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288 results on '"Carrara G."'

2. Systemic sclerosis sine scleroderma: clinical and serological features and relationship with other cutaneous subsets in a large series of patients from the national registry 'SPRING' of the Italian Society for Rheumatology

Author

De Angelis R., Ferri C., Giuggioli D., Bajocchi G., Dagna L., Bellando-Randone S., Zanframundo G., Foti R., Cacciapaglia F., Cuomo G., Ariani A., Rosato E., Lepri G., Girelli F., Riccieri V., Zanatta E., Bosello S. L., Cavazzana I., Ingegnoli F., De Santis M., Murdaca G., Abignano G., Romeo N., Della Rossa A., Caminiti M., Iuliano A. M., Ciano G., Beretta L., Bagnato G., Lubrano E., De Andres I., Giollo A., Saracco M., Agnes C., Cipolletta E., Lumetti F., Spinella A., Magnani L., Campochiaro C., De Luca G., Codullo V., Visalli E., Di Vico C., Gigante A., Pellagrino G., Pigatto E., Lazzaroni M. -G., Franceschini F., Generali E., Mennillo G., Barsotti S., Mariano G. P., Furini F., Vultaggio L., Parisi S., Peroni C. L., Rozza D., Zanetti A., Carrara G., Landolfi G., Scire C. A., Bianchi G., Fusaro E., Sebastiani G. D., Govoni M., D'Angelo S., Cozzi F., Guiducci S., Doria A., Salvarani C., Iannone F., Matucci-Cerinic M., Giorgio A., Alessia B., Francesca C., Renato C., Dall'Ara F., Angelo D. C., Marica D., Gianluca S., Rossella T., De Angelis, R, Ferri, C, Giuggioli, D, Bajocchi, G, Dagna, L, Bellando-Randone, S, Zanframundo, G, Foti, R, Cacciapaglia, F, Cuomo, G, Ariani, A, Rosato, E, Lepri, G, Girelli, F, Riccieri, V, Zanatta, E, Bosello, S, Cavazzana, I, Ingegnoli, F, De Santis, M, Murdaca, G, Abignano, G, Romeo, N, Della Rossa, A, Caminiti, M, Iuliano, A, Ciano, G, Beretta, L, Bagnato, G, Lubrano, E, De Andres, I, Giollo, A, Saracco, M, Agnes, C, Cipolletta, E, Lumetti, F, Spinella, A, Magnani, L, Campochiaro, C, De Luca, G, Codullo, V, Visalli, E, Di Vico, C, Gigante, A, Pellagrino, G, Pigatto, E, Lazzaroni, M, Franceschini, F, Generali, E, Mennillo, G, Barsotti, S, Mariano, G, Furini, F, Vultaggio, L, Parisi, S, Peroni, C, Rozza, D, Zanetti, A, Carrara, G, Landolfi, G, Scire, C, Bianchi, G, Fusaro, E, Sebastiani, G, Govoni, M, D'Angelo, S, Cozzi, F, Guiducci, S, Doria, A, Salvarani, C, Iannone, F, Matucci-Cerinic, M, Giorgio, A, Alessia, B, Francesca, C, Renato, C, Dall'Ara, F, Angelo, D, Marica, D, Gianluca, S, Rossella, T, De Angelis, R., Ferri, C., Giuggioli, D., Bajocchi, G., Dagna, L., Bellando-Randone, S., Zanframundo, G., Foti, R., Cacciapaglia, F., Cuomo, G., Ariani, A., Rosato, E., Lepri, G., Girelli, F., Riccieri, V., Zanatta, E., Bosello, S. L., Cavazzana, I., Ingegnoli, F., De Santis, M., Murdaca, G., Abignano, G., Romeo, N., Della Rossa, A., Caminiti, M., Iuliano, A. M., Ciano, G., Beretta, L., Bagnato, G., Lubrano, E., De Andres, I., Giollo, A., Saracco, M., Agnes, C., Cipolletta, E., Lumetti, F., Spinella, A., Magnani, L., Campochiaro, C., De Luca, G., Codullo, V., Visalli, E., Di Vico, C., Gigante, A., Pellagrino, G., Pigatto, E., Lazzaroni, M. -G., Franceschini, F., Generali, E., Mennillo, G., Barsotti, S., Mariano, G. P., Furini, F., Vultaggio, L., Parisi, S., Peroni, C. L., Rozza, D., Zanetti, A., Carrara, G., Landolfi, G., Scire, C. A., Bianchi, G., Fusaro, E., Sebastiani, G. D., Govoni, M., D'Angelo, S., Cozzi, F., Guiducci, S., Doria, A., Salvarani, C., Iannone, F., Matucci-Cerinic, M., Giorgio, A., Alessia, B., Francesca, C., Renato, C., Dall'Ara, F., Angelo, D. C., Marica, D., Gianluca, S., and Rossella, T.

Subjects
Scleroderma, Systemic, Settore MED/16 - REUMATOLOGIA, Epidemiology, Immunology, Systemic, Autoimmunity, Autoimmune Disease, Autoimmune Diseases, Scleroderma, Rheumatology, Immunology and Allergy, Seasons, Human
Abstract

ObjectiveTo describe demographic, clinical and laboratory features of systemic sclerosis sine scleroderma (ssSSc) in a large multicentre systemic sclerosis (SSc) cohort.MethodsData involving 1808 SSc patients from Italian Systemic sclerosis PRogression INvestiGation registry were collected. The ssSSc was defined by the absence of any cutaneous sclerosis and/or puffy fingers. Clinical and serological features of ssSSc were compared with limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc) subsets.ResultsAmong patients with SSc, only 61 (3.4%) were classified as having ssSSc (F/M=19/1). Time from Raynaud’s phenomenon (RP) onset to diagnosis was longer in ssSSc (3 years, IQR 1–16.5) than lcSSc (2 years, IQR 0–7), and dcSSc (1 year, IQR 0–3) (pConclusionThe ssSSc is a quite rare disease variant characterised by clinico-serological features comparable to lcSSc, but significantly different from dcSSc. Overall, longer RP duration, low percentages of DPS and peripheral microvascular abnormalities, and increased anti-centromere seropositivity distinguish ssSSc. Further investigations based on national registries might provide useful insights on the actual relevance of the ssSSc within the scleroderma spectrum.

Published
2023

3. Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry

Author

Ceresoli, M, Carissimi, F, Nigro, A, Fransvea, P, Lepre, L, Braga, M, Costa, G, Agresta, F., Alemanno, G., Anania, G., Antropoli, M., Argenio, G., Atzeni, J., Avenia, N., Azzinnaro, A., Baldazzi, G., Balducci, G., Barbera, G., Bellanova, G., Bergamini, C., Bersigotti, L., Bianchi, Pp., Bombardini, C., Borzellino, G., Bozzo, S., Brachini, G., Buonanno, Gm., Canini, T., Cardella, S., Carrara, G., Cassini, D., Castriconi, M., Ceccarelli, G., Celi, D., Ceresoli, M., Chiappetta, M., Chiarugi, M., Cillara, N., Cimino, F., Cobuccio, L., Cocorullo, G., Colangelo, E., Costa, G., Crucitti, A., Dallacaneva, P., De Luca, M., de Manzoni Garberini, A., De Nisco, C., De Prizio, M., De Sol, A., Dibella, A., Falcioni, T., Falco, N., Farina, C., Finotti, E., Fontana, T., Francioni, G., Fransvea, P., Frezza, B., Garbarino, G., Garulli, G., Genna, M., Giannessi, S., Gioffrè, A., Giordano, A., Gozzo, D., Grimaldi, S., Gulotta, G., Iacopini, V., Iarussi, T., Laracca, G., Laterza, E., Leonardi, A., Lepre, L., Lorenzon, L., Luridiana, G., Malagnino, A., Mar, G., Marini, P., Marzaioli, R., Massa, G., Mecarelli, V., Mercantini, P., Mingoli, A., Nigri, G., Occhionorelli, S., Paderno, N., Palini, Gm., Paradies, D., Paroli, M., Perrone, F., Petrucciani, N., Petruzzelli, L., Pezzolla, A., Piazza, D., Piazza, V., Piccoli, M., Pisanu, A., Podda, M., Poillucci, G., Porfidia, R., Rossi, G., Ruscelli, P., Spagnoli, A., Sulis, R., Tartaglia, D., Tranà, C., Travaglino, A., Tomaiuolo, P., Valeri, A., Vasquez, G., Zago, M., E. Zanoni., Ceresoli M., Carissimi F., Nigro A., Fransvea P., Lepre L., Braga M., Costa G., Agresta F., Alemanno G., Anania G., Antropoli M., Argenio G., Atzeni J., Avenia N., Azzinnaro A., Baldazzi G., Balducci G., Barbera G., Bellanova G., Bergamini C., Bersigotti L., Bianchi P.P., Bombardini C., Borzellino G., Bozzo S., Brachini G., Buonanno G.M., Canini T., Cardella S., Carrara G., Cassini D., Castriconi M., Ceccarelli G., Celi D., Chiappetta M., Chiarugi M., Cillara N., Cimino F., Cobuccio L., Cocorullo G., Colangelo E., Crucitti A., DallaCaneva P., Luca M., de Manzoni Garberini A., De Nisco C., De Prizio M., De Sol A., Dibella A., Falcioni T., Falco N., Farina C., Finotti E., Fontana T., Francioni G., Frezza B., Garbarino G., Garulli G., Genna M., Giannessi S., Gioffre A., Giordano A., Gozzo D., Grimaldi S., Gulotta G., Iacopini V., Iarussi T., Laracca G., Laterza E., Leonardi A., Lorenzon L., Luridiana G., Malagnino A., Mar G., Marini P., Marzaioli R., Massa G., Mecarelli V., Mercantini P., Mingoli A., Nigri G., Occhionorelli S., Paderno N., Palini G.M., Paradies D., Paroli M., Perrone F., Petrucciani N., Petruzzelli L., Pezzolla A., Piazza D., Piazza V., Piccoli M., Pisanu A., Podda M., Poillucci G., Porfidia R., Rossi G., Ruscelli P., Spagnoli A., Sulis R., Tartaglia D., Trana C., Travaglino A., Tomaiuolo P., Valeri A., Vasquez G., Zago M., Zanoni E., Ceresoli, M, Carissimi, F, Nigro, A, Fransvea, P, Lepre, L, Braga, M, Costa, G, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Chiappetta, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Crucitti, A, Dallacaneva, P, Luca, M, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Frezza, B, Garbarino, G, Garulli, G, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laracca, G, Laterza, E, Leonardi, A, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mercantini, P, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petrucciani, N, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Trana, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
medicine.medical_specialty, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, NO, Postoperative complications, Elderly, Laparotomy, medicine, Hernia, Incarcerated hernia, business.industry, Explorative laparotomy, Groin hernia · Incarcerated hernia · Elderly · Postoperative complications · Emergency surgery · Charlson’s comorbidity index, medicine.disease, Hernia repair, Comorbidity, Surgery, Groin hernia, Inguinal hernia, Charlson’s comorbidity index, Emergency surgery, business, Watchful waiting, Abdominal surgery
Abstract

Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in elderly patients who underwent emergency surgery for complicated hernia in 38 Italian hospitals. Pre-operative, surgical and postoperative data were recorded for each patient. ASA score, Charlson’s comorbidity index, P-POSSUM and CR-POSSUM were assessed. Results 259 patients were recruited, mean age was 80 years. A direct repair without mesh was performed in 62 (23.9%) patients. Explorative laparotomy was performed in 56 (21.6%) patients and bowel resection was necessary in 44 (17%). Mortality occurred in seven (2.8%) patients. Fifty-five (21.2%) patients developed complications, 12 of whom had a major one. At univariate and multivariate analyses, Charlson’s comorbidity index ≥ 6, altered mental status, and need for laparotomy were associated with major complications and mortality Conclusion Emergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson’s comorbidity index could be adopted to select patients for elective operation

Published
2022

4. Perforated peptic ulcer (PPU) treatment: an Italian nationwide propensity score-matched cohort study investigating laparoscopic vs open approach

Author

Costa, Gianluca, Fransvea, Pietro, Lepre, Luca, Liotta, Gianluca, Mazzoni, Gianluca, Biloslavo, Alan, Bianchi, Valentina, Occhionorelli, Savino, Costa, Alessandro, Sganga, Gabriele, FACS on behalf of the IGo-GIPS study group (Agresta, F, Alemanno, G, Altieri, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Badessi, G, Baldazzi, G, Bergamini, C, Biloslavo, A, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Brisinda, G, Buonanno, Gm, Canini, T, Capolupo, Gt, Carannante, F, Cardella, S, Caricato, M, Carrara, G, Cascone, Ca, Cassini, D, Castriconi, M, Catarci, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cimino, F, Cirocchi, R, Cobuccio, L, Coccolini, C, Cocorullo, G, Colangelo, E, Colozzi, S, Cortese, F, Costa, A, Costa, G, Cozza, V, Crucitti, A, Cucinotta, E, D’Alessio, R, Dalla Caneva, P, De Manzini, N, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, De Stefano, M, Dibella, A, Di Cosimi, C, Di Grezia, M, Falcioni, T, Falco, N, Farina, C, Fico, V, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garbarino, Gm, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Iacopini, V, Iarussi, T, Kurihara, H, La Greca, A, Laracca, Gg, Laterza, E, La Vaccara, V, Leonardi, A, Lepre, L, Liotta, G, Luridiana, G, Magalini, S, Malagnino, A, Mar, G, Mariani, D, Marini, P, Marzaioli, R, Macianà, G, Mazzoni, G, Mecarelli, V, Mercantini, P, Mingoli, A, Mirco, P, Montuori, M, Nigro, C, Occhionorelli, S, Paderno, N, Palini, Gm, Paradies, D, Paroli, M, Perrone, F, Pepe, G, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Pignata, G, Pinotti, E, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Puccioni, C, Rocca, A, Rondelli, F, Rossi, G, Sacchi, M, Sapienza, P, Sganga, G, Spagnoli, A, Spinoglio, G, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Tomassini, F, Tropeano, G, Valeri, A, Zago, M, and Zanoni, E. ).

Subjects
Surgical treatment, Laparoscopic approach, Perforated peptic ulcer
Published
2023

6. Gastro-intestinal emergency surgery: Evaluation of morbidity and mortality. Protocol of a prospective, multicenter study in Italy for evaluating the burden of abdominal emergency surgery in different age groups. (The GESEMM study)

Author

Costa, Gianluca, Fransvea, Pietro, Puccioni, Caterina, Giovinazzo, Francesco, Carannante, Filippo, Bianco, Gianfranco, Catamero, Alberto, Masciana, Gianluca, Miacci, Valentina, Caricato, Marco, Capolupo, Gabriella Teresa, Sganga, Gabriele on behalf of the IGo-GIPS Study Group (Agresta, F, Alemanno, G, Altieri, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Badessi, G, Baldazzi, G, Bergamini, C, Biloslavo, A, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Brisinda, G, Buonanno, Gm, Canini, T, Capolupo, Gt, Carannante, F, Cardella, S, Caricato, M, Carrara, G, Cascone, Ca, Cassini, D, Castriconi, M, Catarci, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cimino, F, Cirocchi, R, Cobuccio, L, Coccolini, C, Cocorullo, G, Colangelo, E, Colozzi, S, Cortese, F, Costa, A, Costa, G, Cozza, V, Crucitti, A, Cucinotta, E, D’Alessio, R, Dalla Caneva, P, De Manzini, N, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, De Stefano, M, Dibella, A, Di Cosimi, C, Di Grezia, M, Falcioni, T, Falco, N, Farina, C, Fico, V, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garbarino, Gm, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Iacopini, V, Iarussi, T, Kurihara, H, La Greca, A, Laracca, Gg, Laterza, E, La Vaccara, V, Leonardi, A, Lepre, L, Liotta, G, Luridiana, G, Magalini, S, Malagnino, A, Mar, G, Mariani, D, Marini, P, Marzaioli, R, Macianà, G, Mazzoni, G, Mecarelli, V, Mercantini, P, Mingoli, A, Mirco, P, Montuori, M, Nigro, C, Occhionorelli, S, Paderno, N, Palini, Gm, Paradies, D, Paroli, M, Perrone, F, Pepe, G, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Pignata, G, Pinotti, E, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Puccioni, C, Rocca, A, Rondelli, F, Rossi, G, Sacchi, M, Sapienza, P, Sganga, G, Spagnoli, A, Spinoglio, G, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Tomassini, F, Tropeano, G, Valeri, A, Zago, M, and Zanoni, E. ).

Subjects
acute care, gastrointestinal emergency, morbidity, mortality, surgery, Settore MED/18 - CHIRURGIA GENERALE
Abstract

Gastrointestinal emergencies (GE) are frequently encountered in emergency department (ED), and patients can present with wide-ranging symptoms. more than 3 million patients admitted to US hospitals each year for EGS diagnoses, more than the sum of all new cancer diagnoses. In addition to the complexity of the urgent surgical patient (often suffering from multiple co-morbidities), there is the unpredictability and the severity of the event. In the light of this, these patients need a rapid decision-making process that allows a correct diagnosis and an adequate and timely treatment. The primary endpoint of this Italian nationwide study is to analyze the clinicopathological findings, management strategies and short-term outcomes of gastrointestinal emergency procedures performed in patients over 18. Secondary endpoints will be to evaluate to analyze the prognostic role of existing risk-scores to define the most suitable scoring system for gastro-intestinal surgical emergency. The primary outcomes are 30-day overall postoperative morbidity and mortality rates. Secondary outcomes are 30-day postoperative morbidity and mortality rates, stratified for each procedure or cause of intervention, length of hospital stay, admission and length of stay in ICU, and place of discharge (home or rehabilitation or care facility). In conclusion, to improve the level of care that should be reserved for these patients, we aim to analyze the clinicopathological findings, management strategies and short-term outcomes of gastrointestinal emergency procedures performed in patients over 18, to analyze the prognostic role of existing risk-scores and to define new tools suitable for EGS. This process could ameliorate outcomes and avoid futile treatments. These results may potentially influence the survival of many high-risk EGS procedure.

Published
2022

7. The use of emergency laparoscopy for acute abdomen in the elderly: the FRAILESEL Italian Multicenter Prospective Cohort Study

Author

Costa, Gianluca, Fransvea, Pietro, Podda, Mauro, Pisanu, Adolfo, Carrano, Francesco Maria, Iossa, Angelo, Balducci, Genoveffa, Agresta, Ferdinando Collaborative Study Group: Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, Pp, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, Gm, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Costa, G, Crucitti, A, Dalla Caneva, P, De Luca, M, De Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laterza, E, Leonardi, A, Lepre, L, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, Gm, Paradies, D, Paroli, M, Perrone, F, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, Zanoni, E., Costa G., Fransvea P., Podda M., Pisanu A., Carrano F.M., Iossa A., Balducci G., Agresta F., Alemanno G., Anania G., Antropoli M., Argenio G., Atzeni J., Avenia N., Azzinnaro A., Baldazzi G., Barbera G., Bellanova G., Bergamini C., Bersigotti L., Bianchi P.P., Bombardini C., Borzellino G., Bozzo S., Brachini G., Buonanno G.M., Canini T., Cardella S., Carrara G., Cassini D., Castriconi M., Ceccarelli G., Celi D., Ceresoli M., Chiarugi M., Cillara N., Cimino F., Cobuccio L., Cocorullo G., Colangelo E., Crucitti A., Dalla Caneva P., De Luca M., de Manzoni Garberini A., De Nisco C., De Prizio M., De Sol A., Dibella A., Falcioni T., Falco N., Farina C., Finotti E., Fontana T., Francioni G., Frezza B., Garulli G., Genna M., Giannessi S., Gioffre A., Giordano A., Gozzo D., Grimaldi S., Gulotta G., Iacopini V., Iarussi T., Laterza E., Leonardi A., Lepre L., Luridiana G., Malagnino A., Mar G., Marini P., Marzaioli R., Massa G., Mecarelli V., Mingoli A., Nigri G., Occhionorelli S., Paderno N., Palini G.M., Paradies D., Paroli M., Perrone F., Petruzzelli L., Pezzolla A., Piazza D., Piazza V., Piccoli M., Poillucci G., Porfidia R., Rossi G., Ruscelli P., Spagnoli A., Sulis R., Tartaglia D., Trana C., Travaglino A., Tomaiuolo P., Valeri A., Vasquez G., Zago M., Zanoni E., Costa, G, Fransvea, P, Podda, M, Pisanu, A, Carrano, F, Iossa, A, Balducci, G, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Crucitti, A, Dalla Caneva, P, De Luca, M, de Manzoni Garberini, A, De Nisco, C, De Prizio, M, De Sol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Frezza, B, Garulli, G, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laterza, E, Leonardi, A, Lepre, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Trana, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
Male, Settore MED/18 - CHIRURGIA GENERALE, Endoscopy, Gastrointestinal, Cohort Studies, 0302 clinical medicine, Postoperative Complications, Elderly, Abdomen, 80 and over, Medicine, Prospective Studies, Prospective cohort study, Laparoscopy, Abdomen, Acute, Aged, 80 and over, medicine.diagnostic_test, Mortality rate, Age Factors, Prognosis, Multicenter study, Italy, Acute abdomen, 030220 oncology & carcinogenesis, Emergency surgery, 030211 gastroenterology & hepatology, Female, medicine.symptom, Cohort study, Risk, Gastrointestinal, medicine.medical_specialty, Acute, Malignancy, NO, 03 medical and health sciences, Humans, Aged, business.industry, acute abdomen, elderly, emergency surgery, laparoscopy, multicenter study, Endoscopy, medicine.disease, Surgery, Emergencies, Morbidity, business, Procedures and Techniques Utilization, Abdominal surgery
Abstract

As the world population is aging rapidly, emergency abdominal surgery for acute abdomen in the elderly represents a global issue, both in developed and developing countries. Data regarding all the elderly patients who underwent emergency abdominal surgery from January 2017 to December 2017 at 36 Italian surgical departments were analyzed with the aim to appraise the contemporary reality regarding the use of emergency laparoscopy for acute abdomen in the elderly. 1993 patients were enrolled. 1369 (68.7%) patients were operated with an open technique; whereas, 624 (31.3%) underwent a laparoscopic operation. The postoperative morbidity rate was 32.6%, with a statically significant difference between the open and the laparoscopic groups (36.2% versus 22.1%, p < 0.001). The reported mortality rate was 8.8%, with a statistically significant difference between the open and the laparoscopic groups (11.2% versus 2.2%, p < 0.001). Our results demonstrated that patients in the ASA II (58.1%), ASA III (68.7%) and ASA IV (88.5%) groups were operated with the traditional open technique in most of the cases. Only a small percentage of patients underwent laparoscopy for perforated gastro-duodenal ulcer repair (18.9%), adhesiolyses with/without small bowel resection (12.2%), and large bowel resection (10.7%). Conversion to open technique was associated with a higher mortality rate (11.1% versus 2.2%, p < 0.001) and overall morbidity (38.9% versus 22.1%, p = 0.001) compared with patients who did not undergo conversion. High creatinine (p < 0.001) and glycaemia (p = 0.006) levels, low hemoglobin levels (p < 0.001), oral anticoagulation therapy (p = 0.001), acute respiratory failure (p < 0.001), presence of malignancy (p = 0.001), SIRS (p < 0.001) and open surgical approach (p < 0.001) were associated with an increased risk of postoperative morbidity. Regardless of technical progress, elderly patients undergoing emergency surgery are at very high risk for in-hospital complications. A detailed analysis of complications and mortality in the present study showed that almost 9% of elderly patients died after surgery for acute abdomen, and over 32% developed complications.

Published
2020

10. The Emergency Surgery Frailty Index (EmSFI): development and internal validation of a novel simple bedside risk score for elderly patients undergoing emergency surgery

Author

Costa, Gianluca, Bersigotti, Laura, Massa, Giulia, Lepre, Luca, Fransvea, Pietro, Lucarini, Alessio, Mercantini, Paolo, Balducci, Genoveffa, Sganga, Gabriele, Crucitti, ERASO (Elderly Risk Assessment, Surgical Outcome) Collaborative Study Group:, F Agresta, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, P Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, M Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Costa, G, Crucitti, A, P Dalla Caneva, M De Luca, A de Manzoni Garberini, C De Nisco, M De Prizio, A De Sol, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Fransvea, P, Frezza, B, Garbarino, G, Garulli, G, Genna, M, Giannessi, S, Gioffrè, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laracca, G, Laterza, E, Leonardi, A, Lepre, L, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Massa, G, Mecarelli, V, Mercantini, P, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, M Palini, G, Paradies, D, Paroli, M, Perrone, F, Petrucciani, N, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Tranà, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, Zanoni, E, Costa, G, Bersigotti, L, Massa, G, Lepre, L, Fransvea, P, Lucarini, A, Mercantini, P, Balducci, G, Sganga, G, Crucitti, A, Agresta, F, Alemanno, G, Anania, G, Antropoli, M, Argenio, G, Atzeni, J, Avenia, N, Azzinnaro, A, Baldazzi, G, Barbera, G, Bellanova, G, Bergamini, C, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buonanno, G, Canini, T, Cardella, S, Carrara, G, Cassini, D, Castriconi, M, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cimino, F, Cobuccio, L, Cocorullo, G, Colangelo, E, Dallacaneva, P, Deluca, M, deManzoni Garberini, A, Denisco, C, Deprizio, M, Desol, A, Dibella, A, Falcioni, T, Falco, N, Farina, C, Finotti, E, Fontana, T, Francioni, G, Frezza, B, Garbarino, G, Garulli, G, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Gulotta, G, Iacopini, V, Iarussi, T, Laracca, G, Laterza, E, Leonardi, A, Lorenzon, L, Luridiana, G, Malagnino, A, Mar, G, Marini, P, Marzaioli, R, Mecarelli, V, Mingoli, A, Nigri, G, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petrucciani, N, Petruzzelli, L, Pezzolla, A, Piazza, D, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Spagnoli, A, Sulis, R, Tartaglia, D, Trana, C, Travaglino, A, Tomaiuolo, P, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
Aging, medicine.medical_specialty, Frail Elderly, Frailty Index, Emergency surgery, Frailty, Predictive tool, Procedure-specific morbidity, Procedure-specifc morbidity, Logistic regression, Risk Assessment, NO, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Internal validation, Aged, Frailty, Emergency surgery, Predictive tool, Procedure-specifc morbidity, Univariate analysis, Framingham Risk Score, Receiver operating characteristic, business.industry, Test (assessment), Italy, 030220 oncology & carcinogenesis, Emergency medicine, Original Article, Geriatrics and Gerontology, business
Abstract

Background Frailty assessment has acquired an increasing importance in recent years and it has been demonstrated that this vulnerable profile predisposes elderly patients to a worse outcome after surgery. Therefore, it becomes paramount to perform an accurate stratification of surgical risk in elderly undergoing emergency surgery. Study design 1024 patients older than 65 years who required urgent surgical procedures were prospectively recruited from 38 Italian centers participating to the multicentric FRAILESEL (Frailty and Emergency Surgery in the Elderly) study, between December 2016 and May 2017. A univariate analysis was carried out, with the purpose of developing a frailty index in emergency surgery called “EmSFI”. Receiver operating characteristic curve analysis was then performed to test the accuracy of our predictive score. Results 784 elderly patients were consecutively enrolled, constituting the development set and results were validated considering further 240 consecutive patients undergoing colorectal surgical procedures. A logistic regression analysis was performed identifying different EmSFI risk classes. The model exhibited good accuracy as regard to mortality for both the development set (AUC = 0.731 [95% CI 0.654–0.772]; HL test χ2 = 6.780; p = 0.238) and the validation set (AUC = 0.762 [95% CI 0.682–0.842]; HL test χ2 = 7.238; p = 0.299). As concern morbidity, our model showed a moderate accuracy in the development group, whereas a poor discrimination ability was observed in the validation cohort. Conclusions The validated EmSFI represents a reliable and time-sparing tool, despite its discriminative value decreased regarding complications. Thus, further studies are needed to investigate specifically surgical settings, validating the EmSFI prognostic role in assessing the procedure-related morbidity risk.

Published
2020

11. Persistence of bDMARD therapy in Rheumatoid Arthritis after first-line TNF-inhibitor failure: the RECORD study of the Italian Society for Rheumatology.

Author

Carrara, G, Argnani, L, Zanetti, A, Zabotti, A, Silvagni, E, Sebastiani, GD, Sebastiani, M, and Scirè, CA

Abstract

The optimal choice of a second biological disease-modifying anti-rheumatic drug (bDMARD) after failure with first line tumour necrosis factor inhibitor (TNFi) represents a critical therapeutic challenge. This study aims to evaluate the persistence with treatment using second line bDMARDs with different mechanisms of action in rheumatoid arthritis (RA) patients with inadequate response to first line TNFi. A retrospective cohort study on administrative healthcare databases was conducted. We analysed the relationship between different bDMARDs and persistence with treatment in RA patients who started second line bDMARD therapy according to two different strategies: cycling (second TNFi) or switching [change in mechanism of action: abatacept (ABA), tocilizumab (TCZ), and rituximab (RTX)] with or without concomitant conventional synthetic (cs) DMARDs. The cohort comprised 1434 patients. The mean age was 53.8 years and 1142 (79.6%) were women. Among second line bDMARDs, 969 patients (67.6%) started TNFi, 204 (14.2%) ABA, 145 (10.1%) RTX, and 116 (8.1%) TCZ. A bDMARD was prescribed as monotherapy in 359 patients (25.0%). The switching strategy showed a lower overall discontinuation rate [hazard ratio (HR) 0.72], while switching compared to cycling showed significantly better survival for ABA (HR 0.61) and RTX (HR 0.76), but no significant difference for TCZ (HR 0.82). A lower impact of better drug survival in the switching strategy occurred in patients with concurrent methotrexate. Among RA patients failing a first TNFi, switching is associated with marginally better persistence, in particular for ABA and RTX, with only marginal differences in patients on concurrent csDMARDs. [ABSTRACT FROM AUTHOR]

Published
2022
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13. Comparison of the risks of hospitalisation for cardiovascular events in patients with rheumatoid arthritis treated with tocilizumab and etanercept

Author

Generali, E., Carrara, G., Selmi, C., Verstappen, S., Zambon, A., Bortoluzzi, A., Ettore Silvagni, Scirè, C. A., Generali, E, Carrara, G, Selmi, C, Verstappen, S, Zambon, A, Bortoluzzi, A, Silvagni, E, and Scirè, C

Subjects
Adult, Male, Risk, ResearchInstitutes_Networks_Beacons/MICRA, Epidemiology, Middle Aged, Antibodies, Monoclonal, Humanized, Cardiovascular disease, NO, Etanercept, Arthritis, Rheumatoid, Hospitalization, Manchester Institute for Collaborative Research on Ageing, Retrospective Studie, Cardiovascular Diseases, Humans, Female, Biological therapy, Rheumatoid arthritis, Rheumatoid arthriti, Human, Aged, Retrospective Studies
Abstract

Objective. To verify if tocilizumab (TCZ) is associated with an increased risk of cardiovascular (CV) events compared with etanercept (ETN) in rheumatoid arthritis (RA). Methods. This is a retrospective cohort study on administrative healthcare databases (AHD) in Italy. Patients were identified using a validated algorithm based on AHD. Exposure to specific drugs was estimated by the drug prescription recorded in the AHD. The occurrence of acute CV events (myocardial infarction, stroke, other CV events) was derived from the hospital discharge forms. The association between TCZ or ETN and CV events was estimated using competing risk models, adjusting for pre-specified confounders. Results. We identified 1,752 subjects with RA, 1,086 treated with ETN and 666 with TCZ. TCZ did not increase the overall risk of acute CV events, even when adjusted for pre-specified confounders (hazard ratio HR 0.95, 95% confidence interval 95%CI 0.54-1.66), specifically of acute myocardial infarction (HR 0.39, 95%CI 0.15-1.06), stroke (HR 1.44, 95%CI 0.24-8.68) or other CV event (1.07, 95%CI 0.59-1.92). Conclusion. RA patients with TCZ do not have a medium-term excess of CV risk in patients compared with ETN.

Published
2018

14. Mortality attributable to different Klebsiella susceptibility patterns and to the coverage of empirical antibiotic therapy: a cohort study on patients admitted to the ICU with infection

Author

Bottazzi A., Chieregato A., Fumagalli R., Livigni S., Nardi G., Negro G., Olivieri C., Radrizzani D., Ripamonti C., Tavola M., Bertolini G., Nattino G., Carrara G., Rossi C., Crespi D., Mondini M., Tascini C., Poole D., Viaggi B., Langer M., Rossolini G. M., Malacarne P., Bottazzi, A, Chieregato, A, Fumagalli, R, Livigni, S, Nardi, G, Negro, G, Olivieri, C, Radrizzani, D, Ripamonti, C, Tavola, M, Bertolini, G, Nattino, G, Carrara, G, Rossi, C, Crespi, D, Mondini, M, Tascini, C, Poole, D, Viaggi, B, Langer, M, Rossolini, G, and Malacarne, P

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Klebsiella, 030106 microbiology, Intensive Care Unit, Drug resistance, Critical Care and Intensive Care Medicine, Empirical antibiotic therapy, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Anesthesiology, Intensive care, Anti-Bacterial Agent, medicine, In patient, 030212 general & internal medicine, Carbapenem, Attributable mortality, Aged, biology, business.industry, Microbial Sensitivity Test, Middle Aged, biology.organism_classification, Klebsiella infection, Multicenter study, Klebsiella pneumoniae, Standardized mortality ratio, Italy, Female, Cohort Studie, business, Cohort study, Human
Abstract

Purpose: To evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: multi-susceptible Klebsiella (MS-K), extended-spectrum cephalosporin-resistant, but carbapenem-susceptible Klebsiella (ESCR-CS-K), and carbapenem-resistant Klebsiella (CR-K). Methods: We developed a prognostic model to predict hospital mortality in patients with infection on admission to the intensive care units (ICUs), and assessed its calibration in the subgroups of interest: patients with infections due to MS-K, ESCR-CS-K, CR-K. We assessed the calibration of the model also in ESCR-CS-K treated empirically with carbapenems and with piperacillin-tazobactam. Results: A total of 13,292 adults with an ongoing infection were admitted to 137 Italian ICUs in 2012–2013. Of 801 Klebsiella spp. infected patients, 451 had MS-K, 116 ESCR-CS-K, and 234 CR-K. The prognostic model calibrated well for the MS-K and ESCR-CS-K subgroups. In the CR-K subgroup there were more deaths than predicted (standardized mortality ratio 1.20; 95% CI 1.08–1.31), indicating a negative prognostic role of the infection, mainly in the medium and high risk-of-death patients. When infection was caused by ESCR-CS-K, treatment with piperacillin-tazobactam increased adjusted mortality among the most severe patients (similarly to CR-K), while treatment with carbapenems did not (similarly to MS-K). Conclusions: In low risk-of-death patients admitted to the ICU with a Klebsiella spp. infection, the appropriateness of empirical antibiotic therapy seemed uninfluential to eventual mortality, while it appeared to be crucial in high-risk ones. The use of piperacillin-tazobactam may be inappropriate in severe patients with ESCR-CS-K infection. CR-K is associated to a significant 20% increase of adjusted mortality, only for patients at higher risk of death.

Published
2018

15. Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILESEL Study)

Author

Mingoli, A, Costa, Gianluca, Massa, Giulia, Agresta, F., Anania, G., Ansaloni, L., Antropoli, M., Argenio, G., Atzeni, J., Avenia, N., Azzinnaro, A., Balani, A., Baldazzi, G., Balducci, G., Barbera, G., Bellanova, G., Bergamini, C., Bersigotti, L., Bianchi, P. P., Bombardini, C., Borzellino, G., Bozzo, S., Brachini, G., Buccoliero, F., Buonanno, G. M., Buononato, M., Campanile, F. C., Canini, T., Cardella, S., Carrara, G., Cascini, F., Cassini, D., Castriconi, M., Catalini, G., Catena, F., Ceccarelli, G., Celi, D., Ceresoli, M., Chiarugi, M., Cillara, N., Cimino, F., Cobuccio, L., Coccolini, F., Cocorullo, G., Colangelo, E., Costa, G., Crafa, F., Crucitti, A., Dalla Caneva, P., De&nbsp, Luca, M., de&nbsp, Manzoni Garberini, A., De Nisco, C., Sol, A., Falcioni, T., Falco, N., Farina, C., Filippone, G., Finotti, E., Fiume, S., Fontana, T., Francioni, G., Fransvea, P., Frezza, B., Gemini, Simone, Genna, M., Giannessi, S., Gioffrè, A., Giordano, A., Gozzo, D., Grimaldi, S., Gulotta, G., Iarussi, T., Laterza, E., Lepre, L., Lorenzon, L., Lotti, R., Luridiana, G., Marini, P., Marzaioli, R., Massa, G., Mulas, S., Nagliati, C., Nigri, G., Niolu, P., Noviello, A., Occhionorelli, S., Paderno, N., Palini, G. M., Paradies, D., Paroli, M., Perrone, F., Petruzzelli, L., Pezzolla, A., Piazza, D., Piazza, V., Piccoli, M., Pisanu, A., Podda, M., Poillucci, Gaetano, Porfidia, R., Rossi, G., Ruscelli, P., Santella, S., Sartelli, M., Spagnoli, A., Sulis, R., Tarasconi, A., Tranà, C., Travaglino, A., Valeri, A., Vasquez, G., Zago, Michela, Zanoni, E., Costa, G, Massa, G, Anania, G, Atzeni, J, Cardella, S, Cimino, F, Cocorullo, G, Falco, N, Farina, M, Fontana, T, Gulotta, G, Piazza, D, Agresta, F, Ansaloni, L, Antropoli, M, Argenio, G, Avenia, N, Azzinnaro, A, Balani, A, Baldazzi, G, Balducci, G, Barbera, G, Bellanova, G, Bergamini, C, Bersigotti, L, Bianchi, P, Bombardini, C, Borzellino, G, Bozzo, S, Brachini, G, Buccoliero, F, Buonanno, G, Buononato, M, Campanile, F, Canini, T, Carrara, G, Cascini, F, Cassini, D, Castriconi, M, Catalini, G, Catena, F, Ceccarelli, G, Celi, D, Ceresoli, M, Chiarugi, M, Cillara, N, Cobuccio, L, Coccolini, F, Colangelo, E, Crafa, F, Crucitti, A, Dalla Caneva, P, Deluca, M, deManzoni Garberini, A, De Nisco, C, Desol, A, Falcioni, T, Farina, C, Filippone, G, Finotti, E, Fiume, S, Francioni, G, Fransvea, P, Frezza, B, Gemini, S, Genna, M, Giannessi, S, Gioffre, A, Giordano, A, Gozzo, D, Grimaldi, S, Iarussi, T, Laterza, E, Lepre, L, Lorenzon, L, Lotti, R, Luridiana, G, Marini, P, Marzaioli, R, Mingoli, A, Mulas, S, Nagliati, C, Nigri, G, Niolu, P, Noviello, A, Occhionorelli, S, Paderno, N, Palini, G, Paradies, D, Paroli, M, Perrone, F, Petruzzelli, L, Pezzolla, A, Piazza, V, Piccoli, M, Pisanu, A, Podda, M, Poillucci, G, Porfidia, R, Rossi, G, Ruscelli, P, Santella, S, Sartelli, M, Spagnoli, A, Sulis, R, Tarasconi, A, Trana, C, Travaglino, A, Valeri, A, Vasquez, G, Zago, M, and Zanoni, E

Subjects
Elderly patient, Emergency surgery, Frailty, Geriatric, Risk assessment, Scores, Aged, Aged, 80 and over, Clinical Protocols, Emergencies, Female, Humans, Italy, Logistic Models, Male, Multivariate Analysis, Outcome Assessment, Health Care, Postoperative Complications, Prognosis, Prospective Studies, ROC Curve, Risk Assessment, Frail Elderly, Outcome Assessment, 030230 surgery, law.invention, 0302 clinical medicine, Quality of life, law, 80 and over, Prospective cohort study, Multivariate Analysi, Emergencie, Mortality rate, Score, Intensive care unit, Outcome Assessment (Health Care), 030220 oncology & carcinogenesis, elderly patient, emergency surgery, frailty, geriatric, risk assessment, scores, Human, medicine.medical_specialty, Logistic Model, Prognosi, NO, 03 medical and health sciences, medicine, Clinical Protocol, business.industry, Perioperative, Surgery, Health Care, Prospective Studie, Settore MED/18 - Chirurgia Generale, Emergency medicine, Life expectancy, Observational study, Postoperative Complication, business
Abstract

Improvements in living conditions and progress in medical management have resulted in better quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinicopathological findings, management, and short-term outcome of elderly patients undergoing emergency surgery. The secondary objectives are to evaluate the presence and influence of frailty and analyze the prognostic role of existing risk-scores. The final FRAILESEL protocol was approved by the Ethical Committee of “Sapienza” University of Rome, Italy. The FRAILESEL study is a nationwide, Italian, multicenter, observational study conducted through a resident-led model. Patients over 65years of age who require emergency surgical procedures will be included in this study. The primary outcome measures are 30-day postoperative mortality and morbidity rates. The Clavien-Dindo classification system is used to categorize complications. The secondary outcome measures include length of hospital stay, length of stay in intensive care unit, and predictive value for morbidity and mortality of several frailty and surgical risk-scores. The results of the FRAILESEL study will be disseminated through national and international conference presentations and peer-reviewed journals. The study is also registered at ClinicalTrials.gov (ClinicalTrials.gov identifier: NCT02825082).

Published
2018

17. Role of comorbidities on therapeutic persistence of biological agents in rheumatoid arthritis: results from the RECord-linkage On Rheumatic Disease study on administrative healthcare databases.

Author

D'Amico, ME, Silvagni, E, Carrara, G, Zanetti, A, Govoni, M, Scirè, CA, and Bortoluzzi, A

Subjects
COMORBIDITY, RHEUMATISM, RHEUMATOLOGISTS, MYOCARDIAL infarction, RHEUMATOID arthritis, PROPORTIONAL hazards models, OBSTRUCTIVE lung diseases, MEDICAL care
Abstract

Objectives: This study aimed to evaluate the impact of different comorbidities on thereflecting its safety profile persistence of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA), taking advantage of a retrospective analysis of administrative healthcare databases (AHDs). Method: A retrospective observational study was conducted on AHDs of the Lombardy region, Italy (2004–2013). Among RA patients treated with bDMARDs, drug survival was estimated using Cox proportional hazard models [hazard ratio (HR), 95% confidence interval (CI)], crude and adjusted for prespecified confounders (gender, age, disease duration, concomitant use of non-steroidal anti-inflammatory drugs, glucocorticoids, conventional DMARDs, specific bDMARDs), in first-line and subsequent lines of treatment. The role of comorbidities in administration of specific bDMARDs was analysed through multinomial logistic models. Results: The study included 4657 RA patients. In the first-line treatment strategy, the Charlson Comorbidity Index (CCI) (RA excluded) was significantly associated with an increased rate of bDMARD failure (CCI = 1: HR 1.28, 95% CI 1.13–1.46; CCI ≥ 2: HR 1.26, 95% CI 1.03–1.53). Among selected comorbidities, chronic obstructive pulmonary disease (HR 1.38, 95% CI 1.01–1.91), diabetes (HR 1.18, 95% CI 1.01–1.37), and previous-year bacterial infections (HR 1.18, 95% CI 1.07–1.30) were slightly associated with risk of bDMARD failure, while acute myocardial infarction (HR 1.30, 95% CI 0.97–1.75), mild liver disease (HR 1.21, 95% CI 0.91–1.60), and solid tumours (HR 1.19, 95% CI 0.93–1.53) were not. In the following treatment lines, neoplasms were associated with reduced risk of failure (HR 0.64, 95% CI 0.41–0.99). Multiple comorbidities were associated with first-line abatacept and rituximab administration. Conclusions: Comorbidities affect treatment decisions in RA and influence bDMARD failure, and should be considered when analysing the persistence of biological therapy. [ABSTRACT FROM AUTHOR]

Published
2021
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19. Corrigendum to 'European contribution to the study of ROS:A summary of the findings and prospects for the future from the COST action BM1203 (EU-ROS)' [Redox Biol. 13 (2017) 94-162]

Author

Egea, J., Fabregat, I., Frapart, Y. M., Ghezzi, P., Görlach, A., Kietzmann, T., Kubaichuk, K., Knaus, U. G., Lopez, M. G., Olaso-Gonzalez, G., Petry, A., Schulz, R., Vina, J., Winyard, P., Abbas, K., Ademowo, O. S., Afonso, C. B., Andreadou, I., Antelmann, H., Antunes, F., Aslan, M., Bachschmid, M. M., Barbosa, R. M., Belousov, V., Berndt, C., Bernlohr, D., Bertrán, E., Bindoli, A., Bottari, S. P., Brito, P. M., Carrara, G., Casas, A. I., Chatzi, A., Chondrogianni, N., Conrad, M., Cooke, M. S., Costa, J. G., Cuadrado, A., My-Chan Dang, P., De Smet, B., Debelec-Butuner, B., Dias, I. H.K., Dunn, J. D., Edson, A. J., El Assar, M., El-Benna, J., Ferdinandy, P., Fernandes, A. S., Fladmark, K. E., Förstermann, U., Giniatullin, R., Giricz, Z., Görbe, A., Griffiths, H., Hampl, V., Hanf, A., Herget, J., Hernansanz-Agustín, P., Hillion, M., Huang, J., Ilikay, S., Jansen-Dürr, P., Jaquet, V., Joles, J. A., Kalyanaraman, B., Kaminskyy, D., Karbaschi, M., Kleanthous, M., Klotz, L. O., Korac, B., Korkmaz, K. S., Koziel, R., Kračun, D., Krause, K. H., Křen, V., Krieg, T., Laranjinha, J., Lazou, A., Li, H., Martínez-Ruiz, A., Matsui, R., McBean, G. J., Meredith, S. P., Messens, J., Miguel, V., Mikhed, Y., Milisav, I., Milković, L., Miranda-Vizuete, A., Mojović, M., Monsalve, M., Mouthuy, P. A., Mulvey, J., Münzel, T., Muzykantov, V., Nguyen, I. T.N., Oelze, M., Oliveira, N. G., Palmeira, C. M., Papaevgeniou, N., Pavićević, A., Pedre, B., Peyrot, F., Phylactides, M., Pircalabioru, G. G., Pitt, A. R., Poulsen, H. E., Prieto, I., Rigobello, M. P., Robledinos-Antón, N., Rodríguez-Mañas, L., Rolo, A. P., Rousset, F., Ruskovska, T., Saraiva, N., Sasson, S., Schröder, K., Semen, K., Seredenina, T., Shakirzyanova, A., Smith, G. L., Soldati, T., Sousa, B. C., Spickett, C. M., Stancic, A., Stasia, M. J., Steinbrenner, H., Stepanić, V., Steven, S., Tokatlidis, K., Tuncay, E., Turan, B., Ursini, F., Vacek, J., Vajnerova, O., Valentová, K., Van Breusegem, F., Varisli, L., Veal, E. A., Yalçin, A. S., Yelisyeyeva, O., Žarković, N., Zatloukalová, M., Zielonka, J., Touyz, R. M., Papapetropoulos, A., Grune, T., Lamas, S., Schmidt, H. H.H.W., Di Lisa, F., and Daiber, A.

Published
2018

20. IODP Drilling of the 'Shackleton Sites' on the Iberian Margin: A Plio-Pleistocene Marine Reference Section of Millennial-Scale Climate Change

Author

Abrantes, F., Hodell, D., Carrara, G., Batista, L., and Duarte, H.

Subjects
lcsh:Geology, Mechanical Engineering, lcsh:QE1-996.5, Energy Engineering and Power Technology, Iberian Margin
Abstract

Few marine sediment cores have played such a pivotal role in paleoclimate research as those recovered from the Portuguese Margin, including MD95-2039 to MD95-2042 (hereafter referred to as the “Shackleton sites”) (Fig. 1). These cores preserve a high-fidelity record of millennial-scale climate variability for the last several glacial cycles and can be readily correlated to Greenland ice cores. Moreover, the narrow continental shelf and proximity of the Tagus River results in rapid delivery of terrestrial material to the deep-sea environment, thereby permitting correlation of marine and ice-core records to European terrestrial sequences. Few places exist in the world’s ocean where such marine-ice-terrestrial linkages are possible. Consequently, the Iberian Margin cores have become de facto reference sections for the study of abrupt climate change.

Published
2018

21. Corrigendum to 'European contribution to the study of ROS: A summary of the findings and prospects for the future from the COST action BM1203 (EU-ROS)' (Redox Biol. (2017) 13 (94–162)(S2213231717303373)(10.1016/j.redox.2017.05.007))

Author

Egea, J. Fabregat, I. Frapart, Y.M. Ghezzi, P. Görlach, A. Kietzmann, T. Kubaichuk, K. Knaus, U.G. Lopez, M.G. Olaso-Gonzalez, G. Petry, A. Schulz, R. Vina, J. Winyard, P. Abbas, K. Ademowo, O.S. Afonso, C.B. Andreadou, I. Antelmann, H. Antunes, F. Aslan, M. Bachschmid, M.M. Barbosa, R.M. Belousov, V. Berndt, C. Bernlohr, D. Bertrán, E. Bindoli, A. Bottari, S.P. Brito, P.M. Carrara, G. Casas, A.I. Chatzi, A. Chondrogianni, N. Conrad, M. Cooke, M.S. Costa, J.G. Cuadrado, A. My-Chan Dang, P. De Smet, B. Debelec-Butuner, B. Dias, I.H.K. Dunn, J.D. Edson, A.J. El Assar, M. El-Benna, J. Ferdinandy, P. Fernandes, A.S. Fladmark, K.E. Förstermann, U. Giniatullin, R. Giricz, Z. Görbe, A. Griffiths, H. Hampl, V. Hanf, A. Herget, J. Hernansanz-Agustín, P. Hillion, M. Huang, J. Ilikay, S. Jansen-Dürr, P. Jaquet, V. Joles, J.A. Kalyanaraman, B. Kaminskyy, D. Karbaschi, M. Kleanthous, M. Klotz, L.O. Korac, B. Korkmaz, K.S. Koziel, R. Kračun, D. Krause, K.H. Křen, V. Krieg, T. Laranjinha, J. Lazou, A. Li, H. Martínez-Ruiz, A. Matsui, R. McBean, G.J. Meredith, S.P. Messens, J. Miguel, V. Mikhed, Y. Milisav, I. Milković, L. Miranda-Vizuete, A. Mojović, M. Monsalve, M. Mouthuy, P.A. Mulvey, J. Münzel, T. Muzykantov, V. Nguyen, I.T.N. Oelze, M. Oliveira, N.G. Palmeira, C.M. Papaevgeniou, N. Pavićević, A. Pedre, B. Peyrot, F. Phylactides, M. Pircalabioru, G.G. Pitt, A.R. Poulsen, H.E. Prieto, I. Rigobello, M.P. Robledinos-Antón, N. Rodríguez-Mañas, L. Rolo, A.P. Rousset, F. Ruskovska, T. Saraiva, N. Sasson, S. Schröder, K. Semen, K. Seredenina, T. Shakirzyanova, A. Smith, G.L. Soldati, T. Sousa, B.C. Spickett, C.M. Stancic, A. Stasia, M.J. Steinbrenner, H. Stepanić, V. Steven, S. Tokatlidis, K. Tuncay, E. Turan, B. Ursini, F. Vacek, J. Vajnerova, O. Valentová, K. Van Breusegem, F. Varisli, L. Veal, E.A. Yalçın, A.S. Yelisyeyeva, O. Žarković, N. Zatloukalová, M. Zielonka, J. Touyz, R.M. Papapetropoulos, A. Grune, T. Lamas, S. Schmidt, H.H.H.W. Di Lisa, F. Daiber, A.

Abstract

The authors regret that they have to correct the acknowledgement of the above mentioned publication as follows: This article/publication is based upon work from COST Action BM1203 (EU-ROS), supported by COST (European Cooperation in Science and Technology) which is funded by the Horizon 2020 Framework Programme of the European Union. COST (European Cooperation in Science and Technology) is a funding agency for research and innovation networks. Our Actions help connect research initiatives across Europe and enable scientists to grow their ideas by sharing them with their peers. This boosts their research, career and innovation. For further information see www.cost.eu. The authors would like to apologise for any inconvenience caused. © 2017 The Author(s)

Published
2018

22. European contribution to the study of ROS: A summary of the findings and prospects for the future from the COST action BM1203 (EU-ROS) (vol 13, pg 94, 2017)

Author

Egea, J., Fabregat, I., Frapart, Y.M., Ghezzi, P., Görlach, A., Kietzmann, T., Kubaichuk, K., Knaus, U.G., Lopez, M.G., Olaso-Gonzalez, G., Petry, A., Schulz, R., Vina, J., Winyard, P., Abbas, K., Ademowo, O.S., Afonso, C.B., Andreadou, I., Antelmann, H., Antunes, F., Aslan, M., Bachschmid, M.M., Barbosa, R.M., Belousov, V., Berndt, C., Bernlohr, D., Bertrán, E., Bindoli, A., Bottari, S.P., Brito, P.M., Carrara, G., Casas, A.I., Chatzi, A., Chondrogianni, N., Conrad, M., Cooke, M.S., Costa, J.G., Cuadrado, A., My-Chan Dang, P., De Smet, B., Debelec-Butuner, B., Dias, I.H.K., Dunn, J.D., Edson, A.J., El Assar, M., El-Benna, J., Ferdinandy, P., Fernandes, A.S., Fladmark, K.E., Förstermann, U., Giniatullin, R., Giricz, Z., Görbe, A., Griffiths, H., Hampl, V., Hanf, A., Herget, J., Hernansanz-Agustín, P., Hillion, M., Huang, J., Ilikay, S., Jansen-Dürr, P., Jaquet, V., Joles, J.A., Kalyanaraman, B., Kaminskyy, D., Karbaschi, M., Kleanthous, M., Klotz, L.O., Korac, B., Korkmaz, K.S., Koziel, R., Kračun, D., Krause, K.H., Křen, V., Krieg, T., Laranjinha, J., Lazou, A., Li, H., Martínez-Ruiz, A., Matsui, R., McBean, G.J., Meredith, S.P., Messens, J., Miguel, V., Mikhed, Y., Milisav, I., Milković, L., Miranda-Vizuete, A., Mojović, M., Monsalve, M., Mouthuy, P.A., Mulvey, J., Münzel, T., Muzykantov, V., Nguyen, I.T.N., Oelze, M., Oliveira, N.G., Palmeira, C.M., and Papaevgeniou, N.

Published
2018

23. The conjunct role of social, personality and clinical factors in predicting homonegativity

Author

FALGARES, Giorgio, Lino A, Carrara, G, De Santis, S, Kopala Sibley, DC, Falgares, G, Lino A, Carrara, G, De Santis, S, and Kopala-Sibley, DC

Subjects
Settore M-PSI/07 - Psicologia Dinamica, Homonegativity, Personality, Psychopatology
Abstract

Homonegativity (HN) refers to negative attitudes towards homosexuality, lesbians, and gay men. Few studies have investigated HN by combining the psychosocial and “clinical” factors, such as authoritarianism and neuroticism, with which it is associated. Past research indicates that personality traits (Lingiardi et al., 2016), as well as experiences of authoritarianism (Altemeyer, 1998), render individuals prone to the development of HN. Conversely, past findings concerning attachment styles have been more controversial.

Published
2016

24. A seasonal pattern in the onset of polymyalgia rheumatica and giant cell arteritis? A systematic review and meta-analysis.

Author

Hysa, E., Sobrero, A., Camellino, D., Rumi, F., Carrara, G., Cutolo, M., Scirè, C.A., and Cimmino, M.A.

Abstract

Studies on the seasonality of onset of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) have shown conflicting results. The aim of this systematic literature review and meta-analysis is to determine from aggregated data whether there is a seasonal distribution for these diseases. A literature search was performed using Pubmed Central and Embase scientific databases. The incidences per 6-month periods, season or month of onset, that were reported in the studies were summarised in tables considering the two diseases as separate conditions or together. The Incidence Rate Ratio (IRR) for the cold period versus the warm period was pooled across studies by random effects meta-analysis weighed by inverse variance. Funnel plots and Egger test were used to explore possible publication biases. A sensitivity analysis was performed to weigh articles with a disproportionate number of patients compared to the rest. In the scientific literature 22 suitable papers were found: 6 on PMR with 803 patients, 11 on GCA with 2,807 patients, and 5 studies considering both diseases with 19,613 patients. There was considerable heterogeneity amongst studies regarding their quality, the classification criteria used, and the definition of onset of symptoms. No seasonal aggregation was found for GCA and PMR. The pooled IRR estimate of the meta-analysis (1.13[0.89,1.36]) showed a non-significant, higher frequency of diseases onset in the warm season. Our meta-analysis did not confirm a seasonal onset for PMR and GCA. [ABSTRACT FROM AUTHOR]

Published
2020
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26. Evidencias acústicas de procesos paralelos al talud asociados con depósitos de movimiento en masa en el talud inferior de la Isla de Madeira (Atlántico Central Oriental)

Author

Roque, C. (Cristina), Madureira, P. (Pedro), Hernández-Molina, F.J. (Francisco Javier), Santos de Campos, A., Quartau, R., Carrara, G., Brandão, F., Vázquez, J.T. (Juan Tomás), Somoza-Losada, L. (Luis), Díaz-del-Río-Español, V. (Víctor), Bárcenas-Gascón, P. (Patricia), Fernández-Salas, L.M. (Luis Miguel), López-González, N. (Nieves), Palomino, D. (Desirée), Rueda, J.L. (José Luis), and Vázquez, J.T. (Juan Tomás)

Subjects
alongslope processes, Madeira lower slope, mass movements, Central Atlantic, Madeira drift
Abstract

The Madeira Island lower slope has been build-up mostly by along slope-processes associated with mass movement deposits as seen in GEBCO bathymetry, multibeam bathymetry, Parasound echosounder profiles and multichannel seismic reflection profiles. A plastered contourite drift (Madeira Drift) developed on this lower slope, being composed of seismic units D1, D2 and D3. The most probable water mass responsible for its deposition is the Antarctica Bottom Water (AABW). The youngest sediments of seismic units D2 and D3 are affected by gravity-driven processes, probably slumps and debris flows, which moved downslope towards west. Parasound profiles show evidences of such mass movements on present-day seabottom (e.g. diffraction hyperbolae echoes) but also of past-events buried within the contourite sediments. These older debris flows are recognized by semitransparent/transparent acoustic facies and lenticular shape. Versión del editor

Published
2015

33. The 'Shackleton Site' (IODP Site U1385) on the Iberian Margin

Author

Hodell, D.A., Lourens, L., Stow, D.A.V., Hernández-Molina, F.J., Alvarez-Zarikian, C.A., Abrantes, F., Acton, G.D., Bahr, A., Balestra, B., Llave Barranco, E., Carrara, G., Crowhurst, S., Ducassou, E., Flood, R., Flores, J.-A., Furota, S., Grimalt, J., Grunert, P., Jimenez-Espejo, F.J., Kim, J.K., Konijnendijk, T., Krissek, L., Kuroda, J., Li, B., Lofi, J., Margari, V., Martrat, B., Miller, M.D., Nanayama, F., Nishida, N., Richter, C., Rodrigues, T., Rodríguez-Tovar, F.J., Freixo Roque, A.C., Sanchez Goñi, M.F., Sierro, F.J., Singh, A.D., Skinner, L., Sloss, C.R., Takashimizu, Y., Tjallingii, R., Tzanova, A., Tzedakis, C., Voelker, A., Xuan, C., Williams, T., NWO-VICI: Evolution of astronomically paced climate changes from Greenhouse to Icehouse world, and Stratigraphy and paleontology

Published
2013

35. Early Lupus Project: one-year follow-up of an Italian cohort of patients with systemic lupus erythematosus of recent onset.

Author

Sebastiani, G. D., Prevete, I., Iuliano, A., Piga, M, Iannone, F., Coladonato, L., Govoni, M., Bortoluzzi, A., Mosca, M., Tani, C., Doria, A., Iaccarino, L., Tincani, A., Fredi, M., Conti, F., Spinelli, F. R., Galeazzi, M., Bellisai, F., Zanetti, A., and Carrara, G.

Subjects
SYSTEMIC lupus erythematosus diagnosis, CARDIOVASCULAR diseases, MOUTH ulcers, DISEASE remission, GLUCOCORTICOIDS
Abstract

Objective: To describe the clinical and serological features of a prospectively followed cohort of early diagnosed systemic lupus erythematosus (SLE) patients during a one-year follow-up period. Methods: SLE patients with disease duration less than 12 months were consecutively enrolled in a multicentre, prospective study. At study entry and then every 6 months, a large panel of data was recorded. Results: Of 260 patients enrolled, 185 had at least 12 months of follow-up; of these, 84.3% were female, 92.4% were Caucasians. Mean diagnostic delay was about 20 months; higher values of European Consensus Lupus Activity Measurement (ECLAM) and of organs/systems involved were both associated with shorter diagnostic delay. Clinical and serological parameters improved after study entry. However, patients' quality of life deteriorated and cardiovascular risk factors significantly increased. About one-third of patients with active disease at study entry went into remission (ECLAM=0). Negative predictors for remission were: oral ulcers, arthritis, low C4, anti-SSB (Ro) antibodies and therapy with mycophenolate. There was a widespread use of glucocorticoids both at baseline and during follow-up. Conclusion: Clinical symptoms and serological parameters improve during the first period after diagnosis. However, patients' quality of life deteriorates. The widespread use of glucocorticoids is probably the reason for the early significant increase of some cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Published
2018
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38. The TRANSMED Atlas: geological-geophysical fabric of the Mediterranean region

Author

Cavazza, W, Roure, M. F., Spakman, W, Stampfli, G, Ziegler, P. A., Carminati, Eugenio Ambrogio Maria, Doglioni, Carlo, Argnani, A, Carrara, G, Dabovski, C, Dumurdzhanov, N, Gaetani, M, Georgiev, G, Mauffret, M, Sartori, R, Scionti, V, Scrocca, D, Seranne, M, Torelli, L, and Zagorchev, I.

Published
2004

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