Gaddo Flego | Santa Corona Hspital Italy (original) (raw)
Papers by Gaddo Flego
International Journal of Emergency Medicine, Nov 29, 2023
Italian Journal of Medicine, 2009
Population Medicine
Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.
World Journal of Emergency Surgery, 2021
Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital ... more Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (IS...
The Lancet, 1998
... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awaren... more ... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awareness of visceral leishmaniasis in the Mediterranean area. ... References. 1 Punda-Polic V, Sardelic S, Bradaric N. Visceral leishmaniasis in southern Croatia.. Lancet 1998; 351: 188. ...
Italian Journal of Medicine, 2009
Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care:... more Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care: are we so different from America?
Italian Journal of Medicine, 2013
Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care:... more Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care: are we so different from America?
![Research paper thumbnail of [Clinical and organizational evidence of the efficacy and effectiveness from cardiac rehabilitation: an update]](https://attachments.academia-assets.com/89800256/thumbnails/1.jpg)
](Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2009
The increasing evidence on the favourable cost/effectiveness impact of the comprehensive cardiac ... more The increasing evidence on the favourable cost/effectiveness impact of the comprehensive cardiac rehabilitation program for the treatment of a wide spectrum of cardiovascular conditions have imposed to healthcare services a major attention on a critical analysis of the results in different clinical indications and delivery organisations. The Regional Health Agency of Liguria, in the occasion of drawing up regional guidelines directed to define the clinical indications and the effectiveness of the cardiac rehabilitation delivery model (in-patients, out-patients and home-based) and its requisites, indications and procedures, has updated the reference guidelines (PLNG and SIGN) with the evidence provided by the more recent literature, focusing its attention on the clinical and, in particular, organizational effectiveness. The document, on the base of these evidences, provides some effective proposals and some organizational advices.
Journal of the American College of Cardiology, 2010
Dronedarone is a new antiarrhythmic agent that was recently approved for the prevention of cardio... more Dronedarone is a new antiarrhythmic agent that was recently approved for the prevention of cardiovascular hospitalization driven by atrial fibrillation/flutter. Its approval was based largely on the results of the ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter) trial, which demonstrated a significant 24% reduction in the combined end point of all-cause mortality and cardiovascular hospitalization, primarily driven by the latter. However, several other clinical trials have evaluated the impact of dronedarone on various cardiovascular end points and yielded mixed results. In this article, we summarize the available evidence concerning dronedarone, and offer practical recommendations to health care providers regarding its use in the treatment of atrial fibrillation. We conclude that the available data support the use of dronedarone in select patient populations as a second-or third-line agent.
World Journal of Emergency Surgery : WJES, 2021
Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital ... more Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (IS...
Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of ... more Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients with non-compressible torso injuries and uncontrolled haemorrhagic shock were recently published. To date, the clinical evidence of the efficacy of REBOA is still debated. We aimed to conduct a systematic review assessing the clinical efficacy and safety of REBOA in patients with major trauma and uncontrolled haemorrhagic shock. Methods We systematically searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2020. All randomized controlled trials and observational studies that investigated the use of REBOA compared to resuscitative thoracotomy (RT) with/without REBOA or no-REBOA were eligible. We followed the PRISMA and MOOSE guidelines. Two authors independently extracted data and appraised the risk of bias of included studies. Effect sizes were pooled in a meta-analysis using random-effects models. The quality of evidence was assessed using the Grading o...
European Journal of Clinical Microbiology & Infectious Diseases, 1997
Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresi... more Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresis (PFGE), arbitrarily primed polymerase chain reaction (AP-PCR), and ribotyping were used to compare clinical and environmentalLegionella pneumophila serogroup 1 isolates from an outbreak of Legionnaires' disease presumptively associated with cooling towers. According to the Oxford subtyping scheme, the MAb subtype of patients' isolates and of two strains originating from a cooling tower was Pontiac, whereas the other isolates were subtype Olda. The strains showed no intrinsic strain-to-strain difference in fatty acid profiles, and ribotyping and length polymorphism of the 16S-23S rDNA intervening regions failed to reveal any differences between the isolates. Conversely, PFGE and AP-PCR appeared to be more discriminatory, as the same genomic profile was found for the clinical and some environmental strains. Meteorologic and epidemiological data and the results of molecular analysis of theLegionella pneumophila serogroup 1 isolates support the hypothesis that the infection was transmitted from one of the cooling towers to the indoor environment of the same building, to homes in proximity that had open windows, and to the streets. In fact, the outbreak diminished and later ended after a part in the tower was replaced. This investigation demonstrates the utility of combined molecular methods (i.e., phenotypic and genomic typing) in comparing epidemiologically linked clinical and environmental isolates. Finally, the outbreak confirms the risk of Legionnaires' disease posed by cooling towers, mainly when atmospheric thermal and humidity inversions occur. This finding emphasizes the need to determine whether the source of infection is in the living or working environment or somewhere else.
Lancet, 1998
... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awaren... more ... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awareness of visceral leishmaniasis in the Mediterranean area. ... References. 1 Punda-Polic V, Sardelic S, Bradaric N. Visceral leishmaniasis in southern Croatia.. Lancet 1998; 351: 188. ...
Journal of Pain and Symptom Management, 2002
The aims of this study were to quantify the prevalence of pain among hospitalized Italian patient... more The aims of this study were to quantify the prevalence of pain among hospitalized Italian patients and to describe the potential determinants of pain in this population. All patients older than 18 years and hospitalized for at least 24 hours in one of the 30 public hospitals of the Liguria region (n ϭ 4709) were eligible for pain assessment. Using the Brief Pain Inventory, patients with pain during the last 24 hours were asked to score the intensity of pain at the time of the interview, and the worst pain and average pain during the previous 24 hours on 0-10 rating scales. Overall, 87% (4121 / 4709) of inpatients were interviewed, and 56.6% suffered pain during the last 24 hours. Among patients with pain, the median (interquartile range) score of the worst and of the average pain during the last 24 hours was 7 (5-9) and 5 (3-6), respectively. At the time of interview, 43.1% evaluated patients suffered pain, with a median (interquartile range) of 5 (3-7). Although significant heterogeneity in the distribution of pain was observed among the hospitals, pain prevalence was unacceptably high in most cases. Age, sex, education, diagnosis, and days from surgery were significantly related to pain prevalence in univariate analyses. In a multivariable ordinal regression logistic analysis, only sex, diagnosis, days from surgery, and hospitals remain significantly associated with increased pain prevalence.
International Journal of Emergency Medicine, Nov 29, 2023
Italian Journal of Medicine, 2009
Population Medicine
Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.
World Journal of Emergency Surgery, 2021
Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital ... more Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (IS...
The Lancet, 1998
... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awaren... more ... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awareness of visceral leishmaniasis in the Mediterranean area. ... References. 1 Punda-Polic V, Sardelic S, Bradaric N. Visceral leishmaniasis in southern Croatia.. Lancet 1998; 351: 188. ...
Italian Journal of Medicine, 2009
Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care:... more Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care: are we so different from America?
Italian Journal of Medicine, 2013
Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care:... more Emergenza-urgenza negli ospedali: siamo così diversi dall'America? Hospital-based emergency care: are we so different from America?
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2009
The increasing evidence on the favourable cost/effectiveness impact of the comprehensive cardiac ... more The increasing evidence on the favourable cost/effectiveness impact of the comprehensive cardiac rehabilitation program for the treatment of a wide spectrum of cardiovascular conditions have imposed to healthcare services a major attention on a critical analysis of the results in different clinical indications and delivery organisations. The Regional Health Agency of Liguria, in the occasion of drawing up regional guidelines directed to define the clinical indications and the effectiveness of the cardiac rehabilitation delivery model (in-patients, out-patients and home-based) and its requisites, indications and procedures, has updated the reference guidelines (PLNG and SIGN) with the evidence provided by the more recent literature, focusing its attention on the clinical and, in particular, organizational effectiveness. The document, on the base of these evidences, provides some effective proposals and some organizational advices.
Journal of the American College of Cardiology, 2010
Dronedarone is a new antiarrhythmic agent that was recently approved for the prevention of cardio... more Dronedarone is a new antiarrhythmic agent that was recently approved for the prevention of cardiovascular hospitalization driven by atrial fibrillation/flutter. Its approval was based largely on the results of the ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter) trial, which demonstrated a significant 24% reduction in the combined end point of all-cause mortality and cardiovascular hospitalization, primarily driven by the latter. However, several other clinical trials have evaluated the impact of dronedarone on various cardiovascular end points and yielded mixed results. In this article, we summarize the available evidence concerning dronedarone, and offer practical recommendations to health care providers regarding its use in the treatment of atrial fibrillation. We conclude that the available data support the use of dronedarone in select patient populations as a second-or third-line agent.
World Journal of Emergency Surgery : WJES, 2021
Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital ... more Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (IS...
Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of ... more Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients with non-compressible torso injuries and uncontrolled haemorrhagic shock were recently published. To date, the clinical evidence of the efficacy of REBOA is still debated. We aimed to conduct a systematic review assessing the clinical efficacy and safety of REBOA in patients with major trauma and uncontrolled haemorrhagic shock. Methods We systematically searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2020. All randomized controlled trials and observational studies that investigated the use of REBOA compared to resuscitative thoracotomy (RT) with/without REBOA or no-REBOA were eligible. We followed the PRISMA and MOOSE guidelines. Two authors independently extracted data and appraised the risk of bias of included studies. Effect sizes were pooled in a meta-analysis using random-effects models. The quality of evidence was assessed using the Grading o...
European Journal of Clinical Microbiology & Infectious Diseases, 1997
Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresi... more Fatty acid profile analysis, monoclonal antibody (MAb) subtyping, pulsed-field gel electrophoresis (PFGE), arbitrarily primed polymerase chain reaction (AP-PCR), and ribotyping were used to compare clinical and environmentalLegionella pneumophila serogroup 1 isolates from an outbreak of Legionnaires' disease presumptively associated with cooling towers. According to the Oxford subtyping scheme, the MAb subtype of patients' isolates and of two strains originating from a cooling tower was Pontiac, whereas the other isolates were subtype Olda. The strains showed no intrinsic strain-to-strain difference in fatty acid profiles, and ribotyping and length polymorphism of the 16S-23S rDNA intervening regions failed to reveal any differences between the isolates. Conversely, PFGE and AP-PCR appeared to be more discriminatory, as the same genomic profile was found for the clinical and some environmental strains. Meteorologic and epidemiological data and the results of molecular analysis of theLegionella pneumophila serogroup 1 isolates support the hypothesis that the infection was transmitted from one of the cooling towers to the indoor environment of the same building, to homes in proximity that had open windows, and to the streets. In fact, the outbreak diminished and later ended after a part in the tower was replaced. This investigation demonstrates the utility of combined molecular methods (i.e., phenotypic and genomic typing) in comparing epidemiologically linked clinical and environmental isolates. Finally, the outbreak confirms the risk of Legionnaires' disease posed by cooling towers, mainly when atmospheric thermal and humidity inversions occur. This finding emphasizes the need to determine whether the source of infection is in the living or working environment or somewhere else.
Lancet, 1998
... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awaren... more ... Punda-Polic and colleagues (Jan 17, p 188),1 about the need for control and increased awareness of visceral leishmaniasis in the Mediterranean area. ... References. 1 Punda-Polic V, Sardelic S, Bradaric N. Visceral leishmaniasis in southern Croatia.. Lancet 1998; 351: 188. ...
Journal of Pain and Symptom Management, 2002
The aims of this study were to quantify the prevalence of pain among hospitalized Italian patient... more The aims of this study were to quantify the prevalence of pain among hospitalized Italian patients and to describe the potential determinants of pain in this population. All patients older than 18 years and hospitalized for at least 24 hours in one of the 30 public hospitals of the Liguria region (n ϭ 4709) were eligible for pain assessment. Using the Brief Pain Inventory, patients with pain during the last 24 hours were asked to score the intensity of pain at the time of the interview, and the worst pain and average pain during the previous 24 hours on 0-10 rating scales. Overall, 87% (4121 / 4709) of inpatients were interviewed, and 56.6% suffered pain during the last 24 hours. Among patients with pain, the median (interquartile range) score of the worst and of the average pain during the last 24 hours was 7 (5-9) and 5 (3-6), respectively. At the time of interview, 43.1% evaluated patients suffered pain, with a median (interquartile range) of 5 (3-7). Although significant heterogeneity in the distribution of pain was observed among the hospitals, pain prevalence was unacceptably high in most cases. Age, sex, education, diagnosis, and days from surgery were significantly related to pain prevalence in univariate analyses. In a multivariable ordinal regression logistic analysis, only sex, diagnosis, days from surgery, and hospitals remain significantly associated with increased pain prevalence.