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  1. Article: Panoramica sui numeri del cancro in Italia.

    Rashid, Ivan / Cozza, Valentina / Bisceglia, Lucia

    Epidemiologia e prevenzione

    2024  Volume 48, Issue 1, Page(s) 24–39

    Abstract: Background: the description of the geographical distribution and temporal trends of cancer is relevant for prevention and improving the quality of care. This is primarily achieved through the incidence measures derived from population cancer registries ( ...

    Title translation Cancer figures in Italy: an overview.
    Abstract Background: the description of the geographical distribution and temporal trends of cancer is relevant for prevention and improving the quality of care. This is primarily achieved through the incidence measures derived from population cancer registries (CRs). In recent years, in Italy there has been a prevalence of 'real-time' estimates and projections, although based on rather dated data. Given the significant increase in registration activity and still in absence of a national cancer registry network, the recent publication of Volume 12 of Cancer Incidence in Five Continents (CI5) provides a valuable opportunity to update cancer incidence estimates in Italy and to provide national and macroarea reference estimates.
    Objectives: to explore the pattern of cancer in Italy by reviewing and reorganizing the most recent data from cancer registries.
    Materials and methods: data from Italian cancer registries included in CI5 for the years 2013-2017 were obtained. Populations were verified, corrected for errors, and normalized to Italian National census reconstruction. The completeness of CR data was assessed using the mortality/incidence ratio applied to potential outlier data. Age-specific rates, Age standardized rates (ASRs), and truncated rates for adults (35-64 years) were calculated for 79 different neoplasms. Analyses were performed for individual CRs and macroareas. Temporal comparisons were made for 23 CRs with data from 2008-2012.
    Results: the observed incidence rates show extreme heterogeneity. Among males, the overall ASR ranges from 584 per 100,000 in the province of Reggio Calabria to 809.9 per 100,000 in the province of Sondrio. Among women, ASR is highest in Emilia-Romagna (540.5) and lowest in the province of Avellino (409.9). The gradient with decreasing rates from North to South is clearly visible only for female breast cancer. Higher rates of lung cancer are observed for the city of Naples in both genders. In adult males (35-64 years), ASRs of lung cancer are maximum in the provinces of Caserta and Naples, where they are more than double the ASRs observed in the Veneto Region. In general, a significant decline in male ASRs is observed in Northern Italy compared to the previous five-year period. A significant part of this trend is influenced by lung cancer that is significantly decreasing throughout the Centre-North among men and substantially increasing among women. The database and tables with details of all calculated indicators are provided as supplementary material.
    Conclusions: the analysis has shown the importance of a review of real CR data and, in general, working with real data to not only develop specific estimates of cancers in Italy, but also to share reference rates and basic data for further analysis. The present review has also revealed critical issues with data submitted to the IARC. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network. From the perspective of cancer epidemiology, important indications emerge regarding the distribution of cancers that can fuel aetiological research, as well as the planning of prevention and care activities. The data also show that it is advisable to separate the provinces of Caserta and Naples from the South in estimation and projection models. The comparison and verification of data quality through control and audit processes must represent a concrete operational perspective of the national cancer registry network.
    MeSH term(s) Female ; Humans ; Male ; Breast Neoplasms ; Incidence ; Italy/epidemiology ; Lung Neoplasms ; Neoplasms/epidemiology ; Neoplasms/etiology ; Prevalence ; Registries
    Language Italian
    Publishing date 2024-03-14
    Publishing country Italy
    Document type Review ; English Abstract ; Journal Article
    ZDB-ID 1038112-0
    ISSN 1120-9763
    ISSN 1120-9763
    DOI 10.19191/EP24.1.A715.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Management of acute diverticulitis in Stage 0-IIb: indications and risk factors for failure of conservative treatment in a series of 187 patients.

    Agnes, Amedea L / Agnes, Annamaria / Di Grezia, Marta / Giambusso, Mauro / Savia, Eleonora / Grieco, Michele / Cozza, Valerio / Magalini, Sabina / Sganga, Gabriele

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 1501

    Abstract: Left-sided acute diverticulitis in WSES Stage 0-IIb preferentially undergoes conservative management. However, there is limited understanding of the risk factors for failure of this approach. The aim of this study was to investigate the factors ... ...

    Abstract Left-sided acute diverticulitis in WSES Stage 0-IIb preferentially undergoes conservative management. However, there is limited understanding of the risk factors for failure of this approach. The aim of this study was to investigate the factors associated with the decision to perform conservative treatment as well as the predictors of its failure. We included patients with a diagnosis of WSES diverticulitis CT-driven classification Stage 0-IIb treated in the Emergency Surgery Unit of the Agostino Gemelli University Hospital Foundation between 2014 and 2020. The endpoints were the comparison between the characteristics and clinical outcomes of acute diverticulitis patients undergoing conservative versus operative treatment. We also identified predictors of conservative treatment failure. A set of multivariable backward logistic analyses were conducted for this purpose. The study included 187 patients. The choice for operative versus conservative treatment was associated with clinical presentation, older age, higher WSES grade, and previous conservative treatment. There were 21% who failed conservative treatment. Of those, major morbidity and mortality rates were 17.9% and 7.1%, respectively. A previously failed conservative treatment as well as a greater WSES grade and a lower hemoglobin value were significantly associated with failure of conservative treatment. WSES classification and hemoglobin value at admission were the best predictors of failure of conservative treatment. Patients failing conservative treatment had non-negligible morbidity and mortality. These results promote the consideration of a combined approach including baseline patients' characteristics, radiologic features, and laboratory biomarkers to predict conservative treatment failure and therefore optimize treatment of acute diverticulitis.
    MeSH term(s) Humans ; Conservative Treatment/methods ; Diverticulitis/therapy ; Diverticulitis/complications ; Risk Factors ; Treatment Failure ; Hemoglobins ; Retrospective Studies
    Chemical Substances Hemoglobins
    Language English
    Publishing date 2024-01-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-51526-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Acute intestinal ischemia in patients with COVID-19: single-centre experience and literature review.

    Fransvea, P / Costa, G / Pepe, G / La Greca, A / Magalini, S / Puccioni, C / d'Agostino, L / Altieri, G / Borello, A / Cozza, V / Sganga, G

    European review for medical and pharmacological sciences

    2022  Volume 26, Issue 4, Page(s) 1414–1429

    Abstract: Objective: Acute Intestinal ischemia (AII) may involve the small and/or large bowel after any process affecting intestinal blood flow. COVID-19-related gastrointestinal manifestations, including AII, have been attributed to pharmacologic effects, ... ...

    Abstract Objective: Acute Intestinal ischemia (AII) may involve the small and/or large bowel after any process affecting intestinal blood flow. COVID-19-related gastrointestinal manifestations, including AII, have been attributed to pharmacologic effects, metabolic disorders in ICU patients and other opportunistic colonic pathogens. AII in COVID-19 patients may be due also to "viral enteropathy" and  SARS-CoV-2-induced small vessel thrombosis. A critical appraisal of personal experience regarding COVID-19 and AII was carried out comparing this with a systematic literature review of published series.
    Patients and methods:   A retrospective observational clinical cohort study and a systematic literature review including only COVID-19 positive patients with acute arterial or venous intestinal ischemia were performed. The primary endpoint of the study was the mortality rate. Secondary endpoints were occurrence of major complications and length of hospital stay.
    Results: Patient mean age was 62.9±14.9, with a prevalence of male gender (23 male, 72% vs. 9 female, 28%). The mean Charlson Comorbidity Index was 3.1±2.7. Surgery was performed in 24/32 patients (75.0%), with a mean delay time from admission to surgery of 6.0 ±5.6 days. Small bowel ischemia was confirmed to be the most common finding at surgical exploration (22/24, 91.7%). Acute abdomen at admission to the ED (Group 1) was observed in 10 (31.2%) cases, while 16 (50%) patients developed an acute abdomen condition during hospitalization (Group 2) for SARS-CoV-2 infection.
    Conclusions: Our literature review showed how intestinal ischemia in patients with SARS-CoV-2 has been reported all over the world. The majority of the patients have a high CCI with multiple comorbidities, above all hypertension and cardiovascular disease. GI symptoms were not always present at the admission. A high level of suspicion for intestinal ischemia should be maintained in COVID-19 patients presenting with GI symptoms or with incremental abdominal pain. Nevertheless, a prompt thromboelastogram and laboratory test may confirm the need of improving and fastening the use of anticoagulants and trigger an extended indication for early abdominal CECT in patients with suggestive symptoms or biochemical markers of intestinal ischemia.
    MeSH term(s) Aged ; COVID-19/complications ; COVID-19/epidemiology ; Emergency Service, Hospital ; Female ; Hospitalization ; Humans ; Length of Stay ; Male ; Mesenteric Ischemia/diagnostic imaging ; Mesenteric Ischemia/epidemiology ; Mesenteric Ischemia/etiology ; Mesenteric Ischemia/surgery ; Meta-Analysis as Topic ; Middle Aged ; Retrospective Studies ; Systematic Reviews as Topic ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2022-03-06
    Publishing country Italy
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 605550-3
    ISSN 2284-0729 ; 1128-3602 ; 0392-291X
    ISSN (online) 2284-0729
    ISSN 1128-3602 ; 0392-291X
    DOI 10.26355/eurrev_202202_28135
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Surgical emergencies during SARS-CoV-2 pandemic lockdown: what happened?

    Rosa, F / Covino, M / Sabia, L / Quero, G / Fiorillo, C / Cozza, V / Sganga, G / Gasbarrini, A / Franceschi, F / Alfieri, S

    European review for medical and pharmacological sciences

    2020  Volume 24, Issue 22, Page(s) 11919–11925

    Abstract: Objective: The pandemic from SARS-CoV-2 is having a profound impact on daily life of a large part of world population. Italy was the first Western country to impose a general lockdown to its citizens. Implications of these measures on several aspects of ...

    Abstract Objective: The pandemic from SARS-CoV-2 is having a profound impact on daily life of a large part of world population. Italy was the first Western country to impose a general lockdown to its citizens. Implications of these measures on several aspects of public health remain unknown. The aim of this study was to investigate the effects of the lockdown on surgical emergencies volumes and care in a large, tertiary referral center.
    Materials and methods: Electronic medical records of all patients visited in our Emergency Department (ED) and admitted in a surgical ward from February 21st 2020 to May 3rd 2020 were collected, analyzed and compared with the same periods of 2019 and 2018 and a cross-sectional study was performed.
    Results: Number of surgical admissions dropped significantly in 2020 with respect to the same periods of 2019 and 2018, by almost 50%. The percentage distribution of admissions in different surgical wards did not change over the three years. Time from triage to operating room significantly reduced in 2020 respect to 2019 and 2018 (p<0.001).
    Conclusions: The lockdown in Italy due to SARS-CoV-2 pandemic arguably represents the largest social experiment in modern times. Data provided by our study provide useful information to health authorities and policymakers about the effects of activity restriction on surgical accesses and changing epidemiology due to an exceptional external event.
    MeSH term(s) Adult ; Appendicitis/epidemiology ; Appendicitis/surgery ; COVID-19 ; Cholecystitis, Acute/epidemiology ; Cholecystitis, Acute/surgery ; Diverticulitis/epidemiology ; Diverticulitis/surgery ; Emergencies ; Emergency Service, Hospital ; Female ; Gastrointestinal Diseases/epidemiology ; Gastrointestinal Diseases/surgery ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/surgery ; Hernia/epidemiology ; Herniorrhaphy/trends ; Hospitalization/trends ; Humans ; Intestinal Obstruction/epidemiology ; Intestinal Obstruction/surgery ; Intestinal Perforation/epidemiology ; Intestinal Perforation/surgery ; Italy/epidemiology ; Male ; Middle Aged ; Rectal Diseases/epidemiology ; Rectal Diseases/surgery ; Surgery Department, Hospital ; Surgical Procedures, Operative/trends ; Tertiary Care Centers ; Time-to-Treatment/trends
    Language English
    Publishing date 2020-12-01
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 605550-3
    ISSN 2284-0729 ; 1128-3602 ; 0392-291X
    ISSN (online) 2284-0729
    ISSN 1128-3602 ; 0392-291X
    DOI 10.26355/eurrev_202011_23851
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Letter to the editor: measles on the cruise ship: links with virus spreading into an emergency department in Southern Italy.

    Cozza, V / Chironna, M / Leo, C / Prato, R

    Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

    2014  Volume 19, Issue 19

    MeSH term(s) Disease Outbreaks ; Humans ; Measles/epidemiology ; Ships
    Language English
    Publishing date 2014-05-15
    Publishing country Sweden
    Document type Letter ; Comment
    ZDB-ID 1338803-4
    ISSN 1560-7917 ; 1025-496X
    ISSN (online) 1560-7917
    ISSN 1025-496X
    DOI 10.2807/1560-7917.es2014.19.19.20800
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Leveraging Global Influenza Surveillance and Response System for the COVID-19 Pandemic Response and Beyond.

    Hammond, Aspen / Cozza, Vanessa / Hirve, Siddhi / Medina, Marie-Jo / Pereyaslov, Dmitriy / Zhang, Wenqing

    China CDC weekly

    2021  Volume 3, Issue 44, Page(s) 937–940

    Language English
    Publishing date 2021-10-22
    Publishing country China
    Document type Journal Article
    ISSN 2096-7071
    ISSN (online) 2096-7071
    DOI 10.46234/ccdcw2021.226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Prediction of postoperative nausea and vomiting by point-of-care gastric ultrasound: can we improve complications and length of stay in emergency surgery? A cohort study.

    Cozza, Valerio / Barberis, Lorenzo / Altieri, Gaia / Donatelli, Mario / Sganga, Gabriele / La Greca, Antonio

    BMC anesthesiology

    2021  Volume 21, Issue 1, Page(s) 211

    Abstract: Background: Postoperative nausea and vomiting and postoperative ileus are common after major digestive surgery and represent one of the significant problems in Acute Care Surgery. The delivery model of emergency surgery needs to be improved in order to ... ...

    Abstract Background: Postoperative nausea and vomiting and postoperative ileus are common after major digestive surgery and represent one of the significant problems in Acute Care Surgery. The delivery model of emergency surgery needs to be improved in order to foster a patient-centered care. The multimodal approach suggested by Enhanced Recovery After Surgery (ERAS®) Guidelines is gaining widespread acceptance but is difficult to apply to emergency surgery. Ultrasound examination of the gastric antrum allows a reliable assessment of gastric contents and volume and might help contribute to improve perioperative care in the emergency setting.
    Methods: Gastric ultrasound examinations were performed preoperatively and postoperatively on forty-one patients undergoing emergency abdominal surgery. Gastric cross-sectional area (CSA) was measured, in order to estimate the gastric volume. The data obtained were used to evaluate a possible relationship between delayed gastric emptying and postoperative adverse event.
    Results: Gastric antrum detection rate varied from 31.8% in open up to 78.9% in laparoscopic surgeries (p = 0.003). Six patients experienced adverse outcomes, had an antiemetic therapy administered and/or a nasogastric tube inserted. Mean CSA was significantly higher in this group (12.95 cm
    Conclusions: Sensitivity of gastric ultrasound varies depending on surgical technique. A dilated gastric antrum is significantly related to postoperative adverse outcomes and a careful ultrasound follow-up might help tailor postoperative nutrition and antiemetic therapy. In patients who experienced adverse events, antral CSA showed an average increase of more than 50% over a period of 72 h after surgery. A relative measure could be used to predict the risk of postoperative ileus. Overall, gastric ultrasound seems to be a promising diagnostic tool and a useful way to integrate ERAS® protocol in emergency abdominal surgery.
    MeSH term(s) Abdomen/surgery ; Aged ; Algorithms ; Antiemetics/therapeutic use ; Cohort Studies ; Emergencies ; Feasibility Studies ; Female ; Gastrointestinal Contents/diagnostic imaging ; Humans ; Intubation, Gastrointestinal ; Length of Stay ; Male ; Middle Aged ; Point-of-Care Systems ; Postoperative Nausea and Vomiting/prevention & control ; Risk Assessment ; Stomach/diagnostic imaging ; Ultrasonography
    Chemical Substances Antiemetics
    Language English
    Publishing date 2021-08-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1471-2253
    ISSN (online) 1471-2253
    DOI 10.1186/s12871-021-01428-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Present and future of emergency surgery as independent specialty in Italy: is the rescue surgery turning the underdog into a hero?

    Gui, D / Cozza, V / Pepe, G / Di Grezia, M / La Greca, A / Magalini, S

    European review for medical and pharmacological sciences

    2017  Volume 21, Issue 4, Page(s) 899–902

    Language English
    Publishing date 2017-02
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 605550-3
    ISSN 2284-0729 ; 1128-3602 ; 0392-291X
    ISSN (online) 2284-0729
    ISSN 1128-3602 ; 0392-291X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Early Prediction of Cardiovascular Disease in Kidney Transplant Recipients.

    Bilancio, G / Celano, M / Cozza, V / Zingone, F / Palladino, G / Cirillo, M

    Transplantation proceedings

    2017  Volume 49, Issue 9, Page(s) 2092–2098

    Abstract: Cardiovascular disease (CVD) is frequent after kidney transplantation (KT). This study investigated CVD prediction in KT by information available before KT or within 6 months after KT. The study cohort consisted of 629 patients with KT in 2005-10 and ... ...

    Abstract Cardiovascular disease (CVD) is frequent after kidney transplantation (KT). This study investigated CVD prediction in KT by information available before KT or within 6 months after KT. The study cohort consisted of 629 patients with KT in 2005-10 and with adult age at KT. The end point was incidence up to 2015 of CVD (coronary heart disease, cerebrovascular disease, peripheral artery disease). Graft failure, non-CVD death with functioning graft, and loss to follow-up were considered competing events. CVD prediction was investigated for 34 variables by means of competing-risks regression. Follow-up range was 0.28-10.00 years (mean ± SD, 7.30 ± 3.10). First incident event was CVD in 103 patients and competing events in 146 patients. In the multivariable model for pre-KT variables only, CVD predictors were male sex (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.06-2.66), diabetic nephropathy (HR, 6.63; 95% CI, 1.81-24.35), pre-KT dialysis for ≥5 years (HR, 1.52; 95% CI, 1.02-2.27), pre-KT CVD (HR, 4.87; 95% CI, 2.84-8.35), and age at KT ≥45 years (HR, 2.98; 95% CI, 1.83-4.87). In the model for pre-KT and post-KT variables together, the sole post-KT CVD predictor was estimated glomerular filtration rate <60 mL/min at the 6-month visit (HR, 1.75; 95% CI, 1.11-2.77). Diabetic nephropathy, pre-KT dialysis, pre-KT CVD, and age at KT predicted 91.2% of incident CVD. Early available information effectively predicted CVD in KT independently from competing events.
    Language English
    Publishing date 2017-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2017.09.005
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  10. Article ; Online: Estimating averted illnesses from influenza vaccination for children and pregnant women - El Salvador, Panama, and Peru, 2011-2018.

    Chard, Anna N / Machingaidze, Chiedza / Loayza, Sergio / Gharpure, Radhika / Nogareda, Francisco / González, Rosalba / Domínguez, Rhina / Tinoco, Yeny O / Dawood, Fatimah S / Carreon, Joseph Daniel / Lafond, Kathryn E / Jara, Jorge / Azziz-Baumgartner, Eduardo / Cozza, Vanessa / Couto, Paula / Rolfes, Melissa A / Tempia, Stefano

    Vaccine

    2024  

    Abstract: Background: Estimating the burden of disease averted by vaccination can assist policymakers to implement, adjust, and communicate the value of vaccination programs. Demonstrating the use of a newly available modeling tool, we estimated the burden of ... ...

    Abstract Background: Estimating the burden of disease averted by vaccination can assist policymakers to implement, adjust, and communicate the value of vaccination programs. Demonstrating the use of a newly available modeling tool, we estimated the burden of influenza illnesses averted by seasonal influenza vaccination in El Salvador, Panama, and Peru during 2011-2017 among two influenza vaccine target populations: children aged 6-23 months and pregnant women.
    Methods: We derived model inputs, including incidence, vaccine coverage, vaccine effectiveness, and multipliers from publicly available country-level influenza surveillance data and cohort studies. We also estimated changes in illnesses averted when countries' vaccine coverage was achieved using four different vaccine deployment strategies.
    Results: Among children aged 6-23 months, influenza vaccination averted an estimated cumulative 2,161 hospitalizations, 81,907 medically-attended illnesses, and 126,987 overall illnesses during the study period, with a prevented fraction ranging from 0.3 % to 12.5 %. Among pregnant women, influenza vaccination averted an estimated cumulative 173 hospitalizations, 6,122 medically attended illnesses, and 16,412 overall illnesses, with a prevented fraction ranging from 0.2 % to 10.9 %. Compared to an influenza vaccine campaign with equal vaccine distribution during March-June, scenarios in which total cumulative coverage was achieved in March and April consistently resulted in the greatest increase in averted illness (23 %-3,129 % increase among young children and 22 %-3,260 % increase among pregnant women).
    Discussion: Influenza vaccination campaigns in El Salvador, Panama, and Peru conducted between 2011 and 2018 prevented hundreds to thousands of influenza-associated hospitalizations and illnesses in young children and pregnant women. Existing vaccination programs could prevent additional illnesses, using the same number of vaccines, by achieving the highest possible coverage within the first two months of an influenza vaccine campaign.
    Language English
    Publishing date 2024-04-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2024.04.007
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