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Lopez S, Hampel H, Chiesa PA, Del Percio C, Noce G, Lizio R, Teipel SJ, Dyrba M, González-Escamilla G, Bakardjian H, Cavedo E, Lista S, Vergallo A, Lemercier P, Spinelli G, Grothe MJ, Potier MC, Stocchi F, Ferri R, Habert MO, Dubois B, Babiloni C. The association between posterior resting-state EEG alpha rhythms and functional MRI connectivity in older adults with subjective memory complaint. Neurobiol Aging 2024; 137:62-77. [PMID: 38431999 DOI: 10.1016/j.neurobiolaging.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Resting-state eyes-closed electroencephalographic (rsEEG) alpha rhythms are dominant in posterior cortical areas in healthy adults and are abnormal in subjective memory complaint (SMC) persons with Alzheimer's disease amyloidosis. This exploratory study in 161 SMC participants tested the relationships between those rhythms and seed-based resting-state functional magnetic resonance imaging (rs-fMRI) connectivity between thalamus and visual cortical networks as a function of brain amyloid burden, revealed by positron emission tomography and cognitive reserve, measured by educational attainment. The SMC participants were divided into 4 groups according to 2 factors: Education (Edu+ and Edu-) and Amyloid burden (Amy+ and Amy-). There was a statistical interaction (p < 0.05) between the two factors, and the subgroup analysis using estimated marginal means showed a positive association between the mentioned rs-fMRI connectivity and the posterior rsEEG alpha rhythms in the SMC participants with low brain amyloidosis and high CR (Amy-/Edu+). These results suggest that in SMC persons, early Alzheimer's disease amyloidosis may contrast the beneficial effects of cognitive reserve on neurophysiological oscillatory mechanisms at alpha frequencies and connectivity between the thalamus and visual cortical networks.
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Affiliation(s)
- Susanna Lopez
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Harald Hampel
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Patrizia Andrea Chiesa
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France; Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Roberta Lizio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Stefan J Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE), Greifswald, Rostock, Germany
| | - Martin Dyrba
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Gabriel González-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hovagim Bakardjian
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Enrica Cavedo
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Simone Lista
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Andrea Vergallo
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Pablo Lemercier
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France; Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Giuseppe Spinelli
- Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Rostock, Germany
| | - Marie-Claude Potier
- Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Fabrizio Stocchi
- IRCCS San Raffaele, Rome, Italy; Telematic University, San Raffaele, Rome, Italy
| | | | - Marie-Odile Habert
- Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France; AP-HP, Pitié-Salpêtrière Hospital, Department of Nuclear Medicine, Paris F-75013, France
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; San Raffaele Cassino, Cassino, FR, Italy.
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Ravoni G, Fusilli M, Parretti G, Colpani E, Porzio G, Spinelli G, Marinelli D, Giusti R. Training and telemedicine: the key to the palliative medicine specialist shortage? BMJ Support Palliat Care 2024; 14:119-120. [PMID: 37898505 DOI: 10.1136/spcare-2023-004612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/10/2023] [Indexed: 10/30/2023]
Affiliation(s)
- Giulio Ravoni
- Home Care Service, Associazione Tumori Toscana, Florence, Italy
| | - Maria Fusilli
- Home Care Service, Associazione Tumori Toscana, Florence, Italy
| | - Giulia Parretti
- Home Care Service, Associazione Tumori Toscana, Florence, Italy
| | - Emilia Colpani
- Home Care Service, Associazione Tumori Toscana, Florence, Italy
| | | | | | - Daniele Marinelli
- Department of Experimental Medicine, Sapienza - Università di Roma, Rome, Italy
| | - Raffaele Giusti
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Rome, Italy
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Garzia S, Capellini K, Gasparotti E, Pizzuto D, Spinelli G, Berti S, Positano V, Celi S. Three-Dimensional Multi-Modality Registration for Orthopaedics and Cardiovascular Settings: State-of-the-Art and Clinical Applications. Sensors (Basel) 2024; 24:1072. [PMID: 38400229 PMCID: PMC10891817 DOI: 10.3390/s24041072] [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] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
The multimodal and multidomain registration of medical images have gained increasing recognition in clinical practice as a powerful tool for fusing and leveraging useful information from different imaging techniques and in different medical fields such as cardiology and orthopedics. Image registration could be a challenging process, and it strongly depends on the correct tuning of registration parameters. In this paper, the robustness and accuracy of a landmarks-based approach have been presented for five cardiac multimodal image datasets. The study is based on 3D Slicer software and it is focused on the registration of a computed tomography (CT) and 3D ultrasound time-series of post-operative mitral valve repair. The accuracy of the method, as a function of the number of landmarks used, was performed by analysing root mean square error (RMSE) and fiducial registration error (FRE) metrics. The validation of the number of landmarks resulted in an optimal number of 10 landmarks. The mean RMSE and FRE values were 5.26 ± 3.17 and 2.98 ± 1.68 mm, respectively, showing comparable performances with respect to the literature. The developed registration process was also tested on a CT orthopaedic dataset to assess the possibility of reconstructing the damaged jaw portion for a pre-operative planning setting. Overall, the proposed work shows how 3D Slicer and registration by landmarks can provide a useful environment for multimodal/unimodal registration.
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Affiliation(s)
- Simone Garzia
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
- Department of Information Engineering, University of Pisa, 56122 Pisa, Italy;
| | - Katia Capellini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Emanuele Gasparotti
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Domenico Pizzuto
- Department of Information Engineering, University of Pisa, 56122 Pisa, Italy;
| | - Giuseppe Spinelli
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy;
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana G. Monasterio, 54100 Massa, Italy;
| | - Vincenzo Positano
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Simona Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
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Franceschi D, Conti M, Di Gianfilippo R, Spinelli G. Computer-Assisted Mandibular Reconstruction with a Single-Step Free Fibula Flap and Simultaneous Implant Placement. INT J PERIODONT REST 2022; 42:615-621. [PMID: 36044692 DOI: 10.11607/prd.6348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The free fibula flap is a reliable approach used to reconstruct maxillofacial osseous defects. Virtual surgical planning facilitates the execution of such segmental bony reconstruction, usually preceding the placement of endosseous implants for dental rehabilitation. Novel advances in digital technology allow for fabrication of 3D guides for implant placement in the fibula bone segments before their fixation to the facial defect, with reduced ischemic time, reduced treatment time, faster dental rehabilitations, and unprecedented improvements in the overall treatment efficiency. This case report illustrates the use of digitally designed 3D-printed surgical plates for a single-stage surgery of free fibula flap with implant placement. The patient was successfully treated and followed over 2 years. Comparison between preoperative virtual planning and postoperative scans revealed a high accuracy of implant and bone segment positioning.
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Spinelli G, Bakardjian H, Schwartz D, Potier MC, Habert MO, Levy M, Dubois B, George N. Theta Band-Power Shapes Amyloid-Driven Longitudinal EEG Changes in Elderly Subjective Memory Complainers At-Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 90:69-84. [PMID: 36057818 DOI: 10.3233/jad-220204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) includes progressive symptoms spread along a continuum of preclinical and clinical stages. Although numerous studies uncovered the neuro-cognitive changes of AD, very little is known on the natural history of brain lesions and modifications of brain networks in elderly cognitively-healthy memory complainers at risk of AD for carrying pathophysiological biomarkers (amyloidopathy and tauopathy). OBJECTIVE We analyzed resting-state electroencephalography (EEG) of 318 cognitively-healthy subjective memory complainers from the INSIGHT-preAD cohort at the time of their first visit (M0) and two-years later (M24). METHODS Using 18F-florbetapir PET-scanner, subjects were stratified between amyloid negative (A-; n = 230) and positive (A+; n = 88) groups. Differences between A+ and A-were estimated at source-level in each band-power of the EEG spectrum. RESULTS At M0, we found an increase of theta power in the mid-frontal cortex in A+ compared to A-. No significant association was found between mid-frontal theta and the individuals' cognitive performance. At M24, theta power increased in A+ relative to A-individuals in the posterior cingulate cortex and the pre-cuneus. Alpha band revealed a peculiar decremental trend in posterior brain regions in the A+ relative to the A-group only at M24. Theta power increase over the mid-frontal and mid-posterior cortices suggests an hypoactivation of the default-mode network in the A+ individuals and a non-linear longitudinal progression at M24. CONCLUSION We provide the first source-level longitudinal evidence on the impact of brain amyloidosis on the EEG dynamics of a large-scale, monocentric cohort of elderly individuals at-risk for AD.
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Affiliation(s)
- Giuseppe Spinelli
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Hovagim Bakardjian
- AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | | | - Marie-Claude Potier
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France
| | - Marie-Odile Habert
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Médecine Nucléaire, Paris, France.,Centre d'Acquisition et Traitement des Images (CATI), http://www.cati-neuroimaging.com
| | - Marcel Levy
- AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Bruno Dubois
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Nathalie George
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France
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Mannelli G, Comini LV, Sacchetto A, Santoro R, Spinelli G, Bonomo P, Desideri I, Bossi P, Orlandi E, Alderotti G, Franchi A, Palomba A, Eccher A, Marchioni D, Nocini R, Piazza C, Molteni G. Estimating survival after salvage surgery for recurrent salivary gland cancers: Systematic review. Head Neck 2022; 44:1961-1975. [PMID: 35441406 PMCID: PMC9545583 DOI: 10.1002/hed.27062] [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: 09/07/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this study was to analyze the therapeutic strategies and oncological outcomes of RSC patients through a literature review analysis. This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. Two thousand seven hundred and four records were selected and 1817 recurrences were studied. Three hundred and sixty-five patients underwent salvage surgery (20.1%) and their 5-year mortality rate, overall survival and disease-free survival were 35%, 70%, and 42%, respectively. RSCs are aggressive neoplasms with a high rate of distant metastases (28.9%). Salvage surgery can be considered in patients with limited local and/or regional recurrences, even in case of single distant relapse, appearing within the first 3 years of follow-up.
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Affiliation(s)
- Giuditta Mannelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Lara V Comini
- Head and Neck Oncology and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Sacchetto
- Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Verona, Italy
| | - Roberto Santoro
- Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Giuseppe Spinelli
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Isacco Desideri
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili, Brescia, Italy
| | - Ester Orlandi
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Giammarco Alderotti
- Department of Statistics, Computer Science, Applications "G. Parenti" (DiSIA), University of Florence, Florence, Italy
| | - Alessandro Franchi
- Department of Translational Research, School of Medicine, University of Pisa, Pisa, Italy
| | - Annarita Palomba
- Unit of Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Albino Eccher
- Pathology Unit, Department of Pathology and Diagnostics, University Hospital of Verona, Verona, Italy
| | - Daniele Marchioni
- Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Verona, Italy
| | - Riccardo Nocini
- Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Verona, Italy
| | - Cesare Piazza
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Gabriele Molteni
- Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Verona, Italy
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7
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Cantini L, Mentrasti G, Russo GL, Signorelli D, Pasello G, Rijavec E, Russano M, Antonuzzo L, Rocco D, Giusti R, Adamo V, Genova C, Tuzi A, Morabito A, Gori S, Verde NL, Chiari R, Cortellini A, Cognigni V, Pecci F, Indini A, De Toma A, Zattarin E, Oresti S, Pizzutilo EG, Frega S, Erbetta E, Galletti A, Citarella F, Fancelli S, Caliman E, Della Gravara L, Malapelle U, Filetti M, Piras M, Toscano G, Zullo L, De Tursi M, Di Marino P, D'Emilio V, Cona MS, Guida A, Caglio A, Salerno F, Spinelli G, Bennati C, Morgillo F, Russo A, Dellepiane C, Vallini I, Sforza V, Inno A, Rastelli F, Tassi V, Nicolardi L, Pensieri V, Emili R, Roca E, Migliore A, Galassi T, Rocchi MLB, Berardi R. Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario. ESMO Open 2022; 7:100406. [PMID: 35219245 PMCID: PMC8810307 DOI: 10.1016/j.esmoop.2022.100406] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 09/20/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. Methods Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Results A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36). Conclusions Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. The COVID-19 outbreak had an impact on access to lung cancer (LC) diagnosis and treatment. A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019. Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease. The Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. A reverse migration from high-volume to low-volume cancer centers was noted during the pandemic.
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Affiliation(s)
- L Cantini
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy. https://twitter.com/LucaCantiniMD
| | - G Mentrasti
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - G L Russo
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - D Signorelli
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Russano
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - L Antonuzzo
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - D Rocco
- Department of Pulmonology and Oncology, AORN dei Colli Monaldi, Naples, Italy
| | - R Giusti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - V Adamo
- Oncologia Medica, A.O.Papardo & Università di Messina, Messina, Italy
| | - C Genova
- UOC Clinica di Oncologia Medica, IRCCS Ospedale San Martino, Department of Internal Medicine and Medical Specialties (DIMI), Università degli Studi di Genova, Genoa, Italy
| | - A Tuzi
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - S Gori
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - N La Verde
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - A Cortellini
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - V Cognigni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - F Pecci
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - A Indini
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A De Toma
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E Zattarin
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - S Oresti
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - E G Pizzutilo
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - S Frega
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Erbetta
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - A Galletti
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - F Citarella
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - S Fancelli
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - E Caliman
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - L Della Gravara
- Dipartment of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - U Malapelle
- Department of Public Health, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - M Filetti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - M Piras
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - G Toscano
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - L Zullo
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - M De Tursi
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - P Di Marino
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - V D'Emilio
- UOC Pneumologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - M S Cona
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Guida
- Oncologia Medica e Traslazionale, AO Santa Maria, Terni, Italy
| | - A Caglio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - F Salerno
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - G Spinelli
- UOC Territorial Oncology, University "Sapienza", AUSL Latina, Cds Aprilia, Aprilia, Italy
| | - C Bennati
- Department of Onco-Hematology, AUSL della Romagna, Ravenna, Italy
| | - F Morgillo
- UOC Oncologia ed Ematologia, Department of Precision Medicine, Università degli studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - A Russo
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - C Dellepiane
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - I Vallini
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - V Sforza
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - A Inno
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - F Rastelli
- UOC Oncologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - V Tassi
- Chirurgia Toracica, AO Santa Maria, Terni, Italy
| | - L Nicolardi
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - V Pensieri
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - R Emili
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - E Roca
- Thoracic Oncology - Lung Unit, Pederzoli Hospital, Peschiera Del Garda, Italy
| | - A Migliore
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - T Galassi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - M L Bruno Rocchi
- Biomolecular Sciences Department, University of Urbino, Urbino, Italy
| | - R Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
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8
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Lizio R, Lopez S, Hampel H, Chiesa PA, Del Percio C, Noce G, Teipel SJ, González‐Escamilla G, Bakardjian H, Cavedo E, Lista S, Vergallo A, Lemercier P, Spinelli G, Grothe MJ, Potier M, Stocchi F, Ferri R, Habert M, Dubois B, Babiloni C. Education and brain amyloid load act on temporal lobe function in individual with subjective memory complaint: An EEG‐fMRI study. Alzheimers Dement 2021. [DOI: 10.1002/alz.051191] [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: 11/06/2022]
Affiliation(s)
- Roberta Lizio
- IRCCS SDN Naples Italy
- Sapienza University of Rome Rome Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology, Sapienza University of Rome Rome Italy
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Paris France
| | - Patrizia Andrea Chiesa
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Paris France
- Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 Paris France
| | | | | | - Stefan J. Teipel
- University of Rostock, Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE) ‐ Rostock/Greifswald Rostock Germany
| | | | - Hovagim Bakardjian
- Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225 Paris France
- Institute of Memory and Alzheimer's Disease (IM2A) Paris France
| | - Enrica Cavedo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Paris France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Paris France
- INSERM U1127, Institut du Cerveau et de la Moelle Epiniere (ICM) Paris France
| | - Simone Lista
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Paris France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Paris France
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP‐HP, Pitié‐Salpêtrière Hospital Paris France
| | - Pablo Lemercier
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Paris France
| | - Giuseppe Spinelli
- Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université Paris France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Paris France
| | - Michel J. Grothe
- German Center for Neurodegenerative Diseases (DZNE) Rostock Germany
| | - Marie‐Claude Potier
- Institute of Memory and Alzheimer's Disease (IM2A), Pitié‐Salpêtrière Hospital Paris France
| | | | | | - Marie‐Odile Habert
- Centre pour l'Acquisition et le Traitement des Images Paris France
- AP‐HP, Hôpital Pitié‐Salpêtrière, Département de Médecine Nucléaire, Sorbonne Universities, Pierre et Marie Curie University, Laboratoire d’Imagerie Biomédicale Paris France
- Laboratoire d’Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris, INSERM U1146, CNRS UMR 7371 Paris France
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne University Paris France
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), ICM, Salpetriere Hospital, AP‐HP, University Paris Paris France
| | - Claudio Babiloni
- Department of Physiology and Pharmacology, Sapienza University of Rome Rome Italy
- San Raffaele Cassino Cassino Italy
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9
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De Giorgi V, Scarfì F, Trane L, Silvestri F, Venturi F, Zuccaro B, Spinelli G, Scoccianti S, De Rosa F, Dika E, Longo C. Treatment of Advanced Basal Cell Carcinoma with Hedgehog Pathway Inhibitors: A Multidisciplinary Expert Meeting. Cancers (Basel) 2021; 13:cancers13225706. [PMID: 34830860 PMCID: PMC8616316 DOI: 10.3390/cancers13225706] [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: 10/10/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Despite recent progress and the publishing of several clinical guidelines on the management of advanced basal cell carcinoma, there is still no comprehensive set of clinical guidelines addressing the complexity inherent to the use of Hedgehog pathway inhibitors in the treatment of advanced basal cell carcinoma in real-world clinical practice. To develop practical and valuable tools that help specialists improve the clinical management of these patients, we sought the opinion of expert physicians with extensive knowledge and experience in the treatment of advanced basal cell carcinoma.
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Affiliation(s)
- Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
- Correspondence: ; Tel./Fax: +39-055-6939632
| | - Federica Scarfì
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Luciana Trane
- Cancer Research “AttiliaPofferi” Foundation, 50100 Pistoia, Italy;
| | - Flavia Silvestri
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Federico Venturi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Biancamaria Zuccaro
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Giuseppe Spinelli
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Careggi, 50100 Florence, Italy;
| | - Silvia Scoccianti
- Radiation Oncology Unit, Azienda Toscana Centro, 50100 Florence, Italy;
| | - Francesco De Rosa
- Immunotherapy-Cell Therapy and Biobank, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori” IRCCS, 47014 Meldola, Italy;
| | - Emi Dika
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
- Dermatology, IRCCS Policlinico di Sant’Orsola, Via Massarenti 9, 40138 Bologna, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, 42100 Modena, Italy;
- Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, 41121 Reggio Emilia, Italy
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10
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Bianchi FP, Tafuri S, Spinelli G, Carlucci M, Migliore G, Calabrese G, Daleno A, Melpignano L, Vimercati L, Stefanizzi P. Two years of on-site influenza vaccination strategy in an Italian university hospital: main results and lessons learned. Hum Vaccin Immunother 2021; 18:1993039. [PMID: 34736372 PMCID: PMC8973379 DOI: 10.1080/21645515.2021.1993039] [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] [Indexed: 11/23/2022] Open
Abstract
Although the vaccination of healthcare workers (HCWs) is considered essential for preventing influenza circulation in the hospital setting, vaccination coverage (VC) in this group remains low. Among the reasons cited by HCWs is a lack of time to attend the vaccination clinic. For the 2018/2019 influenza season, active (on-site) influenza vaccination was offered directly in 44 operative units (OUs) of the Bari Policlinico hospital (50 OUs, 3,397 HCWs). At the same time, the hospital granted the HCW access to the vaccination clinic during October and December 2018. VC achieved among HCWs of Bari Policlinico during the 2018/2019 influenza season was then analyzed, and the results compared with those of the 2017/18 season. During the 2018/19 season, VC was 20.4% (n = 798) and thus higher than the 14.2% of the 2017/18 season (+6.2%). The highest VC was among physicians (33.4%), followed by other HCWs (23.8%), auxiliary staff (8.6%), and nurses (7.2%). Overall, 284 (36.5%) HCWs were vaccinated at on-site sessions. Multivariate analysis showed that vaccination uptake was associated with male gender and with work in OU where vaccination was actively offered. On the other hand, being a nurse or auxiliary staff member and working in the surgical area were deterrents. Although VC remained unsatisfactory, active on-site vaccination proved to be an important strategy to improve vaccination compliance, increasing 44% compared to the previous season. Nonetheless, mandatory vaccination directed by public health institutions may be the only way to reach a minimum level of coverage.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Matilde Carlucci
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | | | | | - Antonio Daleno
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - Livio Melpignano
- Hospital Direction, Bari Policlinico General Hospital, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy.,Unit of Occupational Medicine, University Hospital of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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11
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Grosselin F, Breton A, Yahia-Cherif L, Wang X, Spinelli G, Hugueville L, Fossati P, Attal Y, Navarro-Sune X, Chavez M, George N. Alpha activity neuromodulation induced by individual alpha-based neurofeedback learning in ecological context: a double-blind randomized study. Sci Rep 2021; 11:18489. [PMID: 34531416 PMCID: PMC8445968 DOI: 10.1038/s41598-021-96893-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
The neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the link between brain activity and FB. We aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study. Forty-eight healthy participants were assigned to either NF (n = 25) or control (n = 23) group and performed alpha upregulation training (over 12 weeks) with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group. An increase of alpha activity across training sessions was observed in the NF group only (p < 0.001). This neuromodulation was selective in that there was no evidence for similar effects in the theta (4-8 Hz) and low beta (13-18 Hz) bands. While alpha upregulation was found in the NF group only, psychological outcome variables showed overall increased feeling of control, decreased anxiety level and increased relaxation feeling, without any significant difference between the NF and the control groups. This is interpreted in terms of learning context and placebo effects. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems.
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Affiliation(s)
- Fanny Grosselin
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Equipe Aramis, 75013, Paris, France.
- myBrain Technologies, 75010, Paris, France.
- INRIA, Aramis Project-Team, 75013, Paris, France.
| | | | - Lydia Yahia-Cherif
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Xi Wang
- myBrain Technologies, 75010, Paris, France
| | | | - Laurent Hugueville
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Philippe Fossati
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe CIA-Cognitive Control, Interoception, Attention, 75013, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Psychiatrie Adulte, 75013, Paris, France
| | | | | | | | - Nathalie George
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe Experimental Neurosurgery, 75013, Paris, France
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Stefanizzi P, Bianchi FP, Spinelli G, Amoruso F, Ancona D, Stella P, Tafuri S. Postmarketing surveillance of adverse events following meningococcal B vaccination: data from Apulia Region, 2014-19. Hum Vaccin Immunother 2021; 18:1-6. [PMID: 34435938 PMCID: PMC8920168 DOI: 10.1080/21645515.2021.1963171] [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] [Indexed: 12/01/2022] Open
Abstract
Since the multicomponent meningococcal B vaccine introduction, the Apulian Regional Health Authority implemented postmarketing surveillance program, as provided by Italian laws. From National Pharmacovigilance Network, we selected 4CMenB AEFIs reported in Apulia from 01 January 2014 to 31 December 2019, while the number of 4 cMen B doses administered per year was obtained from the regional immunization database (GIAVA). For each subject who experienced an adverse event following meningococcal B vaccine (AEFIs), a predefined form was filled in. A total of 214 AEFIs (26.5 × 100.000 doses) were reported after any dose of MenB-4 c vaccination of which 58/214 (27.1%) were classified as serious (7.2 × 100,000 doses), 145/214 (67.8%) as not serious (180 × 100,000 doses), and 11/214 (5.1%) as undefined (1.3 × 100,000 doses). The average age of subjects who experimented and AEFI was 30 months. The majority of serious AEFIs were reported in 2- to 11-month-old children (44/57; 77.2%). A total of 31/58 (3.8 × 100,000 doses; 53.4%) serious AEFIs were reported as having a ‘consistent causal association’ with vaccination. Of these, fever/hyperpyrexia was reported in 21/31 (2.6 × 100,000 doses; 67.7%); hypotonic-hyporesponsive episode was reported in 7/31 (0.9 × 100,000 doses [add %-age]) and was the most frequent adverse event with neurological symptoms. A total of 13/31 (41.9%) serious AEFIs classified as ‘consistent causal association’ were reported after the first dose of 4cMenB, of these 5/13 (38.5%) children did not complete the vaccination schedule. Our data seemed to confirm, in a large population, the a good safety profile of the universal mass vaccination with 4CMENB.
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Affiliation(s)
- Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Fabio Amoruso
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Domenica Ancona
- Apulian Regional Health Department, Regional Center for Pharmacovigilance Activities, Bari, Italy
| | - Paolo Stella
- Apulian Regional Health Department, Regional Center for Pharmacovigilance Activities, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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13
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De Giorgi V, Trane L, Pieretti G, Santoro N, Silvestri F, Venturi F, Scarfi F, Maio V, Spinelli G, Scoccianti S, Guerrini L, Massi D, Mazzini C, Doni L. Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: a single-center study and a new dedicated therapeutic protocol. Dermatol Reports 2021; 13:9240. [PMID: 35003569 PMCID: PMC8672118 DOI: 10.4081/dr.2021.9240] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 05/21/2021] [Indexed: 12/03/2022] Open
Abstract
The management of difficult-to-treat periocular basal cell carcinoma (BCC) becomes very challenging in cases of delayed diagnosis, leading to the development of locally advanced BCC. The aim of this study was to evaluate the outcomes of Hedgehog pathway inhibitors (vismodegib and sonidegib) treatment in patients affected by periocular locally advanced BCC. We focused on the common adverse events and their correlation with the administration schedule, to determine a management protocol specific for the periocular area. This observational prospective study included a single-center case series with patients who were histologically confirmed to have periocular or orbital locally advanced BCC, treated with Hedgehog pathway inhibitors. All patients benefitted in terms of regression or stabilization of the neoplasm. In the first months of treatment, the HPIs were well tolerated, and the first important side effects appeared after about 5 months of continuous use of the drug. These data could lead to a new type of therapeutic scheme where neoadjuvant therapy could be followed by pulse therapy as an adjuvant to surgery.
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14
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Bonomo P, Stocchi G, Caini S, Desideri I, Santarlasci V, Becherini C, Limatola V, Locatello LG, Mannelli G, Spinelli G, Guido C, Livi L. Acupuncture for radiation-induced toxicity in head and neck squamous cell carcinoma: a systematic review based on PICO criteria. Eur Arch Otorhinolaryngol 2021; 279:2083-2097. [PMID: 34331571 PMCID: PMC8930866 DOI: 10.1007/s00405-021-07002-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/14/2021] [Indexed: 01/04/2023]
Abstract
Purpose In head and neck squamous cell carcinoma (HNSCC), the potential mitigating effect of complementary medicine interventions such as acupuncture for radiation-induced toxicity is unknown. This study aimed to assess the impact of acupuncture on the incidence and degree of severity of common radiation-induced side effects. Methods In accordance with pre-specified PICO criteria, a systematic review was performed. Two electronic databases (Medline and Embase) were searched over a 10-year time frame (01/01/10 to 30/09/20). Patients undergoing a curatively intended, radiation-based treatment for histologically confirmed squamous cell carcinoma of the nasopharynx, oropharynx, larynx, hypopharynx and oral cavity represented the target population of our study. Accurate information on the acupuncture methodology was reported. All included articles were evaluated to identify any potential source of bias Results Five papers were included in our qualitative analysis, for a total of 633 subjects. Compliance to per-protocol defined schedule of acupuncture sessions was high, ranging from 82 to 95.9%. Most patients (70.6%) were randomly allocated to receive acupuncture for its potential preventive effect on xerostomia. The large heterogeneity in study settings and clinical outcomes prevented from performing a cumulative quantitative analysis, thus no definitive recommendations can be provided. Conclusions Although shown to be feasible and safe, no firm evidence currently supports the use of acupuncture for the routine management of radiation-induced toxicity in HNSCC.
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Affiliation(s)
- Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy.
| | - Giulia Stocchi
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy
| | - Isacco Desideri
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Veronica Santarlasci
- Integrative Medicine Unit, Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Carlotta Becherini
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Vittorio Limatola
- Integrative Medicine Unit, Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Luca Giovanni Locatello
- Department of Otorhinolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giuditta Mannelli
- Head and Neck Oncology and Robotic Surgery, Department of Experimental and Clinical Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giuseppe Spinelli
- Maxillo Facial Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Carmelo Guido
- Fior Di Prugna Center for Complementary Medicine, Azienda USL Toscana Centro, Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
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Molteni G, Comini L, Le Pera B, Bassani S, Ghirelli M, Martone A, Mattioli F, Nocini R, Santoro R, Spinelli G, Presutti L, Marchioni D, Mannelli G. Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications. J Surg Oncol 2021; 124:740-750. [PMID: 34152604 DOI: 10.1002/jso.26576] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 05/04/2021] [Accepted: 05/27/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments. METHODS This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020. RESULTS Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease-free survival, or overall survival. CONCLUSIONS IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.
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Affiliation(s)
- Gabriele Molteni
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy
| | - Lara Comini
- Department of Experimental and Clinical Medicine, University of Florence, AOU-Careggi, Florence, Italy
| | - Beatrice Le Pera
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy
| | - Sara Bassani
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy
| | - Michael Ghirelli
- Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy
| | - Andrea Martone
- Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy
| | - Francesco Mattioli
- Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy
| | - Riccardo Nocini
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy
| | - Roberto Santoro
- Department of Experimental and Clinical Medicine, University of Florence, AOU-Careggi, Florence, Italy
| | - Giuseppe Spinelli
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Livio Presutti
- Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy
| | - Daniele Marchioni
- Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy
| | - Giuditta Mannelli
- Head and Neck Oncology and Robotic Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Stefanizzi P, De Nitto S, Spinelli G, Lattanzio S, Stella P, Ancona D, Dell’Aera M, Padovano M, Soldano S, Tafuri S, Bianchi FP. Post-Marketing Active Surveillance of Adverse Reactions Following Influenza Cell-Based Quadrivalent Vaccine: An Italian Prospective Observational Study. Vaccines (Basel) 2021; 9:vaccines9050456. [PMID: 34064483 PMCID: PMC8147936 DOI: 10.3390/vaccines9050456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/21/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/18/2022] Open
Abstract
Since the influenza season 2018/19, the Italian Ministry of Health recommended a dose of cell-based quadrivalent vaccine (Flucelvax Tetra) for HCWs (healthcare workers), because this vaccine seemed more efficacious in the prevention of AH3N2 virus. Due to the lack of pre-registration data, the safety profile of this new vaccine must be investigated in post-marketing surveillance. The aim of our study is to evaluate, through a post-marketing active surveillance program developed during the 2019/20 influenza season, any Adverse Events Following Immunization (AEFIs) that happened in the 7 days after immunization with Flucelvax Tetra. The study was carried out in a sample of HCWs of Policlinico General University-Hospital (Apulia, South Italy). AEFIs were classified as ‘serious’ or ‘not serious’ according to the WHO (World Health Organization) guidelines; the WHO causality assessment algorithm was applied to classify serious AEFIs. A total of 741 HCWs were enrolled, and 430 AEFIs (reporting rate: 58.0 (95%CI: 54.4–61.6) × 100 enrolled) were recorded. Of these, 429 of 430 (99.8%; reporting rate: 57.8 (95%CI: 54.2–61.5) × 100 enrolled) were classified as not serious and one (0.2%; reporting rate: 0.13 (0.03–0.75) × 100 enrolled) was classified as serious. Local reactions were the adverse reaction reported most frequently (88%); regarding the serious AEFI, causality assessment excluded the causal link with the administration of the vaccine. All the AEFIs resolved without sequelae. Flucelvax Tetra showed a profile of high safety. Due to their characteristics of greater sensitivity than passive surveillance, active surveillance programs can be useful in defining the safety profiles of a given vaccine/drug in certain population subgroups.
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Affiliation(s)
- Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
| | - Sara De Nitto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
| | - Sabrina Lattanzio
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
| | - Paolo Stella
- Regional Center for Pharmacovigilance, 52100 Puglia, Italy; (P.S.); (D.A.)
| | - Domenica Ancona
- Regional Center for Pharmacovigilance, 52100 Puglia, Italy; (P.S.); (D.A.)
| | - Maria Dell’Aera
- Department of Pharmacy, Bari Policlinico General Hospital, 70124 Bari, Italy; (M.D.); (M.P.)
| | - Margherita Padovano
- Department of Pharmacy, Bari Policlinico General Hospital, 70124 Bari, Italy; (M.D.); (M.P.)
| | - Savino Soldano
- Health Hospital Management, Bari Policlinico General Hospital, 70124 Bari, Italy;
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
- Correspondence: ; Tel.: +39-80-5478473; Fax: +39-80-5478472
| | - Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, 70124 Bari, Italy; (P.S.); (S.D.N.); (G.S.); (S.L.); (F.P.B.)
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Bianchi FP, Larocca AMV, Bozzi A, Spinelli G, Germinario CA, Tafuri S, Stefanizzi P. Long-term persistence of poliovirus neutralizing antibodies in the era of polio elimination: An Italian retrospective cohort study. Vaccine 2021; 39:2989-2994. [PMID: 33933314 DOI: 10.1016/j.vaccine.2021.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/18/2020] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The extensive use of oral and inactivated poliovirus (PV) vaccines has driven progress toward the global eradication of wild PV2 and PV3 and the elimination of PV1 in most countries, including Italy. Although the persistence of circulating neutralizing antibodies among the vaccinated is unclear, it is estimated that > 99% of the population vaccinated according to the recommended protocol should be protected for at least 18 years. METHODS This study evaluated the seroprevalence of anti-PV neutralizing antibodies and the long-term immunogenicity of the oral poliovirus vaccine (OPV) in a sample of medical students and residents of the University of Bari who attended the Hygiene Department for a biological risk assessment between April 2014 and October 2020. RESULTS The prevalence of protected vaccinated individuals was > 90% for PV1, PV2, and PV3. Specifically, >99% of the study group was protected against PV1, > 98% against PV2, and almost 93% against PV3. Protective antibodies against all three viruses persisted for at least up to 18 years after administration of the last OPV dose, with PV1 and PV2 antibodies detected in > 95% of the participants > 30 years after the last OPV dose. CONCLUSIONS The childhood series of four doses of OPV guarantees a long duration of protection, despite the elimination of the virus and therefore the absence of a natural booster. However, until PV1 is completely eradicated, maximum vigilance on the part of public health institutions must be maintained.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | | | - Anna Bozzi
- Hygiene Department, Bari Policlinico General Hospital, Bari, Italy
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Spinelli G, Brogi E, Sidoti A, Pagnucci N, Forfori F. Assessment of the knowledge level and experience of healthcare personnel concerning CPR and early defibrillation: an internal survey. BMC Cardiovasc Disord 2021; 21:195. [PMID: 33879072 PMCID: PMC8056553 DOI: 10.1186/s12872-021-02009-2] [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: 07/23/2020] [Accepted: 04/12/2021] [Indexed: 11/24/2022] Open
Abstract
Background In‐hospital cardiac arrest (IHCA) is a major public health problem with significant mortality. Rapid cardiopulmonary resuscitation and early defibrillation is extremely connected to patient outcome. In this study, we aimed to assess the effects of a basic life support and defibrillation course in improving knowledge in IHCA management. Methods We performed a prospective observational study recruiting healthcare personnel working at Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. Study consisted in the administration of two questionnaires before and after BLS-D course. The course was structured as an informative meeting and it was held according to European Resuscitation Council guidelines. Results 78 participants completed pre- and post-course questionnaires. Only 31.9% of the participants had taken part in a BLS-D before our study. After the course, we found a significative increase in the percentage of participants that evaluated their skills adequate in IHCA management (17.9% vs 42.3%; p < 0.01) and in the correct use of defibrillator (38.8% vs 67.9% p < 0.001). However, 51.3% of respondents still consider their preparation not entirely appropriate after the course. Even more, we observed a significant increase in the number of corrected responses after the course, especially about sequence performed in case of absent vital sign, CPR maneuvers and use of defibrillator. Conclusions The training course resulted in significant increase in the level of knowledge about the general management of IHCA in hospital staff. Therefore, a simple intervention such as an informative meetings improved significantly the knowledge about IHCA and, consequently, can lead to a reduction of morbidity and mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02009-2.
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Affiliation(s)
- G Spinelli
- Department of Anesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - E Brogi
- Department of Anesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
| | - A Sidoti
- Department of Anesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - N Pagnucci
- Department of Anesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - F Forfori
- Department of Anesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
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Arcuri F, Agostini T, Limbucci N, Laiso A, Mangiafico S, Spinelli G, Panisi I, Nappini S. Salvage transorbital approach for the endovascular treatment of carotid cavernous fistulas. Oral Maxillofac Surg 2021; 26:45-51. [PMID: 33821383 DOI: 10.1007/s10006-021-00961-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Carotid cavernous fistulas (CCFs) are abnormal connections between the cavernous sinus (CS) and carotid arteries. In direct CCFs, a transarterial route is often the preferred vascular access; in case of indirect CCFs, the complex anatomy of the feeder vessels and their extra-intracranial anastomosis makes the transarterial embolization challenging and often ineffective. The aim of this study was to review our experience with the transorbital approach to treat patients affected by CCF who have already experienced an endovascular failure procedure, in order to assess this salvage technique feasibility, by analyzing possible risks and complications. METHODS We performed a retrospective study of all patients affected by CCFs who underwent transorbital embolization between February 2017 and February 2019 at our institution. RESULTS All patients (3 cases) tolerated both the retrograde embolization and the direct surgical approach with clinical improvement; the closure of the fistula was complete and verified intraoperatively by angiography. Esthetic result was acceptable in all cases with reduction of the proptosis and the intraocular pressure, and increased visual acuity. There were no complications or clinical recurrence. CONCLUSION Transorbital approach for the endovascular treatment of CCFs is a feasible and safe salvage procedure, which can find indication after other endovascular access failures.
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Affiliation(s)
- Francesco Arcuri
- Unit of Maxillofacial Surgery, IRCCS San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Tommaso Agostini
- Casa Di Cura San Paolo, Via del Quadrifoglio, 3, 51100, Pistoia, Italy
| | - Nicola Limbucci
- Unit of Interventional Neuroradiology, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
| | - Antonio Laiso
- Unit of Interventional Neuroradiology, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
| | - Salvatore Mangiafico
- Unit of Interventional Neuroradiology, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
| | - Giuseppe Spinelli
- Unit of Maxillofacial Surgery, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
| | - Irene Panisi
- Unit of Maxillofacial Surgery, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
| | - Sergio Nappini
- Unit of Interventional Neuroradiology, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy
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20
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Comini LV, Mannelli G, Tamburini A, Innocenti M, Spinelli G. Pediatric Malignant Mandibular Tumors: Personal Experience and Literature Options Discussion. ORL J Otorhinolaryngol Relat Spec 2021; 83:263-271. [PMID: 33789315 DOI: 10.1159/000513870] [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: 02/21/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Mandibular defects reconstruction could result challenging in childhood, due to facial and mandibular growth patterns. For these reasons, the choice of the most suitable reconstructive option in pediatric patients, affected by mandibular malignancies, still objects of debate. OBJECTIVE The aim of our study was to compare our reconstructive schedules to the existing literature in order to give a personal contribute to the present panorama. METHODS We performed, in October 2019, a retrospective evaluation of pediatric patients treated for biopsy-proven mandibular malignancies at our Institute between January 2013 and December 2016. All of them received multimodal therapy in accordance with standard guidelines and their demographic, clinical, treatment, and outcome parameters were collected and analyzed. RESULTS We observed a shorter duration of surgery, a faster tracheostomy tube and feeding-tube removal, and a minor hospitalization in patients who received grafts transfer compared to those who underwent microsurgical mandibular reconstruction. After a 36-month period of follow-up, osteochondral grafts showed a pattern of growth similar to the mandibular epiphysis (condilylion-gonion linear and vertical ratio ranging to 0.96-1.03 and 1-1.02 at orthopantomogram, respectively). No bone consolidation delays and functional impairment were recorded. CONCLUSIONS Free flaps mandibular reconstruction in children needs to be better assessed and proximal fibular epiphyseal free flap indication might deserve further studies. Osteochondral grafts find indication for lateral defects, 50-55 mm in maximum length and located in the mandibular ramus, without massive teeth or soft tissue defect. Condyle involvement does not represent an absolute contraindication to rib graft use.
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Affiliation(s)
- Lara V Comini
- Department of Experimental and Clinical Medicine, University of Florence, AOU-Careggi, Florence, Italy
| | - Giuditta Mannelli
- Department of Experimental and Clinical Medicine, Head and Neck Oncology and Robotic Surgery, University of Florence, Florence, Italy
| | - Angela Tamburini
- Meyer Children's University Hospital, Hematology-Oncology Service, Florence, Italy
| | - Marco Innocenti
- Reconstructive Microsurgery Unit, AOU-Careggi, Florence, Italy
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21
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Porzio G, Verna L, Ravoni G, Parisi A, Spinelli G, Cortellini A. Into the storms: Organising oncological home care services during natural disasters and global pandemics. Eur J Cancer Care (Engl) 2021; 30:e13433. [PMID: 33751720 DOI: 10.1111/ecc.13433] [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: 11/10/2020] [Revised: 01/09/2021] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Giampiero Porzio
- Medical Oncology Unit, San Salvatore Hospital, L'Aquila, Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lucilla Verna
- Medical Oncology Unit, San Salvatore Hospital, L'Aquila, Italy
| | - Giulio Ravoni
- Tuscany Tumors Association, Home Care Service, Florence, Italy
| | - Alessandro Parisi
- Medical Oncology Unit, San Salvatore Hospital, L'Aquila, Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Alessio Cortellini
- Medical Oncology Unit, San Salvatore Hospital, L'Aquila, Italy.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Cupertino F, Spataro S, Spinelli G, Schirinzi A, Bianchi FP, Stefanizzi P, Di Serio F, Tafuri S. The university as a safe environment during the SARS-COV-2 pandemic: the experience of Bari Politecnico. Ann Ig 2021; 33:201-202. [PMID: 33570091 DOI: 10.7416/ai.2021.2425] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
the SARS-CoV-2 pandemic started in December 2019 and still remains a major global health issue. Every country in the world has adopted drastic measures to contain the virus, although their stringency varies among countries, ranging from increased surveillance and focused interventions to strict lockdown (1). Italy was the second country where the disease had a major impact early in the pandemic, such that a strict nationwide lockdown was declared from March 9 to May 3, 2020. Nonetheless, between January and May 2020, there were 210,000 COVID-19 cases in Italy and 29,000 deaths were recorded (2). Due to the lockdown, universities (and in general all educational services) shifted to online classes, with students attending lessons and taking their exams from home. On-site activities were reduced to those considered indispensable. Research activities also had to be modified, such as by the adoption of a smart-working model (3). Between May and August 2020, the number of SARS-CoV-2 infections in Italy decreased. In response, the lockdown was loosened and some activities were restarted, albeit with specific safety protocols (social distancing, use of masks, temperature checks at the workplace entry, environmental disinfection, mixed models of smart and in-office work). These actions were accompanied by periodic serological and PCR screening tests (4).
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Affiliation(s)
| | | | | | - A Schirinzi
- Diagnostic Department, Bari Policlinico General Hospital, Bari, Italy
| | - F P Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - P Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - F Di Serio
- Diagnostic Department, Bari Policlinico General Hospital, Bari, Italy
| | - S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Bianchi FP, Stefanizzi P, Spinelli G, Mascipinto S, Tafuri S. Immunization coverage among asplenic patients and strategies to increase vaccination compliance: a systematic review and meta-analysis. Expert Rev Vaccines 2021; 20:297-308. [PMID: 33538617 DOI: 10.1080/14760584.2021.1886085] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asplenic or splenectomized patients have a higher risk (ranging from 10 to 50-fold) than the general population of developing an overwhelming post-splenectomy infection (OPSI). Thus, they should receive specific vaccinations to prevent bacterial infections and influenza. The aim of this meta-analysis was to estimate vaccination coverage (VC) with the recommended vaccines among splenectomized patients; strategies recommended in those studies to improve VC worldwide are considered as well. RESEARCH DESIGN AND METHODS Scopus, MEDLINE/PubMed, Google Scholar and ISI Web of Knowledge databases were searched. Research papers, short reports, reviews, and meta-analyses published between January 1, 2010 and July 18, 2020 were included; no geographic restrictions were included. Twenty-four studies were included in the meta-analysis. RESULTS For anti-pneumococcal vaccination, coverage was 55.1% (95%CI = 41.0-69.2%), for anti-Hib 48.3% (95%CI = 34.3-52.3%), for anti-meningococcal C/ACYW135 33.7% (95%CI = 23.6-43.9%), for anti-meningococcal B 13.3% (95%CI = 7.0-19.5%) and for anti-influenza 53.2% (95%CI = 22.0-84.4%). Most studies determined a lack of adherence to international guidelines by healthcare workers and suggested the need to better educate health professionals in the management of post-splenectomy patients. CONCLUSIONS The meta-analysis showed the suboptimal immunization coverage for the vaccines recommended for asplenic patients. Greater efforts must be made by public health professionals to increase VC in this group of patients at risk. Introducing specific prophylaxis protocols in the clinical routine seems to guarantee better immunization compliance in those patients.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Simona Mascipinto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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Devoto F, Zapparoli L, Spinelli G, Scotti G, Paulesu E. How the harm of drugs and their availability affect brain reactions to drug cues: a meta-analysis of 64 neuroimaging activation studies. Transl Psychiatry 2020; 10:429. [PMID: 33318467 PMCID: PMC7736294 DOI: 10.1038/s41398-020-01115-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 01/02/2023] Open
Abstract
Visual drug cues are powerful triggers of craving in drug abusers contributing to enduring addiction. According to previous qualitative reviews, the response of the orbitofrontal cortex to such cues is sensitive to whether subjects are seeking treatment. Here we re-evaluate this proposal and assessed whether the nature of the drug matters. To this end, we performed a quantitative meta-analysis of 64 neuroimaging studies on drug-cue reactivity across legal (nicotine, alcohol) or illegal substances (cocaine, heroin). We used the ALE algorithm and a hierarchical clustering analysis followed by a cluster composition statistical analysis to assess the association of brain clusters with the nature of the substance, treatment status, and their interaction. Visual drug cues activate the mesocorticolimbic system and more so in abusers of illegal substances, suggesting that the illegal substances considered induce a deeper sensitization of the reward circuitry. Treatment status had a different modulatory role for legal and illegal substance abusers in anterior cingulate and orbitofrontal areas involved in inter-temporal decision making. The class of the substance and the treatment status are crucial and interacting factors that modulate the neural reactivity to drug cues. The orbitofrontal cortex is not sensitive to the treatment status per se, rather to the interaction of these factors. We discuss that these varying effects might be mediated by internal predispositions such as the intention to quit from drugs and external contingencies such as the daily life environmental availability of the drugs, the ease of getting them and the time frame of potential reward through drug consumption.
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Affiliation(s)
- F. Devoto
- grid.7563.70000 0001 2174 1754Department of Psychology and PhD Program in Neuroscience of the School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - L. Zapparoli
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - G. Spinelli
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - G. Scotti
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - E. Paulesu
- grid.7563.70000 0001 2174 1754Department of Psychology, University of Milano-Bicocca, Milan, Italy ,fMRI Unit, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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Noce G, Babiloni C, Lopez S, Percio CD, Pascarelli MT, Lizio R, Teipel SJ, González‐Escamilla G, Bakardjian H, George N, Cavedo E, Lista S, Chiesa PA, Vergallo A, Lemercier P, Spinelli G, Grothe M, Potier M, Stocchi F, Ferri R, Habert M, Fraga FJ, Dubois B, Hampel H. Sensitivity and specificity of EEG biomarkers of AD at the preclinical stage. Alzheimers Dement 2020. [DOI: 10.1002/alz.045832] [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: 11/06/2022]
Affiliation(s)
| | - Claudio Babiloni
- Department of Physiology and Pharmacology Sapienza University of Rome Rome Italy
| | - Susanna Lopez
- Department of Emergency and Organ Transplantation Aldo Moro University of Bari Bari Italy
| | - Claudio Del Percio
- Department of Physiology and Pharmacology Sapienza University of Rome Rome Italy
| | | | - Roberta Lizio
- Blood Biomarker‐based Diagnostic Tools for Early Stage Alzheimer’s Disease (BBDiag) project HORIZON 2020 Marie Skłodowska‐Curie MSCA‐ITN‐ETN; 721281; 2017‐2020 Rome Italy
| | - Stefan J. Teipel
- German Center for Neurodegenerative Diseases (DZNE) ‐ Rostock/Greifswald Rostock Germany
| | | | - Hovagim Bakardjian
- Institut du Cerveau et de la Moelle Épinière ICM, INSERM U1127, CNRS UMR 7225 Paris France
| | - Nathalie George
- IHU‐A‐ICM, Paris Institute of Translational Neurosciences Hôpital de la Pitié‐Salpêtrière Paris France
| | - Enrica Cavedo
- Institute of Memory and Alzheimer's Disease (IM2A) Department of Neurology Pitié‐Salpêtrière Hospital, AP‐HP Boulevard de l’Hôpital F‐75013 Paris France
| | - Simone Lista
- Institute of Memory and Alzheimer's Disease (IM2A) Department of Neurology Pitié‐Salpêtrière Hospital, AP‐HP Boulevard de l’Hôpital F‐75013 Paris France
| | - Patrizia Andrea Chiesa
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Boulevard de l’Hôpital F‐75013 Paris France
| | - Andrea Vergallo
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié‐Salpêtrière Hospital, AP‐HP Boulevard de l’Hôpital F‐75013 Paris France
| | - Pablo Lemercier
- Brain & Spine Institute (ICM) INSERM U 1127, CNRS UMR 7225 Boulevard de l’Hôpital F‐75013 Paris France
| | - Giuseppe Spinelli
- Brain & Spine Institute (ICM) INSERM U 1127, CNRS UMR 7225 Boulevard de l’Hôpital F‐75013 Paris France
| | - Michel Grothe
- German Center for Neurodegenerative Diseases (DZNE) Rostock Germany
| | - Marie‐Claude Potier
- Sorbonne Universités, UPMC University Paris 06, CNRS, INSERM, Laboratoire d’Imagerie Biomédicale F‐75013 Paris France
| | | | | | - Marie‐Odile Habert
- Nuclear Medicine Department Pitié‐Salpêtrière Hospital, APHP Sorbonne‐Université, UPMC Paris 06, CNRS UMR 7371, INSERM U1146 Paris France
| | - Francisco J. Fraga
- CECS – Engineering, Modelling and Applied Social Sciences Center Federal University of ABC (UFABC) Santo Andre Brazil
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle (ICM) Paris France
| | - Harald Hampel
- Institut du Cerveau et de la Moelle Épinière (ICM) INSERM U 1127, CNRS UMR 7225 Boulevard de l’Hôpital Paris France
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Mannelli G, Santoro R, Bonomo P, Desideri I, Spinelli G. Will a tumor pandemic come after the COVID-19 pandemic? Head and Neck cancer perspective. Eur Rev Med Pharmacol Sci 2020; 24:8573-8575. [PMID: 32894562 DOI: 10.26355/eurrev_202008_22653] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The COVID-19 pandemic demands a reassessment of head and neck oncology treatment paradigms by posing several challenges for oncology services, with unprecedented pressure on the regional health care system. Since February 2020 this has severely disrupted health-care services, leading to accumulating clinic caseload and substantial delays for operations. The head and neck cancer services have been faced with the difficult task of managing the balance between infection risk to health-care providers and the risk of disease progression from prolonged waiting times. Herein, we share our experience in Firenze (Italy) and propose our action plan on the management of head and neck cancer services via multi-institution collaboration.
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Affiliation(s)
- G Mannelli
- Department of Experimental and Clinical Medicine, Head and Neck Oncology and Robotic Surgery, University of Florence, Florence, Italy.
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Stefanizzi P, Bavaro V, Spinelli G, Anona D, Stella P, Tafuri S. AEFIs active surveillance projects as vaccinovigilance traineeship: Puglia (Italy) experience. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1415] [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
Surveillance of Adverse Events Following Immunization (AEFIs) is a crucial part of vaccination strategies because the most important concern of “No-vax group” is the safety of vaccination. According to UE laws, in Italy a passive surveillance system of AEFIs is established by law and managed by National Drug Authority (AIFA) and Regional Health Governments. The performance of surveillance system is different in the 21 Italian Regions and in some Region, such as Puglia, the AEFIs reporting rate has been, for several years, lower than National figure. The implementation of AEFIs active surveillance projects could increase the performance of AEFIs surveillance system, also after the end of the project.
In Puglia, since 2017, May to 2018, November, an active surveillance of AEFIs has been established, focused on MMRV vaccine. In this study, we analysed the AEFIs general picture in Puglia in 2016 and 2019, before and after active surveillance project. The source of data is the AIFA database; data were reported as number of AEFI and rate for Puglia population (reporting rate RR). The AEFIs were classified as serious, not serious and unclassifiable and causality assessment was performed according to WHO recommendations.
The number of AEFIs detected by the passive surveillance system is 91 for 2016 (RR 2,2 per 100.000 people), and 168 for 2019 (RR 4,2 per 100.000 people). The percentage of serious AEFIs was 23.1% (21/91) in 2016 and 31% (52/168) in 2019 and unclassifiable AEFIs were 22% (20/91) in 2016 and 0 in 2019. The percentage of serious AEFIs for which the result of causality assessment was “consistent” is 23,8% (5/21) in 2016 and 55,8% (29/52) in 2019.
The experience of AEFIs active surveillance project increase the performance of AEFIs surveillance system. From 2016 (pre-project time) to 2019 (post-project time) the number of AEFIs detected was doubled, the number of unclassifiable AEFIs (proxy of poor reliability of the system) was reduced to zero.
Key messages
AEFIs passive surveillance system could be affected by underreporting and lack of quality. The AEFIs active surveillance project are an important occasion of traineeship for vaccinovigilance system, that could increase the sensibility and the reliability.
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Affiliation(s)
- P Stefanizzi
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - V Bavaro
- Dipartimento Promozione della Salute, Regione Puglia, Bari, Italy
| | - G Spinelli
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - D Anona
- Centro Regionale di Farmacovigilanza, Regione Puglia, Bari, Italy
| | - P Stella
- Centro Regionale di Farmacovigilanza, Regione Puglia, Bari, Italy
| | - S Tafuri
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy
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Bonomo P, Desideri I, Mangoni M, Loi M, Saieva C, Marrazzo L, Talamonti C, Salvatore G, Sottili M, Teriaca M, Stocchi G, Cerbai C, Salvestrini V, Ganovelli M, Massi D, Gallo O, Santoro R, Spinelli G, Pallotta S, Livi L. 978TiP Durvalumab with cetuximab and radiotherapy for locally advanced squamous cell carcinoma of the head and neck: A phase I/II trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Porzio G, Cortellini A, Bruera E, Verna L, Ravoni G, Peris F, Spinelli G. Home Care for Cancer Patients During COVID-19 Pandemic: The Double Triage Protocol. J Pain Symptom Manage 2020; 60:e5-e7. [PMID: 32240755 PMCID: PMC7165240 DOI: 10.1016/j.jpainsymman.2020.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/15/2022]
Abstract
Patients with cancer have an increased risk of developing severe forms of coronavirus disease 2019, and patients with advanced cancer who are followed at home represent a particularly frail population. Although with substantial differences, the challenges that cancer care professionals have to face during a pandemic are quite similar to those posed by natural disasters. We have already managed the oncological home care service in L'Aquila (middle Italy) after the 2009 earthquake. With this letter, we want to share the procedures and tools that we have started using at the home care service of the Tuscany Tumor Association during the coronavirus disease 2019 pandemic.
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Affiliation(s)
- Giampiero Porzio
- Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessio Cortellini
- Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lucilla Verna
- Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Giulio Ravoni
- Tuscany Tumors Association, Home Care Service, Florence, Italy
| | - Flaminia Peris
- Tuscany Tumors Association, Home Care Service, Florence, Italy
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30
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Locatello LG, Comini LV, Bettiol A, Vannacci A, Spinelli G, Mannelli G. A model to predict postoperative complications for otorhinolaryngology and maxillofacial surgery procedures in elderly patients. Eur Arch Otorhinolaryngol 2020; 277:3459-3467. [PMID: 32494949 DOI: 10.1007/s00405-020-06084-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/22/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE All kinds of ear, nose, and throat and maxillofacial surgery (ENT/MFS) procedures are being increasingly performed in the elderly although old age is a major risk factor for increased postoperative complications. With only scarce evidence on the topic, surgeons are asked to critically evaluate their procedures' indications and outcomes to balance the treatment risks and benefits. Our primary aim was to identify predictive factors for surgical outcomes in this setting and to create a predictive model for a tailored risk assessment. METHODS We analyzed a case series of 435 patients from an institutional clinical database at our academic tertiary care center. Multivariate logistic regression was used to identify all possible covariates and nomograms using stepwise backward method were generated. The performance was assessed by calibration curves and c-index. RESULTS Overall complication rate was 18.3% within the first 30 days and the need for re-intervention was 5.9%. For those under general anesthesia, we identified specific risk factors and developed three risk-predicting models of overall, early, and late complications. All of the nomograms showed satisfactory accuracy with a c-index of 0.83, 0.75, 0.86, and 0.82, respectively. CONCLUSION Using clinical preoperative variables, we constructed a model for predicting major adverse events in ENT/MFS patients. In our experience, patients over 65 showed a non-negligible risk for postoperative complications depending on several factors. Such tools might help in decision-making, by increasing the risk-awareness of clinicians, to better address peri-operative and post-operative care of these patients.
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Affiliation(s)
- Luca Giovanni Locatello
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
| | - Lara Valentina Comini
- Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy
| | - Alessandra Bettiol
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Giuseppe Spinelli
- Department of Maxillofacial Surgery, Careggi University Hospital, Largo Brambilla, 3, Florence, 50134, Italy
| | - Giuditta Mannelli
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Babiloni C, Lopez S, Del Percio C, Noce G, Pascarelli MT, Lizio R, Teipel SJ, González-Escamilla G, Bakardjian H, George N, Cavedo E, Lista S, Chiesa PA, Vergallo A, Lemercier P, Spinelli G, Grothe MJ, Potier MC, Stocchi F, Ferri R, Habert MO, Fraga FJ, Dubois B, Hampel H. Resting-state posterior alpha rhythms are abnormal in subjective memory complaint seniors with preclinical Alzheimer's neuropathology and high education level: the INSIGHT-preAD study. Neurobiol Aging 2020; 90:43-59. [DOI: 10.1016/j.neurobiolaging.2020.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 01/05/2023]
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Allevi F, Dionisio A, Baciliero U, Balercia P, Beltramini GA, Bertossi D, Bozzetti A, Califano L, Cascone P, Colombo L, Copelli C, De Ponte FS, De Riu G, Della Monaca M, Fusetti S, Galié M, Giannì AB, Longo F, Mannucci N, Nocini PF, Pelo S, Ramieri G, Sesenna E, Solazzo L, Spinelli G, Tarsitano A, Tartaro G, Valentini V, Verrina G, Biglioli F. Impact of COVID-19 epidemic on maxillofacial surgery in Italy. Br J Oral Maxillofac Surg 2020; 58:692-697. [PMID: 32414539 PMCID: PMC7196423 DOI: 10.1016/j.bjoms.2020.04.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/17/2022]
Abstract
Maxillofacial departments in 23 surgical units in Italy have been increasingly involved in facing the COVID-19 emergency. Elective surgeries have been progressively postponed to free up beds and offer human and material resources to those infected. We compiled an inventory of 32 questions to evaluate the impact of the SARS-COV2 epidemic on maxillofacial surgery in 23 selected Italian maxillofacial departments. The questionnaire focused on three different aspects: the variation of the workload, showing both a reduction of the number of team members (-16% among specialists, -11% among residents) due to reallocation or contamination and a consistent reduction of elective activities (the number of outpatient visits cancelled during the first month of the COVID-19 epidemic was about 10 000 all over Italy), while only tumour surgery and trauma surgery has been widely guaranteed; the screening procedures on patients and physicians (22% of maxillofacial units found infected surgeons, which is 4% of all maxillofacial surgeons); and the availability of Personal Protective Equipment, is only considered to be partial in 48% of Maxillofacial departments. This emergency has forced those of us in the Italian health system to change the way we work, but only time will prove if these changes have been effective.
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Affiliation(s)
- F Allevi
- Maxillofacial Surgery Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - A Dionisio
- Maxillofacial Surgery Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - U Baciliero
- Maxillofacial Surgery Department, Azienda ULSS 8 Berica, Vicenza, Italy
| | - P Balercia
- Maxillofacial Surgery Department, Ospedali Riuniti di Ancona, Ancona, Italy
| | - G A Beltramini
- Maxillofacial Surgery Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - D Bertossi
- Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - A Bozzetti
- Maxillofacial Surgery Department, Ospedale San Gerardo di Monza, University of Milan Bicocca, Milan, Italy
| | - L Califano
- Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria, University of Naples "Federico II", Naples, Italy
| | - P Cascone
- Maxillofacial Surgery Department, Policlinico Umberto I, University of Rome Sapienza, Rome, Italy
| | - L Colombo
- Maxillofacial Surgery Department, ASST Lariana, Sant'Anna Hospital, Como, Italy
| | - C Copelli
- Maxillofacial Surgery and Otolaryngology Department, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy
| | - F S De Ponte
- Maxillofacial Surgery Department, Policlinico Gaetano Martino, University of Messina, Messina, Italy
| | - G De Riu
- Maxillofacial Surgery Department, Policlinico di Sassari, University of Sassari, Sassari, Italy
| | - M Della Monaca
- Maxillofacial Surgery Department, Policlinico Umberto I, University of Rome Sapienza, Rome, Italy
| | - S Fusetti
- Maxillofacial Surgery Department, Padua Hospital, University of Padua, Padua, Italy
| | - M Galié
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy
| | - A B Giannì
- Maxillofacial Surgery Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - F Longo
- Maxillofacial Surgery and Otolaryngology Department, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy
| | - N Mannucci
- Maxillofacial Surgery Department, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - P F Nocini
- Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - S Pelo
- Maxillofacial Surgery Department, Policlinico Universitario Agostino Gemelli, Università del Sacro Cuore, Rome, Italy
| | - G Ramieri
- Maxillofacial Surgery Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
| | - E Sesenna
- Maxillofacial Surgery Department, Azienda Ospedaliera Universitaria di Parma, University of Parma, Parma, Italy
| | - L Solazzo
- Maxillofacial Surgery Department, Ospedale Civico di Palermo, Palermo, Italy
| | - G Spinelli
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - A Tarsitano
- Maxillofacial Surgery Department, Azienda Universitaria Ospedaliera Sant'Orsola, Università Alma Mater Studiorum, Bologna, Italy
| | - G Tartaro
- Maxillofacial Surgery Department, Università degli studi della Campania Luigi Vanvitelli, Naples, Italy
| | - V Valentini
- Maxillofacial Surgery Department, Policlinico Umberto I, University of Rome Sapienza, Rome, Italy
| | - G Verrina
- Maxillofacial Surgery Department, E.O. Ospedali Galliera, Genoa, Italy
| | - F Biglioli
- Maxillofacial Surgery Department, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.
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Mannelli G, Agostini T, Arcuri F, Comini LV, Spinelli G. Subclavicular flap: A valid reconstructive option among anterior chest flaps in oral cancer patients. J Surg Oncol 2019; 120:707-714. [PMID: 31364178 DOI: 10.1002/jso.25655] [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: 02/18/2019] [Accepted: 07/23/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND The subclavicular pedicled flap is based on the thoracic branch of the supraclavicular artery, and it represents a versatile reconstructive option for low-middle third face defects. Since its use in head and neck surgical oncology has not been popularized yet, we propose its application for oral cavity reconstruction after cancer resection by showing favorable results. METHODS Eighteen subclavicular pedicled flaps were used to treat intraoral defects after oral squamous-cell cancer resection between June 2015 and December 2018. Tumor dissection type, complications, donor and reconstructed area results, and functional and aesthetic outcomes were assessed. RESULTS No major complications were observed and all of the flaps survived. Adjuvant therapy was administered without delay when needed, and all of the patients had normal functional outcomes and good aesthetic results. CONCLUSIONS The subclavicular flap is an excellent choice for the reconstruction of oral cavity defects. Selection of patients should exclude positive lower-third neck node and include appropriate informed consent for women due to the possibility of deformity of the breast. In our opinion, this flap has the potential for common application given its consistent anatomy and donor site advantages, including long pedicle, high pivot point, and relatively unlimited flap width.
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Affiliation(s)
- Giuditta Mannelli
- Head and Neck Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Agostini
- Department of Plastic and Reconstructive Surgery, Casa di Cura San Paolo, Pistoia, Italy
| | - Francesco Arcuri
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Lara Valentina Comini
- Head and Neck Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuseppe Spinelli
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Babiloni C, Lopez S, Del Percio C, Noce G, Pascarelli MT, Lizio R, Teipel SJ, Bakardjian H, George N, González-Escamilla G, Cavedo E, Chiesa PA, Spinelli G, Weschke S, Grothe MJ, Potier MC, Habert MO, Dubois B, Hampel H. P3-110: PRECLINICAL ALZHEIMER'S DISEASE: WHICH EEG BIOMARKERS FOR PRECISION MEDICINE? Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3138] [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: 11/27/2022]
Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology; Sapienza University of Rome; Rome Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology; Sapienza University of Rome; Rome Italy
| | - Claudio Del Percio
- Department of Physiology and Pharmacology; Sapienza University of Rome; Rome Italy
| | | | | | | | - Stefan J. Teipel
- Department of Psychosomatic Medicine; University of Rostock; Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald; Rostock Germany
| | - Hovagim Bakardjian
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Neurologie; Institut de la Mémoire et de la Maladie d'Alzheimer, Groupe Hospitalier Pitié-Salpêtrière; Paris France
- IHU-A-ICM, Paris Institute of Translational Neurosciences; Hôpital de la Pitié-Salpêtrière; Paris France
| | - Nathalie George
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Neurologie; Institut de la Mémoire et de la Maladie d'Alzheimer, Groupe Hospitalier Pitié-Salpêtrière; Paris France
- IHU-A-ICM, Paris Institute of Translational Neurosciences; Hôpital de la Pitié-Salpêtrière; Paris France
| | - Gabriel González-Escamilla
- Department of Psychosomatic Medicine; University of Rostock; Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald; Rostock Germany
| | - Enrica Cavedo
- AXA Research Fund and Sorbonne University Chair; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- Institute of Memory and Alzheimer's Disease (IM2A); Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain & Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Patrizia Andrea Chiesa
- AXA Research Fund and Sorbonne University Chair; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- Institute of Memory and Alzheimer's Disease (IM2A); Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain & Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Giuseppe Spinelli
- Institute of Memory and Alzheimer's Disease (IM2A); Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain & Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Sarah Weschke
- Department Aging of the Individual and the Society, AGIS; University of Rostock; Rostock Germany
| | - Michel J. Grothe
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald; Rostock Germany
| | - Marie-Claude Potier
- ICM Institut du Cerveau et de la Moelle Épinière; CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière; Paris France
| | - Marie-Odile Habert
- Centre pour l'Acquisition et le Traitement des Images; Paris France
- AP-HP, Hôpital Pitié-Salpêtrière; Département de Médecine Nucléaire; Paris France
- Sorbonne Universites, UPMC Univ Paris 06; INSERM U 1146, CNRS UMR 7371, Laboratoire d'Imagerie Biomédicale; Paris France
| | - Bruno Dubois
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- Institute of Memory and Alzheimer's Disease (IM2A); Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain & Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Harald Hampel
- AXA Research Fund and Sorbonne University Chair; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- Institute of Memory and Alzheimer's Disease (IM2A); Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain & Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
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Chiesa PA, Spinelli G, Schwartz D, Lista S, Potier MC, Bakardjian H, Dubois B, George N, Hampel H. P3-324: CONCURRENT EEG/FMRI NETWORK DYNAMICS ALTERATIONS IN COGNITIVELY INTACT INDIVIDUALS AT RISK FOR ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3356] [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: 11/16/2022]
Affiliation(s)
- Patrizia Andrea Chiesa
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology; Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- AXA Research Fund and Sorbonne University; Paris France
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Giuseppe Spinelli
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Denis Schwartz
- Institut du Cerveau et de la Moelle Epiniere, ICM INSERM U 1127, CNRS UMR 7225; Sorbonne Universite, Centre MEG-EEG; Paris France
| | - Simone Lista
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology; Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- AXA Research Fund and Sorbonne University; Paris France
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Marie-Claude Potier
- Sorbonne Universités, UPMC Universite Paris 06, CNRS, INSERM; Laboratoire d'Imagerie Biomédicale; F-75013 Paris France
| | - Hovagim Bakardjian
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology; Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Neurologie; Institut de la Mémoire et de la Maladie d'Alzheimer, Groupe Hospitalier Pitié-Salpêtrière; Paris France
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology; Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
| | - Nathalie George
- Institut du Cerveau et de la Moelle Epiniere, ICM INSERM U 1127, CNRS UMR 7225; Sorbonne Universite, Centre MEG-EEG; Paris France
| | - Harald Hampel
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology; Pitié-Salpêtrière Hospital, AP-HP; Paris France
- Sorbonne University; Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital; Paris France
- AXA Research Fund and Sorbonne University; Paris France
- Brain and Spine Institute (ICM); INSERM U 1127, CNRS UMR 7225; Paris France
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Cortellini A, Porzio G, Cofini V, Necozione S, Giusti R, Marchetti P, Aloe Spiriti MA, Costanzi A, Peris F, Ravoni G, Spinelli G, Ficorella C, Verna L. What cancer patients actually know regarding medical cannabis? A cross-sectional survey with a critical analysis of the current attitudes. J Oncol Pharm Pract 2019; 25:1439-1444. [PMID: 31042135 DOI: 10.1177/1078155219843161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND In Italy medical cannabis is a prescription drug since 1998. Even though it could not be considered a therapy as such, it is indicated as a symptomatic treatment also in cancer patients, to cure iatrogenic nausea/vomiting and chronic pain. PATIENTS AND METHODS We conducted a knowledge survey about medical cannabis among cancer patients referred to two outpatient cancer care centers and a home care service. RESULTS From February to April 2018, 232 patient were enrolled; 210 patients were on active disease-oriented treatment (90.5%), while 22 (9.5%) not. Eighty-one percent of the patients have heard about medical cannabis, but only 2% from healthcare professionals. Thirty-four percent of responders thought about using cannabis to treat one or more of their own health problems, especially pain (55%). Despite that, 18% of the participants believe that medical cannabis could have negative effects on their own symptoms. Patients with high educational level better knew cannabis (odds ratio = 3.52; 95% confidence interval: 1.07-11.53), and medical cannabis (odds ratio = 3.21; 95% confidence interval: 1.48-6.98), when compared to patient with low educational level. Patients who were on active disease-oriented treatment better knew medical cannabis (odds ratio = 3.91; 95% confidence interval: 1.26-12.11) compared to "out of treatment" patients. Metastatic patients were less informed about medical cannabis compared to patients on adjuvant treatment. CONCLUSIONS Our survey shows that most of Italian cancer patients know medical cannabis and a third of them have considered using cannabis to treat one (or more) of their own health problems. In the same time, they are poorly informed and do not tend to ask for information about medical cannabis to healthcare professionals.
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Affiliation(s)
- Alessio Cortellini
- 1 Medical Oncology, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,2 Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giampiero Porzio
- 1 Medical Oncology, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,2 Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Vincenza Cofini
- 3 Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefano Necozione
- 3 Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Giusti
- 4 Medical Oncology, St Andrea University Hospital, Rome, Italy
| | - Paolo Marchetti
- 4 Medical Oncology, St Andrea University Hospital, Rome, Italy.,5 Medical Oncology (B), Umberto I University Hospital, Rome, Italy
| | | | - Andrea Costanzi
- 6 Simultaneous Care Unit, St Andrea University Hospital, Rome, Italy
| | - Flaminia Peris
- 7 Tuscany Tumors Association, Home Care Service, Florence, Italy
| | - Giulio Ravoni
- 7 Tuscany Tumors Association, Home Care Service, Florence, Italy
| | | | - Corrado Ficorella
- 1 Medical Oncology, St Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.,2 Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Lucilla Verna
- 2 Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Mannelli G, Arcuri F, Comini L, Valente D, Spinelli G. Buccal Fat Pad: Report of 24 Cases and Literature Review of 1,635 Cases of Oral Defect Reconstruction. ORL J Otorhinolaryngol Relat Spec 2018; 81:24-35. [DOI: 10.1159/000494027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
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Comini LV, Spinelli G, Mannelli G. Algorithm for the treatment of oral and peri-oral defects through local flaps. J Craniomaxillofac Surg 2018; 46:2127-2137. [DOI: 10.1016/j.jcms.2018.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/23/2018] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
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Raffaini M, Cocconi R, Spinelli G, Agostini T. Simultaneous Rhinoseptoplasty and Orthognathic Surgery: Outcome Analysis of 250 Consecutive Patients Using a Modified Le Fort I Osteotomy. Aesthetic Plast Surg 2018; 42:1090-1100. [PMID: 29560545 DOI: 10.1007/s00266-018-1121-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/09/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of the present study was to assess the safety and efficacy of both functional intranasal procedures and cosmetic rhinoplasty combined with bimaxillary surgery. METHODS The author executed a retrospective cohort study derived from patients who underwent combined rhinoseptoplasty and bimaxillary surgery at a private practice setting (Face Surgery Center, Parma, Italy) between April 2006 and 2015 by a single surgeon. The minimum follow-up was 12 months. Patients underwent bimaxillary orthognathic surgery, functional nasal surgery and cosmetic rhinoplasty. RESULTS Two-hundred and fifty (250) consecutive, non-randomized patients met the inclusion criteria to enter the study. The overall complication rate was 5%, whereas the revision rate was 9%, showing an overall low rate, comparable to that of primary rhinoplasty (control group). About 94% of the patients polled after this procedure asserted they definitely accepted to have rhinoplasty only because it was included in one single surgical act together with orthognathic surgery. CONCLUSION Cosmetic rhinoplasty shows great potentials to change our patients' appearance, whereas orthognathic surgery corrects jaw skeletal deformities and builds the right foundation for facial harmony. The combination of both procedures magnifies the single results reciprocally and significantly enhances the final outcomes. The quality of the overall aesthetic results, the scarcity of complications and the low percentage of defects that require revisions lead to the conclusion that when alterations to both the jaws and the nose are detected, a single intervention can grant great benefit to the patients in terms of morbidity and costs. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- M Raffaini
- Face Surgery Center, Via R. Bormioli 5/A, 43122, Parma, Italy
| | - R Cocconi
- Face Surgery Center, Via R. Bormioli 5/A, 43122, Parma, Italy
| | - G Spinelli
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Largo Palagi 1, 50134, Florence, Italy
| | - T Agostini
- Department of Maxillo Facial Surgery, Azienda Ospedaliero-Universitaria Careggi, Largo Palagi 1, 50134, Florence, Italy.
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Bakardjian H, Spinelli G, George N, Schwartz D, Hampel H, Dubois B. P4‐027: EVIDENCE FOR COGNITIVE COMPENSATION IN EARLY AMYLOIDOSIS IN HIGH‐PERFORMING HEALTHY ELDERLY AT RISK FOR ALZHEIMER'S DISEASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2429] [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: 11/30/2022]
Affiliation(s)
- Hovagim Bakardjian
- Institute of Memory and Alzheimer's DiseaseInstitut de Neurosciences Translationnelles de ParisParisFrance
- Institut du Cerveau et de la Moelle ÉpinièreParisFrance
| | - Giuseppe Spinelli
- Sorbonne Université, University Pierre and Marie Curie, INSERMCentre National de la Recherche Scientifique, Institut du Cerveau et de la Moelle épinière, Ecole Normale Supérieure, Centre MEG‐EEGParisFrance
| | - Nathalie George
- Sorbonne Universités, University Pierre and Marie Curie, University Paris, INSERMCentre National de la Recherche Scientifiqu, Institut du Cerveau et de la Moelle Épinière, Ecole Normale Supérieure, Centre MEG‐EEGParisFrance
| | - Denis Schwartz
- Sorbonne Universités, University Pierre and Marie Curie, University Paris, INSERMCentre National de la Recherche Scientifiqu, Institut du Cerveau et de la Moelle Épinière, Ecole Normale Supérieure, Centre MEG‐EEGParisFrance
| | - Harald Hampel
- Sorbonne UniversitéAssistance Publique – Hôpitaux de Paris, Alzheimer Precision Medicine, Hôpital de la Pitié-SalpêtrièreParisFrance
| | - Bruno Dubois
- Sorbonne Universities, Pierre et Marie Curie UniversityInstitute of Memory and Alzheimer's Disease, Brain and Spine Institute, Hopital Pitié‐SalpêtrièreParisFrance
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Spinelli G, Mannelli G, Arcuri F, Venturini E, Chiappini E, Galli L. Surgical treatment for chronic cervical lymphadenitis in children. Experience from a tertiary care paediatric centre on non-tuberculous mycobacterial infections. Int J Pediatr Otorhinolaryngol 2018; 108:137-142. [PMID: 29605343 DOI: 10.1016/j.ijporl.2018.02.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/08/2018] [Accepted: 02/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Non-tuberculous mycobacteria are the most frequent cause of chronic lymphadenitis in children. We reviewed treatment and outcomes of paediatric patients with chronic cervical lymphadenitis, to better understand their differential diagnosis, surgical indication, complication and recover. METHODS A retrospective study was carried out on children who underwent surgery from 2013 to 2016 at Meyer Children's University Hospital, Florence, Italy. Time to cure, type of surgery, and complications rate were determined and etiologic agents were identified and correlated to their clinical presentation. RESULTS 275 children were evaluated. Nearly 98% of the patients were cured regardless of which therapeutic option was used and surgery was necessary in 38.2% of children. Complete excisional biopsy ensured recover in 97.7% of patients compared with the non-excisional surgical group 88.2% (p = 0.06). Re-interventions were needed in the 2.3% of complete excision group and in two cases of the incision and drainage group; all of them developed fistula and were caused by Mycobacterium avium complex. Excision followed by adjunctive antibiotic therapy was favoured in the majority of the patients (80.1%, n = 71). CONCLUSION In cases of non-tuberculous mycobacteria lymphadenitis, surgery is the treatment of choice and it is closely related to a favourable prognosis.
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Affiliation(s)
| | - Giuditta Mannelli
- Clinic of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, AOU-Careggi, Via Largo Palagi 1, 50134, Florence, Italy.
| | | | - Elisabetta Venturini
- Pediatric Infectious Diseases Unit, Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | - Elena Chiappini
- Pediatric Infectious Diseases Unit, Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
| | - Luisa Galli
- Pediatric Infectious Diseases Unit, Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy
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Mannelli G, Arcuri F, Agostini T, Innocenti M, Raffaini M, Spinelli G. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol 2018; 117:1092-1099. [DOI: 10.1002/jso.24991] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Giuditta Mannelli
- Unit of Otorhinolaryngology−Head and Neck Surgery; Department of Surgery and Translational Medicine; University of Florence; AOU-Careggi; Florence Italy
| | | | | | - Marco Innocenti
- Department of Plastic and Reconstructive Microsurgery; Careggi University Hospital; Florence Italy
| | - Mirco Raffaini
- Maxillo-Facial Surgery Unit; AOU-Careggi; Florence Italy
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Spinelli G, Tieri G, Pavone EF, Aglioti SM. Wronger than wrong: Graded mapping of the errors of an avatar in the performance monitoring system of the onlooker. Neuroimage 2017; 167:1-10. [PMID: 29146376 DOI: 10.1016/j.neuroimage.2017.11.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 08/03/2017] [Revised: 11/08/2017] [Accepted: 11/10/2017] [Indexed: 11/24/2022] Open
Abstract
EEG studies show that observing errors in one's own or others' actions triggers specific electro-cortical signatures in the onlooker's brain, but whether the brain error-monitoring system operates according to graded or discrete rules is still largely unknown. To explore this issue, we combined immersive virtual reality with EEG recording in participants who observed an avatar reaching-to-grasp a glass from a first-person perspective. The avatar could perform correct or erroneous actions. Erroneous grasps were defined as small or large depending on the magnitude of the trajectory deviation from the to-be-grasped glass. Results show that electro-cortical indices of error detection (indexed by ERN and mid-frontal theta oscillations), but not those of error awareness (indexed by error-Positivity), were gradually modulated by the magnitude of the observed errors. Moreover, the phase connectivity analysis revealed that enhancement of mid-frontal theta phase synchronization paralleled the magnitude of the observed error. Thus, theta oscillations represent an electro-cortical index of the degree of control exerted by mid-frontal regions whose activation depends on how much an observed action outcome results maladaptive for the onlooker. Our study provides novel neurophysiological evidence that the error monitoring system maps observed errors of different magnitude according to fine-grain, graded rather than all-or-none rules.
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Affiliation(s)
- G Spinelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy; IRCCS Santa Lucia Foundation, Rome, Italy.
| | - G Tieri
- IRCCS Santa Lucia Foundation, Rome, Italy; University of Rome Unitelma Sapienza, Rome, Italy.
| | - E F Pavone
- IRCCS Santa Lucia Foundation, Rome, Italy; Braintrends Ltd. Applied Neuroscience, Rome, Italy.
| | - S M Aglioti
- Department of Psychology, Sapienza University of Rome, Rome, Italy; IRCCS Santa Lucia Foundation, Rome, Italy.
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Azzali A, Montagnani C, Simonetti MT, Spinelli G, de Martino M, Galli L. First case of Mycobacterium marseillense lymphadenitis in a child. Ital J Pediatr 2017; 43:92. [PMID: 29017528 PMCID: PMC5635610 DOI: 10.1186/s13052-017-0413-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/03/2017] [Indexed: 11/25/2022] Open
Abstract
Background Nontuberculous mycobacteria (NTM) are pathogens that commonly affect the paediatric population and its most frequent manifestation is a cervicofacial lymphadenopathy. With the improvement of technologies, new species have been recently identified. Case presentation We report the first case of NMT lymphadenitis in a child caused by Mycobacterium marseillense, a newly described species belonging to Mycobacterium avium complex. Conclusions Improving the identification of these newly discovered mycobacteria, further information will be available about their clinical involvement and their best treatment.
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Affiliation(s)
- A Azzali
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini, 24, I-50139, Florence, Italy
| | - C Montagnani
- Pediatric Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - M T Simonetti
- Tuscany Regional Reference Centre for Mycobacteria, Microbiology and Virology Unit, Careggi Hospital, Florence, Italy
| | - G Spinelli
- Maxillo-Facial Surgery Unit, Neurosensorial Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - M de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini, 24, I-50139, Florence, Italy
| | - L Galli
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini, 24, I-50139, Florence, Italy. .,Pediatric Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy.
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Amodio P, Montagnese S, Spinelli G, Schiff S, Mapelli D. Cognitive reserve is a resilience factor for cognitive dysfunction in hepatic encephalopathy. Metab Brain Dis 2017; 32:1287-1293. [PMID: 28573602 DOI: 10.1007/s11011-017-0032-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/11/2017] [Indexed: 12/11/2022]
Abstract
Cognitive Reserve (CR) modulates symptoms of brain disease. The aim of this study was: to evaluate the effect of CR on cognition in cirrhosis and on the mismatch between cognitive and neurophysiologic assessment of hepatic encephalopathy (HE). Eighty-two outpatient patients with cirrhosis without overt HE were studied [73% males; age: 62 (54-68) (median, interq. range) yrs.; education: 8 (6-13) yrs.]. The Psychometric Hepatic Encephalopathy Score (PHES) was used as cognitive measure of HE. The spectral analysis of the electroencephalogram (EEG) was used as neurophysiologic measure of HE. The CR was assessed by the CR Index (CRI), which was measured by the CRI questionnaire (CRIq) ( http://cri.psy.unipd.it ). The PHES was altered in 28% of patients and the EEG in 41%. Altered PHES was related to the severity of cirrhosis as assessed by Child-Pugh classification (R = 0.31, p < 0.005). Patients with maintained PHES had higher CRI than those with altered PHES (CRI = 100 ± 20 vs. 88 ± 12 vs., p < 0.01), but not the ones with normal EEG compared to those with abnormal EEG (CRI = 96 ± 17 vs. 98 ± 17 vs. p: n.s.).The PHES, but not the EEG, was found to be related to the CRI (r = 0.35, p < 0.01). The mismatch between cognitive and neurophysiologic evaluation of non-overt HE (the ratio between PHES and the mean dominant frequency -MDF- of the EEG i.e., cognitive performance normalized by EEG speed) was found to be correlated to the CRI (r = 0.36, p < 0.005). CR is a resilience factor for cognitive dysfunction in cirrhosis, and is easily measurable by CRIq.
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Affiliation(s)
- Piero Amodio
- Department of Medicine-DIMED- & CIRMANMEC, University of Padua, Padova, Italy.
- Clinica Medica 5, via Giustinini 2, 35128, Padova, Italy.
| | - Sara Montagnese
- Department of Medicine-DIMED- & CIRMANMEC, University of Padua, Padova, Italy
- Clinica Medica 5, via Giustinini 2, 35128, Padova, Italy
| | | | - Sami Schiff
- Department of Medicine-DIMED- & CIRMANMEC, University of Padua, Padova, Italy
- Clinica Medica 5, via Giustinini 2, 35128, Padova, Italy
| | - Daniela Mapelli
- Department of General Psychology & CIRMANMEC, University of Padua, Padova, Italy
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Cocchiara G, Cajozzo M, Fazzotta S, Palumbo VD, Geraci G, Maione C, Buscemi S, Romano G, Fatica F, Spinelli G, Ficarella S, Maffongelli A, Caternicchia F, Lo Monte AI. [Risk factors' analysis of transient and permanent hypoparathyroidism after thyroidectomy]. Clin Ter 2017; 168:e271-e277. [PMID: 28703844 DOI: 10.7417/t.2017.2019] [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: 11/20/2022]
Abstract
AIMS This review evaluates those main risk factors that can affect patients undergoing thyroidectomy, to reach a better pre- and post-operative management of transient and permanent hypoparathyroidism. DISCUSSION The transient hypoparathyroidism is a potentially severe complication of thyroidectomy, including a wide range of signs and symptoms that persists for a few weeks. The definitive hypoparathyroidism occurs when a medical treatment is necessary over 12 months. Risk factors that may influence the onset of this condition after thyroidectomy include: pre- and post-operative biochemical factors, such as serum calcium levels, vitamin D blood concentrations and intact PTH. Other involved factors could be summarized as follow: female sex, Graves' or thyroid neoplastic diseases, surgeon's dexterity and surgical technique. The medical treatment includes the administration of calcium, vitamin D and magnesium sometimes. CONCLUSIONS Although biological and biochemical factors could be related to iatrogenic hypoparathyroidism, the surgeon's experience and the used surgical technique still maintain a crucial role in the aetiology of this important complication.
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Affiliation(s)
- G Cocchiara
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - M Cajozzo
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - S Fazzotta
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - V D Palumbo
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - G Geraci
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - C Maione
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - S Buscemi
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - G Romano
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
| | - F Fatica
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - G Spinelli
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - S Ficarella
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - A Maffongelli
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - F Caternicchia
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo
| | - A I Lo Monte
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo, Italia
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Agostini T, Spinelli G, Arcuri F, Perello R. Metastatic Squamous Cell Carcinoma of the Lower Lip: Analysis of the 5-Year Survival Rate. Arch Craniofac Surg 2017; 18:105-111. [PMID: 28913316 PMCID: PMC5556890 DOI: 10.7181/acfs.2017.18.2.105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 03/28/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives The author analyse the impact of extracapsular lymph node spread and bone engagement in the ipsilateral neck of patients suffering squamous cell carcinoma (SCC) of the lower lip. Methods The data of 56 neck dissections performed in patients suffering SCC of the lower lip between January 2000 and December 2008 were retrospectively analysed. Statistical analysis was performed with the Kaplan-Meier life table method, and the survival rate was investigated with the log rank statistic and significance test. The values were considered statistically significant at p<0.05. Results Nine patients took advantage from simultaneous treatment of tumor and prophylactic neck dissection (level I-III), reaching 100% survival rate. Patients suffering metastasized disease, who received radical neck dissection at the time of tumor treatment, presented 83.3% survival rate. Patients who underwent previous surgery and radiotherapy presented worse prognosis although radical neck dissection in case of extra-capsular spread only (24.7%) and osseous engagement (22.2%). Conclusion Prophylactic neck dissection (level I–III) is recommended in T3–T4 N0 SCC. Simultaneous treatment of tumor and cervical lymph nodes provides a better prognosis as respect to delayed nodal management. Extra-capsular spread with or without bone engagement represents independent risk factor responsible for high mortality rate of SCC of the lower lip.
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Affiliation(s)
- Tommaso Agostini
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy.,Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
| | - Giuseppe Spinelli
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - Francesco Arcuri
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - Raffaella Perello
- Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
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Cocchiara G, Fazzotta S, Palumbo VD, Damiano G, Cajozzo M, Maione C, Buscemi S, Spinelli G, Ficarella S, Maffongelli A, Caternicchia F, Ignazio Lo Monte A, Buscemi G. The medical and surgical treatment in secondary and tertiary hyperparathyroidism. Review. Clin Ter 2017; 168:e158-e167. [PMID: 28383630 DOI: 10.7417/ct.2017.1999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism). AIMS There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods. DISCUSSION In secondary hyperparathyroidism (2HPT) there is a progressive hyperplasia of the parathyroid glands and an increased production of parathyroid hormone. Several causes are proposed: chronic renal insufficiency, vitamin D deficiency, malabsorption syndrome. The tertiary hyperparathyroidism (3HPT) is considered a state of excessive autonomous secretion of PTH due to long-standing 2HPT and it's usually the result of a lack of suppression in the production of PTH. The pathophysiological implications are both skeletal and extraskeletal: it damages the cardiovascular system, nervous system, immune, hematopoietic and endocrine system. The introduction of new drugs has improved the survival of these patients, allowing the inhibition of the synthesis of PTH. Indication for surgical treatment is unresponsive medical therapy. CONCLUSIONS There are no large prospective studies that comparing the medical and surgical treatment. The choice is not unique and we have to consider the singolar case and the clinical condition of the patient.
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Affiliation(s)
- G Cocchiara
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo
| | - S Fazzotta
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - V D Palumbo
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo - Istituto Euromediterraneo di Scienza e Tecnologia (IEMEST), Palermo, Italia
| | - G Damiano
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - M Cajozzo
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - C Maione
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - S Buscemi
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - G Spinelli
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - S Ficarella
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - A Maffongelli
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - F Caternicchia
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo
| | - A Ignazio Lo Monte
- Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo - Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
| | - G Buscemi
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università degli Studi di Palermo
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Affiliation(s)
- Tommaso Agostini
- Department of Maxillofacial Surgery, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Raffaella Perello
- Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
| | - Giuseppe Spinelli
- Department of Maxillofacial Surgery, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
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Mannelli G, Arcuri F, Conti M, Agostini T, Raffaini M, Spinelli G. The role of bone marrow aspirate cells in the management of atrophic mandibular fractures by mini-invasive surgical approach: Single-institution experience. J Craniomaxillofac Surg 2017; 45:694-703. [PMID: 28259617 DOI: 10.1016/j.jcms.2017.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/12/2016] [Revised: 12/11/2016] [Accepted: 01/05/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The treatment of fractures involves addressing the biology of fracture repair and the mechanical stability of fracture fixation. Traditionally it has included the addition of bone graft to enhance healing. New advances in the understanding of the cellular and molecular mechanisms of fracture repair have led to the use of growth factors to accelerate bone healing. This study aimed to assess the advantages of autologous stem cell use for atrophic mandibular fracture treatment in comparison to standard technique. MATERIALS AND METHODS A total of 35 patients (14 male and 21 female) were treated for fractures of atrophic mandibles between January 2011 and December 2014. Surgical technique provided mini-invasive open reduction with or without immediate homologous bone graft, while selected patients received autologous bone marrow aspirate cell grafts in addition to the standard treatment. Demographic data and details of treatment and outcomes were recorded. RESULTS Patients were categorized according to the use of autologous stem cells, leaving 17 patients treated with standard technique and autologous stem cells (Group A) and 18 treated with standard osteosynthesis only (Group B). Of the 35 patients, 26 had bilateral fractures; most patients had significant medical co-morbidities. Immediate bone graft was used in 37.1% of patients (7 in group A and 6 in group B). Complications occurred in 5 patients (14.3%). Two patients in group B (11.1%) showed non-union of the fracture. One patient in group A (5.8%) and one patient in group B (5.5%) showed wound dehiscence and were treated conservatively; one patient in group B had a local infection (5.5%), one out of 35 (2.8%), that was managed by prolonged antibiotic treatment. CONCLUSIONS Despite the advanced age and medical co-morbidities of the vast majority of patients, mini-invasive open approach with autologous bone graft ensures a fast and excellent recovery. Moreover, the management of atrophic mandibular fractures by bone marrow aspirate cells is a safe and useful procedure which has a lower complication rate when compared to standard technique.
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Affiliation(s)
- Giuditta Mannelli
- First Clinic of Otorhinolaryngology Head and Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | - Francesco Arcuri
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Marco Conti
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Tommaso Agostini
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Mirco Raffaini
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giuseppe Spinelli
- Maxillo-Facial Surgery Unit, Neurosensorial Department (Head in Chief: Dr. G. Spinelli), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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