Simone Navarra - Academia.edu (original) (raw)

Papers by Simone Navarra

DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2021

OBJECTIVE Mild Traumatic Brain Injury (MTBI) in anticoagulated patients is a common challenge for... more OBJECTIVE Mild Traumatic Brain Injury (MTBI) in anticoagulated patients is a common challenge for Emergency Department (ED) Physicians. Anticoagulation is considered a risk factor for developing delayed intracranial hemorrhage (ICH) after MTBI. The occurrence of this event in patients on Vitamin K Antagonists (VKA) or Direct Oral Anticoagulants (DOACs) remains unclear. Primary endpoint: to analyze the role of anticoagulants as risk factors for developing delayed ICH after MTBI and evaluate the indications to repeat a cranial computed tomography (CT) after a period of observation. Secondary endpoint: to assess the difference in the prevalence rate of delayed ICH in patients on VKA versus those on DOACs. PATIENTS AND METHODS We evaluated all consecutive patients admitted to our ED for MTBI, which had a control CT for late ICH after a negative CT at admission. We used a propensity score match (PSM) on factors affecting the need for oral anticoagulation to adjust the comparison between anticoagulated vs. non-anticoagulated patients for the baseline clinical characteristics. RESULTS Among 685 patients enrolled, 15 (2.2%) developed ICH at control CT. After PSM, the incidence of ICH, although slightly higher, was not statistically different in anticoagulated patients vs. non-anticoagulated (2.3% vs. 0.6%, p=0.371). Among the 111 patients on VKA, 5 (4.5%) had a late ICH, compared to 4 out of 99 (4.0%) on DOACs; the difference was not statistically significant (p=0.868). CONCLUSIONS The risk of developing delayed ICH after MTBI in patients on anticoagulation therapy is low. After correction for baseline covariates, the risk does not appear higher compared to non-anticoagulated patients. Thus, a routine control CT scan seems advisable only for patients presenting a clinical deterioration. Larger, prospective trials are required to clarify the safety profile of DOACs vs. VKA in MTBI.

Reviews on Recent Clinical Trials, Jan 12, 2021

Italian journal of emergency medicine, 2023

Italian Journal of Emergency Medicine

Biomedical Journal of Scientific & Technical Research, 2019

Hypothermia is a harmful condition associated with possible unfavorable outcomes. Literature data... more Hypothermia is a harmful condition associated with possible unfavorable outcomes. Literature data revealed a mortality of about 40% [1]. It is responsible of cardiovascular, respiratory and neurological failure. Electrocardiogram changes, including bradycardia, are common findings during progressive hypothermia [2]; it may be the expression of a breakdown in the compensatory mechanisms of the body and of the progressive decline of vital functions. In the Emergency Department, the available therapeutic strategies are not always effective and new treatments need to be designed. Our case report would show a possible advantageous treatment opportunity in patients with hypothermia.

Journal of the American Geriatrics Society, 2020

Several scoring systems have been specifically developed for risk stratification in COVID‐19 pati... more Several scoring systems have been specifically developed for risk stratification in COVID‐19 patients.

European review for medical and pharmacological sciences, 2019

Capnocytophaga canimorsus is a Gram-negative rods frequently isolated as commensal in the saliva ... more Capnocytophaga canimorsus is a Gram-negative rods frequently isolated as commensal in the saliva of pets that can be transmitted to humans. We report a case of septic shock caused by this pathogen. A 78-year-old man affected by diabetes and hypertension was admitted for fever in our Emergency Department. He reported fever (37.7°C) with normal values of blood pressure, heart rate and saturation of oxygen. Laboratory studies showed increased values of procalcitonin and normal white-cell level. Blood cultures were collected and an empirical antibiotic therapy was started. He reported six days earlier a bite of a dog at the right hand. During the following days the patient presented a deterioration of clinical conditions with fever, asthenia and comparison of petechial lesions. C. canimorsus was isolated from blood cultures. He was treated with fluids and appropriate antibiotic therapy with a full recovery. Dog wounds are frequent minor injuries with an underestimated worldwide incidenc...

International Journal of Clinical Practice, 2021

The COVID‐19 pandemic represents a source of stress and potential burnout for many physicians. Th... more The COVID‐19 pandemic represents a source of stress and potential burnout for many physicians. This single‐site survey aimed at assessing perceived stress and risk to develop burnout syndrome among physicians operating in COVID wards.

European review for medical and pharmacological sciences, 2021

Digestive and Liver Disease, 2020

Current Medicinal Chemistry, 2021

Background: The role of gut microbiota in human disease is fascinating for hundreds of researcher... more Background: The role of gut microbiota in human disease is fascinating for hundreds of researchers worldwide. Many works have highlighted that gut microbiota modulates the immune system, and that its disruption can trigger autoimmune and inflammatory immune-mediated diseases. Probiotics are able to positively modify microbiota composition. Objective: Aim of this review is to report the most important findings regarding the effects of probiotics administration in the most common autoimmune disease and inflammatory immune-mediated diseases. Method: Literature research was performed in PubMed, Google Scholar and Medline, as well as in specific journal websites using the keywords: “autoimmunity”, “microbiota”, and “probiotics”. The article selection has been made independently by three authors, and controversies have been solved by a fourth researcher. Only English-language articles were included and preference was given to clinical trials, meta-analysis, and case series. After the revi...

European Journal of Neurology, 2020

Current Medicinal Chemistry

Reviews on Recent Clinical Trials

Background: Non-invasive ventilation (NIV) is increasingly being used to treat episodes of acute ... more Background: Non-invasive ventilation (NIV) is increasingly being used to treat episodes of acute respiratory failure not only in critical care and respiratory wards, but also in emergency departments. Aim: Aim of this review is to summarize the current indications for the management of NIV for respiratory failure. Methods: Current literature about the topic was reviewed and critically reported to describe the rationale and physiologic advantages of NIV in various situations of respiratory failure. Results: Early NIV use is commonly associated with the significant decrease in endotracheal intubation rate, the incidence of infective complications (especially ventilatory associated pneumonia), Intensive Care Units and the length of hospital stay and, in selected conditions, also in mortality rates. Results: Early NIV use is commonly associated with the significant decrease in endotracheal intubation rate, the incidence of infective complications (especially ventilatory associated pneum...