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3. Sleep in Residents: A Comparison between Anesthesiology and Occupational Medicine Interns

Author

Magnavita, Nicola, Di Prinzio, Reparata Rosa, Meraglia, Igor, Vacca, Maria Eugenia, Soave, Paolo Maurizio, Di Stasio, Enrico, Magnavita N. (ORCID:0000-0002-0988-7344), Di Prinzio R. R., Meraglia I., Vacca M. E., Soave P. M., Di Stasio E. (ORCID:0000-0003-1047-4261), Magnavita, Nicola, Di Prinzio, Reparata Rosa, Meraglia, Igor, Vacca, Maria Eugenia, Soave, Paolo Maurizio, Di Stasio, Enrico, Magnavita N. (ORCID:0000-0002-0988-7344), Di Prinzio R. R., Meraglia I., Vacca M. E., Soave P. M., and Di Stasio E. (ORCID:0000-0003-1047-4261)

Abstract

Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night shift per week have different physical and mental health from occupational medicine residents (OMRs) who do not work at night. A total of 21 ARs and 16 OMRs attending a university general hospital were asked to wear an actigraph to record sleep duration, heart rate and step count and to complete a questionnaire for the assessment of sleep quality, sleepiness, fatigue, occupational stress, anxiety, depression and happiness. ARs had shorter sleep duration than OMRs; on average, they slept 1 h and 20 min less (p < 0.001). ARs also had greater daytime sleepiness, a higher heart rate and lower happiness than OMRs. These results should be interpreted with caution given the cross-sectional nature of the study and the small sample size, but they are an incentive to promote sleep hygiene among residents.

Published
2023

4. Household disinfectant exposure during the COVID-19 pandemic: A retrospective study of the data from an italian poison control center

Author

Soave, P. M., Grassi, S., Oliva, A., Romano, B., Stasio, E. D. I., Dominici, L., Pascali, V., Antonelli, M., Soave P. M., Oliva A. (ORCID:0000-0001-7120-616X), Romano B., Pascali V. (ORCID:0000-0001-6520-5224), Antonelli M. (ORCID:0000-0003-3007-1670), Soave, P. M., Grassi, S., Oliva, A., Romano, B., Stasio, E. D. I., Dominici, L., Pascali, V., Antonelli, M., Soave P. M., Oliva A. (ORCID:0000-0001-7120-616X), Romano B., Pascali V. (ORCID:0000-0001-6520-5224), and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

OBJECTIVE: Since the beginning of the COVID-19 pandemic it has been recommended that chemical disinfectants are used to protect surfaces. This study aimed to determine whether the number of exposure calls related to household disinfectants (HD) received between January 30, 2020 to May 18, 2020 varied from the same time period in the previous year. MATERIALS AND METHODS: A retrospective review of the poison control center database from the Fondazione Universitario Policlinico Agostino Gemelli IRCCS, Rome, Italy, was conducted. Calls from Italian citizens, hospitals, and general practitioners received during the same time period in 2019 and 2020 were compared. RESULTS: The center received 1972 exposure calls during the study period. A 5% increase in calls regarding exposure to HDs was noted from 2019 to 2020 (9.8% to 15.2%, p<0.001). The majority of enquiries regarded bleach-containing products, hand sanitizers, ethanol, and hydrogen peroxide. Most calls were received from patients in their homes (n, 259; prevalence, 86%; increase, 107%) and concerned accidental exposure (n, 280; prevalence, 93%; increase, 76%), while cases of intentional exposure decreased (n, 14; prevalence, 5%; decrease, 33%). The main route of exposure was ingestion (n, 170; prevalence, 57%; increase, 45%), but the highest increase was observed in inhalation cases (n, 82; prevalence, 27%; increase, 122%). CONCLUSIONS: As the incidence of enquiries regarding products that can represent an important health hazard, when improperly used, increased in 2020 suggests that the COVID-19 public health messaging on the proper use of HDs should be improved.

Published
2021

5. Treating Anti-Vax Patients, a New Occupational Stressor—Data from the 4th Wave of the Prospective Study of Intensivists and COVID-19 (PSIC)

Author

Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., Antonelli M. (ORCID:0000-0003-3007-1670), Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

The Prospective Study of Intensivists and COVID-19 (PSIC) is a longitudinal study that besides investigating a cohort of intensivists from one of the two COVID-19 hub hospitals in Central Italy since the beginning of the pandemic (first wave, April 2020), has conducted a new survey at each successive wave. In addition to the variables investigated in previous surveys (job changes due to the pandemic, justice of safety procedures, job stress, sleep quality, satisfaction, happiness, anxiety, depression, burnout, and intention to quit), the latest fourth wave (December 2021) study has evalu-ated discomfort in caring for anti-vax patients. A multivariate logistic regression model confirmed that high levels of occupational stress (distressed 75.8%) were associated with isolation, monotony, lack of time for meditation, and poor relationships with anti-vaccination patients. Compared to the first phase, there was a reduction in levels of insomnia and anxiety, but the percentage of intensivists manifesting symptoms of depression remained high (58.9%). The study underlined the efficacy of organizational interventions and psychological support.

Published
2022

6. Botulism during SARS-CoV-2 pandemic: The importance of differential diagnoses

Author

Gatto, Antonio, Pulitano', Silvia Maria, Conti, Giorgio, Soave, Paolo Maurizio, Di Sarno, Lorenzo, Chiaretti, Antonio, Gatto A., Pulitano S. M. (ORCID:0000-0002-8496-379X), Conti G. (ORCID:0000-0002-8566-9365), Soave P. M., Di Sarno L., Chiaretti A. (ORCID:0000-0002-9971-1640), Gatto, Antonio, Pulitano', Silvia Maria, Conti, Giorgio, Soave, Paolo Maurizio, Di Sarno, Lorenzo, Chiaretti, Antonio, Gatto A., Pulitano S. M. (ORCID:0000-0002-8496-379X), Conti G. (ORCID:0000-0002-8566-9365), Soave P. M., Di Sarno L., and Chiaretti A. (ORCID:0000-0002-9971-1640)

Abstract

Botulism is a neuroparalytic syndrome caused by a neurotoxin produced by Clostridium botulinum. We describe a patient with neurological symptoms associated with intoxication by Clostridium botulinum and infection by SARSCoV2. This report underlines that it is mandatory, even in case of SARS-CoV-2 positivity, to investigate all the causes of a clinical pattern.

Published
2021

7. A one-year prospective study of work-related mental health in the intensivists of a COVID-19 hub hospital

Author

Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., Antonelli M. (ORCID:0000-0003-3007-1670), Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

e h b Abstract: The COVID-19 pandemic has severely tested the physical and mental health of health care workers (HCWs). The various stages of the epidemic have posed different problems; consequently, only a prospective study can effectively describe the changes in the workers’ health. This repeated cross-sectional study is based on a one-year investigation (spring 2020 to spring 2021) of intensive care physicians in one of the two COVID-19 hub hospitals in Central Italy and aims to study the evolution of the mental health status of intensivists during the pandemic. Changes in their work activity due to the pandemic were studied anonymously together with their perception of organisational justice, occupational stress, sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and intention to quit. In May–June 2021, one year after the baseline, doctors reported an increased workload, isolation at work and in their social life, a lack of time for physical activity and meditation, and compassion fatigue. Stress was inversely associated with the perception of justice in safety procedures and directly correlated with work isolation. Occupational stress was significantly associated with anxiety, depression, burnout, dissatisfaction, and their intention to quit. Procedural justice was significantly associated with happiness. Doctors believed vaccinations would help control the problem; however, this positive attitude had not yet resulted in improved mental health. Doctors reported high levels of distress (73%), sleep problems (28%), anxiety (25%), and depression (64%). Interventions to correct the situation are urgently needed.

Published
2021

8. Prolonged stress causes depression in frontline workers facing the covid-19 pandemic—a repeated cross-sectional study in a covid-19 hub-hospital in central italy

Author

Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., Antonelli M. (ORCID:0000-0003-3007-1670), Magnavita, Nicola, Soave, Paolo Maurizio, Antonelli, Massimo, Magnavita N. (ORCID:0000-0002-0988-7344), Soave P. M., and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

The COVID-19 pandemic has severely tested the mental health of frontline health care workers. A repeated cross-sectional study can provide information on how their mental health evolved during the various phases of the pandemic. The intensivists of a COVID-19 hub hospital in Rome were investigated with a baseline survey during the first wave of the pandemic in April 2020, and they were contacted again in December 2020, during the second wave. Of the 205 eligible workers, 152 responded to an online questionnaire designed to measure procedural justice, occupational stress (effort/reward imbalance), sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and turnover intention. Workers reported a further increase in workload and compassion fatigue, which had already risen during the first wave, and a marked reduction in the time devoted to meditation and mental activities. A low level of confidence in the adequacy of safety procedures and the need to work in isolation, together with an increased workload and lack of time for meditation, were the most significant predictors of occupational stress in a stepwise linear regression model. Occupational stress was, in turn, a significant predictor of insomnia, anxiety, low job satisfaction, burnout, and intention to leave the hospital. The number of workers manifesting symptoms of depression increased significantly to exceed 60%. Action to prevent occupational risks and enhance individual resilience cannot be postponed.

Published
2021

10. Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure: the DIANA study

Author

De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), Soave P. M., De Bus, L., Depuydt, P., Steen, J., Dhaese, S., De Smet, K., Tabah, A., Akova, M., Cotta, M. O., De Pascale, Gennaro, Dimopoulos, G., Fujitani, S., Garnacho-Montero, J., Leone, M., Lipman, J., Ostermann, M., Paiva, J. -A., Schouten, J., Sjovall, F., Timsit, J. -F., Roberts, J. A., Zahar, J. -R., Zand, F., Zirpe, K., De Waele, J. J., Rios, F., Vazquez, A. R., Vidal, M. G., Zakalik, G., Attokaran, A. G., Banakh, I., Dey-Chatterjee, S., Ewan, J., Ferrier, J., Forbes, L., Fourie, C., Leditschke, A., Murray, L., Eller, P., Biston, P., Bracke, S., De Crop, L., De Schryver, N., Frans, E., Spapen, H., Van Malderen, C., Vansteelandt, S., Vermeiren, D., Arevalo, E. P., Crespo, M., Flores, R. Z., Piza, P., Tutillo, D. M., Elme, A., Kallaste, A., Starkopf, J., Bourenne, J., Calypso, M., Cohen, Y., Dahyot-Fizelier, C., Depret, F., Guillot, M., Imzi, N., Jochmans, S., Kouatchet, A., Lepape, A., Martin, O., Heim, M., Schaller, S. J., Arvaniti, K., Bekridelis, A., Ioannidis, P., Mitrakos, C., Papanikolaou, M. N., Pouriki, S., Vemvetsou, A., Abraham, B., Bhattacharya, P. K., Budugu, A., Dixit, S., Gurav, S., Kandanuri, P., Prabhu, D. A., Rathod, D., Savaru, K., Udupa, A. N., Varghese, S. B., Bakhodaei, H. H., Dabiri, G., Fallahi, M. J., Feiz, F., Firoozifar, M., Khaloo, V., Maghsudi, B., Masjedi, M., Nikandish, R., Sabetian, G., Marsh, B., Martin-Loeches, I., Steiner, J., Barbagallo, M., Caricato, Anselmo, Cortegiani, A., D'Andrea, R., Deana, C., Donati, A., Girardis, M., Mandala, G., Panarello, G., Pasero, D., Pelagalli, L., Soave, Paolo Maurizio, Spadaro, S., Fujita, Y., Fujiwara, S., Hara, Y., Hashi, H., Hashimoto, S., Hashimoto, H., Hayakawa, K., Inoue, M., Isokawa, S., Kameda, S., Kamohara, H., Kanamoto, M., Katayama, S., Kawagishi, T., Kawano, Y., Kida, Y., Kita, M., Kobayashi, A., Kuriyama, A., Naito, T., Nashiki, H., Nishiyama, K., Shindo, S., Suzuki, T., Takaba, A., Tanaka, C., Tetsuya, K., Tomioka, Y., Yanagawa, Y., Yoshida, H., Adnan, S., Hasan, M. S., Sulaiman, H., Gasca Lopez, G. A., Hernandez-Cardenas, C. M., Namendys-Silva, S. A., Bethlehem, C., de Lange, D., Hunfeld, N., Numan, S., van Leeuwen, H., Owens, D., Almeida, M., Fragoso, E., Leonor, T., Pereira, J. -M., Filipescu, D., Grigoras, I., Popescu, M., Tomescu, D., Alshahrani, M. S., Alvarez-Gonzalez, M., Barrero-Garcia, I., Blasco-Navalpotro, M. A., Claverias, L., Estella, A., Espina, L. F., Garmendia, J. L. G., Prieto, E. G., Gomez-Prieto, G., Conde, C. J., Sagasti, F. M., Cantero, A. M., Orejas-Gallego, A., Papiol, E., Perez-Civantos, D., Laderas, J. C. P., Alvarez, J. T., Vera-Artazcoz, P., Cortes, P. V., Oldner, A., Spangfors, M., Alp, E., Koksal, I., Korten, V., Ozveren, A., Hall, A., Hatton, K. W., Laudanski, K., De Pascale G. (ORCID:0000-0002-8255-0676), Caricato A. (ORCID:0000-0001-5929-120X), and Soave P. M.

Abstract

Purpose: The DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation. Methods: Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied in a prospective observational study from October 2016 until May 2018. ADE was defined as (1) discontinuation of an antimicrobial in case of empirical combination therapy or (2) replacement of an antimicrobial with the intention to narrow the antimicrobial spectrum, within the first 3 days of therapy. Inverse probability (IP) weighting was used to account for time-varying confounding when estimating the effect of ADE on clinical cure. Results: Overall, 1495 patients from 152 ICUs in 28 countries were studied. Combination therapy was prescribed in 50%, and carbapenems were prescribed in 26% of patients. Empirical therapy underwent ADE, no change and change other than ADE within the first 3 days in 16%, 63% and 22%, respectively. Unadjusted mortality at day 28 was 15.8% in the ADE cohort and 19.4% in patients with no change [p = 0.27; RR 0.83 (95% CI 0.60–1.14)]. The IP-weighted relative risk estimate for clinical cure comparing ADE with no-ADE patients (no change or change other than ADE) was 1.37 (95% CI 1.14–1.64). Conclusion: ADE was infrequently applied in critically ill-infected patients. The observational effect estimate on clinical cure suggested no deleterious impact of ADE compared to no-ADE. However, residual confounding is likely.

Published
2020

11. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)

Abstract

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

12. Systemic sclerosis in an anaesthetist

Author

Magnavita, Nicola, Di Prinzio, R R, Soave, P M, Magnavita, N (ORCID:0000-0002-0988-7344), Magnavita, Nicola, Di Prinzio, R R, Soave, P M, and Magnavita, N (ORCID:0000-0002-0988-7344)

Abstract

Introduction. Systemic sclerosis is a potentially devastating disease in which the aetiology and pathogenesis has not yet been fully understood. It has been associated with occupational exposure to silica, vinyl chloride, solvents and other chemical agents. Case summary. In this paper, we present the case of an anaesthetist who developed scleroderma after an occupational exposure to volatile anaesthetic gases (halothane, sevoflurane, isoflurane and enflurane) in operating theatres with poor scavenging systems and we discuss the possible causal link between occupational exposure and the disease. Conclusions. The case reported is the second that we are aware of in recent years. Reporting scleroderma cases in workers may be the first step in assessing the causal link between occupational exposure to anaesthetic gases and the disease.

Published
2020

13. Postoperative respiratory failure in liver transplantation: Risk factors and effect on prognosis

Author

Avolio, Alfonso Wolfango, Gaspari, Rita, Teofili, Luciana, Bianco, G., Spinazzola, Giorgia, Soave, Paolo Maurizio, Paiano, Gianfranco, Francesconi, Alessandra Gioia, Arcangeli, A., Nicolotti, Nicola, Antonelli, Massimo, Avolio A. W. (ORCID:0000-0003-2491-7625), Gaspari R. (ORCID:0000-0003-0141-3686), Teofili L. (ORCID:0000-0002-7214-1561), Spinazzola G. (ORCID:0000-0001-8055-5142), Soave P. M., Paiano G., Francesconi A. G., Nicolotti N., Antonelli M. (ORCID:0000-0003-3007-1670), Avolio, Alfonso Wolfango, Gaspari, Rita, Teofili, Luciana, Bianco, G., Spinazzola, Giorgia, Soave, Paolo Maurizio, Paiano, Gianfranco, Francesconi, Alessandra Gioia, Arcangeli, A., Nicolotti, Nicola, Antonelli, Massimo, Avolio A. W. (ORCID:0000-0003-2491-7625), Gaspari R. (ORCID:0000-0003-0141-3686), Teofili L. (ORCID:0000-0002-7214-1561), Spinazzola G. (ORCID:0000-0001-8055-5142), Soave P. M., Paiano G., Francesconi A. G., Nicolotti N., and Antonelli M. (ORCID:0000-0003-3007-1670)

Abstract

Background :Postoperative respiratory failure (PRF, namely mechanical ventilation >48 hours) significantly affects morbidity and mortality in liver transplantation (LTx). Previous studies analyzed only one or two categories of PRF risk factors (preoperative, intraoperative or postoperative ones). The aims of this study were to identify PRF predictors, to assess the length of stay (LoS) in ICU and the 90-day survival according to the PRF in LTx patients. Methods: Two classification approaches were used: systematic classification (recipient-related preoperative factors; intraoperative factors; logistic factors; donor factors; postoperative ICU factors; postoperative surgical factors) and patient/organ classification (patient-related general factors; native-liver factors; new-liver factors; kidney factors; heart factors; brain factors; lung factors). Two hundred adult non-acute patients were included. Missing analysis was performed. The competitive role of each factor was assessed. Results: PRF occurred in 36.0% of cases. Among 28 significant PRF predictors at univariate analysis, 6 were excluded because of collinearity, 22 were investigated by ROC curves and by logistic regression analysis. Recipient age (OR = 1.05; p = 0.010), female sex (OR = 2.75; p = 0.018), Model for End-Stage Liver Disease (MELD, OR = 1.09; p<0.001), restrictive lung pattern (OR = 2.49; p = 0.027), intraoperative veno-venous bypass (VVBP, OR = 3.03; p = 0.008), pre-extubation PaCO 2 (OR = 1.11; p = 0.003) and Model for Early Allograft Function (MEAF, OR = 1.37; p<0.001) resulted independent PRF risk factors. As compared to patients without PRF, the PRF-group had longer LoS (10 days IQR 7-18 versus 5 days IQR 4-7, respectively; p<0.001) and lower day-90 survival (86.0% versus 97.6% respectively, p<0.001). Conclusion: In conclusion, MELD, restrictive lung pattern, surgical complexity as captured by VVBP, pre-extubation PaCO 2 and MEAF are the main predictors of PRF in non-acute LTx

Published
2019

14. The Influence of a Total Body Resistance Training Program on Autonomic Modulation and Strength Variables in Young Adults.

Author

Altherr, Cody A., Soave, Kayla M., Nagelkirk, Paul R., and Del Pozzi, Andrew T.

Subjects
RESISTANCE training, MUSCLE strength, BODY composition, RESPIRATORY sinus arrhythmia, LEAN body mass
Abstract

The purpose of this study was to examine autonomic modulation using multiple quantitative measures before and after a resistance training (RT) intervention. Seventeen young adults (age 18-35 years) were tested for body composition, muscular strength, and autonomic activity. The RT protocol targeted total-body large muscle groups, which were performed three days a week for eight-weeks. Autonomic assessments included respiratory sinus arrhythmia (RSA), static handgrip exercise, Valsalva maneuver, heart rate variability (HRV), and tilt-table testing. The main finding was that tilt-table duration increased by 68 seconds (p = 0.05) after RT. Upper body strength increased by 11.2 kg (p = 0.001) and lower body strength increased by 68.3 kg (p < 0.001) following completion of the RT intervention. The average total lean mass increased by 1.5 kg (p < 0.01), while total fat mass was unchanged (△ = 0.5 kg, p = 0.23). RSA (△ = 0.4, p = 0.89), Valsalva ratio (△ = -0.09, p = 0.48), static handgrip (△ = 8 mm Hg, p = 0.07), and HRV (△ = -0.4, p = 0.53) were not affected by RT. The results from this study suggest that RT improves tilt-table tolerance in a young healthy population as evidence by improved tilt-table duration. However, RT seemed to have no effect on cardio-vagal or adrenergic function. [ABSTRACT FROM AUTHOR]

Published
2021
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15. Reliability of blood pressure responses used to define an exaggerated blood pressure response to exercise in young healthy adults

Author

Currie, Katharine D., Soave, Kayla M., and Slade, Jill M.

Abstract

Exaggerated blood pressure (BP) responses (EBPR) to exercise are prognostic of future cardiovascular risk. The primary objective of this study was to assess the test–retest reliability of BP responses used to categorize EBPR as absent or present. Twenty-seven healthy adults [21(2) years; 12 males] with resting BP < 130/80 mmHg completed a modified Bruce protocol treadmill exercise test on two visits separated by 6 (3) days. BP measurements were obtained during exercise using an automated auscultatory device. Submaximal and maximal systolic and diastolic BP, the change in diastolic BP from rest to maximal diastolic BP, and the change in systolic BP relative to the change in exercise intensity, quantified using the metabolic equivalent of task (SBP/MET-slope) were determined. Test–retest reliability of these BP responses was assessed using intraclass correlation coefficients (ICC) with a value ≥0.61 considered as substantial reliability. Submaximal diastolic BP demonstrated substantial reliability in the total group (ICC = 0.670; P≤ 0.001). In males, submaximal systolic BP (ICC = 0.655, P< 0.01), submaximal diastolic BP (ICC = 0.699; P< 0.01) and maximal systolic BP (ICC = 0.794; P≤ 0.001) demonstrated substantial reliability. All other BP responses were not reliable. Despite the prognostic value of EBPR, only three BP responses used to categorize EBPR demonstrated substantial test–retest reliability in healthy young males. In clinical practice, these preliminary findings would support the use of exercise BPs to identify young males with elevated cardiovascular risk, but additional research is needed to improve the clinical utility of exercise BPs and EBPR in females.

Published
2021
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16. High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study.

Author

Gaspari, Rita, Spinazzola, Giorgia, Ferrone, Giuliano, Soave, Paolo M., Pintaudi, Gabriele, Cutuli, Salvatore L., Avolio, Alfonso W., Conti, Giorgio, and Antonelli, Massimo

Subjects
OXYGEN therapy equipment, PREVENTION of surgical complications, ACADEMIC medical centers, HYPOXEMIA, DEATH, FISHER exact test, LENGTH of stay in hospitals, INTENSIVE care units, LIVER transplantation, LONGITUDINAL method, SCIENTIFIC observation, OXYGEN therapy, T-test (Statistics), MECHANICAL ventilators, TREATMENT effectiveness, CONTINUING education units, DISEASE incidence, CASE-control method, EXTUBATION, DATA analysis software, NASAL cannula, OXYGEN masks
Abstract

BACKGROUND: High-flow nasal cannula (HFNC) is a key component of oxygen therapy and has largely been used in patients with acute respiratory failure. We conducted a matched controlled study with the aim to compare the preventive use of oxygen therapy delivered by HFNC versus via air-entrainment mask (standard O2) after extubation in adult subjects with liver transplantation for reducing postextubation hypoxemia. METHODS: Twenty-nine subjects with liver transplantation who received HFNC after extubation (HFNC group) were matched 1:1 with 29 controls (standard O2 group) chosen from an historical group of 90 subjects admitted to the ICU during the previous 36 months. The primary outcome of the study was the incidence of hypoxemia at 1 h and 24 h after extubation. Secondary outcomes were the rate of weaning failure, ICU length of stay, and 28-d mortality. RESULTS: The incidence of hypoxemia was not significantly different between the HFNC and standard O2 groups at 1 h and 24 h after extubation. In the HFNC group, there was a trend toward a lower rate of weaning failure compared with the standard O2 group. ICU length of stay and 28-d mortality were similar in both groups. CONCLUSIONS: Early application of HFNC in the subjects with liver transplantation did not reduce the incidence of hypoxemia after extubation compared with standard O2 and did not modify the incidence of weaning failure, ICU length of stay, and 28-d mortality in this high-risk population of subjects. [ABSTRACT FROM AUTHOR]

Published
2020
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18. Disk Battery Ingestion: A Simple User-Guide

Author

Petruzziello, Carmine and Soave, Paolo M.

Abstract

Introduction: Disk Battery Ingestion (DBI) is a cause of access to the emergency department (ED), especially in pediatric age. This problem, if not well managed, may lead to serious injuries, with several complications involving the gastrointestinal and respiratory tract. Objective: The aim of this review is to analyze the literature of the last 25 years to make a decisional flow-chart that may help the emergency physician. Methods: For this review, 36 articles have been analyzed (8 articles and 28 case reports), from 1995 to 2019. Data considered from each study included year of publication, type of study, population studied, type of battery, timing of ingestion, treatment, outcomes, complications. Results: A decisional flow-chart has been configured. X-ray should be performed as the first step in every stable patient, meanwhile CT scan should be performed in unstable patients. When the battery is still localized in the esophagus, endoscopy should be performed as soon as possible, meanwhile, when the battery is beyond the esophagus, its diameter should be noted before taking a decision. Conclusion: The use of the flow-chart proposed may reduce the risk of worse consequences and severe injuries for the patients, helping the emergency physician in his decisional process.

Published
2020
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19. A Comparative Analysis of Sonographic Interpretation of Peripheral Nerves in the Anterior Compartment of the Forearm Between an Experienced and Novice Interpreter.

Author

Hung, Laurie Y., Lucaciu, Octavian C., and Soave, David M.

Abstract

Purpose: This article describes a pilot study that compares the ability of a novice interpreter and an experienced interpreter to interpret ultrasound images of peripheral nerves in the anterior compartment of the forearm. Methods: Twenty subjects between 18 and 50 years of age were included. A student was taken through tutorials in which she was guided through identification of the peripheral nerves of the anterior forearm. After the tutorials, the experienced interpreter traced the subjects' ulnar nerve and artery neurovascular bundle proximally in the anterior compartment of the forearm until just Pefore it separated into the artery and nerve. Here the distance between the median and ulnar nerve was measured by the investigators. The Bland and Altman design and paired t tests were used to compare the agreement between the results of the two investigators. Results: The Bland and Altman analysis reveals that the difference between two sets of measurements (experienced investigator vs. student) is calculated to be 0.08 mm ± 0.22 mm for the left arm and 0.16 mm ± 0.43 mm for the right arm. A paired t test revealed that there is no significant difference in the measurements obtained by the two investigators (left arm: p = .12; right arm: p = .10). These results suggest that the measurements of the two investigators may be interchangeable. Conclusions: This pilot study shows that after tutorials combining dissection and sonographic interpretation, the ability of a novice interpreter to identify ultrasonographic images of peripheral nerves in the anterior compartment of the forearm Is comparable to that of an experienced interpreter. (J Chiropr Educ 2012;26(l):47-50) [ABSTRACT FROM AUTHOR]

Published
2012
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22. The free license codes as decision support system (DSS) for the emergency planning to simulate radioactive releases in case of accidents in the new generation energy plants

Author

Andrea Malizia, Carestia, M., Cafarelli, C., Milanese, L., Pagannone, S., Pappalardo, A., Pedemonte, M., Latini, G., Barlascini, O., Fiorini, E., Soave, P. M., Di Giovanni, D., Cenciarelli, O., Antonelli, L., D’amico, F., Palombi, L., Bellecci, C., and Gaudio, P.

Subjects
Planning and Development, Accident, Biomass, Cesium, Contamination, DSS, Energy, Nuclear fission, Radioactive, Safety, Security, Geography, Planning and Development, 2300, Energy (all), Geography, Settore FIS/01 - Fisica Sperimentale, Settore FIS/07 - Fisica Applicata(Beni Culturali, Ambientali, Biol.e Medicin), Nuclear Fission

23. Alcohol and work. Consensus Document of the La.R.A. (Workers representing a risk for others) group,Alcol e Lavoro. Documento di consenso del gruppo La.R.A

Author

Magnavita, N., Lorenzo, G., Gallo, M., Sergio Garbarino, Goggiamani, A., Janiri, L., Messineo, A., Miggiano, G., Pichini, S., Porpora, A., Poscia, A., Sacco, A., Spagnolo, A. G., Vogel, L., Ciprani, F., Deidda, B., Fenudi, L., Magrini, A., Morini, L., Moscato, U., Proietti, A. R., Ranalletta, D., Santoro, P. E., Soave, P. M., Stanzani, C., Bottaro, L. C., and Ricciardi, W.

24. Alcohol and work. Consensus Document of the La.R.A. (Workers representing a risk for others) group | Alcol e Lavoro. Documento di consenso del gruppo La.R.A

Author

Magnavita, N., Lorenzo, G., Gallo, M., Garbarino, S., Goggiamani, A., Janiri, L., Messineo, A., Miggiano, G., Pichini, S., Porpora, A., Andrea Poscia, Sacco, A., Spagnolo, A. G., Vogel, L., Ciprani, F., Deidda, B., Fenudi, L., Magrini, A., Morini, L., Moscato, U., Proietti, A. R., Ranalletta, D., Santoro, P. E., Soave, P. M., Stanzani, C., Bottaro, L. C., and Ricciardi, W.

25. Household disinfectant exposure during the COVID-19 pandemic: a retrospective study of the data from an Italian poison control center.

Author

Soave PM, Grassi S, Oliva A, Romanò B, Di Stasio E, Dominici L, Pascali V, and Antonelli M

Subjects
COVID-19 transmission, Humans, Italy, Retrospective Studies, COVID-19 prevention & control, Disinfectants poisoning, Disinfection, Housing standards, Poison Control Centers statistics & numerical data, SARS-CoV-2 drug effects
Abstract

Objective: Since the beginning of the COVID-19 pandemic it has been recommended that chemical disinfectants are used to protect surfaces. This study aimed to determine whether the number of exposure calls related to household disinfectants (HD) received between January 30, 2020 to May 18, 2020 varied from the same time period in the previous year., Materials and Methods: A retrospective review of the poison control center database from the Fondazione Universitario Policlinico Agostino Gemelli IRCCS, Rome, Italy, was conducted. Calls from Italian citizens, hospitals, and general practitioners received during the same time period in 2019 and 2020 were compared., Results: The center received 1972 exposure calls during the study period. A 5% increase in calls regarding exposure to HDs was noted from 2019 to 2020 (9.8% to 15.2%, p<0.001). The majority of enquiries regarded bleach-containing products, hand sanitizers, ethanol, and hydrogen peroxide. Most calls were received from patients in their homes (n, 259; prevalence, 86%; increase, 107%) and concerned accidental exposure (n, 280; prevalence, 93%; increase, 76%), while cases of intentional exposure decreased (n, 14; prevalence, 5%; decrease, 33%). The main route of exposure was ingestion (n, 170; prevalence, 57%; increase, 45%), but the highest increase was observed in inhalation cases (n, 82; prevalence, 27%; increase, 122%)., Conclusions: As the incidence of enquiries regarding products that can represent an important health hazard, when improperly used, increased in 2020 suggests that the COVID-19 public health messaging on the proper use of HDs should be improved.

Published
2021
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26. [Alcohol and work. Consensus Document of the La.R.A. (Workers representing a risk for others) group].

Author

Magnavita N, De Lorenzo G, Gallo M, Garbarino S, Goggiamani A, Janiri L, Messineo A, Miggiano G, Pichini S, Porpora A, Poscia A, Sacco A, Spagnolo AG, Vogel L, Ciprani F, Deidda B, Fenudi L, Magrini A, Morini L, Moscato U, Proietti AR, Ranalletta D, Santoro PE, Soave PM, Stanzani C, Bottaro LC, and Ricciardi W

Subjects
Alcoholism diagnosis, Alcoholism epidemiology, European Union, Humans, International Agencies, Italy epidemiology, Sociological Factors, Surveys and Questionnaires, Alcoholism prevention & control, Occupational Health legislation & jurisprudence
Abstract

Aim: Current Italian legislation obliges employers to prevent workers who are occupationally at risk or who perform jobs that may be hazardous for the safety or health of third parties from consuming alcohol. The LaRA Group undertook to assess whether the law fully safeguards the health and safety of both workers and third parties, without impinging upon the civil rights of workers., Method: A written document expressing agreement was produced following discussions between doctors, lawyers, bioethicists and social partners., Results: There are gaps and inconsistencies in current laws; the differences in local and regional provisions prevent authorities from applying a single strategy at national level. There should be a change in existing rules under which the employer's obligation to enforce the ban on consumption alcohol in the workplace is enacted solely by the "competent" physician whose institutional role is to safeguard and promote health. Some occupational categories that are subject to a ban on alcohol consumption do not currently under-go health surveillance. For example, if road transport drivers are not exposed to a specific occupational risk foreseen under another law, they can be placed under health surveillance only in those regions where the local laws contemplate this type of control. In other cases, the practice of assessing the risk to third parties and providing for compulsory health surveillance in the Risk Assessment Document, is considered by some jurists to be a "consuetudo praeter legem" and therefore acceptable in a field not yet covered by a specific law, but to be "contra legem" or unlawful by other jurists. Moreover, the competent physician who uses a breathanalyser or tests for alcohol addiction faces an ethical dilemma, since by communicating the results to an employer or authorities responsible for the issuing of licenses, he may be violating his professional oath of secrecy. Furthermore, the emphasis placed on testing has induced companies and inspectors to overlook educational and rehabilitation aspects. It is essential to involve general practitioners, educators and specialist services in addressing the problems of alcohol abuse so as to inform/train, recover and rehabilitate. The few studies available indicate that the rules are poorly enforced and that non-compliance may go unobserved., Conclusions: The Group urges all employers to assess the risk for third parties caused by alcohol abuse and to devise a policy on alcohol. Controlling alcohol-related risks in the workplace calls for a better definition of the roles of Vigilance Bod-ies and Company Physicians together with a shift from a reactive to a proactive attitude of all the parties involved.

Published
2014

27. New experimental Oximes in the management of organophosphorus pesticides poisoning.

Author

Barelli A, Soave PM, Del Vicario M, and Barelli R

Subjects
Agricultural Workers' Diseases chemically induced, Agricultural Workers' Diseases drug therapy, Agrochemicals poisoning, Animals, Cholinesterase Reactivators therapeutic use, Humans, Occupational Exposure, Antidotes therapeutic use, Organophosphate Poisoning, Oximes therapeutic use, Pesticides poisoning
Abstract

Organophosphorus compounds (OPCs) are widely used in agriculture as pesticides and occasionally in industrial settings. They have also been developed as warfare nerve agents. OPCs poisoning from intentional, accidental, and occupational exposure is a major public health problem, especially across the rural developing world. The main toxic mechanism of OPCs is the inhibition of the enzymes acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), resulting in accumulation of acetylcholine (ACh) at the synapse with cholinergic crisis and possible death. Exposure to even small amounts of an OPC can be fatal and death is usually caused by respiratory failure. Standard treatment involves the administration of intravenous atropine and an oxime to counteract acetylcholinesterase inhibition at the synapse, but the usefulness of oximes is still debated. During more than five decades, pyridinium oximes have been developed as therapeutic agents used in the medical treatment of poisoning with OPCs. They act by reactivation of AChE inhibited by OPCs. However, their activity in poisonings with pesticides and warfare nerve agents is different, and there is still no universal oxime sufficiently effective against all known OPCs. The aim of this article was to review the most recent findings in this field and compare the protection conferred by the new K-oximes and sugar oximes with the effect of the four recommended pyridinium oximes (pralidoxime, obidoxime, trimedoxime, and HI-6), in the search for a broad-spectrum AChE reactivator.

Published
2011

28. Magnesium and anaesthesia.

Author

Soave PM, Conti G, Costa R, and Arcangeli A

Subjects
Heart Diseases blood, Humans, Magnesium blood, Anesthesia, Magnesium administration & dosage
Abstract

Purpose: to review current knowledge concerning the use of magnesium in anesthesiology, the role of hypomagnesemia and hypermagnesemia in perioperative period, analyzing the cardiologic problems related to blood serum concentration changes of magnesium that can interesting in primis the anaesthesist in perioperative period., Methods: References were obtained from Pubmed (1995 to 2009). All categories of articles were selected, such as reviews, meta-analyses, s, clinical trials etc)., Principal Findings: Magnesium is a bivalent ion, like calcium, the fourth most common cation in the body, and the second most common intracellular cation after potassium. Magnesium deficiency has been demonstrated in 7-11% of the hospitalized patients and it has been found to coexist with other electrolyte disorders, particulary hypokalaemia or hypophosphatemia and, to a less extent, hyponatraemia and hypocalcaemia, in more than 40% of patients. Hypomagnesemia needs to be detected and corrected to prevent increased morbidity and mortality. Historically, magnesium sulphate has been proposed as a general anaesthetic. Magnesium reduces the catecholamine release during the stressful manouvres like intubation. Magnesium has also anti-nociceptive effects in animal and human models of pain by blocking the N-methyl-D-aspartate receptor and the associated ion channels and thus preventing central sensitization caused by peripheral nociceptive stimulation. So for some authors it reduces the need for intraoperative anesthetics and relaxant drugs and reduces the amount of morphine for the treatment of pospoperative pain. The use of magnesium is extended not only to general anaesthesia but also in loco-regional anaesthesia. The role of magnesium has been extensively studied in cardiology especially during myocardial infarction, arrhythmia and cardiac surgery. Recent studies show the important of magnesium to prevent the postoperative neurocognitive impairment during carotid endoarterectomy and its utility in treatment of severe asthma., Conclusions: Magnesium has many known indications. In peioperative period blood serum concentration changes of magnesium are frequent so anesthesiologists need to know the role of this important cation.

Published
2009
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