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  1. Article ; Online: Point-of-care airway US

    Amedeo Bianchini / Cristina Felicani / Elena Zangheri / Matteo Bianchin / Antonio Siniscalchi

    The Ultrasound Journal, Vol 15, Iss 1, Pp 1-

    a valuable tool in the management of occult over the cuff bleeding and secretions

    2023  Volume 2

    Keywords Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher SpringerOpen
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The role of transcranial Doppler ultrasonography in differential diagnosis of vertigo in the Emergency Department

    Antonio Siniscalchi / Giovanni Malferrari

    Emergency Care Journal, Vol 15, Iss

    2019  Volume 3

    Abstract: Vertigo represents about 4% of access to the Emergency Department (ED). Several conditions, such as general medical illnesses, otovestibular diseases and neurological diseases (including posterior circulation stroke) cause acute vertigo. The incidence of ...

    Abstract Vertigo represents about 4% of access to the Emergency Department (ED). Several conditions, such as general medical illnesses, otovestibular diseases and neurological diseases (including posterior circulation stroke) cause acute vertigo. The incidence of cerebrovascular disease in patients with vertigo in ED varies from 3 to 5%. Although neurosonology studies on acute vestibular syndrome are scarce, the use of transcranial Doppler (TCD) and transcranial color Doppler (TCCD) in the management of vertigo patients has several advantages: it can be performed at the patient's bedside and repeated and, furthermore, its use is low-cost. In an acute stroke, with an experienced doctor, it can help distinguish an ischemic stroke from a hemorrhagic stroke. In acute central vertigo induced by posterior circulation stroke, the TCD or TCCD can be a screening test before angiographic neuroradiological studies for stenosis of vertebral or basal arteries. As a matter of fact, the clinical outcome, particularly in the posterior circulation stroke, is mainly related to a rapid diagnosis and subsequent treatment that will be able to quickly restore the blood flow. In conclusion, TCD and TCCD are useful in the differential diagnosis of vertigo in the ED, although we recognize the indisputable importance of clinical examination as a first step in vertigo management. In the evaluation of patients with acute central vertigo due to suspected posterior circulation stroke, the use of TCD or TCCD can rapidly reveal steno-occlusive disease of the posterior circulation, arterial dissections and give indirect signs of vertebra-basilar insufficiency.
    Keywords Vertigo ; Emergency Department ; Posterior circulation stroke ; Transcranial Doppler ; Transcranial color Doppler ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2019-10-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Liver Transplantation in Patients with Portal Vein Thrombosis

    Domenico Pinelli / Matteo Cescon / Matteo Ravaioli / Flavia Neri / Annalisa Amaduzzi / Matteo Serenari / Greta Carioli / Antonio Siniscalchi / Michele Colledan

    Journal of Clinical Medicine, Vol 12, Iss 2457, p

    Revisiting Outcomes According to Surgical Techniques

    2023  Volume 2457

    Abstract: Surgical strategies for graft portal vein flow restoration vary from termino-terminal portal vein anastomosis to more complex bypass reconstructions. Although the surgical strategy strongly influences the post-operative outcome, the Yerdel grading is ... ...

    Abstract Surgical strategies for graft portal vein flow restoration vary from termino-terminal portal vein anastomosis to more complex bypass reconstructions. Although the surgical strategy strongly influences the post-operative outcome, the Yerdel grading is still commonly used to determine the prognosis of patients with portal vein thrombosis (PVT) undergoing liver transplantation (LT). We retrospectively reviewed the cases of LT performed on recipients with complex PVT at two high-volume transplantation centres. We stratified the patients by the type of portal vein reconstruction, termino-terminal portal vein anastomosis (TTA) versus bypass reconstruction (bypass group), and assessed a multivariable survival analysis. The rate of mortality at 90 days was 21.4% for the bypass group compared to 9.8% in the TTA group ( p = 0.05). In the multivariable correlation analysis, only a trend for greater risk of early mortality was confirmed in the bypass groups (HR 2.5; p = 0.059). Yerdel grade was uninfluential in the rate of early complications. A wide range of surgical options are available for different situations of PVT which yield an outcome unrelated to the Yerdel grading. An algorithm for PVT management should be based on the technical approach and should include a surgically oriented definition of PVT extension.
    Keywords Yerdel grade ; reno-portal anastomosis ; porto-mesenteric bypass ; spleno-portal shunt ; thrombectomy ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Planned Extracorporeal Life Support Employment during Liver Transplantation

    Cristiana Laici / Amedeo Bianchini / Noemi Miglionico / Niccolò Bambagiotti / Giovanni Vitale / Guido Fallani / Matteo Ravaioli / Antonio Siniscalchi

    Journal of Clinical Medicine, Vol 12, Iss 1239, p

    The Potential of ECMO and CRRT as Preventive Therapies—Case Reports and Literature Review

    2023  Volume 1239

    Abstract: Liver Transplantation (LT) has become the gold standard treatment for End-Stage Liver Disease (ESLD). One of the main strategies to manage life-threatening complications, such as cardio-respiratory failure, is Extracorporeal Membrane Oxygenation (ECMO) ... ...

    Abstract Liver Transplantation (LT) has become the gold standard treatment for End-Stage Liver Disease (ESLD). One of the main strategies to manage life-threatening complications, such as cardio-respiratory failure, is Extracorporeal Membrane Oxygenation (ECMO) in the peri-transplantation period, with different configurations of the technique and in combination with other extracorporeal care devices such as Continuous Renal Replacement Therapy (CRRT). This retrospective study includes three clinical cases of planned ECMO support strategies in LT and evaluates their application compared with current literature exploring PubMed/Medline. The three LT supported with ECMO and CRRT were performed at IRCCS Polyclinic S. Orsola-Malpighi, Bologna. All three cases of patients with compromised organ function analysed produced positive outcomes. The planned use of ECMO and CRRT support in peri-transplantation has allowed the patients to overcome contraindications and successfully undergo LT. In recent years, only a few reports have documented successful LT outcomes performed with intraoperative ECMO in critically ESLD patients. However, the management of LT with ECMO and/or CRRT assistance is an emerging challenge, with the need for more published evidence on this topic to guide treatment choices in patients with severe, acute and reversible respiratory and cardiovascular failure after LT.
    Keywords liver transplant ; Veno-Venous Extracorporeal Membrane Oxygenation ; Veno-Arterial Extracorporeal Membrane Oxygenation ; Continuous Renal Replacement Therapy ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: The Safety of Drug Treatment in Patients with Neuropathic Pain

    Cristina Vocca / Vincenzo Rania / Antonio Siniscalchi / Caterina Palleria / Gianmarco Marcianò / Cecilia Galati / Luca Catarisano / Valentina Mastrangelo / Franco Corasaniti / Francesco Monea / Lucia Muraca / Rita Citraro / Bruno D’Agostino / Luca Gallelli / Giovambattista De Sarro

    Reports, Vol 6, Iss 4, p

    Data from Ambulatory Care in a Real-Life Setting

    2023  Volume 57

    Abstract: Introduction: Drug treatment can be related to the development of adverse drug reactions (ADRs). Aim: In this paper, we evaluated ADRs in patients admitted to the Ambulatory of Pain Medicine of the University Hospital Renato Dulbecco in Catanzaro. ... ...

    Abstract Introduction: Drug treatment can be related to the development of adverse drug reactions (ADRs). Aim: In this paper, we evaluated ADRs in patients admitted to the Ambulatory of Pain Medicine of the University Hospital Renato Dulbecco in Catanzaro. Methods: We conducted a prospective analysis between 1 February 2021 and 20 July 2023 on patients with neuropathic pain referred to the Ambulatory of Pain Medicine of “Renato Dulbecco” University Hospital in Catanzaro (Calabria, Italy). Patients aged >18 years with clinical signs of neurologic pain and a score upon completing the Douleur Neuropathique en 4 Questions (DN4) questionnaire of ≥4 were included. The association between drugs and ADR or between drugs and drug–drug-interactions (DDIs) was evaluated using Naranjo’s probability scale and Drug Interaction Probability Scale (DIPS), respectively. Results: During the study period, we analyzed 2370 patients referred to the ambulatory of pain medicine. After the evaluation of inclusion and exclusion criteria, 33.5% of patients were enrolled. All patients presented at least one comorbidity and daily used a mean of five drugs (range 3–11). Using the Naranjo score, the development of ADRs was documented in 112 patients (score 6). Using parametric and non-parametric statistical analysis, we failed to report an association between ADR and dosage or ADR and patient characteristics. Conclusion: Our results show the development of ADRs in 18% of patients with neuropathic pain. This low percentage of drug interaction could be a limitation in real life because it is probably due to the site of the study and the appropriate prescription of drugs. Therefore, it shows that it is necessary to motivate healthcare to pay attention to the prescription of drugs in poly-treated patients to reduce the risk of ADRs.
    Keywords neuropathic pain ; adverse drug reactions ; clinical records ; pharmacovigilance ; Medicine (General) ; R5-920 ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 616
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: The role of psychological interventions in chronic headache management

    Rosario Iannacchero / Alessandra Sansalone / Amerigo Costa / Ermanno Pisani / Antonio Siniscalchi

    Clinical Management Issues, Vol 11, Iss

    a case report

    2017  Volume 1

    Abstract: According to the biopsychosocial model, biological, psychological, and social factors entwine and influence each other bi-directionally concerning health conditions. Therefore, especially in disorders such as chronic headache, where behavioral and ... ...

    Abstract According to the biopsychosocial model, biological, psychological, and social factors entwine and influence each other bi-directionally concerning health conditions. Therefore, especially in disorders such as chronic headache, where behavioral and environmental factors are prominent risk factors and triggers, psychosocial interventions might contribute to reduce the burden of the health condition and related affective disorders and disability. We present the case of a Medication Overuse Headache patient self-reporting psychosocial and cognitive issues, that prompted further clinical-psychological and neuro-cognitive assessment and eventually psychological interventions targeted at headache management in conjunction with medical treatment. Psychological interventions were tailored to the patient’s features and presentation and were successful in reducing headache attacks in terms of intensity, frequency, and debilitation, thereby resulting also in a better perceived general health.
    Keywords Headache Disorders ; Migraine Disorders ; Psychology ; Medication Overuse Headache ; Medicine (General) ; R5-920
    Subject code 150
    Language English
    Publishing date 2017-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Isolated Hand Palsy in National Institutes of Health Stroke Scale (NIHSS)

    Antonio Siniscalchi / Piergiorgio Lochner / Paolo Perrotta / Stefano Rizzuto / Giovambattista De Sarro / Luca Gallelli

    Western Journal of Emergency Medicine, Vol 19, Iss

    Is It Useful?

    2018  Volume 3

    Keywords Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Language English
    Publishing date 2018-03-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Neuron-specific enolase serum levels in COVID-19 are related to the severity of lung injury.

    Erika Cione / Antonio Siniscalchi / Pietro Gangemi / Lucio Cosco / Manuela Colosimo / Federico Longhini / Filippo Luciani / Giovambattista De Sarro / G&SP Working Group / Liberato Berrino / Bruno D'Agostino / Luca Gallelli

    PLoS ONE, Vol 16, Iss 5, p e

    2021  Volume 0251819

    Abstract: The multifunctional role of neuron-specific enolase (NSE) in lung diseases is well established. As the lungs are greatly affected in COVID-19, we evaluated serum NSE levels in COVID-19 patients with and without dyspnea. In this study, we evaluated both ... ...

    Abstract The multifunctional role of neuron-specific enolase (NSE) in lung diseases is well established. As the lungs are greatly affected in COVID-19, we evaluated serum NSE levels in COVID-19 patients with and without dyspnea. In this study, we evaluated both SARS-CoV-2-infected and uninfected patients aged >18 years who were referred to hospitals in Catanzaro, Italy from March 30 to July 30, 2020. Epidemiological, clinical, and radiological characteristics, treatment, and outcome data were recorded and reviewed by a trained team of physicians. In total, 323 patients (178 men, 55.1% and 145 women, 44.9%) were enrolled; of these, 128 were COVID-19 patients (39.6%) and 195 were control patients (60.4%). Westergren's method was used to determine erythroid sedimentation rate. A chemiluminescence assay was used for measurement of interleukin-6, procalcitonin, C-reactive protein, and NSE. We detected significantly higher NSE values (P<0.05) in COVID-19 patients than in controls. Interestingly, within the COVID-19 group, we also observed a further significant increase in dyspnea (Dyspnea Scale and Exercise score: 8.2 ± 0.8; scores ranging from 0 to 10, with higher numbers indicating very severe shortness of breath). These data provide the background for further investigations into the potential role of NSE as a clinical marker of COVID-19 progression.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Resolution of statin-induced myalgia by correcting vitamin D deficiency

    Luca Gallelli / Andzelika Michniewicz / Antonio Siniscalchi / Giovambattista De Sarro

    Clinical Management Issues, Vol 9, Iss 1, Pp 21-

    a case report

    2015  Volume 26

    Abstract: The onset of myalgia is a well-known side effect of cholesterol-lowering statins. Recent studiesa dvanced the hypothesis that reduced vitamin D levels may play a role in the onset of myalgia in statin users and potentially a vitamin D supplementation may ...

    Abstract The onset of myalgia is a well-known side effect of cholesterol-lowering statins. Recent studiesa dvanced the hypothesis that reduced vitamin D levels may play a role in the onset of myalgia in statin users and potentially a vitamin D supplementation may be useful in these cases, as suggested by the present case report. A 52-year-old man with a history of smoke and successfully controlled hypertension presented with chest pain and asthenia. He was diagnosed with stable angina pectoris and discharged on atorvastatin. Due to the onset of myalgia, the dosage of atorvastatin was reduced (from 40 mg daily to 20 mg daily) and then atorvastatin was switched to rosuvastatin without symptoms improvement. Switching from rosuvastatin to ezetimibe resulted in pain improvement, but also in plasma lipids increase beyond the normal range. Ezetimibe was switched to rosuvastatin+ analgesic; in the meanwhile a high-performance liquid chromatography (HPLC) analysis showed low levels of 25-hydroxy-vitamin D and 1-25-dihydroxy-vitamin D. Therefore, vitamin D3 was added to rosuvastatin, resulting in pain improvement, decrease of plasma lipids and progressive discontinuation of analgesics. During the follow-up, rosuvastatin was switched to atorvastatin + vitamin D3, with a good control of plasma lipid levels and without the onset of myalgia.
    Keywords Myalgia ; Statin ; Vitamin D ; Vitamin supplementation ; Medicine (General) ; R5-920
    Language English
    Publishing date 2015-03-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Asterixis as a Presentation of Cerebellar Ischemic Stroke

    Antonio Siniscalchi / Luca Gallelli / Olindo Di Benedetto / Giovambattista De Sarro

    Western Journal of Emergency Medicine, Vol 13, Iss 6, Pp 507-

    2012  Volume 508

    Abstract: Asterixis is not yet considered a common neurological sign of cerebellum infarction, and the pathogenic mechanism for asterixis remains elusive. We report a 58-year-old male with moderate hypertension who presented to our emergency department for acute ... ...

    Abstract Asterixis is not yet considered a common neurological sign of cerebellum infarction, and the pathogenic mechanism for asterixis remains elusive. We report a 58-year-old male with moderate hypertension who presented to our emergency department for acute headache in both cervical and occipital regions of the left side. About 2 hours later the patient developed ipsilateral asterixis in the upper left limb; 3 days later the asterixis disappeared. Magnetic resonance imaging of the brain disclosed cerebellarinfarctions at the left superior cerebellar artery. In conclusion, we observed that a transitory asterixis associated with ipsilateral headache can be an initial clinical manifestation of ipsilateral cerebellar infarctions in the superior cerebellar artery area.
    Keywords Emergency medicine ; neurosurgery ; neurology ; stroke ; Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Language English
    Publishing date 2012-12-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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