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  1. Article: COVID-19 Biomarkers for Critically Ill Patients: A Compendium for the Physician.

    Arturi, Federica / Melegari, Gabriele / Giansante, Antonio / Giuliani, Enrico / Bertellini, Elisabetta / Barbieri, Alberto

    Neurology international

    2023  Volume 15, Issue 3, Page(s) 881–895

    Abstract: Background: SARS-CoV-2 clinical manifestation and progression are variable and unpredictable, hence the importance of considering biomarkers in clinical practice that can be useful for both diagnosis and prognostic evaluation. This review aims to ... ...

    Abstract Background: SARS-CoV-2 clinical manifestation and progression are variable and unpredictable, hence the importance of considering biomarkers in clinical practice that can be useful for both diagnosis and prognostic evaluation. This review aims to summarize, for intensive care physicians, the most recent state of knowledge regarding known COVID-19 in critical patients. We searched PubMed
    Methods: We divided the results into four essential paragraphs: "Cytokine storm", "Endothelium dysfunction and coagulation biomarkers in COVID-19", "Biomarker of sepsis", and Cardiovascular lung and new perspectives.
    Results: The assessments of the severe COVID-19 prognosis should monitor, over time, IL-6, soluble Von Willebrand factor (VWF), P-selectin, sCD40L, thrombomodulin, VCAM-1, endothelin- Troponin, D-dimer, LDH, CRP, and procalcitonin. Metabolomic alterations and ACE2 receptors represent new perspectives.
    Discussion and conclusions: Early identification of critically ill patients has been crucial in the first COVID-19 pandemic wave for the sustainability of the healthcare emergency system and clinical management. Only through the early identification of the most severe patients can they be provided with the most appropriate treatments.
    Language English
    Publishing date 2023-07-23
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2514727-4
    ISSN 2035-8377 ; 2035-8385
    ISSN (online) 2035-8377
    ISSN 2035-8385
    DOI 10.3390/neurolint15030056
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  2. Article ; Online: Deepening Pathology of SARS-CoV-2 Pneumonia Explains Lung Ventilation Complications.

    Manenti, Antonio / Roncati, Luca / Melegari, Gabriele

    The Annals of thoracic surgery

    2021  Volume 113, Issue 4, Page(s) 1389

    MeSH term(s) COVID-19 ; Humans ; Lung ; Pneumonia ; Respiration, Artificial ; SARS-CoV-2
    Language English
    Publishing date 2021-03-17
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2021.03.009
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    Zs.A 252: Show issues Location:
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  3. Article ; Online: How to humanise the COVID-19 intensive care units.

    Rivi, Veronica / Melegari, Gabriele / Blom, Johanna M C

    BMJ evidence-based medicine

    2021  

    Language English
    Publishing date 2021-01-29
    Publishing country England
    Document type Editorial
    ISSN 2515-4478
    ISSN (online) 2515-4478
    DOI 10.1136/bmjebm-2020-111513
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  4. Article ; Online: Hemoadsorption cartridge and coronavirus disease 2019 infections: A case report and brief literature review.

    Melegari, Gabriele / Bertellini, Elisabetta / Melegari, Alessandra / Trenti, Tommaso / Malaguti, Silvio / Barbieri, Alberto

    Artificial organs

    2020  Volume 45, Issue 5, Page(s) E130–E135

    Abstract: The cytokine storm has been frequently reported to occur in patients with severe coronavirus disease 2019 (COVID-19). Data from the literature suggest that elevated levels of inflammatory mediators, such as interleukin (IL)-6, IL-8, and tumor necrosis ... ...

    Abstract The cytokine storm has been frequently reported to occur in patients with severe coronavirus disease 2019 (COVID-19). Data from the literature suggest that elevated levels of inflammatory mediators, such as interleukin (IL)-6, IL-8, and tumor necrosis factor, indicate a severe course or the fatality of the disease. Several therapeutic options have been employed to treat critically ill patients, including hemoadsorption of inflammatory mediators. We here present a case of severe acute respiratory syndrome caused by COVID-19 and acute renal failure. The patient was admitted to our intensive care unit and treated with mechanical ventilation, renal replacement therapy, and hemoadsorption to reduce the cytokine release syndrome, which plays a fundamental role in the clinical presentation of COVID-19 patients. We also discuss the potential advantages of reducing cytokine plasma levels using a hemoadsorption cartridge.
    MeSH term(s) Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Aged ; Antiviral Agents/therapeutic use ; Biomarkers/blood ; COVID-19/diagnosis ; COVID-19/therapy ; Continuous Renal Replacement Therapy/instrumentation ; Critical Illness ; Cytokine Release Syndrome/therapy ; Cytokine Release Syndrome/virology ; Cytokines/blood ; Drug Therapy, Combination ; Humans ; Intensive Care Units ; Male ; Organ Dysfunction Scores ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; SARS-CoV-2
    Chemical Substances Antiviral Agents ; Biomarkers ; Cytokines
    Keywords covid19
    Language English
    Publishing date 2020-11-29
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.13846
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  5. Article ; Online: To improve the distal duodenal resection.

    Manenti, A / Melegari, G / Zizzo, M / Farinetti, A

    Journal of visceral surgery

    2019  Volume 157, Issue 3, Page(s) 263–264

    MeSH term(s) Adenocarcinoma ; Digestive System Surgical Procedures ; Duodenum ; Humans
    Language English
    Publishing date 2019-06-17
    Publishing country France
    Document type Letter ; Comment
    ISSN 1878-7886
    ISSN (online) 1878-7886
    DOI 10.1016/j.jviscsurg.2019.06.002
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  6. Article ; Online: Could an electronic log-book be effective for medical training in anaesthesiology?

    Barbieri, Alberto / Melegari, Gabriele / Giuliani, Enrico

    European journal of anaesthesiology

    2020  Volume 37, Issue 6, Page(s) 515

    MeSH term(s) Anesthesiology/education ; Books ; Education, Medical, Graduate ; Internship and Residency
    Language English
    Publishing date 2020-05-07
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001210
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  7. Article ; Online: Health Care Management during a Major Planned Event in Italy.

    Melegari, Gabriele / Giuliani, Enrico / Fornaciari, Davide / Cremonini, Claudia / Di Pietro, Giulia / Barbieri, Alberto

    Prehospital and disaster medicine

    2022  Volume 37, Issue 6, Page(s) 847–852

    Abstract: Events involving a high number of participants should be planned and implemented with the primary objective of guaranteeing the highest possible level of safety, which is ever more essential in the recent years due to the risk of terrorism, violence, and ...

    Abstract Events involving a high number of participants should be planned and implemented with the primary objective of guaranteeing the highest possible level of safety, which is ever more essential in the recent years due to the risk of terrorism, violence, and highly transmissible pathogens like coronavirus disease 2019 (COVID-19).The aim of this study was describing health care management of the Vasco Modena Park July 1, 2017 concert by the artist Vasco Rossi that involved 220,000 participants, more than doubling the population of Modena (Italy), the city hosting the event.Data were retrospectively collected from all health care registers used during the concert. Descriptive data regarding the event were recorded, as well as the medical records generated by the advanced medical posts.For analysis, patients were divided into two groups: the LOW-Severity (admission code green) and HIGH-Severity (admission codes yellow and red). The number of patients within the inclusion period was 1,088; there were 953 green discharge codes (97.74%), 16 yellow (1.64%), and six red (0.61%). Patients who needed a second-level assessment were 5.85% (57 events). HIGH-Severity patients needed to be further evaluated in 45.45% of the cases versus 4.93% of the LOW-Severity patient group (P value <.001).The health care management proved adequate to the number of participants and the severity of patients. Descriptive data reported add the mass-gathering database useful for further events.
    Language English
    Publishing date 2022-10-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1025975-2
    ISSN 1945-1938 ; 1049-023X
    ISSN (online) 1945-1938
    ISSN 1049-023X
    DOI 10.1017/S1049023X22001352
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  8. Article ; Online: Dynamic Angiopoietin-2 Serum Level as Endothelial Damage Marker and Potential Therapeutic Target.

    Melegari, Gabriele / Critelli, Rosina M / Lasagni, Simone / Romagnoli, Dante / Bertellini, Elisabetta / Villa, Erica

    The American journal of pathology

    2022  Volume 192, Issue 9, Page(s) 1336–1337

    MeSH term(s) Angiopoietin-2 ; Biomarkers ; Vascular Endothelial Growth Factor A
    Chemical Substances Angiopoietin-2 ; Biomarkers ; Vascular Endothelial Growth Factor A
    Language English
    Publishing date 2022-09-05
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2943-9
    ISSN 1525-2191 ; 0002-9440
    ISSN (online) 1525-2191
    ISSN 0002-9440
    DOI 10.1016/j.ajpath.2022.05.011
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  9. Article ; Online: Point-of-care pancreatic stone protein measurement in critically ill COVID-19 patients.

    Melegari, Gabriele / Giuliani, Enrico / Di Pietro, Giulia / Alberti, Francesco / Campitiello, Mattia / Bertellini, Elisabetta / Barbieri, Alberto

    BMC anesthesiology

    2023  Volume 23, Issue 1, Page(s) 226

    Abstract: Introduction: Pancreatic stone protein (PSP) is a novel biomarker that is reported to be increased in pneumonia and acute conditions. The primary aim of this study was to prospectively study plasma levels of PSP in a COVID-19 intensive care unit (ICU) ... ...

    Abstract Introduction: Pancreatic stone protein (PSP) is a novel biomarker that is reported to be increased in pneumonia and acute conditions. The primary aim of this study was to prospectively study plasma levels of PSP in a COVID-19 intensive care unit (ICU) population to determine how well PSP performed as a marker of mortality in comparison to other plasma biomarkers, such as C reactive protein (CRP) and procalcitonin (PCT).
    Methods: We collected clinical data and blood samples from COVID-19 ICU patients at the time of admission (T0), 72 h later (T1), five days later (T2), and finally, seven days later. The PSP plasma level was measured with a point-of-care system; PCT and CRP levels were measured simultaneously with laboratory tests. The inclusion criteria were being a critical COVID-19 ICU patient requiring ventilatory mechanical assistance.
    Results: We enrolled 21 patients and evaluated 80 blood samples; we found an increase in PSP plasma levels according to mixed model analysis over time (p < 0.001), with higher levels found in the nonsurvivor population (p < 0.001). Plasma PSP levels achieved a statistically significant result in terms of the AUROC, with a value higher than 0.7 at T0, T1, T2, and T3. The overall AUROC of PSP was 0.8271 (CI (0.73-0.93), p < 0.001). These results were not observed for CRP and PCT.
    Conclusion: These first results suggest the potential advantages of monitoring PSP plasma levels through point-of-care technology, which could be useful in the absence of a specific COVID-19 biomarker. Additional data are needed to confirm these results.
    MeSH term(s) Humans ; COVID-19 ; Lithostathine ; Point-of-Care Systems ; Critical Illness ; C-Reactive Protein ; Procalcitonin
    Chemical Substances Lithostathine ; C-Reactive Protein (9007-41-4) ; Procalcitonin
    Language English
    Publishing date 2023-06-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2091252-3
    ISSN 1471-2253 ; 1471-2253
    ISSN (online) 1471-2253
    ISSN 1471-2253
    DOI 10.1186/s12871-023-02187-w
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  10. Article ; Online: Postoperative cognitive worsening in seniors with an age above life expectancy: a prospective longitudinal study.

    Melegari, Gabriele / Giuliani, Enrico / Osmenaj, Suela / Malaguti, Silvio / Zoli, Michele / Meletti, Stefano / Bertellini, Elisabetta / Mascia, Luciana / Barbieri, Alberto

    Minerva anestesiologica

    2023  Volume 90, Issue 3, Page(s) 135–143

    Abstract: Background: The growing number of elderly patients in hospitals is a challenge for healthcare systems. The main objective is to measure the postoperative change in the cognitive status at hospital discharge and one year after discharge in elderly ... ...

    Abstract Background: The growing number of elderly patients in hospitals is a challenge for healthcare systems. The main objective is to measure the postoperative change in the cognitive status at hospital discharge and one year after discharge in elderly patients undergoing planned or deferrable surgery.
    Methods: We planned a prospective longitudinal study, single-center study: secondary care level hospital, enrolment from September 2018 to May 2019. We enroll elderly patients, aged above life expectancy in Italy, who underwent planned or deferrable surgery (men over 80.5 years old, women over 85.0 years old). In six months, we enrolled 76 eligible patients. We collected the scores of the clinical impairment scales Charlson Index, Barthel Index, and Six-Item Cognitive Impairment Test (6CIT). The primary endpoint was the postoperative worsening of the cognitive status at one-year follow-up. Secondary endpoints aimed to describe postoperative disabilities and complications, to investigate possible risk factors for cognitive worsening, and to measure the role of anesthesia in cognitive changes.
    Results: We recorded an increased rate of pathological 6CIT values during the hospitalization period, rising from 39.47% to 55.26% (McNemar test, P=0.007), and this rate was still increased at 55.56% (P=0.021) one year after discharge. Anesthesia did not show any significant harmful effect on cognitive status. The preoperative hemoglobin value seems to be a risk factor for cognitive status and one-year mortality.
    Conclusions: Elderly patients had a significantly worse 6CIT value after planned surgery, which may derive in part from age and in part from hospitalization. It is difficult to determine if general anesthesia alone has no harmful effects on cognitive performance in patients at discharge and one year later. Further data are necessary.
    MeSH term(s) Aged ; Male ; Humans ; Female ; Aged, 80 and over ; Prospective Studies ; Longitudinal Studies ; Hospitalization ; Cognition ; Life Expectancy ; Postoperative Complications
    Language English
    Publishing date 2023-11-21
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123584-9
    ISSN 1827-1596 ; 0026-4717 ; 0375-9393
    ISSN (online) 1827-1596
    ISSN 0026-4717 ; 0375-9393
    DOI 10.23736/S0375-9393.23.17572-9
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