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Lamberto Manzoli
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy

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Journal article
Published: 10 June 2021 in Vaccines
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This retrospective cohort study compared the rates of virologically-confirmed SARS-CoV-2 infections, symptomatic or lethal COVID-19 among the residents of the Italian province of Pescara who received one or two doses of COVID-19 vaccines, versus the unvaccinated. The official data of the National Health System were used, and a total of 69,539 vaccinated adults were compared with 175,687 unvaccinated. Among the subjects who received at least one vaccine dose, 85 infections (0.12%), 18 severe and 3 lethal COVID-19 cases were recorded after an average follow-up of 38 days. Among the unvaccinated, the numbers were 6948 (4.00%), 933 (0.53%) and 241 (0.14%), respectively. The serious adverse event reports—yet unconfirmed—were 24 out of 102,394 administered doses. In a Cox model, adjusting for age, gender, and selected comorbidities, the effectiveness of either BNT162b2, ChAdOx1 nCoV-19 or mRNA-1273 vaccines was higher than 95% in preventing infections (mostly due to B.1.1.7 variant), symptomatic or lethal COVID-19. No differences were observed across genders, and among the 691 subjects who received the second dose of vaccine later than the recommended date. Although preliminary, these findings support current immunization policies and may help reducing vaccine hesitancy.

ACS Style

Maria Flacco; Graziella Soldato; Cecilia Acuti Martellucci; Roberto Carota; Rossano Di Luzio; Antonio Caponetti; Lamberto Manzoli. Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province. Vaccines 2021, 9, 628 .

AMA Style

Maria Flacco, Graziella Soldato, Cecilia Acuti Martellucci, Roberto Carota, Rossano Di Luzio, Antonio Caponetti, Lamberto Manzoli. Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province. Vaccines. 2021; 9 (6):628.

Chicago/Turabian Style

Maria Flacco; Graziella Soldato; Cecilia Acuti Martellucci; Roberto Carota; Rossano Di Luzio; Antonio Caponetti; Lamberto Manzoli. 2021. "Interim Estimates of COVID-19 Vaccine Effectiveness in a Mass Vaccination Setting: Data from an Italian Province." Vaccines 9, no. 6: 628.

Review
Published: 24 April 2021 in European Journal of Obstetrics & Gynecology and Reproductive Biology
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Objective To determine the role of progesterone, pessary and cervical cerclage in reducing the risk of (preterm birth) PTB in twin pregnancies and compare these interventions using pairwise and network meta-analysis. Study design Medline, Embase, CINAHL and Cochrane databases were explored. The inclusion criteria were studies in which twin pregnancies were randomized to an intervention for the prevention of PTB (any type of progesterone, cervical cerclage, cervical pessary, or any combination of these) or to a control group (e.g. placebo or treatment as usual). Interventions of interest were either progesterone [vaginal or oral natural progesterone or intramuscular 17a-hydroxyprogesterone caproate (17-OHPC)], cerclage (McDonald or Shirodkar), or cervical pessary. The primary outcome was PTB < 34 weeks of gestation. Both primary and secondary outcomes were explored in an unselected population of twin pregnancies and in women at higher risk of PTB (defined as those with cervical length <25 mm). Random-effect head-to-head and a multiple-treatment meta-analyses were used to analyze the data and results expressed as risk ratios. Results 26 studies were included in the meta-analysis. When considering an unselected population of twin pregnancies, vaginal progesterone, intra-muscular17-OHPC or pessary did not reduce the risk of PTB < 34 weeks of gestation (all p > 0.05). When stratifying the analysis for spontaneous PTB, neither pessary, vaginal or intramuscular 17-OHPC were associated with a significant reduction in the risk of PTB compared to controls (all p > 0.05), while there was no study on cerclage which explored this outcome in an unselected population of twin pregnancies. When considering twin pregnancies with short cervical length (≤25 mm), there was no contribution of either pessary, vaginal progesterone, intra-muscular 17-OHPC or cerclage in reducing the risk of overall PTB < 34 weeks of gestation. Conclusions Cervical pessary, progesterone and cerclage do not show a significant effect in reducing the rate of PTB or perinatal morbidity in twins, either when these interventions are applied to an unselected population of twins or in pregnancies with a short cervix.

ACS Style

Francesco D’Antonio; Vincenzo Berghella; Daniele Di Mascio; Gabriele Saccone; Filomena Sileo; Maria Elena Flacco; Anthony O. Odibo; Marco Liberati; Lamberto Manzoli; Asma Khalil. Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology 2021, 261, 166 -177.

AMA Style

Francesco D’Antonio, Vincenzo Berghella, Daniele Di Mascio, Gabriele Saccone, Filomena Sileo, Maria Elena Flacco, Anthony O. Odibo, Marco Liberati, Lamberto Manzoli, Asma Khalil. Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021; 261 ():166-177.

Chicago/Turabian Style

Francesco D’Antonio; Vincenzo Berghella; Daniele Di Mascio; Gabriele Saccone; Filomena Sileo; Maria Elena Flacco; Anthony O. Odibo; Marco Liberati; Lamberto Manzoli; Asma Khalil. 2021. "Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis." European Journal of Obstetrics & Gynecology and Reproductive Biology 261, no. : 166-177.

Preprint content
Published: 20 April 2021
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Objective This study compared all patients undergoing surgery for colorectal cancer in 20 hospitals of Northern Italy in 2019 versus 2020, in order to evaluate whether COVID-19-related delays in the execution of colorectal cancer screening resulted in more advanced cancers at diagnosis and worse clinical outcomes. Design A retrospective multicentric cohort analysis of patients who underwent surgery for colorectal cancer in March-December 2019 (2019) versus March-December 2020 (2020). The independent predictors of disease stage (oncologic stage, associated symptoms, clinical T4 stage, metastasis) and postoperative outcome (surgical complications, palliative surgery, 30-day death) were evaluated using logistic regression. Results The sample consisted of 1755 patients operated in 2019, and 1481 in 2020 (both mean ages 69.6 years). The proportions of cancers with symptoms, clinical T4 stage, liver and lung metastases in 2019 and 2020 were, respectively: 80.8% vs 84.5%; 6.2% vs 8.7%; 10.2% vs 10.3%; and 3.0% vs 4.4%. The proportions of surgical complications, palliative surgery, and death in 2019 and 2020 were, respectively: 34.4%vs 31.9%; 5.0% vs 7.5%; and 1.7% vs 2.4%. At multivariate analysis, as compared with 2019, cancers in 2020 were significantly more likely to be symptomatic (Odds Ratio - OR: 1.36, 95% Confidence Interval - CI: 1.09-1.69), in clinical T4 stage (OR: 1.38; 1.03-1.85), with multiple liver metastases (OR: 2.21; 1.24-3.94), but less likely to cause surgical complications (OR: 0.79; 0.68-0.93). Conclusions Colorectal cancer patients who had surgery between March and December 2020 had an increased risk of more advanced disease in terms of associated symptoms, cancer location, clinical T4 stage, and number of liver metastases. SHORT SUMMARY BOX What is already known about this subject? A specific search regarding the correlation between colorectal cancer oncologic outcomes and COVID-19 showed a few modeling studies which reported the predictions of the potential impact of the diagnostic delays (due to the reduction of the screening programs) on the survival of patients affected by colorectal cancer. However, no study reported any real-life evidence regarding the correlation between the COVID-19 outbreak and the deteriorations of the oncologic outcomes of patients with colorectal cancer. What are the new findings? The present study showed that patients who had surgery for colorectal cancer between March and December 2020 had an increased risk of more advanced disease in terms of associated symptoms, cancer location, clinical T4 stage, and number of liver metastases, than patients who had surgery between March and December 2019. How might it impact on clinical practice in the foreseeable future? The present study confirmed that the backlogs of the screening programs have had, and probably will have, detrimental effects on the oncologic outcomes of patients affected by colorectal cancer. Increased resources should be placed in order to reactivate and enhance the screening programs, and to reduce the risk of colorectal cancer patients to be diagnosed with advanced cancer in the next future.

ACS Style

Matteo Rottoli; Gianluca Pellino; Antonino Spinelli; Maria Elena Flacco; Lamberto Manzoli; Mario Morino; Salvatore Pucciarelli; Elio Jovine; Moh’D Abu Hilal; Riccardo Rosati; Alessandro Ferrero; Andrea Pietrabissa; Marcello Guaglio; Nicolò de Manzini; Pierluigi Pilati; Elisa Cassinotti; Giusto Pignata; Orlando Goletti; Enrico Opocher; Piergiorgio Danelli; Gianluca Sampietro; Stefano Olmi; Nazario Portolani; Gilberto Poggioli; the COVID-CRC Collaborative. The impact of COVID-19 on the oncologic outcomes of 3236 patients undergoing ColoRectal Cancer surgery in Northern Italy in 2019 and 2020 (COVID-CRC): results of a multicentric comparative cohort study. 2021, 1 .

AMA Style

Matteo Rottoli, Gianluca Pellino, Antonino Spinelli, Maria Elena Flacco, Lamberto Manzoli, Mario Morino, Salvatore Pucciarelli, Elio Jovine, Moh’D Abu Hilal, Riccardo Rosati, Alessandro Ferrero, Andrea Pietrabissa, Marcello Guaglio, Nicolò de Manzini, Pierluigi Pilati, Elisa Cassinotti, Giusto Pignata, Orlando Goletti, Enrico Opocher, Piergiorgio Danelli, Gianluca Sampietro, Stefano Olmi, Nazario Portolani, Gilberto Poggioli, the COVID-CRC Collaborative. The impact of COVID-19 on the oncologic outcomes of 3236 patients undergoing ColoRectal Cancer surgery in Northern Italy in 2019 and 2020 (COVID-CRC): results of a multicentric comparative cohort study. . 2021; ():1.

Chicago/Turabian Style

Matteo Rottoli; Gianluca Pellino; Antonino Spinelli; Maria Elena Flacco; Lamberto Manzoli; Mario Morino; Salvatore Pucciarelli; Elio Jovine; Moh’D Abu Hilal; Riccardo Rosati; Alessandro Ferrero; Andrea Pietrabissa; Marcello Guaglio; Nicolò de Manzini; Pierluigi Pilati; Elisa Cassinotti; Giusto Pignata; Orlando Goletti; Enrico Opocher; Piergiorgio Danelli; Gianluca Sampietro; Stefano Olmi; Nazario Portolani; Gilberto Poggioli; the COVID-CRC Collaborative. 2021. "The impact of COVID-19 on the oncologic outcomes of 3236 patients undergoing ColoRectal Cancer surgery in Northern Italy in 2019 and 2020 (COVID-CRC): results of a multicentric comparative cohort study." , no. : 1.

Journal article
Published: 14 April 2021 in Journal of Food Protection
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The aim of the present study was to evaluate the contamination levels of some classes of persistent organic pollutants in free-range hen eggs and to estimate the related human dietary exposure in a site of national interest, characterized by a serious state of environmental pollution in the Bussi sul Tirino area in central Italy. For these purposes, 17 samples of free-range hen eggs collected in home-producing farms located in the site of national interest territory were analyzed for 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), 12 dioxin-like polychlorinated biphenyls (dl-PCBs), and 6 non–dioxin-like PCBs (ndl-PCBs). Dietary exposure was assessed assuming a standard consumption of eggs per week. The concentration of ∑PCDD/Fs plus dl-PCBs ranged from 0.463 to 8.028 pg toxic equivalent g−1 fat, whereas the mean contamination level of the ∑ndl-PCBs ranged from 0.234 to 7.741 ng toxic equivalent g−1 fat. PCDD/Fs and PCBs contamination levels were lower than maximum values established by the Commission Regulation (European Union) 1259/2011, except for one sample. The estimated weekly intake, calculated to evaluate the contribution in terms of the monitored pollutants of the locally produced eggs to the diet, was lower than the tolerable weekly intake established by the European Food Safety Authority. HIGHLIGHTS

ACS Style

Federica Castellani; Lamberto Manzoli; Cecilia Acuti Martellucci; Maria Elena Flacco; Maria Luisa Astolfi; Leila Fabiani; Riccardo Mastrantonio; Pasquale Avino; Carmela Protano; Matteo Vitali. Levels of Polychlorinated Dibenzo-p-Dioxins/Furans and Polychlorinated Biphenyls in Free-Range Hen Eggs in Central Italy and Estimated Human Dietary Exposure. Journal of Food Protection 2021, 84, 1455 -1462.

AMA Style

Federica Castellani, Lamberto Manzoli, Cecilia Acuti Martellucci, Maria Elena Flacco, Maria Luisa Astolfi, Leila Fabiani, Riccardo Mastrantonio, Pasquale Avino, Carmela Protano, Matteo Vitali. Levels of Polychlorinated Dibenzo-p-Dioxins/Furans and Polychlorinated Biphenyls in Free-Range Hen Eggs in Central Italy and Estimated Human Dietary Exposure. Journal of Food Protection. 2021; 84 (8):1455-1462.

Chicago/Turabian Style

Federica Castellani; Lamberto Manzoli; Cecilia Acuti Martellucci; Maria Elena Flacco; Maria Luisa Astolfi; Leila Fabiani; Riccardo Mastrantonio; Pasquale Avino; Carmela Protano; Matteo Vitali. 2021. "Levels of Polychlorinated Dibenzo-p-Dioxins/Furans and Polychlorinated Biphenyls in Free-Range Hen Eggs in Central Italy and Estimated Human Dietary Exposure." Journal of Food Protection 84, no. 8: 1455-1462.

Journal article
Published: 13 April 2021 in Vaccines
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In March 2021, the coronavirus disease 2019 (COVID-19) pandemic still poses a threat to the global population, and is a public health challenge that needs to be overcome. Now more than ever, action is needed to tackle vaccine hesitancy, especially in light of the availability of effective and safe vaccines. A cross-sectional online survey was carried out on a representative random sample of 1011 citizens from the Emilia-Romagna region, in Italy, in January 2021. The questionnaire collected information on socio-demographics, comorbidities, past vaccination refusal, COVID-19-related experiences, risk perception of infection, and likelihood to accept COVID-19 vaccination. Multiple logistic regression analyses and classification tree analyses were performed to identify significant predictors of vaccine hesitancy and to distinguish groups with different levels of hesitancy. Overall, 31.1% of the sample reported hesitancy. Past vaccination refusal was the key discriminating variable followed by perceived risk of infection. Other significant predictors of hesitancy were: ages between 35 and 54 years, female gender, low educational level, low income, and absence of comorbidities. The most common concerns about the COVID-19 vaccine involved safety (54%) and efficacy (27%). Studying the main determinants of vaccine hesitancy can help with targeting vaccination strategies, in order to gain widespread acceptance—a key path to ensure a rapid way out of the current pandemic emergency.

ACS Style

Chiara Reno; Elisa Maietti; Maria Fantini; Elena Savoia; Lamberto Manzoli; Marco Montalti; Davide Gori. Enhancing COVID-19 Vaccines Acceptance: Results from a Survey on Vaccine Hesitancy in Northern Italy. Vaccines 2021, 9, 378 .

AMA Style

Chiara Reno, Elisa Maietti, Maria Fantini, Elena Savoia, Lamberto Manzoli, Marco Montalti, Davide Gori. Enhancing COVID-19 Vaccines Acceptance: Results from a Survey on Vaccine Hesitancy in Northern Italy. Vaccines. 2021; 9 (4):378.

Chicago/Turabian Style

Chiara Reno; Elisa Maietti; Maria Fantini; Elena Savoia; Lamberto Manzoli; Marco Montalti; Davide Gori. 2021. "Enhancing COVID-19 Vaccines Acceptance: Results from a Survey on Vaccine Hesitancy in Northern Italy." Vaccines 9, no. 4: 378.

Journal article
Published: 16 December 2020 in Science of The Total Environment
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In 2008 the Italian government classified the Bussi sul Tirino area (Central Italy) as Site of National Interest destined to remediation which, unfortunately, has not yet begun. The decision followed >20 years of illegal dumping of industrial wastes, lasting from 1984 to 2005, that generated the biggest illegal toxic waste disposal site in Europe. The contamination profile of the site was mainly characterized by PCDD/Fs, PCBs, PAHs, chlorinated solvents, Hg, and Pb. Due to the health concern of the population and local authorities, an extensive monitoring and biomonitoring campaign was carried out in 2017–2018, checking the site-specific pollutants in local food (free-range hens' eggs, milk from grazing sheep and goats, wild edible mushrooms, and drinking water), environmental (air and freshwaters) and biological (human urine) matrices. A total of 314 samples were processed, obtaining 3217 analytical data that were compared with regulatory limits, when available, and values reported by international literature. The sum PCDD/Fs and DL-PCBs ranged from 0.24 to 3.6 pg TEQ g−1 fat, and from 0.46 to 8.3 pg TEQ g−1 fat, respectively in milk in eggs, in line with the maximum levels established by CE Regulations except for an egg sample. As regards PAHs, all our results were lower than the literature data, as well as for Hg and Pb. Outdoor air showed levels of chlorinated solvents ranging from

ACS Style

Matteo Vitali; Federica Castellani; Giorgia Fragassi; Alfonso Mascitelli; Cecilia Martellucci; Gianfranco Diletti; Emanuela Scamosci; Maria Luisa Astolfi; Leila Fabiani; Riccardo Mastrantonio; Carmela Protano; Vincenzo Romano Spica; Lamberto Manzoli. Environmental status of an Italian site highly polluted by illegal dumping of industrial wastes: The situation 15 years after the judicial intervention. Science of The Total Environment 2020, 762, 144100 .

AMA Style

Matteo Vitali, Federica Castellani, Giorgia Fragassi, Alfonso Mascitelli, Cecilia Martellucci, Gianfranco Diletti, Emanuela Scamosci, Maria Luisa Astolfi, Leila Fabiani, Riccardo Mastrantonio, Carmela Protano, Vincenzo Romano Spica, Lamberto Manzoli. Environmental status of an Italian site highly polluted by illegal dumping of industrial wastes: The situation 15 years after the judicial intervention. Science of The Total Environment. 2020; 762 ():144100.

Chicago/Turabian Style

Matteo Vitali; Federica Castellani; Giorgia Fragassi; Alfonso Mascitelli; Cecilia Martellucci; Gianfranco Diletti; Emanuela Scamosci; Maria Luisa Astolfi; Leila Fabiani; Riccardo Mastrantonio; Carmela Protano; Vincenzo Romano Spica; Lamberto Manzoli. 2020. "Environmental status of an Italian site highly polluted by illegal dumping of industrial wastes: The situation 15 years after the judicial intervention." Science of The Total Environment 762, no. : 144100.

Letter to the editor
Published: 28 November 2020 in Oral Diseases
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ACS Style

Andrei Cristian Ionescu; Eugenio Brambilla; Lamberto Manzoli; Giovanna Orsini; Valentina Gentili; Roberta Rizzo. Efficacy of personal protective equipment and H 2 O 2 ‐based spray against coronavirus in dental setting. Oral Diseases 2020, 1 .

AMA Style

Andrei Cristian Ionescu, Eugenio Brambilla, Lamberto Manzoli, Giovanna Orsini, Valentina Gentili, Roberta Rizzo. Efficacy of personal protective equipment and H 2 O 2 ‐based spray against coronavirus in dental setting. Oral Diseases. 2020; ():1.

Chicago/Turabian Style

Andrei Cristian Ionescu; Eugenio Brambilla; Lamberto Manzoli; Giovanna Orsini; Valentina Gentili; Roberta Rizzo. 2020. "Efficacy of personal protective equipment and H 2 O 2 ‐based spray against coronavirus in dental setting." Oral Diseases , no. : 1.

Journal article
Published: 12 November 2020 in Open Forum Infectious Diseases
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This retrospective cohort study included all the subjects diagnosed with severe acute respiratory syndrome coronavirus 2 infection (n = 2493) in 2 Italian provinces. Two hundred fifty-eight persons died, after a median of 14.0 ± 11.0 days. Adjusting for age, gender, and main comorbidities, the ≥28-day case-fatality rate did not decrease from March to April 2020 (adjusted hazard ratio, 0.93; P = .6).

ACS Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces. Open Forum Infectious Diseases 2020, 7, ofaa556 .

AMA Style

Maria Elena Flacco, Cecilia Acuti Martellucci, Francesca Bravi, Giustino Parruti, Alfonso Mascitelli, Lorenzo Mantovani, Stefania Boccia, Lamberto Manzoli. Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces. Open Forum Infectious Diseases. 2020; 7 (12):ofaa556.

Chicago/Turabian Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. 2020. "Severe Acute Respiratory Syndrome Coronavirus 2 Lethality Did not Change Over Time in Two Italian Provinces." Open Forum Infectious Diseases 7, no. 12: ofaa556.

Journal article
Published: 08 July 2020 in BMC Health Services Research
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Emergency Department (ED) crowding reduces staff satisfaction and healthcare quality and safety, which in turn increase costs. Despite a number of proposed solutions, ED length of stay (LOS) - a main cause of overcrowding - remains a major issue worldwide. This retrospective cohort study was aimed at evaluating the effectiveness on ED LOS of a procedure called “Diagnostic Anticipation” (DA), which consisted in anticipating the ordering of blood tests by nurses, at triage, following a diagnostic algorithm approved by physicians. In the second half of 2019, the ED of the University Hospital of Ferrara, Italy, adopted the DA protocol on alternate weeks for all patients with chest pain, abdominal pain, and non-traumatic bleeding. A retrospective cohort study on DA impact was conducted. Using ED electronic data, LOS independent predictors (age, sex, NEDOCS and Priority Color Code, imaging tests, specialistic consultations, hospital admission) were evaluated through multiple regression. During the weeks when DA was adopted, as compared to control weeks, the mean LOS was shorter by 18.2 min for chest pain, but longer by 15.7 min for abdominal pain, and 33.3 for non-traumatic bleeding. At multivariate analysis, adjusting for age, gender, triage priority, specialist consultations, imaging test, hospitalization and ED crowding, the difference in visit time was significant for chest pain only (p < 0.001). The impact of DA varied by patients’ condition, being significant for chest pain only. Further research is needed before the implementation, estimating the potential proportion of inappropriate blood tests and ED crowding status.

ACS Style

Andrea Strada; Niccolò Bolognesi; Lamberto Manzoli; Giorgia Valpiani; Chiara Morotti; Francesca Bravi; Roberto Bentivegna; Elena Forini; Antonella Pesci; Armando Stefanati; Eugenio Di Ruscio; Tiziano Carradori. Diagnostic anticipation to reduce emergency department length of stay: a retrospective cohort study in Ferrara University hospital, Italy. BMC Health Services Research 2020, 20, 1 -6.

AMA Style

Andrea Strada, Niccolò Bolognesi, Lamberto Manzoli, Giorgia Valpiani, Chiara Morotti, Francesca Bravi, Roberto Bentivegna, Elena Forini, Antonella Pesci, Armando Stefanati, Eugenio Di Ruscio, Tiziano Carradori. Diagnostic anticipation to reduce emergency department length of stay: a retrospective cohort study in Ferrara University hospital, Italy. BMC Health Services Research. 2020; 20 (1):1-6.

Chicago/Turabian Style

Andrea Strada; Niccolò Bolognesi; Lamberto Manzoli; Giorgia Valpiani; Chiara Morotti; Francesca Bravi; Roberto Bentivegna; Elena Forini; Antonella Pesci; Armando Stefanati; Eugenio Di Ruscio; Tiziano Carradori. 2020. "Diagnostic anticipation to reduce emergency department length of stay: a retrospective cohort study in Ferrara University hospital, Italy." BMC Health Services Research 20, no. 1: 1-6.

Review
Published: 01 July 2020 in Heart
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ObjectiveIt has been hypothesised that the use of ACE inhibitors and angiotensin receptor blockers (ARBs) might either increase or reduce the risk of severe or lethal COVID-19. The findings from the available observational studies varied, and summary estimates are urgently needed to elucidate whether these drugs should be suspended during the pandemic, or patients and physicians should be definitely reassured. This meta-analysis of adjusted observational data aimed to summarise the existing evidence on the association between these medications and severe/lethal COVID-19.MethodsWe searched MedLine, Scopus and preprint repositories up to 8 June 2020 to retrieve cohort or case–control studies comparing the risk of severe/fatal COVID-19 (either mechanical ventilation, intensive care unit admission or death), among hypertensive subjects treated with: (1) ACE inhibitors, (2) ARBs and (3) both, versus untreated subjects. Data were combined using a random-effect generic inverse variance approach.ResultsTen studies, enrolling 9890 hypertensive subjects were included in the analyses. Compared with untreated subjects, those using either ACE inhibitors or ARBs showed a similar risk of severe or lethal COVID-19 (summary OR: 0.90; 95% CI 0.65 to 1.26 for ACE inhibitors; 0.92; 95% CI 0.75 to 1.12 for ARBs). The results did not change when both drugs were considered together, when death was the outcome and excluding the studies with significant, divergent results.ConclusionThe present meta-analysis strongly supports the recommendation of several scientific societies to continue ARBs or ACE inhibitors for all patients, unless otherwise advised by their physicians who should thus be reassured.

ACS Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Rosaria Cappadona; Alfonso Mascitelli; Roberto Manfredini; Lorenzo G Mantovani; Lamberto Manzoli. Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis. Heart 2020, 106, 1 .

AMA Style

Maria Elena Flacco, Cecilia Acuti Martellucci, Francesca Bravi, Giustino Parruti, Rosaria Cappadona, Alfonso Mascitelli, Roberto Manfredini, Lorenzo G Mantovani, Lamberto Manzoli. Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis. Heart. 2020; 106 (19):1.

Chicago/Turabian Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Rosaria Cappadona; Alfonso Mascitelli; Roberto Manfredini; Lorenzo G Mantovani; Lamberto Manzoli. 2020. "Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis." Heart 106, no. 19: 1.

Research article
Published: 24 June 2020 in PLOS ONE
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This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). All adults with SARS-CoV-2 infection in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension, diabetes, cancer, COPD, renal and major cardiovascular diseases (CVD) were extracted from clinical charts and electronic health records, up to two years before infection. The sample consisted of 1603 subjects (mean age 58.0y; 47.3% males): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease (154 deaths; mean age 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged 44 years. Among hypertensive subjects (n = 543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease, respectively. At multivariate analysis, no association was observed between therapy and disease severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50–1.49). Significant predictors of severe disease were older age (with AORs largely increasing after 70 years of age), male gender (AOR: 1.76; 1.40–2.23), diabetes (AOR: 1.52; 1.05–2.18), CVD (AOR: 1.88; 1.32–2.70) and COPD (AOR: 1.88; 1.11–3.20). Only gender, age and diabetes also predicted very severe/lethal disease. No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.

ACS Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. PLOS ONE 2020, 15, e0235248 .

AMA Style

Francesca Bravi, Maria Elena Flacco, Tiziano Carradori, Carlo Alberto Volta, Giuseppe Cosenza, Aldo De Togni, Cecilia Acuti Martellucci, Giustino Parruti, Lorenzo Mantovani, Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. PLOS ONE. 2020; 15 (6):e0235248.

Chicago/Turabian Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. 2020. "Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens." PLOS ONE 15, no. 6: e0235248.

Review
Published: 17 June 2020 in Advances in Biological Regulation
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By the end of May 2020, SARS-CoV-2 pandemic caused more than 350,000 deaths worldwide. In the first months, there have been uncertainties on almost any area: infection transmission route, virus origin and persistence in the environment, diagnostic tests, therapeutic approach, high-risk subjects, lethality, and containment policies. We provide an updated summary of the current knowledge on the pandemic, discussing the available evidence on the effectiveness of the adopted mitigation strategies.

ACS Style

Cecilia Acuti Martellucci; Maria Elena Flacco; Rosaria Cappadona; Francesca Bravi; Lorenzo Mantovani; Lamberto Manzoli. SARS-CoV-2 pandemic: An overview. Advances in Biological Regulation 2020, 77, 100736 -100736.

AMA Style

Cecilia Acuti Martellucci, Maria Elena Flacco, Rosaria Cappadona, Francesca Bravi, Lorenzo Mantovani, Lamberto Manzoli. SARS-CoV-2 pandemic: An overview. Advances in Biological Regulation. 2020; 77 ():100736-100736.

Chicago/Turabian Style

Cecilia Acuti Martellucci; Maria Elena Flacco; Rosaria Cappadona; Francesca Bravi; Lorenzo Mantovani; Lamberto Manzoli. 2020. "SARS-CoV-2 pandemic: An overview." Advances in Biological Regulation 77, no. : 100736-100736.

Other
Published: 24 May 2020
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BackgroundSome experts recently reported that SARS-CoV-2 lethality decreased considerably, but no evidence is yet available. This retrospective cohort study aimed to evaluate whether SARS-CoV-2 case-fatality rate decreased with time, adjusting for several potential confounders.MethodsWe included all subjects diagnosed with SARS-CoV-2 infection in Ferrara and Pescara provinces, Italy. Information were collected from local registries, clinical charts, and electronic health records. We compared the case-fatality rate (after ≥28 days of follow-up) of the subjects diagnosed during April and March, 2020. We used Cox proportional hazards analysis and random-effect logistic regression, adjusting for age, gender, hypertension, type II diabetes, major cardiovascular diseases (CVD), chronic obstructive pulmonary diseases (COPD), cancer and renal disease.ResultsThe sample included 2493 subjects (mean age 58.6y; 47.7% males). 258 persons deceased, after a mean of 16.1 days of follow-up. The mean age of those who died substantially increased from March (78.1±11.0y) to April (84.3±10.2y). From March to April, the case-fatality rate did not decrease in the total sample (9.5% versus 12.1%; adjusted hazard ratio 0.93; 95% Confidence Interval: 0.71-1.21; p=0.6), and in any age-class.ConclusionsIn this sample, SARS-CoV-2 case-fatality rate did not decrease over time, in contrast with recent claims of a substantial improvement of SARS-CoV-2 clinical management. The findings require confirmation from larger datasets.Author summaryWhy was this study done?Some experts recently reported that SARS-CoV-2 lethality decreased considerably, but no evidence is yet available.What did the researchers do and find?We carried out a retrospective cohort study on 2493 SARS-CoV-2 infected subjects from two Italian provinces, evaluating the potential variation of the case-fatality rate over time.From March to April, SARS-CoV-2 case-fatality rate did not decrease, overall and in any age-class.What do these findings mean?The therapies and clinical management of SARS-CoV-2 infected subjects did not determine a substantial change of the clinical course of the disease from March to April, 2020.

ACS Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. SARS-CoV-2 lethality did not change over time in two Italian Provinces. 2020, 1 .

AMA Style

Maria Elena Flacco, Cecilia Acuti Martellucci, Francesca Bravi, Giustino Parruti, Alfonso Mascitelli, Lorenzo Mantovani, Stefania Boccia, Lamberto Manzoli. SARS-CoV-2 lethality did not change over time in two Italian Provinces. . 2020; ():1.

Chicago/Turabian Style

Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli. 2020. "SARS-CoV-2 lethality did not change over time in two Italian Provinces." , no. : 1.

Other
Published: 23 May 2020
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Aims: This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). Methods and Results: All adults with SARS-CoV-2 infection in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension, diabetes, cancer, COPD, renal and major cardiovascular diseases (CVD) were extracted from clinical charts and electronic health records, up to two years before infection. The sample consisted of 1603 subjects (mean age 58.0y; 47.3% males): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease (154 deaths; mean age 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged 44 years. Among hypertensive subjects (n=543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease, respectively. At multivariate analysis, no association was observed between therapy and disease severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50-1.49). Significant predictors of severe disease were older age (with AORs largely increasing after 70 years of age), male gender (AOR: 1.76; 1.40-2.23), diabetes (AOR: 1.52; 1.05-2.18), CVD (AOR: 1.88; 1.32-2.70) and COPD (1.88; 1.11-3.20). Only gender, age and diabetes also predicted very severe/lethal disease. Conclusion: No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.

ACS Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. 2020, 1 .

AMA Style

Francesca Bravi, Maria Elena Flacco, Tiziano Carradori, Carlo Alberto Volta, Giuseppe Cosenza, Aldo De Togni, Cecilia Acuti Martellucci, Giustino Parruti, Lorenzo Mantovani, Lamberto Manzoli. Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens. . 2020; ():1.

Chicago/Turabian Style

Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli. 2020. "Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens." , no. : 1.

Journal article
Published: 01 April 2020
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ACS Style

Maria Elena Flacco; M Fiore; C Acuti Martellucci; M Ferrante; M R Gualano; G Liguori; F Bravi; G M Pirone; C Marzuillo; L Manzoli. Tobacco vs. electronic cigarettes: absence of harm reduction after six years of follow-up. 2020, 24, 3923 -3934.

AMA Style

Maria Elena Flacco, M Fiore, C Acuti Martellucci, M Ferrante, M R Gualano, G Liguori, F Bravi, G M Pirone, C Marzuillo, L Manzoli. Tobacco vs. electronic cigarettes: absence of harm reduction after six years of follow-up. . 2020; 24 (7):3923-3934.

Chicago/Turabian Style

Maria Elena Flacco; M Fiore; C Acuti Martellucci; M Ferrante; M R Gualano; G Liguori; F Bravi; G M Pirone; C Marzuillo; L Manzoli. 2020. "Tobacco vs. electronic cigarettes: absence of harm reduction after six years of follow-up." 24, no. 7: 3923-3934.

Observational study
Published: 05 September 2019 in BMC Pulmonary Medicine
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Idiopathic Pulmonary Fibrosis (IPF) is an aggressive interstitial lung disease with an unpredictable course. Occupational dust exposure may contribute to IPF onset, but its impact on antifibrotic treatment and disease prognosis is still unknown. We evaluated clinical characteristics, respiratory function and prognostic predictors at diagnosis and at 12 month treatment of pirfenidone or nintedanib in IPF patients according to occupational dust exposure. A total of 115 IPF patients were recruited. At diagnosis, we collected demographic, clinical characteristics, occupational history. Pulmonary function tests were performed and two prognostic indices [Gender, Age, Physiology (GAP) and Composite Physiologic Index (CPI)] calculated, both at diagnosis and after the 12 month treatment. The date of long-term oxygen therapy (LTOT) initiation was recorded during the entire follow-up (mean = 37.85, range 12–60 months). At baseline, patients exposed to occupational dust [≥ 10 years (n = 62)] showed a lower percentage of graduates (19.3% vs 54.7%; p = 0.04) and a higher percentage of asbestos exposure (46.8% vs 18.9%; p 0.002) than patients not exposed [< 10 years (n = 53)]. Both at diagnosis and after 12 months of antifibrotics, no significant differences for respiratory function and prognostic predictors were found. The multivariate analysis confirmed that occupational dust exposure did not affect neither FVC and DLCO after 12 month therapy nor the timing of LTOT initiation. Occupational dust exposure lasting 10 years or more does not seem to influence the therapeutic effects of antifibrotics and the prognostic predictors in patients with IPF.

ACS Style

Valeria Casillo; Stefania Cerri; Andrea Ciervo; Mariarita Stendardo; Lamberto Manzoli; Maria Elena Flacco; Maurizio Manno; Marialuisa Bocchino; Fabrizio Luppi; Piera Boschetto. Antifibrotic treatment response and prognostic predictors in patients with idiopathic pulmonary fibrosis and exposed to occupational dust. BMC Pulmonary Medicine 2019, 19, 1 -9.

AMA Style

Valeria Casillo, Stefania Cerri, Andrea Ciervo, Mariarita Stendardo, Lamberto Manzoli, Maria Elena Flacco, Maurizio Manno, Marialuisa Bocchino, Fabrizio Luppi, Piera Boschetto. Antifibrotic treatment response and prognostic predictors in patients with idiopathic pulmonary fibrosis and exposed to occupational dust. BMC Pulmonary Medicine. 2019; 19 (1):1-9.

Chicago/Turabian Style

Valeria Casillo; Stefania Cerri; Andrea Ciervo; Mariarita Stendardo; Lamberto Manzoli; Maria Elena Flacco; Maurizio Manno; Marialuisa Bocchino; Fabrizio Luppi; Piera Boschetto. 2019. "Antifibrotic treatment response and prognostic predictors in patients with idiopathic pulmonary fibrosis and exposed to occupational dust." BMC Pulmonary Medicine 19, no. 1: 1-9.

Journal article
Published: 27 July 2019 in Open Forum Infectious Diseases
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BackgroundPsychological factors (PFs) are known predictors of cardiovascular disease (CVD) in many clinical settings, but data are lacking for human immunodeficiency virus (HIV) infection. We carried out a prospective study to evaluate (1) psychological predictors of preclinical and clinical vascular disease and (2) all-cause mortality (ACM) in HIV patients.MethodsWe conducted a cross-sectional analysis of baseline data to evaluate the predictors of carotid plaques (CPs) and a prospective analysis to explore predictors of vascular events (VEs) and ACM over 10 years. Human immunodeficiency virus patients monitored at the Infectious Disease Units of 6 Italian regions were consecutively enrolled. Traditional CVD risk factors, PFs (depressive symptoms, alexithymia, distress personality), and CPs were investigated. Vascular events and ACM after enrollment were censored at March 2018.ResultsA multicenter cohort of 712 HIV-positive patients (75.3% males, aged 46.1 ± 10.1 years) was recruited. One hundred seventy-five (31.6%) patients had CPs at baseline. At the cross-sectional analysis, alexithymia was independently associated with CPs (odds ratio, 4.93; 95% confidence interval [CI], 2.90–8.50; P < .001), after adjustment for sociodemographic, clinical, and psychological variables. After an average follow-up of 4.4 ± 2.4 years, 54 (7.6%) patients developed a VE, whereas 41 (5.68%) died. Age, current smoking, hypertension, and alexithymia (hazard ratio [HR], 3.66; 95% CI, 1.80–7.44; P < .001) were independent predictors of VE. Likewise, alexithymia was an independent predictor of ACM (HR, 3.93; 95% CI, 1.65–9.0; P = .002), regardless of other clinical predictors.ConclusionsThe present results validate our previous monocentric finding. Alexithymia may be an additional tool for the multifactorial assessment of cardiovascular risk in HIV.

ACS Style

Francesco Vadini; Federica Sozio; Giordano Madeddu; Giuseppe De Socio; Paolo Maggi; Giuseppe Nunnari; Francesca Vichi; Paola Di Stefano; Elisa Tracanna; Ennio Polilli; Antonina Sciacca; Bernardetta Zizi; Vincenzo Lai; Claudio Bartolozzi; Maria Elena Flacco; Paolo Bonfanti; Francesca Santilli; Lamberto Manzoli; Giustino Parruti. Alexithymia Predicts Carotid Atherosclerosis, Vascular Events, and All-Cause Mortality in Human Immunodeficiency Virus-Infected Patients: An Italian Multisite Prospective Cohort Study. Open Forum Infectious Diseases 2019, 6, 1 .

AMA Style

Francesco Vadini, Federica Sozio, Giordano Madeddu, Giuseppe De Socio, Paolo Maggi, Giuseppe Nunnari, Francesca Vichi, Paola Di Stefano, Elisa Tracanna, Ennio Polilli, Antonina Sciacca, Bernardetta Zizi, Vincenzo Lai, Claudio Bartolozzi, Maria Elena Flacco, Paolo Bonfanti, Francesca Santilli, Lamberto Manzoli, Giustino Parruti. Alexithymia Predicts Carotid Atherosclerosis, Vascular Events, and All-Cause Mortality in Human Immunodeficiency Virus-Infected Patients: An Italian Multisite Prospective Cohort Study. Open Forum Infectious Diseases. 2019; 6 (9):1.

Chicago/Turabian Style

Francesco Vadini; Federica Sozio; Giordano Madeddu; Giuseppe De Socio; Paolo Maggi; Giuseppe Nunnari; Francesca Vichi; Paola Di Stefano; Elisa Tracanna; Ennio Polilli; Antonina Sciacca; Bernardetta Zizi; Vincenzo Lai; Claudio Bartolozzi; Maria Elena Flacco; Paolo Bonfanti; Francesca Santilli; Lamberto Manzoli; Giustino Parruti. 2019. "Alexithymia Predicts Carotid Atherosclerosis, Vascular Events, and All-Cause Mortality in Human Immunodeficiency Virus-Infected Patients: An Italian Multisite Prospective Cohort Study." Open Forum Infectious Diseases 6, no. 9: 1.

Review
Published: 06 June 2019 in Ultrasound in Obstetrics & Gynecology
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Objective To determine the potential benefit of the interventional radiology (IR) in improving the outcome of women undergoing surgery for placenta accreta spectrum (PAS) disorders. Methods Medline, Embase and CINAHL databases were explored searching a robust cadre of terms relating to PAS. The primary outcome was the intraoperative estimated blood loss (EBL,L); Secondary outcomes were: units of packed red blood cells (PRBC) fresh frozen plasma (FFP), platelets (PLT) cryoprecipitate transfused, operative time (min), length of hospital stay (d), EBL ≥2.5 L, PRBC transfused ≥5 units, surgical complications, bladder ureteral injuries, re‐laparotomy, infection, disseminated intravascular coagulation (DIC) and complications related to endovascular catheter placement. Only studies reporting the incidence of or the mean difference in the observed outcomes in women affected by PAS disorders who had compared to those who did not have IR procedures before surgery were considered for the inclusion. All these outcomes were explored in the overall population of women with a prenatal diagnosis of PAS and in those undergoing hysterectomy. Quality assessment of each included study was performed using the Risk of Bias In Non‐randomized Studies–of Interventions tool (ROBINS‐I). The GRADE methodology was used to assess the quality of the body of retrieved evidence. Results Fifteen studies (955 women) were included. Mean EBL ((MD ‐1.01, 95% CI‐1.59; ‐0.43); p<0.001) and the risk of EBL ≥2.5 L (OR 0.18, 95% CI 0.04‐0.78, p=0.02) were significantly less in the cases compared to controls. There was no significant difference in the other outcomes explored. In the subgroup analysis of pregnancies complicated by PAS undergoing hysterectomy, the EBL (MD ‐0.68; 95% CI ‐1.24, ‐0.12, p=0.02) and the number of transfused FFP units (MD ‐1.66; 95% CI ‐2.71, ‐0.61, p=0.02) were significantly less in women undergoing endovascular IR procedures compared to controls. Furthermore, women undergoing IR had a significantly lower risk of requiring transfusion of ≥5 PRBC units (OR 0.10, 95% CI 0.02‐0.47, p=0.04). Overall, the complications related to the placement of endovascular catheter occurred in 5.3% (95% CI 2.6‐8.9; I2 65.3%) of the pregnancies undergoing IR. Overall quality of evidence, as qualified by GRADE, was low. Conclusion The current data available provide encouraging evidence that IR procedures may be associated with lower EBL and rates of transfusion in pregnancies complicated by PAS disorders. However, given the overall very low quality of the evidence, as reflected in the GRADE assessment, further large studies are needed in order to confirm the beneficial role of IR in improving the outcome of women undergoing surgery for PAS disorders. This article is protected by copyright. All rights reserved.

ACS Style

Francesco D’Antonio; Antonia Iacovelli; Marco Liberati; Martina Leombroni; Daniela Murgano; Giuseppe Cali; Asma Khalil; Maria Elena Flacco; Gennaro Scutiero; Piergiorgio Iannone; Giovanni Scambia; Lamberto Manzoli; Pantaleo Greco. Role of interventional radiology in pregnancy complicated by placenta accreta spectrum disorder: systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology 2019, 53, 743 -751.

AMA Style

Francesco D’Antonio, Antonia Iacovelli, Marco Liberati, Martina Leombroni, Daniela Murgano, Giuseppe Cali, Asma Khalil, Maria Elena Flacco, Gennaro Scutiero, Piergiorgio Iannone, Giovanni Scambia, Lamberto Manzoli, Pantaleo Greco. Role of interventional radiology in pregnancy complicated by placenta accreta spectrum disorder: systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology. 2019; 53 (6):743-751.

Chicago/Turabian Style

Francesco D’Antonio; Antonia Iacovelli; Marco Liberati; Martina Leombroni; Daniela Murgano; Giuseppe Cali; Asma Khalil; Maria Elena Flacco; Gennaro Scutiero; Piergiorgio Iannone; Giovanni Scambia; Lamberto Manzoli; Pantaleo Greco. 2019. "Role of interventional radiology in pregnancy complicated by placenta accreta spectrum disorder: systematic review and meta-analysis." Ultrasound in Obstetrics & Gynecology 53, no. 6: 743-751.

Review
Published: 23 March 2019 in Journal of Clinical Medicine
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The available evidence on the effects of daylight saving time (DST) transitions on major cardiovascular diseases is limited and conflicting. We carried out the first meta-analysis aimed at evaluating the risk of acute myocardial infarction (AMI) following DST transitions. We searched cohort or case-control studies evaluating the incidence of AMI, among adults (≥18 y), during the weeks following spring and/or autumn DST shifts, versus control periods. The search was made in MedLine and Scopus, up to 31 December 2018, with no language restriction. A summary odds ratio of AMI was computed after: (1) spring, (2) autumn or (3) both transitions considered together. Meta-analyses were also stratified by gender and age. Data were combined using a generic inverse-variance approach. Seven studies (>115,000 subjects) were included in the analyses. A significantly higher risk of AMI (Odds Ratio: 1.03; 95% CI: 1.01⁻1.06) was observed during the two weeks following spring or autumn DST transitions. However, although AMI risk increased significantly after the spring shift (OR: 1.05; 1.02⁻1.07), the incidence of AMI during the week after winter DST transition was comparable with control periods (OR 1.01; 0.98⁻1.04). No substantial differences were observed when the analyses were stratified by age or gender. The risk of AMI increases modestly but significantly after DST transitions, supporting the proposal of DST shifts discontinuation. Additional studies that fully adjust for potential confounders are required to confirm the present findings.

ACS Style

Roberto Manfredini; Fabio Fabbian; Rosaria Cappadona; Alfredo De Giorgi; Francesca Bravi; Tiziano Carradori; Maria Elena Flacco; Lamberto Manzoli. Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis. Journal of Clinical Medicine 2019, 8, 404 .

AMA Style

Roberto Manfredini, Fabio Fabbian, Rosaria Cappadona, Alfredo De Giorgi, Francesca Bravi, Tiziano Carradori, Maria Elena Flacco, Lamberto Manzoli. Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis. Journal of Clinical Medicine. 2019; 8 (3):404.

Chicago/Turabian Style

Roberto Manfredini; Fabio Fabbian; Rosaria Cappadona; Alfredo De Giorgi; Francesca Bravi; Tiziano Carradori; Maria Elena Flacco; Lamberto Manzoli. 2019. "Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis." Journal of Clinical Medicine 8, no. 3: 404.

Review
Published: 05 November 2018 in Ultrasound in Obstetrics & Gynecology
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Objective To explore the outcome of fetuses affected by congenital Parvovirus B19 (PB19) Infection. Methods The outcomes observed were: miscarriage, perinatal death (PND), intra‐uterine death (IUD), neonatal death (NND), spontaneous resolution of hydrops or fetal anemia, intra‐uterine transfusion (IUT), resolution of hydrops or anemia after transfusion, fetal loss following transfusion, abnormal brain scan after birth, abnormal neurodevelopmental outcome. All the observed outcomes were reported in fetuses presenting and in those not presenting signs of hydrops on ultrasound. A sub‐group analysis was performed including hydropic and non‐hydropic fetuses < and ≥ 20 weeks of gestation respectively. Meta‐analyses of proportions and meta‐analyses using individual data random‐effect logistic regression were used to analyze the data. Results Thirty‐seven observational studies (654 fetuses affected by PB19 infection) were included. The risk of miscarriage (OR: 11.5, 95% CI 2.7‐49.7) and PND (OR: 4.2, 95% CI 1.6‐11.0) was higher in fetuses affected by PB19 infection presenting compared to those not presenting with hydrops on ultrasound. In fetuses affected by hydrops, spontaneous resolution of the infection, defined as disappearance of hydrops without the need for IUT, occurred in 5.2% (95% CI 2.5‐8.8) of cases, while in the group of fetuses not affected by hydrops, resolution occurred in 49.6% (95% CI 20.7‐78.6) of cases. IUT was performed in 78.7% (95% CI 66.4‐88.8) of hydropic and in 29.6% (95% CI 6.0‐61.6) of non‐hydropic fetuses affected by congenital PB19 infection and resolution of the infection after IUT occurred in 55.1% (95% CI 34.0‐75.3) of fetuses presenting and in 100% (95% CI 57.3‐100) of cases not presenting signs of hydrops on ultrasound. The risk of fetal loss after IUT was higher in fetuses affected compared to those not affected by hydrops (OR: 9.8 (95% CI 2.8‐34.6). Assessment of neurodevelopmental outcome was affected by the very small number of included cases, thereby precluding the achievement of adequate statistical power. The prevalence of abnormal brain imaging was 9.8% (95% CI 2.5‐21.0) in fetuses affected and 0.0% (95% CI 0.0‐7.0) in those not affected by hydrops, while the corresponding figures for abnormal neurodevelopmental outcome was 9.5% (95% CI2.6‐20.2) and 0.0% (95% 0.0‐0.8). Conclusion Hydrops is the main determinant of mortality and adverse perinatal outcome in fetuses affected by PB19 infection. Perinatal outcome in non‐hydropic fetuses is generally favorable. This article is protected by copyright. All rights reserved

ACS Style

Francesca Bascietto; Marco Liberati; Daniela Murgano; Danilo Buca; Antonia Iacovelli; Maria Elena Flacco; Lamberto Manzoli; Alessandra Familiari; Giovanni Scambia; Francesco D'antonio. Outcome of fetuses with congenital parvovirus B19 infection: systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology 2018, 52, 569 -576.

AMA Style

Francesca Bascietto, Marco Liberati, Daniela Murgano, Danilo Buca, Antonia Iacovelli, Maria Elena Flacco, Lamberto Manzoli, Alessandra Familiari, Giovanni Scambia, Francesco D'antonio. Outcome of fetuses with congenital parvovirus B19 infection: systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology. 2018; 52 (5):569-576.

Chicago/Turabian Style

Francesca Bascietto; Marco Liberati; Daniela Murgano; Danilo Buca; Antonia Iacovelli; Maria Elena Flacco; Lamberto Manzoli; Alessandra Familiari; Giovanni Scambia; Francesco D'antonio. 2018. "Outcome of fetuses with congenital parvovirus B19 infection: systematic review and meta-analysis." Ultrasound in Obstetrics & Gynecology 52, no. 5: 569-576.