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  1. Article ; Online: Hospital staff practical skills and theoretical knowledge in inhaled aerosol therapy

    Martina Santambrogio / Marta Lazzeri / Gianluca Bonitta / Riccardo Guarise / Edoardo Simonetta / Francesco Blasi / Emilia Privitera

    Monaldi Archives for Chest Disease, Vol 91, Iss

    a single centre cross-sectional observational study

    2021  Volume 1

    Abstract: Inhaled therapy is widely used for treatment of many respiratory disorders. Drug delivery in lungs is dependent on the correct use of aerosol devices and patients’ training is vital for a correct therapy administration. Therefore, is very important to ... ...

    Abstract Inhaled therapy is widely used for treatment of many respiratory disorders. Drug delivery in lungs is dependent on the correct use of aerosol devices and patients’ training is vital for a correct therapy administration. Therefore, is very important to assess the skills of professionals involved in training patients to the correct use of inhaler devices. The aim of this study was to check the practical skills and the theoretical knowledge of health care personnel in our University Hospital in using aerosol therapy and to determine differences among professional figures in the management of inhaler devices. Three hundred and fifteen (315) volunteers including physicians, residents, nurses and respiratory physiotherapists were enrolled; an independent professional, not working in our University Hospital, assessed their theoretical knowledge related to aerosol throughout a questionnaire. Practical skills were assessed through placebo simulation with the devices that participants declared to use frequently with patients. None of the respondents correctly answered all questions evaluating theoretical knowledge on the proper use of aerosol therapy. Respiratory physiotherapists obtained significantly better results with 17.2 (1.3) average points compared to 10.3 (3.7) obtained by doctors, 9.0 (3.0) by nurses and 9.1 (4.5) by residents. Analysing in detail physicians’ results, pneumologists showed better theoretical knowledge than other specialists. Concerning the practical skills, about 80% of those stating they knew how to use metered dose inhalers, made mistakes in the basic steps for proper inhalation technique and over 50% of respondents were unable to properly simulate placebo administration of dry powder inhalers. Also here, respiratory physiotherapists and pneumologists had significant better performances, when compared to other health professionals. Our data are in line with those published in the literature in other international clinical settings, noting inadequate practical and theoretical knowledge of the ...
    Keywords Aerosol ; inhaler technique ; practical skills ; health care personnel ; Medicine ; R
    Subject code 796
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Comparison of different sets of immunological tests to identify treatable immunodeficiencies in adult bronchiectasis patients

    Stefano Aliberti / Francesco Amati / Andrea Gramegna / Barbara Vigone / Martina Oriano / Giovanni Sotgiu / Marco Mantero / Edoardo Simonetta / Laura Saderi / Anna Stainer / Serena Tammaro / Paola Marchisio / Eva Polverino / James D. Chalmers / Francesco Blasi

    ERJ Open Research, Vol 8, Iss

    2022  Volume 1

    Abstract: Background The reported prevalence of immunodeficiencies in bronchiectasis patients is variable depending on the frequency and extent of immunological tests performed. European Respiratory Society guidelines recommend a minimum bundle of tests. ... ...

    Abstract Background The reported prevalence of immunodeficiencies in bronchiectasis patients is variable depending on the frequency and extent of immunological tests performed. European Respiratory Society guidelines recommend a minimum bundle of tests. Broadening the spectrum of immunological tests could increase the number of patients diagnosed with an immunodeficiency and those who could receive specific therapy. The primary objective of the present study was to assess the performance of different sets of immunological tests in diagnosing any, primary, secondary or treatable immunodeficiencies in adults with bronchiectasis. Methods An observational, cross-sectional study was conducted at the Bronchiectasis Program of the Policlinico University Hospital in Milan, Italy, from September 2016 to June 2019. Adult outpatients with a clinical and radiological diagnosis of bronchiectasis underwent the same immunological screening during the first visit when clinically stable consisting of: complete blood count; immunoglobulin (Ig) subclass tests for IgA, IgG, IgM and IgG; total IgE; lymphocyte subsets; and HIV antibodies. The primary endpoint was the prevalence of patients with any immunodeficiencies using five different sets of immunological tests. Results A total of 401 bronchiectasis patients underwent the immunological screening. A significantly different prevalence of bronchiectasis patients diagnosed with any, primary or secondary immunodeficiencies was found across different bundles. 44.6% of bronchiectasis patients had a diagnosis of immunodeficiency when IgG subclasses and lymphocyte subsets were added to the minimum bundle suggested by the guidelines. Conclusion A four-fold increase in the diagnosis of immunodeficiencies can be found in adults with bronchiectasis when IgG subclasses and lymphocyte subsets are added to the bundle of tests recommended by guidelines.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher European Respiratory Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Lung Microbiome in Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases

    Francesco Amati / Anna Stainer / Marco Mantero / Andrea Gramegna / Edoardo Simonetta / Giulia Suigo / Antonio Voza / Anoop M. Nambiar / Umberto Cariboni / Justin Oldham / Philip L. Molyneaux / Paolo Spagnolo / Francesco Blasi / Stefano Aliberti

    International Journal of Molecular Sciences, Vol 23, Iss 977, p

    2022  Volume 977

    Abstract: Interstitial lung diseases represent a heterogeneous and wide group of diseases in which factors leading to disease initiation and progression are not fully understood. Recent evidence suggests that the lung microbiome might influence the pathogenesis ... ...

    Abstract Interstitial lung diseases represent a heterogeneous and wide group of diseases in which factors leading to disease initiation and progression are not fully understood. Recent evidence suggests that the lung microbiome might influence the pathogenesis and progression of interstitial lung diseases. In recent years, the utilization of culture-independent methodologies has allowed the identification of complex and dynamic communities of microbes, in patients with interstitial lung diseases. However, the potential mechanisms by which these changes may drive disease pathogenesis and progression are largely unknown. The aim of this review is to discuss the role of the altered lung microbiome in several interstitial lung diseases. Untangling the host–microbiome interaction in the lung and airway of interstitial lung disease patients is a research priority. Thus, lung dysbiosis is a potentially treatable trait across several interstitial lung diseases, and its proper characterization and treatment might be crucial to change the natural history of these diseases and improve outcomes.
    Keywords microbiome ; interstitial lung diseases ; treatable traits ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: COVID-19 multidisciplinary high dependency unit

    Stefano Aliberti / Francesco Amati / Maria Pappalettera / Marta Di Pasquale / Alice D’Adda / Marco Mantero / Andrea Gramegna / Edoardo Simonetta / Anna Maria Oneta / Emilia Privitera / Andrea Gori / Giorgio Bozzi / Flora Peyvandi / Francesca Minoia / Giovanni Filocamo / Chiara Abbruzzese / Marco Vicenzi / Paola Tagliabue / Salvatore Alongi /
    Francesco Blasi

    Respiratory Research, Vol 21, Iss 1, Pp 1-

    the Milan model

    2020  Volume 12

    Abstract: Abstract COVID-19 is a complex and heterogeneous disease. The pathogenesis and the complications of the disease are not fully elucidated, and increasing evidence shows that SARS-CoV-2 causes a systemic inflammatory disease rather than a pulmonary disease. ...

    Abstract Abstract COVID-19 is a complex and heterogeneous disease. The pathogenesis and the complications of the disease are not fully elucidated, and increasing evidence shows that SARS-CoV-2 causes a systemic inflammatory disease rather than a pulmonary disease. The management of hospitalized patients in COVID-19 dedicated units is advisable for segregation purpose as well as for infection control. In this article we present the standard operating procedures of our COVID-19 high dependency unit of the Policlinico Hospital, in Milan. Our high dependency unit is based on a multidisciplinary approach. We think that the multidisciplinary involvement of several figures can better identify treatable traits of COVID-19 disease, early identify patients who can quickly deteriorate, particularly patients with multiple comorbidities, and better manage complications related to off-label treatments. Although no generalizable to other hospitals and different healthcare settings, we think that our experience and our point of view can be helpful for countries and hospitals that are now starting to face the COVID-19 outbreak.
    Keywords COVID-19 ; High dependency unit ; Multidisciplinary approach ; Management ; Diseases of the respiratory system ; RC705-779 ; covid19
    Subject code 610
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis

    Paola Faverio / Anna Stainer / Giulia Bonaiti / Stefano C. Zucchetti / Edoardo Simonetta / Giuseppe Lapadula / Almerico Marruchella / Andrea Gori / Francesco Blasi / Luigi Codecasa / Alberto Pesci / James D. Chalmers / Michael R. Loebinger / Stefano Aliberti

    International Journal of Molecular Sciences, Vol 17, Iss 11, p

    2016  Volume 1913

    Abstract: Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic ... ...

    Abstract Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.
    Keywords non-cystic fibrosis bronchiectasis ; non-tuberculous mycobacteria ; pulmonary infection ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2016-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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