1
|
Stapelberg NJC, Bowman C, Woerwag-Mehta S, Walker S, Davies A, Hughes I, Michel K, Pisani AR, Van Engelen H, Delos M, Hageman T, Fullerton-Smith K, Krishnaiah R, McDowell S, Cameron A, Scales TL, Dillon C, Gigante T, Heddle C, Mudge N, Zappa A, Edwards M, Gutjahr S, Joshi H, Turner K. A lived experience co-designed study protocol for a randomised control trial: the Attempted Suicide Short Intervention Program (ASSIP) or Brief Cognitive Behavioural Therapy as additional interventions after a suicide attempt compared to a standard Suicide Prevention Pathway (SPP). Trials 2021; 22:723. [PMID: 34674732 PMCID: PMC8529364 DOI: 10.1186/s13063-021-05658-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/01/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background Despite being preventable, suicide is a leading cause of death and a major global public health problem. For every death by suicide, many more suicide attempts are undertaken, and this presents as a critical risk factor for suicide. Currently, there are limited treatment options with limited underpinning research for those who present to emergency departments with suicidal behaviour. The aim of this study is to assess if adding one of two structured suicide-specific psychological interventions (Attempted Suicide Short Intervention Program [ASSIP] or Brief Cognitive Behavioural Therapy [CBT] for Suicide Prevention) to a standardised clinical care approach (Suicide Prevention Pathway [SPP]) improves the outcomes for consumers presenting to a Mental Health Service with a suicide attempt. Methods This is a randomised controlled trial with blinding of those assessing the outcomes. People who attempt suicide or experience suicidality after a suicide attempt, present to the Gold Coast Mental Health and Specialist Services, are placed on the Suicide Prevention Pathway (SPP), and meet the eligibility criteria, are offered the opportunity to participate. A total of 411 participants will be recruited for the study, with 137 allocated to each cohort (participants are randomised to SPP, ASSIP + SPP, or CBT + SPP). The primary outcomes of this study are re-presentation to hospitals with suicide attempts. Presentations with suicidal ideation will also be examined (in a descriptive analysis) to ascertain whether a rise in suicidal ideation is commensurate with a fall in suicide attempts (which might indicate an increase in help-seeking behaviours). Death by suicide rates will also be examined to ensure that representations with a suicide attempt are not due to participants dying, but due to a potential improvement in mental health. For participants without a subsequent suicide attempt, the total number of days from enrolment to the last assessment (24 months) will be calculated. Self-reported levels of suicidality, depression, anxiety, stress, resilience, problem-solving skills, and self- and therapist-reported level of therapeutic engagement are also being examined. Psychometric data are collected at baseline, end of interventions, and 6,12, and 24 months. Discussion This project will move both ASSIP and Brief CBT from efficacy to effectiveness research, with clear aims of assessing the addition of two structured psychological interventions to treatment as usual, providing a cost-benefit analysis of the interventions, thus delivering outcomes providing a clear pathway for rapid translation of successful interventions. Trials registration ClinicalTrials.govNCT04072666. Registered on 28 August 2019
Collapse
Affiliation(s)
- Nicolas J C Stapelberg
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,Faculty Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland, 4226, Australia
| | - Candice Bowman
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.
| | - Sabine Woerwag-Mehta
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,Faculty Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland, 4226, Australia
| | - Sarah Walker
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Angela Davies
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Ian Hughes
- Office for Research Governance and Development, Gold Coast Health, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Konrad Michel
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anthony R Pisani
- Departments of Psychiatry and Pediatrics, University of Rochester, 300 Crittenden Blvd., BOX PSYCH, Rochester, NY, 14642, USA
| | - Heidy Van Engelen
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Mia Delos
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Tamara Hageman
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Kim Fullerton-Smith
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Ravikumar Krishnaiah
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Sarah McDowell
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Alison Cameron
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Trudy-Lee Scales
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Cherie Dillon
- Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Titta Gigante
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Cindy Heddle
- Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Natalie Mudge
- Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Anne Zappa
- Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Michelle Edwards
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,Lived Experience Suicide Prevention Research Advisory Committee (this committee was convened specifically for this study and is supported by the Gold Coast Mental Health and Specialist Services Peer Workers), Southport, Australia
| | - Sigi Gutjahr
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Hitesh Joshi
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| | - Kathryn Turner
- Department of Mental Health and Specialist Services Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia
| |
Collapse
|
2
|
Martinelli M, Zappa A, Bianchi S, Frati E, Colzani D, Amendola A, Tanzi E. Human papillomavirus (HPV) infection and genotype frequency in the oral mucosa of newborns in Milan, Italy. Clin Microbiol Infect 2012; 18:E197-9. [DOI: 10.1111/j.1469-0691.2012.03839.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
3
|
Frati E, Bianchi S, Colzani D, Zappa A, Orlando G, Tanzi E. Genetic variability in the major capsid L1 protein of human papillomavirus type 16 (HPV-16) and 18 (HPV-18). Infection, Genetics and Evolution 2011; 11:2119-24. [DOI: 10.1016/j.meegid.2011.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 06/16/2011] [Accepted: 06/21/2011] [Indexed: 11/27/2022]
|
4
|
Abstract
After World War II, mankind believed that infectious diseases were on the way to being defeated. Unfortunately, they still are the second worldwide cause of death. Globalization changes promote the emergence of new infections and pandemics; international deliveries and travelling facilitate the dissemination of infectious agents; man-induced environmental changes create new opportunities for contacts between species, leading to infections in aberrant hosts, including man; global warming enables insects, a major vector of pathogens, to thrive in more countries. The main pandemics have been caused by viruses, such as HIV and novel subtypes of influenza viruses. In addition, prion proteins are a threat. The transmission of the Creutzfeld Jakob disease variant through blood transfusion and the recent discovery of prion protein in the spleen of a haemophilia patient are a matter of further concern. The end of the war against infectious diseases is not in sight. Mankind's battle with pathogens has lasted millennia and is destined to continue.
Collapse
Affiliation(s)
- A R Zanetti
- Dipartimento di Sanità Pubblica-Microbiologia-Virologia, Università degli Studi di Milano, via C Pascal 36, 20133 Milan, Italy.
| | | |
Collapse
|
5
|
Canuti M, Liu C, Frati E, Amendola A, Tanzi E, Zappa A. PIV-25 Phylogenetic analysis of Italian human metapneumovirus (HMPV) and human bocavirus (HBOV) strains. J Clin Virol 2009. [PMCID: PMC7128481 DOI: 10.1016/s1386-6532(09)70121-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Pariani E, Frati ER, Amendola A, Zappa A, Bianchi S, Colzani D, Canuti M, Brambilla D, Zanetti A, Tanzi E. Molecular characterization and phylogenetic analysis of human influenza A viruses in three consecutive seasons with different epidemiological profiles. J Prev Med Hyg 2009; 50:113-116. [PMID: 20099442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Influenza activity and influenza virus circulation were observed in Lombardy (northern Italy) during three consecutive seasons and the molecular characteristics of circulating viruses analysed to control for introduction of new variants. METHODS The molecular characterization of 38 isolates, namely 20 A/H3N2 and 18 A/H1N1 influenza strains from the 2005/06, 2006/07 and 2007/08 seasons, was performed by sequence analysis of the globular head region of the HA protein (HA1 subunit), specific for influenza virus A/H3 and A/H1. RESULTS AND DISCUSSION The last three influenza seasons in the study region were characterized by medium-low activity. A typical co-circulation of several variants was shown for A/H3 viruses for approximately two years and were subsequently almost entirely substituted by new emerging variants. Vice versa, A/H1 viruses had a more homogeneous circulation with a single lineage clearly dominating each season. The HA sequences of the A/H3 and the A/H1 viruses isolated in the last three seasons fell into 4 and 3 principal phylogenetic groups, respectively. No evidence of positive or negative selection in the sequence alignments was observed. CONCLUSIONS Molecular characterization of the influenza viruses in three consecutive seasons highlighted considerable heterogeneity in their HA sequences. A careful surveillance of genetic changes in the HA1 domain during seasonal influenza epidemics may reveal immune escape and provide early information on newly emerging strains with epidemiologic inference.
Collapse
Affiliation(s)
- E Pariani
- Department of Public Health-Microbiology-Virology, University of Milan, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Canuti M, Bianchi S, Zappa A, Koncan R, Pariani E, Cornaglia G, Tanzi E, Zanetti A, Tridente G, Amendola A. O.2.3 Viability of vaccine strains in a pharmaceutical dump. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(08)70029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
8
|
Canuti M, Zappa A, Pariani E, Amendola A, Colzani D, Bianchi S, Brambilla D, Anselmi G, Tanzi E. P.038 Virological-molecular study of aetiological agents associated to Influenza-Like Illness (ILI). J Clin Virol 2009. [PMCID: PMC7128691 DOI: 10.1016/s1386-6532(08)70101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Bianchi S, Amendola A, Canuti M, Zappa A, Tanzi E, Koncan R, Cornaglia G. P1560 Reappraisal of the Berg method to assess viral contamination of the soil. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
Bianchi S, Amendola A, Canuti M, Zappa A, Tanzi E, Koncan R, Cornaglia G. P1559 Biological risk stemming from the long-term burial of NDV vaccinal strains. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71398-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Amendola A, Perin S, Ruzza M, Farina C, Pariani E, Podestà A, Zappa A, Tanzi E. SORVEGLIANZA DELL’INFLUENZA IN ETÀ PEDIATRICA (2004-2005). Microbiol Med 2006. [DOI: 10.4081/mm.2006.3228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
12
|
Tanzi E, Amendola A, Zappa A, Pariani E, Monguzzi A, Colzani D. [Risks and benefits of influenza and pneumococcal immunization in HIV-1 infected individuals]. Ann Ig 2003; 15:567-73. [PMID: 14969311] [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: 04/28/2023]
Abstract
Influenza and Streptococcus pneumoniae diseases can cause severe complications in HIV-1 infected individuals leading to increases in hospital admission and even death. Both vaccinations are recommended for such individuals, but some studies reported that such immunizations may stimulate an increase of HIV-1 viral load and decrease of CD4+ cells count. A review of published studies, including our studies carried out in HIV-1 infected former drugs addicts, indicates that influenza and pneumococcal vaccinations are well tolerated in individuals with HIV-1, and do not induce deterioration of the course of HIV-1 infection, even though the immune response to vaccination is lower than that one observed in immunocompetent individuals. Therefore the lack of significant changes of virological and immunological parameters indicates that such immunizations can be safely administrated to HIV-1 infected individuals.
Collapse
Affiliation(s)
- E Tanzi
- Istituto di Virologia, Università degli Studi di Milano.
| | | | | | | | | | | |
Collapse
|
13
|
Amendola A, Tanzi E, Zappa A, Colzani D, Boschini A, Musher DM, Zanetti AR. Safety and immunogenicity of 23-valent pneumococcal polysaccharide vaccine in HIV-1 infected former drug users. Vaccine 2002; 20:3720-4. [PMID: 12399200 DOI: 10.1016/s0264-410x(02)00357-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The immunogenicity of 23-valent pneumococcal polysaccharide vaccine was assessed in 57 HIV-1 infected former intravenous drug users and in 20 HIV-1 negative controls. The effect of vaccination on HIV-1 infection was studied in a subgroup of 38 patients, 60% of whom under highly active antiretroviral therapy (HAART). Antibody to capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 6B, 19F, 23 F, and changes in CD4+ count, HIV-1 RNA, proviral DNA and HIV-1 phenotype were measured in pre- and post-vaccination samples. Vaccinations were well-tolerated. The rate of responders was higher (P<0.05) in HIV-1 negative than in HIV-1 infected individuals. No difference in antibody response was found within HIV-1 infected patients stratified according to CD4+ counts. Post-vaccination antibody geometric mean concentrations (GMCs) to the five antigens were higher (P<0.05) than baseline in HIV-1 negative subjects, but not in HIV-1 positive individuals. Those with CD4+ >500 cells/mm(3) showed a significant increase of antibody against type 3 only. Immunisation caused no significant changes in CD4+ counts and in either plasma HIV-1 RNA nor proviral DNA levels. Pneumococcal vaccination does not induce virological or immunological deterioration in HIV infected patients, but the antibody response to a single dose of vaccine is poor.
Collapse
Affiliation(s)
- A Amendola
- Institute of Virology, University of Milan, Via Pascal 38, 20133, Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
14
|
Bestetti A, Pierotti C, Terreni M, Zappa A, Vago L, Lazzarin A, Cinque P. Comparison of three nucleic acid amplification assays of cerebrospinal fluid for diagnosis of cytomegalovirus encephalitis. J Clin Microbiol 2001; 39:1148-51. [PMID: 11230445 PMCID: PMC87891 DOI: 10.1128/jcm.39.3.1148-1151.2001] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The diagnostic reliabilities of three cytomegalovirus (CMV) nucleic acid amplification assays of cerebrospinal fluid (CSF) were compared by using CSF samples from human immunodeficiency virus-infected patients with a postmortem histopathological diagnosis of CMV encephalitis (n = 15) or other central nervous system conditions (n = 16). By using a nested PCR assay, the quantitative COBAS AMPLICOR CMV MONITOR PCR, and the NucliSens CMV pp67 nucleic acid sequence-based amplification assay, sensitivities were 93.3, 86.6, and 93.3%, respectively, and specificities were 93.7, 93.7, and 87.5%, respectively. The COBAS AMPLICOR assay revealed significantly higher CMV DNA levels in patients with diffuse ventriculoencephalitis than in patients with focal periventricular lesions.
Collapse
Affiliation(s)
- A Bestetti
- Division of Infectious Diseases, San Raffaele Hospital, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
15
|
Zanetti PP, Rosa G, Sorisio V, Cavanenghi D, Amerio GM, Stillo R, Zappa A, Cardellino S, Franco M, Muncinelli M. [Surgery of the descending thoracic and thoraco-abdominal arteries. Report of 105 cases]. G Ital Cardiol 1997; 27:682-5. [PMID: 9303858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The Authors show their casistic of about 105 cases of thoracic descending and thoraco-abdominal aorta pathologies between 1.1.1993 and 30.12.1995. After a short introduction about the improvements in anesthesia and reanimation of these pathologies as well as the good reliability of diagnostic and currently available instruments, mortality and mobility parameters are taken into account, the last one referring to paraplegia and ARF. The casistic is evaluated splitting the cases into 2 groups, urgent surgery and election surgery, and differentiating the aneurysm type from the dissection type. Besides, the mortality and mobility are reported for any pathology, with a discussion of the parameters which drove the choice of the most suitable methodology to be adopted (ECC femoro-subclavian shunt, simple clamping). The results achieved show a mortality of 40% in urgency, between 5 and 15% in election, with a rate of paraplegia around 8-10% and a ARF between 5 and 15%. These data match the literature statistics and support the quality of the adopted methodologies.
Collapse
Affiliation(s)
- P P Zanetti
- Dipartimento di Chirurgia, Azienda Ospedaliera Regionale Generale, Asti
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Zanetti PP, Rosa G, Cavanenghi D, Sorisio V, Amerio GM, Stillo R, Zappa A, Muncinelli M, Franco M, Cardellino S. Surgical treatment of carotid kinking. J Cardiovasc Surg (Torino) 1997; 38:21-6. [PMID: 9128117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors take in exam 34 anatomical variation in the extracranial internal carotid artery (compared with more than 450 operated carotid artery), 15 of which involved kinking in patients with overt neurological symptoms, underwent corrective surgical treatment, and test the most useful and appropriate techniques in any case.
Collapse
Affiliation(s)
- P P Zanetti
- Division of General and Thoraco-Vascular Surgery, Civilian Hospital, Asti, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Zanetti PP, Sorisio V, Rosa G, Cavanenghi D, Amerio GM, Zappa A, Stillo R, Dutto C, Castenetto E, Cardellino S, Franco M. [Spinal cord protection in surgery of the thoracic, descending, and thoraco-abdominal aorta. Comparison of methods]. MINERVA CHIR 1996; 51:681-9. [PMID: 9082233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors compare the strategus needed for the elimination of paraplegia and for protection of abdominal organs after replacement of descending thoracic or thoraco-abdominal aorta. They analyse single technique considering the advantages and the controindications; furthermore they compare these properties and those of possible variants in the light of the presentation; type of disease and general conditions of the patient. These considerations are in agreement with later literature as well as the attitude of the surgeon.
Collapse
Affiliation(s)
- P P Zanetti
- Ospedale Generale Provinciale, USSL n. 68, Asti
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Zanetti PP, Sorisio V, Rosa G, Accordino R, Amerio GM, Cavanenghi D, Zappa A, Dutto C, Novellone GL, Duc E. [Pseudoaneurysms after carotid endarterectomy]. MINERVA CHIR 1995; 50:889-93. [PMID: 8684637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Pseudoaneurysms after TEA of the internal carotid artery are one of the rarest and most severe complications of this form of surgery. Their etiology appears to depend on 3 causes: a suturing defect due to technical errors made by the surgeon or to the incorrect choice of threads; an infections, and lastly the arterial wall weakened by TEA. The patch increases the risk of false aneurysm approximately four fold. We therefore agree with other authors that, in spite of the undoubted value of the patch in the prevention of restenosis, it must only be used in the presence of an internal carotid of small diameter (less than 4 mm). Contrary to what is reported in the literature we performed both these operations under loco-regional anesthesia and a detailed knowledge of this method allows is to be performed on the carotid axis. Only through a careful follow-up of all the carotids operated can the small dilations which often do not require surgical treatmente identified. The two cases reported here were treated by the removal of the pseudoaneurysms and its replacement with a prosthesis in one case and with the vena saphena in the other. Both were monitored with clinical examination and echo-Doppler and no recidivation has been reported to date.
Collapse
Affiliation(s)
- P P Zanetti
- I Divisione di Chirurgia Generale, Ospedale Civile, Asti
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Zanetti PP, Sorisio V, Baratta V, Amerio GM, Cavanenghi D, Rosa G, Zappa A, Ruscalla L, Piccolini E, Conti P. [Invasion of the chest wall in primary lung neoplasms]. MINERVA CHIR 1994; 49:1263-8. [PMID: 7746446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The authors analyse a series of 5 patients who underwent pulmonary and parietal resection between 1990 and 1993 due to non.microcytoma bronchogenic carcinoma with invasion of the thoracic wall. The patients comprised four men and one woman aged between 45 and 69 years old. Thoracic pain was present in two patients. Pulmonary resection with extrapleural stripping was performed in two patients whereas a block resection from one to five ribs and the corresponding intercostal spaces was performed in the other three patients. The authors' approach is not to perform these operations according to rigid protocols but to adapt them according to the local status of tumour invasion. Therefore to resort to extrapleural resection when there is a free cleavage plane between parietal pleura and rib wall; resection in block of the wall where the carcinoma has infiltrated the endothoracic fascia or deeper. The authors do not report any major complications and record a postoperative mortality rate of 0%. In two cases the thoracic wall was reconstructed using a sheet of Gore-Tex which did not provoke rejection phenomena. Radiotherapy was carried out in cases with positive lymph nodes. The series presented here is too recent to provide significant data regarding survival. However, the only factor seen to influence prognosis in the five patients was the presence or otherwise of lymph node metastasis, irrespective of the histological type and operation performed. The five year survival rate of T3N0M0 patients is in fact similar to that of T2N0M0 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- P P Zanetti
- I Divisione di Chirurgia Generale, USSL n. 68, Regione Piemone, Ospedale Civile, Asti
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Zanetti PP, Cavanenghi D, Baratta V, Sorisio V, Amerio GM, Zappa A, Rosa G. [Hepatic resection. A contribution and its analysis]. MINERVA CHIR 1993; 48:1173-7. [PMID: 8121586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The authors outline their experience in the field of resective hepatic surgery, both with regard to benign and malignant pathologies, and analyse the results in relation to indications and techniques, but also focusing attention on the assessment of postoperative functional alterations, in order to evaluate the hepatic reserve and the organ's response to demolitive surgery. All operations were carried put in the First Division of Surgery at the Ospedale Civile, Asti, from January 1989 to September 1992. In all cases, even in major hepatectomies, a "trans-parenchymal" technique was adopted. Before surgery tests were carried out in relation to the topography of disease, its nature, associated pathologies and the functional hepatic reserve. Operative mortality was zero and morbidity was negligible, probably because rigorous selection criteria and indications for surgery were adopted. Morbidity was even restricted in the two patients suffering from HCC on cirrhosis (?) and this may probably be attributed to the limitation of resection to solely oncological purposes and their classification as Child-Pugh's stage A. The results regarding the liver response to demolitive surgery appear to be indicative and revealed a highly significant and discriminating difference between elective and emergency surgery.
Collapse
Affiliation(s)
- P P Zanetti
- Chirurgia Generale I Divisione, USSL n. 68, Ospedale Civile di Asti
| | | | | | | | | | | | | |
Collapse
|
21
|
Zanetti PP, Sorisio V, Zan S, Cavanenghi D, Amerio GM, Grassini M, Stillo R, Baratta V, Zappa A, Rosa G. [Major and minor complications in carotid surgery]. MINERVA CHIR 1990; 45:1157-9. [PMID: 2287467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Authors report their experience of major and minor complications in carotid surgery. They analyse the causes and emphasize that a thorough preoperative study and a quick surgical technique are very important in reducing the rate of complications in this essentially preventive form of surgery.
Collapse
Affiliation(s)
- P P Zanetti
- 1a Divisione di Chirurgia Generale, Regione Piemonte, USL n. 68, Asti
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Geri G, Franci O, Poli BM, Campodoni G, Zappa A. Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: II. Carcass traits at 95 and 145 kilograms live weight. J Anim Sci 1990; 68:1929-35. [PMID: 2384386 DOI: 10.2527/1990.6871929x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Backfat thickness, carcass length, area of M. longissimus and carcass composition were determined for 253 Large White barrows and gilts to examine the genetic influence on the main characteristics of the carcass and the correlation of these traits with body measurements and fat characteristics at 8 d of age. Pigs were born to 32 sows mated to the same boar. At the age of 8 d, weight, body length and backfat thickness and cellularity were measured. Pigs were slaughtered at 95 and 145 kg live weight. Heritability and genetic correlations were estimated with dam component of variance. Higher adiposity of carcasses was noted for barrows than for gilts and for those animals slaughtered at the heavier vs at the lighter weight. High h2 values were observed for carcass length (.89 +/- .29), area of the M. longissimus (.67 +/- .26) and backfat thickness at the gluteus medius (.77 +/- .28). Percentage of commercial cuts also had high heritabilities. Phenotypic and genetic correlations between the characteristics at 8 d and backfat thickness, carcass length and M. longissimus area at slaughter were not statistically significant. However, significant phenotypic correlations were found between cellularity of the outer and inner layers at 8 d and percentage of major cuts (e.g., rp = .27 with total fat cuts); cellularity of the outer layer at 8 d also was correlated genetically with carcass composition (e.g., rg = .50 +/- .19 with total fat cuts). Genetic predisposition toward intensive fat deposition was more clearly predicted by cellularity than by thickness of adipose tissue in newborn pigs.
Collapse
Affiliation(s)
- G Geri
- Dipartimento di Scienze Zootecniche, Università degli Studi, Florence, Italy
| | | | | | | | | |
Collapse
|
23
|
Geri G, Zappa A, Campodoni G, Franci O, Poli BM. Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: I. Characteristics at 8 days of age and growth rate until slaughter. J Anim Sci 1990; 68:1922-8. [PMID: 2384385 DOI: 10.2527/1990.6871922x] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The genetic influence on body and adipose tissue characteristics of newborn pigs and their correlations to growth rate, BW, body length, backfat thickness and adipocyte size in the outer and inner layers of backfat in 8-d-old Large White piglets were determined. Samples of adipose tissue were obtained by biopsy. Pigs were born to 32 sows mated with the same boar. Heritability and genetic correlations were estimated with dam component of variance; therefore, bias due to common environmental effects cannot be excluded. The heritability estimate for adipocyte volume (.89 +/- .28) was higher than that for backfat thickness at the first and last thoracic vertebrae (.50 +/- .22; .63 +/- .24) and for body weight (.59 +/- .23) at 8 d. Backfat thickness was more closely related genetically and phenotypically to body weight and length than to adipose tissue cellularity. Heritability estimates were .75 +/- .28 for gain from 8 d to weaning and from weaning to 95 d (probably because of common environmental effects) but were .31 +/- .20 for ADG from 95 d to slaughter. Characteristics at 8 d were closely correlated phenotypically with growth rate until weaning. These correlations became lower in the two subsequent periods (to 95 d and to slaughter). Corresponding genetic correlations were nonsignificant.
Collapse
Affiliation(s)
- G Geri
- Dipartimento di Scienze Zootecniche, Università degli Studi, Florence, Italy
| | | | | | | | | |
Collapse
|
24
|
Geri G, Poli BM, Zappa A, Campodoni G, Franci O. Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: III. Histological and chemical characteristics of backfat. J Anim Sci 1990; 68:1936-43. [PMID: 2384387 DOI: 10.2527/1990.6871936x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Genetic and phenotypic relationships between adipose tissue characteristics of 253 piglets aged 8 d and qualitative characteristics of their backfat at 95 and 145 kg live weight were studied. Heritability of these qualitative aspects was estimated as well. Backfat samples were tested for cellularity, moisture, lipid content and fatty acid composition of the outer and inner layers. Adipose cellularity at birth proved to be correlated with cell volume, moisture and total unsaturated fatty acid, C18:0 and C18:2 contents present in backfat at slaughter. Estimates of heritability calculated for the outer layer of backfat indicated that progress can be made by selecting for water content and fatty acid composition. Neonatal cellularity furnishes a useful indicator not only of the backfat cell size at slaughter but also of the chemical factors important in determining the physical and organoleptic characteristics of porcine fat.
Collapse
Affiliation(s)
- G Geri
- Dipartimento di Scienze Zootecniche, Università degli Studi, Florence, Italy
| | | | | | | | | |
Collapse
|
25
|
Giordanello V, Sorisio V, Zappa A, Sacchetto GP, Defilippi L. [Tumors of the anus]. MINERVA CHIR 1990; 45:639-43. [PMID: 2202931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
On the basis of an analysis of a personal series of anal tumours, it is concluded that the polychemotherapeutic protocol with mitomycin and 5-fluorouracil and extensive local tumour removal proposed by Nigro et al. could present a valid alternative to Miles anorectal amputation. The treatment proposed offers better quality of life for the patient without changing oncological radicality and survival.
Collapse
Affiliation(s)
- V Giordanello
- Divisione di Chirurgia Generale, U.S.S.L. n. 65, Ospedale Civile S. Lazzaro, Alba, Cuneo
| | | | | | | | | |
Collapse
|
26
|
Zappa A, Sorisio V, Defilippi L, Giordanello V, Tommassetti S. [Lesions of the colon caused by pancreatitis]. MINERVA CHIR 1990; 45:691-4. [PMID: 2202934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A case of stenosis of the splenic flexure of the colon consequent on acute pancreatitis is reported. Literature reports on the colic complications of pancreatitis are examined, analysing the pathogenetic mechanisms, clinical pictures and therapeutic problems involved in this pathology.
Collapse
Affiliation(s)
- A Zappa
- Divisione Chirurgia Generale, Ospedale Civile, Alba, Cuneo
| | | | | | | | | |
Collapse
|
27
|
Zappa A, Sorisio V, Defilippi L, Tomassetti S, Sacchetto GP. [Palliative gastric resection]. MINERVA CHIR 1990; 45:631-4. [PMID: 1697406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The surgical treatment of stomach carcinoma is reassessed. Stress is laid on the more aggressive attitude with regard to advanced gastric cancer where total or partial palliative resection is the only operation offering good results. This tendency emerges both from the series presented and those reported in the literature. It is concluded that if more aggressive surgery is justified in IVth stage stomach tumours it must still depend on the patient's general condition.
Collapse
Affiliation(s)
- A Zappa
- Divisione di Chirurgia Generale, U.S.S.L. n. 65, Ospedale Civile S. Lazzaro, Alba, Cuneo
| | | | | | | | | |
Collapse
|
28
|
Dellavalle E, Borgna E, Sorisio V, Zappa A, Sacchetto P. [Early diagnosis of intestinal infarcts]. Minerva Med 1989; 80:133-7. [PMID: 2648197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In view of the often poor prognosis of intestinal infarctions personal experience and reports in the literature are reviewed in order to identify the clinical, laboratory and radiological dates that can contribute to early diagnosis. It is concluded that only emergency selective arteriography of the upper mesenteric artery will enable the surgeon to diagnose and accurately locate the infarction.
Collapse
Affiliation(s)
- E Dellavalle
- Divisione di Chirurgia Generale, U.S.S.L. n. 65 - Ospedale Civile, Alba, Cuneo
| | | | | | | | | |
Collapse
|
29
|
Barbieri S, Pirovano C, Scarlato G, Tarchini P, Zappa A, Maranzana M. Long-term effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on the peripheral nervous system. Clinical and neurophysiological controlled study on subjects with chloracne from the Seveso area. Neuroepidemiology 1988; 7:29-37. [PMID: 2829044 DOI: 10.1159/000110133] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This work was set up to investigate the possible presence of peripheral nervous system involvement as a long-term effect of the exposure to dioxin in 152 subjects with chloracne from the Seveso area; 123 age- and sex-matched subjects living in nearby towns with similar environmental pollution formed the control group. The accident in Seveso took place in July, 1976, and this study was carried out from October, 1982, to May, 1983. Although a peripheral neuropathy was not found in any of the subjects, a significant increase of the number of individuals presenting at least two bilateral clinical signs (p less than 0.05) or one abnormal electrophysiological parameter (p less than 0.02) was found in the Seveso group. Principal component analysis did not show any subdivision between these two groups. The Fisher approach to discriminant analysis reveals a clear subdivision between the group of the most exposed subjects and randomly selected subgroups of control subjects. In conclusion, clinical and electrophysiological signs of peripheral nervous system involvement occur with a statistically increased frequency in the Seveso population 6 years after the accident, although a peripheral neuropathy was not evident in any of the chloracne patients using the World Health Organization diagnostic criteria.
Collapse
Affiliation(s)
- S Barbieri
- Istituto Clinica Neurologica, University of Milan, Italy
| | | | | | | | | | | |
Collapse
|
30
|
Tridico F, Sorisio V, Morino M, Zappa A, Panier Suffat P, Zan S, Contessa L. [Our experience in the subject of early gastric cancer]. MINERVA CHIR 1987; 42:1837-45. [PMID: 3431714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|