Marco Cascella

Marco Cascella
Istituto Nazionale Tumori "Fondazione Pascale" | IRCCS · Department of Anesthesia, Pain Medicine and Supportive Care

MD

About

249
Publications
103,351
Reads
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2,048
Citations
Additional affiliations
September 2010 - present
University of Naples Federico II
Position
  • Annual Professor of Physiology in the University Degree of Biomedical Laboratory Techniques
October 2004 - November 2015
Istituto Nazionale Tumori "Fondazione Pascale"
Position
  • Medical Doctor

Publications

Publications (249)
Article
Full-text available
The perioperative management of pediatric patients with psycho-physical disorders with related relational and cognitive problems must be carefully planned, in order to make the entire hospitalization process as comfortable and as less traumatic as possible. This article reports an overview of the anesthetic management of non-cooperative patients be...
Article
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Background: The most effective strategy for managing cancer pain remotely should be better defined. There is a need to identify those patients who require increased attention and calibrated follow-up programs. Methods: Machine learning (ML) models were developed using the data prospectively obtained from a single-center program of telemedicine-b...
Article
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In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality burden that has increased gradually over time, opioid overdose has significant morbidity with se-vere risks and side effects. As a result, opioid misu...
Article
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P53 tumour suppressor gene is our major barrier against neoplastic transformation. It is involved in many cellular functions, including cell cycle arrest, senescence, DNA repair, apoptosis, autophagy, cell metabolism, ferroptosis, immune system regulation, generation of reactive oxygen species, mitochondrial function, global regulation of gene expr...
Article
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Background: Since cancer pain requires complex modalities of care, the proper strategy for addressing its telemedicine-based management should be better defined. This study aimed to trace a pathway for a progressive implementation of the telemedicine process for the treatment of pain in the setting of cancer patients. Methods: The features of th...
Article
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Pain and nociception are different phenomena. Nociception is the result of complex activity in sensory pathways. On the other hand, pain is the effect of interactions between nociceptive processes, and cognition, emotions, as well as the social context of the individual. Alterations in the nociceptive route can have different genesis and affect the...
Article
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Background. It was previously reported that health care professionals working in the fields of anesthesiology and emergency are at higher risk of burnout. However, the correlations between burnout, alexithymia, and other psychological symptoms are poorly investigated. Furthermore, there is a lack of evidence on which risk factors, specific to the w...
Article
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Carcinogenesis is a multistep process that consists of the transformation of healthy cells into cancer cells. Such an alteration goes through various stages and is closely linked to random mutations of genes that have a key role in the neoplastic phenotype. During carcinogenesis, cancer cells acquire and exhibit several characteristics including su...
Article
Background: Retracted articles represent research withdrawn from the existing body of literature after publication. Research articles may be retracted for several reasons ranging from honest errors to intentional misconduct. They should not be used as reliable sources, and it is unclear why they are cited occasionally by other articles. This study...
Article
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Background: Randomised phase III clinical trials represent a methodological milestone to select effective drugs against metastatic cancers. In this context, and particularly in the efficacy assessment of biologic drugs, the initial metastatic tumour burden is a strong prognostic factor. Methods: A systematic literature review of randomised, phas...
Article
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In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the...
Article
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Although ketamine is primarily used for induction and maintenance of general anesthesia, it also presents sedative, amnestic, anesthetics, analgesic, antihyperalgesia, neuroprotective, anti-inflammatory, immunomodulant, and antidepressant effects. Its unique pharmacodynamics and pharmacokinetic properties allow the use of ketamine in various clinic...
Article
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This case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for small intestinal volvulus. Two continuous catheter s...
Preprint
Chemotherapy-induced peripheral neuropathy (CIPN) develops as a challenging nerve-damaging adverse effect of anticancer drugs used in chemotherapy. The disorder may require a dose reduction of chemo-therapy and its most common sensory symptoms are severe pain, tingling, and numbness in the hands and feet. CIPN affects dramatically the patient's qua...
Article
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Background: Juvenile primary fibromyalgia syndrome (JPFS) is a chronic musculoskeletal pain syndrome that affects children and adolescents. Methods: A VOSviewer-based bibliometric network analysis was performed by scanning the global literature on JPFS in the Web of Science (WOS) online database. The search string applied to identify the closest...
Article
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Background: In the Italian Campania Region, 30.517 new cases of solid cancer have been diagnosed, in 2019. Of those, patients with metastatic disease are up to 20%. This class of patients is extremely diversified and copious, and the offer of radiotherapy may vary in different geographical areas within the same region. The aim of this observationa...
Article
Full-text available
Background During and after general anaesthesia, opioids are commonly used for pain treatment. Since preclinical studies underlined the potential immunosuppressive activity of these drugs, it was postulated that their perioperative administration could influence cancer outcomes after surgery. Nevertheless, clinical data have been extrapolated mainl...
Article
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Objectives: Despite guidelines, a large percentage of cancer patients continue to suffer from ineffectively treated pain. The authors undertook this survey to assess the strengths and weaknesses of cancer pain management in Italy. Design: This was a prospectively administered survey. Participants: The participants were anesthesiologists of the...
Article
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The most frequent form of colorectal cancer is represented by adenocarcinoma being about 98% of tumor histological types. However, other rare histotypes can be found in colon and rectum (adenosquamous, goblet cell adenocarcinoma, lymphoma, medullary carcinoma, melanoma, mesenchymal, neuroendocrine, plasmacytoma, signet ring, squamous tumors). Altog...
Article
Background and objectives: Proper breakthrough cancer pain (BTcP) management is of pivotal importance. Although rapid-acting, oral and nasal transmucosal, fentanyl formulations (rapid-onset opioids, ROOs) are licensed for BTcP treatment, not all guidelines recommend their use. Presumably, some research gaps need to be bridged to produce solid evid...
Article
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Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide, becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of the virus. Furthermore, cancer patients (CPs) are a vulnerabl...
Chapter
Symptoms and signs of respiratory involvement characterize the clinical course of COVID-19. Nevertheless, potential extrapulmonary manifestations can occur, and certain symptoms can represent the first manifestation of the disease. They can manifest before fever and respiratory symptoms, or be the unique clinical manifestation of COVID-19. In turn,...
Chapter
Since the beginning of the coronavirus pandemic, clinicians and researchers have realized that COVID-19 is not just a respiratory disease. It is characterized by the potential occurrence of a wide range of clinical presentations with signs and symptoms suggestive of extrapulmonary involvement. In particular, the term neuro-COVID is used to indicate...
Chapter
The terms “Post-COVID” or “Long-COVID” refer to a variety of physical and psychological symptoms that continue for weeks or months beyond the initial illness or develop as new-onset clinical manifestations after resolving of the acute phase. Moreover, these signs and symptoms are collectively referred to as post-acute sequelae of SARS-CoV-2 infecti...
Chapter
The high incidence and the wide range of neurological complications found in COVID-19 patients should lead to early use of neuroimaging studies to better define the type and the extent of the damage. Furthermore, the clinical picture, supplemented by the neuroimaging findings and laboratory tests, could allow clinicians to identify the underlined c...
Book
This book underlines how COVID-19 is a multisystem inflammatory disease and how its pathophysiology can predispose to an increased risk of neurological issues. Several scientific pieces of evidence showes the mechanisms underlying the neuroinvasive capacity of the SARS-CoV-2 through direct viral damage and indirect processes entering the CNS by dif...
Chapter
A wide range of neurologic complications, including central neurotoxicity conditions and peripheral neurotoxicity, are associated with antineoplastic drug regimens. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe cancer treatment-related adverse effect, as well as the most diffuse type of neurotoxicity, becaus...
Article
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In older patients with comorbidities, hip fractures are both an important and debilitating condition. Since multimodal and multidisciplinary perioperativestrategies can hasten functional recovery after surgery improving clinicaloutcomes, the choice of the most effective and safest pathway represents a greatchallenge. A key point of concern is the a...
Article
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Due to a lack of published evidence on the topic, a modified Delphi approach was used to develop recommendations useful for chronic pain management during and after the COVID-19 pandemic. Focusing on the available literature and personal clinical expertise, an Italian board of nine professionals from different disciplines identified four main topic...
Article
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A 20-year-old man was admitted to the intensive care unit for septic shock due to Lemierre’s syndrome. It is a rare syndrome that manifests as an upper respiratory infection, although systemic involvement, severe coagulopathy, and multi-organ failure can dangerously complicate the clinical picture. In this syndrome, sepsis-related neuroendocrine dy...
Article
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Third-generation cephalosporins are medications used in the management and treatment of gram-negative and gram-positive organisms. They are encompassed among the beta-lactam class of drugs. This activity describes the indications, action, and contraindications for third-generation cephalosporins as a valuable agent in the management of gram-negativ...
Article
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Background: Tocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients. Methods: A multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days...
Article
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Background Fragmented data exist on the emotional and psychological distress generated by hospital admission during the pandemic in specific populations of patients, and no data exists on patients scheduled for surgery. The aim of this multicentre nationwide prospective cross-sectional survey was to evaluate the impact of pandemic on emotional stat...
Article
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Background. Among patients with diagnosis of Laryngeal Squamous Cell Carcinoma (LSCC), up to 37.5% of cases may have occult metastasis (OM), and this feature is linked to poor prognosis and high rate of local recurrence. The role of elective neck dissection (END) in clinically negative neck (cN0) LSCC remains controversial. It is of great value to...
Article
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Telemedicine represents a major opportunity to facilitate continued assistance for patients with chronic pain and improve their access to care. Preliminary data show that an improvement can be expected of the monitoring, treatment adherence, assessment of treatment effect including the emotional distress associated with pain. Moreover, this approac...
Article
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Background Emergence Delirium (ED) is a combination of disturbance of perception and psychomotor agitation that is common in pediatric patients after general anesthesia, especially at preschool age. Since the effect of ED on the length of stay has been studied in adults but infrequently in children, the aim of this study was to investigate the rela...
Article
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SARS-CoV-2 infection can impact the physical, cognitive, mental health of patients, especially in those recovered in intensive care units. Moreover, it was proved that the effects of the virus may persist for weeks or months. The term long-COVID or post-COVID syndrome is commonly used for indicating a variety of physical and psychological symptoms...
Article
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Background: Among the several therapeutic options assessed for the treatment of coronavirus disease 2019 (COVID-19), tocilizumab (TCZ), an antagonist of the interleukine-6 receptor, has emerged as a promising therapeutic choice, especially for the severe form of the disease. Proper synthesis of the available randomized clinical trials (RCTs) is ne...
Article
Oncologic emergencies are clinical situations that can lead to death in a short time (24-48 hours) if not quickly faced. In the clinical practice of the medical oncologist, such situations do not infrequently occur. The onset of oncologic emergencies may depend on the presence of cancer itself, the therapies carried out to counteract cancer, or the...
Article
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The present study was undertaken to analyse prognostic and genetic interactions between type 2 diabetes and metastatic colorectal cancer. Patients’ survival was depicted through the Kaplan–Meier product limit method. Prognostic factors were examined through the Cox proportional‐hazards regression model, and associations between diabetes and clinica...
Article
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Sabrina Bimonte,1,* Cira Antonietta Forte,1,* Massimiliano Cuomo,2 Gennaro Esposito,1 Marco Cascella,1 Arturo Cuomo1 1Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy; 2S.C. Project Management e Formazione, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy*Thes...
Article
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Background: Increased attention to the functional impact of chronic pain (CP), as highlighted by the 11th revision of the International Classification of Diseases (ICD-11) and advocated by the International Classification of Functioning, Disability and Health (ICF), is an important step forward for optimizing its management. Evidence about perspec...
Article
Propofol is a hypnotic alkylphenol derivative with many biological activities. It is predominantly used in anesthesia and is the most used parenteral anesthetic agent in the United States. Accumulating preclinical studies have shown that this compound may inhibit cancer recurrence and metastasis. Nevertheless, other investigations provided evidence...
Article
Background: Intraoperative dexmedetomidine can be useful for its sedative and analgesic sparing effects, and for the prevention of emergence delirium. Conversely, it can cause hypotension and bradycardia. The aim of this study was to assess the safety and efficacy of dexmedetomidine in pediatric anesthesia. Methods: This is a retrospective cohor...
Article
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Head and neck squamous cell carcinoma (HNSCC) is characterized by a high mortality rate owing to very few available oncological treatments. For many years, a combination of platinum-based chemotherapy and anti-EGFR antibody cetuximab has represented the only available option for first-line therapy. Recently, immunotherapy has been presented an alte...
Article
Full-text available
Breakthrough cancer pain (BTcP) is a temporary exacerbation of pain that “breaks through” a phase of adequate pain control by an opioid-based therapy. The non-predictable BTcP (NP-BTcP) is a subtype of BTcP that occurs in the absence of any specific activity. Since NP-BTcP has an important clinical impact, this analysis is aimed at characterizing t...
Article
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Anesthesiologists consider professional insurance and its medico-legal problems as a remarkable aspect of their job. “Associazione Anestesisti Rianimatori Ospedalieri Italiani—Emergenza ed Area Critica” (AAROI-EMAC) is the Italian professional association of anesthesiologists and intensivists that works to train its subscribers on safety measures....
Article
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Although the respiratory manifestations of COVID-19 are predominant, signs and symptoms of an extra-pulmonary involvement are usually encompassed among the clinical picture of the disease. Several painful manifestations can occur during the acute phase but also as short- or long-term complications. Myalgia, joint pain, sore throat, abdominal pain,...
Article
Full-text available
We studied acute and chronic pain in pediatric patients who underwent thoracotomy for benign disease with a follow-up of at least three months. A telephone interview investigated about the presence of pain and the analgesic therapy in progress. The results were compared with the anesthetic technique, postoperative pain and the adequacy of pain ther...
Preprint
Full-text available
Breakthrough cancer pain (BTcP) is a temporary exacerbation of pain that "breaks through" a phase of adequate pain control by an opioid-based therapy. The non-predictable BTcP (NP-BTcP) is a subtype of BTcP that occurs in the absence of any specific activity. Since NP-BTcP has an important clinical impact, this analysis is aimed at characterizing t...
Article
Full-text available
Nerve growth factor (NGF) belongs to the neurotrophin family and plays a fundamental role in the endurance of sensory and sympathetic neurons during embryogenesis. NGF, by interacting with tropomyosin receptor kinase A receptor (TrkA), modulates the pain pathway through the enhancement of the neurotrophic and nociceptor functions. Moreover, it has...
Article
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Context: Fraudulent publication is a scourge of scientific research. Objectives: This scoping review was aimed at characterizing retracted publications for fraud or plagiarism in the field of anesthesia. Does the reputation of the journal (Quartile and Impact Factor, IF) protect the reader from the risk of having the manuscript he read withdrawn fo...
Preprint
Full-text available
Background. In the Italian Campania Region, 30.517 new cases of solid cancer have been diagnosed, in 2019. Of those, patients with metastatic disease are up to 20%. This class of patients is extremely diversified and copious, and the offer of radiotherapy may vary in different geographical areas within the same region. The aim of this observational...
Book
This is a review article on Peripheral T-cell Lymphomas. We also framed 5 complex, multistep question on the topic at the end of the review.
Preprint
Full-text available
Background. In the Italian Campania Region, 30.517 new cases of solid cancer have been diagnosed, in 2019. Of those, patients with metastatic disease are up to 20%. This class of patients is extremely diversified and copious, and the offer of radiotherapy may vary in different geographical areas within the same region. The aim of this observational...
Chapter
Trigeminal neuralgia is one of the most severe forms of pain in the human experience. It is a chronic neuropathic disease characterized by recurrent attacks of lancinating facial pain occurring in the dermatomal distribution of the fifth cranial nerve. In most cases, the disorder affects only one side of the face. Trigeminal neuralgia is usually ca...
Article
Introduction : Ibuprofen is a drug widely used in children who underwent elective tonsillectomy or adenotonsillectomy because compared to the other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) it is considered a safe drug with a low risk of postoperative bleeding. Areas covered We conducted a systematic review with meta-analysis of randomized cli...
Article
Background : Within the history of intravenous anesthesia, barbiturates represent a chapter of considerable importance. Although the reference barbiturate thiopental had several limitations, it dominated the scene of the intravenous anesthesia until the mid-1980s, when propofol was introduced on the market. In the meantime, several barbiturate deri...
Article
Full-text available
The emergence from anesthesia is the stage of general anesthesia featuring the patient's progression from the unconsciousness status to wakefulness and restoration of consciousness. This complex process has precise neurobiology which differs from that of induction. Despite the medications commonly used in anesthesia allow recovery in a few minutes,...
Preprint
Full-text available
Background Opioids are commonly used for the treatment of cancer and non-cancer pain, and during and after general anesthesia. Because preclinical studies underlined a potential opioid-mediated immunosuppression, it was postulated that the perioperative administration of opioids could influence cancer outcomes after surgery. Nevertheless, clinical...
Article
Full-text available
Background Tocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients. Methods A multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days...
Article
Background: Pneumonia is the most frequent complication of COVID-19, due to an aberrant host immune response that is associated with an acute respiratory distress syndrome, and, in most critical patients, with a "cytokine storm". IL-6 might play a key role in the cytokine storm and might be a potential target to treat severe and critical COVID-19....