65 results match your criteria: "University Hospital Policlinico Paolo Giaccone[Affiliation]"

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

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Background: In the PROTECTION trial, intravenous amino acids (AA) decreased the occurrence of acute kidney injury (AKI) in cardiac surgery patients with cardiopulmonary bypass (CPB). Recruitment of renal functional reserve may be responsible for such protection. However, patients with chronic kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients.

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Background: Despite advances in pain management, cancer-related pain remains a critical issue for many patients. In recent years, there has been a growing interest in the use of fascial plane blocks, such as the Erector Spinae Plane Block (ESPB), for managing chronic pain, including in the oncology field. We conducted a systematic review to synthetize existing evidence on the use of ESPB for cancer pain management.

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Application of Targeted Optical Coherence Tomography in Oral Cancer: A Cross-Sectional Preliminary Study.

Diagnostics (Basel)

October 2024

Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital "Policlinico Paolo Giaccone" in Palermo, 90127 Palermo, Italy.

Background/objectives: The diagnosis of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) represent a significant challenge in oral medicine. Optical coherence tomography (OCT) shows promise for evaluating oral tissue microstructure but lacks standardized diagnostic protocols tailored to the structural variability and lesions of oral mucosa.

Methods: This cross-sectional observational study aims to evaluate the diagnostic accuracy of targeted biopsy-based and site-coded OCT protocols for common OPMDs and OSCC.

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Article Synopsis
  • HPV is a major cause of oropharyngeal cancer, and detecting it in oral squamous cell carcinoma (OSCC) is important for diagnosis and treatment.
  • This study evaluated two non-invasive methods, oral rinse and oral sponge, for detecting HPV DNA in 26 patients with confirmed OSCC.
  • Results showed that the oral sponge method was more effective, with higher specificity (100%), sensitivity (85.7%), and accuracy (96.2%) compared to oral rinse, suggesting it could improve HPV detection in clinical settings.
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Evaluation of T2 Magnetic Resonance (T2MR) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients.

Antibiotics (Basel)

September 2024

Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, 90127 Palermo, Italy.

Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR) technology may enable fast and sensitive detection of ESKAPEc pathogens directly from whole-blood samples.

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Neuropathic pain, antidepressant drugs, and inflammation: a narrative review.

J Anesth Analg Crit Care

September 2024

Department of Precision Medicine in Medical Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.

Article Synopsis
  • Neuropathic pain (NP) is a long-lasting and painful condition caused by damage to the nervous system, and regular pain medications often don't work for it.
  • Antidepressant drugs can help treat NP because they affect certain chemicals in the body that cause inflammation and pain.
  • Medicines like amitriptyline and nortriptyline not only ease pain but also help control inflammation in the brain, making it less likely for NP to become a chronic problem.
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Opportunities and barriers for telemedicine in pain management: insights from a SIAARTI survey among Italian pain physicians.

J Anesth Analg Crit Care

September 2024

Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, 00165, Italy.

Background: The integration of telemedicine in pain management represents a significant advancement in healthcare delivery, offering opportunities to enhance patient access to specialized care, improve satisfaction, and streamline chronic pain management. Despite its growing adoption, there remains a lack of comprehensive data on its utilization in pain therapy, necessitating a deeper understanding of physicians' perspectives, experiences, and challenges.

Methods: A survey was conducted in Italy between January 2024 and May 2024.

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Purpose Of Review: This review aims to explore the latest evidence on long-term outcomes in patients admitted to the ICU because of acute respiratory failure (ARF).

Recent Findings: As the survival rate of critically ill patients with acute respiratory failure improves, long-term mortality and disability still influence the quality of life of survivors and their caregivers. Patients admitted to the ICU because of ARF are at risk of developing the postintensive care syndrome, which presents with physical, cognitive and mental symptoms, all of which may impair their quality of life.

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Article Synopsis
  • A panel of Italian intensive care specialists explored the use of angiotensin II (ATII) in treating distributive shock, considering patient factors and the effectiveness of existing treatment protocols.
  • They employed a modified Delphi technique to establish consensus on clinical questions and statements related to ATII, resulting in agreement on 13 key statements from a survey.
  • The panel concluded that ATII could be beneficial for specific patients, particularly those with reduced angiotensin-converting enzyme activity or high renin levels, while also noting potential barriers to its use.
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Background: This study aimed to identify factors that influence the mortality rate of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA).

Methods: In this cross-sectional study, data from 23 centers across 15 countries, spanning the period of March 2020 to December 2021, were retrospectively collected. The study population comprised patients who developed invasive pulmonary aspergillosis while being treated for COVID-19 in the intensive care unit.

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End-of-life Care in the Intensive Care Unit and Ethics of Withholding/Withdrawal of Life-sustaining Treatments.

Anesthesiol Clin

September 2024

Main Regional Center of Pain Relief and Supportive/palliative Care, Nutrition (S.M.), La Maddalena Cancer Center, Via San Lorenzo, 312/D, Palermo 90146, Italy.

The medical progress has produced improvements in critically ill patients' survival to early phases of life-threatening diseases, thus producing long intensive care stays and persisting disability, with uncertain long-term survival rates and quality of life. Thus, compassionate end-of-life care and the provision of palliative care, even overlapping with the most aggressive of curative intensive care unit (ICU) care has become crucial. Moreover, withdrawal or withholding of life-sustaining treatment may be adopted, allowing unavoidable deaths to occur, without prolonging agony or ICU stay.

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Objectives: To evaluate the effectiveness of life support training with specific emphasis on team competencies on clinical and educational outcomes.

Methods: This systematic review was prospectively registered (PROSPERO CRD42023473154) and followed the PICOST (population, intervention, comparison, outcome, study design, timeframe) format. All randomized controlled trials and non-randomized studies evaluating learners undertaking life support training with specific emphasis on team competencies in any setting (actual and simulated resuscitations) were included.

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Article Synopsis
  • - Cefiderocol, a new antibiotic, is effective against carbapenem-resistant Gram-negative bacteria but lacks real-world usage data concerning therapy types and patient demographics.
  • - A study of 200 cases found that cefiderocol was primarily used as targeted therapy (72.5%) rather than empirical (27.5%) and was administered equally as monotherapy (50.5%) and in combination (49.5%).
  • - The findings highlight that specific patient histories, like previous infections and conditions, influence the choice between monotherapy and combination therapy, emphasizing the need for better guidelines and further studies on treatment efficacy.
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Association Between Spontaneous Breathing Trial Methods and Reintubation in Adult Critically Ill Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Chest

November 2024

SIAARTI Systematic Review Group, Rome, Italy; Department of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, Italy; Department of Precision Medicine in Medical, Surgical and Critical Care. University of Palermo, Palermo, Italy. Electronic address:

Background: Reintubation is associated with higher risk of mortality. There is no clear evidence on the best spontaneous breathing trial (SBT) method to reduce the risk of reintubation.

Research Question: Are different methods of conducting SBTs in critically ill patients associated with different risk of reintubation compared with T-tube?

Study Design And Methods: We conducted a systematic review and Bayesian network meta-analysis of randomized controlled trials investigating the effects of different SBT methods on reintubation.

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A Randomized Trial of Intravenous Amino Acids for Kidney Protection.

N Engl J Med

August 2024

From the Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute (G.L., F.M., M.B.R., A.M.S., A.F., M.G.C., G.B., A. Belletti, C.G., G.G., C.N., M.L., A.L.D.P., S.F., R. Labanca, M.M., R. Lembo, R. Losiggio, E.F., A.Z.), Vita-Salute San Raffaele University (G.L., A.Z.), and Dipartimento di Chirurgia Cardiovascolare, Unità Operativa di Anestesia e Terapia Intensiva, IRCCS Centro Cadiologico Monzino (C.B.), Milan, S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine Mauriziano Umberto I di Torino, Turin (M.C., C.V., S.P., F. Ferrod), the Department of Medical and Surgical Sciences, University Hospital "R. Dulbecco," Magna Graecia University, Catanzaro (E.G., A. Bruni, F.L.), Cardiovascular Anesthesia and ICU San Carlo Hospital, Potenza (G.P., A. Covino), Cardiac Anesthesia and ICU, AORN "Dei Colli," Monaldi Hospital, Naples (A.P., M.V.), the Department of Medicine, University of Udine (I.V., T.B.), the Division of Cardiac Surgery, Azienda Sanitaria Universitaria Friuli Centrale (I.V.), and the Department of Anesthesia and Intensive Care Medicine, ASUFC University-Hospital of Central Friuli (T.B.), Udine, UOC Anestesia e Rianimazione, Azienda Ospedaliero Universitaria Sant'Andrea (F. Federici), and UO Complessa Anestesia e Rianimazione, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini (L.S.), Rome, the Department of Precision Medicine in Medical, Surgical and Critical Care, University of Palermo, and the Department of Anesthesia Analgesia Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo (A. Cortegiani), the Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese (E.B., M.R.), IRCCS Humanitas Research Hospital, Anestesia e Terapia Intensiva Cardiochirurgica, Rozzano (D.K.), the Department of Anesthesia and ICU Maria Cecilia Hospital GVM Care and Research, Cotignola (L.M.), the Department of Cardiac Anesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS-IRCCS Cardiovascular Network, Genoa (S.S.), the Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa (F.G.), and the Department of Anesthesia, Intensive Care and Emergency, 'Citta della Salute e della Scienza' University Hospital, Turin (R. Lobreglio) - all in Italy; the Department of Anaesthesia, National University Hospital, Singapore (L.K.T.); the Clinic of Anesthesiology, Resuscitation, and Intensive Medicine, University Hospital Dubrava, Zagreb, and University North, Department of Nursing, Varazdin - both in Croatia (N.B.); the Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan (Y.K.); and the Department of Critical Care, University of Melbourne, the Australian and New Zealand Intensive Care Research Centre, Monash University, and the Department of Intensive Care, Austin Hospital - all in Melbourne, VIC, Australia (R.B.).

Background: Acute kidney injury (AKI) is a serious and common complication of cardiac surgery, for which reduced kidney perfusion is a key contributing factor. Intravenous amino acids increase kidney perfusion and recruit renal functional reserve. However, the efficacy of amino acids in reducing the occurrence of AKI after cardiac surgery is uncertain.

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Since January 2024, Italy experiences a pertussis outbreak, primarily affecting neonates and unvaccinated infants at high risk of severe complications and mortality; 11 major paediatric centres noted 108 hospitalisations and three deaths by 10 May. The outbreak reflects increased circulation of and non-adherence to immunisation recommendations during pregnancy. Public health interventions, including maternal immunisation, vaccination of infants as early as possible and post-exposure prophylaxis, are critical for reducing the burden of pertussis and preventing further mortality.

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Aim: To evaluate the effectiveness of Rapid Cycle Deliberate Practice (RCDP) compared to traditional instruction or other forms of learning on resuscitation training outcomes and on clinical and/or patient-related outcomes.

Methods: As part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation it was conducted this review and searched Medline, Embase and Cochrane from inception to Feb 12th, 2024. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions assessment tool and the Revised Cochrane risk-of-bias tool for randomized trials.

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Article Synopsis
  • - The prevalence of invasive fungal infections (IFIs) is increasing in ICUs, particularly due to resistance and rare species, making diagnosis and management challenging.
  • - An expert panel developed a survey with 44 statements about IFI management, targeting healthcare professionals across several European countries to assess their views and practices.
  • - Out of 335 responses, the survey found strong consensus on many management practices, emphasizing the need for physicians to understand local IFI rates and antifungal resistance.
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Effects of fatigue on anaesthetist well-being and patient safety: a narrative review.

Br J Anaesth

July 2024

Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy. Electronic address:

Article Synopsis
  • Being an anesthetist can be exciting but also very stressful and tiring.
  • Fatigue can make it harder for anesthetists to do their jobs well, which can put patients at risk.
  • There are ways to help reduce fatigue and improve both the health of anesthetists and the safety of patients.
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Introduction: Out of hospital cardiac arrest (OHCA) remains one of the main causes of death among industrialized countries. The initiation of cardiopulmonary resuscitation (CPR) by laypeople before the arrival of emergency medical services improves survival. Mouth-to-mouth ventilation may constitute a hindering factor to start bystander CPR, while during continuous chest compressions (CCC) CPR quality decreases rapidly.

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Home Respiratory Strategies in Patients With COPD With Chronic Hypercapnic Respiratory Failure.

Respir Care

October 2024

Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; and Department of Anesthesiology, McMaster University, Hamilton, Ontario, Canada.

Background: Home noninvasive ventilation (NIV) may improve chronic hypercarbia in COPD and patient-important outcomes. The efficacy of home high-flow nasal cannula (HFNC) as an alternative is unclear.

Methods: We searched MEDLINE, Embase, Cochrane CENTRAL, Scopus, and ClinicalTrials.

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Article Synopsis
  • The document outlines the goal of creating standardized research definitions for invasive fungal diseases (IFD) in adult ICU patients without typical risk factors for these infections.
  • A panel of experts assessed existing definitions and lab tests for IFD, using the RAND/UCLA method to reach a consensus on new definitions.
  • Key standardized definitions were made for conditions like invasive candidiasis and aspergillosis, but more data is needed for other IFDs, with the intent to enhance future research studies.
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