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Aim. To investigate the clinical significance of procalcitonin (PCT) elevation on hospital admission for coronavirus disease-19 (COVID-19) and its association with mortality in oldest old patients ( age > 75 years ). Methods. The clinical records of 1074 patients with chest high-resolution computed-tomography (HRCT) positive for interstitial pneumonia and symptoms compatible for COVID-19, hospitalized in medical wards during the first pandemic wave in a single academic center in Northern Italy, were retrospectively analyzed. All patients had serum PCT testing performed within six hours from admission. Information on COVID-19-related symptoms, comorbidities, drugs, autonomy in daily activities, respiratory exchanges, other routine lab tests, and outcomes were collected. Clinical characteristics were compared across different admission PCT levels and ages. The association of admission PCT with mortality was tested separately in participants aged > 75 and ≤75 years old by stepwise multivariate Cox regression model with forward selection. Results. With increasing classes of PCT levels (<0.05, 0.05-0.49, 0.5-1.99, and ≥2 ng/ml), there was a significant trend ( P < 0.0001 ) towards older age, male gender, wider extension of lung involvement on HRCT, worse respiratory exchanges, and several other laboratory abnormalities. Each incremental PCT class was associated with increased risk of hospital death at multivariate models in subjects older than 75 (hazard ratio for PCT ≥ 2 vs. <0.05 ng/ml: 30.629, 95% confidence interval 4.176-224.645, P = 0.001 ), but not in subjects aged 75 or younger. Conclusions. In patients admitted for COVID-19, PCT elevation was associated with several clinical, radiological, and laboratory characteristics of disease severity. However, PCT elevation was strongly associated with hospital mortality only in oldest old subjects ( age > 75 ).
Andrea Ticinesi; Antonio Nouvenne; Beatrice Prati; Loredana Guida; Alberto Parise; Nicoletta Cerundolo; Chiara Bonaguri; Rosalia Aloe; Angela Guerra; Tiziana Meschi. The Clinical Significance of Procalcitonin Elevation in Patients over 75 Years Old Admitted for COVID-19 Pneumonia. Mediators of Inflammation 2021, 2021, 1 -10.
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Beatrice Prati, Loredana Guida, Alberto Parise, Nicoletta Cerundolo, Chiara Bonaguri, Rosalia Aloe, Angela Guerra, Tiziana Meschi. The Clinical Significance of Procalcitonin Elevation in Patients over 75 Years Old Admitted for COVID-19 Pneumonia. Mediators of Inflammation. 2021; 2021 ():1-10.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Beatrice Prati; Loredana Guida; Alberto Parise; Nicoletta Cerundolo; Chiara Bonaguri; Rosalia Aloe; Angela Guerra; Tiziana Meschi. 2021. "The Clinical Significance of Procalcitonin Elevation in Patients over 75 Years Old Admitted for COVID-19 Pneumonia." Mediators of Inflammation 2021, no. : 1-10.
Living longer is associated with an increased risk of chronic diseases, including impairments of the musculoskeletal and immune system as well as metabolic disorders and certain cancers, each of which can negatively affect the relationship between host and microbiota up to the occurrence of dysbiosis. On the other hand, lifestyle factors, including regular physical exercise and a healthy diet, can affect skeletal muscle and immune aging positively at all ages. Accordingly, health benefits could partly depend on the effect of such interventions that influence the biodiversity and functionality of intestinal microbiota. In the present review, we first discuss the physiological effects of aging on the gut microbiota, immune system, and skeletal muscle. Secondly, we describe human epidemiological evidence about the associations between physical activity and fitness and the gut microbiota composition in older adults. The third part highlights the relevance and restorative mechanisms of immune protection through physical activity and specific exercise interventions during aging. Fourth, we present important research findings on the effects of exercise and protein as well as other nutrients on skeletal muscle performance in older adults. Finally, we provide nutritional recommendations to prevent malnutrition and support healthy active aging with a focus on gut microbiota. Key nutrition-related concerns include the need for adequate energy and protein intake for preventing low muscle mass and a higher demand for specific nutrients (e.g., dietary fiber, polyphenols and polyunsaturated fatty acids) that can modify the composition, diversity, and metabolic capacity of the gut microbiota, and may thus provide a practical means of enhancing gut and systemic immune function.
Barbara Strasser; Maike Wolters; Christopher Weyh; Karsten Krüger; Andrea Ticinesi. The Effects of Lifestyle and Diet on Gut Microbiota Composition, Inflammation and Muscle Performance in Our Aging Society. Nutrients 2021, 13, 2045 .
AMA StyleBarbara Strasser, Maike Wolters, Christopher Weyh, Karsten Krüger, Andrea Ticinesi. The Effects of Lifestyle and Diet on Gut Microbiota Composition, Inflammation and Muscle Performance in Our Aging Society. Nutrients. 2021; 13 (6):2045.
Chicago/Turabian StyleBarbara Strasser; Maike Wolters; Christopher Weyh; Karsten Krüger; Andrea Ticinesi. 2021. "The Effects of Lifestyle and Diet on Gut Microbiota Composition, Inflammation and Muscle Performance in Our Aging Society." Nutrients 13, no. 6: 2045.
Numerous metagenome-wide association studies (MWAS) for urolithiasis have been published, leading to the discovery of potential interactions between the microbiome and urolithiasis. However, questions remain about the reproducibility, applicability and physiological relevance of these data owing to discrepancies in experimental technique and a lack of standardization in the field. One barrier to interpreting MWAS is that experimental biases can be introduced at every step of the experimental pipeline, including sample collection, preservation, storage, processing, sequencing, data analysis and validation. Thus, the introduction of standardized protocols that maintain the flexibility to achieve study-specific objectives is urgently required. To address this need, the first international consortium for microbiome in urinary stone disease — MICROCOSM — was created and consensus panel members were asked to participate in a consensus meeting to develop standardized protocols for microbiome studies if they had published an MWAS on urolithiasis. Study-specific protocols were revised until a consensus was reached. This consensus group generated standardized protocols, which are publicly available via a secure online server, for each step in the typical clinical microbiome–urolithiasis study pipeline. This standardization creates the benchmark for future studies to facilitate consistent interpretation of results and, collectively, to lead to effective interventions to prevent the onset of urolithiasis, and will also be useful for investigators interested in microbiome research in other urological diseases.
Naveen Kachroo; Dirk Lange; Kristina L. Penniston; Joshua Stern; Gregory Tasian; Petar Bajic; Alan J. Wolfe; Mangesh Suryavanshi; Andrea Ticinesi; Tiziana Meschi; Manoj Monga; Aaron W. Miller. Standardization of microbiome studies for urolithiasis: an international consensus agreement. Nature Reviews Urology 2021, 18, 303 -311.
AMA StyleNaveen Kachroo, Dirk Lange, Kristina L. Penniston, Joshua Stern, Gregory Tasian, Petar Bajic, Alan J. Wolfe, Mangesh Suryavanshi, Andrea Ticinesi, Tiziana Meschi, Manoj Monga, Aaron W. Miller. Standardization of microbiome studies for urolithiasis: an international consensus agreement. Nature Reviews Urology. 2021; 18 (5):303-311.
Chicago/Turabian StyleNaveen Kachroo; Dirk Lange; Kristina L. Penniston; Joshua Stern; Gregory Tasian; Petar Bajic; Alan J. Wolfe; Mangesh Suryavanshi; Andrea Ticinesi; Tiziana Meschi; Manoj Monga; Aaron W. Miller. 2021. "Standardization of microbiome studies for urolithiasis: an international consensus agreement." Nature Reviews Urology 18, no. 5: 303-311.
Older multimorbid frail subjects have been severely involved in the coronavirus disease-19 (COVID-19) pandemic. The aim of this retrospective study is to compare the clinical features and outcomes of patients admitted in different phases of the outbreak in a COVID-19 hospital hub, with a particular focus on age, multimorbidity, and functional dependency. The clinical records of 1264 patients with clinical and radiological features compatible with COVID-19 pneumonia admitted in February–June, 2020, were analyzed, retrieving demographical, clinical, laboratory data, and outcomes. All variables were compared after stratification by the period of admission (first phase: rising slope of pandemic wave; second phase: plateau and falling slope), age, results of the first reverse transcriptase-polymerase chain reaction (RT-PCR) test for detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), multimorbidity (≥2 chronic diseases), and presence of disability. Factors independently associated with hospital mortality were determined by multivariate forward-selection logistic regression. Patients admitted during the second phase were older, more frequently multimorbid, disabled, and of female gender. However, on admission they exhibited milder respiratory impairment (PaO2/FiO2 268, IQR 174–361, vs. 238, IQR 126–327 mmHg, p < 0.001) and lower mortality (22% vs. 27%, p < 0.001). Age, respiratory exchanges, positive RT-PCR test, number of chronic diseases (odds ratio (OR) 1.166, 95% confidence interval (CI) 1.036–1.313, p = 0.011), and disability (OR 1.927, 95% CI 1.027–3.618, p = 0.022) were positively associated with mortality, while admission during the second phase exhibited an inverse association (OR 0.427, 95% CI 0.260–0.700, p = 0.001). In conclusion, older multimorbid patients were mainly hospitalized during the second phase of the pandemic wave. The prognosis was strongly influenced by the COVID-19 phenotype and period of admission, not just by age, multimorbidity, and disability.
Andrea Ticinesi; Antonio Nouvenne; Nicoletta Cerundolo; Alberto Parise; Beatrice Prati; Angela Guerra; Tiziana Meschi. Trends of COVID-19 Admissions in an Italian Hub during the Pandemic Peak: Large Retrospective Study Focused on Older Subjects. Journal of Clinical Medicine 2021, 10, 1115 .
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Nicoletta Cerundolo, Alberto Parise, Beatrice Prati, Angela Guerra, Tiziana Meschi. Trends of COVID-19 Admissions in an Italian Hub during the Pandemic Peak: Large Retrospective Study Focused on Older Subjects. Journal of Clinical Medicine. 2021; 10 (5):1115.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Nicoletta Cerundolo; Alberto Parise; Beatrice Prati; Angela Guerra; Tiziana Meschi. 2021. "Trends of COVID-19 Admissions in an Italian Hub during the Pandemic Peak: Large Retrospective Study Focused on Older Subjects." Journal of Clinical Medicine 10, no. 5: 1115.
Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.
Caterina Caminiti; Giuseppe Maglietta; Tiziana Meschi; Andrea Ticinesi; Mario Silva; Nicola Sverzellati. Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study. Journal of Clinical Medicine 2021, 10, 880 .
AMA StyleCaterina Caminiti, Giuseppe Maglietta, Tiziana Meschi, Andrea Ticinesi, Mario Silva, Nicola Sverzellati. Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study. Journal of Clinical Medicine. 2021; 10 (4):880.
Chicago/Turabian StyleCaterina Caminiti; Giuseppe Maglietta; Tiziana Meschi; Andrea Ticinesi; Mario Silva; Nicola Sverzellati. 2021. "Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study." Journal of Clinical Medicine 10, no. 4: 880.
The gut microbiota could influence the pathophysiology of age-related sarcopenia through multiple mechanisms implying modulation of chronic inflammation and anabolic resistance. The aim of this study was to compare the fecal microbiota composition and functionality, assessed by shotgun metagenomics sequencing, between two groups of elderly outpatients, differing only for the presence of primary sarcopenia. Five sarcopenic elderly subjects and twelve non-sarcopenic controls, classified according to lower limb function and bioimpedance-derived skeletal muscle index, provided a stool sample, which was analyzed with shotgun metagenomics approaches, to determine the overall microbiota composition, the representation of bacteria at the species level, and the prediction of bacterial genes involved in functional metabolic pathways. Sarcopenic subjects displayed different fecal microbiota compositions at the species level, with significant depletion of two species known for their metabolic capacity of producing short-chain fatty acids (SCFAs), Faecalibacterium prausnitzii and Roseburia inulinivorans, and of Alistipes shahii. Additionally, their fecal metagenome had different representation of genes belonging to 108 metabolic pathways, namely, depletion of genes involved in SCFA synthesis, carotenoid and isoflavone biotransformation, and amino acid interconversion. These results support the hypothesis of an association between microbiota and sarcopenia, indicating novel possible mediators, whose clinical relevance should be investigated in future studies.
Andrea Ticinesi; Leonardo Mancabelli; Sara Tagliaferri; Antonio Nouvenne; Christian Milani; Daniele Del Rio; Fulvio Lauretani; Marcello Giuseppe Maggio; Marco Ventura; Tiziana Meschi. The Gut–Muscle Axis in Older Subjects with Low Muscle Mass and Performance: A Proof of Concept Study Exploring Fecal Microbiota Composition and Function with Shotgun Metagenomics Sequencing. International Journal of Molecular Sciences 2020, 21, 8946 .
AMA StyleAndrea Ticinesi, Leonardo Mancabelli, Sara Tagliaferri, Antonio Nouvenne, Christian Milani, Daniele Del Rio, Fulvio Lauretani, Marcello Giuseppe Maggio, Marco Ventura, Tiziana Meschi. The Gut–Muscle Axis in Older Subjects with Low Muscle Mass and Performance: A Proof of Concept Study Exploring Fecal Microbiota Composition and Function with Shotgun Metagenomics Sequencing. International Journal of Molecular Sciences. 2020; 21 (23):8946.
Chicago/Turabian StyleAndrea Ticinesi; Leonardo Mancabelli; Sara Tagliaferri; Antonio Nouvenne; Christian Milani; Daniele Del Rio; Fulvio Lauretani; Marcello Giuseppe Maggio; Marco Ventura; Tiziana Meschi. 2020. "The Gut–Muscle Axis in Older Subjects with Low Muscle Mass and Performance: A Proof of Concept Study Exploring Fecal Microbiota Composition and Function with Shotgun Metagenomics Sequencing." International Journal of Molecular Sciences 21, no. 23: 8946.
Background Delirium incidence and clinical correlates in coronavirus disease-19 (COVID-19) pneumonia are still poorly investigated. Aim To describe the epidemiology of delirium in patients hospitalized for suspect COVID-19 pneumonia during the pandemic peak in an academic hospital of Northern Italy, identify its clinical correlations and evaluate the association with mortality. Methods The clinical records of 852 patients admitted for suspect COVID-19 pneumonia, defined as respiratory symptoms or fever or certain history of contact with COVID-19 patients, plus chest CT imaging compatible with alveolar-interstitial pneumonia, were retrospectively analyzed. Delirium was defined after careful revision of daily clinical reports in accordance with the Confusion Assessment Method criteria. Data on age, clinical presentation, comorbidities, drugs, baseline lab tests and outcome were collected. The factors associated with delirium, and the association of delirium with mortality, were evaluated through binary logistic regression models. Results Ninety-four patients (11%) developed delirium during stay. They were older (median age 82, interquartile range, IQR 78–89, vs 75, IQR 63–84, p < 0.001), had more neuropsychiatric comorbidities and worse respiratory exchanges at baseline. At multivariate models, delirium was independently and positively associated with age [odds ratio (OR) 1.093, 95% confidence interval (CI) 1.046–1.143, p < 0.001], use of antipsychotic drugs (OR 4.529, 95% CI 1.204–17.027, p = 0.025), serum urea and lactate-dehydrogenase at admission. Despite a higher mortality in patients with delirium (57% vs 30%), this association was not independent of age and respiratory parameters. Conclusions Delirium represents a common complication of COVID-19 and a marker of severe disease course, especially in older patients with neuropsychiatric comorbidity.
Andrea Ticinesi; Nicoletta Cerundolo; Alberto Parise; Antonio Nouvenne; Beatrice Prati; Angela Guerra; Fulvio Lauretani; Marcello Maggio; Tiziana Meschi. Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital. Aging Clinical and Experimental Research 2020, 32, 2159 -2166.
AMA StyleAndrea Ticinesi, Nicoletta Cerundolo, Alberto Parise, Antonio Nouvenne, Beatrice Prati, Angela Guerra, Fulvio Lauretani, Marcello Maggio, Tiziana Meschi. Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital. Aging Clinical and Experimental Research. 2020; 32 (10):2159-2166.
Chicago/Turabian StyleAndrea Ticinesi; Nicoletta Cerundolo; Alberto Parise; Antonio Nouvenne; Beatrice Prati; Angela Guerra; Fulvio Lauretani; Marcello Maggio; Tiziana Meschi. 2020. "Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital." Aging Clinical and Experimental Research 32, no. 10: 2159-2166.
Bedside chest ultrasonography, when integrated with clinical data, is an accurate tool for improving the diagnostic process of many respiratory diseases. This study aims to evaluate the feasibility of a chest ultrasonographic screening program in nursing homes for detecting coronavirus disease-19 (COVID-19)-related pneumonia and improving the appropriateness of hospital referral of residents. Pragmatic, descriptive, feasibility study from April 2 to April 9, 2020. A total of 83 older residents (age 85 ± 8) presenting mild to moderate respiratory symptoms and not previously tested for COVID-19, residing in 5 nursing homes in Northern Italy. Chest ultrasonography was performed at the bedside by a team of hospital specialists with certified expertise in thoracic ultrasonography, following a systematic approach exploring 4 different areas for each hemithorax, from the anterior and posterior side. Presence of ultrasonographic signs of interstitial pneumonia, including comet-tail artifacts (B-lines) with focal or diffuse distribution, subpleural consolidations, and pleural line indentation, was detected. The specialist team integrated ultrasonography data with clinical and anamnestic information, and gave personalized therapeutic advice for each patient, including hospital referral when needed. The most frequent reasons for ultrasonographic evaluation were fever (63% of participants) and mild dyspnea (40%). Fifty-six patients (67%) had abnormal ultrasonographic findings. The most common patterns were presence of multiple subpleural consolidations (32 patients) and diffuse B-lines (24 patients), with bilateral involvement. A diagnosis of suspect COVID-19 pneumonia was made in 44 patients, and 6 of them required hospitalization. Twelve patients had ultrasonographic patterns suggesting other respiratory diseases, and 2 patients with normal ultrasonographic findings were diagnosed with COPD exacerbation. In nursing home residents, screening of COVID-19 pneumonia with bedside chest ultrasonography is feasible and may represent a valid diagnostic aid for an early detection of COVID-19 outbreaks and adequate patient management.
Antonio Nouvenne; Andrea Ticinesi; Alberto Parise; Beatrice Prati; Marcello Esposito; Valentina Cocchi; Emanuele Crisafulli; Annalisa Volpi; Sandra Rossi; Elena Giovanna Bignami; Marco Baciarello; Ettore Brianti; Massimo Fabi; Tiziana Meschi. Point-of-Care Chest Ultrasonography as a Diagnostic Resource for COVID-19 Outbreak in Nursing Homes. Journal of the American Medical Directors Association 2020, 21, 919 -923.
AMA StyleAntonio Nouvenne, Andrea Ticinesi, Alberto Parise, Beatrice Prati, Marcello Esposito, Valentina Cocchi, Emanuele Crisafulli, Annalisa Volpi, Sandra Rossi, Elena Giovanna Bignami, Marco Baciarello, Ettore Brianti, Massimo Fabi, Tiziana Meschi. Point-of-Care Chest Ultrasonography as a Diagnostic Resource for COVID-19 Outbreak in Nursing Homes. Journal of the American Medical Directors Association. 2020; 21 (7):919-923.
Chicago/Turabian StyleAntonio Nouvenne; Andrea Ticinesi; Alberto Parise; Beatrice Prati; Marcello Esposito; Valentina Cocchi; Emanuele Crisafulli; Annalisa Volpi; Sandra Rossi; Elena Giovanna Bignami; Marco Baciarello; Ettore Brianti; Massimo Fabi; Tiziana Meschi. 2020. "Point-of-Care Chest Ultrasonography as a Diagnostic Resource for COVID-19 Outbreak in Nursing Homes." Journal of the American Medical Directors Association 21, no. 7: 919-923.
Background: Lung ultrasound (LUS) is an accurate, safe, and cheap tool assisting in the diagnosis of several acute respiratory diseases. The diagnostic value of LUS in the workup of coronavirus disease-19 (COVID-19) in the hospital setting is still uncertain. Objectives: The aim of this observational study was to explore correlations of the LUS appearance of COVID-19-related pneumonia with CT findings. Methods: Twenty-six patients (14 males, age 64 ± 16 years) urgently hospitalized for COVID-19 pneumonia, who underwent chest CT and bedside LUS on the day of admission, were enrolled in this observational study. CT images were reviewed by expert chest radiologists, who calculated a visual CT score based on extension and distribution of ground-glass opacities and consolidations. LUS was performed by clinicians with certified competency in thoracic ultrasonography, blind to CT findings, following a systematic approach recommended by ultrasound guidelines. LUS score was calculated according to presence, distribution, and severity of abnormalities. Results: All participants had CT findings suggestive of bilateral COVID-19 pneumonia, with an average visual scoring of 43 ± 24%. LUS identified 4 different possible abnormalities, with bilateral distribution (average LUS score 15 ± 5): focal areas of nonconfluent B lines, diffuse confluent B lines, small subpleural microconsolidations with pleural line irregularities, and large parenchymal consolidations with air bronchograms. LUS score was significantly correlated with CT visual scoring (r = 0.65, p < 0.001) and oxygen saturation in room air (r = –0.66, p < 0.001). Conclusion: When integrated with clinical data, LUS could represent a valid diagnostic aid in patients with suspect COVID-19 pneumonia, which reflects CT findings.
Antonio Nouvenne; Marco Davìd Zani; Gianluca Milanese; Alberto Parise; Marco Baciarello; Elena Giovanna Bignami; Anna Odone; Nicola Sverzellati; Tiziana Meschi; Andrea Ticinesi. Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission. Respiration 2020, 99, 617 -624.
AMA StyleAntonio Nouvenne, Marco Davìd Zani, Gianluca Milanese, Alberto Parise, Marco Baciarello, Elena Giovanna Bignami, Anna Odone, Nicola Sverzellati, Tiziana Meschi, Andrea Ticinesi. Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission. Respiration. 2020; 99 (7):617-624.
Chicago/Turabian StyleAntonio Nouvenne; Marco Davìd Zani; Gianluca Milanese; Alberto Parise; Marco Baciarello; Elena Giovanna Bignami; Anna Odone; Nicola Sverzellati; Tiziana Meschi; Andrea Ticinesi. 2020. "Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission." Respiration 99, no. 7: 617-624.
COVID‐19 outbreak is challenging for hospital care. Development of lean, adaptable algorithms for managing patient flows may be pivotal for handling and adapting to a situation of uncertainty and evolving crisis. Here, we present the model of care adopted at Parma University‐Hospital, a large teaching hospital facility located in Northern Italy, to face a massive overflow of COVID‐19 patients presenting to the Emergency Department.
Tiziana Meschi; Sandra Rossi; Annalisa Volpi; Carlo Ferrari; Nicola Sverzellati; Ettore Brianti; Massimo Fabi; Antonio Nouvenne; Andrea Ticinesi. Reorganization of a large academic hospital to face COVID‐19 outbreak: The model of Parma, Emilia‐Romagna region, Italy. European Journal of Clinical Investigation 2020, 50, e13250 .
AMA StyleTiziana Meschi, Sandra Rossi, Annalisa Volpi, Carlo Ferrari, Nicola Sverzellati, Ettore Brianti, Massimo Fabi, Antonio Nouvenne, Andrea Ticinesi. Reorganization of a large academic hospital to face COVID‐19 outbreak: The model of Parma, Emilia‐Romagna region, Italy. European Journal of Clinical Investigation. 2020; 50 (6):e13250.
Chicago/Turabian StyleTiziana Meschi; Sandra Rossi; Annalisa Volpi; Carlo Ferrari; Nicola Sverzellati; Ettore Brianti; Massimo Fabi; Antonio Nouvenne; Andrea Ticinesi. 2020. "Reorganization of a large academic hospital to face COVID‐19 outbreak: The model of Parma, Emilia‐Romagna region, Italy." European Journal of Clinical Investigation 50, no. 6: e13250.
To investigate the current evidence on the use of point-of-care chest ultrasonography in older patients and geriatric settings and present the current state of the art of chest ultrasound applications. Special article based on a literature review with narrative analyses and expert clinical knowledge. All studies performed in a geriatric setting were included. Observational and intervention studies and meta-analyses including participants aged ≥70 years were also considered, even if not specifically focused on a geriatric setting. Data on participant characteristics, diagnostic accuracy of chest ultrasonography, and outcomes were collected for each considered study. Data were analyzed and discussed with a particular focus on the possible applications and advantages of chest ultrasonography in geriatric medicine, underlining the possible areas of future research. We found only 5 studies on the diagnostic accuracy and prognostic relevance of chest ultrasonography in geriatrics. However, several studies performed in emergency departments, intensive care units, and internal medicine wards included a large number of participants ≥70 years old; they suggest that chest ultrasonography may represent a valid aid to the diagnostics of acute dyspnea, pneumonia, acute heart failure, pneumothorax, and pleural diseases, with an accuracy in some cases superior to standard x-rays, especially when mobility limitation is present. Diaphragm ultrasonography may also represent a valid tool to guide mechanical ventilation weaning in older patients with acute respiratory failure. Chest ultrasonography may represent a valid bedside diagnostic aid to the management of acute respiratory diseases in older patients. However, specific evidence is lacking for geriatric patients. Future research will need to focus on defining the reference standards and the diagnostic accuracy for older patients with frailty and multimorbidity, cost-efficacy and cost-effectiveness of the technique, its impact for clinical outcomes, and role for follow-up in the post-acute care.
Andrea Ticinesi; Simone Scarlata; Antonio Nouvenne; Fulvio Lauretani; Raffaele Antonelli Incalzi; Andrea Ungar. The Geriatric Patient: The Ideal One for Chest Ultrasonography? A Review From the Chest Ultrasound in the Elderly Study Group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG). Journal of the American Medical Directors Association 2020, 21, 447 -454.e6.
AMA StyleAndrea Ticinesi, Simone Scarlata, Antonio Nouvenne, Fulvio Lauretani, Raffaele Antonelli Incalzi, Andrea Ungar. The Geriatric Patient: The Ideal One for Chest Ultrasonography? A Review From the Chest Ultrasound in the Elderly Study Group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG). Journal of the American Medical Directors Association. 2020; 21 (4):447-454.e6.
Chicago/Turabian StyleAndrea Ticinesi; Simone Scarlata; Antonio Nouvenne; Fulvio Lauretani; Raffaele Antonelli Incalzi; Andrea Ungar. 2020. "The Geriatric Patient: The Ideal One for Chest Ultrasonography? A Review From the Chest Ultrasound in the Elderly Study Group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG)." Journal of the American Medical Directors Association 21, no. 4: 447-454.e6.
Recent studies have shown that patients with kidney stone disease, and particularly calcium oxalate nephrolithiasis, exhibit dysbiosis in their fecal and urinary microbiota compared with controls. The alterations of microbiota go far beyond the simple presence and representation of Oxalobacter formigenes, a well-known symbiont exhibiting a marked capacity of degrading dietary oxalate and stimulating oxalate secretion by the gut mucosa. Thus, alterations of the intestinal microbiota may be involved in the pathophysiology of calcium kidney stones. However, the role of nutrition in this gut-kidney axis is still unknown, even if nutritional imbalances, such as poor hydration, high salt, and animal protein intake and reduced fruit and vegetable intake, are well-known risk factors for kidney stones. In this narrative review, we provide an overview of the gut-kidney axis in nephrolithiasis from a nutritional perspective, summarizing the evidence supporting the role of nutrition in the modulation of microbiota composition, and their relevance for the modulation of lithogenic risk.
Andrea Ticinesi; Antonio Nouvenne; Giulia Chiussi; Giampiero Castaldo; Angela Guerra; Tiziana Meschi. Calcium Oxalate Nephrolithiasis and Gut Microbiota: Not just a Gut-Kidney Axis. A Nutritional Perspective. Nutrients 2020, 12, 548 .
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Giulia Chiussi, Giampiero Castaldo, Angela Guerra, Tiziana Meschi. Calcium Oxalate Nephrolithiasis and Gut Microbiota: Not just a Gut-Kidney Axis. A Nutritional Perspective. Nutrients. 2020; 12 (2):548.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Giulia Chiussi; Giampiero Castaldo; Angela Guerra; Tiziana Meschi. 2020. "Calcium Oxalate Nephrolithiasis and Gut Microbiota: Not just a Gut-Kidney Axis. A Nutritional Perspective." Nutrients 12, no. 2: 548.
IntroductionNursing home residents represent a particularly vulnerable population experiencing high risk of unplanned hospital admissions, but few interventions have proved effective in reducing this risk. The aim of this research will be to verify the effects of a hospital-based multidisciplinary mobile unit (MMU) team intervention delivering urgent care to nursing home residents directly at their bedside.Methods and analysisFour nursing homes based in the Parma province, in Northern Italy, will be involved in this prospective, pragmatic, multicentre, 18-month quasiexperimental study (sequential design with two cohorts). The residents of two nursing homes will receive the MMU team care intervention. In case of urgent care needs, the nursing home physician will contact the hospital physician responsible for the MMU team by phone. The case will be triaged as (a) manageable by phone advice, (b) requiring urgent assessment by the MMU team or (c) requiring immediate emergency department (ED) referral. MMU team is composed of one senior physician and one emergency-medicine resident chosen within the staff of Internal Medicine and Critical Subacute Care Unit of Parma University-Hospital, usually with different specialty background, and equipped with portable ultrasound, set of drugs and devices useful in urgency. The MMU visits patients in nursing homes, with the mission to stabilise clinical conditions and avoid hospital admission. Residents of the other two nursing homes will receive usual care, that is, ED referral in every case of urgency. Study endpoints include unplanned hospital admissions (primary), crude all-cause mortality, hospital mortality, length of stay and healthcare-related costs (secondary).Ethics and disseminationThe study protocol was approved by the Ethics Committee of Area Vasta Emilia Nord (Emilia-Romagna region). Informed consent will be collected from patients or legal representatives. The results will be actively disseminated through peer-reviewed journals and conference presentations, in compliance with the Italian law.Trial registration numberClinicalTrials.gov Registry (NCT 04085679); Pre-results.
Antonio Nouvenne; Caterina Caminiti; Francesca Diodati; Elisa Iezzi; Beatrice Prati; Stefano Lucertini; Paolo Schianchi; Federica Pascale; Bruno Starcich; Pietro Manotti; Ettore Brianti; Massimo Fabi; Andrea Ticinesi; Tiziana Meschi. Implementation of a strategy involving a multidisciplinary mobile unit team to prevent hospital admission in nursing home residents: protocol of a quasi-experimental study (MMU-1 study). BMJ Open 2020, 10, e034742 .
AMA StyleAntonio Nouvenne, Caterina Caminiti, Francesca Diodati, Elisa Iezzi, Beatrice Prati, Stefano Lucertini, Paolo Schianchi, Federica Pascale, Bruno Starcich, Pietro Manotti, Ettore Brianti, Massimo Fabi, Andrea Ticinesi, Tiziana Meschi. Implementation of a strategy involving a multidisciplinary mobile unit team to prevent hospital admission in nursing home residents: protocol of a quasi-experimental study (MMU-1 study). BMJ Open. 2020; 10 (2):e034742.
Chicago/Turabian StyleAntonio Nouvenne; Caterina Caminiti; Francesca Diodati; Elisa Iezzi; Beatrice Prati; Stefano Lucertini; Paolo Schianchi; Federica Pascale; Bruno Starcich; Pietro Manotti; Ettore Brianti; Massimo Fabi; Andrea Ticinesi; Tiziana Meschi. 2020. "Implementation of a strategy involving a multidisciplinary mobile unit team to prevent hospital admission in nursing home residents: protocol of a quasi-experimental study (MMU-1 study)." BMJ Open 10, no. 2: e034742.
Pure calcium oxalate is the most frequent type of idiopathic kidney stone composition. Fourier transform infrared spectroscopy (FT-IR) allows to detect the ratio of calcium oxalate dihydrate (COD) and monohydrate (COM) crystals in stones, but the clinical significance of this parameter remains uncertain. The objective of this observational study was to verify the association of clinical and laboratory parameters of kidney stone disease with COD/COM ratio in a group of 465 (322 M, age 46 ± 14) patients suffering from idiopathic calcium nephrolithiasis with pure calcium oxalate stones (≥ 97%). Each participant underwent a complete clinical examination, serum chemistry, 24-h urine collection for the determination of the profile of lithogenic risk, and had stones analyzed by FT-IR. Most (62%) of the stones had a COD/COM ratio ≤ 0.25, and the urine chemistry of the corresponding patients showed a low prevalence of urinary metabolic abnormalities. With increasing COD/COM ratio intervals (0–0.25, 0.26–0.50, 0.51–0.75, 0.76–1), a significant association was observed for the number of urological procedures, serum calcium, 24-h urinary calcium excretion, prevalence of hypercalciuria and relative calcium oxalate supersaturation, and a negative trend was detected for the age of the first stone episode (all p values < 0.05). A linear regression model showed that the only parameters significantly associated with COD/COM ratio were 24-h urinary calcium excretion (standardized β = 0.464, p < 0.001) and urine pH (standardized β = 0.103, p = 0.013). In pure calcium oxalate idiopathic stones, COD/COM ratio may reflect the presence of urinary metabolic risk factors, and represent a guide for the prescription of urinary analyses.
Angela Guerra; Andrea Ticinesi; Franca Allegri; Silvana Pinelli; Rosalia Aloe; Tiziana Meschi. Idiopathic calcium nephrolithiasis with pure calcium oxalate composition: clinical correlates of the calcium oxalate dihydrate/monohydrate (COD/COM) stone ratio. Urolithiasis 2019, 48, 271 -279.
AMA StyleAngela Guerra, Andrea Ticinesi, Franca Allegri, Silvana Pinelli, Rosalia Aloe, Tiziana Meschi. Idiopathic calcium nephrolithiasis with pure calcium oxalate composition: clinical correlates of the calcium oxalate dihydrate/monohydrate (COD/COM) stone ratio. Urolithiasis. 2019; 48 (3):271-279.
Chicago/Turabian StyleAngela Guerra; Andrea Ticinesi; Franca Allegri; Silvana Pinelli; Rosalia Aloe; Tiziana Meschi. 2019. "Idiopathic calcium nephrolithiasis with pure calcium oxalate composition: clinical correlates of the calcium oxalate dihydrate/monohydrate (COD/COM) stone ratio." Urolithiasis 48, no. 3: 271-279.
Gut microbiota composition and functionality can influence the pathophysiology of age-related cognitive impairment and dementia, according to a large number of animal studies. The translation of this concept to humans is still uncertain, due to the relatively low number of clinical studies focused on fecal microbiota and large number of environmental factors that influence the microbiota composition. However, the fecal microbiota composition of older patients with dementia is deeply different from that of healthy active controls, conditioning a different metabolic profile. The possible use of fecal microbiota-related parameters and microbiota-derived metabolites as biomarkers of cognitive performance and dementia is critically reviewed in this paper, focusing on the most promising areas of research for the future.
Andrea Ticinesi; Antonio Nouvenne; Claudio Tana; Beatrice Prati; Tiziana Meschi. Gut Microbiota and Microbiota-Related Metabolites as Possible Biomarkers of Cognitive Aging. Advances in Experimental Medicine and Biology 2019, 1178, 129 -154.
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Claudio Tana, Beatrice Prati, Tiziana Meschi. Gut Microbiota and Microbiota-Related Metabolites as Possible Biomarkers of Cognitive Aging. Advances in Experimental Medicine and Biology. 2019; 1178 ():129-154.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Claudio Tana; Beatrice Prati; Tiziana Meschi. 2019. "Gut Microbiota and Microbiota-Related Metabolites as Possible Biomarkers of Cognitive Aging." Advances in Experimental Medicine and Biology 1178, no. : 129-154.
Gut microbiota composition and functionality are involved in the pathophysiology of several intestinal and extraintestinal diseases, and are increasingly considered a modulator of local and systemic inflammation. However, the involvement of gut microbiota in diverticulosis and in diverticular disease is still poorly investigated. In this review, we critically analyze the existing evidence on the fecal and mucosa-associated microbiota composition and functionality across different stages of diverticular disease. We also explore the influence of risk factors for diverticulosis on gut microbiota composition, and speculate on the possible relevance of these associations for the pathogenesis of diverticula. We overview the current treatments of diverticular disease targeting the intestinal microbiome, highlighting the current areas of uncertainty and the need for future studies. Although no conclusive remarks on the relationship between microbiota and diverticular disease can be made, preliminary data suggest that abdominal symptoms are associated with reduced representation of taxa with a possible anti-inflammatory effect, such as Clostridium cluster IV, and overgrowth of Enterobacteriaceae, Bifidobacteria and Akkermansia. The role of the microbiota in the early stages of the disease is still very uncertain. Future studies should help to disentangle the role of the microbiome in the pathogenesis of diverticular disease and its progression towards more severe forms.
Andrea Ticinesi; Antonio Nouvenne; Vincenzo Corrente; Claudio Tana; Francesco Di Mario; Tiziana Meschi. Diverticular Disease: a Gut Microbiota Perspective. Journal of Gastrointestinal and Liver Diseases 2019, 28, 327 -337.
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Vincenzo Corrente, Claudio Tana, Francesco Di Mario, Tiziana Meschi. Diverticular Disease: a Gut Microbiota Perspective. Journal of Gastrointestinal and Liver Diseases. 2019; 28 (3):327-337.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Vincenzo Corrente; Claudio Tana; Francesco Di Mario; Tiziana Meschi. 2019. "Diverticular Disease: a Gut Microbiota Perspective." Journal of Gastrointestinal and Liver Diseases 28, no. 3: 327-337.
New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level rise of NAFLD—in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome—and its association with poor cardiovascular outcomes, the question of how to manage NAFLD properly, in order to reduce the burden of associated incident cardiovascular events, is both timely and highly relevant. This review aims to summarize the current knowledge of the association between NAFLD and cardiovascular disease, and also to discuss possible clinical strategies for cardiovascular risk assessment, as well as the spectrum of available therapeutic strategies for the prevention and treatment of NAFLD and its downstream events.
Claudio Tana; Stefano Ballestri; Fabrizio Ricci; Angelo Di Vincenzo; Andrea Ticinesi; Sabina Gallina; Maria Adele Giamberardino; Francesco Cipollone; Richard Sutton; Roberto Vettor; Artur Fedorowski; Tiziana Meschi. Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications. International Journal of Environmental Research and Public Health 2019, 16, 3104 .
AMA StyleClaudio Tana, Stefano Ballestri, Fabrizio Ricci, Angelo Di Vincenzo, Andrea Ticinesi, Sabina Gallina, Maria Adele Giamberardino, Francesco Cipollone, Richard Sutton, Roberto Vettor, Artur Fedorowski, Tiziana Meschi. Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications. International Journal of Environmental Research and Public Health. 2019; 16 (17):3104.
Chicago/Turabian StyleClaudio Tana; Stefano Ballestri; Fabrizio Ricci; Angelo Di Vincenzo; Andrea Ticinesi; Sabina Gallina; Maria Adele Giamberardino; Francesco Cipollone; Richard Sutton; Roberto Vettor; Artur Fedorowski; Tiziana Meschi. 2019. "Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications." International Journal of Environmental Research and Public Health 16, no. 17: 3104.
Human gut microbiota is able to influence the host physiology by regulating multiple processes, including nutrient absorption, inflammation, oxidative stress, immune function, and anabolic balance. Aging is associated with reduced microbiota biodiversity, increased inter-individual variability, and over-representation of pathobionts, and these phenomena may have great relevance for skeletal muscle mass and function. For this reason, the presence of a gut-muscle axis regulating the onset and progression of age-related physical frailty and sarcopenia has been recently hypothesized. In this narrative review, we summarize the studies supporting a possible association between gut microbiota-related parameters with measures of muscle mass, muscle function, and physical performance in animal models and humans. Reduced muscle mass has been associated with distinct microbiota composition and reduced fermentative capacity in mice, and the administration of probiotics or butyrate to mouse models of muscle wasting has been associated with improved muscle mass. However, no studies have targeted the human microbiome associated with sarcopenia. Limited evidence from human studies shows an association between microbiota composition, involving key taxa such as Faecalibacterium and Bifidobacterium, and grip strength. Similarly, few studies conducted on patients with parkinsonism showed a trend towards a different microbiota composition in those with reduced gait speed. No studies have assessed the association of fecal microbiota with other measures of physical performance. However, several studies, mainly with a cross-sectional design, suggest an association between microbiota composition and frailty, mostly assessed according to the deficit accumulation model. Namely, frailty was associated with reduced microbiota biodiversity, and lower representation of butyrate-producing bacteria. Therefore, we conclude that the causal link between microbiota and physical fitness is still uncertain due to the lack of targeted studies and the influence of a large number of covariates, including diet, exercise, multimorbidity, and polypharmacy, on both microbiota composition and physical function in older age. However, the relationship between gut microbiota and physical function remains a very promising area of research for the future.
Andrea Ticinesi; Antonio Nouvenne; Nicoletta Cerundolo; Pamela Catania; Beatrice Prati; Claudio Tana; Tiziana Meschi. Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia. Nutrients 2019, 11, 1633 .
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Nicoletta Cerundolo, Pamela Catania, Beatrice Prati, Claudio Tana, Tiziana Meschi. Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia. Nutrients. 2019; 11 (7):1633.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Nicoletta Cerundolo; Pamela Catania; Beatrice Prati; Claudio Tana; Tiziana Meschi. 2019. "Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia." Nutrients 11, no. 7: 1633.
Intestinal regulation of oxalate absorption is a complex mechanism, not exclusively reliant on the oxalate-degrading anaerobe Oxalobacter formigenes. Using metagenomics, Miller et al. were able to describe a network of bacterial taxa co-occurring with Oxalobacter formigenes in fecal samples from non–stone forming controls and less represented in stone formers. These findings may help to illuminate why previous intervention studies with probiotics have failed to reduce the risk of hyperoxaluria, opening new possibilities for future research.
Andrea Ticinesi; Antonio Nouvenne; Tiziana Meschi. Gut microbiome and kidney stone disease: not just an Oxalobacter story. Kidney International 2019, 96, 25 -27.
AMA StyleAndrea Ticinesi, Antonio Nouvenne, Tiziana Meschi. Gut microbiome and kidney stone disease: not just an Oxalobacter story. Kidney International. 2019; 96 (1):25-27.
Chicago/Turabian StyleAndrea Ticinesi; Antonio Nouvenne; Tiziana Meschi. 2019. "Gut microbiome and kidney stone disease: not just an Oxalobacter story." Kidney International 96, no. 1: 25-27.
The prognostic value of quick Sepsis-related Organ Failure Assessment (qSOFA) score in geriatric patients is uncertain. We aimed to compare qSOFA vs. Systemic Inflammatory Response Syndrome (SIRS) criteria for mortality prediction in older multimorbid subjects, admitted for suspected sepsis in a geriatric ward. We prospectively enrolled 272 patients (aged 83.7 ± 7.4). At admission, qSOFA and SIRS scores were calculated. Mortality was assessed during hospital stay and three months after discharge. The predictive capacity of qSOFA and SIRS was assessed by calculating the Area Under the Receiver Operating Characteristic Curve (AUROC), through pairwise AUROC comparison, and multivariable logistic regression analysis. Both qSOFA and SIRS exhibited a poor prognostic performance (AUROCs 0.676, 95% CI 0.609–0.738, and 0.626, 95% CI 0.558–0.691 for in-hospital mortality; 0.684, 95% CI 0.614–0.748, and 0.596, 95% CI 0.558–0.691 for pooled three-month mortality, respectively). The predictive capacity of qSOFA showed no difference to that of SIRS for in-hospital mortality (difference between AUROCs 0.05, 95% CI −0.05 to 0.14, p = 0.31), but was superior for pooled three-month mortality (difference between AUROCs 0.09, 95% CI 0.01–0.17, p = 0.029). Multivariable logistic regression analysis, accounting for possible confounders, including frailty, showed that both scores were not associated with in-hospital mortality, although qSOFA, unlike SIRS, was associated with pooled three-month mortality. In conclusion, neither qSOFA nor SIRS at admission were strong predictors of mortality in a geriatric acute-care setting. Traditional geriatric measures of frailty may be more useful for predicting adverse outcomes in this setting.
Davide Bastoni; Andrea Ticinesi; Fulvio Lauretani; Simone Calamai; Maria Letizia Catalano; Pamela Catania; Martina Cecchia; Nicoletta Cerundolo; Claudia Galluzzo; Manuela Giovini; Giulia Mori; Marco Davìd Zani; Antonio Nouvenne; Tiziana Meschi. Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study. Journal of Clinical Medicine 2019, 8, 359 .
AMA StyleDavide Bastoni, Andrea Ticinesi, Fulvio Lauretani, Simone Calamai, Maria Letizia Catalano, Pamela Catania, Martina Cecchia, Nicoletta Cerundolo, Claudia Galluzzo, Manuela Giovini, Giulia Mori, Marco Davìd Zani, Antonio Nouvenne, Tiziana Meschi. Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study. Journal of Clinical Medicine. 2019; 8 (3):359.
Chicago/Turabian StyleDavide Bastoni; Andrea Ticinesi; Fulvio Lauretani; Simone Calamai; Maria Letizia Catalano; Pamela Catania; Martina Cecchia; Nicoletta Cerundolo; Claudia Galluzzo; Manuela Giovini; Giulia Mori; Marco Davìd Zani; Antonio Nouvenne; Tiziana Meschi. 2019. "Application of The Sepsis-3 Consensus Criteria in a Geriatric Acute Care Unit: A Prospective Study." Journal of Clinical Medicine 8, no. 3: 359.