Science.gov

Sample records for invasive multicenter italian

  1. Factors predicting survival in ALS: a multicenter Italian study.

    PubMed

    Calvo, Andrea; Moglia, Cristina; Lunetta, Christian; Marinou, Kalliopi; Ticozzi, Nicola; Ferrante, Gianluca Drago; Scialo, Carlo; Sorarù, Gianni; Trojsi, Francesca; Conte, Amelia; Falzone, Yuri M; Tortelli, Rosanna; Russo, Massimo; Chiò, Adriano; Sansone, Valeria Ada; Mora, Gabriele; Silani, Vincenzo; Volanti, Paolo; Caponnetto, Claudia; Querin, Giorgia; Monsurrò, Maria Rosaria; Sabatelli, Mario; Riva, Nilo; Logroscino, Giancarlo; Messina, Sonia; Fini, Nicola; Mandrioli, Jessica

    2017-01-01

    The aim of this multicenter, retrospective study is to investigate the role of clinical characteristics and therapeutic intervention on ALS prognosis. The study included patients diagnosed from January 1, 2009 to December 31, 2013 in 13 Italian referral centers for ALS located in 10 Italian regions. Caring neurologists collected a detailed phenotypic profile and follow-up data until death into an electronic database. One center collected also data from a population-based registry for ALS. 2648 incident cases were collected. The median survival time from onset to death/tracheostomy was 44 months (SE 1.18, CI 42-46). According to univariate analysis, factors related to survival from onset to death/tracheostomy were: age at onset, diagnostic delay, site of onset, phenotype, degree of certainty at diagnosis according to revised El Escorial criteria (R-EEC), presence/absence of dementia, BMI at diagnosis, patients' provenance. In the multivariate analysis, age at onset, diagnostic delay, phenotypes but not site of onset, presence/absence of dementia, BMI, riluzole use, R-EEC criteria were independent prognostic factors of survival in ALS. We compared patients from an ALS Registry with patients from tertiary centers; the latter ones were younger, less frequently bulbar, but more frequently familial and definite at diagnosis. Our large, multicenter study demonstrated the role of some clinical and demographic factors on ALS survival, and showed some interesting differences between referral centers' patients and the general ALS population. These results can be helpful for clinical practice, in clinical trial design and to validate new tools to predict disease progression.

  2. Influenza vaccination coverage among medical residents: an Italian multicenter survey.

    PubMed

    Costantino, Claudio; Mazzucco, Walter; Azzolini, Elena; Baldini, Cesare; Bergomi, Margherita; Biafiore, Alessio Daniele; Bianco, Manuela; Borsari, Lucia; Cacciari, Paolo; Cadeddu, Chiara; Camia, Paola; Carluccio, Eugenia; Conti, Andrea; De Waure, Chiara; Di Gregori, Valentina; Fabiani, Leila; Fallico, Roberto; Filisetti, Barbara; Flacco, Maria E; Franco, Elisabetta; Furnari, Roberto; Galis, Veronica; Gallea, Maria R; Gallone, Maria F; Gallone, Serena; Gelatti, Umberto; Gilardi, Francesco; Giuliani, Anna R; Grillo, Orazio C; Lanati, Niccolò; Mascaretti, Silvia; Mattei, Antonella; Micò, Rocco; Morciano, Laura; Nante, Nicola; Napoli, Giuseppe; Nobile, Carmelo Giuseppe; Palladino, Raffaele; Parisi, Salvatore; Passaro, Maria; Pelissero, Gabriele; Quarto, Michele; Ricciardi, Walter; Romano, Gabriele; Rustico, Ennio; Saponari, Anita; Schioppa, Francesco S; Signorelli, Carlo; Siliquini, Roberta; Trabacchi, Valeria; Triassi, Maria; Varetta, Alessia; Ziglio, Andrea; Zoccali, Angela; Vitale, Francesco; Amodio, Emanuele

    2014-01-01

    Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.

  3. Management of cholelithiasis in Italian children: A national multicenter study

    PubMed Central

    Corte, Claudia Della; Falchetti, Diego; Nebbia, Gabriella; Calacoci, Marisa; Pastore, Maria; Francavilla, Ruggiero; Marcellini, Matilde; Vajro, Pietro; Iorio, Raffaele

    2008-01-01

    AIM: To evaluate the management of Italian children with cholelithiasis observed at Pediatric and Surgical Departments linked to Italian Society of Pediatric Gastroenterology Hepatology and Nutrition. METHODS: One-hundred-eighty children (90 males, median age at diagnosis 7.3 years; range, 0-18 years) with echographic evidence of cholelithiasis were enrolled in the study; the data were collected by an anonymous questionnaire sent to participating centers. RESULTS: One hundred seventeen patients were treated with ursodeoxycholic acid; in 8 children dissolution of gallstones was observed, but the cholelithiasis recurred in 3 of them. Sixty-five percent of symptomatic children treated became asymptomatic. Sixty-four patients were treated with cholecystectomy and in only 2 cases a postoperative complication was reported. Thirty-four children received no treatment and were followed with clinical and echographic controls; in no case the development of complications was reported. CONCLUSION: The therapeutic strategies were extremely heterogeneous. Ursodeoxycholic acid was ineffective in dissolution of gallstones but it had a positive effect on the symptoms. Laparoscopic cholecystectomy was confirmed to be an efficacy and safe treatment for pediatric gallstones. PMID:18322952

  4. Advanced mast cell disease: an Italian Hematological Multicenter experience.

    PubMed

    Pagano, Livio; Valentini, Caterina Giovanna; Caira, Morena; Rondoni, Michela; Van Lint, Maria Teresa; Candoni, Anna; Allione, Bernardino; Cattaneo, Chiara; Marbello, Laura; Caramatti, Cecilia; Pogliani, Enrico Maria; Iannitto, Emilio; Giona, Fiorina; Ferrara, Felicetto; Invernizzi, Rosangela; Fanci, Rosa; Lunghi, Monia; Fianchi, Luana; Sanpaolo, Grazia; Stefani, Pietro Maria; Pulsoni, Alessandro; Martinelli, Giovanni; Leone, Giuseppe; Musto, Pellegrino

    2008-12-01

    The aim of the study is to evaluate clinical features, treatments and outcome of patients with systemic mast cell disease (MCD) who arrived to the attention of hematologists. A retrospective study was conducted over 1995-2006 in patients admitted in 18 Italian hematological divisions. Twenty-four cases of advanced MCD were collected: 12 aggressive SM (50%), 8 mast cell leukemia (33%), 4 SM with associated clonal non-mast cell-lineage hematologic disease (17%). Spleen and liver were the principal extramedullary organ involved. The c-kit point mutation D816V was found in 13/18 patients in which molecular biology studies were performed (72%). Treatments were very heterogeneous: on the whole Imatinib was administered in 17 patients, alpha-Interferon in 8, 2-CdA in 3; 2 patients underwent allogeneic hematopoietic stem cell transplantation. The overall response rate to Imatinib, the most frequently employed drugs, was of 29%, registering one complete remission and four partial remission; all responsive patients did not present D816V c-kit mutation. Overall three patients (12%) died for progression of disease. We conclude that MCD is characterized by severe mediator-related symptoms but with a moderate mortality rate. D816V c-kit mutation is frequent and associated with resistance against Imatinib. Because of the rarity of these forms, an effective standard of care is lacking. More data are needed to find new and successful therapeutic strategies.

  5. Pregnancy and beta-thalassemia: an Italian multicenter experience.

    PubMed

    Origa, Raffaella; Piga, Antonio; Quarta, Giovanni; Forni, Gian Luca; Longo, Filomena; Melpignano, Angela; Galanello, Renzo

    2010-03-01

    Recent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children. We describe the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies). Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with thalassemia major and spontaneously in all of those with thalassemia intermedia. Among the women with thalassemia major, 91% of the pregnancies resulted in successful delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary complications of iron overload developed or worsened during pregnancy. When considering only the singleton pregnancies, the proportion of babies with intrauterine growth retardation did not differ from that reported in the general Italian population. The high prevalence of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However, women with thalassemia intermedia who had never previously been transfused or who had received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood transfusions were required during pregnancy. Provided that a multidisciplinary team is available, pregnancy is possible, safe and usually has a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism, gonadal function is usually intact and fertility is usually retrievable.

  6. Hospital discharge: results from an Italian multicenter prospective study using Blaylock Risk Assessment Screening Score.

    PubMed

    Dal Molin, Alberto; Gatta, Claudia; Derossi, Valentina; Guazzini, Andrea; Cocchieri, Antonello; Vellone, Ercole; Alvaro, Rosaria; Rasero, Laura

    2014-02-01

    To analyze the predictive validity and reliability of the Blaylock Risk Assessment Screening Score (BRASS) Index in a large group of patients. Prospective multicenter observational study was conducted in six Italian hospitals. Data were collected in three phases. Seven hundred eleven patients were recruited. The mean length of hospitalization for low-risk patients was significantly shorter than those in the medium and high-risk groups. Patients with a BRASS Index lower than 10, unlike those with a higher BRASS Index, were mainly discharged home. Our results indicate that the BRASS Index is useful to identify patients at risk for prolonged hospitalization. The use of a validated BRASS instrument can be useful to screen the patients, improving individual discharge planning. © 2013 NANDA International, Inc.

  7. Neonatal invasive candidiasis: a prospective multicenter study of 118 cases.

    PubMed

    López Sastre, José B; Coto Cotallo, Gil D; Fernández Colomer, Belén

    2003-04-01

    A prospective multicenter study was conducted to assess the epidemiology of neonatal invasive candidiasis in Spain. In a total of 20,565 admissions to the 27 participating neonatal units over an 18-month period, systemic candidiasis was diagnosed in 118 (0.57%) neonates. Candida species were isolated from the blood in 79 infants, from the urine in 33, and from the cerebrospinal fluid in 4; in 2 cases, histologic evidence of deep tissue candidiasis was found at autopsy. Very-low-birth-weight (VLBW) infants (< or = 1500 g) showed a significantly higher incidence of systemic candidiasis (4.8%) than infants weighing > 1500 g (0.2%) ( p < 0.001). Candida albicans was the most frequent species (52.5%) followed by C. parapsilosis (23.7%), and C. tropicalis (7.6%). Only seven infants were treated with amphotericin B (initial dose 0.18 +/- 0.3 mg/kg, maximal daily dose 1.7 +/- 0.9 mg/kg) but treatment was stopped in three of them (43%) due to nephrotoxicity. Liposomal amphotericin B was given to 81 neonates and amphotericin B lipid complex to 29. There were no differences in mortality rate and in the incidence of adverse effects in relation to treatment with liposomal amphotericin B or amphotericin B lipid complex. The mortality rate was 10.2% and all deaths occurred in the VLBW cohort with candidemia.

  8. Rufinamide in children and adults with Lennox-Gastaut syndrome: first Italian multicenter experience.

    PubMed

    Coppola, Giangennaro; Grosso, Salvatore; Franzoni, Emilio; Veggiotti, Pierangelo; Zamponi, Nelia; Parisi, Pasquale; Spalice, Alberto; Habetswallner, Francesco; Fels, Antonio; Capovilla, Giuseppe; Verrotti, Alberto; Mangano, Salvatore; Balestri, Alberto; Curatolo, Paolo; Pascotto, Antonio

    2010-11-01

    This is the first multicenter Italian experience with rufinamide as an adjunctive drug in children, adolescents and adults with Lennox-Gastaut syndrome. The patients were enrolled in a prospective, add-on, open-label treatment study from 11 Italian centers for children and adolescent epilepsy care. Forty-three patients (26 males, 17 females), aged between 4 and 34 years (mean 15.9 ± 7.3, median 15.0), were treated with rufinamide for a mean period of 12.3 months (range 3-21 months). Twenty patients were diagnosed as cryptogenic and 23 as symptomatic. Rufinamide was added to the baseline therapy at the starting dose of 10mg/kg body weight, evenly divided in two daily doses and then increased by 10mg/kg approximately every 3 days up to a maximum of 1000 mg/day in children aged ≥4 years with a body weight less than 30 kg. In patients more than 30 kg body weight, rufinamide could be titrated up to 3200 mg/day. After a mean follow-up period of 12.3 months (range 3-21 months), the final mean dose of rufinamide was 33.5mg/kg/24h (range 11.5-60) if combined to valproic acid, and of 54.5mg/kg/24h (range 21.8-85.6) without valproic acid. The response rate (≥50% decrease in countable seizures) was 60.5% (26 of 45 patients) in total; 51.1% experienced a 50-99% reduction in seizure frequency and complete seizure control was achieved in the last 4 weeks follow-up by 9.3% of patients. Two patients (4.7%) had a 25-50% seizure reduction, while seizure frequency remained unchanged in 13 (30.2%) and increased in 2 (4.7%). Reliable data for atypical absence seizures and myoclonic seizures were not available, as these are usually impossible to count. Ten patients (23.2%) reported adverse side effects, while taking rufinamide. They were generally mild and transient and most frequently included vomiting, drowsiness, irritability and loss of appetite. In conclusion, rufinamide as an adjunctive therapy reduced the number of drop attacks and major motor seizures in about 60% of

  9. Acute diplopia in the pediatric Emergency Department. A cohort multicenter Italian study.

    PubMed

    Raucci, Umberto; Parisi, Pasquale; Vanacore, Nicola; La Penna, Francesco; Ferro, Valentina; Calistri, Lucia; Bondone, Claudia; Midulla, Fabio; Suppiej, Agnese; Falsaperla, Raffaele; Cordelli, Duccio Maria; Palmieri, Antonella; Verrotti, Alberto; Becciani, Sabrina; Aguzzi, Sonia; Mastrangelo, Mario; Pelizza, Federica; Greco, Filippo; Carbonari, Giulia; Tallone, Ramona; Bottone, Gabriella; Trenta, Italo; Masi, Stefano; Villa, Maria Pia; Reale, Antonino

    2017-09-01

    Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify "red flags" associated with potentially life-threatening (LT) conditions. We conducted a cohort multicenter study on children with AD in ten Italian hospitals. Patients were classified into diagnostic categories, comparing children with and without LT disease. 621 children presented AD at a rate of 3.6 per 10.000. The most frequent diagnosis among no-LT conditions (81.2%) were headache, ocular disorders and minor post-traumatic disease, while LT conditions (18.8%) were represented by brain tumors, demyelinating conditions, idiopathic intracranial hypertension and major post-traumatic diseases. The LT group showed a significantly higher age, with the odds increased by 1% for each month of age. Monocular diplopia occurred in 16.1%, but unlike adult one-fifth presented LT conditions. Binocular diplopia, associated ocular manifestations or extraocular neurological signs were significantly more common in the LT group. At regression logistic analysis strabismus and ptosis were associated with LT conditions. The majority of children presented no-LT conditions and more than one-fourth of patients had headache. Monocular diplopia in the LT group was never isolated but associated with other signs or symptoms. Our study was able to identify some specific ocular disturbances or neurologic signs potentially useful for ED physician to recognize patients with serious pathologies. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Surgical management of duodenal stump fistula after elective gastrectomy for malignancy: an Italian retrospective multicenter study.

    PubMed

    Cozzaglio, Luca; Giovenzana, Marco; Biffi, Roberto; Cobianchi, Lorenzo; Coniglio, Arianna; Framarini, Massimo; Gerard, Leonardo; Gianotti, Luca; Marchet, Alberto; Mazzaferro, Vincenzo; Morgagni, Paolo; Orsenigo, Elena; Rausei, Stefano; Romano, Fabrizio; Rosa, Fausto; Rosati, Riccardo; Roviello, Francesco; Sacchi, Matteo; Morenghi, Emanuela; Quagliuolo, Vittorio

    2016-01-01

    Duodenal stump fistula (DSF) is a severe complication of gastrectomy. Although nonsurgical therapy is preferred, surgery is still mandatory in one third of DSF patients. The aim of this article is to analyze the surgical management of DSF and factors related to its outcome. We performed a retrospective multicenter study using data from January 1990 to November 2011 in 16 Italian surgery centers. We collected 8,268 elective gastrectomies for malignancies, 7,987 by the laparotomic and 281 by the laparoscopic approach. Two hundred five patients developed a DSF, 75 of whom underwent surgery for DSF. We analyzed mortality and DSF healing time as well as the impact of clinical, oncological, and surgical characteristics. The laparoscopic approach increased the risk of DSF development (odds ratio 5.6, 95% confidence interval 2.7-10.6, P < 0.001). The indication for first DSF surgery was intra-abdominal sepsis; the failure rate was over 30%, associated with the appearance of fistulas of neighboring organs, bleeding, and the need for reoperations. The mortality rate was 28% and was related to the presence of vascular disease (P = 0.04), more than one reoperation (P = 0.05), sepsis (P < 0.001), and renal failure (P < 0.001). Fifty-four patients recovered after a median of 39 days (interquartile range 22-68 days); the need to perform more reoperations (P < 0.01) and the presence of an abdominal abscess (P < 0.01) led to an increase in healing time. Surgery for DSF has a poor prognosis. Our data will help to identify patients at risk of death, but unfortunately could not establish the best surgical procedure applicable to all cases of DSF.

  11. Cutaneous Invasive Aspergillosis: Retrospective Multicenter Study of the French Invasive-Aspergillosis Registry and Literature Review

    PubMed Central

    Bernardeschi, Céline; Foulet, Francoise; Ingen-Housz-Oro, Saskia; Ortonne, Nicolas; Sitbon, Karine; Quereux, Gaëlle; Lortholary, Olivier; Chosidow, Olivier; Bretagne, Stéphane

    2015-01-01

    Abstract Invasive aspergillosis (IA) has poor prognosis in immunocompromised patients. Skin manifestations, when present, should contribute to an early diagnosis. The authors aimed to provide prevalence data and a clinical and histologic description of cutaneous manifestations of primary cutaneous IA (PCIA) and secondary CIA (SCIA) in a unique clinical series of IA and present the results of an exhaustive literature review of CIA. Cases of proven and probable IA with cutaneous manifestations were retrospectively extracted from those registered between 2005 and 2010 in a prospective multicenter aspergillosis database held by the National Reference Center for Invasive Mycoses and Antifungals, Pasteur Institute, France. Patients were classified as having PCIA (i.e., CIA without extracutaneous manifestations) or SCIA (i.e., disseminated IA). Among the 1,410 patients with proven or probable IA, 15 had CIA (1.06%), 5 PCIA, and 10 SCIA. Hematological malignancies were the main underlying condition (12/15). Patients with PCIA presented infiltrated and/or suppurative lesions of various localizations not related to a catheter site (4/5), whereas SCIA was mainly characterized by disseminated papules and nodules but sometimes isolated nodules or cellulitis. Histologic data were available for 11 patients, and for 9, similar for PCIA and SCIA, showed a dense dermal polymorphic inflammatory infiltrate, with the epidermis altered in PCIA only. Periodic acid Schiff and Gomori-Grocott methenamine silver nitrate staining for all but 2 biopsies revealed hyphae compatible with Aspergillus. Aspergillus flavus was isolated in all cases of PCIA, with Aspergillus fumigatus being the most frequent species (6/10) in SCIA. Two out 5 PCIA cases were treated surgically. The 3-month survival rate was 100% and 30% for PCIA and SCIA, respectively. Our study is the largest adult series of CIA and provides complete clinical and histologic data for the disease. Primary cutaneous IA should be

  12. Cutaneous Invasive Aspergillosis: Retrospective Multicenter Study of the French Invasive-Aspergillosis Registry and Literature Review.

    PubMed

    Bernardeschi, Céline; Foulet, Francoise; Ingen-Housz-Oro, Saskia; Ortonne, Nicolas; Sitbon, Karine; Quereux, Gaëlle; Lortholary, Olivier; Chosidow, Olivier; Bretagne, Stéphane

    2015-07-01

    Invasive aspergillosis (IA) has poor prognosis in immunocompromised patients. Skin manifestations, when present, should contribute to an early diagnosis. The authors aimed to provide prevalence data and a clinical and histologic description of cutaneous manifestations of primary cutaneous IA (PCIA) and secondary CIA (SCIA) in a unique clinical series of IA and present the results of an exhaustive literature review of CIA. Cases of proven and probable IA with cutaneous manifestations were retrospectively extracted from those registered between 2005 and 2010 in a prospective multicenter aspergillosis database held by the National Reference Center for Invasive Mycoses and Antifungals, Pasteur Institute, France. Patients were classified as having PCIA (i.e., CIA without extracutaneous manifestations) or SCIA (i.e., disseminated IA). Among the 1,410 patients with proven or probable IA, 15 had CIA (1.06%), 5 PCIA, and 10 SCIA. Hematological malignancies were the main underlying condition (12/15). Patients with PCIA presented infiltrated and/or suppurative lesions of various localizations not related to a catheter site (4/5), whereas SCIA was mainly characterized by disseminated papules and nodules but sometimes isolated nodules or cellulitis. Histologic data were available for 11 patients, and for 9, similar for PCIA and SCIA, showed a dense dermal polymorphic inflammatory infiltrate, with the epidermis altered in PCIA only. Periodic acid Schiff and Gomori-Grocott methenamine silver nitrate staining for all but 2 biopsies revealed hyphae compatible with Aspergillus. Aspergillus flavus was isolated in all cases of PCIA, with Aspergillus fumigatus being the most frequent species (6/10) in SCIA. Two out 5 PCIA cases were treated surgically. The 3-month survival rate was 100% and 30% for PCIA and SCIA, respectively. Our study is the largest adult series of CIA and provides complete clinical and histologic data for the disease. Primary cutaneous IA should be recognized early

  13. A multicenter survey on distal pancreatectomy in Italy: results of minimally invasive technique and variability of perioperative pathways.

    PubMed

    Balzano, G; Bissolati, M; Boggi, U; Bassi, C; Zerbi, A; Falconi, M

    2014-12-01

    No data are available about distal pancreatectomy (DP) in Italy, regarding variability of care among centers, and outcome of minimally invasive distal pancreatectomy (MIDP) in a multicenter setting. Hence, a survey was conducted among 20 institutions experienced in pancreatic surgery by the Italian Association for Study of Pancreas. Centers were asked to fill in two questionnaires about (1) general approach and perioperative protocols for DP and MIDP; (2) detailed operative results of MIDP in the period 2010-2011. Results of questionnaire 1: a great variability in perioperative approach was observed: octreotide was used in 50 % of centers, enzyme supplementation in 35 %, postoperative gastric suction in 80 % and oral liquids on day 1 in 55 %. All hospitals used at least one drain and its removal ranged between days 3-5 (in absence of fistula). Differences in type and timing of post-splenectomy vaccinations were recorded. As regards MIDP, 17/20 centers performed laparoscopic or robotic DP. MIDP rate on overall DP varied among centers (range 0-82 %) and it doubled from 2007 (14 %) to 2011 (28 %). Results of questionnaire 2: in the period 2010-2011, 171 MIDP were performed (140 laparoscopic, 31 robotic). Overall conversion rate was 17 %, mean operative time was 230 min and blood loss 285 ml. Mortality was nil and morbidity was 62 %, with 4 % relaparotomies. Pancreatic fistula occurred in 49 % (grade A 35 %, B 14 %). Mean postoperative stay was 9.8 days with 10 % readmission rate. The results indicated a great variability in DP management among Italian centers. Most centers performed MIDP, but MIDP rate on overall DP largely varied among centers. As regards MIDP conversion rate and hospital stay were found to be worse than those in single-institution series.

  14. Assessment of the 10-year risk of fracture in Italian postmenopausal women using FRAX®: a north Italian multicenter study.

    PubMed

    Pedrazzoni, M; Girasole, G; Giusti, A; Barone, A; Pioli, G; Passeri, G; Palummeri, E; Bianchi, G

    2011-12-01

    The aim of the study was to estimate the absolute risk of fracture in a sample of postmenopausal women with the Italian version of FRAX®, using femoral neck bone mineral density (BMD) and 3 internationally validated clinical risk factors (CRFs) (history of fragility fracture, family history of hip fracture, current smoking). We retrospectively studied 9586 women (mean age 64.1 yr) examined in three osteoporosis centers from Northern Italy over two years (2001-2002). The risk of major osteoporotic (clinical spine, hip, forearm and humerus) and hip fractures was estimated using the online version of the FRAX algorithm adapted for Italy. The median 10-year risk was 7.5% for osteoporotic fracture and 1.7% for hip fracture. 25% of subjects had a 10-year risk ≥ 12.1% for osteoporotic fracture and ≥ 4.1% for hip fracture. The median 10-year risk of fracture increased with the number of prevalent CRFs. For major osteoporotic fractures risk rose from 6.3% to 10.9%, 21.4% and 40.9% with 1, 2 and 3 prevalent CRFs, respectively. For hip fractures the corresponding figures were: 1.3%, 2.7%, 7.0% and 21.9%, respectively. However, it must be emphasized that in 2 out of 3 women, none of the CRFs examined was present and the assessment of risk was limited to age and BMD. Our data provide the first description of the effect of the combination of BMD, age and CRFs on fracture risk stratification in a large sample of Italian postmenopausal women using FRAX®. The results are a useful starting point to define criteria for the application of FRAX® in clinical practice in Italy.

  15. Pain management during invasive procedures at Italian NICUs: has anything changed in the last 5 years?

    PubMed

    Lago, Paola; Boccuzzo, Giovanna; Garetti, Elisabetta; Pirelli, Anna; Pieragostini, Luisa; Merazzi, Daniele; Ancora, Gina

    2012-10-01

    To ascertain the extent to which neonatal analgesia for invasive procedures has changed in the last 5 years since the publication of Italian guidelines. We compared survey data for the years 2004 and 2010 on analgesia policy and practices for common invasive procedures at Italian Neonatal Intensive Care Units (NICUs); 75 NICUs answered questionnaires for both years and formed the object of this analysis. By 2010, analgesia practices for procedural pain had improved significantly for almost all invasive procedures (p < 0.05), with both non-pharmacological and pharmacological methods being adopted by the majority of NICUs (unlike the situation in 2004). The routine use of medication for major invasive procedures was still limited, however (35% of lumbar punctures, 40% of tracheal intubations, 46% during mechanical ventilation). Postoperative pain treatment was still inadequate, and 41% of facilities caring for patients after surgery did not treat pain routinely. Pain monitoring had definitely improved since 2004 (p < 0.05), but not enough: only 21 and 17% of NICUs routinely assess pain during mechanical ventilation and after surgery, respectively. There have been improvements in neonatal analgesia practices in Italy since national guidelines were published, but pain is still undertreated and underscored, especially during major invasive procedures. It is mandatory to address the gap between the recommendations in the guidelines and clinical practice must be addressed through with effective quality improvement initiatives.

  16. Pain management during invasive procedures at Italian NICUs: has anything changed in the last five years?

    PubMed

    Lago, P; Boccuzzo, G; Garetti, E; Pirelli, A; Pieragostini, L; Merazzi, D; Ancora, G

    2013-02-01

    To ascertain the extent to which neonatal analgesia for invasive procedures has changed in the last 5 years since the publication of Italian guidelines. We compared survey data for the years 2004 and 2010 on analgesia policy and practices for common invasive procedures at Italian Neonatal Intensive Care Units (NICUs); 75 NICUs answered questionnaires for both years and formed the object of this analysis. By 2010 analgesia practices for procedural pain had improved significantly for almost all invasive procedures (p < 0.05), both non-pharmacological and pharmacological methods being adopted by the majority of NICUs (unlike the situation in 2004). The routine use of medication for major invasive procedures was still limited, however (35% of lumbar punctures, 40% of tracheal intubations, 46% during mechanical ventilation). Postoperative pain treatment was still inadequate, and 41% of facilities caring for patients after surgery did not treat pain routinely. Pain monitoring had definitely improved since 2004 (p < 0.05), but not enough: only 21% and 17% of NICUs routinely assess pain during mechanical ventilation and after surgery, respectively. There have been improvements in neonatal analgesia practices in Italy since national guidelines were published, but pain is still undertreated and underscored, especially during major invasive procedures. It is mandatory to address the gap between the recommendations in the guidelines and clinical practice must be addressed through with effective quality improvement initiatives.

  17. Genotypes of Invasive Pneumococcal Isolates Recently Recovered from Italian Patients

    PubMed Central

    Dicuonzo, Giordano; Gherardi, Giovanni; Gertz, Robert E.; D'Ambrosio, Fabio; Goglio, Antonio; Lorino, Giulia; Recchia, Simona; Pantosti, Annalisa; Beall, Bernard

    2002-01-01

    We examined 73 recent invasive pneumococcal isolates within selected areas of Italy for genotypic variability. Thirty-three genomic macrorestriction types were found, three of which represented multiple serotypes. Restriction fragment patterns of pbp2b, pbp2x, and pspA were conserved within the majority of isolates that shared macrorestriction types. Of the nine macrorestriction types found among the 22 penicillin-nonsusceptible Streptococus pneumoniae (PNSP) isolates, seven comprised isolates with allelic profiles showing five to seven allelic matches to profiles in the multilocus sequence typing database (www.mlst.net); however, three of the seven profiles represented serotypes not previously associated with these clonal clusters. Two PNSP macrorestriction types represented new clones with unique allelic profiles. Allelic profiles obtained from isolates of 3 of the 25 macrorestriction types found among the 51 penicillin-susceptible S. pneumoniae (PSSP) isolates were closely related to previously described profiles. One PSSP isolate was a novel type 24F isolate related to the multiresistant clone France9V-3. This work reports new PNSP strains and new serotype-clone associations. PMID:12354862

  18. Prevalence and determinants of preconception folic acid use: an Italian multicenter survey.

    PubMed

    Nilsen, Roy M; Leoncini, Emanuele; Gastaldi, Paolo; Allegri, Valentina; Agostino, Rocco; Faravelli, Francesca; Ferrazzoli, Federica; Finale, Enrico; Ghirri, Paolo; Scarano, Gioacchino; Mastroiacovo, Pierpaolo

    2016-07-13

    Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. This study aimed to update the prevalence and to identify possible determinants of preconception folic acid supplement use in Italian women. The study was based on cross-sectional data from seven maternity clinics located in six Italian regions from January to June, 2012. Data on maternal characteristics and supplement use were collected for 2,189 women using a self-administered questionnaire. Preconception folic acid use was reported by 23.5 % (n = 515) of the participants. Of these, 479 (93 %) women had taken folic acid supplements on a daily basis as recommended by the health authorities. Women who both had intended their pregnancy and had requested a preconception health visit to a doctor/gynecologist were substantially more likely than the reference group to initiate folic acid supplementation before their pregnancy (48.6 versus 4.8 %). Preconception folic acid use was also associated with higher maternal age, higher education, marriage/cohabitation, lower parity, infertility treatments, and chronic disease. Data from seven maternity clinics located in six Italian regions indicate that preconception folic acid supplement use in many Italian women is low. Women who do not plan their pregnancy or do not request a preconception health visit to their doctor have among the lowest prevalence of preconception folic acid use. Improving folate status in these and other supplemental non-users may have important disease preventive effects.

  19. Pregnancy and internet: sociodemographic and geographic differences in e-health practice. Results from an Italian multicenter study.

    PubMed

    Scaioli, G; Bert, F; Galis, V; Brusaferro, S; De Vito, E; La Torre, G; Manzoli, L; Messina, G; Torregrossa, M V; Ricciardi, W; Gualano, M R; Siliquini, R

    2015-09-01

    Since the new millennium, the number of e-health users has significantly increased. Among these, a particular category of people who are interested by this phenomenon is the one of pregnant women. The aim of the present study is to assess the sociodemographic and geographic differences existing in a sample of Italian pregnant women who search for information on the web. Multicenter cross-sectional survey. The present study has been conducted from November 2011 to September 2012, in seven Italian cities, located in the North, in the Centre and in the South of Italy. Data were collected through an anonymous questionnaire, administered in waiting rooms of outpatient departments by trained medical doctors. Data were analysed through multivariate logistic regression models. Overall, 1347 responders were interviewed. Eighty-six percent of them declared to surf the internet to retrieve pregnancy-related information. The most searched topics were fetal development (51.3%), healthy lifestyle during pregnancy (48.7%), physiology of pregnancy (39.8%), generic and specific tips/advices during pregnancy (37.2%) and lactation (36.8%). Statistically significant differences (P < 0.05) according to geographic origin, age and educational level were found with regard to the most frequently searched information on the Web, the reasons that pushed pregnant women to practice e-health, and the possibility to change lifestyles after e-health. Our findings suggest that the phenomenon of pregnancy e-health is widespread and show social and geographic differences, in particular about city of residence, age and educational level. It might encourage healthcare professionals to be more available and exhaustive during routine visits and to be more careful about web content on this topic, also addressing the different needs into different geographic contexts. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Natural history and clinical outcome of "uncorrected" scimitar syndrome patients: a multicenter study of the italian society of pediatric cardiology.

    PubMed

    Vida, Vladimiro L; Padrini, Maddalena; Boccuzzo, Giovanna; Agnoletti, Gabriella; Bondanza, Sara; Butera, Gianfranco; Chiappa, Enrico; Marasini, Maurizio; Pilati, Mara; Pongiglione, Giacomo; Prandstraller, Daniela; Russo, Maria Giovanna; Castaldi, Biagio; Santoro, Giuseppe; Spadoni, Isabella; Stellin, Giovanni; Milanesi, Ornella

    2013-07-01

    To analyze the clinical status of patients with "uncorrected" scimitar syndrome in a multicenter Italian study. The natural history of scimitar syndrome was analyzed in 44 affected individuals (from 9 Italian centers). The median age at diagnosis was 1.05 years (range, 1 day-41 years). Thirty-three patients (75%) had an isolated form; 11 patients (25%) had associated congenital heart diseases. Twenty-two patients (50%) were symptomatic at diagnosis, including respiratory symptoms (n=20) and congestive heart failure (n=6). Patients with associated congenital heart defects had a higher prevalence of congestive heart failure (4 of 11 [36.4%] vs 2 of 33 [6.1%]; P=.027), pulmonary arterial hypertension (7 of 11 [63.6%] vs 2 of 33 [6.1%]; P=.027) than patients with isolated forms. Ten patients (22.7%) underwent correction of associated cardiac defects, leaving the anomalous pulmonary venous drainage intact. The median length of follow-up after diagnosis was 6.4 years (range, 0.2-27.5 years). Two patients died, both with associated cardiac defects and severe pulmonary arterial hypertension. Of 42 survivors, 39 (92.8%) were asymptomatic at the last follow-up visit; 3 patients still complained respiratory symptoms. There was no difference between isolated and associated forms of the disease. In most patients, scimitar syndrome presented as an isolated lesion with a benign outcome. Nonetheless, when associated with other cardiac defects and pulmonary arterial hypertension, there was an increased risk of congestive heart failure and mortality. Correction of associated cardiac defects (transforming "associated" into "isolated" forms), together with the therapeutic occlusion of anomalous arterial supply to the lung, led to a benign outcome comparable to that in primarily isolated forms. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  1. Development of a website and biobank database for the Nanosized Cancer Polymarker Biochip Project: a Multicenter Italian Experience.

    PubMed

    Leon, Antonette E; Fabricio, Aline S C; Benvegnù, Fabio; Michilin, Silvia; Secco, Annamaria; Spangaro, Omar; Meo, Sabrina; Gion, Massimo

    2011-01-01

    The Nanosized Cancer Polymarker Biochip Project (RBLA03S4SP) funded by an Italian MIUR-FIRB grant (Italian Ministry of University and Research - Investment Funds for Basic Research) has led to the creation of a free-access dynamic website, available at the web address https://serviziweb.ulss12.ve.it/firbabo, and of a centralized database with password-restricted access. The project network is composed of 9 research units (RUs) and has been active since 2005. The aim of the FIRB project was the design, production and validation of optoelectronic and chemoelectronic biosensors for the simultaneous detection of a novel class of cancer biomarkers associated with immunoglobulins of the M class (IgM) for early diagnosis of cancer. Biomarker immune complexes (BM-ICs) were assessed on samples of clinical cases and matched controls for breast, colorectal, liver, ovarian and prostate malignancies. This article describes in detail the architecture of the project website, the central database application, and the biobank developed for the FIRB Nanosized Cancer Polymarker Biochip Project. The article also illustrates many unique aspects that should be considered when developing a database within a multidisciplinary scenario. The main deliverables of the project were numerous, including the development of an online database which archived 1400 case report forms (700 cases and 700 matched controls) and more than 2700 experimental results relative to the BM-ICs assayed. The database also allowed for the traceability and retrieval of 21,000 aliquots archived in the centralized bank and stored as backup in the RUs, and for the development of a centralized biological bank in the coordinating unit with 6300 aliquots of serum. The constitution of the website and biobank database enabled optimal coordination of the RUs involved, highlighting the importance of sharing samples and scientific data in a multicenter setting for the achievement of the project goals.

  2. [Role of the Web on behaviors and health choices in six Italian cities: results of a multicenter study].

    PubMed

    Lovato, E; Bert, F; Bruno, S; Ceruti, M; De Vito, E; La Torre, G; Liguori, G; Manzoli, L; Messina, G; Minniti, D; Siliquini, R

    2011-01-01

    A cross-sectional, multicenter study was carried out in 6 Italian cities (Cassino, Chieti, Naples, Rome, Siena, Turin) in order to highlight differences in Web use to find out health information and its related consequences on behavioral choices and to describe the distribution of the phenomenon in Italy. Data were collected from October 2009 to September 2010 on a sample of volunteers recruited from laboratory analysis, with face-to-face interview, including information about socio-demographic, health, and Web use to health. Data analysis shows that e-health use is greater in Northern Italy, in women aged 30-41 years, in chronic patients and those who have been caught up medical malpractice. Behavioral changes are associated with the Region; in particular Rome and Cassino show to choose/change professionals and facilities, engaging in alternative therapies and buy drugs online more frequently. Living in Southern Italy, a lower educational level and the infrequent drugs use are associated with a greater probability of incurring in negative behaviors. Positive results on the behavior are instead low and not significant. Given the regional differences, the potentiality and the risks of e-health use, it will be important to identify strategies for risks containment and implementation of the web in prevention.

  3. Current adoption of lung ultrasound in Intensive Care Units: an Italian multi-center survey.

    PubMed

    Calamai, Italo; Greco, Massimiliano; Bertolini, Guido; Spina, Rosario

    2017-07-01

    Lung ultrasound (LUS) is a useful tool for assessing lung status in critically ill patients, but is not widely applied in intensive care units (ICUs). The aim of this study was to investigate the use of LUS in Italian ICUs. A questionnaire was distributed to 116 ICU representatives belonging to the Italian GiViTI network, participating in a national project on continuous quality of care assessment. The answers to the questionnaire were analyzed with the data collected in the course of said project. 87 ICUs took part in the study. LUS was performed in 94.3% of them, generally by an internal intensivist. The mean number of tests per bed per week was 0.97 (SD, 1.0). A standardized reporting format was present in only 11% of ICUs. LUS was generally used to investigate known or suspected diseases and as a screening tool in only 10%. The number of testes per bed per week was inversely correlated to the number of beds per physician (P<0.001) and to the provider performing the LUS (P<0.001), but not to other structural, organizational or performance data. LUS is performed in the majority of ICUs and is generally used to investigate known or suspected diseases. Frequency of use appears to be low and related to selected organizational factors. There is generally no standardized format for reporting LUS findings.

  4. A multicenter Italian study on pregnancy outcome in women with diabetes.

    PubMed

    Lapolla, Annunziata; Dalfrà, Maria Grazia; Di Cianni, Graziano; Bonomo, Matteo; Parretti, Elena; Mello, Giorgio

    2008-05-01

    To determine pregnancy outcome in women with type 1 and type 2 diabetes. A prospective study was conducted in 33 centers in Italy between 1999 and 2003, mainly recording preterm delivery, stillbirths, neonatal mortality, congenital malformations and birthweight. Of the 668 women examined, 504 had type 1 diabetes and 164 had type 2. Pre-pregnancy counseling had been provided to 43.9% of the women who had type 1 diabetes and 29.1% of the women who had type 2 diabetes and correlated with a better HbA1c value throughout pregnancy. The preterm delivery rate was significantly higher in type 1 and 2 diabetics than in normal pregnant women and was related to HbA1c values higher than 8%, gestational hypertension, pre-eclampsia and the presence of retinopathy before pregnancy. The stillbirth and neonatal mortality rates were also higher in diabetic pregnant women (1.26% and 0.63%, respectively) than in Italian pregnancies in general (0.30% and 0.32%), and the same was true for major congenital malformations (4.9% for diabetic pregnancies, 0.86% for normal Italian pregnancies). In our population, pregnancy in diabetic women was still associated with a high rate of stillbirths, neonatal mortality and congenital malformations. Unplanned pregnancies and non-optimal glycemia control may help explain the high rates of maternal and neonatal complications.

  5. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes.

    PubMed

    Zucchini, Stefano; Scaramuzza, Andrea E; Bonfanti, Riccardo; Buono, Pietro; Cardella, Francesca; Cauvin, Vittoria; Cherubini, Valentino; Chiari, Giovanni; d'Annunzio, Giuseppe; Frongia, Anna Paola; Iafusco, Dario; Maltoni, Giulio; Patera, Ippolita Patrizia; Toni, Sonia; Tumini, Stefano; Rabbone, Ivana

    2016-01-01

    We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0-18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05-0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

  6. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

    PubMed Central

    Zucchini, Stefano; Scaramuzza, Andrea E.; Bonfanti, Riccardo; Buono, Pietro; Cardella, Francesca; Cauvin, Vittoria; Cherubini, Valentino; Chiari, Giovanni; d'Annunzio, Giuseppe; Frongia, Anna Paola; Iafusco, Dario; Maltoni, Giulio; Patera, Ippolita Patrizia; Toni, Sonia; Tumini, Stefano; Rabbone, Ivana; Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED)

    2016-01-01

    We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers. PMID:26649321

  7. Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey.

    PubMed

    Berretta, Massimiliano; Della Pepa, Chiara; Tralongo, Paolo; Fulvi, Alberto; Martellotta, Ferdinando; Lleshi, Arben; Nasti, Guglielmo; Fisichella, Rossella; Romano, Carmela; De Divitiis, Chiara; Taibi, Rosaria; Fiorica, Francesco; Di Francia, Raffaele; Di Mari, Anna; Del Pup, Lino; Crispo, Anna; De Paoli, Paolo; Santorelli, Adriano; Quagliariello, Vincenzo; Iaffaioli, Rosario Vincenzo; Tirelli, Umberto; Facchini, Gaetano

    2017-04-11

    Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.

  8. Assessment of prenatal exposure to ethanol by meconium analysis: results of an Italian multicenter study.

    PubMed

    Pichini, Simona; Marchei, Emilia; Vagnarelli, Federica; Tarani, Luigi; Raimondi, Francesco; Maffucci, Rosalba; Sacher, Bruno; Bisceglia, Massimo; Rapisardi, Gherardo; Elicio, Maria Rosaria; Biban, Paolo; Zuccaro, Piergiorgio; Pacifici, Roberta; Pierantozzi, Andrea; Morini, Luca

    2012-03-01

    This study estimated in 7 Italian cities the prevalence of prenatal exposure to ethanol by determining fatty acid ethyl esters (FAEEs; palmitic, palmitoleic, stearic, oleic, linoleic, linolenic, and arachidonic esters) and ethyl glucuronide (EtG) in neonatal meconium samples. A total of 607 meconium samples were obtained from neonatal wards of 7 public hospitals: Verona and San Daniele del Friuli in the northeast of the country, Reggio Emilia in the middle east, Florence and Rome in the center, and Naples and Crotone in the southwest of the peninsula. Meconium biomarkers were assessed by a validated methodology using liquid chromatography-tandem mass spectrometry and the results categorized using the accepted cutoff of 2 nmol/g total amount of 7 FAEEs and 2 nmol/g EtG, to differentiate between heavy maternal ethanol use during pregnancy and occasional or no use at all. On the basis of the above-reported cutoffs, the overall prevalence of newborns prenatally exposed to maternal ethanol was 7.9%: 0% in Verona, 4.0% in San Daniele del Friuli, 4.9% in Naples, 5.0% in Florence, 6.2% in Crotone, up to 10.6% in Reggio Emilia, and 29.4% in Rome. Low maternal education level and younger maternal age were associated with biomarker scores over the cutoff. There was also a significant correlation between the highest percentage of prenatal exposure in the capital and certain maternal sociodemographic characteristics. These results indicate considerable variability in the prevalence of fetal exposure to ethanol in different Italian cities, as determined by the objective measurement of biomarkers in meconium. These data, together with previous ones obtained in Barcelona, Spain, indicate that gestational ethanol exposure is widespread, at least in parts of Europe. Copyright © 2011 by the Research Society on Alcoholism.

  9. Type and frequency of MUTYH variants in Italian patients with suspected MAP: a retrospective multicenter study.

    PubMed

    Ricci, Maria Teresa; Miccoli, Sara; Turchetti, Daniela; Bondavalli, Davide; Viel, Alessandra; Quaia, Michele; Giacomini, Elisa; Gismondi, Viviana; Sanchez-Mete, Lupe; Stigliano, Vittoria; Martayan, Aline; Mazzei, Filomena; Bignami, Margherita; Bonelli, Luigina; Varesco, Liliana

    2017-02-01

    To determine prevalence, spectrum and genotype-phenotype correlations of MUTYH variants in Italian patients with suspected MAP (MUTYH-associated polyposis), a retrospective analysis was conducted to identify patients who had undergone MUTYH genetic testing from September 2002 to February 2014. Results of genetic testing and patient clinical characteristics were collected (gender, number of polyps, age at polyp diagnosis, presence of colorectal cancer (CRC) and/or other cancers, family data). The presence of large rearrangements of the MUTYH gene was evaluated by Multiplex Ligation-dependent Probe Amplification analysis. In all, 299 patients with colorectal neoplasia were evaluated: 61.2% were males, the median age at polyps or cancer diagnosis was 50 years (16-80 years), 65.2% had <100 polyps and 51.8% had CRC. A total of 36 different MUTYH variants were identified: 13 (36.1%) were classified as pathogenetic, whereas 23 (63.9%) were variants of unknown significance (VUS). Two pathogenetic variants were observed in 78 patients (26.1%). A large homozygous deletion of exon 15 was found in one patient (<1.0%). MAP patients were younger than those with negative MUTYH testing at polyps diagnosis (P<0.0001) and at first cancer diagnosis (P=0.007). MAP patients carrying the p.Glu480del variant presented with a younger age at polyp diagnosis as compared to patients carrying p.Gly396Asp and p.Tyr179Cys variants. A high heterogeneity of MUTYH variants and a high rate of VUS were identified in a cohort of Italian patients with suspected MAP. Genotype-phenotype analysis suggests that the p.Glu480del variant is associated with a severe phenotype.

  10. Relationship between clinical examination, quality of life, disability and depression in CMT patients: Italian multicenter study.

    PubMed

    Padua, L; Aprile, I; Cavallaro, T; Commodari, I; Pareyson, D; Quattrone, A; Rizzuto, N; Vita, G; Tonali, P; Schenone, A

    2008-06-01

    To assess which are the clinical examination tests that are more related to quality of life (QoL), depression, and disability in CMT patients. Large prospective multicenter study through the use of validated clinical, disability, and QoL measurements. Correlations between clinical pattern and disability/QoL and depression were studied. Departments of Neurology. 211 CMT patients (60% females, mean age 42.5 years). None. Sensory function was related to both mental and physical aspects of patient's QoL. Ability to walk on toes and heels was related to physical aspects of QoL/disability but also to bodily pain. Strength of forearm/hand intrinsic muscles was related to disability and physical aspects of QoL. Some clinical tests may be better outcome measures than others because they are related to aspects of life highly relevant to the patients. This information may be useful in clinical practice and in clinical trials to infer the patient's QoL.

  11. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity

    PubMed Central

    2014-01-01

    Background Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. Methods From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. Results In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3–81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial

  12. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity.

    PubMed

    Volta, Umberto; Bardella, Maria Teresa; Calabrò, Antonino; Troncone, Riccardo; Corazza, Gino Roberto

    2014-05-23

    Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between

  13. Survey on treatments for primary headaches in 13 specialized juvenile Headache Centers: The first multicenter Italian study.

    PubMed

    Toldo, Irene; Rattin, Martina; Perissinotto, Egle; De Carlo, Debora; Bolzonella, Barbara; Nosadini, Margherita; Rossi, Livia Nicoletta; Vecchio, Angelo; Simonati, Alessandro; Carotenuto, Marco; Scalas, Cinzia; Sciruicchio, Vittorio; Raieli, Vincenzo; Mazzotta, Giovanni; Tozzi, Elisabetta; Valeriani, Massimiliano; Cianchetti, Carlo; Balottin, Umberto; Guidetti, Vincenzo; Sartori, Stefano; Battistella, Pier Antonio

    2017-05-01

    The purpose of this retrospective multicenter study was to evaluate the use and the self-perceived efficacy and tolerability of pharmacological and non-pharmacological treatments in children and adolescents with primary headaches. Study of a cohort of children and adolescents diagnosed with primary headache, consecutively referred to 13 juvenile Italian Headache Centers. An ad hoc questionnaire was used for clinical data collection. Among 706 patients with primary headaches included in the study, 637 cases with a single type of headache (migraine 76% - with and without aura in 10% and 67% respectively; tension-type headache 24%) were selected (mean age at clinical interview: 12 years). Acetaminophen and non-steroidal anti-inflammatory drugs (in particular ibuprofen) were commonly used to treat attacks, by 76% and 46% of cases respectively. Triptans were used overall by 6% of migraineurs and by 13% of adolescents with migraine, with better efficacy than acetaminophen and non-steroidal anti-inflammatory drugs. Preventive drugs were used by 19% of migraineurs and by 3% of subjects with tension-type headache. In migraineurs, flunarizine was the most frequently used drug (18%), followed by antiepileptic drugs (7%) and pizotifen (6%), while cyproheptadine, propanolol and amitriptyline were rarely used. Pizotifen showed the best perceived efficacy and tolerability. Melatonin and nutraceuticals were used by 10% and 32% of subjects, respectively, both for migraine and tension-type headache, with good results in terms of perceived efficacy and tolerability. Non-pharmacological preventive treatments (i.e. relaxation techniques, biofeedback, cognitive-behavioral therapy, acupuncture) were used only by 10% of cases (migraine 9%, tension-type headache 15%). Non-steroidal anti-inflammatory drugs, especially ibuprofen, should be preferred to acetaminophen for acute attacks of migraine or tension-type headache, because they were usually more effective and well tolerated. Triptans

  14. Obesity and the risk of pancreatic cancer: an italian multicenter study.

    PubMed

    Pezzilli, Raffaele; Morselli-Labate, Antonio Maria; Migliori, Marina; Manca, Marco; Bastagli, Luciana; Gullo, Lucio

    2005-10-01

    The purpose of this work was to determine whether obesity is a risk factor for pancreatic cancer. We studied 400 patients with this tumor and 400 controls matched for sex and age from various Italian cities. We used a standardized questionnaire that was compiled at personal interview, with particular attention to body weight at the time of the interview, and for those with the tumor, their weight before onset of the disease. Body mass index (BMI) was calculated as the patient's weight in kilograms divided by their height in meters squared. The risk of pancreatic cancer adjusted for smoking was 5-fold higher (P < 0.001) in patients with a BMI less than 23 kg/m2 after diagnosis compared with patients with a BMI ranging from 23 to 29.9 kg/m2, whereas the risk in patients with BMI of at least 30 kg/m2 was not significant (P = 0.689). Taking into account BMI before diagnosis, smoking was confirmed as a significant risk factor (odds ratio = 1.68; P = 0.001) for pancreatic cancer, whereas no significant relationship was found between BMI classes and the risk of pancreatic cancer (P = 0.984). These findings indicate that obesity is not a risk factor for pancreatic cancer.

  15. Hydrocephalus Onset after Microsurgical or Endovascular Treatment for Acute Subarachnoid Hemorrhage. Retrospective Italian Multicenter Study

    PubMed Central

    Gangemi, Michelangelo; Cavallo, Luigi Maria; Di Somma, Alberto; Mazzucco, Grazia Marina; Bono, Paolo Sebastiano; Ghetti, Giovanni; Zambon, Giampaolo

    2014-01-01

    Background Chronic shunt-dependent hydrocephalus is a complication of aneurysmal subarachnoid hemorrhage (aSAH). Its incidence and risk factors have been described while the hydrocephalus onset in terms of days after treatment (microsurgical or endovascular) has not been yet analyzed. Materials and Methods 45 patients, treated for aSAH in 4 Italian Neurosurgical Departments, were retrospectively analyzed. It was calculated the time that elapses between treatment and hydrocephalus onset in 36 patients. Results Of the 45 shunted patients, 15 (33.3%) were included in the microsurgical group (group A) and 30 (66.6%) were in the endovascular one (group B). There was no difference of the hydrocephalus onset between the two groups (24,1 days, group A vs. 27,7 days, group B). The presence of intracerebral hematoma (ICH) caused a delay in the hydrocephalus onset after endovascular treatment in terms of 11,5 days compared to microsurgical group as well the absence of vasospasm determined a delay of 13,7 days (not statistically significant). Conclusion No difference in terms of hydrocephalus onset after microsurgical or endovascular treatment has been demonstrated. Only the presence of ICH or the absence of vasospasm can cause a slight delay in the time of hydrocephalus onset in the endovascular series (not statistically significant). Long-term follow-up studies involving higher numbers of subjects are needed to better demonstrate this issue. PMID:24809036

  16. Autoimmune hematological diseases after allogeneic hematopoietic stem cell transplantation in children: an Italian multicenter experience.

    PubMed

    Faraci, Maura; Zecca, Marco; Pillon, Marta; Rovelli, Attilio; Menconi, Maria Cristina; Ripaldi, Mimmo; Fagioli, Franca; Rabusin, Marco; Ziino, Ottavio; Lanino, Edoardo; Locatelli, Franco; Daikeler, Thomas; Prete, Arcangelo

    2014-02-01

    Autoimmune hematological diseases (AHDs) may occur after allogeneic hematopoietic stem cell transplantation (HSCT), but reports on these complications in large cohorts of pediatric patients are lacking. Between 1998 and 2011, 1574 consecutive children underwent allogeneic HSCT in 9 Italian centers. Thirty-three children (2.1%) developed AHDs: 15 autoimmune hemolytic anemia (45%), 10 immune thrombocytopenia (30%), 5 Evans' syndrome (15%), 2 pure red cell aplasia (6%), and 1 immune neutropenia (3%). The 10-year cumulative incidence of AHDs was 2.5% (95% confidence interval, 1.7 to 3.6). In a multivariate analysis, the use of alternative donor and nonmalignant disease was statistically associated with AHDs. Most patients with AHDs (64%) did not respond to steroids. Sustained complete remission was achieved in 87% of cases with the anti-CD20 monoclonal antibody (rituximab). Four patients (9%) (1 autoimmune hemolytic anemia, 1 Evans' syndrome, 2 immune thrombocytopenia) died at a median of 87 days after AHD diagnosis as a direct or indirect consequence of their disorder. Our data suggest that AHDs are a relatively rare complication occurring after HSCT that usually respond to treatment with rituximab.

  17. Baseline findings of the Italian multicenter randomized controlled trial of "once-only sigmoidoscopy"--SCORE.

    PubMed

    Segnan, Nereo; Senore, Carlo; Andreoni, Bruno; Aste, Hugo; Bonelli, Luigina; Crosta, Cristiano; Ferraris, Roberto; Gasperoni, Stefano; Penna, Angelo; Risio, Mauro; Rossini, Francesco Paolo; Sciallero, Stefania; Zappa, Marco; Atkin, Wendy S

    2002-12-04

    A single sigmoidoscopy examination at around age 60 years has been proposed as a cost-effective strategy to prevent colorectal cancer. A multicenter randomized controlled trial, the SCORE trial, is in progress in Italy to estimate the impact of this strategy on colorectal cancer incidence and mortality and the duration of the protective effect. We present the baseline screening outcomes. A questionnaire was mailed to a random sample of 236 568 people aged 55-64 years to assess their eligibility for and interest in screening. Those reporting a history of colorectal cancer, adenomas, inflammatory bowel disease, recent colorectal endoscopy, or two first-degree relatives with colorectal cancer were excluded. Eligible, interested respondents were assigned randomly to the control group (no further contact) or the intervention group (invitation to undergo sigmoidoscopy). Screenees with colorectal cancer, polyps larger than 5 mm, three or more adenomas, adenomas 5 mm or smaller with a villous component of more than 20%, or severe dysplasia were referred for colonoscopy. Of the 56 532 respondents (23.9% of those invited), 34 292 were enrolled and 17 148 were assigned to the screening group. Of those, 9999 attended and 9911 were actually examined by sigmoidoscopy. Distal adenomas were detected in 1070 subjects (10.8%). Proximal adenomas were detected in 116 of 747 (15.5%) subjects without cancer at sigmoidoscopy who then underwent colonoscopy. A total of 54 subjects was found to have colorectal cancer, a rate of 5.4 per 1000 (54% of which were Dukes' A). The procedures were relatively safe, with two perforations (one in 9911 sigmoidoscopy exams and one in 775 colonoscopies) and one hemorrhage requiring hospitalization after polypectomy during colonoscopy. The pain associated with sigmoidoscopy was described as mild or less than expected by 83.3% of the screenees. Sigmoidoscopy screening is generally acceptable to recipients and safe. The high yield of advanced adenomas is

  18. Italian symptomatic intracranial atherosclerosis study (ISIDE) : A multicenter transcranial ultrasound evaluation.

    PubMed

    Baracchini, Claudio; Anzola, Gian Paolo; Cenciarelli, Silvia; Diomedi, Marina; Bella, Rita; Tonon, Agnese; Braga, Massimiliano; Zedde, Maria Luisa; Zanferrari, Carla; Del Sette, Massimo; Caliandro, Pietro; Gandolfo, Carlo; Ricci, Stefano; Meneghetti, Giorgio

    2016-10-01

    There are currently no data available on the prevalence of symptomatic intracranial atherosclerosis (ICAS) in Italy. The aim of this prospective, multicenter, hospital-based, transcranial ultrasound study was to establish the prevalence of ICAS among patients hospitalized with acute ischemic stroke. At 11 stroke centers across Italy, patients consecutively admitted for their first ever acute ischemic stroke were assessed prospectively over a 24-month period either with transcranial color-coded Doppler sonography (TCCS) or transcranial Doppler (TCD) according to validated criteria. ICAS was diagnosed when there was an evidence of a cerebral infarction in the territory of a ≥50 % stenosis detected by TCCS/TCD and confirmed by magnetic resonance angiography or computed tomography angiography. A total of 1134 patients were enrolled, 665 of them (58.6 %) men, with a mean age of 71.2 ± 13.3 years. ICAS was recorded in 99 patients (8.7 % of the whole sample, 8.9 % among Caucasians), most commonly located in the anterior circulation (63 of 99, 5.5 %). After adjusting for potential confounders, multivariate analysis identified carotid/vertebral ≥50 % stenosis [odds ratio (OR) 2.59, 95 % (confidence interval) CI 1.77-6.33; P = 0.02] and hypercholesterolemia (OR 1.38, 95 % CI 1.02-1.89; P = 0.02) as being independently associated with ICAS. ICAS is a surprisingly relevant cause of ischemic stroke in Italy, identified in almost 9 % of first-ever stroke patients. It is more prevalent in the anterior circulation and independently associated with hemodynamically significant cervical vessel atherosclerosis and hypercholesterolemia. These findings support the systematic use of transcranial ultrasound to identify ICAS in patients presenting with acute ischemic stroke and in cases with ≥50 % cervical vessel stenoses.

  19. Human leukocyte antigen polymorphisms in Italian primary biliary cirrhosis: a multicenter study of 664 patients and 1992 healthy controls

    PubMed Central

    Invernizzi, Pietro; Selmi, Carlo; Poli, Francesca; Frison, Sara; Floreani, Annarosa; Alvaro, Domenico; Almasio, Piero; Rosina, Floriano; Marzioni, Marco; Fabris, Luca; Muratori, Luigi; Qi, Lihong; Seldin, Michael F.; Gershwin, M. Eric; Podda, Mauro

    2008-01-01

    Genetic factors are critical in determining susceptibility to primary biliary cirrhosis (PBC), but there has not been a clear association with human leukocyte antigen (HLA) genes. We performed a multi-center case-control study and analyzed HLA class II DRB1 associations using a large cohort of 664 well-defined cases of PBC and 1,992 controls of Italian ancestry. Importantly, healthy controls were rigorously matched not only by age and gender, but also for the geographical origin of the proband four grandparents (Northern, Central, and Southern Italy). Following correction for multiple testing, DRB1*08 (Odds Ratio–OR, 3.3; 95% Confidence Interval–CI, 2.4−4.5) and DRB1*02 (OR 0.9; 95% CI 0.8−1.2) were significantly associated with PBC while alleles DRB1*11 (OR 0.4; 95% CI 0.3−0.4) and DRB1*13 (OR 0.7; 95% CI 0.6−0.9) were protective. When subjects were stratified according to their grandparental geographical origin, only the associations with DRB1*08 and DRB1*11 were common to all three areas. Associated DRB1 alleles were found only in a minority of patients while an additive genetic model is supported by the gene dosage effect for DRB1*11 allele and the interaction of DRB1*11,*13, and *08. Lastly, no significant associations were detected between specific DRB1 alleles and relevant clinical features represented by the presence of cirrhosis or serum autoantibodies. In conclusion, we confirm the role for HLA to determine PBC susceptibility and suggest that the effect of HLA is limited to patient subgroups. We suggest that a large whole-genome approach is required to identify further genetic elements contributing to the loss of tolerance in this disease. PMID:19003916

  20. Vitamin D levels and allergic diseases. An italian cross-sectional multicenter survey.

    PubMed

    Lombardi, C; Passalacqua, G

    2017-03-01

    Background. During the two last decades, the interest in the role of Vitamin D (VD) in allergic disease has increased. Apart from the well-known actions of VD in bone metabolism, recent studies suggested its possible role as an immune-modulator in allergy. Objective. This study, conducted over the Italian territory, evaluated the possible correlations between VD serum level and diagnosed allergic diseases (rhinitis / asthma, food allergy, atopic dermatitis). Thus, VD was assessed in patients with physician-diagnosed allergic diseases. Methods. The study was carried out in hospital- and private practice-based setting between October 2012 and March 2013, and 18 Centers participated. Only adult patients, with at least one positive skin prick test were included. The diagnostic procedures and the data collection were standardized among the centers. VD levels were assayed by the same laboratory test. Results. Three hundred and nine patients were enrolled (132 male, mean age 37.5 ± 17 years). Of them, 40% reported a positive family history for allergies (asthma / rhinitis). Rhinitis plus asthma was present in 47% of patients, atopic dermatitis in 15%, and a consistent clinical history of food allergy associated with positive skin tests was present in 25% of subjects. There was no significant association between VD level and age, sex, family history, rhinitis, or food allergy. VD levels were overall lower in patients with asthma and rhinitis, but without statistical significance. A significant difference in VD levels was detected between patient with or without atopic dermatitis. VD was not related to seasonal allergens, whereas a significant negative correlation was seen for house dust mite and dog dander. Conclusion. Our data, derived from a cross-sectional study involving only allergic patients, agree partially with the current literature. Nonetheless, the association between VD levels and allergies appeared weak. Studies involving larger samples would be required to

  1. A draft genome sequence of an invasive mosquito: an Italian Aedes albopictus.

    PubMed

    Dritsou, Vicky; Topalis, Pantelis; Windbichler, Nikolai; Simoni, Alekos; Hall, Ann; Lawson, Daniel; Hinsley, Malcolm; Hughes, Daniel; Napolioni, Valerio; Crucianelli, Francesca; Deligianni, Elena; Gasperi, Giuliano; Gomulski, Ludvik M; Savini, Grazia; Manni, Mosè; Scolari, Francesca; Malacrida, Anna R; Arcà, Bruno; Ribeiro, José M; Lombardo, Fabrizio; Saccone, Giuseppe; Salvemini, Marco; Moretti, Riccardo; Aprea, Giuseppe; Calvitti, Maurizio; Picciolini, Matteo; Papathanos, Philippos Aris; Spaccapelo, Roberta; Favia, Guido; Crisanti, Andrea; Louis, Christos

    2015-07-01

    The draft genome sequence of Italian specimens of the Asian tiger mosquito Aedes (Stegomyia) albopictus (Diptera: Culicidae) was determined using a standard NGS (next generation sequencing) approach. The size of the assembled genome is comparable to that of Aedes aegypti; the two mosquitoes are also similar as far as the high content of repetitive DNA is concerned, most of which is made up of transposable elements. Although, based on BUSCO (Benchmarking Universal Single-Copy Orthologues) analysis, the genome assembly reported here contains more than 99% of protein-coding genes, several of those are expected to be represented in the assembly in a fragmented state. We also present here the annotation of several families of genes (tRNA genes, miRNA genes, the sialome, genes involved in chromatin condensation, sex determination genes, odorant binding proteins and odorant receptors). These analyses confirm that the assembly can be used for the study of the biology of this invasive vector of disease.

  2. The impact of Acacia saligna invasion on Italian coastal dune EC habitats.

    PubMed

    Del Vecchio, Silvia; Acosta, Alicia; Stanisci, Angela

    2013-07-01

    Alien species can represent a threat to several ecosystems because they can alter species relationships and ecosystem function. In Italy, Acacia saligna is a major invader and it forms dense stands in coastal environments. We analyze the impact of A. saligna in Italian Mediterranean dune systems. We randomly sampled coastal dune vegetation and investigated its floristic composition with ordination techniques. We compared species richness in invaded and non-invaded plots with rarefaction curves and analyzed the frequency of focal and ruderal species. A. saligna invaded Mediterranean scrub (habitats 2250* and 2260) and coastal Pinus dune wood (habitat 2270*) and it is particularly prevalent in sunny areas of habitat 2270*. We observed an increase in ruderal species and a decrease in focal species in the invaded plots of habitat 2270*. We suggest that more open and disturbed areas are more prone to A. saligna invasion.

  3. The Italian dementia with Lewy bodies study group (DLB-SINdem): toward a standardization of clinical procedures and multicenter cohort studies design.

    PubMed

    Bonanni, L; Cagnin, A; Agosta, F; Babiloni, C; Borroni, B; Bozzali, M; Bruni, A C; Filippi, M; Galimberti, D; Monastero, R; Muscio, C; Parnetti, L; Perani, D; Serra, L; Silani, V; Tiraboschi, P; Padovani, A

    2017-01-01

    Dementia with Lewy bodies (DLB) causes elevated outlays for the National Health Systems due to high institutionalization rate and patients' reduced quality of life and high mortality. Furthermore, DLB is often misdiagnosed as Alzheimer's disease. These data motivate harmonized multicenter longitudinal cohort studies to improve clinical management and therapy monitoring. The Italian DLB study group of the Italian Neurological Society for dementia (SINdem) developed and emailed a semi-structured questionnaire to 572 national dementia centers (from primary to tertiary) to prepare an Italian large longitudinal cohort. The questionnaire surveyed: (1) prevalence and incidence of DLB; (2) clinical assessment; (3) relevance and availability of diagnostic tools; (4) pharmacological management of cognitive, motor, and behavioural disturbances; (5) causes of hospitalization, with specific focus on delirium and its treatment. Overall, 135 centers (23.6 %) contributed to the survey. Overall, 5624 patients with DLB are currently followed by the 135 centers in a year (2042 of them are new patients). The percentage of DLB patients was lower (27 ± 8 %) than that of Alzheimer's disease and frontotemporal dementia (56 ± 27 %) patients. The majority of the centers (91 %) considered the clinical and neuropsychological assessments as the most relevant procedure for a DLB diagnosis. Nonetheless, most of the centers has availability of magnetic resonance imaging (MRI; 95 %), electroencephalography (EEG; 93 %), and FP-CIT single photon emission-computerized tomography (SPECT; 75 %) scan for clinical applications. It will be, therefore, possible to recruit a large harmonized Italian cohort of DLB patients for future cross-sectional and longitudinal multicenter studies.

  4. Noninvasive versus invasive ventilation for acute respiratory failure in patients with hematologic malignancies: a 5-year multicenter observational survey.

    PubMed

    Gristina, Giuseppe R; Antonelli, Massimo; Conti, Giorgio; Ciarlone, Alessia; Rogante, Silvia; Rossi, Carlotta; Bertolini, Guido

    2011-10-01

    Mortality is high among patients with hematologic malignancies admitted to intensive care units for acute respiratory failure. Early noninvasive mechanical ventilation seems to improve outcomes. To characterize noninvasive mechanical ventilation use in Italian intensive care units for acute respiratory failure patients with hematologic malignancies and its impact on outcomes vs. invasive mechanical ventilation. Retrospective analysis of observational data prospectively collected in 2002-2006 on 1,302 patients with hematologic malignancies admitted with acute respiratory failure to 158 Italian intensive care units. Mortality (intensive care unit and hospital) was assessed in patients treated initially with noninvasive mechanical ventilation vs. invasive mechanical ventilation and in those treated with invasive mechanical ventilation ab initio vs. after noninvasive mechanical ventilation failure. Findings were adjusted for propensity scores reflecting the probability of initial treatment with noninvasive mechanical ventilation. Few patients (21%) initially received noninvasive mechanical ventilation; 46% of these later required invasive mechanical ventilation. Better outcomes were associated with successful noninvasive mechanical ventilation (vs. invasive mechanical ventilation ab initio and vs. invasive mechanical ventilation after noninvasive mechanical ventilation failure), particularly in patients with acute lung injury/adult respiratory distress syndrome (mortality: 42% vs. 69% and 77%, respectively). Delayed vs. immediate invasive mechanical ventilation was associated with slightly but not significantly higher hospital mortality (65% vs. 58%, p=.12). After propensity-score adjustment, noninvasive mechanical ventilation was associated with significantly lower mortality than invasive mechanical ventilation. The population could not be stratified according to specific hematologic diagnoses. Furthermore, the study was observational, and treatment groups may have

  5. A draft genome sequence of an invasive mosquito: an Italian Aedes albopictus

    PubMed Central

    Dritsou, Vicky; Topalis, Pantelis; Windbichler, Nikolai; Simoni, Alekos; Hall, Ann; Lawson, Daniel; Hinsley, Malcolm; Hughes, Daniel; Napolioni, Valerio; Crucianelli, Francesca; Deligianni, Elena; Gasperi, Giuliano; Gomulski, Ludvik M.; Savini, Grazia; Manni, Mosè; Scolari, Francesca; Malacrida, Anna R.; Arcà, Bruno; Ribeiro, José M.; Lombardo, Fabrizio; Saccone, Giuseppe; Salvemini, Marco; Moretti, Riccardo; Aprea, Giuseppe; Calvitti, Maurizio; Picciolini, Matteo; Papathanos, Philippos Aris; Spaccapelo, Roberta; Favia, Guido; Crisanti, Andrea

    2015-01-01

    The draft genome sequence of Italian specimens of the Asian tiger mosquito Aedes (Stegomyia) albopictus (Diptera: Culicidae) was determined using a standard NGS (next generation sequencing) approach. The size of the assembled genome is comparable to that of Aedes aegypti; the two mosquitoes are also similar as far as the high content of repetitive DNA is concerned, most of which is made up of transposable elements. Although, based on BUSCO (Benchmarking Universal Single-Copy Orthologues) analysis, the genome assembly reported here contains more than 99% of protein-coding genes, several of those are expected to be represented in the assembly in a fragmented state. We also present here the annotation of several families of genes (tRNA genes, miRNA genes, the sialome, genes involved in chromatin condensation, sex determination genes, odorant binding proteins and odorant receptors). These analyses confirm that the assembly can be used for the study of the biology of this invasive vector of disease. PMID:26369436

  6. Six-Month Multicenter Study on Invasive Infections Due to Group B Streptococci in Argentina

    PubMed Central

    Lopardo, Horacio A.; Vidal, Patricia; Jeric, Paola; Centron, Daniela; Paganini, Hugo; Facklam, Richard R.; Elliott, John

    2003-01-01

    There is little information about invasive infections by group B streptococci (GBS) and their antimicrobial susceptibilities in Latin America. We performed a prospective multicenter study to determine the serotype distribution and the antimicrobial susceptibility of GBS in Argentina. We identified 58 cases, but only 44 had sufficient data to be evaluated. Eight early-, four late-, and one fatal late, late-onset neonatal infections due to GBS were found. A total of 31 patients were adults with bacteremia, skin and soft tissue infections, osteomyelitis, arthritis, meningitis, abdominal infections, and renal abscess. Serotype III was prevalent in late-onset neonatal disease, and several serotypes (Ia/c, III, Ia, and II) were involved in early-onset neonatal infections. Serotypes II, Ia/c, III, and IV were commonly found in adults, with serotype II prevalent in younger adults (18 to 69 years old) and serotype Ia/c prevalent in elderly adults (>70 years old). The mortality rate attributable to GBS infections was 10.8%. All GBS were susceptible to penicillin and ceftriaxone. Resistance to clindamycin (1.7%), erythromycin (5.2%), azithromycin (5.2%), minocycline (69%), and tetracycline (72.4%), to high levels of kanamycin and amikacin (1.7%), and to intermediately high levels of gentamicin (1.7%) was observed. The bifunctional enzyme AAC6′-APH2" was detected in the isolate resistant to aminoglycosides, and other genetic determinants were identified in other resistant isolates: tetM and tetO in tetracycline-resistant streptococci and mefA and ermTR for efflux-mediated and inducible macrolide-lincosamide-streptogramin B-resistant streptococci, respectively. For clinical purposes and rapid and easy detection of high-level aminoglycoside-resistant GBS, a screening method that used 1,000-μg kanamycin disks is proposed. PMID:14532204

  7. Multicenter Assessment of Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer

    PubMed Central

    Zargar, Homayoun; Espiritu, Patrick N.; Fairey, Adrian S.; Mertens, Laura S.; Dinney, Colin P.; Mir, Maria C.; Krabbe, Laura-Maria; Cookson, Michael S.; Jacobsen, Niels-Erik; Gandhi, Nilay; Griffin, Joshua; Montgomery, Jeffrey S.; Vasdev, Nikhil; Yu, Evan Y.; Youssef, David; Xylinas, Evanguelos; Campain, Nicholas J.; Kassouf, Wassim; Dall’Era, Marc A.; Seah, Jo-An; Ercole, Cesar E.; Horenblas, Simon; Sridhar, Srikala S.; McGrath, Jonathan S.; Aning, Jonathan; Shariat, Shahrokh F.; Wright, Jonathan L.; Thorpe, Andrew C.; Morgan, Todd M.; Holzbeierlein, Jeff M.; Bivalacqua, Trinity J.; North, Scott; Barocas, Daniel A.; Lotan, Yair; Garcia, Jorge A.; Stephenson, Andrew J.; Shah, Jay B.; van Rhijn, Bas W.; Daneshmand, Siamak; Spiess, Philippe E.; Black, Peter C.

    2016-01-01

    Background The efficacy of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (BCa) was established primarily with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC), with complete response rates (pT0) as high as 38%. However, because of the comparable efficacy with better tolerability of gemcitabine and cisplatin (GC) in patients with metastatic disease, GC has become the most commonly used regimen in the neoadjuvant setting. Objective We aimed to assess real-world pathologic response rates to NAC with different regimens in a large, multicenter cohort. Design, setting, and participants Data were collected retrospectively at 19 centers on patients with clinical cT2–4aN0M0 urothelial carcinoma of the bladder who received at least three cycles of NAC, followed by radical cystectomy (RC), between 2000 and 2013. Intervention NAC and RC Outcome measurements and statistical analysis The primary outcome was pathologic stage at cystectomy. Univariable and multivariable analyses were used to determine factors predictive of pT0N0 and ≤pT1N0 stages. Results and limitations Data were collected on 935 patients who met inclusion criteria. GC was used in the majority of the patients (n = 602; 64.4%), followed by MVAC (n = 183; 19.6%) and other regimens (n = 144; 15.4%). The rates of pT0N0 and ≤pT1N0 pathologic response were 22.7% and 40.8%, respectively. The rate of pT0N0 disease for patients receiving GC was 23.9%, compared with 24.5% for MVAC (p = 0.2). There was no difference between MVAC and GC in pT0N0 on multivariable analysis (odds ratio: 0.89 [95% confidence interval, 0.61–1.34]; p = 0.6). Conclusions Response rates to NAC were lower than those reported in prospective randomized trials, and we did not discern a difference between MVAC and GC. Without any evidence from randomized prospective trials, the best NAC regimen for invasive BCa remains to be determined. Patient summary There was no apparent difference in the response rates to the

  8. A Multicenter Study of Invasive Fungal Infections in Patients with Childhood-onset Systemic Lupus Erythematosus.

    PubMed

    Silva, Marco F; Ferriani, Mariana P; Terreri, Maria T; Pereira, Rosa M; Magalhães, Claudia S; Bonfá, Eloisa; Campos, Lucia M; Okuda, Eunice M; Appenzeller, Simone; Ferriani, Virgínia P; Barbosa, Cássia M; Ramos, Valéria C; Lotufo, Simone; Silva, Clovis A

    2015-12-01

    To study the prevalence, risk factors, and mortality of invasive fungal infections (IFI) in patients with childhood-onset systemic lupus erythematosus (cSLE). A retrospective multicenter cohort study was performed in 852 patients with cSLE from 10 pediatric rheumatology services. An investigator meeting was held and all participants received database training. IFI were diagnosed according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group criteria (proven, probable, and possible). Also evaluated were demographic, clinical, and laboratory data, and disease activity [SLE Disease Activity Index 2000 (SLEDAI-2K)], cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), treatment, and outcomes. IFI were observed in 33/852 patients (3.9%) with cSLE. Proven IFI was diagnosed in 22 patients with cSLE, probable IFI in 5, and possible IFI in 6. Types of IFI were candidiasis (20), aspergillosis (9), cryptococcosis (2), and 1 each disseminated histoplasmosis and paracoccidioidomycosis. The median of disease duration was lower (1.0 vs 4.7 yrs, p < 0.0001) with a higher current SLEDAI-2K [19.5 (0-44) vs 2 (0-45), p < 0.0001] and current prednisone (PRED) dose [50 (10-60) vs 10 (2-90) mg/day, p < 0.0001] in patients with IFI compared with those without IFI. The frequency of death was higher in the former group (51% vs 6%, p < 0.0001). Logistic regression analysis revealed that SLEDAI-2K (OR 1.108, 95% CI 1.057-1.163, p < 0.0001), current PRED dose (OR 1.046, 95% CI 1.021-1.071, p < 0.0001), and disease duration (OR 0.984, 95% CI 0.969-0.998, p = 0.030) were independent risk factors for IFI (R(2) Nagelkerke 0.425). To our knowledge, this is the first study to characterize IFI in patients with cSLE. We identified that disease activity and current glucocorticoid use

  9. Italian multicenter study on infection hazards during dental practice: Control of environmental microbial contamination in public dental surgeries

    PubMed Central

    Castiglia, Paolo; Liguori, Giorgio; Montagna, Maria Teresa; Napoli, Christian; Pasquarella, Cesira; Bergomi, Margherita; Fabiani, Leila; Monarca, Silvano; Petti, Stefano

    2008-01-01

    Background The present study assessed microbial contamination in Italian dental surgeries. Methods An evaluation of water, air and surface microbial contamination in 102 dental units was carried out in eight Italian cities. Results The findings showed water microbial contamination in all the dental surgeries; the proportion of water samples with microbial levels above those recommended decreased during working. With regard to Legionella spp., the proportion of positive samples was 33.3%. During work activity, the index of microbial air contamination (IMA) increased. The level of microbial accumulation on examined surfaces did not change over time. Conclusion These findings confirm that some Italian dental surgeries show high biocontamination, as in other European Countries, which highlights the risk of occupational exposure and the need to apply effective measures to reduce microbial loads. PMID:18644099

  10. Invasive infections caused by Trichosporon species and Geotrichum capitatum in patients with hematological malignancies: a retrospective multicenter study from Italy and review of the literature.

    PubMed

    Girmenia, Corrado; Pagano, Livio; Martino, Bruno; D'Antonio, Domenico; Fanci, Rosa; Specchia, Giorgina; Melillo, Lorella; Buelli, Massimo; Pizzarelli, Giampaolo; Venditti, Mario; Martino, Pietro

    2005-04-01

    Trichosporonosis is an uncommon but frequently fatal mycosis in immunocompromised patients. A multicenter retrospective study was conducted to characterize cases of proven or probable invasive trichosporonosis diagnosed over the past 20 years in Italian patients with hematological diseases. Of the 52 cases identified, 17 were classified as Trichosporon sp. infections and 35 were attributed to Geotrichum capitatum. Acute myeloid leukemia accounted for 65.4% of the cases. The incidence rates of Trichosporon sp. and G. capitatum infections in acute leukemia patients were 0.4 and 0.5%, respectively. Overall, 76.9% of cases had positive blood cultures. Pulmonary involvement was documented in 26.9% of cases. Death was reported for 57.1% of G. capitatum infections and for 64.7% of Trichosporon sp. infections. A literature review on trichosporonosis in patients with any underlying disease or condition reveals G. capitatum as a predominantly European pathogen, particularly in certain Mediterranean areas, while Trichosporon sp. infections are seen with similar frequencies on all continents. The majority of published Trichosporon sp. and G. capitatum infections occurred in patients with hematological diseases (62.8 and 91.7%, respectively). Well over half of these were suffering from acute leukemia (68 and 84% of patients with Trichosporon sp. and G. capitatum infections, respectively). Crude mortality rates were 77% for Trichosporon spp. and 55.7% for G. capitatum. The optimal therapy for trichosporonosis has yet to be identified; however, in vitro experiences are providing encouraging evidence of the potential role of the new triazoles, in particular, voriconazole.

  11. [Current practice and changing trends in the percutaneous treatment of structural heart disease. Results of a multicenter survey promoted by the Italian Society of Interventional Cardiology in six Italian Regions including Tuscany, Lombardy, Veneto, Emilia-Romagna, Campania and Puglia].

    PubMed

    Mojoli, Marco; Musumeci, Giuseppe; Berti, Sergio; Limbruno, Ugo; Marchese, Alfredo; Mauro, Ciro; Tarantino, Fabio; Fineschi, Massimo; Lettieri, Corrado; Menozzi, Alberto; My, Luigi; Attisano, Tiziana; Cernetti, Carlo; Favero, Luca; Napodano, Massimo; Pasquetto, Giampaolo; Pavei, Andrea; La Manna, Alessio; Parodi, Guido; Santarelli, Andrea; Trabattoni, Daniela; Varbella, Ferdinando; Signore, Nicola; Soriani, Nicola; Gregori, Dario; Figliozzi, Stefano; Tarantini, Giuseppe

    2016-06-01

    Significant developments have occurred in the field of percutaneous interventions for structural heart disease over the last decade. The introduction of several innovations has expanded significantly the spectrum of therapeutic applications of structural interventional cardiology. However, the translation of the most recent scientific evidence into clinical practice and the adoption of new technologies may be susceptible to large variability, even within the same geographic area. This study aimed at describing current status and changing trends of structural heart interventions within 6 Regions in Italy. Between July 2015 and October 2015, 6 regional delegations of the Italian Society of Interventional Cardiology (SICI-GISE) promoted a web-based multicenter survey concerning structural heart interventions. An ad hoc questionnaire was administered to head physicians of the cath-labs of 4 Regions of Northern Italy (Tuscany, Lombardy, Veneto and Emilia-Romagna) and 2 Regions of Southern Italy (Puglia and Campania). Also, in this study we considered previous data from a similar survey that involved Tuscany, Lombardy, Veneto and Emilia-Romagna between April 2014 and May 2014. Data from the two surveys were compared, observing the changing trends between 2014 and 2015. The 2015 survey was completed in more than two thirds (68%) of the 145 eligible cath-labs. According to the survey, the application of percutaneous structural heart interventions and the availability of devices were wide and homogeneous within the 6 Regions involved. The main factors perceived as limiting the execution of structural heart interventions resulted economic (e.g. cost of procedures and devices) or organizational (e.g. limited diffusion of hybrid operating rooms). In this study, which was based on the results of a recent survey conducted in 6 Italian Regions, structural heart interventions resulted widely growing throughout the investigated area. The indications for treatment and the

  12. The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study.

    PubMed

    Rossetti, Francesca; Pittiruti, Mauro; Lamperti, Massimo; Graziano, Ugo; Celentano, Davide; Capozzoli, Giuseppe

    2015-01-01

    The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals. Three age groups were considered: A (<4 years, n = 157), B (4-11 years, n = 119), and C (12-18 years, n = 31). IC-ECG was applicable in 307 cases. The increase of the P wave on IC-ECG was detected in all cases but two. The tip of the catheter was positioned at the cavo-atrial junction (CAJ) (i.e., at the maximal height of the P wave on IC-ECG) and the position was checked during the procedure by fluoroscopy or chest x-ray, considering the CAJ at 1-2 cm (group A), 1.5-3 cm (group B), or 2-4 cm (group C) below the carina. There were no complications related to IC-ECG. The overall match between IC-ECG and x-ray was 95.8% (96.2% in group A, 95% in group B, and 96.8% in group C). In 95 cases, the IC-ECG was performed with a dedicated ECG monitor, specifically designed for IC-ECG (Nautilus, Romedex): in this group, the match between IC-ECG and x-ray was 98.8%. We conclude that the IC-ECG method is safe and accurate in the pediatric patients. The applicability of the method is 99.4% and its feasibility is 99.4%. The accuracy is 95.8% and even higher (98.8%) when using a dedicated ECG monitor.

  13. An Italian national multicenter study for the definition of reference ranges for normal values of peripheral blood lymphocyte subsets in healthy adults.

    PubMed

    Santagostino, A; Garbaccio, G; Pistorio, A; Bolis, V; Camisasca, G; Pagliaro, P; Girotto, M

    1999-06-01

    Reference ranges are necessary in clinical chemistry and hematology to compare an observed value and to provide meaningful information. The aim of this multicenter study was the definition of reference ranges of the relative and absolute numbers of lymphocyte subsets by evaluating a large cohort of healthy adults and by using a standard protocol to reduce the variability in both sample preparation methodology and flow cytometer operation. Other aims of this study were the evaluation of the influence of sex, age, obesity, smoking, sport and some methodological variables on lymphocyte subsets and the comparison of differential white blood cell values obtained by flow cytometry and those obtained by hematology counters. Blood samples from 1311 healthy adults (blood donors and volunteers chosen according to the Italian law for donor selection) were analyzed to study, by flow cytometry, the immunophenotype of lymphocyte subsets and their distribution in terms of percentages and absolute values. Pre-analytical and analytical phases were performed according to the guidelines of the International Federation of Clinical Chemistry (IFCC) and the Italian Group of Cytometry (GIC). T cells were defined by the expression of CD3; T subpopulations by the coexpression of CD4 or CD8 or HLA-DR; B-lymphocytes were identified by the expression of CD19 while natural killer lymphocytes were identified by positivity of CD16 and/or CD56 without CD3. We calculated, for each laboratory and for all data collected, the frequency distribution percent values and absolute values of each lymphocyte subset. The influence of age, sex, smoking, obesity and sport was calculated by the t-test. The influence of some methodological variables was calculated by the t-test and multiple regression test. Fifty-three flow cytometry laboratories at different institutions in Italy participated in this study. Data was obtained from 1311 healthy adults aged from 18 to 70; 968 phenotype analyses (74%) were

  14. Real-life clinical practice results with vinflunine in patients with relapsed platinum-treated metastatic urothelial carcinoma: an Italian multicenter study (MOVIE-GOIRC 01-2014).

    PubMed

    Passalacqua, Rodolfo; Lazzarelli, Silvia; Donini, Maddalena; Montironi, Rodolfo; Tambaro, Rosa; De Giorgi, Ugo; Pignata, Sandro; Palumbo, Raffaella; Ceresoli, Giovanni Luca; Del Conte, Gianluca; Tonini, Giuseppe; Morelli, Franco; Nolè, Franco; Panni, Stefano; Rondini, Ermanno; Guida, Annalisa; Zucali, Paolo Andrea; Doni, Laura; Iezzi, Elisa; Caminiti, Caterina

    2017-07-19

    Vinflunine is the only chemotherapeutic agent shown to improve survival in platinum-refractory patients with metastatic transitional cell carcinoma of the urothelium (TCCU) in a phase III clinical trial, which led to product registration for this indication in Europe. The aim of this study was to assess the efficacy of vinflunine and to evaluate the prognostic significance of risk factors in a large, unselected cohort of patients with metastatic TCCU treated according to routine clinical practice. This was a retrospective multicenter study. Italian cancer centers were selected if, according to the Registry of the Italian Medicines Agency (AIFA), at least four patients had been treated with vinflunine between February 2011 and June 2014, after first- or second-line platinum-based chemotherapy. The primary objective was to test whether the efficacy measured by overall survival (OS) in the registration study could be confirmed in routine clinical practice. Multivariate analysis was carried out using Cox proportional hazard model. A total of 217 patients were treated in 28 Italian centers. Median age was 69 years (IQR 62-76) and 84% were male; Eastern Cooperative Oncology Group performance status (ECOG PS) was ≥ 1 in 53% of patients. The median number of cycles was 4 (IQR 2-6); 29%, 35%, and 36% received an initial dose of 320 mg/m(2), 280 mg/m(2) or a lower dose, respectively. Median progression-free survival (PFS) and OS for the entire population was 3.2 months (2.6-3.7) and 8.1 months (6.3-8.9). A complete response was observed in six patients, partial response in 21, stable disease in 60, progressive disease in 108, with a disease control rate of 40%. Multivariate analysis showed that ECOG PS, number of metastatic sites and liver involvement were unfavorable prognostic factors for OS. Toxicity was mild, and grade 3-4 adverse effects were mainly: neutropenia (9%), anemia (6%), asthenia/fatigue (7%) and constipation (5%). In routine clinical practice the results

  15. Gene expression test for the non-invasive diagnosis of bladder cancer: A prospective, blinded, international and multicenter validation study.

    PubMed

    Ribal, Maria J; Mengual, Lourdes; Lozano, Juan J; Ingelmo-Torres, Mercedes; Palou, Joan; Rodríguez-Faba, Oscar; Witjes, Johannes A; Van der Heijden, Antoine G; Medina, Rafael; Conde, Jose M; Marberger, Michael; Schmidbauer, Joerg; Fernández, Pedro L; Alcaraz, Antonio

    2016-02-01

    This study aimed to validate, in a prospective, blinded, international and multicenter cohort, our previously reported four non-invasive tests for bladder cancer (BC) diagnosis based on the gene expression patterns of urine. Consecutive voided urine samples from BC patients and controls were prospectively collected in five European centres (n=789). Finally, 525 samples were successfully analysed. Gene expression values were quantified using TaqMan Arrays and previously reported diagnostic algorithms were applied to gene expression data. Results from the most accurate gene signature for BC diagnosis were associated with clinical parameters using analysis of variance test. High diagnostic accuracy for the four gene signatures was found in the independent validation set (area under curve [AUC]=0.903-0.918), with the signature composed of two genes (GS_D2) having the best performance (sensitivity: 81.48%; specificity: 91.26%; AUC: 0.918). The diagnostic accuracy of GS_D2 was not affected by the number of tumours (p=0.58) but was statistically associated with tumour size (p=0.008). Also, GS_D2 diagnostic accuracy increases with increasing BC tumour risk. We found no differences in the performance of the GS_D2 test among the populations and centres in detecting tumours (p=0.7) and controls (p=0.2). Our GS_D2 test is non-invasive, non-observer dependent and non-labour-intensive, and has demonstrated diagnostic accuracy in an independent, international and multicenter study, equal or superior to the current gold standard (cystoscopy combined with cytology). Additionally, it has higher sensitivity than cytology while maintaining its specificity. Consequently, it meets the requirements for consideration as a molecular test applicable to clinical practice in the management of BC. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Oats in the diet of children with celiac disease: preliminary results of a double-blind, randomized, placebo-controlled multicenter Italian study.

    PubMed

    Gatti, Simona; Caporelli, Nicole; Galeazzi, Tiziana; Francavilla, Ruggiero; Barbato, Maria; Roggero, Paola; Malamisura, Basilio; Iacono, Giuseppe; Budelli, Andrea; Gesuita, Rosaria; Catassi, Carlo; Lionetti, Elena

    2013-11-20

    A gluten-free diet (GFD) is currently the only available treatment for patients with celiac disease (CD). Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet "A", 3 months of standard GFD, 6 months of diet "B"), or B-A treatment (6 months of diet "B", 3 months of standard GFD, 6 months of diet "A"). A and B diets included gluten-free (GF) products (flour, pasta, biscuits, cakes and crisp toasts) with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score) and intestinal permeability tests (IPT), were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M) ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms.

  17. Tumor immunoscintigraphy by means of radiolabeled monoclonal antibodies: Multicenter studies of the Italian National Research Council--Special Project Biomedical Engineering

    SciTech Connect

    Siccardi, A.G. )

    1990-02-01

    Four radioimmunopharmaceuticals ({sup 99m}Tc- and 111In-labeled anti-melanoma and {sup 111}In- and {sup 131}I-labeled anti-carcinoembryonic antigen F(ab')2 fragments derived from monoclonal antibodies 225.28S and F023C5) were developed by means of a collaborative effort coordinated by the Italian National Research Council, Special Project Biomedical Engineering. After appropriate pilot studies, the radioimmunopharmaceuticals, prepared by Sorin Biomedica (Saluggia, Italy), were distributed to 31 Nuclear Medicine departments in Italy and in 10 other European countries within the framework of three immunoscintigraphy multicenter studies. A total of 1245 patients were studied, 898 of whom carried 1725 documented tumor lesions; 1596 of 2193 tumor lesions (468 of which were previously unknown) were imaged by immunoscintigraphy in 785 of 990 lesion-bearing patients. Among the occult lesions, 173 were imaged in 92 patients admitted to the study as lesion-free patients. The results have been analyzed in terms of the reliability, reproducibility, and diagnostic usefulness of the method and of each immunoradiopharmaceutical.

  18. Oats in the Diet of Children with Celiac Disease: Preliminary Results of a Double-Blind, Randomized, Placebo-Controlled Multicenter Italian Study

    PubMed Central

    Gatti, Simona; Caporelli, Nicole; Galeazzi, Tiziana; Francavilla, Ruggiero; Barbato, Maria; Roggero, Paola; Malamisura, Basilio; Iacono, Giuseppe; Budelli, Andrea; Gesuita, Rosaria; Catassi, Carlo; Lionetti, Elena

    2013-01-01

    A gluten-free diet (GFD) is currently the only available treatment for patients with celiac disease (CD). Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet “A”, 3 months of standard GFD, 6 months of diet “B”), or B-A treatment (6 months of diet “B”, 3 months of standard GFD, 6 months of diet “A”). A and B diets included gluten-free (GF) products (flour, pasta, biscuits, cakes and crisp toasts) with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score) and intestinal permeability tests (IPT), were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M) ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms. PMID:24264227

  19. Preventive measures for cyclophosphamide-related hemorrhagic cystitis in blood and bone marrow transplantation: an Italian multicenter retrospective study.

    PubMed

    Gonella, Silvia; di Pasquale, Tania; Palese, Alvisa

    2015-02-01

    Hemorrhagic cystitis (HC) is a troublesome and potentially life-threatening complication of bone marrow transplantation (BMT). HC can appear within a few hours after chemotherapy or after weeks or months. Early-onset HC (EOHC) is usually associated with the conditioning regimen. The main aim of this study was to describe the incidence of EOHC in patients undergoing BMT regimens including high-dose cyclophosphamide (CY) and the effects of the main preventive measures adopted in Italian nursing practice. The authors retrospectively analyzed the clinical records of 158 Italian patients who underwent BMT from 2006-2008. Thirty-one patients (19.6%) developed EOHC. One hundred and forty-seven patients (93%) given high-dose CY were treated with hyperhydration combined with 2-mercaptoethane sulphonate (mesna) and diuresis alkalinization, and only 51 (32.3%) patients were preventively catheterized and received continuous bladder irrigation (CBI). By univariate analysis, prophylactic urethral catheterization and CBI did not decrease EOHC incidence questioning if these measures were to be routinely recommended. Previous studies showed increased discomfort and urinary tract infection in catheterized patients; therefore, nurses may fulfill an important role in balancing the benefits and harms of preventive catheterization and CBI in patients who received BMT conditioning including high-dose CY.

  20. Survival in HIV-Infected Patients after a Cancer Diagnosis in the cART Era: Results of an Italian Multicenter Study

    PubMed Central

    Gotti, Daria; Raffetti, Elena; Albini, Laura; Sighinolfi, Laura; Maggiolo, Franco; Di Filippo, Elisa; Ladisa, Nicoletta; Angarano, Gioacchino; Lapadula, Giuseppe; Pan, Angelo; Esposti, Anna Degli; Fabbiani, Massimiliano; Focà, Emanuele; Scalzini, Alfredo; Donato, Francesco; Quiros-Roldan, Eugenia

    2014-01-01

    Objectives We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC) or non-AIDS-defining cancer (NADC) diagnosis in the modern cART era. Methods Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model. Results Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51%) were ADCs and 431 (49%) were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017). Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001). Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14%) than lung cancer (1-year survival: 28%±8.7%), liver cancer (5-year survival: 31.9%±6.4%) or Hodgkin lymphoma (10-year survival: 24.8%±11.2%). Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs. Conclusions cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group. PMID:24760049

  1. Trabectedin in advanced synovial sarcomas: a multicenter retrospective study from four European institutions and the Italian Rare Cancer Network.

    PubMed

    Sanfilippo, Roberta; Dileo, Palma; Blay, Jean-Yves; Constantinidou, Anastasia; Le Cesne, Axel; Benson, Charlotte; Vizzini, Laura; Contu, Marianna; Baldi, Giacomo G; Dei Tos, Angelo P; Casali, Paolo G

    2015-07-01

    Treatment options for patients with metastatic synovial sarcoma are limited. Over recent years, trabectedin has emerged as an effective agent for patients with advanced soft tissue sarcomas resistant to anthracyclines and ifosfamide. The aim of this retrospective analysis was to study the efficacy of trabectedin in the subgroup of synovial sarcomas. A retrospective analysis was carried out on patients with advanced synovial sarcoma treated with trabectedin at four European reference sarcoma centers and within the Italian Rare Cancer Network between 2000 and 2013. Radiological response, progression-free, and overall survival, as well as serious and unexpected adverse events were retrospectively assessed. Sixty-one patients with metastatic synovial sarcoma were identified. The median number of previous chemotherapy regimens was 2 (range 1-6). Nine patients had a partial response, in addition to two minor responses, and 19 patients had stable disease, for an overall response rate of 15% and a tumor control rate of 50%. The median progression-free survival was 3 months, with 23% of patients free from progression at 6 months. The median progression-free survival in responding patients was 7 months. Trabectedin is a therapeutic option for palliative treatment of a subset of patients with metastatic synovial sarcoma.

  2. Preoperative prediction of lymph node metastasis and deep stromal invasion in women with invasive cervical cancer: prospective multicenter study using 2D and 3D ultrasound.

    PubMed

    Pálsdóttir, K; Fischerova, D; Franchi, D; Testa, A; Di Legge, A; Epstein, E

    2015-04-01

    To determine how various objective two-dimensional (2D) and three-dimensional (3D) ultrasound parameters allow prediction of deep stromal tumor invasion and lymph node involvement, in comparison to subjective ultrasound assessment, in women scheduled for surgery for cervical cancer. This was a prospective multicenter trial including 104 women with cervical cancer at FIGO Stages IA2-IIB, verified histologically. Patients scheduled for surgery underwent a preoperative ultrasound examination. The value of various 2D (size, color score) and 3D (volume, vascular indices) ultrasound parameters was compared to that of subjective assessment in the prediction of deep stromal tumor invasion and lymph node involvement. Histology obtained from radical hysterectomy or trachelectomy and pelvic lymphadenectomy was considered as the gold standard for assessment. All women underwent pelvic lymphadenectomy, with 99 (95%) undergoing subsequent radical surgery; five underwent only pelvic lymphadenectomy because of the presence of a positive sentinel lymph node. Women with deep stromal invasion or lymph node involvement had significantly larger tumors (diameter and volume) but there was no correlation with vascular indices measured on 3D ultrasound. Subjective evaluation was superior (AUC, 0.93; sensitivity, 90.5%; specificity, 97.2%) in the prediction of deep stromal invasion when compared to any objective measurement technique, with maximal tumor diameter at 20.5-mm cut-off (AUC, 0.83; sensitivity, 90.5%; specificity, 61.1%) and 3D tumor volume at 9.1-mm(3) cut-off (AUC, 0.85; sensitivity, 79.4%; specificity, 83.3%) providing the best performance among the objective parameters. Both subjective assessment and objective measurements were poorly predictive of lymph node involvement. In women with cervical cancer, subjective ultrasound evaluation allowed better prediction of deep stromal invasion than did objective measurements; however, neither subjective evaluation nor objective

  3. Detect Long-term Complications After ICD Replacement (DECODE): Rationale and Study Design of a Multicenter Italian Registry.

    PubMed

    Diemberger, Igor; Parisi, Quintino; De Filippo, Paolo; Narducci, Maria Lucia; Zanon, Francesco; Potenza, Domenico Rosario; Ciaramitaro, Gianfranco; Malacrida, Maurizio; Boriani, Giuseppe; Biffi, Mauro

    2015-10-01

    The replacement of implantable cardioverter-defibrillators (ICDs) may give rise to considerable clinical consequences, the importance of which is underrated by the medical community. Replacement-related adverse events are difficult to identify and require monitoring of both short-term complications and long-term patient outcome. The aim of this study is to perform a structured evaluation of both short- and long-term adverse events and a cost analysis of consecutive ICD replacement procedures. Detect Long-term Complications After ICD Replacement (DECODE) is a prospective, single-arm, multicenter cohort study designed to estimate long-term complication rates (at 12 months and 5 years) in patients undergoing ICD generator replacement. The study will also evaluate predictors of complications, patient management before and during the replacement procedure in clinical practice, and the costs related to use of health care resources. About 800 consecutive patients with standard indications for ICD generator replacement will be enrolled in this study. The decision to undertake generator replacement/upgrade will be made according to the investigators' own judgment (which will be recorded). Patients will be followed for 60 months through periodic in-hospital examinations or remote monitoring. Detailed data on complications related to ICD replacement in current clinical practice are still lacking. The analysis of adverse events will reveal the value of new preventive strategies, thereby yielding both clinical and economic benefits. Moreover, assessment of complication rates after ICD replacement in a real-life setting will help estimate the actual long-term cost of ICD therapy and assess the real impact of increasing ICD longevity on cost-effectiveness. © 2015 Wiley Periodicals, Inc.

  4. Gender's equality in evaluation of urine particles: Results of a multicenter study of the Italian Urinalysis Group.

    PubMed

    Manoni, Fabio; Gessoni, Gianluca; Alessio, Maria Grazia; Caleffi, Alberta; Saccani, Graziella; Epifani, Maria Grazia; Tinello, Agostino; Zorzan, Tatiana; Valverde, Sara; Caputo, Marco; Lippi, Giuseppe

    2014-01-01

    We performed a multicenter study to calculate the upper reference limits (URL) for urine particle quantification in mid-stream samples by using automated urine analyzers. Two laboratories tested 283 subjects using a Sysmex UF-100, two other laboratories tested 313 subjects using Sysmex UF-1000i, whereas two other laboratories tested 267 subjects using Iris IQ®200. The URLs of UF-100 in females and males were 7.8/μL and 6.7/μL for epithelial cells (EC), 11.1/μL and 9.9/μL for red blood cells (RBC), 10.2/μL and 9.7/μL for white blood cells (WBC), and 0.85/μL and 0.87/μL for cylinders (CAST). The URLs of UF-1000i in females and males were 7.6/μL and 7.1/μL for EC, 12.2/μL and 11.1/μL for RBC, 11.9/μL and 11.7/μL for WBC, and 0.88/μL and 0.86/μL for CAST. The URLs of Iris IQ®200 in females and males were 7.8/μL and 6.6/μL for EC, 12.4/μL and 10.1/μL for RBC, 10.9/μL and 9.9/μL for WBC, and 1.1/μL and 1.0/μL for CAST. The URLs obtained in this study were comparable to the lowest values previously reported in the literature. Moreover, no gender-related difference was observed, and analyzer-specific upper reference limits were very similar. © 2013.

  5. Quality of Life Assessment With Orthotopic Ileal Neobladder Reconstruction After Radical Cystectomy: Results From a Prospective Italian Multicenter Observational Study.

    PubMed

    Imbimbo, Ciro; Mirone, Vincenzo; Siracusano, Salvatore; Niero, Mauro; Cerruto, Maria Angela; Lonardi, Cristina; Artibani, Walter; Bassi, Pierfrancesco; Iafrate, Massimo; Racioppi, Marco; Talamini, Renato; Ciciliato, Stefano; Toffoli, Laura; Visalli, Francesco; Massidda, Davide; D'Elia, Carolina; Cacciamani, Giovanni; De Marchi, Davide; Silvestri, Tommaso; Creta, Massimiliano; Belgrano, Emanuele; Verze, Paolo

    2015-11-01

    To assess health-related quality of life (HRQoL) parameters in patients who received radical cystectomy (RC) with ileal orthotopic neobladder (IONB) reconstruction and to identify clinic-pathologic predictors of HRQoL. From January 2010 to December 2013, a multicenter, retrospective on 174 RC-IONB patients was carried out. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the IONB-Patient Reported Outcome (IONB-PRO). Univariate and multivariate analyses were computed to identify clinic-pathologic predictors of HRQoL. Median age was 66 years (range, 31-83), and 91.4% of patients were men. Median follow-up period was 37 months (range, 3-247). The EORTC QLQ-C30 revealed that age >65 years, absence of urinary incontinence, and absence of peripheral vascular disease were independent predictors of deteriorated body image. A follow-up > 36 months and the presence of urinary incontinence were independent predictors of worsened urinary symptoms, whereas the absence of urinary incontinence was an independent predictor of a worsened body image according to EORTC QLQ-BLM30 results. A follow-up >36 months and the absence of urinary incontinence were independent predictors of better functioning in terms of relational life, emotional life, and fatigue as revealed by the IONB-PRO. Age, presence of urinary incontinence, length of follow-up, and comorbidity status may influence postoperative HRQoL and should all be taken into account when counseling RC-IONB patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Frovatriptan versus zolmitriptan for the acute treatment of migraine: a double-blind, randomized, multicenter, Italian study.

    PubMed

    Tullo, Vincenzo; Allais, Gianni; Ferrari, Michel D; Curone, Marcella; Mea, Eliana; Omboni, Stefano; Benedetto, Chiara; Zava, Dario; Bussone, Gennaro

    2010-06-01

    The objective of this study is to assess patients' satisfaction with migraine treatment with frovatriptan (F) or zolmitriptan (Z), by preference questionnaire. 133 subjects with a history of migraine with or without aura (IHS criteria) were randomized to F 2.5 mg or Z 2.5 mg. The study had a multicenter, randomized, double-blind, cross-over design, with each of the two treatment periods lasting no more than 3 months. At the end of the study, patients were asked to assign preference to one of the treatments (primary endpoint). The number of pain-free (PF) and pain-relief (PR) episodes at 2 h, and number of recurrent and sustained pain-free (SPF) episodes within 48 h were the secondary study endpoints. Seventy-seven percent of patients expressed a preference. Average score of preference was 2.9 +/- 1.3 (F) versus 3.0 +/- 1.3 (Z; p = NS). Rate of PF episodes at 2 h was 26% with F and 31% with Z (p = NS). PR episodes at 2 h were 57% for F and 58% for Z (p = NS). Rate of recurrence was 21 (F) and 24% (Z; p = NS). Time to recurrence within 48 h was better for F especially between 4 and 16 h (p < 0.05). SPF episodes were 18 (F) versus 22% (Z; p = NS). Drug-related adverse events were significantly (p < 0.05) less under F (3 vs. 10). In conclusion, our study suggests that F has a similar efficacy of Z, with some advantage as regards tolerability and recurrence.

  7. A double-blind, randomized, multicenter, Italian study of frovatriptan versus rizatriptan for the acute treatment of migraine.

    PubMed

    Savi, Lidia; Omboni, Stefano; Lisotto, Carlo; Zanchin, Giorgio; Ferrari, Michel D; Zava, Dario; Pinessi, Lorenzo

    2011-04-01

    The objective of this study was to assess patient satisfaction with acute treatment of migraine with frovatriptan or rizatriptan by preference questionnaire. 148 subjects with a history of migraine with or without aura (IHS 2004 criteria), with at least one migraine attack per month in the preceding 6 months, were enrolled and randomized to frovatriptan 2.5 mg or rizatriptan 10 mg treating 1-3 attacks. The study had a multicenter, randomized, double-blind, cross-over design, with treatment periods lasting <3 months. At the end of the study, patients assigned preference to one of the treatments using a questionnaire with a score from 0 to 5 (primary endpoint). Secondary endpoints were pain-free and pain relief episodes at 2 h, and recurrent and sustained pain-free episodes within 48 h. 104 of the 125 patients (83%, intention-to-treat population) expressed a preference for a triptan. The average preference score was not significantly different between frovatriptan (2.9±1.3) and rizatriptan (3.2±1.1). The rates of pain-free (33% frovatriptan vs. 39% rizatriptan) and pain relief (55 vs. 62%) episodes at 2 h were not significantly different between the two treatments. The rate of recurrent episodes was significantly (p<0.001) lower under frovatriptan (21 vs. 43% rizatriptan). No significant differences were observed in sustained pain-free episodes (26% frovatriptan vs. 22% rizatriptan). The number of patients with adverse events was not significantly different between rizatriptan (34) and frovatriptan (25, p=NS). The results suggest that frovatriptan has a similar efficacy to rizatriptan, but a more prolonged duration of action. © Springer-Verlag 2010

  8. A double-blind, randomized, multicenter, Italian study of frovatriptan versus almotriptan for the acute treatment of migraine.

    PubMed

    Bartolini, Marco; Giamberardino, Maria Adele; Lisotto, Carlo; Martelletti, Paolo; Moscato, Davide; Panascia, Biagio; Savi, Lidia; Pini, Luigi Alberto; Sances, Grazia; Santoro, Patrizia; Zanchin, Giorgio; Omboni, Stefano; Ferrari, Michel D; Brighina, Filippo; Fierro, Brigida

    2011-06-01

    The objective of this study was to evaluate patients' satisfaction with acute treatment of migraine with frovatriptan or almotriptan by preference questionnaire. One hundred and thirty three subjects with a history of migraine with or without aura (IHS 2004 criteria), with at least one migraine attack in the preceding 6 months, were enrolled and randomized to frovatriptan 2.5 mg or almotriptan 12.5 mg, treating 1-3 attacks. The study had a multicenter, randomized, double blind, cross-over design, with treatment periods lasting <3 months. At study end patients assigned preference to one of the treatments using a questionnaire with a score from 0 to 5 (primary endpoint). Secondary endpoints were pain free and pain relief episodes at 2 and 4 h, and recurrent and sustained pain free episodes within 48 h. Of the 133 patients (86%, intention-to-treat population) 114 of them expressed a preference for a triptan. The average preference score was not significantly different between frovatriptan (3.1 ± 1.3) and almotriptan (3.4 ± 1.3). The rates of pain free (30% frovatriptan vs. 32% almotriptan) and pain relief (54% vs. 56%) episodes at 2 h did not significantly differ between treatments. This was the case also at 4 h (pain free: 56% vs. 59%; pain relief: 75% vs. 72%). Recurrent episodes were significantly (P < 0.05) less frequent under frovatriptan (30% vs. 44%), also for the attacks treated within 30 min. No significant differences were observed in sustained pain free episodes (21% vs. 18%). The tolerability profile was similar between the two drugs. In conclusion, our study suggests that frovatriptan has a similar efficacy of almotriptan in the short-term, while some advantages are observed during long-term treatment.

  9. Treatment of isolated testicular relapse in childhood acute lymphoblastic leukemia: an Italian multicenter study. Associazione Italiana Ematologia ed Oncologia Pediatrica.

    PubMed

    Uderzo, C; Grazia Zurlo, M; Adamoli, L; Zanesco, L; Aricò, M; Calculli, G; Comelli, A; Cordero di Montezemolo, L; Di Tullio, M T; Guazzelli, C

    1990-04-01

    Between May 1980 and April 1987, 49 children with acute lymphoblastic leukemia (ALL) in isolated testicular and first leukemia relapse (ITR) were enrolled in the Associazione Italiana Ematologia ed Oncologia Pediatrica (AIEOP) multicenter study REC80-ITR. According to the Rome Workshop criteria, 77% were at standard and 23% at high initial prognostic risk. In 33% of the cases, ITR occurred during first treatment. The REC80-ITR protocol consisted of an induction phase regimen of vincristine (VCR), cytarabine (ARA-C), methotrexate (MTX), and asparaginase (L-asp), and bilateral testicular irradiation, and CNS prophylaxis with intrathecal MTX and a maintenance phase with a multidrug rotating regimen. Total treatment duration was 30 months. The median time of observation after ITR was 51 months. The Kaplan-Meier estimates of survival and disease-free survival (DFS) at 4 years were 67.7% and 41%, respectively. Patients who had an ITR on therapy or within the first off-therapy year showed the poorest outcome. The DFS at 3 years was 20%, 47.6%, and 100%, respectively, for children who had an ITR on treatment (n = 16), within the first year of treatment withdrawal (n = 22), or later (n = 10) (P = .001). Patients with an asymptomatic occult testicular infiltrate at treatment discontinuation had a very unfavorable prognosis. Eighty-one percent of second relapses involved the bone marrow. In our experience, children presenting an early ITR (ie, within 6 months of treatment withdrawal) need a very aggressive treatment because of the high probability of an underlying systemic disease. On the other hand, patients with a late ITR seem to have a truly local recurrence and can apparently be cured by standard protocols, as shown in protocol REC80-ITR.

  10. Osteonecrosis of the Jaw in Patients With Metastatic Renal Cell Cancer Treated With Bisphosphonates and Targeted Agents: Results of an Italian Multicenter Study and Review of the Literature.

    PubMed

    Fusco, Vittorio; Porta, Camillo; Saia, Giorgia; Paglino, Chiara; Bettini, Giordana; Scoletta, Matteo; Bonacina, Riccardo; Vescovi, Paolo; Merigo, Elisabetta; Lo Re, Giovanni; Guglielmini, Pamela; Di Fede, Olga; Campisi, Giuseppina; Bedogni, Alberto

    2015-08-01

    Osteonecrosis of the jaw (ONJ) associated with the use of bisphosphonates has been rarely reported in metastatic renal cell cancer (RCC) patients. Since the introduction of combined therapies consisting of nitrogen-containing bisphosphonates (NBPs) and targeted agents, an increasing number of RCC patients were reported to develop ONJ, suggesting that therapeutic angiogenesis suppression might increase the risk of ONJ in NBPs users. We performed a multicenter retrospective study and reviewed literature data to assess the occurrence and to investigate the nature of ONJ in RCC patients taking NBPs and targeted agents. Nine Italian Centers contributed to the data collection. Patients with exposed and nonexposed ONJ were eligible for the study if they had been taking NBPs and were receiving targeted agents at the time of ONJ diagnosis. Forty-four RCC patients were studied. Patients were mostly male (82%), with a median age of 63 years (range, 45-85 years). Zoledronic acid (93%) and sunitinib (80%) were the most frequently used NBP and antiangiogenic agent, respectively. Other agents included Pamidronate, ibandronate, sorafenib, bevacizumab, mammalian target of rapamycin inhibitors. Forty-nine sites of ONJ were encountered, with the mandible being the preferred site of ONJ (52%); both jaws were affected in 5 cases (12%). The most common precipitating event was dental/periodontal infection (34%), followed by tooth extraction (30%). Oral triggers of ONJ were missing in 10 cases (23%). This unexpectedly high number of ONJ cases, in comparison with literature data, suggests that frequency of ONJ in RCC patients might be largely underestimated and suggests a potential role for targeted agents in the incremental risk of ONJ. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Chronic HBV infection in pregnant immigrants: a multicenter study of the Italian Society of Infectious and Tropical Diseases.

    PubMed

    Sagnelli, Evangelista; Taliani, Gloria; Castelli, Francesco; Bartolozzi, Dario; Cacopardo, Bruno; Armignacco, Orlando; Scotto, Gaetano; Coppola, Nicola; Stroffolini, Tommaso; Sagnelli, Caterina

    2016-04-01

    The aims of the study were to estimate the clinical impact of HBV infection in pregnant immigrants and their family members and to identify a useful approach to managing the healthcare of HBsAg-positive immigrants. Included in this study were 143 HBsAg-positive pregnant immigrants of the 1,970 from countries with intermediate/high HBV endemicity who delivered in 8 Italian hospitals in 2012-2013. In addition, 172 family members of 96 HBsAg-positive pregnant immigrants were tested for serum HBsAg. The median age of the 143 HBsAg-positive pregnant immigrants was 31.0±12.1 years and the length of stay in Italy 5.0±4.1 years; 56.5% were unaware of their HBsAg positivity. HBV DNA was detected in 74.5% of the pregnant immigrants, i.e., 94.3% from Eastern Europe, 72.2% from East Asia and 58.1% from Sub-Saharan Africa. HBV DNA ≥2000 IU/mL was detected in 47.8% of pregnant immigrants, associated with ALT ≥1.5 times the upper normal value in 15% of cases. Anti-HDV was detected in 10% of cases. HBsAg was detected in 31.3% of the 172 family members. All HBsAg-positive immigrants received counseling on HBV infection and its prevention, and underwent a complete clinical evaluation. The findings validate the approach used for the healthcare management of the HBsAg-positive immigrant population.

  12. The role and working conditions of Movement Science students employed in sport and recreational facilities: An Italian multicenter study.

    PubMed

    Gallè, Francesca; Di Onofrio, Valeria; Arpesella, Marisa; Bacci, Silvia; Bianco, Antonino; Brandi, Giorgio; Bruno, Stefania; Anastasi, Daniela; Carraro, Elisabetta; Flacco, Maria Elena; Giampaoli, Saverio; Izzotti, Alberto; Leoni, Erica; Bertoncello, Chiara; Minelli, Liliana; Napoli, Christian; Nobile, Carmelo; Pasquarella, Cesira; Liguori, Giorgio; Romano Spica, Vincenzo

    2015-01-01

    In Italy, students from Movement Science (MS) Degree Courses often work in sport and recreational facilities before graduation. The employment conditions of Movement Science students working in sport/recreational facilities were investigated, and the management and structural features of the facilities were evaluated, including safety policies. Regional differences were also considered. Questionnaires were administered to undergraduate and graduate students (N = 4,217) in 17 Universities. Students' perceptions of the quality of the facilities where they had been employed was evaluated using multivariate analysis. A latent class model with covariates was used to evaluate how variables relating to participants, employment facilities or regions influence their opinions. A high proportion of MS students were employed in sporting facilities (undergraduate level: 33% ; graduate level: 55%), in most cases without any formal employment contracts. Both the structural and hygienic features, as well as the professional knowledge of the staff, were considered good to excellent by the majority of participants (about 70%). Communication of the basic behavioral rules was considered adequate by 61-63% of undergraduate students and 71-75% of graduate students, while nearly half of the participants were dissatisfied with the staff safety training. Correlations between the perceived good structural/hygienic conditions, the presence of regulations and training programs for the staff were investigated. Differences regarding occupational level and safety training among different regions of Italy were also observed. Italian students in Movement Science were easily employed in sport/recreational facilities, but frequently without a formal contract. This is a consequence of the lack of specific regulations in the field of recreational/leisure employment and could have negative implications, especially in terms of safety.

  13. Open versus minimally invasive sacroiliac joint fusion: a multi-center comparison of perioperative measures and clinical outcomes

    PubMed Central

    2013-01-01

    Background Sacroiliac (SI) joint pain is an under diagnosed source of low back pain due in part to lack of visible pathology on radiographs and symptoms mimicking other back-related disorders. Open SI joint fusion has been performed since the 1920s. This technique has fallen out of favor with the introduction of minimally invasive options. To date there has been no direct comparison between open and MIS SI joint fusion. Methods We conducted a multi-center, retrospective comparative cohort study of patients who underwent SI joint fusion using either an open surgical (OS) technique using a combination of screws and cages or a minimally invasive surgical (MIS) technique with a series of titanium plasma spray (TPS) coated triangular implants. Operative measures including surgical operating time, length of hospitalization and estimated blood loss (EBL) were collected along with demographics and medical history, surgical complications, and 12- and 24-month pain scores. Improvements in pain were compared after matching for age and gender and controlling for a history of lumbar spine fusion using repeated measures analysis of variance. Results Data were available for 263 patients treated by 7 surgeons; 149 patients treated with OS and 114 treated with MIS SI joint fusion. Compared to OS patients, MIS patients were on average 10 years older (mean age 57 vs. 46) and 69% of all patients were female. MIS operative measures of EBL, operating time and length of hospitalization were significantly lower than open surgery (p < 0.001). Pain relief, measured as change from baseline to 12 months in VAS pain rating, was 3.5 points lower in the MIS vs. OS group (-6.2 vs. -2.7 points, p < 0.001). When matched for age, gender and a history of prior lumbar spinal fusion, postoperative pain scores were on average 3.0 points (95% CI 2.1 – 4.0) lower in MIS vs. OS (rANOVA p < 0.001). Conclusions In this multi-center comparative study, patients who underwent either OS or MIS SI

  14. Triangular Titanium Implants for Minimally Invasive Sacroiliac Joint Fusion: 2-Year Follow-Up from a Prospective Multicenter Trial

    PubMed Central

    Bitan, Fabien; Lockstadt, Harry; Kovalsky, Don; Cher, Daniel; Hillen, Travis

    2016-01-01

    Background Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable mid-term outcomes after SIJ fusion using titanium implants placed across the SIJ. Herein we report long-term (24-month) results from a prospective multicenter clinical trial. Methods One hundred and seventy-two subjects at 26 US sites with SI joint dysfunction were enrolled and underwent minimally invasive SI joint fusion with triangular titanium implants. Subjects underwent structured assessments preoperatively and at 1, 3, 6, 12, 18 and 24 months postoperatively, including SIJ pain ratings (0-100 visual analog scale), Oswestry Disability Index (ODI), Short Form-36 (SF-36), EuroQOL-5D (EQ-5D), and patient satisfaction. Adverse events were collected throughout follow-up. All participating patients underwent a high-resolution pelvic CT scan at 1 year. Results Mean subject age was 50.9 years and 69.8% were women. SIJ pain was present for an average of 5.1 years prior to surgical treatment. SIJ pain decreased from 79.8 at baseline to 30.4 at 12 months and remained low at 26.0 at 24 months (p<.0001 for change from baseline). ODI decreased from 55.2 at baseline to 31.5 at 12 months and remained low at 30.9 at 24 months (p<.0001 for change from baseline). Quality of life (SF-36 and EQ-5D) improvements seen at 12 months were sustained at 24 months. The proportion of subjects taking opioids for SIJ or low back pain decreased from 76.2% at baseline to 55.0% at 24 months (p <.0001). To date, 8 subjects (4.7%) have undergone one or more revision SIJ surgeries. 7 device-related adverse events occurred. CT scan at one year showed a high rate (97%) of bone adherence to at least 2 implants on both the iliac and sacral sides with modest rates of bone growth across the SIJ. Conclusions In this study of patients with SIJ dysfunction, minimally invasive SI joint fusion using triangular titanium implants showed marked improvements in pain, disability and

  15. Non-invasive repeated therapeutic stimulation for aphasia recovery: a multilingual, multicenter aphasia trial.

    PubMed

    Thiel, Alexander; Black, Sandra E; Rochon, Elizabeth A; Lanthier, Sylvain; Hartmann, Alexander; Chen, Joyce L; Mochizuki, George; Zumbansen, Anna; Heiss, Wolf-Dieter

    2015-04-01

    Noninvasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) has been used in case series and small randomized controlled trials to improve recovery from poststroke aphasia in combination with speech and language therapy. Results of these studies suggest possible clinical efficacy and an excellent safety profile. Therefore, a larger international multicenter proof-of-concept trial was launched, to directly compare the safety and efficacy of rTMS, tDCS, and sham stimulation as adjuvant therapy to speech and language therapy in subacute poststroke aphasia. In the 4 participating centers, subacute stroke patients with aphasia are randomized between 5 and 30 days after ischemic stroke to either receive rTMS, tDCS, or sham stimulation in combination with a daily 45 minutes speech and language therapy session for 10 days. Efficacy is evaluated at 1 and 30 days after the last of the 10 treatment sessions using 3 outcome measures, validated in all participating languages: Boston naming test, Token test, and verbal fluency test. Additionally, adverse events are recorded to prove safety. In this study, a total of 90 patients will be recruited, and data analysis will be completed in 2016. This is the first multilingual and multinational randomized and controlled trial in poststroke aphasia and if positive, will add an effective new strategy for early stage poststroke aphasia rehabilitation.

  16. Molecular characterization of invasive Streptococcus dysgalactiae subsp. equisimilis. Multicenter study: Argentina 2011-2012.

    PubMed

    Traverso, Fernando; Blanco, Alejandra; Villalón, Pilar; Beratz, Noelia; Sáez Nieto, Juan Antonio; Lopardo, Horacio

    Streptococcus dysgalactiae subsp. equisimilis (SDSE) has virulence factors similar to those of Streptococcus pyogenes. Therefore, it causes pharyngitis and severe infections indistinguishable from those caused by the classic pathogen. The objectives of this study were: to know the prevalence of SDSE invasive infections in Argentina, to study the genetic diversity, to determine the presence of virulence genes, to study antibiotic susceptibility and to detect antibiotic resistance genes. Conventional methods of identification were used. Antibiotic susceptibility was determined by the disk diffusion and the agar dilution methods and the E-test. Twenty eight centers from 16 Argentinean cities participated in the study. Twenty three isolates (16 group G and 7 group C) were obtained between July 1 2011 and June 30 2012. Two adult patients died (8.7%). Most of the isolates were recovered from blood (60.9%). All isolates carried speJ and ssa genes. stG62647, stG653 and stG840 were the most frequent emm types. Nineteen different PFGE patterns were detected. All isolates were susceptible to penicillin and levofloxacin, 6 (26.1%) showed resistance or reduced susceptibility to erythromycin [1 mef(A), 3 erm(TR), 1 mef(A)+erm(TR) and 1 erm(TR)+erm(B)] and 7 (30.4%) were resistant or exhibited reduced susceptibility to tetracycline [2 tet(M), 5 tet(M)+tet(O)]. The prevalence in Argentina was of at least 23 invasive infections by SDSE. A wide genetic diversity was observed. All isolates carried speJ and ssa genes. Similarly to other studies, macrolide resistance (26.1%) was mainly associated to the MLSB phenotype. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Evidence of exercise-induced myocardial ischemia in patients with primary aldosteronism: the Cross-sectional Primary Aldosteronism and Heart Italian Multicenter Study.

    PubMed

    Napoli, C; Di Gregorio, F; Leccese, M; Abete, P; Ambrosio, G; Giusti, R; Casini, A; Ferrara, N; De Matteis, C; Sibilio, G; Donzelli, R; Montemarano, A; Mazzeo, C; Rengo, F; Mansi, L; Liguori, A

    1999-05-01

    Primary aldosteronism (PA) is a disease associated with hypersecretion of aldosterone caused by an aldosterone-producing adrenal adenoma, bilateral adrenal hyperplasia, and, although rarely, by adrenal carcinoma. Arterial hypertension induces several cardiovascular alterations that yield a high cardiovascular risk. It has been shown that reduced myocardial perfusion at rest, assessed by thallium-201 myocardial scintigraphy, was greater in PA than in essential hypertension (EH). However, it is still unknown whether reduced myocardial perfusion at rest and/or regional function abnormalities are present during exercise-induced myocardial stress. We addressed the impact of PA on myocardial ischemia and sought to identify signs of exercise-induced myocardial ischemia (assessed by MIBI-SPECT and echocardiography) in patients with PA compared to patients with EH. Patients with consistent signs of myocardial ischemia on all of the tests were studied by coronary arteriography. We studied 72 patients with PA and an age/sex-matched group of 72 patients with EH enrolled in the cross-sectional Primary Aldosteronism and Heart Italian Multicenter Study (PAHIMS). Regional function was detected from echocardiographic measurement of wall motion done at baseline and immediately after exercise. Myocardial perfusion was evaluated by SPECT imaging after injecting 99mTc-MIBI with the same-day protocol using the rest-stress sequence. Although the conditions of arterial pressure, duration of hypertension, and target organ damage were equivalent, the patients with PA had greater incidence of both reversible perfusion defects and abnormalities of regional function. Moreover, multiple regression analysis showed that the high plasma aldosterone level was highly predictive for SPECT ischemic score and wall motion index, suggesting that PA contributes to cardiovascular risk over and above that associated with ventricular hypertrophy. Exercise-induced myocardial ischemia in PA was not segmental

  18. BE-POSITIVE: Beyond progression after tyrosine kinase inhibitor in EGFR- positive non small cell lung cancer patients: Results from a multicenter Italian observational study.

    PubMed

    Vavalà, Tiziana; Follador, Alessandro; Tiseo, Marcello; Galetta, Domenico; Morabito, Alessandro; Di Maio, Massimo; Martelli, Olga; Caffo, Orazio; Piovano, Pier Luigi; Cortinovis, Diego; Zilembo, Nicoletta; Casartelli, Clelia; Banna, Giuseppe Luigi; Ardizzoia, Antonio; Barzelloni, Maria Luisa; Bearz, Alessandra; Genestreti, Giovenzio; Mucciarini, Claudia; Filipazzi, Virginio; Menis, Jessica; Rizzo, Elisa; Barbieri, Fausto; Rijavec, Erika; Cecere, Fabiana; Bria, Emilio; Spitaleri, Gianluca; Rossi, Antonio; Novello, Silvia

    2016-05-01

    Non-small-cell-lung-cancer (NSCLC) patients harbouring epidermal growth factor receptor (EGFR) mutations develop drug resistance after 9-12 months of EGFR tyrosine kinase inhibitors (TKIs) therapy pointing out the issue of the second-line treatment choice. From June 2009 until May 2013 patients affected by advanced NSCLC harbouring EGFR mutations receiving first-line TKI were collected mainly retrospectively in 24 Italian Centers. Primary objective was to describe the percentage of EGFR mutated patients receiving second-line therapy after progression to first-line EGFR-TKIs assessing the type, the activity in terms of objective response rate (ORR), efficacy in terms of progression free survival (PFS) and overall survival (OS), and safety of second-line treatment. Secondary objective was to describe the efficacy of first-line EGFR-TKIs. 312 patients were included. Most of them were females (203, 65.1%), never smokers (200, 64.1%), with adenocarcinoma histology (290, 92.9%). The most common mutations were EGFR exon 19 deletion and L858R, detected in 186 and 97 cases (59.6% and 31.1%), respectively. At data cut-off, 274 patients (95.1%) received any second-line treatment (including best supportive care or local treatments only). A total of 163 patients received second-line systemic therapy with an ORR of 20.9% (95% CI:14.62-27.10), a median PFS and OS of 4.7 (95% CI:3.81-5.26) and 24.5 (95% CI:21.65-27.37) months, respectively. Grade 3-4 hematological and non-hematological toxicities were reported in 9% and 6.3% of 144 patients treated with chemotherapy while non-hematological toxicity was reported in 4 cases of the 17 patients receiving second-line target agents. BE-Positive is the first multicenter observational study reporting outcomes of therapies in a "real-life Caucasian EGFR-mutated population", highlighting the need of further researches about new treatment strategies in this setting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Gender and triptan efficacy: a pooled analysis of three double-blind, randomized, crossover, multicenter, Italian studies comparing frovatriptan vs. other triptans.

    PubMed

    Franconi, Flavia; Finocchi, Cinzia; Allais, Gianni; Omboni, Stefano; Tullo, Vincenzo; Campesi, Ilaria; Reggiardo, Giorgio; Benedetto, Chiara; Bussone, Gennaro

    2014-05-01

    Migraine is three times as common in females as in males, and attacks may be more severe and difficult to treat in women. However, no study specifically addressed possible gender differences in response to antimigraine therapy. The objective of this study was to review the efficacy of frovatriptan vs. other triptans, in the acute treatment of migraine in subgroups of subjects classified according to gender (men vs. women) through a pooled analysis of three individual randomized Italian studies. 414 patients suffering from migraine with or without aura were randomized to frovatriptan 2.5 mg or rizatriptan 10 mg (study 1), frovatriptan 2.5 mg or zolmitriptan 2.5 mg (study 2), frovatriptan 2.5 mg or almotriptan 12.5 mg (study 3). All studies had a multicenter, randomized, double-blind, crossover design. After treating 1-3 episodes of migraine in no more than 3 months with the first treatment, patients switched to the other treatment for the next 3 months. In this analysis, traditional migraine endpoints were compared between the 66 men and 280 women of the intent-to-treat population. At baseline, long-term and debilitating migraine attacks were more frequently reported by women than men. During the observation period, the proportion of pain-free attacks at 2 h did not significantly differ between frovatriptan and the comparators in either men (32 vs. 38 %, p = NS) or women (30 vs. 33 %, p = NS). Pain relief was also similar between treatments for both genders (men: 56 % frovatriptan vs. 57 % comparators; women: 55 vs. 57 %; p = NS for both). The rate of relapse was significantly lower with frovatriptan than with the comparators in men (24 h: 10 vs. 30 %; 48 h: 21 vs. 39 %; p < 0.05) as well as in women (24 h: 14 vs. 23 %; 48 h: 28 vs. 40 %; p < 0.05). The rate of adverse drug reactions was significantly larger with comparators, irrespectively of gender. Although migraine presents in a more severe form in women, frovatriptan seems to retain its good efficacy and

  20. Characterization, distribution, biology and impact on Italian walnut orchards of the invasive North-American leafminer Coptodisca lucifluella (Lepidoptera: Heliozelidae).

    PubMed

    Bernardo, U; van Nieukerken, E J; Sasso, R; Gebiola, M; Gualtieri, L; Viggiani, G

    2015-04-01

    The leafminer Coptodisca sp. (Lepidoptera: Heliozelidae), recently recorded for the first time in Europe on Italian black and common walnut trees, is shown to be the North-American Coptodisca lucifluella (Clemens) based on morphological (forewing pattern) and molecular (cytochrome oxidase c subunit I sequence) evidence. The phylogenetic relatedness of three species feeding on Juglandaceae suggests that C. lucifluella has likely shifted, within the same host plant family, from its original North-American hosts Carya spp. to Juglans spp. Over the few years since its detection, it has established in many regions in Italy and has become a widespread and dominant invasive species. The leafminer completes three to four generations per year, with the first adults emerging in April-May and mature larvae of the last generation starting hibernation in September-October. Although a high larval mortality was recorded in field observations (up to 74%), the impact of the pest was substantial with all leaves infested at the end of the last generation in all 3 years tested. The distribution of the leafminer in the canopy was homogeneous. The species is redescribed and illustrated, a lectotype is designated and a new synonymy is established.

  1. Rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes): A multicenter retrospective nationwide Italian study and crowdsourcing opportunity.

    PubMed

    Fadini, G P; Zatti, G; Consoli, A; Bonora, E; Sesti, G; Avogaro, A

    2017-08-08

    Randomized controlled trials (RCTs) in the field of diabetes have limitations inherent to the fact that design, setting, and patient characteristics may be poorly transferrable to clinical practice. Thus, evidence from studies using routinely accumulated clinical data are increasingly valued. We herein describe rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes), a multicenter retrospective nationwide study conducted at 50 specialist outpatient clinics in Italy and promoted by the Italian Diabetes Society. The primary objective of the study is to describe the baseline clinical characteristics (particularly HbA1c) of patients initiated on dapagliflozin from marketing authorization approval to the end of 2016. Secondary and exploratory objectives will evaluate the changes in glycaemic and extraglycaemic efficacy parameters after initiation of dapagliflozin or after initiation of comparator glucose lowering medications (DPP-4 inhibitors, gliclazide extended release, and long-acting GLP-1 receptor agonists). An automated software will extract relevant data from the same electronic chart system at all centres, thereby minimizing data treatment and human intervention. The study is expected to collect an enormous dataset of information on dapagliflozin- and comparator-using patients. After study completion, the Italian Diabetes Society will launch an open crowdsourcing call on the DARWIN-T2D database, challenging diabetes researchers to apply their ideas and approaches to address new unmet needs and knowledge gaps in diabetes. We believe this will move DARWIN-T2D to the next generation of real world studies. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  2. Multicenter study on invasive Streptococcus pyogenes infections in children in Argentina.

    PubMed

    Cancellara, Aldo D; Melonari, Pablo; Firpo, María V; Mónaco, Andrea; Ezcurra, Gustavo C; Ruizf, Lía; Aletti, Alicia M; Gregorio, Gabriela; Gaiano, Alejandra; Aird, Alberto; Bellone, Luciana; Calvari, Miriam; Torregrosa, Carolina; Morinigo, Sandra; Vozzan, María L; Tonetto, Ivana; Flynn, Luis P; Bidone, Nancy M; Russ, Carlota; Ellis, Alejandro

    2016-06-01

    Invasive Streptococcus pyogenes infections (ISpIs) cause a high morbidity and mortality, even at present; however, at a regional level there are few publications on this subject in the field of pediatrics. To describe the prevalence, predisposing factors and clinical characteristics of children hospitalized for ISpI, and analyze risk factors associated with bacteremia and lethality. Material and methods. Retrospective, descriptive study on ISpIs in children <18 years old hospitalized in the Pediatric Ward of 20 healthcare facilities across Argentina between 2010 and 2012. Assessed outcome measures: age, gender, early and late clinical sources of infection, prior chronic condition, predisposing factors, treatment and evolution. To describe the prevalence, predisposing factors and clinical characteristics of children hospitalized for ISpI, and analyze risk factors associated with bacteremia and lethality. Material and methods. Retrospective, descriptive study on ISpIs in children <18 years old hospitalized in the Pediatric Ward of 20 healthcare facilities across Argentina between 2010 and 2012. Assessed outcome measures: age, gender, early and late clinical sources of infection, prior chronic condition, predisposing factors, treatment and evolution. Most ISpIs were observed in patients without a prior chronic condition. The most common manifestation was, frequently with bacteremia, in the skin and soft tissue. A statistically significant association was observed between bacteremia and ≥2 early sources of infection and no surgery. Fatality rate, in association with streptococcal toxic shock syndrome and necrotizing fasciitis, was similar to that observed in other publications. Sociedad Argentina de Pediatría.

  3. Open Surgical versus Minimal Invasive Necrosectomy of the Pancreas—A Retrospective Multicenter Analysis of the German Pancreatitis Study Group

    PubMed Central

    Rasch, Sebastian; Phillip, Veit; Reichel, Stephanie; Rau, Bettina; Zapf, Christian; Rosendahl, Jonas; Halm, Ulrich; Zachäus, Markus; Müller, Martin; Kleger, Alexander; Neesse, Albrecht; Hampe, Jochen; Ellrichmann, Mark; Rückert, Felix; Strauß, Peter; Algül, Hana

    2016-01-01

    Background Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. Methods The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014. Data were analysed for the primary endpoints "severe complications" and "mortality" as well as secondary endpoints including "length of hospital stay", "follow up", and predisposing or prognostic factors. Results Of all patients 13.6% were treated primarily with surgery and 86.4% underwent a step-up approach. More men (71.8%) required intervention for necrotising pancreatitis. The most frequent etiology was biliary (41.4%) followed by alcohol (29.1%). Compared to open necrosectomy, the step-up approach was associated with a lower number of severe complications (primary composite endpoint including sepsis, persistent multiorgan dysfunction syndrome (MODS) and erosion bleeding: 44.7% vs. 73.3%), lower mortality (10.5% vs. 33.3%) and lower rates of diabetes mellitus type 3c (4.7% vs. 33.3%). Low hematocrit and low blood urea nitrogen at admission as well as a history of acute pancreatitis were prognostic for less complications in necrotising pancreatitis. A combination of drainage with endoscopic necrosectomy resulted in the lowest rate of severe complications. Conclusion A step-up approach starting with minimal invasive drainage techniques and endoscopic necrosectomy results in a significant reduction of morbidity and mortality in necrotising pancreatitis compared to a primarily surgical intervention. PMID:27668746

  4. Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients.

    PubMed

    Eigl, Susanne; Prattes, Juergen; Lackner, Michaela; Willinger, Birgit; Spiess, Birgit; Reinwald, Mark; Selitsch, Brigitte; Meilinger, Michael; Neumeister, Peter; Reischies, Frederike; Wölfler, Albert; Raggam, Reinhard B; Flick, Holger; Eschertzhuber, Stephan; Krause, Robert; Buchheidt, Dieter; Thornton, Christopher R; Lass-Flörl, Cornelia; Hoenigl, Martin

    2015-04-17

    The incidence of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is increasing, and early diagnosis of the disease and treatment with antifungal drugs is critical for patient survival. Serum biomarker tests for IPA typically give false-negative results in non-neutropenic patients, and galactomannan (GM) detection, the preferred diagnostic test for IPA using bronchoalveolar lavage (BAL), is often not readily available. Novel approaches to IPA detection in ICU patients are needed. In this multicenter study, we evaluated the performance of an Aspergillus lateral-flow device (LFD) test for BAL IPA detection in critically ill patients. A total of 149 BAL samples from 133 ICU patients were included in this semiprospective study. Participating centers were the medical university hospitals of Graz, Vienna and Innsbruck in Austria and the University Hospital of Mannheim, Germany. Fungal infections were classified according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Two patients (four BALs) had proven IPA, fourteen patients (sixteen BALs) had probable IPA, twenty patients (twenty-one BALs) had possible IPA and ninety-seven patients (one hundred eight BALs) did not fulfill IPA criteria. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic odds ratios for diagnosing proven and probable IPA using LFD tests of BAL were 80%, 81%, 96%, 44% and 17.6, respectively. Fungal BAL culture exhibited a sensitivity of 50% and a specificity of 85%. LFD tests of BAL showed promising results for IPA diagnosis in ICU patients. Furthermore, the LFD test can be performed easily and provides rapid results. Therefore, it may be a reliable alternative for IPA diagnosis in ICU patients if GM results are not rapidly available. ClinicalTrials.gov NCT02058316. Registered 20 January 2014.

  5. Italian Tailored Assessment Of Lung Indeterminate Accidental Nodule By Proposing A Segmental Pet/Computed Tomography (S-Pet/Ct): Rationale And Study Design Of A Retrospective, Multicenter Trial.

    PubMed

    Evangelista, Laura; Spadafora, Marco; Pace, Leonardo; Mansi, Luigi; Cuocolo, Alberto

    2017-10-02

    The Italian Tailored Assessment of Lung Indeterminate Accidental Nodule (ITALIAN) is a retrospective, multicenter trial designed to compare the diagnostic information provided by segmental positron emission tomography (PET)/computed tomography (CT) (s-PET/CT) with those of whole body (wb)-PET/CT in patients with single pulmonary nodules (SPN). This report describes the details and implications of the ITALIAN trial design. Between September 2016 and May 2017, 502 consecutive patients (302 men, mean age 67±12 years) with SPN undergoing 18F-fluorodeoxyglucose (FDG) PET/CT were enrolled. PET/CT images will be visually and semiquantitatively evaluated. For visual analysis, a 4-point scoring system (1=absent; 2=mild; 3=moderate and 4=intense) will be used; for semiquantitative analysis, maximum standardized uptake value (SUV) in the SPN and mean SUV in the mediastinal blood pool and in the liver will be computed. The results of this trial might help to define the role of s-PET/CT in patients with SPN. This trial will also evaluate the impact on radiobiology and costs subsequent the introduction of this alternative imaging acquisition modality. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Adjuvant radiotherapy after radical cystectomy for muscle-invasive bladder cancer: A retrospective multicenter study

    PubMed Central

    Orré, Mathieu; Latorzeff, Igor; Fléchon, Aude; Roubaud, Guilhem; Brouste, Véronique; Gaston, Richard; Piéchaud, Thierry; Richaud, Pierre; Chapet, Olivier

    2017-01-01

    Objectives Radical cystectomy (RC) and pelvic lymph-node dissection (LND) is standard treatment for non-metastatic muscle-invasive urothelial bladder cancer (MIBC). However, loco-regional recurrence (LRR) is a common early event associated with poor prognosis. We evaluate 3-year LRR-free (LRRFS), metastasis-free (MFS) and overall survivals (OS) after adjuvant radiotherapy (RT) for pathological high-risk MIBC. Material and methods We retrospectively reviewed data from patients in 3 institutions. Inclusion criteria were MIBC, histologically-proven urothelial carcinoma treated by RC and adjuvant RT. Patients with conservative surgery were excluded. Outcomes were evaluated by Kaplan-Meier method. Acute toxicities were recorded according to CTCAE V4.0 scale. Results Between 2000 and 2013, 57 patients [median age 66.3 years (45–84)] were included. Post-operative pathological staging was ≤pT2, pT3 and pT4 in 16%, 44%, and 39%, respectively. PLND revealed 28% pN0, 26% pN1 and 42% pN2. Median number of lymph-nodes retrieved was 10 (2–33). Forty-eight patients (84%) received platin-based chemotherapy. For RT, clinical target volume 1 (CTV 1) encompassed pelvic lymph nodes for all patients. CTV 1 also included cystectomy bed for 37 patients (65%). CTV 1 median dose was 45 Gy (4–50). A boost of 16 Gy (5–22), corresponding to CTV 2, was administered for 30 patients, depending on pathological features. One third of patients received intensity-modulated RT. With median follow-up of 40.4 months, 8 patients (14%) had LRR. Three-year LRRFS, MFS and OS were 45% (95%CI 30–60), 37% (95%CI 24–51) and 49% (95%CI 33–63), respectively. Five (9%) patients had acute grade ≥3 toxicities (gastro-intestinal, genito-urinary and biological parameters). One patient died with intestinal fistula in a septic context. Conclusions Because of poor prognosis, an effective post-operative standard of care is needed for pathological high-risk MIBC. Adjuvant RT is feasible and may have

  7. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study)

    PubMed Central

    Caira, Morena; Candoni, Anna; Verga, Luisa; Busca, Alessandro; Delia, Mario; Nosari, Annamaria; Caramatti, Cecilia; Castagnola, Carlo; Cattaneo, Chiara; Fanci, Rosa; Chierichini, Anna; Melillo, Lorella; Mitra, Maria Enza; Picardi, Marco; Potenza, Leonardo; Salutari, Prassede; Vianelli, Nicola; Facchini, Luca; Cesarini, Monica; De Paolis, Maria Rosaria; Di Blasi, Roberta; Farina, Francesca; Venditti, Adriano; Ferrari, Antonella; Garzia, Mariagrazia; Gasbarrino, Cristina; Invernizzi, Rosangela; Lessi, Federica; Manna, Annunziata; Martino, Bruno; Nadali, Gianpaolo; Offidani, Massimo; Paris, Laura; Pavone, Vincenzo; Rossi, Giuseppe; Spadea, Antonio; Specchia, Giorgina; Trecarichi, Enrico Maria; Vacca, Adriana; Cesaro, Simone; Perriello, Vincenzo; Aversa, Franco; Tumbarello, Mario; Pagano, Livio

    2015-01-01

    Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient’s risk category and improve targeted prophylactic

  8. Pre-chemotherapy risk factors for invasive fungal diseases: prospective analysis of 1,192 patients with newly diagnosed acute myeloid leukemia (SEIFEM 2010-a multicenter study).

    PubMed

    Caira, Morena; Candoni, Anna; Verga, Luisa; Busca, Alessandro; Delia, Mario; Nosari, Annamaria; Caramatti, Cecilia; Castagnola, Carlo; Cattaneo, Chiara; Fanci, Rosa; Chierichini, Anna; Melillo, Lorella; Mitra, Maria Enza; Picardi, Marco; Potenza, Leonardo; Salutari, Prassede; Vianelli, Nicola; Facchini, Luca; Cesarini, Monica; De Paolis, Maria Rosaria; Di Blasi, Roberta; Farina, Francesca; Venditti, Adriano; Ferrari, Antonella; Garzia, Mariagrazia; Gasbarrino, Cristina; Invernizzi, Rosangela; Lessi, Federica; Manna, Annunziata; Martino, Bruno; Nadali, Gianpaolo; Offidani, Massimo; Paris, Laura; Pavone, Vincenzo; Rossi, Giuseppe; Spadea, Antonio; Specchia, Giorgina; Trecarichi, Enrico Maria; Vacca, Adriana; Cesaro, Simone; Perriello, Vincenzo; Aversa, Franco; Tumbarello, Mario; Pagano, Livio

    2015-02-01

    Correct definition of the level of risk of invasive fungal infections is the first step in improving the targeting of preventive strategies. We investigated the potential relationship between pre-hospitalization exposure to sources of fungi and the development of invasive fungal infections in adult patients with newly diagnosed acute myeloid leukemia after their first course of chemotherapy. From January 2010 to April 2012, all consecutive acute myeloid leukemia patients in 33 Italian centers were prospectively registered. Upon first admission, information about possible pre-chemotherapy risk factors and environmental exposure was collected. We recorded data regarding comorbid conditions, employment, hygienic habits, working and living environment, personal habits, hobbies, and pets. All invasive fungal infections occurring within 30 days after the first course of chemotherapy were recorded. Of the 1,192 patients enrolled in this study, 881 received intensive chemotherapy and were included in the present analysis. Of these, 214 developed an invasive fungal infection, including 77 proven/probable cases (8.7%). Of these 77 cases, 54 were proven/probable invasive mold infections (6.1%) and 23 were proven yeast infections (2.6%). Upon univariate analysis, a significant association was found between invasive mold infections and age, performance status, diabetes, chronic obstructive pulmonary disease, smoking, cocaine use, job, hobbies, and a recent house renovation. Higher body weight resulted in a reduced risk of invasive mold infections. Multivariate analysis confirmed the role of performance status, job, body weight, chronic obstructive pulmonary disease, and house renovation. In conclusion, several hospital-independent variables could potentially influence the onset of invasive mold infections in patients with acute myeloid leukemia. Investigation of these factors upon first admission may help to define a patient's risk category and improve targeted prophylactic

  9. Adherence to Guidelines among Italian Urologists on Imaging Preoperative Staging of Low-Risk Prostate Cancer: Results from the MIRROR (Multicenter Italian Report on Radical Prostatectomy Outcomes and Research) Study

    PubMed Central

    Simonato, Alchiede; Varca, Virginia; Gacci, Mauro; Gontero, Paolo; De Cobelli, Ottavio; Maffezzini, Massimo; Salvioni, Roberto; Carini, Marco; Decensi, Andrea; Mirone, Vincenzo; Carmignani, Giorgio

    2012-01-01

    Objective. A number of evidence-based guidelines for diagnosis and management of prostate cancer have been published. The aim of this study is to evaluate the adherence of Italian urologists to the guidelines concerning the preoperative imaging staging of prostate cancer. Methods. In October 2007 a multicentric observational perspective study called Multicentric Italian Report on Radical prostatectomy Outcome and Research (MIRROR) was started in 135 Italian urology centers. Recruitment was closed in December 2008 and 2,408 cases were collected. In this paper we have taken into consideration all examinations carried out for preoperative imaging staging, evaluating compliance with the recommendations in the American Urological Association (AUA) and European Association of Urology (EAU) guidelines. Results. Five hundred sixty-seven (53.34%) patients were not managed according to the EAU guidelines concerning T-staging, 545 (51.27%) concerning N-staging and 757 (71.21%) concerning M-staging. According to AUA guidelines, we also analyzed patients with a Gleason grade of biopsy specimens of 7: 238 (57.35%) of these patients had undergone testing for T staging, 244 (57.35%) for N-staging and 322 (77.60%) for M-staging. Conclusions. The compliance of Italian urologists with the guidelines is low, leading to an inappropriate increase in cost of care and unnecessary anxiety for the patients. PMID:22666241

  10. Anti-nuclear antibodies as predictor of outcome in a multi-center cohort of Italian children and adolescents with Raynaud's phenomenon.

    PubMed

    Falcini, Fernanda; Rigante, Donato; Candelli, Marcello; Martini, Giorgia; Corona, Fabrizia; Petaccia, Antonella; La Torre, Francesco; Raffaele, Carmela G L; Matucci Cerinic, Marco

    2015-01-01

    A retrospective multi-center data collection of clinical, laboratory, and treatment characteristics of 94 Caucasian children and adolescents with Raynaud's phenomenon (RP) started at a mean age of 12.8 ± 5 years, with variable involvement of hands, feet, and face, was performed for a period of 3 years. Collected data included nailfold videocapillaroscopy (NVC), lung function tests, and different laboratory tests finalized to characterize an eventual connective tissue disease (CTD), disclosed by RP itself. Twelve patients presented an early-scleroderma pattern at NVC, 1 a late-scleroderma pattern, and 58 a nonspecific pattern. Laboratory data results showed the positivity of anti-nuclear antibodies (ANA) in 29 % of patients. After this 3-year period of observation, 8 patients had developed a CTD. Our data examined by multivariate analysis, though limited to a multi-center cohort of pediatric patients with RP, strongly suggest that ANA positivity is a significant predictor of progression of RP towards a CTD.

  11. Bendamustine with or without rituximab for the treatment of heavily pretreated non-Hodgkin's lymphoma patients : A multicenter retrospective study on behalf of the Italian Lymphoma Foundation (FIL).

    PubMed

    Rigacci, Luigi; Puccini, Benedetta; Cortelazzo, Sergio; Gaidano, Gianluca; Piccin, Andrea; D'Arco, Alfonso; Freilone, Roberto; Storti, Sergio; Orciuolo, Enrico; Zinzani, Pier Luigi; Zaja, Francesco; Bongarzoni, Velia; Balzarotti, Monica; Rota-Scalabrini, Delia; Patti, Caterina; Gobbi, Marco; Carpaneto, Andrea; Liberati, Anna Marina; Bosi, Alberto; Iannitto, Emilio

    2012-07-01

    Bendamustine is an alkylating agent with a nitrogen mustard group and a purine-like benzimidazole group. The aim of this study was to collect all the Italian experiences with this drug in order to evaluate the results in term of response to therapy and toxicities. We analyzed lymphoma patients treated in 24 Italian haematological centres with bendamustine alone or in combination with anti-CD20 antibody. One hundred seventy-five relapsed or refractory lymphoma patients were enrolled. The median age was 69 years (range 26-87). Seventy-nine patients were relapsed, 35 were refractory and 61 presented a progressive disease after partial response. The diagnoses were 60 indolent non-follicular lymphomas, 34 diffuse large B-cell lymphomas, 48 follicular lymphomas, 30 mantle cell lymphomas and three peripheral T-cell lymphomas. All patients were evaluable for response: 52 (29%) with complete remission, 72 (43%) with partial response with an overall response rate of 71%, and 51 non-responders. With a median observation period of 10 months (1-43), 70% of patients are alive. In summary, this retrospective study shows that treatment with bendamustine alone or in combination with rituximab is a safe and effective regimen in a subset of multi-resistant patients.

  12. Depressive Symptoms Correlate with Disability and Disease Course in Multiple Sclerosis Patients: An Italian Multi-Center Study Using the Beck Depression Inventory

    PubMed Central

    Solaro, C.; Trabucco, E.; Signori, A.; Martinelli, V.; Radaelli, M.; Centonze, D.; Rossi, S.; Grasso, M. G.; Clemenzi, A.; Bonavita, S.; D’Ambrosio, A.; Patti, F.; D’Amico, E.; Cruccu, G.; Truini, A.

    2016-01-01

    Background Depression occurs in about 50% of patients with multiple sclerosis. The aims of this study was to investigate the prevalence of depressive symptoms in a multicenter MS population using the Beck Depression Inventory II (BDI II) and to identify possible correlations between the BDI II score and demographic and clinical variables. Methods Data were collected in a multi-center, cross-sectional study over a period of six months in six MS centers in Italy using BDI II. Results 1,011 MS patients participated in the study. 676 subjects were female, with a mean age of 34 years (SD 10.8), mean EDSS of 3.3 (0–8.5) and mean disease duration of 10.3 years (range 1–50 years). 668 (%) subjects scored lower than 14 on the BDI II and 343 (33.9%) scored greater than 14 (14 cut-off score). For patients with BDI>14 multivariate analysis showed a significant difference between EDSS and disease course. BDI II scores for subjects with secondary progressive (SP) MS were significantly different from primary progressive (PP) patients (p < 0.001) but similar to relapsing-remitting (RR) patients. Considering subjects with moderate to severe depressive symptoms (BDI II score from 20–63), in relation to disease course, 11.7% (83/710) had RR MS, 40.7% (96/236) SP and 13.6% (6/44) PP. Conclusions Using the BDI II, 30% of the current sample had depressive symptoms. BDI II score correlates with disability and disease course, particularly in subjects with SP MS. The BDI II scale can be a useful tool in clinical practice to screen depressive symptoms in people with MS. PMID:27632167

  13. Efficacy of frovatriptan in the acute treatment of menstrually related migraine: analysis of a double-blind, randomized, multicenter, Italian, comparative study versus zolmitriptan.

    PubMed

    Allais, Gianni; Tullo, Vincenzo; Benedetto, Chiara; Zava, Dario; Omboni, Stefano; Bussone, Gennaro

    2011-05-01

    Menstrually related migraine (MRM) is a particularly difficult-to-treat pain condition, associated with substantial disability. Aim of this study was to compare the efficacy and safety of frovatriptan and zolmitriptan in the treatment of MRM attacks, analyzing data from a multicenter, randomized, double blind, cross-over study. We analyzed the subset of 76 regularly menstruating women who participated in one head-to-head multicenter, randomized, double blind, cross-over clinical trial and who took the study drugs to treat MRM attacks. In a randomized sequence, each patient received frovatriptan 2.5 mg or zolmitriptan 2.5 mg: after treating three episodes of migraine in no more than 3 months with the first treatment, the patient had to switch to the other treatment. MRM was defined according to the criteria listed in the Appendix of the last Classification of Headache disorders of the International Headache Society. A total of 73 attacks, classified as MRM, were treated with frovatriptan and 65 with zolmitriptan. Rate of pain relief at 2 h was 52% for frovatriptan and 53% for zolmitriptan (p = NS), while rate of pain free at 2 h was 22 and 26% (p = NS), respectively. At 24 h, 74 and 83% of frovatriptan-treated and 69 and 82% of zolmitriptan-treated patients were pain free and had pain relief, respectively (p = NS). Recurrence at 24 h was significantly (p < 0.05) lower with frovatriptan (15 vs. 22% zolmitriptan). Frovatriptan proved to be effective in the immediate treatment of MRM attacks, similarly to zolmitriptan, but showed lower recurrence rates, and thus a better sustained relief.

  14. Pregnancy e-health: a multicenter Italian cross-sectional study on Internet use and decision-making among pregnant women.

    PubMed

    Bert, Fabrizio; Gualano, Maria Rosaria; Brusaferro, Silvio; De Vito, Elisabetta; de Waure, Chiara; La Torre, Giuseppe; Manzoli, Lamberto; Messina, Gabriele; Todros, Tullia; Torregrossa, Maria Valeria; Siliquini, Roberta

    2013-12-01

    Our study aimed to estimate the prevalence of pregnancy e-health seekers in a large Italian sample; to explore the factors influencing the choices of the childbearing women regarding their lifestyles after internet consultation; and finally to investigate potential differences between primiparous and multiparous women in internet use to find information about pregnancy. A multicentre survey was carried out in seven Italian cities. Data were collected through a validated questionnaire administered in waiting rooms of outpatient departments by medical doctors. Respondents were questioned about their sociodemographic status, their use of the internet to seek pregnancy information and their consequent choices to modify their lifestyles. Data were analysed using descriptive statistics and logistic regression. Almost all women were pregnancy e-health seekers (95%), including those who also received information from healthcare professionals. Indeed, the main reason for searching the web was the need of further knowledge on pregnancy-related topic, over and beyond other key advantages of the net such as anonymity, simplicity and rapidity. A higher likelihood of changing lifestyle after pregnancy e-health was observed among the women who searched institutional websites; declared more confidence in the information retrieved; participated into pregnancy-centred forum online; and were residents in Italy. To reduce the likelihood for women of both finding erroneous information or misinterpreting correct ones, healthcare professionals should commit to fill the information gap and guide pregnant women in the online searches. Also, future studies are strongly needed to analyse the quality and accuracy of health information found on the web.

  15. Assessment of the risk of bleeding in patients undergoing surgery or invasive procedures: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET).

    PubMed

    Cosmi, Benilde; Alatri, Adriano; Cattaneo, Marco; Gresele, Paolo; Marietta, Marco; Rodeghiero, Francesco; Tripodi, Armando; Ansaloni, Luca; Fusari, Maurizio; Taddei, Stefania

    2009-11-01

    SYNOPSIS OF RECOMMENDATIONS: The Italian Society for Thrombosis and Haemostasis (SISET: Società Italiana per lo Studio dell' Emostasi e della Trombosi) promoted the development of a series of guidelines which would adopt evidence-based medicine methodology on clinically relevant problems in the field of haemostasis and thrombosis. The objective of the present guidelines is to provide recommendations for the pre-operative and pre-procedural assessment of the bleeding risk with the aim of reducing the incidence of preventable bleeding complications and limiting laboratory tests to the those necessary. The predictive value of haemostatic tests for bleeding complications after surgery or invasive procedures has been evaluated in prospective or retrospective cohort studies only. All retrieved studies were of low methodological quality with a high potential for bias because none conducted a blinded outcome assessment. In addition, different criteria for the severity of bleeding events and different reference values of the laboratory tests were adopted. The low methodological quality limits the validity of the results of these studies. Some of the clinical queries proposed by the working group were not addressed by the studies available in the literature. The areas with evidence, although of low quality, are the following: general surgery in adults (for history, PT, APTT, platelet count and bleeding time), neurosurgery in adults (for history, PT, APTT, platelet count), adenotonsillectomy in children (for history, PT, APTT, platelet count and bleeding time), invasive procedures in adults (for PT, APTT, platelet count), dental extractions (for the bleeding time only), cataract extraction (for platelet count). No studies are available in children for major surgery other than adenotonsillectomy, neurosurgery and invasive procedures.

  16. Non-invasive cardiac assessment in high risk patients (The GROUND study): rationale, objectives and design of a multi-center randomized controlled clinical trial

    PubMed Central

    de Vos, Alexander M; Rutten, Annemarieke; van de Zaag-Loonen, Hester J; Bots, Michiel L; Dikkers, Riksta; Buiskool, Robert A; Mali, Willem P; Lubbers, Daniel D; Mosterd, Arend; Prokop, Mathias; Rensing, Benno J; Cramer, Maarten J; van Es, H Wouter; Moll, Frans L; van de Pavoordt, Eric D; Doevendans, Pieter A; Velthuis, Birgitta K; Mackaay, Albert J; Zijlstra, Felix; Oudkerk, Matthijs

    2008-01-01

    Background Peripheral arterial disease (PAD) is a common disease associated with a considerably increased risk of future cardiovascular events and most of these patients will die from coronary artery disease (CAD). Screening for silent CAD has become an option with recent non-invasive developments in CT (computed tomography)-angiography and MR (magnetic resonance) stress testing. Screening in combination with more aggressive treatment may improve prognosis. Therefore we propose to study whether a cardiac imaging algorithm, using non-invasive imaging techniques followed by treatment will reduce the risk of cardiovascular disease in PAD patients free from cardiac symptoms. Design The GROUND study is designed as a prospective, multi-center, randomized clinical trial. Patients with peripheral arterial disease, but without symptomatic cardiac disease will be asked to participate. All patients receive a proper risk factor management before randomization. Half of the recruited patients will enter the 'control group' and only undergo CT calcium scoring. The other half of the recruited patients (index group) will undergo the non invasive cardiac imaging algorithm followed by evidence-based treatment. First, patients are submitted to CT calcium scoring and CT angiography. Patients with a left main (or equivalent) coronary artery stenosis of > 50% on CT will be referred to a cardiologist without further imaging. All other patients in this group will undergo dobutamine stress magnetic resonance (DSMR) testing. Patients with a DSMR positive for ischemia will also be referred to a cardiologist. These patients are candidates for conventional coronary angiography and cardiac interventions (coronary artery bypass grafting (CABG) or percutaneous cardiac interventions (PCI)), if indicated. All participants of the trial will enter a 5 year follow up period for the occurrence of cardiovascular events. Sequential interim analysis will take place. Based on sample size calculations about

  17. Six-Month Multicenter Study on Invasive Infections Due to Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis in Argentina

    PubMed Central

    Lopardo, Horacio A.; Vidal, Patricia; Sparo, Monica; Jeric, Paola; Centron, Daniela; Facklam, Richard R.; Paganini, Hugo; Pagniez, N. Gaston; Lovgren, Marguerite; Beall, Bernard

    2005-01-01

    During a 6-month period, 95 invasive infections due to Streptococcus pyogenes and group C or group G Streptococcus dysgalactiae subsp. equisimilis were recorded from 40 centers of 16 cities in Argentina. We describe here epidemiologic data available for 55 and 19 patients, respectively, associated with invasive infections due to S. pyogenes and S. dysgalactiae subsp. equisimilis. The associated isolates and 58 additional pharyngeal isolates were genotyped and subjected to serologic and/or antibiotic susceptibility testing. Group A streptococcal emm type distribution and strain association with toxic shock appeared to differ somewhat from results found within the United States; however, serologic characterization and sof sequence typing suggested that emm types found in both countries are reflective of shared clonal types. PMID:15695683

  18. Frovatriptan versus zolmitriptan for the acute treatment of migraine with aura: a subgroup analysis of a double-blind, randomized, multicenter, Italian study.

    PubMed

    Tullo, Vincenzo; Allais, Gianni; Curone, Marcella; Ferrari, Michel D; Omboni, Stefano; Benedetto, Chiara; Colombo, Bruno; Zava, Dario; Bussone, Gennaro

    2012-05-01

    Migraine with aura affects ~20-30 % of migraineurs and it is much less common than migraine without aura. The aim of this study was to compare the efficacy of frovatriptan 2.5 mg and zolmitriptan 2.5 mg in the treatment of migraine with aura. Analysis was carried out in a subset of 18 subjects with migraine with aura (HIS criteria) out of the 107 enrolled in a multicenter, randomized, double-blind, cross-over study. According to the study design, each patient had to treat three episodes of migraine in no more than 3 months with one drug, before switching to the other treatment. The rate of pain-free episodes at 2 h was significantly (p < 0.05) larger under frovatriptan (45.8 %) than under zolmitriptan (16.7 %). Pain free at 4 h, pain relief at 2 and 4 h and recurrent episodes were similar between the two treatments, while sustained pain-free episode was significantly (p < 0.05) more frequent during frovatriptan treatment (33.3 vs. 8.3 % zolmitriptan). Our study suggests that frovatriptan is superior to zolmitriptan in the immediate treatment of patients with migraine with aura, and it is capable of maintaining its acute analgesic effect over 48 h.

  19. Lenalidomide monotherapy in heavily pretreated patients with non-Hodgkin lymphoma: an Italian observational multicenter retrospective study in daily clinical practice.

    PubMed

    Zinzani, Pier Luigi; Rigacci, Luigi; Cox, Maria Cristina; Devizzi, Liliana; Fabbri, Alberto; Zaccaria, Alfonso; Zaja, Francesco; Di Rocco, Alice; Rossi, Giuseppe; Storti, Sergio; Fattori, Pier Paolo; Argnani, Lisa; Tura, Sante; Vitolo, Umberto

    2015-06-01

    Clinical trial results indicate that lenalidomide, an immunomodulatory drug, is a promising treatment in relapsed/refractory non-Hodgkin lymphoma (NHL). This retrospective multicenter study was conducted in patients with relapsed/refractory NHL treated with lenalidomide monotherapy through a Named Patient Program in Italy. Principal endpoints were overall response rate (ORR), safety and overall survival (OS). The ORR in 64 evaluable patients was 42.2% and was similar among patients receiving 10, 15 or 25 mg/day lenalidomide. Response rates in patients with mantle cell, diffuse large B-cell and follicular lymphoma were 45.5%, 42.1% and 20%, respectively. Among patients who responded to most recent prior therapy, ORR was 50.0% versus 36.8% in patients with refractory NHL. Mean duration of response in patients receiving any lenalidomide dose was 10.5 months; 1-year progression-free survival and OS were 50.3% and 82.6%, respectively. These findings suggest that lenalidomide is effective and safe for heavily pretreated patients with NHL in the clinical setting.

  20. Use of Implant-Derived Minimally Invasive Sinus Floor Elevation: A Multicenter Clinical Observational Study With 12- to 65-Month Follow-Up.

    PubMed

    Mijiritsky, Eitan; Barbu, Horia; Lorean, Adi; Shohat, Izhar; Danza, Matteo; Levin, Liran

    2016-08-01

    The aim of this study is to evaluate the performance of implant-derived minimally invasive sinus floor elevation. A multicenter retrospective study was performed in 5 dental clinics. Patients requiring sinus augmentation for single implant placement were recorded and followed up. The dental implant used in this trial was a self-tapping endosseous dental implant that contains an internal channel to allow the introduction of liquids through the implant body into the maxillary sinus; those liquids include saline and a flowable bone grafting material. Overall, 37 implants were installed in 37 patients. The age range of the patients was 37-75 years (mean: 51.2 years). The average residual bone height prior to the procedure was 5.24 ± 1 mm. Of all cases, 25 implants replaced the maxillary first molar and 12 replaced the maxillary second premolar. All surgeries were uneventful with no apparent perforation of the sinus membrane. The mean follow-up time was 24.81 ± 13 months ranging from 12 to 65 months. All implants integrated and showed stable marginal bone level. No adverse events were recorded during the follow-up period. The presented method for transcrestal sinus floor elevation procedure can be accomplished using a specially designed dental implant. Further long-term studies are warranted to reaffirm the results of this study.

  1. Minimally invasive transcrestal sinus floor elevation with deproteinized bovine bone or β-tricalcium phosphate: a multicenter, double-blind, randomized, controlled clinical trial.

    PubMed

    Trombelli, Leonardo; Franceschetti, Giovanni; Stacchi, Claudio; Minenna, Luigi; Riccardi, Orio; Di Raimondo, Rosario; Rizzi, Alessandro; Farina, Roberto

    2014-03-01

    To evaluate the outcomes of transcrestal sinus floor elevation (tSFE) performed with a minimally invasive procedure (Smart Lift technique) combined with the additional use of deproteinized bovine bone mineral (DBBM) or β-tricalcium phosphate (β-TCP). In a multicenter randomized controlled trial, 38 sites in 38 patients were treated with the Smart Lift technique in association with DBBM (n = 19) or β-TCP (n = 19). The extent of the sinus lift (SL) and the height of the graft apical to the implant apex (aGH) were assessed on periapical radiographs taken immediately after surgery and at 6 months following surgery. (i) Substantial aGH and SL were observed immediately after surgery and at 6 months, with no significant differences between DBBM and β-TCP groups; (ii) a significant graft remodelling was observed from post-surgery to 6-months in the β-TCP group and (iii) limited incidence of complications as well as limited post-operative pain and discomfort were associated with the use of both graft materials. The Smart Lift technique in conjunction with the additional use of either DBBM or β-TCP may provide a substantial elevation of the maxillary sinus floor along with limited post-surgical complications and post-operative pain/discomfort. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry.

    PubMed

    Aldrighetti, Luca; Ratti, Francesca; Cillo, Umberto; Ferrero, Alessandro; Ettorre, Giuseppe Maria; Guglielmi, Alfredo; Giuliante, Felice; Calise, Fulvio

    2017-08-31

    The Italian Group of MILS (I Go MILS) prospective registry was established in 2014 with the goals to create a hub for data and projects on a national basis and to promote the diffusion and implementation of MILS programs on a national scale. The primary endpoint of the present study is to give a snapshot of the real diffusion and outcomes of MILS in Italy, while analyzing the role of the registry in the implementation of MILS programs nationwide. The I Go MILS Registry is a prospective and intention-to-treat registry opened to any Italian center performing MILS, without restriction criteria based on number of procedures. The Registry is developed through the eClinical, an electronic platform for the management of clinical trials and is based on 34 clinical variables, regarding indication, intra- and postoperative course. Clinical outcomes and data regarding implementation of MILS activity have been analyzed for the aim of the study. Between November 2014 and June 2017, data from 1678 MILS performed in 48 centers have been collected (mean number of procedures per center 35, range 1-302). 22% of procedures were performed for benign and 78% for malignant disease (HCC constituted the 49.1% and CRLM the 31.2% of malignant tumors). Major liver resections (>3 liver segments), including right and left hepatectomies, trisectionectomies and ALPPS procedures were 10% of the series. Mean blood loss was 200 ± 230 mL Morbidity rate was 20.5% and mortality was 0.3%. 10.4% of cases were converted to open approach. Median length of stay was 5 days. MILS/total resections ratio in 13 experienced centers increased from 14 to 30% after Registry establishment. MILS programs are well established in Italy, with progressive increase both in the number of cases and in the numerosity of centers. The I Go MILS Registry is playing a crucial role in monitoring the development of MILS in the real world on a national basis while giving a significant contribution to the implementation of MILS

  3. Predictive Factors of Lapatinib and Capecitabine Activity in Patients with HER2-Positive, Trastuzumab-Resistant Metastatic Breast Cancer: Results from the Italian Retrospective Multicenter HERLAPAC Study

    PubMed Central

    Gori, Stefania; Inno, Alessandro; Rossi, Valentina; Turazza, Monica; Fiorio, Elena; Fabi, Alessandra; Bisagni, Giancarlo; Foglietta, Jennifer; Santini, Daniele; Pavese, Ida; Pellegrino, Arianna; Zambelli, Alberto; Vici, Patrizia; Leonardi, Vita; Barni, Sandro; Saracchini, Silvana; Bogina, Giuseppe; Marchetti, Fabiana; Duranti, Simona; Lunardi, Gianluigi; Montemurro, Filippo

    2016-01-01

    Background There are no validated predictive markers for lapatinib and capecitabine in patients with trastuzumab-resistant HER2 positive metastatic breast cancer. Methods Data of 148 consecutive patients treated with lapatinib and capecitabine from March 2007 to December 2013 were collected from 13 Italian institutions. Estimates of progression-free survival (PFS) and overall survival (OS) were obtained with the Kaplan-Meier method and compared with logrank test. The association of clinicopathological variables and the outcome was studied by binary logistic regression analysis and Cox proportional hazard analysis. Results At a median follow-up of 41 months, median PFS and OS were 7 and 21 months, respectively. Patents with a PFS longer than 7 months had a significantly longer OS, compared with patients with a PFS equal to or shorter than 7 months (36 vs 15 months; p<0.001). Multivariate analysis revealed the benefit of lapatinib-based therapy in terms of PFS and OS was significantly associated with time-to-progression (TTP) on prior first-line trastuzumab-based therapy. In particular, each additional month on first-line trastuzumab based therapy was associated with a reduction in hazard of progression and death after the initiation of lapatinib-based therapy of 2% and 4%, respectively. Conclusions A longer TTP to first line trastuzumab seems to predict a prolonged PFS and OS with subsequent lapatinib and capecitabine. PMID:27224517

  4. Prevalence of Sleep Disturbances in Mild Cognitive Impairment and Dementing Disorders: A Multicenter Italian Clinical Cross-Sectional Study on 431 Patients

    PubMed Central

    Guarnieri, B.; Adorni, F.; Musicco, M.; Appollonio, I.; Bonanni, E.; Caffarra, P.; Caltagirone, C.; Cerroni, G.; Concari, L.; Cosentino, F.I.I.; Ferrara, S.; Fermi, S.; Ferri, R.; Gelosa, G.; Lombardi, G.; Mazzei, D.; Mearelli, S.; Morrone, E.; Murri, L.; Nobili, F.M.; Passero, S.; Perri, R.; Rocchi, R.; Sucapane, P.; Tognoni, G.; Zabberoni, S.; Sorbi, S.

    2012-01-01

    Background/Aims: Sleep disturbances are common in the elderly and in persons with cognitive decline. The aim of this study was to describe frequency and characteristics of insomnia, excessive daytime sleepiness, sleep-disordered breathing, REM behavior disorder and restless legs syndrome in a large cohort of persons with mild cognitive impairment or dementia. Methods 431 consecutive patients were enrolled in 10 Italian neurological centers: 204 had Alzheimer's disease, 138 mild cognitive impairment, 43 vascular dementia, 25 frontotemporal dementia and 21 Lewy body dementia or Parkinson's disease dementia. Sleep disorders were investigated with a battery of standardized questions and questionnaires. Results Over 60% of persons had one or more sleep disturbances almost invariably associated one to another without any evident and specific pattern of co-occurrence. Persons with Alzheimer's disease and those with mild cognitive impairment had the same frequency of any sleep disorder. Sleep-disordered breathing was more frequent in vascular dementia. REM behavior disorder was more represented in Lewy body or Parkinson's disease dementia. Conclusion A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of persons with cognitive decline. Instrumental supports should be used only in selected patients. PMID:22415141

  5. Frovatriptan versus other triptans in the acute treatment of migraine: pooled analysis of three double-blind, randomized, cross-over, multicenter, Italian studies.

    PubMed

    Cortelli, Pietro; Allais, Gianni; Tullo, Vincenzo; Benedetto, Chiara; Zava, Dario; Omboni, Stefano; Bussone, Gennaro

    2011-05-01

    The objective of the study is to systematically review the efficacy and safety of frovatriptan (F) versus rizatriptan (R), zolmitriptan (Z) and almotriptan (A), through a pooled analysis of three individual studies. 414 subjects with a history of migraine with or without aura (IHS criteria) were randomized to F 2.5 mg or R 10 mg (study 1), F 2.5 mg or Z 2.5 mg (study 2), and F 2.5 mg or A 12.5 mg (study 3). The studies had an identical multicenter, randomized, double blind, cross-over design, with each of the two treatment periods lasting not more than 3 months. The number of pain free (PF) and pain relief (PR) episodes at 2 h, and the number of sustained pain free (SPF) and recurrent episodes within the 48 h were the efficacy endpoints. 346 patients were included in the intention-to-treat analysis. Rate of PF episodes at 2 h was 30% with F and 34% with comparators (p = NS). PR episodes at 2 h were 55% for F and 59% for comparators (p = NS). SPF episodes at 48 h were also similar between the two groups (22% F vs. 21% comparators). Rate of recurrence was significantly (p < 0.001) lower under F (27 vs. 40% comparators). Drug-related adverse events were significantly (p < 0.05) less under F, particularly cardiovascular symptoms. Our systematic analysis of individual studies suggests that F has a similar immediate efficacy, but a more sustained effect and a better tolerability than R, Z and A.

  6. Efficacy of frovatriptan in the acute treatment of menstrually related migraine: analysis of a double-blind, randomized, cross-over, multicenter, Italian, comparative study versus rizatriptan.

    PubMed

    Savi, Lidia; Omboni, Stefano; Lisotto, Carlo; Zanchin, Giorgio; Ferrari, Michel D; Zava, Dario; Pinessi, Lorenzo

    2011-12-01

    The objectives of this study are to assess the efficacy and safety of frovatriptan, and rizatriptan in the subgroup of women with menstrually related migraine of a multicenter, randomized, double blind, cross-over study. Each patient received frovatriptan 2.5 mg or rizatriptan 10 mg in a randomized sequence: after treating 3 episodes of migraine in not more than 3 months with the first treatment, the patient had to switch to the other treatment. Menstrually related migraine was defined according to the criteria listed in the Appendix of the last IHS Classification of Headache disorders. 99 out of the 125 patients included in the intention-to-treat analysis of the main study were of a female gender: 93 had regular menstrual cycles and were, thus, included in this analysis. A total of 49 attacks classified as menstrually related migraine were treated with frovatriptan and 59 with rizatriptan. Rate of pain relief at 2 h was 58% for frovatriptan and 64% for rizatriptan (p = NS), while rate of pain free at 2 h was 31 and 34% (p = NS), respectively. At 24 h, 67 and 81% of frovatriptan-treated, and 61 and 74% of rizatriptan-treated patients were pain free and had pain relief, respectively (p = NS). Recurrence at 24 h was significantly (p < 0.01) lower with frovatriptan (10 vs. 32% rizatriptan). Frovatriptan was as effective as rizatriptan in the immediate treatment of menstrually related migraine attacks while showing a favorable sustained effect with a lower rate of migraine recurrence. These results need to be confirmed by randomized, double-blind, prospective, large clinical trials.

  7. Frovatriptan versus almotriptan for acute treatment of menstrual migraine: analysis of a double-blind, randomized, cross-over, multicenter, Italian, comparative study.

    PubMed

    Bartolini, Marco; Giamberardino, Maria Adelaide; Lisotto, Carlo; Martelletti, Paolo; Moscato, Davide; Panascia, Biagio; Savi, Lidia; Pini, Luigi Alberto; Sances, Grazia; Santoro, Patrizia; Zanchin, Giorgio; Omboni, Stefano; Ferrari, Michel D; Fierro, Brigida; Brighina, Filippo

    2012-07-01

    The objective of the study was to compare the efficacy and safety of frovatriptan and almotriptan in women with menstrually related migraine (IHS Classification of Headache disorders) enrolled in a multicenter, randomized, double-blind, cross-over study. Patients received frovatriptan 2.5 mg or almotriptan 12.5 mg in a randomized sequence: after treating 3 episodes of migraine in no more than 3 months with the first treatment, the patient was switched to the other treatment. 67 of the 96 female patients of the intention-to-treat population of the main study had regular menstrual cycles and were thus included in this subgroup analysis. 77 migraine attacks classified as related to menses were treated with frovatriptan and 78 with almotriptan. Rate of pain relief at 2 and 4 h was 36 and 53 % for frovatriptan and 41 and 50 % for almotriptan (p = NS between treatments). Rate of pain free at 2 and 4 h was 19 and 47 % with frovatriptan and 29 and 54 % for almotriptan (p = NS). At 24 h, 62 % of frovatriptan-treated and 67 % of almotriptan-treated patients had pain relief, while 60 versus 67 % were pain free (p = NS). Recurrence at 24 h was significantly (p < 0.05) lower with frovatriptan (8 vs. 21 % almotriptan). This was the case also at 48 h (9 vs. 24 %, p < 0.05). Frovatriptan was as effective as almotriptan in the immediate treatment of menstrually related migraine attacks. However, it showed a more favorable sustained effect, as shown by a lower rate of migraine recurrence.

  8. Improving survival with deferiprone treatment in patients with thalassemia major: a prospective multicenter randomised clinical trial under the auspices of the Italian Society for Thalassemia and Hemoglobinopathies.

    PubMed

    Maggio, Aurelio; Vitrano, Angela; Capra, Marcello; Cuccia, Liana; Gagliardotto, Francesco; Filosa, Aldo; Magnano, Carmelo; Rizzo, Michele; Caruso, Vincenzo; Gerardi, Calogera; Argento, Crocetta; Campisi, Saveria; Cantella, Francesco; Commendatore, Francesca; D'Ascola, Domenico Giuseppe; Fidone, Carmelo; Ciancio, Angela; Galati, Maria Concetta; Giuffrida, Gaetano; Cingari, Rocca; Giugno, Giovanni; Lombardo, Turi; Prossomariti, Luciano; Malizia, Roberto; Meo, Anna; Roccamo, Gaetano; Romeo, Maria Antonietta; Violi, Pietro; Cianciulli, Paolo; Rigano, Paolo

    2009-01-01

    The prognosis for thalassemia major has dramatically improved in the last two decades. However, many transfusion-dependent patients continue to develop progressive accumulation of iron. This can lead to tissue damage and eventually death, particularly from cardiac disease. Previous studies that investigated iron chelation treatments, including retrospective and prospective non-randomised clinical trials, suggested that mortality, due mainly to cardiac damage, was reduced or completely absent in patients treated with deferiprone (DFP) alone or a combined deferiprone-deferoxamine (DFP-DFO) chelation treatment. However, no survival analysis has been reported for a long-term randomised control trial. Here, we performed a multicenter, long-term, randomised control trial that compared deferoxamine (DFO) versus DFP alone, sequential DFP-DFO, or combined DFP-DFO iron chelation treatments. The trial included 265 patients with thalassemia major, with 128 (48.3%) females and 137 (51.7%) males. No deaths occurred with the DFP-alone or the combined DFP-DFO treatments. One death occurred due to graft versus host disease (GVHD) in a patient that had undergone bone marrow transplantation; this patient was censored at the time of transplant. Only one death occurred with the DFP-DFO sequential treatment in a patient that had experienced an episode of heart failure one year earlier. Ten deaths occurred with the deferoxamine treatment. The main factors that correlated with an increase in the hazard ratio for death were: cirrhosis, arrhythmia, previous episode of heart failure, diabetes, hypogonadism, and hypothyroidism. In a Cox regression model, the interaction effect of sex and age was statistically significant (p-value<0.013). For each increasing year of age, the hazard ratio for males was 1.03 higher than that for females (p-value<0.013). In conclusion, the results of this study show that the risk factors for predicting mortality in patients with thalassemia major are deferoxamine

  9. A prospective, multicenter evaluation of predictive factors for positive surgical margins after nephron-sparing surgery for renal cell carcinoma: the RECORd1 Italian Project.

    PubMed

    Schiavina, Riccardo; Serni, Sergio; Mari, Andrea; Antonelli, Alessandro; Bertolo, Riccardo; Bianchi, Giampaolo; Brunocilla, Eugenio; Borghesi, Marco; Carini, Marco; Longo, Nicola; Martorana, Giuseppe; Mirone, Vincenzo; Morgia, Giuseppe; Porpiglia, Francesco; Rocco, Bernardo; Rovereto, Bruno; Simeone, Claudio; Sodano, Mario; Terrone, Carlo; Ficarra, Vincenzo; Minervini, Andrea

    2015-04-01

    The purpose of this study was to evaluate the predictors of positive margins in one of the largest available prospective multi-institutional studies. We evaluated all patients who underwent NSS for radiologically diagnosed kidney tumors between January 2009 and December 2012 at 19 urological Italian centers (Registry of Conservative Renal Surgery [RECORd] project). Preoperative and anthropometric data, comorbidities, intraoperative and postoperative outcomes, and histological findings were analyzed. The negative and PSMs were compared according to the clinical and surgical variables. Multivariable logistic regression models were applied to analyze predictors of PSMs. Eight hundred consecutive patients were evaluated. Seven hundred sixty-one (95.1%) and 39 patients (4.9%) achieved negative and PSMs, respectively. Patients with PSMs were significantly older compared with those with negative margins (median age: 66.6 vs. 61.8 years, respectively; P = .001). A higher incidence of PSMs was observed when NSS was performed for renal masses located in the upper pole (P = .001). A lower rate of PSMs was found in patients treated with simple enucleation rather than standard PN (1.6% vs. 7.4%, respectively; P < .0001). A greater incidence of PSMs was found in Fuhrman 3/4 tumors (11.3%; P < .0001). At multivariable analysis, age (odds ratio [OR], 1.04; P = .01), upper pole tumor location (OR, 2.85; P = .005), standard PN (OR, 3.45; P = .004), and Fuhrman 3-4 nuclear grade (OR, 4.81; P = .001) were found to be independent predictors of PSMs. In our multi-institutional report, young age, simple enucleation, middle or lower tumor location, and low-grade tumor were demonstrated to be independent predictors of negative SMs. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Treatment of cancer of the base of the tongue and glosso-epiglottic region: a multicenter Italian survey. GLOCC Group. Gruppo di Lavoro in Oncologia Cervico Cefalica.

    PubMed

    Grandi, C; Guzzo, M; Cavina, R; Gardani, G; Tana, S; Licitra, L; Rossi, N; Barbaccia, C; Mingardo, M; Fallahdar, D; Bruno, P; Molinari, R

    2000-01-01

    The current treatment options for cancer of the base of the tongue and glosso-epiglottic region are surgery, radiotherapy, or a combination of both modalities. Comparisons between different modalities are not common in the literature, and a real standard of treatment has not yet been established. The purpose of our study was to evaluate the results of treatment in a large series of patients from 18 Italian institutions in relation to the main treatment adopted. The present study is a retrospective survey. The series was divided into a combined surgery group and a radiotherapy group. The Kaplan-Meier method and the log-rank test were used for survival calculations and comparisons. Eight hundred patients were registered (25.7% stage III and 62% stage IV), 336 in the surgery and 372 in the radiotherapy group. Conventional fractionation was adopted in almost all cases. The five-year overall and disease free survival of the whole series was 32% and 38%, respectively. Survival was slightly better for patients with tumors of the glosso-epiglottic region than for those with a tumor of the base of the tongue. Five-year disease-free survival was 55% for patients treated with surgery +/- radiochemotherapy and 26% for those submitted to radiotherapy alone or in combination with chemotherapy. As far as the total dose and the treatment duration were concerned, only 26% of the patients of the radiotherapy group met the established criteria of adequacy, but in patients with adequate radiation the control rate was better only for small tumors (T1-T2). The results in patients treated with surgery +/- postoperative radiotherapy were similar to or better than those reported in the best series in the literature. By contrast, the survival rate of irradiated patients was lower than those reported by other centers.

  11. Blood born viral infections, sexually transmitted diseases and latent tuberculosis in italian prisons: a preliminary report of a large multicenter study.

    PubMed

    Sagnelli, E; Starnini, G; Sagnelli, C; Monarca, R; Zumbo, G; Pontali, E; Gabbuti, A; Carbonara, S; Iardino, R; Armignacco, O; Babudieri, S

    2012-12-01

    Recent screenings of inmates for Hepatitis C virus (HCV), Hepatitis B virus (HBV), human immunodeficiency virus (HIV), Syphilis and Latent Tuberculosis (LTB) did not provide sufficient information to improve healthcare strategies. To obtain valuable information on the endemicity of the above mentioned Infections in prisons of Italy. A screening based on a peer-to-peer communication, followed by a month of blood sampling on a voluntary basis was performed to detect antibody to 4 of the 5 above mentioned infections and detect LTB by PPD (purified protein derivative) Skin Test. The present analysis regards data obtained in 9 of the 20 prisons. The percentage of patients who accepted the screening varied between jails (37.3-95.2%, median 62.2), but it was higher than 10.0-20.5% obtained in the same 9 prisons using traditional methods before our intervention. The participation to the screening reached 65.3% for HBV, 64.6% for HCV, 67.4%for HIV, 55.7% for TPHA (Treponema Pallidum Hemagglutination Assay) and 42.8% for LTB. HBsAg was detected in 4.4% of 2265 subjects, anti-HCV in 22.8% of 2241, anti-HIV in 3.8% of 2339 and TPHA in 2.1% of 1932; PPD Skin Test was positive in 17.2% of 1486 subjects. The screening identified 183 subjects with an unknown infection, 56 italian and 127 foreigners to be evaluated for clinical decisions: 35 with HBV chronic infection, 34 with HCV chronic infection, 3 anti-HIV positive, 14 with syphilis and 97 with LTB. The new approach to the screening, based on a peer-to-peer communication followed by blood sampling on a voluntary basis provided valuable information to improve the healthcare system in each single prison.

  12. Surgical Data and Early Postoperative Outcomes after Minimally Invasive Lumbar Interbody Fusion: Results of a Prospective, Multicenter, Observational Data-Monitored Study

    PubMed Central

    Pereira, Paulo; Buzek, David; Franke, Jörg; Senker, Wolfgang; Kosmala, Arkadiusz; Hubbe, Ulrich; Manson, Neil; Rosenberg, Wout; Assietti, Roberto; Martens, Frederic; Barbanti Brodano, Giovanni; Scheufler, Kai-Michael

    2015-01-01

    Minimally invasive lumbar interbody fusion (MILIF) offers potential for reduced operative morbidity and earlier recovery compared with open procedures for patients with degenerative lumbar disorders (DLD). Firm conclusions about advantages of MILIF over open procedures cannot be made because of limited number of large studies of MILIF in a real-world setting. Clinical effectiveness of MILIF in a large, unselected real-world patient population was assessed in this Prospective, monitored, international, multicenter, observational study. Objective: To observe and document short-term recovery after minimally invasive interbody fusion for DLD. Materials and Methods: In a predefined 4-week analysis from this study, experienced surgeons (≥30 MILIF surgeries pre-study) treated patients with DLD by one- or two-level MILIF. The primary study objective was to document patients’ short-term post-interventional recovery (primary objective) including back/leg pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), health status (EQ-5D) and Patient satisfaction. Results: At 4 weeks, 249 of 252 patients were remaining in the study; the majority received one-level MILIF (83%) and TLIF was the preferred approach (94.8%). For one-level (and two-level) procedures, surgery duration was 128 (182) min, fluoroscopy time 115 (154) sec, and blood-loss 164 (233) mL. Time to first ambulation was 1.3 days and time to study-defined surgery recovery was 3.2 days. Patients reported significantly (P < 0.0001) reduced back pain (VAS: 2.9 vs 6.2), leg pain (VAS: 2.5 vs 5.9), and disability (ODI: 34.5% vs 45.5%), and a significantly (P < 0.0001) improved health status (EQ-5D index: 0.61 vs 0.34; EQ VAS: 65.4 vs 52.9) 4 weeks postoperatively. One adverse event was classified as related to the minimally invasive surgical approach. No deep site infections or deaths were reported. Conclusions: For experienced surgeons, MILIF for DLD demonstrated early benefits (short time to

  13. Does the intragastric balloon have a predictive role in subsequent LAP-BAND(®) surgery? Italian multicenter study results at 5-year follow-up.

    PubMed

    Genco, Alfredo; Lorenzo, Michele; Baglio, Giovanni; Furbetta, Francesco; Rossi, Angelo; Lucchese, Marcello; Zappa, Marco A; Giardiello, Cristiano; Micheletto, Giancarlo; Bottari, Giorgio; Puglisi, Francesco; Montanari, Luca; Simona, Civitelli; Forestieri, Pietro

    2014-01-01

    The intragastric balloon has been reported to be a safe and effective tool for temporary weight loss. The aim of this study is the evaluation of the possible predictive role of intragastric balloon when used before laparoscopic adjustable gastric banding. A longitudinal multicenter study was conducted in patients with body mass index (BMI)>35 kg/m(2) who underwent gastric banding with the BioEnterics Intragastric Balloon (BIB). After balloon removal (6 mo), patients were allocated into 2 group according to their percentage of excess weight loss (%EWL): group>25 (%EWL>25%) and group<25 (%EWL<25%). Patients from both group underwent laparoscopic adjustable gastric banding (LAGB) 1-3 months after BIB removal. The LAP-BAND AP band was placed in all patients via pars flaccida. Weight loss parameters were considered in both groups. From January 2005 to December 2009, 1357 patients were enrolled in this study. Mean BMI at time of BIB positioning was 44.9±8.4 (range 29-82.5). After 6 months, at time of removal, mean BMI was 39.4±7.3. According to the cutoff, patients were allocated into group A (n = 699) and group B (n = 658). At this time the mean BMI was 36.4±6.4 and 42.7±6.9 (P = .001) in groups A and B, respectively. At 1-year follow-up from LAGB, mean BMI was 35.8±6.5 and 40.0±7.4 (P<.001) in groups A and B, respectively. This significant difference was confirmed at 3- and 5-year follow-ups. A similar pattern was observed with the %EWL. Satisfactory results with BIB are predictive of a positive outcome of LASB at 1, 3, and 5 years after the procedure, and poor results do not inevitably indicate a negative outcome for gastric banding. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  14. Treatment Modalities and Outcomes in Patients with Advanced Invasive Thymoma or Thymic Carcinoma: A Retrospective Multicenter Study

    PubMed Central

    Modh, Ankit; Rimner, Andreas; Allen, Pamela K.; Greenfield, Brad; Marom, Edith M.; Rice, David; Huang, James; Rosenzweig, Kenneth E.; Komaki, Ritsuko; Gomez, Daniel R.

    2016-01-01

    Introduction We investigated relationships between treatment characteristics and long-term outcomes in patients with locally advanced thymoma or thymic carcinoma. Methods We retrospectively reviewed 146 patients treated in 1980–2011 at two tertiary cancer care centers, 110 with Masaoka-Koga stage III–IVa invasive thymoma and 36 with stage I–IVa thymic carcinoma. Survival probabilities were estimated with the Kaplan-Meier method. Risk factors related to survival were identified by univariate and multivariate competing risk analysis, with overall survival (OS) as the competing risk. Cox regression analysis was used to identify risk factors for OS. Results Median follow-up time for all patients was 64 months. At 5/10 years, rates of OS and freedom from recurrence (FFR) were 81/58% and 81/65%, respectively. Of patients who underwent surgery, trimodality treatment produced better survival compared to less aggressive treatment among patients with stage III disease (p=0.03). Among patients who underwent trimodality treatment, patients with stage III disease had better OS (p=0.03) and FFR (p<0.001) than those with stage IVA disease. On Cox regression analysis, decreased OS was associated with thymic carcinoma (hazard ratio [HR]=7.36, 95% CI=2.38–22.77, p=0.001), R2/unresectable disease (HR=8.45, 95% CI=1.44–49.42, p=0.02) and an Eastern Cooperative Oncology Group performance score of 1 (HR=8.14, 95% CI=1.55–42.75, p=0.01) or 2–3 (HR=29.60, 95% CI=4.0–218.98, p=0.001) versus 0. Conclusion Aggressive treatment with chemotherapy, surgical resection, and postoperative radiation therapy can produce long-term survival for patients with invasive thymic malignanices. PMID:24390276

  15. Infection Cycle of Artichoke Italian Latent Virus in Tobacco Plants: Meristem Invasion and Recovery from Disease Symptoms

    PubMed Central

    Santovito, Elisa; Mascia, Tiziana; Siddiqui, Shahid A.; Minutillo, Serena Anna; Valkonen, Jari P. T.; Gallitelli, Donato

    2014-01-01

    Nepoviral infections induce recovery in fully expanded leaves but persist in shoot apical meristem (SAM) by a largely unknown mechanism. The dynamics of infection of a grapevine isolate of Artichoke Italian latent virus (AILV-V, genus Nepovirus) in tobacco plants, including colonization of SAM, symptom induction and subsequent recovery of mature leaves from symptoms, were characterized. AILV-V moved from the inoculated leaves systemically and invaded SAM in 7 days post-inoculation (dpi), remaining detectable in SAM at least up to 40 dpi. The new top leaves recovered from viral symptoms earliest at 21 dpi. Accumulation of viral RNA to a threshold level was required to trigger the overexpression of RDR6 and DCL4. Consequently, accumulation of viral RNA decreased in the systemically infected leaves, reaching the lowest concentration in the 3rd and 4th leaves at 23 dpi, which was concomitant with recovery of the younger, upper leaves from disease symptoms. No evidence of virus replication was found in the recovered leaves, but they contained infectious virus particles and were protected against re-inoculation with AILV-V. In this study we also showed that AILV-V did not suppress initiation or maintenance of RNA silencing in transgenic plants, but was able to interfere with the cell-to-cell movement of the RNA silencing signal. Our results suggest that AILV-V entrance in SAM and activation of RNA silencing may be distinct processes since the latter is triggered in fully expanded leaves by the accumulation of viral RNA above a threshold level rather than by virus entrance in SAM. PMID:24911029

  16. The PREgnancy and FERtility (PREFER) study: an Italian multicenter prospective cohort study on fertility preservation and pregnancy issues in young breast cancer patients.

    PubMed

    Lambertini, Matteo; Anserini, Paola; Fontana, Valeria; Poggio, Francesca; Iacono, Giuseppina; Abate, Annalisa; Levaggi, Alessia; Miglietta, Loredana; Bighin, Claudia; Giraudi, Sara; D'Alonzo, Alessia; Blondeaux, Eva; Buffi, Davide; Campone, Francesco; Merlo, Domenico F; Del Mastro, Lucia

    2017-05-19

    Fertility and pregnancy issues are of key importance for young breast cancer patients. Despite several advances in the field, there are still multiple unmet needs and barriers in discussing and dealing with these concerns. To address the significant challenges related to fertility and pregnancy issues, the PREgnancy and FERtility (PREFER) study was developed as a national comprehensive program aiming to optimize care and improve knowledge around these topics. The PREFER study is a prospective cohort study conducted across several Italian institution affiliated with the Gruppo Italiano Mammella (GIM) group evaluating patterns of care and clinical outcomes of young breast cancer patients dealing with fertility and pregnancy issues. It is composed of two distinctive studies: PREFER-FERTILITY and PREFER-PREGNANCY. The PREFER-FERTILITY study is enrolling premenopausal patients aged 18-45 years, diagnosed with non-metastatic breast cancer, who are candidates to (neo)adjuvant chemotherapy and not previously exposed to anticancer therapies. The primary objective is to obtain and centralize data about patients' preferences and choices towards the available fertility preserving procedures. The success and safety of these strategies and the hormonal changes during chemotherapy and study follow-up are secondary objectives. The PREFER-PREGNANCY study is enrolling survivors achieving a pregnancy after prior history of breast cancer and patients diagnosed with pregnancy-associated breast cancer (PABC). The primary objectives are to obtain and centralize data about the management and clinical outcomes of these women. Patients' survival outcomes, and the fetal, obstetrical and paediatric care of their children are secondary objectives. For both studies, the initial planned recruitment period is 5 years and patients will remain in active follow-up for up to 15 years. The PREFER-FERTILITY study was first activated in November 2012, and the PREFER-PREGNANCY study in May 2013

  17. Prognostic indicators of risk for first variceal bleeding in cirrhosis: a multicenter study in 711 patients to validate and improve the North Italian Endoscopic Club (NIEC) index.

    PubMed

    Merkel, C; Zoli, M; Siringo, S; van Buuren, H; Magalotti, D; Angeli, P; Sacerdoti, D; Bolondi, L; Gatta, A

    2000-10-01

    The best known indicator of risk for first bleeding in patients with cirrhosis without previous bleeding is the index devised by the North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices (NIEC index), which results from the combination of size of esophageal varices, severity of red wale marks, and Child-Pugh class. Its efficiency is far from optimal, and validation studies have reported sensitivities and specificities markedly lower than those reported in the original study. In the present study we analyzed the efficiency of NIEC index in a large series of cirrhotic patients with varices without previous bleeding. In addition, we tried to improve the effectiveness of the index by modifying it, and to validate the modifications in an independent group of patients. A total of 627 patients were enrolled and followed until either a variceal bleeding or for a maximum of 2 yr. During this time, 117 experienced a first variceal Using Cox's regression analysis, size of varices, severity of red wale marks, and Child-Pugh score were significant and independent predictors of first bleeding, as already noted in the original report of the NIEC group. However, coefficients and standard errors were markedly different, and the importance of size of esophageal varices in the regression was much larger, whereas that of Child-Pugh score was much lower. According to these data, a revised index was developed (Rev-NIEC). Using receiver operating characteristic (ROC) curve analysis, the revised index showed a larger efficiency, and the area under the curve was significantly larger (0.80 +/- 0.02 vs 0.74 +/- 0.02; p < 0.01). In particular, the curve showed that for a specificity of 75%, the new index had a sensitivity of 72% compared to that of 55% of the NIEC index. Validation in an independent sample of 84 patients showed good agreement between predicted and observed risk for bleeding. Validation with the bootstrap technique also showed adequate stability of

  18. Invasive candidiasis in low birth weight preterm infants: risk factors, clinical course and outcome in a prospective multicenter study of cases and their matched controls

    PubMed Central

    2014-01-01

    Background This multicenter prospective study of invasive candidiasis (IC) was carried out to determine the risk factors for, incidence of, clinical and laboratory features, treatment and outcome of IC in infants of birth weight <1250 g. Methods Neonates <1250 g with IC and their matched controls (2:1) were followed longitudinally and descriptive analysis was performed. Survivors underwent neurodevelopmental assessment at 18 to 24 months corrected age. Neurodevelopmental impairment (NDI) was defined as blindness, deafness, moderate to severe cerebral palsy, or a score <70 on the Bayley Scales of Infant Development 2nd edition. Multivariable analyses were performed to determine risk factors for IC and predictors of mortality and NDI. Results Cumulative incidence rates of IC were 4.2%, 2.2% and 1.5% for birth-weight categories <750 g, <1000 g, <1500 g, respectively. Forty nine infants with IC and 90 controls were enrolled. Necrotizing enterocolitis (NEC) was the only independent risk factor for IC (p = 0.03). CNS candidiasis occurred in 50% of evaluated infants, while congenital candidiasis occurred in 31%. Infants with CNS candidiasis had a higher mortality rate (57%) and incidence of deafness (50%) than the overall cohort of infants with IC. NDI (56% vs. 33%; p = 0.017) and death (45% vs. 7%; p = 0.0001) were more likely in cases than in controls, respectively. IC survivors were more likely to be deaf (28% vs. 7%; p = 0.01). IC independently predicted mortality (p = 0.0004) and NDI (p = 0.018). Conclusion IC occurred in 1.5% of VLBW infants. Preceding NEC increased the risk of developing IC. CNS candidiasis is under-investigated and difficult to diagnose, but portends a very poor outcome. Mortality, deafness and NDI were independently significantly increased in infants with IC compared to matched controls. PMID:24924877

  19. One-year outcomes after minimally invasive sacroiliac joint fusion with a series of triangular implants: a multicenter, patient-level analysis

    PubMed Central

    Sachs, Donald; Capobianco, Robyn; Cher, Daniel; Holt, Timothy; Gundanna, Mukund; Graven, Timothy; Shamie, A Nick; Cummings, John

    2014-01-01

    Background Sacroiliac joint (SI) pain is an often-overlooked cause of lower-back pain, due in part to a lack of specific findings on radiographs and a symptom profile similar to other back-related disorders. A minimally invasive surgical (MIS) approach to SI joint fusion using a series of triangular, titanium plasma spray-coated implants has shown favorable outcomes in patients with SI joint pain refractory to conservative care. The aim of this study was to provide a multicenter experience of MIS SI joint fusion using a patient-level analysis. Patients and methods We report a patient-level analysis from 144 patients with a mean of 16 months postoperative follow-up. Demographic information, perioperative measures, complications, and clinical outcomes using a visual analog scale for pain were collected prospectively. Random-effects regression models were used to account for intersite variability. Results The mean age was 58 years, 71% of patients were female, and 62% had a history of lumbar spinal fusion. Mean (95% confidence interval [CI]) operative time was 73 minutes (25.4–118), blood loss was minimal, and hospital stay was 0.8 days (0.1–1.5). At follow-up, mean (95% CI) visual analog scale pain scores improved by 6.1 points (5.7–6.6). Substantial clinical benefit, defined as a decrease in pain by >2.5 points or a score of 3.5 or less, was achieved in 91.9% of patients (95% CI 83.9%–96.1%), and 96% (95% CI 86.3%–98.8%) of patients indicated they would have the same surgery again. Conclusion When conservative measures fail to relieve symptoms resulting from degeneration or disruption of the SI joint, MIS SI joint fusion using a series of triangular, porous, titanium plasma spray-coated implants is a safe and effective treatment option. PMID:25210479

  20. Incidence and clinical relevance of TEL/AML1 fusion genes in children with acute lymphoblastic leukemia enrolled in the German and Italian multicenter therapy trials. Associazione Italiana Ematologia Oncologia Pediatrica and the Berlin-Frankfurt-Münster Study Group.

    PubMed

    Borkhardt, A; Cazzaniga, G; Viehmann, S; Valsecchi, M G; Ludwig, W D; Burci, L; Mangioni, S; Schrappe, M; Riehm, H; Lampert, F; Basso, G; Masera, G; Harbott, J; Biondi, A

    1997-07-15

    The molecular approach for the analysis of leukemia associated chromosomal translocations has led to the identification of prognostic relevant subgroups. In pediatric acute lymphoblastic leukemia (ALL), the most common translocations, t(9;22) and t(4;11), have been associated with a poorer clinical outcome. Recently the TEL gene at chromosome 12p13 and the AML1 gene at chromosome 21q22 were found to be involved in the translocation t(12;21)(p13;q22). By conventional cytogenetics, however, this chromosomal abnormality is barely detectable and occurs in less than 0.05% of childhood ALL. To investigate the frequency of the molecular equivalent of the t(12;21), the TEL/AML1 gene fusion, we have undertaken a prospective screening in the running German Berlin-Frankfurt-Münster (BFM) and Italian Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) multicenter ALL therapy trials. We have analyzed 334 unselected cases of pediatric ALL patients consecutively referred over a period of 5 and 9 months, respectively. The overall incidence of the t(12;21) in pediatric ALL is 18.9%. The 63 cases positive for the TEL/AML1 chimeric products ranged in age between 1 and 12 years, and all but one showed CD10 and pre-B immunophenotype. Interestingly, one case displayed a pre-pre-B immunophenotype. Among the B-lineage subgroup, the t(12;21) occurs in 22.0% of the cases. Fifteen of 61 (24.6%) cases coexpressed at least two myeloid antigens (CD13, CD33, or CDw65) in more than 20% of the gated blast cells. DNA index was available for 59 of the 63 TEL/AML1 positive cases; a hyperdiploid DNA content (> or = 1.16) was detected in only four patients, being nonhyperdiploid in the remaining 55. Based on this prospective analysis, we retrospectively evaluated the impact of TEL/AML1 in prognosis by identifying the subset of B-lineage ALL children enrolled in the closed German ALL-BFM-90 and Italian ALL-AIEOP-91 protocols who had sufficient material for analysis. A total of 342 children

  1. MASTERS-D Study: A Prospective, Multicenter, Pragmatic, Observational, Data-Monitored Trial of Minimally Invasive Fusion to Treat Degenerative Lumbar Disorders, One-Year Follow-Up

    PubMed Central

    Manson, Neil; Buzek, David; Kosmala, Arkadiusz; Hubbe, Ulrich; Rosenberg, Wout; Pereira, Paulo; Assietti, Roberto; Martens, Frederic; Lam, Khai; Barbanti Brodano, Giovanni; Durny, Peter; Lidar, Zvi; Scheufler, Kai; Senker, Wolfgang

    2016-01-01

    The objective of the study is to assess effectiveness and safety of minimally invasive lumbar interbody fusion (MILIF) for degenerative lumbar disorders (DLD) in daily surgical practice and follow up with patients for one year after surgery. A prospective, multicenter, pragmatic, monitored, international outcome study in patients with DLD causing back/leg pain was conducted (19 centers). Two hundred fifty-two patients received standard of care available in the centers. Patients were included if they were aged >18 years, required one- or two-level lumbar fusion for DLD, and met the criteria for approved device indications. Primary endpoints: time to first ambulation (TFA) and time to surgery recovery (TSR). Secondary endpoints: patient-reported outcomes (PROs)--back and leg pain (visual analog scale), disability (Oswestry Disability Index (ODI)), health status (EQ-5D), fusion rates, reoperation rates, change in pain medication, rehabilitation, return to work, patient satisfaction, and adverse events (AEs). Experienced surgeons (≥30 surgeries pre-study) treated patients with DLD by one- or two-level MILIF and patients were evaluated for one year (NCT01143324). At one year, 92% (233/252) of patients remained in the study. Primary outcomes: TFA, 1.3 ±0.5 days and TSR, 3.2 ±2.0 days. Secondary outcomes: Most patients (83.3%) received one level MILIF; one (two-level) MILIF mean surgery duration, 128 (182) min; fluoroscopy time, 115 (154) sec; blood loss, 164 (233) mL; at one year statistically significant (P<.0001) and clinically meaningful changes from baseline were reported in all PROs--reduced back pain (2.9 ±2.5 vs. 6.2 ±2.3 at intake), reduced leg pain (2.2 ±2.6 vs. 5.9 ±2.8), and ODI (22.4% ± 18.6 vs. 45.3% ± 15.3), as well as health-related quality of life (EQ-5D index: 0.71 ±0.28 vs. 0.34 ±0.32). More of the professional workers were working at one year than those prior to surgery (70.3% vs. 55.2%). Three AEs and one serious AE were considered

  2. Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711

    PubMed Central

    2013-01-01

    Background Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care. A promising minimally invasive alternative is the endoscopic transluminal step-up approach. This approach consists of endoscopic transluminal drainage followed, if necessary, by endoscopic transluminal necrosectomy. We hypothesise that the less invasive endoscopic step-up approach is superior to the surgical step-up approach in terms of clinical and economic outcomes. Methods/Design The TENSION trial is a randomised controlled, parallel-group superiority multicenter trial. Patients with (suspected) infected necrotising pancreatitis with an indication for intervention and in whom both treatment modalities are deemed possible, will be randomised to either an endoscopic transluminal or a surgical step-up approach. During a 4 year study period, 98 patients will be enrolled from 24 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of death and major complications within 6 months following randomisation. Secondary endpoints include complications such as pancreaticocutaneous fistula, exocrine or endocrine pancreatic insufficiency, need for additional radiological, endoscopic or surgical intervention, the need for necrosectomy after drainage, the number of (re-)interventions, quality of life, and total direct and indirect costs. Discussion The TENSION trial will answer the question whether an endoscopic step-up approach reduces the combined primary endpoint of death and major complications, as well as hospital stay and related costs compared with a surgical step-up approach in patients with infected necrotising pancreatitis. PMID:24274589

  3. The use of analgesic drugs in postoperative patients: the neglected problem of pain control in intensive care units. An observational, prospective, multicenter study in 128 Italian intensive care units.

    PubMed

    Bertolini, Guido; Minelli, Cosetta; Latronico, Nicola; Cattaneo, Alessandro; Mura, Giorgio; Melotti, Rita M; Iapichino, Gaetano

    2002-04-01

    The use of analgesic drugs in patients admitted to Italian intensive care units (ICUs) was assessed. An observational, prospective, cohort study was conducted, involving all adult patients admitted during a 1-month period in 128 Italian general ICUs. The use of analgesic drugs was evaluated for the first 2 postoperative days in surgical patients who stayed in ICU for at least 2 days. We observed 661 postoperative patients who underwent elective (72%) or emergency surgery. Of the patients with an ICU stay of at least 2 days, 49% did not receive any opioids in the first 48 postoperative hours, and more than 35% did not receive any analgesic at all. The most used opioid was fentanyl, followed by morphine and buprenorphine. Among the 336 patients who received at least one opioid, as many as 42% had only a single bolus per day. Pain control was reported as the reason for drug use in 54.5% of opioid administrations, while control of anxiety covered 10.3% of them. The probability of receiving an opioid was lower for patients in coma. Management of postoperative pain in Italian ICUs was insufficient, particularly in neurosurgical and comatose patients. A general lack of knowledge about pain and misconceptions about pain drugs may be at the basis of these results.

  4. [Italian multicenter study for the verification of the efficacy and tolerability of short-term substitution hormone therapy using conjugated estrogens and progestagens administered orally in the postmenopausal a period].

    PubMed

    De Aloysio, D; Mauloni, M; Altieri, P; Cappi, G P; Monterubbianesi, M; Bottiglioni, F

    1992-12-01

    Three hundred and sixty-three postmenopausal women received 6 months of cyclic hormone replacement therapy with conjugated estrogens in differing doses (0.625 mg and 1.25 mg) associated in a sequential pattern lasting 12 days with progestagens (medroxyprogesterone acetate or medrogestone) in 16 italian health centres. The results of the multicentre study confirm the efficacy of this conjugated estrogen-progestogen regimen in resolving climacteric syndrome, offering cardiovascular protection and vaginal trophic effect and preventing postmenopausal osteoporosis, as well as confirming its tolerability in relation to blood pressure, body weight, breast, endometrium, blood coagulation and hepato-renal function.

  5. Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study.

    PubMed

    Sebastiani, Giada; Tempesta, Diego; Fattovich, Giovanna; Castera, Laurent; Halfon, Philippe; Bourliere, Marc; Noventa, Franco; Angeli, Paolo; Saggioro, Alfredo; Alberti, Alfredo

    2010-10-01

    Preliminary data suggest that non-invasive methods could be useful to assess presence of oesophageal varices (OV) in cirrhotic patients. We aimed to further investigate simple serum non-invasive markers for diagnosing and grading OV. A retrospective set of 510 cirrhotics and a prospective set of 110 cirrhotics were enrolled consecutively in five centers. Platelets, AST-to-ALT ratio, AST-to-platelet-ratio index, Forns' index, Lok index, Fib-4, and Fibroindex were measured within 2 months from upper endoscopy, taken as a gold standard. Performance was expressed as sensitivity, specificity, positive, and negative predictive values (PPV, NPV), accuracy, and area under the curve (AUC). A combination of Lok index (cutoff=1.5) and Forns' index (cutoff=8.8) had 0.80 AUC (0.76-0.84, 95% CI), and high NPV (>90%) to exclude clinically relevant OV, defined as large OV or small OV with red signs or in Child-Pugh C cirrhosis. By applying this combination, upper endoscopy would have been avoided in 1/3 of our cirrhotics. Large OV could be excluded with 96% NPV by Lok index (cutoff=1.5). A combination of Lok index (cutoff=0.9) and Forns' index (cutoff=8.5) predicted presence of any grade OV with good performance: 0.82 AUC (0.76-0.88, 95% CI), 88% PPV. Serum non-invasive markers may be useful as a first line tool to identify cirrhotic patients in which the risk of clinically relevant OV is trivial, and to reduce the number of upper endoscopies. However, we are still far from the possibility of replacing upper endoscopy by simple serum non-invasive markers in the vast majority of patients. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  6. Minimally Invasive Prostate Convective Water Vapor Energy Ablation: A Multicenter, Randomized, Controlled Study for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

    PubMed

    McVary, Kevin T; Gange, Steven N; Gittelman, Marc C; Goldberg, Kenneth A; Patel, Kalpesh; Shore, Neal D; Levin, Richard M; Rousseau, Michael; Beahrs, J Randolf; Kaminetsky, Jed; Cowan, Barrett E; Cantrill, Christopher H; Mynderse, Lance A; Ulchaker, James C; Larson, Thayne R; Dixon, Christopher M; Roehrborn, Claus G

    2016-05-01

    This report reveals the results of a multicenter, randomized, controlled study using transurethral prostate convective water vapor thermal energy to treat lower urinary tract symptoms associated with benign prostatic hyperplasia. Men 50 years old or older with an International Prostate Symptom Score of 13 or greater, maximum flow rate of 15 ml per second or less and prostate size 30 to 80 cc were randomized 2:1 between thermal therapy with the Rezūm® System and control. Thermal water vapor was injected into the transition zone and median lobe as needed. The control procedure was rigid cystoscopy with simulated active treatment sounds. The primary end point compared International Prostate Symptom Score reduction at 3 months. Treatment subjects were followed for 12 months. There were 197 men randomized (active 136, control 61). Thermal therapy and control International Prostate Symptom Score was reduced by 11.2 ± 7.6 and 4.3 ± 6.9 respectively (p <0.0001). Treatment subject baseline International Prostate Symptom Score of 22 decreased at 2 weeks (18.6, p=0.0006) and by 50% or greater at 3, 6 and 12 months, p <0.0001. The peak flow rate increased by 6.2 ml per second at 3 months and was sustained throughout 12 months (p <0.0001). No de novo erectile dysfunction was reported. Adverse events were mild to moderate and resolved quickly. Convective water vapor thermal therapy provides rapid and durable improvements in benign prostatic hyperplasia symptoms and preserves erectile and ejaculatory function. Treatment can be delivered in an office or hospital setting using oral pain medication and is applicable to all prostate zones including the median lobe. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. A multicenter, randomized, controlled trial of transureteral and shock wave lithotripsy--which is the best minimally invasive modality to treat distal ureteral calculi in children?

    PubMed

    Basiri, Abbas; Zare, Samad; Tabibi, Ali; Sharifiaghdas, Farzaneh; Aminsharifi, Alireza; Mousavi-Bahar, Seyed Habibollah; Ahmadnia, Hassan

    2010-09-01

    Since there is insufficient evidence to determine the best treatment modality in children with distal ureteral calculi, we designed a multicenter, randomized, controlled trial to evaluate the efficacy and complications of transureteral and shock wave lithotripsy in these patients. A total of 100 children with distal ureteral calculi were included in the study. Of the patients 50 were randomized consecutively to undergo shock wave lithotripsy using a Compact Delta II lithotriptor (Dornier MedTech, Kennesaw, Georgia), and 50 were randomized to undergo transureteral lithotripsy with holmium laser and pneumatic lithotriptor between February 2007 and October 2009. Stone-free, complication and efficiency quotient rates were assessed in each group. Mean +/- SD patient age was 6.5 +/- 3.7 years (range 1 to 13). Mean stone surface was 35 mm(2) in the transureteral group and 37 mm(2) in the shock wave lithotripsy group. Stone-free rates at 2 weeks after transureteral lithotripsy and single session shock wave lithotripsy differed significantly, at 78% and 56%, respectively (p = 0.004). With 2 sessions of shock wave lithotripsy the stone-free rate increased to 72%. Efficiency quotient was significantly higher for transureteral vs shock wave lithotripsy (81% vs 62%, p = 0.001). Minor complications were comparable and negligible between the groups. Two patients (4%) who underwent transureteral lithotripsy sustained a ureteral perforation. In the short term it seems that transureteral and shock wave lithotripsy are acceptable modalities for the treatment of distal ureteral calculi in children. However, transureteral lithotripsy has a higher efficacy rate when performed meticulously by experienced hands using appropriate instruments. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN38327949

    PubMed Central

    Besselink, Marc GH; van Santvoort, Hjalmar C; Nieuwenhuijs, Vincent B; Boermeester, Marja A; Bollen, Thomas L; Buskens, Erik; Dejong, Cornelis HC; van Eijck, Casper HJ; van Goor, Harry; Hofker, Sijbrand S; Lameris, Johan S; van Leeuwen, Maarten S; Ploeg, Rutger J; van Ramshorst, Bert; Schaapherder, Alexander FM; Cuesta, Miguel A; Consten, Esther CJ; Gouma, Dirk J; van der Harst, Erwin; Hesselink, Eric J; Houdijk, Lex PJ; Karsten, Tom M; van Laarhoven, Cees JHM; Pierie, Jean-Pierre EN; Rosman, Camiel; Bilgen, Ernst Jan Spillenaar; Timmer, Robin; van der Tweel, Ingeborg; de Wit, Ralph J; Witteman, Ben JM; Gooszen, Hein G

    2006-01-01

    Background The initial treatment of acute necrotizing pancreatitis is conservative. Intervention is indicated in patients with (suspected) infected necrotizing pancreatitis. In the Netherlands, the standard intervention is necrosectomy by laparotomy followed by continuous postoperative lavage (CPL). In recent years several minimally invasive strategies have been introduced. So far, these strategies have never been compared in a randomised controlled trial. The PANTER study (PAncreatitis, Necrosectomy versus sTEp up appRoach) was conceived to yield the evidence needed for a considered policy decision. Methods/design 88 patients with (suspected) infected necrotizing pancreatitis will be randomly allocated to either group A) minimally invasive 'step-up approach' starting with drainage followed, if necessary, by videoscopic assisted retroperitoneal debridement (VARD) or group B) maximal necrosectomy by laparotomy. Both procedures are followed by CPL. Patients will be recruited from 20 hospitals, including all Dutch university medical centres, over a 3-year period. The primary endpoint is the proportion of patients suffering from postoperative major morbidity and mortality. Secondary endpoints are complications, new onset sepsis, length of hospital and intensive care stay, quality of life and total (direct and indirect) costs. To demonstrate that the 'step-up approach' can reduce the major morbidity and mortality rate from 45 to 16%, with 80% power at 5% alpha, a total sample size of 88 patients was calculated. Discussion The PANTER-study is a randomised controlled trial that will provide evidence on the merits of a minimally invasive 'step-up approach' in patients with (suspected) infected necrotizing pancreatitis. PMID:16606471

  9. State of the art of aldosterone immunoassays. A multicenter collaborative study on the behalf of the Cardiovascular Biomarkers Study Group of the Italian Section of European Society of Ligand Assay (ELAS) and Società Italiana di Biochimica Clinica (SIBIOC).

    PubMed

    Fortunato, Antonio; Prontera, Concetta; Masotti, Silvia; Franzini, Maria; Marchetti, Cristina; Giovannini, Stefania; Zucchelli, Gian Carlo; Emdin, Michele; Passino, Claudio; Clerico, Aldo

    2015-04-15

    Two new immunoassay methods for aldosterone assay using automated platforms recently became available into market. The main aim of the present study is to evaluate the analytical performance of these automated direct immunoassay methods, and also to compare their analytical characteristics to those of the most popular RIA and EIA methods used in an Italian External Quality Assessment (EQA) study. In this study analytical performances of two aldosterone immunoassays using the IDS iSYS and DiaSorin LIAISON fully automated platforms, were evaluated. Results obtained with the two platforms in EDTA plasma samples of healthy subjects and patients were compared with those obtained by RIA and EIA methods used in the Italian EQA scheme, named Immunocheck study. The two automated methods showed similar analytical performances: LoD 83.9 vs 92.2 pmol/L, LoQ 104.4 vs 111.1 pmol/L, respectively; moreover, the within-run and total imprecision values showed CV% between 8.1 and 14.1 for samples with 180.8 and 387.2 pmol/L concentration for both methods. There was a close linear regression between methods, however we found a significant proportional bias between LIAISON and iSYS methods. The EQA samples results obtained with these two methods were highly correlated to the consensus mean values. Our data indicate that aldosterone values measured with the two automated methods actually show better reproducibility, shorter laboratory Turn Around Time (TAT) and require less "hands on labor" compared to RIA and EIA immunoassays. However, in our study significant bias was observed in result comparison, this means that translating aldosterone concentration in clinical information an appropriate definition of reference ranges for each method is mandatory. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Transanal minimally invasive surgery (TAMIS): new treatment for early rectal cancer and large rectal polyps—experience of an Italian center.

    PubMed

    Maglio, Riccardo; Muzi, Gallinella Marco; Massimo, Massimo Meucci; Masoni, Luigi

    2015-03-01

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for excision of rectal tumors that avoids conventional pelvic resectional surgery along with its risks and side effects. Although appealing, the associated cost and complex learning curve limit TEM use by colorectal surgeons. Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to TEM. This platform uses ordinary laparoscopic instruments to achieve high-quality local excision. The aim of the study is to assess reliability of the technique. From July 2012 to August 2013, 15 consecutive patients with rectal pathology underwent TAMIS. After a single-incision laparoscopic surgery port was introduced into the anal canal, a pneumorectum was established with a laparoscopic device followed by transanal excision with conventional laparoscopic instruments, including graspers, electrocautery, and needle drivers. Patient demographics, operative data, and pathologic data were recorded. Of the 15 patients, 10 had rectal cancers (six T1 lesions and four T2 after preoperative chemoradiotherapy). The remainder of patients had a local excision for voluminous benign rectal adenomas. The median length of the lesions from the anal verge was 7 cm (range, 4 to 20 cm). The median operating time was 86 minutes (range, 33 to 160 minutes). There was no surgical morbidity or mortality. The median postoperative hospital stay was two days (range, 1 to 4 days). TAMIS seems to be a feasible and safe treatment option for early rectal cancer. We believe that this new technique is easy to perform, cost-effective, and less traumatic to the anal sphincter compared with traditional TEM.

  11. Multicenter evaluation of molecular and culture-dependent diagnostics for Shigella species and Entero-invasive Escherichia coli in the Netherlands.

    PubMed

    van den Beld, Maaike J C; Friedrich, Alexander W; van Zanten, Evert; Reubsaet, Frans A G; Kooistra-Smid, Mirjam A M D; Rossen, John W A

    2016-12-01

    An inter-laboratory collaborative trial for the evaluation of diagnostics for detection and identification of Shigella species and Entero-invasive Escherichia coli (EIEC) was performed. Sixteen Medical Microbiological Laboratories (MMLs) participated. MMLs were interviewed about their diagnostic methods and a sample panel, consisting of DNA-extracts and spiked stool samples with different concentrations of Shigella flexneri, was provided to each MML. The results of the trial showed an enormous variety in culture-dependent and molecular diagnostic techniques currently used among MMLs. Despite the various molecular procedures, 15 out of 16 MMLs were able to detect Shigella species or EIEC in all the samples provided, showing that the diversity of methods has no effect on the qualitative detection of Shigella flexneri. In contrast to semi quantitative analysis, the minimum and maximum values per sample differed by approximately five threshold cycles (Ct-value) between the MMLs included in the study. This indicates that defining a uniform Ct-value cut-off for notification to health authorities is not advisable.

  12. Clinical and epidemiological factors associated with methicillin resistance in community-onset invasive Staphylococcus aureus infections: prospective multicenter cross-sectional study in Korea.

    PubMed

    Kim, Eu Suk; Kim, Hong Bin; Kim, Gayeon; Kim, Kye-Hyung; Park, Kyung-Hwa; Lee, Shinwon; Choi, Young Hwa; Yi, Jongyoun; Kim, Chung Jong; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Kim, Nam-Joong; Lee, Yeong-Seon; Oh, Myoung-Don

    2014-01-01

    Successful empirical therapy of Staphylococcus aureus infections requires the ability to predict methicillin resistance. Our aim was to identify predictors of methicillin resistance in community-onset (CO) invasive S. aureus infections. Sixteen hospitals across Korea participated in this study from May to December 2012. We prospectively included cases of S. aureus infection in which S. aureus was isolated from sterile clinical specimens ≤ 72 hours after hospitalization. Clinical and epidemiological data were gathered and compared in methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) cases. Community-associated (CA) infections were defined as in previous studies. In total, there were 786 cases of community-onset S. aureus infection, 102 (13.0%) of which were CA-MRSA. In addition to known risk factors, exposure to 3rd generation cephalosporins in the past 6 months [odds ratio (OR), 1.922; 95% confidence interval (CI), 1.176-3.142] and close contact with chronically ill patients in the past month (OR, 2.647; 95% CI, 1.189-5.891) were independent risk factors for MRSA infection. However, no clinical predictors of CA-MRSA were identified. Methicillin resistance, CO infection, and appropriateness of empirical antibiotics were not significantly related to 30-day mortality. MRSA infection should be suspected in patients recently exposed to 3rd generation cephalosporins or chronically-ill patients. There were no reliable predictors of CA-MRSA infection, and mortality was not affected by methicillin resistance.

  13. An EORTC international multicenter randomized trial (EORTC number 19923) comparing two dosages of liposomal amphotericin B for treatment of invasive aspergillosis.

    PubMed

    Ellis, M; Spence, D; de Pauw, B; Meunier, F; Marinus, A; Collette, L; Sylvester, R; Meis, J; Boogaerts, M; Selleslag, D; Krcmery, V; von Sinner, W; MacDonald, P; Doyen, C; Vandercam, B

    1998-12-01

    This is the first completed prospective randomized clinical efficacy trial of antifungals in the treatment of invasive aspergillosis (IA) and the first to compare the clinical efficacy of two dosages of liposomal amphotericin B (L-AmB) for IA in neutropenic patients with cancer or those undergoing bone marrow transplantation. Eighty-seven of 120 patients were eligible and evaluable. Clinical responses were documented for 26 (64%) of 41 patients receiving 1 mg/(kg.d) (L-AmB-1) and 22 (48%) of 46 receiving 4 mg/(kg.d) (L-AmB-4). Radiologic response rates were similar: 24 (58%) of the L-AmB-1 recipients and 24(52%) of the L-AmB-4 recipients. The six-month survival rates were 43% (L-AmB-1) and 37% (L-AmB-4). These differences were not significant. The numbers of deaths directly due to IA at 6 months were similar: 9 (22%) of 41 L-AmB-1 recipients and 9 (20%) of 46 L-AmB-4 recipients. No other variable independently influenced survival, apart from central nervous system IA. L-AmB is effective in treating approximately 50%-60% of patients who have IA. A 1-mg/(kg.d) dosage is as effective as a 4-mg/(kg.d) dosage, and no advantages to use of the higher, more expensive, dosage has been observed.

  14. Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post-partum posterior pelvic girdle pain: 12-month outcomes from a prospective, multi-center trial.

    PubMed

    Capobianco, Robyn; Cher, Daniel

    2015-01-01

    Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (-51 mm on VAS), function (-20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.

  15. The application of adjuvant autologous antravesical macrophage cell therapy vs. BCG in non-muscle invasive bladder cancer: a multicenter, randomized trial

    PubMed Central

    2010-01-01

    Introduction While adjuvant immunotherapy with Bacille Calmette Guérin (BCG) is effective in non-muscle-invasive bladder cancer (BC), adverse events (AEs) are considerable. Monocyte-derived activated killer cells (MAK) are discussed as essential in antitumoural immunoresponse, but their application may imply risks. The present trial compared autologous intravesical macrophage cell therapy (BEXIDEM®) to BCG in patients after transurethral resection (TURB) of BC. Materials and methods This open-label trial included 137 eligible patients with TaG1-3, T1G1-2 plurifocal or unifocal tumours and ≥ 2 occurrences within 24 months and was conducted from June 2004 to March 2007. Median follow-up for patients without recurrence was 12 months. Patients were randomized to BCG or mononuclear cells collected by apheresis after ex vivo cell processing and activation (BEXIDEM). Either arm treatment consisted of 6 weekly instillations and 2 cycles of 3 weekly instillations at months 3 and 6. Toxicity profile (primary endpoint) and prophylactic effects (secondary endpoint) were assessed. Results Patient characteristics were evenly distributed. Of 73 treated with BCG and 64 with BEXIDEM, 85% vs. 45% experienced AEs and 26% vs. 14% serious AEs (SAE), respectively (p < 0.001). Recurrence occurred significantly less frequent with BCG than with BEXIDEM (12% vs. 38%; p < 0.001). Discussion This initial report of autologous intravesical macrophage cell therapy in BC demonstrates BEXIDEM treatment to be safe. Recurrence rates were significantly lower with BCG however. As the efficacy of BEXIDEM remains uncertain, further data, e.g. marker lesions studies, are warranted. Trial registration The trial has been registered in the ISRCTN registry http://isrctn.org under the registration number ISRCTN35881130. PMID:20529333

  16. Quality of Life Assessment After Concurrent Chemoradiation for Invasive Bladder Cancer: Results of a Multicenter Prospective Study (GETUG 97-015)

    SciTech Connect

    Lagrange, Jean-Leon; Bascoul-Mollevi, Caroline; Geoffrois, Lionnel; Beckendorf, Veronique; Ferrero, Jean-Marc; Joly, Florence; Allouache, Nedjila; Bachaud, Jean-Marc; Chevreau, Christine; Kramar, Andrew; Chauvet, Bruno

    2011-01-01

    Purpose: To evaluate bladder preservation and functional quality after concurrent chemoradiotherapy for muscle-invasive cancer in 53 patients included in a Phase II trial. Patient and Methods: Pelvic irradiation delivered 45Gy, followed by an 18-Gy boost. Concurrent chemotherapy with cisplatin and 5-fluorouracil by continuous infusion was performed at Weeks 1, 4, and 7 during radiotherapy. Patients initially suitable for surgery were evaluated with macroscopically complete transurethral resection after 45Gy, followed by radical cystectomy in case of incomplete response. The European Organization for Research and Treatment of Cancer quality of life questionnaire QLQ-C30, specific items on bladder function, and the Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic (LENT-SOMA) symptoms scale were used to evaluate quality of life before treatment and 6, 12, 24, and 36 months after treatment. Results: Median age was 68 years for 51 evaluable patients. Thirty-two percent of patients had T2a tumors, 46% T2b, 16% T3, and 6% T4. A visibly complete transurethral resection was possible in 66%. Median follow-up was 8 years. Bladder was preserved in 67% (95% confidence interval, 52-79%) of patients. Overall survival was 36% (95% confidence interval, 23-49%) at 8 years for all patients, and 45% (28-61%) for the 36 patients suitable for surgery. Satisfactory bladder function, according to LENT-SOMA, was reported for 100% of patients with preserved bladder and locally controlled disease 6-36 months after the beginning of treatment. Satisfactory bladder function was reported for 35% of patients before treatment and for 43%, 57%, and 29%, respectively, at 6, 18, and 36 months. Conclusions: Concurrent chemoradiation therapy allowed bladder preservation with tumor control for 67% patients at 8 years. Quality of life and quality of bladder function were satisfactory for 67% of patients.

  17. Determinants of all-cause mortality in different age groups in patients with severe systolic left ventricular dysfunction receiving an implantable cardioverter defibrillator (from the Italian ClinicalService Multicenter Observational Project).

    PubMed

    Fumagalli, Stefano; Gasparini, Maurizio; Landolina, Maurizio; Lunati, Maurizio; Boriani, Giuseppe; Proclemer, Alessandro; Santini, Massimo; Mangoni, Lorenza; Padeletti, Margherita; Marchionni, Niccolò; Padeletti, Luigi

    2014-05-15

    Heart failure (HF) is a common condition in elderly patients. Despite great improvements in medical therapy, HF mortality remains high. Implantable cardioverter defibrillator (ICD) significantly lengthens the survival rate of subjects with severe HF, but little evidence exists on its effect in elderly persons. Aim of this study was to compare the age-related determinants of prognosis in a large population of patients with ICD. We divided all patients who underwent an ICD implantation in 117 Italian centers of the "ClinicalService Project" into 3 age groups (<65, 65 to 74, ≥ 75 years), and collected clinical and instrumental variables at baseline and during follow-up (median length: 27 months). Between 2004 and 2011, 6,311 patients were enrolled (5,174 men; left ventricular ejection fraction 29% ± 9%); 1,510 subjects were ≥ 75 years (23.9%; mean age 78 ± 3 years). The prevalence of co-morbidities increased with age. HF was most frequently due to coronary artery disease in the elderly, who also showed the worst New York Heart Association class. At multivariate analysis, older age, coronary artery disease, chronic obstructive pulmonary disease, chronic renal failure, diabetes, complex ventricular arrhythmias, and left ventricular ejection fraction were significant predictors of all-cause mortality. After adjustment, the hazard ratio(age group) for mortality was 22.6% less than at univariate analysis. When groups were analyzed separately, age alone predicted mortality in the oldest. In conclusion, a large proportion of our population was aged ≥ 75 years. Mortality was related to age and several co-morbidities, except for the oldest patients in whom age alone resulted predictive.

  18. Evaluation of a Minimally Invasive Cell Sampling Device Coupled with Assessment of Trefoil Factor 3 Expression for Diagnosing Barrett's Esophagus: A Multi-Center Case–Control Study

    PubMed Central

    Ross-Innes, Caryn S.; Debiram-Beecham, Irene; O'Donovan, Maria; Walker, Elaine; Varghese, Sibu; Lao-Sirieix, Pierre; Lovat, Laurence; Griffin, Michael; Ragunath, Krish; Haidry, Rehan; Sami, Sarmed S.; Kaye, Philip; Novelli, Marco; Disep, Babett; Ostler, Richard; Aigret, Benoit; North, Bernard V.; Bhandari, Pradeep; Haycock, Adam; Morris, Danielle; Attwood, Stephen; Dhar, Anjan; Rees, Colin; Rutter, Matthew D. D.; Sasieni, Peter D.; Fitzgerald, Rebecca C.

    2015-01-01

    Background Barrett's esophagus (BE) is a commonly undiagnosed condition that predisposes to esophageal adenocarcinoma. Routine endoscopic screening for BE is not recommended because of the burden this would impose on the health care system. The objective of this study was to determine whether a novel approach using a minimally invasive cell sampling device, the Cytosponge, coupled with immunohistochemical staining for the biomarker Trefoil Factor 3 (TFF3), could be used to identify patients who warrant endoscopy to diagnose BE. Methods and Findings A case–control study was performed across 11 UK hospitals between July 2011 and December 2013. In total, 1,110 individuals comprising 463 controls with dyspepsia and reflux symptoms and 647 BE cases swallowed a Cytosponge prior to endoscopy. The primary outcome measures were to evaluate the safety, acceptability, and accuracy of the Cytosponge-TFF3 test compared with endoscopy and biopsy. In all, 1,042 (93.9%) patients successfully swallowed the Cytosponge, and no serious adverse events were attributed to the device. The Cytosponge was rated favorably, using a visual analogue scale, compared with endoscopy (p < 0.001), and patients who were not sedated for endoscopy were more likely to rate the Cytosponge higher than endoscopy (Mann-Whitney test, p < 0.001). The overall sensitivity of the test was 79.9% (95% CI 76.4%–83.0%), increasing to 87.2% (95% CI 83.0%–90.6%) for patients with ≥3 cm of circumferential BE, known to confer a higher cancer risk. The sensitivity increased to 89.7% (95% CI 82.3%–94.8%) in 107 patients who swallowed the device twice during the study course. There was no loss of sensitivity in patients with dysplasia. The specificity for diagnosing BE was 92.4% (95% CI 89.5%–94.7%). The case–control design of the study means that the results are not generalizable to a primary care population. Another limitation is that the acceptability data were limited to a single measure. Conclusions The

  19. Epidemiology, management, and outcome of invasive fungal disease in patients undergoing hematopoietic stem cell transplantation in China: a multicenter prospective observational study.

    PubMed

    Sun, Yuqian; Meng, Fanyi; Han, Mingzhe; Zhang, Xi; Yu, Li; Huang, He; Wu, Depei; Ren, Hanyun; Wang, Chun; Shen, Zhixiang; Ji, Yu; Huang, Xiaojun

    2015-06-01

    The China Assessment of Antifungal Therapy in Hematological Disease study, the first large-scale observational study of invasive fungal disease (IFD) in China, enrolled 1401 patients undergoing hematopoietic stem cell transplantation (HSCT) (75.2% allogeneic and 24.8% autologous) at 31 hospitals across China. The overall incidence of proven or probable IFD was 7.7% (108 of 1401); another 266 cases (19.0%) were possible IFD. After allogeneic or autologous HSCT, the incidence of proven/probable IFD was 8.9% (94 of 1053) and 4.0% (14 of 348), respectively. Some cases (14 of 108) developed during conditioning before transplantation. The cumulative incidence of proven/probable IFD increased steeply in the first month after transplantation and after 6 months, the incidence was significantly higher in allogeneic than it was in autologous transplant recipients (9.2% versus 3.5%; P = .001) and when stem cells were derived from cord blood or bone marrow and peripheral blood (P = .02 versus other sources). Independent risk factors for proven/probable IFD in allogeneic HSCT were diabetes, HLA-matched unrelated donor, prolonged severe neutropenia (absolute neutrophil count > 500/mm(3) for >14 days), and immunosuppressants (odds ratio, 2.0 to 3.4 for all). Antifungal prophylaxis was independently protective (P = .01). Previous IFD and prolonged severe neutropenia were significant independent risk factors among autologous transplantation patients (P < .01, P = .04, respectively). In total, 1175 (83.9%) patients received antifungal prophylaxis (91.6% triazoles) and 514 (36.7%) were treated in the hospital with therapeutic antifungals (89.1% triazoles; median 27 days). Empirical, pre-emptive, and targeted antifungals were used in 82.3%, 13.6%, and 4.1% of cases, respectively. Overall mortality (13.4%; 188 deaths) was markedly higher in patients with proven (5 of 16; 31.3%), probable (20 of 92; 21.7%), or possible (61 of 266; 22.9%) IFD; allogeneic (171 of 1053; 16.2%) rather

  20. Active surveillance for low-risk Non-Muscle Invasive Bladder Cancer (NMIBC): a confirmatory and resource consumption study from Bladder cancer Italian Active Surveillance (BIAS) project.

    PubMed

    Hurle, Rodolfo; Lazzeri, Massimo; Vanni, Elena; Lughezzani, Giovanni; Buffi, NicolòMaria; Casale, Paolo; Saita, Alberto; Morenghi, Emanuela; Forni, Giovanni; Cardone, Pasquale; Lista, Giuliana; Colombo, Piergiuseppe; Peschechera, Roberto; Pasini, Luisa; Zandegiacomo, Silvia; Benetti, Alessio; Maffei, Davide; Vavassori, Ivano; Guazzoni, Giorgio

    2017-08-25

    To investigate the predictive factors of failure and to provide a resource consumption analysis in patients who underwent active surveillance (AS) for Non-Muscle Invasive Bladder Cancer (NMIBC). This is a prospective observational study, which monitored patients with a history of pathologically confirmed stage pTa (G1-G2) or pT1a (G2) NMIBC and recurrent small size and number tumors without haematuria and positive urine cytology. The primary end-point was the failure rate of AS. The assessment of failure-predictive variables and per-year "direct-hospital" resource consumption analysis were secondary outcomes. Descriptive statistical analysis and Cox regression test with univariable and multivariable analysis complemented data. Out of 625 patients with NMIBC, 122 patients (overall 146 AS events) were included in the protocol. Fifty-nine (40.4%) events were deemed to require treatment after entering in AS. The median time on AS was 11 months (IQI 5-26). Currently, 76 patients (62.3%) are still under observation. In univariable analysis only time from first TUR to active surveillance start seems to be inversely associated with recurrence free survival (HR 0.99, 95% CI 0.98-1.00, p=0.027), while multivariable analysis showed association also with age at AS start (HR 0.97, 95% CI 0.94 - 1.00, p=0.031) and the size of the lesion at first TUR (HR 1.55, 95% CI 1.06 - 2.27, p=0.025). Specific annual resource consumption savings for each avoided TURBT was on average 1.378€ for each intervention avoided. AS might be a reasonable clinical and cost-effective strategy in patients presenting with small low-grade pTa/pT1a recurrent papillary bladder tumors. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Midterm and one-year outcome of amphilimus polymer free drug eluting stent in patients needing short dual antiplatelet therapy. Insight from the ASTUTE registry (AmphilimuS iTalian mUlticenTer rEgistry).

    PubMed

    Godino, Cosmo; Chiarito, Mauro; Donahue, Michael; Testa, Luca; Colantonio, Riccardo; Cappelletti, Alberto; Monello, Alberto; Magni, Valeria; Milazzo, Diego; Parisi, Rosario; Nicolino, Annamaria; Moshiri, Shahram; Fattori, Rossella; Aprigliano, Gianfranco; Palloshi, Altin; Caramanno, Giuseppe; Montorfano, Matteo; Bedogni, Francesco; Briguori, Carlo; Margonato, Alberto; Colombo, Antonio

    2017-03-15

    To assess clinical outcomes of patients needing short dual antiplatelet therapy (S-DAPT) after PCI with Cre8 polymer-free amphilimus eluting-stent (AES). The Cre8-AES with pure i-Carbofilm coating was supposed to induce faster stent endothelialization and reduce device thrombogenicity. We performed a sub-analysis of unrestricted consecutive patients treated with Cre8-AES between August 2011 and January 2015. Two groups were formed: 1) patients discharged with S-DAPT (≤3-month), because of high bleeding risk or attending urgent non-cardiac surgery; and 2) patients discharged with Recommended DAPT duration (R-DAPT; ≥6-month). The primary ischemic- and bleeding-safety endpoints were Target Vessel Failure (TVF, composite endpoint of cardiac-death, target vessel-myocardial infarction and target vessel-revascularization), and major-bleeding (BARC ≥type-3a) at 6-month and 1-year. 106 patients (8.7%) were discharged with ≤3-month DAPT (83±19days; S-DAPT group) and 1102 patients (90.6%) with ≥6-month DAPT (342±62days; R-DAPT group). Between S-DAPT and R-DAPT groups no significant differences were observed in TVF at 1-year (5.7% vs 5.1%); 1-year BARC major bleeding rate was higher in S-DAPT group (3.4% vs 0.2%, p=0.007) with all bleeding events occurred within 3months. The landmark analysis (started at 90days, ended at 1year) showed no differences in BARC major bleedings between groups (0% vs. 0.3%). The results of this multicenter registry show that the use of Cre8 AES in patients needing short DAPT (≤3-month) was safe regarding ischemic events and could favor a reduction of bleeding events related to the recommended DAPT. A large randomized trial is necessary to support these preliminary findings. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. A prospective multicenter study on laparoscopic treatment of gastroesophageal reflux disease in Italy: type of surgery, conversions, complications, and early results. Study Group for the Laparoscopic Treatment of Gastroesophageal Reflux Disease of the Italian Society of Endoscopic Surgery (SICE).

    PubMed

    Zaninotto, G; Molena, D; Ancona, E

    2000-03-01

    A national survey was undertaken by the Italian Society for Laparoscopic Surgery to investigate the prevalence, indications, conversion rate, mortality, morbidity, and early results of laparoscopic antireflux surgery. Beginning on January 1, 1996, all of the centers taking part in this study were asked to complete a questionnaire on each patient. The questionnaire was divided into four parts and covered such areas as indications for surgery and preoperative workup, type of operation performed and certain aspects of the surgical technique, conversions and their causes, intraoperative and postoperative complications (within 4 weeks), and details of the postoperative course. The last part of the questionnaire focused on the follow-up period and was designed to gather data on recurrence of preoperative symptoms, postoperative symptoms (dysphagia, gas bloat), and postoperative test findings. As of June 30, 1998, 21 centers were taking part in the study and 621 patients were enrolled, with a median of 27 patients per center (less than one patient/month). The most popular technique was the Nissen-Rossetti (52%), followed by the Nissen (33%) and Toupet procedures (13%). Other techniques, such as the Dor and Lortat-Jacob, were used in the remainder of cases. Patients who received a Toupet procedure had a higher incidence of defective peristalsis (p<0.05). The conversion rate to open surgery was 2.9%. The most common causes of conversion were inability to reduce the hiatus hernia or distal esophagus in the abdomen and adhesions from previous surgery. Perforation of the stomach and esophagus occurred in <1% of patients. Mortality was nil. Postoperative complications were observed in 7.3% of cases. The most common complication was acute dysphagia (19 patients), which required reoperation in 10 patients. No differences in the incidence of acute dysphagia were found for the different surgical techniques employed. Follow-up data were obtained for 319 patients (53%): 91.5% of the

  3. Patterns of Care and Clinical Outcomes of First-Line Trastuzumab-Based Therapy in HER2-Positive Metastatic Breast Cancer Patients Relapsing After (Neo)Adjuvant Trastuzumab: An Italian Multicenter Retrospective Cohort Study

    PubMed Central

    Ferreira, Arlindo R.; Poggio, Francesca; Puglisi, Fabio; Bernardo, Antonio; Montemurro, Filippo; Poletto, Elena; Pozzi, Emma; Rossi, Valentina; Risi, Emanuela; Lai, Antonella; Zanardi, Elisa; Sini, Valentina; Ziliani, Serena; Minuti, Gabriele; Mura, Silvia; Grasso, Donatella; Fontana, Andrea; Del Mastro, Lucia

    2015-01-01

    Background. We evaluated the patterns of care and clinical outcomes of metastatic breast cancer patients treated with first-line trastuzumab-based therapy after previous (neo)adjuvant trastuzumab. Materials and Methods. A total of 416 consecutive, HER2-positive metastatic breast cancer patients who had received first-line trastuzumab-based therapy were identified at 14 Italian centers. A total of 113 patients had presented with de novo stage IV disease and were analyzed separately. Dichotomous clinical outcomes were analyzed using logistic regression and time-to-event outcomes using Cox proportional hazards models. Results. In the 202 trastuzumab-naïve patients and 101 patients with previous trastuzumab exposure, we observed the following outcomes, respectively: overall response rate, 69.9% versus 61.3% (adjusted odds ratio [OR], 0.62; p = .131), clinical benefit rate, 79.1% versus 72.5% (adjusted OR, 0.73; p = .370), median progression-free survival (PFS), 16.1 months versus 12.0 months (adjusted hazards ratio [HR], 1.33; p = .045), and median overall survival (OS), 52.2 months versus 48.2 months (adjusted HR, 1.18; p = .404). Patients with a trastuzumab-free interval (TFI) <6 months, visceral involvement, and hormone receptor-negative disease showed a worse OS compared with patients with a TFI of ≥6 months (29.5 vs. 48.3 months; p = .331), nonvisceral involvement (48.0 vs. 60.3 months; p = .270), and hormone receptor-positive disease (39.8 vs. 58.6 months; p = .003), respectively. Conclusion. Despite the inferior median PFS, trastuzumab-based therapy was an effective first-line treatment for patients relapsing after (neo)adjuvant trastuzumab. Previous trastuzumab exposure and the respective TFI, type of first site of disease relapse, and hormone receptor status should be considered in the choice of the best first-line treatment option for HER2-positive metastatic breast cancer patients. Implications for Practice: A paucity of data is available outlining the

  4. Rationale and Design of the Dual Energy Computed Tomography for Ischemia Determination Compared to “Gold Standard” Non-invasive and Invasive Techniques (DECIDE-Gold): A Multicenter International Efficacy Diagnostic Study of Rest-Stress Dual-Energy Computed Tomography Angiography with Perfusion

    PubMed Central

    Truong, Quynh A.; Knaapen, Paul; Pontone, Gianluca; Andreini, Daniele; Leipsic, Jonathon; Carrascosa, Patricia; Lu, Bin; Branch, Kelley; Raman, Subha; Bloom, Stephen; Min, James K.

    2014-01-01

    BACKGROUND Dual-energy CT (DECT) has potential to improve myocardial perfusion for physiologic assessment of coronary artery disease (CAD). Diagnostic performance of rest-stress DECT perfusion (DECTP) is unknown. OBJECTIVE DECIDE-Gold is a prospective multicenter study to evaluate the accuracy of DECT to detect hemodynamic (HD) significant CAD, as compared to fractional flow reserve (FFR) as a reference standard. METHODS Eligible participants are subjects with symptoms of CAD referred for invasive coronary angiography (ICA). Participants will undergo DECTP, which will be performed by pharmacological stress, and participants will subsequently proceed to ICA and FFR. HD-significant CAD will be defined as FFR ≥ 0.80. In those undergoing myocardial stress imaging (MPI) by positron emission tomography (PET), single photon emission computed tomography (SPECT) or cardiac magnetic resonance (CMR) imaging, ischemia will be graded by % ischemic myocardium. Blinded core laboratory interpretation will be performed for CCTA, DECTP, MPI, ICA and FFR. RESULTS Primary endpoint is accuracy of DECTP to detect ≥ 1 HD-significant stenosis at the subject-level when compared to FFR. Secondary and tertiary endpoints are accuracies of combinations of DECTP at the subject and vessel levels compared to FFR and MPI. CONCLUSION DECIDE-Gold will determine the performance of DECTP for diagnosing ischemia. PMID:25549826

  5. Why Study Italian?

    ERIC Educational Resources Information Center

    Haines, Charles

    1978-01-01

    One studies Italian for the same reason one studies any language--to become educated. Even more than for art and music, Italian is necessary for literature. Dante must be read, and in the original. Further, we study Italian to know our cultural roots and heritage. (AMH)

  6. Teaching Business Italian.

    ERIC Educational Resources Information Center

    Trivelli, Remo J.

    The University of Rhode Island's business Italian course is an advanced language course whose focus is the Italian business world and its reflection of values, customs, and traditions. The course begins with presentations on salient features of contemporary Italian, such as syntactical simplification and nominalization, and how the social,…

  7. Prognostic Value of Combined CT Angiography and Myocardial Perfusion Imaging versus Invasive Coronary Angiography and Nuclear Stress Perfusion Imaging in the Prediction of Major Adverse Cardiovascular Events: The CORE320 Multicenter Study.

    PubMed

    Chen, Marcus Y; Rochitte, Carlos E; Arbab-Zadeh, Armin; Dewey, Marc; George, Richard T; Miller, Julie M; Niinuma, Hiroyuki; Yoshioka, Kunihiro; Kitagawa, Kakuya; Sakuma, Hajime; Laham, Roger; Vavere, Andrea L; Cerci, Rodrigo J; Mehra, Vishal C; Nomura, Cesar; Kofoed, Klaus F; Jinzaki, Masahiro; Kuribayashi, Sachio; Scholte, Arthur J; Laule, Michael; Tan, Swee Yaw; Hoe, John; Paul, Narinder; Rybicki, Frank J; Brinker, Jeffrey A; Arai, Andrew E; Matheson, Matthew B; Cox, Christopher; Clouse, Melvin E; Di Carli, Marcelo F; Lima, João A C

    2017-07-01

    Purpose To compare the prognostic importance (time to major adverse cardiovascular event [MACE]) of combined computed tomography (CT) angiography and CT myocardial stress perfusion imaging with that of combined invasive coronary angiography (ICA) and stress single photon emission CT myocardial perfusion imaging. Materials and Methods This study was approved by all institutional review boards, and written informed consent was obtained. Between November 2009 and July 2011, 381 participants clinically referred for ICA and aged 45-85 years were enrolled in the Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) prospective multicenter diagnostic study. All images were analyzed in blinded independent core laboratories, and a panel of physicians adjudicated all adverse events. MACE was defined as revascularization (>30 days after index ICA), myocardial infarction, or cardiac death; hospitalization for chest pain or congestive heart failure; or arrhythmia. Late MACE was defined similarly, except for patients who underwent revascularization within the first 182 days after ICA, who were excluded. Comparisons of 2-year survival (time to MACE) used standard Kaplan-Meier curves and restricted mean survival times bootstrapped with 2000 replicates. Results An MACE (49 revascularizations, five myocardial infarctions, one cardiac death, nine hospitalizations for chest pain or congestive heart failure, and one arrhythmia) occurred in 51 of 379 patients (13.5%). The 2-year MACE-free rates for combined CT angiography and CT perfusion findings were 94% negative for coronary artery disease (CAD) versus 82% positive for CAD and were similar to combined ICA and single photon emission CT findings (93% negative for CAD vs 77% positive for CAD, P < .001 for both). Event-free rates for CT angiography and CT perfusion versus ICA and single photon emission CT for either positive or negative results were not

  8. Health Information in Italian (Italiano)

    MedlinePlus

    ... Videos & Tools You Are Here: Home → Multiple Languages → Italian (Italiano) URL of this page: https://medlineplus.gov/languages/italian.html Health Information in Italian (Italiano) To use ...

  9. Italienischunterricht (Italian Instruction).

    ERIC Educational Resources Information Center

    Moine, Virgile; And Others

    1965-01-01

    This issue of "Schulpraxis," a Swiss journal for language teaching, is devoted to Italian instruction in Switzerland. It includes: (1) an interpretation of the poem "Le morte chitarre" by Salvatore Quasimodo, conducted in a girls' school in German Switzerland, (2) a presentation of principles for an Italian textbook to be based…

  10. Italian 102 Workbook.

    ERIC Educational Resources Information Center

    Lazzarino, Graziana

    This workbook was prepared as a supplement to "Basic Italian" by C. Speroni and C. L. Golino, lessons 20-35. It reflects a typical second-semester program at the University of Colorado. Although each lesson deals with the specific grammar, vocabulary and subject matter used in the respective lessons of "Basic Italian," the workbook can be used…

  11. Teaching Contemporary Italian Culture.

    ERIC Educational Resources Information Center

    Trivelli, Remo J.

    1985-01-01

    Describes a workshop offered at the Middlebury College Italian School on contemporary Italy. The morning sessions consisted of a discussion by a native Italian scholar of contemporary Italy and of related readings and the afternoon sessions consisted of readings and discussions and hands-on activities in lesson preparation. (SED)

  12. Italian in Colonial America

    ERIC Educational Resources Information Center

    Pace, Antonio

    1976-01-01

    A brief historical review shows the cultural influence of Italy on England, a cultural climate the colonists brought to America. The attitude of J. Adams, J. Madison, T. Jefferson and B. Franklin towards the Italian language are reported. In particular, Franklin's considerable appreciation for the Italian culture is pointed out. (MS)

  13. Prospective Multicenter International Surveillance of Azole Resistance in Aspergillus fumigatus

    PubMed Central

    Arendrup, M.C.; Warris, A.; Lagrou, K.; Pelloux, H.; Hauser, P.M.; Chryssanthou, E.; Mellado, E.; Kidd, S.E.; Tortorano, A.M.; Dannaoui, E.; Gaustad, P.; Baddley, J.W.; Uekötter, A.; Lass-Flörl, C.; Klimko, N.; Moore, C.B.; Denning, D.W.; Pasqualotto, A.C.; Kibbler, C.; Arikan-Akdagli, S.; Andes, D.; Meletiadis, J.; Naumiuk, L.; Nucci, M.; Melchers, W.J.G.; Verweij, P.E.

    2015-01-01

    To investigate azole resistance in clinical Aspergillus isolates, we conducted prospective multicenter international surveillance. A total of 3,788 Aspergillus isolates were screened in 22 centers from 19 countries. Azole-resistant A. fumigatus was more frequently found (3.2% prevalence) than previously acknowledged, causing resistant invasive and noninvasive aspergillosis and severely compromising clinical use of azoles. PMID:25988348

  14. "The Italianate Englishman": The Italian Influence in Elizabethan Literature

    ERIC Educational Resources Information Center

    Fox, Maureen

    2011-01-01

    Whether it was thought of positively or negatively, Italy is a popular topic of discussion in Elizabethan literature. Some Elizabethan writers mimic Italian writers and incorporate Italian ideas into their own works, while other writers alter Italian literary conventions and openly attack Italian morals. This range of positive and negative…

  15. The Italian activist

    NASA Astrophysics Data System (ADS)

    Catanzaro, Michele

    2012-02-01

    Italian theoretical physicist Giorgio Parisi has been an outspoken critic of Silvio Berlusconi's lack of support for science. He talks about how physics may fare under the new administration led by the economist Mario Monti.

  16. A three-tier classification system based on the depth of submucosal invasion and budding/sprouting can improve the treatment strategy for T1 colorectal cancer: a retrospective multicenter study.

    PubMed

    Kawachi, Hiroshi; Eishi, Yoshinobu; Ueno, Hideki; Nemoto, Tetsuo; Fujimori, Takahiro; Iwashita, Akinori; Ajioka, Yoichi; Ochiai, Atsushi; Ishiguro, Shingo; Shimoda, Tadakazu; Mochizuki, Hidetaka; Kato, Yo; Watanabe, Hidenobu; Koike, Morio; Sugihara, Kenichi

    2015-06-01

    More than 85% of patients with T1 colorectal cancer have no lymph node metastasis and can be cured by endoscopic resection. To avoid unnecessary surgery after complete endoscopic resection, accurate histologic methods for evaluating resected specimens are needed to discriminate those at high risk for lymph node metastasis. A retrospective multi-institutional, cross-sectional study of 806 T1 colorectal cancer patients was conducted. A budding/sprouting score was incorporated for predicting lymph node metastasis in addition to other parameters, including the depth of submucosal invasion, histologic grade, and lymphovascular invasion. Lymph node metastasis was detected in 97 patients. Independent predictors of lymph node metastasis by multivariate analysis were depth of submucosal invasion ≥1000 μm (odds ratio (95% confidence interval)=5.56 (2.14-19.10)) and high-grade budding/sprouting (3.14 (1.91-5.21)). Among lesions with a depth of submucosal invasion ≥1000 μm, lymph node metastasis was detected in 59 (29%) of 207 patients with high-grade budding/sprouting, and in 34 (9%) of 396 with low-grade budding/sprouting. Lymph node metastasis was detected in only 4 (2%) of 203 lesions with a depth of submucosal invasion <1000 μm. Of these four tumors, three invaded lymphatic and/or venous vessels. Thus, the risk for lymph node metastasis can be classified into three groups: high risk with a depth of submucosal invasion ≥1000 μm and high-grade budding/sprouting, intermediate-risk with a depth of submucosal invasion ≥1000 μm and low-grade budding/sprouting, and low-risk with a depth of submucosal invasion <1000 μm. These findings revealed that a depth of submucosal invasion ≥1000 μm and high-grade budding/sprouting are powerful predictive parameters for lymph node metastasis in T1 colorectal cancer. This three-tier risk classification system will facilitate the decision for additional major surgery for T1 colorectal cancer patients after

  17. Italian in the Modern World.

    ERIC Educational Resources Information Center

    Adorno, Elvira, Ed.

    This booklet of 15 reprinted letters sent in response to a query concerning the actual use of Italian in the United States designates various areas of professional application. Some reference to current Italian publications is included. It is hoped that these letters will help promote the study of Italian in American schools. (RL)

  18. Bolting multicenter solutions

    NASA Astrophysics Data System (ADS)

    Bena, Iosif; Bossard, Guillaume; Katmadas, Stefanos; Turton, David

    2017-01-01

    We introduce a solvable system of equations that describes non-extremal multicenter solutions to six-dimensional ungauged supergravity coupled to tensor multiplets. The system involves a set of functions on a three-dimensional base metric. We obtain a family of non-extremal axisymmetric solutions that generalize the known multicenter extremal solutions, using a particular base metric that introduces a bolt. We analyze the conditions for regularity, and in doing so we show that this family does not include solutions that contain an extremal black hole and a smooth bolt. We determine the constraints that are necessary to obtain smooth horizonless solutions involving a bolt and an arbitrary number of Gibbons-Hawking centers.

  19. Multicenter Patient Records Research

    PubMed Central

    Behlen, Fred M.; Johnson, Stephen B.

    1999-01-01

    The expanding health information infrastructure offers the promise of new medical knowledge drawn from patient records. Such promise will never be fulfilled, however, unless researchers first address policy issues regarding the rights and interests of both the patients and the institutions who hold their records. In this article, the authors analyze the interests of patients and institutions in light of public policy and institutional needs. They conclude that the multicenter study, with Institutional Review Board approval of each study at each site, protects the interests of both. “Anonymity” is no panacea, since patient records are so rich in information that they can never be truly anonymous. Researchers must earn and respect the trust of the public, as responsible stewards of facts about patients' lives. The authors find that computer security tools are needed to administer multicenter patient records studies and describe simple approaches that can be implemented using commercial database products. PMID:10579601

  20. Italian survey in postoperative radiation therapy for prostate carcinoma by the AIRO National Working Group on Prostate Radiotherapy: definitive results.

    PubMed

    Malinverni, Giuseppe; Greco, Carlo; Bianchi, Pieromaria; Busutti, Luciano; Cagna, Emanuela; Cozzarini, Cesare; Del Duca, Massimo; Franzone, Paola; Frezza, Giovanni; Gabriele, Pietro; Genovesi, Domenico; Girelli, Giuseppe Franco; Italia, Corrado; Mandoliti, Giovanni; Mauro, Floranna; Nava, Simonetta; Pratissoli, Silvia; Saracino, Maria Bianca; Squillace, Luigi; Signor, Marco; Tagliagambe, Angiolo; Vavassori, Vittorio; Villa, Sergio; Zini, Giampaolo; Valdagni, Riccardo

    2005-01-01

    The National Working Group on Prostate Radiotherapy of AIRO (Associazione Italiana Radioterapia Oncologica, Italian Association of Radiotherapeutic Oncology) was established in March 2001. A retrospective multi-center survey was performed to analyze the patterns of care for prostate cancer patients treated with postoperative radiotherapy following radical prostatectomy in Italy with regard to the year 2000. A structured questionnaire was mailed to 47 Italian radiotherapy centers to assess patient accrual in the postoperative setting in the interval comprised between period January-December 2000. Numbers of patients treated for different stages, specific prognostic factors indicating the need for adjuvant radiotherapy, fractionation schedules and prescription doses were acquired as well as other clinically important factors such as radiotherapy timing and the use of hormone therapy. More technical features of the treatment, such as patient positioning, mode of simulation, typical field setup and dose prescription criteria were also included in the questionnaire. The questionnaire was returned by 24 radiotherapy Institutions (51%) with a total number of 470 patients treated postoperatively in the year 2000. An average of about 20 patients were enrolled by each radiotherapy center. The age range was 45-81 years. Radiotherapy was delivered within 6 months of radical prostatectomy in 297 patients (65.4%) (mean, 3.4 months). In 157 (34.6%), the treatment was delivered as a salvage approach for biochemical or micro-macroscopic recurrence. Most of patients had locally advanced stage disease (pT3-pT4) (76%). Unfavorable prognostic factors, such as positive margins, capsular invasion, Gleason pattern score > 7 were present in about 50% of patients. The study confirmed that important risk factors for recurrences are present in a significant percentage of patients treated by radical prostatectomy. The number of patients that would benefit from adjuvant radiotherapy is

  1. Know Your Laws. Italian.

    ERIC Educational Resources Information Center

    Watson, Joan Q.

    This Italian language version of "Know Your Laws" consists of 24 self-contained modules designed to acquaint the Florida adult students with law they will meet in everyday life; fundamentals of local, state, and federal governments; and the criminal and juvenile justice systems. (The 130 objectives are categorized in the first three…

  2. Thematic Issue: Italian Theatre.

    ERIC Educational Resources Information Center

    Kirby, Michael, Ed.

    1978-01-01

    In 1964, when the "living" theatre appeared to be dying in New York, theater in Italy began changing from an author-oriented to a performance-oriented, nonliterary form. The articles in this document trace the historical development of Italian theatre and analyze current dramas which demonstrate the diversity of approaches and the energy…

  3. Know Your Laws. Italian.

    ERIC Educational Resources Information Center

    Watson, Joan Q.

    This Italian language version of "Know Your Laws" consists of 24 self-contained modules designed to acquaint the Florida adult students with law they will meet in everyday life; fundamentals of local, state, and federal governments; and the criminal and juvenile justice systems. (The 130 objectives are categorized in the first three…

  4. Thematic Issue: Italian Theatre.

    ERIC Educational Resources Information Center

    Kirby, Michael, Ed.

    1978-01-01

    In 1964, when the "living" theatre appeared to be dying in New York, theater in Italy began changing from an author-oriented to a performance-oriented, nonliterary form. The articles in this document trace the historical development of Italian theatre and analyze current dramas which demonstrate the diversity of approaches and the energy…

  5. I Can Speak Italian.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

    The guide presents content and techniques for teaching conversational Italian in the elementary grades. It contains an introductory section and 20 units for classroom instruction. The introduction includes notes on the overall objectives of the course, general guidelines on classroom procedure, and specific techniques for use of the materials…

  6. I Can Speak Italian.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

    The guide presents content and techniques for teaching conversational Italian in the elementary grades. It contains an introductory section and 20 units for classroom instruction. The introduction includes notes on the overall objectives of the course, general guidelines on classroom procedure, and specific techniques for use of the materials…

  7. The frailty in elderly patients receiving cardiac interventional procedures (FRASER) program: rational and design of a multicenter prospective study.

    PubMed

    Campo, Gianluca; Pavasini, Rita; Maietti, Elisa; Tonet, Elisabetta; Cimaglia, Paolo; Scillitani, Giulia; Bugani, Giulia; Serenelli, Matteo; Zaraket, Fatima; Balla, Cristina; Trevisan, Filippo; Biscaglia, Simone; Sassone, Biagio; Galvani, Marcello; Ferrari, Roberto; Volpato, Stefano

    2016-10-28

    Frailty has become a high-priority issue in cardiovascular medicine because of the aging of cardiovascular patients. Simple and reproducible tools to assess frailty in elderly patients are clearly on demand. Their application may help physicians in the selection of invasive and medical treatments and in the timing and modality of the follow-up. The frailty in elderly patients receiving cardiac interventional procedures (FRASER) program is designed with the aim to validate the use of the short physical performance battery (SPPB) as prognostic tools in patients admitted to hospital for acute coronary syndrome (ACS). The FRASER program is a multicenter prospective study involving 4 Italian cardiology units. The FRASER program enrolls only patients aged ≥70 years. The core of the FRASER program includes patients admitted to hospital for ACS. The aims are (1) to describe SPPB distribution before hospital discharge and (2) to investigate the prognostic role of SPPB score. The primary outcome is a composite of 1-year all-cause mortality and hospital readmission for any cause. Ancillary analyses will be focused on different study populations (patients hospitalized for arrhythmias or acute heart failure or symptomatic severe aortic stenosis) and on different tools to assess frailty (multidimensional prognostic index, clinical frailty score, grip strength). The FRASER program will fill critical gaps in the knowledge regarding the link between frailty, cardiovascular disease, interventional procedures and outcome and will help physicians in the generation of a more personalized risk assessment and in the identification of potential targets for interventions.

  8. Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: A multicenter retrospective review.

    PubMed

    Choi, Yoon Seok; Park, Sang Gon; Song, Eun-Kee; Cho, Sang-Hee; Park, Moo-Rim; Park, Keon Uk; Lee, Ki-Hyeong; Song, Ik-Chan; Lee, Hyo Jin; Jo, Deog-Yeon; Kim, Samyong; Yun, Hwan-Jung

    2016-08-01

    In T4a laryngeal cancer with thyroid cartilage invasion, no optimal frontline treatment has yet been defined in controlled trials. We reviewed data from 89 patients with T4a laryngeal cancer featuring thyroid cartilage invasion who were treated initially with either total laryngectomy (n = 53) or a larynx-preservation strategy (n = 36). The median progression-free survival (PFS) of the total laryngectomy group had not been attained at the time of analysis and was thus significantly longer than that of the larynx-preservation group (8.7 months). The median overall survival (OS) of patients who underwent total laryngectomy was 87.2 months, significantly longer than that of the larynx-preservation group (31.3 months). The survival benefit of primary surgery compared to a larynx-preservation strategy was more striking in patients of lower N classifications. Total laryngectomy may be a better therapeutic option to treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially in patients exhibiting limited nodal involvement (N0/N1). © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38:1271-1277, 2016. © 2016 Wiley Periodicals, Inc.

  9. Urinary bladder preservation for muscle-invasive bladder cancer: a survey among radiation oncologists of Lombardy, Italy.

    PubMed

    Jereczek-Fossa, Barbara Alicja; Colombo, Renzo; Magnani, Tiziana; Fodor, Cristiana; Gerardi, Marianna Alessandra; Antognoni, Paolo; Barsacchi, Lucia; Bedini, Nice; Bracelli, Stefano; Buffoli, Alberto; Cagna, Emanuela; Catalano, Gianpiero; Gottardo, Stefania; Italia, Corrado; Ivaldi, Giovanni Battista; Masciullo, Stefano; Merlotti, Anna; Sarti, Enrico; Scorsetti, Marta; Serafini, Flavia; Toninelli, Mariasole; Vitali, Elisabetta; Valdagni, Riccardo; Villa, Elisa; Zerini, Dario; De Cobelli, Ottavio; Orecchia, Roberto

    2015-01-01

    Bladder preservation is a treatment option in muscle-invasive bladder carcinoma. The most investigated approach is a trimodality schedule including maximum transurethral resection of bladder tumor (TURBT) followed by chemoradiotherapy. Our aim was to evaluate the use of bladder preservation by radiation oncologists of the Lombardy region in Italy. A survey with 13 items regarding data of 2012 was sent to all 32 radiotherapy centers within the collaboration between the Lombardy Oncological Network and the Lombardy Section of the Italian Society of Oncological Radiotherapy. Thirteen centers (41%) answered the survey; the presented data come from 11 active centers. In these centers, 11,748 patients were treated with external-beam radiotherapy in 2012, 100 of whom having bladder cancer (0.9%). 74/100 patients received radiotherapy as palliative treatment for T, N or M lesions. A further 9 and 5 patients received radiotherapy for oligometastatic disease (ablative doses to small volumes) and postoperatively, respectively. Bladder preservation was performed in 12 cases and included trimodality and other strategies (mainly TURBT followed by radiotherapy). A multidisciplinary urology tumor board met regularly in 5 of 11 centers. All responders declared their interest in the Lombardy multicenter collaboration on bladder preservation. Our survey showed that bladder preservation is rarely used in Lombardy despite the availability of the latest radiotherapy technologies and the presence of an urology tumor board in half of the centers. The initiative of multicenter and multidisciplinary collaboration was undertaken to prepare the platform for bladder preservation as a treatment option in selected patients.

  10. Oral Tradition of Italian-Americans.

    ERIC Educational Resources Information Center

    Birnbaum, Lucia Chiavola

    The assimilation of Italians into American culture led to the loss of the Italian language, and an oral tradition of Italian peasants in which Italian feminist philosophy was grounded. The legends, parables, and proverbs told by these Italian women challenged the teachings of Catholicism, perpetuating an underground religious tradition which…

  11. Oral Tradition of Italian-Americans.

    ERIC Educational Resources Information Center

    Birnbaum, Lucia Chiavola

    The assimilation of Italians into American culture led to the loss of the Italian language, and an oral tradition of Italian peasants in which Italian feminist philosophy was grounded. The legends, parables, and proverbs told by these Italian women challenged the teachings of Catholicism, perpetuating an underground religious tradition which…

  12. The Italian Dystonia Registry: rationale, design and preliminary findings.

    PubMed

    Defazio, Giovanni; Esposito, M; Abbruzzese, G; Scaglione, C L; Fabbrini, G; Ferrazzano, G; Peluso, S; Pellicciari, R; Gigante, A F; Cossu, G; Arca, R; Avanzino, L; Bono, F; Mazza, M R; Bertolasi, L; Bacchin, R; Eleopra, R; Lettieri, C; Morgante, F; Altavista, M C; Polidori, L; Liguori, R; Misceo, S; Squintani, G; Tinazzi, M; Ceravolo, R; Unti, E; Magistrelli, L; Coletti Moja, M; Modugno, N; Petracca, M; Tambasco, N; Cotelli, M S; Aguggia, M; Pisani, A; Romano, M; Zibetti, M; Bentivoglio, A R; Albanese, A; Girlanda, P; Berardelli, A

    2017-05-01

    The Italian Dystonia Registry is a multicenter data collection system that will prospectively assess the phenomenology and natural history of adult-onset dystonia and will serve as a basis for future etiological, pathophysiological and therapeutic studies. In the first 6 months of activity, 20 movement disorders Italian centres have adhered to the registry and 664 patients have been recruited. Baseline historical information from this cohort provides the first general overview of adult-onset dystonia in Italy. The cohort was characterized by a lower education level than the Italian population, and most patients were employed as artisans, builders, farmers, or unskilled workers. The clinical features of our sample confirmed the peculiar characteristics of adult-onset dystonia, i.e. gender preference, peak age at onset in the sixth decade, predominance of cervical dystonia and blepharospasm over the other focal dystonias, and a tendency to spread to adjacent body parts, The sample also confirmed the association between eye symptoms and blepharospasm, whereas no clear association emerged between extracranial injury and dystonia in a body site. Adult-onset dystonia patients and the Italian population shared similar burden of arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidemia, and hypothyroidism, while hyperthyroidism was more frequent in the dystonia population. Geographic stratification of the study population yielded no major difference in the most clinical and phenomenological features of dystonia. Analysis of baseline information from recruited patients indicates that the Italian Dystonia Registry may be a useful tool to capture the real world clinical practice of physicians that visit dystonia patients.

  13. Construction of predictive models for cancer-specific survival of patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guérin: results from a multicenter retrospective study.

    PubMed

    Nishiyama, Naotaka; Kitamura, Hiroshi; Hotta, Hiroshi; Takahashi, Atsushi; Yanase, Masahiro; Itoh, Naoki; Tachiki, Hitoshi; Miyao, Noriomi; Matsukawa, Masanori; Kunishima, Yasuharu; Taguchi, Keisuke; Masumori, Naoya

    2014-11-01

    The aims of this study were to clarify the prognostic factors and to validate the bacillus Calmette-Guérin failure classification advocated by Nieder et al. in patients with non-muscle-invasive bladder cancer who had intravesical recurrence after bacillus Calmette-Guérin therapy. Data from 402 patients who received intravesical bacillus Calmette-Guérin therapy between January 1990 and November 2011 were collected from 10 institutes. Among these patients, 187 with bacillus Calmette-Guérin failure were analyzed for this study. Twenty-nine patients (15.5%) were diagnosed with progression at the first recurrence after bacillus Calmette-Guérin therapy. Eighteen (62.1%) of them died of bladder cancer. A total of 158 patients were diagnosed with non-muscle-invasive bladder cancer at the first recurrence after bacillus Calmette-Guérin therapy. Of them, 23 (14.6%) underwent radical cystectomy. No patients who underwent radical cystectomy died of bladder cancer during the follow-up. On multivariate analysis of the 135 patients with bladder preservation, the independent prognostic factors for cancer-specific survival were age (≥70 [P = 0.002]), tumor size (≥3 cm [P = 0.015]) and the Nieder classification (bacillus Calmette-Guérin refractory [P < 0.001]). In a subgroup analysis, the estimated 5-year cancer-specific survival rates in the groups with no positive, one positive and two to three positive factors were 100, 93.4 and 56.8%, respectively (P < 0.001). Patients with stage progression at the first recurrence after bacillus Calmette-Guérin therapy had poor prognoses. Three prognostic factors for predicting survival were identified and used to categorize patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guérin into three risk groups based on the number of prognostic factors in each one. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Accelerated methotrexate, vinblastine, doxorubicin, and cisplatin is safe, effective, and efficient neoadjuvant treatment for muscle-invasive bladder cancer: results of a multicenter phase II study with molecular correlates of response and toxicity.

    PubMed

    Plimack, Elizabeth R; Hoffman-Censits, Jean H; Viterbo, Rosalia; Trabulsi, Edouard J; Ross, Eric A; Greenberg, Richard E; Chen, David Y T; Lallas, Costas D; Wong, Yu-Ning; Lin, Jianqing; Kutikov, Alexander; Dotan, Efrat; Brennan, Timothy A; Palma, Norma; Dulaimi, Essel; Mehrazin, Reza; Boorjian, Stephen A; Kelly, William Kevin; Uzzo, Robert G; Hudes, Gary R

    2014-06-20

    Neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer (MIBC); however, it is infrequently adopted in practice because of concerns regarding toxicity and delay to cystectomy. We hypothesized that three cycles of neoadjuvant accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (AMVAC) would be safe, shorten the time to surgery, and yield similar pathologic complete response (pT0) rates compared with historical controls. Patients with cT2-T4a and N0-N1 MIBC were eligible and received three cycles of AMVAC with pegfilgrastim followed by radical cystectomy with lymph node dissection. The primary end point was pT0 rate. Telomere length (TL) and p53 mutation status were correlated with response and toxicity. Forty-four patients were accrued; 60% had stage III to IV disease; median age was 64 years. Forty patients were evaluable for response, with 15 (38%; 95% CI, 23% to 53%) showing pT0 at cystectomy, meeting the primary end point of the study. Another six patients (14%) were downstaged to non-muscle invasive disease. Most (82%) experienced only grade 1 to 2 treatment-related toxicities. There were no grade 3 or 4 renal toxicities and no treatment-related deaths. One patient developed metastases and thus did not undergo cystectomy; all others (n = 43) proceeded to cystectomy within 8 weeks after last chemotherapy administration. Median time from start of chemotherapy to cystectomy was 9.7 weeks. TL and p53 mutation did not predict response or toxicity. AMVAC is well tolerated and results in similar pT0 rates with 6 weeks of treatment compared with standard 12-week regimens. Further analysis is ongoing to ascertain whether molecular alterations in tumor samples can predict response to chemotherapy. © 2014 by American Society of Clinical Oncology.

  15. Accelerated Methotrexate, Vinblastine, Doxorubicin, and Cisplatin Is Safe, Effective, and Efficient Neoadjuvant Treatment for Muscle-Invasive Bladder Cancer: Results of a Multicenter Phase II Study With Molecular Correlates of Response and Toxicity

    PubMed Central

    Plimack, Elizabeth R.; Hoffman-Censits, Jean H.; Viterbo, Rosalia; Trabulsi, Edouard J.; Ross, Eric A.; Greenberg, Richard E.; Chen, David Y.T.; Lallas, Costas D.; Wong, Yu-Ning; Lin, Jianqing; Kutikov, Alexander; Dotan, Efrat; Brennan, Timothy A.; Palma, Norma; Dulaimi, Essel; Mehrazin, Reza; Boorjian, Stephen A.; Kelly, William Kevin; Uzzo, Robert G.; Hudes, Gary R.

    2014-01-01

    Purpose Neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer (MIBC); however, it is infrequently adopted in practice because of concerns regarding toxicity and delay to cystectomy. We hypothesized that three cycles of neoadjuvant accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (AMVAC) would be safe, shorten the time to surgery, and yield similar pathologic complete response (pT0) rates compared with historical controls. Patients and Methods Patients with cT2-T4a and N0-N1 MIBC were eligible and received three cycles of AMVAC with pegfilgrastim followed by radical cystectomy with lymph node dissection. The primary end point was pT0 rate. Telomere length (TL) and p53 mutation status were correlated with response and toxicity. Results Forty-four patients were accrued; 60% had stage III to IV disease; median age was 64 years. Forty patients were evaluable for response, with 15 (38%; 95% CI, 23% to 53%) showing pT0 at cystectomy, meeting the primary end point of the study. Another six patients (14%) were downstaged to non–muscle invasive disease. Most (82%) experienced only grade 1 to 2 treatment-related toxicities. There were no grade 3 or 4 renal toxicities and no treatment-related deaths. One patient developed metastases and thus did not undergo cystectomy; all others (n = 43) proceeded to cystectomy within 8 weeks after last chemotherapy administration. Median time from start of chemotherapy to cystectomy was 9.7 weeks. TL and p53 mutation did not predict response or toxicity. Conclusion AMVAC is well tolerated and results in similar pT0 rates with 6 weeks of treatment compared with standard 12-week regimens. Further analysis is ongoing to ascertain whether molecular alterations in tumor samples can predict response to chemotherapy. PMID:24821881

  16. Legionella contamination in hot water of Italian hotels.

    PubMed

    Borella, Paola; Montagna, Maria Teresa; Stampi, Serena; Stancanelli, Giovanna; Romano-Spica, Vincenzo; Triassi, Maria; Marchesi, Isabella; Bargellini, Annalisa; Tatò, Daniela; Napoli, Christian; Zanetti, Franca; Leoni, Erica; Moro, Matteo; Scaltriti, Stefania; Ribera D'Alcalà, Gabriella; Santarpia, Rosalba; Boccia, Stefania

    2005-10-01

    A cross-sectional multicenter survey of Italian hotels was conducted to investigate Legionella spp. contamination of hot water. Chemical parameters (hardness, free chlorine concentration, and trace element concentrations), water systems, and building characteristics were evaluated to study risk factors for colonization. The hot water systems of Italian hotels were strongly colonized by Legionella; 75% of the buildings examined and 60% of the water samples were contaminated, mainly at levels of > or =10(3) CFU liter(-1), and Legionella pneumophila was the most frequently isolated species (87%). L. pneumophila serogroup 1 was isolated from 45.8% of the contaminated sites and from 32.5% of the hotels examined. When a multivariate logistic model was used, only hotel age was associated with contamination, but the risk factors differed depending on the contaminating species and serogroup. Soft water with higher chlorine levels and higher temperatures were associated with L. pneumophila serogroup 1 colonization, whereas the opposite was observed for serogroups 2 to 14. In conclusion, Italian hotels, particularly those located in old buildings, represent a major source of risk for Legionnaires' disease due to the high frequency of Legionella contamination, high germ concentration, and major L. pneumophila serogroup 1 colonization. The possible role of chlorine in favoring the survival of Legionella species is discussed.

  17. Italian Polar Metadata System

    NASA Astrophysics Data System (ADS)

    Longo, S.; Nativi, S.; Leone, C.; Migliorini, S.; Mazari Villanova, L.

    2012-04-01

    Italian Polar Metadata System C.Leone, S.Longo, S.Migliorini, L.Mazari Villanova, S. Nativi The Italian Antarctic Research Programme (PNRA) is a government initiative funding and coordinating scientific research activities in polar regions. PNRA manages two scientific Stations in Antarctica - Concordia (Dome C), jointly operated with the French Polar Institute "Paul Emile Victor", and Mario Zucchelli (Terra Nova Bay, Southern Victoria Land). In addition National Research Council of Italy (CNR) manages one scientific Station in the Arctic Circle (Ny-Alesund-Svalbard Islands), named Dirigibile Italia. PNRA started in 1985 with the first Italian Expedition in Antarctica. Since then each research group has collected data regarding biology and medicine, geodetic observatory, geophysics, geology, glaciology, physics and atmospheric chemistry, earth-sun relationships and astrophysics, oceanography and marine environment, chemistry contamination, law and geographic science, technology, multi and inter disciplinary researches, autonomously with different formats. In 2010 the Italian Ministry of Research assigned the scientific coordination of the Programme to CNR, which is in charge of the management and sharing of the scientific results carried out in the framework of the PNRA. Therefore, CNR is establishing a new distributed cyber(e)-infrastructure to collect, manage, publish and share polar research results. This is a service-based infrastructure building on Web technologies to implement resources (i.e. data, services and documents) discovery, access and visualization; in addition, semantic-enabled functionalities will be provided. The architecture applies the "System of Systems" principles to build incrementally on the existing systems by supplementing but not supplanting their mandates and governance arrangements. This allows to keep the existing capacities as autonomous as possible. This cyber(e)-infrastructure implements multi-disciplinary interoperability following

  18. A "Quiz" on Italian Civilization.

    ERIC Educational Resources Information Center

    Russo, Giuseppe Antonio

    1940-01-01

    The cultural achievements of Italy are utilized to spur interest in the study of Italian. A weekly, multiple-choice type quiz posted on the Italian bulletin board questions curious passers-by in the areas of fine arts, literature, science, geography, history, and miscellaneous items. Sample items of this motivational device follow a description of…

  19. The Languages of Italian Canadians.

    ERIC Educational Resources Information Center

    Vizmuller-Zocco, Jana

    1995-01-01

    Examines the transplantation of dialects of Italian abroad, particularly to Canada. Argues that any discussion of the language of immigrants from Italy has to start from the premise that they brought their dialect, not Italian, to their new home. Conclusions indicate that "Italo-Canadian" shares many linguistic characteristics with…

  20. Italian families and family interventions.

    PubMed

    Casacchia, Massimo; Roncone, Rita

    2014-06-01

    In Italy, as in many countries, relatives are closely involved in caring for persons with physical and mental disorders. The Italian scenario lends itself to routine involvement of family members in psychiatric treatment because, despite becoming smaller and smaller, Italian families keep close ties, and men and women do not leave the parental home until relatively late. The authors describe the impact of international family psychosocial research on the Italian mental health services (MHSs) and the main psychosocial interventions currently in use, including family psychoeducational interventions and the "Milan family therapy approach." They also highlight the contribution Italian researchers have given to the study of important variables in integrated mental disorder care, such as family burden of care, relatives' attitudes, family functioning, and satisfaction with the MHSs. Finally, they discuss the difficulties of implementing and disseminating family interventions within the Italian MHS, despite the growing evidence of their effectiveness.

  1. The Italian genome reflects the history of Europe and the Mediterranean basin.

    PubMed

    Fiorito, Giovanni; Di Gaetano, Cornelia; Guarrera, Simonetta; Rosa, Fabio; Feldman, Marcus W; Piazza, Alberto; Matullo, Giuseppe

    2016-07-01

    Recent scientific literature has highlighted the relevance of population genetic studies both for disease association mapping in admixed populations and for understanding the history of human migrations. Deeper insight into the history of the Italian population is critical for understanding the peopling of Europe. Because of its crucial position at the centre of the Mediterranean basin, the Italian peninsula has experienced a complex history of colonization and migration whose genetic signatures are still present in contemporary Italians. In this study, we investigated genomic variation in the Italian population using 2.5 million single-nucleotide polymorphisms in a sample of more than 300 unrelated Italian subjects with well-defined geographical origins. We combined several analytical approaches to interpret genome-wide data on 1272 individuals from European, Middle Eastern, and North African populations. We detected three major ancestral components contributing different proportions across the Italian peninsula, and signatures of continuous gene flow within Italy, which have produced remarkable genetic variability among contemporary Italians. In addition, we have extracted novel details about the Italian population's ancestry, identifying the genetic signatures of major historical events in Europe and the Mediterranean basin from the Neolithic (e.g., peopling of Sardinia) to recent times (e.g., 'barbarian invasion' of Northern and Central Italy). These results are valuable for further genetic, epidemiological and forensic studies in Italy and in Europe.

  2. The Italian genome reflects the history of Europe and the Mediterranean basin

    PubMed Central

    Fiorito, Giovanni; Di Gaetano, Cornelia; Guarrera, Simonetta; Rosa, Fabio; Feldman, Marcus W; Piazza, Alberto; Matullo, Giuseppe

    2016-01-01

    Recent scientific literature has highlighted the relevance of population genetic studies both for disease association mapping in admixed populations and for understanding the history of human migrations. Deeper insight into the history of the Italian population is critical for understanding the peopling of Europe. Because of its crucial position at the centre of the Mediterranean basin, the Italian peninsula has experienced a complex history of colonization and migration whose genetic signatures are still present in contemporary Italians. In this study, we investigated genomic variation in the Italian population using 2.5 million single-nucleotide polymorphisms in a sample of more than 300 unrelated Italian subjects with well-defined geographical origins. We combined several analytical approaches to interpret genome-wide data on 1272 individuals from European, Middle Eastern, and North African populations. We detected three major ancestral components contributing different proportions across the Italian peninsula, and signatures of continuous gene flow within Italy, which have produced remarkable genetic variability among contemporary Italians. In addition, we have extracted novel details about the Italian population's ancestry, identifying the genetic signatures of major historical events in Europe and the Mediterranean basin from the Neolithic (e.g., peopling of Sardinia) to recent times (e.g., ‘barbarian invasion' of Northern and Central Italy). These results are valuable for further genetic, epidemiological and forensic studies in Italy and in Europe. PMID:26554880

  3. Effect of Granulocyte-Macrophage Colony-Stimulating Factor on Prevention and Treatment of Invasive Fungal Disease in Recipients of Allogeneic Stem-Cell Transplantation: A Prospective Multicenter Randomized Phase IV Trial.

    PubMed

    Wan, Liping; Zhang, Yicheng; Lai, Yongrong; Jiang, Ming; Song, Yongping; Zhou, Jianfeng; Zhang, Zhongming; Duan, Xianlin; Fu, Yuewen; Liao, Lianming; Wang, Chun

    2015-12-01

    For recipients of allogeneic hematopoietic stem-cell transplantation (alloHSCT), we hypothesized that prophylactic therapy during neutropenia with granulocyte-macrophage colony-stimulating factor (GM-CSF) decreases invasive fungal disease (IFD). We randomly assigned 206 patients undergoing alloHSCT to receive once-daily subcutaneous GM-CSF (5 to 7 μg/kg per day), granulocyte colony-stimulating factor (G-CSF; 5 to 7 μg/kg per day), or a combination of G-CSF and GM-CSF (2 to 3 μg/kg per day each). Treatment was started on day 5 after transplantation and was continued until the absolute neutrophil count was ≥ 1.5 × 10(9)/L for 2 consecutive days. The primary outcomes were 100-day incidence of proven and probable IFD and response rate of antifungal treatment. For the intent-to-treat population, there was no significant difference in 100-day incidences of proven and probable IFD among the three groups. The antifungal treatment response was better in the GM-CSF group and G-CSF+GM-CSF group than in G-CSF group from day 22 to day 100 (P = .009). The 100-day cumulative mortality after transplantation was lower in the GM-CSF group than in the G-CSF group (10.3% v 24.6%, respectively; P = .037). The GM-CSF and G-CSF+GM-CSF groups had lower 100-day transplantation-related mortality than the G-CSF group (8.8%, 8.7%, and 21.7%, respectively; P = .034). After a median follow-up of 600 days, IFD-related mortality was lower in the groups that received GM-CSF or G-CSF+GM-CSF compared with G-CSF (1.47%, 1.45%, and 11.59%, respectively; P = .016). There were no significant differences in relapse, graft-versus-host disease, or hemorrhage-related mortality among the three groups of patients. For recipients of alloHSCT, compared with G-CSF, prophylactic GM-CSF was associated with lower 100-day transplantation-related mortality, lower 100-day cumulative mortality, and lower 600-day IFD-related mortality. © 2015 by American Society of Clinical Oncology.

  4. Non-Standard Italian Dialect Heritage Speakers' Acquisition of Clitic Placement in Standard Italian

    ERIC Educational Resources Information Center

    Chan, Lionel

    2014-01-01

    This dissertation examines the acquisition of object clitic placement in Standard Italian by heritage speakers (HSs) of non-standard Italian dialects. It compares two different groups of Standard Italian learners--Northern Italian dialect HSs and Southern Italian dialect HSs--whose heritage dialects contrast with each other in clitic word order.…

  5. Non-Standard Italian Dialect Heritage Speakers' Acquisition of Clitic Placement in Standard Italian

    ERIC Educational Resources Information Center

    Chan, Lionel

    2014-01-01

    This dissertation examines the acquisition of object clitic placement in Standard Italian by heritage speakers (HSs) of non-standard Italian dialects. It compares two different groups of Standard Italian learners--Northern Italian dialect HSs and Southern Italian dialect HSs--whose heritage dialects contrast with each other in clitic word order.…

  6. Investigating Invasives

    ERIC Educational Resources Information Center

    Lightbody, Mary

    2008-01-01

    Invasive species, commonly known as "invasives," are nonnative plants, animals, and microbes that completely take over and change an established ecosystem. The consequences of invasives' spread are significant. In fact, many of the species that appear on the Endangered Species list are threatened by invasives. Therefore, the topic of invasive…

  7. Investigating Invasives

    ERIC Educational Resources Information Center

    Lightbody, Mary

    2008-01-01

    Invasive species, commonly known as "invasives," are nonnative plants, animals, and microbes that completely take over and change an established ecosystem. The consequences of invasives' spread are significant. In fact, many of the species that appear on the Endangered Species list are threatened by invasives. Therefore, the topic of invasive…

  8. Understanding Italian American cultural norms.

    PubMed

    Rozendal, N

    1987-02-01

    The components of Italian American culture in many ways provide a striking contrast to current American beliefs, values, and living habits. The challenge to the psychiatric nurse lies in maximizing the strengths of this culture to enhance the individual's ability to be what he or she can and chooses to be within the Italian culture and within the broader context of contemporary American society. By being culturally well informed and sensitive, and sharing goals and expectations with clients (Louie), the psychiatric nurse will be accepted and trusted to provide the kind of high quality care that will ultimately have a positive impact on the mental health status of Italian Americans.

  9. Italian Volcano Supersites

    NASA Astrophysics Data System (ADS)

    Puglisi, G.

    2011-12-01

    Volcanic eruptions are among the geohazards that may have a substantial economic and social impact, even at worldwide scale. Large populated regions are prone to volcanic hazards worldwide. Even local phenomena may affect largely populated areas and in some cases even megacities, producing severe economic losses. On a regional or global perspective, large volcanic eruptions may affect the climate for years with potentially huge economic impacts, but even relatively small eruptions may inject large amounts of volcanic ash in the atmosphere and severely affect air traffic over entire continents. One of main challenges of the volcanological community is to continuously monitor and understand the internal processes leading to an eruption, in order to give substantial contributions to the risk reduction. Italian active volcanoes constitute natural laboratories and ideal sites where to apply the cutting-edge volcano observation systems, implement new monitoring systems and to test and improve the most advanced models and methods for investigate the volcanic processes. That's because of the long tradition of volcanological studies resulting into long-term data sets, both in-situ and from satellite systems, among the most complete and accurate worldwide, and the large spectrum of the threatening volcanic phenomena producing high local/regional/continental risks. This contribution aims at presenting the compound monitoring systems operating on the Italian active volcanoes, the main improvements achieved during the recent studies direct toward volcanic hazard forecast and risk reductions and the guidelines for a wide coordinated project aimed at applying the ideas of the GEO Supersites Initiative at Mt. Etna and Campi Flegrei / Vesuvius areas.

  10. An Xrootd Italian Federation

    NASA Astrophysics Data System (ADS)

    Boccali, T.; Donvito, G.; Diacono, D.; Marzulli, G.; Pompili, A.; Della Ricca, G.; Mazzoni, E.; Argiro, S.; Gregori, D.; Grandi, C.; Bonacorsi, D.; Lista, L.; Fabozzi, F.; Barone, L. M.; Santocchia, A.; Riahi, H.; Tricomi, A.; Sgaravatto, M.; Maron, G.

    2014-06-01

    The Italian community in CMS has built a geographically distributed network in which all the data stored in the Italian region are available to all the users for their everyday work. This activity involves at different level all the CMS centers: the Tier1 at CNAF, all the four Tier2s (Bari, Rome, Legnaro and Pisa), and few Tier3s (Trieste, Perugia, Torino, Catania, Napoli, ...). The federation uses the new network connections as provided by GARR, our NREN (National Research and Education Network), which provides a minimum of 10 Gbit/s to all the sites via the GARR-X[2] project. The federation is currently based on Xrootd[1] technology, and on a Redirector aimed to seamlessly connect all the sites, giving the logical view of a single entity. A special configuration has been put in place for the Tier1, CNAF, where ad-hoc Xrootd changes have been implemented in order to protect the tape system from excessive stress, by not allowing WAN connections to access tape only files, on a file-by-file basis. In order to improve the overall performance while reading files, both in terms of bandwidth and latency, a hierarchy of xrootd redirectors has been implemented. The solution implemented provides a dedicated Redirector where all the INFN sites are registered, without considering their status (T1, T2, or T3 sites). An interesting use case were able to cover via the federation are disk-less Tier3s. The caching solution allows to operate a local storage with minimal human intervention: transfers are automatically done on a single file basis, and the cache is maintained operational by automatic removal of old files.

  11. Cross-cultural validation of health literacy measurement tools in Italian oncology patients.

    PubMed

    Zotti, Paola; Cocchi, Simone; Polesel, Jerry; Cipolat Mis, Chiara; Bragatto, Donato; Cavuto, Silvio; Conficconi, Alice; Costanzo, Carla; De Giorgi, Melissa; Drace, Christina A; Fiorini, Federica; Gangeri, Laura; Lisi, Andrea; Martino, Rosalba; Mosconi, Paola; Paradiso, Angelo; Ravaioli, Valentina; Truccolo, Ivana; De Paoli, Paolo

    2017-06-19

    The aim of this study was to assess the psychometric characteristics of four Health Literacy (HL) measurement tools, viz. Newest Vital Sign (NVS), Short Test of Functional Health Literacy in Adults (STOFHLA), Single Item Literacy Screener (SILS) and Single question on Self-rated Reading Ability (SrRA) among Italian oncology patients. The original version of the tools were translated from the English language into Italian using a standard forward-backward procedure and according to internationally recognized good practices. Their internal consistency (reliability) and validity (construct, convergent and discriminative) were tested in a sample of 245 consecutive cancer patients recruited from seven Italian health care centers. The internal consistency of the STOFHLA-I was Chronbach's α=0.96 and that of NVS-I was α=0.74. The STOFHLA-I, NVS-I, SILS-I and SrRA-I scores were in a good relative correlation and in all tools the discriminative known-group validity was confirmed. The reliability and validity values were similar to those obtained from other cultural context studies. The psychometric characteristics of the Italian version of NVS, STHOFLA, SILS and SrRA were found to be good, with satisfactory reliability and validity. This indicates that they could be used as a screening tool in Italian patients. Moreover, the use of the same cross-cultural tools, validated in different languages, is essential for implementing multicenter studies to measure and compare the functional HL levels across countries.

  12. Security Implications Of Italian Nationalism

    DTIC Science & Technology

    2016-03-01

    13. ABSTRACT Italy boasts the fourth -largest military establishment within the European Union and the sixth-largest in NATO, so Italian national... fourth -largest military establishment within the European Union and the sixth-largest in NATO, so Italian national security efforts and collective...is highly dependent upon political stability12 and governing parties.13 Fourth , European integration may threaten not only strong national and local

  13. Factors in Italian Military Modernization

    DTIC Science & Technology

    2005-06-17

    Italian public’s ambiguous support for the war in Iraq, threaten the relationship. President Bush and Prime Minister Berlusconi share a rare relationship...between US and European leaders. Their relationship is such that the Italian press considered Prime Minister Berlusconi a trusted communications...Verderami “Italy’s Berlusconi Unleashes Bid To Regain Lost Popularity, Foil Allies’ Coup,” Corriere della Sera, 26 November 2004 [article on-line

  14. EMpowerment of PArents in THe Intensive Care Questionnaire: Translation and Validation in Italian PICUs.

    PubMed

    Wolfler, Andrea; Giannini, Alberto; Finistrella, Martina; Salvo, Ida; Calderini, Edoardo; Frasson, Giulia; Dall'Oglio, Immacolata; Di Furia, Michela; Iuzzolino, Rossella; Musicco, Massimo; Latour, Jos M

    2017-02-01

    To translate and validate the EMpowerment of PArents in THe Intensive Care questionnaire to measure parent satisfaction and experiences in Italian PICUs. Prospective, multicenter study. Four medical/surgical Italian PICUs in three tertiary hospitals. Families of children, 0-16 years old, admitted to the PICUs were invited to participate. Inclusion criteria were PICU length of stay greater than 24 hours and good comprehension of Italian language by parents/guardians. Exclusion criteria were readmission within 6 months and parents of a child who died in the PICU. Distribution, at PICU discharge, of the EMpowerment of PArents in THe Intensive Care questionnaire with 65 items divided into five domains and a six-point rating scale: 1 " certainly no" to 6 "certainly yes." Back and forward translations of the EMpowerment of PArents in THe Intensive Care questionnaire between Dutch (original version) and Italian languages were deployed. Cultural adaptation of the instrument was confirmed by a consultation with a representative parent group (n = 10). Totally, 150 of 190 parents (79%) participated in the study. On item level, 12 statements scored a mean below 5.0. The Cronbach's α, measured for internal consistency, on domain level was between 0.67 and 0.96. Congruent validity was measured by correlating the five domains with four gold standard satisfaction measures and showed adequate correlations (rs, 0.41-0.71; p < 0.05). No significant differences occurred in the nondifferential validity testing between three children's characteristics and the domains; excepting parents with a child for a surgical and planned admission were more satisfied on information and organization issues. The Italian version of the EMpowerment of PArents in THe Intensive Care questionnaire has satisfactory reliability and validity estimates and seems to be appropriate for Italian PICU setting. It is an important instrument providing benchmark data to be used in the process of quality improvement

  15. Appropriateness of upper-GI endoscopy: an Italian survey on behalf of the Italian Society of Digestive Endoscopy.

    PubMed

    Hassan, Cesare; Bersani, Gianluca; Buri, Luigi; Zullo, Angelo; Anti, Marcello; Bianco, Maria Antonia; Di Giulio, Emilio; Ficano, Leonardo; Morini, Sergio; Di Matteo, Giovanni; Loriga, Piero; Pietropaolo, Vincenzo; Cipolletta, Livio; Costamagna, Guido

    2007-05-01

    Open-access endoscopy allows physicians to directly schedule endoscopic procedures for their patients without prior consultation. An evaluation of both appropriateness and diagnostic yield of endoscopic procedures is critical when assessing the costs and benefits of endoscopy in an open-access setting. The aim of this Italian multicenter study was to assess the appropriate use of upper endoscopy (EGD) in an open-access system and to establish the yield of diagnostic information relevant to patient care. Cross-sectional, prospective, multicenter study. A total of 6270 patients referred to 44 Italian centers for open-access EGD during 1 month were prospectively enrolled. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines were used to assess the relation between the appropriate use of EGD and the presence of relevant endoscopic findings. The rate for "generally not indicated" EGDs was 22.9%: 29.4% for primary care physicians and 12.9% for specialists (P < .01). A relevant endoscopic finding was detected in 2929 examinations (46.7%). The diagnostic yield was significantly higher for "generally indicated" EGDs compared with "generally not indicated" procedures (52% vs 29%; odds ratio [OR] 2.65, 99% confidence interval [CI] 2.23-3.20; P < .01). Of the 133 malignant lesions diagnosed, all but 1 were diagnosed in patients with an appropriate indication (OR >20, 99% CI 3 to >100; P < .01). Open-access EGD is an useful procedure for clinical practice. Because most of the relevant findings were detected during examinations performed for appropriate indications, the use of ASGE guidelines emerges as crucial to the cost-effectiveness of an open-access system.

  16. Invasive Candidiasis

    MedlinePlus

    ... Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida . Unlike Candida ... mouth and throat (also called “thrush”) or vaginal “yeast infections,” invasive candidiasis is a serious infection that ...

  17. Invasive Species

    EPA Pesticide Factsheets

    Invasive species have significantly changed the Great Lakes ecosystem. An invasive species is a plant or animal that is not native to an ecosystem, and whose introduction is likely to cause economic, human health, or environmental damage.

  18. The Italian reaction to the Giubilini and Minerva paper.

    PubMed

    Mori, Maurizio

    2013-05-01

    From 28 February to the end of March 2012, the Italian media reacted fiercely to the Giubilini and Minerva paper published in the Journal of Medical Ethics a few days earlier. The first article viewed the proposal as analogous to 'barbaric invasions', but in a first stage of the debate it could be seen as a case of the usual controversy between Catholics and secularists. Then emotive reactions prevailed and a flood of papers expressed strong opposition to 'infanticide'. The authors were even deemed insane; the fact that both are Italian certainly increased interest in the subject as well as surprise at their proposal, which some reckoned to be an insult to their 'national identity'. Even freedom of academic research and discussion was put in question, and defenders of free debate were accused of being supporters of the theory of infanticide.

  19. Pros-IT CNR: an Italian prostate cancer monitoring project.

    PubMed

    Noale, Marianna; Maggi, Stefania; Artibani, Walter; Bassi, Pier Francesco; Bertoni, Filippo; Bracarda, Sergio; Conti, Giario Natale; Corvò, Renzo; Gacci, Mauro; Graziotti, Pierpaolo; Magrini, Stefano Maria; Maurizi Enrici, Riccardo; Mirone, Vincenzo; Montironi, Rodolfo; Muto, Giovanni; Pecoraro, Stefano; Porreca, Angelo; Ricardi, Umberto; Tubaro, Andrea; Zagonel, Vittorina; Zattoni, Filiberto; Crepaldi, Gaetano

    2017-04-01

    The Pros-IT CNR project aims to monitor a sample of Italian males ≥18 years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, naïve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient's health status, the treatment carried out, and the quality of life will be made. A third assessment, evaluating the treatment follow-up and the quality of life, will be made 12 months after the initial diagnosis. The 4th, 5th, 6th and 7th assessments, similar to the third, will be completed 24, 36, 48 and 60 months after the initial diagnosis, respectively, and will include also a Food Frequency Questionnaire and the Physical Activity Scale for the Elderly. The study will provide information on patients' quality of life and its variations over time in relation to the treatments received for the prostate cancer.

  20. A modular informatics platform for effective support of collaborative and multicenter studies in cardiology.

    PubMed

    Marinelli, Martina; Positano, Vincenzo; Lorenzoni, Valentina; Caselli, Chiara; Mangione, Maurizio; Marcheschi, Paolo; Puzzuoli, Stefano; Esposito, Natalia; L'Abbate, Giuseppe Andrea; Neglia, Danilo

    2016-12-01

    Collaborative and multicenter studies permit a large number of patients to be enrolled within a reasonable time and providing the opportunity to collect different data. Informatics platforms play an important role in management, storage, and exchange of data between the participants involved in the study. In this article, we describe a modular informatics platform designed and developed to support collaborative and multicenter studies in cardiology. In each developed module, data management is implemented following local defined protocols. The modular characteristic of the developed platform allows independent transfer of different kinds of data, such as biological samples, imaging raw data, and patients' digital information. Moreover, it offers safe central storage of the data collected during the study. The developed platform was successfully tested during a European collaborative and multicenter study, focused on evaluating multimodal non-invasive imaging to diagnose and characterize ischemic heart disease.

  1. [Italian Thesaurus of Bioethics, TIB].

    PubMed

    Navarini, Claudia; Poltronieri, Elisabetta

    2004-01-01

    The article aims at illustrating the characteristics and functions of a monolingual thesaurus, focusing on the Italian Thesaurus of Bioethics (Thesaurus Italiano di Bioetica, TIB) the controlled vocabulary used to index and retrieve documents within SIBIL (Italian Online Bioethics Information System). TIB includes controlled terms (descriptors) translated from the Bioethics Thesaurus adopted by the Kennedy Institute of Ethics of the Georgetown University of Washington and revised according to the Italian context of study and scientific debate in the field of bioethics. The overall amount of TIB terms consists in over 1600 headings. Methods to link thesaurus terms hierarchically, by association and by showing synonyms as recommended in ISO standards are applied with reference to descriptors drawn from TIB. Future plans to make the English version of TIB available online within European networks are also illustrated, aiming at spreading information relating to bioethics at an international level.

  2. Italian/Italiano. Resource Guides for Teachers.

    ERIC Educational Resources Information Center

    Jackson, Jenny

    This resource guide, intended for current prospective teachers of Italian, is designed as a source of information and inspiration for Italian instructors at all educational levels. The first of the guide's 11 chapters provides a brief general introduction to this book. Chapter 2 looks at the status of and rationale for Italian language instruction…

  3. Italian neurology: past, present and future

    PubMed Central

    Federico, Antonio

    Summary This short history of the Italian Society of Neurology focuses on its founders and leading personalities. The article also considers the present and the future of Italian neurology, emphasising in particular the scientific impact of Italian neurological research on the main international journals and the activities undertaken to increase the role of neurologists. PMID:21729588

  4. Italian/Italiano. Resource Guides for Teachers.

    ERIC Educational Resources Information Center

    Jackson, Jenny

    This resource guide, intended for current prospective teachers of Italian, is designed as a source of information and inspiration for Italian instructors at all educational levels. The first of the guide's 11 chapters provides a brief general introduction to this book. Chapter 2 looks at the status of and rationale for Italian language instruction…

  5. A Handbook for Teachers of Italian.

    ERIC Educational Resources Information Center

    Mollica, Anthony, Ed.

    This handbook for teachers of Italian consists of a collection of 16 essays by noted professionals in the field of Italian instruction: (1) "Fundamentals of Language Learning and Language Instruction," by A. Papalia; (2) "Linguistic Methodology and the Teacher of Italian," by R.J. Di Pietro; (3) "Preparation for Language Teaching," by F.J. Bosco;…

  6. The Female Sexual Function Index (FSFI): linguistic validation of the Italian version.

    PubMed

    Filocamo, Maria Teresa; Serati, Maurizio; Li Marzi, Vincenzo; Costantini, Elisabetta; Milanesi, Martina; Pietropaolo, Amelia; Polledro, Patrizio; Gentile, Barbara; Maruccia, Serena; Fornia, Samanta; Lauri, Irene; Alei, Rosanna; Arcangeli, Paola; Sighinolfi, Maria Chiara; Manassero, Francesca; Andretta, Elena; Palazzetti, Anna; Bertelli, Elena; Del Popolo, Giulio; Villari, Donata

    2014-02-01

    Although several new measurements for female sexual dysfunction (FSD) have recently been developed, the Female Sexual Function Index (FSFI) remains the gold standard for screening and one of the most widely used questionnaires. The Italian translation of the FSFI has been used in several studies conducted in Italy, but a linguistic validation of the Italian version does not exist. The aim of this study was to perform a linguistic validation of the Italian version of the FSFI. A multicenter cross-sectional study conducted in 14 urological and gynecological clinics, uniformly distributed over Italian territory. We performed all steps necessary to determine the reliability and the test-retest reliability of the Italian version of the FSFI. The study population was a convenience sample of 409 Italian women. The reliability of the questionnaire was calculated using Cronbach's alpha, which was considered weak, moderate, or high if its value was found less than 0.6, between 0.6 and 0.8, or equal to or greater than 0.8, respectively. The test-retest reliability was assessed for all women in the sample by calculating Pearson's concordance correlation coefficient for each domain and for the total score, both at baseline and after 15 days (r range between -1.00 to +1.00, where +1.00 indicates the strongest positive association). Cronbach's alpha coefficients for total and domain score were sufficiently high, ranging from 0.92 to 0.97 for the total sample. The test-retest procedure revealed that the concordance correlation coefficient was very high both for FSFI-I total score (Pearson's P = 0.93) and for each domain (Pearson's P always >0.92). For the first time in the literature, our study has produced a validated and reliable Italian version of the FSFI questionnaire. Consequently, the Italian FSFI can be used as a reliable tool for preliminary screening for female sexual dysfunction for Italian women. © 2013 International Society for Sexual Medicine.

  7. Minimally invasive surgery for Achilles tendon pathologies

    PubMed Central

    Maffulli, Nicola; Longo, Umile Giuseppe; Spiezia, Filippo; Denaro, Vincenzo

    2010-01-01

    Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT) hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones. PMID:24198547

  8. Nonverbal Communication among Italian Americans.

    ERIC Educational Resources Information Center

    Ferri-Bernardoni, Joseph M.

    Participant observation and author introspection were used to collect data in this study of nonverbal communication among Italian Americans in three large American cities. Discussion is given to kinesics (gestures and signs), haptics (touch), proxemics (interiors of homes, exteriors of homes, and spatial arrangements at a wedding dinner), and…

  9. ITALIAN IN THE ELEMENTARY SCHOOLS.

    ERIC Educational Resources Information Center

    GILLERS, LILLIAN M.; AND OTHERS

    THE FIRST PART OF THIS CURRICULUM GUIDE FOR SUPERVISORS AND ELEMENTARY SCHOOL TEACHERS OF ITALIAN IS DEVOTED TO AN EXPLANATION OF THE PHILOSOPHY, OBJECTIVES, COURSE CONTENT, AND METHODS OF TEACHING FOREIGN LANGUAGES IN THE ELEMENTARY SCHOOLS. IN THE SECOND PART, THE TOPICS TO BE TAUGHT ARE DEVELOPED IN DETAIL. EACH TOPIC FOR THE FIRST, SECOND, AND…

  10. Nonverbal Communication among Italian Americans.

    ERIC Educational Resources Information Center

    Ferri-Bernardoni, Joseph M.

    Participant observation and author introspection were used to collect data in this study of nonverbal communication among Italian Americans in three large American cities. Discussion is given to kinesics (gestures and signs), haptics (touch), proxemics (interiors of homes, exteriors of homes, and spatial arrangements at a wedding dinner), and…

  11. GENERATIVE RULES FOR ITALIAN PHONOLOGY.

    ERIC Educational Resources Information Center

    DI PIETRO, ROBERT J.

    TWO MODELS OF DESCRIPTION, GENERATIVE AND NONGENERATIVE, ARE APPLIED TO THE PHONOLOGY OF ITALIAN TO DETERMINE WHICH OF THE TWO OFFERS A SIMPLER YET MORE COMPREHENSIVE STATEMENT. THE NONGENERATIVE MODEL IS GIVEN IN A LISTING OF PHONEMES AND A BRIEF STATEMENT OF THE PHONOTACTICS AND ALLOPHONICS. THE GENERATIVE MODEL STATES THE FACTS IN 11 REWRITE…

  12. Remote sensing of Italian volcanos

    NASA Technical Reports Server (NTRS)

    Bianchi, R.; Casacchia, R.; Coradini, A.; Duncan, A. M.; Guest, J. E.; Kahle, A.; Lanciano, P.; Pieri, D. C.; Poscolieri, M.

    1990-01-01

    The results of a July 1986 remote sensing campaign of Italian volcanoes are reviewed. The equipment and techniques used to acquire the data are described and the results obtained for Campi Flegrei and Mount Etna are reviewed and evaluated for their usefulness for the study of active and recently active volcanoes.

  13. Italian telematics initiatives and achievements.

    PubMed

    Pinciroli, Francesco

    2003-01-01

    Depending on their legislation, the European countries have different telematics initiatives and different scenarios. Cultural roots cause differences even within a country or a region, and different organisational structures can cause further problems. With regard to the Italian telematics approach, the author intends to explain the basis and the main achievements in Italy and especially in the Lombaria region.

  14. Education and Italian Regional Development

    ERIC Educational Resources Information Center

    Di Liberto, Adriana

    2008-01-01

    In this paper, we study the connection between growth and human capital in a convergence regression for the panel of Italian regions. We include measures of average primary, secondary and tertiary education. We find that increased education seems to contribute to growth only in the South. Decomposing total schooling into its three constituent…

  15. [MISSCARE Survey - Italian Version: findings from an Italian validation study].

    PubMed

    Sist, Luisa; Contini, Carla; Bandini, Anna; Bandini, Stefania; Massa, Licia; Zanin, Roberta; Maricchio, Rita; Gianesini, Gloria; Bassi, Erika; Tartaglini, Daniela; Palese, Alvisa; Ferraresi, Annamaria

    2017-01-01

    The Missed Nursing Care (MNC) refers to nursing interventions that are not completed, partially completed, or postponed. Despite the relevance of MNC, no assessment tools are available in the Italian context, and no data regarding the occurrence of this phenomenon has been documented on a large scale to date. The study aims were: (1) to validate the Italian version of the MISSCARE Survey tool; (2) to measure the prevalence of missed interventions and reasons for missed care as perceived by clinical nurses working in Italian health care settings. After having conducted the forward and backward translation, pre-pilot and pilot phases were developed to ensure face and content validity as well as semantic and conceptual equivalence of the Italian version with the original version. The MISSCARE survey questionnaire was then distributed to 1,233 clinical nurses of whom 1,003 completed the questionnaire. Overall, 979 questionnaires were analysed. The questionnaires were completed from January to March 2012, by nurses working in medical and surgical hospital departments in the Emilia Romagna region of Italy. Construct validity and internal consistency of the instrument were assessed. The face and content validity were ascertained by a group of experts. The instrument acceptability was good given that 79.4% of respondents replied to all items. Construct validity was investigated by an Exploratory Factor Analysis. Four factors explaining 64.18% of variance emerged: communication, lack of facilities/supplies, lack of staff, and unexpected events. Internal consistency, evaluated with Cronbach a, was 0.94. The nursing interventions omitted with greater frequency were, in order: ambulation (74.8%), passive mobilization (69.6%) and oral care (51.3%). The three main reasons for missed interventions were: an unexpected increase in the number of patients (90.5%), increased instability of the clinical condition (86.1%) and insufficient human resources (85.5%). The Italian version of

  16. The Astronomy Olympiad italian experience

    NASA Astrophysics Data System (ADS)

    Sandrelli, S.; Giacomini, L.

    2011-10-01

    The International Astronomy Olympiad (IAO) is an internationally annual astronomy scientific-educating event, born in 1996, which includes an intellectual competition between students aged between 14 and 17. In Italy, the Olympiad is coorganized since 2007 by INAF (Istituto Nazionale di Astrofisica) and SAiT (Società Astronomica Italiana) becoming every year a more visible and global event in the italian scenario (in 2011, INAF institutes participating to the local activities were 13). Unluckily, the Italian Committee of the Olympiads cannot involve directly nor rely on schools, since astronomy is no longer part of the scholastic programs. For this reason, the Committee needed to develop in the last years a non traditional mediatic approach that allowed in 2011 to reach a participation of more than 500 teenagers to the Olympics. We will give an overview of the Astronomy Olympics project in Italy and of this non conventional mediatic approach.

  17. The history of Italian parasitology.

    PubMed

    Roncalli Amici, R

    2001-07-12

    The history of Italian parasitology can be subdivided into two periods: pre-Redi and post-Redi. The first period includes the contributions to parasitology by savants who operated during the Roman, medieval and Renaissance eras; the second period started in 1668 when Francesco Redi published his experiments to debunk the theory of spontaneous generation; the work of Redi was subsequently continued by Vallisnieri, Spallanzani and others. The latter period includes classic contributions in the field of parasitology provided by veterinarians such as Ercolani, Perroncito, Piana and Rivolta, and by physicians such as Bassi, Grassi, Golgi, and Celli. Also, two outstanding pages of medical parasitology were written during this period--the unraveling and defeat of St. Gotthard's disease and the conquering of malaria on Italian soil--both accomplished through the generous efforts of dedicated individuals.

  18. Language Policy and Planning: The Case of Italian Sign Language

    ERIC Educational Resources Information Center

    Geraci, Carlo

    2012-01-01

    Italian Sign Language (LIS) is the name of the language used by the Italian Deaf community. The acronym LIS derives from Lingua italiana dei segni ("Italian language of signs"), although nowadays Italians refers to LIS as Lingua dei segni italiana, reflecting the more appropriate phrasing "Italian sign language." Historically,…

  19. Language Policy and Planning: The Case of Italian Sign Language

    ERIC Educational Resources Information Center

    Geraci, Carlo

    2012-01-01

    Italian Sign Language (LIS) is the name of the language used by the Italian Deaf community. The acronym LIS derives from Lingua italiana dei segni ("Italian language of signs"), although nowadays Italians refers to LIS as Lingua dei segni italiana, reflecting the more appropriate phrasing "Italian sign language." Historically,…

  20. Overwhelming Force, Indecisive Victory: The German Invasion of Yugoslavia, 1941

    DTIC Science & Technology

    1993-05-13

    from the 10 vicinity of Trieste along the Adriatic to relieve their base at Zadar and secure the coastal plain. The German High Command provided the...southeastern direction down the Vardar Valley toward 29 Salonika. It anticipated a German invasion and included an attack on the Italian base at Zadar and

  1. Driving forces push Italian exploration

    SciTech Connect

    Steven, R.R.

    1982-03-01

    The Italian offshore is one of the most active in Europe. Although it cannot be compared with the North Sea in terms of hydrocarbon production or potential, Italy is expending a great deal of effort in order to reduce imported oil and gas from the current level of around 90% of total domestic consumption of 147 million tons of oil equivalent a year. The drilling program, major targets, and development of new oil fields are discussed briefly. (JMT)

  2. New Italian device registration requirements.

    PubMed

    Donawa, Maria

    2008-01-01

    A medical device manufacturer located outside Europe was informed by an Italian distributor that the European Authorised Representative must designate the distributor as the authorised entity when registering the manufacturer's devices in Italy in a new online data bank. This is incorrect. This article discusses the new requirements for registering medical devices in Italy, together with the steps in the registration process and common problems encountered.

  3. Somatotype of elite Italian gymnasts.

    PubMed

    Massidda, Myosotis; Toselli, Stefania; Brasili, Patricia; Calò, Carla M

    2013-09-01

    The somatotyping method is especially helpful in sports in which the body could directly influence the biomechanics of movements and the performance's results. The purpose of this study was to determine the somatotype of elite Italian gymnasts and to compare it in terms of competition levels. The sample comprised 64 elite gymnasts (42 females (F), somatotype 1.4-4.4-3.2; and 22 males (M), somatotype 1.6-6.3-2.1) belonging to the Italian National Artistic Gymnastic Team (2007) at different competition levels: Allieve, Junior, and Senior. Mean whole somatotypes, by competition levels, were not significantly different in both sexes (Female gymnasts: Allieve, 1.3-4.6-3.3; Junior, 1.3-4.2-3.6; Senior, 1.7-4.2-2.7; Male gymnasts: Junior, 1.5-6.3-2.5; Senior, 1.7-6.3-1.6). Male Junior gymnasts exhibited greater ectomorphy than Senior athletes (F1,20 = 7.75, p < 0.01). Compared to other elite athletes male and female gymnasts tend to be less endomorphic and more mesomorphic. This study highlighted the peculiarities of the somatotype of Italian elite gymnasts and their strong homogeneity, evident also from the low values of somatotype attitudinal mean (SAM). The results emphasize the need for a specific somatotype to reach an elite level in sport and the need to integrate the somatotype analysis between the scientific instruments for selecting talent also in artistic gymnastics.

  4. Opera in the Italian Language Classroom.

    ERIC Educational Resources Information Center

    Bruno, Salvatore

    1989-01-01

    Describes class activities for incorporating and teaching about opera into the Italian language instruction classroom, focusing on the enhancement of cultural knowledge and understanding that opera offers. (CB)

  5. Physician-initiated prospective Italian Registry of carotid stenting with the C-Guard mesh-stent: the IRON-Guard registry. Rationale and design.

    PubMed

    Setacci, C; Speziale, F; De Donato, G; Sirignano, P; Setacci, F; Capoccia, L; Galzerano, G; Mansour, W

    2015-10-01

    According to the World Health Organization, every year, 5 million peoples die for stroke and another 5 million are permanently disabled. Although there are many causes of acute stroke, a common treatable cause of acute stroke is atheromatous narrowing at the carotid bifurcation. Carotid endarterectomy is still the standard of car, even if carotid artery stenting (CAS) has become an effective, less invasive alterantive. Unfortunately, CAS procedure is not yet perfect; regardless the use of an embolic protection device (EPD), percutaneous treatment has been correlated with a risk of cerebral ischemic events related to distal embolization. The objective of the IRON-Guard Registry is to evaluate the clinical outcome of treatment by means of stenting with the C-Guard (InspireMD, Boston, MA, USA) in subjects requiring CAS due to significant extracranial carotid artery stenosis with a physician-initiated, Italian, prospective, multicenter, single-arm study. A total of 200 enrolled subjects divided over different centers are planned to be enrolled. CAS will performed by implanting of C-Guard stent. Procedure will be performed according to the physician's standard of care. Standard procedures will be followed based on the Instructions for Use, for the C-Guard device of Inspire. The primary endpoint of this study is the 30-day rate of major adverse events (MAE), defined as the cumulative incidence of any periprocedural (≤30 days postprocedure) death, stroke or myocardial infarction. Secondary endpoints are rate of late ipsilateral stroke (31 through 365 days), system technical success, device malfunctions, major adverse events (MAEs), serious device-related and procedure-related adverse events, target lesion revascularization, and in-stent restenosis rates.

  6. Development of an algorithm for the management of cervical lymphadenopathy in children: consensus of the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases and the Italian Society of Pediatric Otorhinolaryngology.

    PubMed

    Chiappini, Elena; Camaioni, Angelo; Benazzo, Marco; Biondi, Andrea; Bottero, Sergio; De Masi, Salvatore; Di Mauro, Giuseppe; Doria, Mattia; Esposito, Susanna; Felisati, Giovanni; Felisati, Dino; Festini, Filippo; Gaini, Renato Maria; Galli, Luisa; Gambini, Claudio; Gianelli, Umberto; Landi, Massimo; Lucioni, Marco; Mansi, Nicola; Mazzantini, Rachele; Marchisio, Paola; Marseglia, Gian Luigi; Miniello, Vito Leonardo; Nicola, Marta; Novelli, Andrea; Paulli, Marco; Picca, Marina; Pillon, Marta; Pisani, Paolo; Pipolo, Carlotta; Principi, Nicola; Sardi, Iacopo; Succo, Giovanni; Tomà, Paolo; Tortoli, Enrico; Tucci, Filippo; Varricchio, Attilio; de Martino, Maurizio; Italian Guideline Panel For Management Of Cervical Lymphadenopathy In Children

    2015-01-01

    Cervical lymphadenopathy is a common disorder in children due to a wide spectrum of disorders. On the basis of a complete history and physical examination, paediatricians have to select, among the vast majority of children with a benign self-limiting condition, those at risk for other, more complex, diseases requiring laboratory tests, imaging and, finally, tissue sampling. At the same time, they should avoid expensive and invasive examinations when unnecessary. The Italian Society of Preventive and Social Pediatrics, jointly with the Italian Society of Pediatric Infectious Diseases, the Italian Society of Pediatric Otorhinolaryngology, and other Scientific Societies, issued a National Consensus document, based on the most recent literature findings, including an algorithm for the management of cervical lymphadenopathy in children. The Consensus Conference method was used, following the Italian National Plan Guidelines. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through March 21, 2014. Basing on literature results, an algorithm was developed, including several possible clinical scenarios. Situations requiring a watchful waiting strategy, those requiring an empiric antibiotic therapy, and those necessitating a prompt diagnostic workup, considering the risk for a severe underling disease, have been identified. The present algorithm is a practice tool for the management of pediatric cervical lymphadenopathy in the hospital and the ambulatory settings. A multidisciplinary approach is paramount. Further studies are required for its validation in the clinical field.

  7. Comparing knowledge of beta-thalassemia in samples of Italians, Italian-Americans, and non-Italian-Americans.

    PubMed

    Armeli, Christina; Robbins, Steven J; Eunpu, Deborah

    2005-10-01

    The purpose of this study was to determine the level of beta-thalassemia awareness among Italians living on the eastern side of Sicily (Bronte, Catania, and Tortorici, Messina), Italian-Americans, and Americans of other ethnic backgrounds (Other-Americans). A questionnaire was developed which asked respondents knowledge questions about both beta-thalassemia and Down Syndrome. Five hundred questionnaires were distributed, and 456 were ultimately returned and analyzed (150 Italians, 156 Italian-Americans, 150 Other-Americans). Italians answered an average of 55% of the beta-thalassemia correctly compared to scores of 17 and 24% for the Italian-Americans and Other-Americans, respectively. The groups did not differ in their knowledge of Down Syndrome (all answered between 58 and 60% of the questions correctly on average). Over 80% of the Italian respondents had heard of beta-thalassemia compared to only 19% of the Italian-Americans. beta-Thalassemia education programs in Italy appear to have dramatically increased awareness of the disorder. Similar programs need to be developed for at-risk populations in the United States.

  8. Occurrence and Duration of Interruptions During Nurses' Work in Surgical Wards: Findings From a Multicenter Observational Study.

    PubMed

    Dante, Angelo; Andrigo, Isabella; Barone, Francesca; Bonamico, Rossella; De Chiara, Antonio; Nait, Michela; Toci, Ergyseda; Palese, Alvisa

    2016-01-01

    This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).

  9. The Italian National Seismic Network

    NASA Astrophysics Data System (ADS)

    Michelini, Alberto

    2016-04-01

    The Italian National Seismic Network is composed by about 400 stations, mainly broadband, installed in the Country and in the surrounding regions. About 110 stations feature also collocated strong motion instruments. The Centro Nazionale Terremoti, (National Earthquake Center), CNT, has installed and operates most of these stations, although a considerable number of stations contributing to the INGV surveillance has been installed and is maintained by other INGV sections (Napoli, Catania, Bologna, Milano) or even other Italian or European Institutions. The important technological upgrades carried out in the last years has allowed for significant improvements of the seismic monitoring of Italy and of the Euro-Mediterranean Countries. The adopted data transmission systems include satellite, wireless connections and wired lines. The Seedlink protocol has been adopted for data transmission. INGV is a primary node of EIDA (European Integrated Data Archive) for archiving and distributing, continuous, quality checked data. The data acquisition system was designed to accomplish, in near-real-time, automatic earthquake detection and hypocenter and magnitude determination (moment tensors, shake maps, etc.). Database archiving of all parametric results are closely linked to the existing procedures of the INGV seismic monitoring environment. Overall, the Italian earthquake surveillance service provides, in quasi real-time, hypocenter parameters which are then revised routinely by the analysts of the Bollettino Sismico Nazionale. The results are published on the web page http://cnt.rm.ingv.it/ and are publicly available to both the scientific community and the the general public. This presentation will describe the various activities and resulting products of the Centro Nazionale Terremoti. spanning from data acquisition to archiving, distribution and specialised products.

  10. Communities in Italian corporate networks

    NASA Astrophysics Data System (ADS)

    Piccardi, Carlo; Calatroni, Lisa; Bertoni, Fabio

    2010-11-01

    The community structure of two real-world financial networks, namely the board network and the ownership network of the firms of the Italian Stock Exchange, is analyzed by means of the maximum modularity approach. The main result is that both networks exhibit a strong community structure and, moreover, that the two structures overlap significantly. This is due to a number of reasons, including the existence of pyramidal groups and directors serving in several boards. Overall, this means that the “small world” of listed companies is actually split into well identifiable “continents” (i.e., the communities).

  11. Invasive Candidiasis.

    PubMed

    McCarty, Todd P; Pappas, Peter G

    2016-03-01

    Invasive candidiasis is a collective term that refers to a group of infectious syndromes caused by a variety of species of Candida, 5 of which cause most cases. Candidemia is the most commonly recognized syndrome associated with invasive candidiasis. Certain conditions may influence the likelihood for one species versus another in a specific clinical scenario, and this can have important implications for selection of antifungal therapy and the duration of treatment. Molecular diagnostic technology plays an ever-increasing role as an adjunct to traditional culture-based diagnostics, offering significant potential toward improvement in patient care.

  12. Assessing the Cost Efficiency of Italian Universities

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Salerno, Carlo

    2007-01-01

    This study uses Data Envelopment Analysis to evaluate the cost efficiency of 52 Italian public universities. In addition to being one of the first such cost studies of the Italian system, it explicitly takes into account the internal cost structure of institutions' education programs; a task not prevalent in past Data Envelopment Analysis studies…

  13. Syllabic Effects in Italian Lexical Access

    ERIC Educational Resources Information Center

    Tagliapietra, Lara; Fanari, R.; Collina, S.; Tabossi, P.

    2009-01-01

    Two cross-modal priming experiments tested whether lexical access is constrained by syllabic structure in Italian. Results extend the available Italian data on the processing of stressed syllables showing that syllabic information restricts the set of candidates to those structurally consistent with the intended word (Experiment 1). Lexical…

  14. From Immigrants to Ethnics: The Italian Americans.

    ERIC Educational Resources Information Center

    Nelli, Humbert S.

    A sociological, political, and cultural history of Italians in America, this book's chapters discuss (1) Italian explorers, intellectuals, and artisans who participated in the settlement and establishment of the United States; (2) socioeconomic conditions in nineteenth century Italy that led to mass emigration; (3) the distribution of Italian…

  15. Secondary Predicates in Italian and English.

    ERIC Educational Resources Information Center

    Merlo, Paola

    An analysis of the nature of secondary predicates takes a comparative approach, using Italian and English. Distributional properties and extraction facts are accounted for, and an explanation for the fact that resultatives are not allowed in Romance languages is sought on the basis of Italian evidence. It is argued that the semantic distinction…

  16. [Naples: the historic capital of Italian paediatrics].

    PubMed

    Farnetani, I; Farnetani, F

    2008-06-01

    No other Italian city has contributed to the birth and development of paediatrics more than Naples. This is why it can be considered the historic capital of Italian paediatrics. Here are the main reasons: Luigi Somma was the first professor of Italian paediatrics whereas Francesco Fede was the first president of the Italian Paediatrics Association. Neapolitan paediatricians have been the most numerous amongst the founder members. The first three Italian journals of paediatrics were founded in Naples as well as the journal ''La Pediatria'' which was the most distributed and long-lasting journal in this field. Moreover, Neapolitans have been the most numerous presidents of the Italian Paediatrics Association, while Rocco Jemma was the one who remained the longest in charge. ''Rocco Jemma's school'' taught not only to most professors in paediatrics who afterwards taught in most Italian universities, but also four out of five paediatricians who took charge of the position as president. The first regional department of the Italian Paediatrics Association was founded in Naples as well as the Association of Nipiology.

  17. Slavic and Italian Canadian Attitudes towards Authority.

    ERIC Educational Resources Information Center

    Ryan, Michael G.

    Predicting that Italian Canadians would hold attitudes of greater hostility and anxiety toward authority than Slavic Canadians, this study, using 58 part-time summer students (29 Italians and 29 Slavs) at three universities in Canada, analyzed the subjects' responses to the five-response option Likert type scale. Results confirmed the early…

  18. The ECDL Programme in Italian Universities

    ERIC Educational Resources Information Center

    Calzarossa, Maria Carla; Ciancarini, Paolo; Maresca, Paolo; Mich, Luisa; Scarabottolo, Nello

    2007-01-01

    The European Computer Driving Licence (ECDL) programme aims at testing practical skills and competences in using ICT tools. This paper presents the results of a monitoring exercise aimed at analyzing the impact of the ECDL programme in the Italian Universities. The ECDL programme, adopted in most Italian Universities since the year 2000, has…

  19. Syllabic Effects in Italian Lexical Access

    ERIC Educational Resources Information Center

    Tagliapietra, Lara; Fanari, R.; Collina, S.; Tabossi, P.

    2009-01-01

    Two cross-modal priming experiments tested whether lexical access is constrained by syllabic structure in Italian. Results extend the available Italian data on the processing of stressed syllables showing that syllabic information restricts the set of candidates to those structurally consistent with the intended word (Experiment 1). Lexical…

  20. Italian Culture through Audio-Visual Aids.

    ERIC Educational Resources Information Center

    Mollica, Anthony

    The language teacher automatically teaches culture when he teaches language, but there are many ways in which the Italian teacher can specifically bring culture to the Italian classroom. Through use of vocabulary certain differences in culture can be made clear to students. Dialogues should be used to reveal major areas of contrast and similarity…

  1. Assessing the Cost Efficiency of Italian Universities

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Salerno, Carlo

    2007-01-01

    This study uses Data Envelopment Analysis to evaluate the cost efficiency of 52 Italian public universities. In addition to being one of the first such cost studies of the Italian system, it explicitly takes into account the internal cost structure of institutions' education programs; a task not prevalent in past Data Envelopment Analysis studies…

  2. Euclidean supergravity and multi-centered solutions

    NASA Astrophysics Data System (ADS)

    Sabra, W. A.

    2017-04-01

    In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein-Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D = 5, N = 2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein-Maxwell multi-centered solutions are also presented.

  3. Drug-resistant chronic migraine: the Italian GON project.

    PubMed

    Proietti Cecchini, A; Leone, M; Manzoni, G C; Torelli, P; Bussone, G

    2012-05-01

    Chronic daily headache is a major problem due to severe disability and high socio-economic costs. In the last years, some trials have shown potential benefit from new therapeutic approach by occipital neurostimulation techniques, already applied with some success for the treatment of chronic cluster headache. Due to the extremely heterogeneous population suffering from refractory chronic daily headaches, we propose a national multicenter experimental study involving Italian ANIRCEF Headache Centres with the aim to evaluate the efficacy of occipital neurostimulation in a selected group representative for the drug-resistant chronic migraine. Patients with chronic migraine according to Manzoni's modified IHS criteria-2011, with or without medication overuse headache, will be selected. Duration of illness should be at least 2 years and pharmacological refractoriness defined strictly for experimental-surgical purposes as those patients who have properly tried without success almost all available classes of prophylactic medications. Those presenting with medication overuse should have tried at least two previous detoxification treatments. A full psychopathological assessment will be performed by a psychiatrist, to exclude mainly psychotic disorder, ongoing severe status of an affective disorder, severe post traumatic stress disorder. Headache characteristics and abortive treatments used will be reported daily on a predisposed diary during 3-month baseline and continuously through the post implant follow up, while disability and QoL scale (MIDAS, SF-12) will be completed baseline, 6 and 12 months after implant.

  4. Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

    PubMed Central

    Montagna, Maria Teresa; De Giglio, Osvalda; Cristina, Maria Luisa; Napoli, Christian; Pacifico, Claudia; Agodi, Antonella; Baldovin, Tatjana; Casini, Beatrice; Coniglio, Maria Anna; D’Errico, Marcello Mario; Delia, Santi Antonino; Deriu, Maria Grazia; Guida, Marco; Laganà, Pasqualina; Liguori, Giorgio; Moro, Matteo; Mura, Ida; Pennino, Francesca; Privitera, Gaetano; Romano Spica, Vincenzo; Sembeni, Silvia; Spagnolo, Anna Maria; Tardivo, Stefano; Torre, Ida; Valeriani, Federica; Albertini, Roberto; Pasquarella, Cesira

    2017-01-01

    Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis®μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis®μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis®μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis®μ resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigations. PMID:28640202

  5. Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study.

    PubMed

    Montagna, Maria Teresa; De Giglio, Osvalda; Cristina, Maria Luisa; Napoli, Christian; Pacifico, Claudia; Agodi, Antonella; Baldovin, Tatjana; Casini, Beatrice; Coniglio, Maria Anna; D'Errico, Marcello Mario; Delia, Santi Antonino; Deriu, Maria Grazia; Guida, Marco; Laganà, Pasqualina; Liguori, Giorgio; Moro, Matteo; Mura, Ida; Pennino, Francesca; Privitera, Gaetano; Romano Spica, Vincenzo; Sembeni, Silvia; Spagnolo, Anna Maria; Tardivo, Stefano; Torre, Ida; Valeriani, Federica; Albertini, Roberto; Pasquarella, Cesira

    2017-06-22

    Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis(®)μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis(®)μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis(®)μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis(®)μ resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigations.

  6. Lacosamide in children with refractory status epilepticus. A multicenter Italian experience.

    PubMed

    Grosso, Salvatore; Zamponi, Nelia; Bartocci, Arnaldo; Cesaroni, Elisabetta; Cappanera, Silvia; Di Bartolo, Rosanna; Balestri, Paolo

    2014-09-01

    Status epilepticus (SE) is considered a life-threatening medical emergency. First-line treatment with antiepileptic drugs (AEDs) consists of intravenous benzodiazepines followed by phenytoin. SE is considered refractory (RSE) when unresponsive to standard doses of the first two AEDs. Scarce evidence is available to support specific guidelines for the management of RSE in either adults or children. This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in children affected by RSE. Children with RSE who were treated with ivLCM were included in the study. Efficacy was defined as the cessation of seizures after administration of ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following standard protocols before ivLCM was administered. Eleven children entered the study (mean age: 9.4 years). Etiology was symptomatic in 7 patients (63%). RSE was convulsive (focal or generalized) in 6 patients and nonconvulsive in 5. The mean initial bolus dose of LCM was 8.6 mg/kg. The drug, which was used as a fourth or later option, was effective in stopping RSE in 45% of patients, with seizures terminating within 12 h in three children. No serious adverse events attributable to LCM were reported. LCM might be an effective and well-tolerated AED in children with RSE. Copyright © 2014. Published by Elsevier Ltd.

  7. Asymptomatic Left Ventricular Dysfunction and Metabolic Syndrome: Results from an Italian Multicenter Study

    PubMed Central

    La Carrubba, Salvatore; Todaro, Maria Chiara; Zito, Concetta; Antonini-Canterin, Francesco; Monte, Ines Paola; Caso, Pio; Colonna, Paolo; de Gregorio, Cesare; Pezzano, Antonio; Benedetto, Frank; Salvo, Giovanni Di; Carerj, Scipione; Bello, Vitantonio Di

    2013-01-01

    Context: Metabolic syndrome (MS) is a cluster of interrelated common clinical disorders, including obesity, insulin resistance, glucose intolerance, hypertension and dyslipidemia, associated with a greater risk of atherosclerotic cardiovascular disease than any of its individual components. Although MS is associated with increased cardiovascular risk (CVR), its relationship with heart failure (HF) and left ventricular (LV) dysfunction is not fully understood. Aims: We sought to determine whether MS is associated to LV systolic and diastolic dysfunction in a sample of patients with MS and no symptoms for HF. Subjects and Methods: We enrolled 6422 consecutive asymptomatic patients admitted to echo-lab for a routine echocardiogram. We calculated LV systolic and diastolic function, by Simpson biplane method and validated Doppler parameters, respectively. MS was diagnosed if three or more CVR factors were found. Results: LV systolic function was evaluated in 6175 patients (96.2%). In the group of patients without MS (n = 5630), the prevalence of systolic dysfunction was 10.8% (n = 607) while in the group of patients with MS (n = 545) it was 12.5% (n = 87), (RR1.57; CI 95% 1.2-2.0; P < 0.001). Diastolic function was evaluated in 3936 patients (61.3%). In the group of patients without MS (n = 3566) the prevalence of diastolic dysfunction was 33.3% (n = 1187), while in patients with MS (n = 370) it was 45.7% (n = 169), (RR1.68; CI95% 1.3-2.0; P < 0.001). After adjustment for age and gender, MS proved to be an independent predictor of LV systolic and diastolic dysfunction. Conclusions: Our data show that asymptomatic LV systolic and diastolic dysfunction, is correlated with MS and demonstrate that echocardiography is a useful tool to detect patients at high risk for HF. Echocardiography in asymptomatic patients with MS may lead to a therapy initiation at early stages to prevent future cardiovascular events and HF. PMID:28465894

  8. Italian Rett database and biobank.

    PubMed

    Sampieri, Katia; Meloni, Ilaria; Scala, Elisa; Ariani, Francesca; Caselli, Rossella; Pescucci, Chiara; Longo, Ilaria; Artuso, Rosangela; Bruttini, Mirella; Mencarelli, Maria Antonietta; Speciale, Caterina; Causarano, Vincenza; Hayek, Giuseppe; Zappella, Michele; Renieri, Alessandra; Mari, Francesca

    2007-04-01

    Rett syndrome is the second most common cause of severe mental retardation in females, with an incidence of approximately 1 out of 10,000 live female births. In addition to the classic form, a number of Rett variants have been described. MECP2 gene mutations are responsible for about 90% of classic cases and for a lower percentage of variant cases. Recently, CDKL5 mutations have been identified in the early onset seizures variant and other atypical Rett patients. While the high percentage of MECP2 mutations in classic patients supports the hypothesis of a single disease gene, the low frequency of mutated variant cases suggests genetic heterogeneity. Since 1998, we have performed clinical evaluation and molecular analysis of a large number of Italian Rett patients. The Italian Rett Syndrome (RTT) database has been developed to share data and samples of our RTT collection with the scientific community (http://www.biobank.unisi.it). This is the first RTT database that has been connected with a biobank. It allows the user to immediately visualize the list of available RTT samples and, using the "Search by" tool, to rapidly select those with specific clinical and molecular features. By contacting bank curators, users can request the samples of interest for their studies. This database encourages collaboration projects with clinicians and researchers from around the world and provides important resources that will help to better define the pathogenic mechanisms underlying Rett syndrome.

  9. Epilepsy and vaccinations: Italian guidelines.

    PubMed

    Pruna, Dario; Balestri, Paolo; Zamponi, Nelia; Grosso, Salvatore; Gobbi, Giuseppe; Romeo, Antonino; Franzoni, Emilio; Osti, Maria; Capovilla, Giuseppe; Longhi, Riccardo; Verrotti, Alberto

    2013-10-01

    Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination.

  10. Somatotype of Italian rugby players.

    PubMed

    Casagrande, G; Viviani, F

    1993-03-01

    Our aim was to collect lacking first-hand data on Italian rugby players. The Heath/Carter anthropometric somatotype method was applied to 28 "A" League performers (RP) aged 25 +/- 3.9 years of age. Their somatotypes and dimensions were compared with those found in previous studies on athletes involved in the same sporting activity, with data collected on 25 "sedentary" young Italians, and with Bailey et al.'s study on Canadians (1982). On average, the RP group resulted as being endomorphic mesomorphs (3.1 +/- 1.1 - 5.6 +/- 1.3 - 1.4 +/- 1.1), a result that is congruent with international data. They differed significantly from the balanced mesomorph CG (2.3 +/- 1.0 - 4.5 +/- 1.2 - 2.5 +/- 1.4) for all the measurements taken, apart from bi-epycondylar width. The peculiar somatotype scores found are congruent with the needs of rugby, an aerobic-anaerobic discipline which requires performers with great muscular power associated with a capacity to furnish energy, mainly through the anaerobic metabolism.

  11. 9 CFR 319.145 - Italian sausage products.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Italian sausage products. 319.145... Sausage § 319.145 Italian sausage products. (a) Italian sausage products are cured or uncured sausages... optional ingredients listed in paragraph (b) of this section. (1) “Italian Sausage” shall be prepared with...

  12. Discovering "The Italian Flag" by Fernando Melani (1907-1985)

    NASA Astrophysics Data System (ADS)

    Carlesi, Serena; Bartolozzi, Giovanni; Cucci, Costanza; Marchiafava, Veronica; Picollo, Marcello; La Nasa, Jacopo; Di Girolamo, Francesca; Dilillo, Marialaura; Modugno, Francesca; Degano, Ilaria; Colombini, Maria Perla; Legnaioli, Stefano; Lorenzetti, Giulia; Palleschi, Vincenzo

    2016-11-01

    In the occasion of the celebrations for the 150th anniversary of the founding of Italy (1861-2011), it was decided to analyse the artwork ;The Italian Flag; (La Bandiera Italiana) created by the artist Fernando Melani (Pistoia, 1907-1985), one of the precursors of the Poor Art artistic movement in Italy. This project is a follow-up to a previous study which was mainly focused on the pigments and dyes found in his home-studio. The main goal of this paper is to identify a correct diagnostic plan, based on the use of a combination of non-invasive and micro-invasive methodologies, in order to determine the state of preservation and define the best conservation procedures for a contemporary artwork. Visible, infrared and infrared false colour images as well as the Fibre Optic Reflectance Spectroscopy (FORS) technique were applied in situ to analyse The Italian Flag. Laser Induced Breakdown Spectroscopy (LIBS), Fourier Transform Infrared (FT-IR) and micro-Raman spectroscopies, Pyrolysis-Gas Chromatography/Mass Spectroscopy (Py-GC/MS), High Performance Liquid Chromatography with Diode Arrays Detection (HPLC-DAD) and Mass Spectrometric Detection (HPLC-ESI-Q-ToF) were all applied to three small samples detached from the three painted (green-blue, white and red-yellow, respectively) areas of the flag. The combination of the data obtained with all these techniques made possible a comprehensive understanding of both the chemical composition and physical behaviour of the materials used by the artist and supported curators in defining the preventive conservation of this artwork.

  13. Discovering "The Italian Flag" by Fernando Melani (1907-1985).

    PubMed

    Carlesi, Serena; Bartolozzi, Giovanni; Cucci, Costanza; Marchiafava, Veronica; Picollo, Marcello; La Nasa, Jacopo; Di Girolamo, Francesca; Dilillo, Marialaura; Modugno, Francesca; Degano, Ilaria; Colombini, Maria Perla; Legnaioli, Stefano; Lorenzetti, Giulia; Palleschi, Vincenzo

    2016-11-05

    In the occasion of the celebrations for the 150th anniversary of the founding of Italy (1861-2011), it was decided to analyse the artwork "The Italian Flag" (La Bandiera Italiana) created by the artist Fernando Melani (Pistoia, 1907-1985), one of the precursors of the Poor Art artistic movement in Italy. This project is a follow-up to a previous study which was mainly focused on the pigments and dyes found in his home-studio. The main goal of this paper is to identify a correct diagnostic plan, based on the use of a combination of non-invasive and micro-invasive methodologies, in order to determine the state of preservation and define the best conservation procedures for a contemporary artwork. Visible, infrared and infrared false colour images as well as the Fibre Optic Reflectance Spectroscopy (FORS) technique were applied in situ to analyse The Italian Flag. Laser Induced Breakdown Spectroscopy (LIBS), Fourier Transform Infrared (FT-IR) and micro-Raman spectroscopies, Pyrolysis-Gas Chromatography/Mass Spectroscopy (Py-GC/MS), High Performance Liquid Chromatography with Diode Arrays Detection (HPLC-DAD) and Mass Spectrometric Detection (HPLC-ESI-Q-ToF) were all applied to three small samples detached from the three painted (green-blue, white and red-yellow, respectively) areas of the flag. The combination of the data obtained with all these techniques made possible a comprehensive understanding of both the chemical composition and physical behaviour of the materials used by the artist and supported curators in defining the preventive conservation of this artwork. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Multicenter Breast Cancer Collaborative Registry

    PubMed Central

    Sherman, Simon; Shats, Oleg; Fleissner, Elizabeth; Bascom, George; Yiee, Kevin; Copur, Mehmet; Crow, Kate; Rooney, James; Mateen, Zubeena; Ketcham, Marsha A.; Feng, Jianmin; Sherman, Alexander; Gleason, Michael; Kinarsky, Leo; Silva-Lopez, Edibaldo; Edney, James; Reed, Elizabeth; Berger, Ann; Cowan, Kenneth

    2011-01-01

    The Breast Cancer Collaborative Registry (BCCR) is a multicenter web-based system that efficiently collects and manages a variety of data on breast cancer (BC) patients and BC survivors. This registry is designed as a multi-tier web application that utilizes Java Servlet/JSP technology and has an Oracle 11g database as a back-end. The BCCR questionnaire has accommodated standards accepted in breast cancer research and healthcare. By harmonizing the controlled vocabulary with the NCI Thesaurus (NCIt) or Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), the BCCR provides a standardized approach to data collection and reporting. The BCCR has been recently certified by the National Cancer Institute’s Center for Biomedical Informatics and Information Technology (NCI CBIIT) as a cancer Biomedical Informatics Grid (caBIG®) Bronze Compatible product. The BCCR is aimed at facilitating rapid and uniform collection of critical information and biological samples to be used in developing diagnostic, prevention, treatment, and survivorship strategies against breast cancer. Currently, seven cancer institutions are participating in the BCCR that contains data on almost 900 subjects (BC patients and survivors, as well as individuals at high risk of getting BC). PMID:21918596

  15. Invasive forest species

    Treesearch

    Barbara L. Illman

    2006-01-01

    Nonnative organisms that cause a major change to native ecosystems-once called foreign species, biological invasions, alien invasives, exotics, or biohazards–are now generally referred to as invasive species or invasives. invasive species of insects, fungi, plants, fish, and other organisms present a rising threat to natural forest ecosystems worldwide. Invasive...

  16. The history of Italian psychiatry during Fascism.

    PubMed

    Piazzi, Andrea; Testa, Luana; Del Missier, Giovanni; Dario, Mariopaolo; Stocco, Ester

    2011-09-01

    Specific features characterized Italian psychiatry during Fascism (1922-45), distinguishing it from Nazi psychiatry and giving rise to different operational outcomes, so we have investigated the state of Italian psychiatry during this period. We review the historical situation that preceded it and describe the social and health policies that Fascism introduced following new legislative and regulatory acts. We examine the preventive and therapeutic role played by psychiatry (the electric shock was an Italian invention) and, thanks to the Enciclopedia Italiano published during those years, we are able to highlight psychiatry's relationship to psychology, psychoanalysis, philosophy and religion. The shortcomings of Italian psychiatric research and practice are also seen in terms of what the State failed to do rather than what it did.

  17. Alomar and Marinetti: Catalan and Italian Futurism

    ERIC Educational Resources Information Center

    Litvak de Perez de la Dehesa, Lil

    1972-01-01

    Suggests that a lecture on Futurism delivered in Catalan at the Ateneo in Barcelona on June 18, 1904, by Gabriel Alomar probably was the greatest influence on F. T. Marinetti and Italian Futurism. (DS)

  18. [Gastrointestinal system tumors in Italian emigrants].

    PubMed

    Balzi, D; Geddes, M; Buiatti, E

    1996-01-01

    In this paper we present the risk of death for stomach, colon, rectum and pancreas cancers in Italian migrants to Canada, Argentina, Australia, France and England and Wales. Estimations of relative risks (RR) in Italian migrants, in residents in Italy and in Southern Italy relative to the local born in the host country are shown. Relative risks in Italian migrants to Australia were analysed also by duration of stay in the host country. The Italian migrants' cancer profile in intermediate between the origin and the host population: a reduction of risk of death for stomach cancer and an increase of risk for colorectal cancers are the main results. The results are discussed taking into account the analysis by duration of residence and the pattern of food prevalent in the different countries considered.

  19. Alomar and Marinetti: Catalan and Italian Futurism

    ERIC Educational Resources Information Center

    Litvak de Perez de la Dehesa, Lil

    1972-01-01

    Suggests that a lecture on Futurism delivered in Catalan at the Ateneo in Barcelona on June 18, 1904, by Gabriel Alomar probably was the greatest influence on F. T. Marinetti and Italian Futurism. (DS)

  20. COST Action 724: the Italian contribution .

    NASA Astrophysics Data System (ADS)

    Messerotti, M.; Candidi, M.; Storini, M.; Zuccarello, F.

    COST Action 724, devoted to developing the scientific basis for monitoring, modelling and predicting Space Weather, is briefly outlined with emphasis to the contribution by Italian researchers of the solar and solar-terrestrial communities.

  1. Serial correlation in the Italian futures market

    NASA Astrophysics Data System (ADS)

    Bianco, Simone; Reno, Roberto

    2005-05-01

    We study the serial correlation of high-frequency intraday returns on the Italian stock index futures (FIB30) in the period 2000-2002. We adopt three different methods of analysis: the spectral density via Fast Fourier Transform, Detrended Fluctuation Analysis (DFA) and the Variance Ratio test. We find that intraday autocorrelation is mostly negative for time scales lower than 20 minutes, but we support the efficiency of the Italian futures market.

  2. Small field output factors evaluation with a microDiamond detector over 30 Italian centers.

    PubMed

    Russo, Serenella; Reggiori, Giacomo; Cagni, Elisabetta; Clemente, Stefania; Esposito, Marco; Falco, Maria Daniela; Fiandra, Christian; Giglioli, Francesca Romana; Marinelli, Marco; Marino, Carmelo; Masi, Laura; Pimpinella, Maria; Stasi, Michele; Strigari, Lidia; Talamonti, Cinzia; Villaggi, Elena; Mancosu, Pietro

    2016-12-01

    The aim of the study was a multicenter evaluation of MLC&jaws-defined small field output factors (OF) for different linear accelerator manufacturers and for different beam energies using the latest synthetic single crystal diamond detector commercially available. The feasibility of providing an experimental OF data set, useful for on-site measurements validation, was also evaluated. This work was performed in the framework of the Italian Association of Medical Physics (AIFM) SBRT working group. The project was subdivided in two phases: in the first phase each center measured OFs using their own routine detector for nominal field sizes ranging from 10×10cm(2) to 0.6×0.6cm(2). In the second phase, the measurements were repeated in all centers using the PTW 60019 microDiamond detector. The project enrolled 30 Italian centers. Micro-ion chambers and silicon diodes were used for OF measurements in 24 and 6 centers respectively. Gafchromic films and TLDs were used for very small field OFs in 3 and 1 centers. Regarding the measurements performed with the user's detectors, OF standard deviations (SD) for field sizes down to 2×2cm(2) were in all cases <2.7%. In the second phase, a reduction of around 50% of the SD was obtained using the microDiamond detector. The measured values presented in this multicenter study provide a consistent dataset for OFs that could be a useful tool for improving dosimetric procedures in centers. The microDiamond data present a small variation among the centers confirming that this detector can contribute to improve overall accuracy in radiotherapy. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Pronominal Objects in English-Italian and Spanish-Italian Bilingual Children

    ERIC Educational Resources Information Center

    Serratrice, Ludovica; Sorace, Antonella; Filiaci, Francesca; Baldo, Michela

    2012-01-01

    This study investigated the role of typological relatedness, language of the community, and age, in predicting similarities and differences between English-Italian, Spanish-Italian bilingual children and their monolingual child and adult counterparts in the acceptability of pre- and postverbal object pronouns in [[plus or minus]focus] contexts in…

  4. College and University Italian Programs in North America: Where Is Italian Phonetics and Phonology?

    ERIC Educational Resources Information Center

    Mason, Keith

    1990-01-01

    Argues for the inclusion of courses in phonetics and phonology in college Italian programs, claiming that the myth of Italian as a phonetic language blurs the clear need for such training and that students actually require advanced coursework in phonetics and phonology to improve their articulation and pronunciation. (43 references) (Author/CB)

  5. College and University Italian Programs in North America: Where Is Italian Phonetics and Phonology?

    ERIC Educational Resources Information Center

    Mason, Keith

    1990-01-01

    Argues for the inclusion of courses in phonetics and phonology in college Italian programs, claiming that the myth of Italian as a phonetic language blurs the clear need for such training and that students actually require advanced coursework in phonetics and phonology to improve their articulation and pronunciation. (43 references) (Author/CB)

  6. Pronominal Objects in English-Italian and Spanish-Italian Bilingual Children

    ERIC Educational Resources Information Center

    Serratrice, Ludovica; Sorace, Antonella; Filiaci, Francesca; Baldo, Michela

    2012-01-01

    This study investigated the role of typological relatedness, language of the community, and age, in predicting similarities and differences between English-Italian, Spanish-Italian bilingual children and their monolingual child and adult counterparts in the acceptability of pre- and postverbal object pronouns in [[plus or minus]focus] contexts in…

  7. Teaching Italian Language, Literature, and Culture through Performance: The Italian Theatrical Workshop.

    ERIC Educational Resources Information Center

    Savoia, Francesca

    2000-01-01

    Describes a theatrical workshop developed to teach Italian to third-year students. The aim of the course was to increase students' understanding of Italian language and culture and to enhance their communicative skills and appreciation of literary texts. (Author/VWL)

  8. The First Italian Radar Experiment

    NASA Astrophysics Data System (ADS)

    Delbo, M.; di Martino, M.; Saba, L.; Montebugnoli, S.; Righini, S.; Poppi, S.; Orlati, A.; Ostro, S.; Cevolani, G.

    Radar is a uniquely powerful source of information about physical properties and orbits of solar system bodies, such as sizes, shapes, albedos, surface textures and bulk features. We discuss a project which aims at using the Sardinia Radio Telescope (SRT) as radar system for physical studies of planetary targets, and in particular of near-Earth Aster- oids (NEAs). Within the feasibility study of this project, we discuss the results of the first italian radar experiment, which has been performed in bistatic mode with the joint collabo- ration Goldstone (California)-Medicina (Bologna). We have successfully observed the NEA 1998 WT24 on December 2001. Besides the physical study of 1998 WT24, the goals of this project were to test the existing technical facilities and capabilities for crucial radar follow-up observations of near- Earth Asteroids and thus to transfer the acquired skills to SRT radar project. The case and future prospects for an SRT based planetary radar project in Europe is reviewed.

  9. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    PubMed Central

    Rizzi, Massimiliano; Mazzuoli, Silvia; Regano, Nunzia; Inguaggiato, Rosa; Bianco, Margherita; Leandro, Gioacchino; Bugianesi, Elisabetta; Noè, Donatella; Orzes, Nicoletta; Pallini, Paolo; Petroni, Maria Letizia; Testino, Gianni; Guglielmi, Francesco William

    2016-01-01

    AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last three-six months. Values of Malnutrition Universal Screening Tool (MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment (MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition (OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment. PMID:27559436

  10. Linguistic and Cognitive Skills in Sardinian-Italian Bilingual Children.

    PubMed

    Garraffa, Maria; Beveridge, Madeleine; Sorace, Antonella

    2015-01-01

    We report the results of a study which tested receptive Italian grammatical competence and general cognitive abilities in bilingual Italian-Sardinian children and age-matched monolingual Italian children attending the first and second year of primary school in the Nuoro province of Sardinia, where Sardinian is still widely spoken. The results show that across age groups the performance of Sardinian-Italian bilingual children is in most cases indistinguishable from that of monolingual Italian children, in terms of both Italian language skills and general cognitive abilities. However, where there are differences, these emerge gradually over time and are mostly in favor of bilingual children.

  11. Asthma control in elderly asthmatics. An Italian observational study.

    PubMed

    Milanese, M; Di Marco, F; Corsico, A G; Rolla, G; Sposato, B; Chieco-Bianchi, F; Costantino, M T; Crivellaro, M A; Guarnieri, G; Scichilone, N

    2014-08-01

    The exponential increase of individuals aged >64 yrs is expected to impact the burden of asthma. We aimed to explore the level of asthma control in elderly subjects, and factors influencing it. A multicenter observational study was performed on consecutive patients >64 years old with a documented physician-diagnosis of asthma. Sixteen Italian centers were involved in this 6-month project. A total of 350 patients were enrolled in the study. More than one-third of elderly asthmatic patients, despite receiving GINA step 3-4 antiasthmatic therapy, had an Asthma Control Test score ≤19, with a quarter experiencing at least one severe asthma exacerbation in the previous year. Twenty-nine percent of patients (n = 101) were classified as having Asthma-COPD Overlap Syndrome (ACOS) due to the presence of chronic bronchitis and/or CO lung diffusion impairment. This subgroup of patients had lower mean Asthma Control Test scores and more exacerbations compared to the asthmatic patients (18 ± 4 compared to 20 ± 4, p < 0.01, and 43% compared to 18%, p < 0.01, respectively). Modified Medical Research Council dyspnea mMRC scores and airway obstruction, assessed on the basis of a FEV(1)/FVC ratio below the lower limit of normal, were more severe in ACOS than in asthma, without any difference in responses to salbutamol. In a multivariate analysis, the mMRC dyspnea score, FEV(1)% of predicted and the coexistence of COPD were the only variables to enter the model. Our results highlight the need to specifically evaluate the coexistence of features of COPD in elderly asthmatics, a factor that worsens asthma control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Multicenter Guidelines | Division of Cancer Prevention

    Cancer.gov

    A Lead Organization conducting multi-institutional studies in the consortium has specific responsibilities in order to comply with the DCP Multicenter Guidelines. The Lead Organization is responsible for the following at all Participating Organizations as well as the Lead Organization: |

  13. Survey of Italian human milk banks.

    PubMed

    De Nisi, Giuseppe; Moro, Guido E; Arslanoglu, Sertac; Ambruzzi, Amalia M; Biasini, Augusto; Profeti, Claudio; Tonetto, Paola; Bertino, Enrico

    2015-05-01

    At present, the Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del Latte Umano Donato, AIBLUD) consists of 31 milk banks, whose management is based on Italian Guidelines. In 2013, AIBLUD performed a systematic survey to collect data on the activities of banks operating in Italy in the years previous to this date. The purpose of this survey was to evaluate the operational procedures of Italian Human Milk Banks in order to identify both areas of strength and room for improvement. A questionnaire was utilized to obtain national data from the 28 banks active in the year 2012 in order to evaluate the number of donors, volume of human milk collected, and other information relating to the period 2007 to 2012. In all, 89% of the banks (25/28) responded to the survey. Data received primarily concerned the number of donors, volume of milk collected, and average amount of milk from each donor in the period 2007 to 2012. It was evident that in 2012 human milk banks collected a higher volume of milk than in 2007. Further, the average amount of milk from each donor was higher. Most of the milk banks were following the Italian Guidelines for traceability, control of donors, bacteriological checks, method of pasteurization, storage, thawing, type of containers, and utilization of the Hazard Analysis and Critical Control Points system. This survey identified both areas of strength and room for improvement in the Italian human milk banks. © The Author(s) 2015.

  14. Questionable research practices among italian research psychologists.

    PubMed

    Agnoli, Franca; Wicherts, Jelte M; Veldkamp, Coosje L S; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants' estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes.

  15. Questionable research practices among italian research psychologists

    PubMed Central

    Wicherts, Jelte M.; Veldkamp, Coosje L. S.; Albiero, Paolo; Cubelli, Roberto

    2017-01-01

    A survey in the United States revealed that an alarmingly large percentage of university psychologists admitted having used questionable research practices that can contaminate the research literature with false positive and biased findings. We conducted a replication of this study among Italian research psychologists to investigate whether these findings generalize to other countries. All the original materials were translated into Italian, and members of the Italian Association of Psychology were invited to participate via an online survey. The percentages of Italian psychologists who admitted to having used ten questionable research practices were similar to the results obtained in the United States although there were small but significant differences in self-admission rates for some QRPs. Nearly all researchers (88%) admitted using at least one of the practices, and researchers generally considered a practice possibly defensible if they admitted using it, but Italian researchers were much less likely than US researchers to consider a practice defensible. Participants’ estimates of the percentage of researchers who have used these practices were greater than the self-admission rates, and participants estimated that researchers would be unlikely to admit it. In written responses, participants argued that some of these practices are not questionable and they have used some practices because reviewers and journals demand it. The similarity of results obtained in the United States, this study, and a related study conducted in Germany suggest that adoption of these practices is an international phenomenon and is likely due to systemic features of the international research and publication processes. PMID:28296929

  16. Minimally invasive thoracic surgery: new trends in Italy

    PubMed Central

    2015-01-01

    In Italy there exists quite a long and rich history in minimally invasive thoracic surgery. Pioneer Italian surgeons have been amongst those who first adopted video-assisted thoracic surgery (VATS) to perform procedures such as lobectomy and esophagectomy, respectively and quite many others have provided important contributions related to minimally invasive thoracic surgery and have proposed innovative ideas and creative technical refinements. According to a web search on recent studies published in Italy on minimally invasive thoracic surgery along the last 3 years, uniportal, nonintubated, and robotic VATS as well as VATS lobectomy have been found to represent the most frequently investigated issues. An ongoing active investigation in each of these sub-topics is contributing to a better definition of indications advantages and disadvantages of the various surgical strategies. In addition it is likely that combination strategies including adoption of uniportal and nonintubated approaches will lead to define novel ultra-minimally invasive treatment options. PMID:26605315

  17. Recognition and management of delirium among doctors, nurses, physiotherapists, and psychologists: an Italian survey.

    PubMed

    Bellelli, G; Morandi, A; Zanetti, E; Bozzini, M; Lucchi, E; Terrasi, M; Trabucchi, M

    2014-12-01

    There are no studies that have identified the ability to recognize and manage delirium among Italian health providers caring for patients at risk. Therefore, the Italian Association of Psychogeriatrics (AIP) conducted a multicenter survey among doctors, nurses, psychologists and physiotherapists to assess their competence regarding the theme of delirium and its management in the everyday clinical practice. The survey period was 1st June 2013 to 30th November 2013. The invitation to participate was sent via email, with publication on the AIP website. The survey included 14 questions and two case vignettes. A total of 648/1,500 responses were collected. Most responders were doctors (n = 322/800), followed by nurses (n = 225/500), psychologists (n = 51/100), and physiotherapists (n = 30/100). Generally, doctors and psychologists correctly defined delirium, while nurses and physiotherapists did not. The most frequently used diagnostic tools were the Confusion Assessment Method (CAM) and the Diagnostic and Statistical Manual of Mental Disorders-IV. Delirium intensity was rarely assessed. Hypoactive delirium was generally managed with non-pharmacological approaches, while hyperactive delirium with a combination of non-pharmacological and pharmacological approaches. However, possible causes of delirium were under-assessed by half of doctors and by the majority of other professionals. Nurses, psychologists and physiotherapists did not answer the case vignettes, while doctors identified the correct answer in most cases. This is the first Italian survey among health providers caring for patients at risk of delirium. This is also the first survey including doctors, nurses, psychologists and physiotherapists. The results emphasize the importance of training to improve knowledge of this relevant unmet medical need.

  18. Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

    PubMed

    Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

    2017-06-01

    Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

  19. Variation in Institutional Review Board (IRB) Responses to a Standard Protocol for a Multicenter Randomized Controlled Surgical Trial

    PubMed Central

    Helfand, Brian T.; Mongiu, Anne K.; Roehrborn, Claus G.; Donnell, Robert F.; Bruskewitz, Reginald; Kaplan, Steven A.; Kusek, John W.; Coombs, Laura; McVary, Kevin T.

    2016-01-01

    Purpose The primary responsibility of Institutional Review Boards (IRBs) is to protect human research subjects and therefore ensure that studies are conducted in accordance with a standard set of ethical principles. A number of studies have compared the responses from IRBs in multicenter clinical trials involving medical therapies. To date, none have been conducted in trials investigating surgical interventions. The intent of this study was to investigate the consistency of the recommendations issued from one institutional IRB to another in the Minimally Invasive Surgical Therapies (MIST) for benign prostatic hyperplasia (BPH), a multicenter trial with a uniform consent and study protocol. Materials and Methods We obtained the IRB responses from six of the seven participating institutions after the initial submission of the MIST study protocol and classified the responses. We then re-distributed the approved protocols to an IRB at another participating institution and analyzed their review of these protocols. Results We found that both the number and types of responses required for IRB approval of an identical study protocol varied significantly among the participating institutions. We also found that IRB responses were inconsistent in the second review, although all protocols were ultimately approved. Conclusion We conclude that the current system of local IRB review in the context of a multicenter surgical trial is inefficient in the review process and may not provide expertise in overseeing surgical trials. Based on these results, a central surgical IRB may be needed to improve of the ethical review process in multicenter trials. PMID:19375101

  20. Esophagectomy - minimally invasive

    MedlinePlus

    Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the ...

  1. Syllables in the processing of spoken Italian.

    PubMed

    Tabossi, P; Collina, S; Mazzetti, M; Zoppello, M

    2000-04-01

    Five experiments explored the role of the syllable in the processing of spoken Italian. According to the syllabic hypothesis, the sublexical unit used by speakers of Romance languages to segment speech and access the lexicon is the syllable. However, languages with different degrees of acoustic-phonetic transparency give rise to syllabic effects that vary in robustness. It follows from this account that speakers of phonologically similar languages should behave in a similar way. By exploiting the similarities between Spanish and Italian, the authors tested this prediction in Experiments 1-4. Indeed, Italian listeners were found to produce syllabic effects similar to those observed in Spanish listeners. In Experiment 5, the predictions of the syllabic hypothesis with respect to lexical access were tested. The results corroborated these predictions. The findings are discussed in relation to current models of speech processing.

  2. Burden of Invasive Staphylococcus aureus Infections in Hospitalized Infants

    PubMed Central

    Ericson, Jessica E.; Popoola, Victor O.; Smith, P. Brian; Benjamin, Daniel K.; Fowler, Vance G.; Benjamin, Daniel K.; Clark, Reese H.; Milstone, Aaron M.

    2015-01-01

    Importance Staphylococcus aureus is a frequent cause of infection in hospitalized infants. These infections are associated with increased mortality and morbidity, and longer hospital stays, but data on the burden of S. aureus disease in hospitalized infants are limited. Objective To compare demographics and mortality of infants with invasive methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA), determine the annual proportion of S. aureus infections that were MRSA, and compare the risk of death following an invasive MRSA infection to the risk following an invasive MSSA infection. Design Multicenter retrospective study of a large, nationally representative cohort. Setting 348 neonatal intensive care units managed by the Pediatrix Medical Group. Participants 3888 infants with an invasive S. aureus infection who were discharged between 1997 and 2012. Exposure Invasive S. aureus infection. Main Outcomes and Measures Incidence of invasive S. aureus infections. Infant characteristics and mortality following MRSA or MSSA infection. Results The 3888 infants had 3978 invasive S. aureus infections (2868 MSSA, 1110 MRSA). The incidence of invasive S. aureus infection was 44.8 infections/10,000 infants. The yearly proportion of invasive infections caused by MRSA increased from 1997 to 2006 and has remained relatively stable since then. Infants with invasive MRSA or MSSA infections had similar gestational ages and birth weights. Invasive MRSA infections occurred more often at a younger postnatal age. For infants with available mortality data, more infants with invasive MSSA infections died at hospital discharge (N=237) than those with invasive MRSA infections (N=110). The proportion of infants who died following invasive MSSA or MRSA infection were similar: 237/2474 (9.6%) and 110/926 (11.9%), P=.05, respectively. Adjusted risk of death at hospital discharge was similar after invasive MSSA and MRSA infections overall (risk ratio, 1.19; 95% CI, 0

  3. 75 FR 64611 - Italian American Heritage and Culture Month, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... Proclamation 8585--Italian American Heritage and Culture Month, 2010 #0; #0; #0; Presidential Documents #0; #0...; #0; #0;Title 3-- #0;The President ] Proclamation 8585 of October 14, 2010 Italian American Heritage..., generations of Italian Americans have helped shape our society and steer the course of our history. During...

  4. Italian in the Linguistic Landscape of Kuala Lumpur (Malaysia)

    ERIC Educational Resources Information Center

    Coluzzi, Paolo

    2017-01-01

    This article looks at the presence of Italian in the linguistic landscape (LL) of Kuala Lumpur, Malaysia. Rather surprisingly, Italian is quite visible, and it might even be the most used European language after English. After a general introduction on the Italian language and Malaysia, including the latter's LL, the article goes on to outline the…

  5. A Program of Italian Studies (Suggestions for the College Student).

    ERIC Educational Resources Information Center

    Ragusa, Olga

    1961-01-01

    This program of Italian studies considers five areas of major importance. The college student is advised on: (1) the study of Italian in the United States, (2) preparation for the study of Italian, (3) studying the language, (4) the study of literature, and (5) related studies and study abroad. The section on language study emphasizes a review of…

  6. Perspective: The Liberal Arts Tradition in Business Italian at Harvard.

    ERIC Educational Resources Information Center

    DiFabio, Elvira G.

    1993-01-01

    A college-level course in business Italian was designed to incorporate not only language and business communication skills but also perspective on Italian culture. The curriculum includes study of research, literature, economic trends, and popular culture that reflect the broad and varied role of Italian culture in the modern world. (MSE)

  7. The current state of facial prosthetics – A multicenter analysis.

    PubMed

    Thiele, Oliver C; Brom, Jörn; Dunsche, Anton; Ehrenfeld, Michael; Federspil, Philippe; Frerich, Bernhard; Hölzle, Frank; Klein, Martin; Kreppel, Matthias; Kübler, Alexander C; Kübler, Norbert R; Kunkel, Martin; Kuttenberger, Johannes; Lauer, Günter; Mayer, Boris; Mohr, Christopher; Neff, Andreas; Rasse, Michael; Reich, Rudolf H; Reinert, Siegmar; Rothamel, Daniel; Sader, Robert; Schliephake, Henning; Schmelzeisen, Rainer; Schramm, Alexander; Sieg, Peter; Terheyden, Hendrik; Wiltfang, Jörg; Ziegler, Christoph M; Mischkowski, Robert A; Zöller, Joachim E

    2015-09-01

    Even though modern surgical techniques are dominating reconstructive facial procedures, the capability to use facial epitheses for reconstruction is still an important skill for the maxillofacial surgeon. We present an international multicenter analysis to clarify which techniques are used to fixate facial prostheses. We contacted all maxillofacial departments in Germany, Austria, Switzerland and Norway which were registered with the German society for oral and maxillofacial surgery (DGMKG). These centers were asked via electronical mail to provide information on the type of epithesis fixation systems currently in use. The return rate from 58 departments was 43.1% (n = 25). Overall, implant fixation was the preferred fixation system (92%). Plates were the second most common fixation technique (32%). No centers reported the standard use of non-invasive fixation techniques for permanent epithesis fixation. The main retention systems in use were magnets (24/25), other retention systems are used much less often. The current preferred fixation technique for facial epitheses consists of implant-based, magnet-fixated epitheses. For nasal prostheses, a plate-based, magnet-fixated system is often used.

  8. Face Orientations in Reacting to Accusatory Complaints: Italian L1, English L1, and Italian as a Community Language.

    ERIC Educational Resources Information Center

    Frescura, Marina

    A study investigated the linguistic behavior of three groups of speakers in reacting to accusatory complaints: (1) native speakers of Italian residing in Italy (SI); (2) native speakers of Canadian English residing in Toronto (CE); and (3) speakers of Italian residing in Toronto, first-generation immigrants, defined as speakers of Italian as a…

  9. Hypermedia in the Teaching of Italian.

    ERIC Educational Resources Information Center

    Sanne, Signe Marie

    1993-01-01

    Results of a two-year project (L'Italiano interattivo) conducted in collaboration with the Norwegian Computing Centre for the Humanities to produce learner-directed Italian courseware are reported. The SuperCard-developed program allows students to work with video, exercises, grammar, dictionary, or transcripts. (Author/LB)

  10. Self-Employment among Italian Female Graduates

    ERIC Educational Resources Information Center

    Rosti, Luisa; Chelli, Francesco

    2009-01-01

    Purpose: The purpose of this paper is to investigate the gender impact of tertiary education on the probability of entering and remaining in self-employment. Design/methodology/approach: A data set on labour market flows produced by the Italian National Statistical Office is exploited by interviewing about 62,000 graduate and non-graduate…

  11. Stereotype and Identity: The Italian Case.

    ERIC Educational Resources Information Center

    La Sorte, Michael A.

    When analyzing the question of ehtnic identity, it is crucial to pay attention to oral history and biographical material: ethnicity is not so much a collective phenomenon as an individual one. For example, much has been written about Italian migration to the United States, but the lives of the ordinary immigrants and the rich detail of their…

  12. Italian Students' Views of Christopher Columbus.

    ERIC Educational Resources Information Center

    Aucoin, Linda; Cangemi, JoAnn

    1992-01-01

    Describes a project where students in an Italian elementary school wrote letters about Columbus and his contributions. Finds that these students have not lost their view of Columbus as a great hero. Includes a list of organizations and resources for teaching about Italy and Columbus. (CFR)

  13. Letting Off that Loose Italian Canon Again?

    ERIC Educational Resources Information Center

    Bressan, Dino

    2001-01-01

    Discusses the decline in the use of literature in foreign language instruction at the secondary level, despite the role literature plays in college level instruction. Describes a project in an Italian studies program that introduced units based on a number of canonical texts. (Author/VWL)

  14. INTAMEL Working Party, Italy, 1972. Italian Studies

    ERIC Educational Resources Information Center

    Pagetti, R.; And Others

    1973-01-01

    The papers included in this group are: (1) The Organization of Public Libraries in Milan,'' (2) The Organization of Italian Libraries,'' and (3) Initial Assumptions for an Approach to Library Development in Lombardy.'' INTAMEL: International Association of Metropolitan City Libraries. (KE)

  15. The Italian American Parent Training Institutes.

    ERIC Educational Resources Information Center

    Lombardo, Maria

    To help parents of Italian descent take an active part in their children's education, a 2-year program was implemented in New York City and Boston. The project attempted to examine the impact of training upon (1) parents' active participation in the schools and the bilingual programs; (2) parents' home activities with their children; and (3) the…

  16. Typical and Delayed Lexical Development in Italian

    ERIC Educational Resources Information Center

    Rescorla, Leslie; Frigerio, Alessandra; Sali, Maria Enrica; Spataro, Pietro; Longobardi, Emiddia

    2014-01-01

    Purpose: The Language Development Survey (LDS; Rescorla, 1989) was used to compare Italian and English lexical development. The authors addressed the issue of universal versus language-specific aspects of lexical development by testing language, age, and gender effects on vocabulary scores and by comparing vocabulary composition across languages.…

  17. Lexical Stress Assignment in Italian Developmental Dyslexia

    ERIC Educational Resources Information Center

    Paizi, Despina; Zoccolotti, Pierluigi; Burani, Cristina

    2011-01-01

    Stress assignment to Italian polysyllabic words is unpredictable, because stress is neither marked nor predicted by rule. Stress assignment, especially to low frequency words, has been reported to be a function of stress dominance and stress neighbourhood. Two experiments investigate stress assignment in sixth-grade, skilled and dyslexic, readers.…

  18. The Italian Restaurant Project: Lessons of Restructuring.

    ERIC Educational Resources Information Center

    McBride, Mary Ellen

    1995-01-01

    Project learning, with community and school staff assistance, helped a fifth-grade class transform the school lunchroom and their own behavior. A $2,500 Alcoa grant spearheaded an Italian restaurant project. Children served on five committees: public relations and advertising, management, art and design, planning and budgeting, and research. The…

  19. Written language abilities in deaf Italians.

    PubMed

    Fabbretti, D; Volterra, V; Pontecorvo, C

    1998-01-01

    Written texts produced by 10 Italian deaf native signers in four different writing tasks were analyzed. Data analysis focused on linguistic and orthographic nonstandard forms. The written production of deaf subjects with deaf parents (DD) was compared to the written production in two control groups: a group of 10 hearing subjects with deaf parents (HD) and a group of 10 subjects who have had no contact with deaf people or sign language (HH). The results duplicate findings from previous studies. Deaf subjects display a pattern of selective difficulty with Italian grammatical morphology, especially with free-standing function words. The four different writing tasks used in the present study yield results indicating that text type does influence our assessment of deaf writing abilities. A comparison of the texts written by deaf native signers with those of two hearing groups confirms the view that difficulties in the acquisition of written Italian are best explained by deafness itself, not by the influence of a previously acquired Sign Language, and that the specific difficulties with grammatical morphology displayed by our deaf subjects cannot be attributed solely to their limited experience with written Italian.

  20. Perspectives in Italian Immigration and Ethnicity.

    ERIC Educational Resources Information Center

    Tomasi, S. M., Ed.

    The essays prepared for this symposium range from the scholarly and highly structured to the impressionistic and subjective. Together, they comprise a substantive exploration of Italian American life and serve as a model for research into American ethnicity. In the papers three different areas are addressed: (1) current research and issues in the…

  1. Hypermedia in the Teaching of Italian.

    ERIC Educational Resources Information Center

    Sanne, Signe Marie

    1993-01-01

    Results of a two-year project (L'Italiano interattivo) conducted in collaboration with the Norwegian Computing Centre for the Humanities to produce learner-directed Italian courseware are reported. The SuperCard-developed program allows students to work with video, exercises, grammar, dictionary, or transcripts. (Author/LB)

  2. Informatics Education in Italian Secondary Schools

    ERIC Educational Resources Information Center

    Bellettini, Carlo; Lonati, Violetta; Malchiodi, Dario; Monga, Mattia; Morpurgo, Anna; Torelli, Mauro; Zecca, Luisa

    2014-01-01

    This article describes the state of informatics education in the Italian secondary schools, highlighting how the learning objectives set up by the Ministry of Education are difficult to meet, due to the fact that the subject is often taught by teachers not holding an informatics degree, the lack of suitable teaching material and the expectations…

  3. Priming Lexical Stress in Reading Italian Aloud

    ERIC Educational Resources Information Center

    Sulpizio, Simone; Job, Remo; Burani, Cristina

    2012-01-01

    Two experiments using a lexical priming paradigm investigated how stress information is processed in reading Italian words. In both experiments, prime and target words either shared the stress pattern or they had different stress patterns. We expected that lexical activation of the prime would favour the assignment of congruent stress to the…

  4. Stress Assignment in Reading Italian Polysyllabic Pseudowords

    ERIC Educational Resources Information Center

    Sulpizio, Simone; Arduino, Lisa S.; Paizi, Despina; Burani, Cristina

    2013-01-01

    In 4 naming experiments we investigated how Italian readers assign stress to pseudowords. We assessed whether participants assign stress following distributional information such as stress neighborhood (the proportion and number of existent words sharing orthographic ending and stress pattern) and whether such distributional information affects…

  5. An Italian Perspective on Learning Disabilities.

    ERIC Educational Resources Information Center

    Fabbro, Franco; Masutto, Cristina

    1994-01-01

    This article considers sociocultural and linguistic aspects of children with learning disabilities in one region of Italy, noting the role of bilingualism and "standard" Italian language learning problems. The article examines legislative aspects; the roles of the school, hospitals, public services, and private institutes; and parental…

  6. Stress Assignment in Reading Italian Polysyllabic Pseudowords

    ERIC Educational Resources Information Center

    Sulpizio, Simone; Arduino, Lisa S.; Paizi, Despina; Burani, Cristina

    2013-01-01

    In 4 naming experiments we investigated how Italian readers assign stress to pseudowords. We assessed whether participants assign stress following distributional information such as stress neighborhood (the proportion and number of existent words sharing orthographic ending and stress pattern) and whether such distributional information affects…

  7. Lexical Stress Assignment in Italian Developmental Dyslexia

    ERIC Educational Resources Information Center

    Paizi, Despina; Zoccolotti, Pierluigi; Burani, Cristina

    2011-01-01

    Stress assignment to Italian polysyllabic words is unpredictable, because stress is neither marked nor predicted by rule. Stress assignment, especially to low frequency words, has been reported to be a function of stress dominance and stress neighbourhood. Two experiments investigate stress assignment in sixth-grade, skilled and dyslexic, readers.…

  8. Barriers to reforming healthcare: the Italian case.

    PubMed

    Adinolfi, Paola

    2014-03-01

    Using the conceptual lenses offered by the ideational and cultural path taken in the health care arena, this article attempts to explain the trajectory of recent major health care reforms in Italy and the reasons for their failure, as well as providing some directions for successful intervention. A diachronic analysis of the relatively under-investigated phenomenon of health care reforms in Italy is carried out, drawing on a systematic review of the Italian and international literature combined with the research work carried out by the Author. For all the three major health reforms examined, a significant gap between the authoritative policy choices taken and the overall implementation, in terms of process and system changes, can be observed, determining a growing distance between the theoretical efficiency and the practical effectiveness of the Italian National Health Service (NHS) as well as its detachment from the social system. The main obstacle to effective reform seems to be the cultural hegemony of the administrative-managerial and the biomedical paradigms, which, by reinforcing one another, yielded infertile ground for renewing in a post-modern sense the Italian NHS. The various Reforms have not been conceived to break such a positivistic monopoly in that they did not promote cultural or educational intervention. In this context, intervention that acts at a cultural level, such as reforming university education for physicians and managers or devising immigration policies to attract adequately acculturated people to the Italian NHS, seems to be the most promising.

  9. [The demographic profile of Italian nephrologists].

    PubMed

    De Pietro, Carlo

    2010-01-01

    For many years Italy has had more active physicians than most Western countries. However, the numerus clausus introduced in 1986 for entry into medical schools together with a sharp decrease in places available in specialty training have changed the situation dramatically and today several specialties suffer actual shortages. In such a situation, professional demography is crucial to outline possible developments for the medical profession and nephrology in particular. Our analysis of the medical profession as a whole was based on data from OECD (international comparative analysis) and the yearly estimate of the General Accounts Office (Italian NHS employees). For calculation of the nephrologists we used the administrative data of the members of the Italian Nephrology Society (SIN) and a survey run among nephrology units in the Lombardy region. Data for the university system (medical and specialty schools) were provided by the University Ministry. We found that Italy is no longer an outlier in terms of physician density compared with other Western countries. This ''normalization'' conceals the high concentration of doctors in the older cohorts and the insufficient number of new doctors to replace those leaving the profession for retirement or other reasons. These patterns are similar - and often more severe - in the case of Italian nephrologists. The aging and increasingly female population of Italian nephrologists calls for a major task shift of many activities to nurses and other healthcare professionals.

  10. Stereotype and Identity: The Italian Case.

    ERIC Educational Resources Information Center

    La Sorte, Michael A.

    When analyzing the question of ehtnic identity, it is crucial to pay attention to oral history and biographical material: ethnicity is not so much a collective phenomenon as an individual one. For example, much has been written about Italian migration to the United States, but the lives of the ordinary immigrants and the rich detail of their…

  11. Opera: A Natural Component of Italian Courses.

    ERIC Educational Resources Information Center

    Mason, Keith

    1998-01-01

    Presents ideas for a special unit about opera that can be used in high school or college Italian courses. Offers a rationale for using opera, discusses opera in terms of multiple intelligences, explains the integration of an opera unit into regular curriculum, and describes how to develop an opera unit and what concepts to teach. (SM)

  12. Italian High-speed Airplane Engines

    NASA Technical Reports Server (NTRS)

    Bona, C F

    1940-01-01

    This paper presents an account of Italian high-speed engine designs. The tests were performed on the Fiat AS6 engine, and all components of that engine are discussed from cylinders to superchargers as well as the test set-up. The results of the bench tests are given along with the performance of the engines in various races.

  13. Informatics Education in Italian Secondary Schools

    ERIC Educational Resources Information Center

    Bellettini, Carlo; Lonati, Violetta; Malchiodi, Dario; Monga, Mattia; Morpurgo, Anna; Torelli, Mauro; Zecca, Luisa

    2014-01-01

    This article describes the state of informatics education in the Italian secondary schools, highlighting how the learning objectives set up by the Ministry of Education are difficult to meet, due to the fact that the subject is often taught by teachers not holding an informatics degree, the lack of suitable teaching material and the expectations…

  14. Uneven Equity and Italian Interculturalism(s)

    ERIC Educational Resources Information Center

    Mincu, Monica E.; Allasia, Maurizio; Pia, Francesca

    2011-01-01

    This article proposes a brief investigation of Italian interculturalism(s) as documented by scholarship, relevant policy documents and teaching textbooks, and presents some key practical issues relating to the integration of students of immigrant origin. The authors then analyse the 2008 "White Paper on Intercultural Dialogue"'s core…

  15. Priming Lexical Stress in Reading Italian Aloud

    ERIC Educational Resources Information Center

    Sulpizio, Simone; Job, Remo; Burani, Cristina

    2012-01-01

    Two experiments using a lexical priming paradigm investigated how stress information is processed in reading Italian words. In both experiments, prime and target words either shared the stress pattern or they had different stress patterns. We expected that lexical activation of the prime would favour the assignment of congruent stress to the…

  16. Linguistic and Cognitive Skills in Sardinian–Italian Bilingual Children

    PubMed Central

    Garraffa, Maria; Beveridge, Madeleine; Sorace, Antonella

    2015-01-01

    We report the results of a study which tested receptive Italian grammatical competence and general cognitive abilities in bilingual Italian–Sardinian children and age-matched monolingual Italian children attending the first and second year of primary school in the Nuoro province of Sardinia, where Sardinian is still widely spoken. The results show that across age groups the performance of Sardinian–Italian bilingual children is in most cases indistinguishable from that of monolingual Italian children, in terms of both Italian language skills and general cognitive abilities. However, where there are differences, these emerge gradually over time and are mostly in favor of bilingual children. PMID:26733903

  17. Elliptic genera from multi-centers

    NASA Astrophysics Data System (ADS)

    Gaddam, Nava

    2016-05-01

    I show how elliptic genera for various Calabi-Yau threefolds may be understood from supergravity localization using the quantization of the phase space of certain multi-center configurations. I present a simple procedure that allows for the enumeration of all multi-center configurations contributing to the polar sector of the elliptic genera — explicitly verifying this in the cases of the quintic in {P} 4, the sextic in {W}{P} (2,1,1,1,1), the octic in {W}{P} (4,1,1,1,1) and the dectic in {W}{P} (5,2,1,1,1). With an input of the corresponding `single-center' indices (Donaldson-Thomas invariants), the polar terms have been known to determine the elliptic genera completely. I argue that this multi-center approach to the low-lying spectrum of the elliptic genera is a stepping stone towards an understanding of the exact microscopic states that contribute to supersymmetric single center black hole entropy in {N} = 2 supergravity.

  18. Neuropsychological assessment of the severely impaired elderly patient: validation of the Italian short version of the Severe Impairment Battery (SIB). Gruppo di Studio sull'Invecchiamento Cerebrale della Società Italiana di Gerontologia e Geriatria.

    PubMed

    Pippi, M; Mecocci, P; Saxton, J; Bartorelli, L; Pettenati, C; Bonaiuto, S; Cucinotta, D; Masaraki, G; Neri, M; Tammaro, A E; Vergani, C; Chionne, F; Senin, U

    1999-08-01

    One hundred and sixty-nine severely demented patients were tested in a multicenter study with the short version of the Severe Impairment Battery which was translated into Italian with the purpose of adapting and validating it for an Italian population. Patients were enrolled in Italian geriatric centers participating in the Study Group on Aging Brain of the Italian Society of Gerontology and Geriatrics. Following thorough clinical and instrumental examinations, they were evaluated with the Mini Mental State Examination, the Clinical Dementia Rating, the Severe Impairment Battery (SIB), the Gottfries-Bråne-Steen Rating Scale for Dementia, the Activity of Daily Living index, and the Bedford Alzheimer Nursing Severity scale (BANS.s). The inter-rater reliability of the SIB was highly significant for the total score and its subtests; test-retest reliability showed the same significance in all items. Also concurrent validity, performed comparing the total SIB score with the total BANS.s score, was significant. The short Italian version of the SIB proved to be a very reliable tool for the evaluation of severely demented patients; it has the advantage of being easy to administer, it evaluates more cognitive domains that, are typically assessed in dementia, and has a wide enough range of scores to detect even small differences in the examined abilities.

  19. Cryptic invasions: A review.

    PubMed

    Morais, Pedro; Reichard, Martin

    2017-06-22

    Cryptic invasions are defined as the introduction and spread of non-native lineages within the species' native range (intra-specific cryptic invasion) or the invasion of non-native species that goes unnoticed due to misidentification as a native or another invasive species (inter-specific cryptic invasion). While population-specific attributes are acknowledged to play a critical role in the success and impact of biological invasions in general, our knowledge of the causes and consequences of cryptic invasions is largely neglected. Cryptic invasions are inherently difficult to recognize and, despite being likely widespread, often go undetected. In this review, we analyse the sources, mechanisms, and consequences of cryptic invasions. Using a bibliometric survey, we first quantify the relative proportion of study questions, taxa, and geographic regions. We then highlight the value of comparative information from archived specimens in uncovering the occurrence and timing of cryptic invasions. We examine the mechanisms of cryptic invasions and emphasise the role of anthropogenic environmental changes on the arrival of cryptic invaders. We then discuss the role of interspecific biological interactions in the success of cryptic invasions and the role of hybridization between native and non-native lineages in cryptic invasions. We examine the competitive advantage of some invasive lineages in key physiological, ecological or sexually-selected traits. We argue that cryptic invasions, often undetected, may trigger subsequent rapid range expansions. We suggest that cryptic invasions are much more common than currently acknowledged. We highlight the role of coevolved associations (host-parasite, mutualism, herbivory), inherently population-specific, in the impacts of cryptic invasions on local communities. Finally, we outline a framework to manage intraspecific cryptic invasions. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Psychometric properties of the Italian version of the Developmental Coordination Disorder Questionnaire (DCDQ-Italian).

    PubMed

    Caravale, Barbara; Baldi, Silvia; Capone, Luca; Presaghi, Fabio; Balottin, Umberto; Zoppello, Marina

    2014-11-14

    A valid tool that contributes to the diagnosis of Developmental Coordination Disorder (DCD) is represented by the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). Recently we developed the Italian version of DCDQ (DCDQ-Italian). The aim of this study was to further analyze the psychometric properties in a sample of Italian school children aged 5-12 years and to establish cut-off scores with respect to age groups. A total of 698 parents completed the DCDQ-Italian and 45 of them repeated it after 2 weeks for test-retest reliability. One hundred and seventeen children were tested using the Movement Assessment Battery for Children. Confirmatory factor analysis supported this version to be consistent with the original. Cronbach's alpha for the total score was 0.89 and test-retest reliability was 0.88. Two-ways ANOVA for total and single subscales showed a significant main effect for age group only and not for gender. Sensitivity and specificity for our community based sample were 59% and 65% respectively, considering the cut-off scores for the 15th percentile of M-ABC and increasing when age groups were taken into account (ROC curve=0.62). The agreement with the original was good if 15th is considered. This is the first study on the psychometric property of DCDQ in a community sample of Italian children. The DCDQ-Italian could be used as a screening tool for motor coordination difficulties in Italian children. Slight differences in cut-offs should be considered when using this version. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Multidisciplinary approach to congenital Toxoplasma infection: an Italian nationwide survey.

    PubMed

    Tomasoni, Lina R; Meroni, Valeria; Bonfanti, Carlo; Bollani, Lina; Lanzarini, Paolo; Frusca, Tiziana; Castelli, Francesco

    2014-07-01

    Italy provides a free voluntary serological screening for toxoplasmosis in pregnancy supported by public health system, as there is an estimated congenital toxoplasmosis rate of 1-2/10,000. The aim of this study was to make an inventory of diagnostic and therapeutic protocols in use in Italy in the absence of a national guideline. A semistructured questionnaire was distributed to AMCLI (Italian Association of Clinical Microbiologists) members who were asked to involve other specialists to fill in the form. Data from 26 centers show: a) a general use of the IgG avidity test to solve diagnosis in IgG/IgM positive, pregnant women; b) a widespread attitude to spyramicin antenatal treatment in suspected, unconfirmed maternal infection; c) avoidance of invasive antenatal diagnosis only in suspected early or late (>24 weeks), even confirmed, maternal infection d) fetal diagnosis performed by PCR assays on amniotic fluid; e) variability of both indications and dosage of pyrimethamine-sulfadiazine (P-S) as fetal treatment; f) use of comparative mother and newborn IgG/IgM Immuneblot in most centers; g) no diagnostic tests performed on placenta and cord blood; h) spyramicin is no longer used in congenital infections; i) no P-S-based treatment for children at high risk of congenital infection (late maternal infection) in the absence of diagnosis. As there is the opportunity to test pregnant women for Toxoplasma gondii infection in Italy free of charge, standardized diagnostic and therapeutic national guidelines would focus on a more uniform approach.

  2. The History of Italian Volcanoes Revised by Archeomagnetism

    NASA Astrophysics Data System (ADS)

    Tanguy, Jean-Claude; LeGoff, Maxime; Arrighi, Simone; Principe, Claudia; LaDelfa, Santo; Patanè, Giuseppe

    2009-10-01

    The volcanoes Etna and Vesuvius are famous for their historical record, which goes back to Greek and Roman times. The name “Etna” first appears in one of Pindar's Pythian odes (475 B.C.E), and the Vesuvius outburst in 79 C.E. was reported in detail by Pliny the Younger. Other written accounts mention Stromboli and Vulcano (located on the Aeolian Islands), so it might seem that the eruptive history of these Italian volcanoes for the past few millennia is well known. This is not the case, however, because of many limitations in the historical data. There are enormous gaps due to social events such as wars, barbarian invasions, and the Dark Ages. In particular, the historical record has no valuable account at Etna from 252 to 1062 C.E. Furthermore, the preserved documents are too imprecise to identify the lavas and eruptive systems. Most of the ages prior to 1700 C.E. displayed in the present research catalogs were attributed by pioneering geologists in the 1800s on the mere basis of the morphology of flows. These estimates remained unchanged for nearly a century—for example, the Atlas de L'Etna by Sartorius von Waltershausen [1845] was used unaltered for age attribution of “historical lavas” in much more recent geological maps [e.g., Consiglio Nazionale delle Ricerche (CNR), 1979].

  3. A Bayesian Approach to Multicenter Trials and Metaanalysis.

    ERIC Educational Resources Information Center

    Berry, Donald A.

    The use of a Bayesian approach in evaluating data from clinical trials with many treatment centers and from many studies is discussed. The main distinction between a metaanalysis and an analysis of a multicenter trial is that different studies may have very different designs, while the centers in a multicenter trial usually follow the same…

  4. [MIPS: multicenter Italian pneumonia study. Results of an observational, prospective and multicenter study on the clinical approach to community-acquired pneumonia].

    PubMed

    Artom, A; Artom, P; Rattenni, S; Castello, C; Lo Pinto, G

    2004-09-01

    In a survey of 25 Divisions of Internal Medicine and Pneumology throughout Italy, our study aimed to ascertain the diagnostic and therapeutic pathway, the gravity in accordance with Fine's score (PSI), the median hospital length of stay and mortality rate among patients consecutively hospitalized for community-acquired pneumonia (CAP), from January 1 to March 31, 2002. Overall 407 patients were evaluated, with a mean age of 69 years; the following Fine's scores: 28% less than 70, 21.4% between 71 and 90, 31.25% between 91 and 130, 19.4% more than130. A single chest radiography was performed in 27.2% of the patients, two chest radiographs in 55.2% of the patients, more than two chest radiographs in 13.2% of the patients. A CT scan of the thorax was performed in 20.1% of the patients; arterial blood gas tensions were measured in 73.4% of the patients. Antibiotics were used as follows: beta-lactams in 46.5% of the patients, fluoroquinolones in 30% of the patients, macrolides in 13.2% of the patients, glycopeptides in 2.2% of the patients, others in 2.9% of the patients. Mean hospital stay was 11 days; the 30-day in-hospital mortality was 9.6%. This study showed that a large number of patients with low-risk CAP were unnecessarily hospitalized.

  5. Italian-validated questionnaires for pelvic floor disorders: on behalf of the Italian Society of Urodynamics.

    PubMed

    Braga, Andrea; Soligo, Marco; Serati, Maurizio; Palleschi, Giovanni; Li Marzi, Vincenzo; Finazzi Agrò, Enrico

    2016-09-26

    Pelvic floor disorders (PFDs), which include urinary incontinence, pelvic organ prolapse, sexual dysfunction and gastrointestinal disorders, affect over 20% of adult population. The prevalence and demand for care of PFDs appear to be increasing more quickly than would be expected from simple population growth, creating substantial physical and emotional distress and a large financial burden. Suitable diagnostic tools are necessary to investigate these problems. The aim of this article is to list Symptom and Quality of Life questionnaires [briefly identified as patient-reported outcomes (PROs)] formally validated into the Italian language to provide Italian clinicians and researchers a tool for the assessment of pelvic area dysfunctions in our country. A synthetic key points summary concerning concepts behind Symptom and Quality of Life Questionnaires will be also provided. PubMed/MEDLINE databases and websites were used to identify Italian-validated questionnaires for PFDs. Once identified, the possibility to get a copy of the questionnaire was verified and steps to obtain it are reported in the table. Questionnaires validated into the Italian language, for diagnosis and overall management of common urinary, vaginal, sexual and bowel conditions, are listed in the table. This format is intended to serve as a tool to promote appropriateness in PROs adoption while investigating PFDs in Italian patients.

  6. The Italian Dementia National Plan. Commentary.

    PubMed

    Di Fiandra, Teresa; Canevelli, Marco; Di Pucchio, Alessandra; Vanacore, Nicola

    2015-01-01

    The Italian Dementia National Plan was formulated in October 2014 by the Italian Ministry of Health in close cooperation with the regions, the National Institute of Health and the three major national associations of patients and carers. The main purpose of this strategy was to provide directive indications for promoting and improving interventions in the dementia field, not limiting to specialist and therapeutic actions, but particularly focusing on the support of patients and families throughout the pathways of care. Four main objectives are indicated: 1) promote health- and social-care interventions and policies; 2) create/strengthen the integrated network of services for dementia based on an integrated approach; 3) implement strategies for promoting appropriateness and quality of care; and 4) improve the quality of life of persons with dementia and their families by supporting empowerment and stigma reduction. These objectives and the pertaining actions are described in the present paper.

  7. Great landslide events in Italian artificial reservoirs

    NASA Astrophysics Data System (ADS)

    Panizzo, A.; de Girolamo, P.; di Risio, M.; Maistri, A.; Petaccia, A.

    2005-09-01

    The empirical formulations to forecast landslide generated water waves, recently defined in the framework of a research program funded by the Italian National Dam Office RID (Registro Italiano Dighe), are here used to study three real cases of subaerial landslides which fell down italian artificial reservoirs. It is well known that impulse water waves generated by landslides constitute a very dangerous menace for human communities living in the shoreline of the artificial basin or downstream the dam. In 1963, the menace became tragedy, when a 270 millions m3 landslide fell down the Vajont reservoir (Italy), generated an impulse wave which destroyed the city of Longarone, and killed 2000 people. The paper is aimed at presenting the very satisfactorily reproduction of the events at hand by using forecasting formulations.

  8. Internet addiction disorder: an Italian study.

    PubMed

    Ferraro, Giovanni; Caci, Barbara; D'Amico, Antonella; Di Blasi, Marie

    2007-04-01

    The Italian version of the Young's Internet Addiction Test (IAT) was administered online to a sample of Italian chatters (n = 236) who were different in terms of gender, age, and occupation. Results revealed that young users are more at-risk subjects for Internet addiction than adults, perceiving a compromised social and individual quality of their life that led them to make a compensatory usage of the Internet. Similarly, employed users perceive their social and individual quality of life as more compromised by the Internet than students. Moreover, subjects who declared spending much time online obtained IAT scores higher than others in all the IAT subscales. Finally, nightly users are more at-risk subjects for developing an Internet addiction disorder, diminishing their individual quality of life and disabling their time control.

  9. Syllabic effects in Italian lexical access.

    PubMed

    Tagliapietra, Lara; Fanari, R; Collina, S; Tabossi, P

    2009-12-01

    Two cross-modal priming experiments tested whether lexical access is constrained by syllabic structure in Italian. Results extend the available Italian data on the processing of stressed syllables showing that syllabic information restricts the set of candidates to those structurally consistent with the intended word (Experiment 1). Lexical access, however, takes place as soon as possible and it is not delayed till the incoming input corresponds to the first syllable of the word. And, the initial activated set includes candidates whose syllabic structure does not match the intended word (Experiment 2). The present data challenge the early hypothesis that in Romance languages syllables are the units for lexical access during spoken word recognition. The implications of the results for our understanding of the role of syllabic information in language processing are discussed.

  10. The Italian contribution to the CSES satellite

    NASA Astrophysics Data System (ADS)

    Conti, Livio

    2016-04-01

    We present the Italian contribution to the CSES (China Seismo-Electromagnetic Satellite) mission. The CSES satellite aims at investigating electromagnetic field, plasma and particles in the near-Earth environment in order to study in particular seismic precursors, particles fluxes (from Van Allen belts, cosmic rays, solar wind, etc.), anthropogenic electromagnetic pollution and more in general the atmosphere-ionosphere-magnetosphere coupling mechanisms that can affect the climate changes. The launch of CSES - the first of a series of several satellite missions - is scheduled by the end of 2016. The CSES satellite has been financed by the CNSA (China National Space Agency) and developed by CEA (China Earthquake Administration) together with several Chinese research institutes and private companies such as the DFH (that has developed the CAST2000 satellite platform). Italy participates to the CSES satellite mission with the LIMADOU project funded by ASI (Italian Space Agency) in collaboration with the Universities of Roma Tor Vergata, Uninettuno, Trento, Bologna and Perugia, as well as the INFN (Italian National Institute of Nuclear Physics), INGV (Italian National Institute of Geophysics and Volcanology) and INAF-IAPS (Italian National Institute of Astrophysics and Planetology). Many analyses have shown that satellite observations of electromagnetic fields, plasma parameters and particle fluxes in low Earth orbit may be useful in order to study the existence of electromagnetic emissions associated with the occurrence of earthquakes of medium and high magnitude. Although the earthquakes forecasting is not possible today, it is certainly a major challenge - and perhaps even a duty - for science in the near future. The claims that the reported anomalies (of electromagnetic, plasma and particle parameters) are seismic precursors are still intensely debated and analyses for confirming claimed correlations are still lacking. In fact, ionospheric currents, plasma

  11. Multicenter neonatal databases: Trends in research uses.

    PubMed

    Creel, Liza M; Gregory, Sean; McNeal, Catherine J; Beeram, Madhava R; Krauss, David R

    2017-01-13

    In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging. Several large, multi-center neonatal databases have been developed to improve research and quality improvement of treatments for and outcomes of premature and LBW infants. The purpose of this systematic review was to describe three multi-center neonatal databases. We conducted a literature search using PubMed and Google Scholar over the period 1990 to August 2014. Studies were included in our review if one of the databases was used as a primary source of data or comparison. Included studies were categorized by year of publication; study design employed, and research focus. A total of 343 studies published between 1991 and 2014 were included. Studies of premature and LBW infants using these databases have increased over time, and provide evidence for both neonatology and community-based pediatric practice. Research into treatment and outcomes of premature and LBW infants is expanding, partially due to the availability of large, multicenter databases. The consistency of clinical conditions and neonatal outcomes studied since 1990 demonstrates that there are dedicated research agendas and resources that allow for long-term, and potentially replicable, studies within this population.

  12. Haemoglobin Hasharon in a north Italian community.

    PubMed Central

    Alberti, R; Mariuzzi, G M; Marinucci, M; Bruni, E; Tenteri, L

    1975-01-01

    A survey of haemoglobin variants undertakin in an Italian community (Polesine) has revealed the presence of haemoglobin Hasharon (alpha2 47 Asp yields His beta2) in 108 subjects from 40 families. The variant accounted for 30 to 40% of the total haemoglobin. In subjects doubly heterozygous for Hb Hasharon and beta thalassaemia, the proportion was 17 to 19%. Though there was some evidence that the variant was unstable in vitro, there was no obvious haemoglobinopathy in vivo. Images PMID:1177281

  13. National invasive species program

    Treesearch

    Anna Rinick; Hilda Diaz-Soltero

    2007-01-01

    The structure and function of the National Invasive Species Council was presented below. The names and contact information for the USDA Invasive Species coordinators as of February 2006 were presented on the next page.

  14. Repetition of the same pair of surnames in marriages in Albanian Italians, Greek Italians, and the Italian population of Campobasso Province.

    PubMed

    Biondi, G; Raspe, P; Mascie-Taylor, C G; Lasker, G W

    1996-08-01

    The isolation of a population as a result of any boundary leads to a kinship mating pattern, the extent of which can be measured by the frequency of repeated pairs of surnames in actual marriages compared with that in random pairings. The repeated pairs within surname lineages (RPw) method can be used to assess random repetitions and the endogamous or exogamous behavior of a population. The RPw method was applied to data from grandparent surnames of children living in 45 Albanian Italian and 13 Greek Italian villages of southern Italy and Sicily and in 22 Italian villages of Campobasso Province (central Italy). The total mean RPw was 0.02782 in Albanian Italians, 0.01993 in Greek Italians, and 0.03427 in the Italian-speaking population. When RPw was subdivided into its components and compared with random and marital isonymy, the low level of inbreeding shown by the two southern Italian ethnic minorities and by the Italian population of Campobasso Province could be accounted for by the subdivision of the populations.

  15. Pharmacovigilance and the italian medicines agency.

    PubMed

    Pimpinella, Giuseppe; Tartaglia, Loriana

    2013-12-01

    The new European Union (EU) regulations on pharmacovigilance require that the national systems are strengthened in order to fit the new requirements. The Italian Pharmacovigilance System, coordinated by the Italian Medicines Agency (AIFA), is made by local and regional structures. In 2007, a program for funding active pharmacovigilance projects in the Italian Regions was established by the National law. The AIFA is responsible for the preparation of guidelines aimed at the identification of research areas and for the approval of the projects submitted by the regions. In April 2012, the AIFA started a program of visits at the regional pharmacovigilance centers (RPCs), aimed at monitoring their performances, evaluating the quality of the activities in order to understand the main differences and discrepancies and with a view to start a program of harmonization of the procedures in place. The outcome of the visits program highlighted major differences among the quality management systems of the various centers; hence, AIFA has decided to launch an initiative to promote in the next months the harmonization of procedures. The synergy among AIFA, regional structures, RPCs, and local structure responsible for pharmacovigilance is needed in order to establish a robust pharmacovigilance system working in full compliance with the provisions of the new EU legislation.

  16. Itineraries and specificities of Italian medical anthropology.

    PubMed

    Seppilli, Tullio

    2012-04-01

    This paper describes the birth (or rebirth) of Italian medical anthropology around the middle of the 1950s, and its subsequent complex development up to the present. During this fairly long process, the author played a role that was probably of some importance, that of both a direct witness and active participant. Here these developments are briefly reviewed, in an attempt to single out some of the stimuli and the most significant occasions that have happened, their theoretical and methodological reference points, the main lines of research that have been tackled along the way, as well as the 'social demand' and the 'social use' that have integrated and oriented the practice of the new discipline within the horizon of some of the more general problems of Italian society. In outlining here the profile of and the various events in Italian medical anthropology, this paper takes into account the fact that, although a medical anthropology with that name and the disciplinary set-up that are now internationally attributed to it began in Italy only in the mid-1950s, important lines of research to which we would today attach that name had been undertaken long ago.

  17. Residential construction cost: An Italian survey.

    PubMed

    Canesi, Rubina; Marella, Giuliano

    2017-04-01

    This paper reports data describing development projects for new buildings according to construction costs in North-East Italy. A survey was carried out on local companies undertaking new residential development projects in two Italian regions (Veneto and Lombardy). The aim of this survey was to record new real estate construction projects, collecting both technical and socio-economic cost features. It is extremely difficult to collect such data for the Italian real estate construction sector, due to its lack of transparency, so that the novelty for the Italian scenario is the dataset itself. Another interest perspective of this survey is that socio-economic characteristics were also recorded; they are often studied in urban economics, but are usually related to property purchase prices and values, not to construction costs. The data come from an analysis of Canesi and Marella regarding the relationship between the trend of construction costs and the socio-economic conditions of the reference setting, such as the mean years of schooling of the workforce, housing market trends, and average per capita income.

  18. Pharmacovigilance and the Italian Medicines Agency

    PubMed Central

    Pimpinella, Giuseppe; Tartaglia, Loriana

    2013-01-01

    The new European Union (EU) regulations on pharmacovigilance require that the national systems are strengthened in order to fit the new requirements. The Italian Pharmacovigilance System, coordinated by the Italian Medicines Agency (AIFA), is made by local and regional structures. In 2007, a program for funding active pharmacovigilance projects in the Italian Regions was established by the National law. The AIFA is responsible for the preparation of guidelines aimed at the identification of research areas and for the approval of the projects submitted by the regions. In April 2012, the AIFA started a program of visits at the regional pharmacovigilance centers (RPCs), aimed at monitoring their performances, evaluating the quality of the activities in order to understand the main differences and discrepancies and with a view to start a program of harmonization of the procedures in place. The outcome of the visits program highlighted major differences among the quality management systems of the various centers; hence, AIFA has decided to launch an initiative to promote in the next months the harmonization of procedures. The synergy among AIFA, regional structures, RPCs, and local structure responsible for pharmacovigilance is needed in order to establish a robust pharmacovigilance system working in full compliance with the provisions of the new EU legislation. PMID:24347980

  19. Composition, coagulation properties and Parmigiano-Reggiano cheese yield of Italian Brown and Italian Friesian herd milks.

    PubMed

    Malacarne, Massimo; Summer, Andrea; Fossa, Enrico; Formaggioni, Paolo; Franceschi, Piero; Pecorari, Mauro; Mariani, Primo

    2006-05-01

    The authors report the results of a study aimed at the comparison of the basic chemical composition, the main protein fractions distribution, rennet coagulation properties and Parmigiano-Reggiano cheese yield of vat milk from Italian Brown and Italian Friesian herds. Parmigiano-Reggiano cheese factories which manufacture milk separately from Italian Brown herds and Italian Friesian herds were used in the study. Thirteen cheesemaking trials were performed at 10 different commercial cheese factories. The study was carried out from March to October 2003. For each cheesemaking trial in each factory, approximately 1100 kg milk from Italian Brown cows and from Italian Friesian cows were processed in parallel. The animals involved in the study came from farms with comparable management practices, size, location, number of lactation and days in milking. Each vat contained milk obtained by combining milk collected during the evening milking (partially skimmed milk by natural creaming) and the following morning milking (full-cream milk), from at least 2 dairy herds. Milk from Italian Brown cows is characterised by a higher casein content (27.1 v. 23.7 g/kg; P < or = 0.0001) than Italian Friesian cows' milk. Curd firming time (k20) of Italian Brown cows' milk was markedly lower than that of Italian Friesian cows' milk (6.6 v. 10.0 min; P < or = 0.001). This implies a higher rate of aggregation of para-casein micelles for Italian Brown cows' milk. The coagulum of Italian Brown cows' milk had better rheological properties and lower losses of fat in the cheese whey. Parmigiano-Reggiano cheese yield at 24 h was also higher for Italian Brown cows' milk, + 0.99 kg cheese for every 100 kg vat milk.

  20. Attacking invasive grasses

    USGS Publications Warehouse

    Keeley, Jon E.

    2015-01-01

    In grasslands fire may play a role in the plant invasion process, both by creating disturbances that potentially favour non-native invasions and as a possible tool for controlling alien invasions. Havill et al. (Applied Vegetation Science, 18, 2015, this issue) determine how native and non-native species respond to different fire regimes as a first step in understanding the potential control of invasive grasses.

  1. Invasive species in agriculture

    USDA-ARS?s Scientific Manuscript database

    Agricultural production of food, feed, fiber or fuel is a local human activity with global ecological impacts, including the potential to foster invasions. Agriculture plays an unusual role in biological invasions, in that it is both a source of non-indigenous invasive species (NIS) and especially s...

  2. Neurophysiology versus clinical genetics in Rett syndrome: A multicenter study

    PubMed Central

    Halbach, Nicky; Julu, Peter; Witt‐Engerström, Ingegerd; Pini, Giorgio; Bigoni, Stefania; Hansen, Stig; Apartopoulos, Flora; Delamont, Robert; van Roozendaal, Kees; Scusa, Maria F.; Borelli, Paolo; Candel, Math; Curfs, Leopold

    2016-01-01

    Many studies have attempted to establish the genotype–phenotype correlation in Rett syndrome (RTT). Cardiorespiratory measurements provide robust objective data, to correlate with each of the different clinical phenotypes. It has important implications for the management and treatment of this syndrome. The aim of this study was to correlate the genotype with the quantitative cardiorespiratory data obtained by neurophysiological measurement combined with a clinical severity score. This international multicenter study was conducted in four European countries from 1999 to 2012. The study cohort consisted of a group of 132 well‐defined RTT females aged between 2 and 43 years with extended clinical, molecular, and neurophysiological assessments. Diagnosis of RTT was based on the consensus criteria for RTT and molecular confirmation. Genotype–phenotype analyses of clinical features and cardiorespiratory data were performed after grouping mutations by the same type and localization or having the same putative biological effect on the MeCP2 protein, and subsequently on eight single recurrent mutations. A less severe phenotype was seen in females with CTS, p.R133C, and p.R294X mutations. Autonomic disturbances were present in all females, and not restricted to nor influenced by one specific group or any single recurrent mutation. The objective information from non‐invasive neurophysiological evaluation of the disturbed central autonomic control is of great importance in helping to organize the lifelong care for females with RTT. Further research is needed to provide insights into the pathogenesis of autonomic dysfunction, and to develop evidence‐based management in RTT. © 2016 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals, Inc. PMID:27354166

  3. Immediate Postoperative Oral Nutrition Following Esophagectomy: A Multicenter Clinical Trial.

    PubMed

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Dolmans, Annemarie C P; Kouwenhoven, Ewout A; Rosman, Camiel; Ruurda, Jelle P; van Workum, Frans; van Det, Marc J; Silva Corten, Luis C; van Hillegersberg, Richard; Luyer, Misha D P

    2016-10-01

    Immediate start of oral intake is beneficial following colorectal surgery. However, following esophagectomy the safety and feasibility of immediate oral intake is unclear, thus these patients are still kept nil by mouth. This study therefore aimed to determine the feasibility and safety of oral nutrition immediately after esophagectomy. A multicenter, prospective trial was conducted in 3 referral centers between August 2013 and May 2014, including 50 patients undergoing a minimally invasive esophagectomy. Oral nutrition was started postoperatively immediately (clear liquids on postoperative day [POD] 0, liquid nutrition on POD 1 to 6, solid food from POD 7). Nonoral enteral nutrition was started when <50% of caloric need was met on postoperative day POD 5 or when oral intake was impossible. A comparison was made with a retrospective cohort (n = 50) with a per-protocol delayed start of oral intake until POD 4 to 7. The median caloric intake at POD 5 was 58% of required. In 38% of the patients nonoral nutrition was started, mainly due to complications (36%). The pneumonia rate was 28% following immediate oral intake and 40% following delayed oral intake (p = 0.202). The aspiration pneumonia rate was 4% in both groups. The anastomotic leakage rate was 14% after immediate oral intake versus 24% following delayed oral intake (p = 0.202). The 90-day mortality rate was 2% in both groups. Hospital stay and intensive care unit stay were significantly shorter following immediate oral intake. Immediate start of oral nutrition following esophagectomy seems to be feasible and does not increase complications compared to a retrospective cohort and literature. However, if complications arise an alternative nutritional route is required. This explorative study shows that a randomized controlled trial is needed. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. The Italian Association on Addiction Psychiatry (SIPDip), formerly The Italian Association on Abuse and Addictive Behaviours.

    PubMed

    Carrà, Giuseppe; Clerici, Massimo

    2003-08-01

    The Italian Association on Addiction Psychiatry (SIPDip) is a special section of the Italian Psychiatric Association (SIP). It started, under the name of the Italian Association on Abuse and Addictive Behaviours (SICAD), in 1989 from the awareness that the addiction field had been starved of a psychiatrists' contribution since 1975. SIPDip aims to improve and implement study, clinical, research and educational topics about substance abuse and addictive behaviours. The National Board composition aims to provide an equal distribution of psychiatrists working in psychiatric and addiction facilities inside the National Health System, and private non-profit agencies. All psychiatrists and members of the Italian Psychiatric Association can become SIPDip ordinary members, while other health professionals working in psychiatric and addiction fields can become associate members. SIPDip has its National Congress every second year. In 2001 it promoted a network called the National Council of Addiction Disorders. It is recognized officially by the Drug Policy National Department and was created under the direct authority of the Prime Minister. In this, SIPDip is particularly involved in review groups relating to ethical issues, substitutive therapies and dual diagnosis. Furthermore, it organized the first Consensus Conference on Dual Diagnosis, under the sponsorship of the Italian Psychiatric Association. This was held in June 2003 to implement relevant national guidelines. The SIPDip main topics that will be addressed in the near future are: psychiatric comorbidity in substance related disorders; intervention efficacy assessment; and special populations and novel addictions. The National Board meeting on 15 December 2002 decided to submit to the General Assembly in April 2003, a motion to modify the Association's byelaws and to rename the organization 'The Italian Association of Addiction Psychiatry'.

  5. Representation of the serial killer on the Italian Internet.

    PubMed

    Villano, P; Bastianoni, P; Melotti, G

    2001-10-01

    The representation of serial killers was examined from the analysis of 317 Web pages in the Italian language to study how the psychological profiles of serial killers are described on the Italian Internet. The correspondence analysis of the content of these Web pages shows that in Italy the serial killer is associated with words such as "monster" and "horror," which suggest and imply psychological perversion and aberrant acts. These traits are peculiar for the Italian scenario.

  6. Prevalence and clinical management of complicated urinary tract infections in Italy: a prospective multicenter epidemiological study in urological outpatients.

    PubMed

    Ferri, C; Marchetti, F; Nickel, J C; Naber, K G

    2005-12-01

    The objectives of the study were to evaluate the prevalence of complicated urinary tract infections among Italian patients attending the urologist's office, to describe the frequency of different complication factors, the encountered bacterial pathogens and the clinical attitude of urologists in management of complicated urinary tract infections (CUTIs). The study was a prospective, multicenter study which was undertaken by office urologists throughout Italy. During the May-June 2002 timeframe, the prevalence of each urologist's diagnosis of CUTIs was noted for a 4-week slot. The prevalence of CUTIs in over 13,000 patients observed was 10.8% (n = 1201), with a trend (not statistically significant) of higher figures in the South/Islands (12.2%) with respect to Center (11.4%) or North (8.7%) of Italy. We have confirmed the significant relevance of CUTI among the Italian patients attending the urologist office and the clinical data collected may contribute to improve the diagnosis and empiric therapy of complicated urinary tract infections.

  7. Smoking habit in pregnancy and sociodemographic background in six Italian centres.

    PubMed

    Boracchi, P; Cortinovis, I; De Scrilli, A; Milani, S; Bertulessi, C; Marconi, A; Pardi, G; Zuliani, G; Bevilacqua, G; Davanzo, R

    1986-01-01

    Studies carried out in foreign countries (US and UK, mainly) indicate that maternal characteristics, such as age, parity, social class, and prenatal care, are related to child's growth, mortality, and morbidity, as well as to cigarette smoking. These characteristics may act as confounding variables in the analysis of the effects of maternal smoking on babies in fetal and neonatal periods. Until now there has been a lack of information on the subject, because even the most recent available data concern women over age 14 regardless of obstetric history. This paper deals with smoking habits, before and during pregnancy, of 37,664 women included in a multicenter survey of perinatal preventive medicine (MPPI), which was performed in 6 Italian centres (Trieste, Milan, Parma, Rome, Naples, Bari) between 1973 and 1979, with the financial support of the Italian National Research Council. The results of the MPPI and other surveys are compared and the association between maternal smoking habits and sociodemographic background is investigated by multiple correspondence analysis. As to Italy, unlike UK and US, in the 1970s women of high social status show the highest prevalence of the smoking habit. Moreover, in pregnancy, the large majority gives up smoking, or at least reduces it, mainly in high socioeconomic levels, so that the proportion of pregnant women who keep on smoking over 10 cigaretts per day is very low (0.5-3.8%) and poorly related to sociodemographic factors. Therefore, it seems unlikely that these may exert serious confounding effects on the relationships between smoking in pregnancy and perinatal outcome.

  8. Knowledge, opinions and attitudes of Italian mothers towards HPV vaccination and Pap test.

    PubMed

    La Torre, Giuseppe; De Vito, Elisabetta; Ficarra, Maria Giovanna; Firenze, Alberto; Gregorio, Pasquale; Miccoli, Silvia; Giraldi, Guglielmo; Unim, Brigid; De Belvis, Giulio; Boccia, Antonio; Saulle, Rosella; Semyonov, Leda; Ferrara, Maria; Langiano, Elisa; Capizzi, Silvio; Nardella, Rosaria; Marsala, Maria Grazia Laura; Bonanno, Valentina; Ferrara, Clara; Guidi, Enrica; Bergamini, Mauro; Lupi, Silvia

    2015-01-01

    This study evaluated the knowledge and attitudes of Italian mothers - whose daughters had been vaccinated in 2012 - towards primary (anti-HPV vaccination) and secondary (Pap test screening) cervical cancer prevention, as well as sources of information and mother-daughter communication on health issues. The survey - part of a multicenter study carried out in 4 Italian cities (Ferrara, Rome, Cassino and Palermo) - was conducted through self-administered questionnaires. The first univariate analysis evaluated differences between mothers of under-18s and over-18s relative to knowledge and attitudes on HPV vaccination and Pap test. The second univariate analysis evaluated differences between the 2 groups of mothers and possible geographical variations regarding the sources of information on HPV and Pap test. The sample proved knowledgeable about the correlation between HPV and cervical cancer (>85%) but less aware of other HPV-related diseases. HPV vaccination should be administered before first sexual intercourse according to mothers of over-18s, and to 14- to 17-year-olds according to mothers of under-18s. Up to 88% of mothers of under-18s and 80% of mothers of over-18s declared that the vaccine should be given free of charge. More mothers of under-18s consulted a general practitioner (GP) or gynecologist before deciding to vaccinate their daughters. Mothers of under-18s received information on HPV vaccination mainly from GPs and gynecologists, while mothers of over-18s were informed through TV and books/journals. Over 80% of the sample declared satisfaction with the information received from their gynecologist during the Pap test. The findings provide useful information for the development of effective public health interventions that may help improve acceptance of HPV vaccination among mothers.

  9. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry.

    PubMed

    Violi, Francesco; Corazza, Roberto Gino; Caldwell, Stephen Hugh; Perticone, Francesco; Gatta, Angelo; Angelico, Mario; Farcomeni, Alessio; Masotti, Michela; Napoleone, Laura; Vestri, Annarita; Raparelli, Valeria; Basili, Stefania

    2016-12-01

    Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the "Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry" (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child-Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p < 0.001), Child-Pugh Class B + C (p < 0.001), hepatocellular carcinoma (p = 0.01), previous upper gastrointestinal bleeding (p = 0.030) and older age (p = 0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate-severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547.

  10. Outcome of pregnancy in type 1 diabetic patients treated with insulin lispro or regular insulin: an Italian experience.

    PubMed

    Lapolla, Annunziata; Dalfrà, M G; Spezia, R; Anichini, R; Bonomo, M; Bruttomesso, D; Di Cianni, G; Franzetti, I; Galluzzo, A; Mello, G; Menato, G; Napoli, A; Noacco, G; Parretti, E; Santini, C; Scaldaferri, E; Scaldaferri, L; Songini, M; Tonutti, L; Torlone, E; Gentilella, R; Rossi, A; Valle, D

    2008-03-01

    Some studies have shown that fetal outcome observed in patients using insulin lispro is much the same as in pregnant women using regular insulin. This study aims to analyze the Italian data emerging from a multinational, multicenter, retrospective study on mothers with type 1 diabetes mellitus before pregnancy, comparing those treated with insulin lispro for at least 3 months before and 3 months after conception with those treated with regular insulin. The data collected on pregnant women with diabetes attending 15 Italian centers from 1998 to 2001 included: HbA1c at conception and during the first and third trimesters, frequency of severe hypoglycemic episodes, spontaneous abortions, mode and time of delivery, fetal malformations and mortality. Seventy-two diabetic pregnancies treated with lispro and 298 treated with regular insulin were analyzed, revealing a trend towards fewer hypoglycemic episodes in the former, who also had a significantly greater reduction in HbA1c during the first trimester. The rate of congenital malformations was similar in the offspring of the two groups of women treated with insulin lispro or regular insulin. These findings suggest that insulin lispro could be useful for the treatment of hyperglycemia in type 1 diabetic pregnant women.

  11. Italian Sixteenth-Century Italian Writing Books and the Scribal Reality in Verona.

    ERIC Educational Resources Information Center

    Clement, Richard W.

    1986-01-01

    Uses evidence of common writings found in the Rosenthal Collection of North Italian Documents at the University of Chicago to determine that the type of hand written script most popular in sixteenth century Verona was not the "cancellaresca" found in most copy books, but rather the italic and mercantilist scripts. (SKC)

  12. Italian School Psychology as Perceived by Italian School Psychologists: The Results of a National Survey

    ERIC Educational Resources Information Center

    Trombetta, Carlo; Alessandri, Guido; Coyne, Julia

    2008-01-01

    International research in school psychology has suggested that Italy is among the remaining nations that have not generated systematic inquiry to clarify the practice of psychology in its schools. Italian school psychology has long been presumed to be nonexistent due to historical factors hindering its development and lack of local research…

  13. The Italian Job: Reforming a Beginners' Italian Curriculum at University Level

    ERIC Educational Resources Information Center

    Absalom, Matthew

    2012-01-01

    In 2008, the Faculty of Arts at The University of Melbourne embarked upon a major overhaul of curriculum in nine languages: Arabic, Chinese, Indonesian and Japanese in the Asia Institute; and French, German, Italian, Russian and Spanish in the School of Languages and Linguistics. This article details the changes to the beginners' Italian…

  14. WIDEN: A tool for medical image management in multicenter clinical trials.

    PubMed

    Chauvie, Stéphane; Biggi, Alberto; Stancu, Alexandru; Cerello, Piergiorgio; Cavallo, Anna; Fallanca, Federico; Ficola, Umberto; Gregianin, Michele; Guerra, Ugo Paolo; Chiaravalloti, Agostino; Schillaci, Orazio; Gallamini, Andrea

    2014-06-01

    Background It has been proposed that in clinical trials in which the therapeutic strategy is driven by functional imaging, central review of the images should be done in real time. Purpose We report our experience with a new tool for image exchange and review, called Web-Based Imaging Diagnosis by Expert Network (WIDEN), which we implemented for the HD0607 prospective multicenter Italian clinical trial in which Hodgkin lymphoma treatment was adapted based on results of an interim positron emission tomography (PET) scan performed after the first two cycles of chemotherapy. Methods We used WIDEN for general management of the clinical trial, site imaging qualification, image exchange, workflow control, blinded independent central review, inter-observer variability assessment, consensus creation, audit, and statistical analysis. Results As of February 2013, the interim PET was available for 512 patients; upon central review, 103 of the scans were judged to be positive and 409 to be negative. The median scan uploading and downloading times were 1 min, 25 s and 1 min, 55 s, respectively; the average and median times for diagnosis exchange were 47 h, 53 min and 37 h, 43 min, respectively. The binary concordance between pairs of reviewers (Cohen's kappa) ranged from 0.72 to 0.85. The 5-point scale concordance among all reviewers (Krippendorf's alpha) was 0.77. Conclusions WIDEN proved to be an effective tool for medical imaging exchange and online review. Data security, simplicity, feasibility, and prompt scan review were demonstrated. Central reviews were completed promptly.

  15. Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate.

    PubMed

    Rotini, R; Cavaciocchi, M; Fabbri, D; Bettelli, G; Catani, F; Campochiaro, G; Fontana, M; Colozza, A; De Biase, C F; Ziveri, G; Zapparoli, C; Stacca, F; Lupo, R; Rapisarda, S; Guerra, E

    2015-09-01

    Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates. In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores. The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws. CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion.

  16. Center-Related Determinants of VKA Anticoagulation Quality: A Prospective, Multicenter Evaluation.

    PubMed

    Tosetto, Alberto; Manotti, Cesare; Marongiu, Francesco

    2015-01-01

    Center-specific TTR (c-TTR) is a measure reporting the mean patient TTR within an anticoagulation clinic describing the quality of anticoagulant monitoring offered by that clinic. c-TTR has a considerable between-center variation, but its determinants are poorly understood. We aimed at evaluating which clinical, procedural or laboratory factors could be associated with c-TTR variability in a multicenter, observational cross-sectional study over a five-year period. Data from 832,204 individual patients followed for VKA therapy in 292 Centers affiliated with the Italian Federation of Anticoagulation Clinics (FCSA) were analyzed. c-TTR was computed based on the TTR of patients followed at each Center, and a mixed linear regression model was used for a predefined set of explanatory variables. The Center next-visit interval ratio (the mean number of days after a visit with an INR outside the therapeutic range, divided by the days after a visit with an INR within the therapeutic range), the Center mean patient INR and the Center laboratory performance at EQA proficiency testing were the only variables that were independently associated with c-TTR (β-coefficients -17.32, 9.67, and -0.11, respectively; r2 = 0.635). These findings suggest that c-TTR associates with proactive strategies aimed at keeping patients very close to their target INR with a prompt re-evaluation of those patients with under- or over-therapeutic INR.

  17. Complications of Microwave Ablation for Liver Tumors: Results of a Multicenter Study

    SciTech Connect

    Livraghi, Tito; Meloni, Franca; Solbiati, Luigi; Zanus, Giorgio; Collaboration: For the Collaborative Italian Group using AMICA system

    2012-08-15

    Purpose: New technologies for microwave ablation (MWA) have been conceived, designed to achieve larger areas of necrosis compared with radiofrequency ablation (RFA). The purpose of this study was to report complications by using this technique in patients with focal liver cancer. Methods: Members of 14 Italian centers used a 2.45-GMHz generator delivering energy through a cooled miniature-choke MW antenna and a standardized protocol for follow-up. They completed a questionnaire regarding number and type of deaths, major and minor complications and side effects, and likelihood of their relationship to the procedure. Enrollment included 736 patients with 1.037 lesions: 522 had hepatocellular carcinoma with cirrhosis, 187 had metastases predominantly from colorectal cancer, and 27 had cholangiocellular carcinoma. Tumor size ranged from 0.5 to 10 cm. In 13 centers, the approach used was percutaneous, in 4 videolaparoscopic, and in 3 laparotomic. Results: No deaths were reported. Major complications occurred in 22 cases (2.9%), and minor complications in 54 patients (7.3%). Complications of MWA do not differ from those RFA, both being based on the heat damage. Conclusion: Results of this multicenter study confirmed those of single-center experiences, indicating that MWA is a safe procedure, with no mortality and a low rate of major complications. The low rate of complications was probably due to precautions adopted, knowing in advance possible risk conditions, on the basis of prior RFA experience.

  18. Nurses' Job satisfaction: an Italian study.

    PubMed

    Sansoni, J; De Caro, W; Marucci, A R; Sorrentino, M; Mayner, L; Lancia, L

    2016-01-01

    The aim of the work presented was to assess job satisfaction of a number of nurses from different departments working in public hospitals in Italy. The assessment was carried out through the combined use of questionnaires, which measured different aspects of job satisfaction, such as coping abilities, stress level and optimism/pessimism. The literature supports the fact that nurses' job dissatisfaction is closely connected with high levels of stress, burnout and physical and mental exhaustion, together with high workload levels and the complexity of care. The growing interest in measuring the levels of nurses' job satisfaction is attributable to a number of problems that have been raised worldwide, two of which are becoming ever so important: turnover and shortage of nurses. The research question is: Which are the main motivating factors of Italian nurses' job satisfaction/dissatisfaction? The study used a convenience (non probability) sample of 1,304 nurses from 15 different wards working in Italian public hospitals from a number of cities in northern, central and southern Italy. The survey instrument was a questionnaire consisting of 205 items which included 5 different questionnaires combined together. The results show a low level of job satisfaction (IWS= 11.5, JSS=126.4). However, the participants were overall happy about their job and considered autonomy and salary important factors for job satisfaction. Research has shown that the nurses' level of satisfaction in Italian hospitals is low. The results revealed dissatisfaction with task requirements, organizational policies and advance in career. Nurses interviewed did not feel stressed and showed to be optimistic overall. New research on the subject should be conducted by focusing on ward differences, North and South of Italy and on gender differences.

  19. The geochemical atlas of Italian soils

    NASA Astrophysics Data System (ADS)

    De Vivo, Benedetto; Cicchella, Domenico; Albanese, Stefano; Dinelli, Enrico; Giaccio, Lucia; Lima, Annamaria; Valera, Paolo

    2014-05-01

    The geochemical Atlas of Italian agricultural and grazing land soils was carried out as part of GEMAS project whose objective was to characterize soils of rural areas of the whole Europe. Soil samples were collected at an average sampling density of 1 site per 2500 km2. Two different sample types were collected: (1) 121 agricultural soils (Ap) on regularly ploughed land to a depth of 20 cm and (2) 121 grazing land soils (Gr) (land under permanent grass cover) to a depth of 10 cm. All soil samples were air dried, sieved to <2 mm, homogenised and finally split into 10 sub-samples. Both sample types (Ap and Gr) were analysed at the BGR for a suite of 41 elements by WD-XRFS. The same samples were also analysed after AR and MMI extractions by a combination of ICP-AES and ICP-MS for 53 elements. In addition, other parameters were determined: pH, TOC, total carbon and total sulphur, LOI, CEC, Sr-isotopes, Pb-isotopes, MIR-spectra. By means of a GIS software, georeferenced data of the Italian territory were used to produce the geochemical maps of all the analysed elements for both agricultural and grazing land soils. Specifically, for each element and sampling media a map reporting interpolated data and graduated dots was produced; univariate statistics and graphs were also associated to each map. The Atlas also contain: 5 maps for regional variability of factor scores of elemental associations resulting from R-mode factor analysis and 15 baseline and land use maps for some selected elements (As, Be, Cd, Co, Cr, Cu, Hg, Ni, Pb, Sb, Se, Sn, Tl, V, Zn) following the Italian intervention criteria.

  20. [Sickness Impact Profile: the Italian version].

    PubMed

    Bertolotti, G; Vidotto, G; Baiardi, P; Carone, M; Sommaruga, M; Zotti, A M

    2001-01-01

    The Sickness Impact Profile (SIP) is one of the questionnaires most widely used for the generic evaluation of functional health status. Besides measuring functional status or quality of life, it is also a precious font of information for the psychologist in the inpatient-rehabilitative context when planning an intervention focused on the most dysfunctional areas indicated by the subject. In producing the Italian version of the SIP, attention was duly paid in the translation to maintain equivalence in terms of idioms, grammar and syntax, so as to render it free of erroneous translations or possible. misunderstandings. Since the SIP employs "weighted" items, in order to obtain the weights corresponding to each individual statement a 3-phase procedure was followed: A) each subject "judge" was asked to express on a scale his/her own dysfunctionality judgement for each item; B) statements with the highest and lowest mean weight for each category were identified; C) the same "judges" were then asked to reclassify the statements which had obtained the highest and lowest weights, respectively, on a scale of 15 equidistant intervals; subsequently the same subjects completed the SIP a second time (retest). Results show that the judges were coherent in their estimation of the specific weights for each item. In the judges' second completion of the SIP it was found that the majority of the test-retest correlations fell almost always within the r = 0.70-0.90 range. Moreover, given the marginal difference between Italian and United States weights, both methods may be used for the calculation of the scores. One thus concludes that the SIP questionnaire can be applied in the Italian context.

  1. Single-Incision Multiport/Single Port Laparoscopic Abdominal Surgery (SILAP): A Prospective Multicenter Observational Quality Study

    PubMed Central

    Diener, Markus; Kropf, Siegfried; Otto, Ronny; Manger, Thomas; Vestweber, Boris; Mirow, Lutz; Winde, Günther; Lippert, Hans

    2016-01-01

    Background Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist. Objective This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients’ perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making. Methods The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period. Results Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year). Conclusions This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful. Trial Registration German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http

  2. Italian and French Experiments on Wind Tunnels

    NASA Technical Reports Server (NTRS)

    Knight, WM

    1920-01-01

    Given here are the results of experiments conducted by Colonel Costanzi of the Italian Army to determine the influence of the surrounding building in which a wind tunnel was installed on the efficiency of the installation, and how the efficiency of the installation was affected by the design of the tunnel. Also given are the results of a series of experiments by Eiffel on 34 models of tunnels of different dimensions. This series of experiments was started in order to find out if, by changing the shape of the nozzle or of the diffuser of the large tunnel at Auteuil, the efficiency of the installation could be improved.

  3. Italian Validation of Homophobia Scale (HS)

    PubMed Central

    Ciocca, Giacomo; Capuano, Nicolina; Tuziak, Bogdan; Mollaioli, Daniele; Limoncin, Erika; Valsecchi, Diana; Carosa, Eleonora; Gravina, Giovanni L; Gianfrilli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A

    2015-01-01

    Introduction The Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self-reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition. Aim The aim of this study was to validate the HS in the Italian context. Methods An Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back into the English language. A psychologist and sexologist checked the translated items from a clinical point of view. We recruited 100 subjects aged18–65 for the Italian validation of the HS. The Pearson coefficient and Cronbach's α coefficient were performed to test the test–retest reliability and internal consistency. Main Outcome Measures A sociodemographic questionnaire including the main information as age, geographic distribution, partnership status, education, religious orientation, and sex orientation was administrated together with the translated version of HS. Results The analysis of the internal consistency showed an overall Cronbach's α coefficient of 0.92. In the four domains, the Cronbach's α coefficient was 0.90 in behavior/negative affect, 0.94 in affect/behavioral aggression, and 0.92 in negative cognition, whereas in the total score was 0.86. The test–retest reliability showed the following results: the HS total score was r = 0.93 (P < 0.0001), behavior/negative affect was r = 0.79 (P < 0.0001), affect/behavioral aggression was r = 0.81 (P < 0.0001), and negative cognition was r = 0.75 (P < 0.0001). Conclusions The Italian validation of the HS revealed the use of this self-report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior. PMID:26468384

  4. The Italian Strong Motion Network (RAN)

    NASA Astrophysics Data System (ADS)

    Costa, Giovanni; Ammirati, Alfredo; de Nardis, Rita; Filippi, Luisa; Gallo, Antonella; Lavecchia, Giusy; Sirignano, Sebastiano; Zambonelli, Elisa; Nicoletti, Mario

    2014-05-01

    A network for the strong motion monitoring of the territory allows recording data that provide an excellent opportunity to study the source, path, and site effects on the ground motions, specifically in near source area, for updating seismic hazard map and consequently construction codes and earthquake resistant design. Strong motion data also help to increase the effective preparation and response to seismic emergencies and the ability of a community to quickly recover from the damages of an earthquake contributes to lower the seismic risk usually measured in term of casualties and economic losses. The Italian network for monitoring the strong movement of the national territory (RAN) is the result of a fruitful cooperation over the last 16 years between the Italian government, the regions and local authorities and now counts more than 500 stations. Over the years, as a priority the DPC has focused mainly on the expansion of the network in terms of the number of measurement points and technological improvement of instrumentation as well as the data transmission system. A data acquisition centre was implemented in which the Antelope software collects, processes and archives, automatically, the data of the RAN and of the external strong motion networks that contribute to the database of the RAN. Recently the DPC has dedicated specific resources to improve the response of the network, in particular, in case of emergency. The efficiency of the network on a daily basis is not less than 95% and temporary networks were installed in the epicentral area within 24 hours after the earthquake and connected to the data acquisition centre in Rome. A fast seismic data analysis is essential to provide useful information to Authorities which make decisions immediately after a strong earthquake occurrence. During a strong earthquake, the modern accelerometers are the only instruments which can provide near source high-quality data that are important both for scientific and for civil

  5. Italian Validation of Homophobia Scale (HS).

    PubMed

    Ciocca, Giacomo; Capuano, Nicolina; Tuziak, Bogdan; Mollaioli, Daniele; Limoncin, Erika; Valsecchi, Diana; Carosa, Eleonora; Gravina, Giovanni L; Gianfrilli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A

    2015-09-01

    The Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self-reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition. The aim of this study was to validate the HS in the Italian context. An Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back into the English language. A psychologist and sexologist checked the translated items from a clinical point of view. We recruited 100 subjects aged18-65 for the Italian validation of the HS. The Pearson coefficient and Cronbach's α coefficient were performed to test the test-retest reliability and internal consistency. A sociodemographic questionnaire including the main information as age, geographic distribution, partnership status, education, religious orientation, and sex orientation was administrated together with the translated version of HS. The analysis of the internal consistency showed an overall Cronbach's α coefficient of 0.92. In the four domains, the Cronbach's α coefficient was 0.90 in behavior/negative affect, 0.94 in affect/behavioral aggression, and 0.92 in negative cognition, whereas in the total score was 0.86. The test-retest reliability showed the following results: the HS total score was r = 0.93 (P < 0.0001), behavior/negative affect was r = 0.79 (P < 0.0001), affect/behavioral aggression was r = 0.81 (P < 0.0001), and negative cognition was r = 0.75 (P < 0.0001). The Italian validation of the HS revealed the use of this self-report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior.

  6. Italian payload development status for Columbus

    NASA Astrophysics Data System (ADS)

    Loria, A.; Mirra, C.

    1992-07-01

    Starting from a brief historical background, ideas and concepts for Italian payloads development for Columbus are reported. Ongoing efforts on precursor missions proposals analysis and future activities are also briefly depicted. These include a microgravity program to define the first steps necessary for future payload building. The following facilities are outlined: boiling; two phase; combustion; fluidized bed. The expectation for the future is to continue in the development of the instruments and facilities depicted in order to be able to allocate part of them for the beginning of the Columbus space station operations.

  7. Italian hybrid and fission reactors scenario analysis

    SciTech Connect

    Ciotti, M.; Manzano, J.; Sepielli, M.

    2012-06-19

    Italy is a country where a long tradition of studies both in the fission and fusion field is consolidated; nevertheless a strong public opinion concerned with the destination of the Spent Nuclear Fuel hinders the development of nuclear power. The possibility to a severe reduction of the NSF mass generated from a fleet of nuclear reactors employing an hypothetical fusionfission hybrid reactor has been investigated in the Italian framework. The possibility to produce nuclear fuel for the fission nuclear reactors with the hybrid reactor was analyzed too.

  8. Italian hybrid and fission reactors scenario analysis

    NASA Astrophysics Data System (ADS)

    Ciotti, M.; Manzano, J.; Sepielli, M.

    2012-06-01

    Italy is a country where a long tradition of studies both in the fission and fusion field is consolidated; nevertheless a strong public opinion concerned with the destination of the Spent Nuclear Fuel hinders the development of nuclear power. The possibility to a severe reduction of the NSF mass generated from a fleet of nuclear reactors employing an hypothetical fusionfission hybrid reactor has been investigated in the Italian framework. The possibility to produce nuclear fuel for the fission nuclear reactors with the hybrid reactor was analyzed too.

  9. HLA-DR EXPRESSION AS A BIOMARKER OF INFLAMMATION FOR MULTICENTER CLINICAL TRIALS OF OCULAR SURFACE DISEASE

    PubMed Central

    Epstein, Seth P.; Gadaria-Rathod, Neha; Wei, Yi; Maguire, Maureen G.; Asbell, Penny A.

    2014-01-01

    There are currently no validated minimally invasive objective metrics for the classification and evaluation of ocular surface diseases and/or for evaluating treatment efficacy. We thus sought to establish a standardized methodology for determining the relative amount of the inflammatory biomarker HLA-DR on the ocular surface and to evaluate the precision, reliability and repeatability of its use for large multicenter clinical trials and translational research studies of ocular surface disease. Multiple studies were conducted to establish a Standard Operating Procedure (SOP) for utilizing HLA-DR expression as a minimally invasive, objective, ocular surface inflammatory biomarker. The established SOPs provide specific guidelines for HLA-DR collection and analysis, in order to incorporate it reliably into multicenter clinical trials and/or translational research. Duplicate cell samples from impression cytology (IC) samples of both normal and dry eye individuals were collected and split to assess repeatability (between the splits and between the duplicate samples). To determine storage capability, one duplicate was stained immediately and the other after 30 days cold storage. To demonstrate the feasibility of the use of the SOP for a multicenter clinical trial, clinicians out-of-state were trained to collect IC samples, and the samples shipped to our Biomarker Laboratory, logged, processed and analyzed. Demonstration of the ability to incorporate of IC into a randomized double masked clinical trial of dry eye disease (DED) was performed. In all cases, processing and analyses were performed by a masked independent observer. The validity/viability of the SOPs was established by demonstrating that: 1) sufficient numbers of cells can be collected via IC; 2) the precision/repeatability of the relative biomarker expression quantified in samples; 3) personnel at distant sites can be taught to collect, store and ship samples successfully; 4) samples can be stored for up to 30

  10. Real and Perceived Employability: A Comparison among Italian Graduates

    ERIC Educational Resources Information Center

    Caricati, Luca; Chiesa, Rita; Guglielmi, Dina; Mariani, Marco Giovanni

    2016-01-01

    The research undertaken for this article aims to analyse the correspondence between perceived employability and the actual national employment rate among Italian students and graduates undertaking different courses in a large Italian university. Data were collected through a cross-sectional survey of 2087 students in 19 faculties, and compared…

  11. Identity Formation in Adolescents from Italian, Mixed, and Migrant Families

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Fermani, Alessandra; Pojaghi, Barbara; Meeus, Wim

    2011-01-01

    The purpose of this study was to compare identity formation in adolescents from Italian (n = 261), mixed (n = 100), and migrant families (n =148). Participants completed the Italian version of the Utrecht-Management of Identity Commitments Scale that assesses identity processes in educational and relational domains. Within a variable-centered…

  12. An Italian Social Learning Experience in High Schools

    ERIC Educational Resources Information Center

    Pieri, Michelle; Diamantini, Davide; Paini, Germano

    2013-01-01

    This work focuses on an experience of social learning realized in six Italian high schools in the 2012-2013 academic year. In this experience we used ThinkTag Smart, a new learning platform, to train 400 students. After an introduction concerning Information and Communication Technologies in Italian schools, this contribution will describe the…

  13. Real and Perceived Employability: A Comparison among Italian Graduates

    ERIC Educational Resources Information Center

    Caricati, Luca; Chiesa, Rita; Guglielmi, Dina; Mariani, Marco Giovanni

    2016-01-01

    The research undertaken for this article aims to analyse the correspondence between perceived employability and the actual national employment rate among Italian students and graduates undertaking different courses in a large Italian university. Data were collected through a cross-sectional survey of 2087 students in 19 faculties, and compared…

  14. Divergent Thinking in Italian Students with and without Reading Impairments

    ERIC Educational Resources Information Center

    Bigozzi, Lucia; Tarchi, Christian; Pinto, Giuliana; Donfrancesco, Renato

    2016-01-01

    Several studies have explored the relationship between dyslexia and creativity, but results have been rather mixed. This study examines whether Italian dyslexic children are more creative than their peers without a reading impairment. One hundred ninety Italian children aged between 9 and 13 participated in this study, divided into two groups:…

  15. Italian ryegrass (Lolium multiflorum) and corn (Zea mays)competition

    USDA-ARS?s Scientific Manuscript database

    Italian ryegrass is an annual/biennial grass that is typically used as a pasture crop or a cover crop along roadsides, rights-of-way, and industrial areas. Glyphosate-resistant (GR) Italian ryegrass populations have been documented around the world, mostly in orchard and vineyard situations. The fir...

  16. Identity Formation in Adolescents from Italian, Mixed, and Migrant Families

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Fermani, Alessandra; Pojaghi, Barbara; Meeus, Wim

    2011-01-01

    The purpose of this study was to compare identity formation in adolescents from Italian (n = 261), mixed (n = 100), and migrant families (n =148). Participants completed the Italian version of the Utrecht-Management of Identity Commitments Scale that assesses identity processes in educational and relational domains. Within a variable-centered…

  17. Italian in Malta: A Socio-Educational Perspective

    ERIC Educational Resources Information Center

    Caruana, Sandro

    2013-01-01

    In this contribution I present an overview of Italian in Malta, the third language of Malta, focusing on the role of this language within educational institutions and other domains of society. Italian was one of Malta's official languages till 1936 and, historically, it was used mainly within administrative and cultural spheres of society. Contact…

  18. Occupational Gender Stereotypes and Problem-Solving in Italian Adolescents

    ERIC Educational Resources Information Center

    Ginevra, Maria Cristina; Nota, Laura

    2017-01-01

    The first purpose of the study was to establish how Italian adolescents perceive jobs in the newly emerging economy sectors as well as more traditional jobs from gender-stereotyped and gender-segregated perspectives. The second purpose was to verify the role of problem-solving and gender in gender-role stereotyping. A total of 217 Italian high…

  19. Italian in Malta: A Socio-Educational Perspective

    ERIC Educational Resources Information Center

    Caruana, Sandro

    2013-01-01

    In this contribution I present an overview of Italian in Malta, the third language of Malta, focusing on the role of this language within educational institutions and other domains of society. Italian was one of Malta's official languages till 1936 and, historically, it was used mainly within administrative and cultural spheres of society. Contact…

  20. Practicing Reflexivity in the Study of Italian Migrants in London

    ERIC Educational Resources Information Center

    Seganti, Francesca Romana

    2010-01-01

    This article discusses the centrality of reflexivity in qualitative research through examples from my study on the role new media play in the lives of Italians in London. My hypothesis was that Italians were "in transit" in London and they were using new media to build "temporary" communities. I conducted in-depth interviews…

  1. Italian Americans: A Study Guide and Source Book.

    ERIC Educational Resources Information Center

    Meloni, Alberto

    Aspects of Italian immigration to the United States outlined in this guide include: (1) historical precedents for the Italian migration to North and South America; (2) economic reasons for the migration; (3) costs and resulting permanence of the migration; (4) characteristics of the family and individuals who migrated; (5) assimilation of these…

  2. Socio-Demographic Vulnerability: The Condition of Italian Young People

    ERIC Educational Resources Information Center

    Busetta, A.; Milito, A. M.

    2010-01-01

    For a kind of inertia effect, today the Italian welfare state protects the older too much and, on the contrary, it does not counter sufficiently the new risks associated with other phases of life. Not much seems to be implemented in favour of Italian young people who, as a matter of fact, seem to suffer a lot from the present changes: young people…

  3. Divergent Thinking in Italian Students with and without Reading Impairments

    ERIC Educational Resources Information Center

    Bigozzi, Lucia; Tarchi, Christian; Pinto, Giuliana; Donfrancesco, Renato

    2016-01-01

    Several studies have explored the relationship between dyslexia and creativity, but results have been rather mixed. This study examines whether Italian dyslexic children are more creative than their peers without a reading impairment. One hundred ninety Italian children aged between 9 and 13 participated in this study, divided into two groups:…

  4. Attrition in the Verb System of Italian in Australia

    ERIC Educational Resources Information Center

    Caruso, Marinella

    2004-01-01

    This article reports on an investigation into the loss of morphology expressing temporality in the Italian of second generation Italo-Australians. The purpose of the study is to verify whether the loss of Italian tense and aspect morphology proceeds from marked to unmarked, where markedness is defined on the basis of formal and semantic criteria.…

  5. Italian Developmental Dyslexic and Proficient Readers: Where Are the Differences?

    ERIC Educational Resources Information Center

    Barca, Laura; Burani, Cristina; Di Filippo, Gloria; Zoccolotti, Pierluigi

    2006-01-01

    Italian dyslexic children are characterized by a pervasive reading speed deficit, with relatively preserved accuracy. This pattern has been associated with predominant use of the nonlexical reading procedure. However, there is no evidence of a deficit in the lexical route of Italian dyslexics. We investigated both lexical and nonlexical reading…

  6. Genre and Function in the Italian Business Letter.

    ERIC Educational Resources Information Center

    Eiler, Mary Ann; Victor, David A.

    A study compared and contrasted the use of openings, summational closings, and closures in Italian and U.S. business letters to examine the role of culture in international business communication. It is argued that the Italian business letter should be studied in a functional intra-cultural perspective where its meaning creates and maintains…

  7. Attitudes toward Suicide: Italian and United States Physicians.

    ERIC Educational Resources Information Center

    Domino, George; Perrone, Luisa

    1993-01-01

    Administered Suicide Opinion Questionnaire to 100 Italian and 100 U.S. physicians, comparable in age, gender, and medical field. Found significant difference on seven of eight scales, with Italian physicians showing greater agreement on mental illness, right to die, religion, impulsivity, normality, aggression, and moral evil scales. Found gender…

  8. Understanding Contemporary Italy: Supplementing Texts in Beginning Italian.

    ERIC Educational Resources Information Center

    Skubikowski, Ugo

    1985-01-01

    Addresses the problem of the scarcity of instructional materials for teaching Italian and contemporary Italian culture to beginning college students. Looks at current practices and materials. Argues the need for preassessing cultural content of structural materials and suggests some criteria for devising supplementary cultural materials, along…

  9. Italian Language Instruction: The Need for Teacher Development in Technology.

    ERIC Educational Resources Information Center

    Tognozzi, Elissa

    2001-01-01

    Suggests that teacher preparation and training is the key to successful integration of technology in Italian as a foreign language instruction. Results of a study show that students taught by teachers who had undergone a technology program had better perceptions of what they were learning about Italian language and culture via the Web and improved…

  10. Gesture and Identity in the Teaching and Learning of Italian

    ERIC Educational Resources Information Center

    Peltier, Ilaria Nardotto; McCafferty, Steven G.

    2010-01-01

    This study investigated the use of mimetic gestures of identity by foreign language teachers of Italian and their students in college classes as a form of meaning-making. All four of the teachers were found to use a variety of Italian gestures as a regular aspect of their teaching and presentation of self. Students and teachers also were found to…

  11. Strategic Management Accounting in Universities: The Italian Experience

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni

    2008-01-01

    This paper presents an investigation of management accounting in four major Italian universities, which have been struggling to build their strategy in a context of significant change. Following many OECD countries the Italian government has been changing its higher education system by giving more autonomy to universities. These changes pose a…

  12. Strategic Management Accounting in Universities: The Italian Experience

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni

    2008-01-01

    This paper presents an investigation of management accounting in four major Italian universities, which have been struggling to build their strategy in a context of significant change. Following many OECD countries the Italian government has been changing its higher education system by giving more autonomy to universities. These changes pose a…

  13. Gesture and Identity in the Teaching and Learning of Italian

    ERIC Educational Resources Information Center

    Peltier, Ilaria Nardotto; McCafferty, Steven G.

    2010-01-01

    This study investigated the use of mimetic gestures of identity by foreign language teachers of Italian and their students in college classes as a form of meaning-making. All four of the teachers were found to use a variety of Italian gestures as a regular aspect of their teaching and presentation of self. Students and teachers also were found to…

  14. Multicenter Epidemiological Studies of Atherosclerosis Imaging

    PubMed Central

    Liu, Songtao; Bluemke, David A.

    2011-01-01

    Cardiovascular disease is the leading course of death and disability. Conventional cardiac risk factors do not fully explain the level of cardiovascular risk, incidence of coronary artery disease, and coronary events. Risk stratification and therapy based solely on these conventional risk factors may overlook a population who would benefit from lifestyle and risk factor modification. Thus, research has recently focused on improving risk assessment with new tools in an effort to better identify subjects at highest risk and in need of aggressive management. Cardiovascular imaging, both in coronary and extracoronary arterial beds, has proven to be very helpful in this regard. In this article, we review the current literature from multicenter epidemiology studies on the utility of noninvasive imaging modalities for risk stratification in the context of conventional risk factor evaluation. PMID:20805734

  15. A premarketing multicenter trial of lorazepam injection.

    PubMed

    Philbrook, F A; Hatt, D L

    1983-01-01

    Before the introduction of lorazepam injection to the Canadian market, its usefulness and acceptability were assessed in an open multicenter study. Anesthesiologists in teaching hospitals across the country were asked to substitute lorazepam injection for their usual anxiolytic premedicant in ten patients and to complete a brief case report on each patient. The results from 360 patients showed that suitable preoperative sedation, accompanied by anxiolysis but without undue effects on arousability, was obtained in 88% of the patients prior to surgery. The adverse effect most often reported, accounting for 84% of the drug-related adverse reactions, was postoperative drowsiness, which highlighted the need to administer the drug at least two hours before surgery. The anesthesiologists found lorazepam injection to be a satisfactory premedicant, rating it excellent to good in 73% of the patients treated.

  16. Telemedicine fetal phonocardiography surveillance: an italian satisfactory experience.

    PubMed

    Romano, Maria; Cesarelli, Mario; D'Addio, Gianni; Mazzoleni, M Cristina; Bifulco, Paolo; Ferrara, Nicola; Rengo, Franco

    2010-01-01

    In this paper we describe an Italian experience of fetal home monitor, organized using a portable phonocardiography system (product by Pentavox, Hungary), and the method utilized to evaluate its effectiveness in providing quality services and patient satisfaction. Patient satisfaction is an important dimension in the evaluation of quality care delivery. We used phonocardiography technique in our experience of fetal home monitoring as it is non invasive and passive in nature, low-cost and easy to use. A lightweight portable phonocardiograph (Fetaphon-home) was assigned to six selected patients, without effective pregnancy risk to monitor fetal heartbeat, uterine contractions and fetal movements at home or wherever they need it. The selected patients were instructed by trained personnel in the use of the monitoring device. Patients were asked to perform the recording two times a week and to transmit 20-min signal to the reference centre. The home monitoring sessions were performed in addition to the routine surveillance at a gynecologist's office; thus, the home monitoring did not replace clinic visits. The women were requested to fill a satisfaction questionnaire in order to evaluate their quality of life and anxiety state. Preliminary results have shown that home fetal surveillance appreciably reduces the need of travel for patients and consequently their stress. Furthermore, our results suggest that, after a short training, pregnant women are able to record and transmit long traces without troubles. Use of telemedicine system was generally well accepted by pregnant women since it increased the possibility of fetal long-term home surveillance which in turn could increase the efficiency of the service offered to them.

  17. Head trauma and Parkinson's disease: results from an Italian case-control study.

    PubMed

    Nicoletti, Alessandra; Vasta, Rosario; Mostile, Giovanni; Nicoletti, Giuseppe; Arabia, Gennarina; Iliceto, Giovanni; Lamberti, Paolo; Marconi, Roberto; Morgante, Letterio; Barone, Paolo; Quattrone, Aldo; Zappia, Mario

    2017-07-26

    We evaluated the possible association between head trauma and Parkinson's disease (PD). The FRAGAMP (Fattori di Rischio Ambientali e Genetici Associati alla Malattia di Parkinson) study is a large Italian multicenter case-control study carried out to evaluate the possible role of environmental and genetic factors in PD. Cases and controls were enrolled from six movement disorders centers located in the Central-Southern Italy. A standardized questionnaire was administered to record demographic, epidemiological, and clinical data. Positive history of head trauma was considered only if the head trauma preceded the onset of PD. All cases and controls underwent a standard neurological examination. Adjusted ORs and 95% CI were estimated using multivariate analysis (logistic regression). Four hundred ninety-two PD patients (292 men and 200 women) and 459 controls (160 men and 299 women) were enrolled in the study. A positive history for head trauma was reported by 106 (21.5%) PD patients and by 62 (13.5%) healthy controls. Multivariate analysis (OR adjusted by age, sex, family history, coffee smoking, and alcohol consumption) showed a significant positive association between PD and head trauma with an adjusted OR of 1.50 (95%CI 1.04-2.17; p value 0.03). In agreement with literature data, our study supports the positive association between head trauma and PD.

  18. Perioperative management of hypertensive neuroblastoma: A study from the Italian Group of Pediatric Surgical Oncologists (GICOP).

    PubMed

    Pio, Luca; Avanzini, Stefano; Mattioli, Girolamo; Martucciello, Giuseppe; Sementa, Angela Rita; Conte, Massimo; Gigliotti, Annarita; Granata, Claudio; Leva, Ernesto; Fagnani, Anna Maria; Caccioppoli, Umberto; Tedesco, Nino; Schleef, Jurgen; Tirtei, Elisa; Siracusa, Fortunato; D'Angelo, Paolo; Lelli Chiesa, Pierluigi; Miglionico, Lucia; Noccioli, Bruno; Severi, Elisa; Carlini, Claudio; Vaccarella, Francesco; Camoglio, Francesco; Cesaro, Simone; Narciso, Alessandra; Riccipetitoni, Giovanna; Cecchetto, Giovanni; Inserra, Alessandro

    2017-10-01

    Hypertension (HT) is rarely reported in patients affected by Neuroblastoma (NB), and management guidelines are lacking. Clinical features and perioperative medical treatment in such patients were reviewed to 1) ascertain whether a shared treatment strategy exists among centers and 2) if possible, propose some recommendations for the perioperative management of HT in NB patients. A retrospective multicenter survey was conducted on patients affected by NB who presented HT symptoms. From 2006 to 2014, 1126 children were registered in the Italian Registry of Neuroblastoma (RINB). Of these, 21 with HT (1.8%) were included in our analysis. Pre- and intraoperative HT management was somewhat dissimilar among the participating centers, apart from a certain consistency in the intraoperative use of the alpha-1 blocker urapidil. Six of the 21 patients (28%) needed persistent antihypertensive treatment at a median follow-up of 36months (range 4-96months) despite tumor removal. Involvement of the renal pedicle was the only risk factor constantly associated to HT persistency following surgery. A correlation between the presence of HT and the secretion of specific catecholamines and/or compression of the renal vascular pedicle could not be demonstrated. Based on this retrospective review of NB patients with HT, no definite therapeutic protocol can be recommended owing to heterogeneity of adopted treatments in different centers. A proposal of perioperative HT management in NB patients is however presented. IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Missed treatment in an Italian HBV infected patients cohort: HBV RER.

    PubMed

    Cuomo, Gianluca; Borghi, Vanni; Andreone, Pietro; Massari, Marco; Villa, Erica; Pietrangelo, Antonello; Verucchi, Gabriella; Ferrari, Carlo

    2016-11-01

    Very little is known about the access to treatment for Chronic Hepatitis B in the real clinical practice and the characteristics of the patients who do not receive antiviral therapy. HBV-RER is an observational multicenter network that collected data of patients with HBV infection during a 3 years observational period (2009-2012). Among 2527 HBsAg positive patients, 1099 were never treated (NT); only 280 were included in the analysis due to different exclusion causes A minority was HBeAg-positive. The median age was 42. At liver biopsy most patients had Metavir score of F0-F1. Univariate analysis between 280 NT patients and the 290 naïve to treatment showed that NT patients were mostly female (P=0.002), not Italian (P=0.044), younger (P<0.001). Metavir score was lower in NT (P0.002), such as the Fib4 score (P<0.001). HBV DNA level was significantly higher in NT. At multivariate analysis, independent variables associated with no-treatment were younger age, female gender, Metavir score F0-F1, Fib4 lower than 1.6 and lower blood level of HBV-DNA. There is a large number of patients eligible to treatment who do not receive it. A younger age and a less severe disease seem to be associated to deferral of treatment. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Unveiling an ancient biological invasion: molecular analysis of an old European alien, the crested porcupine (Hystrix cristata)

    PubMed Central

    Trucchi, Emiliano; Sbordoni, Valerio

    2009-01-01

    Background Biological invasions can be considered one of the main threats to biodiversity, and the recognition of common ecological and evolutionary features among invaders can help developing a predictive framework to control further invasions. In particular, the analysis of successful invasive species and of their autochthonous source populations by means of genetic, phylogeographic and demographic tools can provide novel insights into the study of biological invasion patterns. Today, long-term dynamics of biological invasions are still poorly understood and need further investigations. Moreover, distribution and molecular data on native populations could contribute to the recognition of common evolutionary features of successful aliens. Results We analyzed 2,195 mitochondrial base pairs, including Cytochrome b, Control Region and rRNA 12S, in 161 Italian and 27 African specimens and assessed the ancient invasive origin of Italian crested porcupine (Hystrix cristata) populations from Tunisia. Molecular coalescent-based Bayesian analyses proposed the Roman Age as a putative timeframe of introduction and suggested a retention of genetic diversity during the early phases of colonization. The characterization of the native African genetic background revealed the existence of two differentiated clades: a Mediterranean group and a Sub-Saharan one. Both standard population genetic and advanced molecular demography tools (Bayesian Skyline Plot) did not evidence a clear genetic signature of the expected increase in population size after introduction. Along with the genetic diversity retention during the bottlenecked steps of introduction, this finding could be better described by hypothesizing a multi-invasion event. Conclusion Evidences of the ancient anthropogenic invasive origin of the Italian Hystrix cristata populations were clearly shown and the native African genetic background was preliminary described. A more complex pattern than a simple demographic exponential

  1. Progression of renal damage in glycogen storage disease type I is associated to hyperlipidemia: a multicenter prospective Italian study.

    PubMed

    Melis, Daniela; Cozzolino, Mariarosaria; Minopoli, Giorgia; Balivo, Francesca; Parini, Rossella; Rigoldi, Miriam; Paci, Sabrina; Dionisi-Vici, Carlo; Burlina, Alberto; Andria, Generoso; Parenti, Giancarlo

    2015-04-01

    Angiotensin converting enzyme (ACE)-inhibitors decrease glomerular hyperfiltration but not microalbuminuria and proteinuria in glycogen storage disease type I. In the current study, we demonstrated that severe hyperlipidemia is associated with ACE-inhibitor ineffectiveness. We underline the importance of adequate metabolic control in glycogen storage disease type I. A combination therapy with ACE-inhibitors and lipid lowering drugs might be considered.

  2. [Recurrence of varicose veins after treatment. Multicenter study by the Italian Doppler Club, Clinical and Technological Society].

    PubMed

    Berni, A; Tromba, L; Mosti, G; Mele, R; Tombesi, T; Bedoni, P; Avruscio, G P; Neroni, G; Ofria, F; Lantone, G; Selvaggio, M; Amicucci, G; Iabichella, M L

    1998-04-01

    The first results of a multicentric study dealing with recurrent varicose veins after surgery are presented. The aims of the study are: identifying the type of varicose vein, specifying the most frequent complaints (esthetical or functional), locating the causes of recurrence, establishing the causes and the most frequent seat of recurrence, clarifying whether it is enough to call recurrent all the varicose veins which appear after surgery or whether it is necessary to distinguish various typologies. 194 patients (139 women and 55 men) aged 51.6 average (range 28-87), have been studied up to now with duplex and color scanner following a precise protocol which consisted of three stages: before treatment, within 2 months from treatment and after recurrence of varicose veins or venous insufficiency symptoms. Recurrent varicose veins represented 65.7%, residual ones 14.3%, new ones 2.5%. It has not been possible to identify the type of varicose vein in 8.3% of cases. Stripping of the great saphenous veins was carried out in 88% of cases, short stripping in 4.1%, stripping of the short saphenous veins in 6.9%. Recurrent varicose veins were due to technical error in 78.7% of cases, to diagnostic error in 9.2%, to unidentifiable causes in 12% of cases. Data relating to the prospective study of the research will be published in subsequent papers.

  3. Deferiprone versus deferoxamine in thalassemia intermedia: Results from a 5-year long-term Italian multicenter randomized clinical trial.

    PubMed

    Calvaruso, Giuseppina; Vitrano, Angela; Di Maggio, Rosario; Lai, Eliana; Colletta, Grazia; Quota, Alessandra; Gerardi, Calogera; Rigoli, Luciana Concetta; Sacco, Massimiliano; Pitrolo, Lorella; Maggio, Aurelio

    2015-07-01

    In patients with thalassemia intermedia (TI), such as beta-TI, alpha-thalassemia (mainly HbH disease and mild/moderate forms of HbE/beta-thalassemia), iron overload is an important challenge in terms of diagnosis, monitoring, and treatment. Moreover, to date, the only possible chelators available are deferoxamine, deferasirox, and deferiprone. Here, we report the first 5-year long-term randomized clinical trial comparing the effectiveness of deferiprone versus deferoxamine in patients with TI. Body iron burden, which was determined by measuring serum ferritin levels in the same patient over 5 years and analyzed according to the generalized linear mixed model (GLMM), showed a linear decrease over time in the mean serum ferritin levels in both treatment groups (P-value = 0.035). The overall period of observation was 235.2 person-years for the deferiprone patients compared with 214.3 person-years for the deferoxamine patients. The results of the log-rank test suggested that the deferiprone treatment did not affect survival compared with the deferoxamine treatment (P-value = 0.360). The major adverse events observed included gastrointestinal symptoms and joint pain or arthralgia. Neutropenia and agranulocytosis were also detected, suggesting needing of strict hematological control. In conclusion, long-term iron chelation therapy with deferiprone is associated with an efficacy and safety similar to that of deferoxamine, suggesting that this drug is an alternative option in cases in which deferoxamine and deferasirox are contraindicated.

  4. Abdominal obesity as risk factor for prostate cancer diagnosis and high grade disease: a prospective multicenter Italian cohort study.

    PubMed

    De Nunzio, Cosimo; Albisinni, Simone; Freedland, Stephen J; Miano, Lucio; Cindolo, Luca; Finazzi Agrò, Enrico; Autorino, Riccardo; De Sio, Marco; Schips, Luigi; Tubaro, Andrea

    2013-10-01

    To evaluate the association between abdominal obesity and prostate cancer (CaP) diagnosis and grade in patients undergoing prostate biopsy. Between 2008 and 2011, we prospectively enrolled patients referred to 3 clinics in Italy who were scheduled for transrectal ultrasound (TRUS) guided prostate biopsy. Before biopsy, digital rectal examination (DRE), prostate specific antigen (PSA), body mass index (BMI), and waist circumference (WC) were measured. Men were categorized in 4 groups of body habitus, according to BMI and waist circumference values. Crude and adjusted logistic regressions were performed to assess the association of BMI (continuous), waist circumference (continuous), body habitus (categorical), and CaP diagnosis and grade. Six hundred sixty-eight patients were enrolled. CaP was detected in 246 patients (38%), of whom 136 had low-grade (Gleason score ≤ 6) and 110 high-grade cancer (Gleason score ≥ 7). Logistic regression multivariate analysis showed that BMI (OR 1.05 per unit, CI 95% 1.00-1.10 P = 0.033) and waist circumference (OR 1.02 per cm, CI 95% 1.00-1.04 P = 0.026) were significant predictors of CaP diagnosis. BMI (OR 1.11 95% CI 1.04-1.18 P = 0.001) and WC (OR 1.04 95% CI 1.02-1.06 P = 0.001) were also associated with high-grade CaP. Furthermore, obesity with central adiposity (BMI ≥ 30 kg/m(2) and WC ≥ 102 cm) was significantly associated with CaP diagnosis (OR 1.66, CI 95% 1.05-2.63, P = 0.03) and high-grade disease (OR 2.56, CI 95% 1.38-4.76, P = 0.003). Obesity defined by BMI and WC seems to be associated with CaP and, more specifically, with high-grade disease at the time of biopsy. The relationship between obesity and CaP is complex and remains to be further addressed. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Italian occupational health: concepts, conflicts, implications.

    PubMed Central

    Reich, M R; Goldman, R H

    1984-01-01

    This paper examines Italy's worker-based model for occupational health, especially its key concepts and its relation to social conflict. It briefly reviews the history of three approaches to occupational health in Italy: university-based, industry-based, and government-based. It then analyzes the worker-based approach, which emerged in the late 1960s and early 1970s as worker groups and trade unions mobilized around new concepts of occupational health. Five key concepts are discussed: the workers' homogeneous group; workers' subjectivity; the use of contract language; the development of local occupational health institutions; and the use of occupational hazard risk maps. The analysis illustrates how the social processes of mobilization and institutionalization affected the ideas and structures of Italian occupational health. Worker mobilization in Italy produced ideological changes in the nation's occupational health system, institutional changes in universities and governments, and legislative changes at national and local levels. The institutionalization of reforms, however, created new conflicts and problems and tended to restrict worker participation and promote expert intervention. The paper concludes with a brief outline of the history of occupational health approaches in the United States and then discusses the implications of the five Italian concepts for US occupational health policy. PMID:6380322

  6. Education in Soil Science: the Italian approach

    NASA Astrophysics Data System (ADS)

    Benedetti, Anna; Canfora, Loredana; Dazzi, Carmelo; Lo Papa, Giuseppe

    2017-04-01

    The Italian Society of Soil Science (SISS) was founded in Florence on February 18th, 1952. It is an association legally acknowledged by Decree of the President of the Italian Republic in February 1957. The Society is member of the International Union of Soil Sciences (IUSS) of the European Confederation of Soil Science Societies (ECSSS) and collaborates with several companies, institutions and organizations having similar objectives or policy aspects. SISS promotes progress, coordination and dissemination of soil science and its applications encouraging relationships and collaborations among soil lovers. Within the SISS there are Working Groups and Technical Committees for specific issues of interest. In particular: • the Working Group on Pedotechniques; • the Working Group on Hydromorphic and Subaqueous Soils and • the Technical Committee for Soil Education and Public Awareness. In this communication we wish to stress the activities developed since its foundation by SISS to spread soil awareness and education in Italy through this last Technical Committee, focusing also the aspect concerning grants for young graduates and PhD graduates to stimulate the involvement of young people in the field of soil science. Keywords: SISS, soil education and awareness.

  7. The Italian Tau/charm project

    NASA Astrophysics Data System (ADS)

    Enrica Biagini, Maria

    2014-06-01

    A τ/charm Factory, an e + e- collider with very high luminosity at the 2-4.6 GeV center of mass energy, to be built on the Rome University at Tor Vergata campus, was studied by the Consortium Nicola Cabibbo Laboratory and the INFN Frascati Laboratories. This project is the natural evolution of the flagship Italian project SuperB Factory, funded by the Italian Government in 2010 with a budget that turned out to be insufficient to cover the total costs of the project. The study of rare events at the τ/charm energy was already planned as a Phase-II of SuperB [1]. This design keeps all the unique features of SuperB, including the polarization of the electron beam, with the possibility to take data in a larger energy range, with reduced accelerator dimensions and construction and operation costs. A Report on the accelerator design has been published in September 2013 [2].

  8. Italian Registry of Congenital Bleeding Disorders

    PubMed Central

    Giampaolo, Adele; Abbonizio, Francesca; Arcieri, Romano; Hassan, Hamisa Jane

    2017-01-01

    In Italy, the surveillance of people with bleeding disorders is based on the National Registry of Congenital Coagulopathies (NRCC) managed by the Italian National Institute of Health (Istituto Superiore di Sanità). The NRCC collects epidemiological and therapeutic data from the 54 Hemophilia Treatment Centers, members of the Italian Association of Hemophilia Centres (AICE). The number of people identified with bleeding disorders has increased over the years, with the number rising from approx. 7000 in 2000 to over 11,000 in 2015. The NRCC includes 4020 patients with hemophilia A and 859 patients with hemophilia B. The prevalence of the rare type 3 vWD is 0.20/100,000 inhabitants. Less common congenital bleeding disorders include the following deficiencies: Factor I (fibrinogen), Factor II (prothrombin), Factor V, Factor VII, Factor X, Factor XI and Factor XIII, which affect 1953 patients. Hepatitis C Virus (HCV) infection affects 1561 patients, more than 200 of whom have two infections (HCV + HIV). Estimated hemophilia-related drug consumption in 2015 was approx. 550 million IU of FVIII for hemophilia A patients and approx. 70 million IU of FIX for hemophilia B patients. The NRCC, with its bleeding disorder data set, is a tool that can provide answers to fundamental questions in public health, monitoring care provision and drug treatment, as well as facilitating clinical and epidemiological research. PMID:28335488

  9. Life gain in Italian smokers who quit.

    PubMed

    Carrozzi, Laura; Falcone, Franco; Carreras, Giulia; Pistelli, Francesco; Gorini, Giuseppe; Martini, Andrea; Viegi, Giovanni

    2014-02-26

    This study aims to estimate the number of life years gained with quitting smoking in Italian smokers of both sexes, by number of cigarettes smoked per day (cig/day) and age at cessation. All-cause mortality tables by age, sex and smoking status were computed, based on Italian smoking data, and the survival curves of former and current smokers were compared. The more cig/day a man/woman smokes, and the younger his/her age of quitting smoking, the more years of life he/she gains with cessation. In fact, cessation at age 30, 40, 50, or 60 years gained, respectively, about 7, 7, 6, or 5, and 5, 5, 4, or 3 years of life, respectively, for men and women that smoked 10-19 cig/day. The gain in life years was higher for heavy smokers (9 years for >20 cig/day) and lower for light smokers (4 years for 1-9 cig/day). Consistently with prospective studies conducted worldwide, quitting smoking increases life expectancy regardless of age, gender and number of cig/day. The estimates of the number of years of life that could be gained by quitting smoking, when computed specifically for a single smoker, could be used by physicians and health professionals to promote a quit attempt.

  10. The Size and Composition of the Productive Holophrastic Lexicon: German-Italian Bilingual Acquisition vs. Italian Monolingual Acquisition

    ERIC Educational Resources Information Center

    Klammler, Astrid; Schneider, Stefan

    2011-01-01

    In the present study, the natural and simultaneous first language acquisition of a German-Italian bilingual boy and an Italian monolingual girl from 1;8 to 2;1 are analyzed and compared. The investigation focuses on the rate of acquisition and the size and composition of the productive lexicons. At the end of the observation period, the bilingual…

  11. Specific and Generic Subjects in the Italian of German-Italian Simultaneous Bilinguals and L2 Learners

    ERIC Educational Resources Information Center

    Kupisch, Tanja

    2012-01-01

    This study investigates definite articles in specific and generic subject nominals in Italian spoken by adult simultaneous bilinguals (2L1ers) and second language learners (L2ers). The study focuses on plural and mass DPs, in which German and Italian differ. The aims are to (i) compare acquisition outcomes between the weaker and the stronger…

  12. [Invasive and minimally invasive hemodynamic monitoring].

    PubMed

    Hansen, Matthias

    2016-10-01

    Advanced hemodynamic monitoring is necessary for adequate management of high-risk patients or patients with derangement of circulation. Studies demonstrate a benefit of early goal directed therapy in unstable cardiopulmonary situations. In these days we have different possibilities of minimally invasive or invasive hemodynamic monitoring. Minimally invasive measurements like pulse conture analysis or pulse wave analysis being less accurate under some circumstances, however only an artery catheter is needed for cardiac output monitoring. Pulmonary artery, transpulmonary thermodilution and lithium dilution technology have acceptable accuracy in cardiac output measurement. For therapy of unstable circulation there are additionally parameters to obtain. The pulmonary artery catheter is the device with the largest rate of complications, used by a trained crew and with a correct indication, his use is unchained justified.

  13. Minimally invasive surgery for atrial fibrillation

    PubMed Central

    Suwalski, Piotr

    2013-01-01

    Atrial fibrillation (AF) remains the most common cardiac arrhythmia, affecting nearly 2% of the general population worldwide. Minimally invasive surgical ablation remains one of the most dynamically evolving fields of modern cardiac surgery. While there are more than a dozen issues driving this development, two seem to play the most important role: first, there is lack of evidence supporting percutaneous catheter based approach to treat patients with persistent and long-standing persistent AF. Paucity of this data offers surgical community unparalleled opportunity to challenge guidelines and change indications for surgical intervention. Large, multicenter prospective clinical studies are therefore of utmost importance, as well as honest, clear data reporting. Second, a collaborative methodology started a long-awaited debate on a Heart Team approach to AF, similar to the debate on coronary artery disease and transcatheter valves. Appropriate patient selection and tailored treatment options will most certainly result in better outcomes and patient satisfaction, coupled with appropriate use of always-limited institutional resources. The aim of this review, unlike other reviews of minimally invasive surgical ablation, is to present medical professionals with two distinctly different, approaches. The first one is purely surgical, Standalone surgical isolation of the pulmonary veins using bipolar energy source with concomitant amputation of the left atrial appendage—a method of choice in one of the most important clinical trials on AF—The Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) Trial. The second one represents the most complex approach to this problem: a multidisciplinary, combined effort of a cardiac surgeon and electrophysiologist. The Convergent Procedure, which includes both endocardial and epicardial unipolar ablation bonds together minimally invasive endoscopic surgery with electroanatomical mapping, to deliver best of

  14. Serum DNA hypermethylation in patients with bladder cancer: results of a prospective multicenter study.

    PubMed

    Hauser, Stefan; Kogej, Monika; Fechner, Guido; VON Pezold, Jochen; Vorreuther, Roland; Lümmen, Gerd; Müller, Stefan C; Ellinger, Jörg

    2013-03-01

    Cell-free serum DNA levels are increased in patients with cancer, and at least partially, these DNA fragments are derived from cancer cells. A few reports indicated that methylated serum DNA in patients with bladder cancer (BCA) is a useful non-invasive biomarker. The purpose of this prospective multicenter study was to validate earlier studies. In total, 227 consecutive participants (non-muscle invasive BCA, n=75; muscle-invasive BCA, n=20; transurethral bladder resection (TURB) without BCA, n=48; benign disease, n=31; healthy individuals, n=53), were recruited for this study. Cell-free serum DNA was isolated and digested with methylation-sensitive restriction-enzymes (Bsh1236I, HpaII and HinP1I) to quantify the amount of methylated (TIMP3, APC, RARB, TIG1, GSTP1, p14, p16, PTGS2 and RASSF1A) DNA fragments. The amount of methylated DNA was usually small (<10%), and the methylation frequencies varied for different genes (e.g. frequent: TIMP3; moderate: APC, RARB, TIG1; infrequent: p16, PTGS2, p14, RASSF1A, GSTP1). Methylation levels at each gene site and the number of methylated genes were increased in BCA compared to healthy individuals, but were similar in BCA and patients with non-malignant disease. The number of methylated genes allowed for discrimination (62% sensitivity, 89% specificity) of BCA patients from healthy individuals. DNA hypermethylation was not correlated with advanced stage or grade in patients with BCA. The detection of hypermethylated DNA in serum allows for discrimination of patients with BCA and healthy individuals, but there is no difference between patients with BCA and those with non-malignant disease, thereby limiting its value as a non-invasive biomarker.

  15. Cluster of invasive Neisseria meningitidis infections on a cruise ship, Italy, October 2012.

    PubMed

    Stefanelli, P; Fazio, C; Neri, A; Isola, P; Sani, S; Marelli, P; Martinelli, C; Mastrantonio, P; Pompa, M G

    2012-12-13

    We describe a cluster of four cases of invasive meningococcal disease that occurred on a cruise ship sailing along the Italian coast in October 2012. All four cases were hospitalised with severe illness and one of them died. This report illustrates the importance of rapid implementation of emergency control measures such as administration of prophylaxis to all crew members and passengers to prevent the spread of the disease in such a close environment.

  16. One-step 3D-TV-hysterosalpingo-foam-sonography (3D-TV-HyFoSy) confirmation test for Essure® follow-up: a multicenter study.

    PubMed

    Zizolfi, Brunella; Lazzeri, Lucia; Franchini, Mario; Di Spiezio Sardo, Attilio; Nappi, Carmine; Piccione, Emilio; Exacoustos, Caterina

    2017-01-09

    To evaluate the feasibility and accuracy of a three-dimensional-transvaginal-hysterosalpingo-contrast-sonography using the new dedicated contrast-enhanced gel foam (3D-TV-HyFoSy) to assess the position of the tubal sterilization Essure® devices and consequent tubal occlusion in patients who underwent Essure® hysteroscopic tubal sterilization. This multicenter study was prospectively conducted from June 2012 to July 2014 in four italian centers and included 50 women who underwent hysteroscopic Essure® microinsert placement, for a total of 95 tubes. Insertion of the microinserts was performed in outpatient setting following standard procedure recommendations. All patients underwent 3D-TV-HyFoSy and hysterosalpingography (HSG) about 3 months to 3 months and 2 weeks after the procedure. The devices' positions were first seen on 3D- transvaginal sonography (TVS) and classified according to specific criteria in 4 positions. Then a hysterosalpingo-contrast-sonography (HyCoSy) with 3D technique and ExEm® Foam gel as ultrasound contrast agent (HyFoSy) was performed to confirm tubal occlusion by the absence of contrast agent within the tubes and/or around the ovaries. To evaluate the feasibility of 3D-TV-HyFoSy, consecutive volume acquisitions were performed while injecting the gel foam. After sonographic evaluation all women underwent HSG to assess as standard methodology the success of sterilization. Side effects and pain evoked during and after 3D- TV-HyFoSy and HSG, using a 10-point numeric pain rating scale (NRS), were also evaluated. At 3D-TVS, 10 devices (10.5%) were in position "A", 2 (2.1%) in position"B", 59 (62.1%) in position "C", 24 (25.2%) in position"D". During 3D-HyFoSy, we observed tubal occlusion in 89 out of 95 tubes (93.7%). In the 6 cases in which the passage of the contrast was observed, one device (16.7%) was in position "B", one device (16.7%) in position "D"and four devices (66.7%) were found to lie in position "C". Tubal patency was confirmed at

  17. Factors influencing plant invasiveness

    Treesearch

    Yvette Ortega; Dean Pearson

    2009-01-01

    Invasiveness of spotted knapweed and biological control agents. Dean and Yvette are examining the influence of drought on the invasiveness of spotted knapweed (Centaurea maculosa) and its susceptibility to herbivory by biological control agents. In collaboration with the University of Montana and Forest Health Protection, researchers have constructed 150...

  18. Fecal water genotoxicity in healthy free-living young Italian people.

    PubMed

    Daniela, Erba; Sara, Soldi; Marcella, Malavolti; Giovanni, Aragone; Meynier, Alexandra; Sophie, Vinoy; Cristina, Casiraghi M

    2014-02-01

    Dietary habit affects the composition of human feces thus determining intestinal environment and exposure of colon mucosa to risk factors. Fecal water (FW) citotoxicity and genotoxicity were investigated in 33 healthy young Italian people, as well as the relationship between genotoxicity and nutrient intake or microflora composition. Two fecal samples were collected at 2 weeks apart and 3-d dietary diary was recorded for each volunteer. Cytotoxicity was measured using the Trypan Blue Dye Exclusion assay and genotoxicity using the Comet Assay (alkaline single-cell electrophoresis). Fecal bifidobacteria, total microbial count and nutrient intakes were also assessed. High intra- and inter-variability in genotoxicity data and in bacteria counts were found. None of the FW samples were citotoxic, but 90% of FW samples were genotoxic. Seventy five percent indicated intermediate and 15% were highly genotoxic. There was a different sex-related distribution. Genotoxicity was positively correlated to the total lipid intake in females and to the bifidobacteria/total bacteria count ratio in male volunteers. These results demonstrate that the majority of FW samples isolated from free-living Italian people show intermediate level of genotoxicity and sustain a relation between this possible non-invasive marker of colorectal cancer risk with both dietary habits and colonic ecosystem.

  19. Female genital mutilation: the ethical impact of the new Italian law.

    PubMed

    Turillazzi, E; Fineschi, V

    2007-02-01

    Despite global and local attempts to end female genital mutilation (FGM), the practice persists in some parts of the world and has spread to non-traditional countries through immigration. FGM is of varying degrees of invasiveness, but all forms raise health-related concerns that can be of considerable physical or psychological severity. FGM is becoming increasingly prohibited by law, both in countries where it is traditionally practised and in countries of immigration. Medical practice prohibits FGM. The Italian parliament passed a law prohibiting FGM, which has put in place a set of measures to prevent, to oppose and to suppress the practice of FGM as a violation of a person's fundamental rights to physical and mental integrity and to the health of women and girls. The Italian law not only treats new offences but also wants to deal with the problem in its entirety, providing important intervention in all the sectors. Different kinds of interventions are considered, starting with the development of informative campaigns, training of health workers, institution of a tollfree number, international cooperation programmes and the responsibility of the institution where the crime is committed. Particularly, the law recognises that doctors have a role in eliminating FGM by educating patients and communities.

  20. [The representation of Italian psychiatry in Italian Treccani Encyclopedia in 1930's].

    PubMed

    Piazzi, Andrea; Piazzi, Gioia; Testa, Luana; Coccanari dè Fornari, Maria Antonietta

    2013-01-01

    The article reconstruct the situation of Italian psychiatry around 1930, using as unusual sources the pages of the Enciclopedia Italiana di Scienze, Lettere e Arti. This important work, conceived in 1925 and finished in 1937, is due - as well known - to the strong interest of Giovanni Gentile and to his capacity to involve in the project a great part of Italian intellectual world, without any ideological preclusion. The section devoted to Medical Sciences, including Psychiatry, was directed by Nicola Pende (1880-1970) and Giacinto Viola (1870-1943). A prevalent positivistic approach to science is well testified by their specific attention to preventive and social medicine, researches in Genetics and in biotypological constitutions. Psycopathological and psycological lemmas are very limited, underlying the medical disinterest towards contemporary philosophy and psycology.

  1. ITALIAN PEAK AND ITALIAN PEAK MIDDLE ROADLESS AREAS, IDAHO AND MONTANA.

    USGS Publications Warehouse

    Skipp, Betty; Lambeth, Robert H.

    1984-01-01

    The Italian Peak and Italian Peak Middle Roadless Areas, in southwestern Montana and east-central Idaho, contain areas of probable mineral-resource potential based on combined geologic, geophysical, and geochemical studies and prospect examination. Small areas along the western, southern, and northeastern boundaries of the roadless areas have probable mineral resource potential for zinc, lead, silver, and uranium. An area of probable resource potential just east of and including a part of the Birch Creek mining district, may contain stratabound and fault-controlled silver and base metals, even though geochemical anomalies are low, and extensive prospecting has not identified any significant mineralization. The roadless areas are a part of the overthrust belt, and oil and gas possibilities must be assessed.

  2. Goethe's Italian Journey and the geological landscape

    NASA Astrophysics Data System (ADS)

    Coratza, Paola; Panizza, Mario

    2015-04-01

    Over 220 years ago Johann Wolfgang von Goethe undertook a nearly two-years long and fascinating journey to Italy, a destination dreamed for a long time by the great German writer. During his journey from Alps to Sicily Goethe reflects on landscape, geology, morphology of "Il Bel Paese", sometimes providing detailed descriptions and acute observations concerning the great and enduring laws by which the earth and all within it are governed. He was an observer, with the eye of the geologist and landscape painter, as he himself stated, and therefore he had a 360 degree focus on all parts of the territory. From the Brenner Pass to Sicily, Goethe reflects on landscape, contrasting morphologies, the genesis of territories, providing detailed descriptions useful for reconstructing the conditions of the territory and crops of the late 18th century. His diary is a description of the impressions he received from the country and its people, mingled with reflections upon art, science and literature. Goethe studied mineralogical and geological phenomena and drew up notes on the life of the people, the climate and the plants. On various scientific occasions and, in particular, within the framework of the Italian Association "Geologia & Turismo", of the Working Group "Geomorphosites" of the International Association of Geomorphologists and the International Year of Planet Earth, the opportunity to re-examine Goethe's travels in Italy from a geological viewpoint was recognised. In the present paper an attempt was made to reproduce the geotourism itinerary ante litteram of the writer to Italy, one of the most important tourist destination worldwide, thanks to its rich cultural and natural heritage and the outstanding aesthetic qualities of the complex natural landscape. This project was essentially conceived with a twofold purpose. First of all, an attempt was made to reproduce the journey of a great writer, as an example of description of landscape perceived and described as

  3. Italian validation of the Amsterdam Preoperative Anxiety and Information Scale.

    PubMed

    Buonanno, Pasquale; Laiola, Anna; Palumbo, Chiara; Spinelli, Gianmario; Terminiello, Virginia; Servillo, Giuseppe

    2017-07-01

    Preoperative anxiety is usually experienced by patients awaiting surgical procedures and it can negatively impact patient's outcome. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a questionnaire created to identify anxious patients and their need for information: it has been translated and validated in many languages because of its reliability and ease of completion. To date, no Italian version of the APAIS has been produced; our aim was to translate and validate the APAIS in Italian. We produced an Italian version of the APAIS and we administered it to 110 patients undergoing elective surgery; we explored its structure by factor analysis and its reliability by Cronbach's alpha. We analyzed its external validity by confronting it to the Spielberg's State-Trait Anxiety Inventory (STAI). Sensitivity, specificity, and positive and negative predictive values of the Italian version of the APAIS were determined. The Italian version of the APAIS confirmed the original structure of the questionnaire and its internal consistency; it well correlated with the STAI-Y1, the subscale of the STAI which explore the anxiety "state." An APAIS score of 14 was found as best cutoff to distinguish anxious and non-anxious patients. The Italian translation of the APAIS showed psychometric properties similar to the original version. Its reliability and its efficiency make it a powerful tool even in Italian population to detect anxiety and need for information.

  4. ILISI® digital index of the Italian scientific literature of nursing.

    PubMed

    Stievano, Alessandro; Bonfigli, Alessandra; Fanfera, Edvige; Finocchi, Giovanna; Montevecchi, Alessandro; Nappini, Patrizia; Tallarita, Fabrizio; Turci, Carlo; Rocco, Gennaro

    2011-04-01

    The IPASVI Rome Nursing Board-Centre of Excellence-began the project of building a free accessed database, Ilisi®, where the main Italian nursing and health-related journals could be consulted (including the few peer reviewed, at international level, Italian journals of nursing). Today, it includes the abstracts of more than 2700 articles from 2004 of about 25 Italian journals of nursing and/or related to nursing disciplines. The Ilisi® project has got with Thisi-Italian thesaurus of nursing science-a controlled vocabulary specifically built for nursing science, its tool of feasibility. This project was developed to foster nursing scholarship in Italy and to offer a free controlled database for all stakeholders (students, nurses, other health professionals, and scholars). The abstracts of the articles of these Italian journals are a tool for lifelong learning and constitute a patrimony for nursing science even at a wider level if this patrimony could be translated in English that will be a further step of the project. The project group who developed this database is going to value Italian nursing literature production and implement an electronic tool that, in the near future, might be used by all students and healthcare professionals in the world. Besides, with this project scientific productions by Italian students, nurses could be encouraged. More of them need to be trained in the use of the most frequently used databases, and Ilisi® could be a good training experience for them.

  5. Oral health awareness in Croatian and Italian urban adolescents.

    PubMed

    Cuković-Bagić, Ivana; Dumancić, Jelena; Nuzzolese, Emilio; Marusić, Miljenko; Lepore, Maria Maddalena

    2012-03-01

    Purpose of this study was to investigate and compare differences in oral health awareness between Croatian and Italian urban adolescents. The sample consisted of primary school last grade students aged between 13 and 15 years, 300 children from Zagreb (Croatia) and 298 children from Bari (Italy). Oral health awareness was evaluated using a self-administered standardized questionnaire. Self-perception of oral health proved to be different between the two groups (p < 0.001). The Croatians reported that their oral health was "excellent" or "very-good" more often than the Italians (68.6% vs. 50.2%). The reasons given for visiting a dentist were different (p < 0.001). The Italians cleaned their teeth more often than the Croatians ("two or more times a day", 83.1% vs. 72.2%, p < 0.003). Wooden toothpicks were preferred by the Croatians (p < 0.001), while floss was preferred by the Italians (p = 0.03). The awareness regarding the use of fluoridated toothpaste was higher in the Italian group (95.6% vs. 72.5%, p < 0.001). The Croatians were consuming sweetened foods more often than the Italians (p < 0.001). Croatian adolescents reported more indicators of a lower level of oral health awareness than the Italians, while on the contrary Croatians had higher esteem of their oral health. Defining national preventive strategies is essential for improving adolescents' attitudes toward oral health in both countries, particularly in Croatia.

  6. Italian for Business and Communication: Research Methodology and Creation of a Syllabus.

    ERIC Educational Resources Information Center

    Iandoli, Louis J.

    This paper discusses the development and content of a third-year Italian course entitled "Italian for Business and Communication," taught at Bentley College in Waltham, Massachusetts. Since there are few texts that focus on business Italian, the instructor conducted on-site research at three Italian companies in Milan. Observations and…

  7. Exposure to secondhand smoke in Italian non-smokers 5 years after the Italian smoking ban.

    PubMed

    Martínez-Sánchez, Jose M; Gallus, Silvano; Zuccaro, Piergiorgio; Colombo, Paolo; Fernández, Esteve; Manzari, Marco; La Vecchia, Carlo

    2012-10-01

    No data on secondhand smoke (SHS) exposure are available on a national level in Italy. To assess the prevalence of exposure to SHS in indoor public places, home and cars in non-smoking Italian population, we conducted a survey 5 years after the national smoking ban. In 2010, we conducted a survey on a representative sample of the Italian population aged≥15 years. Analyses were conducted on 2365 non-smokers. Current (during the previous week) self-reported exposure to SHS was assessed in public places, at home and in private cars. The prevalence of SHS exposure in any setting (excluding workplaces) was 31.2%. SHS exposure was 10.2% in public places, 15.6% at home and 17.9% in cars. The corresponding estimates among the young (15-24 years) were 54.2% in any setting, 21.4% in public places, 27.1% at home and 32.9% in cars. By multivariate analysis, males, the young, subjects from southern Italy and former smokers were more frequently exposed in any setting. The Italian smoking ban substantially decreased SHS exposure. However, specific subpopulations, including the young, are still frequently exposed both in public and private places. We observed a relatively high SHS exposure in private vehicles. Thus, further control to improve compliance with the smoking ban and an extension of the smoke-free legislation to motor vehicles are needed.

  8. Word reading and picture naming in Italian.

    PubMed

    Bates, E; Burani, C; D'Amico, S; Barca, L

    2001-10-01

    Results from two separate norming studies of lexical access in Italian were merged, permitting a comparison of word-reading and picture-naming latencies and the factors that predict each one for an overlapping subsample of 128 common nouns. Factor analysis of shared lexical predictors yielded four latent variables: a frequency factor, a semantic factor, a length factor, and a final factor dominated by frication on the initial phoneme. Age of acquisition (AoA) loaded highly on the first two factors, suggesting that it can be split into separate sources of variance. Regression analyses using factor scores as predictors showed that word reading and picture naming are both influenced by the frequency/AoA factor. The semantics/AoA factor influenced only picture naming, whereas the length and frication factors influenced only word reading. Generalizability of these results to other languages is discussed, including potential effects of cross-language differences in orthographic transparency.

  9. Body composition analysis for healthy Italian vegetarians.

    PubMed

    Siani, V; Mohamed, E I; Maiolo, C; Di Daniele, N; Ratiu, A; Leonardi, A; De Lorenzo, A

    2003-10-01

    The elementary nutritional needs of vegetarians are totally, or in great part, supplied by vegetarian food; thus the body composition of vegetarians could differ from that of omnivorous persons. The objective of the present study was to compare healthy Italian vegetarians to healthy omnivorous individuals in terms of body composition, determined using dual X-ray absorptiometry. The study population consisted of 20 vegetarians [mean age (+/-SD), 34.78+/-15.07 years; mean BMI, 22.41+/-2.15 kg/m(2)] and 10 omnivorous persons matched for age and BMI. We found no significant differences between the two groups in terms of fat mass, lean body mass, soft tissue, bone mineral content, or bone mineral density. These findings suggest that the vegetarian diet does not induce negative alterations in body composition.

  10. The Italian contribution to plastic surgery.

    PubMed

    Micali, G

    1993-12-01

    The birth of what we now call plastic surgery dates to the fifteenth century, when the diffusion of nose amputation as a punishment was paralleled by the blossoming of surgical procedures for nose reconstruction. The relationship between the Eastern and the Western world fostered the spreading of the so-called Indian method, based on the use of a forehead flap. This technique was first introduced in Italy by the Branca family from Catania, Sicily. Eventually, a member of this family switched to a different approach to nose reconstruction using a cutaneous arm flap. This "Italian" method was followed and theorized by Tagliacozzi in Bologna. From the nineteenth century, distinguished surgeons like Sabattini, Tansini, Sterzi, Pieri, and more recently, Sanvenero Rosselli, with their pioneering work, substantially improved and helped develop plastic surgery in Italy as we know it today.

  11. Declination of supralaryngeal gestures in spoken Italian.

    PubMed

    Vayra, M; Fowler, C A

    1992-01-01

    Two experiments investigate a weakening of supralaryngeal gestures in an utterance, analogous in some ways to declination of fundamental frequency and amplitude. In one experiment, acoustic measures revealed progressive centralization of stressed /i/, /a/ and /u/ left to right in trisyllabic utterances read by Tuscan subjects. A second experiment, using speakers of a different (Northern) variety of Standard Italian, found reduction in jaw opening for stressed /a/ left to right, but generally failed to replicate a centralization of /i/. This experiment further suggested that the progressive weakening of supralaryngeal gestures is largely a phrase level rather than a word level phenomenon. Both experiments found a different, V-shaped, pattern of opening to be generally characteristic of unstressed syllables.

  12. Minimally invasive sinus lift implant device: a multicenter safety and efficacy trial preliminary results.

    PubMed

    Better, Hadar; Slavescu, Dragos; Barbu, Horia; Cochran, David L; Chaushu, Gabi

    2014-08-01

    In cases of advanced maxillary sinus atrophy of the bone (pneumatization), the sinus floor has to be augmented in order to obtain acceptable bone volume for implantation. The objective of the present study is to evaluate a new procedure and device, designed as a closed sinus lift using a dedicated dental implant that allows for Schneiderian membrane elevation and the placement of a flowable bone replacement graft. Eighteen patients (8 males, 10 females) underwent 23 procedures. All procedures were completed successfully, with elevation of the sinus membrane and insertion of bone graft and the dental implant at the planned site. No membrane tears were noted. No intraoperative or postoperative adverse events were observed in any of the cases. There were no postprocedural emergency or distress calls. The patients' average age was 52 (range 38-72). The mean residual alveolar ridge height was 5.5 mm (range 4.0-7.0). The average bone gain was 11.2 mm (range 9-13) after an average healing period of 8.7 months (range 6.7-13.1). All implants achieved clinical stability and prosthetic rehabilitation was uneventful. A closed sinus floor elevation procedure can be accomplished using a dedicated dental implant that allows for hydraulic elevation of the Schneiderian membrane and placement of a flowable bone replacement graft and dental implant placement all at the same time with minimal patient discomfort. © 2012 Wiley Periodicals, Inc.

  13. Diffusion and applications of musculoskeletal ultrasound in Italian Rheumatology Units.

    PubMed

    Iagnocco, A; Ceccarelli, F; Cuomo, G; Delle Sedie, A; Filippou, G; Filippucci, E; Grassi, W; Porta, F; Sakellariou, Garifallia

    2013-03-28

    The Musculoskeletal Ultrasound Study Group of the Italian Society of Rheumatology (SIR) was founded during the 68th SIR Congress, on November 2011. The request of activation of this group was based on the increasing interest and the widespread diffusion of ultrasound in the scientific rheumatology community and on the solid experience of some Italian rheumatologists in the field. The aims of the Study Group are to stimulate the applications and use of ultrasound in the clinical practice at the level of the Italian rheumatology units and, in addition, to develop research projects at a national level...

  14. Communication about vaccinations in Italian websites

    PubMed Central

    Tafuri, Silvio; Gallone, Maria S; Gallone, Maria F; Zorico, Ivan; Aiello, Valeria; Germinario, Cinzia

    2014-01-01

    Babies’ parents and people who look for information about vaccination often visit anti-vaccine movement’s websites, blogs by naturopathic physicians or natural and alternative medicine practitioners. The aim of this work is to provide a quantitative analysis on the type of information available to Italian people regarding vaccination and a quality analysis of websites retrieved through our searches. A quality score was created to evaluate the technical level of websites. A research was performed through Yahoo, Google, and MSN using the keywords “vaccine” and “vaccination,” with the function “OR” in order to identify the most frequently used websites. The 2 keywords were input in Italian, and the first 15 pages retrieved by each search engine were analyzed. 149 websites were selected through this methodology. Fifty-three per cent of the websites belonged to associations, groups, or scientific companies, 32.2% (n = 48) consisted of a personal blog and 14.8% (n = 22) belonged to some of the National Health System offices. Among all analyzed websites, 15.4% (n = 23) came from anti-vaccine movement groups. 37.6% reported webmaster name, 67.8% webmaster e-mail, 28.6% indicated the date of the last update and 46.6% the author’s name. The quality score for government sites was higher on average than anti-vaccine websites; although, government sites don’t use Web 2.0 functions, as the forums. National Health System institutions who have to promote vaccination cannot avoid investing in web communication because it cannot be managed by private efforts but must be the result of Public Health, private and scientific association, and social movement synergy. PMID:24607988

  15. Wandering spleen in children: multicenter retrospective study.

    PubMed

    Fiquet-Francois, Caroline; Belouadah, Mohamed; Ludot, Hugues; Defauw, Benoit; Mcheik, Jiad Noel; Bonnet, Jean Paul; Kanmegne, Charly Udozen; Weil, Dominique; Coupry, Lionel; Fremont, Benjamin; Becmeur, Francois; Lacreuse, Isabelle; Montupet, Philippe; Rahal, Eliane; Botto, Nathalie; Cheikhelard, Alaa; Sarnacki, Sabine; Petit, Thierry; Poli Merol, Marie Laurence

    2010-07-01

    Wandering spleen in children is a rare condition. The diagnosis is difficult, and any delay can cause splenic ischemia. An epidemiologic, semiological, and surgical diagnosis questionnaire on incidence of wandering spleen in children was sent to several French surgical teams. We report the results of this multicenter retrospective study. Fourteen cases (6 girls, 8 boys) were reported between 1984 and 2009; the age range varies between 1-day-old and 15 years; 86% were seen in the emergency department. Ninety-three percent had diffuse abdominal pain. For 57% of the cases, it was their first symptomatic episode of this type. No diagnosis was established based on the clinical results alone. All patients had presurgical imaging diagnosis. Open surgery was performed on 64% cases. Forty-three had splenectomy for splenic ischemia. Thirty-six percent had splenopexy, 14% had laparoscopic gastropexy, and 7% had spleen repositioning and regeneration. Complications were noted in 60% of the cases resulting in postsplenopexy splenic ischemia. Early diagnosis and surgery are the best guarantee for spleen preservation. Even if the choice of one technique, splenopexy or gastropexy, can be argued, gastropexy has the advantage of avoiding splenic manipulation and restoring proper physiologic anatomy. When there is no history of abdominal surgery, laparoscopy surgery seems the best procedure.

  16. Acute necrotizing pancreatitis: a multicenter study.

    PubMed

    Fernández-Cruz, L; Navarro, S; Valderrama, R; Sáenz, A; Guarner, L; Aparisi, L; Espi, A; Jaurietta, E; Marruecos, L; Gener, J

    1994-04-01

    A multicenter study of acute necrotizing pancreatitis (ANP) classified in accordance with the Balthazar criteria (grades D and E), has been performed in 12 teaching hospitals. A total of 233 patients were reviewed, and the mortality rate was 26.6%. The most common etiology was biliary pancreatitis (45.5%). Among the complications, shock, renal insufficiency, pulmonary insufficiency and hemorrhagic gastritis were associated with a mortality rate of 51-66%. Diffuse fluid collections were associated with a higher mortality rate (26.8%) than localized fluid collections (14.5%). In 106 patients with gallstone pancreatitis, early surgery was performed in 17, and 5 patients (29.4%) died. No mortality was observed in 32 patients with delayed surgery. Sphincterotomy was performed in 13 patients, and 4 (30.7%) died. Early surgery (necrosectomy and closed peritoneal lavage) was undertaken in 75 patients, with a mortality rate of 39%. In conclusion, the morbidity and mortality rates of ANP can be improved with proper monitoring, adequate supportive care and the judicious use of surgery based on clinical and morphological findings.

  17. The opinion of clinical staff regarding painfulness of procedures in pediatric hematology-oncology: an Italian survey

    PubMed Central

    2011-01-01

    Background Beliefs of caregivers about patient's pain have been shown to influence assessment and treatment of children's pain, now considered an essential part of cancer treatment. Painful procedures in hematology-oncology are frequently referred by children as the most painful experiences during illness. Aim of this study was to evaluate professionals' beliefs about painfulness of invasive procedures repeatedly performed in Pediatric Hemato-Oncology Units. Methods Physicians, nurses, psychologists and directors working in Hemato-Oncology Units of the Italian Association of Pediatric Hematology-Oncology (AIEOP) were involved in a wide-nation survey. The survey was based on an anonymous questionnaire investigating beliefs of operators about painfulness of invasive procedures (lumbar puncture, bone marrow aspirate and bone marrow biopsy) and level of pain management. Results Twenty-four directors, 120 physicians, 248 nurses and 22 psychologists responded to the questionnaire. The score assigned to the procedural pain on a 0-10 scale was higher than 5 in 77% of the operators for lumbar puncture, 97.5% for bone marrow aspiration, and 99.5% for bone marrow biopsy. The scores assigned by nurses differed statistically from those of the physicians and directors for the pain caused by lumbar puncture and bone marrow aspiration. Measures adopted for procedural pain control were generally considered good. Conclusions Invasive diagnostic-therapeutic procedures performed in Italian Pediatric Hemato-Oncology Units are considered painful by all the caregivers involved. Pain management is generally considered good. Aprioristically opinions about pain depend on invasiveness of the procedure and on the professional role. PMID:21663631

  18. Multicenter Case-Control Study on Restless Legs Syndrome in Multiple Sclerosis: the REMS Study

    PubMed Central

    Manconi, Mauro; Ferini-Strambi, Luigi; Filippi, Massimo; Bonanni, Enrica; Iudice, Alfonso; Murri, Luigi; Gigli, Gian Luigi; Fratticci, Lara; Merlino, Giovanni; Terzano, Giovanni; Granella, Franco; Parrino, Liborio; Silvestri, Rosalia; Aricò, Irene; Dattola, Vincenzo; Russo, Giovanna; Luongo, Carmela; Cicolin, Alessandro; Tribolo, Antonella; Cavalla, Paola; Savarese, Mariantonietta; Trojano, Maria; Ottaviano, Salvatore; Cirignotta, Fabio; Simioni, Valentina; Salvi, Fabrizio; Mondino, Fiorella; Perla, Franco; Chinaglia, Giorgia; Zuliani, Cristina; Cesnik, Edward; Granieri, Enrico; Placidi, Fabio; Palmieri, Maria Giuseppina; Manni, Raffaele; Terzaghi, Michele; Bergamaschi, Roberto; Rocchi, Raffaele; Ulivelli, Monica; Bartalini, Sabina; Ferri, Raffaele; Fermo, Salvatore Lo; Ubiali, Emilio; Viscardi, Massimo; Rottoli, Mariarosa; Nobili, Lino; Protti, Alessandra; Ferrillo, Franco; Allena, Marta; Mancardi, Gianluigi; Guarnieri, Biancamaria; Londrillo, Francesco

    2008-01-01

    Study objectives: To verify the existence of a symptomatic form of restless legs syndrome (RLS) secondary to multiple sclerosis (MS) and to identify possible associated risk factors. Design: Prospective, multicenter, case-control epidemiologic survey. Settings: Twenty sleep centers certified by the Italian Association of Sleep Medicine. Patients: Eight hundred and sixty-one patients affected by MS and 649 control subjects. Interventions: N/A. Measures and results: Data regarding demographic and clinical factors, presence and severity of RLS, the results of hematologic tests, and visual analysis of cerebrospinal magnetic resonance imaging studies were collected. The prevalence of RLS was 19% in MS and 4.2% in control subjects, with a risk to be affected by RLS of 5.4 (95%confidence interval: 3.56–8.26) times greater for patients with MS than for control subjects. In patients with MS, the following risk factors for RLS were significant: older age; longer MS duration; the primary progressive MS form; higher global, pyramidal, and sensory disability; and the presence of leg jerks before sleep onset. Patients with MS and RLS more often had sleep complaints and a higher intake of hypnotic medications than patients with MS without RLS. RLS associated with MS was more severe than that of control subjects. Conclusions: RLS is significantly associated with MS, especially in patients with severe pyramidal and sensory disability. These results strengthen the idea that the inflammatory damage correlated with MS may induce a secondary form of RLS. As it does in idiopathic cases, RLS has a significant impact on sleep quality in patients with MS; therefore, it should be always searched for, particularly in the presence of insomnia unresponsive to treatment with common hypnotic drugs. Citation: Manconi M; Ferini-Strambi L; Filippi M; Bonanni E; Iudice A; Murri L; Gigli GL; Fratticci L; Merlino G; Terzano G; Granella F; Parrino L; Silvestri R; Aricò I; Dattola V; Russo G; Luongo

  19. A Bibliography of Italian Studies in North America

    ERIC Educational Resources Information Center

    Cherubini, Jon C., Comp.

    1977-01-01

    This quarterly bibliography of Italian studies in North America includes books, bibliographies, and reviews of comparative literature studies, translations, and publications on art, music, philosophy, history, cinema, and sociology, which are closely related to literature. (SW)

  20. An historical perspective of early Italian air medical transport.

    PubMed

    Bellini, Carlo

    2008-01-01

    The early times of aviation medicine were dominated by military actions and needs. This article describes the pioneering era of Italian air medical transport during the period between World War I and early World War II.

  1. [Organizational models in the Italian nephrology, dialysis and transplantation network].

    PubMed

    Manno, Carlo; Zuccalà, Alessandro

    2013-01-01

    In this article, the Italian Society of Nephrology discusses the recent statement of the Italian National Government regarding the 'The definition of the structure and technological standards of hospital health care' and suggests a new model of organization of the Italian Nephrology, Dialysis and Transplantation Network. In particular, the Italian Society of Nephrology proposes the presence of a nephrologist as part of the Emergency Hospital Network, to oversee all extracorporeal replacement treatments taking place in Intensive Care Units. Finally, this article recommends the cooperation of the nephrologist with primary health care teams and general practitioners as a move to prevent the complications of chronic kidney disease, thus improving short-term and long-term survival outcomes and reducing the costs to the National Health System.

  2. An Investigation of Piagetian Stages in Italian Secondary School Students.

    ERIC Educational Resources Information Center

    Violino, Paolo; Di Giacomo, Beatrice Semino

    1981-01-01

    Reports results of a study examining the Piagetian stages of Italian secondary school students in which student responses to three puzzles were analyzed. Compares results with studies done in the United States and the United Kingdom. (CS)

  3. Phonological devices in poems by English and Italian children.

    PubMed

    Dowker, A; Pinto, G

    1993-10-01

    Poems were elicited from 133 English children between two and six and 171 Italian children between three and seven, using a similar technique, and the results were compared. Both groups produced large numbers of poems. There were great similarities and some differences. The majority of poems in both samples contained phonological devices (mostly rhyme and alliteration) and the proportion was higher (87%) in the Italian sample than in the English sample (59%). The proportion of poems that contained rhyme was close to 45% in each sample, with no consistent age difference in either sample. About one-third of Italian poems and just over a fifth of English poems contained alliteration. The frequency of alliteration declined with age in the English sample but not in the Italian sample. Possible reasons for the differences between the samples are considered. It is argued that the similarities are more important, and their theoretical implications are discussed.

  4. Dall'italo-austrliano all'italiano: apprendmento linguistico fra gli scolari della seconda generazione (From Italian-Australian to Italian: Language Acquisition among the Students of the Second Generation).

    ERIC Educational Resources Information Center

    Rubino, Antonia

    1989-01-01

    Discusses the results of research to determine the success of the efforts currently being made in schools to teach pure Italian to the second generation of Italians in Australia in order to replace Italian Australian, a mixture of Italian dialects, Italian, and English. 33 references. (CFM)

  5. Dall'italo-austrliano all'italiano: apprendmento linguistico fra gli scolari della seconda generazione (From Italian-Australian to Italian: Language Acquisition among the Students of the Second Generation).

    ERIC Educational Resources Information Center

    Rubino, Antonia

    1989-01-01

    Discusses the results of research to determine the success of the efforts currently being made in schools to teach pure Italian to the second generation of Italians in Australia in order to replace Italian Australian, a mixture of Italian dialects, Italian, and English. 33 references. (CFM)

  6. Prostate resection - minimally invasive

    MedlinePlus

    ... invasive - discharge Transurethral resection of the prostate - discharge Review Date 6/29/2015 Updated by: Jennifer Sobol, ... the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by ...

  7. Invasive Prenatal Testing

    PubMed Central

    Hunter, A.

    1988-01-01

    Invasive prenatal diagnosis is a major diagnostic tool which is used in modern obstetrical care. A synopsis of these techniques is provided to assist the family practitioner in providing this information to his patients. PMID:21253097

  8. [The decoration of Italian Renaissance drug jars after engravings].

    PubMed

    Drey, R E

    1994-01-01

    Although Italian drug jar painters generally devised original compositions for the ornamentation of their products, on occasion they derived their subjects from printed sources. Printed sources used by drug jar artists of the Renaissance include wood-engraved Italian tarot cards and wood-engraved illustrations by Hans Sebald Beham and Bernard Salomon in miniature bibles published in the sixteenth century in Frankfurt and in Lyons respectively.

  9. Tuning Nursing Educational in an Italian academic context.

    PubMed

    Marchetti, Anna; Venturini, Giulia; Virgolesi, Michele; Gobbi, Mary; Rocco, Gennaro; Pulimeno, Ausilia Maria Lucia; Stievano, Alessandro; Piredda, Michela; De Marinis, Maria Grazia

    2015-09-01

    The European Union Bologna Process has laid the foundation for a common European competence-based educational framework. In many countries, nursing education is in transition from vocational to higher education, with many diverse systems. The competence-based approach provided by the project Tuning Educational Structures offers a common and coherent framework able to facilitate the implementation of the principles underpinning the Bologna Process reform. This study aimed to ascertain the relevance that Italian nursing university lecturers attributed to the 40 competences of the Italian version of the nursing Bachelor's and Master's Degrees. These competences were developed through adoption of the Tuning Methodology in the nursing context. The study was conducted in the 4 universities of one region of Italy which offer nursing Bachelor's and Master's Degrees. A total of 164 Italian university nursing lecturers. Using a four point scale, a cross sectional survey was conducted from March 2011 to April 2012. Participants evaluated each competence according to its relevance for Bachelor's or Master's Education. Frequency analysis was conducted. The significance for each competence of Tuning was rated very high by Italian lecturers and appeared to overlap partially with the original European study. In Italy, the most relevant competences for Bachelor's Degree were the skills associated with the use of appropriate interventions, activities and skills in nursing and the skills associated with nursing practice and clinical decision-making. For Master's Degree, leadership, management and team competences were the most important. The Tuning Nursing Project was accepted by the Italian lecturers. The competence-based approach was considered by Italian lectures as a support enabling to reflect on the current Italian nursing education cycles of study and to ensure shared visions and common approaches between Italian and European lecturers. Copyright © 2015 Elsevier Ltd. All

  10. Italian contributions to Turkish paediatrics during the Ottoman Empire.

    PubMed

    Yurdakok, Murat; Cataldi, Luigi

    2013-01-01

    The Ottoman Empire maintained close relations with the neighbouring Italian city states in the 16th and 17th century. Yacub Pasha (1425-1481), personal physician of Mehmed II the Conqueror, was an Italian Jew who advanced to the title of pasha and vizier. Domenico Hierosolimitano (ca. 1552-1622), the third physician to Sultan Murad III, was a Jerusalemite rabbi. His book is an important source about everyday life and medical practice in Istanbul at the time. Nuh bin Abd al-Mennab (1627-1707), also of Italian stock, was the Chief Physician of the Ottoman Empire, who translated a pharmacopoeia into Turkish. In the same century, two Italians, Israel Conegliano (Conian) and Tobia Cohen became private physicians to leading Ottoman pashas and the Grand Vizier. A. Vuccino (1829-1893) and Antoine Calleja Pasha (1806-1893) taught at the Istanbul Medical School. Italy was a favoured country for medical education during the early period of Ottoman westernisation. Sanizade Mehmet Ataullah Efendi (1771-1826) translated the first medical book printed in the Ottoman Empire from Italian into Turkish. Mustafa Behcet Efendi (1774-1833), chief physician to the Sultan and the founder of the first western medical school in Turkey, translated several medical books from Italian into Turkish. The first printed pharmacopeia in the Ottoman Empire was also originally Italian In the 19th century, Edouard Ottoni and his son Giuseppe Ottoni were well-known military pharmacists, both under the name of Faik Pasha. Probably the most influential physician of Italian origin was Giovanni Battista Violi (1849-1928), who had practiced paediatrics in Turkey for more than fifty years. Violi was the founder of the first children's hospital, the first vaccine institute, and the first paediatric journal in the Ottoman Empire.

  11. Italian law on assisted conception: clinical and research implications.

    PubMed

    Manna, Claudio; Nardo, Luciano G

    2005-11-01

    The Italian law 40/2004 regulating the use of assisted conception will remain on the statutes after the failure of the referendum in June 2005. Italy is now one of the most restrictive countries in the world in the field of assisted conception. It is thought that the new regulations, which have already increased 'reproductive tourism' in Italian subfertile couples, will also have clinical and research implications.

  12. Minimally invasive stomas.

    PubMed

    Hellinger, Michael D; Al Haddad, Abdullah

    2008-02-01

    Traditionally, stoma creation and end stoma reversal have been performed via a laparotomy incision. However, in many situations, stoma construction may be safely performed in a minimally invasive nature. This may include a trephine, laparoscopic, or combined approach. Furthermore, Hartmann's colostomy reversal, a procedure traditionally associated with substantial morbidity, may also be performed laparoscopically. The authors briefly review patient selection, preparation, and indications, and focus primarily on surgical techniques and results of minimally invasive stoma creation and Hartmann's reversal.

  13. Minimally invasive lumbar foraminotomy.

    PubMed

    Deutsch, Harel

    2013-07-01

    Lumbar radiculopathy is a common problem. Nerve root compression can occur at different places along a nerve root's course including in the foramina. Minimal invasive approaches allow easier exposure of the lateral foramina and decompression of the nerve root in the foramina. This video demonstrates a minimally invasive approach to decompress the lumbar nerve root in the foramina with a lateral to medial decompression. The video can be found here: http://youtu.be/jqa61HSpzIA.

  14. Parasites and marine invasions

    USGS Publications Warehouse

    Torchin, M.E.; Lafferty, K.D.; Kuris, A.M.

    2002-01-01

    Introduced marine species are a major environmental and economic problem. The rate of these biological invasions has substantially increased in recent years due to the globalization of the world's economies. The damage caused by invasive species is often a result of the higher densities and larger sizes they attain compared to where they are native. A prominent hypothesis explaining the success of introduced species is that they are relatively free of the effects of natural enemies. Most notably, they may encounter fewer parasites in their introduced range compared to their native range. Parasites are ubiquitous and pervasive in marine systems, yet their role in marine invasions is relatively unexplored. Although data on parasites of marine organisms exist, the extent to which parasites can mediate marine invasions, or the extent to which invasive parasites and pathogens are responsible for infecting or potentially decimating native marine species have not been examined. In this review, we present a theoretical framework to model invasion success and examine the evidence for a relationship between parasite presence and the success of introduced marine species. For this, we compare the prevalence and species richness of parasites in several introduced populations of marine species with populations where they are native. We also discuss the potential impacts of introduced marine parasites on native ecosystems.

  15. First Italian Consensus Conference on VATS lobectomy for NSCLC.

    PubMed

    Nosotti, Mario; Droghetti, Andrea; Luzzi, Luca; Solli, Piergiorgio; Crisci, Roberto

    2017-03-24

    Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted procedure for the treatment of selected cases of lung cancer. The aim of this project was to establish national practical recommendations for the management of patients suitable for VATS lobectomy. The Scientific Committee of the VATS Lobectomy Group (a branch of the Italian Society of Thoracic Surgery) identified the consensus conference as an appropriate tool for a national debate. The consensus conference was organized following indications of the Italian Department of Health: a panel of experts reviewed the literature, the jury board revised the experts' reports, and the national conference discussed and voted on statements. The strength of recommendation for a statement was classified as weak, fair, or high when the total score ranged between 51% and 67%, 68% and 84%, or 85% and 100%, respectively. Eighty-six Italian thoracic surgeons attended the 1st Italian Consensus Conference on VATS lobectomy in Giulianova, Italy, on October 29-30, 2015. Thirty-three topics were discussed: indications, surgical strategy, perioperative management, and training were the main topics. Consensus was reached on 24 statements that were consequently recommended. The Italian Consensus Conference is the first attempt to discuss VATS lobectomy-related issues in a national scientific community. Such experience determined an improvement in epistemic knowledge among the Italian thoracic surgeons and could be a suggestion for other national communities.

  16. [Generations of Italian nurses compared: an exploratory study].

    PubMed

    Stevanin, Simone; Gregori, Dario; Poletti, Piera

    2015-01-01

    The influence that generations have on complex nursing work environment have not been investigated yet in Italy. The majority of studies realized on this topic up to now has a small sample size and is monocentric. None Italian study has directly investigated nursing multigenerational workforce. The study aimed to investigate the existence of generational differences in Italian nurses professional within the italian context and describe their characteristics. A 33 items questionnaire devised for the purpose was administred to a sample of 317 nurses of two major Italian North-East hospital. Five dimensions were analyzed: professional space, professional role, professional culture, orientation to care, relationships among generations. Data showed statistically significant differences among nurses generations in 9 items. The dimensions with the greatest number of significant items were found to be relationship among generations (6 items), followed by orientation to care, professional space and professional role (1 item each). Results highlighted the existence of generational differences and give some information on perceptions and relationships between italian nurses generations. Being the first exploratory study on Italian nurses, it is currently impossible to compare these results with those of previous studies. Further investigation is needed to make more comparisons with international literature.

  17. Validation of the Italian Version of the Haemophilia Activities List.

    PubMed

    Balestri, Elena; Villafañe, Jorge Hugo; Bertozzi, Lucia; Berlini, Stefano; Rocino, Angiola; Paganoni, Anna Maria; Drago, Lorenzo; Berjano, Pedro

    2016-01-01

    The aim of this study was to provide an Italian version of the Haemophilia Activities List (HAL) and check its reliability in Italian medical centers. The Italian version of this assessment was administered to 80 patients (aged 18-65 years) affected by haemophilia A and B (moderate or severe). The validation was accomplished by comparing it to the revised and expanded Arthritis Impact Measurement Scales (AIMS2). The internal consistency of the Italian version of the HAL had statistically high results: Cronbach's α 0.957-0.579. The highest internal consistency was measured in the domains 'leg functionality' and in the overall points of the HAL questionnaire. The correlation between the AIMS2, which has been translated into Italian, and the version of the HAL questionnaire that we proposed, yielded good results for the following correlations: AIMS2 all and HAL overall (r = 0.64), AIMS2 physical function and HAL overall (r = 0.66), AIMS2 pain and HAL overall (r = 0.66). The Italian version of the HAL questionnaire presents both internal coherence and convergent validity. It can be used in addition to other functional tests to measure outcomes in moderate and severe haemophiliac diseases or to determine the quality of life as observed in the everyday life of patients. © 2016 S. Karger AG, Basel.

  18. Scientific research of Italian neurologists from 2008 to 2011.

    PubMed

    Tinazzi, Michele; Toni, Danilo; Veronese, Marco; Ajena, Domenico; Cruccu, Giorgio; Calabresi, Paolo

    2014-03-01

    Quantifying the number of publications is the easiest way to estimate the scientific production of a country in any scientific field. The aim of this article is to provide information about the scientific production from 2008 to 2011 of Italian neurologists and to compare it with scientific production data of other countries. The analysis regarded the research in Web of Science, in the Subject Category Clinical Neurology, of the publications published from 2008 to 2011, with at least one Italian author belonging to a scientific Italian institution. The overall data, their quality and scientific impact were compared with those of the first 15 world countries for scientific production. We observed that even if the Gross National Product of Italy registered a slight and gradual reduction from 2008 to 2011, the neurological scientific production of Italian neurologists showed an increase in the number of papers, maintaining the fifth position in these four years after USA, Germany, England and Japan. Moreover, dividing the neurological journals in quartiles according to the impact factor, we observed constant increase of the numbers of Italian publications in the highest quartile journals during the considered period. These data suggest that from 2008 to 2011 Italian neurologists have increased the number of publications, also improving the quality of works.

  19. [World Kidney Day 2013 and the Italian experience since 2006].

    PubMed

    Galassi, Andrea; Battaglia, Yuri; Andreucci, Vittorio; Brancaccio, Diego; Balducci, Alessandro

    2013-01-01

    Renal disease is common, insidious and treatable. The prevalence of chronic kidney disease and its cumulative global costs are rapidly increasing. Since 2006 the World Kidney Day (WKD) has worked to raise awareness of the disease and the importance of its prevention within communities and institutions. Italian Nephrology, through the joint action of the Italian Society of Nephrology (SIN) and the Italian Kidney Foundation (FIR) has worked to convey the message during WKD celebrations,meeting the community directly in Italian town squares and high schools, where informative material was provided together with blood pressure and urine dip-stick testing. This year, the WKD was held on March 14th, and was preceded by an extensive program of information broadcast on TV and radio and published in newspapers and magazines. More than 100 nephrology units in 118 cities were either involved in at least one of the programs organized in Italian town squares, high schools and renal clinics, or provided other spontaneous initiatives. This paper describes the history of the Italian experience in the WKD from its beginning in 2006 until the present day.

  20. Multicenter Clinical Trial of the Nucleus® Hybrid™ S8 Cochlear Implant: Final Outcomes

    PubMed Central

    Gantz, Bruce J; Dunn, Camille; Oleson, Jacob; Hansen, Marlan; Parkinson, Aaron; Turner, Christopher

    2015-01-01

    Objective The concept expanding electrical speech processing to those with more residual acoustic hearing with a less invasive shorter cochlear implant has been ongoing since 1999. A multi-center study of the Nucleus Hybrid S8 CI took place between 2002–11. This report describes the final outcomes of this clinical trial. Study Design Multi-Center longitudinal single subject design Methods Eighty-seven subjects received a Nucleus® Hybrid™ S8 implant in their poorer ear. Speech perception in quiet (CNC words) and in noise (BKB-SIN) was collected pre- and post-operatively at 3, 6, and 12 months. Subjective questionnaire data using the APHAB was also collected. Results Some level of hearing preservation was accomplished in 98% subjects with 90% maintaining a functional low-frequency pure-tone average (LFPTA) at initial activation. By 12 months, 5 subjects had total hearing loss and 80% of subjects maintained functional hearing. CNC words demonstrated that 82.5% and 87.5% of subjects had significant improvements in the Hybrid and Combined conditions. The majority of had improvements with BKB-SIN. Results also indicated that as long as subjects maintained at least a severe LFPTA, there was significant improvement in speech understanding. Furthermore, all subjects reported positive improvements in hearing in three of the 4 subscales of the APHAB. Conclusion The concept of hybrid speech processing has significant advantages for subjects with residual low-frequency hearing. In this study, the Nucleus® Hybrid™ S8 provided improved word understanding in quiet and noise. Additionally, there appears to be stability of the residual hearing after initial activation of the device. Level of evidence 2c PMID:26756395

  1. Problemi di comunicazione interculturale tra Italiani e parlanti di italiano in Nord America (Intercultural Communication Problems Between Italians and Speakers of Italian in North America).

    ERIC Educational Resources Information Center

    Balboni, Paolo E.

    2001-01-01

    Examines intercultural communication between Italians and speakers of Italian in North America. Argues intercultural communicative competence comprises three elements: deep cultural values or "mental software"; non-verbal means of communication; and language. Offers advice to teachers of Italian who want to help their students develop…

  2. Problemi di comunicazione interculturale tra Italiani e parlanti di italiano in Nord America (Intercultural Communication Problems Between Italians and Speakers of Italian in North America).

    ERIC Educational Resources Information Center

    Balboni, Paolo E.

    2001-01-01

    Examines intercultural communication between Italians and speakers of Italian in North America. Argues intercultural communicative competence comprises three elements: deep cultural values or "mental software"; non-verbal means of communication; and language. Offers advice to teachers of Italian who want to help their students develop…

  3. 5-Aminolevulinic acid in intraoperative photodynamic therapy of bladder cancer (results of multicenter trial).

    PubMed

    Filonenko, E V; Kaprin, A D; Alekseev, B Y A; Apolikhin, O I; Slovokhodov, E K; Ivanova-Radkevich, V I; Urlova, A N

    2016-12-01

    The results of multicenter prospective trial for efficacy of combined modality treatment: transurethral resection (TUR)+photodynamic therapy (PDT) with alasens for bladder cancer are represented in the article. Trials were organized by Research Institute of Organic Intermediates and Dyes and conducted according to clinical protocol approved by Ministry of Health of Russia, at the sites of leading Russian cancer clinical centers. The trial included 45 subjects with verified diagnosis of non-muscle-invasive bladder cancer. Patients underwent TUR of bladder with simultaneous PDT as anti-relapse treatment. Alasens was administered to patients as intravesicular instillation of 3% solution in volume of 50ml with 1.5-2h exposure (prior to TUR). TUR was performed after instillation. PDT session was conducted immediately after the completion of TUR on a single occasion by means of combined local irradiation on tumor bed with diffuse irradiation on whole urinary bladder mucosa (light dose of local irradiation - 100J/cm2, diffuse irradiation - 20J/cm2). Good tolerance of the treatment was noticed, there were no complications. Among 45 patients included in the trial, 35 (78%) completed 12 month protocol follow-up without relapse. In our study PDT with alasens after TUR reported a recurrence rate of non-muscle-invasive bladder cancer for 1st year after treatment of 22%. TUR with intraoperative PDT with 5-aminolevulinic acid may offer an alternative in the treatment of non-muscle-invasive intermediate and high-risk bladder cancer. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. [Nosocomial risk factors of hepatitis C infection. A multicenter study in a hospital-based population].

    PubMed

    Maugat, S; Astagneau, P; Thibault, V; Desruennes, E; Baffoy, N; Desenclos, J-C; Brücker, G

    2003-06-01

    Drug abuse and blood transfusion are well known risk factors for hepatitis C virus (HCV) infection. However, the route of transmission remains undetermined for 30% of HCV infections. The potential for nosocomial transmission of HCV in health care settings has been suggested but remains poorly estimated. The aim of the study was to assess the prevalence and to identify risk factors for hepatitis C virus (HCV) infection in hospitalized patients frequently exposed to invasive procedures. A multi-center sero-prevalence study was conducted in hospitalized patients who underwent invasive procedures in interventional radiology wards in 6 University hospitals in Paris between 1998 and 1999. Each patient presenting in the ward was consecutively interviewed by a medical investigator. Data were collected on a standardized questionnaire including items on socio-demographic characteristics, past exposure to intravenous drug use, blood transfusions, underlying diseases and type and number of previous invasive procedures. Before procedure, HCV antibody testing (ELISA) was performed in all patients after informed consent. In all HCV-positive patients, HCV viremia was detected using polymerase chain reaction. Overall, 91 of 944 (9.7%) patients were HCV-positive, of whom 90% had positive viremia and 10 were identified HCV positive by the screening. HCV prevalence decreased with age and ranged from 4.5% to 22% according to center. Logistic regression analysis showed that intravenous drug use, history of blood transfusions and endoscopy were found as independent risk factors for HCV infection (odds ratio [CI95%]: 77.3 [23.3-256.3], 4.7 [2.7-8.2] et 1.20 [1.01-1.44]). No other risk factor for nosocomial or iatrogenic transmission was identified. The results suggest that, except for blood transfusions, other healthcare-related procedures may partly explain HCV transmission. This emphasizes the need to reinforce compliance with standard precautions of hygiene.

  5. Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicenter prospective study.

    PubMed

    Napoleon, Bertrand; Gincul, Rodica; Ponchon, Thierry; Berthiller, Julien; Escourrou, Jean; Canard, Jean-Marc; Boyer, Jean; Barthet, Marc; Ponsot, Philippe; Laugier, René; Helbert, Thierry; Coumaros, Dimitri; Scoazec, Jean-Yves; Mion, François; Saurin, Jean-Christophe

    2014-02-01

    Endoscopic papillectomy of early tumors of the ampulla of Vater is an alternative to surgery. This large prospective multicenter study was aimed at evaluating the long-term results of endoscopic papillectomy. Between September 2003 and January 2006, 10 centers included all patients referred for endoscopic papillectomy and meeting the inclusion criteria: biopsies showing at least adenoma, a uT1N0 lesion without intraductal involvement at endoscopic ultrasound (EUS), and no previous treatment. A standardized endoscopic papillectomy was done, with endoscopic monitoring with biopsies 4 - 8 weeks later where complications were recorded and complementary resection performed when necessary. Follow-up with duodenoscopy, biopsies, and EUS was done at 6, 12, 18, 24 and 36 months. Therapeutic success was defined as complete resection (no residual tumor found at early monitoring) without duodenal submucosal invasion in the resection specimen in the case of adenocarcinoma and without relapse during follow-up. 93 patients were enrolled. Mortality was 0.9 % and morbidity 35 %, including pancreatitis in 20 %, bleeding 10 %, biliary complications 7 %, perforation 3.6 %, and papillary stenosis in 1.8 %. Adenoma was not confirmed in the resection specimen in 14 patients who were therefore excluded. Initial treatment was insufficient in 9 cases (8 carcinoma with submucosal invasion; 1 persistence of adenoma). During follow-up, 5 patients had tumor recurrence and 7 died from unrelated diseases without recurrence. Finally, 81.0 % of patients were cured (95 % confidence interval 72.3 % - 89.7 %). Endoscopic papillectomy of selected ampullary tumors is curative in 81.0 % of cases. It must be considered to be the first-line treatment for early tumors of the ampulla of Vater without intraductal invasion. © Georg Thieme Verlag KG Stuttgart · New York.

  6. A unified approach for quantifying invasibility and degree of invasion

    Treesearch

    Qinfeng Guo; Songlin Fei; Jeffrey S. Dukes; Christopher M. Oswalt; Basil V. Iannone III; Kevin M. Potter

    2015-01-01

    Habitat invasibility is a central focus of invasion biology, with implications for basic ecological patterns and processes and for effective invasion management. ‘‘Invasibility’’ is, however, one of the most elusive metrics and misused terms in ecology. Empirical studies and meta-analyses of invasibility have produced inconsistent and even conflicting results. This ...

  7. Multicenter prospective evaluation of dogs with trauma.

    PubMed

    Hall, Kelly E; Holowaychuk, Marie K; Sharp, Claire R; Reineke, Erica

    2014-02-01

    To determine hospital admission variables for dogs with trauma including values determined with scoring systems (animal trauma triage [ATT], modified Glasgow coma scale [MGCS], and acute patient physiologic and laboratory evaluation [APPLE] scores) and the usefulness of such variables for the prediction of outcome (death vs survival to hospital discharge). Prospective, multicenter, cohort study. 315 client-owned dogs. By use of a Web-based data capture system, trained personnel prospectively recorded admission ATT, MGCS, and APPLE scores; clinical and laboratory data; and outcome (death vs survival to discharge) for dogs with trauma at 4 veterinary teaching hospitals during an 8-week period. Cause of injury was most commonly blunt trauma (173/315 [54.9%]) followed by penetrating trauma (107/315 [34.0%]), or was unknown (35/315 [11.1%]). Of the 315 dogs, 285 (90.5%) survived to hospital discharge. When 16 dogs euthanized because of cost were excluded, dogs with blunt trauma were more likely to survive, compared with dogs with penetrating trauma (OR, 8.5). The ATT (OR, 2.0) and MGCS (OR, 0.47) scores and blood lactate concentration (OR, 1.5) at the time of hospital admission were predictive of outcome. Surgical procedures were performed for 157 (49.8%) dogs; surgery was associated with survival to discharge (OR, 7.1). Results indicated ATT and MGCS scores were useful for prediction of outcome for dogs evaluated because of trauma. Penetrating trauma, low blood lactate concentration, and performance of surgical procedures were predictive of survival to hospital discharge. The methods enabled collection of data for a large number of dogs in a short time.

  8. Canadian multicenter azidothymidine trial: AZT pharmacokinetics.

    PubMed

    Child, S; Montaner, J; Tsoukas, C; Fanning, M; Le, T; Wall, R A; Ruedy, J

    1991-01-01

    The study objective was to describe the pharmacokinetics of azidothymidine (AZT) in a large population of early, asymptomatic human immunodeficiency virus (HIV)-infected individuals. The study design was a multicenter, prospective, descriptive single-dose pharmacokinetic study. Each of 66 fasting, male, HIV-infected homosexuals older than 18 years of age and in CDC classifications II, III, and IVC2 received a single 400-mg oral dose of AZT with subsequent pharmacokinetic measurements performed during an 8-h period for AZT and its major metabolite, glucuronylazidothymidine (GAZT). Results were obtained in 65 patients (36 smokers, 29 nonsmokers), of whom 3 were noted to have hepatic dysfunction. In those with normal hepatic function, the following parameters were described: AZT, area under the curve (AUC) +/- SD, 9.9 +/- 5.7 microM.h, maximum concentration (Cmax) +/- SD, 7.3 +/- 4.7 microM; time to maximum concentration (Tmax) +/- SD, 0.93 +/- 0.42 h, and half-life (t1/2) +/- SD, 1.0 +/- 0.8 h. Corresponding values for GAZT were: AUC +/- SD 35.7 +/- 10.3 microM.h, Cmax +/- SD 21.3 +/- 7.3 microM, Tmax +/- SD 1.2 +/- 0.50 h, t1/2 +/- SD 0.98 +/- 0.62 h, No significant differences were found in comparisons of study site, CDC classification of disease, smokers versus nonsmokers, and in patients with hepatic dysfunction, although a higher AUC and earlier Cmax for AZT was noted in the latter group. It is concluded that AZT pharmacokinetics are similar in patients with early asymptomatic HIV disease when compared with previous reports in patients with later disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. [Inguinofemoral hernia: multicenter study of surgical techniques].

    PubMed

    Porrero, José L; Sánchez-Cabezudo, Carlos; Bonachía, Oscar; López-Buenadicha, Adolfo; Sanjuánbenito, Alfonso; Hidalgo, Manuel

    2005-07-01

    The present study was performed by the Spanish Association of surgeons through its abdominal wall and sutures section. The aim was to determine the current situation of inguinofemoral hernias in Spain and was based on an anonymous multicenter study with the participation of various national hospitals. Fifty general surgery departments in distinct surgical centers throughout Spain responded to an anonymous survey in 2000. The survey gathered data on anesthetic features, surgical techniques and complications in the treatment of inguinofemoral hernias. Sixty-six percent of hospital centers had a specific abdominal wall unit and 24% performed laparoscopic hernia surgery. Prosthetic techniques (especially Lichtenstein) were the most frequently used in the treatment of primary inguinal hernia (72%) and recurrent hernia (100%). The most frequently used prosthetic material was polypropylene mesh (76%). Only 28% of the departments surveyed performed anatomic techniques in the repair of primary inguinal hernia (Shouldice and Bassini). The most frequent treatment for femoral hernia was the Lichtenstein "plug" (78%). Sixty-eight percent of the centers surveyed performed regional anesthesia, 18% used general anesthesia and only 14% used local anesthesia with sedation. Severe complications were found in 20% of departments. Clinical postoperative follow-up was performed in 96% of the centers and telephone follow-up was used in 4%. The recurrence rate was 1.2% for primary inguinal hernia, 2.7% for recurrent inguinal hernia and 0.3% for femoral hernia. In Spain the most commonly used surgical technique in the treatment of inguinal hernia is Lichtenstein hernioplasty under spinal anesthesia and with polypropylene prosthesis. The Lichtenstein plug is the most commonly used technique in the treatment of femoral hernia.

  10. Invasive Pulmonary Fungal Infections in Cystic Fibrosis.

    PubMed

    Schwarz, Carsten; Brandt, Claudia; Whitaker, Paul; Sutharsan, Sivagurunathan; Skopnik, Heino; Gartner, Silvia; Smazny, Christina; Röhmel, Jobst F

    2017-09-01

    Invasive pulmonary mycosis is after allergic bronchopulmonary aspergillosis (ABPA) a frequent and severe complication of CF lung disease. Among CF caregivers, there is an insecurity when and how to treat infections of the lung parenchyma caused by different fungi in patients with CF. This case series provides a multicenter experience on diagnostic, manifestation, and treatment of non-ABPA cases of pulmonary. Non-ABPA cases of pulmonary mycoses in patients with CF have been collected from the CF Centers in Berlin, Essen, Worms, Frankfurt (Germany), Leeds (UK), and Barcelona (Spain). Non-ABPA was defined as total serum IgE level <500 kU/L. Scedosporium and Lomentospora species seem to be more virulent in patients with CF and have been successfully treated with triple antifungal drug regimens in several cases. Rare fungi including yeasts can have pathogenic potential in CF. In this series, antibiotic treatment failure was the main indicator for the initiation of antifungal treatment. For an early and effective treatment of pulmonary mycoses in CF, the identification of biomarkers and of risk factors beyond antibiotic treatment failure is crucial and urgently needed. Furthermore, treatment efficacy studies are necessary for the different causative agents of these infections.

  11. Multicenter case-control study on restless legs syndrome in multiple sclerosis: the REMS study.

    PubMed

    Manconi, Mauro; Ferini-Strambi, Luigi; Filippi, Massimo; Bonanni, Enrica; Iudice, Alfonso; Murri, Luigi; Gigli, Gian Luigi; Fratticci, Lara; Merlino, Giovanni; Terzano, Giovanni; Granella, Franco; Parrino, Liborio; Silvestri, Rosalia; Aricò, Irene; Dattola, Vincenzo; Russo, Giovanna; Luongo, Carmela; Cicolin, Alessandro; Tribolo, Antonella; Cavalla, Paola; Savarese, Mariantonietta; Trojano, Maria; Ottaviano, Salvatore; Cirignotta, Fabio; Simioni, Valentina; Salvi, Fabrizio; Mondino, Fiorella; Perla, Franco; Chinaglia, Giorgia; Zuliani, Cristina; Cesnik, Edward; Granieri, Enrico; Placidi, Fabio; Palmieri, Maria Giuseppina; Manni, Raffaele; Terzaghi, Michele; Bergamaschi, Roberto; Rocchi, Raffaele; Ulivelli, Monica; Bartalini, Sabina; Ferri, Raffaele; Lo Fermo, Salvatore; Ubiali, Emilio; Viscardi, Massimo; Rottoli, Mariarosa; Nobili, Lino; Protti, Alessandra; Ferrillo, Franco; Allena, Marta; Mancardi, Gianluigi; Guarnieri, Biancamaria; Londrillo, Francesco

    2008-07-01

    To verify the existence of a symptomatic form of restless legs syndrome (RLS) secondary to multiple sclerosis (MS) and to identify possible associated risk factors. Prospective, multicenter, case-control epidemiologic survey. Twenty sleep centers certified by the Italian Association of Sleep Medicine. Eight hundred and sixty-one patients affected by MS and 649 control subjects. N/A. Data regarding demographic and clinical factors, presence and severity of RLS, the results of hematologic tests, and visual analysis of cerebrospinal magnetic resonance imaging studies were collected. The prevalence of RLS was 19% in MS and 4.2% in control subjects, with a risk to be affected by RLS of 5.4 (95%confidence interval: 3.56-8.26) times greater for patients with MS than for control subjects. In patients with MS, the following risk factors for RLS were significant: older age; longer MS duration; the primary progressive MS form; higher global, pyramidal, and sensory disability; and the presence of leg jerks before sleep onset. Patients with MS and RLS more often had sleep complaints and a higher intake of hypnotic medications than patients with MS without RLS. RLS associated with MS was more severe than that of control subjects. RLS is significantly associated with MS, especially in patients with severe pyramidal and sensory disability. These results strengthen the idea that the inflammatory damage correlated with MS may induce a secondary form of RLS. As it does in idiopathic cases, RLS has a significant impact on sleep quality in patients with MS; therefore, it should be always searched for, particularly in the presence of insomnia unresponsive to treatment with common hypnotic drugs.

  12. Satisfaction and expectations of patients with inflammatory bowel disease on biologic therapy: a multicenter study

    PubMed Central

    Guarini, Alessandra; Biagini, Silvia; Capaldi, Antonella; Carretto, Daniela; Angelis, Anna De; Iudice, Salvatore; Martino, Giuseppina; Marziali, Barbara; Mattiola, Roberta; Ongarelli, Cristina; Onidi, Francesca Maria; Prinzio, Manuela; Puthiavettil, Reetha; Sardi, Romina; Schiavoni, Elisa; Sinatora, Rita; Zullo, Angelo

    2017-01-01

    Background The satisfaction perceived by patients with chronic diseases affects clinical outcomes and healthcare costs. Some patients with inflammatory bowel disease (IBD) develop a more severe form requiring biologic therapy. We assessed the quality of care perceived by IBD patients in dedicated centers. Methods This prospective, cross-sectional, multicenter study enrolled consecutive IBD patients who underwent biologic therapy in the participating centers. The nurses directly involved in the management of these patients explained the rationale of the survey, provided a specific questionnaire (CACHE), and collected data. The CACHE included 31 items structured in 6 domains: staff care, clinician care, center facilities, patient information, accessibility, and patient support. Patients’ satisfaction score for each domain ranged from 0 to 100%. Results Sixteen different Italian centers participated and a total of 450 patients were enrolled (283 with Crohn’s disease and 167 with ulcerative colitis). The overall score was 82.2±19.6, satisfaction with the clinicians care scoring the highest (87.6±3.2) and the information provided to the patient scoring the lowest (70.7±7.9). More specifically, it emerged that 5.2-19.5% of patients were unsatisfied with: 1) the communication between the IBD medical team and primary care physicians; 2) information received about the disease or patients’ associations; and 3) the accessibility of the center. Conclusion Although our data revealed an acceptably high rate of global satisfaction among IBD patients receiving biologic therapy, more effort should be made to improve patient information and communication between IBD teams, other specialists and primary care physicians. PMID:28042244

  13. The new Italian code of medical ethics.

    PubMed

    Fineschi, V; Turillazzi, E; Cateni, C

    1997-08-01

    In June 1995, the Italian code of medical ethics was revised in order that its principles should reflect the ever-changing relationship between the medical profession and society and between physicians and patients. The updated code is also a response to new ethical problems created by scientific progress; the discussion of such problems often shows up a need for better understanding on the part of the medical profession itself. Medical deontology is defined as the discipline for the study of norms of conduct for the health care professions, including moral and legal norms as well as those pertaining more strictly to professional performance. The aim of deontology is therefore, the in-depth investigation and revision of the code of medical ethics. It is in the light of this conceptual definition that one should interpret a review of the different codes which have attempted, throughout the various periods of Italy's recent history, to adapt ethical norms to particular social and health care climates.

  14. Activity profile in elite Italian soccer team.

    PubMed

    Vigne, G; Gaudino, C; Rogowski, I; Alloatti, G; Hautier, C

    2010-05-01

    The purpose of this study was to analyse the activity profile of players in a top-class team in the Italian national football league over the course of a season (n=388). The effect of playing position and the two halves on the number and duration of short, intense bursts of effort and recovery phases was studied. The main results show that midfielders cover significantly more distance than players in other positions (p<0.001). For midfielders, the number of displacements of 2-40 m and the number of sprints covering between 2 and 9 m and between 30 and 40 m are considerably greater than for other positions (p<0.05). The distances covered in the second half compared to the first half are significantly lower for all categories of run (p<0.05). In the second half, the distance covered at very high intensity is significantly lower (p<0.01), whilst the number of recovery times greater than 120 s increases significantly compared to the first half (p<0.01). This study provides data which could be used as a basis for the work of scientists as well as football professionals.

  15. Observed Seismic Vulnerability of Italian Buildings

    SciTech Connect

    Rota, Maria; Magenes, Guido; Penna, Andrea; Strobbia, Claudio L.

    2008-07-08

    A very large database of post-earthquake building inspections carried out after the main Italian events of the last 30 years has been processed in order to derive fragility curves for 23 building typologies, mostly referring to masonry structures. The records (more than 91000) of this very complete and homogeneous dataset have been converted into a single damage scale with five levels of damage, plus the case of no damage. For each affected municipality a value of PGA and Housner Intensity (I{sub H}) has been evaluated using attenuation laws. Damage probability matrices have been then extracted. These experimental data have been fitted through lognormal fragility curves using an advanced nonlinear regression algorithm also taking into account the relative reliability of each point by the bootstrap technique. The significant concentration of experimental data at low levels of ground motion, associated to the selected analytical expression, determine the peculiar shape of some of the curves, with a very steep initial branch followed by an almost horizontal curve for increasing values of ground motion. Explanations and possible solutions are discussed.

  16. Gender and lexical access in Italian.

    PubMed

    Bates, E; Devescovi, A; Pizzamiglio, L; D'Amico, S; Hernandez, A

    1995-08-01

    Two new procedures were employed to investigate the effects of semantic and grammatical gender on lexical access in Italian and to investigate the interaction of gender with other factors that are known to influence lexical access in other languages. The gender-monitoring task requires a conscious decision about the gender of each noun, whereas the word repetition task does not require explicit attention to gender. In both tasks, single words are presented out of context, under speeded conditions. Both procedures proved to be sensitive indices of word recognition, with reaction times that are closely tied to the point at which words can be uniquely identified (although some processing before and after the uniqueness point was seen). In both tasks, reaction times were strongly affected by phonological factors (e.g., length, number of syllables, and presence of frication on the initial consonant). Phonological transparency of gender marking had a reliable effect on gender monitoring but had no effect on word repetition, suggesting that explicit attention to gender may be a factor affecting utilization of this phonological cue. Semantic factors (including semantic gender) had no effect on performance. Frequency and age of acquisition had very small effects when other factors were controlled. Implications for current models of lexical access are discussed, with special reference to the role of gender.

  17. The new Italian code of medical ethics.

    PubMed Central

    Fineschi, V; Turillazzi, E; Cateni, C

    1997-01-01

    In June 1995, the Italian code of medical ethics was revised in order that its principles should reflect the ever-changing relationship between the medical profession and society and between physicians and patients. The updated code is also a response to new ethical problems created by scientific progress; the discussion of such problems often shows up a need for better understanding on the part of the medical profession itself. Medical deontology is defined as the discipline for the study of norms of conduct for the health care professions, including moral and legal norms as well as those pertaining more strictly to professional performance. The aim of deontology is therefore, the in-depth investigation and revision of the code of medical ethics. It is in the light of this conceptual definition that one should interpret a review of the different codes which have attempted, throughout the various periods of Italy's recent history, to adapt ethical norms to particular social and health care climates. PMID:9279746

  18. Analysis of some Italian lemon liquors (limoncello).

    PubMed

    Andrea, Versari; Nadia, Natali; Teresa, Russo Maria; Andrea, Antonelli

    2003-08-13

    The chemical composition of several commercial Italian Limoncellos, lemon-peel-based alcoholic beverages, was studied by chromatographic techniques. These methods allowed a rapid monitoring of Limoncello, giving information on quality markers and possible adulteration of the product. Quantitative data for more than 60 compounds are reported. Limoncellos were characterized by the presence of selected volatile (terpenes, aldehydes, alcohols) and nonvolatile compounds (psoralens, coumarins, phenolics, carbohydrates and acids). On the basis of their composition, the samples were grouped by PCA analysis in two sets; the first group showed a composition similar to lemon essential oils, with a high content of b-pinene, myrcene, trans-a-bergamottene, and b-bisabolene, and a low content in neral and geranial. The composition of the second group suggested the occurrence of oxidative phenomena and/or the addition of flavors. The presence of ethyl acetate, acetaldehyde, 2-methyl-1-propanol and glycerol showed that a fermentation probably occurred in the sugar syrup used to dilute the Limoncello after the extraction process.

  19. Reduced male births in major Italian cities.

    PubMed

    Astolfi, P; Zonta, L A

    1999-12-01

    The downward trend in the sex ratio at birth that has occurred in several countries over the last 30 years was postulated to signal a deterioration in environmental conditions, particularly unfavourable for male conception and fetus survival. In Italy, in contrast, an upward trend has been observed. Assuming that exposure to reproductive hazards occurs mainly in the major cities, we contrasted the 1970-1995 sex ratio trend for the metropolitan area (defined as the four provinces containing the largest Italian cities) with that for the non-metropolitan area (defined as the rest of the country). In the metropolitan area, the proportion of live-born males showed a negative trend significantly different from the positive trend observed in the rest of the country. Moreover, the stillbirth rate among males was constantly and significantly higher in the metropolitan area. Our results suggest that the decrease in the sex ratio at birth observed in the metropolitan area might be interpreted as a signal of increasing exposure to hazardous environmental conditions for male conceptions and neonates.

  20. [The gender gap in Italian medicine].

    PubMed

    De Simone, Silvia; Podda, Daiana; Lampis, Jessica

    2015-01-28

    This study is collocated in the debate about the gender gap in Medicine giving voice to female physicians who have damaged the "glass ceiling". Our research offers a contribute to the exploration about the motivations of persistence of gender gap in Medicine despite current changes. This study is based on 21 biographical interviews to female physicians who are managers in Italian hospitals. The themes emerged by data analysis concerned the participants 'discrimination experiences in their hierarchical advancement, the evidences of a persistence of horizontal segregation in some medical specializations, the difficult to find a work-life balance and the effects of this difficult on the female physicians' health. Our research confirmed a persistence of gender gap in the medical world, which disadvantages women in their career choices and in their hierarchical advancement and which appears in the form of invisible barriers impregnated of stereotypes and prejudices that are taken for granted by many men and women, especially those who have the power; these barriers make the female doctors 'health more vulnerable to the event of work-related stress. By the dates emerged the necessity of cultural and institutional interventions, actions for deconstruction of gender stereotypes, and the necessity of intervention for a more flexible and functioning work organization that satisfies the female physicians' needs.

  1. Antibiotic resistance: Italian awareness survey 2016.

    PubMed

    Prigitano, Anna; Romanò, Luisa; Auxilia, Francesco; Castaldi, Silvana; Tortorano, Anna M

    2017-03-09

    Antimicrobial resistance has become a public health priority worldwide. The WHO conducted a survey concerning the personal use of antibiotics, knowledge of appropriate use and awareness of the issue of resistance. A similar survey was conducted in Italy involving 666 young university students and 131 seniors attending courses of the University of the third age. Antibiotics seem to be taken with moderate frequency and appropriately: 30% of respondents took them in the past six months and 94% took these drugs only prescribed by a doctor, in the correct dose and for the proper duration. Notable confusion concerning the conditions treatable with antibiotics was detected (only 30% indicated gonorrhea, and 30-40% believed that antibiotics should be employed for fever, cold, and flu), while 94% of participants seemed aware of the problem of antibiotic resistance. Most of the respondents identified the behaviors that can reduce the phenomenon of resistance (regular handwashing and use of antibiotics only when prescribed and needed). The results of our survey, that involved people of high level of instruction and living in urban areas of northern regions, cannot be extended to all the Italian population. However, they provide valid elements to promote initiatives aimed to a more aware use of antibiotics.

  2. [Italian Cystic Fibrosis Register - Report 2010].

    PubMed

    Amato, Annalisa; Ferrigno, Luigina; Salvatore, Marco; Toccaceli, Virgilia

    2016-01-01

    The Italian National CF Registry (INCFR) is based on the official agreement between the clinicians of the Italian National Referral Centers for Cystic Fibrosis and the researchers of the Istituto Superiore di Sanità (National Center for Rare Diseases; National Center for Epidemiology, Surveillance and Health Care Promotion). OBJECTIVES The main aim of INCFR is to contribute to the improvement in CF patients health care and clinical management through: i. the estimates of CF prevalence and incidence in Italy; ii. the analyses of medium and long term clinical and epidemiological trends of the disesase; iii. the identification of the main health care needs at regional and national level to contribute to the Health Care programmes and to the distribution of resources. MATERIALS AND METHODS Analyses and results described in the present Report are referred to patients in charge to the Italian National Referral Centers for Cystic Fibrosis in 2010. Data were sent by Centers by means of a specific software (Camilla, Ibis Informatica). The Italian National Referral Centers for Cystic Fibrosis sent a total of 5,271 individual records; 1,112 records were excluded from the analyses due to restricted inclusion criteria. The total number of patients included in INCFR for analyses is 4,159. RESULTS INCFR database includes all prevalent cases at 1th January 2010 as well as all new diagnoses done in 2010. The present Report has been organized into 9 sections. 1. Demography: estimated 2010 CF prevalence was 7/100,000 residents in Italy; 52% of the patients were male, CF distribution showed higher frequency in patients aged 7 to 35 years. In 2010, 48.9% of the patients were more than 18 years old. 2. Diagnoses: most of the CF patients were diagnosed before two years of age (66.7%); a significant percentage of patients (11.4%) was diagnosed in adult-age. 3. New diagnoses (2010): new diagnoses were 168. Sixty-five percent of them was diagnosed before the second year of age and 17%in

  3. [Significance of mobbing in Italian law].

    PubMed

    Bollani, A

    2008-01-01

    The author analyzes the juridical profile that the phenomenon of mobbing assumes within the Italian legal system, emphasizing that the English term of current usage does not designate any specific legal entity as such but simply refers, in summary fashion, to deeds and behaviours that need to be qualified according to the law in vigour. The normative frame of reference for mobbing is found in article 2087 of the Civil code, which states, as an open, teleologically oriented norm, the employer's obligation to safeguard the moral person of the employee; hence the onus is on the interpreter, essentially, to evaluate if there has been, in actual fact, a contravention of this safeguarded legal right. The author then discusses profiles that intersect with mobbing (or behaviours perceived as such) drawing on other cases regulated by the law such as the safeguarding of professionality (art. 2103 of the Civil code), and underlines that often mobbing ends by being construed as a mere accompaniment to, if not duplication of, other typical cases. Finally, the author discusses aspects of the judicial process related to the allegation and proof of the facts constituting the offence, and to the damage, in its various non patrimonial components.

  4. The French-Italian Concordia Station

    NASA Astrophysics Data System (ADS)

    Mekarnia, Djamel; Frenot, Yves

    2013-01-01

    Concordia is a French-Italian permanent station located at Dome C, Antarctica. The station provides accommodation for up to 16 people over winter and more than 70 scientists and technicians during the austral summer. The scientific projects implemented at Concordia are strictly dependent on the characteristics of the site: a) the presence of a 3 300 m thick ice cap that allows access to the planet's climate archives and the reconstruction of glacial-interglacial cycles over more than 800 000 years; b) a particularly stable pure and dry atmosphere ideal for astronomy observations and for research on the chemical composition of the atmosphere; c) a distant location from coastal perturbations favourable to magnetic and seismological observatories to complement a poor world data network in the southern hemisphere; and d) a small totally isolated group of people confined to the station over a long winter, offering an opportunity for a range of medical and psychological studies useful to prepare long duration deep space missions. We will address the main characteristics of this station and its interest for science.

  5. Light - Shadow Interactions in Italian Medieval Churches

    NASA Astrophysics Data System (ADS)

    Incerti, Manuela

    In the relationship between architecture and the sky, it is possible to identify three different design issues. The first regards the alignment of buildings with visible points on the horizon that coincide with the rising or setting of a celestial body (sun, planets, stars, or moon) on particular dates during the astronomical year (or liturgical year for sacred buildings). The second is the relationship between planimetric design and the design of the elevations. We are all familiar today with several "light effects", which sometimes have almost hierophanic characteristics that, on certain days of the year, were used to engross, captivate, and amaze the spectator. Contrary to the first two issues, the third comes after the design and building stages and concerns the question of decorative elements. It is reasonable to believe that many years after the works were terminated, certain wall finishings were chosen over others, such as painted frescoes or statues. Whoever did this was fully aware, thanks to direct observation, that such decoration would be struck by a single ray of light on a specific day. This chapter examines light-shadow interactions in some Italian medieval churches.

  6. Biological dosimetry in Russian and Italian astronauts

    NASA Astrophysics Data System (ADS)

    Greco, O.; Durante, M.; Gialanella, G.; Grossi, G.; Pugliese, M.; Scampoli, P.; Snigiryova, G.; Obe, G.

    Large uncertainties are associated with estimates of equivalent dose and cancer risk for crews of longterm space missions. Biological dosimetry in astronauts is emerging as a useful technique to compare predictions based on quality factors and risk coefficients with actual measurements of biological damage in-flight. In the present study, chromosomal aberrations were analyzed in one Italian and eight Russian cosmonauts following missions of different duration on the MIR and the international space station (ISS). We used the technique of fluorescence in situ hybridization (FISH) to visualize translocations in chromosomes 1 and 2. In some cases, an increase in chromosome damage was observed after flight, but no correlation could be found between chromosome damage and flight history, in terms of number of flights at the time of sampling, duration in space and extra-vehicular activity. Blood samples from one of the cosmonauts were exposed in vitro to 6 MeV X-rays both before and after the flight. An enhancement in radiosensitivity induced by the spaceflight was observed.

  7. Acoustics of Italian Historical Opera Houses.

    PubMed

    Prodi, Nicola; Pompoli, Roberto; Martellotta, Francesco; Sato, Shin-ichi

    2015-08-01

    Opera houses represent a large group of performance spaces characterized by great complexity and, at the same time, versatility with respect to different usage (from opera to symphonic music and ballet). This kind of building originated in Italy during the 17th century and later spread across the country and then Europe and the rest of the world, slowly evolving into modern theatre shapes. As a consequence of the changes undergone by the interior space, the original acoustic features, which likely influenced many composers, experienced important variations. Thanks to acoustic measurement campaigns inside Italian Historical Opera Houses, promoted by National and Regional Projects, the distinctive features of these spaces were investigated in comparison to modern spaces. In this work, the newly acquired data are merged with data in the literature in order to present and discuss some of the distinctive acoustic features of historical spaces as regards their original function. Moreover, specific issues such as listening in stalls and boxes and the criteria governing the preference judgment of listeners are considered. The concept and the crucial role of the balance between stage and pit sources are also discussed by means of previous literature studies.

  8. Biological dosimetry in Russian and Italian astronauts.

    PubMed

    Greco, O; Durante, M; Gialanella, G; Grossi, G; Pugliese, M; Scampoli, P; Snigiryova, G; Obe, G

    2003-01-01

    Large uncertainties are associated with estimates of equivalent dose and cancer risk for crews of long-term space missions. Biological dosimetry in astronauts is emerging as a useful technique to compare predictions based on quality factors and risk coefficients with actual measurements of biological damage in-flight. In the present study, chromosomal aberrations were analyzed in one Italian and eight Russian cosmonauts following missions of different duration on the MIR and the international space station (ISS). We used the technique of fluorescence in situ hybridization (FISH) to visualize translocations in chromosomes 1 and 2. In some cases, an increase in chromosome damage was observed after flight, but no correlation could be found between chromosome damage and flight history, in terms of number of flights at the time of sampling, duration in space and extra-vehicular activity. Blood samples from one of the cosmonauts were exposed in vitro to 6 MeV X-rays both before and after the flight. An enhancement in radiosensitivity induced by the spaceflight was observed. c2003 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  9. Markers of Deception in Italian Speech

    PubMed Central

    Spence, Katelyn; Villar, Gina; Arciuli, Joanne

    2012-01-01

    Lying is a universal activity and the detection of lying a universal concern. Presently, there is great interest in determining objective measures of deception. The examination of speech, in particular, holds promise in this regard; yet, most of what we know about the relationship between speech and lying is based on the assessment of English speaking participants. Few studies have examined indicators of deception in languages other than English. The world’s languages differ in significant ways, and cross-linguistic studies of deceptive communications are a research imperative. Here we review some of these differences amongst the world’s languages, and provide an overview of a number of recent studies demonstrating that cross-linguistic research is a worthwhile endeavor. In addition, we report the results of an empirical investigation of pitch, response latency, and speech rate as cues to deception in Italian speech. True and false opinions were elicited in an audio-taped interview. A within-subjects analysis revealed no significant difference between the average pitch of the two conditions; however, speech rate was significantly slower, while response latency was longer, during deception compared with truth-telling. We explore the implications of these findings and propose directions for future research, with the aim of expanding the cross-linguistic branch of research on markers of deception. PMID:23162502

  10. Hardcore smoking among Italian men and women.

    PubMed

    Ferketich, Amy K; Gallus, Silvano; Colombo, Paolo; Pacifici, Roberta; Zuccaro, Piergiorgio; La Vecchia, Carlo

    2009-04-01

    Hardcore smokers are described as heavy smokers who have not attempted to quit and have no future intentions to quit. The objectives of this study were to characterize hardcore and nonhardcore smokers in Italy. The data for this analysis were collected from 3057 Italians aged 15 years and older in March and April 2007 who were randomly selected to be representative of the population. Hardcore smoking, defined as consuming 15 or more cigarettes per day with no earlier quit attempts and no future intention to quit, was examined in individuals who were aged 26 years and older. Hardcore smokers were compared with their nonhardcore counterparts with respect to sociodemographic and smoking characteristics, perceived stress, and attitudes and beliefs about smoking. The smoking prevalence overall was 23.5% (27.9% among males and 19.3% among females). An estimated 7.8% of individuals were hardcore smokers (9.7% among males and 6% among females), which translates into 33.1% of all smokers in Italy. Age at smoking initiation, occupation (among males), home smoking rules, and perceived stress (among females) distinguished hardcore from nonhardcore smokers. This is the highest prevalence of hardcore smoking that has been reported in the literature to date. This reflects the general attitude toward smoking cessation in Italy. Although the indoor smoking ban has helped to reduce the rate of smoking, it is clearly not enough. Stronger tobacco control measures are warranted.

  11. Socio-demographic and clinical characterization of patients with Bipolar Disorder I vs II: a Nationwide Italian Study.

    PubMed

    Altamura, A Carlo; Buoli, Massimiliano; Cesana, Bruno; Dell'Osso, Bernardo; Tacchini, Gianluigi; Albert, Umberto; Fagiolini, Andrea; de Bartolomeis, Andrea; Maina, Giuseppe; Sacchetti, Emilio

    2017-04-01

    Bipolar disorders (BDs) are prevalent, comorbid and disabling conditions, associated with the highest suicide risk among psychiatric illnesses. In the last few years, new efforts to better characterize the socio-demographic and clinical profiles of BD type I vs II have been documented by several reports, with novel and insightful findings in the field. The present multicenter study aimed to provide a comprehensive and reliable representation of the Italian reality, through the analysis of the largest national sample of bipolar patients collected so far. A total of 1500 patients (BD I n = 963 and BD II n = 537) from different psychiatric departments, participating in the Italian Chapter of the "International Society of Bipolar Disorders" (ISBD), were assessed and divided into two groups on the basis of their diagnostic subtype, and different socio-demographic and clinical variables were compared between the two subgroups. Chi-squared tests for categorical variables and t tests for continuous variables were performed for group comparison. Furthermore, a multivariable logistic regression was performed, considering diagnostic bipolar subtype (type I or II) as dependent variable, and socio-demographic/clinical characteristics as independent variables. BD I vs II patients showed an overall less favorable socio-demographic and clinical profile. In addition, the multivariable logistic regression showed that BD II vs BD I was predicted by the absence of lifetime suicide attempts (OR = 1.58, p = 0.01), a later age of diagnosis (OR = 1.03, p < 0.01), less hypomanic episodes in the last year (OR = 2.29, p < 0.0001) and absence of psycho-educational interventions in the last year (OR = 0.51, p < 0.01). BD I and II patients were found to significantly differ in relation to specific clinical variables, which should be considered within updated diagnostic-therapeutic algorithms.

  12. Minimally invasive procedures

    PubMed Central

    Baltayiannis, Nikolaos; Michail, Chandrinos; Lazaridis, George; Anagnostopoulos, Dimitrios; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Lampaki, Sofia; Papaiwannou, Antonis; Karavergou, Anastasia; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

    2015-01-01

    Minimally invasive procedures, which include laparoscopic surgery, use state-of-the-art technology to reduce the damage to human tissue when performing surgery. Minimally invasive procedures require small “ports” from which the surgeon inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then a miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized equipment is inserted through the trocars based on the type of surgery. There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry—meaning only one small incision, like the “uniport” video-assisted thoracoscopic surgery (VATS). Not only do these procedures usually provide equivalent outcomes to traditional “open” surgery (which sometimes require a large incision), but minimally invasive procedures (using small incisions) may offer significant benefits as well: (I) faster recovery; (II) the patient remains for less days hospitalized; (III) less scarring and (IV) less pain. In our current mini review we will present the minimally invasive procedures for thoracic surgery. PMID:25861610

  13. Practice parameters for early colon cancer management: Italian Society of Colorectal Surgery (Società Italiana di Chirurgia Colo-Rettale; SICCR) guidelines.

    PubMed

    Bianco, F; Arezzo, A; Agresta, F; Coco, C; Faletti, R; Krivocapic, Z; Rotondano, G; Santoro, G A; Vettoretto, N; De Franciscis, S; Belli, A; Romano, G M

    2015-10-01

    Early colon cancer (ECC) has been defined as a carcinoma with invasion limited to the submucosa regardless of lymph node status and according to the Royal College of Pathologists as TNM stage T1 NX M0. As the potential risk of lymph node metastasis ranges from 6 to 17% and the preoperative assessment of lymph node metastasis is not reliable, the management of ECC is still controversial, varying from endoscopic to radical resection. A meeting on recent advances on the management of colorectal polyps endorsed by the Italian Society of Colorectal Surgery (SICCR) took place in April 2014, in Genoa (Italy). Based on this material the SICCR decided to issue guidelines updating the evidence and to write a position statement paper in order to define the diagnostic and therapeutic strategy for ECC treatment in context of the Italian healthcare system.

  14. TRAIN: Training through Research Application Italian iNitiative.

    PubMed

    Lombardo, Claudio; Bottero, Sergio; d'Alessandro, Francesca; Giacomini, Mauro; Guderzo, Angela; Moretti, Franca; Marincola, Margherita; Pesce, Giorgia; Pierotti, Marco A; Spagnoli, Luigi Giusto; Belardelli, Filippo

    2011-01-01

    Training through Research Application Italian iNitiative (TRAIN) is a mobility program financed under the EU action called "Cofinancing of regional, national and international programs" (COFUND) of the European Commission Seventh Framework Program (FP7) - People, and has been designed to encourage the promotion and development of international programs of research through mobility at various stages of research careers. The aim of TRAIN is to improve translational skills in the field of cancer by promoting a three-year international mobility program assigning a total of 51 fellowships subdivided into incoming, outgoing and reintegration fellowships.?The TRAIN proposal has been submitted in February 2009 to the European Commission in reply to the 2008 FP7-PEOPLE-COFUND call and has been successfully evaluated. TRAIN is addressed to postdoctoral scientists or scientists who have at least four years' full-time equivalent research experience and who wish to improve their careers spending one year abroad. The mobility program is open also to non-Italian experienced scientists wishing to spend one year in an Italian research center or private company. Part of the scheme is targeted to experienced Italian scientists who have completed at least three years of research in a foreign country and are interested in returning to Italy.?TRAIN is part of an overall Italian strategy outlined by the International Program of the Italian Cancer Network "Alleanza Contro il Cancro" to promote Italian participation in the building of the European Area for translational cancer research and to enhance the interaction between academy and industry.

  15. Immigration and health: the Italian situation. Italian National Focal Point (NFP) of the AIDS & Mobility Project.

    PubMed

    Colucci, A; Covre, P; D'Agostini, A; Gallo, P; Geraci, S; Kanieff, M; Luzi, A M; Mayer, R; Morrone, A; Morte Karag, M R; Petrosillo, N; Spizzichino, L; Claver, P T; Volpicelli, S

    1998-01-01

    This report is a description of the situation of migrant populations in Italy. It was written as part of the European project "AIDS & Mobility", which is being co-ordinated by the Netherlands Institute for Health Promotion and Disease Prevention and financed by the European Union (EU). The report was written by the Italian National Focal Point (NFP) of the AIDS & Mobility Project, which consists of a committed team of experts from public institutions, non-governmental organizations, volunteer associations, and researchers from the Telefono Verde AIDS (National AIDS Help-line of Italy) of the Centro Operativo AIDS (COA, National AIDS Unit of Italy) of the Istituto Superiore di Sanità. The report illustrates the phenomenon of immigration in Italy, with demographic data (updated at 31 December 1997) on the presence of non-Italians and a review of the current laws pertinent to this phenomenon, with particular reference to health care laws. Moreover, epidemiological data on HIV/AIDS and on sexually transmitted diseases are provided, particularly as they relate to drug addiction and prostitution. Finally, following an accurate analysis of the situation and in light of the experience gained, the report includes proposals for identifying needs, objectives to pursue, and strategies to adopt, with respect to confronting the issue of immigration.

  16. Distribution of human papillomavirus genotypes in invasive cervical cancer in Italy: a representative, single institution case series.

    PubMed

    Sideri, Mario; Cristoforoni, Paolo; Casadio, Chiara; Boveri, Sara; Igidbashian, Sarah; Schmitt, Marcus; Gheit, Tarik; Tommasino, Massimo

    2009-05-29

    Despite worldwide human papillomavirus (HPV) types distribution showed constant rates of HPV 16/18 in cervical cancers, regional variations have been consistently documented. Very little data is available on HPV genotype prevalence among Italian women with invasive cervical cancer. This study aims to determine the HPV type distribution in cervical specimens obtained from Italian women diagnosed with invasive cervical cancer and referred to the European Institute of Oncology (IEO). Two hundred-sixty eight cervical specimens were obtained from patients diagnosed with invasive cervical cancer referred to the European Institute of Oncology between 1996 and 2006. Following preparation, all cervical samples were sent to laboratories at the International Agency for Research on Cancer (IARC, Lyon, France) for DNA extraction and HPV typing by the multiplex PCR/APEX assay. The study population was divided into four groups from different macro regions: (i) Milan and surrounding area (n=57, 21.3%), (ii) northern Italy (n=81, 30.2%), (iii) central Italy (n=64, 23.9%) and (iv) southern Italy (n=66, 24.6%). The present study is the first at our knowledge that examines a fair number of Italian cervical cancers, about one tenth of all estimated cervical cancer cases occurring yearly, distributed across the whole country. Two-hundred and fifty-one patients (93.7%) resulted HPV DNA positive; of these 201 patients (80.1%) presented a single infection, whereas 50 women (19.9%) presented multiple infection. One hundred and eighty-nine specimens (75.3%) tested positive for either HPV 16 or HPV 18, whereas 62 (24.7%) resulted positive for other high-risk HPV genotypes only. The proportion of HPV 16/18 positive invasive cervical cancers was similar for all the four geographical Italian areas considered. A statistically significant association with younger age and earlier stage was observed for HPV 16/18 related invasive cervical cancers. The results demonstrate that the proportion of HPV

  17. Multicenter observational prehospital resuscitation on helicopter study.

    PubMed

    Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

    2017-07-01

    at any time point, although only 10% of the high-risk sample were able to be matched. Because of the unexpected imbalance in systolic blood pressure, Glasgow Coma Scale, and Injury Severity Score between systems with and without blood products on helicopters, matching was limited, and the results of this study are inconclusive. With few units transfused to each patient and small outcome differences between groups, it is likely large, multicenter, randomized studies will be required to detect survival differences in this important population. Level II.

  18. Diagnostic Performance of Treadmill Exercise Cardiac Magnetic Resonance: The Prospective, Multicenter Exercise CMR's Accuracy for Cardiovascular Stress Testing (EXACT) Trial.

    PubMed

    Raman, Subha V; Dickerson, Jennifer A; Mazur, Wojciech; Wong, Timothy C; Schelbert, Erik B; Min, James K; Scandling, Debbie; Bartone, Cheryl; Craft, Jason T; Thavendiranathan, Paaladinesh; Mazzaferri, Ernest L; Arnold, John W; Gilkeson, Robert; Simonetti, Orlando P

    2016-08-19

    Stress cardiac magnetic resonance (CMR) has typically involved pharmacologic agents. Treadmill CMR has shown utility in single-center studies but has not undergone multicenter evaluation. Patients referred for treadmill stress nuclear imaging (SPECT) were prospectively enrolled across 4 centers. After rest (99m)Tc SPECT, patients underwent resting cine CMR. In-room stress was then performed using an MR-compatible treadmill with continuous 12-lead electrocardiogram monitoring. At peak stress, (99m)Tc was injected, and patients rapidly returned to the MR scanner isocenter for real-time, free-breathing stress cine and perfusion imaging. After recovery, cine and rest perfusion followed by late gadolinium enhancement acquisitions concluded CMR imaging. Stress SPECT was then acquired in adjacent nuclear laboratories. A subset of patients not referred for invasive coronary angiography within 2 weeks of stress underwent coronary computed tomography angiography. Angiographic data available in 94 patients showed sensitivity of 79%, specificity of 99% for exercise CMR with positive predictive value of 92% and negative predictive value of 96%. Agreement between treadmill stress CMR and angiography was strong (κ=0.82), and moderate between SPECT and angiography (κ=0.46) and CMR versus SPECT (κ=0.48). The multicenter EXACT trial indicates excellent diagnostic value of treadmill stress CMR in typical patients referred for exercise SPECT. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation – A Multicenter Comparison to Echocardiography

    PubMed Central

    Simprini, Lauren A.; Afroz, Anika; Cooper, Mitchell A.; Klem, Igor; Jensen, Christoph; Kim, Raymond J.; Srichai, Monvadi B.; Heitner, John F.; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J.; Lopez-Mattei, Juan; Biederman, Robert W.; Grizzard, John D.; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2016-01-01

    Background/Aim MR is an important complication after PMV. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-CMR holds potential to non-invasively assess regurgitant severity based on MR-induced inter-voxel dephasing. This study evaluated routine cine-CMR for visual assessment of prosthetic mitral valve (PMV) associated mitral regurgitation (MR). Methods Routine cine-CMR was performed at 9 sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild <1/3, moderate 1/3–2/3, severe >2/3): MR was graded in each long axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PSFR). Visual interpretation was compared to quantitative analysis in a single center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. Results The population comprised 85 PMV patients (59% mechanical, 41% bioprosthetic). Among the derivation cohort (n=25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p=0.001): Patients with severe MR had nearly a 3-fold increase in quantitative jet area (p=0.002), and 2-fold increase in density (p=0.04) than did others. Among the multicenter cohort, cine-CMR and TEE (Δ=2±3 days) demonstrated moderate agreement (κ=0.44); 64% of discordances differed by ≤ 1 grade (Δ=1.2±0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value=100%). Patients with visually graded severe MR also had more frequent PVSFR (p<0.001), denser jets (p<0.001), and larger left atria (p=0.01) on cine-CMR. Conclusions Cine-CMR is useful for assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter

  20. Routine cine-CMR for prosthesis-associated mitral regurgitation: a multicenter comparison to echocardiography.

    PubMed

    Simprini, Lauren A; Afroz, Anika; Cooper, Mitchell A; Klem, Igor; Jensen, Christoph; Kim, Raymond J; Srichai, Monvadi B; Heitner, John F; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J; Lopez-Mattei, Juan; Biederman, Robert W; Grizzard, John D; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2014-09-01

    Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magnetic resonance (CMR) holds the potential for the non-invasive assessment of regurgitant severity based on MR-induced inter-voxel dephasing. The study aim was to evaluate routine cine-CMR for the visual assessment of PMV-associated MR. Routine cine-CMR was performed at nine sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild < 1/3, moderate 1/3-2/3, severe > 2/3). MR was graded in each long-axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PVSFR). Visual interpretation was compared to quantitative analysis in a single-center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. The population comprised 85 PMV patients (59% mechanical valves, 41% bioprostheses). Among the derivation cohort (n = 25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p = 0.001). Patients with severe MR had an almost three-fold increase in quantitative jet area (p = 0.002), and a two-fold increase in density (p = 0.04) than did other patients. Among the multicenter cohort, cine-CMR and TEE (Δ =. 2 ± 3 days) demonstrated moderate agreement (κ = 0.44); 64% of discordances differed by ≤ 1 grade (Δ = 1.2 ± 0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value = 100%). Patients with visually graded severe MR also had more frequent PVSFR (p < 0.001), denser jets (p < 0.001), and larger left atria (p = 0.01) on cine-CMR. Cine-CMR is useful for the assessment of PMV-associated MR, which manifests