8 results on '"Davide Giusti"'
Search Results
2. Identification and validation of diagnostic cut-offs of the ELISpot assay for the diagnosis of invasive aspergillosis in high-risk patients.
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Francesca Bettelli, Daniela Vallerini, Ivana Lagreca, Patrizia Barozzi, Giovanni Riva, Vincenzo Nasillo, Ambra Paolini, Roberto D'Amico, Fabio Forghieri, Monica Morselli, Valeria Pioli, Andrea Gilioli, Davide Giusti, Andrea Messerotti, Paola Bresciani, Angela Cuoghi, Elisabetta Colaci, Roberto Marasca, Livio Pagano, Anna Candoni, Johan Maertens, Pierluigi Viale, Cristina Mussini, Rossella Manfredini, Enrico Tagliafico, Mario Sarti, Tommaso Trenti, Russell Lewis, Patrizia Comoli, Albino Eccher, Mario Luppi, and Leonardo Potenza
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Medicine ,Science - Abstract
ObjectiveWe investigated the performance of enzyme linked immunospot (ELISpot) assay for the diagnosis of invasive aspergillosis (IA) in high-risk patients with hematologic malignancies.MethodsWe prospectively enrolled two cohorts of patients undergoing intensive myelosuppressive or immunosuppressive treatments at high risk for IA. ELISpot was performed to detect Aspergillus-specific T cells producing Interleukin-10.ResultsIn the discovery cohort, a derived cut-off of 40 spot forming cells (SFCs)/106 PBMCs has shown to correctly classify IA cases with a sensitivity and specificity of 89.5% and 88.6%, respectively. This cut-off is lowered to 25 SFC when considering the subset of possible IA patients, with sensitivity and specificity of 76% and 93%, respectively. The application of the 40 SFCs cut-off to the validation cohort resulted in a positivity rate of 83.3% in proven/probable cases and a negativity rate of 92.5% in possible/non-IA cases. Adopting the 25 SCFs cut-off, the assay resulted positive in 83.3% of proven/probable cases while it resulted negative in 66.7% of possible/non-IA cases.ConclusionsELISpot shows promises in the diagnosis of IA and the possibility to use two distinct cut-offs with similar diagnostic performances according to patients' different pre-test probability of infection can widen its use in patients at risk.
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- 2024
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3. Investigating the association between physicians self-efficacy regarding communication skills and risk of 'burnout'
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Andrea Messerotti, Federico Banchelli, Silvia Ferrari, Emiliano Barbieri, Francesca Bettelli, Elena Bandieri, Davide Giusti, Hillary Catellani, Eleonora Borelli, Elisabetta Colaci, Valeria Pioli, Monica Morselli, Fabio Forghieri, Gian Maria Galeazzi, Roberto Marasca, Sarah Bigi, Roberto D’Amico, Peter Martin, Fabio Efficace, Mario Luppi, and Leonardo Potenza
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Breaking serious news ,Attitudes ,Burnout ,Communication skills ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Breaking bad news (BBN) may be associated with increasing risk of burnout in practising physicians. However, there is little research on the association between the way bad news is broken and burnout. We investigated the association between physicians’ self-efficacy regarding communication to patients and risk of burnout. Methods We performed a cross-sectional study by proposing an ad-hoc survey exploring attitudes and practice regarding BBN and the Maslach Burnout Inventory - Human Service Survey to 379 physicians from two University Hospitals in Italy. Associations were assessed by multivariable logistic regression models. Results Two-hundred twenty-six (60%) physicians returned the questionnaires. 76% of physicians acquired communication skills by observing mentors or colleagues, 64% considered BBN as discussing a poor prognosis, 56% reported discussing prognosis as the most difficult task, 38 and 37% did not plan a BBN encounter and considered it stressful. The overall burnout rate was 59%. Considering BBN a stressful task was independently associated with high risk of burnout (OR 3.01; p = 0.013). Planning the encounter (OR = 0.43, p = 0.037), mastering communication skills (OR = 0.19, p = 0.034) and the self-evaluation as good or very good at BBN (OR 0.32; 0.15 to 0.71; p = 0.0) were associated with low risk of burnout. Conclusions Our findings suggest that some physicians’ BBN attitudes and knowledge of conceptual frameworks may influence the risk of burnout and support the notion that increasing knowledge about communication skills may protect clinicians from burnout. Further research is needed in this area.
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- 2020
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4. Physicians’ Perceptions of Clinical Utility of a Digital Health Tool for Electronic Patient-Reported Outcome Monitoring in Real-Life Hematology Practice. Evidence From the GIMEMA-ALLIANCE Platform
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Fabio Efficace, Andrea Patriarca, Mario Luppi, Leonardo Potenza, Giovanni Caocci, Agostino Tafuri, Francesca Fazio, Claudio Cartoni, Maria Teresa Petrucci, Ida Carmosino, Riccardo Moia, Gloria Margiotta Casaluci, Paola Boggione, Elisabetta Colaci, Davide Giusti, Valeria Pioli, Francesco Sparano, Francesco Cottone, Paolo De Fabritiis, Nicolina Rita Ardu, Pasquale Niscola, Isabella Capodanno, Anna Paola Leporace, Sabrina Pelliccia, Elisabetta Lugli, Edoardo La Sala, Luigi Rigacci, Michelina Santopietro, Claudio Fozza, Sergio Siragusa, Massimo Breccia, Paola Fazi, and Marco Vignetti
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digital health ,symptoms ,quality of life ,hematology ,patient-reported outcomes (PROs) ,leukemia ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians’ perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff. Based on a predefined algorithm, automated alerts are sent to medical staff. Participating hematologists completed an online survey on their experience with the platform. Of the 201 patients invited to participate between December 2020 and June 2021 (cut-off date for current analysis), 180 (90%) agreed to enter the platform and had a median age of 57 years. Twenty-three hematologists with a median age of 42 years and an average of 17 years of experience in clinical practice were surveyed. All hematologists agreed or strongly agreed that the platform was easy to use, and 87%, agreed or strongly agreed that ePROs data were useful to enhance communication with their patients. The majority of physicians (78%) accessed the platform at least once per month to consult the symptom and health status profile of their patients. The frequency of access was independent of physician sex (p=0.393) and years of experience in clinical practice (p=0.404). In conclusion, our preliminary results support the clinical utility, from the perspective of the treating hematologist, of integrating ePROs into the routine cancer care of patients with hematologic malignancies.
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- 2022
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5. Diagnostic accuracy of the Novel 29 MHz micro-ultrasound 'ExactVuTM' for the detection of clinically significant prostate cancer: A prospective single institutional study. A step forward in the diagnosis of prostate cancer
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Francesco Chessa, Riccardo Schiavina, Amelio Ercolino, Caterina Gaudiano, Davide Giusti, Lorenzo Bianchi, Cristian Pultrone, Emanuela Marcelli, Concetta Distefano, Luca Lodigiani, and Eugenio Brunocilla
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Prostate Cancer ,Imaging ,Detection rate ,Microultrasound ,PRI-MUS score ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Introduction and Objective: ExactVuTM is a real-time micro-ultrasound system which provides, according to the Prostate Risk Identification Using Micro-Ultrasound protocol (PRI-MUS), a 300% higher resolution compared to conventional transrectal ultrasound. To evaluate the performance of ExactVuTM in the detection of Clinically significant Prostate Cancer (CsPCa). Materials and methods: Patients with Prostate Cancer diagnosed at fusion biopsy were imaged with ExactVuTM. CsPCa was defined as any Gleason Score ≥ 3+4. ExactVuTM examination was considered as positive when PRI-MUS score was ≥ 3. PRI-MUS scoring system was considered as correct when the fusion biopsy was positive for CsPCa. A transrectal fusion biopsy- proven CsPCa was considered as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operator characteristic (ROC) curve (AUC) were calculated. Results: 57 patients out of 68 (84%) had a csPCa. PRI-MUS score was correctly assessed in 68% of cases. Regarding the detection of CsPCa, ExactVuTM ’s sensitivity, specificity, PPV, and NPV was 68%, 73%, 93%, and 31%, respectively and the AUC was 0.7 (95% CI 0.5-0-8). For detecting CsPCa in the transition/ anterior zone the sensitivity, specificity, PPV, and NPV was 45%, 66%, 83% and 25% respectively ant the AUC was 0.5 (95% CI 0.2-0.9). Accounting only the CsPCa located in the peripheral zone, sensitivity, specificity, PPV, and NPV raised up to 74%, 75%, 94%, 33%, respectively with AUC 0.75 (95% CI 0.5-0-9). Conclusions: ExactVuTM provides high resolution of the prostatic peripheral zone and could represent a step forward in the detection of CsPCa as a triage tool. Further studies are needed to confirm these promising results.
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- 2021
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6. How to Improve Prognostication in Acute Myeloid Leukemia with CBFB-MYH11 Fusion Transcript: Focus on the Role of Molecular Measurable Residual Disease (MRD) Monitoring
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Annalisa Talami, Francesca Bettelli, Valeria Pioli, Davide Giusti, Andrea Gilioli, Corrado Colasante, Laura Galassi, Rachele Giubbolini, Hillary Catellani, Francesca Donatelli, Rossana Maffei, Silvia Martinelli, Patrizia Barozzi, Leonardo Potenza, Roberto Marasca, Tommaso Trenti, Enrico Tagliafico, Patrizia Comoli, Mario Luppi, and Fabio Forghieri
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acute myeloid leukemia ,CBFB-MYH11 fusion transcript ,molecular measurable residual disease monitoring ,prognostic thresholds and timepoints ,intensive chemotherapy ,clinical outcomes ,Biology (General) ,QH301-705.5 - Abstract
Acute myeloid leukemia (AML) carrying inv(16)/t(16;16), resulting in fusion transcript CBFB-MYH11, belongs to the favorable-risk category. However, even if most patients obtain morphological complete remission after induction, approximately 30% of cases eventually relapse. While well-established clinical features and concomitant cytogenetic/molecular lesions have been recognized to be relevant to predict prognosis at disease onset, the independent prognostic impact of measurable residual disease (MRD) monitoring by quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR), mainly in predicting relapse, actually supersedes other prognostic factors. Although the ELN Working Party recently indicated that patients affected with CBFB-MYH11 AML should have MRD assessment at informative clinical timepoints, at least after two cycles of intensive chemotherapy and after the end of treatment, several controversies could be raised, especially on the frequency of subsequent serial monitoring, the most significant MRD thresholds (most commonly 0.1%) and on the best source to be analyzed, namely, bone marrow or peripheral blood samples. Moreover, persisting low-level MRD positivity at the end of treatment is relatively common and not predictive of relapse, provided that transcript levels remain stably below specific thresholds. Rising MRD levels suggestive of molecular relapse/progression should thus be confirmed in subsequent samples. Further prospective studies would be required to optimize post-remission monitoring and to define effective MRD-based therapeutic strategies.
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- 2021
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7. Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis
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Davide Giustivi, Mattia Donadoni, Stefano Maria Elli, Francesco Casella, Massimiliano Quici, Chiara Cogliati, Silvia Cavalli, Giulia Rizzi, Leyla La Cava, Arianna Bartoli, Elena Martini, Alba Taino, Martina Perego, Antonella Foschi, Roberto Castelli, Maria Calloni, and Antonio Gidaro
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Peripherally Inserted Central Catheter (PICC) ,tunnel ,infection ,catheter-related thrombosis (CRT) ,bleeding ,wound oozing ,Nursing ,RT1-120 - Abstract
Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. Methods: Randomized controlled trials without language restrictions were searched using PUBMED®, EMBASE®, EBSCO®, CINAHL®, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. Results: There were no significant differences in overall success and nerve or artery injuries between the two groups (p = 0.62 and p = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (p < 0.001; RR0.41 [0.31–0.54] CI 95%), catheter-related thrombosis (p < 0.001; RR0.35 [0.20–0.59] IC 95%), infection-triggering catheter removal (p < 0.001; RR0.33 [0.18–0.61] IC 95%), wound oozing (p < 0.001; RR0.49 [0.37–0.64] IC 95%), and dislodgement (p < 0.001; RR0.4 [0.31–0.54] CI 95%). Conclusions: The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization.
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- 2024
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8. Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review
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Fabio Borgonovo, Massimiliano Quici, Antonio Gidaro, Davide Giustivi, Dario Cattaneo, Cristina Gervasoni, Maria Calloni, Elena Martini, Leyla La Cava, Spinello Antinori, Chiara Cogliati, Andrea Gori, and Antonella Foschi
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antimicrobials ,antifungals ,antiprotozoals ,antivirals ,antimycotics ,antibiotics ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Most antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH, osmolarity, dosage, infusion rate, vesicant properties, and phlebitis rate of the most commonly used antimicrobial drugs evaluated in randomized controlled studies (RCT) till 31 March 2023. The authors searched for available IV antimicrobial drugs in RCT in PUBMED EMBASE®, EBSCO® CINAHL®, and the Cochrane Controlled Clinical trials. Drugs’ chemical features were searched online, in drug data sheets, and in scientific papers, establishing that the drugs with a pH of 9, osmolarity >600 mOsm/L, high incidence of phlebitis reported in the literature, and vesicant drugs need the adoption of utmost caution during administration. We evaluated 931 papers; 232 studies were included. A total of 82 antimicrobials were identified. Regarding antibiotics, 37 reach the “caution” criterion, as well as seven antivirals, 10 antifungals, and three antiprotozoals. In this subgroup of antimicrobials, the correct vascular access device (VAD) selection is essential to avoid complications due to the administration through a peripheral vein. Knowing the physicochemical characteristics of antimicrobials is crucial to improve the patient’s safety significantly, thus avoiding administration errors and local side effects.
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- 2023
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