Publications by authors named "Curto F"

Article Synopsis
  • The study investigates how percutaneous tracheostomy (PT) affects respiratory compliance and end-expiratory lung volume during mechanical ventilation, focusing on patients with acute brain injury.
  • Results showed a significant decrease in lung volume and compliance immediately after PT, but a recruitment maneuver (RM) successfully reversed the loss and restored lung function.
  • The research also suggests that dynamic inflation during PT can help prevent lung derecruitment, and introduces a new formula to monitor this risk in real-time using electrical impedance tomography.
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Objectives: To compare respiratory system compliance (C rs ) calculation during controlled mechanical ventilation (MV) and, subsequently, during assisted MV.

Design: This is a single-center, retrospective, observational study.

Setting: This study was conducted on patients admitted to Neuro-ICU of Niguarda Hospital (tertiary referral hospital).

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Background: Alternative noninvasive methods capable of excluding intracranial hypertension through use of transcranial Doppler (ICPtcd) in situations where invasive methods cannot be used or are not available would be useful during the management of acutely brain-injured patients. The objective of this study was to determine whether ICPtcd can be considered a reliable screening test compared to the reference standard method, invasive ICP monitoring (ICPi), in excluding the presence of intracranial hypertension.

Methods: This was a prospective, international, multicenter, unblinded, diagnostic accuracy study comparing the index test (ICPtcd) with a reference standard (ICPi), defined as the best available method for establishing the presence or absence of the condition of interest (i.

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Objectives: to test if cavity dimensions and restorative protocol have potential to influence in-vitro adaptation of class II restoration after simulated thermo-occlusal stressing.

Methods: A total of 32 prepared teeth were randomly assigned to one of the 4 experimental groups depending on cavity size, composite system and filling technique; group 1: small cavity and multi-layered conventional restorative composite (Tetric Evo-ceram: TEC), group 2: small cavity and flowable bulk-filled composite (SDRFlow: SDR) + one single occlusal layer of conventional restorative composite (TEC), group 3: large cavity and multilayered conventional restorative composite (TEC) and group 4: large cavity and bulk-filled flowable composite (SDR) + one single occlusal layer conventional restorative composite (TEC). All specimens were submitted to 500'000 cycles of thermomechanical loading (50 N, 5 to 55 °C).

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Background: Patients with high spinal cord injury (SCI) are unable to breathe on their own and require mechanical ventilation (MV). The long-term use of MV is associated with increased morbidity and mortality. In patients with intact phrenic nerve function, patients can be partially or completely removed from MV by directly stimulating the diaphragm motor points with a diaphragm pacing system (DPS).

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Article Synopsis
  • Lombardy faced a significant COVID-19 outbreak, prompting a regional law to reorganize healthcare resources from March 8 to May 8, 2020, to better manage COVID-19 patients alongside other time-sensitive medical cases.
  • Key changes included reallocating ICU beds and supporting trauma, neurosurgical emergency, and stroke patients while maintaining transplant activities, with a focus on comparing patient outcomes from 2020 to 2019.
  • The study found a doubling in admissions for time-dependent conditions and an increase in local organ procurement, with unchanged in-ICU mortality ratios, indicating effective management despite the pandemic's challenges.
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Article Synopsis
  • Predicting outcomes for brain-injured patients with disorders of consciousness is challenging, particularly in the early stages of their recovery.
  • In this study, researchers used multiple techniques to analyze 15 acute DOC patients, focusing on brain activity and autonomic responses when exposed to emotional words.
  • They discovered that patients who later showed positive outcomes had a stronger autonomic response to meaningful words and retained activity in a specific brain region (PCC), suggesting these measures could help predict recovery potential in similar cases.
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Background: Diaphragm atrophy and dysfunction are consequences of mechanical ventilation and are determinants of clinical outcomes. We hypothesize that partial preservation of diaphragm function, such as during assisted modes of ventilation, will restore diaphragm thickness. We also aim to correlate the changes in diaphragm thickness and function to outcomes and clinical factors.

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OTX homeobox (HB) genes are expressed during embryonic morphogenesis and during the development of olfactory epithelium in adult organisms. Mutations occurring in these genes are often related to tumorigenesis in human. No data are available today regarding the possible correlation between OTX genes and tumors of the nasal cavity.

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In the case of discolored devitalized anterior teeth, several treatments are available to enhance the esthetic outcome, from noninvasive external/internal bleaching to freehand resin composites and more complex prosthetic solutions such as veneers or full crowns. Innovative computer-aided design/computer-aided manufacturing (CAD/CAM) chairside technologies and the introduction of new industrially polymerized composite resin blocks coupled with modern adhesive strategies have reduced both biological and financial costs compared to the classic post-core-crown approach. The aim of this article is to show how these new materials can be used in association with noninvasive internal and external tooth bleaching to restore a discolored, fractured, non-vital central incisor.

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Since the first introduction of the Cerec system (Sirona) in the early 1980s, the use of computer-aided design/computer-aided manufacture (CAD/CAM) technology has spread widely in modern adhesive dentistry. Thanks to this innovative technology, it has been possible to carry out chairside restorations fully managed by the clinician, with the advantages of lower costs for the patient, more rapid execution of the restorations, and the exclusion of the provisional phase. With further improvements in chairside technologies and materials, specifically in the field of composite resin blocks, it is now possible to fabricate multiple ultrathin, minimally invasive or even noninvasive restorations in one single appointment.

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The last few decades have seen an upward trend of the pathologies of abrasion, erosion, and abfraction. These pathologies, especially in combination, can provoke a significant loss of tooth substance. Nowadays, modern digital chairside technologies and new restorative materials allow clinicians to restore the lost tooth structure with a minimally invasive and fully digital approach.

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OTX Homeobox genes are involved in embryonic morphogenesis and in the development of olfactory epithelium in adult. Mutations occurring in the OTX genes are reported to be associated to tumorigenisis in human. No reports correlate the expression of OTX genes and neoplasms of the nasal cavity.

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Objective: Validating objective, brain-based indices of consciousness in behaviorally unresponsive patients represents a challenge due to the impossibility of obtaining independent evidence through subjective reports. Here we address this problem by first validating a promising metric of consciousness-the Perturbational Complexity Index (PCI)-in a benchmark population who could confirm the presence or absence of consciousness through subjective reports, and then applying the same index to patients with disorders of consciousness (DOCs).

Methods: The benchmark population encompassed 150 healthy controls and communicative brain-injured subjects in various states of conscious wakefulness, disconnected consciousness, and unconsciousness.

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Background: Mechanically assisted cough devices are used in patients with impaired cough to avoid secretion accumulation. We compared 5 mechanically assisted cough devices by bench testing using a breathing simulator and assessed their user-friendliness.

Methods: We measured inspiratory and expiratory airway pressures and peak expiratory flow, the strongest indicator of cough efficacy.

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We analyzed the results of periodic chromosome analyses performed on bone marrow of 22 patients with Shwachman-Diamond syndrome (SDS), 8 directly observed and 14 from the literature, selected because of changes in the cytogenetic picture during the course of the disease. This study points out some features of the cytogenetic evolution in SDS relevant for prognostic evaluation but never noted in the literature. In particular, the lack of any clonal progression and the frequent appearance of independent clones with chromosomal changes different from the one initially discovered, with possible severe prognostic implications, are reported.

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Background: Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED.

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Article Synopsis
  • Imatinib mesylate (IM) is the main treatment for Chronic Myeloid Leukemia (CML) and is necessary for long-term survival, but stopping it may lead to relapse.
  • Traditional tests for checking minimal residual disease are not very sensitive, but a new genomic DNA Q-PCR assay has been developed to more accurately detect the presence of leukemic cells.
  • In a study of 8 CML patients on IM for over 8 years, the new gDNA Q-PCR method revealed persistent leukemic cells in nearly one-third of cases where traditional mRNA tests showed undetectable levels, suggesting it could improve decision-making for treatment.
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