Sandra Magnoni

• Bachelor of Medicine
• Medical Doctor at Santa Chiara Hospital

To evaluate the clinical practice and timing of use of tier-three therapies (TTT) after traumatic brain injury (TBI), and to explore their association with intensive care unit (ICU) mortality and 3 months neurological outcome. International multicenter, retrospective, observational, cohort study performed in 16 ICUs including 408 adult TBI patients...

Background and Objectives Severe Traumatic Brain Injury (TBI) is associated with secondary injury and poor outcomes, but the underlying mechanisms are poorly understood. Vascular mechanisms may be important. We aimed to characterise how blood vascular endothelial growth factor A (VEGF-A) levels are affected by TBI, and its associations with seconda...

Acute brain injuries (ABIs) pose a significant global health challenge, characterized by a high incidence of overall mortality and the potential for long-term neurological disabilities. The trajectory of ABI involves primary injury and a cascade of systemic and local events leading to secondary injury. The brain, a vital regulator of metabolic acti...

Pathophysiology and outcomes after Traumatic Brain Injury (TBI) are complex and heterogenous. Current classifications are uninformative about pathophysiology. Proteomic approaches with fluid-based biomarkers are ideal for exploring complex disease mechanisms, as they enable sensitive assessment of an expansive range of processes potentially relevan...

Pathophysiology and outcomes after Traumatic Brain Injury (TBI) are complex and highly heterogenous. Current classifications are uninformative about pathophysiology, which limits prognostication and treatment. Fluid-based biomarkers can identify pathways and proteins relevant to TBI pathophysiology. Proteomic approaches are well suited to exploring...

Background Traumatic brain injury (TBI) is associated with the tauopathies Alzheimer’s disease and chronic traumatic encephalopathy. Advanced immunoassays show significant elevations in plasma total tau (t-tau) early post-TBI, but concentrations subsequently normalise rapidly. Tau phosphorylated at serine-181 (p-tau181) is a well-validated Alzheime...

Introduction A significant environmental risk factor for neurodegenerative disease is traumatic brain injury (TBI). However, it is not clear how TBI results in ongoing chronic neurodegeneration. Animal studies show that systemic inflammation is signalled to the brain. This can result in sustained and aggressive microglial activation, which in turn...

Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all...

Background: Investigating the health-related quality of life (HRQoL) after intensive care unit (ICU) discharge is necessary to identify possible modifiable risk factors. The primary aim of this study was to investigate the HRQoL in COVID-19 critically ill patients one year after ICU discharge. Methods: In this multicenter prospective observation...

Purpose Assess long-term quality of life (HR-QoL) and socio-economic impact in COVID-19-related ARDS (C-ARDS) survivors. Methods C-ARDS survivors were followed up at 6 months in this prospective, cohort study. HR-QoL was assessed using SF-36 and EQ-5D-5L, and the socio-economic burden of COVID-19 was evaluated with a dedicated questionnaire. Clini...

Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive ca...

Following traumatic brain injury (TBI), cerebral metabolic dysfunction, characterized by an elevated cerebral microdialysis (CMD) lactate/pyruvate (LP) ratio, is associated with poor outcome. However, the exact pathophysiological mechanisms underlying this association are not entirely established. In this pre-planned analysis of the BIOmarkers of A...

Background: Recent reports of patients with severe, late-stage COVID-19 ARDS with reduced respiratory system compliance described paradoxical decreases in plateau pressure and increases in respiratory system compliance in response to anterior chest wall loading. We aimed to assess the effect of chest wall loading during supine and prone position i...

Background Outcomes after traumatic brain injury (TBI) are variable and frequently poor. Axonal injury is considered a significant determinant of outcome, which may be quantified using novel fluid biomark- ers and advanced MRI. Methods BIO-AX-TBI is a multi-centre cohort study of acute moderate-severe TBI. Patients underwent clinical and blood bio...

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Background TBI is an environmental risk factor for the development of dementia. Axonal injury is thought be a significant determinant of clinical outcomes post‐injury, which can now be assessed using novel techniques such as fluid biomarkers including plasma neurofilament light and advanced MRI assessment. Method BIO‐AX‐TBI (Developing and Validat...

Axonal injury is a key determinant of long-term outcomes after traumatic brain injury (TBI) but has been difficult to measure clinically. Fluid biomarker assays can now sensitively quantify neuronal proteins in blood. Axonal components such as neurofilament light (NfL) potentially provide a diagnostic measure of injury. In the multicenter BIO-AX-TB...

Introduction Limited evidence exists on the health-related quality of life and the socio-economic impact of disease in critically-ill, COVID-19 survivors. Aims of this study were to: assess the quality of life of survivors after ICU discharge; identify social and disease-related risk factors for long-term health consequences; recognize changes in r...

Introduction: Critical illness from SARS-CoV-2 infection (COVID-19) is associated with a high burden of pulmonary embolism (PE) and thromboembolic events despite standard thromboprophylaxis. Available guidance is discordant, ranging from standard care to the use of therapeutic anticoagulation for enhanced thromboprophylaxis (ET). Local ET protocol...

Purpose The COVID-19-related shortage of ICU beds magnified the need of tools to properly titrate the ventilator assistance. We investigated whether bedside-available indices such as the ultrasonographic changes in diaphragm thickening ratio (TR) and the tidal swing in central venous pressure (ΔCVP) are reliable estimates of inspiratory effort, ass...

Introduction and aims Traumatic brain injury (TBI) often results in persistent disability, due particularly to cognitive impairments. Outcomes remain difficult to predict but appear to relate to axonal injury. Several new approaches involving fluid and neuroimaging biomarkers show promise to sensitively quantify axonal injury. By assessing these lo...

Introduction and aims: Traumatic brain injury (TBI) often results in persistent disability, due particularly to cognitive impairments. Outcomes remain difficult to predict but appear to relate to axonal injury. Several new approaches involving fluid and neuroimaging biomarkers show promise to sensitively quantify axonal injury. By assessing these l...

Background: Whilst there has been progress in supportive treatment for traumatic brain injury (TBI), specific neuro- protective interventions are lacking. Models of ischaemic heart and brain injury show the therapeutic potential of argon gas, but it is still not known whether inhaled argon (iAr) is protective in TBI. We tested the effects of acute...

The company ADAM (Application of Detectors and Accelerators to Medicine), a CERN spin-off, is working on the construction and testing of its first linear accelerator for medical application: LIGHT (Linac for Image-Guided Hadron Therapy). LIGHT is an innovative high frequency proton linac designed to accelerate proton beams up to 230 MeV for proton...

Background: Near-infrared spectroscopy, a non-invasive technique for monitoring cerebral oxygenation, is widely used, but its accuracy is questioned because of the possibility of extra-cranial contamination. Ultrasound-tagged near-infrared spectroscopy (UT-NIRS) has been proposed as an improvement over previous methods. We investigated UT-NIRS in...

The Compact Linear Collider (CLIC) is a TeV-scale high-luminosity linear e+e− collider under development at CERN. Following the CLIC conceptual design published in 2012, this report provides an overview of the CLIC project, its current status, and future developments. It presents the CLIC physics potential and reports on design, technology, and imp...

Traumatic brain injury (TBI) is understood as an interplay between the initial injury, subsequent secondary injuries, and a complex host response all of which are highly heterogeneous. An understanding of the underlying biology suggests a number of windows where mechanistically inspired interventions could be targeted. Unfortunately, biologically p...

Traumatic brain injury (TBI) is understood as an interplay between the initial injury, subsequent secondary injuries, and a complex host response all of which are highly heterogeneous. An understanding of the underlying biology suggests a number of windows where mechanistically inspired interventions could be targeted. Unfortunately, biologically p...

Neuroprotection after traumatic brain injury (TBI) is an important goal pursued strenuously in the last 30 years. The acute cerebral injury triggers a cascade of biochemical events that may worsen the integrity, function, and connectivity of the brain cells and decrease the chance of functional recovery. A number of molecules acting against this de...

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

A1154 Principal features in potsurgical patients with multidrug-resistant organisms isolation, acquired before the admission at the intensive care unit. G.E. Kaminsky, R. Carreño, A. Escribá, M. Fuentes, V. Gálvez, R. Del Olmo, B. Nieto, C. Vaquerizo, J. Alvarez, M.A. De la Torre, E. Torres. Hospital Universitario de Fuenlabrada, Intensive Care Un...

A772 Effects of lipid emulsions based on n-3 polyunsaturated fatty acids on metabolic and infectious complications compared with MCT/LCT lipid emulsion in critically ill patients receiving parenteral nutrition R. del Olmo1, M.J. Esteban2, C. Vaquerizo3, R. Carreño3, V. Gálvez3, G. Kaminsky3, B. Nieto3, M. Fuentes3, M.A. De la Torre3, E. Torres3, A...

Prognostic models for traumatic brain injury (TBI) are important tools both in clinical practice and research, if properly validated, preferably by external validation. Prognostic models offer also the possibility of monitoring performance, by comparing predicted to observed outcomes. In this study we applied the prognostic models developed by the...

Background: Therapeutic hypothermia (i.e., temperature management) is an effective option for improving survival and neurological outcome after cardiac arrest and is potentially useful for the care of the critically ill neurological patient. We analyzed the feasibility of a device to control the temperature of the brain by controlling the temperat...

Introduction: Intracranial pressure (ICP) measurement is used to tailor interventions and to assist in formulating the prognosis for traumatic brain injury patients. Accurate data are therefore essential. The aim of this study was to verify the accuracy of ICP monitoring systems on the basis of a literature review. Methods: A PubMed search was c...

Microdialysis enables the chemistry of the extracellular interstitial space to be monitored. Use of this technique in patients with acute brain injury has increased our understanding of the pathophysiology of several acute neurological disorders. In 2004, a consensus document on the clinical application of cerebral microdialysis was published. Sinc...

The great majority of acute brain injury results from trauma or from disorders of the cerebrovasculature, i.e. ischaemic stroke or haemorrhage. These injuries are characterized by an initial insult that triggers a cascade of injurious cellular processes. The nature of these processes in spontaneous intracranial haemorrhage is poorly understood. Sub...

Axonal injury is a major contributor to adverse outcomes following brain trauma. However, the extent of axonal injury cannot currently be assessed reliably in living humans. Here, we used two experimental methods with distinct noise sources and limitations in the same cohort of 15 patients with severe traumatic brain injury to assess axonal injury....

Jugular oxygen saturation monitoring was introduced in neurointensive care after severe traumatic brain injury (TBI) to explore the adequacy of brain perfusion and guide therapeutic interventions. The brain was considered homogeneous, and oxygen saturation was taken as representative of the whole organ. We investigated whether venous outflow from t...

CLIC is a world-wide collaboration to study the next ``terascale'' lepton collider, relying upon a very innovative concept of two-beam-acceleration. This accelerator, currently under study, will be composed of the subsequence of 21000 two-beam-modules. Each module requires more than 300 analogue and digital signals which need to be acquired and con...

Background: The identification of risk factors associated with perioperative seizures would be of great benefit to the anesthesiologist in managing brain tumor patients undergoing craniotomy with intraoperative brain mapping. Methods: A series of 316 supratentorial craniotomies for tumor resection, in which intraoperative brain mapping was used,...

The Compact Linear Collider (CLIC) is an e+/e- collider based on the two-beam acceleration principle, proposed to support precision high-energy physics experiments in the energy range 0.5-3 TeV [1]. To achieve a high luminosity of up to 6×1034cm-2s-1, the transport and preservation of a low emittance beam is mandatory. A large number and great vari...

Traumatic axonal injury (TAI) is a major contributor to adverse outcomes following traumatic brain injury (TBI). Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique, which provides a robust measure of white matter integrity in patients with TBI. Certain brain regions have been identified as particularly susceptible to TAI by me...

Introduction: Posterior reversible encephalopathy syndrome (PRES) is a largely reversible disease with long-term favorable outcome. A minority of patients, however, may develop progressive cerebral edema and ischemia resulting in severe disability or death. We report a case of severe intracranial hypertension associated with PRES that was successf...

Microthrombosis has been demonstrated in early and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH). Markers of coagulation activation as microparticles (MPs) are an established risk factor for thrombosis. Our hypothesis was that levels of microparticles might correlate with aSAH severity, early cerebral ischemia (ECI) and...

Background / Purpose: Early and delayed cognitive dysfunctions are an understudied issue after aneurismal subarachnoid hemorrage (aSAH).The aim of this study is to describe early and late changes after aSAH in terms of cognitive functions, activities of everyday life and quality of life. Main conclusion: Cognitive dysfunction has different tim...

To clarify the dynamics of glucose delivery to the brain and the effects of changes in blood glucose after severe traumatic brain injury. Retrospective analysis of a prospective observational cohort study. Neurosurgical intensive care unit of a university hospital. Seventeen patients with acute traumatic brain injury monitored with cerebral and sub...

Axonal injury is believed to be a major determinant of adverse outcomes following traumatic brain injury. However, it has been difficult to assess acutely the severity of axonal injury in human traumatic brain injury patients. We hypothesized that microdialysis-based measurements of the brain extracellular fluid levels of tau and neurofilament ligh...

The links between traumatic brain injury and Alzheimer disease have been of great interest for many years. However, the importance of amyloid-β-related neurodegenerative pathophysiologic processes after traumatic brain injury is still unknown. In this review, we present a brief overview of the scientific evidence regarding traumatic brain injury as...

There is no general consensus about the best anesthesiologic approach to use during craniotomies with intraoperative brain mapping, and large prospective studies evaluating the complications associated with different approaches are lacking. Objective of this study was to prospectively collect and evaluate data about a large series of consecutive as...

The amyloid-beta peptide (Abeta) plays a central pathophysiological role in Alzheimer's disease, but virtually nothing is known about the concentration and dynamics of this secreted peptide in the extracellular space of the human brain. We used intracerebral microdialysis to obtain serial brain interstitial fluid (ISF) samples in 18 patients who we...

The amyloid-β peptide (Aβ) plays a central pathophysiological role in Alzheimer's disease, but little is known about the concentration and dynamics of this secreted peptide in the extracellular space of the human brain. We used intracerebral microdialysis to obtain serial brain interstitial fluid (ISF) samples in 18 patients who were undergoing inv...

This review focuses on the potential application of hypothermia in adults suffering traumatic brain injury (TBI). Hypothermia is neuroprotective, reducing the damaging effects of trauma to the brain in a variety of experimental situations, such as brain ischemia and brain injury, but it has failed to demonstrate outcome improvement in a major contr...

We compared brain tissue oxygen tension (PtiO2) measured in peri-focal and in normal-appearing brain parenchyma on computerized tomography (CT) in patients following traumatic brain injury (TBI). Prospective observational study. Neurointensive care unit. Thirty-two consecutive TBI patients were subjected to PtiO2 monitoring. Peri-focal tissue was i...

Gene therapy may be a promising approach for treatment of brain ischemia. We and others previously demonstrated that increased activity of matrix metalloproteinases (MMPs) contributes to the tissue damage that results from ischemic injury. The proteolysis of MMPs is tightly controlled by tissue inhibitors of MMPs (TIMPs). In this study, we examined...

Apolipoprotein E (apoE, protein; APOE, gene) is the major lipid-transport protein in the brain and plays an important role in modulating the outcome and regenerative processes after acute brain injury. The aim of the present study was to determine if gene transfer of the epsilon3 form of APOE improves outcome in a murine model of transient focal ce...

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Postischaemic pyrexia exacerbates neuronal damage. Hyperthermia related cerebral changes have still not been well investigated in humans. To study how pyrexia affects neurochemistry and cerebral oxygenation after acute brain injury. 18 acutely brain injured patients were studied at the onset and resolution of febrile episodes (brain temperature > o...

Abnormal expression and activity of matrix metalloproteinases (MMPs) may contribute to the pathophysiology of cerebral disease such as ischemic injury. In this study, we compared the cellular localization, expression, and activity of MMP-2 and -9 in relation to the evolution of neuronal damage 24 and 72 h after transient global ischemia. In respons...

This study investigated AJDO2 (arterio-jugular difference of oxygen content) in a large sample of severely head-injured patients to identify its pattern during the first days after injury and to describe the relationship of AJDO2 with acute neurological severity and with outcome 6 mo after trauma. In 229 comatose head-injured patients, we monitored...

Clinical and experimental studies have shown a reduction of cerebral blood flow (CBF) and metabolic alterations following traumatic brain injury (TBI). The incidence of ischemia and the meaning of post-traumatic metabolic alterations are still unclear. Revision of CBF and metabolic changes following TBI based on the literature and on our clinical e...

Intracranial pressure monitoring is recommended for the management of severe head injury and is increasingly used during intensive care for other pathologies, such as subarachnoid hemorrhage. However, it is still not uniformly applied in different centers. The objectives of this paper are to summarize the frequency and the modalities of intracrania...

Adequate early assessment of brain damage is essential. Location, extension and severity of structural damage affect brain function and ultimately determine the outcome. The extent of functional impairment, and the morphology of intracranial lesions, require specific treatment, often a combination of medical and surgical interventions. Brain damage...

The authors investigated the effects of hyperoxia on brain tissue PO2 and on glucose metabolism in cerebral and adipose tissue after traumatic brain injury (TBI). After 3 hours of ventilation with pure O2, 18 tests were performed on different days in eight comatose patients with TBI. Lactate, pyruvate, glucose, glutamate, and brain tissue PO2 were...

The neuropeptide alpha-melanocyte-stimulating hormone (alpha-MSH) is a proopiomelanocortin derivative that has potent anti-inflammatory influences within the brain. The aim of the present research was to determine if there are changes in blood concentrations of this peptide in patients with acute traumatic brain injury (TBI) or subarachnoid hemorrh...

The aim of the present study was to assess the veno-arterial difference in pCO2 (ApCO2) as an indicator of ischemia compared to the arteriovenous O2 difference (AVDO2). Staircase cerebral blood flow (CBF) reductions were obtained in seven domestic pigs by inducing intracranial hypertension: CBF 100%, 50–60% of baseline, 20soba1105160014930% of base...

Patients with severe head injury require timely and aggressive treatment. They are potentially exposed to multiple life-threatening lesions, which cannot be properly treated by a single specialist; they can be better tackled by a team. Only the availability of the right expertise at the right time could offer, in fact, the best surgical and medical...

Brain injury occurs with a range of severity: even less severe cases should be carefully observed since they may deteriorate. By definition severe head injury has a Glasgow Coma Scale score of 8 or less; comatose patients are defined as cases who do not obey commands, do not open their eyes and do not speak. Very often (50% of case in our series) b...

Monitoring cerebral oxygenation has been one of the main fields of interest in neurointensive care during the past few years. In fact it is strongly believed that restoring adequate cerebral oxygenation is the premise to maintaining the viability and restoring the function of the damaged CNS. Global monitoring provides an indirect estimation of ade...

The Advanced Breast Biopsy Instrumentation (ABBI) system, which uses surgical cannulas up to 20 mm in diameter, is an alternative to conventional surgical biopsy for the diagnosis of non-palpable breast lesions. Since the need for radiological skill outweighs the surgical content of the technique, we evaluated the feasibility of complete management...

To evaluate the advisability of use by interventional radiologists of the ABBI system for stereotactic biopsy in the diagnosis of mammographically detected nonpalpable breast lesions considered suspicious for cancer. Breast biopsy with the ABBI cannula, available in various diameters, was offered to 61 patients who gave their informed consent and w...