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2. Immutable and Democratic Data in permissionless Peer-to-Peer Systems

Author

Tschuchnig, Maximilian Ernst, Radovanovic, Dejan, Hirsch, Eduard, Oberluggauer, Anna-Maria, and Schäfer, Georg

Subjects
Computer Science - Databases, Computer Science - Cryptography and Security
Abstract

Conventional data storage methods like SQL and NoSQL offer a huge amount of possibilities with one major disadvantage, having to use a centralized authority. This authority may be in the form of a centralized or decentralized master server or a permissioned peer-to-peer setting. This paper looks at different technologies on how to persist data without using a central authority, mainly looking at permissionless peer-to-peer networks, primarily Distributed Ledger Technologies (DLTs) and a combination of DLTs with conventional databases. Afterwards it is shown how a system like this might be implemented in two prototypes which are then evaluated against conventional databases.

Published
2021
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6. Interventional pulmonology techniques in lung transplantation

Author

Mondoni, Michele, Rinaldo, Rocco Francesco, Solidoro, Paolo, Di Marco, Fabiano, Patrucco, Filippo, Pavesi, Stefano, Baccelli, Andrea, Carlucci, Paolo, Radovanovic, Dejan, Santus, Pierachille, Raimondi, Federico, Vedovati, Sergio, Morlacchi, Letizia Corinna, Blasi, Francesco, Sotgiu, Giovanni, and Centanni, Stefano

Published
2023
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12. A Response to: Letter to the Editor Regarding Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

Author

Bassetti, Matteo, Giacobbe, Daniele Roberto, Bruzzi, Paolo, Barisione, Emanuela, Centanni, Stefano, Castaldo, Nadia, Corcione, Silvia, De Rosa, Francesco Giuseppe, Di Marco, Fabiano, Gori, Andrea, Gramegna, Andrea, Granata, Guido, Gratarola, Angelo, Maraolo, Alberto Enrico, Mikulska, Malgorzata, Lombardi, Andrea, Pea, Federico, Petrosillo, Nicola, Radovanovic, Dejan, Santus, Pierachille, Signori, Alessio, Sozio, Emanuela, Tagliabue, Elena, Tascini, Carlo, Vancheri, Carlo, Vena, Antonio, Viale, Pierluigi, and Blasi, Francesco

Published
2022
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16. Burden and Risk Factors for Coinfections in Patients with a Viral Respiratory Tract Infection.

Author

Santus, Pierachille, Danzo, Fiammetta, Signorello, Juan Camilo, Rizzo, Alberto, Gori, Andrea, Antinori, Spinello, Gismondo, Maria Rita, Brambilla, Anna Maria, Contoli, Marco, Rizzardini, Giuliano, and Radovanovic, Dejan

Subjects
VIRUS diseases, MYCOSES, MIXED infections, RESPIRATORY syncytial virus, RESPIRATORY infections
Abstract

Which patients should be monitored for coinfections or should receive empirical antibiotic treatment, in patients with an acute viral respiratory infection, is largely unknown. We evaluated the prevalence, characteristics, outcomes of coinfected patients, and risk factors associated with a coinfection among patients with an acute viral infection. A retrospective, single-center study recruited consecutive patients from October 2022 to March 2023 presenting to the emergency department with signs of a respiratory tract infection. Patients were screened for respiratory viruses and bacterial/fungal secondary infections according to local standard procedures. Outcomes included severe disease, in-hospital complications, all-cause in-hospital and ICU-related mortality, time to death, time to discharge, and time to coinfection. The analysis included 652 patients. A viral infection and a secondary bacterial/fungal infection were detected in 39.1% and 40% of cases. Compared with the rest of the cohort, coinfected patients had more frequently severe disease (88.3%, p < 0.001; 51% in patients with SARS-CoV-2) and higher in-hospital mortality (16.5%, p = 0.010). Nephropathy (OR 3.649, p = 0.007), absence of COVID-19 vaccination (OR 0.160, p < 0.001), SARS-CoV-2 infection (OR 2.390, p = 0.017), and lower blood pressure at admission (OR 0.980, p = 0.007) were independent risk factors for coinfection. Multidrug-resistant pathogens were detected in 30.8% of all coinfections. Patients with a viral infection are at high risk of bacterial coinfections, which carry a significant morbidity and mortality burden. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Exacerbation Burden in COPD and Occurrence of Mortality in a Cohort of Italian Patients: Results of the Gulp Study

Author

Santus, Pierachille, primary, Di Marco, Fabiano, additional, Braido, Fulvio, additional, Contoli, Marco, additional, Corsico, Angelo, additional, Micheletto, Claudio, additional, Pelaia, Girolamo, additional, Radovanovic, Dejan, additional, Rogliani, Paola, additional, Saderi, Laura, additional, Scichilone, Nicola, additional, Tanzi, Silvia, additional, Vella, Manlio, additional, Boarino, Silvia, additional, Sotgiu, Giovanni, additional, and Solidoro, Paolo, additional

Published
2024
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21. Policy predictive model for better management of chronic obstructive pulmonary disease: economic-organisational implications in the Italian healthcare system

Author

Antonini, Debora, De Michele, Fausto, Micheletto, Claudio, Radovanovic, Dejan, Basile, Michele, Di Brino, Eugenio, Fortunato, Agostino, Donati, Valentina, Rumi, Filippo, Antonini, Debora, De Michele, Fausto, Micheletto, Claudio, Radovanovic, Dejan, Basile, Michele, Di Brino, Eugenio, Fortunato, Agostino, Donati, Valentina, and Rumi, Filippo

Abstract

Background: Chronic obstructive pulmonary disease (COPD) represents a significant public health problem in Italy, with a high prevalence and a substantial economic burden on the National Health Service (NHS). Effective management of the disease is crucial for reducing exacerbations and improving patients’ quality of life. Methods: This study employs a dynamic predictive model to assess the economic impact of implementing three specific health policies aimed at improving COPD management over a five-year horizon. The analysis is conducted from the perspective of the NHS, focusing on the direct costs associated with disease management. Results: The implementation of the proposed policies demonstrated potential significant savings in direct healthcare costs. The first policy, focused on increasing therapeutic adherence, generated an estimated savings of 202 million €. The second, concerning the wider use of triple therapies, led to savings of about 142 million €. Finally, the third policy, aimed at reducing the delay in prescribing appropriate therapies, contributed to an additional saving of over 175 million € in the time horizon considered in the analysis. Overall, these results suggest a substantial improvement opportunity in COPD management, with significant economic benefits for the Italian NHS. Conclusion: The study confirms the importance of targeted policies in the management of COPD, highlighting how strategic interventions can lead to significant resource savings while simultaneously improving patient care. These results provide a solid foundation for further research and serve as a useful guide for decision-makers in planning effective intervention strategies, aimed at optimizing resources and enhancing disease management in the Italian healthcare context.

Published
2024

22. Exacerbation Burden in COPD and Occurrence of Mortality in a Cohort of Italian Patients: Results of the Gulp Study

Author

Santus,Pierachille, Di Marco,Fabiano, Braido,Fulvio, Contoli,Marco, Corsico,Angelo, Micheletto,Claudio, Pelaia,Girolamo, Radovanovic,Dejan, Rogliani,Paola, Saderi,Laura, Scichilone,Nicola, Tanzi,Silvia, Vella,Manlio, Boarino,Silvia, Sotgiu,Giovanni, Solidoro,Paolo, Santus,Pierachille, Di Marco,Fabiano, Braido,Fulvio, Contoli,Marco, Corsico,Angelo, Micheletto,Claudio, Pelaia,Girolamo, Radovanovic,Dejan, Rogliani,Paola, Saderi,Laura, Scichilone,Nicola, Tanzi,Silvia, Vella,Manlio, Boarino,Silvia, Sotgiu,Giovanni, and Solidoro,Paolo

Abstract

Pierachille Santus,1 Fabiano Di Marco,2 Fulvio Braido,3 Marco Contoli,4 Angelo Guido Corsico,5 Claudio Micheletto,6 Girolamo Pelaia,7 Dejan Radovanovic,1 Paola Rogliani,8 Laura Saderi,9 Nicola Scichilone,10 Silvia Tanzi,11 Manlio Vella,11 Silvia Boarino,11 Giovanni Sotgiu,9 Paolo Solidoro12 1Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Division of Respiratory Diseases, Ospedale L. Sacco, ASST Fatebenefratelli-Sacco, Milano, Italy; 2Department of Health Sciences, Università degli Studi di Milano Pneumology, ASST Papa Giovanni XXIII, Bergamo, Italy; 3Department of Internal Medicine (DiMI), Respiratory Unit for Continuity of Care, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy; 4Department of Translational Medicine, Respiratory Section, University of Ferrara, Ferrara, Italy; 5Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy; 6Cardio-Thoracic Department, Respiratory Unit, University Integrated Hospital, Verona, Italy; 7Dipartimento di Scienze della Salute, Università Magna Graecia, Catanzaro, Italy; 8Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome ”Tor Vergata”, Division of Respiratory Medicine, University Hospital ”Tor Vergata”, Rome, Italy; 9Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; 10Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy; 11AstraZeneca Italia, Milan, Italy; 12Department of Medical Sciences, University of Turin, S.C. Pneumologia, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Torino, ItalyCorrespondence: Pierachille Santus, Università degli Studi di Milano, Via G.B. Grassi 74, Milano, 20157, Italy, Tel +39 0239042801, Fax +39 0239042473, Email pierachille.santus@unimi.itObjective: To describe t

Published
2024

28. Lung Ultrasound Signs

Author

Inchingolo, Riccardo, primary, Zanforlin, Alessandro, additional, Buonsenso, Danilo, additional, Perrone, Tiziano, additional, Torri, Elena, additional, Limoli, Giuseppe, additional, Mossolani, Elisa Eleonora, additional, Tursi, Francesco, additional, Soldati, Gino, additional, Marchetti, Giampietro, additional, Carlucci, Paolo, additional, Radovanovic, Dejan, additional, Lohmeyer, Franziska Michaela, additional, and Smargiassi, Andrea, additional

Published
2024
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29. Anti-Inflammatory and Anti-Oxidant Properties of N-Acetylcysteine: A Fresh Perspective.

Author

Santus, Pierachille, Signorello, Juan Camilo, Danzo, Fiammetta, Lazzaroni, Giada, Saad, Marina, and Radovanovic, Dejan

Subjects
IDIOPATHIC pulmonary fibrosis, CHRONIC obstructive pulmonary disease, CYSTIC fibrosis, LUNG diseases, RESPIRATORY diseases
Abstract

N-acetyl-L-cysteine (NAC) was initially introduced as a treatment for mucus reduction and widely used for chronic respiratory conditions associated with mucus overproduction. However, the mechanism of action for NAC extends beyond its mucolytic activity and is complex and multifaceted. Contrary to other mucoactive drugs, NAC has been found to exhibit antioxidant, anti-infective, and anti-inflammatory activity in pre-clinical and clinical reports. These properties have sparked interest in its potential for treating chronic lung diseases, including chronic obstructive pulmonary disease (COPD), bronchiectasis (BE), cystic fibrosis (CF), and idiopathic pulmonary fibrosis (IPF), which are associated with oxidative stress, increased levels of glutathione and inflammation. NAC's anti-inflammatory activity is noteworthy, and it is not solely secondary to its antioxidant capabilities. In ex vivo models of COPD exacerbation, the anti-inflammatory effects have been observed even at very low doses, especially with prolonged treatment. The mechanism involves the inhibition of the activation of NF-kB and neurokinin A production, resulting in a reduction in interleukin-6 production, a cytokine abundantly present in the sputum and breath condensate of patients with COPD and correlates with the number of exacerbations. The unique combination of mucolytic, antioxidant, anti-infective, and anti-inflammatory properties positions NAC as a safe, cost-effective, and efficacious therapy for a plethora of respiratory conditions. [ABSTRACT FROM AUTHOR]

Published
2024
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30. An international perspective on hospitalized patients with viral community-acquired pneumonia

Author

Aruj, Patricia Karina, Attorri, Silvia, Barimboim, Enrique, Caeiro, Juan Pablo, Garzón, María I., Cambursano, Victor Hugo, Ceccato, Adrian, Chertcoff, Julio, Cordon Díaz, Ariel, de Vedia, Lautaro, Ganaha, Maria Cristina, Lambert, Sandra, Lopardo, Gustavo, Luna, Carlos M., Malberti, Alessio Gerardo, Morcillo, Nora, Tartara, Silvina, Pensotti, Claudia, Pereyra, Betiana, Scapellato, Pablo Gustavo, Stagnaro, Juan Pablo, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Anseeuw, Kurt, Francois, Camille A., Van Braeckel, Eva, Vincent, Jean Louis, Djimon, Marcel Zannou, Aranha Nouér, Simone, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Balkissou, Adamou Dodo, Pefura Yone, Eric Walter, Mbatchou Ngahane, Bertrand Hugo, Shen, Ning, Xu, Jin-fu, Bustamante Rico, Carlos Andres, Buitrago, Ricardo, Pereira Paternina, Fernando Jose, Kayembe Ntumba, Jean-Marie, Vladic-Carevic, Vesna, Jakopovic, Marko, Matkovic, Zinka, Mitrecic, Ivan, Bouchy Jacobsson, Marie-Laure, Bro Christensen, Anette, Bødtger, Uffe, Meyer, Christian Niels, Vestergaard Jensen, Andreas, El-Said Abd El-Wahhab, Ibrahim, Elsayed Morsy, Nesreen, Shafiek, Hanaa, Sobh, Eman, Abdulsemed, Kedir Abdella, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthias, Pletz, Mathias W., Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Dimakou, Katerina, Papapetrou, Dimosthenis, Tsigou, Evdoxia, Ampazis, Dimitrios, Kaimakamis, Evangelos, Bhatia, Mohit, Dhar, Raja, D’Souza, George, Garg, Rajiv, Koul, Parvaiz A., Jayaraj, B.S., Narayan, Kiran Vishnu, Udnur, Hirennappa B., Krishnamurthy, Shashi Bhaskara, Kant, Surya, Swarnakar, Rajesh, Salvi, Sundeep, Limaye, Sneha, Golshani, Keihan, Keatings, Vera M., Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d’Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Gammino, Maria Antonia, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Petrino, Roberta, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, Franzetti, Fabio, Carone, Mauro, Patella, Vincenzo, Scarlata, Simone, Comel, Andrea, Kurahashi, Kiyoyasu, Aoun Bacha, Zeina, Barajas Ugalde, Daniel, Ceballos Zuñiga, Omar, Villegas, José F., Medenica, Milic, van de Garde, E.M.W., Raj Mihsra, Deebya, Shrestha, Poojan, Ridgeon, Elliott, Ishola Awokola, Babatunde, Nwankwo, Ogonna N.O., Olufunlola, Adefuye Bolanle, Olumide, Segaolu, Ukwaja, Kingsley N., Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Ravara, Sofia B., Brocovschii, Victoria, Ion, Chesov, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Dorobat, Carmen Mihaela, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Bukhary, Zakeya Abdulbaqi Ali, Edathodu, Jameela, Fathy, Amal, Mushira Abdulaziz Enani, Abdullah, Eltayeb Mohamed, Nazik, Ulhadi Memon, Jawed, Bella, Abdelhaleem, Bogdanović, Nada, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Luis, Bordon Garcia, Noel Manuel, Cabello Alarcón, Hugo, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicens, Casas, Xavier, Encabo González, Alicia, Fernández-Almira, Maria Luisa, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, González Del Castillo, Juan, Javaloyes Victoria, Patricia, Laserna Martínez, Elena, Malo de Molina, Rosa, Menéndez, Rosario, Pando-Sandoval, Ana, Prat Aymerich, Cristina, Lacoma de la Torre, Alicia, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Sanz, Francisco, Sibila, Oriol, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, van Boven, Job F.M., Vendrell Torra, Ester, Pujol, Jordi Almirall, Feldman, Charles, Kee Yum, Ho, Fiogbe, Arnauld Attannon, Yangui, Ferdaous, Bilaceroglu, Semra, Dalar, Levent, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, Dhasmana, Devesh J., Feneley, Andrew, Hancock, Carole, Hill, Adam T., Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Youzguin, Alexander, Singanayagam, Anika, Allen, Karen S., Brito, Veronica, Dietz, Jessica, Dysart, Claire E., Kellie, Susan M., Franco-Sadud, Ricardo A., Meier, Garnet, Gaga, Mina, Holland, Thomas L., Bergin, Stephen P., Kheir, Fayez, Landmeier, Mark, Lois, Manuel, Nair, Girish B., Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Soni, Nilam J., Noda, Julio, Hinojosa, Cecilia I., Levine, Stephanie M., Angel, Luis F., Anzueto, Antonio, Scott Whitlow, K., Hipskind, John, Sukhija, Kunal, Totten, Vicken, Wunderink, Richard G., Shah, Ray D., Mateyo, Kondwelani John, Carugati, Manuela, Morosi, Manuela, Monge, Elisa, Radovanovic, Dejan, Sotgiu, Giovanni, Jankovic, Mateja, Mahesh, Padukudru Anand, Marcos, Pedro Jorge, Abdalla, Mohamed I., Di Pasquale, Marta Francesca, Gramegna, Andrea, Terraneo, Silvia, Blasi, Francesco, Santus, Pierachille, Aliberti, Stefano, Reyes, Luis F., and Restrepo, Marcos I.

Published
2019
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33. Incidence of Tracheal Stenosis in ICU Hospitalized COVID-19 Patients: Results from a Prospective, Observational, Multicenter Study

Author

Perroni, Gianluca, primary, Radovanovic, Dejan, additional, Mondoni, Michele, additional, Mangiameli, Giuseppe, additional, Giudici, Veronica Maria, additional, Crepaldi, Alessandro, additional, Giatti, Valentina, additional, Morenghi, Emanuela, additional, Stella, Giulia Maria, additional, Pavesi, Stefano, additional, Mantero, Marco, additional, Corsico, Angelo Guido, additional, Spotti, Maura, additional, Premuda, Chiara, additional, Mangili, Stefano Attilio, additional, Franceschi, Elisa, additional, Narvena, Veronica Macioce, additional, Vanoni, Nicolò, additional, Pilocane, Tommaso, additional, Russo, Gianluca, additional, Di Marco, Fabiano, additional, Alloisio, Marco, additional, Aliberti, Stefano, additional, Marulli, Giuseppe, additional, Bertuzzi, Alexia Francesca, additional, Cipolla, Giuseppe, additional, Centanni, Stefano, additional, Blasi, Francesco, additional, Santus, Pierachille, additional, and Cariboni, Umberto, additional

Published
2023
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38. The Successful Procedures Of weaning from Tracheostomy (SPOT) study: preliminary analysis of predictive factors for failure and validation of the QsQ score

Author

Radovanovic, Dejan, primary, Gatti, Marina, additional, Spitaleri, Debora, additional, Pini, Stefano, additional, Saad, Marina, additional, Gramegna, Andrea, additional, Mondoni, Michele, additional, Aliberti, Stefano, additional, Di Marco, Fabiano, additional, Centanni, Stefano, additional, Blasi, Francesco, additional, and Santus, Pierachille, additional

Published
2023
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43. Lung Ultrasound Signs: The Beginning. Part 3–An Accademia di Ecografia Toracica Comprehensive Review on Ultrasonographic Signs and Real Needs.

Author

Inchingolo, Riccardo, Zanforlin, Alessandro, Buonsenso, Danilo, Perrone, Tiziano, Torri, Elena, Limoli, Giuseppe, Mossolani, Elisa Eleonora, Tursi, Francesco, Soldati, Gino, Marchetti, Giampietro, Carlucci, Paolo, Radovanovic, Dejan, Lohmeyer, Franziska Michaela, and Smargiassi, Andrea

Subjects
SCIENTIFIC literature, ULTRASONIC imaging, LUNGS
Abstract

Over the last 20 years, scientific literature and interest on chest/lung ultrasound (LUS) have exponentially increased. Interpreting mixed—anatomical and artifactual—pictures determined the need of a proposal of a new nomenclature of artifacts and signs to simplify learning, spread, and implementation of this technique. The aim of this review is to collect and analyze different signs and artifacts reported in the history of chest ultrasound regarding normal lung, pleural pathologies, and lung consolidations. By reviewing the possible physical and anatomical interpretation of these artifacts and signs reported in the literature, this work aims to present the AdET (Accademia di Ecografia Toracica) proposal of nomenclature and to bring order between published studies. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Incidence of Tracheal Stenosis in ICU Hospitalized COVID-19 Patients: Results from a Prospective, Observational, Multicenter Study.

Author

Perroni, Gianluca, Radovanovic, Dejan, Mondoni, Michele, Mangiameli, Giuseppe, Giudici, Veronica Maria, Crepaldi, Alessandro, Giatti, Valentina, Morenghi, Emanuela, Stella, Giulia Maria, Pavesi, Stefano, Mantero, Marco, Corsico, Angelo Guido, Spotti, Maura, Premuda, Chiara, Mangili, Stefano Attilio, Franceschi, Elisa, Narvena, Veronica Macioce, Vanoni, Nicolò, Pilocane, Tommaso, and Russo, Gianluca

Subjects
*TRACHEAL stenosis, *COVID-19, *COVID-19 pandemic, *TRACHEOTOMY, *COMPUTED tomography, *ALCOHOL drinking, *NONINVASIVE ventilation
Abstract

Background: Tracheal stenosis represents a fearsome complication that substantially impairs quality of life. The recent SARS-CoV-2 pandemic increased the number of patients requiring invasive ventilation through prolonged intubation or tracheostomy, increasing the risk of tracheal stenosis. Study design and methods: In this prospective, observational, multicenter study performed in Lombardy (Italy), we have exanimated 281 patients who underwent prolonged intubation (more than 7 days) or tracheostomy for severe COVID-19. Patients underwent CT scan and spirometry 2 months after hospital discharge and a subsequent clinical follow-up after an additional 6 months (overall 8 months of follow-up duration) to detect any tracheal lumen reduction above 1%. The last follow-up evaluation was completed on 31 August 2022. Results: In the study period, 24 patients (8.5%, CI 5.6–12.4) developed tracheal stenosis in a median time of 112 days and within a period of 200 days from intubation. Compared to patients without tracheal stenosis, tracheostomy was performed more frequently in patients that developed stenosis (75% vs 54%, p = 0.034). Tracheostomy and alcohol consumption (1 unit of alcohol per day) increased risk of developing tracheal stenosis of 2.6-fold (p = 0.047; IC 0.99–6.8) and 5.4-fold (p = 0.002; CI 1.9–16), respectively. Conclusions: In a large cohort of patients, the incidence of tracheal stenosis increased during pandemic, probably related to the increased use of prolonged intubation. Patients with histories of prolonged intubation should be monitored for at least 200 days from invasive ventilation in order to detect tracheal stenosis at early stage. Alcohol use and tracheostomy are risk factors for developing tracheal stenosis. [ABSTRACT FROM AUTHOR]

Published
2024
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47. Modello predittivo di policy per una migliore gestione della broncopneumopatia cronica ostruttiva: implicazioni economico-organizzative nel contesto sanitario italiano.

Author

Antonini, Debora, De Michele, Fausto, Micheletto, Claudio, Radovanovic, Dejan, Basile, Michele, Di Brino, Eugenio, Fortunato, Agostino, Donati, Valentina, and Rumi, Filippo

Subjects
CHRONIC obstructive pulmonary disease, DISEASE management, ECONOMIC aspects of diseases, MEDICAL care costs, QUALITY of life
Abstract

Background: Chronic obstructive pulmonary disease (COPD) represents a significant public health problem in Italy, with a high prevalence and a substantial economic burden on the National Health Service (NHS). Effective management of the disease is crucial for reducing exacerbations and improving patients' quality of life. Methods: This study employs a dynamic predictive model to assess the economic impact of implementing three specific health policies aimed at improving COPD management over a five-year horizon. The analysis is conducted from the perspective of the NHS, focusing on the direct costs associated with disease management. Results: The implementation of the proposed policies demonstrated potential significant savings in direct healthcare costs. The first policy, focused on increasing therapeutic adherence, generated an estimated savings of 202 million €. The second, concerning the wider use of triple therapies, led to savings of about 142 million €. Finally, the third policy, aimed at reducing the delay in prescribing appropriate therapies, contributed to an additional saving of over 175 million € in the time horizon considered in the analysis. Overall, these results suggest a substantial improvement opportunity in COPD management, with significant economic benefits for the Italian NHS. Conclusion: The study confirms the importance of targeted policies in the management of COPD, highlighting how strategic interventions can lead to significant resource savings while simultaneously improving patient care. These results provide a solid foundation for further research and serve as a useful guide for decision-makers in planning effective intervention strategies, aimed at optimizing resources and enhancing disease management in the Italian healthcare context. [ABSTRACT FROM AUTHOR]

Published
2024
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