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1. Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial

Author

Vincenzi B, Spalletta B, La Cesa A, Giordani P, Baldelli AM, Testa E, Di Seri M, Catalano V, Graziano F, Santini D, Russo A, Caraglia M, Virzi V, Cascinu S, and Tonini G

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. Methods Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. Results A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%–56%) with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients). Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%), diarrhoea (4.8%), mucositis (2.4%), neurotoxicity (2.4%) and neutropenia (4.8%). The median response duration was 5.3 months (95% CIs: 2.13 – 7.34), the median time to disease progression was 5.0 months (95% CIs: 3.75 – 6.25) and the median survival time was 9.0 months (95% CIs: 6.18 – 11.82). Conclusion OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer.

Published
2006
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4. Haemoglobin values, transfusion practices, and long-term outcomes in critically ill patients with traumatic brain injury: a secondary analysis of CENTER-TBI

Author

Guglielmi, A, Graziano, F, Bogossian Gouvêa, E, Turgeon, A, Taccone, F, Citerio, G, Turgeon, AF, Taccone, FS, Guglielmi, A, Graziano, F, Bogossian Gouvêa, E, Turgeon, A, Taccone, F, Citerio, G, Turgeon, AF, and Taccone, FS

Abstract

Haemoglobin (Hb) thresholds and red blood cells (RBC) transfusion strategies in traumatic brain injury (TBI) are controversial. Our objective was to assess the association of Hb values with long-term outcomes in critically ill TBI patients. We conducted a secondary analysis of CENTER-TBI, a large multicentre, prospective, observational study of European TBI patients. All patients admitted to the Intensive Care Unit (ICU) with available haemoglobin data on admission and during the first week were included. During the first seven days, daily lowest haemoglobin values were considered either a continous variable or categorised as < 7.5 g/dL, between 7.5–9.5 and > 9.5 g/dL. Anaemia was defined as haemoglobin value < 9.5 g/dL. Transfusion practices were described as “restrictive” or “liberal” based on haemoglobin values before transfusion (e.g. < 7.5 g/dL or 7.5–9.5 g/dL). Our primary outcome was the Glasgow outcome scale extended (GOSE) at six months, defined as being unfavourable when < 5. Of 1590 included, 1231 had haemoglobin values available on admission. A mean Injury Severity Score (ISS) of 33 (SD 16), isolated TBI in 502 (40.7%) and a mean Hb value at ICU admission of 12.6 (SD 2.2) g/dL was observed. 121 (9.8%) patients had Hb < 9.5 g/dL, of whom 15 (1.2%) had Hb < 7.5 g/dL. 292 (18.4%) received at least one RBC transfusion with a median haemoglobin value before transfusion of 8.4 (IQR 7.7–8.5) g/dL. Considerable heterogeneity regarding threshold transfusion was observed among centres. In the multivariable logistic regression analysis, the increase of haemoglobin value was independently associated with the decrease in the occurrence of unfavourable neurological outcomes (OR 0.78; 95% CI 0.70–0.87). Congruous results were observed in patients with the lowest haemoglobin values within the first 7 days < 7.5 g/dL (OR 2.09; 95% CI 1.15–3.81) and those between 7.5 and 9.5 g/dL (OR 1.61; 95% CI 1.07–2.42) compared to haemoglobin values > 9.5 g

Published
2024

5. Monoclonal antibodies against SARS-CoV-2 to prevent COVID-19 worsening in a large multicenter cohort

Author

Soria, A, Graziano, F, Ghilardi, G, Lapadula, G, Gasperina, D, Benatti, S, Quiros-Roldan, E, Milesi, M, Bai, F, Merli, M, Minisci, D, Franzetti, M, Asperges, E, Chiabrando, F, Pocaterra, D, Pandolfo, A, Zanini, F, Lombardi, D, Cappelletti, A, Rugova, A, Borghesi, M, Squillace, N, Pusterla, L, Piconi, S, Morelli, P, Querini, P, Bruno, R, Rusconi, S, Casari, S, Bandera, A, Franzetti, F, Travi, G, D'Arminio Monforte, A, Marchetti, G, Pan, A, Castelli, F, Rizzi, M, Dentali, F, Mallardo, M, Rossi, E, Valsecchi, M, Galimberti, S, Bonfanti, P, Soria, Alessandro, Graziano, Francesca, Ghilardi, Giulia, Lapadula, Giuseppe, Gasperina, Daniela Dalla, Benatti, Simone Vasilij, Quiros-Roldan, Eugenia, Milesi, Maurizio, Bai, Francesca, Merli, Marco, Minisci, Davide, Franzetti, Marco, Asperges, Erika, Chiabrando, Filippo, Pocaterra, Daria, Pandolfo, Alessandro, Zanini, Fabio, Lombardi, Domenico, Cappelletti, Anna, Rugova, Alban, Borghesi, Maria Lucia, Squillace, Nicola, Pusterla, Luigi, Piconi, Stefania, Morelli, Paola, Querini, Patrizia Rovere, Bruno, Raffaele, Rusconi, Stefano, Casari, Salvatore, Bandera, Alessandra, Franzetti, Fabio, Travi, Giovanna, D'Arminio Monforte, Antonella, Marchetti, Giulia, Pan, Angelo, Castelli, Francesco, Rizzi, Marco, Dentali, Francesco, Mallardo, Maria, Rossi, Emanuela, Valsecchi, Maria Grazia, Galimberti, Stefania, Bonfanti, Paolo, Soria, A, Graziano, F, Ghilardi, G, Lapadula, G, Gasperina, D, Benatti, S, Quiros-Roldan, E, Milesi, M, Bai, F, Merli, M, Minisci, D, Franzetti, M, Asperges, E, Chiabrando, F, Pocaterra, D, Pandolfo, A, Zanini, F, Lombardi, D, Cappelletti, A, Rugova, A, Borghesi, M, Squillace, N, Pusterla, L, Piconi, S, Morelli, P, Querini, P, Bruno, R, Rusconi, S, Casari, S, Bandera, A, Franzetti, F, Travi, G, D'Arminio Monforte, A, Marchetti, G, Pan, A, Castelli, F, Rizzi, M, Dentali, F, Mallardo, M, Rossi, E, Valsecchi, M, Galimberti, S, Bonfanti, P, Soria, Alessandro, Graziano, Francesca, Ghilardi, Giulia, Lapadula, Giuseppe, Gasperina, Daniela Dalla, Benatti, Simone Vasilij, Quiros-Roldan, Eugenia, Milesi, Maurizio, Bai, Francesca, Merli, Marco, Minisci, Davide, Franzetti, Marco, Asperges, Erika, Chiabrando, Filippo, Pocaterra, Daria, Pandolfo, Alessandro, Zanini, Fabio, Lombardi, Domenico, Cappelletti, Anna, Rugova, Alban, Borghesi, Maria Lucia, Squillace, Nicola, Pusterla, Luigi, Piconi, Stefania, Morelli, Paola, Querini, Patrizia Rovere, Bruno, Raffaele, Rusconi, Stefano, Casari, Salvatore, Bandera, Alessandra, Franzetti, Fabio, Travi, Giovanna, D'Arminio Monforte, Antonella, Marchetti, Giulia, Pan, Angelo, Castelli, Francesco, Rizzi, Marco, Dentali, Francesco, Mallardo, Maria, Rossi, Emanuela, Valsecchi, Maria Grazia, Galimberti, Stefania, and Bonfanti, Paolo

Abstract

Objective Monoclonal antibodies (mAbs) against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reduced Coronavirus Disease 2019 (COVID-19) hospitalizations in people at risk of clinical worsening. Real-world descriptions are limited. Methods CONDIVIDIAMO, a two-year multicenter observational study, consecutively enrolled SARS-CoV-2 outpatients with ≥1 risk factor for COVID-19 progression receiving mAbs. Demographic data, underlying medical condition, type of mAbs combination received, duration of symptoms before mAbs administration, COVID-19 vaccination history, were collected upon enrolment and centrally recorded. Data on outcomes (hospitalizations, reasons of hospitalization, deaths) were prospectively collected. The primary endpoint was the rate of hospitalization or death in a 28-day follow-up, whichever occurred first; subjects were censored at the day of last follow-up or up to 28 days. The Kaplan-Meier method was used to estimate the incidence rate curve in time. The Cox regression model was used to assess potential risk factors for unfavorable outcome. Results were shown as hazard ratio (HR) along with the corresponding 95 % Confidence Interval (95%CI). Results Among 1534 subjects (median [interquartile range, IQR] age 66.5 [52.4–74.9] years, 693 [45.2 %] women), 632 (41.2 %) received bamlanivimab ± etesevimab, 209 (13.6 %) casirivimab/imdevimab, 586 (38.2 %) sotrovimab, 107 (7.0 %) tixagevimab/cilgavimab. After 28-day follow-up, 87/1534 (5.6 %, 95%CI: 4.4%–6.8 %) met the primary outcome (85 hospitalizations, 2 deaths). Hospitalizations for COVID-19 (52, 3.4 %) occurred earlier than for other reasons (33, 2.1 %), after a median (IQR) of 3.5 (1–7) versus 8 (3–15) days (p = 0.006) from mAbs administration. In a multivariable Cox regression model, factors independently associated with increased hospitalization risk were age (hazard ratio [HR] 1.02, 95%CI 1.00–1.03, p = 0.021), immunodeficiency (HR 1.78, 95%CI 1.11–2.85, p = 0.017), pre-Omicron cale

Published
2024

6. Early systemic insults following traumatic brain injury: association with biomarker profiles, therapy for intracranial hypertension, and neurological outcomes-an analysis of CENTER-TBI data

Author

Robba, C, Graziano, F, Picetti, E, Åkerlund, C, Addis, A, Pastore, G, Sivero, M, Rebora, P, Galimberti, S, Stocchetti, N, Maas, A, Menon, D, Citerio, G, Menon, DK, Robba, C, Graziano, F, Picetti, E, Åkerlund, C, Addis, A, Pastore, G, Sivero, M, Rebora, P, Galimberti, S, Stocchetti, N, Maas, A, Menon, D, Citerio, G, and Menon, DK

Abstract

Purpose: We analysed the impact of early systemic insults (hypoxemia and hypotension, SIs) on brain injury biomarker profiles, acute care requirements during intensive care unit (ICU) stay, and 6-month outcomes in patients with traumatic brain injury (TBI). Methods: From patients recruited to the Collaborative European neurotrauma effectiveness research in TBI (CENTER-TBI) study, we documented the prevalence and risk factors for SIs and analysed their effect on the levels of brain injury biomarkers [S100 calcium-binding protein B (S100B), neuron-specific enolase (NSE), neurofilament light (NfL), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and protein Tau], critical care needs, and 6-month outcomes [Glasgow Outcome Scale Extended (GOSE)]. Results: Among 1695 TBI patients, 24.5% had SIs: 16.1% had hypoxemia, 15.2% had hypotension, and 6.8% had both. Biomarkers differed by SI category, with higher S100B, Tau, UCH-L1, NSE and NfL values in patients with hypotension or both SIs. The ratio of neural to glial injury (quantified as UCH-L1/GFAP and Tau/GFAP ratios) was higher in patients with hypotension than in those with no SIs or hypoxia alone. At 6 months, 380 patients died (22%), and 759 (45%) had GOSE ≤ 4. Patients who experienced at least one SI had higher mortality than those who did not (31.8% vs. 19%, p < 0.001). Conclusion: Though less frequent than previously described, SIs in TBI patients are associated with higher release of neuronal than glial injury biomarkers and with increased requirements for ICU therapies aimed at reducing intracranial hypertension. Hypotension or combined SIs are significantly associated with adverse 6-month outcomes. Current criteria for hypotension may lead to higher biomarker levels and more negative outcomes than those for hypoxemia suggesting a need to revisit pressure targets in the prehospital settings.

Published
2024

8. Induction of Remission with Exclusive Enteral Nutrition in Children with Crohn's Disease: Determinants of Higher Adherence and Response

Author

Cuomo, M, Carobbio, A, Aloi, M, Alvisi, P, Banzato, C, Bosa, L, Bramuzzo, M, Campanozzi, A, Catassi, G, D'Antiga, L, Di Paola, M, Felici, E, Fioretti, M, Gatti, S, Graziano, F, Lega, S, Lionetti, P, Marseglia, A, Martinelli, M, Musto, F, Sansotta, N, Scarallo, L, Zuin, G, Norsa, L, Cuomo M., Carobbio A., Aloi M., Alvisi P., Banzato C., Bosa L., Bramuzzo M., Campanozzi A., Catassi G., D'Antiga L., Di Paola M., Felici E., Fioretti M. T., Gatti S., Graziano F., Lega S., Lionetti P., Marseglia A., Martinelli M., Musto F., Sansotta N., Scarallo L., Zuin G., Norsa L., Cuomo, M, Carobbio, A, Aloi, M, Alvisi, P, Banzato, C, Bosa, L, Bramuzzo, M, Campanozzi, A, Catassi, G, D'Antiga, L, Di Paola, M, Felici, E, Fioretti, M, Gatti, S, Graziano, F, Lega, S, Lionetti, P, Marseglia, A, Martinelli, M, Musto, F, Sansotta, N, Scarallo, L, Zuin, G, Norsa, L, Cuomo M., Carobbio A., Aloi M., Alvisi P., Banzato C., Bosa L., Bramuzzo M., Campanozzi A., Catassi G., D'Antiga L., Di Paola M., Felici E., Fioretti M. T., Gatti S., Graziano F., Lega S., Lionetti P., Marseglia A., Martinelli M., Musto F., Sansotta N., Scarallo L., Zuin G., and Norsa L.

Published
2023

9. Exoscopic Microsurgery: A Change of Paradigm in Brain Tumor Surgery? Comparison with Standard Operative Microscope

Author

Di Cristofori, A, Graziano, F, Rui, C, Rebora, P, Di Caro, D, Chiarello, G, Stefanoni, G, Julita, C, Florio, S, Ferlito, D, Basso, G, Citerio, G, Remida, P, Carrabba, G, Giussani, C, Di Cristofori A., Graziano F., Rui C. B., Rebora P., Di Caro D., Chiarello G., Stefanoni G., Julita C., Florio S., Ferlito D., Basso G., Citerio G., Remida P., Carrabba G., Giussani C., Di Cristofori, A, Graziano, F, Rui, C, Rebora, P, Di Caro, D, Chiarello, G, Stefanoni, G, Julita, C, Florio, S, Ferlito, D, Basso, G, Citerio, G, Remida, P, Carrabba, G, Giussani, C, Di Cristofori A., Graziano F., Rui C. B., Rebora P., Di Caro D., Chiarello G., Stefanoni G., Julita C., Florio S., Ferlito D., Basso G., Citerio G., Remida P., Carrabba G., and Giussani C.

Abstract

Background: The exoscope is a high-definition telescope recently introduced in neurosurgery. In the past few years, several reports have described the advantages and disadvantages of such technology. No studies have compared results of surgery with standard microscope and exoscope in patients with glioblastoma multiforme (GBM). Methods: Our retrospective study encompassed 177 patients operated on for GBM (WHO 2021) between February 2017 and August 2022. A total of 144 patients were operated on with a microscope only and the others with a 3D4K exoscope only. All clinical and radiological data were collected. Progression-free survival (PFS) and overall survival (OS) have been estimated in the two groups and compared by the Cox model adjusting for potential confounders (e.g., sex, age, Karnofsky performance status, gross total resection, MGMT methylated promoter, and operator’s experience). Results: IDH was mutated in 9 (5.2%) patients and MGMT was methylated in 76 (44.4%). Overall, 122 patients received a gross total resection, 14 patients received a subtotal resection, and 41 patients received a partial resection. During follow-up, 139 (73.5%) patients experienced tumor recurrence and 18.7% of them received a second surgery. After truncation to 12 months, the median PFS for patients operated on with the microscope was 8.82 months, while for patients operated on with the exoscope it was >12 months. Instead, the OS was comparable in the two groups. The multivariable Cox model showed that the use of microscope compared to the exoscope was associated with lower progression-free survival (hazard ratio = 3.55, 95%CI = 1.66–7.56, p = 0.001). Conclusions: The exoscope has proven efficacy in terms of surgical resection, which was not different to that of the microscope. Furthermore, patients operated on with the exoscope had a longer PFS. A comparable OS was observed between microscope and exoscope, but further prospective studies with longer follow-up are needed.

Published
2023

10. High flow nasal cannula combined with non-invasive ventilation versus high flow nasal cannula alone in patients with acute hypoxemic respiratory failure due to pneumonia: a randomized controlled trial

Author

Ghezzi, L, Graziano, F, Bottani, G, Marullo, G, Capsoni, N, Forni, E, Vincenti, F, Rebora, P, Bellone, A, Ghezzi L., Graziano F., Bottani G., Marullo G., Capsoni N., Forni E., Vincenti F., Rebora P., Bellone A., Ghezzi, L, Graziano, F, Bottani, G, Marullo, G, Capsoni, N, Forni, E, Vincenti, F, Rebora, P, Bellone, A, Ghezzi L., Graziano F., Bottani G., Marullo G., Capsoni N., Forni E., Vincenti F., Rebora P., and Bellone A.

Abstract

Patients with hypoxemic respiratory failure due to community acquired pneumonia are actually treated with a wide range of oxygen devices from nasal cannula to mechanical ventilation. In this monocentric, open label, randomized controlled trial we aimed to compare the efficacy of combined High Flow Nasal Cannula (HFNC) and Non-Invasive Ventilation (NIV) versus HFNC alone in acute Hypoxemic Respiratory Failure (hARF) in patients affected by Community Acquired Pneumonia (CAP). We enrolled 49 patients affected by CAP with hypoxemic respiratory failure (PO2/FiO2 < 300). The patients were randomized into two groups: one has been treated with HFNC alone (group A) while the other received NIV alternated to HFNC every 3 hours (group B). The primary outcome was PO2/FiO2 change from baseline to 21 hours. Secondary outcomes included variation of pH and pCO2, need to continue HFNC or NIV/HFNC after 45 hours, orotracheal intuba-tion, mortality rate, and device comfort. No statistically significant differences between the two arms were shown in PO2/FiO2 change at 21 hours since baseline, in pCO2 and pH variation, mortality at hospital and at follow-up. Further research is needed to better understand the role of combined HFNC and NIV in hypoxemic respiratory failure in patients with CAP. r.

Published
2023

12. P1198 Pediatric inflammatory bowel diseases in patients with genetic syndromes: a case-control multicentre SIGENP study

Author

Di Sario, F, primary, Olivetti, L, additional, Felici, E, additional, Garassino, C, additional, Labriola, F, additional, Branislava, C, additional, Pensabene, L, additional, Murone, P, additional, Arrigo, S, additional, Ancona, S, additional, Zuin, G, additional, Colella, G, additional, Penagini, F, additional, Martinelli, M, additional, Miele, E, additional, Fioretti, M T, additional, Graziano, F, additional, D'Arcangelo, G, additional, Bramuzzo, M, additional, Lega, S, additional, Catassi, C, additional, and Gatti, S, additional

Published
2024
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13. P1181 Prevalence and trend of anemia in a large cohort of children with inflammatory bowel disease

Author

D'Arcangelo, G, primary, Brecciaroli, M, additional, Gagliostro, G, additional, Auletta, D, additional, Pellegrino, S, additional, Arrigo, S, additional, Graziano, F, additional, Miele, E, additional, Illiceto, M T, additional, Alvisi, P, additional, Dilillo, D, additional, De Giacomo, C, additional, Lionetti, P, additional, Pastore, M, additional, Cananzi, M, additional, Bramuzzo, M, additional, Panceri, R, additional, Norsa, L, additional, Aloi, M, additional, and Scarallo, L, additional

Published
2024
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16. Effect of frailty on 6-month outcome after traumatic brain injury: a multicentre cohort study with external validation

Author

Galimberti, S, Graziano, F, Maas, A, Isernia, G, Lecky, F, Jain, S, Sun, X, Gardner, R, Taylor, S, Markowitz, A, Manley, G, Valsecchi, M, Bellelli, G, Citerio, G, Ackerlund, C, Adams, H, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castano-Leon, A, Cavallo, S, Chevallard, G, Chieregato, A, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Marechal, H, Martino, C, Mattern, J, Mcfadyen, C, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyiradi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Singh, R, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vamos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Ziverte, A, Zoerle, T, Adeoye, O, Badjatia, N, Barber, J, Bergin, M, Boase, K, Bodien, Y, Chesnut, R, Corrigan, J, Crawford, K, Diaz-Arrastia, R, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gaudette, E, Giacino, J, Gonzalez, L, Gopinath, S, Grandhi, R, Gullapalli, R, Hemphill, C, Hotz, G, Huie, R, Jha, R, Keene, C, Kitagawa, R, Korley, F, Kramer, J, Kreitzer, N, Levin, H, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Mccrea, M, Merchant, R, Mukherjee, P, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Okonkwo, D, Palacios, E, Perl, D, Puccio, A, Rabinowitz, M, Robertson, C, Rodgers, R, Rosand, J, Rosenthal, E, Sander, A, Sandsmark, D, Sugar, G, Schneider, A, Schnyer, D, Seabury, S, Sherer, M, Stein, M, Temkin, N, Toga, A, Torres-Espin, A, Valadka, A, Vassar, M, Wang, V, Yue, J, Yuh, E, Zafonte, R, Galimberti S., Graziano F., Maas A. I. R., Isernia G., Lecky F., Jain S., Sun X., Gardner R. C., Taylor S. R., Markowitz A. J., Manley G. T., Valsecchi M. G., Bellelli G., Citerio G., Ackerlund C., Adams H., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Castano-Leon A. M., Cavallo S., Chevallard G., Chieregato A., Clusmann H., Coburn M. S., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J. -Y., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Maegele M., Majdan M., Manara A., Marechal H., Martino C., Mattern J., McFadyen C., McMahon C., Melegh B., Menon D., Menovsky T., Mikolic A., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Oresic M., Ortolano F., Otesile O., Palotie A., Parizel P. M., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Polinder S., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez-Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Singh R. D., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Steyerberg E. W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Valeinis E., Vallance S., Vamos Z., van der Jagt M., van der Naalt J., Van der Steen G., van Dijck J. T. J. M., van Erp I. A., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., van Wijk R., Vande Vyvere T., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. K. W., Wiegers E., Williams G., Wilson L., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Ziverte A., Zoerle T., Adeoye O., Badjatia N., Barber J., Bergin M., Boase K., Bodien Y., Chesnut R., Corrigan J., Crawford K., Diaz-Arrastia R., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V., Ferguson A. R., Foreman B., Gaudette E., Giacino J., Gonzalez L., Gopinath S., Grandhi R., Gullapalli R., Hemphill C., Hotz G., Huie R., Jha R., Keene C. D., Kitagawa R., Korley F., Kramer J., Kreitzer N., Levin H., Lindsell C., Machamer J., Madden C., Martin A., McAllister T., McCrea M., Merchant R., Mukherjee P., Nelson L., Ngwenya L. B., Noel F., Nolan A., Okonkwo D., Palacios E., Perl D., Puccio A., Rabinowitz M., Robertson C., Rodgers R. B., Rosand J., Rosenthal E., Sander A., Sandsmark D., Sugar G., Schneider A., Schnyer D., Seabury S., Sherer M., Stein M., Temkin N., Toga A., Torres-Espin A., Valadka A., Vassar M., Wang K., Wang V., Yue J. K., Yuh E., Zafonte R., Galimberti, S, Graziano, F, Maas, A, Isernia, G, Lecky, F, Jain, S, Sun, X, Gardner, R, Taylor, S, Markowitz, A, Manley, G, Valsecchi, M, Bellelli, G, Citerio, G, Ackerlund, C, Adams, H, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castano-Leon, A, Cavallo, S, Chevallard, G, Chieregato, A, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Marechal, H, Martino, C, Mattern, J, Mcfadyen, C, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyiradi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Singh, R, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vamos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Ziverte, A, Zoerle, T, Adeoye, O, Badjatia, N, Barber, J, Bergin, M, Boase, K, Bodien, Y, Chesnut, R, Corrigan, J, Crawford, K, Diaz-Arrastia, R, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gaudette, E, Giacino, J, Gonzalez, L, Gopinath, S, Grandhi, R, Gullapalli, R, Hemphill, C, Hotz, G, Huie, R, Jha, R, Keene, C, Kitagawa, R, Korley, F, Kramer, J, Kreitzer, N, Levin, H, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Mccrea, M, Merchant, R, Mukherjee, P, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Okonkwo, D, Palacios, E, Perl, D, Puccio, A, Rabinowitz, M, Robertson, C, Rodgers, R, Rosand, J, Rosenthal, E, Sander, A, Sandsmark, D, Sugar, G, Schneider, A, Schnyer, D, Seabury, S, Sherer, M, Stein, M, Temkin, N, Toga, A, Torres-Espin, A, Valadka, A, Vassar, M, Wang, V, Yue, J, Yuh, E, Zafonte, R, Galimberti S., Graziano F., Maas A. I. R., Isernia G., Lecky F., Jain S., Sun X., Gardner R. C., Taylor S. R., Markowitz A. J., Manley G. T., Valsecchi M. G., Bellelli G., Citerio G., Ackerlund C., Adams H., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Castano-Leon A. M., Cavallo S., Chevallard G., Chieregato A., Clusmann H., Coburn M. S., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J. -Y., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Maegele M., Majdan M., Manara A., Marechal H., Martino C., Mattern J., McFadyen C., McMahon C., Melegh B., Menon D., Menovsky T., Mikolic A., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Oresic M., Ortolano F., Otesile O., Palotie A., Parizel P. M., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Polinder S., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez-Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Singh R. D., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Steyerberg E. W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Valeinis E., Vallance S., Vamos Z., van der Jagt M., van der Naalt J., Van der Steen G., van Dijck J. T. J. M., van Erp I. A., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., van Wijk R., Vande Vyvere T., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. K. W., Wiegers E., Williams G., Wilson L., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Ziverte A., Zoerle T., Adeoye O., Badjatia N., Barber J., Bergin M., Boase K., Bodien Y., Chesnut R., Corrigan J., Crawford K., Diaz-Arrastia R., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V., Ferguson A. R., Foreman B., Gaudette E., Giacino J., Gonzalez L., Gopinath S., Grandhi R., Gullapalli R., Hemphill C., Hotz G., Huie R., Jha R., Keene C. D., Kitagawa R., Korley F., Kramer J., Kreitzer N., Levin H., Lindsell C., Machamer J., Madden C., Martin A., McAllister T., McCrea M., Merchant R., Mukherjee P., Nelson L., Ngwenya L. B., Noel F., Nolan A., Okonkwo D., Palacios E., Perl D., Puccio A., Rabinowitz M., Robertson C., Rodgers R. B., Rosand J., Rosenthal E., Sander A., Sandsmark D., Sugar G., Schneider A., Schnyer D., Seabury S., Sherer M., Stein M., Temkin N., Toga A., Torres-Espin A., Valadka A., Vassar M., Wang K., Wang V., Yue J. K., Yuh E., and Zafonte R.

Abstract

Background: Frailty is known to be associated with poorer outcomes in individuals admitted to hospital for medical conditions requiring intensive care. However, little evidence is available for the effect of frailty on patients’ outcomes after traumatic brain injury. Many frailty indices have been validated for clinical practice and show good performance to predict clinical outcomes. However, each is specific to a particular clinical context. We aimed to develop a frailty index to predict 6-month outcomes in patients after a traumatic brain injury. Methods: A cumulative deficit approach was used to create a novel frailty index based on 30 items dealing with disease states, current medications, and laboratory values derived from data available from CENTER-TBI, a prospective, longitudinal observational study of patients with traumatic brain injury presenting within 24 h of injury and admitted to a ward or an intensive care unit at 65 centres in Europe between Dec 19, 2014, and Dec 17, 2017. From the individual cumulative CENTER-TBI frailty index (range 0–30), we obtained a standardised value (range 0–1), with high scores indicating higher levels of frailty. The effect of frailty on 6-month outcome evaluated with the extended Glasgow Outcome Scale (GOSE) was assessed through a proportional odds logistic model adjusted for known outcome predictors. An unfavourable outcome was defined as death or severe disability (GOSE score ≤4). External validation was performed on data from TRACK-TBI, a prospective observational study co-designed with CENTER-TBI, which enrolled patients with traumatic brain injury at 18 level I trauma centres in the USA from Feb 26, 2014, to July 27, 2018. CENTER-TBI is registered with ClinicalTrials.gov, NCT02210221; TRACK-TBI is registered at ClinicalTrials.gov, NCT02119182. Findings: 2993 participants (median age was 51 years [IQR 30–67], 2058 [69%] were men) were included in this analysis. The overall median CENTER-TBI frailty index score was 0·07

Published
2022

17. Italian children seem to be spared from the mysterious severe acute hepatitis outbreak: A report by SIGENP Acute Hepatitis Group

Author

Di Dato, F, Di Giorgio, A, Mandato, C, Maggiore, G, Iorio, R, Aloi, M, Antonucci, R, Banzato, C, Buccella, V, Calvo, P, Campanozzi, A, Cananzi, M, Cherubini, S, Cristofori, F, D'Antiga, L, Saccomani, M, De Giorgi, A, Dell'Omo, V, Ferrari, F, Francavilla, R, Fuoti, M, Gaio, P, Graziano, F, Indolfi, G, Inferrera, R, Madeo, A, Mesini, A, Moramarco, F, Motta, V, Parma, B, Pinon, M, Provera, S, Ranucci, G, Tulone, A, Valentini, P, Veraldi, S, Villirillo, A, Di Dato F., Di Giorgio A., Mandato C., Maggiore G., Iorio R., Aloi M., Antonucci R., Banzato C., Buccella V., Calvo P. L., Campanozzi A., Cananzi M., Cherubini S., Cristofori F., D'Antiga L., Saccomani M. D., De Giorgi A., Dell'Omo V., Ferrari F., Francavilla R., Fuoti M. G., Gaio P., Graziano F., Indolfi G., Inferrera R., Madeo A., Mesini A., Moramarco F., Motta V., Parma B., Pinon M., Provera S., Ranucci G., Tulone A., Valentini P., Veraldi S., Villirillo A., Di Dato, F, Di Giorgio, A, Mandato, C, Maggiore, G, Iorio, R, Aloi, M, Antonucci, R, Banzato, C, Buccella, V, Calvo, P, Campanozzi, A, Cananzi, M, Cherubini, S, Cristofori, F, D'Antiga, L, Saccomani, M, De Giorgi, A, Dell'Omo, V, Ferrari, F, Francavilla, R, Fuoti, M, Gaio, P, Graziano, F, Indolfi, G, Inferrera, R, Madeo, A, Mesini, A, Moramarco, F, Motta, V, Parma, B, Pinon, M, Provera, S, Ranucci, G, Tulone, A, Valentini, P, Veraldi, S, Villirillo, A, Di Dato F., Di Giorgio A., Mandato C., Maggiore G., Iorio R., Aloi M., Antonucci R., Banzato C., Buccella V., Calvo P. L., Campanozzi A., Cananzi M., Cherubini S., Cristofori F., D'Antiga L., Saccomani M. D., De Giorgi A., Dell'Omo V., Ferrari F., Francavilla R., Fuoti M. G., Gaio P., Graziano F., Indolfi G., Inferrera R., Madeo A., Mesini A., Moramarco F., Motta V., Parma B., Pinon M., Provera S., Ranucci G., Tulone A., Valentini P., Veraldi S., and Villirillo A.

Published
2022

18. Sodium changes in trauma brain injury patients as a proxy of severity: modeling of trajectories fit for 1346 patients from CENTER‐TBI

Author

Mulazzani, F, Graziano, F, Rossi, A, Mangli, P, Addis, A, Zadek, F, Noè, B, Langer, T, Citerio, G, F. Mulazzani, F. Graziano, A. Rossi, P. Mangli, A. Addis, F. Zadek, B. Noè, T. Langer, G. Citerio, Mulazzani, F, Graziano, F, Rossi, A, Mangli, P, Addis, A, Zadek, F, Noè, B, Langer, T, Citerio, G, F. Mulazzani, F. Graziano, A. Rossi, P. Mangli, A. Addis, F. Zadek, B. Noè, T. Langer, and G. Citerio

Published
2023

20. Placebo and Nocebo Effects as Bayesian-Brain Phenomena: The Overlooked Role of Likelihood and Attention

Author

Pagnini, Francesco, Barbiani, Diletta, Cavalera, Cesare Massimo, Volpato, Eleonora, Grosso, Francesca, Minazzi, Giacomo Andrea, Vailati Riboni, Francesco Carlo Paolo, Graziano, F., Di Tella, Sonia, Manzoni, Gian Mauro, Silveri, Maria Caterina, Riva, Giuseppe, Phillips, Deborah, Pagnini F. (ORCID:0000-0003-1612-4211), Barbiani D., Cavalera C. (ORCID:0000-0001-9309-0874), Volpato E. (ORCID:0000-0003-0266-6386), Grosso F. (ORCID:0000-0001-5232-8313), Minazzi G. A. (ORCID:0000-0003-1262-0701), Vailati Riboni F., Di Tella S. (ORCID:0000-0002-2248-5120), Manzoni G. M., Silveri M. C. (ORCID:0000-0001-5012-0682), Riva G. (ORCID:0000-0003-3657-106X), Phillips D., Pagnini, Francesco, Barbiani, Diletta, Cavalera, Cesare Massimo, Volpato, Eleonora, Grosso, Francesca, Minazzi, Giacomo Andrea, Vailati Riboni, Francesco Carlo Paolo, Graziano, F., Di Tella, Sonia, Manzoni, Gian Mauro, Silveri, Maria Caterina, Riva, Giuseppe, Phillips, Deborah, Pagnini F. (ORCID:0000-0003-1612-4211), Barbiani D., Cavalera C. (ORCID:0000-0001-9309-0874), Volpato E. (ORCID:0000-0003-0266-6386), Grosso F. (ORCID:0000-0001-5232-8313), Minazzi G. A. (ORCID:0000-0003-1262-0701), Vailati Riboni F., Di Tella S. (ORCID:0000-0002-2248-5120), Manzoni G. M., Silveri M. C. (ORCID:0000-0001-5012-0682), Riva G. (ORCID:0000-0003-3657-106X), and Phillips D.

Abstract

The Bayesian-brain framework applied to placebo responses and other mind-body interactions suggests that the effects on the body result from the interaction between priors, such as expectations and learning, and likelihood, such as somatosensorial information. Significant research in this area focuses on the role of the priors, but the relevance of the likelihood has been surprisingly overlooked. One way of manipulating the relevance of the likelihood is by paying attention to sensorial information. We suggest that attention can influence both precision and position (i.e., the relative distance from the priors) of the likelihood by focusing on specific components of the somatosensorial information. Two forms of attention seem particularly relevant in this framework: mindful attention and selective attention. Attention has the potential to be considered a "major player" in placebo/nocebo research, together with expectations and learning. In terms of application, relying on attentional strategies as "amplifiers" or "silencers" of sensorial information could lead to an active involvement of individuals in shaping their care process and health. In this contribution, we discuss the theoretical implications of these intuitions with the aim to provide a comprehensive framework that includes Bayesian brain, placebo/nocebo effects, and the role of attention in mind-body interactions.

Published
2023

21. Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study

Author

Robba, C, Graziano, F, Guglielmi, A, Rebora, P, Galimberti, S, Taccone, F, Citerio, G, Robba, Chiara, Graziano, Francesca, Guglielmi, Angelo, Rebora, Paola, Galimberti, Stefania, Taccone, Fabio S, Citerio, Giuseppe, Robba, C, Graziano, F, Guglielmi, A, Rebora, P, Galimberti, S, Taccone, F, Citerio, G, Robba, Chiara, Graziano, Francesca, Guglielmi, Angelo, Rebora, Paola, Galimberti, Stefania, Taccone, Fabio S, and Citerio, Giuseppe

Abstract

Purpose: Uncertainties remain about the safety and efficacy of therapies for managing intracranial hypertension in acute brain injured (ABI) patients. This study aims to describe the therapeutical approaches used in ABI, with/without intracranial pressure (ICP) monitoring, among different pathologies and across different countries, and their association with six months mortality and neurological outcome. Methods: A preplanned subanalysis of the SYNAPSE-ICU study, a multicentre, prospective, international, observational cohort study, describing the ICP treatment, graded according to Therapy Intensity Level (TIL) scale, in patients with ABI during the first week of intensive care unit (ICU) admission. Results: 2320 patients were included in the analysis. The median age was 55 (I-III quartiles = 39–69) years, and 800 (34.5%) were female. During the first week from ICU admission, no-basic TIL was used in 382 (16.5%) patients, mild-moderate in 1643 (70.8%), and extreme in 295 cases (eTIL, 12.7%). Patients who received eTIL were younger (median age 49 (I–III quartiles = 35–62) vs 56 (40–69) years, p < 0.001), with less cardiovascular pre-injury comorbidities (859 (44%) vs 90 (31.4%), p < 0.001), with more episodes of neuroworsening (160 (56.1%) vs 653 (33.3%), p < 0.001), and were more frequently monitored with an ICP device (221 (74.9%) vs 1037 (51.2%), p < 0.001). Considerable variability in the frequency of use and type of eTIL adopted was observed between centres and countries. At six months, patients who received no-basic TIL had an increased risk of mortality (Hazard ratio, HR = 1.612, 95% Confidence Interval, CI = 1.243–2.091, p < 0.001) compared to patients who received eTIL. No difference was observed when comparing mild-moderate TIL with eTIL (HR = 1.017, 95% CI = 0.823–1.257, p = 0.873). No significant association between the use of TIL and neurological outcome was observed. Conclusions: During the first week of ICU admission, therapies to contro

Published
2023

22. Intracranial Pressure Monitoring Practice, Treatment, and Effect on Outcome in Aneurysmal Subarachnoid Hemorrhage

Author

Baggiani, M, Graziano, F, Rebora, P, Robba, C, Guglielmi, A, Galimberti, S, Giussani, C, Suarez, J, Helbok, R, Citerio, G, Baggiani, M, Graziano, F, Rebora, P, Robba, C, Guglielmi, A, Galimberti, S, Giussani, C, Suarez, J, Helbok, R, and Citerio, G

Abstract

Background: Intracranial pressure (ICP) monitoring and its management in aneurysmal subarachnoid hemorrhage (aSAH) is variable worldwide. The present study aimed to explore the practice of ICP monitoring, its variability across countries, and the association with 6-month outcomes in aSAH. Methods: This was a preplanned subanalysis of SYNAPSE-ICU, a multicenter, international, prospective, observational cohort study focused on patients diagnosed with aSAH. We evaluated the variability in ICP monitoring across countries through a logistic regression model adjusted for case-mix and considered countries as a random effect. The association between ICP probe insertion and 6-month mortality and a poor neurological outcome, defined as an Glasgow Outcome Score Extended ≤ 4, was assessed by using a propensity score approach. Results: A total of 423 patients with aSAH from 92 centers across 32 countries were included in this analysis. ICP monitoring was used in 295 (69.7%) patients. Significant between-country variability in ICP insertion was observed, with an incidence ranging between 4.7% and 79.9% (median odd ratio 3.04). The median duration of ICP monitoring was 12 days (first quartile [Q1] through third quartile [Q3] range 8–18), with an overall daily median ICP value of 14 mm Hg (Q1–Q3 10–19) and a median maximum value of 21 mm Hg (Q1–Q3 16–30). Patients monitored with ICP received more aggressive therapy treatments compared with non-monitored patients (therapy intensity level, TIL, score 10.33 [standard deviation 3.61] vs. 6.3 [standard deviation 4.19], p < 0.001). In more severe patients, ICP monitoring was significantly associated with better 6-month outcome (poor neurological outcome: odds ratio 0.14, 95% confidence interval 0.02–0.53, p = 0.0113; mortality: hazard ratio 0.25, 95% confidence interval 0.13–0.49, p < 0.0001). However, no significant effect was observed in patients with both reactive pupils. Conclusions: Our cohort demonstrated high variability in

Published
2023

24. P95 A RARE CASE OF INFECTIOUS AORTITIS

Author

Amato, F, primary, Mainardi, C, additional, Meneghin, S, additional, Graziano, F, additional, Licchelli, L, additional, Famoso, G, additional, Cacciavillani, L, additional, and Pergola, V, additional

Published
2023
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28. Sampling strategies to evaluate the prognostic value of a new biomarker on a time-to-event end-point

Author

Graziano, F, Valsecchi, M, Rebora, P, Graziano F., Valsecchi M. G., Rebora P., Graziano, F, Valsecchi, M, Rebora, P, Graziano F., Valsecchi M. G., and Rebora P.

Abstract

Background: The availability of large epidemiological or clinical data storing biological samples allow to study the prognostic value of novel biomarkers, but efficient designs are needed to select a subsample on which to measure them, for parsimony and economical reasons. Two-phase stratified sampling is a flexible approach to perform such sub-sampling, but literature on stratification variables to be used in the sampling and power evaluation is lacking especially for survival data. Methods: We compared the performance of different sampling designs to assess the prognostic value of a new biomarker on a time-to-event endpoint, applying a Cox model weighted by the inverse of the empirical inclusion probability. Results: Our simulation results suggest that case-control stratified (or post stratified) by a surrogate variable of the marker can yield higher performances than simple random, probability proportional to size, and case-control sampling. In the presence of high censoring rate, results showed an advantage of nested case-control and counter-matching designs in term of design effect, although the use of a fixed ratio between cases and controls might be disadvantageous. On real data on childhood acute lymphoblastic leukemia, we found that optimal sampling using pilot data is greatly efficient. Conclusions: Our study suggests that, in our sample, case-control stratified by surrogate and nested case-control yield estimates and power comparable to estimates obtained in the full cohort while strongly decreasing the number of patients required. We recommend to plan the sample size and using sampling designs for exploration of novel biomarker in clinical cohort data.

Published
2021

33. Management of iatrogenic atrial perforation caused by pacemaker electrodes: a case report

Author

Graziano Fiorillo, Seyedali Ghazihosseini, Simone Agizza, Francesco Lanza, Simona Piccirillo, Giuseppe Gargiulo, Paola Gargiulo, Giovanni Battista Pinna, Emanuele Pilato, Carlo De Rosa, Carmine Morisco, and Giovanni Esposito

Subjects
Cardiac tamponade, Pericardial effusion, Cardiac surgery, Ecocardiography, Case report, Medicine
Abstract

Abstract Background The complications associated with cardiac device implants ranges between 5.3% and 14.3%. Cardiac perforation due to “leads” represent a very rare complication of cardiac device implantation, ranging between 0.3% and 0.7%. Clinically, they can manifest different, nonspecific symptoms; hence, the diagnosis may not be immediate. Case presentation Our clinical case describes the successful treatment of cardiac tamponade occurring in a Caucasian 79-year-old man following a pacemaker implantation. Two days after the procedure, the patient reported an episode of nonspecific chest pain associated with syncope. The echocardiogram performed revealed a pericardial effusion in the apical area, along the right chambers, with a thickness of 7 mm, not hemodynamically significant. A chest computed tomography scan with contrast showed hemopericardium (maximum thickness of 11 mm), caused by an atrial perforation. A few hours later, the patient experienced hemodynamic instability. For this reason, an urgent sternotomy was performed with drainage of a significant hemopericardial effusion, revealing a perforation of the upper free wall of the right atrium with pericardial injury caused by the retractable screw lead. The perforation site was sutured and the sternal wound was closed. The patient was discharged after 4 days without further complications. At the control visit, scheduled 30 days after the hospital discharge, the patient was in good conditions. Conclusions Although the atrial perforations from leads are very rare complications of pacemaker implantation procedures, they are potentially lethal. In conclusion, this clinical case highlights the need, before hospital discharge, of an accurate screening for evaluation the pericardial effusion in patients that undergo to the cardiac implantable electronic devices.

Published
2024
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34. Pulsed radiofrequency energy device (PEAK plasmablade™) and CustomBone® Cranioplasty: an appealing surgical rendez-vous.

Author

Graziano, F., Maugeri, R., Giammalva, G. R., Lo Bue, E., Zabbia, G., and Iacopino, D. G.

Subjects
*RADIO frequency therapy, *SCARS, *HOSPITAL admission & discharge, *OPERATIVE surgery, *TREATMENT effectiveness, *RADIO frequency
Abstract

CustomBone® prosthesis is a widely recognized effective and successful technique for the reconstruction of cranial bone defects. Prior the cranioplasty implant, meticulous dissection within thick scar tissue is required. During this delicate surgical manoeuvre is vital to avoid damage to the skin flap itself and to the underlying cerebrovascular structures. We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc). It reduced the incidence of post operativesubgaleal hematoma, the operative times and the intra operative blood loss following cranioplasty compared to the traditional scalpel and scissor dissection. The authors present a one centre case series study to review the indications, safety and efficacy of the PEAK PlasmaBlade™ in adult patientsunderwent cranioplasty. Two surgical techniques for tissue dissection were compared: PEAK PlasmaBlade™ versus scalpel and scissor dissection (SSD). Treatment outcomes following each of these surgical approaches, relative to rate of post-operative subgalealhematoma formation, hospital admission, and operative times were compared. A total of 10 patients that had cranioplasty treatment were evaluated. In patients underwent scalp dissection with the PEAKPlasmaBlade™, we observed a reduction in the operative times, in the subgaleal hematoma formation and then in the hospital stay. PEAK PlasmaBlade™ revealed to be a safe and effective device in tissues dissection for cranioplasty implant. It provided reduction of the rate of subgaleal hematoma formation, operating times and less potential risk to damage cerebrovascular structures. [ABSTRACT FROM AUTHOR]

Published
2023
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37. Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future

Author

Garozzo, D., primary, Rispoli, R., additional, Graziano, F., additional, Gerardi, R. M., additional, Grotenhuis, A., additional, Jenkins, A., additional, Sammons, V., additional, Visocchi, M., additional, Pinazzo, S., additional, Lima, R., additional, Martinez, F., additional, Emamhadi, M., additional, Pedro, M. T., additional, Shirwari, H. S., additional, Guedes, F., additional, Bhagavatula, I. D., additional, Shukla, D. P., additional, Bhat, I. D., additional, Ojo, O. A., additional, Tirsit, A., additional, Gonzales-Gonzales, M. E., additional, Luna, F., additional, Kretschmer, T., additional, Benzel, E., additional, and Cappelletto, B., additional

Published
2022
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39. The use of 3D-Printed PA6-GF components for the construction of structural specimens

Author

Reza Nazar Shahsavani and Graziano Fiorillo

Subjects
3D Printing, PA6-GF, Structural testing, Material properties, Construction productivity, Materials of engineering and construction. Mechanics of materials, TA401-492
Abstract

The current study shows the application of 3D printing methods for structural testing. The primary goal of the experiments was to facilitate mechanical testing using polyamide 6 (Nylon) augmented with glass fibres, or PA6-GF. The assessment aims to demonstrate the efficacy of 3D printing techniques in preparing structural specimens and determining the material’s suitability for mechanical testing. This approach has the potential to optimize the process, save time, and reduce operational costs, including technician time and workload. the PA6-GF was tested to assess stress-strain curves and ultimate capacity before being employed as a construction material in the structural laboratory. Test results had shown a modulus of elasticity for the PA6-GF in the range of 992 MPa and 2040 MPa and a Poisson’s ratio in the range of 0.34–0.40. The application of 3D printing techniques and PA6-GF were successfully applied to overcome the limitation of commercially available stands to support steel meshes for the construction of a bridge deck to a reduced scale of 1–6. The use of PA6-GF material provided adequate mechanical properties and helped in reducing both construction time and cost on the order of 14 % and 7 %, respectively. These results indicates that this technology is a promising tool to enhance both construction processes and construction quality.

Published
2024
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40. Relationship between salt consumption and iodine intake in a pediatric population

Author

Iacone, R., Iaccarino Idelson, P., Campanozzi, A., Rutigliano, I., Russo, O., Formisano, P., Galeone, D., Macchia, P. E., Strazzullo, P., Agabiti-Rosei, E., Carcea, M., Donfrancesco, C., Galletti, F., Giampaoli, S., Iacoviello, L., Scalfi, L., Siani, A., De Filippo, G., Malamisura, B., Cecere, G., Micillo, M., D'Angelo, E., Maschione, R., De Marco, G., D'Angelo, G., Cosenza, C., Gualano, R., Borsetti, R., Cela, G., Francavilla, R., Tetro, A., Pensabene, L., Talarico, V., Graziano, F., Palermo, B. V. E., Lombardi, G., Illiceto, M. T., Tonelli, L., Catassi, C., Tonelli, G., Castellucci, G., Ferraro, L., Cozzali, R., Di Biase, R., Cipolli, S., Lezo, A., Santini, B., Salvatore, S., Morando, L., Paoletti, S., Gallese, A., Mazzone, T., Iacone, Roberto, IACCARINO IDELSON, Paola, Campanozzi, Angelo, Rutigliano, Irene, Russo, Ornella, Formisano, Pietro, Galeone, Daniela, Macchia, PAOLO EMIDIO, and Strazzullo, Pasquale

Subjects
Adolescent, Endocrinology, Diabetes and Metabolism, Salt (chemistry), Nutritional Status, Medicine (miscellaneous), Context (language use), Sodium Chloride, World health, Animal science, 24 h urinary excretion, Environmental health, salt, Humans, Medicine, Sodium Chloride, Dietary, Salt intake, Child, Iodine intake, chemistry.chemical_classification, Thyroid, Consumption (economics), Nutrition and Dietetics, iodine prophylaxi, business.industry, Salt reduction, Iodine deficiency disorders, Original Contribution, Iodised salt, pediatric, chemistry, Italy, iodine deficiency disorder, Salt restriction, Hypertension, Iodine prophylaxis, Cardiology and Cardiovascular Medicine, business, Pediatric age, Iodine, Pediatric population
Abstract

Purpose The World Health Organization recommends reduction of salt intake to Methods The study population was made of 1270 children and adolescents. Estimates of salt consumption and iodine intake were obtained by measuring 24 h urinary sodium and iodine excretion. Results The iodine intake increased gradually across quartiles of salt consumption independently of sex, age and body weight (p 10.2 g/day). We estimated that approximately 65–73% of the total iodine intake was derived from food and 27–35% from iodized salt and that iodized salt made actually only 20% of the total salt intake. Conclusion In this pediatric population, in face of an elevated average salt consumption, the use of iodized salt was still insufficient to ensure an adequate iodine intake, in particular among teenagers. In the perspective of a progressive reduction of total salt intake, the health institutions should continue to support iodoprophylaxis, in the context of the national strategies for salt reduction. In order for these policies to be successful, in addition to educational campaigns, it is needed that the prescriptions contained in the current legislation on iodoprophylaxis are made compelling through specific enforcement measures for all the involved stakeholders.

Published
2020
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41. Largest neurosurgical social media group and its impact on communication and research

Author

Chaurasia, B., Umana, G.E., Scalia, G., Barresi, F., Yağmurlu, K., Soldozy, S., Deora, H., Raudino, G., Graziano, F., Nicoletti, G.F., Cicero, S. Lo, Maugeri, R., Tomasi, S.O., Zileli, M., Graffeo, C.S., Herrera, R.R., Shah, A., Ha, Y., Chaurasiya, R.K., Kim, H.S., Sameshima, T., Borba, L., Rotta, J.M., Chowdhury, D., Chaurasia, R.K., Grotenhuis, J.A., Linfante, I., Sekhar, L.N., Chaurasia, B., Umana, G.E., Scalia, G., Barresi, F., Yağmurlu, K., Soldozy, S., Deora, H., Raudino, G., Graziano, F., Nicoletti, G.F., Cicero, S. Lo, Maugeri, R., Tomasi, S.O., Zileli, M., Graffeo, C.S., Herrera, R.R., Shah, A., Ha, Y., Chaurasiya, R.K., Kim, H.S., Sameshima, T., Borba, L., Rotta, J.M., Chowdhury, D., Chaurasia, R.K., Grotenhuis, J.A., Linfante, I., and Sekhar, L.N.

Abstract

Item does not contain fulltext, BACKGROUND: The use of social media to communicate and disseminate knowledge has increased exponentially, especially in the field of neurosurgery. 'Neurosurgery cocktail' (NC) was developed by a group of young neurosurgeons as a means of sharing didactic materials and clinical experiences via social media. It connects 35.000 neurosurgeons worldwide on multiple platforms, primarily Facebook and Twitter. Given the rising utilization of social media in neurosurgery, the popularity of NC has also increased since its inception. In this study, the authors surveyed the social media analytics of NC for both Facebook and Twitter. Besides, we reviewed the literature on the use of social media in neurosurgery. METHODS: Facebook and Twitter metrics were extracted through each respective platform's analytics tools from December 2020 (earliest available date for data analysis) through January 2021. A literature search was conducted using PubMed (MEDLINE) and Scopus databases. RESULTS: On Facebook, as of January 2021, the group had a total of 25.590 members (87.6% male), most commonly (29%) between 35 and 44 years of age with over 100 countries were represented. As of January 2021, they had amassed 6457 followers on Twitter. During the last 28 d between December 2020 and January 2021, the account published 65 tweets that garnered a total of 196,900 impressions. Twelve articles were identified in our literature review on the use of social media within the neurosurgical community. CONCLUSIONS: NC is one of the most widely utilized neurosurgical social media resources available. Sharing knowledge has been broadened thanks to the recent social media evolution, and NC has become a leading player in disseminating neurosurgical knowledge.

Published
2022

42. Asthma expectations predict symptoms over time: a longitudinal cohort study

Author

Pagnini, Francesco, Volpato, Eleonora, Poletti, Valentina, Cavalera, Cesare Massimo, Graziano, F, Spina, Francesca, Banfi, P, Pagnini, F (ORCID:0000-0003-1612-4211), Volpato, E (ORCID:0000-0003-0266-6386), Poletti, V (ORCID:0000-0001-7458-7498), Cavalera, C (ORCID:0000-0001-9309-0874), Spina, F, Pagnini, Francesco, Volpato, Eleonora, Poletti, Valentina, Cavalera, Cesare Massimo, Graziano, F, Spina, Francesca, Banfi, P, Pagnini, F (ORCID:0000-0003-1612-4211), Volpato, E (ORCID:0000-0003-0266-6386), Poletti, V (ORCID:0000-0001-7458-7498), Cavalera, C (ORCID:0000-0001-9309-0874), and Spina, F

Abstract

Background: Illness expectations are cognitive schemas, both explicit and implicit, describing how symptoms are expected to be in the future. They can be particularly relevant to disease in a mind/body framework. Asthma is a condition in which the psychological aspects can highly influence the body, but no study has directly explored these specific expectations, and no dedicated assessment tools are available. Methods: We developed a questionnaire to assess the illness expectations, together with an ad hoc version of the Implicit Association Test (IAT). We tested its factorial structure, and the internal and test–retest validity, recruiting a sample of 183 asthmatic people. We also explored the convergent validity and the correlations with objective and subjective clinical assessments. Results: Data suggested a three-factorial structure of the questionnaire into expectations about future symptoms, change in current health status, and rigidity of these expectations. The questionnaire showed good psychometric properties and strong associations with the other considered outcomes, including implicit expectations. The implicit evaluation, however, lacked test–retest reliability. Conclusion: The questionnaire is a valid tool to assess illness expectations in people with asthma. The two expectation scales are highly related, and the implicit expectations are moderately associated with the explicit ones. The lack of stability related to IAT results may reflect a lack of stability of the implicit expectations. The implications for the mind/body framework still need to be fully explored.

Published
2022

43. Intracranial Pressure Monitoring in Patients With Spontaneous Intracerebral Hemorrhage: Insights From the SYNAPSE-ICU Study

Author

Dallagiacoma, S, Robba, C, Graziano, F, Rebora, P, Hemphill, J, Galimberti, S, Citerio, G, Dallagiacoma, Stefania, Robba, Chiara, Graziano, Francesca, Rebora, Paola, Hemphill, J Claude, Galimberti, Stefania, Citerio, Giuseppe, Dallagiacoma, S, Robba, C, Graziano, F, Rebora, P, Hemphill, J, Galimberti, S, Citerio, G, Dallagiacoma, Stefania, Robba, Chiara, Graziano, Francesca, Rebora, Paola, Hemphill, J Claude, Galimberti, Stefania, and Citerio, Giuseppe

Abstract

Background: Uncertainties remain regarding the indications, management, and effect of intracranial pressure (ICP) monitoring and treatment on outcome in spontaneous intracranial hemorrhage (ICH) patients. Methods: Analysisof spontaneous ICH patients enrolled in the SYNAPSE-ICU study an international prospective observational study on the use of ICP monitoring. This study aimed to describe, in a large cohort of patients with spontaneous ICH admitted to ICU, the clinical practice of ICP monitoring, the occurrence of intracranial hypertension and its therapeutic management. We further assessed in-hospital mortality and the association between ICP monitoring and 6-months mortality and outcome by a propensity score approach with inverse probability weighting. Results: 587 ICH patients were included in this study; 281 (47.9%) received ICP monitoring. ICP-monitored patients, compared to non-monitored, were younger (61 vs 67 years, p<0.001), presented more frequently with both reactive pupils (67.2%, vs 55.2%, p=0.008), with better neurological status at admission (GCS≤ 8, 82.3% vs 88.8%, p=0.038) and received higher therapy intensity level during ICU stay. In 70.5% (170 out of 241) of ICP monitored patients the ICH score was equal to 3 or 4. Nearly half of monitored patients (46.6%) had at least one episode of ICP ≥ 20 mmHg during the first week. An intraventricular catheter (53.6%) was the most frequently used device and had fewer episodes of intracranial hypertension compared to the other monitoring devices (43.7% vs 64.9%, respectively). At weighted Cox regression model, ICP monitoring was associated with a significant reduction of 6-month mortality (Hazard Ratio, HR= 0.49 (95% Confidence Intervals CI=0.35-0.71, p=0.001), but not with neurological outcome (OR=0.83, 95%CI= 0.41-1.68, p=0.6077). Conclusions: ICP monitoring in ICH was utilized mainly in moderately severe cases. ICP monitoring was associated with a reduction of in-hospital and 6-month mortality but did n

Published
2022

47. T.06.10 EFFICACY AND SAFETY OF BIOSIMILARS OF ANTI-TNF-APLHA IN PAEDIATRIC-ONSET INFLAMMATORY BOWEL DISEASE: DATA FROM THE SICILIAN NETWORK FOR INFLAMMATORY BOWEL DISEASES (SN-IBD)

Author

Dipasquale, V., primary, Pellegrino, S., additional, Ventimiglia, M., additional, Cucinotta, U., additional, Citrano, M., additional, Graziano, F., additional, Cappello, M., additional, Busacca, A., additional, Orlando, A., additional, Accomando, S., additional, and Romano, C., additional

Published
2022
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