Publications by authors named "Giuseppe F Sferrazza Papa"

Article Synopsis
  • Acute respiratory failure (ARF) is a sudden condition where the respiratory system fails to provide enough oxygen, often caused by diseases like pneumonia, asthma, and neuromuscular disorders, particularly affecting children more severely than adults.
  • Diagnosing ARF in children is challenging due to their inability to express symptoms and their limited cooperation during tests, making clinical assessments crucial for identifying the severity and underlying causes.
  • Effective treatment involves immediate actions like providing oxygen and possibly mechanical ventilation, while the review highlights advancements in understanding ARF through new imaging techniques, biomarkers, and the use of artificial intelligence.
View Article and Find Full Text PDF

Long COVID syndrome has emerged as a long-lasting consequence of acute SARS-CoV-2 infection in adults. In addition, children may be affected by Long COVID, with potential clinical issues in different fields, including problems in school performance and daily activities. Yet, the pathophysiologic bases of Long COVID in children are largely unknown, and it is difficult to predict who will develop the syndrome.

View Article and Find Full Text PDF

Background: There is limited information available on fast and safe bedside tools that could help clinicians establish whether the pathological process underlying cases of wheezing is due to asthmatic exacerbation, asthmatic bronchitis, or pneumonia. The study's aim was to characterize Lung Ultrasound (LUS) in school-aged children with wheezing and evaluate its use for their follow-up treatment.

Materials And Methods: We carried out a cross-sectional study involving 68 consecutive outpatients (mean age 9.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the psychological effects experienced by COVID-19 patients hospitalized during the pandemic, specifically focusing on anxiety, depression, PTSD, and post-traumatic growth six months after discharge.
  • Out of 100 participants, significant percentages reported anxiety (34%), depression (24%), and 20% showed signs of potential PTSD, with these symptoms linked to prior mood disorders and receiving psychological care post-discharge.
  • Younger patients and those who sought psychological consultation after discharge experienced higher levels of post-traumatic growth, highlighting the importance of mental health support for recovering COVID-19 patients.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the effectiveness of noninvasive respiratory strategies, specifically CPAP and NIV, in managing COVID-19 pneumonia and the subsequent need for endotracheal intubation (ETI).
  • From 156 patients treated with CPAP, 30% required ETI, with a mortality rate of 18% and an average hospital stay of 24 days.
  • The research suggests that trying NIV after CPAP failure may be beneficial, as it doesn't worsen the situation and could decrease the necessity for ETI in patients.
View Article and Find Full Text PDF

Respiratory infection diseases are among the major causes of morbidity and mortality in children. Diagnosis is focused on clinical presentation, yet signs and symptoms are not specific and there is a need for new non-radiating diagnostic tools. Among these, lung ultrasound (LUS) has recently been included in point-of-care protocols showing interesting results.

View Article and Find Full Text PDF

Discriminating between cardiac and pulmonary dyspnea is essential for patients' management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects.

View Article and Find Full Text PDF

Objective: To investigate whether the decrease in dyspnea in neuromuscular diseases after air stacking (AS) occurs mostly in patients with decreased inspiratory muscle force and ensuing chest wall restriction or heterogeneous ventilation across the lungs.

Design: Interventional, before-after study.

Setting: A neurorehabilitation inpatient and outpatient center.

View Article and Find Full Text PDF
Article Synopsis
  • A study on ALS patients aimed to see how different mouthpiece interfaces affect vital capacity (VC) measurements and the potential learning effect over a week.
  • In patients with bulbar ALS, a flanged mouthpiece provided 8.4% higher VC than a cylindrical mouthpiece, while spinal ALS patients saw a 4.6% increase with the flanged mouthpiece compared to an oronasal mask.
  • The results suggested that using a flanged mouthpiece not only gave the highest VC readings but also showed improvements when measured again after a week, indicating a possible learning effect.
View Article and Find Full Text PDF

Background: Findings from February 2020, indicate that the clinical spectrum of COVID-19 can be heterogeneous, probably due to the infectious dose and viral load of SARS-CoV-2 within the first weeks of the outbreak. The aim of this study was to investigate predictors of overall 28-day mortality at the peak of the Italian outbreak.

Methods: Retrospective observational study of all COVID-19 patients admitted to the main hospital of Bergamo, from February 23 to March 14, 2020.

View Article and Find Full Text PDF

The presence of respiratory symptoms in Parkinson's disease (PD) has been known since the first description of the disease, even though the prevalence and incidence of these disturbances are not well defined. Several causes have been reported, comprising obstructive and restrictive pulmonary disease and changes in the central ventilatory control, and different pathogenetic mechanisms have been postulated accordingly. In our review, we encompass the current knowledge about respiratory abnormalities in PD, as well as the impact of anti-Parkinsonian drugs as either risk or protective factors.

View Article and Find Full Text PDF
Article Synopsis
  • - The study focused on understanding how COVID-19 patients were managed in hospitals across Italy, using a survey sent to physicians who care for these patients.
  • - Key findings showed that chest CT scans were the primary method for monitoring pneumonia, with non-invasive techniques like CPAP being commonly used for acute respiratory failure; most experts also favored hydroxychloroquine for treatment.
  • - Despite the insights gathered, there was notable disagreement among experts regarding treatment approaches, highlighting a need for more robust evidence-based guidelines and the importance of developing respiratory therapy programs for recovering patients.
View Article and Find Full Text PDF
Article Synopsis
  • * A survey sent to 2010 Italian physicians resulted in 514 responses, with 99% affirming the clinical significance of thoracic ultrasound; 79% use it monthly mainly in pulmonology wards, focusing on conditions like pleural effusion and pneumothorax.
  • * Key barriers to wider use include the lack of available ultrasound systems (52%), insufficient training and protected time (22%), and competition from other specialists (15%).
View Article and Find Full Text PDF

Objectives: Lung CT is the reference imaging technique for acute respiratory distress syndrome, but requires transportation outside the intensive care and x-ray exposure. Lung ultrasound is a promising, inexpensive, radiation-free, tool for bedside imaging. Aim of the present study was to compare the global and regional diagnostic accuracy of lung ultrasound and CT scan.

View Article and Find Full Text PDF

Interstitial lung diseases (ILDs) may be complicated by chronic respiratory failure (CRF), especially in the advanced stages. Aim of this narrative review is to evaluate the current evidence in management of CRF in ILDs. Many physiological mechanisms underlie CRF in ILDs, including lung restriction, ventilation/perfusion mismatch, impaired diffusion capacity and pulmonary vascular damage.

View Article and Find Full Text PDF

Chest imaging in patients with acute respiratory failure plays an important role in diagnosing, monitoring and assessing the underlying disease. The available modalities range from plain chest X-ray to computed tomography, lung ultrasound, electrical impedance tomography and positron emission tomography. Surprisingly, there are presently no clear-cut recommendations for critical care physicians regarding indications for and limitations of these different techniques.

View Article and Find Full Text PDF

In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure and death. Non-invasive positive pressure ventilation (NIPPV) appears to reduce lung function decline, thus improving survival and quality-of-life of patients affected by the disease. Unfortunately, clinical features and timing to start NIPPV are not well defined.

View Article and Find Full Text PDF
Article Synopsis
  • Interstitial lung diseases (ILDs) are a range of conditions that cause lung inflammation and fibrosis, leading to common issues like respiratory failure, especially in later stages or after acute worsening of the disease.
  • This review evaluates the best practices for managing acute respiratory failure (ARF) in patients with ILDs by analyzing literature from medical databases up to November 2017.
  • Effective management of ARF requires accurate diagnosis based on whether the patient has a known chronic ILD or a new case, with necessary investigations into potential causes and treatment options, including the consideration of high-flow nasal oxygen and non-invasive ventilation in specific scenarios, though the overall outcomes for advanced ILDs remain poor.
View Article and Find Full Text PDF

Severe bronchial asthma affects at least 5% of the asthmatic population and remains a clinical challenge. Data from the UK National Registry for Severe Asthma suggest that dedicated centers may improve asthma control, quality of life, reduce healthcare use and oral steroid burden. A multidisciplinary approach through complete lung function evaluation, optimization of adherence to treatment and immunological characterization are key issues to improve patients' care.

View Article and Find Full Text PDF