SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to... more
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
Research Interests: Surgery, Neurosurgery, Vascular Surgery, Medicine, General Surgery, and 15 moreAnaesthesia, Pulmonary Embolism, Thromboembolism, Clinical Sciences, Cirugia, DVT Prevention, Odds ratio, Venous thromboembolism, Chirurgia, Neurosciences, Cirugía, Deep Venous Thrombosis, Chirurgie, Prospective Cohort Study, and CoVid
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international,... more
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
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Lo scopo di questo studio è stato quello di dimostrare se pazienti affetti da disfonia organica presentino alterazioni posturali caratteristiche e se lintervento di fonomicrochirurgia delle corde vocali determini modificazioni... more
Lo scopo di questo studio è stato quello di dimostrare se pazienti affetti da disfonia organica presentino alterazioni posturali caratteristiche e se lintervento di fonomicrochirurgia delle corde vocali determini modificazioni dellassetto posturale. Sono stati esaminati 40 soggetti (22 maschi, 18 femmine; età media 32,6 ± 7,5 anni) affetti da disfonia organica (15 polipi cordali, 11 cisti da ritenzione sottomucosa, 10 noduli vocali fibrosi bilaterali e 4 edema di Reinke). Lassetto posturale è stato studiato mediante stabilometria statica in respirazione spontanea, ad occhi aperti e ad occhi chiusi, in tre diverse fasi: prima dellintervento chirurgico, 24 ore dopo la chirurgia e 6 mesi dopo lintervento. Le variabili prese in considerazione sono state: le coordinate del centro di pressione sul piano frontale e sagittale, la lunghezza e la superficie della traccia, la velocità media delle oscillazioni e le relative deviazioni standard, lanalisi spettrale della frequenza di oscill...
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La malattia da reflusso faringo-laringeo, spesso abbreviata come RFL (in inglese LPR, Laryngo-Pharyngeal Reflux), è una malattia di interesse gastroenterologico che viene causata dal reflusso in faringe ed in laringe di gas contenuti... more
La malattia da reflusso faringo-laringeo, spesso abbreviata come RFL (in inglese LPR, Laryngo-Pharyngeal Reflux), è una malattia di interesse gastroenterologico che viene causata dal reflusso in faringe ed in laringe di gas contenuti nello stomaco. La reale incidenza di questa patologia non è univocamente determinabile. Recentemente, nella pratica clinica, sta prendendo forma il dubbio che tale patologia venga sovrastimata, in quanto ad essa vengono attribuiti sintomi talora di altra origine e di difficile interpretazione funzionale da parte dello specialista ORL. Lo scopo dello studio è stato quello di determinare quanti pazienti con sintomatologia ed obiettività compatibile con reflusso faringo-laringeo durante la visita ORL/Foniatrica, fossero realmente affetti da malattia da reflusso, e di valutare l'accuratezza diagnostica e la precisione della scala RSI (Reflux Symptom Index), sulla base delle proprietà psicometriche, mediante tecniche di scaling ottimale. Sono stati studi...
Objective; Neoplasm of accessory parotid glands are very rare, accounting for only 1% to 7.7% of all parotid gland tumors. External appproaches including parotidectomy or facelift incision are the recommended treatment, allowing a good... more
Objective; Neoplasm of accessory parotid glands are very rare, accounting for only 1% to 7.7% of all parotid gland tumors. External appproaches including parotidectomy or facelift incision are the recommended treatment, allowing a good control over the anterior facial nerve's branches and Stensen's duct, but they require a large flap elevation and leave an external scar. METHODS We report the case of a 76-year-old woman presented with a chief complaint of swelling in the right cheek. The patient underwent ultrasonography, FNAC and MRI which identified a subcutaneous mass over the anterior border of the masseter muscle. RESULTS An endoscopic-assisted transoral resection was performed, no postoperative complications were recorded. Final histology was consistent with pleomorphic adenoma. CONCLUSION In selected cases, the endoscope-assisted transoral approach allow accessory parotid mass excision with better cosmetic results if compared to the transcutaneous approach. Although not negligible, the risk of facial nerve injury is minimized under endoscopic magnification.
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Research Interests: Mathematics and Physics
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The relationship between voice and posture has been previously investigated. The aim of this study was to evaluate postural alterations in subjects with dysfunctional dysphonia and to analyse their variations after rehabilitation. Forty... more
The relationship between voice and posture has been previously investigated. The aim of this study was to evaluate postural alterations in subjects with dysfunctional dysphonia and to analyse their variations after rehabilitation. Forty subjects with hypokinetic dysfunctional dysphonia were submitted to posturographic analysis with alternatively open and closed eyes; subjects were invited to stand upright and breath normally so that the vestibular-spinal reflex could be assessed. The following variables were considered: pressure centre coordinates on frontal and sagittal planes and standard deviations (SD), length and surface of the tract, mean velocity of the oscillations and SD, spectral frequency analysis of oscillations, statokinesigram and stabilogram. At baseline, the parameters showing the highest alterations were surface and velocity SD. All parameters improved after rehabilitation, particularly SD(X) and SD(Y), surface, velocity and relative SD; the centre of pressure shift...
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Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to... more
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Research Interests: Surgery, Neurosurgery, Surgical Oncology, Medicine, General Surgery, and 15 moreVaccination, Cirugia, Oxford university, Carotid Endarterectomy, Chirurgia, Chronic Venous Disease, Aortic Surgery, Endovascular Surgery, Peripheral Arterial Disease, Cirugía, Chirurgie, Vascular and Endovascular Surgery, CoVid, Medical and Health Sciences, and Open varicose vein surgery
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To perform a retrospective evaluation of the incidence of complications and adverse events during fiberoptic endoscopic evaluation of swallowing (FEES) in 2,820 examinations. Subjects included in- and outpatients at Pisa University... more
To perform a retrospective evaluation of the incidence of complications and adverse events during fiberoptic endoscopic evaluation of swallowing (FEES) in 2,820 examinations. Subjects included in- and outpatients at Pisa University Hospital referred for FEES by other physicians due to dysphagia symptoms. Neurologic diseases were the most commonly diagnosed conditions in the patients tested (48.3%). Informed consent was obtained from all subjects. Our study showed minor side effects (discomfort, occasional gagging and vomiting) and a few complications [three cases of anterior epistaxis (0.1%), one case of posterior epistaxis (0.04%), three cases of vasovagal syncope (0.1%) and two cases of laryngospasm (0.07%)]. These cases of laryngospasm occurred in patients with amyotrophic lateral sclerosis (ALS) and spontaneously resolved after some difficulty. Our study confirms the published data regarding the safety of FEES and the incidence of complications with this procedure, but also high...