Publications by authors named "Annarita Tullio"

Objectives: Out-of-hospital cardiac arrest (OHCA) presents significant regional variations in incidence, management, and survival rates. The Friuli-Venezia-Giulia (FVG) region in northeastern Italy has established a cardiac arrest registry to evaluate epidemiological trends and the effectiveness of its emergency medical service (EMS) interventions. This study analyses EMS-treated OHCAs over a three-year period, focusing on patient characteristics, resuscitation practices, and survival outcomes.

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Introduction: Inflammatory bowel disease (IBD) related arthritis is the most prevalent extraintestinal manifestation (EIM) of IBD, ranging between 10 and 39%. Magnetic resonance enterography (MRE) is used to assess small bowel disease involvement in Crohn's disease (CD) and can detect signs of sacroiliitis in up to 23.5% of patients.

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This work is the third in a series of articles dedicated to the EASY-NET network programme. The first article described the rationale, structure, and methodologies; while the second evaluated the adherence of individual audit&feedback A&F interventions tested in EASY-NET to literature recommendations. This contribution provides a concise summary of the effectiveness results of A&ented by clinical and organizational areas: chronic disease management, emergency territorial and hospital care for acute conditions, post-acute rehabilitation, hospital oncology care, childbirth, and caesarean sections.

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Article Synopsis
  • Lung ultrasonography (LUS) is a useful, non-invasive tool for diagnosing respiratory conditions, particularly in resource-limited settings, as it reduces radiation exposure and quantifies regional loss of aeration.
  • A study assessed the agreement among 20 experienced LUS operators by having them evaluate 25 video clips, revealing strong but not perfect inter-rater reliability, with varying levels of consensus on the scores assigned to the clips.
  • Despite some discrepancies, the findings indicate that LUS scoring can reliably inform severity assessments in respiratory diseases, making it a valuable clinical tool.
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Purpose: To test the inter-reader agreement in classifying pulmonary hypertension (PH) on chest contrast-enhanced computed tomography (CECT) between a consensus of two cardio-pulmonary-devoted radiologists (CRc) and inexperienced readers (radiology residents, RRs) when using a CECT-based quick hands-on tool built upon PH imaging literature, i.e., the "Rapid Access and Practical Information Digest on Computed Tomography for PH-RAPID-CT-PH".

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Background: Increasing work-related stress in academia can have an impact on physical and mental health. The aim of this study was to analyse the coping strategies of staff employed at the University of Udine and to verify whether sociodemographic data, professional position, and the presence of anxiety or depression symptoms are related to the use of different coping strategies.

Methods: We conducted a cross-sectional study between June and December 2020 using the Brief COPE questionnaire.

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Our study investigates the post-mortem findings of the diaphragm's muscular structural changes in mechanically ventilated COVID-19 patients. Diaphragm samples of the right side from 42 critically ill COVID-19 patients were analyzed and correlated with the type and length of mechanical ventilation (MV), ventilatory parameters, prone positioning, and use of sedative drugs. The mean number of fibers was 550±626.

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Objective: Subjects with subclinical psoriatic arthritis (PsA), defined as the presence of arthralgia in psoriasis (PsO), are at higher risk of PsA but scant real-world data exist. Our aims were to (1) estimate the probability of PsA development in subclinical PsA, (2) characterise subclinical PsA symptoms and (3) determine the clinical patterns at PsA diagnosis.

Methods: Patients with PsO, mainly subclinical PsA, were evaluated longitudinally in two European cohorts.

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  • Postoperative pulmonary complications remain a significant risk after esophagectomy, and this study explores the benefits of high flow nasal cannula (HFNC) compared to traditional oxygen therapy.
  • The study analyzed 71 cancer patients who underwent esophagectomy between May 2020 and November 2022, comparing those treated with HFNC to a historical cohort using conventional masks.
  • Results revealed that HFNC patients had significantly better ROX index scores and blood gas measurements, though both groups had similar rates of atelectasis and pneumonia; HFNC also showed a trend towards reduced acute respiratory failure.
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This is the second of a series of papers dedicated to the EASY-NET research programme (NET-2016-02364191). The rationale, structure and methodologies are described in the previous contribution. Scientific literature demonstrated that Audit & Feedback (A&F) is an effective strategy for continuous quality improvement and its effectiveness varies considerably according to factors that are currently little known.

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Clinical record (CR) is a tool for recording details about the patient and the most commonly used source of information for detecting adverse events (AEs). Its completeness is an indicator of the quality of care provided and may provide clues for improving professional practice. The primary aim of this study was to estimate the prevalence of AEs.

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Purpose: To describe the occurrence of gastrointestinal (GI) complications, specifically diarrhoea and constipation, in artificially (enterally or parenterally) fed critically ill patients within their first seven-day stay in Intensive Care Unit (ICU).

Methods: Observational prospective study conducted from September 1st to October 30th, 2019 and from August 1st to October 30th, 2021, in an ICU of a 1000-bed third-level hospital. General characteristics, nutritional variables, and medications administered were recorded and analysed.

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The COVID-19 global pandemic has changed considerably the way time-sensitive disorders are treated. Home isolation, people's fear of contracting the virus and hospital reorganisation have led to a significant decrease in contacts between citizens and the healthcare system, with an expected decrease in calls to the Emergency Medical Services (EMS) of the Friuli-Venezia Giulia (FVG) region. However, mortality in clinical emergencies like acute ST-elevation myocardial infarction (STEMI), stroke and out-of-hospital cardiopulmonary arrest (OHCA) remained high.

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Objective: This paper illustrates the results of a mono-institutional registry trial, aimed to test whether gastrointestinal (GI) and genitourinary (GU) toxicity rates were lower in localized prostate cancer patients treated with image-guided volumetric modulated arc therapy (IG-VMAT) compared to those treated with IG-3D conformal radiation therapy (IG-3DCRT). Materials and Methods: Histologically proven prostate cancer patients with organ-confined disease, treated between October 2008 and September 2014 with moderately hypofractionated radiotherapy, were reviewed. Fiducial markers were placed in the prostate gland by transrectal ultrasound guide.

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Objective: To test the inter-reader agreement in assessing lung disease extent, HRCT signs, and Radiological Society of North America (RSNA) categorization between a chest-devoted radiologist (CR) and two HRCT-naïve radiology residents (RR1 and RR2) after the latter attended a COVID-19-based chest high-resolution computed tomography (HRCT) "crash course".

Methods: The course was built by retrospective inclusion of 150 patients who underwent HRCT for COVID-19 pneumonia between November 2020 and January 2021. During a first 10-days-long "training phase", RR1 and RR2 read a pool of 100/150 HRCTs, receiving day-by-day access to CR reports as feedback.

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Article Synopsis
  • The study aimed to systematically review the literature on the effectiveness of musculoskeletal ultrasound in diagnosing and predicting outcomes for rheumatoid arthritis (RA) using a treat to target (T2T) approach.
  • After analyzing 4,632 records, it was found that ultrasound is better at predicting disease relapses compared to clinical examinations in patients who are in remission, although both methods are equally effective in evaluating therapy response and achieving remission.
  • Overall, ultrasound is crucial for assessing joint inflammation in RA and identifying patients at risk for relapse, but further research is required to clarify its role in T2T management strategies for RA.
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Objectives: Patients with Crohn's disease (CD) usually undergo magnetic resonance enterography (MRE) for evaluating small bowel involvement. Musculoskeletal symptoms are the most frequent extraintestinal manifestation in inflammatory bowel diseases, especially in CD, with sacroiliitis at imaging occurring in about 6-46% of patients and possibly correlating with axial spondyloarthritis. The primary study aim was to assess the prevalence of sacroiliitis in adult and pediatric patients with CD performing an MRE.

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Background: An assessment of viral load in biologic specimens of subjects with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may have important implications for public health planning. The aim of this study was to estimate the prevalence of high viral load in upper respiratory specimens of patients with SARS-CoV-2 infection during the first Italian wave (spring) and at the beginning of the second wave (summer) of the COVID-19 epidemic, through the measurement of cycle threshold (Ct) values from real-time reverse transcription-polymerase chain reaction tests conducted at the University Hospital of Udine, Italy, serving 530,000 inhabitants.

Methods: We compared the prevalence of high viral load, defined as Ct ≤ 20 at the first positive test result, in 262 subjects from the spring and 453 from the summer period.

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Objectives: Data on the long-term results with the standard CarboSeal™ mechanical conduit used for the modified Bentall procedure are lacking as well as information on performance of the Valsalva CarboSeal™ conduit.

Methods: We have analysed 208 recipients of a standard (n = 110) or a Valsalva (n = 98) CarboSeal™ conduit. The median age was 60 years and 90% were males; 35 (17%) had type A aortic dissection and 65 (30%) a bicuspid aortic valve.

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Objective: The aim of the study is to assess the performance of the DACTOS (DACtylitis glObal Sonographic) score in a PsA dactylitis clinical setting. In particular, we evaluated the ability of DACTOS to identify the affected fingers, its sensitivity to change after treatment, the correlations between DACTOS and clinical parameters, and the capacity of the score to identify the treatment responders.

Methods: Forty-six consecutive patients with symptomatic PsA hand dactylitis were enrolled.

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Objectives: We evaluated the long-term results of aortic root (AR) preservation and replacement in patients operated on for acute type A aortic dissection.

Methods: Out of 302 patients discharged after repair of acute aortic dissection (1977-2019), 124 patients had an AR ≥40 mm, which was preserved in 84 (68%, group A) patients and replaced in 40 (32%, group B) patients. Group B patients were younger (mean age 57 ± 12 vs 62 ± 11 years, P = 0.

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Salivary gland ultrasonography (SGUS) is increasingly applied for the management of primary Sjögren's syndrome (pSS). This study aims to: (i) compare the reliability between two SGUS scores; (ii) test the reliability among sonographers with different levels of experience. In the reliability exercise, two four-grade semi-quantitative SGUS scoring systems, namely De Vita et al.

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Article Synopsis
  • The study aimed to evaluate lacrimal gland (LG) ultrasounds in healthy individuals, identify sonographic lesions, and compare findings with primary Sjögren's syndrome (pSS) patients.
  • Researchers conducted ultrasound examinations on both healthy subjects and pSS patients while evaluating the agreement between four rheumatologists on their findings.
  • Results showed good to excellent reliability in assessments, with significant differences in glandular inhomogeneity and fibrous appearance between healthy individuals and pSS patients, suggesting these characteristics may aid in differentiating the two groups.
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Aims: The aim of this study was to investigate the epidemiology of histology-proven Neuroendocrine neoplasms (NENs) in an Italian area.

Background: NENs are a rare and poorly known disease and the global incidence and prevalence appear to be increasing over the past decades.

Objective: The objectives of this study were to estimate the incidence and trends of NENs in a 250,000-inhabitant area in the North-East of Italy in the 1998-2018 period and to compare them with international data.

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