Publications by authors named "Annalisa de Silvestri"

Background: Asthma exacerbations in children pose a significant burden on healthcare systems and families. While traditional risk assessment tools exist, artificial intelligence (AI) offers the potential for enhanced prediction models.

Objective: This study aims to systematically evaluate and quantify the performance of machine learning (ML) algorithms in predicting the risk of hospitalisation and emergency department (ED) admission for acute asthma exacerbations in children.

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  • Severe asthma affects a small percentage of children, leading to frequent symptoms and hospitalizations, but global data on its prevalence is limited.
  • This study performs a systematic review and meta-analysis of existing research to provide insights into the prevalence and regional variations of severe asthma in children, sourcing data from studies published since 2003.
  • The meta-analysis found that the prevalence of severe asthma in European children aged 5-18 is around 3%, highlighting the need for future research to establish incidence rates, standardize definitions, and explore related health issues and treatment options.
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Endothelin-1 (ET-1) and transforming growth factor-β (TGF-β) play a pivotal role in the pathophysiology and vascular remodeling of chronic thromboembolic pulmonary hypertension (CTEPH) which is an under-diagnosed complication of acute pulmonary embolism (PE). Currently, pulmonary endarterectomy (PEA) is still the treatment of choice for selected patients suffering from CTEPH. The aim of this study was to evaluate the preoperative and postoperative circulating levels of ET-1 and TGF-β in subjects affected by CTEPH undergoing successful surgical treatment by PEA.

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  • The study investigates the relationship between vitamin D levels and lipid profiles in children and adolescents with obesity, highlighting the high prevalence of vitamin D deficiency in this group compared to those with normal weight.
  • Results show that individuals with low vitamin D levels had significantly worse indicators of metabolic health, including higher glucose levels, insulin resistance, and unfavorable lipid ratios.
  • The findings suggest that vitamin D deficiency is a modifiable risk factor for cardiometabolic issues, indicating the need for early intervention and preventive strategies.
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  • This study looked at two ways to measure how stiff the liver is, which helps doctors see if there is damage or disease in the liver.
  • They compared the results of these two methods, VCTE and ElastQ, using data from 840 people.
  • The findings showed that the differences in results got bigger as liver problems worsened, and some factors like BMI and distance between the skin and liver affected the measurements differently.
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Background: Psychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population.

Methods: A sample of high school adolescents was enrolled, and demographic and clinical data were collected.

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Background And Objective: Renal replacement therapy (RRT) plays a critical role in antimicrobial removal, particularly for low-molecular-weight drugs with low plasma protein binding, low distribution volume and hydrophilicity. Medium cut-off (MCO) membranes represent a new generation in dialysis technology, enhancing diffusive modality efficacy and increasing the cut-off from 30 to 45 kDa, crucial for middle molecule removal. This monocentric randomized crossover pilot study aimed to evaluate the impact of continuous haemodialysis with MCO membrane (MCO-CVVHD) on the removal of piperacillin, tazobactam and meropenem compared with continuous veno-venous hemodiafiltration with standard high-flux membrane (HFM-CVVHDF).

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  • The study investigates how the backscatter coefficient (BSC) in ultrasound measurements of the liver changes with depth, similar to how the attenuation coefficient (AC) does.
  • Using a Sequoia ultrasound system, researchers analyzed data from 104 individuals, adjusting for factors like age, sex, and skin-to-liver-capsule distance.
  • The results revealed that BSC decreases significantly with depth (around -13.98 dB/cm-steradian per cm), suggesting a need for a standardized protocol to improve measurement consistency and reliability over time.
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Integrating video clips in the discharge process may enhance patients' understanding and awareness of their condition. To determine the effect of video clip-integrated discharge discussion on patient comprehension of atrial fibrillation (AF) and deep vein thrombosis (DVT), and their main complications (stroke and pulmonary embolism), we designed a multicentre, pragmatic, parallel groups, randomised clinical trial, that was conducted at two Emergency Units in Italy. A convenience sample of 144 adult patients (or their caregivers) discharged home with either AF or DVT were randomised to receive standard verbal instructions (control) or video clip-integrated doctor-patient discharge discussion.

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  • Daptomycin is an antibiotic effective against serious infections like endocarditis caused by Staphylococcus aureus, and its effectiveness is best measured by the AUC 0-24 to minimum inhibitory concentration ratio.
  • The study involved calculating AUC 0-24 values in 50 White patients over at least five days, using a high-performance liquid chromatography method to analyze plasma concentrations.
  • The results showed that measuring daptomycin levels prior to and two hours after dosing provides a reliable estimation of AUC 0-24, facilitating personalized dosing strategies, particularly for patients at higher risk of treatment failure.
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Objectives: To assess whether meal or water intake may affect the measurement of the ultrasound (US) attenuation coefficient (AC) imaging, a parameter that is directly related to liver fat content.

Methods: The study was performed in two centers (Italy and USA). AC was obtained using the ATI algorithm implemented in the Aplio i-series US systems (Canon Medical Systems, Japan) by one operator at each center.

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Introduction: Diverticular disease (DD), commonly associated with the elderly, is becoming more prevalent among younger individuals. This retrospective study aimed to evaluate the differences in the natural history and outcomes between young and old patients with DD.

Methods: Adult patients with DD diagnosed between 2010 and 2022 at an Italian tertiary referral center were enrolled, and their demographic and clinical data were retrieved.

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  • The study investigates the diagnostic delay experienced by pediatric patients with celiac disease across 13 referral centers in Italy, covering cases from 2010 to 2019 and analyzing data in 2023.
  • It finds that the median diagnostic delay for these patients is about 5 months, with a notable portion experiencing extreme delays of 11 months or more.
  • Factors such as age at diagnosis influence delays, with younger patients (under 3 years) generally facing shorter wait times for diagnosis.
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  • Several mechanisms, such as immune system changes and new blood vessel formation, contribute to endometriosis development, prompting research into markers like the neutrophil-to-lymphocyte ratio (NLR).
  • This study analyzed 199 premenopausal women with endometriosis to explore the relationship between NLR values and symptoms like chronic pelvic pain.
  • While no significant associations were found between NLR and common indicators (like CA 125), the data suggests a potential link between higher NLR and chronic pelvic pain, particularly in women without prior treatments, which could help in tailoring follow-up care.
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  • The study examines the role of neutrophil-lymphocyte ratio (NLR) as a potential predictor for recurrence of high-grade cervical lesions (CIN2+) after treatment, focusing on the impact of persistent HPV infection.
  • The analysis was conducted on a dataset of 444 patients treated between 2011 and 2020, evaluating clinical characteristics and NLR at diagnosis.
  • Results indicate that patients with an NLR below 1.34 had a significantly higher recurrence rate and lower 5-year recurrence-free survival, suggesting NLR could be a useful marker in clinical settings.
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Structured light plethysmography (SLP) is a novel light-based method that captures chest wall movements to evaluate tidal breathing. Thirty-two children who underwent lung surgery were enrolled. Their clinical history was collected along with spirometry and SLP.

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Objectives: A connection between thyroid hormones (THs) and diverse metabolic pathways has been reported. We evaluated thyroid function and tissue sensitivity to THs in children and adolescents with T1D in comparison to euthyroid controls. Additionally, we investigate whether a relationship exists between sensitivity indices and metabolic parameters.

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The COVID-19 pandemic has led to significant psychological distress among frontline healthcare workers (HCWs), with a particular increase in trauma-related symptoms. This study investigated the longitudinal course of trauma-associated symptoms and behaviors in HCWs and the effectiveness of a brief dialectical behavior therapy (DBT)-informed intervention in mitigating these symptoms over 12 months. The trial included 225 HCWs randomly assigned to one of three groups: no intervention (control), in-person DBT-informed intervention, or online DBT-informed intervention.

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Purpose: Colonic pseudopolyps are a frequent finding in inflammatory bowel disease (IBD). Yet there are no published data describing the characteristics of pseudopolyposis in intestinal ultrasound (IUS). This study aimed at identifying the key features of pseudopolyposis in IUS.

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Objective: Human papillomavirus (HPV) persistence is considered the main risk factor for neoplastic progression, and evidence suggests that regulatory T cells play an important role in the failure of viral elimination. Regulatory T cells may be involved in maintaining a microenvironment favourable for viral persistence and neoplasticity, through a deregulation of the local immune response. The association between altered immune function and the development of chronic infections, cancer (solid and haematological), and autoimmune diseases is documented in the literature.

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  • Congestion in critically ill patients can lead to acute kidney injury (AKI), with a new concept called congestive nephropathy (CN) being linked to worsening kidney health.
  • This study assesses the use of pulsed Doppler (PD) to measure intrarenal venous flow (IRVF) and its potential to predict AKI occurrence in these patients, analyzing data from four studies involving 660 patients.
  • Results indicate that patients with a specific pulsatile PD pattern have a lower risk of developing AKI, but the studies showed a high level of variability, suggesting that more research is needed to confirm these findings.
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Background: Asthma is a common chronic disease in pediatric patients, and perimenstrual asthma (PMA), refers to the worsening of asthma symptoms during the perimenstrual period, mainly reported in adult women. However, there is limited information regarding the exacerbation of symptoms in the presence of premenstrual disorders (PMDs) in adolescents. The aim of this pilot observational study was to investigate the frequency and potential association of PMA and PMDs in a clinical sample of adolescents with asthma.

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