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  1. AU="Michele Totaro"
  2. AU="Liu, Feiyang"
  3. AU=Mignardi Marco
  4. AU=Yoon Mee-Sup
  5. AU="Schmitt, L."
  6. AU="Clark, Roger"
  7. AU="Tütüncüoğlu, Atacan"
  8. AU=Onuigbo Macaulay Amechi Chukwukadibia
  9. AU="Ohanyerenwa, Chioma"
  10. AU=Kaur Kirandeep
  11. AU=Shrimal Shiteshu
  12. AU=Hamp Thomas
  13. AU="Fazila Aloweni"
  14. AU="Mitchel, Liz"
  15. AU="Aguirre González, Alejandra"
  16. AU="Abdelhak, Bensaid"

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  1. Artikel ; Online: Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation

    Filippo Graziani / Rossana Izzetti / Lisa Lardani / Michele Totaro / Angelo Baggiani

    International Journal of Environmental Research and Public Health, Vol 18, Iss 3357, p

    An Analysis on Fine Particulate Matter Perturbation

    2021  Band 3357

    Abstract: Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt ... ...

    Abstract Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region. A gravimetric impactor was positioned 1 m away and at the same height of the head of the patient. Particles of different sizes (0.3–10 µm) were measured at the beginning of instrumentation, at the end of instrumentation (EI), and then every 15 min up to 105 min. The 0.3-µm particles showed non-significant increases at 15/30 min. The 0.5–1-µm particles increased at EI ( p < 0.05), and 0.5 µm remained high for another 15 min. Overall, all submicron aerosol particles showed a slow decrease to normal values. Particles measuring 3–5 µm showed non-significant increases at EI. Particles measuring 10 µm did not show any increases but a continuous reduction ( p < 0.001 versus 0.3 µm, p < 0.01 versus 0.5 µm, and p < 0.05 versus 1–3 µm). Aerosol particles behaved differently according to their dimensions. Submicron aerosols peaked after instrumentation and slowly decreased after the end of instrumentation, whilst larger particles did not show any significant increases. This experimental study produces a benchmark for the measurement of aerosol particles during dental procedures and raises some relevant concerns about indoor air quality after instrumentation.
    Schlagwörter aerosols ; particulate matter ; dental scaling ; occupational exposure ; air pollution ; indoor ; Medicine ; R
    Thema/Rubrik (Code) 650
    Sprache Englisch
    Erscheinungsdatum 2021-03-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Implementation of an Environmental Cleaning Protocol in Hospital Critical Areas Using a UV-C Disinfection Robot

    Beatrice Casini / Benedetta Tuvo / Michela Scarpaci / Michele Totaro / Federica Badalucco / Silvia Briani / Grazia Luchini / Anna Laura Costa / Angelo Baggiani

    International Journal of Environmental Research and Public Health, Vol 20, Iss 4284, p

    2023  Band 4284

    Abstract: Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two ... ...

    Abstract Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two successive patients was evaluated. Twenty high-touch surfaces in different critical areas were sampled according to ISO 14698-1, both immediately pre- and post-cleaning and disinfection standard operating protocol (SOP) and after UV-C disinfection (160 sampling sites in each condition, 480 in total). Dosimeters were applied at the sites to assess the dose emitted. A total of 64.3% (103/160) of the sampling sites tested after SOP were positive, whereas only 17.5% (28/160) were positive after UV-C. According to the national hygienic standards for health-care setting, 9.3% (15/160) resulted in being non-compliant after SOP and only 1.2% (2/160) were non-compliant after UV-C disinfection. Operation theaters was the setting that resulted in being less compliant with the standard limit (≤15 colony-forming unit/24 cm 2 ) after SOP (12%, 14/120 sampling sites) and where the UV-C treatment showed the highest effectiveness (1.6%, 2/120). The addition of UV-C disinfection to the standard cleaning and disinfection procedure had effective results in reducing hygiene failures.
    Schlagwörter hospital environmental cleaning and disinfection ; ultraviolet C light-emitting device ; high-touch surfaces ; Medicine ; R
    Thema/Rubrik (Code) 333
    Sprache Englisch
    Erscheinungsdatum 2023-02-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel: Efficacy of Plant Sterol-Enriched Food for Primary Prevention and Treatment of Hypercholesterolemia: A Systematic Literature Review

    Elisa, Turini / Miriana, Sarsale / Davide, Petri / Michele, Totaro / Ersilia, Lucenteforte / Lara, Tavoschi / Angelo, Baggiani

    Foods. 2022 Mar. 15, v. 11, no. 6

    2022  

    Abstract: Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and ... ...

    Abstract Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia. Randomized controlled clinical studies reporting the use of PS-enriched foods to reduce LDL-c among adult individuals were retrieved and assessed for risk of bias. Meta-analyses were performed to assess changes in LDL-c by treatment, food matrix, LDL-c range, sterols dosage and risk of bias (RoB). In the 13 studies analyzed, LDL-c in PS-treated participants decreased by an average of 12.14 (8.98; 15.29) mg/dL. PS administration was statistically more effective in patients with LDL-c ≥ 140 mg/dL and for PS dosages > 2 g/day. It can be concluded that PSs can be used as an important primary prevention measure for hypercholesterolemia and as tertiary prevention for cardiovascular events in patients who already have mild to moderate LDL-c. However, in severe hypercholesterolemia and in cases of familial hypercholesterolemia, it is necessary to combine dietary treatment with the use of statins.
    Schlagwörter adults ; cholesterol ; exercise ; food matrix ; healthy diet ; hypercholesterolemia ; meta-analysis ; nutritional intervention ; phytosterols ; risk ; systematic review
    Sprache Englisch
    Erscheinungsverlauf 2022-0315
    Erscheinungsort Multidisciplinary Digital Publishing Institute
    Dokumenttyp Artikel
    ZDB-ID 2704223-6
    ISSN 2304-8158
    ISSN 2304-8158
    DOI 10.3390/foods11060839
    Datenquelle NAL Katalog (AGRICOLA)

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  4. Artikel ; Online: Role of Hydrogen Peroxide Vapor (HPV) for the Disinfection of Hospital Surfaces Contaminated by Multiresistant Bacteria

    Michele Totaro / Beatrice Casini / Sara Profeti / Benedetta Tuvo / Gaetano Privitera / Angelo Baggiani

    Pathogens, Vol 9, Iss 408, p

    2020  Band 408

    Abstract: The emergence of multiresistant bacterial strains as agents of healthcare-related infection in hospitals has prompted a review of the control techniques, with an added emphasis on preventive measures, namely good clinical practices, antimicrobial ... ...

    Abstract The emergence of multiresistant bacterial strains as agents of healthcare-related infection in hospitals has prompted a review of the control techniques, with an added emphasis on preventive measures, namely good clinical practices, antimicrobial stewardship, and appropriate environmental cleaning. The latter item is about the choice of an appropriate disinfectant as a critical role due to the difficulties often encountered in obtaining a complete eradication of environmental contaminations and reservoirs of pathogens. The present review is focused on the effectiveness of hydrogen peroxide vapor, among the new environmental disinfectants that have been adopted. The method is based on a critical review of the available literature on this topic
    Schlagwörter hydrogen peroxide vapor ; multidrug-resistant bacteria ; hospital disinfection ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2020-05-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  5. Artikel ; Online: Evaluation, Description and Magnitude of Readmission Phenomenon in Azienda Ospedaliero Universitaria Pisana (AOUP) for Chronic-Degenerative Diseases in the Period 2018–2021

    Matteo Filippi / Erika Del Prete / Ferruccio Aquilini / Michele Totaro / Francesca Di Serafino / Sara Civitelli / Giulia Geminale / David Rocchi / Nunzio Zotti / Angelo Baggiani

    Healthcare, Vol 11, Iss 651, p

    2023  Band 651

    Abstract: Background: Readmissions are hospitalizations following a previous hospitalization (called index hospitalization) of the same patient that occurred in the same facility or nursing home. They may be a consequence of the progression of the natural history ... ...

    Abstract Background: Readmissions are hospitalizations following a previous hospitalization (called index hospitalization) of the same patient that occurred in the same facility or nursing home. They may be a consequence of the progression of the natural history of a disease, but they may also reveal a previous suboptimal stay, or ineffective management of the underlying clinical condition. Preventing avoidable readmissions has the potential to improve both a patient’s quality of life, by avoiding exposure to the risks of re-hospitalization, and the financial well-being of health care systems. Methods: We investigated the magnitude of 30 day repeat hospitalizations for the same Major Diagnostic Category (MDC) in the Azienda Ospedaliero Universitaria Pisana (AOUP) over the period from 2018 to 2021. Records were divided into only admissions, index admissions and repeated admission. The length of the stay of all groups was compared using analysis of variance and subsequent multi-comparison tests. Results: Results showed a reduction in readmissions over the period examined (from 5.36% in 2018 to 4.46% in 2021), likely due to reduced access to care during the COVID-19 pandemic. We also observed that readmissions predominantly affect the male sex, older age groups, and patients with medical Diagnosis Related Groups (DRGs). The length of stay of readmissions was longer than that of index hospitalization (difference of 1.57 days, 95% CI 1.36–1.78 days, p < 0.001). The length of stay of index hospitalization is longer than that of single hospitalization (difference of 0.62 days, 95% CI 0.52–0.72 days, p < 0.001). Conclusions: A patient who goes for readmission thus has an overall hospitalization duration of almost two and a half times the length of the stay of a patient with single hospitalization, considering both index hospitalization and readmission. This represents a heavy use of hospital resources, about 10,200 more inpatient days than single hospitalizations, corresponding to a 30-bed ward working with an occupancy ...
    Schlagwörter readmissions ; health economics ; Diagnosis Related Group ; chronic diseases ; continuity of care ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2023-02-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  6. Artikel ; Online: Effectiveness of Disinfection with Chlorine Dioxide on Respiratory Transmitted, Enteric, and Bloodborne Viruses

    Michele Totaro / Federica Badalucco / Anna Laura Costa / Benedetta Tuvo / Beatrice Casini / Gaetano Privitera / Giovanni Battista Menchini Fabris / Angelo Baggiani

    Pathogens, Vol 10, Iss 1017, p

    A Narrative Synthesis

    2021  Band 1017

    Abstract: A viral spread occurrence such as the SARS-CoV-2 pandemic has prompted the evaluation of different disinfectants suitable for a wide range of environmental matrices. Chlorine dioxide (ClO 2 ) represents one of the most-used virucidal agents in different ... ...

    Abstract A viral spread occurrence such as the SARS-CoV-2 pandemic has prompted the evaluation of different disinfectants suitable for a wide range of environmental matrices. Chlorine dioxide (ClO 2 ) represents one of the most-used virucidal agents in different settings effective against both enveloped and nonenveloped viruses. This narrative synthesis is focused on the effectiveness of ClO 2 applied in healthcare and community settings in order to eliminate respiratory transmitted, enteric, and bloodborne viruses. Influenza viruses were reduced by 99.9% by 0.5–1.0 mg/L of ClO 2 in less than 5 min. Higher concentration (20 mg/L) eliminated SARS-CoV-2 from sewage. ClO 2 concentrations from 0.2 to 1.0 mg/L ensured at least a 99% viral reduction of AD40, HAV, Coxsackie B5 virus, and other enteric viruses in less than 30 min. Considering bloodborne viruses, 30 mg/L of ClO 2 can eliminate them in 5 min. Bloodborne viruses (HIV-1, HCV, and HBV) may be completely eliminated from medical devices and human fluids after a treatment with 30 mg/L of ClO 2 for 30 min. In conclusion, ClO 2 is a versatile virucidal agent suitable for different environmental matrices.
    Schlagwörter chlorine dioxide ; SARS-CoV-2 ; enteric viruses ; bloodborne viruses ; Medicine ; R
    Thema/Rubrik (Code) 290
    Sprache Englisch
    Erscheinungsdatum 2021-08-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  7. Artikel ; Online: Adoption of Improved Reprocessing Decreased Microbiological Non-Compliance for Bronchoscopes

    Benedetta Tuvo / Michela Scarpaci / Tommaso Cosci / Alessandro Ribechini / Silvia Briani / Grazia Luchini / Michele Totaro / Angelo Baggiani / Maria Luisa Cristina / Simona Barnini / Simone Leonetti / Beatrice Casini

    International Journal of Environmental Research and Public Health, Vol 19, Iss 13978, p

    2022  Band 13978

    Abstract: Background: In the past few decades, the inadequate reprocessing of bronchoscopes has been associated with several serious outbreaks caused by multidrug-resistant microorganisms. In this study we evaluated the improvement in the quality of reprocessing ... ...

    Abstract Background: In the past few decades, the inadequate reprocessing of bronchoscopes has been associated with several serious outbreaks caused by multidrug-resistant microorganisms. In this study we evaluated the improvement in the quality of reprocessing in a Bronchoscopy Unit (BU), after the introduction of a new procedure. Methods: In 2019, observational and clinical audits were conducted in the BU. After the introduction of an improved procedure in 2020, a microbiological surveillance plan was implemented in 2021. Results: In 2019, 13 of 22 bronchoscopes (59%) resulted as non-compliant, 18% as high concern organisms (HCO) and 36.4% as high microbial count (≥100 CFU/all channels) and HCO. The most frequent microorganisms were Staphylococcus aureus (38.5%) and NDM-producing Klebsiella pneumoniae (15.4%). The bronchoscopes were stored inside their transport cases, which in some cases were found to be contaminated by the same strains isolated on the bronchoscopes ( Enterobacter gergoviae and Vibrio alginolyticus ). In 2021, all 31 bronchoscopes were sampled at least three times and 13/99 (13.1%) resulted as non-compliant, mostly K. pneumoniae (4.04%). Contamination level increases weakly in bronchoscopes in use for more than 14 years (R = 0.32). Conclusions: The adoption of an improved reprocessing procedure decreased the non-compliance of bronchoscopes, increasing the quality of the process and patient safety.
    Schlagwörter endoscope reprocessing ; bronchoscopes ; microbiological surveillance ; NDM-producing Klebsiella pneumoniae ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2022-10-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  8. Artikel ; Online: Effectiveness of a Water Disinfection Method Based on Osmosis and Chlorine Dioxide for the Prevention of Microbial Contamination in Dental Practices

    Michele Totaro / Federica Badalucco / Francesca Papini / Niccolò Grassi / Marina Mannocci / Matteo Baggiani / Benedetta Tuvo / Beatrice Casini / Giovanni Battista Menchini Fabris / Angelo Baggiani

    International Journal of Environmental Research and Public Health, Vol 19, Iss 10562, p

    2022  Band 10562

    Abstract: In dental clinics, the infections may be acquired through contaminated devices, air, and water. Aerosolized water may contain bacteria, grown into the biofilm of dental unit waterlines (DUWLs). We evaluated a disinfection method based on water osmosis ... ...

    Abstract In dental clinics, the infections may be acquired through contaminated devices, air, and water. Aerosolized water may contain bacteria, grown into the biofilm of dental unit waterlines (DUWLs). We evaluated a disinfection method based on water osmosis and chlorination with chlorine dioxide (O-CD), applied to DUWL of five dental clinics. Municipal water was chlorinated with O-CD device before feeding all DUWLs. Samplings were performed on water/air samples in order to research total microbial counts at 22–37 °C, Pseudomonas aeruginosa , Legionella spp., and chlorine values. Water was collected from the taps, spittoons, and air/water syringes. Air was sampled before, during, and after 15 min of aerosolizing procedure. Legionella and P. aeruginosa resulted as absent in all water samples, which presented total microbial counts almost always at 0 CFU/mL. Mean values of total chlorine ranged from 0.18–0.23 mg/L. Air samples resulted as free from Legionella spp. and Pseudomonas aeruginosa. Total microbial counts decreased from the pre-aerosolizing (mean 2.1 × 10 2 CFU/m 3 ) to the post-aerosolizing samples (mean 1.5 × 10 CFU/m 3 ), while chlorine values increased from 0 to 0.06 mg/L. O-CD resulted as effective against the biofilm formation in DUWLs. The presence of residual activity of chlorine dioxide also allowed the bacteria reduction from air, at least at one meter from the aerosolizing source.
    Schlagwörter dental unit waterlines ; reverse osmosis ; chlorine dioxide ; waterborne pathogens ; Medicine ; R
    Thema/Rubrik (Code) 333
    Sprache Englisch
    Erscheinungsdatum 2022-08-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: Evaluation of Legionella spp. Colonization in Residential Buildings Having Solar Thermal System for Hot Water Production

    Michele Totaro / Anna Laura Costa / Lorenzo Frendo / Sara Profeti / Beatrice Casini / Antonio Gallo / Gaetano Privitera / Angelo Baggiani

    International Journal of Environmental Research and Public Health, Vol 17, Iss 7050, p

    2020  Band 7050

    Abstract: Despite an increase of literature data on Legionella spp. presence in private water systems, epidemiological reports assert a continuing high incidence of Legionnaires’ disease infection in Italy. In this study, we report a survey on Legionella spp. ... ...

    Abstract Despite an increase of literature data on Legionella spp. presence in private water systems, epidemiological reports assert a continuing high incidence of Legionnaires’ disease infection in Italy. In this study, we report a survey on Legionella spp. colonization in 58 buildings with solar thermal systems for hot water production (TB). In all buildings, Legionella spp. presence was enumerated in hot and cold water samples. Microbiological potability standards of cold water were also evaluated. Legionella spp. was detected in 40% of the buildings. Moreover, we detected correlations between the count of Legionella spp. and the presence of the optimal temperature for the microorganism growth (less than 40 °C). Our results showed that cold water was free from microbiological hazards, but Legionella spp., was detected when the mean cold water temperature was 19.1 ± 2.2 °C. This may considered close to the suboptimal value for the Legionella growth (more then 20 °C). In conclusion, we observed the presence of a Legionnaires’ disease risk and the need of some strategies aimed to reduce it, such as the application of training programs for all the workers involved in water systems maintenance.
    Schlagwörter Legionella spp ; residential buildings ; waterborne pathogens ; solar thermal panels ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2020-09-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  10. Artikel ; Online: Evaluation of the Cleaning Procedure Efficacy in Prevention of Nosocomial Infections in Healthcare Facilities Using Cultural Method Associated with High Sensitivity Luminometer for ATP Detection

    Beatrice Casini / Benedetta Tuvo / Michele Totaro / Francesco Aquino / Angelo Baggiani / Gaetano Privitera

    Pathogens, Vol 7, Iss 3, p

    2018  Band 71

    Abstract: In healthcare facilities, environmental surfaces may be a reservoir of infectious agents even though cleaning and disinfection practices play a role in the control of healthcare-associated infections. In this study, the effectiveness of cleaning/ ... ...

    Abstract In healthcare facilities, environmental surfaces may be a reservoir of infectious agents even though cleaning and disinfection practices play a role in the control of healthcare-associated infections. In this study, the effectiveness of cleaning/disinfection procedures has been evaluated in two hospital areas, which have different risk category classifications. According to the contract with the cleaning service, after the daily ambulatory activities, the housekeeping staff apply an alcohol-based detergent followed by a chlorine-based disinfectant (2% Antisapril, Angelini; 540 mg/L active chlorine), properly diluted and sprayed. The contract provides for the use of disposable microfiber wipes which must be replaced with new ones in each health out-patient department. Surface contamination was analyzed using cultural methods and ATP detection, performed with a high-sensitivity luminometer. The values 100 CFU/cm2 and 40 RLU/cm2 were considered as the threshold values for medium-risk category areas, while 250 CFU/cm2 and 50 RLU/cm2 were defined for the low-risk category ones. Air quality was evaluated using active and passive sampling microbiological methods and particle count (0.3 μm–10 μm) detection. The cleaning/disinfection procedure reduced the medium bacterial counts from 32 ± 56 CFU/cm2 to 2 ± 3 CFU/cm2 in the low-risk area and from 25 ± 40 CFU/cm2 to 7 ± 11 CFU/cm2 in the medium-risk one. Sample numbers exceeding the threshold values decreased from 3% and 13% to 1% and 5%, respectively. RLU values also showed a reduction in the samples above the thresholds from 76% to 13% in the low-risk area. From the air samples collected using the active method, we observed a reduction of 60% in wound care and 53% in an ambulatory care visit. From the air samples collected using the passive method, we highlighted a 71.4% and 50% reduction in microbial contamination in the medium-risk area and in the low-risk one, respectively. The 10 μm size particle counts decreased by 52.7% in wound care and by 63% in the ambulatory ...
    Schlagwörter environmental surfaces ; air quality ; ATP bioluminometry ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2018-08-01T00:00:00Z
    Verlag MDPI AG
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