Giulia Cenci | Imed - Academia.edu (original) (raw)

Papers by Giulia Cenci

Clinical Drug Investigation, Dec 8, 2022

Critical Care Medicine, Dec 15, 2022

Arquivos De Neuro-psiquiatria, May 1, 2023

Background Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagon... more Background Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear. Objective To perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia. Methods The Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ! 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs). Results We included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higher doses relating to a longer TST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] ¼-25.40; 95% confidence interval [95%CI] ¼-40.02-10.78), followed by suvorexant 20/15mg (SMD ¼-25.29; 95%CI ¼-36.42-14.15), which also appeared to provide the largest decrease in long-term WASO (SMD ¼-23.70; 95%CI ¼-35.89-11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%. Conclusion Our results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.

Dementia & Neuropsychologia, 2021

Background: Considering that Delirium is a very common neuropsychiatric disorder, it is very impo... more Background: Considering that Delirium is a very common neuropsychiatric disorder, it is very important that the characteristics and clinical evolution of patients who develop the condition are thoroughly known. Objective: Describe the clinical profile of patients with Delirium in order to help in the discernment of the most prevalent risk factors and the characteristics of involvement of Delirium. Methods: Descriptive, quantitative and prospective study, which analyzed epidemiological and medical history data, collected through interviews and data from medical records in a tertiary hospital, from March to June 2021. Results: The sample consisted of 5 individuals, with a mean age of 74.2 years, with a predominance of males. All of them had previous comorbidities and forty percent had previous dementia. Among the interviewees, only one presented the development of the Delirium condition as a reason for admission, the majority (80%) was hospitalized for other clinical conditions and developed Delirium only after admission. It was observed that a large part of the sample (60%) was in polypharmacy, and the only individuals with Delirium under 60 years old used 5 or more medications and had HIV infection. Conclusion: The most effective way to reduce the incidence rates of Delirium, improve the prognosis and assist in early diagnosis is through the recognition of associated factors and the characteristics of the most affected population, in order to identify individuals at risk and be able to promote more targeted prevention strategies.

Research, Society and Development, Mar 28, 2022

óbitos, distribuídos de maneira pouco variável entre os anos observados. Destes, 51,82% ocorreu n... more óbitos, distribuídos de maneira pouco variável entre os anos observados. Destes, 51,82% ocorreu no estado de São Paulo; 94,55% em ambiente hospitalar; 62,09% em crianças de cor/raça branca e 53,3% em crianças do sexo masculino. Conclusão: O presente estudo elucidou e relacionou os aspectos epidemiológicos dos óbitos por malformações congênitas em aparelho circulatório em crianças menores de 1 ano entre 2014 e 2019, contribuindo, assim, para o reconhecimento do impacto destas condições sobre a vida da criança e da importância de medidas diagnósticas precoces na redução da mortalidade.

International Journal of Stroke

Background: There is concern that recommendations on prophylactic antiseizure drugs (PASDs) for p... more Background: There is concern that recommendations on prophylactic antiseizure drugs (PASDs) for patients with spontaneous intracerebral hemorrhage (sICH) are biased by studies using older drugs and no electrographic monitoring. Aims: We performed a systematic review and meta-analysis to determine whether PASDs in patients with sICH reduced seizure occurrence and improved functional outcomes. We included analyses of newer trials, newer antiseizure drugs, and effectiveness in patients with consistent electrographic monitoring. Methods: Medline, Embase, and Cochrane were searched from inception until 12 August 2022, to identify studies with patients with sICH treated with PASDs, regardless of study design. The studied outcomes were functional status and occurrence of seizures. Results: Fourteen studies were included, including 6742 patients. Risk of bias was low overall. There was no effect of PASD on seizure occurrence overall (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.47–1...

Clinical Drug Investigation, Dec 8, 2022

Critical Care Medicine, Dec 15, 2022

Arquivos De Neuro-psiquiatria, May 1, 2023

Background Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagon... more Background Several randomized clinical trials (RCTs) have shown that dual orexin receptor antagonists (DORAs) are effective in the treatment of chronic insomnia. However, the superiority of one particular DORA over the others remains unclear. Objective To perform a network meta-analysis to evaluate the efficacy of different DORAs in patients with chronic insomnia. Methods The Medline, Embase, and Cochrane Central databases were searched for RCTs that compared DORA with placebo in patients ! 18 years of age with a diagnosis of insomnia disorder. We pooled outcomes for wake time after sleep onset (WASO), latency to persistent sleep (LPS), total sleep time (TST), and adverse events (AEs). Results We included 10 RCTs with 7,806 patients, 4,849 of whom received DORAs as the intervention. Overall, we found that DORAs were associated with the improvement of all analyzed efficacy outcomes. Concerning TST, an apparent dose-dependent pattern was noticed, with higher doses relating to a longer TST. Lemborexant 10mg provided the largest reduction in WASO (at month 1) in minutes (standardized mean difference [SMD] ¼-25.40; 95% confidence interval [95%CI] ¼-40.02-10.78), followed by suvorexant 20/15mg (SMD ¼-25.29; 95%CI ¼-36.42-14.15), which also appeared to provide the largest decrease in long-term WASO (SMD ¼-23.70; 95%CI ¼-35.89-11.51). The most frequent AEs were somnolence, nasopharyngitis, and headache, with rates of up to 14.8%. Conclusion Our results suggest that DORAs are associated with greater efficacy when compared with placebo in the treatment of insomnia, a complex 24-hour sleep disorder. Additionally, dosing might play an important role in the management of chronic insomnia.

Dementia & Neuropsychologia, 2021

Background: Considering that Delirium is a very common neuropsychiatric disorder, it is very impo... more Background: Considering that Delirium is a very common neuropsychiatric disorder, it is very important that the characteristics and clinical evolution of patients who develop the condition are thoroughly known. Objective: Describe the clinical profile of patients with Delirium in order to help in the discernment of the most prevalent risk factors and the characteristics of involvement of Delirium. Methods: Descriptive, quantitative and prospective study, which analyzed epidemiological and medical history data, collected through interviews and data from medical records in a tertiary hospital, from March to June 2021. Results: The sample consisted of 5 individuals, with a mean age of 74.2 years, with a predominance of males. All of them had previous comorbidities and forty percent had previous dementia. Among the interviewees, only one presented the development of the Delirium condition as a reason for admission, the majority (80%) was hospitalized for other clinical conditions and developed Delirium only after admission. It was observed that a large part of the sample (60%) was in polypharmacy, and the only individuals with Delirium under 60 years old used 5 or more medications and had HIV infection. Conclusion: The most effective way to reduce the incidence rates of Delirium, improve the prognosis and assist in early diagnosis is through the recognition of associated factors and the characteristics of the most affected population, in order to identify individuals at risk and be able to promote more targeted prevention strategies.

Research, Society and Development, Mar 28, 2022

óbitos, distribuídos de maneira pouco variável entre os anos observados. Destes, 51,82% ocorreu n... more óbitos, distribuídos de maneira pouco variável entre os anos observados. Destes, 51,82% ocorreu no estado de São Paulo; 94,55% em ambiente hospitalar; 62,09% em crianças de cor/raça branca e 53,3% em crianças do sexo masculino. Conclusão: O presente estudo elucidou e relacionou os aspectos epidemiológicos dos óbitos por malformações congênitas em aparelho circulatório em crianças menores de 1 ano entre 2014 e 2019, contribuindo, assim, para o reconhecimento do impacto destas condições sobre a vida da criança e da importância de medidas diagnósticas precoces na redução da mortalidade.

International Journal of Stroke

Background: There is concern that recommendations on prophylactic antiseizure drugs (PASDs) for p... more Background: There is concern that recommendations on prophylactic antiseizure drugs (PASDs) for patients with spontaneous intracerebral hemorrhage (sICH) are biased by studies using older drugs and no electrographic monitoring. Aims: We performed a systematic review and meta-analysis to determine whether PASDs in patients with sICH reduced seizure occurrence and improved functional outcomes. We included analyses of newer trials, newer antiseizure drugs, and effectiveness in patients with consistent electrographic monitoring. Methods: Medline, Embase, and Cochrane were searched from inception until 12 August 2022, to identify studies with patients with sICH treated with PASDs, regardless of study design. The studied outcomes were functional status and occurrence of seizures. Results: Fourteen studies were included, including 6742 patients. Risk of bias was low overall. There was no effect of PASD on seizure occurrence overall (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.47–1...