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Filip G, Sala A, Modolo V, Arnoldo L, Brunelli L, Driul L. Vaccination: Adherence and Hesitancy among Pregnant Women for COVID-19, Pertussis, and Influenza Vaccines. Vaccines (Basel) 2024; 12:427. [PMID: 38675809 PMCID: PMC11054588 DOI: 10.3390/vaccines12040427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
In the realm of antenatal care, vaccinations serve as a cornerstone, crucial for safeguarding the health of both the mother and the fetus, while also extending protection to the newborn against communicable diseases. Nevertheless, vaccine adherence among pregnant women remains very low. The aim of our study was to evaluate the uptake of vaccines (influence, pertussis, and COVID-19) among women during pregnancy and to understand pregnant women's knowledge of vaccines and the diseases they protect against. The purpose was to investigate the reasons why pregnant women chose not to be vaccinated and to develop effective strategies for informing them about the importance of vaccination for both maternal and fetal safety. A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, "Ospedale Santa Maria della Misericordia" in Udine, from 1 December 2021 to 30 June 2022. During this period, a self-completed paper questionnaire was administered to women at the end of pregnancy or during the puerperium. A total of 161 questionnaires were collected. Higher educational level was found to be significantly associated with influenza vaccination uptake (p = 0.037, OR = 2.18, 95% CI 1.05-4.51). Similarly, for pertussis vaccination, adherence was mainly associated with higher educational level (p = 0.014, OR = 2.83, 95% CI 1.24-6.47), but also with Italian nationality (p = 0.003, OR = 3.36, 95% CI 1.56-8.43) and pregnancy attended by a midwife or private gynecologist (p = 0.028, OR = 0.39, 95% CI 0.17-0.90). Regarding the COVID-19 vaccine, the only factor positively influencing uptake was Italian nationality (p = 0.044, OR = 2.66, 95% CI 1.03-6.91). Women's fear that vaccines would endanger the fetus appeared to be the most important reason for refusing vaccinations. Simultaneously, patients also exhibited a desire to receive more information about maternal vaccination, particularly from their general physician or gynecologist. For this reason, it is imperative to enhance maternal vaccination counselling, making it a routine step in prenatal care from the first antenatal visit until the postpartum period.
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Affiliation(s)
- Gabriele Filip
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, 33100 Udine, Italy;
| | - Alessia Sala
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
| | - Veronica Modolo
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
| | - Luca Arnoldo
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
- Accreditation, Quality and Clinical Risk Unit, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy
| | - Laura Brunelli
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
- Accreditation, Quality and Clinical Risk Unit, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy
| | - Lorenza Driul
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, 33100 Udine, Italy;
- Department of Medical Area, University of Udine, 33100 Udine, Italy; (A.S.); (V.M.); (L.A.); (L.B.)
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Gazzetta S, Valent F, Sala A, Driul L, Brunelli L. Sexually transmitted infections and the HPV-related burden: evolution of Italian epidemiology and policy. Front Public Health 2024; 12:1336250. [PMID: 38560434 PMCID: PMC10978588 DOI: 10.3389/fpubh.2024.1336250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Sexually transmitted infections (STIs) are a major public health problem worldwide, with a high prevalence between the ages of 15 and 25 in most Western countries. High notification rates of chlamydia, gonorrhea, and syphilis are reported in the WHO European Region, with differences between countries. In Italy, the total number of STIs alerts increased by 18% from 2020 to 2021. HPV is the most common sexually transmitted infection; globally one in seven women is infected by this virus, and certain sexual behaviors are important risk factors for HPV-related cancers, particularly cervical cancer (CC), anogenital cancers and cancers of the head and neck. The burden of CC is relevant worldwide, in particular in Europe CC is the third leading cause of cancer-related deaths in women aged 15-44. This HPV-related tumor is preventable through a combined strategy of vaccination and screening for precursor lesions. In Italy, the coverage of organized screening varies from region to region and the average HPV vaccination rate is still far from the expected optimal threshold of 95% at the age of 12. To address the challenges of health promotion and HPV prevention, priority actions are needed such as: promoting education and information at every level, from schools to healthcare professionals. In Italy, education of adolescents on sexual and reproductive health, still remains critical, regionally inhomogeneous and much lower than in other European countries. Equitable measures need to be taken, and schools are an important place for health promotion activities.
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Affiliation(s)
| | - Francesca Valent
- Institute of Hygiene and Clinical Epidemiology, Friuli Centrale University Healthcare Trust, Udine, Italy
| | - Alessia Sala
- Departement of Medicine, University of Udine, Udine, Italy
| | - Lorenza Driul
- Departement of Medicine, University of Udine, Udine, Italy
- Department of Obstetrics and Gynaecology, ASUFC, Ospedale Santa Maria Della Misericordia, Udine, Italy
| | - Laura Brunelli
- Departement of Medicine, University of Udine, Udine, Italy
- Accreditation, Quality and Clinical Risk Unit, Friuli Centrale University Healthcare Trust, Udine, Italy
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Soldani C, De Simone G, Polidoro MA, Morabito A, Franceschini B, Colombo FS, Anselmo A, Milana F, Lleo A, Torzilli G, Pastorelli R, Donadon M, Brunelli L. Riboflavin-LSD1 axis participates in the in vivo tumor-associated macrophage morphology in human colorectal liver metastases. Cancer Immunol Immunother 2024; 73:63. [PMID: 38430255 PMCID: PMC10908638 DOI: 10.1007/s00262-024-03645-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
Tumor-associated macrophages (TAMs) are key components of the tumor microenvironment (TME). In colorectal liver metastasis (CLM), TAM morphology correlates with prognosis, with smaller TAMs (S-TAMs) conferring a more favorable prognosis than larger TAMs (L-TAMs). However, the metabolic profile of in vivo human TAM populations remains unknown. Multiparametric flow cytometry was used to freshly isolate S- and L-TAMs from surgically resected CLM patients (n = 14S-, 14L-TAMs). Mass spectrometry-based metabolomics analyses were implemented for the metabolic characterization of TAM populations. Gene expression analysis and protein activity were used to support the biochemical effects of the enzyme-substrate link between riboflavin and (lysine-specific demethylase 1A, LSD1) with TAM morphologies. L-TAMs were characterized by a positive correlation and a strong association between riboflavin and TAM morphologies. Riboflavin in both L-TAMs and in-vitro M2 polarized macrophages modulates LSD1 protein expression and activity. The inflammatory stimuli promoted by TNFα induced the increased expression of riboflavin transporter SLC52A3 and LSD1 in M2 macrophages. The modulation of the riboflavin-LSD1 axis represents a potential target for reprogramming TAM subtypes, paving the way for promising anti-tumor therapeutic strategies.
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Affiliation(s)
- Cristiana Soldani
- Laboratory of Hepatobiliary Immunopathology, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giulia De Simone
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
- Department of Biotechnologies and Biosciences, Università degli Studi Milano Bicocca, Milan, Italy
| | - Michela Anna Polidoro
- Laboratory of Hepatobiliary Immunopathology, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Aurelia Morabito
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Barbara Franceschini
- Laboratory of Hepatobiliary Immunopathology, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Federico Simone Colombo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Struttura Complessa di Patologia Clinica, Laboratorio di Citometria, Milano, Italy
| | - Achille Anselmo
- Flow Cytometry Resource, Advanced Cytometry Technical Application Laboratory, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Flavio Milana
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy
- Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Ana Lleo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Guido Torzilli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy
- Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Roberta Pastorelli
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy
| | - Matteo Donadon
- Laboratory of Hepatobiliary Immunopathology, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy.
- Division of Hepatobiliary and General Surgery, Department of Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
- Department of General Surgery, University Maggiore Hospital, Novara, Italy.
| | - Laura Brunelli
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milan, Italy.
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Dobrina R, Starec A, Brunelli L, Orzan E, De Vita C, Bicego L, Ronfani L, Castro V, Di Rocco P, Zanchiello S, Dal Cin M, Tagliapietra B, Cinello M, Fontanot D, Stampalija T, Dante A, Petrucci C, Cassone A. Applying the Participatory Slow Design Approach to a mHealth Application for Family Caregivers in Pediatric Ear, Nose, and Throat Surgery. Healthcare (Basel) 2024; 12:442. [PMID: 38391818 PMCID: PMC10888311 DOI: 10.3390/healthcare12040442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/15/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Pediatric ear, nose, and throat (ENT) surgery is very common, and its outcomes may improve with family education. In this regard, mobile health (mHealth) applications (apps), which are on the rise due to digital transformation, can be beneficial in healthcare. This study outlines the user-centered design and development of a mHealth app (version 5.15.0) to support family caregivers during the perioperative process of pediatric ENT surgery. Conducted over two years in an Italian maternal and child health hospital (January 2020-May 2022), the study employed a participatory design method based on the Information System Research (ISR) framework and guided by the principles of Slow Medicine. Utilizing the Relevance, Rigor, and Design cycles of the ISR framework, the mHealth app's content, functionalities, and technical features were defined and developed. A committee of fifteen experts guided the process with input from 25 family caregivers and 24 healthcare providers enrolled in the study. The mHealth app content was structured around five crucial educational moments characterizing the ENT perioperative period, providing evidence-based information on surgical procedures, strategies for preparing children for hospitalization and surgery, pain management, and post-discharge care. The mHealth app featured a function that sends customized notifications to guide caregivers at specific perioperative stages. The development of mHealth apps by implementing a rigorous, participatory, and Slow design process can foster accessible and family-centered information and care in the field of maternal and child health and beyond.
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Affiliation(s)
- Raffaella Dobrina
- Healthcare Professions Directorate, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | | | - Laura Brunelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy
| | - Eva Orzan
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | | | - Livia Bicego
- Healthcare Professions Directorate, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | - Veronica Castro
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | - Paola Di Rocco
- Surgery Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | | | - Margherita Dal Cin
- Department of Health Prevention, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy
| | - Benedetta Tagliapietra
- Surgery Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | | | - Donatella Fontanot
- Public Relations Office, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | - Tamara Stampalija
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
| | - Angelo Dante
- Department of Health, Life and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Cristina Petrucci
- Department of Health, Life and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Andrea Cassone
- Healthcare Professions Directorate, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy
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Saramin A, Del Pin M, Miotto E, Smaniotto C, Cadez L, Kodilja R, Marangon F, Parpinel M, Brunelli L. UNO's Sustainable Development Goals in academic courses: a pilot analysis on the programs of an Italian university. Ann Ig 2024; 36:60-71. [PMID: 37724579 DOI: 10.7416/ai.2023.2579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Background Universities are critical in educating tomorrow's citizens and achieving the Sustainable Development Goals of the United Nations Organization. The aim of this study was to investigate the integration of these goals in the curricula of an Italian university. Study design Cross-sectional study. Methods In February 2021, as part of the annual Syllabus preparation for each course, the teaching staffs at the University of Udine (Italy) were asked to complete an additional section in which they could indicate up to three Sustainable Development Goals for their courses. Descriptive statistics, Chi-square test and logistic regression were performed to determine whether the professors' sex, age, or department affected the likelihood of mentioning Sustainable Development Goals. Results In 723 courses, 360/1040 professors 59% male, mean age 53 years (range 30-73), mentioned one (29%), two (23%), or three (31%) Sustainable Development Goals. No Sustainable Development Goals were mentioned in 16% of courses, the majority of which were from the Mathematical, Computer and Physical Sciences Department (58%). The top six Sustainable Development Goals quoted were: Good health and well-being (35%), Responsible consumption and production (22%), Quality education (17%), Industry, innovation and infrastructure (13%), Gender equality (13%), Decent work and economic growth (13%). The least frequently mentioned Goal was Life below water (1%). Women (p<0.0001) and senior professors (p=0.0148) were more likely to consider at least one of the Sustainable Development Goals, while Mathematical, Computer and Physical Sciences Department showed a negative correlation (p<0.0001). Conclusions Gaps were identified with respect to specific Sustainable Development Goals, but discrepancies between departments may indicate deficits in respondent awareness. A transparent description of the Sustainable Development Goals in courses is recommended, to increase students' and university's engagement in sustainability.
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Affiliation(s)
- A Saramin
- Department of Medicine, University of Udine, Italy
| | - M Del Pin
- Department of Medicine, University of Udine, Italy
| | - E Miotto
- Department of Medicine, University of Udine, Italy
| | - C Smaniotto
- Department of Prevention, Western Friuli Healthcare Trust, Pordenone Udine, Italy
| | - L Cadez
- Department of Agrifood, Environmental and Animal Sciences, University of Udine, Italy
| | - R Kodilja
- Department of Languages, Literatures, Communication, Education and Society, University of Udine
| | - F Marangon
- Department of Economics and Statistics, University of Udine, Italy
| | - M Parpinel
- Department of Medicine, University of Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Italy
- Accreditation, Quality and Clinical Risk Unit, Central Friuli Healthcare University Trust, Udine, Italy
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Scarpis E, Cautero P, Tullio A, Mellace F, Farneti F, Londero C, Cocconi R, Brunelli L. Are adverse events related to the completeness of clinical records? Results from a retrospective records review using the Global Trigger Tool. Int J Qual Health Care 2023; 35:mzad094. [PMID: 37952101 DOI: 10.1093/intqhc/mzad094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/15/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
Clinical record (CR) is a tool for recording details about the patient and the most commonly used source of information for detecting adverse events (AEs). Its completeness is an indicator of the quality of care provided and may provide clues for improving professional practice. The primary aim of this study was to estimate the prevalence of AEs. The secondary aims were to determine the completeness of CRs and to examine the relationship between the two variables. We retrospectively reviewed randomly selected CRs of patients discharged from the Academic Hospital of Udine (Italy) in the departments of general surgery, internal medicine, and obstetrics between July and September 2020. Evaluation was performed using the Global Trigger Tool and a checklist to evaluate the completeness of CRs. The relationship between the occurrence of AEs and the completeness of CRs was analyzed using nonparametric tests. A binomial logistic regression analysis was also performed. We reviewed 291 CRs and identified 368 triggers and 56 AEs. Among them, 16.2% of hospitalizations were affected by at least one AE, with a higher percentage in general surgery. The most common AEs were surgical injuries (42.6%; 24) and care related (26.8%; 15). A significant positive correlation was found between the length of hospital stay and the number of AEs. The average completeness of CRs was 72.9% and was lower in general surgery. The decrease in CR completeness correlated with the increase in the total number of AEs (R = -0.14; P = .017), although this was not confirmed by regression analysis by individual departments. Our results seem to suggest that completeness of CRs may benefit patient safety, so ongoing education and involvement of health professionals are needed to maintain professional adherence to CRs.
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Affiliation(s)
- Enrico Scarpis
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine 33100, Italia
| | - Peter Cautero
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine 33100, Italia
| | - Annarita Tullio
- SOC Istituto di Igiene ed Epidemiologia Valutativa, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italia
| | - Flavio Mellace
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine 33100, Italia
| | - Federico Farneti
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italia
| | - Carla Londero
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italia
| | - Roberto Cocconi
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italia
| | - Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine 33100, Italia
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine 33100, Italia
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Brunelli L, Miotto E, Del Pin M, Celotto D, Moccia A, Borghi G, De Monte A, Macor C, Cocconi R, Lattuada L, Brusaferro S, Arnoldo L. A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B. Front Med (Lausanne) 2023; 10:1253673. [PMID: 38053617 PMCID: PMC10694263 DOI: 10.3389/fmed.2023.1253673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
Objective The urgent transfer of an intensive care unit (ICU) is particularly challenging because it carries a high clinical and infectious risk and is a critical node in a hospital's patient flow. In early 2017, exceptional rainfall damaged the roof of the tertiary hospital in Udine, necessitating the relocation of one of the three ICUs for six months. We decided to assess the impact of this transfer on quality of care and patient safety using a set of indicators, primarily considering the incidence of healthcare-associated infections (HAIs) and mortality rates. Methods We performed a retrospective, observational analysis of structural, process, and outcome indicators comparing the pre- and posttransfer phases. Specifically, we analyzed data between July 2016 and June 2017 for the transferred ICU and examined mortality and the incidence of HAI. Results Despite significant changes in structural and organizational aspects of the unit, no differences in mortality rates or cumulative incidence of HAIs were observed before/after transfer. We collected data for all 393 patients (133 women, 260 men) admitted to the ICU before (49.4%) and after transfer (50.6%). The mortality rate for 100 days in the ICU was 1.90 (34/1791) before and 2.88 (37/1258) after transfer (p = 0.063). The evaluation of the occurrence of at least one HAI included 304 patients (102 women and 202 men), as 89 of them were excluded due to a length of stay in the ICU of less than 48 h; again, there was no statistical difference between the two cumulative incidences (13.1% vs. 6.9%, p = 0.075). Conclusion In the case studied, no adverse effects on patient outcomes were observed after urgent transfer of the injured ICU. The indicators used in this study may be an initial suggestion for further discussion.
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Affiliation(s)
- Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Edoardo Miotto
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Massimo Del Pin
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Daniele Celotto
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Adriana Moccia
- Direzione Medica, Presidio Ospedaliero Universitario S. Maria della Misericordia di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Gianni Borghi
- Direzione Medica, Presidio Ospedaliero Universitario S. Maria della Misericordia di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Amato De Monte
- Dipartimento di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Cristiana Macor
- Dipartimento di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Roberto Cocconi
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Luca Lattuada
- Direzione Medica, Presidio Ospedaliero Universitario S. Maria della Misericordia di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Silvio Brusaferro
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Luca Arnoldo
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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8
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Brunelli L, Scarpis E, Lo Presti T, Fiorillo F, Campanella F, Zuliani P, Farneti F, Croci E, Pellizzari B, Cocconi R, Arnoldo L. Health professionals who have worked in COVID-19 immunization centers suffer the effects of violence. Front Public Health 2023; 11:1264301. [PMID: 37799152 PMCID: PMC10548233 DOI: 10.3389/fpubh.2023.1264301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023] Open
Abstract
Background The phenomenon violence against health professionals has received increasing attention in recent years because of its frequency and significant impact on victims' mental health and disruption of health services. Despite this attention, little is known about the incidence of workplace violence in the highly politicized immunization services. Therefore, we decided to examine the prevalence of workplace violence in the COVID-19 immunization campaign, the risk and protective factors, and the impact on victims' mental health. Methods Between March and April 2022, we conducted an anonymous online survey among health professionals working in COVID-19 vaccination centers in the Friuli-Venezia Giulia Region (Italy). We used the Questionnaire for Workplace Violence in Healthcare Settings and the Impact of Event Scale-Revised. Results Of the 200 participants, 93 (46.5%) reported being victims of an act of violence during the vaccination campaign, 60 of them verbally and 7 physically. In 35.5% of cases, the IES score indicated a possible post-traumatic stress reaction in the victim. Opinions on measures to prevent violence and support workers in the workplace differed according to the sex of the health professional, with women emphasizing the need for self-defense training and improvement of security arrangements (p < 0.001). Conclusion One-third of health professionals involved in the COVID-19 immunization campaign reported that their mental health was affected by workplace violence. Public health professionals dealing with politicized and debated issues such as immunization should receive more attention, as should the implementation of a more structured and multidisciplinary approach to the problem within healthcare organizations.
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Affiliation(s)
- Laura Brunelli
- Department of Medicine, University of Udine, Udine, Italy
- Clinical Risk, Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Enrico Scarpis
- Medical Directorate of Palmanova-Latisana Hospital, Friuli Centrale Healthcare University Trust, Udine, Italy
| | | | - Francesca Fiorillo
- Regional Transplant Centre, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Fabio Campanella
- Neurosurgery Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Paola Zuliani
- Clinical Risk, Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Federico Farneti
- Clinical Risk, Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Eleonora Croci
- Department of Prevention, Giuliano Isontina Healthcare University Trust, Trieste, Italy
| | - Barbara Pellizzari
- Department of Prevention, Friuli Occidentale Healthcare Trust, Pordenone, Italy
| | - Roberto Cocconi
- Clinical Risk, Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Luca Arnoldo
- Department of Medicine, University of Udine, Udine, Italy
- Clinical Risk, Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
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9
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Resovi A, Persichitti P, Brunelli L, Minoli L, Borsotti P, Garattini G, Tironi M, Dugnani E, Redegalli M, De Simone G, Pastorelli R, Bani MR, Piemonti L, Mosher DF, Giavazzi R, Taraboletti G, Belotti D. Fibronectin fragments generated by pancreatic trypsin act as endogenous inhibitors of pancreatic tumor growth. J Exp Clin Cancer Res 2023; 42:201. [PMID: 37559126 PMCID: PMC10411016 DOI: 10.1186/s13046-023-02778-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The pancreatic microenvironment has a defensive role against cancer but it can acquire tumor-promoting properties triggered by multiple mechanisms including alterations in the equilibrium between proteases and their inhibitors. The identification of proteolytic events, targets and pathways would set the basis for the design of new therapeutic approaches. METHODS AND RESULTS Here we demonstrate that spheroids isolated from human and murine healthy pancreas and co-transplanted orthotopically with pancreatic ductal adenocarcinoma (PDAC) in mouse pancreas inhibited tumor growth. The effect was mediated by trypsin-generated fibronectin (FN) fragments released by pancreatic spheroids. Tumor inhibition was observed also in a model of acute pancreatitis associated with trypsin activation. Mass spectrometry proteomic analysis of fragments and mAb against different FN epitopes identified the FN type III domain as responsible for the activity. By inhibiting integrin α5β1, FAK and FGFR1 signaling, the fragments induced tumor cell detachment and reduced cell proliferation. Consistent with the mutual relationship between the two pathways, FGF2 restored both FGFR1 and FAK signaling and promoted PDAC cell adhesion and proliferation. FAK and FGFR inhibitors additively inhibited PDAC growth in vitro and in orthotopic in vivo models. CONCLUSIONS This study identifies a novel role for pancreatic trypsin and fibronectin cleavage as a mechanism of protection against cancer by the pancreatic microenvironment. The finding of a FAK-FGFR cross-talk in PDAC support the combination of FAK and FGFR inhibitors for PDAC treatment to emulate the protective effect of the normal pancreas against cancer.
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Affiliation(s)
- Andrea Resovi
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Perla Persichitti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Laura Brunelli
- Department of Environmental Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Lucia Minoli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Patrizia Borsotti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Giulia Garattini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Matteo Tironi
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Erica Dugnani
- Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Miriam Redegalli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Giulia De Simone
- Department of Environmental Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Roberta Pastorelli
- Department of Environmental Science, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maria Rosa Bani
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Deane F Mosher
- Departments of Biomolecular Chemistry and Medicine, University of Wisconsin, Madison, WI, USA
| | - Raffaella Giavazzi
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Giulia Taraboletti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy
| | - Dorina Belotti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo and Milan, Italy.
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10
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Boso D, Tognon M, Curtarello M, Minuzzo S, Piga I, Brillo V, Lazzarini E, Carlet J, Marra L, Trento C, Rasola A, Masgras I, Caporali L, Del Ben F, Brisotto G, Turetta M, Pastorelli R, Brunelli L, Navaglia F, Esposito G, Grassi A, Indraccolo S. Anti-VEGF therapy selects for clones resistant to glucose starvation in ovarian cancer xenografts. J Exp Clin Cancer Res 2023; 42:196. [PMID: 37550722 PMCID: PMC10405561 DOI: 10.1186/s13046-023-02779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Genetic and metabolic heterogeneity are well-known features of cancer and tumors can be viewed as an evolving mix of subclonal populations, subjected to selection driven by microenvironmental pressures or drug treatment. In previous studies, anti-VEGF therapy was found to elicit rewiring of tumor metabolism, causing marked alterations in glucose, lactate ad ATP levels in tumors. The aim of this study was to evaluate whether differences in the sensitivity to glucose starvation existed at the clonal level in ovarian cancer cells and to investigate the effects induced by anti-VEGF therapy on this phenotype by multi-omics analysis. METHODS Clonal populations, obtained from both ovarian cancer cell lines (IGROV-1 and SKOV3) and tumor xenografts upon glucose deprivation, were defined as glucose deprivation resistant (GDR) or glucose deprivation sensitive (GDS) clones based on their in vitro behaviour. GDR and GDS clones were characterized using a multi-omics approach, including genetic, transcriptomic and metabolic analysis, and tested for their tumorigenic potential and reaction to anti-angiogenic therapy. RESULTS Two clonal populations, GDR and GDS, with strikingly different viability following in vitro glucose starvation, were identified in ovarian cancer cell lines. GDR clones survived and overcame glucose starvation-induced stress by enhancing mitochondrial oxidative phosphorylation (OXPHOS) and both pyruvate and lipids uptake, whereas GDS clones were less able to adapt and died. Treatment of ovarian cancer xenografts with the anti-VEGF drug bevacizumab positively selected for GDR clones that disclosed increased tumorigenic properties in NOD/SCID mice. Remarkably, GDR clones were more sensitive than GDS clones to the mitochondrial respiratory chain complex I inhibitor metformin, thus suggesting a potential therapeutic strategy to target the OXPHOS-metabolic dependency of this subpopulation. CONCLUSION A glucose-deprivation resistant population of ovarian cancer cells showing druggable OXPHOS-dependent metabolic traits is enriched in experimental tumors treated by anti-VEGF therapy.
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Affiliation(s)
- Daniele Boso
- Basic and Translational Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128, Padova, Italy
| | - Martina Tognon
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Matteo Curtarello
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Sonia Minuzzo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, via Giustiniani 2, Padova, 35124, Italy
| | - Ilaria Piga
- Department of Surgery, Oncology and Gastroenterology, University of Padova, via Giustiniani 2, Padova, 35124, Italy
| | | | - Elisabetta Lazzarini
- Basic and Translational Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128, Padova, Italy
| | - Jessica Carlet
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Ludovica Marra
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Chiara Trento
- Department of Surgery, Oncology and Gastroenterology, University of Padova, via Giustiniani 2, Padova, 35124, Italy
| | - Andrea Rasola
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Ionica Masgras
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Leonardo Caporali
- Department of Biomedical and Neuromotor Sciences - DIBINEM, University of Bologna, Bologna, Italy
| | - Fabio Del Ben
- Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO)-IRCCS, Aviano, Italy
| | - Giulia Brisotto
- Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO)-IRCCS, Aviano, Italy
| | - Matteo Turetta
- Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO)-IRCCS, Aviano, Italy
| | - Roberta Pastorelli
- Laboratory of Mass Spectrometry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Laura Brunelli
- Laboratory of Mass Spectrometry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Filippo Navaglia
- Laboratory Medicine, Department of Medicine-DIMED, University Hospital of Padova, Padova, Italy
| | - Giovanni Esposito
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Angela Grassi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Stefano Indraccolo
- Basic and Translational Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, via Gattamelata 64, 35128, Padova, Italy.
- Department of Surgery, Oncology and Gastroenterology, University of Padova, via Giustiniani 2, Padova, 35124, Italy.
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11
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De Simone G, Soldani C, Morabito A, Franceschini B, Ferlan F, Costa G, Pastorelli R, Donadon M, Brunelli L. Implication of metabolism in the polarization of tumor-associated-macrophages: the mass spectrometry-based point of view. Front Immunol 2023; 14:1193235. [PMID: 37503340 PMCID: PMC10368868 DOI: 10.3389/fimmu.2023.1193235] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/22/2023] [Indexed: 07/29/2023] Open
Abstract
Tumor-associated macrophages (TAMs) represent one of the main tumor-infiltrating immune cell types and are generally categorized into either of two functionally contrasting subtypes, namely classical activated M1 macrophages and alternatively activated M2 macrophages. TAMs showed different activation states that can be represent by the two extremes of the complex profile of macrophages biology, the M1-like phenotype (pro-inflammatory activity) and the M2-like phenotype (anti-inflammatory activity). Based on the tumor type, and grades, TAMs can acquire different functions and properties; usually, the M1-like phenotype is typical of early tumor stages and is associated to an anti-tumor activity, while M2-like phenotype has a pro-inflammatory activity and is related to a poor patients' prognosis. The classification of macrophages into M1/M2 groups based on well-defined stimuli does not model the infinitely more complex tissue milieu where macrophages (potentially of different origin) would be exposed to multiple signals in different sequential order. This review aims to summarize the recent mass spectrometry-based (MS-based) metabolomics findings about the modifications of metabolism in TAMs polarization in different tumors. The published data shows that MS-based metabolomics is a promising tool to help better understanding TAMs metabolic phenotypes, although it is still poorly applied for TAMs metabolism. The knowledge of key metabolic alterations in TAMs is an essential step for discovering TAMs polarization novel biomarkers and developing novel therapeutic approaches targeting TAM metabolism to repolarize TAMs towards their anti-tumor phenotype.
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Affiliation(s)
- Giulia De Simone
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Department of Biotechnologies and Biosciences, Università degli Studi Milano Bicocca, Milan, Italy
| | - Cristiana Soldani
- Hepatobiliary Immunopathology Laboratory, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Aurelia Morabito
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Barbara Franceschini
- Hepatobiliary Immunopathology Laboratory, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Fabrizio Ferlan
- Hepatobiliary Immunopathology Laboratory, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Guido Costa
- Hepatobiliary Immunopathology Laboratory, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Hepatobiliary and General Surgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Roberta Pastorelli
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Matteo Donadon
- Hepatobiliary Immunopathology Laboratory, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Hepatobiliary and General Surgery, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
- Department of General Surgery, University Maggiore Hospital, Novara, Italy
| | - Laura Brunelli
- Laboratory of Metabolites and Proteins in Translational Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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12
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Dobrina R, Cassone A, Dal Cin M, Ronfani L, Giangreco M, Schreiber S, Zanchiello S, Starec A, Brunelli L, Brumatti LV, Bicego L. Study protocol for a randomised controlled trial to determine the effectiveness of a mHealth application as a family supportive tool in paediatric otolaryngology perioperative process (TONAPP). Trials 2023; 24:355. [PMID: 37231477 DOI: 10.1186/s13063-023-07376-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Otorhinolaryngology (ORL) surgery is common in children, but hospitalisation, surgery, and home care after discharge are stressful experiences for young patients and their family caregivers. Findings from literature highlight a lack of time in hospitals to support ORL surgery children and their caregivers through the perioperative process, along with the risks of caregivers' autonomous web or social media resources investigation. Therefore, this study aims to evaluate the effectiveness of a mobile health application with content to support ORL patients and their caregivers in the perioperative period to reduce caregiver anxiety and child distress compared to standard care. METHODS An open-label, two-arm randomised control trial design is being adopted. The intervention consists of a mobile health application with content to support ORL patients and their caregivers during the perioperative period. One hundred eighty participants will be enrolled and randomly assigned to the experimental group using the mHealth application or the control group. The control group receives standard information and education about the ORL perioperative period from healthcare providers orally or through brochures. The primary outcome is the difference between the intervention and control groups in preoperative caregiver state anxiety. Secondary outcome measures include children's distress before surgery and family preparation for hospitalisation. DISCUSSION The results of this study will be critical to the implementation of a new and safe model for the management of care and education in paediatrics. This model can achieve positive organisational and health outcomes by supporting continuity of care and empowering citizens to have informed participation and satisfaction in paediatric health promotion and management. TRIAL REGISTRATION Trial identifier: NCT05460689 registry name: ClinicalTrials.gov. Date of registration: July 15, 2022. Last update posted: February 23, 2023.
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Affiliation(s)
- Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
| | - Andrea Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Margherita Dal Cin
- Department of Health Prevention, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Silvana Schreiber
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | | | - Laura Brunelli
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Liza Vecchi Brumatti
- Scientific Direction, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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13
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Conte A, Brunelli L, Moretti V, Valdi G, Guelfi MR, Masoni M, Anelli F, Parpinel M, Arnoldo L. Can a validated website help improve university students' e-health literacy? Ann Ig 2023; 35:257-268. [PMID: 36178128 DOI: 10.7416/ai.2022.2542] [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] [Indexed: 03/11/2023]
Abstract
Background The fight against fake news, mainly spread through Internet, is a major public health issue, even among undergraduate students. This study aims to evaluate the effectiveness of a website promoted by the Italian Federation of the Provincial Orders of the Medical Doctors as a first aid communication kit for health topics. Study design Pre-post study using a web-based survey, conducted in April-May 2019 on Medical students and October-November 2020 on Communication Sciences students at the University of Florence (Italy). Methods. Undergraduate students of both schools were exposed to the use of the "dottoremaeveroche" website. Primary and secondary outcomes measures: the Italian-electronic Health Literacy Scale self-assessment tool was used to examine subjects' electronic Health literacy, and source quality. All responses were rated on a 5-point Likert scale. Changing in perception of abilities were examined using the Wilcoxon test. Results The 362 participants felt moderately confident in electronic Health Literacy, with an initial Italian-electronic Health Literacy Scale overall mean score of 3.6±0.7 for medical and 3.2±0.8 for communication students. Medical students had a good idea of how to find helpful sources (3.9±0.8) and communication students felt confident in recognizing their quality (3.5±1.0). In contrast, their confidence in using Web information to make health decisions was low (medical: 2.9±1.1; communication: 2.8±1.1). All items improved significantly after "dottoremaeveroche" use (p<.001), with the overall mean score of Italian-electronic Health Literacy Scale increasing to 4.3±0.6 for medical and 4.1±0.8 for communication students. Conclusions Low electronic health literacy levels can affect public health efforts, as seen during the COVID-19 pandemic. The effectiveness of "dottoremaeveroche" among students showed the usefulness of online educational interventions that, if further implemented, could help combat the spread of infodemic.
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Affiliation(s)
- A Conte
- Medical Directorate of San Daniele Hospital, Friuli Centrale University Healthcare Trust, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Italy.,Clinical Risk, Quality and Accreditation Unit, Friuli Centrale University Healthcare Trust, Udine, Italy
| | - V Moretti
- Department of Medicine, University of Udine, Italy
| | - G Valdi
- Department of Medicine, University of Udine, Italy
| | - M R Guelfi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - M Masoni
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - F Anelli
- Italian Federation of the Provincial Orders of Medical Doctors (FNOMCEO), Rome, Italy
| | - M Parpinel
- Department of Medicine, University of Udine, Italy
| | - L Arnoldo
- Department of Medicine, University of Udine, Italy.,Clinical Risk, Quality and Accreditation Unit, Friuli Centrale University Healthcare Trust, Udine, Italy
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14
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Moretti V, Brunelli L, Conte A, Valdi G, Guelfi MR, Masoni M, Anelli F, Arnoldo L. A Web Tool to Help Counter the Spread of Misinformation and Fake News: Pre-Post Study Among Medical Students to Increase Digital Health Literacy. JMIR Med Educ 2023; 9:e38377. [PMID: 36996010 PMCID: PMC10131978 DOI: 10.2196/38377] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/07/2023] [Accepted: 02/27/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic was accompanied by the spread of uncontrolled health information and fake news, which also quickly became an infodemic. Emergency communication is a challenge for public health institutions to engage the public during disease outbreaks. Health professionals need a high level of digital health literacy (DHL) to cope with difficulties; therefore, efforts should be made to address this issue starting from undergraduate medical students. OBJECTIVE The aim of this study was to investigate the DHL skills of Italian medical students and the effectiveness of an informatics course offered by the University of Florence (Italy). This course focuses on assessing the quality of medical information using the "dottoremaeveroche" (DMEVC) web resource offered by the Italian National Federation of Orders of Surgeons and Dentists, and on health information management. METHODS A pre-post study was conducted at the University of Florence between November and December 2020. First-year medical students participated in a web-based survey before and after attending the informatics course. The DHL level was self-assessed using the eHealth Literacy Scale for Italy (IT-eHEALS) tool and questions about the features and quality of the resources. All responses were rated on a 5-point Likert scale. Change in the perception of skills was assessed using the Wilcoxon test. RESULTS A total of 341 students participated in the survey at the beginning of the informatics course (women: n=211, 61.9%; mean age 19.8, SD 2.0) and 217 of them (64.2%) completed the survey at the end of the course. At the first assessment, the DHL level was moderate, with a mean total score of the IT-eHEALS of 2.9 (SD 0.9). Students felt confident about finding health-related information on the internet (mean score of 3.4, SD 1.1), whereas they doubted the usefulness of the information they received (mean score of 2.0, SD 1.0). All scores improved significantly in the second assessment. The overall mean score of the IT-eHEALS significantly increased (P<.001) to 4.2 (SD 0.6). The item with the highest score related to recognizing the quality of health information (mean score of 4.5, SD 0.7), whereas confidence in the practical application of the information received remained the lowest (mean of 3.7, SD 1.1) despite improvement. Almost all students (94.5%) valued the DMEVC as an educational tool. CONCLUSIONS The DMEVC tool was effective in improving medical students' DHL skills. Effective tools and resources such as the DMEVC website should be used in public health communication to facilitate access to validated evidence and understanding of health recommendations.
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Affiliation(s)
- Valentina Moretti
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
- Accreditamento, Qualità e Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Alessandro Conte
- Direzione Medica del Presidio Ospedaliero di San Daniele - Tolmezzo, Azienda Sanitaria Universitaria Friuli Centrale, San Daniele del Friuli, Italy
| | - Giulia Valdi
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Maria Renza Guelfi
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - Marco Masoni
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | - Filippo Anelli
- Federazione Nazionale degli Ordini dei Medici Chirurghi e Odontoiatri, Roma, Italy
| | - Luca Arnoldo
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
- Accreditamento, Qualità e Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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15
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Favole A, Testori C, Bergagna S, Gennero MS, Ingravalle F, Costa B, Barresi S, Curti P, Barberis F, Ganio S, Orusa R, Vallino Costassa E, Berrone E, Vernè M, Scaglia M, Palmitessa C, Gallo M, Tessarolo C, Pederiva S, Ferrari A, Lorenzi V, Fusi F, Brunelli L, Pastorelli R, Cagnotti G, Casalone C, Caramelli M, Corona C. Brain-Derived Neurotrophic Factor, Kynurenine Pathway, and Lipid-Profiling Alterations as Potential Animal Welfare Indicators in Dairy Cattle. Animals (Basel) 2023; 13:ani13071167. [PMID: 37048423 PMCID: PMC10093196 DOI: 10.3390/ani13071167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Complete animal welfare evaluation in intensive farming is challenging. With this study, we investigate new biomarkers for animal physical and mental health by comparing plasma expression of biochemical indicators in dairy cows reared in three different systems: (A) semi-intensive free-stall, (B) non-intensive tie-stall, and (C) intensive free-stall. Additionally, protein levels of mature brain-derived neurotrophic factor (mBDNF) and its precursor form (proBDNF) and indoleamine 2,3-dioxygenase (IDO1) specific activity were evaluated in brain samples collected from 12 cattle culled between 73 and 138 months of age. Alterations in plasma lipid composition and in the kynurenine pathway of tryptophan metabolism were observed in the tie-stall-reared animals. The total plasma BDNF concentration was higher in tie-stall group compared to the two free-housing groups. Brain analysis of the tie-stall animals revealed a different mBDNF/proBDNF ratio, with a higher level of proBDNF (p < 0.001). Our data are similar to previous studies on animal models of depression, which reported that inhibition of the conversion of proBDNF in its mature form and/or elevated peripheral kynurenine pathway activation may underlie cerebral biochemical changes and induce depressive-like state behavior in animals.
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Scarpis E, Bravo G, Cocconi R, Brunelli L. Psychological impact of COVID-19 on healthcare leaders: a cross-sectional survey in Friuli-Venezia Giulia, Italy. BMJ Lead 2023; 7:16-20. [PMID: 37013876 PMCID: PMC8914404 DOI: 10.1136/leader-2021-000534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Although several studies highlighted the psychological burden of 2019 coronavirus disease (COVID-19) pandemic, no data are available regarding professionals leading healthcare organisations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs), along with the leadership skills and coping strategies needed for successful leadership. METHODS A cross-sectional survey was conducted in Friuli-Venezia Giulia (Italy) between October and November 2020. We assessed the presence of depressive symptoms (DS), anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Coping strategies and skills needed to overcome the crisis were examined, along with the most challenging phases. RESULTS A total of 48 HeLs participated. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate and severe insomnia was found in 12.5% and 6.3% of them, respectively. Leaders showed moderate (45.8%) and high 4,2%) level of PS. The two most challenging phases were recognised in early recognition (45.2%) and peak phase (31.0%). Concerning healthcare leaders' skills required to manage with pandemic, the most reported were communication (35.1%) and decision-making (25.5%). CONCLUSION The high level of PS, insomnia, DS and AS experienced by healthcare leaders shows the COVID-19 pandemic's psychological impact. The two most challenging phases identified enhances the importance of public health surveillance and monitoring systems, and communication appeared a critical success skill for healthcare leaders. Given the key role these professional play in addressing the current crisis in healthcare organisations, their mental health and well-being deserve greater attention.
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Affiliation(s)
- Enrico Scarpis
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Giulia Bravo
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Roberto Cocconi
- Accreditamento e Gestione del Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
- Accreditamento e Gestione del Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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Brunelli L, Bussolaro S, Dobrina R, De Vita C, Mazzolini E, Verardi G, Degrassi M, Piazza M, Cassone A, Starec A, Ricci G, Zanchiello S, Stampalija T. Exploring the Needs and Expectations of Expectant and New Parents for an mHealth Application to Support the First 1000 Days of Life: Steps toward a Co-Design Approach. Int J Environ Res Public Health 2023; 20:1227. [PMID: 36673978 PMCID: PMC9858695 DOI: 10.3390/ijerph20021227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 05/05/2023]
Abstract
To improve maternal and child health, it is essential to adhere to health-promoting and preventive measures. However, reliable information as well as effective tools are not easy to identify in this field. Our cross-sectional study investigated the needs and expectations of expectant and new mothers and fathers as potential primary users of a hypothetical application supporting the first 1000 days of life. Between May and August 2022, we recruited expectant and new parents by administering an 83-item 5-point Likert scale questionnaire related to the content, functionalities, and technical features of the hypothetical app. We stratified responses using sociodemographic characteristics and then performed ward hierarchical clustering. The 94 women and 69 men involved in our study generally agreed with the proposed content, but expressed low interest in certain app functionalities or features, including those related to the interaction mechanism and interactivity. Women were generally more demanding than men. Our findings, resulting from the engagement of end-users, may be useful for designers and technology providers to implement mHealth solutions that, in addition to conveying reliable information, are tailored to the needs and preferences of end-users in the first 1000 days of life.
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Affiliation(s)
- Laura Brunelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Sofia Bussolaro
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Elena Mazzolini
- Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Giuseppa Verardi
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Maura Degrassi
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Maria Piazza
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Andrea Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Giuseppe Ricci
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
- Obstetrics and Gynecology Clinic, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | | | - Tamara Stampalija
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
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18
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Brunelli L, Dobrina R, De Vita C, Mazzolini E, Verardi G, Bussolaro S, Degrassi M, Hervatich G, Piazza M, Strajn T, Cassone A, Starec A, Ricci G, Zanchiello S, Stampalija T. What do hospital-based health professionals need and expect from an mHealth app to support the first 1000 days of life? Results from a cross sectional study. PLoS One 2023; 18:e0284448. [PMID: 37083657 PMCID: PMC10121055 DOI: 10.1371/journal.pone.0284448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/01/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Several attempts have been made to introduce mHealth solutions to support maternal, newborn, and child health (MNCH). However, most of the available apps do not meet the needs of end-users, underscoring the urgency of involving them in the co-design of telehealth interventions. OBJECTIVE With this in mind, we investigated the needs and expectations of hospital-based health professionals (i.e., secondary users) providing care to pregnant women and new mothers with their babies for a hypothetical mHealth app to support the first 1000 days of life. METHODS From November 2021 to March 2022, we surveyed health professionals using a questionnaire that explored the perceived importance of specific content, functionalities, and technical features of the proposed app. We also collected sociodemographic information from secondary users. We performed descriptive analysis and then used Ward hierarchical clustering method to classify respondents according to their response patterns. RESULTS We recorded the needs and expectations of 145 hospital-based health professionals from obstetrics/gynecology, nursery/neonatology, and pediatrics. We found general agreement with the proposed content of the app, particularly general information about health during pregnancy (92%) and potential risky infections during pregnancy (91%). Three clusters emerged from the analysis, with the high and medium demanding clusters rating the importance of app content and technical features as very high and high, respectively, while low demanding cluster expressing more skepticism, especially about some of the proposed functionalities of the app. CONCLUSIONS Assessing the needs and expectations of end-users is an essential process for developing tailored and effective mHealth solutions. This study has shown that hospital-based health professionals generally recognize the value of the proposed app, suggesting their propensity to integrate such a telehealth solution into mainstream clinical practice.
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Affiliation(s)
- Laura Brunelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Raffaella Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Elena Mazzolini
- Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, Udine e Legnaro, Italy
| | - Giuseppa Verardi
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sofia Bussolaro
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Maura Degrassi
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Hervatich
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Maria Piazza
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Tamara Strajn
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Andrea Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Giuseppe Ricci
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Obstetrics and Gynecology Clinic, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Tamara Stampalija
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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Gianni M, Terao M, Kurosaki M, Paroni G, Brunelli L, Pastorelli R, Zanetti A, Lupi M, Acquavita A, Bolis M, Fratelli M, Rochette-Egly C, Garattini E. Correction: S100A3 a partner protein regulating the stability/activity of RARα and PML-RARα in cellular models of breast/lung cancer and acute myeloid leukemia. Oncogene 2023; 42:254-258. [PMID: 36476834 PMCID: PMC9836929 DOI: 10.1038/s41388-022-02564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Maurizio Gianni
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Mineko Terao
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Mami Kurosaki
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Gabriela Paroni
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Laura Brunelli
- grid.4527.40000000106678902Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Roberta Pastorelli
- grid.4527.40000000106678902Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Adriana Zanetti
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Monica Lupi
- grid.4527.40000000106678902Laboratory of Cancer Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Andrea Acquavita
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Marco Bolis
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Maddalena Fratelli
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
| | - Cecile Rochette-Egly
- grid.11843.3f0000 0001 2157 9291Department of Functional Genomics and Cancer, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), INSERM, U964; CNRS, UMR7104, Université de Strasbourg, 1 rue Laurent Fries, BP 10142, 67404 Illkirch Cedex, France
| | - Enrico Garattini
- grid.4527.40000000106678902Laboratory of Molecular Biology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, via La Masa 19, 20156 Milano, Italy
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20
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Morabito A, De Simone G, Ferrario M, Falcetta F, Pastorelli R, Brunelli L. EASY-FIA: A Readably Usable Standalone Tool for High-Resolution Mass Spectrometry Metabolomics Data Pre-Processing. Metabolites 2022; 13:metabo13010013. [PMID: 36676938 PMCID: PMC9861133 DOI: 10.3390/metabo13010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Flow injection analysis coupled with high-resolution mass spectrometry (FIA-HRMS) is a fair trade-off between resolution and speed. However, free software available for data pre-processing is few, web-based, and often requires advanced user specialization. These tools rarely embedded blank and noise evaluation strategies, and direct feature annotation. We developed EASY-FIA, a free standalone application that can be employed for FIA-HRMS metabolomic data pre-processing by users with no bioinformatics/programming skills. We validated the tool's performance and applicability in two clinical metabolomics case studies. The main functions of our application are blank subtraction, alignment of the metabolites, and direct feature annotation by means of the Human Metabolome Database (HMDB) using a minimum number of mass spectrometry parameters. In a scenario where FIA-HRMS is increasingly recognized as a reliable strategy for fast metabolomics analysis, EASY-FIA could become a standardized and feasible tool easily usable by all scientists dealing with MS-based metabolomics. EASY-FIA was implemented in MATLAB with the App Designer tool and it is freely available for download.
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Affiliation(s)
- Aurelia Morabito
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Giulia De Simone
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Department of Biotechnologies and Biosciences, Università degli Studi Milano Bicocca, 20126 Milan, Italy
| | - Manuela Ferrario
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Francesca Falcetta
- Unit of Biophysics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Roberta Pastorelli
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Laura Brunelli
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Correspondence: ; Tel.: +39-0239014742
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21
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Brunelli L, Arnoldo L, Mazzilis G, d'Angelo M, Colautti L, Cojutti PG, Parpinel M. The knowledge and attitudes of pharmacists related to the use of dietary supplements: An observational study in northeastern Italy. Prev Med Rep 2022; 30:101986. [PMID: 36164506 PMCID: PMC9508580 DOI: 10.1016/j.pmedr.2022.101986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/05/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022] Open
Abstract
Inappropriate use of dietary supplements can be potentially harmful to patients, especially given the uncontrolled information on the Internet and social media. The role that pharmacists play in advising citizens and purchasing these products can help improve their safer use, but the knowledge, attitudes, and practices of these professionals on this topic are still largely unknown. Pharmacists in the Italian Region of Friuli-Venezia Giulia (FVG) were surveyed from September 2020 to February 2021 using a 54-item online questionnaire. The questions were related to knowledge, attitudes, and practice. Data on gender, age, work experience, degree, and function in pharmacy were also collected. 232 questionnaires were completed, predominantly by women (71 %). The majority of respondents had a degree in Pharmacy (77 %) and were employed in a pharmacy (66 %) where they had worked for at least 10 years (61 %). Pharmacists’ knowledge was rated as low, with one-third of participants above the median; knowledge was higher among more experienced pharmacists. Larger knowledge gaps were noted regarding the potential carcinogenicity of multivitamin misuse and the undesirable presence of unlabeled ingredients in dietary supplements. Employees were more likely than owners to report purchasing dietary supplements at the direct request of patients (p < 0.05). The low level of pharmacists’ knowledge about the use of dietary supplements is unsatisfactory, with concerning impact on patient safety. Young professionals in particular would benefit from continuous education to better advise patients. Nevertheless, the European regulatory framework for the manufacture, sale and post-marketing surveillance of dietary supplements needs to be strengthened.
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Affiliation(s)
- Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna, 50, Udine, Italy.,SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, via Pozzuolo 330, Udine, Italy
| | - Luca Arnoldo
- Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna, 50, Udine, Italy.,SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, via Pozzuolo 330, Udine, Italy
| | - Giada Mazzilis
- Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna, 50, Udine, Italy
| | - Matteo d'Angelo
- Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna, 50, Udine, Italy
| | | | - Pier Giorgio Cojutti
- Farmacologia Clinica, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Maria Parpinel
- Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna, 50, Udine, Italy
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22
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Colombo M, Passarelli F, Corsetto PA, Rizzo AM, Marabese M, De Simone G, Pastorelli R, Broggini M, Brunelli L, Caiola E. NSCLC Cells Resistance to PI3K/mTOR Inhibitors Is Mediated by Delta-6 Fatty Acid Desaturase (FADS2). Cells 2022; 11:cells11233719. [PMID: 36496978 PMCID: PMC9736998 DOI: 10.3390/cells11233719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Hyperactivation of the phosphatidylinositol-3-kinase (PI3K) pathway is one of the most common events in human cancers. Several efforts have been made toward the identification of selective PI3K pathway inhibitors. However, the success of these molecules has been partially limited due to unexpected toxicities, the selection of potentially responsive patients, and intrinsic resistance to treatments. Metabolic alterations are intimately linked to drug resistance; altered metabolic pathways can help cancer cells adapt to continuous drug exposure and develop resistant phenotypes. Here we report the metabolic alterations underlying the non-small cell lung cancer (NSCLC) cell lines resistant to the usual PI3K-mTOR inhibitor BEZ235. In this study, we identified that an increased unsaturation degree of lipid species is associated with increased plasma membrane fluidity in cells with the resistant phenotype and that fatty acid desaturase FADS2 mediates the acquisition of chemoresistance. Therefore, new studies focused on reversing drug resistance based on membrane lipid modifications should consider the contribution of desaturase activity.
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Affiliation(s)
- Marika Colombo
- Laboratory of Molecular Pharmacology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Federico Passarelli
- Laboratory of Molecular Pharmacology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Paola A. Corsetto
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Angela M. Rizzo
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Mirko Marabese
- Laboratory of Molecular Pharmacology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Giulia De Simone
- Protein and Metabolite Biomarkers Unit, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Roberta Pastorelli
- Protein and Metabolite Biomarkers Unit, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Massimo Broggini
- Laboratory of Molecular Pharmacology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Correspondence: (M.B.); (L.B.)
| | - Laura Brunelli
- Protein and Metabolite Biomarkers Unit, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Correspondence: (M.B.); (L.B.)
| | - Elisa Caiola
- Laboratory of Molecular Pharmacology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
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Brusaferro S, Arnoldo L, Brunelli L, Croci R, Mistretta A. Six Ps to drive the future of public health. J Public Health (Oxf) 2022; 44:i94-i96. [DOI: 10.1093/pubmed/fdac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/25/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Silvio Brusaferro
- Istituto Superiore di Sanità , 00161 Rome, Italy
- University of Udine Department of Medicine, , 33100 Udine, Italy
| | - Luca Arnoldo
- University of Udine Department of Medicine, , 33100 Udine, Italy
- Accreditation and Quality Unit, Friuli Centrale Healthcare University Trust , 33100 Udine, Italy
| | - Laura Brunelli
- University of Udine Department of Medicine, , 33100 Udine, Italy
- Accreditation and Quality Unit, Friuli Centrale Healthcare University Trust , 33100 Udine, Italy
| | - Roberto Croci
- School of Medicine, University Vita-Salute San Raffaele , 20132 Milan, Italy
- Scientific Communication Unit, Istituto Superiore di Sanità ; 00161 Rome, Italy
| | - Antonio Mistretta
- Scientific Communication Unit, Istituto Superiore di Sanità ; 00161 Rome, Italy
- Section of Hygiene and Preventive Medicine, University of Catania Department of Medical and Surgical Sciences and Advanced Technologies “G.F.Ingrassia”, , 95125 Catania, Italy
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Dobrina R, Cassone A, Brunelli L, Zanchiello S, DeVita C, Starec A, Bicego L. The design of a user-centred m-health application for caregivers of children undergoing ORL surgery. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the context of common surgical procedures in pediatric otorhinolaryngology (ORL) patients, providing for education to families for hospitalization, surgery, and postoperative home management has been shown to improve peri-operative outcomes. In this regard, the use of Mobile Health Applications (MHA) is increasing. However, for these tools to be needs-appropriate and effective, their development requires a user-centred approach.
Methods
Our study aimed to explore the informational needs and preferences - in terms of features and functionalities - of health care providers and ORL patients’ caregivers (end-users) to inform the development of an MHA supporting ORL peri-operative process effectively. The study was conducted at a 136-bed maternal and child health hospital in Trieste. A user-centred participatory study design was employed, and the methodology steps were informed by the 3 cycles of the Information System Research Framework (Schnall et al., 2016).
Results
The Relevance cycle was performed to better understand the environment as well as end users’ (64 participants) informational needs and desired features for the MHA. Five critical information/education moments of the ORL perioperative period were identified. In the Rigour cycle a literature review was performed to identify further key topics relevant to understanding ORL end-users’ needs and relevant features for the MHA. In the Design cycle the final contents were defined to be displayed on the MHA spread across the 5 identified moments. A randomized controlled trial will then be conducted to evaluate the effectiveness of the MHA compared to standard care.
Conclusions
Triangulation of data sources collected by experts, ORL patients’ caregivers, and healthcare professionals ensured the rigour of the methodology adopted in the study. Moreover, such a MHA user-centred developed MHA favours end-users positive health outcomes and organizational benefits of health services.
Key messages
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Affiliation(s)
- R Dobrina
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo , Trieste, Italy
| | - A Cassone
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo , Trieste, Italy
| | - L Brunelli
- Department of Medical, Surgical and Health Science, University of Trieste , Trieste, Italy
| | - S Zanchiello
- Innovation and Complex Systems Department, Area Science Park , Trieste, Italy
| | - C DeVita
- Innovation and Complex Systems Department, Area Science Park , Trieste, Italy
| | - A Starec
- Innovation and Complex Systems Department, Area Science Park , Trieste, Italy
| | - L Bicego
- Healthcare Professions Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo , Trieste, Italy
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Lo Presti T, Scarpis E, Arnoldo L, Fiorillo F, Zuliani P, Farneti F, Croci E, Pellizzari B, Cocconi R, Brunelli L. Violence against healthcare workers during COVID-19 vaccination campaign. Eur J Public Health 2022. [PMCID: PMC9594677 DOI: 10.1093/eurpub/ckac131.266] [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] Open
Abstract
Background Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region. Methods Between January and March 2022, in the 1.2 million-inhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents. Results 200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%); there were no differences between victims. In 72 cases, these incidents affected the HCW’s private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%). Conclusions Violence in COVID-19 vaccination campaign appears to be common and to affect both the personal and professional lives of HCWs. Improvements at the institutional and personal level could help to address this problem that affects the health workforce. Key messages • Given the growing public debate, violence in healthcare settings is an important issue that needs to be addressed in the coming years. • Assessing workplace violence and its associated risk factors will help focus on the strategies that can be usefully employed to prevent it in the future.
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Affiliation(s)
- T Lo Presti
- Department of Medicine, University of Udine , Udine, Italy
| | - E Scarpis
- Department of Medicine, University of Udine , Udine, Italy
| | - L Arnoldo
- Department of Medicine, University of Udine , Udine, Italy
- Quality and Clinical Risk Management Unit, Friuli Centrale Healthcare University Trust , Udine, Italy
| | - F Fiorillo
- Regional Transplant Center, Friuli Centrale Healthcare University Trust , Udine, Italy
| | - P Zuliani
- Quality and Clinical Risk Management Unit, Friuli Centrale Healthcare University Trust , Udine, Italy
| | - F Farneti
- Quality and Clinical Risk Management Unit, Friuli Centrale Healthcare University Trust , Udine, Italy
| | - E Croci
- Department of Prevention, Giuliano Isontina Healthcare University Trust , Trieste, Italy
| | - B Pellizzari
- Department of Prevention, Friuli Occidentale Healthcare Trust , Pordenone, Italy
| | - R Cocconi
- Quality and Clinical Risk Management Unit, Friuli Centrale Healthcare University Trust , Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine , Udine, Italy
- Quality and Clinical Risk Management Unit, Friuli Centrale Healthcare University Trust , Udine, Italy
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Moretti V, Arnoldo L, Valdi G, Conte A, Masoni M, Guelfi MR, Anelli F, Brunelli L. Digital Health Literacy and Infodemic: the impact on Italian medical students between 2019-2020. Eur J Public Health 2022. [PMCID: PMC9593434 DOI: 10.1093/eurpub/ckac130.063] [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: 11/15/2022] Open
Abstract
Background The COVID-19 infodemic is putting pressure on public health systems to control the pandemic. With the internet and social media playing a key role in emergency communication, digital health literacy (DHL) can be considered a determinant of health. This study aims to assess the impact of infodemic on the skills of medical students, for whom low levels of DHL may affect the ability to identify the best available medical evidence. Methods A cross-sectional web-based survey was conducted at the University of Florence (Italy) in Apr-May 2019 (pre-pandemic period) and in Nov-Dec 2020 (pandemic period) to investigate DHL skills. Two different cohorts of students, both in their first year of medical school, participated in the survey. The 8-item self-assessment tool (IT-eHEALS) with a 5-point Likert scale was used to examine DHL. The change in perception of ability between the two cohorts was examined using the Wilcoxon test. Results A total of 329 students participated in the survey in 2019 (F: 58.1%; mean age 20.6±2.1) and 341 in 2020 (F:61.9%; mean age 19.8±2.0). In 2019, participants’ DHL level was moderate with a IT-eHEALS overall mean score (MS) of 28.4±5.8. Students had a good idea of how to find helpful health information (MS 3.9±0.8) and how to use the web for this purpose (MS 3.8±0.9), but they were less confident about the usefulness of the information they received (MS 2.9±1.1). In 2020, the medical students’ DHL level deteriorated as the overall MS of IT-eHEALS decreased to 23.4±7.2 (p < 0.01). The scores of the IT-eHEALS items were significantly lower and students indicated that they found it difficult to assess the information they found (MS 2.4±1.1; p < 0.01). Conclusions DHL can contrast infodemic, but the latter in turn may have a negative impact on perceived DHL skills if personal knowledge base is not well structured. Training programmes for medical students as future health care providers should be reinforces to guide their practise. Key messages
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Affiliation(s)
- V Moretti
- Department of Medicine, University of Udine , Udine, Italy
| | - L Arnoldo
- Department of Medicine, University of Udine , Udine, Italy
- Quality and Risk Management Unit, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - G Valdi
- Department of Medicine, University of Udine , Udine, Italy
| | - A Conte
- Medical Directorate, Friuli Centrale Healthcare and University Trust , Udine, Italy
| | - M Masoni
- Department of Medicine, University of Firenze , Firenze, Italy
| | - MR Guelfi
- Department of Medicine, University of Firenze , Firenze, Italy
| | - F Anelli
- FNOMCEO, Italian Federation of Medical Professional Associations , Rome, Italy
| | - L Brunelli
- Department of Medicine, University of Udine , Udine, Italy
- Quality and Risk Management Unit, Friuli Centrale Healthcare and University Trust , Udine, Italy
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Brunelli L, Poelzl L, Hirsch J, Engler C, Naegele F, Egelseer-Bruendl T, Scheffauer T, Rassel C, Schmit C, Nawabi F, Luckner-Hornischer A, Bauer A, Poelzl G. The effectiveness of a telemedical program for COVID-19 positive high-risk patients in domestic isolation. Eur Heart J 2022. [PMCID: PMC9619603 DOI: 10.1093/eurheartj/ehac544.2802] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background For almost two years, the Covid-19 pandemic has posed an enormous challenge to healthcare systems. Recurrent waves of disease brought the health systems to the limit of their resilience. Purpose The Tele-Covid telemedicine care program was installed in December 2020 to monitor high-risk patients in home isolation. Close monitoring allows early detection of disease deterioration and timely intensification of therapy, ideally avoiding intensive care. Conversely, if the course of the disease is stable, unnecessary hospitalisation can be avoided, thus reducing the burden on the healthcare system. Methods Patient acquisition was performed in collaboration with the local public health service and primary care physicians. Covid-19 positive high-risk patients (age >65 years and/or severe comorbidities) from the greater Innsbruck area were fitted with an ear sensor-based home monitoring system. The ear sensor measures SpO2, respiratory rate, body temperature and heart rate. The monitoring team (25 medical students supervised by 6 physicians) provided continuous monitoring of vital signs (24/7). After validation of the measurements, the collected parameters were evaluated using a specially developed risk score. If a defined risk score was exceeded, the patient was contacted by telephone. The combination of the clinical condition and the risk score determined the further course of action: (a) wait and see, (b) notify the primary care physician, or (c) refer for inpatient admission. The program was active from December 2020 to March 2022. In Summer 2021, the program was temporarily paused due to the epidemiological situation. Results A total of 132 patients (59.8% women) were monitored. The median age was 74 years (IQR: [67.3–80.8]). 91 patients (68.9%) had at least one relevant comorbidity. During the monitoring period, hospitalisation was required in 20 patients (15.2%), 3 of whom were transferred to the intensive care unit. Of the hospitalised patients, 3 (15%) patients died. During the same monitoring period, the Austrian Ministry of Health reported a mortality rate of 20.5% of all hospitalised patients in Austria aged 70–79 years. Subjectively, the patients felt safe due to close monitoring. Conclusion The Tele-Covid program is the successful implementation of a remote monitoring system in a pandemic situation. In the future, a broad application of the program is feasible. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Funded by the Region of the Tyrol
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Affiliation(s)
- L Brunelli
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - L Poelzl
- Medical University of Innsbruck, Department of Cardiac Surgery , Innsbruck , Austria
| | - J Hirsch
- Medical University of Innsbruck, Department of Cardiac Surgery , Innsbruck , Austria
| | - C Engler
- Medical University of Innsbruck, Department of Cardiac Surgery , Innsbruck , Austria
| | - F Naegele
- Medical University of Innsbruck, Department of Cardiac Surgery , Innsbruck , Austria
| | - T Egelseer-Bruendl
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - T Scheffauer
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - C Rassel
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - C Schmit
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - F Nawabi
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | | | - A Bauer
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
| | - G Poelzl
- Medical University of Innsbruck, Department of Internal Medicine III, Cardiology and Angiology , Innsbruck , Austria
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Palese F, Arnoldo L, Brunelli L, Buzancic S, De Giusti VA, Ferrazzano A, Gallo T, Iob A, Mauro K, Pipan C, Polonia M, Ruscio E, Treleani M, Conte A. SARS-CoV-2 transmission by asymptomatic healthcare workers positive to screening swab: an Italian study. Eur J Public Health 2022; 32:813-817. [PMID: 36069907 PMCID: PMC9494409 DOI: 10.1093/eurpub/ckac121] [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] Open
Abstract
BACKGROUND SARS-CoV-2 spreads primarily through respiratory droplets of symptomatic individuals. With respect to asymptomatic individuals, there are conflicting results in the literature and a lack of studies specifically examining transmission in healthcare settings. METHODS The aim of this retrospective study, conducted in a northeastern Italian region, was to estimate the contagiousness of asymptomatic healthcare workers (HCWs) who tested positive for SARS-CoV-2. Asymptomatic HCWs who tested positive for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) at a regular screening nasopharyngeal or oropharyngeal swab between 1 February 2020 and 15 September 2020 were considered index cases. Contacts who were at high risk of infection and had follow-up swabs were included. Contacts were considered infected if they had a positive follow-up swab and/or symptoms associated with COVID-19 confirmed by a positive test within 14 days of exposure. Information was taken from records previously collected to identify contacts. Infectivity was estimated using the attack rate (AR) with a 95% confidence interval (95% CI). RESULTS Thirty-eight asymptomatic HCWs who were positive at the screening swab and 778 contacts were identified. Contacts included 63.8% of colleagues, 25.6% of patients, 7.7% of family members and 3.0% of other contacts. Seven contacts tested positive for SARS-CoV-2 (AR: 0.91%, 95% CI: 0.89-0.93). Five of them were family members (AR: 8.3%), one was a colleague (0.2%) and one was a contact of other type (4.2%). CONCLUSIONS Viral spread by asymptomatic HCWs was less than in other settings. Identification of risk factors for transmission and reliable indicators of infectivity would be important to prioritize preventive measures.
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Affiliation(s)
- Francesca Palese
- Specialization School in Hygiene and Preventive Medicine, University of Udine, Udine, Italy
| | - Luca Arnoldo
- Accreditation and Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Laura Brunelli
- Accreditation and Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Medical Area Department, University of Udine, Udine, Italy
| | - Silvana Buzancic
- Prevention Department of Latisana, Azienda Sanitaria Universitaria Friuli Centrale, Latisana, Italy
| | - Valentina Anna De Giusti
- Occupational Medicine-Health Care Workers, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Alberto Ferrazzano
- Medical Directorate, Pordenone Hospital, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy
| | - Tolinda Gallo
- Hygiene and Public Health Service, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Andrea Iob
- Community Preventive Medicine, Azienda Sanitaria Universitaria Friuli Centrale, Gemona del Friuli, Italy
| | - Katia Mauro
- Prevention Department of Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Corrado Pipan
- Specialization School in Hygiene and Preventive Medicine, University of Udine, Udine, Italy.,Medical Area Department, University of Udine, Udine, Italy.,Department of Laboratory Medicine, University Teaching Hospital of Udine, Udine, Italy
| | - Marta Polonia
- Quality, Accreditation and Clinical Risk Unit, Health Administration, Azienda Sanitaria Universitaria Friuli Centrale, Gemona del Friuli, Italy
| | - Edoardo Ruscio
- Specialization School in Hygiene and Preventive Medicine, University of Udine, Udine, Italy
| | - Maurizio Treleani
- Occupational Medicine-Health Care Workers, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Alessandro Conte
- Medical Directorate, San Daniele del Friuli and Tolmezzo Hospitals, Azienda Sanitaria Universitaria Friuli Centrale, San Daniele del Friuli and Tolmezzo, Italy
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29
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Brunelli L, De Vitis V, Ferrari R, Minuzzo M, Fiore W, Jäger R, Taverniti V, Guglielmetti S. In vitro assessment of the probiotic properties of an industrial preparation containing Lacticaseibacillus paracasei in the context of athlete health. Front Pharmacol 2022; 13:857987. [PMID: 36016576 PMCID: PMC9397523 DOI: 10.3389/fphar.2022.857987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 01/19/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Intense physical activity is often associated with undesirable physiological changes, including increased inflammation, transient immunodepression, increased susceptibility to infections, altered intestinal barrier integrity, and increased oxidative stress. Several trials suggested that probiotics supplementation may have beneficial effects on sport-associated gastro-intestinal and immune disorders. Recently, in a placebo-controlled human trial, the AminoAlta™ probiotic formulation (AApf) was demonstrated to increase the absorption of amino acids from pea protein, suggesting that the administration of AApf could overcome the compositional limitations of plant proteins. In this study, human cell line models were used to assess in vitro the potential capacity of AApf to protect from the physiological damages that an intense physical activity may cause. The obtained results revealed that the bacteria in the AApf have the ability to adhere to differentiated Caco-2 epithelial cell layer. In addition, the AApf was shown to reduce the activation of NF-κB in Caco-2 cells under inflammatory stimulation. Notably, this anti-inflammatory activity was enhanced in the presence of partially hydrolyzed plant proteins. The AApf also triggered the expression of cytokines by the THP-1 macrophage model in a dose-dependent manner. In particular, the expression of cytokines IL-1β, IL-6, and TNF-α was higher than that of the regulatory cytokine IL-10, resembling a cytokine profile characteristic of M1 phenotype, which typically intervene in counteracting bacterial and viral infections. Finally, AApf was shown to reduce transepithelial permeability and increase superoxide dismutase activity in the Caco-2 cell model. In conclusion, this study suggests that the AApf may potentially provide a spectrum of benefits useful to dampen the gastro-intestinal and immune detrimental consequences of an intense physical activity.
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Affiliation(s)
| | | | | | | | | | - Ralf Jäger
- Increnovo LLC, Whitefish Bay, WI, United States
| | - Valentina Taverniti
- Division of Food Microbiology and Bioprocesses, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Simone Guglielmetti
- Division of Food Microbiology and Bioprocesses, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- *Correspondence: Simone Guglielmetti,
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Scarpis E, Del Pin M, Ruscio E, Tullio A, Brusaferro S, Brunelli L. Symptoms of Anxiety and Depression within the UNiversity community: the cross-sectional UN-SAD study. BMC Public Health 2022; 22:1479. [PMID: 35922783 PMCID: PMC9351172 DOI: 10.1186/s12889-022-13876-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
The increasing complexity of academia, with its demanding working conditions and uncertain career opportunities, may affect the mental health of academics and potentially lead to mental health problems. The aim of this study is to determine the prevalence of depressive and anxiety symptoms in the academic population of the University of Udine and to compare symptoms in senior and younger academics and administrative staff. A cross-sectional survey was conducted between June and December 2020, involving academic and administrative staff in all departments. The prevalence of depressive and anxiety symptoms was assessed using the PHQ-9 and GAD-7 tools. The relationship between mental health outcomes and job role was analyzed using nonparametric tests and ordinal logistic regression. A total of 366 individuals participated: 109 junior academics, 146 senior and 111 administrative staff. The proportion of women was 55.7% and the mean age was 47.9 years. The prevalence of depressive and anxiety symptoms in the studied population was 25.7% (95% IC 21.5–30.4) and 22.7% (95% IC 18.7–27.2) respectively, with junior academics having the higher prevalence of both symptoms. Univariate models suggest a higher risk for anxiety symptoms OR 1.89 (1.13–3.17) for women. The prevalence of depressive symptoms is higher in our academic community than in the general population, especially among junior academics. These findings may reflect the impact of uncertain career and challenging environment on the mental health of young academics. Universities should provide more support to young academics so that they can contribute effectively and healthily to the advancement of research.
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Affiliation(s)
- E Scarpis
- Dipartimento di Area Medica, Università degli studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - M Del Pin
- Dipartimento di Area Medica, Università degli studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - E Ruscio
- Dipartimento di Area Medica, Università degli studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - A Tullio
- Istituto di Igiene ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italia
| | - S Brusaferro
- Dipartimento di Area Medica, Università degli studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - L Brunelli
- Dipartimento di Area Medica, Università degli studi di Udine, Via Colugna 50, 33100, Udine, Italy. .,Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italia.
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31
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Brunelli L, Bravo G, Romanese F, Righini M, Lesa L, De Odorico A, Bastiani E, Pascut S, Miceli S, Brusaferro S. Sexual and reproductive health-related knowledge, attitudes and support network of Italian adolescents. Public Health in Practice 2022; 3:100253. [PMID: 36101775 PMCID: PMC9461229 DOI: 10.1016/j.puhip.2022.100253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives What is the state of sexual and reproductive health (SRH) knowledge among teens? What about adolescents’ attitudes toward SRH and the available supporting network? Study design A cross-sectional study conducted between April and May 2018. Methods An anonymous 36-item questionnaire on SRH knowledge, behaviors, and networks was developed, revised and validated by a multidisciplinary health professional team, then distributed to high school students in Udine (Italy). Results 747 questionnaires were collected in five high schools; respondents were predominantly male, mean age 14.8 years; 48% of students have sufficient SRH knowledge (considered as above the mean value). Factors associated with higher knowledge levels were female sex, age, SES according to father's profession, first SRH information at age 11–13, Italy as country of origin, and attendance at a technical school. Conclusions Students’ knowledge on SHR resulted relatively poor. Sex, school type and previous experience of sexuality education were the most important factor associated with SRH knowledge.
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Covolo L, Guana M, Bonaccorsi G, Brunelli L, Castaldi S, De Donno A, Mereu A, Verani M, Gelatti U. Exploring the Online Health Information-Seeking Behavior in a Sample of Italian Women: The "SEI Donna" Study. Int J Environ Res Public Health 2022; 19:ijerph19084745. [PMID: 35457610 PMCID: PMC9024845 DOI: 10.3390/ijerph19084745] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023]
Abstract
There is much discussion about the skills of people in understanding and managing online health information. The Italian survey “SEI Donna” aimed to investigate perceptions and use of the web in women regarding health issues considering their health literacy (HL) and healthcare skills. We used an online questionnaire to explore different aspects of online health-related information-seeking behavior. The study participants (n = 7027) were categorized into healthcare workers (HW), healthcare students (HS), and non-healthcare women (non-HW). Half the sample (52%) searched online for a second opinion after the medical examination without statistical difference among HW, HS, and non-HW. Women in the age range of 26−40 years (OR = 1.28, p < 0.001), having chronic illness (OR = 1.48; p < 0.001), and being moderately (OR = 1.58; p < 0.001) or not satisfied (OR = 2.04; p < 0.001) with healthcare professionals were more likely to use the Internet to seek medical insight. Overall, 34% of women had a functional HL, the same being higher in HW (64%) and in HS (43%) than the rest of the women (18%) (p < 0.0001). The suboptimal HL suggests the need to improve HL in the general population to be skilled in surfing the web and, at the same time, to reorganize health training to improve the HL of healthcare professionals, also enriching their communication skills.
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Affiliation(s)
- Loredana Covolo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Viale Europa, 11, 25123 Brescia, Italy;
- Correspondence:
| | - Miriam Guana
- Department of Clinical and Experimental Sciences, School of Midwifery, University of Brescia, 25123 Brescia, Italy;
| | | | - Laura Brunelli
- Department of Medicine, University of Udine, 33100 Udine, Italy;
- Quality and Accreditation Unit, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Fondazione IRCCS Ca’ Granda OMP Milan, 20122 Milan, Italy
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy;
| | - Alessandra Mereu
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy;
| | - Marco Verani
- Department of Biology, University of Pisa, 56127 Pisa, Italy;
| | - Umberto Gelatti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Viale Europa, 11, 25123 Brescia, Italy;
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Bollen Pinto B, Ferrario M, Herpain A, Brunelli L, Bendjelid K, Carrara M, Pastorelli R. Metabolites Concentration in Plasma and Heart Tissue in Relation to High Sensitive Cardiac Troponin T Level in Septic Shock Pigs. Metabolites 2022; 12:metabo12040319. [PMID: 35448505 PMCID: PMC9024493 DOI: 10.3390/metabo12040319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 12/10/2022] Open
Abstract
Elevated circulating cardiac troponin T (cTnT) is frequent in septic shock patients. Signs of myocardial ischemia and myocyte necrosis are not universally present, but the precise mechanism for elevated cTnT is unknown. We investigated plasma and heart tissue metabolites concentration in six septic shock (SS) and three sham swine undergoing a protocol of polymicrobial septic shock and resuscitation, in order to highlight possible pathways and biomarkers involved in troponin release (high sensitive cardiac troponin T, hs-cTnT). The animals were divided into two groups: the high cTnT group (n = 3) were pigs showing a significantly higher concentration of cTnT and lactate after resuscitation; the low cTnT group (n = 6, three sham and three septic shock) characterized by a lower value of cTnT and a lactate level < 2 mmol/L. Spearman correlation was assessed on plasma fold-change of cTnT, cytokines (TNF-α and IL-10), and metabolites. Finally, the fold-change between the end of resuscitation and baseline values (Res./BL) of plasma metabolites was used to perform a partial least square discriminant analysis (PLS-DA) with three latent variables. Before building the model, the number of features was reduced by summing up the metabolites of the same class that resulted similarly correlated to cTnT fold-change. Proline and glycine were significantly higher in the high cTnT group at the end of experiment both in the myocardium and plasma analyses. Moreover, plasma proline fold-change was found to be positively correlated with cTnT and cytokine fold-changes, and trans-4-hydroxyproline (t4-OH-Pro) fold-change was positively correlated with cTnT fold-change. The PLS-DA model was able to separate the two groups and, among the first ranked features based on VIP score, we found sugars, t4-OH-Pro, proline, creatinine, total amount of sphingomyelins, and glycine. Proline, t4-OH-Pro, and glycine are very abundant in collagen, and our results may suggest that collagen degradation could represent a possible mechanism contributing to septic myocardial injury. The common phenotype of septic cardiomyopathy could be associated to dysregulated collagen metabolism and/or degradation, further exacerbated by higher inflammation and oxidative stress.
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Affiliation(s)
- Bernardo Bollen Pinto
- Department of Acute Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland; (B.B.P.); (K.B.)
- Geneva Perioperative Basic, Translational and Clinical Research Group, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Manuela Ferrario
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy;
- Correspondence:
| | - Antoine Herpain
- Department of Intensive Care, Erasme University Hospital—Université Libre de Bruxelles, 1070 Brussels, Belgium;
- Experimental Laboratory of Intensive Care—Erasme University Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Laura Brunelli
- Laboratory of Mass Spectrometry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (L.B.); (R.P.)
| | - Karim Bendjelid
- Department of Acute Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland; (B.B.P.); (K.B.)
- Department of Anesthesiology, Pharmacology and Intensive Care, Geneva Hemodynamic Research Group, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Marta Carrara
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy;
| | - Roberta Pastorelli
- Laboratory of Mass Spectrometry, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (L.B.); (R.P.)
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Ghilardi C, Moreira-Barbosa C, Brunelli L, Ostano P, Panini N, Lupi M, Anastasia A, Fiordaliso F, Salio M, Formenti L, Russo M, Arrigoni E, Chiaradonna F, Chiorino G, Draetta G, Marszalek JR, Vellano CP, Pastorelli R, Bani M, Decio A, Giavazzi R. PGC1α/β Expression Predicts Therapeutic Response to Oxidative Phosphorylation Inhibition in Ovarian Cancer. Cancer Res 2022; 82:1423-1434. [PMID: 35131872 PMCID: PMC9359716 DOI: 10.1158/0008-5472.can-21-1223] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/11/2021] [Accepted: 02/02/2022] [Indexed: 01/07/2023]
Abstract
Ovarian cancer is the deadliest gynecologic cancer, and novel therapeutic options are crucial to improve overall survival. Here we provide evidence that impairment of oxidative phosphorylation (OXPHOS) can help control ovarian cancer progression, and this benefit correlates with expression of the two mitochondrial master regulators PGC1α and PGC1β. In orthotopic patient-derived ovarian cancer xenografts (OC-PDX), concomitant high expression of PGC1α and PGC1β (PGC1α/β) fostered a unique transcriptional signature, leading to increased mitochondrial abundance, enhanced tricarboxylic acid cycling, and elevated cellular respiration that ultimately conferred vulnerability to OXPHOS inhibition. Treatment with the respiratory chain complex I inhibitor IACS-010759 caused mitochondrial swelling and ATP depletion that consequently delayed malignant progression and prolonged the lifespan of high PGC1α/β-expressing OC-PDX-bearing mice. Conversely, low PGC1α/β OC-PDXs were not affected by IACS-010759, thus pinpointing a selective antitumor effect of OXPHOS inhibition. The clinical relevance of these findings was substantiated by analysis of ovarian cancer patient datasets, which showed that 25% of all cases displayed high PGC1α/β expression along with an activated mitochondrial gene program. This study endorses the use of OXPHOS inhibitors to manage ovarian cancer and identifies the high expression of both PGC1α and β as biomarkers to refine the selection of patients likely to benefit most from this therapy. SIGNIFICANCE OXPHOS inhibition in ovarian cancer can exploit the metabolic vulnerabilities conferred by high PGC1α/β expression and offers an effective approach to manage patients on the basis of PGC1α/β expression.
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Affiliation(s)
- Carmen Ghilardi
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.,Corresponding Author: Carmen Ghilardi, Department of Oncology, Laboratory of Cancer Metastasis Therapeutics; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy. Phone: 39-02-39014226; Fax: 39-02-39014734; E-mail:
| | - Catarina Moreira-Barbosa
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Laura Brunelli
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Paola Ostano
- Cancer Genomics Laboratory, Fondazione Edo ed Elvo Tempia Valenta, Biella, Italy
| | - Nicolò Panini
- Laboratory of Anticancer Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Monica Lupi
- Laboratory of Anticancer Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessia Anastasia
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Fabio Fiordaliso
- Laboratory of Cardiovascular Clinical Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Monica Salio
- Laboratory of Cardiovascular Clinical Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Laura Formenti
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.,Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Massimo Russo
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Edoardo Arrigoni
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | | | - Giovanna Chiorino
- Cancer Genomics Laboratory, Fondazione Edo ed Elvo Tempia Valenta, Biella, Italy
| | - Giulio Draetta
- Institute for Applied Cancer Science, Therapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, Texas.,TRACTION Platform, Therapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph R. Marszalek
- TRACTION Platform, Therapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christopher P. Vellano
- TRACTION Platform, Therapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roberta Pastorelli
- Laboratory of Mass Spectrometry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - MariaRosa Bani
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Decio
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Raffaella Giavazzi
- Laboratory of Cancer Metastasis Therapeutics, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Bravo G, Cattani G, Malacarne F, Tricarico P, Arnoldo L, Brunelli L, Zotti C, Moro ML, Diegoli G, Pezzotti P, Bella A, Pantosti A, Punzo O, Grossi A, Barchitta M, Agodi A, Castellini G, Marrazzo M, Auxilia F, Cavallaro G, Alborali GL, Mazzolini E, Brusaferro S. SPiNCAR: A systematic model to evaluate and guide actions for tackling AMR. PLoS One 2022; 17:e0265010. [PMID: 35271635 PMCID: PMC8912127 DOI: 10.1371/journal.pone.0265010] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Italy records very alarming levels antimicrobial resistance (AMR), so a National Action Plan on Antimicrobial resistance (PNCAR) was developed, adopting the AMR European Union’s recommendations based on the results of the ECDC site visit of January 2017. For achieving PNCAR objectives, it is necessary to support and harmonize the implementation of recommendations in all the different healthcare levels (regional authorities and local trusts), so the SPiNCAR project was launched to create a tool for reaching this goal. Methods We developed a framework based on a scientific literature and national and international guidelines. Firstly, we identified the major intervention areas for tackling AMR, then, for each area, we built a set of standards, both for regional authorities than for local trusts. Every standard is composed by a set of essential and additional criteria, which refer to a minimum or supplemental performance level respectively. The contents were firstly discussed by the project’s team during face-to-face kick-off meetings, then confirmed with Delphi methodology and finally validated through a pilot study. Results The final framework consists of seven different areas that reflect the PNCAR structure: Governance, Surveillance and Monitoring, Appropriate Use of antimicrobials, Healthcare-associated Infections (HAIs) control and prevention, Education and Training, Alliance among Stakeholders, Implementation. The total number of standards for the regional framework was 34 with 264 criteria and for the local version 36 criteria with 279 standards. Conclusion The ongoing use of this tool, developed on international evidences and recommendations that were tailored on the Italian specific context, allows monitoring the improvement achieved over time and plan the next steps.
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Affiliation(s)
- Giulia Bravo
- Department of Medicine, University of Udine, Udine, Italy
| | | | | | | | - Luca Arnoldo
- Friuli Centrale Healthcare University Trust, Udine, Italy
- * E-mail:
| | - Laura Brunelli
- Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Carla Zotti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Maria Luisa Moro
- Regional Health and Social Agency of Emilia-Romagna, Bologna, Italy
| | - Giuseppe Diegoli
- Direzione Generale Cura della Persona, Salute e Welfare Regione Emilia-Romagna, Bologna, Italy
| | | | | | | | | | - Adriano Grossi
- Italian National Institute of Health, Rome, Italy
- ASL Roma 1, Rome, Italy
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | | | - Francesco Auxilia
- Department of Biomedical Sciences for Health, University of Milan—ASST Fatebenefratelli- Sacco, Milan, Italy
| | | | - Giovanni Loris Alborali
- Direzione Generale Cura della Persona, Salute e Welfare Regione Emilia-Romagna, Bologna, Italy
| | - Elena Mazzolini
- Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, Padua, Italy
| | - Silvio Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
- Italian National Institute of Health, Rome, Italy
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Guaita A, Brunelli L, Davin A, Poloni TE, Vaccaro R, Gagliardi S, Pansarasa O, Cereda C. Homocysteine, Folic Acid, Cyanocobalamin, and Frailty in Older People: Findings From the “Invece. Ab” Study. Front Physiol 2021; 12:775803. [PMID: 34975530 PMCID: PMC8717775 DOI: 10.3389/fphys.2021.775803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Frailty is an important age-related syndrome associated with several adverse health outcomes. Its biological basis is undefined. Raised plasma homocysteine (HOcy) is an established risk factor for cardiovascular disease, dementia, cognitive impairment, and mortality, but little is known about the possible role of plasma HOcy, cyanocobalamin (B12), and folate (FO levels in the development of frailty. Our first aim was to explore the possible association between frailty and plasma concentrations of HOcy, FO, and B12 in a cohort of community-dwelling older people. The second was to assess the influence of these metabolic factors on six-year incidence of frailty in the 875 individuals eligible for inclusion in this study (those with a full follow-up dataset). This research is based on data from three waves – 2012 (herein taken as baseline), 2014, and 2018 – of a longitudinal study (InveCe.Ab) in which non-frail men and women born between 1935 and 1939 underwent multidimensional assessments. Frailty was estimated using a deficit accumulation-based frailty index (FI). HOcy concentration was significantly positively correlated with FI at all timepoints, while B12 and FO levels were not. Plasma concentration of HOcy emerged as a predictor of six-year cumulative incidence of frailty, independent of age, sex, and education, while B12 and FO levels showed no relationship with frailty incidence. Individuals with plasma HOcy in the top quintile showed five months less frailty-free survival (HR 1.487; 95% CI: 1.063–2.078), regardless of age, sex, and education. These results demonstrate that higher HOcy is a risk factor for frailty onset in older adults.
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Affiliation(s)
- Antonio Guaita
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
- *Correspondence: Antonio Guaita,
| | - Laura Brunelli
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Annalisa Davin
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Tino Emanuele Poloni
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Roberta Vaccaro
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Stella Gagliardi
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Orietta Pansarasa
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Cereda
- Epidemiological and Neuropathological Laboratories, Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Woman, Mother and Newborn, ASST Fatebenefratelli Sacco, “V. Buzzi” Children Hospital, Milan, Italy
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Scarpis E, Brunelli L, Tricarico P, Poletto M, Panzera A, Londero C, Castriotta L, Brusaferro S. How to assure the quality of clinical records? A 7-year experience in a large academic hospital. PLoS One 2021; 16:e0261018. [PMID: 34882705 PMCID: PMC8659650 DOI: 10.1371/journal.pone.0261018] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Clinical record (CR) is the primary tool used by healthcare workers (HCWs) to record clinical information and its completeness can help achieve safer practices. CR is the most appropriate source in order to measure and evaluate the quality of care. In order to achieve a safety climate is fundamental to involve a responsive healthcare workforce thorough peer-review and feedbacks. This study aims to develop a peer-review tool for clinical records quality assurance, presenting the seven-year experience in the evolution of it; secondary aims are to describe the CR completeness and HCWs' diligence toward recording information in it. METHODS To assess the completeness of CRs a peer-review tool was developed in a large Academic Hospital of Northern Italy. This tool included measurable items that examined different themes, moments and levels of the clinical process. Data were collected every three months between 2010 and 2016 by appointed and trained HCWs from 42 Units; the hospital Quality Unit was responsible for of processing and validating them. Variations in the proportion of CR completeness were assessed using Cochran-Armitage test for trends. RESULTS A total of 9,408 CRs were evaluated. Overall CR completeness improved significantly from 79.6% in 2010 to 86.5% in 2016 (p<0.001). Doctors' attitude showed a trend similar to the overall completeness, while nurses improved more consistently (p<0.001). Most items exploring themes, moments and levels registered a significant improvement in the early years, then flattened in last years. Results of the validation process were always above the cut-off of 75%. CONCLUSIONS This peer-review tool enabled the Quality Unit and hospital leadership to obtain a reliable picture of CRs completeness, while involving the HCWs in the quality evaluation. The completeness of CR showed an overall positive and significant trend during these seven years.
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Affiliation(s)
- Enrico Scarpis
- Department of Medicine, University of Udine, Udine, Italy
| | - Laura Brunelli
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Marco Poletto
- Department of Medicine, University of Udine, Udine, Italy
| | - Angela Panzera
- Health District of Udine, Friuli Centrale Healthcare and University Integrated Trust, ASUFC, Udine, Italy
| | - Carla Londero
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Friuli Centrale Healthcare and University Integrated Trust, ASUFC, Udine, Italy
| | - Luigi Castriotta
- Hygiene and Clinical Epidemiology Institute, Friuli Centrale Healthcare and University Integrated Trust, ASUFC, Udine, Italy
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Brunelli L, Bravo G, Romanese F, Righini M, Lesa L, De Odorico A, Bastiani E, Pascut S, Miceli S, Brusaferro S. Beliefs about HPV vaccination and awareness of vaccination status: Gender differences among Northern Italy adolescents. Prev Med Rep 2021; 24:101570. [PMID: 34976634 PMCID: PMC8683877 DOI: 10.1016/j.pmedr.2021.101570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/12/2021] [Revised: 08/16/2021] [Accepted: 09/19/2021] [Indexed: 01/28/2023] Open
Abstract
Human papillomavirus (HPV) is one of the most frequent sexually transmitted infectious agents worldwide, and it is responsible for a significant burden of cancers. The aim of this study was to evaluate HPV knowledge and awareness in a sample of Northeastern Italian adolescents and parental support available to them, in order to highlight potential room for improvement towards optimal HPV vaccination adherence. Between April and May 2018 an observational questionnaire-based study was conducted in 1st year students of secondary upper schools in Udine (Italy). We quantitatively evaluated HPV knowledge, awareness and parental support level of male and female adolescents. The contribution of sociodemographic characteristics to HPV vaccination knowledge and uptake were explored using Chi-Square or Fisher test and multivariate logistic. Knowledge about HPV vaccine resulted to be mostly insufficient among enrolled adolescents, with a worrying proportion of them believing that HPV vaccine was expected to prevent HIV/AIDS. Awareness about their vaccination status was poor, and more than half of them were not involved in HPV vaccine uptake deliberation. Girls performed better than boys in relation to knowledge, awareness and engagement. Our results support the hypothesis that HPV vaccine knowledge and uptake can be affected by some gender bias. Improvements in adolescent health education and vaccination strategies are needed to engage and finally protect both genders from HPV.
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Affiliation(s)
- Laura Brunelli
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
- SOC Accreditamento e Qualità, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giulia Bravo
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
| | - Federico Romanese
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
- Dipartimento di Prevenzione, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marco Righini
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
| | - Lucia Lesa
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
- Direzione Medica di Presidio, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Anna De Odorico
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
| | - Elisa Bastiani
- Clinica di Malattie Infettive, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Stefania Pascut
- Dipartimento di Salute e Benessere Sociale, Comune di Udine, Udine, Italy
| | - Stefano Miceli
- Dipartimento di Prevenzione, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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De Simone G, Balducci C, Forloni G, Pastorelli R, Brunelli L. Hippuric acid: Could became a barometer for frailty and geriatric syndromes? Ageing Res Rev 2021; 72:101466. [PMID: 34560280 DOI: 10.1016/j.arr.2021.101466] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
Aging is a natural biological event that has some downsides such as increased frailty, decline in cognitive and physical functions leading to chronical diseases, and lower quality of life. There is therefore a pressing need of reliable biomarkers to identify populations at risk of developing age-associated syndromes in order to improve their quality of life, promote healthy ageing and a more appropriate clinical management, when needed. Here we discuss the importance of hippuric acid, an endogenous co-metabolite, as a possible hallmark of human aging and age-related diseases, summarizing the scientific literature over the last years. Hippuric acid, the glycine conjugate of benzoic acid, derives from the catabolism by means of intestinal microflora of dietary polyphenols found in plant-based foods (e.g. fruits, vegetables, tea and coffee). In healthy conditions hippuric acid levels in blood and/or urine rise significantly during aging while its excretion drops in conditions related with aging, including cognitive impairments, rheumatic diseases, sarcopenia and hypomobility. This literature highlights the utility of hippuric acid in urine and plasma as a plausible hallmark of frailty, related to low fruit and vegetable intake and changes in gut microflora.
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Affiliation(s)
- Giulia De Simone
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Claudia Balducci
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | | | - Laura Brunelli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
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Brunelli L, Davin A, Sestito G, Mimmi MC, De Simone G, Balducci C, Pansarasa O, Forloni G, Cereda C, Pastorelli R, Guaita A. Plasmatic Hippuric Acid as a Hallmark of Frailty in an Italian Cohort: The Mediation Effect of Fruit-Vegetable Intake. J Gerontol A Biol Sci Med Sci 2021; 76:2081-2089. [PMID: 34436596 PMCID: PMC8599087 DOI: 10.1093/gerona/glab244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Indexed: 12/12/2022] Open
Abstract
Frailty syndrome is an age-related condition involving a loss of resilience, susceptibility to adverse health outcomes, and poor quality of life. This study was conducted in the framework of InveCe.Ab, an ongoing longitudinal population-based study. Plasma from 130 older individuals (older adults aged 76–78 years) was analyzed and validated (on 303 participants) using mass spectrometry-based metabolomics approaches. Equivalence tests showed that metabolites from the central cellular metabolic pathways were equivalent in frail and fit participants. Hippuric acid was the only cometabolite that distinguished fit from frail older adults. Logistic regression analysis indicated that high hippuric acid levels are significantly associated with a reduction of the risk of frailty after 4 years. Mediation analysis using a Frailty Index, hippuric acid, and fruit–vegetable intake supported the role of fruit–vegetable consumption in the hippuric acid relationship with the Frailty Index. These data point to low plasma hippuric acid as a plausible hallmark of frailty status, associated with lower fruit–vegetable intakes.
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Affiliation(s)
- Laura Brunelli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Giovanna Sestito
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Giulia De Simone
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Claudia Balducci
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Chirico L, Moretti V, Valdi G, Varadi G, Da Ros R, Pozzi D, Brunelli L, Cocconi R. 2020 healthcare workers flu vaccination during covid-19: the experience of Udine University Hospital. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
To prevent flu spread, Italian healthcare workers (HCWs) are annually recommended and given free flu vaccination. This measure of healthcare system protection resulted to be fundamental during COVID-19 pandemic to prevent staff shortage issue. Being the minimum coverage target set at 75%, we decided to evaluate vaccination adherence among HCWs at Udine University hospital.
Methods
The 2020 vaccination campaign started 4 weeks earlier than usual and was based on a multiple offer strategy including a daily-dedicated clinic, in-ward administrations along with wide vaccination agenda promotion within hospital. The prevalence and the characteristics of vaccinated HCWs were compared with the same 2019 data.
Results
During 2020, 1868 out of 3839 (48.7%) of HCWs were vaccinated, compared to 29.1% in 2019 (p < 0.0001). Doctors and residents were the most vaccinated categories in both years, being respectively 64.7% and 67.2% in 2020 vs 45.0% and 52.4% in 2019 (p < 0.0001). Midwives showed the best improvement in coverage passing from 44.4% to 20.4% (p = 0.0096). HCWs working in emergency areas and intensive care unit reached the highest adherence in 2020 (61.3%) and the best improvement compared to 2019 as well (37.9%; p < 0.0001).
Conclusions
Even if the target was not reached, strategies adopted for 2020 vaccination campaign significantly increased HCWs adherence. COVID-19 contribution in this achievement cannot be ruled out, possibly representing a strong reinforcing element for HCWs awareness towards infectious disease prevention.
Key messages
Despite the improvement in vaccination adherence, HCWs flu vaccination coverage still remains a concerning issue to be addressed. Increased flu shot adherence reached during COVID-19 pandemic should be not only a target to be maintained but even improved next year getting closer to herd immunity.
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Affiliation(s)
- L Chirico
- Department of Medicine, University of Udine, Udine, Italy
| | - V Moretti
- Department of Medicine, University of Udine, Udine, Italy
| | - G Valdi
- Department of Medicine, University of Udine, Udine, Italy
| | - G Varadi
- Department of Medicine, University of Udine, Udine, Italy
| | - R Da Ros
- Department of Medicine, University of Udine, Udine, Italy
| | - D Pozzi
- Department of Medicine, University of Udine, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Udine, Italy
- Accreditation, Clinical Risk Management and Health Performan, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - R Cocconi
- Accreditation, Clinical Risk Management and Health Performan, Friuli Centrale Healthcare and University Trust, Udine, Italy
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Scarpis E, Bravo G, Cocconi R, Brunelli L. Psychological impact of COVID-19 on healthcare leaders in Friuli-Venezia Giulia, Italy. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The current pandemic scenario may cause psychological distress among healthcare workers (HCWs). Although several studies highlighted this issue as particularly affecting frontline HCWs, no data are available regarding professionals dealing with the governance of healthcare organizations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs).
Methods
A cross-sectional study was carried out between October and November 2020, among HeLs working within Friuli-Venezia Giulia healthcare system (Italy). HeLs included: heads of surgical or medical department, deans of hospital, heads of doctors and nurses working at regional level or in hospital/community settings. We collected demographic data and assessed the presence of depressive (DS) and anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Relationship between mental health outcomes and professional role was analysed using nonparametric tests.
Results
A total of 48 HeLs participated; their mean age was 53.4±7.9, women were 56.3%. Most (45.8%) were heads of department, 16.7% deans of hospital, 8.3% heads of doctors, 29.2% heads of nurses. The majority (60.4%) worked in hospital setting, 22.9% in the community and 16.7% at regional level. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate insomnia was found in 12.5% of HeLs, while severe insomnia in 6.3% of them. The 45.8% of HeLs showed moderate level of stress, whereas 4.2% high level. PS was significantly higher among deans of hospital. Moreover, lower PS correlated with lower DS, AS and insomnia (p < 0.05).
Conclusions
The high level of perceived stress, insomnia, depressive and anxious symptoms experienced by HeLs shows another issue of the COVID-19 pandemic psychological impact. Considered the key role of HeLs in leading healthcare organizations over the current crisis, mental health of these professionals is a major issue that needs higher attention.
Key messages
Psychological impact of COVID19 not only affects frontline HCWs, but also the professionals who are leading healthcare organization through the crisis. Promotion of mental well-being among HCWs should be improved at all levels of healthcare organizations, ensuring a healthier workplace for all professionals working for public health.
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Affiliation(s)
| | - G Bravo
- University of Udine, Udine, Italy
| | - R Cocconi
- Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - L Brunelli
- University of Udine, Udine, Italy
- Friuli Centrale Healthcare and University Trust, Udine, Italy
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Moretti V, Valdi G, Brunelli L, Arnoldo L, Conte A, Masoni M, Guelfi MR, Anelli F. e-Health Literacy among medical students. Eur J Public Health 2021. [PMCID: PMC8574746 DOI: 10.1093/eurpub/ckab165.145] [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: 11/16/2022] Open
Abstract
Background The struggle against fake medical news, nowadays widely spread by web sources, is a main issue in public health especially in a pandemic period. Even among medical students, there is a lack of eHealth literacy (eHL) skills to solve medical problems. The Italian Medical Doctors Federation (FNOMCeO) promoted a Web source as a first-aid communication kit for basic notions in health hot-topics named “dottoremaeveroche” (DMVEC). This study aims to evaluate its effectiveness in improving eHL. Methods Between April and November 2019, medical students from the University of Firenze (Italy) joined a cross-sectional web-based survey before and after accessing the DMVEC Web source. The 8-item self-assessment tool (IT-eHEALS) was used to examine subject's eHL, in addition to questions on source's features and its quality. All responses were rated on a 5-points Likert scale. Changing of abilities' perception was assessed using Wilcoxon test. Results A total of 329 joined the survey, 42% male, mean age of 20.6±2.1. Participants felt moderately confident in eHL, in fact the initial eHEALS overall mean score was 3.6± 0.7. Students had a good perception on how to find helpful health resources (mean score 3.9±0.8) and how to use the Internet to answer health questions (mean score 3.8±0.9), but their ability in using this information to make health decisions was low (mean score 2.9±1.1). All items improved after the use of DMVEC, with overall mean score of IT-eHEALS increasing to 4.3±0.6 (p < 0.0001). Regarding source's quality, mean score related to transparency of sources, an aspect underestimated at first, increased from 3.5±1.2 to 4.7±0.7 (p < 0.0001). Conclusions Low levels of eHL can damage public health efforts, as seen during COVID19 pandemic. DMVEC effectiveness in medical students demonstrated that the scaling up to the general population of online educational interventions, with further implementation, could help in tackling infodemic and fake news spreading. Key messages Moderate levels of eHL among medical students could reflect lower levels in general population, highlighting this as critical issue in public health. Educational programs addressed to Health professionals could be adapted and empowered considering general population as target.
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Affiliation(s)
- V Moretti
- Department of Medicine, University of Udine, Udine, Italy
| | - G Valdi
- Department of Medicine, University of Udine, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Udine, Italy
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - L Arnoldo
- Department of Medicine, University of Udine, Udine, Italy
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - A Conte
- Medical Directorate, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - M Masoni
- Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - MR Guelfi
- Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - F Anelli
- Italian Federation of Medical Professional Associations, FNOMCEO, Rome, Italy
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Del Pin M, Scarpis E, Ruscio E, Tullio A, Brunelli L, Brusaferro S. Symptoms of Anxiety and Depression among Italian UNiversity academics: the 2020 UN-SAD study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The potential impact of demanding working conditions and career opportunities on the mental health of academic professionals has recently arisen some concerns, possibly resulting in psychological distress. This study aims to assess the prevalence of depression and anxiety within Udine University, comparing academic and administrative staff.
Methods
A cross-sectional survey involving regular (RP) and short-term academic professionals (STP), and administrative staff (AS) was carried out between June and December 2020 throughout the administration of an online anonymous survey. Prevalence of depressive and anxiety symptoms was assessed using PHQ-9 and GAD-7 tools. Demographic information about age, gender, marital status and seniority was collected. Relationship between mental health outcomes and professional role was analysed using nonparametric tests and ordinal logistic regression.
Results
All 5 university departments participated for a total of 366 people, being 109 of them STP, 146 RP and 111 AS. 55,7% of them were female, with a mean age of 47,9 years. Compared to administrative and regular staff, short-term professionals have a higher prevalence (95%CI) of both depressive (39,4% (30,8 - 48,8) vs 14,4% (9,6 - 21,0) vs 27,0% (19,6 - 35,9); p < 0,001) and anxiety symptoms (STP: 33,0% (24,9 - 42,3); RP: 15,1% (10,2 - 21,8); AS: 22,5% (15,8 - 31,1); p < 0.005). Multivariate models suggest an increased risk of depression OR 1.61 (0.98-2.64) and anxiety OR 2.08 (1.27-3.41) for female.
Conclusions
The higher prevalence of depressive and anxiety symptoms among STP could represent the effect on younger academics' mental health of the career uncertainty and challenging arena. The difference between AS and STP in psychological distress could be explained by the different job security status. More support should be given by universities to young academics for their both effective and healthy contribution to the progress of research.
Key messages
The high level of external pressure, referred as “publish or perish”, can play an important role in determining academics’ mental health. Investment to provide coping tools for young academics could be strategical for researchers’ empowerment.
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Affiliation(s)
- M Del Pin
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
| | - E Scarpis
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
| | - E Ruscio
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
| | - A Tullio
- Azienza Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - L Brunelli
- Azienza Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - S Brusaferro
- Department of Medicine, Università degli Studi di Udine, Udine, Italy
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45
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Mazzilis G, D'Angelo M, Brunelli L, Colautti L, Cojutti P, Arnoldo L, Parpinel M. Food supplements consumption and the role of pharmacies: a north-eastern Italy observational study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Even if the food supplement industry is one of the fastest growing worldwide, the inappropriate use of these products can potentially cause harms. Considering the key role played by pharmacists in advising citizens on the purchase of food supplements, this cross-sectional observational study evaluates pharmacists' knowledge, attitudes and practice on this topic.
Methods
From September 2020 to February 2021, an online questionnaire implemented through the EU-Survey tool, was administered to pharmacists of both public and private authorized pharmacies of the Friuli-Venezia Giulia (FVG) Region (Italy). The 47 multiple-choice questions about pharmacists' knowledge (20), attitudes and practice (27), were followed by a sociodemographic section (7 items) collecting data about sex, age, years of experience, degree, role within pharmacy (owner, employee). Descriptive analyses, Chi-square, Shapiro-Wilk and Mann Whitney tests were used and a p-value<0.05 was considered as statistically significant.
Results
A sample of 232 questionnaires was collected, 70.7% of which from women. Most responders (77.2%) had a Pharmacy degree, with owners representing the 34.5%. The 61.2% of pharmacists had at least 10 years of experience. Knowledge was generally poor with just 49.2% of the sample scoring above the median value of 11 but higher among pharmacists with more than 11 years of experience. Lesser-known aspects were the possible link between cancer and multivitamin's abuse and presence of non-labeled agents in food supplements. Responders < =10 years of experience felt more unprepared about vitamin's dosage and in counselling particular groups of patients (p < 0.05). Employees more frequently reported the attitude to purchase food supplements under patient specifical request (p < 0.05).
Conclusions
Pharmacists' knowledge about food supplements is scarce and young professionals in particular need further education to ensure a safe and effective purchase of these products to patients.
Key messages
The use of vitamin supplements is growing but their consumption needs to be evaluated by expert and qualified professionals. Pharmacists play a key role in counselling people about food supplements but need continuous professional education to give adequate advice.
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Affiliation(s)
- G Mazzilis
- Dipartimento di Area Medica, Università degli studi di Udine, Udine, Italy
| | - M D'Angelo
- Dipartimento di Area Medica, Università degli studi di Udine, Udine, Italy
| | - L Brunelli
- Dipartimento di Area Medica, Università degli studi di Udine, Udine, Italy
- Accreditamento, Gestione del Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | | | - P Cojutti
- Istituto di Farmacologia Clinica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - L Arnoldo
- Dipartimento di Area Medica, Università degli studi di Udine, Udine, Italy
- Accreditamento, Gestione del Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - M Parpinel
- Dipartimento di Area Medica, Università degli studi di Udine, Udine, Italy
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46
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Scarpis E, Bravo G, Cocconi R, Brunelli L. The most challenging COVID19 phases and the skills healthcare leaders need to face the pandemic. Eur J Public Health 2021. [PMCID: PMC8574668 DOI: 10.1093/eurpub/ckab165.019] [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] Open
Abstract
Abstract
Introduction
Coronavirus disease 2019 (COVID19) pandemic is the most significant public health threat of the century, a crisis that have been challenging healthcare systems around the world. Assessment of leadership skills is needed in order to identify attributes of successful leadership during public health emergencies. This study aims to highlight the critical role played by healthcare leaders during this pandemic, assessing the most challenging and demanding phases of the health crisis and the characteristics required for a healthcare leader.
Methods
A cross-sectional survey was carried out between October and November 2020, using online questionnaires, involving medical and nursing leaders working in the healthcare organizations of the Friuli-Venezia Giulia Region (Northeast of Italy). Professionals from hospital, community setting and regional level were asked about the two most challenging phases of the current pandemic among: crisis early recognition, peak of the emergency phase, declining epidemic, long tail. The most important healthcare leaders' skills were investigated among competence, awareness, communication, decision-making, inspiring trust and data interpretation.
Results
A total of 48 healthcare leaders participated. Women were 56.3%. Mean age was 53.4±7.9. According to the leaders interviewed, the two most challenging phases of such crisis were crisis early recognition (45%) and the peak phase (31%). Lesser important phases were recognized in the declining epidemic (15%) and the long tail phases (8%). Concerning healthcare leaders' skills required to manage with pandemic, the most reported were communication (35%) and decision-making (26%); while lower importance was identified in inspiring confidence (5%).
Conclusions
The two most challenging phases identified by this study suggested the importance of public health surveillance and monitoring systems. Communication appeared a critical success factor for leaders in public health emergencies.
Key messages
Early recognition of the crisis and the emergency peak management are considered the most challenging phases of the COVID19 pandemic by healthcare leaders. Ability to communicate and decision-making emerged as the two most important crisis skills, and should be included among public health leaders core competencies.
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Affiliation(s)
| | - G Bravo
- University of Udine, Udine, Italy
| | - R Cocconi
- Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - L Brunelli
- University of Udine, Udine, Italy
- Friuli Centrale Healthcare and University Trust, Udine, Italy
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47
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Mellace F, Scarpis E, Brunelli L, Tullio A, Cautero P, Londero C, Farneti F, Valent F, Cocconi R. Relationship between clinical record completeness and occurrence of adverse events within hospitals. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Clinical record (CR) is an appropriate source for adverse events (AEs) detection and Italian law requires its compilation. Its completeness is used as an indicator of the quality of care provided and offers guidance on system changes to improve professional practice. This study aimed at assessing the completeness of CRs, describing AEs' rate and triggers, and investigating the relationship between CR completeness and the occurrence of AEs.
Methods
A retrospective review of CRs was conducted, randomly selecting patients discharged from Internal Medicine (IM), General Surgery (GS) and Obstetrics (O) between June and September 2020 at the Academic Hospital of Udine (Italy). The completeness of CRs was assessed using a 65-items checklist developed by the hospital Quality Unit. Triggers and rate of AEs were detected by using Global Trigger Tool. Relationship between AEs and completeness of CR was analyzed using nonparametric tests.
Results
Among 93 reviewed CRs, 91.4% were from the GS, 5.4% from IM and 3.2% from O. Patient mean age was 64.6±18, women were 51.6%. The average completeness of CRs was 50.4% [30.4%-83.5%]. Identified triggers and AEs were 125 and 29 respectively, with at least one AE every 23.7% admissions, 31.2 AEs per 100 admissions and 40 AEs per 1000 patient-days. The most frequent AEs were surgical damage (51.7%; 15) and hospital-acquired infection (24.1%; 7). Hospitalization length for patients with at least one AE was 12.6 days, whereas it was 6.3 days without AEs. A significant positive correlation (R = 0.36; p < 0.001) was found between length of hospitalization and number of AEs. The increase in CR completeness is associated with the decrease of the total number of AEs (R=-0.18; p = 0.083).
Conclusions
These findings suggest a direct association between the number of AEs and the length of hospital stay. The correlation between CR completeness and AEs suggest that patient safety could benefit from the improvement of clinical record compilation.
Key messages
More studies are needed to understand if the occurrence of AEs to patients may cause a prolonged length of hospitalization. A better compilation of CRs should allow to reach a more effective communication between healthcare workers, creating a work environment less prone to errors and AEs.
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Affiliation(s)
- F Mellace
- Department of Medicine, University of Udine, Udine, Italy
| | - E Scarpis
- Department of Medicine, University of Udine, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Udine, Italy
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - A Tullio
- Department of Medicine, University of Udine, Udine, Italy
| | - P Cautero
- Department of Medicine, University of Udine, Udine, Italy
| | - C Londero
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - F Farneti
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - F Valent
- Institute of Epidemiology, Friuli Centrale Healthcare and University Trust, Udine, Italy
| | - R Cocconi
- Quality and Risk Management, Friuli Centrale Healthcare and University Trust, Udine, Italy
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Brunelli L, De Vita C, Cenedese F, Cinello M, Paris M, Samogizio F, Bava M, Dal Cin M, Zanchiello S, Stampalija T. The role of mobile apps for pregnancy and postnatal care in promoting maternal and child health. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Within the growing availability of health apps worldwide, apps for pregnancy and postnatal care still raise critical issues. The content they provide might rise some concerns in terms of quality, completeness, as well as practical implications for effective prevention and health promotion. This study aims at evaluating free pregnancy and postnatal care apps available in Italian language, shedding light on the main shortcomings and future challenges in this public health field.
Methods
Between July and November 2020, a multidisciplinary research group conducted a systematic review on iOS and Android stores. Data about information, functionalities and technical features of the apps were collected through a 71-items questionnaire including six domains: pregnancy and postnatal care and counselling, reminders and push notifications, notes and records, social support, and technical features.
Results
From 684 identified apps, 22 were deeply analyzed. Resulting apps did not include most desirable features, with just one achieving the 50% of them. The most lacking domain was postnatal care and counselling (17.3%), with particularly scarce information about immunizations that mothers or newborns need (9.1%). Information about free-of-charge and upon payment clinical exams during pregnancy is also absent in half of the apps. Moreover, most apps did not provide users social support with other mothers nor with the healthcare professionals (95.5%). Finally, just one app was CE marked as a medical device.
Conclusions
The identified gaps highlight large room for improvement in the use of pregnancy and postnatal care apps for prevention and health promotion. More efforts are needed to design and implement increasingly high-quality apps providing information related to preventive or diagnostic medical practices, as well as social and certified mechanism to interact with healthcare staff.
Key messages
Increase in use of pregnancy and postnatal care apps should be considered as an opportunity for public health in terms of prevention and health promotion. Providing appropriate information as well as social mechanism to interact with healthcare staff could help to direct mothers and mothers-to-be to the most suitable screening and therapeutic paths.
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Affiliation(s)
- L Brunelli
- Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy
| | - C De Vita
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - F Cenedese
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - M Cinello
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - M Paris
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - F Samogizio
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - M Bava
- Ingegneria Clinica, Informatica e Approvvigionamenti, IRCCS Burlo Garofolo, Trieste, Italy
| | - M Dal Cin
- Direzione Sanitaria, IRCCS Burlo Garofolo, Trieste, Italy
| | - S Zanchiello
- Struttura Innovazione e Sistemi Complessi, Area Science Park, Trieste, Italy
| | - T Stampalija
- Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy
- Medicina Fetale e Diagnostica Prenatale, IRCCS Burlo Garofolo, Trieste, Italy
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49
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Perri G, d’Angelo M, Smaniotto C, Del Pin M, Ruscio E, Londero C, Brunelli L, Castriotta L, Brusaferro S. Do medical students and residents impact the quality of patient care? An assessment from different stakeholders in an Italian academic hospital, 2019. PLoS One 2021; 16:e0258633. [PMID: 34648577 PMCID: PMC8516237 DOI: 10.1371/journal.pone.0258633] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 10/03/2021] [Indexed: 11/18/2022] Open
Abstract
Medical students and residents play an important role in patient care and ward activities, thus they should follow hospital procedures and ensure best practices and patient safety. A survey concerning staff on training was conducted to assess the perceived quality of healthcare from healthcare workers (HCWs), residents, medical students and patients in Udine Academic Hospital, Italy. Between December, 2018 and March, 2019, a 5-point Likert-scale questionnaire was administered in 21 units, covering four thematic areas: patients and medical staff satisfaction with the quality of care provided by residents and students, patient privacy, clinical risk management, patient perception of staff on training. Data analysis included descriptive analysis and ordered logistic regressions. A total of 596/1,863 questionnaires were collected from: HCWs (165/772), residents (110/355), students (121/389), and patients (200/347). Residents were rated high both by patients (median = 5, IQR = 4–5, OR 0.49, 95%CI 0.26–0.93) and HCWs (median = 4, IQR = 3–5, OR 0.14, 95%CI 0.08–0.26), with a lower score for medical students on the same topic, both by patients (median = 4, IQR = 3–5, OR 2.94, 95%CI 1.49–5.78) and HCWs (median = 3, IQR = 2–3, OR 0.41, 95%CI 0.25–0.67). Therefore, the role of staff on training in quality and safety of healthcare deserves integrated regular evaluation, since direct interaction with patients contributes to patients’ perception of healthcare.
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Affiliation(s)
- Giuseppe Perri
- Department of Medicine, University of Udine, Udine, Italy
| | | | | | | | - Edoardo Ruscio
- Department of Medicine, University of Udine, Udine, Italy
| | - Carla Londero
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Laura Brunelli
- Department of Medicine, University of Udine, Udine, Italy
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Friuli Centrale Healthcare University Trust, Udine, Italy
| | - Luigi Castriotta
- Institute of Hygiene and Clinical Epidemiology, Friuli Centrale Healthcare University Trust, Udine, Italy
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50
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Brunelli L, Romanese F, Tricarico P, Murati A, Benetollo PP, Iob A, Forgiarini M, Valent F, Brusaferro S. Parental thoughts after the Codroipo case: the other side of the story. Ann Ig 2021; 34:279-285. [PMID: 34623370 DOI: 10.7416/ai.2021.2481] [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] [Indexed: 11/03/2022]
Abstract
Background To address vaccine hesitancy and to build public trust, many factors need to be considered in the process of planning consistent public health interventions. After uncertain vaccinations of the Codroipo case, hesitant parents were surveyed about own beliefs and trusted sources of information. Methods A semi-structured phone survey was conducted between December 2017 and February 2018, collecting also age and educational level of respondents. Results The most trusted sources of information of the 258 surveyed parents were pediatricians (27.2%), general practitioners (25.4%) and institutional channels (12.1%). Highly educated parents trusted self-study of the scientific literature and expressed doubts about vaccine effectiveness more than others (p=0.0018). Conclusion Despite the underlying improper vaccination issue undermined public trust, healthcare professionals and institutional channels maintained their role as trusted sources of information. Educational patterns emerged among doubtful parents should be considered by public health policies to effectively tackle vaccine hesitancy.
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Affiliation(s)
- L Brunelli
- Department of Medicine, University of Udine, Udine, Italy.,Present address: Accreditation and Quality Unit, Friuli Centrale Healthcare University Trust, Via Colugna 50, Udine, Italy
| | - F Romanese
- Department of Medicine, University of Udine, Udine, Italy.,Present address: Health Prevention Department, Giulano Isontina Healthcare University Trust, Via Paolo De' Ralli, 3, Trieste, Italy
| | - P Tricarico
- Department of Medicine, University of Udine, Udine, Italy.,Present address: Medical Directorate, ULSS7 Pedemontana, Via dei Lotti 40, Bassano del Grappa, Vicenza, Italy
| | - A Murati
- Department of Medicine, University of Udine, Udine, Italy
| | - P P Benetollo
- Local Health Trust no.3 (AAS3, Azienda per l'Assistenza Sanitaria n.3) of Friuli Venezia Giulia, Gemona, Italy.,Present address: Healthcare Trust of the Autonomous Province of Trento, Via Alcide Degasperi 79, Trento, Italy
| | - A Iob
- Local Health Trust no.3 (AAS3, Azienda per l'Assistenza Sanitaria n.3) of Friuli Venezia Giulia, Gemona, Italy.,Present address: Health Prevention Department, Friuli Centrale Healthcare University Trust, Piazzetta Portuzza 2, Gemona, Italy
| | - M Forgiarini
- Local Health Trust no.3 (AAS3, Azienda per l'Assistenza Sanitaria n.3) of Friuli Venezia Giulia, Gemona, Italy.,Present address: Health Prevention Department, Friuli Centrale Healthcare University Trust, Piazzetta Portuzza 2, Gemona, Italy
| | - F Valent
- Institute of Hygiene and Clinical Epidemiology, Udine Healthcare and University Integrated Trust, Udine, Italy.,Present address: Healthcare Trust of the Autonomous Province of Trento, Via Alcide Degasperi 79, Trento, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
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