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Search Results: 1 - 10 of 48 matches for " Giustino Varrassi "
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Pain Management Techniques and Practice: New Approaches, Modifications of Techniques, and Future Directions
Andrea Trescot,Hans Hansen,Standiford Helm,Giustino Varrassi,Magdi Iskander
Anesthesiology Research and Practice , 2012, DOI: 10.1155/2012/239636
Tramadol Extended-Release for the Management of Pain due to Osteoarthritis
Chiara Angeletti,Cristiana Guetti,Antonella Paladini,Giustino Varrassi
ISRN Pain , 2013, DOI: 10.1155/2013/245346
Abstract: Current knowledge on pathogenesis of osteoarticular pain, as well as the consequent several, especially on the gastrointestinal, renal, and cardiovascular systems, side effects of NSAIDs, makes it difficult to perform an optimal management of this mixed typology of pain. This is especially observable in elderly patients, the most frequently affected by osteoarthritis (OA). Tramadol is an analgesic drug, the action of which has a twofold action. It has a weak affinity to mu opioid receptors and, at the same time, can result in inhibition of the reuptake of noradrenaline and serotonin in nociceptorial descending inhibitory control system. These two mechanisms, “opioidergic” and “nonopioidergic,” are the grounds for contrasting certain types of pain that are generally less responsive to opioids, such as neuropathic pain or mixed OA pain. The extended-release formulation of tramadol has good efficacy and tolerability and acts through a dosing schedule that allows a high level of patients compliance to therapies with a good recovery outcome for the patients' functional status. 1. Background Pain is the most common symptom of osteoarthritis (OA), and, as pain levels rise, patients experience a reduced range of motion with a consequent increase of disability [1]. Pain and function limitations substantially reduce the life quality of people affected by OA. The treatment planning for OA is designed to essentially provide pain relief, to prevent from complications such as muscle atrophy or joint deformities, and to maintain and/or improve the functional status with the final aim to produce a sensible life quality improvement [2]. The effectiveness of pain relief not only may result in a reduction of the intensity of pain itself but can also lead to an improvement of life aspects that are strictly related to pain. As has been widely documented, chronic persistent pain can sensibly reduce the health-related quality of life, causing reduced sleep, interference with social/family relationships [3], activity of daily living and productivity, and increased anxiety and depression [4]. There is, therefore, a general need for optimized pharmacologic treatment strategies in patients with chronic/persistent pain due to OA. A management strategy for such patients also should require individualized therapies that are able to ensure a positive risk/benefit profile. It should also provide analgesia outcomes covering an extended period of time. Tramadol is a centrally acting synthetic analgesic with two mechanisms of action. It involves weak -opioid receptors agonism and
Low Back Pain
Seiji Ohtori,Yasuchika Aoki,Gen Inoue,Laura S. Stone,Giustino Varrassi
Pain Research and Treatment , 2012, DOI: 10.1155/2012/165479
GlideScope and Frova Introducer for Difficult Airway Management
Alessandra Ciccozzi,Chiara Angeletti,Cristiana Guetti,Roberta Papola,Paolo Matteo Angeletti,Antonella Paladini,Giustino Varrassi,Franco Marinangeli
Case Reports in Anesthesiology , 2013, DOI: 10.1155/2013/717928
Abstract: The introduction into clinical practice of new tools for intubation as videolaringoscopia has dramatically improved the success rate of intubation and the work of anesthesiologists in what is considered the most delicate maneuver. Nevertheless intubation difficulties may also be encountered with good anatomical visualization of glottic structures in videolaringoscopia. To overcome the obstacles that may occur both in a difficult provided intubation such as those unexpected, associated endotracheal introducer able to facilitate the passage of the endotracheal tube through the vocal cords into the trachea may be useful. We report 4 cases of difficult intubation planned and unplanned and completed successfully using the GlideScope videolaryngoscope associated with endotracheal Frova introducer. 1. Introduction Difficult airway management is a major task for anesthesiologists [1, 2]. Failure in airway management indeed, is a major cause of mortality and morbidity in the setting of anesthesiology and intensive care units [3, 4]. The GlideScope (GS) is a videolaryngoscope (VLS), the last generation of intubation devices available in clinical practice in the last decade. GS provides an indirect airway view, improves the assessment of Cormack-Lehane score, and does not require a specific training [5, 6]. Recent studies underline the advantages of VLS in the management of predicted difficult airway [7, 8] as well as prehospital emergencies [9]. Unfortunately, the direct laryngeal view provided by VLS does not always assure the correct insertion of endotracheal tube (ETT), due to the 60-degree angle in the distal portion of GS blade, that tends to hamper the passage of the ETT from oropharynx to trachea. To facilitate the placement of the ETT, a rigid stylet shaped with the same angle as the blade, the GlideRite stylet (GRs), has been made up. Recently, the most suitable characteristics of the introducer have been largely debated: gum elastic bougie, rigid stylet, malleable stylet, and several experiences have been published with different endotracheal introducer utilized in combination with VLS to facilitate intubation maneuver [10–14]. We report our clinical experience in 4 patients, three characterized by potential and one by unexpected difficult intubation, in whom videolaryngo-GlideScope (VLGS) combined with Frova bougie has been used to facilitate endotracheal intubation. 2. Case??1 A 61-year-old woman (BMI: 22.6?kg/m2) was urgently admitted to the anesthesiological evaluation before undergoing the intervention of spinal decompression of cervical C3–C6
Pain after earthquake
Chiara Angeletti, Cristiana Guetti, Roberta Papola, Emiliano Petrucci, Maria Laura Ursini, Alessandra Ciccozzi, Francesca Masi, Maria Rosaria Russo, Salvatore Squarcione, Antonella Paladini, Joseph Pergolizzi, Robert Taylor, Giustino Varrassi, Franco Marinangeli
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-43
Abstract: This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009).958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy.A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions.This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations.
Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report
Giustino Parruti, Giuseppe Toro
BMC Infectious Diseases , 2005, DOI: 10.1186/1471-2334-5-80
Abstract: A 35 year old Caucasian HIV infected female developed severe diffuse lipodystrophy while on highly active antiretroviral therapy. A remarkable increase of breast size, fat accumulation at waist, and a fat pad on her lumbar spine were paralleled by progressive and disfiguring lipoatrophy of face, limbs and buttocks. The patient decided to interrupt her therapy after 20 months, with a stably suppressed viremia and a CD4 lymphocyte count >500/μL. She could carry on a safe treatment interruption for longer than 4 years. Most sites of fat accumulation switched to nearly normal appearance, whereas lipoatrophy was substantially unchanged at all affected sites.our observation provides pictorial evidence that lipoatrophy may not be reversible even under ideal circumstances. Therefore, strategies to prevent lipoatrophy should be considered when defining therapeutic regimens for HIV infected patients, especially those at high risk.HIV-infected patients on long-term highly active antiretroviral therapy (HAART) often present peculiar patterns of fat redistribution, involving both visceral and peripheral adipose tissue, referred to as lipodystrophy [1,2]. This complex condition was recognized shortly after the introduction of HAART; to date, however, it has been poorly elucidated in terms of pathogenesis [3,4]. Its main features are lipoatrophy of peripheral fat at face, limbs and buttocks, and/or fat accumulation at breasts, abdomen and the dorso-cervical region [3-5].Complex methods for objective measurements of fat deposits on affected sites involve the use of Dual-energy X-ray absorptiometry, Magnetic Resonance Tomography or CT scans. These methods, however, are costly and not always accessible in routine clinical practice. Moreover, they still lack adequate standardization, so that the diagnosis of lipodystrophy more frequently relies on concordant patient's and physician's evaluation [3-5].Cross sectional cohort studies indicate that lipodystrophy affects some 50% of patien
Fr?hlich electron-phonon vertex from first principles
Carla Verdi,Feliciano Giustino
Physics , 2015, DOI: 10.1103/PhysRevLett.115.176401
Abstract: We develop a method for calculating the electron-phonon vertex in polar semiconductors and insulators from first principles. The present formalism generalizes the Fr\"ohlich vertex to the case of anisotropic materials and multiple phonon branches, and can be used either as a post-processing correction to standard electron-phonon calculations, or in conjunction with {\it ab initio} interpolation based on maximally localized Wannier functions. We demonstrate this formalism by investigating the electron-phonon interactions in anatase TiO$_2$, and show that the polar vertex significantly reduces the electron lifetimes and enhances the anisotropy of the coupling. The present work enables {\it ab initio} calculations of carrier mobilities, lifetimes, mass enhancement, and pairing in polar materials.
Spectral Fingerprints of Electron-Plasmon Coupling
Fabio Caruso,Feliciano Giustino
Physics , 2015, DOI: 10.1103/PhysRevB.92.045123
Abstract: We investigate the spectroscopic fingerprints of electron-plasmon coupling in integrated (PES) and angle-resolved photoemission spectroscopy (ARPES). To account for electron-plasmon interactions at a reduced computational cost, we derived the plasmonic polaron model, an approach based on the cumulant expansion of many-body perturbation theory that circumvents the calculation of the GW self-energy. Through the plasmonic polaron model, we predict the complete spectral functions and the effects of electron-plasmon coupling for Si, Ge, GaAs, and diamond. Si, Ge, and GaAs exhibit well-defined plasmonic polaron band structures, i.e., broadened replica of the valence bands redshifted by the plasmon energy. Based on these results, (i) we assign the structures of the plasmon satellite of silicon (as revealed by PES experiments) to plasmonic Van Hove singularities occurring at the L, $\Omega$, and X high-symmetry points and (ii) we predict the ARPES signatures of electron-plasmon coupling for Si, Ge, GaAs, and diamond. Overall, the concept of plasmonic polaron bands emerges as a new paradigm for the interpretation of electronic processes in condensed matter, and the theoretical approach presented here provides a computationally affordable tool to explore its effect in a broad set of materials.
Cerebellopontine Angle Epidermoid Cyst: Case Report  [PDF]
Fabio Di Giustino, Rudi Pecci, Beatrice Giannoni, Paolo Vannucchi
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2013, DOI: 10.4236/ijohns.2013.21002
Abstract: Epidermoid cysts are rare congenital tumors of the central nervous system (CNS), histologically benign and slow- growing lesions. Their frequency among primitive intracranial tumors is about 1% and they account for 40% of all intracranial epidermoid of the cerebellopontine angle (CPA); there they constitute the third most frequent neoplasm (5%), after acoustic neuromas and meningiomas. We report the case of a patient with a paucisymptomatic epidermoid cyst of the CPA.
GW quasiparticle bandgaps of anatase TiO2 starting from DFT+U
Christopher E. Patrick,Feliciano Giustino
Physics , 2012, DOI: 10.1088/0953-8984/24/20/202201
Abstract: We investigate the quasiparticle band structure of anatase TiO2, a wide gap semiconductor widely employed in photovoltaics and photocatalysis. We obtain GW quasiparticle energies starting from density-functional theory (DFT) calculations including Hubbard U corrections. Using a simple iterative procedure we determine the value of the Hubbard parameter yielding a vanishing quasiparticle correction to the fundamental band gap of anatase TiO2. The band gap (3.3 eV) calculated using this optimal Hubbard parameter is smaller than the value obtained by applying many-body perturbation theory to standard DFT eigenstates and eigenvalues (3.7 eV). We extend our analysis to the rutile polymorph of TiO2 and reach similar conclusions. Our work highlights the role of the starting non-interacting Hamiltonian in the calculation of GW quasiparticle energies in TiO2, and suggests an optimal Hubbard parameter for future calculations.
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