San Camillo-Forlanini Hospital Research Articles

Foreign bodies in the pediatric age: the experience of an Italian tertiary care hospital.

Foreign bodies in pediatric age represent an extremely frequent pathological condition and can undergo fearsome complications. Within the ENT area, foreign bodies in the pediatric age can be found in various districts such as external auditory canal, nasal passages, oral cavity, pharynx, larynx and trachea. They can be various and shape; generally, the main ones are buttons, beads, small parts of toys, caps of pens, pebbles, fragments of food bolus and others. As described in the literature, the main localizations are the external auditory canal and nasal cavities. Laryngeal and tracheal localization is infrequent but can be fatal. The aspiration of foreign bodies, mainly small parts of toys, occurs more frequently under three years age and mainly-especially in males. The experience of the ENT Department of the San Camillo-Forlanini Hospital in Rome, in the period between January 2007 and December 2018, consists a total of 1443 patients, aged between 0 and 14, who arrived in the emergency room with a foreign body diagnosis; of these, 613 (42.5%) were found with foreign body in the external auditory canal, 458 (31.7%) in nasal fossa, 298 (20.5%) in pharynx, 64 (4.4%) in oropharynx, and 10 (0.7%) in larynx and trachea. Treatment was in 1255 (87%) removal in the emergency room and home discharge, 79 (5.4%) with outpatient discharge, 40 (2.7%) need for hospitalization and surgery, 64 (4.4 %) refusal of hospitalization and 1 case (0.07%) died in the emergency room. (www.actabiomedica.it)

Improving operating room efficiency: an observational and multidimensional approach in the San Camillo-Forlanini Hospital, Rome

The management of operating rooms (ORs) is a complex process which requires an effective organizational scheme. In order to amore convinient allocation of resources a rigorous monitoring plan is needed to ensure operating rooms performances. All the necessary actions should be taken to improve the quality of the planning and scheduling procedure. Between April-December, 2016 an organizational analysis has been carried out on the performances of the A.O. S. Camillo-Forlanini Hospital Operating Block applying the "process management" approach to the ORs efficiency. The project involved two different surgical areas of the same operating block the multi-specialist and elective surgery and cardio-vascular surgery . The analyses of the processes was made through the product, patient and safety approach and from different points of view: the "asis", process and stakeholder perspectives. Descriptive statistics was used to process raw data and Student's t-distribution was used to assess the difference between the two means (significant p value ˂0,05). The Coefficient of Variation (CV) was used to describe the variabilityamong data. The asis approach allowed us to describe the ORs inbound activities. For both operating block the most demanding weekly commitments in terms of time turned out to be the inventory management procedures of controlling and stocking medicines, general medical supplies and instruments (130[DS=±14] for BOE and 30[DS=±18] for CCH. The average time spent on preparing the operating room, separately calculated starting from the first surgical case, was of 27 minutes (SD=± 17) while for the following surgical procedures preparation time decreased to 15 minutes (SD= ± 10), which highlighted a meaningful difference of 12 minutes. A great variability was registered in CCH due to the unpredictability of these operations (CV 82%). The stakeholders' perspective revealed a reasonable level of satisfaction among nurses and surgeons (2.9 vs 2.3, respectively) and in anesthesiologist (2.8-BOE vs 2.4 CCH).Being brought to the surgical suite from an "external Unit" seems to have negatively influenced the patient's perception: preparation time turned out to be significantly lower for CCH patients rather than BOE ones (p˂0,001).The results of the safety procedure approach highlighted a moderate criticality in terms of cleaning up time and delay in the starting time of the first surgical case. More effort should be made to avoid any slowdown during the whole process. It is advisable to implement a lean system that may improve efficiency and quality of the service to reduce wastes and unproductive times. This would inevitably generate a more positive outcomes.

Sharing information about cancer with one's family is associated with improved quality of life.

The aim of this study was to investigate the association between cancer patients' ability to share information about their illness with their social network and attachment style dimensions, alexithymia, and quality of life. We hypothesised that ability to share information about one's cancer with family, friends, and medical teams would be positively associated with quality of life and secure attachment and negatively associated with alexithymia. Forty-five cancer patients were recruited from the Psycho-oncology Unit of the San Camillo-Forlanini Hospital in Rome. We collected anamnestic data and self-report data on social sharing ability, quality of life, alexithymia, and attachment. Sharing with family (B=4.66; SE=1.82; β=.52; SE=0.20; t(41)=2.6; P=.0143) was the only predictor of global health status, and attachment security was the only predictor of mean social sharing (B=0.25; SE=0.06; β=.63; SE=0.14; t(41)=4.4; P<.0001). Encouraging patients to share information about their experience of cancer may help to improve their quality of life. Attachment security seems to promote social sharing. Psychological assessments of cancer patients should cover both ability to share information about one's cancer with family and attachment security.

Transient Ischemic Attack Fast-track and Long-Term Stroke Risk: Role of Diffusion-Weighted Magnetic Resonance Imaging

Acute ischemic lesions on diffusion-weighted magnetic resonance imaging (DWI-MRI) are reliable predictors of recurrent stroke at 90 days. However, to date, limited information on transient ischemic attack (TIA) patients with positive DWI lesions for stroke risk from 1 to 5 years is available. In this study, we evaluated the role of positive DWI lesions and vascular risk factors on stroke, cardiovascular death, and mortality at 90 days (T0), 1 year (T1), and 5 years (T2). Moreover, we also evaluated the association between stroke risk and the presence of DWI lesions. We performed an observational study on consecutive patients admitted to the emergency department of San Camillo-Forlanini Hospital, Rome, Italy, from January 2007 to November 2012. Over the study period, 4300 patients with TIA or ischemic stroke were examined by stroke specialists in an emergency room setting within 1 hour from admittance. In 510 of 4300 patients (11.86%), a TIA was diagnosed, and 445 patients satisfy the study inclusion criteria. For all 445 patients, the mean ABCD2 score was 4.35 ± 1.30. Using DWI-MRI, we identified acute ischemic lesions in 185 patients (41.57%). We did not observe any correlation between duration of symptoms, ABCD2 score, and positive or negative DWI lesions. Positivity for DWI was not associated with the presence of diabetes mellitus, hypertension, smoking habit, or age; however, an association with weakness was observed. We documented a time-dependent increase in the absolute risk of stroke: T0: 1.35% (95% confidence interval [CI], .81-2.8); T1: 4.78% (95% CI, 2.88-7.47); T2: 9.02% (95% CI, 4.66-5.70). We did not record any difference in stroke risk in patients with positive DWI lesions: T0: hazard ratio [HR], 1.43; 95% CI, .35-5.88; log-rank P = .60; T1: HR, 1.04; 95%CI, .42-2.61; log-rank P = .91; T2: HR, .83; 95% CI, .25-2.67; log-rank P = .86. This long-term follow-up study in TIA patients documents that both positive and negative DWI patients treated with fast-track had similar long-term risks of stroke.

Deliveries and induced abortions at the San Camillo-Forlanini Hospital, Rome, Italy

A descriptive analysis of deliveries and induced abortions between 2000 and 2012 at San Camillo Forlanini Hospital in Rome has been performed. About 20% of deliveries and 50% of abortions concerned foreigners from countries at high migration levels. Comparing the characteristics between Italian and foreign women Authors point out a median age at first delivery higher for Italian women, even if recently both Italian and foreign women tend to have babies later. Caesarean sections are more frequent among Italian women. Deliveries among very young women are more common for foreigners and for less educated people. Different patterns seem to characterize induced abortions among Italian and foreign women. The former tend to be young and single the latter older and married. The results suggest the opportunity of carrying out educational intervention addressed especially to young foreign women.

The story of San Camillo-Forlanini Hospital

Aim of this article is to present the history of San Camillo-Forlanini Hospital in Rome. It includes two of the most important and well-known hospitals in the capital: the San Camillo, where the almost of diseases are cared and the Carlo Forlanini hospital, primarily engaged in pulmonology. The article is divided in two part that treat separately the history and evolution of the two hospitals. They still today constitute one of the centers of the largest and most reputable care of the Lazio region and, generally, of the Italian context.

Towards a re‐thinking of the clinical significance of generalized joint hypermobility, joint hypermobiity syndrome, and Ehlers‐Danlos syndrome, hypermobility type

American Journal of Medical Genetics Part AVolume 164, Issue 3 p. 588-590 Invited Comment Towards a re-thinking of the clinical significance of generalized joint hypermobility, joint hypermobiity syndrome, and Ehlers-Danlos syndrome, hypermobility type Marco Castori, Corresponding Author Marco Castori Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy Correspondence to: Marco Castori, M.D., Ph.D., Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87 00152 Rome, Italy. E-mail: [email protected]Search for more papers by this authorSilvia Morlino, Silvia Morlino Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, ItalySearch for more papers by this authorPaola Grammatico, Paola Grammatico Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, ItalySearch for more papers by this author Marco Castori, Corresponding Author Marco Castori Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy Correspondence to: Marco Castori, M.D., Ph.D., Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87 00152 Rome, Italy. E-mail: [email protected]Search for more papers by this authorSilvia Morlino, Silvia Morlino Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, ItalySearch for more papers by this authorPaola Grammatico, Paola Grammatico Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, ItalySearch for more papers by this author First published: 06 February 2014 https://doi.org/10.1002/ajmg.a.36437Citations: 8 All authors declare that there is no conflict of interest concerning this work. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume164, Issue3March 2014Pages 588-590 RelatedInformation

Screening for celiac disease in the joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type

Screening for Celiac Disease in the Joint Hypermobility Syndrome/Ehlers–Danlos Syndrome Hypermobility Type Chiara Danese, Marco Castori,* Claudia Celletti, Silvia Amato, Caterina Lo Russo, Paola Grammatico, and Filippo Camerota Department of Clinical Science, Sapienza University, Umberto I Hospital, Rome, Italy Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy Department of Physical Medicine and Rehabilitation, Sapienza University, Umberto I Hospital, Rome, Italy

Ehlers–Danlos syndrome hypermobility type and the excess of affected females: Possible mechanisms and perspectives

Ehlers–Danlos Syndrome Hypermobility Type and the Excess of Affected Females: Possible Mechanisms and Perspectives Marco Castori,* Filippo Camerota, Claudia Celletti, Paola Grammatico, and Luca Padua Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy Physical Medicine and Rehabilitation Division, Sapienza University, Umberto I Hospital, Rome, Italy Don Carlo Gnocchi Onlus Foundation, Milan, Italy Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy

Novel approaches for the surgical treatment of atrial fibrillation: Time for a guideline revision?

Atrial fibrillation is a major health problem in Western countries, and is associated with considerable morbidity and resource consumption. Safe and reliable surgical techniques for the termination of this arrhythmia have been developed since the time of the original Cox "maze I" procedure. Novel equipment based on radiofrequency and microwave technologies can be employed to create transmural atrial lesions, even in the context of minimally invasive surgery to the atrioventricular valves via right minithoracotomy. The aim of this paper is to review the recent literature on this approach, and the clinical results in terms of arrhythmia termination and postoperative morbidity. With the aim to substantiate the practice of a simple, yet reliable, surgical ablation during minimally invasive heart valve surgery, we discuss the results of different patterns of atrial lesions having different degrees of surgical complexity. Finally, minimally invasive epicardial ablation for lone atrial fibrillation represents an emerging surgical indication. The results of state-of-the-art transcatheter ablation represent now its benchmark of comparison.

The protocol for infancy and adolescence of the SAIFIP, San Camillo-Forlanini Hospital Complex, Rome, Italy

The here-expressed considerations of the authors are based on their own personal work experience as members of the interdisciplinary team of the Servizio di Adeguamento tra Identita Fisica e Identita Psichica - SAIFI P - (Centre for the treatment of gender identity disorders and sex-reassignment therapy) operating within the framework of the Reconstructive and Plastic Surgery Unit at the San Camillo-Forlanini Hospital Complex in Rome, Italy since 1992. The SAIFIP team has set up a protocol that offers, within the Italian National Government Healthcare Plan, integrated and interdisciplinary clinical services for persons affected by gender identity disorders that lay emphasis on the psychological, medical-surgical and social-legal aspects implied in the process of sex-reassignment therapy. Said protocol originates from the indispensable integration and coordination of the various reference theories and their models which form the training basis of the various healthcare providers and from the absolute necessity to organize the various therapeutic procedures (endocrinology therapy, surgery, counselling, psychotherapy, sociotherapy) in synchronization with the patient, with his/her family and with his/her extended ecosystem. During recent years, there has been an increase in the demand for aid both on the part of adolescents and children with problems related to gender identity, and children of individuals with gender identity disturbances. These conditions would appear to co-exist along with a state of acute intra-psychic and relational suffering, often linked to behavioral and emotional difficulty. Subsequently, an ad hoc area to deal with children and adolescents has been created within SAIFIP.