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Is Burn-Out the Main Issue？ Impact of Aggressiveness and Depression in Burn-Out Among Operators in Oncology

Psychology Research 2017年第9期7卷 509-514页

作者： Romeo Marco anna vespa Maria Velia Giulietti Riccardo Giampieri Tania Meletani Ilaria Fiordoliva Mafia Giuditta Baleani Sofia Formentini Rossana Berardi Universita Politecnica delle Marche Ancona Italy Fondazione Rossetti Fedecostante Ancona Italy INRCA-IRCCS-National Institute of Science and Health for Aging Ancona Italy Universita Politecnica delle Marche Ancona Italy

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Structure of Personality at Intrapsychic and Interpersonal Levels and Depression of Caregivers of Patients Affected by Alzheimer’s Disease: Which Psychotherapeutic Approach?

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Advances in Alzheimer's Disease 2018年第4期7卷 103-118页

作者： Giulietti Maria Velia anna vespa Stefano Berti Guido Gori Marica Ottaviani Cristina Meloni Paolo Fabbietti Giuseppe Pelliccioni Lucia Paciaroni Roberta Spatuzzi Department of Research INRCA-IRCCS National Institute of Science and Health for Aging Ancona Italy Department of Research Scientific and Technological Area INRCA-IRCCS National Institute of Science and Health for Aging Anco-na Italy Health Promotion Department Ancona Alzheimer Daily Center Florence Italy Biostatistical Center INRCA-IRCCS National Institute of Health and Science on Aging Ancona Italy U.O.C. Hospice/Palliative Care Departments Potenza Italy

Background: Many studies have underlined as caregiving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences. Objectives: The study of the structure of personality, can help to understand the association between depression, intrapsychic and interpersonal processes of caregivers of Alzheimer’s disease patients and what kind of intervention can be planned to favor the stress burden management. Methods: Case group: Caregivers (CG) (n = 75);control group, Subjects not Caregivers (nCG) (n. 104). Tests: SASB questionnaire (Structural Analysis of Interpersonal Behavior) describing intrapsychic and interpersonal processes of the structure of personality validated on the basis of DSMIV;CDQ questionnaires—depression. Results: Intrapsychic level: From the results it emerged that CGs had lower autonomy in their choices, and lower acceptance of their own feelings, and exercised greater self-control exhausting themselves toward predetermined goals, and more depression compared to the control group. They may be not able to achieve psychic equilibrium in the presence of stress: they may likely become disoriented and engage in behaviors that may be self-defeating. SASB-Cl = Autonomy (p 0.001);SASB-Cl2-Autonomy and Love (p 0.001), SASB-CL3-Love (p 0.001);SASB-Cl4 Love and control (p 0.001), SASB-CL5-Control (p = 0.015), SASB-Cl6-Control and hate (p 0.001), SASB-Cl7-Hate (p Conclusions: Intrapsychic characteristics such as tendency to depression, inability to being in contact with their own feelings, excessive self-control may be linked to difficulties in facing burden of care and indicate serious difficulties to adaptation to burden condition. The knowledge of these modalities could allow to plan a psychotherapeutic and multidisciplinary intervention aimed at facing and overcoming the psychological distress of the caregiver.

关键词： Caregiver Alzheimer Depression Intrapsychic Behaviours Interpersonal Behaviours Personality

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Evaluation of Anxiety and Depression in Caregivers of Patients Affected by Alzheimer’s Disease

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Advances in Alzheimer's Disease 2015年第2期4卷 15-20页

作者： anna vespa Maria Velia Giulietti Marica Ottaviani R. Spatuzzi F. Merico Guido Gori Olimpia Claudia Rossi L. Paciaroni Giuseppe Pelliccioni Pietro Scendoni Cristina Meloni Department of Neurology INRCA-IRCCS Italian National Institute of Health and Science on Aging Ancona Italy Unity of Neurology INRCA-National Institute of Health and Science on Aging Ancona Italy Department of Neurology INRCA-IRCCS National Institute of Health and Science on Aging Ancona Italy U.O.C. Hospice/Palliative care Departments A.O.R. San Carlo di Potenza Italy Hospice Casa di Betania Palliative Care Center Lecce Italy Director Day Alzheimer Center “Le Civette” ASL-Florence Italy Department of Rheumatology INRCA-IRCCS National Institute of Health and Science on Aging Fermo Italy INRCA-IRCCS National Institute of Health and Science on Aging Ancona Italy

Background: Many studies have been underlined as care giving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences, such as anxiety and depression. Objective: The specific aim of our study is to establish whether a difference exists in the prevalence of depression of family caregivers of Alzheimer’s disease patients and healthy subjects not caregiver. Methods: Study group (n = 60) consists of caregivers of patients affected by Alzheimer’s disease, whereas control group (n = 120) consists of healthy individuals who are not care giving (from at least 5 years). All the subjects were subdivided on the basis of the following independent variables: sex, age, marital status and educational level. The subjects of study and control groups studied have filled in the following tests: IPAT CDQ e IPAT ASQ Tests by Cattell which describe depression and anxiety. Such tests have been validated on the adult and elderly Italian population. Statistical analysis: Student t test has been applied for the comparison between experimental and control groups. Results: The caregivers show higher levels of anxiety (medium to high, P < 0.001) and depression in comparison to the group of control (medium to high, P < 0.001). This result indicates the caregiver shows serious depression. Conclusions: The high levels of depression and anxiety suggest the following considerations: interventions of social and psychological support are fundamental not only to maintain the patient in the family nucleus but also to maintain the caregiver’s psychological health.

关键词： Caregiver Alzheimer’s Disease Anxiety Depression

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Evaluation of Anxiety and Depression in Caregivers of Patients Affected by Alzheimer’s Disease

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Advances in Alzheimer's Disease 2015年第2期

作者： anna vespa Maria Velia Giulietti Marica Ottaviani R. Spatuzzi F. Merico Guido Gori Olimpia Claudia Rossi L. Paciaroni Giuseppe Pelliccioni Pietro Scendoni Cristina Meloni

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Relief of jaundice in malignant biliary obstruction:When should we consider endoscopic ultrasonography-guided hepaticogastrostomy as an option?

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 234-240页

作者： Alessandro Fugazza Matteo Colombo Marco Spadaccini Edoardo vespa Roberto Gabbiadini Antonio Capogreco Alessandro Repici Andrea Anderloni Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSMilanItaly Department of Biomedical Sciences Humanitas UniversityMilanItaly

Background:Since it was first described in 2001,endoscopic ultrasonography-guided biliary drainage(EUS-BD)has emerged as an alternative procedure for achieving an endoscopic internal drainage in case of endoscopic retrograde cholangiopancreatography(ERCP)*** drainage can be achieved by either a transduodenal extrahepatic approach through EUS-guided choledochoduodenostomy(EUS-CDS),or a transgastric intrahepatic approach,namely EUS-guided hepaticogastrostomy(EUS-HGS)which already holds a remarkable place in the treatment of patients with malignant biliary *** sources:For this review we did a comprehensive search of PubMed/MEDLINE from inception to May 31,2021 for papers with a significant sample size(at least 20 patients enrolled)dealing with *** on technical success,clinical success and rate of adverse events were ***:A total of 22 studies with different design,com prising 874 patients,were *** success was achieved in about 96% of cases(ranging from 65% to 100%).Clinical success was obtained in almost 91% of cases(ranging from 76% to 100%).Overall rate of adverse events was 19%(ranging from 0% to 35%).Abdominal pain,self-limiting pneumoperitoneum,bile leak,cholangitis,bleeding,perforation and intraperitoneal migration of the stent were the most ***:Despite both safety and efficacy profile,at the moment HGS still remains a challenging procedure at every single step and must therefore be conducted by a very experienced endoscopist in interventional EUS and ERCP procedures,who is able to deal with the possible severe adverse events of this procedure.A rapid introduction in clinical practice of dedicated devices is desiderable.

关键词： EUS-guided hepaticogastrostomy EUS-guided biliary drainage Hepaticogastrostomy Interventional EUS

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Advanced imaging and artificial intelligence for Barrett's esophagus:What we should and soon will do

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World Journal of Gastroenterology 2022年第11期28卷 1113-1122页

作者： Marco Spadaccini Edoardo vespa Viveksandeep Thoguluva Chandrasekar Madhav Desai Harsh K Patel Roberta Maselli Alessandro Fugazza Silvia Carrara Andrea Anderloni Gianluca Franchellucci Alessandro De Marco Cesare Hassan Pradeep Bhandari Prateek Sharma Alessandro Repici Department of Endoscopy Humanitas Research HospitalIRCCSRozzano 20089Italy Department of Biomedical Sciences Humanitas UniversityRozzano 20089Italy Department of Gastroenterology and Hepatology Mayo ClinicPhoenixAZ 85054United States Department of Gastroenterology and Hepatology Kansas City VA Medical CenterKansas CityMO 66045United States Department of Internal Medicine Ochsner Clinic FoundationNew OrleansLA 70124United States Endoscopy Unit Nuovo Regina Margherita HospitalRoma 00153Italy Department of Gastroenterology Portsmouth Hospitals University NHS TrustPortsmouth PO63LYUnited Kingdom School of Pharmacy and Biomedical Sciences University of PortsmouthPortsmouth PO63LYUnited Kingdom

Barrett’s esophagus(BE)is a well-established risk factor for esophageal *** is recommended that patients have regular endoscopic surveillance,with the ultimate goal of detecting early-stage neoplastic lesions before they can progress to invasive *** of both dysplasia or early adenocarcinoma permits curative endoscopic treatments,and with this aim,thorough endoscopic assessment is crucial and improves *** burden of missed neoplasia in BE is still far from being negligible,likely due to inappropriate endoscopic *** the last two decades,advanced imaging techniques,moving from traditional dye-spray chromoendoscopy to more practical virtual chromoendoscopy technologies,have been introduced with the aim to enhance neoplasia detection in *** witnessed in other fields,artificial intelligence(AI)has revolutionized the field of diagnostic endoscopy and is set to cover a pivotal role in BE as *** aim of this commentary is to comprehensively summarize present evidence,recent research advances,and future perspectives regarding advanced imaging technology and AI in BE;the combination of computer-aided diagnosis to a widespread adoption of advanced imaging technologies is eagerly *** will also provide a useful step-by-step approach for performing high-quality endoscopy in BE,in order to increase the diagnostic yield of endoscopy in clinical practice.

关键词： Barrett’s esophagus Endoscopy Artificial intelligence Surveillance Advanced imaging Neoplasia

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Impact of chronic exposure to bevacizumab on EpCAM-based detection of circulating tumor cells

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Chinese Journal of Cancer Research 2015年第5期27卷 491-496页

作者： Chiara Nicolazzo Isabella Massimi Lavinia V.Lotti Simone vespa Cristina Raimondi Fabio Maria Pulcinelli Angela Gradilone Paola Gazzaniga Dipartimento di Medicina Molecolare Sapienza Università di Roma Dipartimento di Medicina Sperimentale Sapienza Università di Roma

Background： Circulating tumor cells （CTCs） are often undetected through the immunomagnetic epithelial cell adhesion molecule （EpCAM）-based CellSearch~ System in breast and colorectal cancer （CRC） patients treated with bevacizumab （BEV）, where low CTC numbers have been reported even in patients with evidence of progression of disease. To date, the reasons for this discrepancy have not been clarified. This study was carried out to investigate the molecular and phenotypic changes in CRC cells after chronic exposure to BEV in vitro. Methods： The human CRC cell line WiDr was exposed to a clinically relevant dose of BEV for 3 months in vitro. The expression of epithelial and mesenchymal markers and EpCAM isoforms was determined by western blotting and immunofluorescence. To evaluate the impact of EpCAM variant isoforms expression on CTC enumeration by CellSearch, untreated and treated colon cancer cells were spiked into 7.5 mL of blood from a healthy donor and enumerated by CellSearch. Results： Chronic exposure of CRC cell line to BEV induced decreased expression of EpCAM 40 kDa isoform and increased expression EpCAM 42 kDa isoform, together with a decreased expression of cytokeratins （CK）, while no evidence of epithelial to mesenchymal transition （EMT） in treated cells was observed. The recovery rate of cells through CellSearch was gradually reduced in course of treatment with BEV, being 84% , 70% and 40% at l, 2 and 3 months, respectively. Conclusions： We hypothesize that BEV may prevent CellSearch from capturing CTCs through altering EpCAM isoforms.

关键词： Circulating tumor cells (CTCs) epithelial cell adhesion molecule (EpCAM) isoform bevacizumab(BEV) colorectal cancer (CRC)

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创伤性脑损伤后理想的脑灌注压阈值

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中国现代神经疾病杂志 2004年第6期4卷 346-349页

作者： Paul vespa 刘暌 10833 Le Conte Avenue CHS 18-218 Los Angeles California 90095 300060 天津市环湖医院神经外科

《神经外科焦点》(NeurosurgicalFo-cus)是由美国神经外科医师协会(AmericanAssocia-tionofNeurologicalSurgeons,AANS)创办的第1部电子版神经外科专业期刊,创刊于1996年7月,以月刊形式发行。该刊的宗旨为及时报道神经外科领域基础与临... 详细信息

《神经外科焦点》(NeurosurgicalFo-cus)是由美国神经外科医师协会(AmericanAssocia-tionofNeurologicalSurgeons,AANS)创办的第1部电子版神经外科专业期刊,创刊于1996年7月,以月刊形式发行。该刊的宗旨为及时报道神经外科领域基础与临床的新观点和新技术,总结临床工作的成败,提倡科学的思维和评价方法。其最突出的特点为每期集中讨论某一特定的专题,刊登相关的综述或论著,尤其关注当今神经外科领域争论的焦点问题。本刊经美国神经外科医师协会授权,从本期起将陆续刊登一些自NeurosurgicalFocus上摘译或编译的优秀论著,为国内同道提供一个窗口,观察国外神经外科领域的发展趋势,借鉴国外同行的工作经验,最终的目的是为提高我国神经外科的整体水平并与世界接轨;同时我们也希望国内的同道对此栏目提出建设性的意见,使其成为真正的焦点论坛。

关键词：神经外科脑灌注压医师协会创伤性脑损伤摘译临床工作观察论著整体水平国内

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延长净零碳玻璃窑炉寿命的新型熔铸耐火材料

延长净零碳玻璃窑炉寿命的新型熔铸耐火材料

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第26届全国玻璃窑炉技术研讨交流会

作者： Pierrick vespa Patrice Fournier 西普耐材–普罗旺斯研发中心西普耐材–Le Pontet工厂

实现净零碳窑炉需要新的熔化技术,如混合熔炉、超级电助熔、高吨位全电窑,很可能还有氢燃料的全氧窑。这些新技术将导致更恶劣的操作条件,例如温度更高、温度变化大、局部玻璃液对流更快,以及炉内气氛成分的改变。所有这些变化都将对耐...

实现净零碳窑炉需要新的熔化技术,如混合熔炉、超级电助熔、高吨位全电窑,很可能还有氢燃料的全氧窑。这些新技术将导致更恶劣的操作条件,例如温度更高、温度变化大、局部玻璃液对流更快,以及炉内气氛成分的改变。所有这些变化都将对耐火材料产生重大影响。为了更好地了解这些变化,必须设计特定的实验室试验来重现新一代熔炉的操作条件,并量化其对耐火材料的影响。本文的第一部分描述了这些创新试验。由于预料到这些窑炉会遭受更强的侵蚀,导致寿命缩短和过早停炉的风险增加,因此正在开发新一代耐火材料。本文第二部分的目的是强调新一代熔铸耐火材料的优点,这些耐火材料氧化锆含量高,但也含有一定量的氧化铝。与目前的AZS相比,这种全新的材料具备更高的抗侵蚀性,同时没有高锆产品那样对向上钻蚀机理那么敏感。此产品还能保持所需的高玻璃质量,不会产生结石或着色问题。首先描述了实验室规模的测试,以评估这种材料在抗侵蚀性方面的优异性能及其对玻璃质量的影响。然后我们描述了流液洞和池壁安装的第一个成功案例。

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Gait Analysis of a Subject with Total Hip Arthroplasty

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Journal of Biosciences and Medicines 2022年第10期10卷 135-143页

作者： Carlos Díaz Novo Micaela González Castillo Juan Bentos Dupuy Maximiliano vespa Correa Martín Machado López Felipe Gorla Gargano Biomedical Engineering Program Technological University of Uruguay UTEC Fray Bentos Uruguay

Introduction: gait analysis of a subject with total hip replacement is described. Objective: instrumental gait analysis of a subject 12 years after the total hip arthroplasty. Materials and Methods: in a movement analysis laboratory, locomotion studies were carried out at freely chosen walking speed by a 64-year-old subject, obtaining kinematic, kinetic and surface electromyographic data in time and space. All measurements were assessments by applying walking protocols on a straight surface of 8 m long. Results: abnormal slight activations of semitendinosus and tibialis anterior muscles, of the left limb, were observed throughout the gait cycle, no spatiotemporal parameters far from normal values were detected. Conclusions: it was possible to obtain an exhaustive analysis of the parameters associated with the gait of a subject after 12 years of total hip arthroplasty.

关键词： Total Hip Arthroplasty Kinetics Kinematics Surface Electromyography Motion Analysis Laboratory Pathological

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