4 results on '"Tabbi L."'
Search Results
2. Stenting versus balloon dilatation in patients with tracheal benign stenosis: The STROBE trial
- Author
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Alessandro Marchioni, Dario Andrisani, Roberto Tonelli, Alessandro Andreani, Gaia Francesca Cappiello, Margherita Ori, Filippo Gozzi, Giulia Bruzzi, Chiara Nani, Raimondo Feminò, Linda Manicardi, Serena Baroncini, Francesco Mattioli, Matteo Fermi, Riccardo Fantini, Luca Tabbì, Ivana Castaniere, Livio Presutti, Enrico Clini, Marchioni A., Andrisani D., Tonelli R., Andreani A., Cappiello G.F., Ori M., Gozzi F., Bruzzi G., Nani C., Femino R., Manicardi L., Baroncini S., Mattioli F., Fermi M., Fantini R., Tabbi L., Castaniere I., Presutti L., and Clini E.
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benign tracheal stenosis ,benign tracheal stenosis, tracheal stenting, balloon dilatation, rigid bronchoscopy ,balloon dilatation ,tracheal stenting ,rigid bronchoscopy ,General Medicine ,benign tracheal stenosi - Abstract
Background: It is well known that benign tracheal stenosis represents an obstacle to open surgery, and that its treatment could be challenging. Two endoscopic techniques have so far been adopted to restore tracheal patency: balloon dilatation (BA) through laryngoscopy, and tracheal stenting (ST) with rigid bronchoscopy. The main objective of this study was to compare the efficacy of BA and ST to treat benign tracheal stenosis not eligible for surgery. We also compared the rate of adverse events in the two treatment groups. Methods: A retrospective, observational cohort study was carried out at the University Hospital of Modena (Italy) from November 2012 to November 2017 in two separate departments. Patients were considered to be “stabilized” (primary outcome) if they did not report significant respiratory symptoms, or restenosis in the long-term (2 years) following the endoscopic procedure. Results: Sixty-six patients were included in the study (33 in the BA and 33 in the ST group, respectively). Unadjusted Kaplan–Meier estimates showed a greater therapeutic effect of ST compared to BA at 2 years (hazard ratio=3.9 95%CI [1.5–9.8], p=.01). After adjusting for confounders, stratified analyses showed that this effect was significant in patients with complex stenosis, idiopathic etiology, and degree of stenosis >70%. Compared with BA, ST showed a higher rate of adverse events (p=.01). Conclusions: Compared to BA, ST seems to be more effective in achieving stabilization of tracheal patency in complex benign tracheal stenosis, although burdened with a significantly higher number of adverse effects. These findings warrant future prospective study for confirmation. Level of evidence: 3.
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- 2022
3. Early awake proning in critical and severe COVID-19 patients undergoing noninvasive respiratory support: A retrospective multicenter cohort study
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Luca Tabbì, Giulia Bruzzi, Enrico Clini, Linda Manicardi, Stefano Nava, Stefano Busani, Gabriele Corsi, Cristina Mussini, Irene Prediletto, Vittoria Comellini, Roberto D'Amico, Ilaria Bassi, Riccardo Fantini, Ivana Castaniere, Federico Tagariello, Massimo Girardis, Filippo Gozzi, Marco Carpano, Lara Pisani, Alessandro Marchioni, Roberto Tonelli, Dario Andrisani, Tonelli R., Pisani L., Tabbi L., Comellini V., Prediletto I., Fantini R., Marchioni A., Andrisani D., Gozzi F., Bruzzi G., Manicardi L., Busani S., Mussini C., Castaniere I., Bassi I., Carpano M., Tagariello F., Corsi G., d'Amico R., Girardis M., Nava S., and Clini E.
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Pulmonary and Respiratory Medicine ,Coronavirus disease 2019 (COVID-19) ,ARF, acute respiratory failure ,Vt, tidal volume ,medicine.medical_treatment ,RR, respiratory rate ,Acute respiratory failure ,NRS, non-invasive respiratory support ,law.invention ,Cohort Studies ,03 medical and health sciences ,Prone position ,0302 clinical medicine ,Randomized controlled trial ,law ,ICU, Intensive Care Unit ,medicine ,Humans ,Intubation ,030212 general & internal medicine ,Wakefulness ,APACHE II, acute physiology and chronic health evaluation II score ,HFNC, High Flow Nasal Cannulae ,Retrospective Studies ,COVID-19, Acute respiratory failure, Non-invasive mechanical ventilation, Prone position ,NIV, non-invasive mechanical ventilation ,business.industry ,ETI, endotracheal intubation ,CPAP, continuous positive airways pressure ,Confounding ,COVID-19 ,MV, mechanical ventilation ,Retrospective cohort study ,SAPS II, simplified acute physiology score ,PSV, pressure support ventilation ,HR, hazard ratio ,SOFA, subsequent organ failure assessment ,OR, odds ratio ,030228 respiratory system ,PEEP, positive end expiratory pressure ,Anesthesia ,Breathing ,Original Article ,Non-invasive mechanical ventilation ,Respiratory Insufficiency ,business ,Cohort study - Abstract
BACKGROUND/MATERIALS AND METHODS: This retrospective cohort study was conducted in two teaching hospitals over a 3-month period (March 2010-June 2020) comparing severe and critical COVID-19 patients admitted to Respiratory Intensive Care Unit for non-invasive respiratory support (NRS) and subjected to awake prone position (PP) with those receiving standard care (SC). Primary outcome was endotracheal intubation (ETI) rate. In-hospital mortality, time to ETI, tracheostomy, length of RICU and hospital stay served as secondary outcomes. Risk factors associated to ETI among PP patients were also investigated. RESULTS: A total of 114 patients were included, 76 in the SC and 38 in the PP group. Unadjusted Kaplan-Meier estimates showed greater effect of PP compared to SC on ETI rate (HRâ¯=â¯0.45 95% CI [0.2-0.9], pâ¯=â¯0.02) even after adjustment for baseline confounders (HRâ¯=â¯0.59 95% CI [0.3-0.94], pâ¯=â¯0.03). After stratification according to non-invasive respiratory support, PP showed greater significant benefit for those on High Flow Nasal Cannulae (HRâ¯=â¯0.34 95% CI [0.12-0.84], pâ¯=â¯0.04). Compared to SC, PP patients also showed a favorable difference in terms of days free from respiratory support, length of RICU and hospital stay while mortality and tracheostomy rate were not significantly different. CONCLUSIONS: Prone positioning in awake and spontaneously breathing Covid-19 patients is feasible and associated with a reduction of intubation rate, especially in those patients undergoing HFNC. Although our results are intriguing, further randomized controlled trials are needed to answer all the open questions remaining pending about the real efficacy of PP in this setting.
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- 2022
4. Molecular Mechanisms and Physiological Changes behind Benign Tracheal and Subglottic Stenosis in Adults
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Alessandro Marchioni, Roberto Tonelli, Alessandro Andreani, Gaia Francesca Cappiello, Matteo Fermi, Fabiana Trentacosti, Ivana Castaniere, Riccardo Fantini, Luca Tabbì, Dario Andrisani, Filippo Gozzi, Giulia Bruzzi, Linda Manicardi, Antonio Moretti, Serena Baroncini, Anna Valeria Samarelli, Massimo Pinelli, Giorgio De Santis, Alessandro Stefani, Daniele Marchioni, Francesco Mattioli, Enrico Clini, Marchioni A., Tonelli R., Andreani A., Cappiello G.F., Fermi M., Trentacosti F., Castaniere I., Fantini R., Tabbi L., Andrisani D., Gozzi F., Bruzzi G., Manicardi L., Moretti A., Baroncini S., Samarelli A.V., Pinelli M., De Santis G., Stefani A., Marchioni D., Mattioli F., and Clini E.
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tracheostomy ,Granulomatosis with polyangiiti ,Mechanotransduction, Cellular ,Subglottic stenosis ,tracheal stenosis ,relapsing polychondritis ,granulomatosis with polyangiitis ,web-like stenosis ,Catalysis ,Inorganic Chemistry ,Tracheostomy ,Laryngostenosi ,Web-like stenosi ,Intercellular Signaling Peptides and Protein ,Humans ,Genetic Predisposition to Disease ,Physical and Theoretical Chemistry ,Cytokine ,Molecular Biology ,Spectroscopy ,Relapsing polychondriti ,Organic Chemistry ,Laryngostenosis ,Biomarker ,General Medicine ,Subglottic stenosi ,Biomechanical Phenomena ,Computer Science Applications ,Tracheal stenosi ,Cytokines ,Intercellular Signaling Peptides and Proteins ,Tracheal Stenosis ,Biomarkers ,Human - Abstract
Laryngotracheal stenosis (LTS) is a complex and heterogeneous disease whose pathogenesis remains unclear. LTS is considered to be the result of aberrant wound-healing process that leads to fibrotic scarring, originating from different aetiology. Although iatrogenic aetiology is the main cause of subglottic or tracheal stenosis, also autoimmune and infectious diseases may be involved in causing LTS. Furthermore, fibrotic obstruction in the anatomic region under the glottis can also be diagnosed without apparent aetiology after a comprehensive workup; in this case, the pathological process is called idiopathic subglottic stenosis (iSGS). So far, the laryngotracheal scar resulting from airway injury due to different diseases was considered as inert tissue requiring surgical removal to restore airway patency. However, this assumption has recently been revised by regarding the tracheal scarring process as a fibroinflammatory event due to immunological alteration, similar to other fibrotic diseases. Recent acquisitions suggest that different factors, such as growth factors, cytokines, altered fibroblast function and genetic susceptibility, can all interact in a complex way leading to aberrant and fibrotic wound healing after an insult that acts as a trigger. However, also physiological derangement due to LTS could play a role in promoting dysregulated response to laryngo-tracheal mucosal injury, through biomechanical stress and mechanotransduction activation. The aim of this narrative review is to present the state-of-the-art knowledge regarding molecular mechanisms, as well as mechanical and physio-pathological features behind LTS.
- Published
- 2022
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