Publications by authors named "Grieco D"

Introduction: During mitosis, chromosome alignment at the mitotic spindle equator grants correct chromosome segregation and proper nuclei formation in daughter cells. The kinesin 8 family member Kif18A plays a crucial role for chromosome alignment by localizing at the kinetochore-microtubule (K-MT) plus ends to dampen MT dynamics and stabilize K-MT attachments. Kif18A action is directly antagonized by the master mitotic kinase cyclin B-dependent kinase 1 (Cdk1) and is promoted by protein phosphatase 1 (PP1).

View Article and Find Full Text PDF

Purpose: The optimal physiologic parameters to monitor after a session of awake prone positioning in patients with acute respiratory failure are not well understood. This study aimed to identify which early physiologic changes after the first session of awake prone positioning are linked to the need for invasive mechanical ventilation or death in patients with acute respiratory failure.

Methods: We performed a secondary analysis of a prospective cohort study of adult patients with acute respiratory failure related to coronavirus disease 2019 (COVID-19) treated with awake prone positioning.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare the effects of personalized positive end-expiratory pressure (PEEP) versus a standard low PEEP/FiO2 table on patients with acute respiratory distress syndrome (ARDS) undergoing pressure support ventilation (PSV).
  • Researchers conducted a cross-over randomized trial with 30 ARDS patients, measuring how different PEEP settings affected lung mechanics and patient comfort.
  • Results showed that the personalized PEEP significantly improved lung function, reduced respiratory effort, and did not lead to lung overdistension, making it a promising approach for treating ARDS during ventilation.
View Article and Find Full Text PDF
Article Synopsis
  • Acute hypercapnic respiratory failure is a serious condition primarily caused by insufficient breathing, often linked to chronic obstructive pulmonary disease and muscle dysfunction.
  • Noninvasive ventilation using a mask is the preferred first-line treatment to improve patient survival and outcomes, while high-flow nasal oxygen is considered a supportive option, although it has a higher failure rate compared to noninvasive ventilation.
  • The review discusses optimal settings for high-flow nasal oxygen and highlights its potential benefits when used after noninvasive ventilation or during weaning from mechanical ventilation.
View Article and Find Full Text PDF
Article Synopsis
  • Colistin, specifically colistimethate (CMS), is still used in critically ill patients, particularly those on continuous renal replacement therapy (CRRT) for infections caused by carbapenem-resistant bacteria, despite limited real-life data on its effectiveness and safety.
  • A study involving 20 critically ill patients receiving a specific dosage of CMS showed high colistin levels in their blood but raised concerns about exceeding safety limits, as many patients experienced poor outcomes including a high mortality rate.
  • The findings suggest that while the recommended dosing achieves effective concentrations against bacteria, it poses risks of toxicity, and close monitoring is necessary to balance efficacy and safety.
View Article and Find Full Text PDF

Introduction: Left bundle branch area pacing (LBBAP) comprises pacing at the left ventricular septum (LVSP) or left bundle branch (LBBP). The aim of the present study was to investigate the differences in ventricular electrical heterogeneity between LVSP, LBBP, right ventricular pacing (RVP) and intrinsic conduction with different dyssynchrony measures using the ECG, vectorcardiograpy, ECG belt, and Ultrahigh frequency (UHF-)ECG.

Methods: Thirty-seven patients with a pacemaker indication for bradycardia or cardiac resynchronization therapy underwent LBBAP implantation.

View Article and Find Full Text PDF
Article Synopsis
  • Coral reef fisheries are crucial for providing nutrients to coastal communities that are nutritionally at risk, and expanding marine protected areas (MPAs) can boost fish populations.
  • Our study suggests that expanding sustainable-use MPAs could increase fish catch by up to 20%, potentially preventing millions of cases of micronutrient deficiency in reef nations.
  • These findings are important as they align with global efforts to protect 30% of the ocean by 2030 and tackle malnutrition worldwide.
View Article and Find Full Text PDF

Background: The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.

Objective: To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.

Methods: We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022.

View Article and Find Full Text PDF

Study Objective: During laparoscopic surgery, the role of PEEP to improve outcome is controversial. Mechanistically, PEEP benefits depend on the extent of alveolar recruitment, which prevents ventilator-induced lung injury by reducing lung dynamic strain. The hypotheses of this study were that pneumoperitoneum-induced aeration loss and PEEP-induced recruitment are inter-individually variable, and that the recruitment-to-inflation ratio (R/I) can identify patients who benefit from PEEP in terms of strain reduction.

View Article and Find Full Text PDF

In acute respiratory distress syndrome, the role of positive end-expiratory pressure (PEEP) to prevent ventilator-induced lung injury is controversial. Randomized trials comparing higher versus lower PEEP strategies failed to demonstrate a clinical benefit. This may depend on the inter-individually variable potential for lung recruitment (i.

View Article and Find Full Text PDF

Background: To determine whether a decrease in serum (1,3)-β-D-glucan (BDG) was associated with reduced mortality and to investigate the performance of BDG downslope in predicting clinical outcome in invasive candidiasis.

Methods: Observational cohort study in ICU patients over a ten-year period (2012-2022) in Italy. Proven invasive candidiasis with at least 2 BDG determinations were considered.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the impact of periprocedural myocardial injury (PMI) on clinical outcomes in patients undergoing Left Bundle Branch Area Pacing (LBBAP), finding that PMI is common and might worsen outcomes.
  • Among 130 patients, 55% experienced PMI, with those showing significant increases in troponin levels (above four times the normal threshold) facing higher hospitalization rates, particularly for acute coronary syndrome.
  • Factors like multiple lead reposition attempts and specific lead types were linked to a greater risk of experiencing PMI during the procedure.
View Article and Find Full Text PDF

Background: The recruitment-to-inflation ratio (R/I) has been recently proposed to bedside assess response to PEEP. The impact of PEEP on ventilator-induced lung injury depends on the extent of dynamic strain reduction. We hypothesized that R/I may reflect the potential for lung recruitment (i.

View Article and Find Full Text PDF

Background: Reverse triggering (RT) was described in 2013 as a form of patient-ventilator asynchrony, where patient's respiratory effort follows mechanical insufflation. Diagnosis requires esophageal pressure (P) or diaphragmatic electrical activity (EA), but RT can also be diagnosed using standard ventilator waveforms.

Hypothesis: We wondered (1) how frequently RT would be present but undetected in the figures from literature, especially before 2013; (2) whether it would be more prevalent in the era of small tidal volumes after 2000.

View Article and Find Full Text PDF

Introduction And Objectives: Quantifying breathing effort in non-intubated patients is important but difficult. We aimed to develop two models to estimate it in patients treated with high-flow oxygen therapy.

Patients And Methods: We analyzed the data of 260 patients from previous studies who received high-flow oxygen therapy.

View Article and Find Full Text PDF

Antimicrobial de-escalation (ADE) is defined as the discontinuation of one or more antimicrobials in empirical therapy, or the replacement of a broad-spectrum antimicrobial with a narrower-spectrum antimicrobial. The aim of this review is to provide an overview of the available literature on the effectiveness and safety of ADE in critically ill patients, with a focus on special conditions such as anti-fungal therapy and high-risk categories. Although it is widely considered a safe strategy for antimicrobial stewardship (AMS), to date, there has been no assessment of the effect of de-escalation on the development of resistance.

View Article and Find Full Text PDF

Our study investigates the post-mortem findings of the diaphragm's muscular structural changes in mechanically ventilated COVID-19 patients. Diaphragm samples of the right side from 42 COVID-19 critically ill patients were analyzed and correlated with the type and length of mechanical ventilation (MV), ventilatory parameters, prone positioning, and use of sedative drugs. The mean number of fibers was 550±626.

View Article and Find Full Text PDF

Unlabelled: Few data are available on the lung microbiota composition of patients with coronavirus disease 2019-related acute respiratory distress syndrome (C-ARDS) receiving invasive mechanical ventilation (IMV). Moreover, it has never been investigated whether there is a potential correlation between lung microbiota communities and respiratory mechanics. We performed a prospective observational study in two intensive care units of a university hospital in Italy.

View Article and Find Full Text PDF
Article Synopsis
  • Myocardial injury is common in COVID-19 patients, but the impact of COVID-19 vaccines on this risk is not well understood.
  • A study involving 1019 hospitalized COVID-19 patients found that older age, chronic kidney disease, and hypertension were linked to myocardial injury, while vaccination status did not significantly impact risk.
  • In patients aged 76 and older, vaccines appeared to protect against myocardial injury, but in those aged 60 and younger, vaccination was associated with an increased risk of injury.
View Article and Find Full Text PDF
Article Synopsis
  • In patients with COVID-19 respiratory failure, transitioning from controlled mechanical ventilation (CMV) to pressure support ventilation (PSV) is crucial when their condition improves, but predicting success in this transition is challenging.
  • A study conducted across 24 Italian ICUs between February and May 2020 analyzed 514 patients, finding that a better Pao/Fio ratio was a key predictor of successfully moving to PSV, while those who failed faced higher mortality rates and longer ICU stays.
  • The research concludes that monitoring the Pao/Fio ratio can help identify patients at risk of unsuccessful transitions, thus affecting their overall outcome.
View Article and Find Full Text PDF