March. In the period 2011-2020, 832 RSV-cases were matched with the corresponding hospital admissions; 75.2% were aged < 1 year (49.6% 0-2 months). Bronchiolitis was the most frequent admission diagnosis occurring in 63.3% of patients; 25% of children were affected by a very severe RSV-disease. Younger age ≤ 2 months (OR:14.8, 95%CI:8.30-26.31, p = 0.000), higher length-of-hospital-stay (OR:1.01, 95%CI:1.0-1.02, p = 0.030) and history of prematurity (OR:4.4, 95%CI:1.57-12.11, p = 0.005) were associated with a higher disease severity. RSV caused 48.9% of ARIs among children < 1 year. The mean cost of an RSV-associated hospitalization was 3,036 euros/year, with the higher cost in the 0-2 months age group (4,225 euros/year). Immunization programs with nirsevimab could prevent 51.4 RSV hospitalizations/year and 18.1 very severe RSV disease/year in infants < 1 year of age. RSV vaccine could prevent 46.1 of hospitalizations/year caused by RSV within 180 days after birth. CONCLUSIONS Our study contributes to outlining the baseline profile of RSV-associated hospitalizations among Italian children by providing epidemiological/clinical/economic estimates. While awaiting new recommendations on immunization, healthcare-workers should persist in implementing public health measures and appropriate case management to control RSV seasonal epidemics. Strengthened laboratory RSV surveillance is needed to inform the implementation of the new immunization strategies.
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Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy.
- Department of Medical and Surgical Sciences, Department of Hygiene, University of Foggia, Policlinico Riuniti University Hospital of Foggia, Ospedale "Colonnello D'Avanzo" Viale degli Aviatori, 2, 71122, Foggia, Italy.
| | - Angelo Campanozzi
- Pediatrics Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gianfranco Maffei
- Neonatology and Intensive Care Unit, Policlinico Foggia Hospital, Foggia, Italy
| | - Fabio Arena
- Microbiology and Virology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Valeria Delli Carri
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
| | - Tiziana Rollo
- Microbiology and Virology Unit, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
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Pugni L, Crippa BL, Raimondi F, Vento G, Mangili G, Coscia A, Artieri G, Ronchi A, Ventura ML, Lago P, Pietrasanta C, Crimi R, Bonfante G, Perrone S, Boncompagni A, Solinas A, Agosti M, Poggi C, Falcone A, Pagliotta C, Gianotti D, Gottardi G, Paviotti G, Allodi A, Maffei G, Proto A, Travierso A, Salomè S, Costa S, Ferrari S, Peila C, Sinelli M, Fanelli F, Giordano L, Saruggia M, Capasso L, Spada E, Gizzi C, Orfeo L, Mosca F. SARS-CoV-2 perinatal transmission and neonatal outcomes across four different waves of COVID-19 pandemic: A nationwide prospective cohort study from the Italian Society of Neonatology. Int J Infect Dis 2024; 140:17-24. [PMID: 38157929 DOI: 10.1016/j.ijid.2023.12.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/13/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES To describe how SARS-CoV-2 infection at the time of delivery affected maternal and neonatal outcomes across four major waves of the COVID-19 pandemic in Italy. METHODS This is a large, prospective, nationwide cohort study collecting maternal and neonatal data in case of maternal peripartum SARS-CoV-2 infection between February 2020 and March 2022. Data were stratified across the four observed pandemic waves. RESULTS Among 5201 COVID-19-positive mothers, the risk of being symptomatic at delivery was significantly higher in the first and third waves (20.8-20.8%) than in the second and fourth (13.2-12.2%). Among their 5284 neonates, the risk of prematurity (gestational age <37 weeks) was significantly higher in the first and third waves (15.6-12.5%). The risk of intrauterine transmission was always very low, while the risk of postnatal transmission during rooming-in was higher and peaked at 4.5% during the fourth wave. A total of 80% of positive neonates were asymptomatic. CONCLUSION The risk of adverse maternal and neonatal outcomes was significantly higher during the first and third waves, dominated by unsequenced variants and the Delta variant, respectively. Postnatal transmission accounted for most neonatal infections and was more frequent during the Omicron period. However, the paucity of symptoms in infected neonates should lead us not to separate the dyad.
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Affiliation(s)
- Lorenza Pugni
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Francesco Raimondi
- Division of Neonatology, University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - Giovanni Vento
- Neonatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Neonatology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Alessandra Coscia
- AOU Città della Salute e della Scienza di Torino, Neonatologia Universitaria, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Torino, Italy
| | - Giacomo Artieri
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Ronchi
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Paola Lago
- NICU, Ospedale Regionale Cà Foncello, Treviso, Italy
| | - Carlo Pietrasanta
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Riccardo Crimi
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppina Bonfante
- NICU, AOU Città della Salute e della Scienza di Torino, PO S. Anna, Torino, Italy
| | - Serafina Perrone
- University of Parma, Pietro Barilla University Children's Hospital, Parma, Italy
| | - Alessandra Boncompagni
- Women's and Children's Health Department, NICU, University of Modena and Reggio Emilia, Modena, Italy
| | - Agostina Solinas
- NICU, Azienda Ospedaliero Universitaria di Ferrara, Arcispedale S.Anna, Ferrara, Italy
| | - Massimo Agosti
- NICU, Del Ponte Hospital, Varese, Italy; Department of Pediatrics, University of Insubria, Varese, Italy
| | - Chiara Poggi
- Department of Mother and Child Care, NICU, Careggi University Hospital, Florence, Italy
| | | | | | | | - Genny Gottardi
- NICU, ULSS8 Berica, Ospedale San Bortolo, Vicenza, Italy
| | - Giulia Paviotti
- Neonatology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero di Udine - Santa Maria della Misericordia, Udine, Italy
| | | | | | - Alice Proto
- NICU, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Serena Salomè
- Division of Neonatology, University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - Simonetta Costa
- Neonatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Chiara Peila
- AOU Città della Salute e della Scienza di Torino, Neonatologia Universitaria, Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Torino, Italy
| | | | - Federica Fanelli
- Division of Neonatology, University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - Lucia Giordano
- Neonatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Letizia Capasso
- Division of Neonatology, University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - Elena Spada
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Gizzi
- Pediatric and Neonatal Unit, Sandro Pertini Hospital, Rome, Italy; NICU, Sant'Eugenio Hospital, Rome, Italy
| | - Luigi Orfeo
- NICU, Ospedale Isola Tiberina Gemelli, Isola, Rome, Italy
| | - Fabio Mosca
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Baldassarre ME, Loconsole D, Centrone F, Caselli D, Martire B, Quartulli L, Acquafredda A, D'Amato G, Maffei G, Latorre G, Riganti A, Di Noia M, Chironna M, Laforgia N. Hospitalization for bronchiolitis in children aged ≤ 1year, Southern Italy, year 2021: need for new preventive strategies? Ital J Pediatr 2023; 49:66. [PMID: 37280662 DOI: 10.1186/s13052-023-01455-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/07/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Bronchiolitis is a major cause of hospitalization in infants, particularly in the first six months of life, with approximately 60-80% of admissions due to respiratory syncytial virus (RSV) infection. Currently, no prophylactic options are available for healthy infants. The present study aimed at describing the demographic, clinical, and epidemiological characteristics of infants hospitalized for bronchiolitis in the Apulia region of Italy in 2021. METHODS From January to December 2021, data on children aged 0-12 months admitted for bronchiolitis in nine neonatal or pediatric units covering 61% of pediatric beds of hospitals in the Apulia region of Italy were analyzed. Demographic data, comorbidities, need for oxygen support, length of hospital stay, palivizumab administration, and outcomes were collected. For the purpose of the analysis, patients were divided into those aged 0-3 months and > 3 months. A multivariate logistic regression model was used to explore associations between the need for oxygen support and sex, age, comorbidities, history of prematurity, length of hospital stay, and palivizumab administration. RESULTS This study included 349 children aged 0-12 months admitted for bronchiolitis, with a peak of hospitalization in November (7.4 cases/1,000 children). Of these patients, 70.5% were RSV positive, 80.2% were aged 0-3 months, and 73.1% required oxygen support. Moreover, 34.9% required observation in the sub-intensive care unit, and 12.9% in the intensive care unit. Of the infants who required intensive care, 96.9% were aged 0-3 months and 78.8% were born at term. Three patients required mechanical ventilation and one, who required Extra Corporeal Membrane Oxygenation, died. Children aged 0-3 months were more likely to show dyspnea, need oxygen support, and have a longer hospital stay. CONCLUSIONS The present study showed that almost all of the children who required intensive care support were aged ≤ 3 months and most were born at term. Therefore, this age group remains the highest risk group for severe bronchiolitis. Preventive measures such as single-dose monoclonal antibody immunoprophylaxis, and maternal and childhood vaccination against RSV, may reduce the high public health burden of bronchiolitis.
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Affiliation(s)
- Maria Elisabetta Baldassarre
- Unit of Neonatology and Intensive Care, Interdisciplinary Department of Medicine, Aldo Moro University, Bari, 70124, Italy
| | - Daniela Loconsole
- Hygiene Section, Interdisciplinary Department of Medicine, Aldo Moro University, Bari, 70124, Italy
| | - Francesca Centrone
- Hygiene Section, Interdisciplinary Department of Medicine, Aldo Moro University, Bari, 70124, Italy
| | - Desiree Caselli
- Pediatric Infectious Diseases Unit, Giovanni XXIII Children Hospital, Azienda Ospedaliero Universitaria Consorziale Policlinico, Bari, 70124, Italy
| | - Baldassarre Martire
- Unit of Pediatrics and Neonatology, "Monsignor Dimiccoli" Hospital, Barletta, BT, Italy
| | | | - Angelo Acquafredda
- Unit of Pediatrics and Neonatology, "G. Tatarella" Hospital, Cerignola, Foggia, Italy
| | | | - Gianfranco Maffei
- Neonatology and Intensive Care Unit, "Ospedali Riuniti" Hospital, Foggia, Italy
| | - Giuseppe Latorre
- Neonatology and Intensive Care Unit, "Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Anita Riganti
- Neonatology Unit, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | | | - Maria Chironna
- Hygiene Section, Interdisciplinary Department of Medicine, Aldo Moro University, Bari, 70124, Italy.
| | - Nicola Laforgia
- Unit of Neonatology and Intensive Care, Interdisciplinary Department of Medicine, Aldo Moro University, Bari, 70124, Italy
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Stocker M, Klingenberg C, Navér L, Nordberg V, Berardi A, El Helou S, Fusch G, Bliss JM, Lehnick D, Dimopoulou V, Guerina N, Seliga-Siwecka J, Maton P, Lagae D, Mari J, Janota J, Agyeman PKA, Pfister R, Latorre G, Maffei G, Laforgia N, Mózes E, Størdal K, Strunk T, Giannoni E. Less is more: Antibiotics at the beginning of life. Nat Commun 2023; 14:2423. [PMID: 37105958 PMCID: PMC10134707 DOI: 10.1038/s41467-023-38156-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Antibiotic exposure at the beginning of life can lead to increased antimicrobial resistance and perturbations of the developing microbiome. Early-life microbiome disruption increases the risks of developing chronic diseases later in life. Fear of missing evolving neonatal sepsis is the key driver for antibiotic overtreatment early in life. Bias (a systemic deviation towards overtreatment) and noise (a random scatter) affect the decision-making process. In this perspective, we advocate for a factual approach quantifying the burden of treatment in relation to the burden of disease balancing antimicrobial stewardship and effective sepsis management.
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Affiliation(s)
- Martin Stocker
- Department of Pediatrics, Children's Hospital Lucerne, Lucerne, Switzerland.
| | - Claus Klingenberg
- Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
- Dept. of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Lars Navér
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Viveka Nordberg
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Mother and Child Department, Policlinico University Hospital, Modena, Italy
| | - Salhab El Helou
- Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton Health Sciences, Hamilton, Canada
| | - Gerhard Fusch
- Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton Health Sciences, Hamilton, Canada
| | - Joseph M Bliss
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Richmond, USA
| | - Dirk Lehnick
- Biostatistics and Methodology, CTU-CS, Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Varvara Dimopoulou
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicholas Guerina
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Richmond, USA
| | - Joanna Seliga-Siwecka
- Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, Warszawa, Poland
| | - Pierre Maton
- Service néonatal, Clinique CHC-Montlegia, groupe santé CHC, Liège, Belgium
| | - Donatienne Lagae
- Neonatology and Neonatal Intensive Care Unit, CHIREC-Delta Hospital, Brussels, Belgium
| | - Judit Mari
- Department of Paediatrics, University of Szeged, Szeged, Hungary
| | - Jan Janota
- Neonatal Unit, Department of Obstetrics and Gynecology, Motol University Hospital Prague, Prague, Czech Republic
- Department of Neonatology, Thomayer University Hospital Prague, Prague, Czech Republic
| | - Philipp K A Agyeman
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Riccardo Pfister
- Neonatology and Paediatric Intensive Care Unit, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Giuseppe Latorre
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Gianfranco Maffei
- Neonatology and Neonatal Intensive Care Unit, Policlinico Riuniti Foggia, Foggia, Italy
| | - Nichola Laforgia
- Neonatologia e Terapia Intensiva Neonatale, University of Bari, Bari, Italy
| | - Enikő Mózes
- Perinatal Intensive Care Unit, Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
| | - Ketil Størdal
- Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Tobias Strunk
- Neonatal Directorate, Child and Adolescent Health Service, King Edward Memorial Hospital, Perth, Western, Australia
| | - Eric Giannoni
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Bartoli F, Cocomazzi R, Campanella V, Maggipinto C, Fischetti P, Yilmaz H, Canale F, Magistro D, Campanelli E, Nobili M, Maffei G. Attempt to shift from traditional to minimal invasive treatment of congenital diaphragmatic hernia at a low volume center. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102466] [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: 11/06/2022] Open
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Giannoni E, Dimopoulou V, Klingenberg C, Navér L, Nordberg V, Berardi A, el Helou S, Fusch G, Bliss JM, Lehnick D, Guerina N, Seliga-Siwecka J, Maton P, Lagae D, Mari J, Janota J, Agyeman PKA, Pfister R, Latorre G, Maffei G, Laforgia N, Mózes E, Størdal K, Strunk T, Stocker M. Analysis of Antibiotic Exposure and Early-Onset Neonatal Sepsis in Europe, North America, and Australia. JAMA Netw Open 2022; 5:e2243691. [PMID: 36416819 PMCID: PMC9685486 DOI: 10.1001/jamanetworkopen.2022.43691] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Appropriate use of antibiotics is life-saving in neonatal early-onset sepsis (EOS), but overuse of antibiotics is associated with antimicrobial resistance and long-term adverse outcomes. Large international studies quantifying early-life antibiotic exposure along with EOS incidence are needed to provide a basis for future interventions aimed at safely reducing neonatal antibiotic exposure. OBJECTIVE To compare early postnatal exposure to antibiotics, incidence of EOS, and mortality among different networks in high-income countries. DESIGN, SETTING, AND PARTICIPANTS This is a retrospective, cross-sectional study of late-preterm and full-term neonates born between January 1, 2014, and December 31, 2018, in 13 hospital-based or population-based networks from 11 countries in Europe and North America and Australia. The study included all infants born alive at a gestational age greater than or equal to 34 weeks in the participating networks. Data were analyzed from October 2021 to March 2022. EXPOSURES Exposure to antibiotics started in the first postnatal week. MAIN OUTCOMES AND MEASURES The main outcomes were the proportion of late-preterm and full-term neonates receiving intravenous antibiotics, the duration of antibiotic treatment, the incidence of culture-proven EOS, and all-cause and EOS-associated mortality. RESULTS A total of 757 979 late-preterm and full-term neonates were born in the participating networks during the study period; 21 703 neonates (2.86%; 95% CI, 2.83%-2.90%), including 12 886 boys (59.4%) with a median (IQR) gestational age of 39 (36-40) weeks and median (IQR) birth weight of 3250 (2750-3750) g, received intravenous antibiotics during the first postnatal week. The proportion of neonates started on antibiotics ranged from 1.18% to 12.45% among networks. The median (IQR) duration of treatment was 9 (7-14) days for neonates with EOS and 4 (3-6) days for those without EOS. This led to an antibiotic exposure of 135 days per 1000 live births (range across networks, 54-491 days per 1000 live births). The incidence of EOS was 0.49 cases per 1000 live births (range, 0.18-1.45 cases per 1000 live births). EOS-associated mortality was 3.20% (12 of 375 neonates; range, 0.00%-12.00%). For each case of EOS, 58 neonates were started on antibiotics and 273 antibiotic days were administered. CONCLUSIONS AND RELEVANCE The findings of this study suggest that antibiotic exposure during the first postnatal week is disproportionate compared with the burden of EOS and that there are wide (up to 9-fold) variations internationally. This study defined a set of indicators reporting on both dimensions to facilitate benchmarking and future interventions aimed at safely reducing antibiotic exposure in early life.
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Affiliation(s)
- Eric Giannoni
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Varvara Dimopoulou
- Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Claus Klingenberg
- Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Lars Navér
- Department of Neonatology, Karolinska University Hospital and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Viveka Nordberg
- Department of Neonatology, Karolinska University Hospital and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Mother and Child Department, Policlinico University Hospital, Modena, Italy
| | - Salhab el Helou
- Division of Neonatology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Gerhard Fusch
- Division of Neonatology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Joseph M. Bliss
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence
| | - Dirk Lehnick
- Biostatistics and Methodology, CTU-CS, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Nicholas Guerina
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence
| | - Joanna Seliga-Siwecka
- Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, Warsaw, Poland
| | - Pierre Maton
- Service Néonatal, Clinique CHC-Montlegia, Groupe Santé CHC, Liège, Belgium
| | - Donatienne Lagae
- Neonatology and Neonatal Intensive Care Unit, CHIREC-Delta Hospital, Brussels, Belgium
| | - Judit Mari
- Department of Paediatrics, University of Szeged, Szeged, Hungary
| | - Jan Janota
- Neonatal Unit, Department of Obstetrics and Gynecology, Motol University Hospital Prague, Prague, Czech Republic
- Department of Pathological Physiology, 1st Medical School, Charles University Prague, Prague, Czech Republic
- Department of Neonatology, Thomayer University Hospital Prague, Prague, Czech Republic
| | - Philipp K. A. Agyeman
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Riccardo Pfister
- Neonatology and Paediatric Intensive Care Unit, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Giuseppe Latorre
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Gianfranco Maffei
- Neonatology and Neonatal Intensive Care Unit, Policlinico Riuniti Foggia, Foggia, Italy
| | - Nicola Laforgia
- Neonatologia e Terapia Intensiva Neonatale, University of Bari, Bari, Italy
| | - Enikő Mózes
- Perinatal Intensive Care Unit, Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
| | - Ketil Størdal
- Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Tobias Strunk
- Neonatal Directorate, Child and Adolescent Health Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Martin Stocker
- Department of Pediatrics, Children’s Hospital Lucerne, Lucerne, Switzerland
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7
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Zaza P, Indrio F, Fracchiolla A, Rinaldi M, Meliota G, Salatto A, Bonacaro A, Maffei G. Cleft Palate and Aortic Dilatation as Clues for Loeys–Dietz Syndrome. Children 2022; 9:children9091290. [PMID: 36138598 PMCID: PMC9497579 DOI: 10.3390/children9091290] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022]
Abstract
Loeys–Dietz syndrome (LDS) is a rare autosomal-dominant disorder of the connective tissue with some typical vascular findings, skeletal manifestations, craniofacial features, and cutaneous findings with a wide phenotypic spectrum. Six different genes are involved in LDS and the diagnosis is based on the identification of a heterozygous pathogenic variant in TGFBR1, TGFBR2, SMAD3, TGFB2, TGFB3, or SMAD2 in children with suggestive findings. These genes distinguish LDS into six classes (LDS1–LDS6, respectively). Delay in diagnosis of Loeys–Dietz syndrome may be associated with an adverse prognosis due to a very high augmented risk of early complications such as aortic or vascular rupture. The present report describes a case of an early diagnosis of LDS in a neonate with cleft soft palate and aortic root dilatation.
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Affiliation(s)
- Pierluigi Zaza
- Ospedali Riuniti Foggia Italy-U.O.C. Neonatologia e Terapia Intensiva Neonatale, 71100 Foggia, Italy
| | - Flavia Indrio
- Department of Medical and Surgical Science Pediatric Section, University of Foggia, 71100 Foggia, Italy
- Correspondence:
| | - Annalisa Fracchiolla
- Ospedali Riuniti Foggia Italy-U.O.C. Neonatologia e Terapia Intensiva Neonatale, 71100 Foggia, Italy
| | - Matteo Rinaldi
- Ospedali Riuniti Foggia Italy-U.O.C. Neonatologia e Terapia Intensiva Neonatale, 71100 Foggia, Italy
| | - Giovanni Meliota
- Ospedale Giovanni XXIII U.O. Cardiologia Pediatrica, 70124 Bari, Italy
| | - Alessia Salatto
- DAI Materno-Infantile, Azienda Ospedaliera-Universitaria Federico II di Napoli, 80100 Napoli, Italy
| | - Antonio Bonacaro
- School of Health and Sports Sciences, University of Suffolk, Ipswich IP4 1QJ, UK
| | - Gianfranco Maffei
- Ospedali Riuniti Foggia Italy-U.O.C. Neonatologia e Terapia Intensiva Neonatale, 71100 Foggia, Italy
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Salatto A, Indrio F, Campanella V, Maggipinto C, Cocomazzi R, Canale F, Nobili M, Maffei G, Bartoli F. Correction to: Idiopathic neonatal hemoperitoneum presented as scrotal hematoma: it's a diagnostic challenge? Ital J Pediatr 2022; 48:16. [PMID: 35101063 PMCID: PMC8805336 DOI: 10.1186/s13052-022-01212-x] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Alessia Salatto
- Department of Medical and Surgical Science University of Foggia, Pediatric Surgery Ospedali Riuniti Foggia, Foggia, Italy
| | - Flavia Indrio
- Department of Medical and Surgical Science University of Foggia, Pediatric Surgery Ospedali Riuniti Foggia, Foggia, Italy.
| | - Vittoria Campanella
- Department of Medical and Surgical Science University of Foggia, Pediatric Surgery Ospedali Riuniti Foggia, Foggia, Italy
| | - Cosetta Maggipinto
- Department of Medical and Surgical Science University of Foggia, Pediatric Surgery Ospedali Riuniti Foggia, Foggia, Italy
| | | | - Francesco Canale
- Department of Pediatric Surgery, AUO "Ospedali Riuniti", Foggia, Italy
| | - Maria Nobili
- Department of Pediatric Surgery, AUO "Ospedali Riuniti", Foggia, Italy
| | | | - Fabio Bartoli
- Department of Medical and Surgical Science University of Foggia, Pediatric Surgery Ospedali Riuniti Foggia, Foggia, Italy
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Indrio F, Marchese F, Rinaldi M, Maffei G, Dargenio V, Cinquepalmi R, Mantovani MP, Aceti A. Is acidemia at birth a risk factor for functional gastrointestinal disorders? Eur J Pediatr 2022; 181:3625-3633. [PMID: 35927380 PMCID: PMC9508039 DOI: 10.1007/s00431-022-04565-x] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/15/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
Abstract
UNLABELLED Functional gastrointestinal disorders (FGIDs) are common in early childhood. It has been demonstrated that neonatal acidemia at delivery can lead to significant neonatal morbidity. The primary aim of this study was to evaluate the relationship between acidemia at birth and the development of FGIDs, as regurgitation, colic, and constipation, in term infants. Term newborns born at the Foggia University Hospital, Italy during the year 2020 were included in the study. As per routine clinical practice, a cord blood gas analysis on a blood sample drawn from the umbilical artery (UA) of each infant immediately after birth was performed, and Apgar score was recorded. One year after birth, each infant's parents were interviewed through a phone call to investigate development of FGIDs, feeding practices, and morbidities. During the study period, 1574 term newborns met the inclusion criteria. The prevalence of infantile colic, regurgitation, and constipation was higher in infants with low UA pH (colic 51.5% vs. 25.4%, p < 0.001; regurgitation 30.6% vs. 15.2%, p < 0.001; constipation 24.6% vs. 16.0%, p = 0.015), with infants having moderate-severe acidemia facing the highest risk for all the examined FGIDs. In binary logistic regression analyses, UA pH and perinatal antibiotic exposure proved to be independently associated with the later diagnosis of each FGID. CONCLUSION Newborns with acidemia at birth appear to face a higher risk of FGIDs in infancy. Avoiding low cord blood pH should continue to be the goal for obstetricians, while enhanced long-term surveillance for infants who experienced birth acidemia should be required. WHAT IS KNOWN • Cord blood gas analysis is recommended in all high-risk deliveries, and in some centers, it is performed after all deliveries. • Neonatal acidemia at birth has been linked to adverse outcomes, mainly neurological. Recently, perinatal asphyxia has been reported to increase the risk of developing necrotizing enterocolitis in term infants. WHAT IS NEW • An association between acidemia at birth and risk of developing FGIDs such as regurgitation and colic during the first year of life had never been described so far. • An increased surveillance of infants with low UA pH at birth may be beneficial and could allow for early detection of any of the reported FGIDs.
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Affiliation(s)
- Flavia Indrio
- Department of Medical and Surgical Science, Pediatric Section, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Flavia Marchese
- Department of Medical and Surgical Science, Pediatric Section, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Matteo Rinaldi
- Department of Neonatology and NICU, Ospedali Riuniti Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Gianfranco Maffei
- Department of Neonatology and NICU, Ospedali Riuniti Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Vanessa Dargenio
- Department of Medical and Surgical Science, Pediatric Section, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Roberta Cinquepalmi
- Department of Medical and Surgical Science, Pediatric Section, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Massimo Pettoello Mantovani
- European Pediatric Association, Union of National European Pediatric Societies and Associations, Berlin, Germany ,Association Pour L’Activité Et La Recherche Scìentifiques, Nouchatel, Switzerland ,University of Foggia, Foggia, Italy ,Italian Society of Pediatrics, Rome, Italy ,Italian Academy of Pediatrics, Milan, Italy
| | - Arianna Aceti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy ,Neonatal Intensive Care Unit, IRCCS AOUBO, Via Massarenti 9, 40138 Bologna, Italy
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Indrio F, Pettoello Mantovani M, Salatto A, Rinaldi M, Nadia Dargenio V, Cristofori F, Marchese F, Paolo Bianchi F, Nappi L, Maffei G. Retrospective Study on Breastfeeding Practices by SARS-COV-2 Positive Mothers in a High Risk Area for Coronavirus Infection. Turk Arch Pediatr 2021; 56:479-484. [PMID: 35110118 PMCID: PMC8849628 DOI: 10.5152/turkarchpediatr.2021.21156] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND During the pandemic of SARS-Cov-2, among other clinical and public health issues, a major concern raised by SARS-CoV-2 is the possibility of transmission of the infection from mother to child in the perinatal period. This has placed a question mark on the safety of breastfeeding, with ambiguity on the joint management of SARS-CoV-2 positive or suspected mothers and their children. It was aimed to evaluate breastfeeding rates for newborns of asymptomatic SARS-CoV-2 positive mothers who were temporarily separated from their babies at birth, compared to those who were not separated. RESULTS Babies who were not isolated from their mothers at delivery were significantly more likely to be breastfed and were at no higher risk of infection with SARS-CoV-2. CONCLUSION Following the World Health Organization (WHO) recommendations and strict hand and mask hygiene measures, breastfeeding practices can be established and maintained through rooming-in, thus promoting the mother-child bond without compromising the safety of the newborn.
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Affiliation(s)
- Flavia Indrio
- Department of Medical and Surgical Science, University of Foggia, Italy,Corresponding author:Flavia Indrio ✉
| | | | - Alessia Salatto
- Department of Medical and Surgical Science, University of Foggia, Italy
| | - Matteo Rinaldi
- Department of Neonatology and NICU, Ospedali Riuniti, Foggia, Italy
| | - Vanessa Nadia Dargenio
- Department of Medical and Surgical Science, University of Foggia, Italy,Department of Biomedical Sciences and Human Oncology, “A. Moro” University, Bari, Italy
| | - Fernanda Cristofori
- Department of Biomedical Sciences and Human Oncology, “A. Moro” University, Bari, Italy
| | - Flavia Marchese
- Department of Medical and Surgical Science, University of Foggia, Italy
| | | | - Luigi Nappi
- Department of Medical and Surgical Science, University of Foggia, Italy
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Campanella V, Salatto A, Rinaldi M, Indrio F, Maggipinto C, Cocomazzi R, Canale F, Fracchiolla A, Nobili M, Maffei G, Bartoli F. Midgut volvulus and meconium peritonitis induced non-immune hydrops. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101927] [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: 11/26/2022] Open
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Liberatore P, Maffei G. Nasal High Frequency Oscillatory Ventilation for Respiratory Failure due to Respiratory Syncytial Virus Bronchiolitis: Case Report. AJP Rep 2020; 10:e253-e254. [PMID: 33094013 PMCID: PMC7571569 DOI: 10.1055/s-0040-1715179] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/01/2020] [Indexed: 11/12/2022] Open
Abstract
The authors describe a case of acute respiratory failure due to severe bronchiolitis. During high-flow nasal cannula ventilation, the blood's high levels of hypercapnia had taken them to plan the sedation and the orotracheal intubation. However, before attempting intubation, a nasal high frequency oscillatory ventilation cycle was performed and it led to a marked improvement in the blood gas, avoiding in this way the invasive ventilation.
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Affiliation(s)
- Pio Liberatore
- Neonatal Intensive Care Unit, Policlinico Riuniti, Foggia, Italy
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Dani C, Mosca F, Cresi F, Lago P, Lista G, Laforgia N, Del Vecchio A, Corvaglia L, Paolillo P, Trevisanuto D, Capasso L, Fanos V, Maffei G, Boni L. Patent ductus arteriosus in preterm infants born at 23-24 weeks' gestation: Should we pay more attention? Early Hum Dev 2019; 135:16-22. [PMID: 31212222 DOI: 10.1016/j.earlhumdev.2019.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Infants born at 23-24 weeks' gestation have the highest risk of developing a hemodynamically significant patent ductus arteriosus (hsPDA), that is refractory to pharmacological closure requiring surgical ligation. Thus, these patients might have the greatest benefits from hsPDA closure, although previous studies on PDA closure were not focused on this population. AIM To compare the occurrence of hsPDA, failure rate of the first course of ibuprofen in closing hsPDA, and need of surgical closure in infants born at 23+0-24+6 weeks' gestation to those in infants born at 25+0-28+6 weeks' gestation. STUDY DESIGN This is a retrospective multicenter study including infants born at 23+0-28+6 weeks of gestation admitted to the neonatal care units from January 2013 to December 2017. All infants underwent echocardiographical assessment for hsPDA diagnosis and eventually pharmacological treatment, and surgical closure. RESULTS We studied a total of 842 infants of which 562 (67%) developed a PDA. Among those with PDA, 511 (91%) received a pharmacological treatment for a hsPDA. We found that a hsPDA occurred in 70% (106/151) of infants born at 23-24 weeks and in 59% (405/691) of infants born at 25-28 weeks of gestation (P < 0.001). Failure of closure with the first-treatment cycle (69 vs. 40%; P < 0.001) and need of surgical closure (19 vs 10%) were more frequent (P < 0.011) in infants born at 23-24 than 25-28 gestational weeks. Paracetamol vs. ibuprofen treatment and gestational age of 23-24 versus 25-28 weeks increased closure failure, while less severe RDS and maternal clinical chorioamnionitis decreased it. CONCLUSIONS Among extremely preterm infants, infants born at 23-24 weeks of gestation have the highest risk of developing a hsPDA refractory to pharmacological treatment requiring surgical closure. Our findings support the need of individualized more careful strategies for hsPDA management in this special population.
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Affiliation(s)
- Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy; Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Italy.
| | - Fabio Mosca
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Francesco Cresi
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Paola Lago
- NICU, Ca' Foncello Hospital, Treviso, Italy
| | - Gianluca Lista
- Division of Neonatology, "V. Buzzi" Children's Hospital - ASST FBF/Sacco, Milan, Italy
| | - Nicola Laforgia
- Neonatal Intensive Care Unit, University Aldo Moro of Bari, Bari, Italy
| | - Antonello Del Vecchio
- Neonatal Intensive Care Unit, Department of Women's and Children's Health, "Di Venere" Hospital of Bari, Bari, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Piermichele Paolillo
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care, Casilino General Hospital, ASL RM B, Roma, Italy
| | - Daniele Trevisanuto
- Department of Woman's and Child's Health, Azienda Ospedaliera di Padova, University of Padua, Padua, Italy
| | - Letizia Capasso
- Division of Neonatology, Section of Pediatrics, Department of Translational Medical Sciences, Università Federico II of Naples, Naples, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Institute of Puericulture and Neonatal Section, Department of Surgery, University of Cagliari, Cagliari, Italy
| | - Gianfranco Maffei
- Neonatal Intensive Care Unit, University Hospital of Foggia, Foggia, Italy
| | - Luca Boni
- Clinical Trials Coordinating Center, Careggi University Hospital of Florence, Florence, Italy
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Petrillo F, Gizzi C, Maffei G, Matassa PG, Ventura ML, Ricci C, Pastorino R, Vento G. Neonatal respiratory support strategies for the management of extremely low gestational age infants: an Italian survey. Ital J Pediatr 2019; 45:44. [PMID: 30971298 PMCID: PMC6458627 DOI: 10.1186/s13052-019-0639-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/29/2019] [Indexed: 11/20/2022] Open
Abstract
Background We aimed to survey Delivery Room and Neonatal Intensive Care Unit (NICU) respiratory strategies dedicated to the extremely low gestational age newborn (ELGAN – GA < 28 wks) in Italy. Methods A questionnaire was sent to 113 Italian level III centres. A lead physician and a nurse with expertise in mechanical ventilation (MV) were identified in each unit to answer. Information about those aspects of ventilatory support considered by center’s staff as needing improvement was also collected. Results A 100% response rate was obtained. In the Delivery Room, sustained lung inflation was performed in 74.8% of centres, and 89.2% used NCPAP. For ELGANs who need invasive MV, conventional MV was the most used strategy. Volume-targeted ventilation and High-frequency oscillatory ventilation (HFOV) were considered as primary mode in < 30% of centres. Among non-invasive strategies, NCPAP was the most utilized, followed by BiPAP, High-flow nasal cannula and nasal intermittent positive pressure ventilation. Nurses more commonly recorded in the nursing charts the ventilator’s setting parameters rather than measured ones. HFOV and non-invasive ventilation were the most quoted aspects of neonatal ventilation felt as to be improved. Conclusion The routine respiratory support practices in Italy showed marked variations among units. Focused interventions are largely required to improve clinical practice.
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Affiliation(s)
| | - Camilla Gizzi
- Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy
| | - Gianfranco Maffei
- Division of Neonatology, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Foggia", Foggia, Italy
| | - Piero G Matassa
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | | | - Cinzia Ricci
- Department of Woman and Child Health and Public Health, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy.
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Luzi F, Puglia D, Sarasini F, Tirillò J, Maffei G, Zuorro A, Lavecchia R, Kenny J, Torre L. Valorization and extraction of cellulose nanocrystals from North African grass: Ampelodesmos mauritanicus (Diss). Carbohydr Polym 2019; 209:328-337. [DOI: 10.1016/j.carbpol.2019.01.048] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 02/08/2023]
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Bottino R, Pontiggia F, Ricci C, Gambacorta A, Paladini A, Chijenas V, Liubsys A, Navikiene J, Pliauckiene A, Mercadante D, Colnaghi M, Tana M, Tirone C, Lio A, Aurilia C, Pastorino R, Purcaro V, Maffei G, Liberatore P, Consigli C, Haass C, Lista G, Agosti M, Mosca F, Vento G. Nasal high-frequency oscillatory ventilation and CO 2 removal: A randomized controlled crossover trial. Pediatr Pulmonol 2018; 53:1245-1251. [PMID: 29999596 DOI: 10.1002/ppul.24120] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/20/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To compare short-term application of nasal high-frequency oscillatory ventilation (nHFOV) with nasal continuous positive airway pressure (nCPAP). WORKING HYPOTHESIS nHFOV improves CO2 removal with respect to nCPAP in preterm infants needing noninvasive respiratory support and persistent oxygen supply after the first 72 h of life. STUDY DESIGN Multicenter non-blinded prospective randomized crossover study. PATIENT SELECTION Thirty premature infants from eight tertiary neonatal intensive care units, of mean ± SD 26.4 ± 1.8 weeks of gestational age and 921 ± 177 g of birth weight. METHODOLOGY Infants were randomly allocated in a 1:1 ratio to receive a starting treatment mode of either nCPAP or nHFOV delivered by the ventilator CNO (Medin, Germany), using short binasal prongs of appropriate size. A crossover design with four 1-h treatment periods was used, such that each infant received both treatments twice. The primary outcome was the mean transcutaneous partial pressure of CO2 (TcCO2 ) value during the 2-h cumulative period of nHFOV compared with the 2-h cumulative period of nCPAP. RESULTS Significantly lower TcCO2 values were observed during nHFOV compared with nCPAP: 47.5 ± 7.6 versus 49.9 ± 7.2 mmHg, respectively, P = 0.0007. A different TcCO2 behavior was found according to the random sequence: in patients starting on nCPAP, TcCO2 significantly decreased from 50.0 ± 8.0 to 46.6 ± 7.5 mmHg during nHFOV (P = 0.001). In patients starting on nHFOV, TcCO2 slightly increased from 48.5 ± 7.8 to 49.9 ± 6.7 mmHg during nCPAP (P = 0.13). CONCLUSIONS nHFOV delivered through nasal prongs is more effective than nCPAP in improving the elimination of CO2 .
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Affiliation(s)
- Roberto Bottino
- Department for the Protection of Women's Health and the Nascent Life, Division of Neonatology, Fondazione Poliambulanza, Brescia, Italy
| | - Federica Pontiggia
- Department for the Protection of Women's Health and the Nascent Life, Division of Neonatology, Fondazione Poliambulanza, Brescia, Italy
| | - Cinzia Ricci
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Gambacorta
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angela Paladini
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Arunas Liubsys
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Jurate Navikiene
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Ausrine Pliauckiene
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Domenica Mercadante
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Mariarosa Colnaghi
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Milena Tana
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Chiara Tirone
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Lio
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudia Aurilia
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore Rome, Rome, Italy
| | - Velia Purcaro
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianfranco Maffei
- Division of Neonatology, Azienda Ospedaliero, Universitaria Ospedali Riuniti di Foggia, Foggia, Italy
| | - Pio Liberatore
- Division of Neonatology, Azienda Ospedaliero, Universitaria Ospedali Riuniti di Foggia, Foggia, Italy
| | - Chiara Consigli
- Division of Neonatology, Ospedale San Pietro FBF, Rome, Italy
| | - Cristina Haass
- Division of Neonatology, Ospedale San Pietro FBF, Rome, Italy
| | - Gianluca Lista
- Department of Pediatrics, NICU, Ospedale dei Bambini V. Buzzi, ASST-FBF-Sacco, Milan, Italy
| | - Massimo Agosti
- Division of Neonatology, Ospedale Pilippo del Ponte, Varese, Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Vento
- Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
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Puigbò JY, Maffei G, Herreros I, Ceresa M, González Ballester MA, Verschure PFMJ. Cholinergic Behavior State-Dependent Mechanisms of Neocortical Gain Control: a Neurocomputational Study. Mol Neurobiol 2017; 55:249-257. [DOI: 10.1007/s12035-017-0737-6] [Citation(s) in RCA: 3] [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] [Indexed: 01/01/2023]
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Maffei G, Gorgoglione S, Vento G. Noninvasive ventilation: Systematic approach and new perspectives for preterm infants. J Clin Neonatol 2017. [DOI: 10.4103/jcn.jcn_121_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vento G, Pastorino R, Boni L, Cota F, Carnielli V, Cools F, Dani C, Mosca F, Pillow J, Polglase G, Tagliabue P, van Kaam AH, Ventura ML, Tana M, Tirone C, Aurilia C, Lio A, Ricci C, Gambacorta A, Consigli C, D'Onofrio D, Gizzi C, Massenzi L, Cardilli V, Casati A, Bottino R, Pontiggia F, Ciarmoli E, Martinelli S, Ilardi L, Colnaghi M, Matassa PG, Vendettuoli V, Villani P, Fusco F, Gazzolo D, Ricotti A, Ferrero F, Stasi I, Magaldi R, Maffei G, Presta G, Perniola R, Messina F, Montesano G, Poggi C, Giordano L, Roma E, Grassia C, Ausanio G, Sandri F, Mescoli G, Giura F, Garani G, Solinas A, Lucente M, Nigro G, Del Vecchio A, Petrillo F, Orfeo L, Grappone L, Quartulli L, Scorrano A, Messner H, Staffler A, Gargano G, Balestri E, Nobile S, Cacace C, Meli V, Dallaglio S, Pasqua B, Mattia L, Gitto E, Vitaliti M, Re MP, Vedovato S, Grison A, Berardi A, Torcetta F, Guidotti I, di Fabio S, Maranella E, Mondello I, Visentin S, Tormena F. Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - "IN-REC-SUR-E" - in preterm neonates with respiratory distress syndrome: study protocol for a randomized controlled trial. Trials 2016; 17:414. [PMID: 27538798 PMCID: PMC4991115 DOI: 10.1186/s13063-016-1498-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 07/31/2016] [Indexed: 11/15/2022] Open
Abstract
Background Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an “optimal” functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria. Methods/design In this study, 206 spontaneously breathing infants born at 24+0–27+6 weeks’ gestation and failing nCPAP during the first 24 h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3 days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30 min after surfactant administration or when they meet the nCPAP failure criteria after extubation. Discussion From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following hypothesis: a lung recruitment maneuver performed with a step-by-step Continuous Distending Pressure increase during High-Frequency Oscillatory Ventilation (and not with a sustained inflation) could have a positive effects in terms of improved surfactant distribution and consequent its major efficacy in preterm newborns with respiratory distress syndrome. This represents our challenge. Trial registration ClinicalTrials.gov identifier: NCT02482766. Registered on 1 June 2015.
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Affiliation(s)
- Giovanni Vento
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Luca Boni
- Clinical Trials Coordinating Center of Istituto Toscano Tumori, Department of Oncology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Cota
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Virgilio Carnielli
- Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Filip Cools
- Department of Neonatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Carlo Dani
- Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital, Viale Morgagni 85, 50141, Florence, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan-Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Della Commenda 12, 20122, Milan, Italy
| | - Jane Pillow
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia
| | - Graeme Polglase
- The Ritchie Centre Hudson Institute of Medical Research and Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168, VIC, Australia
| | | | - Anton H van Kaam
- Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Milena Tana
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Chiara Tirone
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Claudia Aurilia
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Alessandra Lio
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Cinzia Ricci
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Alessandro Gambacorta
- Division of Neonatology, Department for the Protection of Women's Health and the Nascent Life, Child and Adolescent, Policlinico A. Gemelli - Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
| | | | | | - Camilla Gizzi
- Ospedale S. Giovanni Calibita Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Luca Massenzi
- Ospedale S. Giovanni Calibita Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Viviana Cardilli
- Università di Roma "La Sapienza"/Policlinico Umberto I, Rome, Italy
| | | | | | | | | | | | | | - Mariarosa Colnaghi
- Department of Clinical Sciences and Community Health, University of Milan-Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Della Commenda 12, 20122, Milan, Italy
| | - Piero Giuseppe Matassa
- Department of Clinical Sciences and Community Health, University of Milan-Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Della Commenda 12, 20122, Milan, Italy
| | - Valentina Vendettuoli
- Department of Clinical Sciences and Community Health, University of Milan-Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Della Commenda 12, 20122, Milan, Italy
| | | | | | - Diego Gazzolo
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Ricotti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Federica Ferrero
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Ilaria Stasi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Rosario Magaldi
- Azienda Ospedaliero-Universitaria Ospedali Riuniti, Foggia, Italy
| | | | | | | | | | | | | | | | - Enza Roma
- Casa di Cura Pineta Grande, Castelvolturno (CE), Italy
| | | | - Gaetano Ausanio
- Azienda Ospedaliera Sant' Anna e San Sebastiano, Caserta, Italy
| | | | | | | | - Giampaolo Garani
- Azienda Ospedaliero-Universitaria Arcispedale S. Anna, Ferrara, Italy
| | - Agostina Solinas
- Azienda Ospedaliero-Universitaria Arcispedale S. Anna, Ferrara, Italy
| | | | | | | | | | | | | | | | | | | | | | - Giancarlo Gargano
- Azienda Ospedaliera Arcispedale S.Maria Nuova di Reggio Emilia/IRCCS, Reggio Emilia, Italy
| | - Eleonora Balestri
- Azienda Ospedaliera Arcispedale S.Maria Nuova di Reggio Emilia/IRCCS, Reggio Emilia, Italy
| | - Stefano Nobile
- Polytechnic University of Marche and Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | | | | | - Sara Dallaglio
- Azienda Ospedaliera-Universitaria di Parma, Parma, Italy
| | - Betta Pasqua
- Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele- PO G. Rodolico, Catania, Italy
| | - Loretta Mattia
- Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele- PO G. Rodolico, Catania, Italy
| | - Eloisa Gitto
- Azienda Ospedaliero-Universitaria Policlinico "G. Martino", Messina, Italy
| | - Marcello Vitaliti
- Azienda Ospedaliera di rilievo nazionale e di alta specializzazione Arnas Civico, Palermo, Italy
| | - Maria Paola Re
- Azienda Ospedaliera di rilievo nazionale e di alta specializzazione Arnas Civico, Palermo, Italy
| | | | | | | | | | | | | | | | - Isabella Mondello
- Azienda ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
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Abstract
Preterm birth is a significant problem in the world regarding perinatal mortality and morbidity in the long term, especially bronchopulmonary dysplasia (BPD). Premature delivery is often associated to failure in transition to create an early functional residual capacity (FRC), since many preterm babies need frequently respiratory support. The first and most effective preventive measure to reduce the incidence of BPD is represented by the attempt to avoid preterm birth. Whenever this fails, the prevention of every known risk factors for BPD should start in the delivery room and should be maintained in the NICU through the use of tailored management of high-risk infants.
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Affiliation(s)
- Francesca Castoldi
- Neonatal Pulmonology Study Group, Italian Society of Neonatology, Italy; NICU-V. Buzzi-Ospedale dei Bambini, ICP, Milan, Italy.
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Maffei G, Magaldi L, Cassano P, Cassano M, Cella A, Magaldi R. Reversible facial nerve palsy secondary to nasal continuous positive airway pressure. J Perinat Med 2009; 36:550-1. [PMID: 18673084 DOI: 10.1515/jpm.2008.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Maffei G, Rinaldi M, Rinaldi G. Resolution of peripheral tissue ischemia secondary to arterial vasospasm following treatment with a topical nitroglycerin device in two newborns: case reports. J Perinat Med 2006; 34:252. [PMID: 16602850 DOI: 10.1515/jpm.2006.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
BACKGROUND The use of flexible rings for tricuspid valve repair is becoming popular. The purpose of this study was to evaluate the Cosgrove-Edwards annuloplasty system for tricuspid regurgitation. METHODS From June 1998 to December 2000, 22 patients with significant secondary tricuspid regurgitation underwent tricuspid valve repair with the Cosgrove-Edwards annuloplasty system. All patients had disease of left-sided heart valves in addition to tricuspid disease; 34 concomitant procedures were performed. Twenty-one patients (95.5%) were in preoperative New York Heart Association functional class 3 or 4. The mean follow-up was 19.9 +/- 9.7 months. RESULTS There were two in-hospital nonvalve-related cardiac deaths (9.1%) and one noncardiac death after discharge (4.5%). All survivors were in New York Heart Association functional class 1 or 2; their tricuspid regurgitation was well controlled within grade 1+ and there was a significant reduction of systolic pulmonary artery pressure. Five (83.3%) of the 6 survivors with preoperative pulmonary hypertension had no or trivial residual tricuspid regurgitation. CONCLUSIONS The Cosgrove-Edwards annuloplasty system is very effective in the treatment of secondary tricuspid regurgitation, also in the presence of pulmonary hypertension.
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Affiliation(s)
- G Gatti
- Division of Cardiac Surgery, Nursing Home Villa Torri, Bologna, Italy.
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van Steenberghe D, Quirynen M, Naert I, Maffei G, Jacobs R. Marginal bone loss around implants retaining hinging mandibular overdentures, at 4-, 8- and 12-years follow-up. J Clin Periodontol 2001; 28:628-33. [PMID: 11422583 DOI: 10.1034/j.1600-051x.2001.028007628.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [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: 11/23/2022]
Abstract
AIM The aim of the present study was to study the effect of occlusal factors, oral hygiene, gender and age on the long-term maintenance of alveolar bone height around screw-shaped machined surface commercially pure (c.p.) titanium implants retaining hinging mandibular overdentures. METHOD In this retrospective study a long-term (4-, 8-, up to 12-years) follow-up of such implant-retained overdentures was performed. From the population of patients so treated at the University Hospital of the Catholic University Leuven, Department of Periodontology and Department of Prosthetic Dentistry, 158 patients were selected on the basis of being treated before March 1994, and the availability of intra-oral radiographs (paralleling technique) present at abutment connection (baseline) and at years 4, 8, and 12. For each patient, all relevant clinical data were recorded, and measurements of marginal bone height around the implants were performed on intra-oral radiographs by means of a digital sliding caliper. RESULTS Results indicated that only the factor "time" had a significant influence on marginal bone loss. The age and gender of the patients, dental/prosthetic status in the antagonistic jaw, oral hygiene variables, and location of the implants had no significant effect. CONCLUSION The very high cumulative success rate (97.2%) and limited marginal bone loss (on average 1.7 mm) after 12-years, encourage this kind of treatment using this type of implants.
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Affiliation(s)
- D van Steenberghe
- Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Catholic University Leuven, Leuven, Belgium.
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Maffei G, Colarizi P, Orzalesi M, Favata P, Favata F. Care procedures in the healthy full-term newborn infant: a territorial survey. Acta Biomed Ateneo Parmense 1999; 68 Suppl 1:7-10. [PMID: 10021710] [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: 02/10/2023]
Abstract
The Italian Academy of Pediatrics and the Italian Academy of Neonatology have carried out an investigation regarding assistance routines for the healthy full-term newborn. The results confirm a need for modifications in the majority of the centers, especially with regard to Vitamin K prophylaxis which is implemented with extremely variable dosages and not repeated, and to breast-feeding and rooming-in, both of which should be more encouraged. The length of stay in hospital for both vaginal and cesarean deliveries, especially in Lazio, is excessive. Regarding ocular prophylaxis and allergic disease prophylaxis, the attitude is uniform and in agreement with recent literature.
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Azzali G, Gennari PU, Maffei G, Ferri T. Vallate, foliate and fungiform human papillae gustatory cells. An immunocytochemical and ultrastructural study. Minerva Stomatol 1996; 45:363-79. [PMID: 8950860] [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: 02/03/2023]
Abstract
We studied the classifications, topographic distribution and cellular lines of taste bud components in vallate, foliate and fungiform papillae of young, mature and old men with light microscopy, SEM, and TEM. By identifying ultrastructural and immunocytochemical characteristics, three distinct sensorial cells were identified, along with a few basal cells: dark type I cells, light type II cells and light type III cells. These cells extend from the epithelial basal lamina to the gustatory canal, where their apical cytoplasm sends long microvillous expansions. Excluding those of the fungiform papillae-which never go beyond the lower third of the gustatory canal, and are always void of dense substance-the microvillous expansions continue to the external border of the taste pore. Dark type I cells are rich in free ribosomes, tubular RER and large dense granules. Light type II cells with scarce ribosomes and RER, do not have enough peculiar ultrastructural characteristics to be considered effector or phagocyte elements. Light type III cells are characterizes by dense core vesicles whose peculiar ultrastructural characteristics in the foliate and vallate papillae, should be considered a consequence of different functional phases. After comparative evaluation the authors hypothesized on the functional value of some ultrastructural aspects and on the dense core vesicles which are immunoreactive to 5-HT. They observed that all gustatory cells are involved in taste transduction based on behaviours caused by microvilli in the gustatory canal and gustatory cell relationships with nerve endings. Moreover the authors noted that age does not seem to influence taste perception.
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Affiliation(s)
- G Azzali
- Istituto di Anatomia Umana Normale, Università degli Studi, Parma
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Sulpasso M, Campagnola S, Maffei G, Bailoni W, Fasoli L, Bettili G, Ottolenghi A. [Transsphincteral anorectal malformations]. MINERVA CHIR 1992; 47:407-10. [PMID: 1589089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Sulpasso
- Istituto di Patologia Speciale Chirurgica, Università degli Studi di Verona
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Commeau P, Grollier G, Lamy E, Foucault JP, Durand C, Maffei G, Maiza D, Khayat A, Potier JC. Percutaneous balloon dilatation of calcific aortic valve stenosis: anatomical and haemodynamic evaluation. Heart 1988; 59:227-38. [PMID: 3342163 PMCID: PMC1276989 DOI: 10.1136/hrt.59.2.227] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Two groups of elderly patients with calcified aortic stenosis were treated by balloon dilatation. In group 1, the valve was dilated just before surgical replacement of the valve. The valvar and annular changes occurring during dilatation were examined visually. In 20 of the 26 patients in this group there was no change. In the six remaining patients mobilisation of friable calcific deposits (1 case), slight tearing of the commissure (4 cases), or tearing of the aortic ring (1 case) were seen. Dilatation did not appear to alter valvar rigidity. In 14 patients (group 2) the haemodynamic gradient across the aortic valve was measured before and immediately after dilatation and one week after the procedure. Dilatation produced an immediate significant decrease of the aortic mean gradient and a significant increase of the aortic valve area. Eight days later the mean gradient had increased and the aortic valve area had decreased. Nevertheless there was a significant difference between the initial gradient and the gradient eight days after dilatation. The initial aortic valve area was also significantly larger than the area eight days after dilatation. The aortic valve gradient rose significantly in the eight days after dilatation and at follow up the gradients were those of severe aortic stenosis.
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Affiliation(s)
- P Commeau
- Service de Réanimation Cardiologique, CHU Côte de Nâcre, Caen, France
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29
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Ciuffo C, Maffei G, Guadagni AM, Virgili Q. [Renal damage in post-asphyxia syndrome]. Minerva Pediatr 1987; 39:1139-45. [PMID: 3451070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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30
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Pignatelli V, Maffei G, Ruiu U, Orsitto E, Savino A. [Xerography in the study of Achilles paratendinopathies and tendinopathies]. Radiol Med 1987; 73:407-13. [PMID: 3589015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The authors report their experience in the examination of Achilles tendon, performed with xeroradiography, in 120 young men, affected by Achilles tendon diseases caused by sports. With xeroradiography it is possible to diagnose tendinosis with peritendinitis and pure tendinosis not revealed by clinical examination; radiological diagnostic contribution is particularly important in partial and old ruptures. The necessity is remarked to employ xeroradiography in association with ultrasound to correctly classify the various forms of Achilles tendinopathies and paratendinopathies.
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Giannini S, Girolami M, Ceccarelli F, Maffei G. Modified Jones operation in the treatment of pes cavovarus. Ital J Orthop Traumatol 1985; 11:165-70. [PMID: 4066287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The authors describe their technique and results in the treatment of pes cavovarus by transposition of extensor hallucis brevis to the first metatarsal (Jones operation) in association with arthrodesis of the interphalangeal joint of the hallux. In cases of structural deformity it is also combined with osteotomy of the base of the first metatarsal.
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Giannini S, Maffei G, Girolami M, Ceccarelli F. The treatment of supracondylar fractures of the humerus in children by closed reduction and fixation with percutaneous Kirschner wires. Ital J Orthop Traumatol 1983; 9:181-8. [PMID: 6654653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The results are reported of 50 consecutive cases of supracondylar fracture of the humerus in children treated by closed reduction and fixation by two parallel percutaneous Kirschner wires. A classification based on clinical and radiological findings is proposed. This is orientated both to treatment and prognosis. The technique of fixation is described and the results of four years experience of this method are reported. The long term results confirm the validity of the method, which has undoubted advantages over traditional methods. Early treatment is essential in cases with neurological or vascular complications.
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Pellegrini-Caliumi G, Agostino R, Nodari S, Maffei G, Moretti C, Bucci G. Evaluation of an automatic oscillometric method and of various cuffs for the measurement of arterial pressure in the neonate. Acta Paediatr Scand 1982; 71:791-7. [PMID: 7180448 DOI: 10.1111/j.1651-2227.1982.tb09521.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We compared simultaneous measurement of aortic, direct (Dir) and of indirect (Ind) systolic (S), mean (M) and diastolic (D) arterial pressure (AP) determined by an automatic oscillometric instrument (DINAMAP) in neonates with birthweight of 1000-3680 g. DINAMAP measurements were performed with cuffs of increasing width and length, recommended by the manufacturer for increasing arm circumference, and with a Standard sized cuff (2.5 X 15 cm), previously considered as suitable for neonates of any body size. In addition, we compared simultaneous measurements of Dir SAP and of Ind SAP determined by a Doppler technique and the Standard cuff. In DINAMAP SAP measurements with the Standard cuff, a statistically significant correlation between arm circumference and delta Ind-Dir SAP values (i.e. the difference between simultaneous Ind and Dir SAP measurements) was found. In DINAMAP MAP measurements with the cuff recommended for arm circumference, a statistically significant difference of the mean delta Ind-Dir MAP values was observed in infants whose arm was or was not completely encircled by the bladder of the cuff. In SAP as well as in MAP DINAMAP determinations, the overall error of measurement with the Standard cuff was smaller than with the recommended cuff. The Doppler method was found considerably more accurate than the DINAMAP method for the determination of SAP. In spite of these limitations, the DINAMAP method with the Standard cuff was considered to be reasonably accurate for the clinical determination of SAP and MAP, provided that several consecutive measurements are performed and averaged in order to minimize the error of measurement. When considering DAP measurements the error was so unacceptably high that the DINAMAP method cannot be recommended for clinical use. The need for a careful consideration of the cuff characteristics when evaluating new methods for the indirect measurement of AP in the neonate is emphasized.
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35
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Giovannucci Uzielli ML, Bettini F, Carattoli MT, Maffei G. [Greig's syndrome or Pehu's essential hypertelorism syndrome]. Minerva Pediatr 1979; 31:1015-22. [PMID: 481368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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36
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Klein H, Maffei G, D'Elia L, Binazzi. [Functional morphology of the synovial membrane]. Wien Med Wochenschr 1978; 128:165-8. [PMID: 645087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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37
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Ioppolo C, Amiconi G, Currell DL, Maffei G, Zolla L, Antonini E. Biochemical changes on storage of blood. Decrease in rate of methemoglobin reduction and increase in oxygen affinity on storage of ACD blood. Vox Sang 1974; 27:403-10. [PMID: 4420776 DOI: 10.1111/j.1423-0410.1974.tb02437.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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38
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Confalonieri A, Lucchese V, Maffei G. [Report and comments on gynecologic surgical activity at the Ospedale di Circolo di Cittiglio]. Minerva Ginecol 1971; 23:746-60. [PMID: 5131183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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39
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Maffei G, Zini C, Jemmi A, Bottazzi D. [Research on the vascularization of the facial nerve (with special reference to the intratemporal portion)]. Arch Ital Otol Rinol Laringol Patol Cervicofacc Suppl 1970; 51:1-106. [PMID: 5271054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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40
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De Sanctis C, Maffei G. [Effects of irradiation with gamma rays of cobalt-60 on injectable solutions of cyanocobalamin and hydroxycobalamin]. Minerva Med 1969; 60:3889-902. [PMID: 5348218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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41
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Maffei G, Zini C. [The lymph of the lingual tonsil. (Comparative study of the morphological composition of pre- and post-lymph-node lymph of the lingual and palatine tonsils]. Clin Otorinolaringoiatr 1968; 20:3-27. [PMID: 5700353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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42
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Maffei G. [Prevention and therapy of disorders in maternal-fetal circulation during labor and in uterosclerosis]. Quad Clin Ostet Ginecol 1968; 23:9-26. [PMID: 5735180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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43
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Maffei G, Zini C, Bottazzi D. [Labyrinthine thermal stimulator with automatic temperature conntrol]. Arch Ital Otol Rinol Laringol Patol Cervicofacc 1967; 78:668-72. [PMID: 4388650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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44
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Maffei G, Zini C, Bottazzi D. [On the phenomenon of paradoxical lateralization of sound by air conduction (P.L.A.)]. Clin Otorinolaringoiatr 1967; 19:163-70. [PMID: 5603395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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45
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Maffei G, Bottazzi D, Boles Carenini B, Orzalesi N. [Influence of acoustic stimuli on electroretinographic tracings of normal subjects]. Riv Otoneurooftalmol 1966; 41:503-10. [PMID: 5998148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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46
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Pescetto G, Maffei G. [Pharmacological treatment of tics]. Riv Neurobiol 1966; 12:365-73. [PMID: 5981852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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47
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Boles Carenini B, Orzalesi N, Maffei G, Zini C. [Pupillographic changes induced by diverse acoustic stimulations in normal subjects]. Boll Ocul 1966; 45:75-82. [PMID: 5918769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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48
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Maffei G, Fontana L. [The fragiligram in clinical use]. Minerva Med 1965; 56:3972-4. [PMID: 5847549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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49
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Maffei G, Poggiali B. [Considerations on the concepts of C. G. Jung on the subject of the pathogenesis of schizophrenia]. Riv Patol Nerv Ment 1965; 86:455-72. [PMID: 5331796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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50
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Salvatori R, Maffei G, Mango G. [Blood protein picture in primary syphilis]. G Med Mil 1965; 115:343-350. [PMID: 5845805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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