Publications by authors named "Giani M"
Selective progesterone receptor modulators for the treatment of dysmenorrhea: an update.
Expert Opin Pharmacother
January 2025
Introduction: Dysmenorrhea is a painful symptom associated with uterine contractions and menstrual bleeding and is treated by administering analgesic drugs. Since progesterone receptors (PRs) have a major role in regulating uterine tissues (myometrium and endometrium) physiology, oral contraceptives are used off-label for treating primary or secondary dysmenorrhea. The development of selective progesterone receptor modulators (SPRMs), a class of synthetic steroids with agonistic, antagonistic, or mixed effects in targeting PRs in different tissues, stimulated their possible clinical use for treating secondary dysmenorrhea related to uterine diseases (endometriosis, adenomyosis, uterine fibroids).
View Article and Find Full Text PDFCranioplasty is a major surgical procedure typically performed in children under 1 year of age, often associated with significant complications. The scientific literature on perioperative management for children with craniosynostosis undergoing cranioplasty is limited. The authors' objective was to retrospectively evaluate the management, complication rates, and outcomes among children undergoing cranioplasty at our institution.
View Article and Find Full Text PDFSustainability in ICU: Less plastic, greener future - Letter on Eid et al.
Intensive Crit Care Nurs
November 2024
Background: The role of autoimmune IgE responses in atopic dermatitis (AD) is highly debated. While IgE targeting self-proteins has been extensively studied, IgE responses induced by human-homologous exogenous molecular allergens (HEMAs) remains less understood.
Aim: To investigate whether IgE antibody responses to HEMAs are associated with AD, its severity, and response to dupilumab.
Noninvasive Respiratory Support in Acute Respiratory Distress Syndrome.
Clin Chest Med
December 2024
Noninvasive respiratory supports have been successfully used as an alternative to endotracheal intubation especially in patients with a milder degree of hypoxemia. In patients with acute respiratory distress syndrome (ARDS), the main goals of noninvasive oxygenation strategies are to improve oxygenation, unload the respiratory muscles, and relieve dyspnea. On the other hand, recent studies have suggested that spontaneous breathing could represent an additional mechanism of lung injury, especially in the more severe forms.
View Article and Find Full Text PDFBackground: Infusion therapy is widely used in clinical settings, particularly in intensive care units.
Aim: to explore the influence of simulated cardiac output on "bolus" or "backflow" events that can occur during syringe pump changeover, considering several factors that have been previously outlined in published research. Syringe infusion pumps are commonly used for precise continuous intravenous drug delivery.
Article Synopsis
- - The study analyzed 79 patients with severe tuberculosis-related ARDS who received ECMO treatment at 20 centers worldwide, focusing on their 90-day survival rates and related complications.
- - Results showed that 51% of patients survived for 90 days, with significant complications including major bleeding and infections; miliary TB patients had a notably higher survival rate than those with cavitary TB.
- - Factors like older age, drug-resistant TB, and higher pre-ECMO SOFA scores were identified as key predictors of mortality, suggesting that ECMO could be a valuable intervention for patients with TB-induced ARDS.
Impact of new lighting technology versus traditional fluorescent bulbs on sedation and delirium in the ICU.
Intensive Crit Care Nurs
February 2025
Article Synopsis
- - The study investigated the effects of a new natural light-mimicking lighting technology on critically ill ICU patients, comparing it to conventional fluorescent lighting.
- - Conducted in a ten-bed Italian ICU with limited natural light, the study included 86 patients and measured outcomes like delirium, sedative use, and long-term mental health issues post-discharge.
- - Results showed no significant differences between the two groups in terms of delirium rates, sedation needs, or mental health issues, indicating the new lighting system did not improve patient outcomes.
Article Synopsis
- Researchers conducted a 7-year study in France and Italy to investigate the best timing and methods for weaning patients from venovenous ECMO (VV ECMO) after severe ARDS.
- The study analyzed 393 patients, comparing those who were weaned from controlled ventilation versus spontaneous breathing, but found no significant differences in their 90-day successful weaning rates.
- The study concluded that factors like age and existing health issues had a greater impact on weaning success than the ventilation strategy used during ECMO, indicating a need for more research in this area.
Article Synopsis
- Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is increasingly used for severe respiratory issues, but the study examines the impact of multi-drug resistant (MDR) bacteria on outcomes in these patients.
- The study involved 279 adults across five Italian hospitals and found 50% had MDR Gram-negative bacteria; 21% were detected before and 29% after V-V ECMO placement.
- Results indicated a 42% one-year mortality rate, with those having pre-existing MDR bacteria at higher risk, emphasizing that higher hospital V-V ECMO volumes could reduce the rate of acquiring MDR bacteria.*
Article Synopsis
- Catheter-related bloodstream infections (CRBSIs) pose significant health risks and additional costs for ICU patients, prompting a study to evaluate their prevalence in accordance with international guidelines for vascular line management.
- The study, conducted in an Italian ICU over five years, involved 1240 patients, revealing a total of 9 diagnosed CRBSIs with varying infection rates depending on catheter types.
- Results indicated that CRBSIs are associated with factors like nursing activity levels and specific ICU admission reasons, and implementing recommended care protocols incurred a cost of EUR 130.00 per patient.
Article Synopsis
- * Out of 191 adult ARDS patients on VV ECMO, 69% successfully switched to PSV, which led to better respiratory mechanics, increased compliance, and lower pulmonary shunt fraction.
- * The findings suggest that PSV during VV ECMO is not only possible but may improve patient outcomes, with 94% of those transitioned to PSV being weaned from ECMO and a high percentage being discharged alive from ICU.
Article Synopsis
- Airway closure during mechanical ventilation can cause inaccuracies in respiratory pressure assessments, particularly in patients with severe ARDS, and can be identified using low-flow inflation techniques.
- The study observed a patient with ARDS on VV ECMO, noting that prone positioning improved airway closure, as indicated by a decrease in airway opening pressure from 23 cmHO in the supine position to 13 cmHO when prone.
- Post-prone positioning, airway closure remained lower at 17 cmHO compared to the supine baseline, suggesting that this therapeutic maneuver may be beneficial in managing respiratory mechanics in ARDS patients.
The aim of this work is to define harmonized reference conditions and assessment thresholds for selected criteria elements of the Marine Strategy Framework Directive (MSFD) Descriptor 5 (Eutrophication) in the Eastern Mediterranean Sea and to test if a tool for integrated assessment of the status of marine systems can be used as a common methodological approach. In this frame, we tested two statistical approaches in order to set threshold values for four criteria of Descriptor 5: nutrients, chlorophyll a, transparency and dissolved oxygen in the bottom waters. It is noteworthy that this work revealed the need to apply common procedures in data treatment and assessment evaluation.
View Article and Find Full Text PDFObjective: To present characteristics, surgical variables, complications, and postoperative care in pediatric patients with craniofacial synostosis undergoing Le Fort III osteotomy.
Background: Craniofacial synostoses are a group of genetic syndromes that result in premature fusion of cranial and facial sutures, leading to craniofacial deformities and associated complications. Midface advancement through Le Fort III osteotomy is the most frequent surgical option for these conditions.
Halophilic archaea, also termed haloarchaea, are a group of moderate and extreme halophilic microorganisms that constitute the major microbial populations in hypersaline environments. In these ecosystems, mainly aquatic, haloarchaea are constantly exposed to ionic and oxidative stress due to saturated salt concentrations and high incidences of UV radiation (mainly in summer). To survive under these harsh conditions, haloarchaea have developed molecular adaptations including hyperpigmentation.
View Article and Find Full Text PDFArticle Synopsis
- - Blood flow rate during venovenous ECMO impacts mixed venous oxygenation (Sv), which can influence pulmonary circulation and right heart function in patients with severe acute respiratory distress syndrome (ARDS).
- - A study evaluated the physiological effects of varying ECMO blood flow levels on Sv in 20 ARDS patients, revealing that higher blood flow rates led to decreased cardiac output, pulmonary artery pressure, and right ventricular workload.
- - The results showed an inverse relationship between cardiac output and mixed venous oxygenation, indicating that as ECMO blood flow increased, overall cardiac efficiency and workload on the right heart decreased without affecting mismatching measures significantly.
Article Synopsis
- The study investigates the effects of helmet CPAP on oxygenation levels in hypoxemic patients, analyzing improvements linked to PEEP or oxygen fraction.
- A test called the "ZEEP-PEEP test" was developed to determine whether improvements in oxygenation after helmet application were due to PEEP or better oxygen delivery.
- Results showed significant oxygenation improvements in patients after applying helmet CPAP, with 41% of patients responding positively to PEEP, while the ZEEP-PEEP test could help identify those who would benefit from PEEP use.
Article Synopsis
- Sodium nitrite (NaNO) poisoning can lead to acute methemoglobinemia, which complicates emergency medical responses during cardiac arrest.
- A case is reported where a patient suffered cardiac arrest after deliberate self-intoxication, but methemoglobinemia went undetected during resuscitation efforts, contributing to the outcome.
- The case underscores the importance of quickly identifying the poison and administering the appropriate antidotes to improve survival chances in similar emergencies.