Carlo Giaquinto

Società Italiana di Musicologia, Roma, Latium, Italy

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Publications (286)1735.6 Total impact

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    ABSTRACT: We describe the case of a young girl with HIV infection vertically transmitted who presented a long-lasting ocular involvement characterized by several relapses and remissions. Good viral and immunological status made infective or neoplastic facts unlike; diagnosis was really challenging and finally spontaneous remission was observed after several months. Clinical and histopathological findings made idiopathic orbital inflammatory syndrome the most probable diagnosis for our patient.
    No preview · Article · Jan 2016 · International Journal of STD & AIDS
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    ABSTRACT: . Rotavirus (RV) is the commonest pathogen in the hospital and primary care settings, followed by Adenovirus (AV) and Norovirus (NV). Only few studies that assess the burden of RV gastroenteritis at the community level have been carried out. Objectives . To estimate incidence, disease characteristics, seasonal distribution, and working days lost by parents of RV, AV, and NV gastroenteritis leading to a family pediatrician (FP) visit among children < 5 years. Methods . 12-month, observational, prospective, FP-based study has been carried out using Pedianet database. Results . RVGE incidence was 1.04 per 100 person-years with the highest incidence in the first 2 years of life. Incidences of AVGEs (1.74) and NVGEs (1.51) were slightly higher with similar characteristics regarding age distribution and symptoms. Risk of hospitalisation, access to emergency room (ER), and workdays lost from parents were not significantly different in RVGEs compared to the other viral infections. Conclusions . Features of RVGE in terms of hospitalisation length and indirect cost are lower than those reported in previous studies. Results of the present study reflect the large variability of data present in the literature. This observation underlines the utility of primary care networks for AGE surveillance and further studies on community-acquired gastroenteritis in children.
    Preview · Article · Jan 2016 · International Journal of Pediatrics
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    ABSTRACT: Background Suboptimal use of antibiotics may lead to antimicrobial resistance. The aim of this study was to develop and assess two new quality indicators (QIs) of optimal community-based prescribing applied to childhood community antibiotic (AB) prescribing in three European countries. Methods A cohort study was conducted using electronic primary care medical records of 2,195,312 children up to 14 (Italy, Pedianet database, 2001–2010) or 18 years of age (UK, THIN database, 1995–2010; the Netherlands, IPCI database, 1996–2010) contributing for a total of 12,079,620 person-years (PYs). Prevalence rates of antibiotic prescribing were defined as the number of children with at least one antibiotic prescription per year and were expressed as the number of users per 100 PYs (%). Quality of prescribing was determined using four QIs: the drug utilisation 90% method, the ratio between users of broad and narrow spectrum penicillins, cephalosporins and macrolides (B/N ratio) and two new QMs: (i) the overall proportion of amoxicillin users (amoxicillin index, AI); (ii) the ratio between users of amoxicillin and those of broad spectrum antibiotics (the A/B ratio). Results The overall annual prevalence of antibiotic prescriptions was 18% in the Netherlands, 36.2% in the UK and 52% in Italy. Prevalence was highest in the youngest children. Almost half of all prescriptions included amoxicillin with or without clavulanic acid. Cephalosporins were frequently prescribed in Italy. The AI provided trends for the utilization of a relatively narrow spectrum option targeting acute respiratory infections, and was highest in the Netherlands and in the UK (50–60%) and lower in Italy (30%), with a slight decrease over time in the UK and Italy. The overall B/N ratio varied between countries from 0.3 to 74.7, whereas the overall A/B ratio varied less from 0.5 in Italy to 6 in the UK, indicating a substantial proportion of narrower-spectrum prescribing in the UK. Conclusions The prevalence of antibiotic prescribing varied highly with age and country. A combination of total antibiotic prevalence and quality of prescribing based on amoxicillin use provide a clear picture of community childhood antibiotic prescribing. These measures could be used to evaluate the impact of programs aiming at reduction of AB use and appropriate antibiotic prescribing.
    No preview · Article · Jan 2016 · Archives of Disease in Childhood
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    ABSTRACT: Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity.
    Full-text · Article · Dec 2015
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    ABSTRACT: Introduction Acute gastroenteritis (AGE) is one of the most important causes of morbidity and mortality in childhood. Among all the causative agents of AGE, rotavirus (RV) is the most common pathogen. The aim of this study is to estimate the incidence by age group of rotavirus gastroenteritis (RVGE) in children <5 years of age seen at primary care level. This estimation relies on a specifically developed statistical model applied on AGE data reported in the Pedianet database. Materials and Methods This was an observational, retrospective, cohort study using the Pedianet database that included all children aged 12 years with a diagnosis of AGE or acute diarrhea, and registered on the network during the period from January 2002 to December 2008. Since development of the model was specifically based on data collected during the Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in Public Health and Society Study (REVEAL study), RVGE estimation was restricted to children aged <60 months who experienced an AGE. Results A total of 128,154 children <12 years of age were registered on the Pedianet database during the study period by 83 family pediatricians (FPs). Information on 36,679 episodes of AGE between 2002 and 2008 was collected. Of overall 36,679 AGE cases, 24,275 (66.2%) occurred in children <5 years of age. For children <5 years of age, more than half the episodes of AGE occurred in children between 12 and 35 months. Number of RVGE predicted by the model ranged from 2,864 to 4,700 cases, allowing for the estimated underreporting as calculated from the patients participating both in the REVEAL study and included in Pedianet. As expected, the highest rate occurred from November to May, whereas a lower incidence was reported during the summer season from June to September. Conclusions The Pedianet database was found to be a useful instrument for collecting information about the number and main features of AGE episodes at the primary care level in Italy. The statistical model presented in this study has proved reliable to predict RV-positive cases. Epidemiological results showed a consistent RVGE incidence from year to year in children less than 5 years old at the primary care level and underlined the persistent contribution of RV infections to the winter workload of Italian FPs.
    No preview · Article · Nov 2015
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    ABSTRACT: Background and objectives: Acute otitis media (AOM) not only affects childhood quality of life (QoL), but can also affect parental QoL. We adapted a previously published questionnaire on the effect of childhood recurrent ear, nose and throat infections on parental QoL for use with AOM and used it in an observational, multicentre, prospective study of children with AOM. Methods: The AOM-specific parental QoL questionnaire grouped 15 items into emotional, daily disturbance, total and overall parental QoL impact scores. The questionnaire was assessed using item-convergent and item-discriminant validity criteria and internal consistency reliability; and then used with parents of children aged <6 years diagnosed with AOM at 73 practices in Germany, Italy, Spain, Sweden and the UK. Bivariate analyses explored the differences in mean parental QoL impact scores by various characteristics. Results: The questionnaire demonstrated good to excellent internal consistency reliability for the various components (Cronbach's α 0.82-0.97). There were 1419 AOM episodes among 5882 healthy children over 1 year, of which 1063 episodes (74.9 %) among 852 children had a questionnaire. Parents reported interrupted sleep (68.4 %), worry (51.0 %), altered daily schedule (44.6 %) and less leisure time (41.5 %) with a score ≥3 (1 = least to 5 = most impact). Factors that adversely affected parental QoL included: increased parental perception of AOM severity, younger child age and multiple AOM episodes. Conclusions: The AOM-specific parental QoL questionnaire demonstrated good performance across five European countries. Parental QoL was affected by childhood AOM proportionally to severity, number of episodes and younger child age.
    Full-text · Article · Sep 2015 · Clinical Drug Investigation

  • No preview · Article · Sep 2015 · European Respiratory Journal

  • No preview · Article · Sep 2015 · European Respiratory Journal
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    ABSTRACT: From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015 · The Lancet Infectious Diseases
  • Miguel O'Ryan · Carlo Giaquinto · Bernd Benninghoff
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    ABSTRACT: A decade after licensure of the human rotavirus vaccine (HRV), a wealth of evidence supports a reduction of rotavirus (RV) gastroenteritis-associated mortality and hospitalizations following HRV inclusion in national immunization programs. Nevertheless, the majority of real-world data has been generated in high- or middle-income settings. Clinical efficacy trials previously indicated RV vaccine performance may be lower in less-developed countries compared with wealthier counterparts. Using recently published data from Africa, we examine the effectiveness and impact of HRV in resource-deprived areas, exploring whether vaccine performance differs by socioeconomic setting and the potential underlying factors. HRV vaccine effectiveness in early adopting African countries has proven to be similar or even superior to the efficacy results observed in pre-licensure studies.
    No preview · Article · Jun 2015 · Expert Review of Vaccines
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    ABSTRACT: Objectives: To describe use of treatment for chronic hepatitis C virus (HCV) infection in HIV/HCV co-infected children and young people living in Europe and to evaluate treatment outcomes. Methods: HCV treatment data on children and young people aged <25 years with HIV/HCV co-infection were collected in a cohort collaboration of 11 European paediatric HIV cohorts. Factors associated with receipt of HCV treatment and with sustained virological response 24 weeks after treatment completion (SVR24) were explored. Results: Of 229 HIV/HCV co-infected patients, 22% had a history of AIDS and of 55 who were treated for HCV, 47 (85%) were receiving combined antiretroviral therapy. The overall HCV treatment rate was 24% (n =55) but it varied substantially between countries, with the highest rate being in Russia at 61% (30/49). Other factors associated with treatment receipt were older age [adjusted odds ratio (AOR) 5.24, 95% confidence interval (CI) 1.9–14.4, for 18–24-year-olds vs 11–17-year-olds, P =0.001] and advanced fibrosis (AOR 5.5, 95% CI 1.3–23.7; for ≥9.6 vs ≤7.2 kPa, P =0.02). Of 50 patients with known treatment outcomes, 50% attained SVR24. Of these, 16 (80%) had genotype (GT) 2,3 and 8 (29%) had GT 1,4 (P <0.001). After adjusting for genotype (GT 1,4 vs GT 2,3), females (P =0.003), patients with non-vertical HCV acquisition (P =0.002) and those with shorter duration of HCV (P =0.009) were more likely to have successful treatment outcomes. Conclusion: Only half of the HIV/HCV co-infected youth achieved an HCV cure. HCV treatment success appears to be lower in the context of HIV co-infection than in HCV mono-infection, underscoring the urgent need to speed up approvals of new direct-acting antiviral combinations in children.
    Full-text · Article · Jun 2015

  • No preview · Article · May 2015
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    ABSTRACT: B> Background. The use of raltegravir in human immunodeficiency virus (HIV)–infected pregnant women is important in the prevention of mother-to-child HIV transmission, especially in circumstances when a rapid decline of HIV RNA load is warranted or when preferred antiretroviral agents cannot be used. Physiological changes during pregnancy can reduce antiretroviral drug exposure. We studied the effect of pregnancy on the pharmacokinetics of raltegravir and its safety and efficacy in HIV-infected pregnant women. Methods. An open-label, multicenter, phase 4 study in HIV-infected pregnant women receiving raltegravir 400 mg twice daily was performed (Pharmacokinetics of Newly Developed Antiretroviral Agents in HIV-Infected Pregnant Women Network). Steady-state pharmacokinetic profiles were obtained in the third trimester and postpartum along with cord and maternal delivery concentrations. Safety and virologic efficacy were evaluated. Results. Twenty-two patients were included, of which 68% started raltegravir during pregnancy. Approaching delivery, 86% of the patients had an undetectable viral load (<50 copies/mL). None of the children were HIV-infected. Exposure to raltegravir was highly variable. Overall area under the plasma concentration-time curve (AUC) and plasma concentration at 12 hours after intake (C<SUB>12h</SUB>) plasma concentrations in the third trimester were on average 29% and 36% lower, respectively, compared with postpartum: Geometric mean ratios (90% confidence interval) were 0.71 (.53–.96) for AUC<SUB>0–12h</SUB> and 0.64 (.34–1.22) for C<SUB>12h</SUB>. The median ratio of raltegravir cord to maternal blood was 1.21 (interquartile range, 1.02–2.17; n = 9). Conclusions. Raltegravir was well tolerated during pregnancy. The pharmacokinetics of raltegravir showed extensive variability. The observed mean decrease in exposure to raltegravir during third trimester compared to postpartum is not considered to be of clinical importance. Raltegravir can be used in standard dosages in HIV-infected pregnant women. Clinical Trials Registration. NCT00825929 .
    No preview · Article · May 2015 · Clinical Infectious Diseases
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    ABSTRACT: Recent estimates indicate an increase in the prevalence of skin diseases in children. Few large epidemiologic studies have examined prevalence trends in Europe. This study evaluated the incidence and prevalence of frequently occurring pediatric skin diseases (PSDs) in Italy as seen by family pediatricians (FPs). Data were retrospectively extracted from the Pedianet database (2006-2012) in children ages 0 to 14 years presenting with a skin disease at their FP. The incidence and prevalence estimates were calculated per year and stratified according to sex, age, and geographic area. A mean of 145,233 children (52.1% male) across five Italian regions were registered with their participating FP for a total of 913,253 person-years of follow-up. The majority of patients were from the northeast (44.6%) and 37.7% were ages 5-9 years. Incidence estimates (new cases/1,000 person-years) for most PSDs increased from 2006 to 2012, the highest being for atopic dermatitis (AD) (14.1 vs 16.5), acute urticaria (10.1 vs 11.6), and contact dermatitis (9.3 vs 10.8), whereas psoriasis remained unchanged over the 7 years (0.61 vs 0.57). In contrast, prevalence estimates (cases/100 patients) increased two to three times for several PSDs, including AD (2.7% vs 8.5%), seborrheic dermatitis (0.5% vs 1.6%), chronic urticaria (0.4% vs 0.8%), and psoriasis (0.09% vs 0.22%). Differences in prevalence according to age range and geographic area were observed for psoriasis, AD, and urticaria. This study provides comprehensive evidence of the increasing prevalence and incidence of PSDs across Italy. Additional causality studies to address this important clinical and psychosocial problem are recommended. © 2015 Wiley Periodicals, Inc.
    Full-text · Article · Apr 2015 · Pediatric Dermatology
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    ABSTRACT: The first evidence-based recommendations for rotavirus vaccination in Europe were prepared at the time of licensure of two live oral rotavirus vaccines (Rotarix™, GlaxoSmithKline, and RotaTeq®, Sanofipasteur-MSD) in 2006 and published in 2008. Since then several countries in Europe and more globally have adopted universal rotavirus vaccination of all healthy infants as part of their national immunization programs (NIP). The experience from these NIPs has produced a wealth of post-introduction effectiveness data that, together with the evidence from pre-licensure efficacy trials presented in the 2008 Recommendations, support the case of rotavirus vaccination in Europe.The prelicensure safety trials of Rotarix™ and RotaTeq®, each in populations of more than 60.000 infants, did not reveal risk of intussusception (IS), but post-vaccination surveillance in several countries, particularly Australia and Mexico, has established that the risk of IS for both vaccines after the first dose might be between 1:50.000 and 1:80.000. While it may be argued that the risk is acceptable vis-àis the great benefits of rotavirus vaccination, this argument alone may not suffice, and every effort should be made to reduce the risk of IS. Considerable evidence, including post-vaccination surveillance data from Germany, suggests that the risk of IS can be reduced by early administration of the first dose of oral rotavirus vaccine. The previous ESPID/ESPGHAN recommendations held that the first dose of oral rotavirus vaccine should be given between 6 and 12 weeks of age; this recommendation is sustained but with an emphasis towards the lower range of the recommended age, i.e. preferably between 6 to 8 weeks of age. At the time of the earlier recommendations experience of rotavirus vaccination in premature infants and other special target groups was limited. It is now recommended with greater confidence than before that prematurely born infants should be vaccinated according to their calendar age as recommended for full term infants. It is now strongly recommended that all HIV-infected or HIV-exposed infants be vaccinated with oral rotavirus vaccine. While specific information on many immunodeficiencies is lacking, infants with known severe combined immunodeficiency should not receive live rotavirus vaccine.
    Full-text · Article · Apr 2015 · The Pediatric Infectious Disease Journal
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    ABSTRACT: By January 2015, rotavirus vaccination has been implemented in national vaccination programs in 75 countries worldwide. Two live oral rotavirus vaccines are internationally available: human, monovalent vaccine and human-bovine pentavalent reassortant vaccine. Since January 2014, another live, oral human-bovine monovalent vaccine has been available in India. After implementation of rotavirus vaccines in childhood immunization programs, over 90% reduction of rotavirus hospitalizations has been observed in industrialized and resource deprived countries. Additionally, in Latin America, significant reduction of rotavirus-associated deaths has been observed. Still, numerous countries do not recommend rotavirus mass vaccination because of assumed lack of cost-effectiveness and potential risk of intussusception which is estimated at 1 per 50-70,000 doses of rotavirus vaccines. Cost-effectiveness of vaccination is affected in some countries by high price. Inclusion of herd protection and indirect costs in calculations for cost effectiveness results in clear benefit: costs saved by health systems due to reduced rotavirus gastroenteritis hospitalizations exceed by far costs for implementation of rotavirus vaccination. There have been objections that high rotavirus vaccination coverage could put selective pressure on certain rotavirus strains against which protection after vaccination is less distinct. However, data now strongly suggest that even if there might be a relative increase of some specific genotypes after the use of rotavirus vaccines, this is not an absolute increase in incidence from certain genotypes and does not affect the overall effectiveness of rotavirus mass vaccination which resulted in a major decrease of severe cases of rotavirus gastroenteritis in both industrialized and resource deprived countries. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Feb 2015 · Clinical Microbiology and Infection
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    ABSTRACT: The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV-1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short-term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long-term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first- and second-line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART 'pipeline' of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained. © 2015 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
    Full-text · Article · Feb 2015 · HIV Medicine
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    ABSTRACT: Over a period of 25 years only 1 % of new drugs were approved specifically for so-called neglected diseases, which represent over 12 % of the global disease burden in terms of mortality and chronic disability. The authors briefly describe the Drugs for Neglected Diseases initiative (DNDi) model set up to address this gap, and give an example of the paediatric HIV project that has been undertaken in support of the needed HIV response. The role that research networks (such as PENTA, IMAACT and GRIP), public-private partnerships and strategic mobilization of key stakeholders have played in drug development and drug/formulation access for children has been highlighted. The effective achievements obtained in scaling up deployment of antiretroviral drugs in resource limited settings show the importance of consolidating public and private partnership (WHO, innovative research intensive and generic pharmaceutical companies and international agencies working with partners from countries where diseases are endemic).
    No preview · Article · Jan 2015
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    ABSTRACT: Objectives: To describe the pharmacokinetics of darunavir in pregnant HIV-infected women in the third trimester and post-partum. Patients and methods: This was a non-randomized, open-label, multicentre, Phase IV study in HIV-infected pregnant women recruited from HIV treatment centres in Europe. HIV-infected pregnant women treated with darunavir (800/100 mg once daily or 600/100 mg twice daily) as part of their combination ART were included. Pharmacokinetic curves were recorded in the third trimester and post-partum. A cord blood sample and maternal sample were collected. The study is registered at ClinicalTrials.gov under number NCT00825929. Results: Twenty-four women were included in the analysis [darunavir/ritonavir: 600/100 mg twice daily (n=6); 800/100 mg once daily (n=17); and 600/100 mg once daily (n=1)]. Geometric mean ratios of third trimester versus post-partum (90% CI) were 0.78 (0.60-1.00) for total darunavir AUC0-tau after 600/100 mg twice-daily dosing and 0.67 (0.56-0.82) for total darunavir AUC0-tau after 800/100 mg once-daily dosing. The unbound fraction of darunavir was not different during pregnancy (12%) compared with post-partum (10%). The median (range) ratio of darunavir cord blood/maternal blood was 0.13 (0.08-0.35). Viral load close to delivery was <300 copies/mL in all but two patients. All children were tested HIV-negative and no congenital abnormalities were reported. Conclusions: Darunavir AUC and Cmax were substantially decreased in pregnancy for both darunavir/ritonavir regimens. This decrease in exposure did not result in mother-to-child transmission. For antiretroviral-naive patients, who are adherent, take darunavir with food and are not using concomitant medication reducing darunavir concentrations, 800/100 mg of darunavir/ritonavir once daily is adequate in pregnancy. For all other patients 600/100 mg of darunavir/ritonavir twice daily is recommended during pregnancy.
    No preview · Article · Oct 2014 · Journal of Antimicrobial Chemotherapy

  • No preview · Article · Oct 2014 · Open Journal of Hematology

Publication Stats

5k Citations
1,735.60 Total Impact Points

Institutions

  • 2016
    • Società Italiana di Musicologia
      Roma, Latium, Italy
  • 1988-2015
    • University of Padova
      • Department of Pediatrics
      Padua, Veneto, Italy
  • 2014
    • San Raphael of St. Francis Nsambya Hospital
      Kampala, Central Region, Uganda
  • 2006-2014
    • University-Hospital of Padova
      Padua, Veneto, Italy
  • 2012
    • Università di Pisa
      Pisa, Tuscany, Italy
  • 2011
    • Erasmus University Rotterdam
      • Department of Medical Informatics
      Rotterdam, South Holland, Netherlands
    • Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
      • Neonatology and Neonatal Intensive Care
      Milano, Lombardy, Italy
  • 2007
    • University of Florence
      • Dipartimento di Medicina Sperimentale e Clinica
      Florens, Tuscany, Italy
  • 2005
    • Pedianet
      Padua, Veneto, Italy
    • University of Iowa Children's Hospital
      Iowa City, Iowa, United States
  • 2000
    • St George's, University of London
      Londinium, England, United Kingdom
  • 1998
    • Great Ormond Street Hospital for Children NHS Foundation Trust
      Londinium, England, United Kingdom
  • 1987-1996
    • It-Robotics
      Vicenza, Veneto, Italy
  • 1995
    • University of London
      Londinium, England, United Kingdom
  • 1991
    • University of Milan
      Milano, Lombardy, Italy
  • 1989
    • Karolinska Institutet
      • Department of Medicine, Huddinge
      Сольна, Stockholm, Sweden