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Fiocco A, Dini M, Lorenzoni G, Gregori D, Colli A, Besola L. The prophylactic use of negative-pressure wound therapy after cardiac surgery: a meta-analysis. J Hosp Infect 2024; 148:95-104. [PMID: 38677481 DOI: 10.1016/j.jhin.2024.04.003] [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: 10/30/2023] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024]
Abstract
Surgical site infections (SSIs) pose a frequent complication in cardiac surgery patients and lead to increased patient discomfort and extended hospitalization. This meta-analysis aimed to evaluate the protective role of single-use negative-pressure wound therapy (sNPWT) devices on closed surgical wounds after cardiac surgery, and explored their potential preventive application across all cardiac surgery patients. A comprehensive literature search was conducted on ScienceDirect, focusing on studies related to "negative pressure wound therapy" or "PICO negative pressure wound therapy" combined with "cardiac surgery" or "sternotomy," published between 2000 and 2022. Inclusion criteria encompassed case-control studies comparing sNPWT with traditional dressings on closed cardiac surgical incisions in adult patients undergoing median sternotomy without immediate postoperative infective complications, with available details on SSIs. A retrospective analysis of cases treated with sNPWT in our centre was also performed. The meta-analysis revealed a protective role of sNPWT, indicating a 44% risk reduction in overall SSIs (odds ratio 0.56) and a 40% risk reduction in deep wound infections (odds ratio 0.60). Superficial wound infections, however, showed non-significant protective effects. A single-centre study aligned with the meta-analysis findings, confirming the efficacy of sNPWT and was included in the meta-analysis. In conclusion, the meta-analysis and the single-centre study collectively support the protective role of negative pressure wound therapy against overall and deep SSIs, suggesting its potential prophylactic use on all cardiac surgery populations.
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Affiliation(s)
- A Fiocco
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - M Dini
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - G Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - D Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - A Colli
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
| | - L Besola
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Besola L, Fiocco A, Colli A. Transapical Beating Heart Anterior Mitral Leaflet Endosplitting: On-The-Bench Testing. European Heart Journal - Case Reports 2023; 7:ytad098. [PMID: 36969514 PMCID: PMC10032297 DOI: 10.1093/ehjcr/ytad098] [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] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023]
Affiliation(s)
- L Besola
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa
| | - A Fiocco
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa
| | - A Colli
- Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa
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D’Onofrio A, Mastro F, Nadali M, Fiocco A, Pittarello D, Aruta P, Evangelista G, Lorenzoni G, Gregori D, Gerosa G. OUP accepted manuscript. Interact Cardiovasc Thorac Surg 2022; 35:6540696. [PMID: 35234902 PMCID: PMC9252130 DOI: 10.1093/icvts/ivac053] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/31/2022] [Accepted: 02/19/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- A D’Onofrio
- Division of Cardiac Surgery, University of Padova, Padova, Italy
- Corresponding author. Division of Cardiac Surgery, University of Padova, Via Giustiniani 2, Padova 35178, Italy. Tel: +39-0498212410; e-mail: (A. D’Onofrio)
| | - F Mastro
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | - M Nadali
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | - A Fiocco
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | - D Pittarello
- Division of Anesthesiology, University of Padova, Padova, Italy
| | - P Aruta
- Division of Cardiology, Echo Lab, University of Padova, Padova, Italy
| | - G Evangelista
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | - G Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - D Gregori
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - G Gerosa
- Division of Cardiac Surgery, University of Padova, Padova, Italy
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Huang V, Fiocco A. ETHNIC IDENTITY MODERATES THE RELATIONSHIP BETWEEN SOCIAL SUPPORT AND DEPRESSION OLDER CHINESE CANADIANS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fiocco A, Krieger L, D’Amico D. THE ASSOCIATION BETWEEN BDNF POLYMORPHISM AND BIOMARKERS OF STRESS IN MIDDLE AGED AND OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bernad D, Collins L, Fiocco A, Ge M, Shenouda G, Panet-Raymond V, Giacomini P, del Carpio R, Souhami L. Analysis of Structural Changes in Hippocampal and Amygdala Volume After Systemic Therapy and Prophylactic Cranial Irradiation in Patients With Limited Stage-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lupien SJ, Maheu F, Tu M, Fiocco A, Schramek TE. The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain Cogn 2007; 65:209-37. [PMID: 17466428 DOI: 10.1016/j.bandc.2007.02.007] [Citation(s) in RCA: 806] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 02/04/2007] [Accepted: 02/21/2007] [Indexed: 11/20/2022]
Abstract
In this review, we report on studies that have assessed the effects of exogenous and endogenous increases in stress hormones on human cognitive performance. We first describe the history of the studies on the effects of using exogenous stress hormones such as glucocorticoids as anti-inflammatory medications on human cognition and mental health. Here, we summarize the cases that led to the diagnosis of glucocorticoid-induced 'steroid psychosis' in human populations and which demonstrated that these stress hormones could thus cross the blood-brain barrier and access the brain where they could influence cognition and mental health. We then summarize studies that assessed the effects of the exogenous administration of glucocorticoids on cognitive performance supported by the hippocampus, the frontal lobes and amygdala. In the second section of the paper, we summarize the effects of the endogenous release of glucocorticoids induced by exposure to a stressful situation on human cognition and we further dissociate the effects of emotion from those of stress on human learning and memory. Finally, in the last section of the paper, we discuss the potential impact that the environmental context to which we expose participants when assessing their memory could have on their reactivity to stress and subsequent cognitive performance. In order to make our point, we discuss the field of memory and aging and we suggest that some of the 'age-related memory impairments' observed in the literature could be partly due to increased stress reactivity in older adults to the environmental context of testing. We also discuss the inverse negative correlations reported between hippocampal volume and memory for young and older adults and suggest that these inverse correlations could be partly due to the effects of contextual stress in young and older adults, as a function of age-related differences in hippocampal volume.
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Affiliation(s)
- S J Lupien
- Center for Studies on Human Stress, Douglas Hospital Research Center, McGill University, Montreal, QC, Canada.
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Di Prospero S, Fiocco A, Di Lazzaro M, Hernandez R. ["Precursor phenomena" as a criterion in the choice of prevention of primary headache of the hemicrania type]. Clin Ter 1990; 133:9-17. [PMID: 2140744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The importance of headache precursors as expression of latent headache is emphasized. The authors report data from a clinical-epidemiological survey of 322 youngster (143 m and 179 f) aged 4-16 with primary headache aimed at assessing latent time between precursors and onset of headache. The appearance of precursors is considered the time appropriate for prophylaxis.
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