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Mariani MV, Pierucci N, Forleo GB, Schiavone M, Bernardini A, Gasperetti A, Mitacchione G, Mei M, Giunta G, Piro A, Chimenti C, Miraldi F, Vizza CD, Lavalle C. The Feasibility, Effectiveness and Acceptance of Virtual Visits as Compared to In-Person Visits among Clinical Electrophysiology Patients during the COVID-19 Pandemic. J Clin Med 2023; 12:jcm12020620. [PMID: 36675547 PMCID: PMC9865180 DOI: 10.3390/jcm12020620] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/27/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
The feasibility and effectiveness of virtual visits (VVs) for cardiac electrophysiology patients are still unknown. We aimed to assess the feasibility and effectiveness of VVs as compared to in-person visits, and to describe patient experience with virtual care in clinical electrophysiology. We prospectively enrolled patients scheduled to receive a clinical electrophysiology evaluation, dividing them in two groups: a VV group and an in-person visit group. Outcomes of interest were: (1) improvement in symptoms after the index visit, (2) disappearance of remote monitoring (RM) alerts at follow-up, (3) necessity of urgent hospitalization and (4) patient satisfaction measured by the Patient Satisfaction Questionnaire-18 (PSQ-18). This study included 162 patients in the VV group and 185 in the in-office visit group. As compared to in-person visits, VVs resulted in a similar reduction in RM alerts (51.5% vs. 43.2%, p-value 0.527) and in symptomatic patient rates (73.6% vs. 56.9%, p-value 0.073) at follow-up, without differences in urgent hospitalization rates (p-value 0.849). Patient satisfaction with VVs was higher than with in-person evaluation (p-value < 0.012). VVs proved to be as feasible and as effective as in-person visits, with high patient satisfaction. A hybrid model of care including VVs and in-person visits may become the new standard of care after the COVID-19 pandemic is over.
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Affiliation(s)
- Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Nicola Pierucci
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Giovanni Battista Forleo
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Marco Schiavone
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Alessio Gasperetti
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Gianfranco Mitacchione
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Mariachiara Mei
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Fabio Miraldi
- Cardio Thoracic-Vascular and Organ Transplantation Surgery Department, Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Carmine Dario Vizza
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Correspondence:
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2
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Magnocavallo M, Vetta G, Bernardini A, Piro A, Mei MC, Di Iorio M, Mariani MV, Della Rocca DG, Severino P, Quaglione R, Giunta G, Chimenti C, Miraldi F, Vizza CD, Fedele F, Lavalle C. Impact of COVID-19 Pandemic on Cardiac Electronic Device Management and Role of Remote Monitoring. Card Electrophysiol Clin 2022; 14:125-131. [PMID: 35221081 PMCID: PMC8556573 DOI: 10.1016/j.ccep.2021.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
During the coronavirus disease 2019 (COVID-19) worldwide pandemic, patients with cardiac implantable electronic device (CIED) refused scheduled follow-up visits because of the risk of infection. In this scenario, different telemedicine strategies have been implemented to ensure continuity of care to CIED patients. Patients can be monitored through dedicated applications, telephone calls, or virtual visits providing easy access to valuable information, such as arrhythmic events, acute decompensation manifestations, and device-related issues, without the need for in-person visits. This review provides a comprehensive description of the many possible applications of telemedicine for CIED patients during the COVID-19 period.
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Affiliation(s)
- Michele Magnocavallo
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 720, Austin, TX 78705, USA
| | - Giampaolo Vetta
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Domenico G Della Rocca
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 North IH-35, Suite 720, Austin, TX 78705, USA
| | - Paolo Severino
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Fabio Miraldi
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Carmine Dario Vizza
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Francesco Fedele
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular/Respiratory Diseases, Nephrology, Anesthesiology, and Geriatric Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
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Magnocavallo M, Vetta G, Trivigno S, Mariani MV, DI Lullo L, Bellasi A, Della Rocca DG, Severino P, Piro A, Giunta G, Quaglione R, Lavalle C. The Connubium among diabetes, chronic kidney disease and atrial fibrillation. Minerva Cardiol Angiol 2022; 70:393-402. [PMID: 35212508 DOI: 10.23736/s2724-5683.22.05891-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The burden of cardiovascular comorbid conditions was significantly higher in patients with Atrial Fibrillation (AF); most of them are affected by hypertension, Chronic Kidney Disease (CKD) and/or Diabetes Mellitus (DM). DM represents a well-known risk factor for the development and maintenance of AF; the coexistence of DM and AF is also associated with an increased risk of mortality and stroke. Moreover, DM is currently the main cause of renal impairment and the leading cause of dialysis in the world. The hyperglycemia is responsible for inducing redox imbalance and both systemic and intrarenal inflammation, playing a critical role in the pathogenesis of diabetic kidney disease. Long-term thromboembolic preventive therapy in AF patients with DM and CKD may be more challenging because both DM and CKD have been independently associated with an increased thromboembolic and bleeding risk, which results from the prothrombotic and pro-inflammatory status. Vitamin K Antagonists (VKAs) are characterized by numerous critical issues such as a narrow therapeutic window, increased tissue calcification and an unfavourable risk/benefit ratio with low stroke prevention effect and augmented risk of major bleeding. On the other hand, Direct Oral Anticoagulants (DOACs) are currently contraindicated in dialysis patients even if mounting evidence suggests that they may have a nephroprotective role in AF patients with DM and CKD. Consequently, the choice of anticoagulant therapy in this setting of patient seems to be very challenging. The aim of this review is to investigate the role of DOACs in diabetic patients and its nephroprotective role by reviewing the current literature.
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Affiliation(s)
- Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco V Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Luca DI Lullo
- Department of Nephrology and Dialysis, L. Parodi - Delfino Hospital, Colleferro, Roma, Italy
| | - Antonio Bellasi
- Innovation and Brand Reputation Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Paolo Severino
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy -
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Mancone M, Maestrini V, Fusto A, Adamo F, Scarparo P, D’Ambrosi A, Cinque A, Gatto MC, Salvi N, Agnes G, Pucci M, Birtolo LI, Marruncheddu L, Genuini I, De Lazzari C, Severino P, Giunta G, Lavalle C, Fegatelli DA, Vestri A, Fedele F. ECG evaluation in 11 949 Italian teenagers: results of screening in secondary school. J Cardiovasc Med (Hagerstown) 2022; 23:98-105. [PMID: 34570036 PMCID: PMC8855949 DOI: 10.2459/jcm.0000000000001259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/04/2021] [Accepted: 08/29/2021] [Indexed: 01/02/2023]
Abstract
AIM There is lack of evidence regarding the screening role of ECG for sudden cardiac death (SCD) prevention. Our aim was to evaluate the prevalence of ECG abnormalities among teenagers according to sport participation and competitive status. METHODS Eleven thousand nine hundred and forty-nine Italian pupils from 179 secondary schools (13-19 years) were consecutively enrolled. ECG abnormalities were divided into minor and major. Medical history, clinical examination and sport activity information were acquired. Further evaluations were suggested in case of major ECG abnormalities. Follow-up was performed at 2 years. RESULTS N = 1945 (16%) pupils had ECG abnormalities. Major ECG abnormalities were detected in 13% of the cohort, minor in 34%. ECG abnormalities were more common in nonathletes compared with athletes. A diagnosis of cardiac disease was reached in 25 (1.6%) of the pupils with major ECG abnormalities. CONCLUSION ECG abnormalities are common among young populations and more prevalent in nonathletes. Among pupils with major ECG abnormalities 1.6% had a cardiac disease diagnosis. Our results are in line with the data supporting ECG screening in the general young population.
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Affiliation(s)
- Massimo Mancone
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Antonio Fusto
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Francesco Adamo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Paola Scarparo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Alessandra D’Ambrosi
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Alessandra Cinque
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Maria Chiara Gatto
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Nicolò Salvi
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Gianluca Agnes
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Mariateresa Pucci
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Lucia Ilaria Birtolo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Laura Marruncheddu
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Igino Genuini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | | | - Paolo Severino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Giuseppe Giunta
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Carlo Lavalle
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infections Disease, Sapienza University of Rome, Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infections Disease, Sapienza University of Rome, Rome, Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome
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5
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Di Iorio M, Mei M, Bernardini A, Magnocavallo M, Vetta G, Piro A, Mariani MV, Giunta G, Quaglione R, Chimenti C, Trivigno S, Mancone M, Fedele F, Lavalle C. 428 The role of virtual visits in COVID-19 cardiovascular patients. Eur Heart J Suppl 2021. [PMCID: PMC8689819 DOI: 10.1093/eurheartj/suab135.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aims The outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic forced a reorganization of the healthcare system. In order to prevent potential risk of exposure, virtual visit (VV) has been implemented in the treatment and follow-up of COVID-19 patients with cardiovascular diseases. The aim of this study is to evaluate the feasibility and efficacy of VV in the management of post COVID-19 cardiovascular patients. Methods and results We enrolled all patients with cardiovascular comorbidities tested negative for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) and discharged from our Cardiology Department from January 2021 to June 2021. We scheduled a VV after 30 days from discharge to check the clinical status of the patients, optimize therapy, and establish a Follow-up protocol. Blood pressure, arterial oxygen saturation, heart rate and body weight were registered. To evaluate the patients’ satisfaction of VV, a questionnaire was administered. We performed 25 VVs in the study period; the mean age of patients was 67.5 ± 15.6 and male were 15 (65.2%). The mean duration of VV was 25.9 ± 4.6 min. The caregiver had an active role in nine (36%) cases. No urgent/emergent in‐person examinations were performed. A high degree of patient satisfaction was reached and VV was preferred to in-person evaluation. Conclusions VV visit was useful to Follow-up post COVID-19 cardiovascular patients. A high degree of patient satisfaction was reached without jeopardizing quality of care.
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Affiliation(s)
- Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Mariachiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Italy
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6
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Bernardini A, Magnocavallo M, Mariani MV, Mei MC, Di Iorio M, Vetta G, Piro A, Trivigno S, Giunta G, Chimenti C, Nicosia A, Adduci C, Grossi S, Saporito D, Quaglione R, Rapacciuolo A, Marini M, Santarpia G, Pentimalli F, Rordorf R, Vaccaro P, Campari M, Valsecchi S, Fedele F, Lavalle C. 281 Home delivery of the communicator for remote monitoring of cardiac implantable devices: a multicentre experience during the COVID-19 lockdown. Eur Heart J Suppl 2021. [PMCID: PMC8689764 DOI: 10.1093/eurheartj/suab135.048] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aims During the COVID-19 pandemic in-person visits for patients with cardiac implantable electronic devices should be replaced by remote monitoring (RM), in order to prevent viral transmission. A direct home-delivery service of the RM communicator has been implemented at 49 Italian arrhythmia centres. Methods and results According to individual patient preference or the organizational decision of the centre, patients were assigned to the home-delivery group or the standard in-clinic delivery group. In the former case, patients received telephone training on the activation process and use of the communicator. In June 2020, the centres were asked to reply to an ad hoc questionnaire to describe and evaluate their experience in the previous 3 months. RM was activated in 1324 patients: 821 (62%) received the communicator at home and the communicator was activated remotely. Activation required one additional call in 49% of cases, and the median time needed to complete the activation process was 15 min (25th–75th percentile: 10–20). 753 (92%) patients were able to complete the correct activation of the system. At the time when the questionnaire was completed, 743 (90%) communicators were regularly transmitting data. The service was generally deemed useful (96% of respondents) in facilitating the activation of RM during the COVID-19 pandemic and possibly beyond. Conclusions Home delivery of the communicator proved to be a successful approach to system activation, and received positive feedback from clinicians. The increased use of a RM protocol will reduce risks for both providers and patients, while maintaining high-quality care.
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Affiliation(s)
- Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Carmen Adduci
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Grossi
- Cardiology Department, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | | | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Rapacciuolo
- Cardiology Unit, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - Giuseppe Santarpia
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Roberto Rordorf
- Department of Cardiology, Fondazione IRCCS Policlinico S. Matteo Pavia, Italy
| | - Paola Vaccaro
- Cardiology Unit, Riuniti Hospital, P.O. Cervello, Palermo, Italy
| | | | | | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
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7
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Mei M, Di Iorio M, Bernardini A, Magnocavallo M, Vetta G, Piro A, Giunta G, Quaglione R, Chimenti C, Trivigno S, Mitacchione G, Fedele F, Schiavone M, Forleo GB, Lavalle C. 427 The role of virtual visits in cardiology: from the pandemic era to future perspectives. Eur Heart J Suppl 2021. [PMCID: PMC8689814 DOI: 10.1093/eurheartj/suab146.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
During the Coronavirus Disease 2019 (COVID-19) pandemic in-person visits were reduced to prevent potential risk of exposure. Virtual visits (VVs) represent an innovative model to take care of patients with cardiac implantable electronic devices (CIEDs). The aim of this study is to evaluate the safety and feasibility of VV in the management of CIED patients.
Methods and results
We performed a prospective study including all CIED patients who received a VV from July 2020 to July 2021. Blood pressure, arterial oxygen saturation, heart rate, and body weight were registered by the patient. Moreover, we sent to the patient a questionnaire to evaluate the patients’ satisfaction about VV. We enrolled 182 patients in the study period. The mean age of patients was 70.2 ± 13.5 years-old and the majority (61.1%) was male. In two cases, VVs were not performed due to technical issues. Overall, 70.9% of patients utilized a smartphone, while 20.1% and 9% used, respectively, a tablet or a personal computer. The mean duration of VV was 27.8 ± 7.8 min. Patients helped by a caregiver were 64 (35.2%). One urgent/emergent in-person visit was performed in a patient with acute heart failure. Overall, VV was preferred to in-person evaluation.
Conclusion
VV is a safe and feasible approach to follow-up CIED patients. A high degree of patient satisfaction was reached after VV. The use of VV has promising potential and should be implemented beyond COVID-19 period and integrated in the healthcare system as a new model of care.
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Affiliation(s)
- Mariachiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Gianfranco Mitacchione
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
| | - Marco Schiavone
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Giovanni Battista Forleo
- Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza Univerisity of Rome, Italy
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8
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Piro A, Magnocavallo M, Vetta G, Bernardini A, Mariani MV, Chimenti C, Giunta G, Trivigno S, Di Iorio M, Mei MC, Severino P, Straito M, Iannucci G, Neccia M, Rocca DGD, Manzi G, Quaglione R, Natale A, Fedele F, Lavalle C. 269 Management of cardiac implantable electronic device follow-up in COVID-19 pandemic: lessons learned during Italian lock down. Eur Heart J Suppl 2021. [PMCID: PMC8689771 DOI: 10.1093/eurheartj/suab146.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims Remote monitoring (RM) has significantly transformed the standard of care for patients with cardiac electronic implantable devices. It provides easy access to valuable information, such as arrhythmic events, acute decompensation manifestations, and device‐related issues, without the need of in‐person visits. Methods and results Starting 1 March, 332 patients were introduced to an RM programme during the Italian lockdown to limit the risk of in‐hospital exposure to severe acute respiratory syndrome‐coronavirus‐2. Patients were categorized into two groups based on the modality of RM delivery [home (n = 229) vs. office (n = 103) delivered]. The study aimed at assessing the efficacy of the new follow‐up protocol, assessed as mean RM activation time (AT), and the need for technical support. In addition, patients’ acceptance and anxiety status were quantified via the Home Monitoring Acceptance and Satisfaction Questionnaire and the Generalized Anxiety Disorder 7‐item scale. AT time was less than 48 h in 93% of patients and 7% of them required further technical support. Despite a higher number of trans‐telephonic technical support in the home‐delivered RM group, mean AT was similar between groups (1.33 ± 0.83 days in home‐delivered vs. 1.28 ± 0.81 days in office‐delivered patients; P = 0.60). A total of 28 (2.5%) urgent/emergent in‐person examinations were required. A high degree of patient satisfaction was reached in both groups whereas anxiety status was higher in the office‐delivered group. Conclusions The adoption of RM resulted in high patient satisfaction, regardless of the modality of modem delivery; nonetheless, in‐office modem delivery was associated with a higher prevalence of anxiety symptoms.
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Affiliation(s)
- Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Giampaolo Vetta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Sara Trivigno
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Maria Chiara Mei
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Paolo Severino
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Martina Straito
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Gino Iannucci
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Matteo Neccia
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | | | - Giovanni Manzi
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Raffaele Quaglione
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Andrea Natale
- St David’s Medical Center, Texas Cardiac Arrhythmia Institute, Austin, TX, USA
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, ‘Sapienza’ University of Rome, Rome, Italy
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Magnocavallo M, Bernardini A, Mariani MV, Piro A, Marini M, Nicosia A, Adduci C, Rapacciuolo A, Saporito D, Grossi S, Santarpia G, Vaccaro P, Rordorf R, Pentimalli F, Giunta G, Campari M, Valsecchi S, Lavalle C. Home delivery of the communicator for remote monitoring of cardiac implantable devices: A multicenter experience during the covid-19 lockdown. Pacing Clin Electrophysiol 2021; 44:995-1003. [PMID: 33908052 PMCID: PMC8207054 DOI: 10.1111/pace.14251] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/25/2021] [Accepted: 04/18/2021] [Indexed: 12/20/2022]
Abstract
Background During the COVID‐19 pandemic in‐person visits for patients with cardiac implantable electronic devices should be replaced by remote monitoring (RM), in order to prevent viral transmission. A direct home‐delivery service of the RM communicator has been implemented at 49 Italian arrhythmia centers. Methods According to individual patient preference or the organizational decision of the center, patients were assigned to the home‐delivery group or the standard in‐clinic delivery group. In the former case, patients received telephone training on the activation process and use of the communicator. In June 2020, the centers were asked to reply to an ad hoc questionnaire to describe and evaluate their experience in the previous 3 months. Results RM was activated in 1324 patients: 821 (62%) received the communicator at home and the communicator was activated remotely. Activation required one additional call in 49% of cases, and the median time needed to complete the activation process was 15 min [25th‐75th percentile: 10–20]. 753 (92%) patients were able to complete the correct activation of the system. At the time when the questionnaire was completed, 743 (90%) communicators were regularly transmitting data. The service was generally deemed useful (96% of respondents) in facilitating the activation of RM during the COVID‐19 pandemic and possibly beyond. Conclusions Home delivery of the communicator proved to be a successful approach to system activation, and received positive feedback from clinicians. The increased use of a RM protocol will reduce risks for both providers and patients, while maintaining high‐quality care.
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Affiliation(s)
- Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Carmen Adduci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, St. Andrea Hospital, Rome, Italy
| | - Antonio Rapacciuolo
- Cardiology Unit, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - Stefano Grossi
- Cardiology Department, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | - Giuseppe Santarpia
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Paola Vaccaro
- Cardiology Unit, Riuniti Hospital, P.O. Cervello, Palermo, Italy
| | - Roberto Rordorf
- Department of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | | | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
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10
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Giunta G, Chiricotto M, Jackson I, Karimi-Varzaneh HA, Carbone P. Multiscale modelling of heterogeneous fillers in polymer composites: the case of polyisoprene and carbon black. J Phys Condens Matter 2021; 33:194003. [PMID: 33556928 DOI: 10.1088/1361-648x/abe44e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
The dispersion of inorganic particles within polymeric materials is an extensively used method to enhance their mechanical properties. One of the major challenges in the simulation of polymer composites is to model the uneven surface of the fillers which strongly affects the dynamics of the adsorbed polymers and consequently the macroscopic mechanical properties of the final composite. Here we propose a new multiscale approach that, using experimental adsorption data, constructs the filler surface to statistically reproduce the surface defects. We use this approach to analyse the structure and dynamics of highly entangled polyisoprene melt in contact with different realistic carbon black samples. We show that the presence of the heterogeneous surface has a negligible influence on the structure of the polymer chains but a major effect on their dynamics and the surface wettability.
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Affiliation(s)
- G Giunta
- Department of Chemical Engineering and Analytical Science, The University of Manchester, Oxford Road, M13 9PL, Manchester, United Kingdom
| | - M Chiricotto
- Department of Chemical Engineering and Analytical Science, The University of Manchester, Oxford Road, M13 9PL, Manchester, United Kingdom
| | - I Jackson
- Department of Chemical Engineering and Analytical Science, The University of Manchester, Oxford Road, M13 9PL, Manchester, United Kingdom
| | | | - P Carbone
- Department of Chemical Engineering and Analytical Science, The University of Manchester, Oxford Road, M13 9PL, Manchester, United Kingdom
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11
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Piro A, Magnocavallo M, Della Rocca DG, Neccia M, Manzi G, Mariani MV, Straito M, Bernardini A, Severino P, Iannucci G, Giunta G, Chimenti C, Natale A, Fedele F, Lavalle C. Management of cardiac implantable electronic device follow-up in COVID-19 pandemic: Lessons learned during Italian lockdown. J Cardiovasc Electrophysiol 2020; 31:2814-2823. [PMID: 32954600 PMCID: PMC7646650 DOI: 10.1111/jce.14755] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 06/22/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/23/2022]
Abstract
Introduction Remote monitoring (RM) has significantly transformed the standard of care for patients with cardiac electronic implantable devices. It provides easy access to valuable information, such as arrhythmic events, acute decompensation manifestations and device‐related issues, without the need of in‐person visits. Methods Starting March 1st, 332 patients were introduced to an RM program during the Italian lockdown to limit the risk of in‐hospital exposure to severe acute respiratory syndrome‐coronavirus‐2. Patients were categorized into two groups based on the modality of RM delivery (home [n = 229] vs. office [n = 103] delivered). The study aimed at assessing the efficacy of the new follow‐up protocol, assessed as mean RM activation time (AT), and the need for technical support. In addition, patients' acceptance and anxiety status were quantified via the Home Monitoring Acceptance and Satisfaction Questionnaire and the Generalized Anxiety Disorder 7‐item scale. Results AT time was less than 48 h in 93% of patients and 7% of them required further technical support. Despite a higher number of trans‐telephonic technical support in the home‐delivered RM group, mean AT was similar between groups (1.33 ± 0.83 days in home‐delivered vs 1.28 ± 0.81 days in office‐delivered patients; p = .60). A total of 28 (2.5%) urgent/emergent in‐person examinations were required. A high degree of patient satisfaction was reached in both groups whereas anxiety status was higher in the office‐delivered group. Conclusions The adoption of RM resulted in high patient satisfaction, regardless of the modality of modem delivery; nonetheless, in‐office modem delivery was associated with a higher prevalence of anxiety symptoms.
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Affiliation(s)
- Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Michele Magnocavallo
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Matteo Neccia
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giovanna Manzi
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Martina Straito
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Alessia Bernardini
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Severino
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Gino Iannucci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, Texas, USA.,Interventional Electrophysiology, Scripps Clinic, La Jolla, California, USA.,Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Division of Cardiology, Stanford University, Stanford, California, USA.,Dell Medical School, University of Texas, Austin, Texas, USA
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
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Museli JT, Zambruno L, Coria N, Giunta G, Salmo JF, Vigliano C, Guevara E. P6486Flow state, gradients and anatomopathological valvular calcification: influence in aortic stenosis surgical outcomes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Aortic stenosis (AS) patients are heterogeneous. The relationship between stenosis severity, transvalvular flow state and gradients is conflictive and non-linear.
Objective
To evaluate the relationship between transvalvular flow state and gradients with the anatomopathological aortic valve characteristics and perioperative morbimortality among patients (pt) submitted to aortic valve replacement (AVR).
Methods
We analyzed 516 pt with symptomatic severe AS (effective valve area <1 cm2) with preserved left ventricular ejection fraction (>50%) submitted to AVR. Perioperative mortality and a combined endpoint (death, low cardiac output syndrome and acute renal injury) were analyzed dividing the population by transvalvular flow (35 ml/m2) and mean gradient (40 mmHg), both measured by echocardiography. A morphologic evaluation of 383 operatively excised native cardiac valves was performed. Valvular thickening and calcification were categorized in mild, moderate and severe.
Results
Male subjects represented 52.9% (283 pt). Mean age were 69±11.5 years. Pt showed a mean ejection fraction of 61±4.8%, the peak gradient was 86.2±24 mmHg, and mean gradient was 53±18 mmHg.
Cardiac low output syndrome (normal flow (NF) – 14%, low flow (LF) – 23%; p<0,02), IABP (NF 1,8%, LF 6%, p<0,02) and perioperative mortality (NF 2,7%, LF 7%, p<0,02) were more frequent in low flow pt (185 – 35%).
Bicuspid valves represented 24.5% of the whole population. Bicuspid patients were younger 64±9 vs 73±12 years (p<0.05) and had more moderate–severe calcification (MSC) 93.4% vs 75.6% (p<0.05).
No difference was found in moderate -severe thickening (MSTh) and MSC when analyzing the population by flow (35 ml/m2). On the contrary, low gradient pt (<40mmHg) had lower MSC and MSTh. (Table)
Finally, 4 groups were considered: normal flow–high gradient NFHG (52.2%), normal flow–low gradient NFLG (12%), low flow–high gradient LFHG (25.5%) and low flow–low gradient LFLG (10.1%). A trend toward more perioperative events was seen in the LF-LG group despite less calcified and thickened valves. (Figure)
Table 1 Normal Flow Low Flow P value Normal gradient Low gradient P value M-S thickening 143 (58.1%) 80 (58.3%) NS 186 (62.4%) 37 (43.5%) 0.0018 M-S calcification 195 (79.2%) 119 (86.8%) NS 263 (88.2%) 51 (60%) <0.05 Bicuspid valve 62 (25%) 32 (23%) NS 62 (25.2%) 32 (23.3%) NS M-S: Moderate-Severe.
Figure 1
Conclusions
In our population of severe symptomatic AS with preserved ejection fraction submitted to AVR, low gradient pts had less calcified and thickened valves. LFLG pts presented a trend towards more perioperative events despite having less valvular calcification.
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Affiliation(s)
- J T Museli
- Fundaciόn Favaloro Universitary Hospital, Echocardiography, Buenos Aires, Argentina
| | - L Zambruno
- Fundaciόn Favaloro Universitary Hospital, Echocardiography, Buenos Aires, Argentina
| | - N Coria
- Fundaciόn Favaloro Universitary Hospital, Echocardiography, Buenos Aires, Argentina
| | - G Giunta
- Favaloro Foundation University Hospital, Ambulatory cardiology, Buenos Aires, Argentina
| | - J F Salmo
- Fundaciόn Favaloro Universitary Hospital, Echocardiography, Buenos Aires, Argentina
| | - C Vigliano
- Favaloro Foundation University Hospital, Anatomic Pathology, Buenos Aires, Argentina
| | - E Guevara
- Fundaciόn Favaloro Universitary Hospital, Echocardiography, Buenos Aires, Argentina
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Lavalle C, Straito M, Caroli A, Piro A, Giunta G, Mariani MV, Fedele F. Rivaroxaban in atrial fibrillation cardioversion: an update. Ther Clin Risk Manag 2019; 15:613-626. [PMID: 31118649 PMCID: PMC6504667 DOI: 10.2147/tcrm.s201162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 01/11/2019] [Accepted: 04/08/2019] [Indexed: 01/02/2023] Open
Abstract
Currently, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with a prevalence of about 2–3% in the general population, representing a powerful risk factor for stroke and systemic thromboembolism and increased mortality and morbidity. Restoration of sinus rhythm is an important treatment option in AF and has a high success rate, but there is the need for an effective anticoagulation strategy to reduce the risk of embolic events. Anticoagulation with vitamin K antagonists is often associated with failure to achieving effective international normalized ratio. In this setting, recent data have led to extended approval for rivaroxaban in clinical practice, because it is effective and safe in patients with AF undergoing cardioversion, avoiding additional health costs and related time loss, while improving patient satisfaction. The present report provides an overview of the main randomized controlled trial and the main real-life studies, documenting the use of rivaroxaban in patients with non-valvular AF who underwent the cardioversion procedure. Considering that novel non-vitamin K antagonist oral anticoagulants in left atrial appendage thrombi resolution is still unknown in the real-world practice, the main findings on the use of rivaroxaban in this setting are also discussed.
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Affiliation(s)
- Carlo Lavalle
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Martina Straito
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Annalisa Caroli
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Agostino Piro
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giuseppe Giunta
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Marco Valerio Mariani
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy
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Giunta G, Matarazzo M, Panella M, Rapisarda A, Caruso S, Cianci A. Is calcium levofolinate pentahydrate more effective than folic acid in young healthy women before conception? CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4352.2018] [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: 11/01/2022]
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15
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Chianese E, Galletti A, Giunta G, Landi T, Marcellino L, Montella R, Riccio A. Spatiotemporally resolved ambient particulate matter concentration by fusing observational data and ensemble chemical transport model simulations. Ecol Modell 2018. [DOI: 10.1016/j.ecolmodel.2018.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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16
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Helman L, Aguilo Iztueta M, Catalina L, Cuniberti L, Alvarez D, Dangelo P, Giunta G. Abdominal aorta atheromatosis is associated with the presence of risk factors in primary prevention patients. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.692] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Gómez, Helman L, Parolín M, Kaeser L, Cuniberti L, Aguiló Iztueta M, Toscanini U, Giunta G. Influence of the presence of mutation in LDLR, on the clinical characteristics of a population of familial hypercholesterolemia in the city of Buenos aires. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.553] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Museli J, Abud J, Salmo J, Giunta G, Raffaelli H, Dulbecco E, Figal J, Casabe H, Favaloro R, Guevara E. P5448Impact of low flow on the outcome of aortic valve replacement in patients with preserved ejection fraction severe aortic stenosis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5448] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mergoni G, Giovannacci I, Giunta G, Ghidini G, Meleti M, Manfredi M, Vescovi P. Neoformazione gengivale mascellare in una giovane paziente. Dental Cadmos 2017. [DOI: 10.19256/d.cadmos.05.2017.03] [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: 11/20/2022]
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Valiño N, Giunta G, Gallo DM, Akolekar R, Nicolaides KH. Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol 2016; 47:308-315. [PMID: 25970847 DOI: 10.1002/uog.14898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of uterine artery (UtA) Doppler at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. METHODS This was a screening study in 30 780 singleton pregnancies at 30-34 weeks. UtA pulsatility index (UtA-PI) was measured and the values were converted to multiples of the median (MoM) after adjustment for variables relating to maternal characteristics and medical history that affect the measurements. Multivariable logistic regression analysis was used to determine if measuring UtA-PI improved the prediction of adverse perinatal outcome provided by screening with maternal characteristics, medical history and obstetric factors. The detection rate (DR) and false-positive rate (FPR) of screening by UtA-PI were estimated for stillbirth, Cesarean section for fetal distress, umbilical arterial cord blood pH ≤ 7.0 or umbilical venous cord blood pH ≤ 7.1 and 5-min Apgar score < 7. RESULTS The incidence of adverse perinatal outcome was higher in small-for-gestational-age (SGA) fetuses than in non-SGA fetuses, but the majority of cases with each adverse outcome were in the non-SGA group, including about 70% of stillbirths and more than 80% with Cesarean section for fetal distress, low cord blood pH and low Apgar score. The performance of UtA-PI > 95(th) percentile in screening for each adverse outcome was poor with DR of 6-16% and a FPR of 5-6%. The DR of adverse outcome when screening by high UtA-PI was greater in pregnancies complicated by SGA than in non-SGA pregnancies; 24% vs 13% for stillbirth, 15% vs 5% for Cesarean section for fetal distress, 30% vs 9% for low cord blood pH and 20% vs 3% for low 5-min Apgar score, respectively. CONCLUSION High UtA-PI at 30-34 weeks' gestation may be useful in the prediction of adverse perinatal outcome in pregnancies with a SGA fetus, however, in the absence of SGA, UtA-PI is a poor predictor of adverse outcome. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- N Valiño
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Giunta
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, Kent, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Valiño N, Giunta G, Gallo DM, Akolekar R, Nicolaides KH. Biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol 2016; 47:194-202. [PMID: 26094952 DOI: 10.1002/uog.14928] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/09/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the potential value of biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. METHODS This was a screening study in 8268 singleton pregnancies at 30-34 weeks' gestation. Estimated fetal weight (EFW), uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, fetal middle cerebral artery (MCA) PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured. The detection rate (DR) and false-positive rate (FPR) of screening by each biomarker were estimated for stillbirth, pre-eclampsia, delivery of small-for-gestational-age (SGA) neonate, Cesarean section for fetal distress before or during labor, umbilical arterial cord blood pH ≤7.0 or umbilical venous cord blood pH ≤7.1, 5-min Apgar score < 7 and admission to the neonatal unit (NNU). RESULTS Multivariable regression analysis demonstrated that significant prediction of PE was provided by PlGF, sFlt-1, MAP and MCA-PI, with a DR of 98% for PE delivering < 37 weeks' gestation and 56% for those delivering ≥ 37 weeks, at a 10% FPR. Prediction of SGA was provided by EFW, PlGF, sFlt-1, UtA-PI, UA-PI and MCA-PI, with a DR of 88% for SGA delivering < 37 and 51% for those delivering ≥ 37 weeks' gestation, at a 10% FPR. Prediction of stillbirth was provided by EFW, UtA-PI and MCA-PI, with DR of 30% at 10% FPR. Prediction of Cesarean section for fetal distress before labor was provided by EFW, sFlt-1, UtA-PI and UA-PI, with a DR of 90% at a 10% FPR. Prediction of fetal distress in labor was provided by EFW and sFlt-1, with a DR of 16% at a 10% FPR. There were no significant differences from the normal outcome group in any of the biomarkers for low cord blood pH, low Apgar score or NNU admission for cases other than those with PE and/or SGA. CONCLUSION At 30-34 weeks' gestation, biomarkers of impaired placentation and fetal hypoxemia provide good prediction of PE, SGA and fetal distress before labor, but poor or no prediction of stillbirth and adverse events in labor or after birth.
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Affiliation(s)
- N Valiño
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - G Giunta
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D M Gallo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, Kent, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Calo’ L, Martino A, Tota C, Fagagnini A, Iulianella R, Rebecchi M, Sciarra L, Giunta G, Romano MG, Colaceci R, Ciccaglioni A, Ammirati F, Ruvo ED. Comparison of partners-heart failure algorithm vs care alert in remote heart failure management. World J Cardiol 2015; 7:922-930. [PMID: 26730298 PMCID: PMC4691819 DOI: 10.4330/wjc.v7.i12.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/05/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the utility of the partners-heart failure (HF) algorithm with the care alert strategy for remote monitoring, in guiding clinical actions oriented to treat impending HF.
METHODS: Consecutive cardiac resynchronization-defibrillator recipients were followed with biweekly automatic transmissions. After every transmission, patients received a phone contact in order to check their health status, eventually followed by clinical actions, classified as “no-action”, “non-active” and “active”. Active clinical actions were oriented to treat impending HF. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation, were also calculated.
RESULTS: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo, 665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9% (95%CI: 0.96-0.98) and 92.5% (95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6% (95%CI: 0.82-0.87) and 98.6% (95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8% (95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions, care alert had a sensitivity and specificity of 11.05% (95%CI: 0.09-0.13) and 93.6% respectively (95%CI: 0.92-0.95). The positive predictive value was 42.3% (95%CI: 0.38-0.46); the negative predictive value was 71.1% (95%CI: 0.68-0.74). Care alert had an accuracy of 68.9% (95%CI: 0.65-0.72) in determining active clinical actions.
CONCLUSION: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impending HF. Future studies in larger populations should evaluate partners-HF ability to improve HF-related clinical outcomes.
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Bollero D, Malvasio V, Gangemi E, Giunta G, Collard B, Stella M. Saturday night burns: an increasing problem? Ann Burns Fire Disasters 2015; 28:67-70. [PMID: 26668565 PMCID: PMC4665186] [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] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 08/19/2014] [Indexed: 06/05/2023]
Abstract
In Italy the economic crisis has caused changes in behavior in daily as well as leisure activities. For instance, night clubs have changed both their scenography and what they can offer. From simply providing a place to dance, they can now offer more complex scenography with spectacular fireworks and lit cocktails. While this can be amazing for all of us it can also be another cause of burn injuries. We conducted a retrospective study of all burns patients admitted to the Accident and Emergency Department at CTO Hospital in Turin from 2009 to 2013, after a night clubbing. A total of five patients were identified with an average age of 20 years old: four were burned by flaming cocktails and one was burned by a firework. Two received outpatient treatment, while orotracheal intubation and admission were needed for three, and two required surgical debridement and resurfacing with split skin graft. All patients had permanent sequelae caused by pathologic scarring and/or dyschromia. Our findings show that the risk of burn injuries is higher at weekends, mainly in summer, if all correct safety procedures are not followed. Meanwhile it is important to highlight that the promotion of inappropriate behavior at night clubs during firework displays and the passing of flaming cocktails should be avoided.
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Affiliation(s)
- D. Bollero
- Department of Surgery, Division of Plastic and Reconstructive Surgery and Burn Center, AOU Città della Salute, CTO Hospital, Turin, Italy
| | - V. Malvasio
- Department of Surgery, Division of Plastic and Reconstructive Surgery and Burn Center, AOU Città della Salute, CTO Hospital, Turin, Italy
| | - E.N. Gangemi
- Department of Surgery, Division of Plastic and Reconstructive Surgery and Burn Center, AOU Città della Salute, CTO Hospital, Turin, Italy
| | - G. Giunta
- Department of Plastic Surgery, Royal Devon and Exeter Foundation Hospital, Exeter, UK
| | - B. Collard
- Department of Plastic Surgery, Royal Devon and Exeter Foundation Hospital, Exeter, UK
| | - M. Stella
- Department of Surgery, Division of Plastic and Reconstructive Surgery and Burn Center, AOU Città della Salute, CTO Hospital, Turin, Italy
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Colombo G, Garlaschi A, Stifanese R, Giunta G, Ruvolo V. Necrosis of the nipple-areola complex in breast reduction. Our personal way to solve problem. Ann Ital Chir 2015; 86:156-162. [PMID: 25952718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Necrosis of the NAC is a condition that penalizes patients who underwent breast reduction surgery or mastopexy. Breast reduction is a widely used technique for over-sized breasts. Breast hypertrophy, in fact, can cause the onset of many issues--both aesthetical and pathological--because of the excessive weight that the breasts exert on the patient's spine. Aim and objective of our study is to suggest a systematic use of diagnostic imaging composed of pre-operative and intraoperative ultrasound with color-Doppler and pre-operative MRI. Trying to solve this problem definitively, we relied on our notions of anatomy on ten fresh cadavers, on whose twenty breasts we could make very detailed dissections. The dissections led us to conclude that, albeit with their anatomic differences, each breast was characterized by a vascular-nervous pedicle coming out from the inter-costal spaces and aimed to the blood supply to the NAC. To overcome the anatomic variations between one subject and another--but also between one breast and the other from the same patient, we relied on diagnostic imaging, both in the pre-operative and in the intra-operative staging. This way we were able to intervene successfully with 15 patients, none of which has complained damages to the vascularity or innervation of the NAC so far. In conclusion we believe that pre and intra operative diagnostic imaging is the only way to completely eliminate any potential risk of NAC necrosis. Only by means of the systematic use of conventional imaging--especially during surgery--it is possible to constantly monitor the position of the NAC's pedicle in a breast that is being reduced in volume.
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Gil MM, Giunta G, Macalli EA, Poon LC, Nicolaides KH. UK NHS pilot study on cell-free DNA testing in screening for fetal trisomies: factors affecting uptake. Ultrasound Obstet Gynecol 2015; 45:67-73. [PMID: 25302655 DOI: 10.1002/uog.14683] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 09/24/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study reports on the clinical implementation of cell-free DNA (cfDNA) testing, contingent on the results of the combined test, in screening for fetal trisomies 21, 18 and 13 in two UK National Health Service hospitals. Women with a combined-test risk of ≥ 1:100 (high risk) were offered the options of chorionic villus sampling (CVS), cfDNA testing or no further testing and those with a risk of 1:101 to 1:2500 (intermediate risk) were offered cfDNA or no further testing. The objective of the study was to examine the factors affecting patient decisions concerning their options. METHODS Combined screening was performed in 6651 singleton pregnancies in which the risk for trisomies was high in 260 (3.9%), intermediate in 2017 (30.3%) and low in 4374 (65.8%). Logistic regression analysis was used to determine which factors among maternal characteristics, fetal nuchal translucency thickness (NT) and risk for trisomies were significant predictors of opting for CVS in the high-risk group and opting for cfDNA testing in the intermediate-risk group. RESULTS In the high-risk group, 104 (40.0%) women opted for CVS; predictors for CVS were increasing fetal NT and increasing risk for trisomies, while the predictor against CVS was being of Afro-Caribbean racial origin (r = 0.366). In the intermediate-risk group, 1850 (91.7%) women opted for cfDNA testing; predictors for cfDNA testing were increasing maternal age, increasing risk for trisomies and university education, while predictors against cfDNA testing were being of Afro-Caribbean racial origin, smoking and being parous (r = 0.105). CONCLUSIONS This study has identified factors that can influence the decision of women undergoing combined screening in favor of or against CVS and in favor of or against cfDNA testing.
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Affiliation(s)
- M M Gil
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Giunta G, Duaip G, Rojo D, Yannarelli G, Pacienza N, Maggi L, Cuniberti L. Oxidized low density lipoprotein concentration is associated with thyrotropin levels in euthyroid normocholesterolemic subjects. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.436] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Giunta G, Gennero E, Mendez P, Rodriguez N, Jacob PB, Skorka R, Guevara E, Cuniberti L, Sanchez R. Association of aortic valve sclerosis and atherosclerosis in different vascular territories. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.817] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Squillace N, Bresciani E, Torsello A, Bandera A, Sabbatini F, Giovannetti C, Giunta G, Rovati L, Del Bene M, Locatelli V, Gori A. Changes in subcutaneous adipose tissue microRNA expression in HIV-infected patients. J Antimicrob Chemother 2014; 69:3067-75. [PMID: 25063777 DOI: 10.1093/jac/dku264] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We evaluated the possibility that a pattern of abnormal microRNA (miRNA) expression could be fuelling the mechanisms causing HIV-associated lipodystrophy (HAL). METHODS In this case-control study, samples of subcutaneous adipose tissue from eight consecutive HIV-infected patients on combination antiretroviral therapy with HAL (cases) were compared with those of eight HIV-negative subjects (controls). Human miRNA microarrays were used to probe the transcriptomes of the samples. Analysis of differentially expressed miRNAs was performed using DataAssist v2.0 software, applying a paired Student's t-test. RESULTS Data showed that 21 miRNAs out of 754 were overexpressed in the patient group. Ten of these (i.e. miR-186, miR-199a-3p, miR-214, miR-374a, miR-487b, miR-532-5p, miR-628-5p, miR-874, miR-125-b-1* and miR-374b*) were up-regulated to a significant degree (fold change >2.5; P < 0.01). Eleven other miRNAs (i.e. miR-let-7d, miR-24, miR-30c, miR-125a-3p, miR-149, miR-191, miR-196-b, miR-218, miR-342-3p, miR-452 and miR-454*) were 2- to 2.5-fold more expressed in HIV+ samples than in controls. Levels of mRNA for lipin 1, the target of miR-218, were significantly lower in subcutaneous adipose tissue from HIV patients. CONCLUSIONS In adipocytes of HIV-infected patients, the up-regulation of specific miRNAs could lead to an increased 'activation' that might contribute to the pathogenesis of HAL by increasing cell turnover and/or promotion of apoptosis.
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Affiliation(s)
- Nicola Squillace
- Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, Monza, Italy
| | - Elena Bresciani
- Department of Health Sciences, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | - Antonio Torsello
- Department of Health Sciences, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | - Alessandra Bandera
- Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, Monza, Italy
| | - Francesca Sabbatini
- Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, Monza, Italy
| | - Chiara Giovannetti
- Department of Health Sciences, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | | | - Luca Rovati
- Plastic Surgery Unit, San Gerardo Hospital, Monza, Italy
| | | | - Vittorio Locatelli
- Department of Health Sciences, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | - Andrea Gori
- Division of Infectious Diseases, Department of Internal Medicine, San Gerardo Hospital, Monza, Italy Department of Health Sciences, School of Medicine, University of Milano-Bicocca, Monza, Italy
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Giunta G, Marruncheddu L, Scarparo P, Cinque A, Marceca A, Adamo F, Fusto A, D'Ambrosi A, Mancone M, Fedele F. EKG abnormalities distribution between athletes and no athletes in a population of 10.000 young Italian students. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4953] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mancone M, D'Ambrosi A, Adamo F, Fusto A, Mancini I, Marceca A, Gatto MC, Marruncheddu L, Giunta G, Fedele F. PRELIMINARY RESULTS FROM ITALIAN ELECTROCARDIOGRAPHIC SCREENING IN 10,000 HEALTHY YOUNG STUDENTS. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61341-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boffano P, Ferretti F, Giunta G, Gallesio C. Surgical removal of a third molar at risk for mandibular pathologic fracture: case report and clinical considerations. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e1-4. [DOI: 10.1016/j.oooo.2011.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 08/23/2011] [Accepted: 09/17/2011] [Indexed: 11/29/2022]
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Riccio A, Ciaramella A, Giunta G, Galmarini S, Solazzo E, Potempski S. On the systematic reduction of data complexity in multimodel atmospheric dispersion ensemble modeling. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jd016503] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Giunta G, Fava A, Trentadue G, Mendez P, Hnatiuk A, Chiaramonte L, Pereyra A, D'Angelo P, Cuniberti L, Baglivo H, Sanchez R. 770 METABOLIC SYNDROME IS ASSOCIATED WITH ELEVATED GLOMERULAR FILTRATION RATE AND INCREASED RENAL RESISTANCE INDEX. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70771-1] [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: 11/29/2022]
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Potempski S, Galmarini S, Riccio A, Giunta G. Bayesian model averaging for emergency response atmospheric dispersion multimodel ensembles: Is it really better? How many data are needed? Are the weights portable? ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2010jd014210] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Calò L, Martino A, Sciarra L, Ciccaglioni A, De Ruvo E, De Luca L, Sette A, Giunta G, Lioy E, Fedele F. Upstream effect for atrial fibrillation: still a dilemma? Pacing Clin Electrophysiol 2010; 34:111-28. [PMID: 21029134 DOI: 10.1111/j.1540-8159.2010.02942.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Atrial fibrillation is the most common arrhythmia in clinical practice. Ion channel blocking agents are often characterized by limited long-term efficacy and several side effects. In addition, ablative invasive procedures are neither easily accessible nor always efficacious. The "upstream therapy," which includes angiotensin-converting enzyme inhibitors, aldosterone receptor antagonists, statins, glucocorticoids, and ω-3 poly-unsaturated fatty acids, targets arrhythmia substrate, influencing atrial structural and electrical remodeling that play an essential role in atrial fibrillation induction and maintenance. The mechanisms involved and the most important clinical evidence regarding the upstream therapy influence on atrial fibrillation are presented in this review. Some open questions are also proposed.
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Affiliation(s)
- Leonardo Calò
- Division of Cardiology, Policlinico Casilino ASL RMB, Rome, Italy
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Giunta G, Guevara E, Marziali L, Yannarelli G, Gomez Rosso L, Meroño T, Favaloro R, Brites F, Cuniberti L. MS330 ROSUVASTATIN DELAYS PROGRESSION OF AORTIC VALVE STENOSIS CAUSED BY HYPERTENSION. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70831-x] [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: 11/17/2022]
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Brites F, Rosso LG, Meroño T, Giunta G, Marzialli L, Boero L, Schreier L, Cuniberti L. Abstract: P1177 INCREASED ATHEROGENIC RISK IN MEN AT HIGHER WAIST CIRCUMFERENCE QUARTILES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gómez Rosso L, Meroño T, Benítez MB, López G, Giunta G, D'Ambrosio ML, Wikinski R, Cuniberti L, Brites F. Low adiponectin levels in primary hypertriglyceridemic male patients. Nutr Metab Cardiovasc Dis 2009; 19:135-139. [PMID: 18472252 DOI: 10.1016/j.numecd.2008.02.008] [Citation(s) in RCA: 5] [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] [Received: 09/05/2007] [Revised: 02/08/2008] [Accepted: 02/26/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Adiponectin is an adipokine highly and specifically expressed by adipose cells with antiatherogenic and antiinflammatory activities. The aim of the present study was to evaluate plasma adiponectin concentration in patients with primary hypertriglyceridemia and its relationship with metabolic parameters. METHODS AND RESULTS Male patients with primary hypertriglyceridemia and without the metabolic syndrome (n=22) were compared with normotriglyceridemic individuals (n=25). Plasma adiponectin concentration was measured by standardised enzyme-linked immunosorbent assay. Body mass index, waist circumference, glucose, insulin and non-esterified fatty acid levels, lipoprotein profile, and CETP activity were evaluated. Adiponectin levels were significantly decreased in hypertriglyceridemic patients in comparison with normotriglyceridemic subjects (4292+/-1717 vs. 6939+/-3249 ng/ml, p<0.005, respectively). Adiponectin was negatively associated with glucose (r=-0.44, p<0.01), insulin (r=-0.37, p<0.01), HOMA (r=-0.40, p<0.01), triglycerides (r=-0.36, p<0.01), VLDL-C (r=-0.34, p<0.05), and CETP (r=-0.47, p<0.001). Positive and significant correlations were observed with QUICKI (r=0.49, p<0.001) and HDL-C (r=0.33, p<0.05). In the multiple linear regression analysis, considering waist circumference, QUICKI, Log-triglycerides, HDL-C, and CETP as independent variables, Log-adiponectin showed a positive correlation with QUICKI, with an r(2)=0.229 and p<0.001. Therefore, the independent variable QUICKI explained the 23% of the variance in Log-adiponectin concentration. CONCLUSIONS We found low adiponectin levels in a population of primary hypertriglyceridemic men without the metabolic syndrome and an independent relationship between adiponectin concentration and insulin resistance. A reduction in insulin sensitivity and its impact on adiponectin concentration could be linked to high non-esterified fatty acid levels, increased triglyceride synthesis in the liver and impaired catabolism of triglyceride-rich lipoproteins.
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Affiliation(s)
- L Gómez Rosso
- Laboratory of Lipids and Lipoproteins, Department of Clinical Biochemistry, Institute of Physiopathology and Clinical Biochemistry, Faculty of Pharmacy and Biochemistry, University of Buenos Aires, CONICET, Buenos Aires, Argentina
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Bevilacqua L, Magnavita N, Becchetti G, De Matteis B, Giunta G, Lancia F, Mammi F, Pisciottano V, Roccia K, Pupp N. [Vigilance on health surveillance in wood sector]. G Ital Med Lav Ergon 2007; 29:794-795. [PMID: 18409965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES A program to promote occupational health among wood dust workers in the district of Civitavecchia. METHODS In recent years, occupational health physicians charged of medical surveillance of wood workers (Competent Physicians, CPs) had been invited to perform a peer-review of their methods and activities. In the present phase, CPs have been invited to show the result of their medical surveillance. RESULTS One hundred forty seven wood workers were submitted to rhinoscopic examination. The prevalence of woodwork-related rhinitis and other pathologic signs, including nasal adenocarcinoma (one case), was 32.7%. The prevalence of rhinitis in woodworkers increased with years of working as a woodworker. CONCLUSION Wood dust and chemical exposures in wood workers represent a serious risk of disease for the nasal cavity and paranasal sinuses.
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Riccio A, Giunta G, Chianese E. The application of a trajectory classification procedure to interpret air pollution measurements in the urban area of Naples (Southern Italy). Sci Total Environ 2007; 376:198-214. [PMID: 17307238 DOI: 10.1016/j.scitotenv.2007.01.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Revised: 11/29/2006] [Accepted: 01/02/2007] [Indexed: 05/14/2023]
Abstract
In this work we apply a trajectory classification approach, aiming at identifying the role exerted by meteorology on air quality in the Naples urban area (Southern Italy). Towards that end, the HYSPLIT (HYbrid Single-Particle Lagrangian Integrated Trajectory) model was used; backward trajectories were calculated for the period 1995-2004 and classified, based on a combination of the k-means and PCA (Principal Component Analysis) approaches. The robustness of the classification was strengthened using an ensemble approach, based on back-trajectories calculated for different (in the horizontal and vertical directions) arrival points around Naples and different arrival time. Eight clusters were identified, and the effects on air quality were evaluated. We focused on ozone and PM10 concentration, and evaluated to what extent the prevailing meteorological conditions were associated with different levels and temporal profiles of these two pollutants. We found that ozone and PM10 profiles share some similarities since they both load high during anti-cyclonic, subsiding conditions, a common situation during the summer months. During these days stagnation and recirculation effects enhance the concentration of locally emitted air pollutant. We also found that ozone exhibits a marked seasonal cycle, whose maxima appears during the summer season, but the discrimination with respect to the area of origin indicated the presence of a second relative maxima, appearing early during the spring season. PM10 pollution levels often exceed the annual limit of 50 microg/m(3). The days associated with a significant exogenous contribution from the North African countries were identified.
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Affiliation(s)
- A Riccio
- Department of Applied Science, University of Naples Parthenope, Via De Gasperi 5, 80133 -- Napoli, Italy.
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Affiliation(s)
- C. Caccamo
- a Dipartimento di Fisica, Sez. Teorica , Universita' di Messina , C.P. 50, 98166 , S. Agata di Messina, Messina , Italy
| | - G. Giunta
- a Dipartimento di Fisica, Sez. Teorica , Universita' di Messina , C.P. 50, 98166 , S. Agata di Messina, Messina , Italy
| | - G. Malescio
- a Dipartimento di Fisica, Sez. Teorica , Universita' di Messina , C.P. 50, 98166 , S. Agata di Messina, Messina , Italy
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Kardjilov N, Fiori F, Giunta G, Hilger A, Rustichelli F, Strobl M, Banhart J, Triolo R. Neutron tomography for archaeological investigations. Journal of Neutron Research 2006. [DOI: 10.1080/10238160600673201] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Elikir G, Christen A, Graf S, Brandani L, Miranda A, Giunta G, Ramirez A, Baglivo H, Sanchez R. Mo-P1:90 Non-invasive subclinical atherosclerosis assessment and cardiovascular risk stratificacion. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80225-4] [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: 11/15/2022]
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Luchini L, Brega M, Giani I, Cosimini P, Santini L, Giunta G. [Tracheal rupture a complication of orotracheal intubation]. Minerva Anestesiol 2002; 68:621-5. [PMID: 12244294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
One of the most frequent anesthesiological manoeuvres is orotracheal intubation (OTI). Many complications can occur during OTI, one of these is the rupture of the trachea (TR) and/or of the bronchi. The aim of this study is to highlight the risk of TR during OTI. Over a period of three years of activity (1997-1999) in the Cardiothoracic Department of Pisa University nine patients we treated, eight of which were women ranging from 35 to 95 years of age. In the majority of the cases clinical signs like subcutaneous emphysema of the face and neck, hemoptysis and dyspnoea, variably combined were present. An X-ray of the thorax carried out on six patients did not permit the diagnosis. Bronchoscopy was the diagnostic examination in all nine patients. Seven cases were treated by senior anaesthesiologists, without stilet and OTI was easy. Predictive elements for difficult intubation were not observed in any case. Only one patient had a voluminous intrathoracic goitre dislocating the trachea. The nine patients were all treated surgically as they were all symptomatic and with important transmural lacerations that caused pneumothorax or pneumomediastinum. The survival percentage in the third month is 100%. Although rare TR must be suspected when clinical signs are present; bronchoscopy is the examination which permits diagnosis and a correct therapy.
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Affiliation(s)
- L Luchini
- IV U.O. Anestesia e Rianimazione Universitaria, A.O.P., Pisa, Italy
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Terrada E, Kerschbaumer RJ, Giunta G, Galeffi P, Himmler G, Cambra M. Fully "Recombinant Enzyme-Linked Immunosorbent Assays" Using Genetically Engineered Single-Chain Antibody Fusion Proteins for Detection of Citrus tristeza virus. Phytopathology 2000; 90:1337-1344. [PMID: 18943374 DOI: 10.1094/phyto.2000.90.12.1337] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
ABSTRACT Recombinant single-chain variable fragment antibodies (scFv) that bind specifically to Citrus tristeza virus (CTV), which cause the most detrimental viral disease in the citrus industry worldwide, were obtained from the hybridoma cell lines 3DF1 and 3CA5. These scFv were genetically fused with dimerization domains as well as with alkaline phosphatase, respectively, and diagnostic reagents were produced by expressing these fusion proteins in bacterial cultures. The engineered antibodies were successfully used for CTV diagnosis in plants by tissue print enzyme-linked immunosorbent assay (ELISA) and double antibody sandwich-ELISA. The fully recombinant ELISAs were as specific and sensitive as conventional ELISAs performed with the parental monoclonal antibodies, showing the usefulness of recombinant antibodies for routine detection of a virus in woody plants for the first time.
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Abstract
Global motion is very likely to occur in image sequences analysis. For example, it arises if the observer is moving during the sequence acquisition (ego-motion). Our aim is to get a simple method to estimate in a reliable may a set of parameters that can take into account the presence of a global motion component, using only local information. The novelty of our approach is in regarding spatial shift, change of scale, and rotation (corresponding to usual camera effects such as pan and zoom) as a two-dimensional (2-D) Doppler effect. The mathematical treatment is carried on in the complex plane, so that the results can be easily deduced as an extension of the one-dimensional (1-D) case; in this way, we obtain simple expressions, well suited for a practical realization of the estimate. The method has been experimentally validated by both real pictures with a synthetic motion and real image sequences.
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Giunta G, Grasso V, Neri F, Silipigni L. Electrical conductivity of lithium-intercalated thiophosphate NiPS3 single crystals. Phys Rev B Condens Matter 1994; 50:8189-8194. [PMID: 9974835 DOI: 10.1103/physrevb.50.8189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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