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Mattioli P, Grisanti S, Massa F, Morbelli S, Boni S, Beronio A, Rebella G, Roccatagliata L, Nobili L, Franciotta D, Micalizzi E, Nobili F, Arnaldi D, Villani F, Benedetti L. Ma2 antibody-associated limbic encephalitis: The early etiology treatment may modify the disease clinical trajectory. Epileptic Disord 2024. [PMID: 38619369 DOI: 10.1002/epd2.20225] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/27/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano Grisanti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Silvia Boni
- Infectious Diseases Department, Galliera Hospital, Genoa, Italy
| | | | - Giacomo Rebella
- Neuroradiology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Roccatagliata
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Neuroradiology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lino Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Diego Franciotta
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa Micalizzi
- Division of Neurophysiology and Epilepsy Centre, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Division of Neurophysiology and Epilepsy Centre, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Flavio Villani
- Division of Neurophysiology and Epilepsy Centre, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Massa F, Vigo T, Bellucci M, Giunti D, Emanuela MM, Visigalli D, Capodivento G, Cerne D, Assini A, Boni S, Rizzi D, Narciso E, Grisanti GS, Coco E, Uccelli A, Schenone A, Franciotta D, Benedetti L. COVID-19-associated serum and cerebrospinal fluid cytokines in post- versus para-infectious SARS-CoV-2-related Guillain-Barré syndrome. Neurol Sci 2024; 45:849-859. [PMID: 38169013 DOI: 10.1007/s10072-023-07279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Guillain-Barré syndrome associated with Coronavirus-2-related severe acute respiratory syndrome (COV-GBS) occurs as para- or post-infectious forms, depending on the timing of disease onset. In these two forms, we aimed to compare the cerebrospinal fluid (CSF) and serum proinflammatory cytokine profiles to evaluate differences that could possibly have co-pathogenic relevance. MATERIALS AND METHODS We studied a retrospective cohort of 26 patients with either post-COV-GBS (n = 15), with disease onset occurring > 7 days after SARS-CoV-2 infection, or para-COV-GBS (n = 11), with disease onset 7 days or less. TNF-α, IL-6, and IL-8 were measured in the serum with SimplePlex™ Ella™ immunoassay. In addition to the para-/post-COV-GBS patients, serum levels of these cytokines were determined in those with non-COVID-associated-GBS (NC-GBS; n = 43), paucisymptomatic SARS-CoV-2 infection without GBS (COVID, n = 20), and in healthy volunteers (HV; n = 12). CSF cytokine levels were measured in patients with para-/post-COV-GBS, in those with NC-GBS (n = 29), or with Alzheimer's disease (AD; n = 24). RESULTS Serum/CSF cytokine levels did not differ in para- vs post-COV-GBS. We found that SARS-CoV-2 infection raises the serum levels of TNF-α, IL-6, and IL-8, as well as an increase of IL-6 (in serum and CSF) and IL-8 (in CSF) in either NC-GBS or COV-GBS than controls. CSF and serum cytokine levels resulted independent one with another. CONCLUSIONS The change of cytokines linked to SARS-CoV-2 in COV-GBS appears to be driven by viral infection, although it has unique characteristics in GBS as such and does not account for cases with para- or post-infectious onset.
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Affiliation(s)
- Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy.
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy.
| | - Tiziana Vigo
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Margherita Bellucci
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
| | - Debora Giunti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | | | - Davide Visigalli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Giovanna Capodivento
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Denise Cerne
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
| | - Andrea Assini
- Neurology Unit, Galliera Hospital, Via Mura Delle Cappuccine 14, 1628, Genova, Italy
| | - Silvia Boni
- Department of Infectious Diseases, Galliera Hospital, Via Mura Delle Cappuccine 14, 1628, Genoa, Italy
| | - Domenica Rizzi
- Neurology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Eleonora Narciso
- Department of Neurology, ASL3 Genovese, Corso Onofrio Scassi 1, 16149, Genova, Italy
| | - Giuseppe Stefano Grisanti
- Department of Neurology, Santa Corona Hospital, Viale XXV Aprile 38, 17027, Pietra Ligure, Savona, Italy
| | - Elena Coco
- Department of Neurology, Santa Corona Hospital, Viale XXV Aprile 38, 17027, Pietra Ligure, Savona, Italy
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | | | - Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Largo Paolo Daneo 3, 16132, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, Italy
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Boni S, Sartini M, Del Puente F, Adriano G, Blasi Vacca E, Bobbio N, Carbone A, Feasi M, Grasso V, Lattuada M, Nelli M, Oliva M, Parisini A, Prinapori R, Santarsiero MC, Tigano S, Cristina ML, Pontali E. Innovative Approaches to Monitor Central Line Associated Bloodstream Infections (CLABSIs) Bundle Efficacy in Intensive Care Unit (ICU): Role of Device Standardized Infection Rate (dSIR) and Standardized Utilization Ratio (SUR)-An Italian Experience. J Clin Med 2024; 13:396. [PMID: 38256530 PMCID: PMC10816537 DOI: 10.3390/jcm13020396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
In several settings, the COVID-19 pandemic determined a negative impact on the occurrence of healthcare-associated infection, particularly for on central lines associated bloodstream infections (CLABSI). In our setting, we observed a significant increase in CLABSI in our intensive care unit (ICU) during 2020 and 2021 vs. 2018 to 2019. A refresher training activity on central venous catheter (CVC) management bundles was carried out in September-October 2021 for the ICU health staff. We assessed the impact of bundle implementation by means of standardized indicators, such as the Device Utilization Ratio (DUR), in this case, the Central Line Utilization Ratio, the Standardized Utilization Ratio (SUR), and the device Standardized Infection Ratio (dSIR). Standardized ratios for device use and infection ratio were computed using data from 2018 and 2019 as expectation data. After bundle implementation, we observed a significant reduction of dSIR (p < 0.001), which dropped from 3.23 and 2.99 in the 2020-2021 biennium to 1.11 in 2022 (CLABSI in the first quarter only); no more CLABSI were observed afterwards. Standardized ratios proved helpful in identify increasing trends of CLABSI in the ICU and monitoring the impact of a simple effective tool, i.e., training on and implementation of a bundle for CVC management.
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Affiliation(s)
- Silvia Boni
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Marina Sartini
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Giulia Adriano
- Hospital Infection Control Committee, Galliera Hospital, 16128 Genoa, Italy; (G.A.); (M.C.S.)
| | - Elisabetta Blasi Vacca
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Alessio Carbone
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
| | - Marcello Feasi
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Viviana Grasso
- Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, Italy; (V.G.); (M.L.)
| | - Marco Lattuada
- Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, Italy; (V.G.); (M.L.)
| | - Mauro Nelli
- Medical Service Management, Galliera Hospital, 16128 Genoa, Italy;
| | - Martino Oliva
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
| | - Andrea Parisini
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Roberta Prinapori
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | | | - Stefania Tigano
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
| | - Maria Luisa Cristina
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy; (S.B.); (F.D.P.); (E.B.V.); (N.B.); (M.F.); (A.P.); (R.P.); (S.T.)
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy; (M.S.); (A.C.); (M.O.); (M.L.C.)
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Cristina ML, Spagnolo AM, Sartini M, Carbone A, Oliva M, Schinca E, Boni S, Pontali E. An Overview on Candida auris in Healthcare Settings. J Fungi (Basel) 2023; 9:913. [PMID: 37755021 PMCID: PMC10532978 DOI: 10.3390/jof9090913] [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: 07/26/2023] [Revised: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Candida auris has become a major concern in critical care medicine due to the increasing number of immunocompromised patients and candidiasis is the most frequent cause of fungal infections. C. auris and other fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year. In immunocompromised patients, infections can quickly become severe, causing wound infections, otitis and candidemia, resulting in high morbidity and mortality. The clinical presentation of C. auris is often non-specific and similar to other types of systemic infections; in addition, it is harder to identify from cultures than other, more common types of Candida spp. Some infections are particularly difficult to treat due to multi-resistance to several antifungal agents, including fluconazole (and other azoles), amphotericin B and echinocandins. This entails treatment with more drugs and at higher doses. Even after treatment for invasive infections, patients generally remain colonized for long periods, so all infection control measures must be followed during and after treatment of the C. auris infection. Screening patients for C. auris colonization enables facilities to identify individuals with C. auris colonization and to implement infection prevention and control measures. This pathogenic fungus shows an innate resilience, enabling survival and persistence in healthcare environment and the ability to rapidly colonize the patient's skin and be easily transmitted within the healthcare setting, thus leading to a serious and prolonged outbreak.
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Affiliation(s)
- Maria Luisa Cristina
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
- Hospital Hygiene Unit, E.O. Ospedali Galliera, 16128 Genova, Italy
| | - Anna Maria Spagnolo
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
- Hospital Hygiene Unit, E.O. Ospedali Galliera, 16128 Genova, Italy
| | - Marina Sartini
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
- Hospital Hygiene Unit, E.O. Ospedali Galliera, 16128 Genova, Italy
| | - Alessio Carbone
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
| | - Martino Oliva
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
| | - Elisa Schinca
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy; (M.L.C.); (A.M.S.); (E.S.)
- Hospital Hygiene Unit, E.O. Ospedali Galliera, 16128 Genova, Italy
| | - Silvia Boni
- Infectious Disease Unit, Galliera Hospital, 16128 Genoa, Italy
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Parisini A, Boni S, Vacca EB, Bobbio N, Puente FD, Feasi M, Prinapori R, Lattuada M, Sartini M, Cristina ML, Usiglio D, Pontali E. Impact of the COVID-19 Pandemic on Epidemiology of Antibiotic Resistance in an Intensive Care Unit (ICU): The Experience of a North-West Italian Center. Antibiotics (Basel) 2023; 12:1278. [PMID: 37627698 PMCID: PMC10451647 DOI: 10.3390/antibiotics12081278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 06/27/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023] Open
Abstract
The SARS-CoV-2 pandemic caused an increase in intensive care unit (ICU) hospitalizations with a rise in morbidity and mortality; nevertheless, there is still little evidence on the impact of the pandemic on antibiotic resistance in ICUs. This is a retrospective, monocentric epidemiological study. The aim of the study was to describe and analyze the impact of the SARS-CoV-2 pandemic on ICU bacterial resistance patterns. All bacteria isolated from all patients admitted to the E.O. Galliera ICU from January 2018 to December 2022 were included. Antibiotic resistance (AR) profiles were evaluated. A total of 1021 microorganisms were identified, of which 221 (12.47%) had a resistance pattern (resistant organisms; ROs). In this time, there were 1679 patients with a total of 12,030 hospitalization days. The majority of microorganisms were Gram-negative (79.66% in 2018, 77.29% in 2019, 61.83% in 2020, 62.56% in 2021, and 60.75% in 2022), but an increase in Gram-positive microorganisms was observed (20.34 to 39.25% between 2018 and 2022). The prevalence of AR was 19.44% in 2018, 11.54% in 2019, 38.04% in 2020, 34.15% in 2021, and 39.29% in 2022 for Gram-positive microorganisms and 19.86% in 2018, 13.56% in 2019, 18.12% in 2020, 12.41% in 2021, and 12.31% in 2012 for Gram-negative microorganisms. The incidence of ROs showed a COVID-19-related increase in 2020-2021, followed by a lowering trend since 2021, and a new increase in 2022. Possible explanations are antibiotic overtreatment and a decrease in containment measures. An interesting finding was the cumulative lowering trend of carbapenem-resistant K. pneumoniae and P. aeruginosa, probably due to different patient features.
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Affiliation(s)
- Andrea Parisini
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Silvia Boni
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Elisabetta Blasi Vacca
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Marcello Feasi
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Roberta Prinapori
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
| | - Marco Lattuada
- Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa, Italy;
| | - Marina Sartini
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (M.S.); (M.L.C.)
- Operating Unit (S.S.D.U.O.) Hospital Hygiene Unit, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genoa, Italy; (M.S.); (M.L.C.)
- Operating Unit (S.S.D.U.O.) Hospital Hygiene Unit, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - David Usiglio
- Department of Laboratory and Microbiological Analysis, Galliera Hospital, 16128 Genoa, Italy;
| | - Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (A.P.); (S.B.); (E.B.V.); (N.B.); (F.D.P.); (M.F.); (R.P.)
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Brusasco C, Corradi F, Dazzi F, Isirdi A, Romei C, Parisini A, Boni S, Santori G, Brusasco V. The use of continuous positive airway pressure during the second and third waves of the COVID-19 pandemic. ERJ Open Res 2023; 9:00365-2022. [PMID: 36879904 PMCID: PMC9675983 DOI: 10.1183/23120541.00365-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background In a preliminary study during the first COVID-19 pandemic wave, we reported a high rate of success with continuous positive airway pressure (CPAP) in preventing death and invasive mechanical ventilation (IMV). That study, however, was too small to identify risk factors for mortality, barotrauma and impact on subsequent IMV. Thus, we re-evaluated the efficacy of the same CPAP protocol in a larger series of patients during second and third pandemic waves. Methods 281 COVID-19 patients with moderate-to-severe acute hypoxaemic respiratory failure (158 full-code and 123 do-not-intubate (DNI)), were managed with high-flow CPAP early in their hospitalisation. IMV was considered after 4 days of unsuccessful CPAP. Results The overall recovery rate from respiratory failure was 50% in the DNI and 89% in the full-code group. Among the latter, 71% recovered with CPAP-only, 3% died under CPAP and 26% were intubated after a median CPAP time of 7 days (IQR: 5-12 days). Of the patients who were intubated, 68% recovered and were discharged from the hospital within 28 days. Barotrauma occurred during CPAP in <4% of patients. Age (OR 1.128; p <0.001) and tomographic severity score (OR 1.139; p=0.006) were the only independent predictors of mortality. Conclusions Early treatment with CPAP is a safe option for patients with acute hypoxaemic respiratory failure due to COVID-19.
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Affiliation(s)
- Claudia Brusasco
- Anesthesia and Intensive Care Unit, E.O. Ospedali Galliera, Genoa, Italy
| | - Francesco Corradi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Federico Dazzi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Isirdi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Chiara Romei
- Department Radiology, 2nd Radiology Unit, Pisa University-Hospital, Pisa, Italy
| | | | | | - Gregorio Santori
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Vito Brusasco
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
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Boni S, Marin GH, Tarragona S, Limeres M, Garay V. [Characterization of the drug supply in Argentina]. Medicina (B Aires) 2023; 83:522-532. [PMID: 37582126] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
INTRODUCTION Knowing the characteristics of the pharmaceutical market allows obtaining sensitive information to understand the supply, demand and access of the population to medicines. In order to provide primary data regarding the marketing of drugs in Argentina, the following research was performed. METHOD This is a cross-sectional quantitative-qualitative descriptive study of the Argentine pharmaceutical market, taking into account 30 years of official information provided by the National Regulatory Agency (ANMAT). RESULTS Two hundred and sixteen laboratories (182 national) drug producers / importers, 53 distributors and 479 drugstores (wholesale drug distribution establishments) were identified. A high concentration of marketing was detected, grouping 90% in only 5 intermediaries. There are currently 6670 products/certificates in the country, an amount that fluctuated over the last 30 years. Six laboratories are owners of between 116 and 208 certificates; 84% of these products come from national laboratories, 5002 are mono-drugs, while 83% are marketed under a fancy name. The three main indications for which the registration of drugs in Argentina is intended are diseases of digestive system, nervous system and infectious diseases; 58% of the marketed products consist of oral formulations. DISCUSSION Based on data provided by this study, it is possible to assert that the Argentinian pharmaceutical market has a majority share of national capital, with a great concentration in a few pharmaceutical companies and distributors. The products are mostly available as non-combined drugs, in their oral form, and available by their brand names.
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Affiliation(s)
- Silvia Boni
- Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT), Buenos Aires, Argentina
| | - Gustavo H Marin
- Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT), Buenos Aires, Argentina
- Universidad Nacional de La Plata - CONICET, Buenos Aires, Argentina. E-mail:
| | | | - Manuel Limeres
- Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT), Buenos Aires, Argentina
| | - Valeria Garay
- Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT), Buenos Aires, Argentina
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar 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M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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9
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Parisini A, Boni S, Vacca EB, Del Puente F, Feasi M, Bobbio N, Prinapori R, Bolla C, Castellaneta M, Pontali E, Chichino G. Down Syndrome and COVID-19: not always a poor prognosis. Int J Tuberc Lung Dis 2022; 26:691-693. [PMID: 35768929 DOI: 10.5588/ijtld.22.0192] [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: 11/10/2022] Open
Affiliation(s)
- A Parisini
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - S Boni
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - E Blasi Vacca
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - F Del Puente
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - M Feasi
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - N Bobbio
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - R Prinapori
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - C Bolla
- Department of Infectious Diseases, S. S. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - M Castellaneta
- Department of Internal Medicine, Galliera Hospital, Genoa, Italy
| | - E Pontali
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - G Chichino
- Department of Infectious Diseases, S. S. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
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10
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Boni S, Antonucci M, Manca A, Nicolò AD, Martinelli L, Artioli S, Pacini G, Di Perri G, D'Avolio A. Ceftobiprole and daptomycin concentrations in valve tissue in a patient with mitralic native valve endocarditis. J Chemother 2022; 34:416-418. [PMID: 35484923 DOI: 10.1080/1120009x.2022.2068850] [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] [Indexed: 10/18/2022]
Abstract
Ceftobiprole (CFB), especially in combination, could be a promising alternative treatment for infective endocarditis. A main determinant of clinical response to antibiotic treatment is drug concentration at the infected site. Data on CFB and Daptomycin (DPT) heart valve penetration are lacking.Here we report a clinical case of CFB and DPT treatment combination for endocarditis. Then, we measured CFB and DPT concentrations in a native infected valve to verify their pharmacokinetic penetration and relationship with pharmacodynamic microbiological markers.The isolated microorganism was a MRSA with CFB and DPT MIC < 2 mg/L and <1 mg/L, respectively. The CFB and DPT plasma concentrations were 36.2 and 14.1 mg/L, respectively and the extrapolated concentration, based on each half-life, at the operatory time were 16.4 and 19.1 mg/L for CFB and DPT, respectively; the corresponding median CFB and DPT valve concentrations were 2.26 (IQR 2.14-2.69) and 12.9 µg/g (IQR 5.69-20.9), respectively; the estimated tissue/plasma ratios for CFB and DTP were 0.14 and 0.67, respectively.The association of CFB and DPT showed a good efficacy in this single endocarditis clinical case, confirmed by plasma and tissue PK/PD data.This report shows the first data on CFB valve tissue penetration, and it needs to be confirmed in other patient valve tissues. Moreover, relative studies of correlation with clinical efficacy are needed.
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Affiliation(s)
- Silvia Boni
- Infectious Diseases Galliera Hospital, Genoa, Italy
| | - Miriam Antonucci
- Laboratory of Clinical Pharmacology and Pharmacogenetics #, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alessandra Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics #, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Amedeo De Nicolò
- Laboratory of Clinical Pharmacology and Pharmacogenetics #, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | | | - Giovanni Di Perri
- Laboratory of Clinical Pharmacology and Pharmacogenetics #, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonio D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics #, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, Turin, Italy
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11
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Marin GH, Giangreco L, Dorati C, Mordujovich P, Boni S, Mantilla-Ponte H, Alfonso Arvez MJ, López Peña M, Aldunate González MF, Ching Fung SM, Barcelona L, Campaña L, Vaquero Orellana A, Orjuela Rodríguez T, Ginés Cantero L, Villar RA, Sandoval Fuentes N, Melero E, Marin-Piva H, Soler G, Gabriel F, Pineda Velandia L, Ojeda Florentín C, Risso Patron S, Ortiz Rivas M, Mendoza Benítez C, Mellado R, Ivanovska V, Muller A, Rojas R, Castro JL. Antimicrobial Consumption in Latin American Countries: First Steps of a Long Road Ahead. J Prim Care Community Health 2022; 13:21501319221082346. [PMID: 35438037 PMCID: PMC9021473 DOI: 10.1177/21501319221082346] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Irrational antimicrobial consumption (AMC) became one of the main global health problems in recent decades. Objective: In order to understand AMC in Latin-American Region, we performed the present research in 6 countries. Methods: Antimicrobial consumption (J01, A07A, P01AB groups) was registered in Argentina, Chile, Colombia, Costa Rica, Paraguay, and Peru. Source of information, AMC type, DDD (Defined Daily Doses), DID (DDD/1000 inhabitants/day), population were variables explored. Data was analyzed using the Global Antimicrobial Resistance and Use Surveillance System (GLASS) tool. Results: Source of information included data from global, public, and private sectors. Total AMC was highly variable (range 1.91-36.26 DID). Penicillin was the most consumed group in all countries except in Paraguay, while macrolides and lincosamides were ranked second. In terms of type of AMC according to the WHO-AWaRe classification, it was found that for certain groups like “Reserve,” there are similarities among all countries. Conclusion and Relevance: This paper shows the progress that 6 Latin-American countries made toward AMC surveillance. The study provides a standardized approach for building a national surveillance system for AMC data analysis. These steps will contribute to the inclusion of Latin-America among the regions of the world that have periodic, regular, and quality data of AMC.
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Affiliation(s)
- Gustavo H Marin
- CUFAR-University Centre of Pharmacology, UNLP; WHO-PAHO Col., La Plata, Argentina
| | - Lucia Giangreco
- CUFAR-University Centre of Pharmacology, UNLP; WHO-PAHO Col., La Plata, Argentina
| | - Cristian Dorati
- CUFAR-University Centre of Pharmacology, UNLP; WHO-PAHO Col., La Plata, Argentina
| | - Perla Mordujovich
- CUFAR-University Centre of Pharmacology, UNLP; WHO-PAHO Col., La Plata, Argentina
| | - Silvia Boni
- ANMAT & Ministry of Health, Buenos Aires, Argentina
| | | | - Ma José Alfonso Arvez
- National Pharmacovigilance Dep-Ministry of Health, Asuncion, Gran Asunción, Paraguay
| | | | | | | | | | | | | | | | - Larissa Ginés Cantero
- National Pharmacovigilance Dep-Ministry of Health, Asuncion, Gran Asunción, Paraguay
| | - Rosa A Villar
- Pan-American Health Organization (PAHO), Washington, DC, USA
| | | | | | | | - Gisela Soler
- ANMAT & Ministry of Health, Buenos Aires, Argentina
| | | | | | | | | | - Mariela Ortiz Rivas
- National Pharmacovigilance Dep-Ministry of Health, Asuncion, Gran Asunción, Paraguay
| | | | | | | | - Arno Muller
- World Health Organization, Geneva, Switzerland
| | - Robin Rojas
- Pan-American Health Organization (PAHO), Washington, DC, USA
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12
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Sartini M, Del Puente F, Oliva M, Carbone A, Blasi Vacca E, Parisini A, Boni S, Bobbio N, Feasi M, Battistella A, Pontali E, Cristina ML. Riding the COVID Waves: Clinical Trends, Outcomes, and Remaining Pitfalls of the SARS-CoV-2 Pandemic: An Analysis of Two High-Incidence Periods at a Hospital in Northern Italy. J Clin Med 2021; 10:jcm10225239. [PMID: 34830521 PMCID: PMC8624682 DOI: 10.3390/jcm10225239] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/02/2021] [Accepted: 11/09/2021] [Indexed: 02/07/2023] Open
Abstract
Background. Italy was the first western country to face an uncontrolled outbreak of SARS-CoV-2 infection. The epidemic began in March 2020 within a context characterised by a general lack of knowledge about the disease. The first scientific evidence emerged months later, leading to treatment changes. The aim of our study was to evaluate the effects of these changes. Methods. Data from a hospital in Genoa, Italy, were analysed. Patients deceased from SARS-CoV-2 infection were selected. Data were compared by dividing patients into two cohorts: “phase A” (March–May 2020) and “phase B” (October–December 2020). Results. A total of 5142 patients were admitted. There were 274 SARS-CoV-2-related deaths (162 phase A and 112 phase B). No differences were observed in terms of demographics, presentation, or comorbidities. A significant increase was recorded in corticosteroid use. Mortality was 33.36% during phase A, falling to 21.71% during phase B. When subdividing the trend during the two phases by age, we found a difference in people aged 65–74 years. Conclusions. There is scarce evidence regarding treatment for SARS-CoV-2 (especially for severe infection). However, treatment changes improved the prognosis for people under the age of 75. The prognosis for older people remains poor, despite the improvements achieved.
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Affiliation(s)
- Marina Sartini
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy;
- Operating Unit (S.S.D. U.O.) Hospital Hygiene, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (M.O.); (A.C.)
- Correspondence: (M.S.); (F.D.P.)
| | - Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
- Correspondence: (M.S.); (F.D.P.)
| | - Martino Oliva
- Operating Unit (S.S.D. U.O.) Hospital Hygiene, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (M.O.); (A.C.)
| | - Alessio Carbone
- Operating Unit (S.S.D. U.O.) Hospital Hygiene, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (M.O.); (A.C.)
| | - Elisabetta Blasi Vacca
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Andrea Parisini
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Silvia Boni
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Marcello Feasi
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Alessandra Battistella
- Medical Service Management, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy;
| | - Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (E.B.V.); (A.P.); (S.B.); (N.B.); (M.F.); (E.P.)
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genova, Via Pastore 1, 16132 Genova, Italy;
- Operating Unit (S.S.D. U.O.) Hospital Hygiene, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (M.O.); (A.C.)
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13
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Emanuele M, Nazzaro G, Marini M, Veronesi C, Boni S, Polletta G, D'Ausilio A, Fadiga L. Motor synergies: Evidence for a novel motor signature in autism spectrum disorder. Cognition 2021; 213:104652. [DOI: 10.1016/j.cognition.2021.104652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
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14
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Boni S, Marin GH, Campaña L, Marin L, Corso A, Risso-Patron S, Gabriel F, Garay V, Limeres M. Disparities in antimicrobial consumption and resistance within a country: the case of beta-lactams in Argentina. Rev Panam Salud Publica 2021; 45:e76. [PMID: 34322161 PMCID: PMC8312146 DOI: 10.26633/rpsp.2021.76] [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: 02/08/2021] [Accepted: 04/23/2021] [Indexed: 12/23/2022] Open
Abstract
Objective. To describe bacterial resistance and antimicrobial consumption ratio at the subnational level in Argentina during 2018, considering beta-lactams group as a case-study. Methods. Antimicrobial consumption was expressed as defined daily doses (DDD)/1000 inhabitants. Resistance of Escherichia coli, Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus to beta-lactams was recorded. Resistance/consumption ratio was estimated calculating “R” for each region of Argentina, and this data was compared with other countries. Results. The most widely consumed beta-lactams in Argentina were amoxicillin (3.64) for the penicillin sub-group, cephalexin (0.786) for first generation cephalosporins, cefuroxime (0.022) for second generation; cefixime (0.043) for third generation and cefepime (0.0001) for the fourth generation group. Comparison between beta-lactams consumption and bacterial resistance demonstrated great disparities between the six regions of the country. Conclusions. The case-study of Argentina shows that antimicrobial consumption and resistance of the most common pathogens differed among regions, reflecting different realities within the same country. Because this situation might also be occurring in other countries, this data should be taken into account to target local efforts towards better antimicrobial use, to improve antimicrobial stewardship programs and to propose more suitable sales strategies in order to prevent and control antimicrobial resistance.
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Affiliation(s)
- Silvia Boni
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
| | - Gustavo H Marin
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina.,National University La Plata-CUFAR-CONICET La Plata Argentina National University La Plata-CUFAR-CONICET, La Plata, Argentina
| | - Laura Campaña
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
| | - Lupe Marin
- National University La Plata-CUFAR-CONICET La Plata Argentina National University La Plata-CUFAR-CONICET, La Plata, Argentina
| | - Alejandra Corso
- Ministry of Health Buenos Aires Argentina Ministry of Health, Buenos Aires, Argentina
| | - Soledad Risso-Patron
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
| | - Fernanda Gabriel
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
| | - Valeria Garay
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
| | - Manuel Limeres
- National Administration of Drugs, Food and Technology Buenos Aires Argentina National Administration of Drugs, Food and Technology, Buenos Aires, Argentina
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15
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Giacobbe DR, Saffioti C, Losito AR, Rinaldi M, Aurilio C, Bolla C, Boni S, Borgia G, Carannante N, Cassola G, Ceccarelli G, Corcione S, Dalla Gasperina D, De Rosa FG, Dentone C, Di Bella S, Di Lauria N, Feasi M, Fiore M, Fossati S, Franceschini E, Gori A, Granata G, Grignolo S, Grossi PA, Guadagnino G, Lagi F, Maraolo AE, Marinò V, Mazzitelli M, Mularoni A, Oliva A, Pace MC, Parisini A, Patti F, Petrosillo N, Pota V, Raffaelli F, Rossi M, Santoro A, Tascini C, Torti C, Trecarichi EM, Venditti M, Viale P, Signori A, Bassetti M, Del Bono V, Giannella M, Mikulska M, Tumbarello M, Viscoli C. Use of colistin in adult patients: A cross-sectional study. J Glob Antimicrob Resist 2019; 20:43-49. [PMID: 31207379 DOI: 10.1016/j.jgar.2019.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 04/01/2019] [Revised: 06/03/2019] [Accepted: 06/08/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess colistin use in a country endemic for multidrug-resistant Gram-negative bacteria (MDR-GNB). METHODS Colistin prescription patterns were evaluated in 22 Italian centres. Factors associated with use of colistin in combination with other anti-MDR-GNB agents were also assessed. RESULTS A total of 221 adults receiving colistin were included in the study. Their median age was 64 years (interquartile range 52-73 years) and 134 (61%) were male. Colistin was mostly administered intravenously (203/221; 92%) and mainly for targeted therapy (168/221; 76%). The most frequent indications for colistin therapy were bloodstream infection and lower respiratory tract infection. Intravenous colistin was administered in combination with at least another anti-MDR-GNB agent in 80% of cases (163/203). A loading dose of 9 MU of colistimethate was administered in 79% of patients receiving i.v. colistin and adequate maintenance doses in 85%. In multivariable analysis, empirical therapy [odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.24-8.53;P = 0.017] and targeted therapy for carbapenem-resistant Enterobacterales infection (OR = 4.76, 95% CI 1.69-13.43; P = 0.003) were associated with use of colistin in combination with other agents, whilst chronic renal failure (OR = 0.39, 95% CI 0.17-0.88; P = 0.024) was associated with use of colistin monotherapy. CONCLUSION Colistin remains an important option for severe MDR-GNB infections when other treatments are not available. Despite inherent difficulties in optimising its use owing to peculiar pharmacokinetic/pharmacodynamic characteristics, colistin was mostly used appropriately in a country endemic for MDR-GNB.
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Affiliation(s)
| | - Carolina Saffioti
- Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Angela Raffaella Losito
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Matteo Rinaldi
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Caterina Aurilio
- Anaesthesia and Intensive Care Unit, Department of Women, Children, General and Specialistic Surgery, L. Vanvitelli University of Campania, Naples, Italy
| | - Cesare Bolla
- SC Malattie Infettive, ASO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Silvia Boni
- Divisione di Malattie Infettive, Ospedale Sant'Andrea, La Spezia, Italy
| | - Guglielmo Borgia
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Novella Carannante
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy
| | - Giovanni Cassola
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy
| | - Daniela Dalla Gasperina
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Chiara Dentone
- Medical Department, Infectious Diseases Unit, Sanremo Hospital, Imperia, Italy
| | - Stefano Di Bella
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Nicoletta Di Lauria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marcello Feasi
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - Marco Fiore
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Sara Fossati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Erica Franceschini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Gori
- University of Milan and Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Granata
- Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - Sara Grignolo
- Divisione di Malattie Infettive, Ospedale Sant'Andrea, La Spezia, Italy
| | - Paolo Antonio Grossi
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Filippo Lagi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Alberto Enrico Maraolo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | | | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy; IRCCS INM Neuromed, Pozzilli, Italy
| | - Maria Caterina Pace
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Andrea Parisini
- SC Malattie Infettive, ASO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Francesca Patti
- Medical Department, Infectious Diseases Unit, Sanremo Hospital, Imperia, Italy
| | - Nicola Petrosillo
- Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - Vincenzo Pota
- Anaesthesia and Intensive Care Unit, Department of Women, Children, General and Specialistic Surgery, L. Vanvitelli University of Campania, Naples, Italy
| | - Francesca Raffaelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marianna Rossi
- Clinic of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Antonella Santoro
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Tascini
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Matteo Bassetti
- Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Valerio Del Bono
- Infectious Diseases Unit, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
| | - Maddalena Giannella
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Malgorzata Mikulska
- Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Mario Tumbarello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio Viscoli
- Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
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Ouffoue GY, Boni S, Ouattara AO, Gbe K, Kouassi LJK, Konan AJ, Gombe E, Ouonnebo L, Agbohoun RP, Fanny A, Cheucheu WJ. [Contribution of break up time in the diagnosis and the treatment of dry eye syndrome in tropic area: about 234 patients in Abidjan]. J Fr Ophtalmol 2019; 42:716-721. [PMID: 31133400 DOI: 10.1016/j.jfo.2018.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/26/2018] [Accepted: 08/29/2018] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Dry eye disease (DED) can be evaluated clinically by the tear film break up time (BUT). There is a discrepancy between symptoms in relationship with dry eye disease and objectives measures of BUT. So we tried to evaluate the reliability of BUT in the diagnosis and treatment of this disease in black African people. METHODS We carried out a prospective study of 6 months where melanoderms adults presenting subjective symptoms of dry eye disease according a questionnaire of 7 items were included. Then the measure of BUT is performed after ocular instillation of fluorescein eyedrop. This measured is done by recording the time elapsed from the last complete palpebral blink to the appearance of the first dry spot. Patients with subjective symptoms and time of BUT lower than 10seconds were called concordants (suffering really of DED). The discrepant group was represented by a BUT upper than 10seconds despite the fact that these patients answered positively to the questionnaire. RESULTS This survey included 234 patients and the average age was 49.1 years. Sex-ratio was 0.68 and we noticed predominance of BUT between 5 and 10seconds in 42.3% of cases. Subjective symptoms were strengthened clinically by a BUT lower to 10seconds in 149 patients. Therefore, the reliability of BUT as clinic tool for the diagnosis after symptoms in relationship with DED was 63.7%. In the group of concordants, women were more likely than men to experience symptoms of DED (P=0.0005). Age upper than 50 years and computer usage were risk factors of DED (P<0.01). DISCUSSION Dry eye disease is a multifactorial affection of tear and ocular surface frequently seen in female and people using computer and older than 50. The reliability of BUT near to 65% is a reason to perform this test in our daily practice. CONCLUSION Tear BUT is a reliable clinical test which must be performed systematically to assess the diagnosis of DED in black African people.
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Affiliation(s)
- G Y Ouffoue
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire.
| | - S Boni
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - A O Ouattara
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Unité d'épidémiologie, institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - K Gbe
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - L J K Kouassi
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - A J Konan
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - E Gombe
- Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - L Ouonnebo
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - R P Agbohoun
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - A Fanny
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
| | - W J Cheucheu
- Service d'ophtalmologie du CHU de Treichville, Abidjan, Cote d'Ivoire; Université Felix-Houphouet-Boigny, 25 bp 1455 Abidjan 25, Côte d'Ivoire
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Ouffoue GY, Boni S, Kouassi LJK, Konan AJ, Ouattara AO, Sowagnon TC, Gombe E, Cheucheu NW, Fanny A. [Indications and efficacy of intravitreal injections of anti-VEGF in black people in Abidjan]. J Fr Ophtalmol 2018; 42:e18-e19. [PMID: 30594419 DOI: 10.1016/j.jfo.2018.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 01/28/2018] [Accepted: 02/19/2018] [Indexed: 10/27/2022]
Affiliation(s)
- G Y Ouffoue
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire.
| | - S Boni
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - L J K Kouassi
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - A J Konan
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - A O Ouattara
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - T C Sowagnon
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - E Gombe
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - N W Cheucheu
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
| | - A Fanny
- UFR des sciences médicales, 01 BP V34, Abidjan 01, Cote d'Ivoire
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Bohoussou E, Kouamé B, Djanhan L, Djanhan Y, Manzan K, Gnanazan G, Boni S. Results of urogenital fistulas repair using caravan approach in Côte d’Ivoire. Nepal J Obstet Gynaecol 2018. [DOI: 10.3126/njog.v13i2.21910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: To report the experience of surgical caravans for urogenital fistulas care.
Methods: It was a retrospective study covering the period from January 1st 2014 to December 31st 2014 and which took place on 7 sites of fistula care. The epidemiological, anatomic, clinical, therapeutic and evolutionary aspects were studied. Recruitment was made by radio announcements and word of mouth approaches. Treatment was free of charge for patients.
Results: During 14 caravans 346 patients were operated. Their mean age was 33.11 years (12 - 70 years). Most of these patients were without remunerative activities (80%) and without education (63.3%). They had been living with fistula for 6.08 years on average (0 to 42). Obstetrical etiology was predominant (87.9%), the otherswere iatrogenic and traumatic. According to the Kees Waaldijk classification, fistulas were distributed as follows: type I (67.4%), type II Aa (12.7%), type II Ab (8.4%) and type III (11.5%). The most common surgical approach was the transvaginal route (82.1%). The vesicovaginal splitting with separated suture of the bladder and the vagina was the basic technique (94.7%). The therapeutic results were judged after a follow-up of 1 month and 3 months. Lost to follow-up within that period was 23% i.e. 80 patients in month one and 70% (245 patients) at month three. The success rates evaluated in patients reviewed at month one and at month 3 were respectively 70% and 64%.
Conclusions: Caravan approach to recruit patients with fistula was feasible using local advertisements mans. Patients have been living with fistula for long time. Follow-up was difficult at Month 3.
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Ouffoue YG, Boni S, Kouassi KLJ, Konan AJ, Ouattara OAS, Cheucheu NJA, Ilupeju V, Gombe E, Fanny A. [When pterygium leads to blindness!!!]. J Fr Ophtalmol 2018; 41:879-880. [PMID: 30366622 DOI: 10.1016/j.jfo.2018.01.029] [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: 12/25/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Y G Ouffoue
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire.
| | - S Boni
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - K L J Kouassi
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - A J Konan
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - O A S Ouattara
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - N J A Cheucheu
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - V Ilupeju
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - E Gombe
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - A Fanny
- Service d'Ophtalmologie du Centre Hospitalier et Universitaire de Treichville, Abidjan, Côte d'Ivoire
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Bhangu A, Ademuyiwa AO, Aguilera ML, Alexander P, Al-Saqqa SW, Borda-Luque G, Costas-Chavarri A, Drake TM, Ntirenganya F, Fitzgerald JE, Fergusson SJ, Glasbey J, Ingabire JCA, Ismaïl L, Salem HK, Kojo ATT, Lapitan MC, Lilford R, Mihaljevic AL, Morton D, Mutabazi AZ, Nepogodiev D, Adisa AO, Ots R, Pata F, Pinkney T, Poškus T, Qureshi AU, Ramos-De la Medina A, Rayne S, Shaw CA, Shu S, Spence R, Smart N, Tabiri S, Harrison EM, Khatri C, Mohan M, Jaffry Z, Altamini A, Kirby A, Søreide K, Recinos G, Cornick J, Modolo MM, Iyer D, King S, Arthur T, Nahar SN, Waterman A, Walsh M, Agarwal A, Zani A, Firdouse M, Rouse T, Liu Q, Correa JC, Talving P, Worku M, Arnaud A, Kalles V, Kumar B, Kumar S, Amandito R, Quek R, Ansaloni L, Altibi A, Venskutonis D, Zilinskas J, Poskus T, Whitaker J, Msosa V, Tew YY, Farrugia A, Borg E, Bentounsi Z, Gala T, Al-Slaibi I, Tahboub H, Alser OH, Romani D, Shu S, Major P, Mironescu A, Bratu M, Kourdouli A, Ndajiwo A, Altwijri A, Alsaggaf MU, Gudal A, Jubran AF, Seisay S, Lieske B, Ortega I, Jeyakumar J, Senanayake KJ, Abdulbagi O, Cengiz Y, Raptis D, Altinel Y, Kong C, Teasdale E, Irwin G, Stoddart M, Kabariti R, Suresh S, Gash K, Narayanan R, Maimbo M, Grizhja B, Ymeri S, Galiqi G, Klappenbach R, Antezana D, Mendoza Beleño AE, Costa C, Sanchez B, Aviles S, Fermani CG, Balmaceda R, Villalobos S, Carmona JM, Hamill D, Deutschmann P, Sandler S, Cox D, Nataraja R, Sharpin C, Ljuhar D, Gray D, Haines M, Iyer D, Niranjan N, D'Amours S, Ashtari M, Franco H, Rahman Mitul A, Karim S, Aman NF, Estee MM, Salma U, Razzaque J, Hamid Kanta T, Tori SA, Alamin S, Roy S, Al Amin S, Karim R, Haque M, Faruq A, Iftekhar F, O'Shea M, Padmore G, Jonnalagadda R, Litvin A, Filatau A, Paulouski D, Shubianok M, Shachykava T, Khokha D, Khokha V, Djivoh F, Dossou F, Seto DM, Gbessi DG, Noukpozounkou B, Imorou Souaibou Y, Keke KR, Hodonou F, Ahounou EYS, Alihonou T, Dénakpo M, Ahlonsou G, Ginbo Bedada A, Nsengiyumva C, Kwizera S, Barendegere V, Choi P, Stock S, Jamal L, Azzie G, Kushwaha S, Chen TL, Yip C, Montes I, Zapata F, Sierra S, Villegas Lanau MI, Mendoza Arango MC, Mendoza Restrepo I, Restrepo Giraldo RS, Domini E, Karlo R, Mihanovic J, Youssef M, Elfeki H, Thabet W, Sanad A, Tawfik G, Zaki A, Abdel-Hameed N, Mostafa M, Omar MFW, Ghanem A, Abdallah E, Denewer A, Emara E, Rashad E, Sakr A, Elashry R, Emile S, Khafagy T, Elhamouly S, Elfarargy A, Mamdouh Mohamed A, Saied Nagy G, Esam A, Elwy E, Hammad A, Khallaf S, Ibrahim E, Said Badr A, Moustafa A, Eldosouky Mohammed A, Elgheriany M, Abdelmageed E, Al Raouf EA, Samir Elbanby E, Elmasry M, Morsy Farahat M, Yahya Mansor E, Magdy Hegazy E, Gamal E, Gamal H, Kandil H, Maher Abdelrouf D, Moaty M, Gamal D, El-Sagheer N, Salah M, Magdy S, Salah A, Essam A, Ali A, Badawy M, Ahmed S, Mohamed M, Assal A, Sleem M, Ebidy M, Abd-Elrazek A, Zahran D, Adam N, Nazir M, Hassanein AB, Ismail A, Elsawy A, Mamdouh R, Mabrouk M, Ahmed LAM, Hassab Alnaby M, Magdy E, Abd-Elmawla M, Fahim M, Mowafy B, Ibrahim Mahmoud M, Allam M, Alkelani M, Halim El Gendy N, Saad Aboul-Naga M, Alaa El-Din R, Elgendy AH, Ismail M, Shalaby M, Adel Elsharkawy A, Elsayed Moghazy M, Hesham Elbisomy K, Abdel Gawad Shakshouk H, Hamed MF, Ebidy MM, Abdelkader M, Karkeet M, Ahmed H, Adel I, Omar ME, Ibrahim M, Ghoneim O, Hesham O, Gamal S, Hilal K, Arafa O, Adel Awad S, Salem M, Abdellatif Elsherif F, Elsabbagh N, Aboelsoud MR, Hossam Eldin Fouad Rida A, Hossameldin A, Hany E, Hosny Asar Y, Anwar N, Gadelkarim M, Abdelhady S, Mohamed Morshedy E, Saad R, Soliman N, Salama M, Ezzat E, Mohamed A, Ibrahim A, Fergany A, Mohammed S, Reda A, Allam Y, Saad HA, Abdelfatah A, Fathy AM, El-Sehily A, Abdalmageed Kasem E, Hassan ATA, Mohammed AR, Saad AG, Elfouly Y, Elfouly N, Ibrahim A, Hassaan A, Mohammed MM, Elhoseny G, Magdy M, Abd Elkhalek E, Zakaria Y, Ezzat T, Abo El Dahab A, Kelany M, Arafa S, Mokhtar Mohamed Hassan O, Mohamed Badwi N, Saber Sleem A, Ahmed H, Abdelbadeai K, Abozed Abdullah M, Lokman MAA, Bahar S, Rady Abdelazeam A, Adelshone A, Bin Hasnan M, Zulkifli A, Kamarulzamil SNA, Elhendawy A, Latif A, Bin Adnan A, Shaharuddin S, Haji Abdul Majid AH, Amreia M, Al-Marakby D, Salma M, Ismail MJB, Mohd Basir ER, Mohd Ali CD, Ata AY, Nasr M, Rezq A, Sheta A, Tariq S, Sallam AE, Darwish AKZ, Elmihy S, Elhadry S, Farag A, Hajeh H, Abdelaal A, Aglan A, Zohair A, Essam M, Moussa O, El-Gizawy E, Samy M, Ali S, El Halawany E, Ata A, El Halawany M, Nashat M, Soliman S, Elazab A, Samy M, Abdelaziz MA, Ibrahim K, Ibrahim AM, Gado A, Hantour U, Alm Eldeen E, Loaloa MR, Abouzaid A, Ahmed Bahaa Eldin M, Hashad E, Sroor F, Gamil D, Mahmoud Abdulhakeem E, Zakaria M, Mohamed F, Abubakr M, Ali E, Magdy H, Ramadan MT, Abdelaty Mohamed M, Mansour S, Abdul Aziz Amin H, Rabie Mohamed A, Saami M, Ahmed Reda Elsayed N, Tarek A, Mohy Eldeen Mahmoud S, Magdy El Sayed I, Reda A, Yusuf Shawky M, Mousa Salem M, Alaa El-Din S, Abdullah Soliman N, Talaat M, Alaael-Dein S, Abd Elmoen Elhusseiny A, Abdullah N, Elshaar M, Abdelfatah Ibraheem A, Abdulaziz H, Kamal Ismail M, Hamdy Madkor M, Abdelaty M, Mahmoud Abdel-Kader S, Mohamed Salah O, Eldafrawy M, Zaki Eldeeb A, Mahmoud Eid M, Attia A, Salah El-Dien K, Shwky A, Badenjki MA, Soliman A, Mahmoud Al Attar S, Sayed F, Abdel Sabour F, Azizeldine MG, Shawqi M, Hashim A, Aamer A, Abdelraouf AM, Abdelshakour M, Ibrahim A, Mahmoud B, Ali Mahmoud M, Qenawy M, Rashed AM, Dahy A, Sayed M, Shamsedine AW, Mohamed B, Hasan A, Saad MM, Abdul Bassit K, Khalid Abd El-Latif N, Elzahed N, El Kashash A, Bekhet NM, Hafez S, Gad A, Maher ME, Abd El-Sameea A, Hafez M, Sabe A, Ahmed A, Shahine A, Dawood K, Gaafar S, Husseiny R, Aboelmagd O, Soliman A, Mesbah N, Emadeldin H, Al Meligy A, Bekhet AH, Hasan D, Alhady K, Sabe AK, Elnajjar MA, Aboelella M, Hamsho W, Hassan I, Saad H, Abdelazim G, Mahmoud H, Wael N, Kandil AM, Magdy A, Said Elkholy S, Adel BE, Dabbour K, Elsherbiney S, Mattar O, Khaled AbdRabou A, Aly MYM, Geuoshy A, Elnagar A, Ahmed S, Abdelmotaleb I, Saleh AA, Mohammed Bakry H, Saeed M, Mahmoud S, Tawfik BA, Ismail SA, Zakaria E, Gad MO, Salah Elhelbawy M, Bassem M, Maraie N, Medhat Elhadary N, Semeda N, Rabie Mohamed S, Bakry HM, Essam AA, Tarek D, Ashour K, Elhadad A, Abdel-Aty A, Rakha I, Mamdouh Matter S, Abdelhamed R, Abdelkader O, Hassaan A, Soliman Y, Mohamed A, Ghanem S, Amr Mohamed Farouk S, Ibrahim EM, El-Taher E, Mostafa M, Mahrous Badr MF, Elsemelawy R, El-Sawy A, Bakr A, Al Rafati AAR, Saar S, Reinsoo A, Seyoum N, Worku T, Fitsum A, Tolonen M, Leppäniemi A, Sallinen V, Parmentier B, Peycelon M, Irtan S, Dardenne S, Robert E, Maillot B, Courboin E, Arnaud AP, Hascoet J, Abbo O, Ait Kaci A, Prudhomme T, Ballouhey Q, Grosos C, Fourcade L, Cecilia T, Jean-Francois C, Helene FC, Delforge X, Haraux E, Dousset B, Schiavone R, Gaujoux S, Marret JB, Haffreingue A, Rod J, Renaux-Petel M, Lecompte JF, Bréaud J, Gastaldi P, Taieb C, Claire R, Anis E, Bustangi N, Lopez M, Scalabre A, Grella MG, Mariani A, Podevin G, Schmitt F, Hervieux E, Broch A, 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Ali THA, Rekhis S, Rommaneh M, Sam ZH, Pugliesi TB, Pardo G, Blanco R. Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis 2018; 18:516-525. [PMID: 29452941 PMCID: PMC5910057 DOI: 10.1016/s1473-3099(18)30101-4] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/06/2017] [Accepted: 12/15/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. METHODS This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. FINDINGS Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05-2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). INTERPRETATION Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. FUNDING DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.
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Sticchi C, Alberti M, Artioli S, Assensi M, Baldelli I, Battistini A, Boni S, Cassola G, Castagnola E, Cattaneo M, Cenderello N, Cristina ML, De Mite AM, Fabbri P, Federa F, Giacobbe DR, La Masa D, Lorusso C, Marioni K, Masi VM, Mentore B, Montoro S, Orsi A, Raiteri D, Riente R, Samengo I, Viscoli C, Carloni R. Regional point prevalence study of healthcare-associated infections and antimicrobial use in acute care hospitals in Liguria, Italy. J Hosp Infect 2017; 99:8-16. [PMID: 29253622 DOI: 10.1016/j.jhin.2017.12.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 08/03/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Given the importance of monitoring healthcare-associated infections (HCAIs) and the consumption of antibiotics, a regional point prevalence survey was conducted in Liguria between March and April 2016. AIM To measure the overall prevalence of HCAI and describe the use of antibiotics in all public hospitals. METHODS Data on risk factors and use of antibiotics were collected for each hospitalized patient. To define the variables significantly associated with HCAI, univariate and multivariate analyses were conducted. Standardized infection ratio and standardized antimicrobial use ratio were measured for each participating hospital. FINDINGS A total of 3647 patients were enrolled. In all, 429 HCAIs were diagnosed in 376 patients, giving a prevalence of HCAI of 10.3%. Respiratory tract (21.7%) and urinary tract (20%) were the most frequent sites of infection. High rates of meticillin-resistant Staphylococcus aureus (47.4%) and Enterobacteriaceae resistant to carbapenems (26.3%) were isolated. Forty-six percent of patients received at least one antibiotic. Combinations of penicillins including β-lactamase inhibitors (24.1%) were the most widely used; the main indication (46.7%) was the treatment of a community-acquired infection. CONCLUSION There was an increase in HCAI prevalence compared to a similar survey conducted in 2007; however, the performance of overlapping investigations will enable more reliable considerations. Nevertheless, data on antimicrobial resistance and use of antibiotics are consistent with the national trend. Despite methodological limitations, prevalence studies are useful to monitor HCAI over time and encourage greater awareness of the problem by all stakeholders.
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Affiliation(s)
- C Sticchi
- Infectious Diseases, Epidemiology and Prevention, Health Regional Agency, Liguria, Italy.
| | - M Alberti
- International Evangelical Hospital, Genoa, Italy
| | | | | | - I Baldelli
- IRCCS Giannina Gaslini Institute, Genoa, Italy
| | | | - S Boni
- ASL 5 Spezzino, La Spezia, Italy
| | - G Cassola
- Infectious Diseases Unit, Galliera Hospital, Genoa, Italy
| | - Elio Castagnola
- Infectious Diseases Unit, Giannina Gaslini Institute, Genoa, Italy
| | | | | | | | | | | | | | - D R Giacobbe
- Infectious Diseases Unit, San Martino Polyclinic Hospital, University of Genoa, Italy
| | - D La Masa
- IRCCS Giannina Gaslini Institute, Genoa, Italy
| | | | | | - V M Masi
- International Evangelical Hospital, Genoa, Italy
| | | | | | - A Orsi
- San Martino Polyclinic Hospital, Genoa, Italy
| | - D Raiteri
- Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - R Riente
- San Paolo Hospital, Savona, Italy
| | | | - C Viscoli
- Infectious Diseases Unit, San Martino Polyclinic Hospital, University of Genoa, Italy
| | - R Carloni
- Infectious Diseases, Epidemiology and Prevention, Health Regional Agency, Liguria, Italy
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Fumagalli S, Pupo S, Scardia A, Giannini I, Boni S, Migliorini M, Fumagalli C, Di Bari M, Potpara T, Dagres N, Padeletti L, Marchionni N. P1377The effects of sinus rhythm restoration on physical performance of elderly patients with persistent atrial fibrillation. Does it matter? Europace 2017. [DOI: 10.1093/ehjci/eux158.005] [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: 11/14/2022] Open
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Tanon AK, Assouan C, Anzouan-Kacou E, N'guessan D, Salami A, Boni S, Konan E. [Pseudo-tumoral invasive fungus infection of the maxillary sinus in Abidjan]. J Mycol Med 2017; 27:285-289. [PMID: 28336168 DOI: 10.1016/j.mycmed.2017.02.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The invasive fungal infection of the maxillary sinus is a rare and serious disease generally favored by immunosuppression. We report an exceptional case of pseudotumoral invasive fungal infection of the maxillary sinus in an immunocompetent patient. OBSERVATION A 32-year-old patient consulted for labial and left temporal swelling associated with proptosis and chemosis that has been developing for 18 months. The scanner objectified a filling of the left maxillary sinus, and the ipsilateral orbital cavity, and the surrounding muscles. Histological examination of the surgical specimen revealed invasive fungal infection of the left maxillary sinus. The relevant antifungal therapy, namely voriconazole, could not be administered due to the unavailability of the medicine. However, the patient has received 200mg of itraconazole every 12hours for three weeks. The change proved disappointing with recurrence and significant sequelae, sort of sagging of the right hemifacial, severe limitation of mouth opening and functional loss of the right eye. CONCLUSION The invasive fungus infections of the maxillary sinus and the orbit are exceptional in immunocompetent patient. Healing is based on early diagnosis and administration of the reference antifungal to face the risk of recurrence.
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Affiliation(s)
- A K Tanon
- Service des maladies infectieuses et tropicales, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - C Assouan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Anzouan-Kacou
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - D N'guessan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - A Salami
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire.
| | - S Boni
- Service d'ophtalmologie, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Konan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
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Abstract
La diagnosi di instabilità del rachide lombo-sacrale è, a tutt'oggi, fondamentalmente clinica. Anche le più sofisticate tecniche di diagnostica radiologica consentono infatti solo una valutazione statica di questa entità nosologica (che, per definizione si manifesta durante la deambulazione e con la stazione eretta) la cui definizione dinamica è campo pressochè esclusivo della radiologia convenzionale. Presentiamo i risultati di uno studio condotto attraverso l'uso di uno strumento originale progettato per sviluppare un carico assiale variabile e riproducibile in un paziente supino: il Compressore assiale. Con questo strumento, compatibile con l'esecuzione di esami TC, sono stati valutati 24 pazienti con forte sospetto clinico-radiologico di instabilità lombare. La metodica di studio, denominata Axial Loaded - Computed Tomography (AL-CT) si basa sull'acquisizione successiva di esami TC basali e con carico assiale (AL), che vengono poi comparati. Il confronto avviene sia sulle scansioni assiali che su immagini ricostruite su piani sagittali e con «rendering» tridimensionale (3D-TC). La valutazione comparativa prevede sia l'uso di immagini statiche che l'organizzazione in sequenze cine (cine AL-CT) delle immagini 2D e 3D ottenute. Tutti i procedimenti di rielaborazione sono indispensabili nella valutazione dei risultati. I risultati mostrano con chiarezza reperti (numerosi e spesso simultanei) a carico di tutte le component le unità funzionali spinali; fra questi meritano una segnalazione: l'incremento o la accentuazione di protrusioni discali sotto carico; la scomparsa del vacuum discale e/o intraarticolare durante la compressione («segno del vacuum»); l'accentuazione della listesi sotto carico; la ottimale ed originale visualizzazione dell' ipermobilità delle faccette articolari. Proponiamo AL-CT e cine AL-CT come metodiche di scelta nello studio dell'instabilità lombare.
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Affiliation(s)
| | - G.B. Scarfò
- Cattedra di Neurochirurgia, Università di Siena
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Cartolari R, Boni S, Perugini L, Vocino L, Scarfò G. La Tomografia Computerizzata Tridimensionale (3D-TC) nella patologia vascolare intracranica. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099400700504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
È stata valutata l'utilità diagnostica del rendering tridimensionale di esami TC (3D-TC) nelle malformazioni artero-venose e negli aneurismi del poligono di Willis. Particolare attenzione è stata posta sulla scelta dei valori di soglia di campionamento delle tessere, da cui dipendono sia la qualità che il significato diagnostico dell'imagine 3D ottenuta. Il rendering 3D concentra in poche immagini significative una considerevole quantità di informazioni con passaggio di un elevato flusso informativo dal radiologo al clinico. In particolari situazioni di diagnostica differenziale la scelta di corretti valori di soglia («segno dell a soglia») può fornire informazioni diagnostiche originali.
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Affiliation(s)
| | | | | | | | - G.B. Scarfò
- Cattedra di Neurochirurgia, Policlinico Le Scotte, Università degli Studi di Siena
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Affiliation(s)
- R. Cartolari
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
| | - G. Argento
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
| | - P. Cardello
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
| | - M. Ortenzi
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
| | - R. Petti
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
| | - S. Boni
- Servizio di Radiologia, Ospedale Provinciale di Belcolle; Viterbo
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Ippolito A, Boni S, Cinque E, Greco A, Salis S. Using Time-Driven Activity-Based Costing to Establish a Tariff System for Home Health Care Services. J Healthc Manag 2016; 61:436-447. [PMID: 28319962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Adelaide Ippolito
- Adelaide Ippolito, PhD, consultant, Formez PA, Rome, Italy; Silvia Boni, Dr., head, Health Organization and Social Policy Unit, Formez PA, Rome; Ettore Cinque, professor of accounting, Second University of Naples, Italy, and former acting subcommissioner for health services, Campania Region, Italy; Annarita Greco, Dr., public servant, Health and Social Interventions Unit, Campania Region, Naples; and Salima Salis, Dr., coordinator, Campania Region Activities, Formez PA, Cagliari, Italy
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Bozzano F, Marras F, Ascierto ML, Cantoni C, Cenderello G, Dentone C, Di Biagio A, Orofino G, Mantia E, Boni S, De Leo P, Picciotto A, Braido F, Antonini F, Wang E, Marincola F, Moretta L, De Maria A. 'Emergency exit' of bone-marrow-resident CD34(+)DNAM-1(bright)CXCR4(+)-committed lymphoid precursors during chronic infection and inflammation. Nat Commun 2015; 6:8109. [PMID: 26436997 PMCID: PMC4600731 DOI: 10.1038/ncomms9109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 07/20/2015] [Indexed: 02/07/2023] Open
Abstract
During chronic inflammatory disorders, a persistent natural killer (NK) cell derangement is observed. While increased cell turnover is expected, little is known about whether and how NK-cell homeostatic balance is maintained. Here, flow cytometric analysis of peripheral blood mononuclear cells in chronic inflammatory disorders, both infectious and non-infectious, reveals the presence of a CD34(+)CD226(DNAM-1)(bright)CXCR4(+) cell population displaying transcriptional signatures typical of common lymphocyte precursors and giving rise to NK-cell progenies with high expression of activating receptors and mature function and even to α/β T lymphocytes. CD34(+)CD226(bright)CXCR4(+) cells reside in bone marrow, hardly circulate in healthy donors and are absent in cord blood. Their proportion correlates with the degree of inflammation, reflecting lymphoid cell turnover/reconstitution during chronic inflammation. These findings provide insight on intermediate stages of NK-cell development, a view of emergency recruitment of cell precursors, and upgrade our understanding and monitoring of chronic inflammatory conditions.
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Affiliation(s)
- Federica Bozzano
- Department of Experimental Medicine, University of Genova, Via Pastore 1, Genova 16132, Italy.,Center for Excellence in Biomedical Research, University of Genova, Via Pastore 1, Genova 16132, Italy
| | | | - Maria Libera Ascierto
- Department of Transfusion Medicine, Clinical Center and Center of Human Immunology, National Institutes of Health, Bethesda, Maryland 20892, USA.,Department of Oncology, Johns Hopkins University, Baltimore, Maryland 21231, USA
| | - Claudia Cantoni
- Department of Experimental Medicine, University of Genova, Via Pastore 1, Genova 16132, Italy.,Center for Excellence in Biomedical Research, University of Genova, Via Pastore 1, Genova 16132, Italy.,Istituto Giannina Gaslini, Genova 16148, Italy
| | - Giovanni Cenderello
- U.O.C. Malattie Infettive, Ospedale Galliera, Mura delle Cappuccine 14, Genova 16128, Italy
| | - Chiara Dentone
- U.O.C. Malattie Infettive, Ospedale Sanremo, Via Privata Barabino 15, Sanremo 18038, Italy
| | - Antonio Di Biagio
- Clinica Malattie Infettive, IRCCS AOU San Martino-IST Genova, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi 10, Genova 16132, Italy
| | - Giancarlo Orofino
- SOC Malattie Infettive ASO S.S. Antonio e Biagio e C. Arrigo Alessandria, 15100, Italy
| | - Eugenio Mantia
- U.O.C. Malattie Infettive, Ospedale Amedeo di Savoia, Torino 10149, Italy
| | - Silvia Boni
- U.O.C. Malattie Infettive, Ospedale Sant'Andrea, La Spezia 19121, Italy
| | - Pasqualina De Leo
- U.O.C. Malattie Infettive, Azienda Sanitaria Locale n.2, Savona 17100, Italy
| | - Antonino Picciotto
- Allergy and Respiratory Unit, Department of Internal Medicine, University of Genova, Via Pastore 1, Genova 16132, Italy
| | - Fulvio Braido
- Hepatology Unit, Department of Internal Medicine, University of Genova, Via Pastore 1, Genova 16132, Italy
| | | | - Ena Wang
- Department of Transfusion Medicine, Clinical Center and Center of Human Immunology, National Institutes of Health, Bethesda, Maryland 20892, USA.,Sidra Medical and Research Centre, Doha P.O. BOX 26999, Qatar
| | | | | | - Andrea De Maria
- Center for Excellence in Biomedical Research, University of Genova, Via Pastore 1, Genova 16132, Italy.,Clinica Malattie Infettive, IRCCS AOU San Martino-IST Genova, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi 10, Genova 16132, Italy.,Department of Health Sciences, DISSAL, University of Genova, Via Pastore 1, Genova 16132, Italy
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Boni S, Barbieri S, Frisoni P, Benedetti S, Snenghi R, Bergamini M, Vettore G, Omizzolo L, Avato FM, Feltracco P, Gaudio RM. The influence of social networks on unusual sexual practices and the related health impact. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.106] [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: 11/12/2022] Open
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Mian D, Itoua C, Angoi V, Gbary E, Nguessan K, Iloki H, Boni S. Late diagnosis of positive HIV serology in pregnancy incidentally discovered by the widespread appearance of Kaposi’s sarcoma. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1706.2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Mian DB, Itoua C, Angoi V, Gbary E, Nguessan KLP, Iloki H, Boni S. Late diagnosis of positive HIV serology in pregnancy incidentally discovered by the widespread appearance of Kaposi's sarcoma. CLIN EXP OBSTET GYN 2015; 42:378-380. [PMID: 26152016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The authors report a case of Kaposi's sarcoma (KS) found in a pregnant woman. On discovery, the condition had spread throughout her body as is characteristic in some cases of individuals with HIV-positive serology. She was unaware of her HIV positive status. Her HIV infection had been diagnosed at the same time as KS at her last prenatal consultation. The newborn was delivered by an uncomplicated cesarean section. Appropriate treatment and multidisciplinary management after childbirth resulted in complete remission.
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Sulyok M, Beed F, Boni S, Abass A, Mukunzi A, Krska R. Quantitation of multiple mycotoxins and cyanogenic glucosides in cassava samples from Tanzania and Rwanda by an LC-MS/MS-based multi-toxin method. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2014; 32:488-502. [PMID: 25350522 DOI: 10.1080/19440049.2014.975752] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A multi-mycotoxin method based on liquid chromatography/tandem mass spectrometry (LC-MS/MS) was used for a mycotoxin survey in 627 samples of processed cassava collected from different districts across Tanzania and Rwanda after the method performance for this matrix had been determined. Matrix effects as well as extraction efficiencies were found to be similar to most other previously investigated matrices with the exception of distinct matrix effects in the negative ionisation mode for early eluting compounds. Limits of detection were far below the regulatory limits set in the European Union for other types of commodities. Relative standard deviations were generally lower than 10% as determined by replicates spiked on two concentration levels. The sample-to-sample variation of the apparent recoveries was determined for 15 individually spiked samples during three different analytical sequences. The related standard deviation was found to be lower than 15% for most of the investigated compounds, thus confirming the applicability of the method for quantitative analysis. The occurrence of regulated mycotoxins was lower than 10% (with the exception of zearalenone) and the related limits were exceeded only in few samples, which suggests that cassava is a comparatively safe commodity as regards mycotoxins. The most prevalent fungal metabolites were emodin, kojic acid, beauvericin, tryptophol, 3-nitropropionic acid, equisetin, alternariol methylether, monocerin, brevianamide F, tenuazonic acid, zearalenone, chrysophanol, monilifomin, enniatins, apicidin and macrosporin. The related concentrations exceeded 1 mg kg(-1) only in few cases. However, extremely high levels of cyanogenic plant toxins, which had been previously added to the method, were observed in few samples, pointing out the need for improved post-harvest management to decrease the levels of these compounds.
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Affiliation(s)
- M Sulyok
- a Department for Agrobiotechnology (IFA-Tulln) , University of Natural Resources and Life Sciences, Vienna (BOKU) , Tulln , Austria
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Nguessan K, Nguessan E, Mian D, Guie P, Boni S. Spontaneous cutaneous umbilical endometriosis: a rare variant of extragenital endometriosis. CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog17072014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Mian D, Nguessan K, Aissi G, Boni S. Amniotic band syndrome (ABS): can something be done during pregnancy in African poor countries? Three cases and review of the literature. CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog16172014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Fanny A, Coulibaly F, Ouattara A, Sangaré Y, Bérété-Coulibaly R, Gbé K, Boni S. [Cataracts related to the extended application of dermocorticosteroids. A study of 8 cases in Abidjan]. J Fr Ophtalmol 2014; 37:388-92. [PMID: 24703192 DOI: 10.1016/j.jfo.2013.11.011] [Citation(s) in RCA: 3] [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: 05/06/2013] [Revised: 11/17/2013] [Accepted: 11/22/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cataract induced by corticosteroids is an entity, which has been well described for a relatively long time, but this eventuality caused by the cutaneous application of corticosteroids remains inadequately reported. The purpose of this study was to describe cataract as one of the complications of the misuse of cutaneous application of corticosteroids. MATERIALS AND METHODS In eight patients seen for visual loss, bilateral cataract was discovered. The only probable etiology in these cases appeared to be the cutaneous application of corticosteroids. Indeed, the work-up and careful history performed did not uncover any other etiology. RESULTS Eight patients, six women and two men, exhibited cataracts related to the application of topical corticosteroids. The age of the patients ranged between 39 and 45 years. The cataracts were bilateral and posterior subcapsular alone or combined. The period of use of corticosteroids ranged from 5 to 10 years. The products used consisted of a variety of chemicals including corticosteroids mainly in the form of traditionally manufactured soap, but also as ointment or other types of mixtures. CONCLUSION Topical corticosteroids induce posterior subcapsular cataract. The mechanism of action is direct access to the eye without any hepatic-first pass effect on the corticosteroid in question. The increasingly frequent use of corticosteroids in African blacks for skin lightening raises concern regarding the risk of epidemic cataracts in young women attempting to lighten their skin to be beautiful. Increased public awareness should be undertaken to prevent this growing and harmful phenomenon.
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Affiliation(s)
- A Fanny
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire
| | - F Coulibaly
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire
| | - A Ouattara
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire.
| | - Y Sangaré
- Hôpital des fonctionnaires, angle du boulevard Angoulvan et de l'avenue Terrasson de Fougères, Abidjan, Côte d'Ivoire
| | - R Bérété-Coulibaly
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire
| | - K Gbé
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire
| | - S Boni
- Service d'ophtalmologie, CHU de Treichville, boulevard de Marseille, 01 BP V 03, Abidjan 01, Côte d'Ivoire
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Mian DB, Nguessan KLP, Aissi G, Boni S. Amniotic band syndrome (ABS): can something be done during pregnancy in African poor countries? Three cases and review of the literature. CLIN EXP OBSTET GYN 2014; 41:226-232. [PMID: 24779260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Amniotic band syndrome (ABS) is a fetal congenital malformation, affecting mainly the limbs, but also the craniofacial area and internal organs. Two mains pathogenic mechanisms are proposed in its genesis. Firstly the early amnion rupture (exogenous theory) leading to fibrous bands, which wrap up the fetal body; secondly, the endogenous theory privileges vascular origin, mesoblastic strings not being a causal agent. The authors believe that the second theory explain the occurrence of ABS. The outcome of the disease during pregnancy depends on the gravity of the malformations. Interruption of the pregnancy is usually proposed when diagnosis of severe craniofacial and visceral abnormalities is confirmed. Whereas minor limb defects can be repaired with postnatal surgery. In case of an isolated amniotic band with a constricted limb, in utero lysis of the band can be considered to avoid a natural amputation. In an African country, such treatment is not possible as far as the antenatal diagnosis.
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Nguessan KLP, Nguessan E, Mian DB, Guie P, Boni S. Spontaneous cutaneous umbilical endometriosis: a rare variant of extragenital endometriosis. CLIN EXP OBSTET GYN 2014; 41:486-488. [PMID: 25134308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Umbilical endometriosis is a very uncommon condition which presents as a pigmented umbilical nodule, papular or cystic, with symptoms punctuated rhythmed by menses. The authors report the case of a 32-year-old with spontaneous umbilical endometriosis. Surgical resection was performed with a good cosmetic result and no recurrence at six months. A review of the literature allowed the authors to discuss the diagnosis difficulties and treatment in a underdeveloped country.
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Nguessan KLP, Mian DB, Kasse K, Boni S. Vulvar squamous cell carcinoma developing in a young black African HIV woman. EUR J GYNAECOL ONCOL 2013; 34:496-499. [PMID: 24475594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Vulvar cancers are uncommon, represented in 90% of cases by squamous cell carcinoma (SCC). The reduction of the frequency and the severity proceed by recognition of precancerous or beginning lesions. They occur most often in the third age in postmenopausal women. The diagnosis is almost difficult and often late and therefore prognosis is severe. Conditions for diagnosis and treatment are difficult in underdeveloped countries due to the inaccessibility of proper equipment in the healthcare system. The authors report a case of SCC diagnosed late in a young human immunodeficiency virus (HIV) women who have been treated with neoadjuvant chemotherapy and radical surgery of the vulva.
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Affiliation(s)
- K L P Nguessan
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Republic of Ivory Coast
| | - D B Mian
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Republic of Ivory Coast
| | - K Kasse
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Republic of Ivory Coast
| | - S Boni
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Republic of Ivory Coast
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Nguessan KLP, Mian DB, Aissi GA, Oussou C, Boni S. Spontaneous rupture of uterine varices in third trimester pregnancy: an unexpected cause of hemoperitoneum. A case report and literature review. CLIN EXP OBSTET GYN 2013; 40:175-177. [PMID: 23724540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The authors report a case of spontaneous rupture of uterine varices occurring in the third trimester of pregnancy. It was responsible for a collapse in breast hemoperitoneum. The patient, whose pregnancy was a simple, suddenly felt symptoms of preterm labor. There was a rapid onset of maternal collapse with acute fetal distress. Only emergency exploratory laparotomy allowed for etiological diagnosis and treatment.
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Affiliation(s)
- K L P Nguessan
- Department of Gynecology and Obstetrics of the University High School of Cocody-Abidjan, Cote D'lvoire
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Boni S, Barale PO, Gendron G, Poisson F, Scheer S, Sahel JA. [Surgery of the idiopathic epimacular membrane on transconjunctival 25-gauge vitrectomy (TSV): a series of 50 cases]. J Fr Ophtalmol 2010; 33:544-50. [PMID: 20863595 DOI: 10.1016/j.jfo.2010.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 06/29/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND The surgery of the idiopathic epimacular membrane has gained from the advent of 25-gauge transconjunctival vitrectomy (TSV) initiated by Fujii in 2002. PATIENTS AND METHODS In this retrospective study, we tested 50 patients operated on for epimacular membrane with 25-gauge TSV at the Quinze-Vingts National Ophthalmology Hospital in Paris from December 2004 to June 2006. RESULTS No postoperative endophthalmitis, major hypotonia, or sclerotomy leakage were observed. However, two cases (4%) of retinal detachment and 47% postoperative cataract were noted at 3 months. After evolving 3 months later, distant and close visual acuity were significantly improved. CONCLUSION TSV appears to be a useful method for epimacular membrane ablation.
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Affiliation(s)
- S Boni
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France.
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Odoulami Yehouessi L, Twagirayezu B, Boni S, Tchabi S, Sounouvou I, Doutetien C. [Influence of ethnic and eye condition on ultrasound A in ophthalmology at UHNC-HKM of Cotonou]. Mali Med 2010; 25:28-31. [PMID: 21435995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To study impact of sociocultural groups and ocular condition on biometric data at University and Hospital National Center of Cotonou PATIENTS AND METHODS We conducted a descriptive cross-sectional study from 1st January to March 31, 2009 in the eye clinic at CNHU-HKM of Cotonou. It involved 116 patients aged over 16 years and Beninese nationality. RESULTS The mean age was 48 years ± 15.7. The sex ratio was 0.78. The "fon" socio-cultural's group was the largest with 43.96%. The eye condition was normal in 79 cases (68.10%). Primary glaucoma with open angle (OAPG) and cataract were observed in respectively 18.10% and 13.79%. Biometrics eye was not influenced by the socio-cultural groups, or by the OAPG. In contrast, cataract induced increase in the lens's thickness and reducing the depth of anterior chamber. CONCLUSION The lens plays a key role in changing the biometrics of the anterior segment.
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Affiliation(s)
- L Odoulami Yehouessi
- Clinique Ophtalmologique du Centre National et Universitaire de Cotonou, 01BP188 Cotonou.
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Torre F, Basso M, Giannini EG, Feasi M, Boni S, Grasso A, De Leo P, Dodi F, Marazzi MG, Azzola E, Bartolacci V, Percario G, Beltrame A, Borro P, Picciotto A. Clinical and virological survey of patients with hepatitis B surface antigen in an Italian region: Clinical considerations and disease burden. J Med Virol 2009; 81:1882-6. [DOI: 10.1002/jmv.21523] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Boni S, Tuil E, Barale P, Scheer S, Sahel J. Aspect de nécrose maculaire précédant un trou maculaire à la suite d’un accident de laser. J Fr Ophtalmol 2009; 32:286.e1-3. [DOI: 10.1016/j.jfo.2009.01.011] [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] [Received: 07/29/2008] [Accepted: 01/27/2009] [Indexed: 11/26/2022]
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N'guessan K, Kouakou F, Loué V, Angoi V, Abauleth Y, Boni S. [Cervical cancer: epidemiology and medical assistance in African society]. Mali Med 2009; 24:27-30. [PMID: 20093208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The aim of this study was to improve the medical assistance and the prognostic of cervical cancer in African society. MATERIALS AND METHODS It was a retrospective and descriptive study carried out in the gynecology and obstetrics department at the teaching hospital of Cocody. It spanned over five years, from January 1st, 2002 to December 31st, 2006. It was focused on 171 cases of cervical cancer histologically confirmed. RESULTS The frequency of cervical cancer in that study was 1.7%. Patients had an average age of 48.5 years. 38.7% of patients were aged between 41 and 50. Multiparous represented 73.1% of patient with a majority of 38.6% for seven births and more. Patient socio-economic background was low in 72% of cases, married and divorced patients represented 63.2%. Patients who had an early sex and those with numerous partners respectively represented 77.2% and 73.2%. In 70.2% of cases, they had suffered a sexually transmitted infection once. Extension rate was limited to the financial capacities of our patients. Operable stages represented 19.3% and belated stages 57.1%. Only 8.8% of our patients were operated. The average theoretical cost of the surgical treatment was 298.203 F CFA. CONCLUSION This study showed that to improve medical assistance to patients, it is (capital) urgent to face efficiently the out break of factors of risk and improve diagnosis and therapy.
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N'guessan K, Kouakou F, Loué V, Angoi V, Abauleth Y, Boni S. [Placenta praevia: maternal and featal prognosis in University Hospital of Cocody (Abidjan-Cote d'Ivoire)]. Mali Med 2009; 24:57-59. [PMID: 19666372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION In Africa, in spite of systematical practice of echography, Placenta praevia (PP) remains a high risky gravid complication, very unpredictable, with a high lethality rate. OBJECTIVES The aim of our study was to reconsider the frequency of this pathology, to appreciate the maternal and fetal prognosis. PATIENTS AND METHODS This was a retrospective cohort study, about 340 cases of PP, at the University Hospital of Cocody in Abidjan, during 5 years, from January 1st 2002 to December 31st 2006. We included in this study all the parturients with a gestational age > or = 28 weeks of amenorrhea, and a PP diagnosed during either pregnancy, or labour, or after placenta stage. Maternal age, parity, gynecologic and obstetrical antecedents, mode of delivery and maternal and fetal prognosis was compared between patients with PP and a group of witness chosen among normal pregnancies. The comparison has been done by using X² and Fischer test with a threshold of signification of 5%. RESULTS The frequency of PP in our study was 1.6%. The maternal age was > or = 30 years old for 43.2% of patients with PP against 28% in witness group (p=0.000). Among cases of PP, multiparous and high multiparous represented 37.7% against 10% in the witness group. Healing uterus was an increasing factor of PP (32 cases against 8 in witness group; p=0.024). Caesarean operation has been the principal mode of delivery among the patients with PP (80%). 43.8% of newborn was premature against 8.5% in the witness group (p=0.0000). The perinatal mortality was 21.3% in cases of PP against 3.8% in witness group. Three maternal deaths (0.9%) have been noticed among patients with PP. CONCLUSION The management of PP is still badly definite in Africa. The early diagnostic by ultrasound examination permit an adapted supervision and the prevention of all obstetrical complications of this pathology.
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Affiliation(s)
- K N'guessan
- University Hospital of Cocody, Abidjan, Cote d'Ivoire
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Fanny A, Gbé K, Coulibaly F, Bérété-Coulibaly R, Boni S, Ouattara A, Kéita M. [Central serous chorioretinopathy: a study of six cases observed in Abidjan between 2003 and 2005, suggesting a role played by the Ivorian political-military crisis]. J Fr Ophtalmol 2008; 31:1018-24. [PMID: 19107079 DOI: 10.1016/s0181-5512(08)74749-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to show that central serous chorioretinopathy is present in Ivory Coast and that the emotional and psychosocial context plays an important role in this disorder's pathogenesis. PATIENTS AND METHOD The authors report six central serous chorioretinopathy cases based on angiographic diagnosis, five in Black African subjects and one in a European subject. These cases were observed over a period of 2 years during the Ivorian political-military crisis. RESULTS In a center where angiography has been a current practice since 1999, up to 2002 479 angiographies were done without a single central serous chorioretinopathy case being diagnosed. After the beginning of the political-military crisis, six cases of central serous chorioretinopathy were observed out of 417 angiographies over a period of 2 years. All the patients were males, between 20 and 50 years old, five were Black Africans and one was a white European. Their professions varied (a contractor, a soldier, a business executive, for example). The angiography showed break points in ink spots in the majority of the cases, with one case showing multiple break points. All the patients were emotionally distraught because of the uncertainty of the political situation. CONCLUSION This study confirms that central serous chorioretinopathy does indeed exist in the Black African subject, as it exists in the leucoderma subject without discrimination. This study emphasizes the anxiety and extreme emotional context as an initiating factor in the occurrence of central serous chorioretinopathy.
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Affiliation(s)
- A Fanny
- Service d'ophtalmologie, CHU Treichville, Abidjan, Côte d'Ivoire.
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Fanny A, Ouattara A, Coulibaly F, Nigué L, Gbé K, Bérété-Coulibaly R, Boni S, Soumahoro M. Épaisseur cornéenne centrale et erreur potentielle de la tonométrie à aplanation de Goldmann chez le patient noir africain atteint de glaucome primitif à angle ouvert. J Fr Ophtalmol 2008; 31:405-8. [PMID: 18563040 DOI: 10.1016/s0181-5512(08)71435-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Odoulami L, Le-Lez ML, Boni S, Madern F, Pisella PJ. [Endothelial changes during penetrating keratoplasty]. Mali Med 2008; 23:41-44. [PMID: 19437814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The authors analyzed the post operative results of the penetrating keratoplasty after removal suture in Ophthalmology Service of University and Hospital's Center in Tours. The age of patients varied 20 to 90 years with an average of 56,83 years. 41,71% of patients had a pseudophakic or aphakic bullous keratopathy. Ocular hypertony was the most frequently post operative complication (63,67%). Final removal's suture improved the transparency of grafts and so the visual acuity in spite of greater endothelial cell loss (65,65%) and residual corneal oedema.
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Affiliation(s)
- L Odoulami
- Service d' Ophtalmologie du Centre National Hospitalier et Universitaire de Cotonou, Bénin
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Bassetti M, Repetto E, Righi E, Boni S, Diverio M, Molinari MP, Mussap M, Artioli S, Ansaldi F, Durando P, Orengo G, Bobbio Pallavicini F, Viscoli C. Colistin and rifampicin in the treatment of multidrug-resistant Acinetobacter baumannii infections. J Antimicrob Chemother 2007; 61:417-20. [DOI: 10.1093/jac/dkm509] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Boni S, Artioli S, Amodeo C, Derchi A, Battola E, Dono M. DUE CASI DI MENINGO/ENCEFALITE DA L. MONOCYTOGENES: ATTUALITÀ DEL SISTEMA DI SORVEGLIANZA DELLE LISTERIOSI. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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