Francesca Tesi
University of Florence
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Featured researches published by Francesca Tesi.
Europace | 2016
Andrea Ungar; Francesca Tesi; Valentina Maddalena Chisciotti; Giuseppe Pepe; Simone Vanni; Stefano Grifoni; Daniela Balzi; Martina Rafanelli; Niccolò Marchionni; Michele Brignole
AIMS High hospitalization rates (39-58% in the literature) of patients admitted to Emergency Department (ED) for transient loss of consciousness (T-LOC) suspected for syncope are still an unresolved issue. The presence of an Observation Unit has reduced hospital admissions and the duration of hospitalization in controlled studies, and a Syncope Unit (SU) in the hospital may reduce hospitalization and increase the number of diagnoses in patients with T-LOC. We assessed the effect of a structured organization on hospitalization rate and outcome. METHODS AND RESULTS Consecutive patients referred to the ED for a T-LOC of a suspected syncopal nature as the main diagnosis were included. The ED physician was trained to choose between: hospital admission (directly or after short observation); discharge after short (<48-h) observation; discharge on a fast track to the SU; and direct discharge without any further diagnostics. From January to June 2010, 362 patients were evaluated in the ED: 29% were admitted, 20% underwent short observation in the ED, 20% were referred to the SU, and 31% were directly discharged. Follow-up data were available on 295 patients who were discharged alive: of these, 1 (0.3%) previously hospitalized patient died within 30 days and 16 (5.4%) died within 1 year. Death rates were 12.9, 3.3, 0, and 2.5% among admitted, observation, SU, and ED-discharged patients, respectively. No death could be directly attributed to T-LOC. Re-admission within 1 year for any cause occurred in 72 (24%) patients; re-admission rates were 45.9, 19.3, 11.5, and 18.0% among admitted, observation, SU, and ED-discharged patients, respectively. CONCLUSIONS The availability of short observation and a SU seems to reduce the hospitalization rate compared with previous reported historical reports from our and other centres. Most deaths during follow-up occurred in patients who had been hospitalized. High rates of re-admission to the ED within 1 year are still an issue.
Heart | 2017
Diana Solari; Francesca Tesi; Matthias Unterhuber; Germano Gaggioli; Andrea Ungar; Marco Tomaino; Michele Brignole
Objectives Most elderly patients affected by reflex vasodepressor syncope take one or more hypotensive drugs. The role of these drugs in causing syncope has not yet been established. We hypothesised that recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy without increasing the risk of cardiovascular and neurological events. Methods This randomised, parallel, prospective, trial was conducted from January 2014 to March 2016 in four general hospitals. Of 328 initially screened participants, 58 patients (mean (SD) age 74±11 years) affected by vasodepressor reflex syncope, which was reproduced by tilt testing (n=54) or carotid sinus massage (n=4), were randomised to stop/reduce vasoactive therapy or to continue it. Primary end point was recurrence of syncope, presyncope or adverse events (defined as stroke, cerebral transient ischaemic attacks, worsening heart failure, myocardial infarction). Results Of 58 patients who were randomised, 55 completed the trial. After 1 month, systolic blood pressure was significantly higher in the ‘stop/reduce’ group than in the ‘continue’ group, in both supine (141±13 mm Hg vs 128±14 mm Hg; p=0.004) and standing (133±13 mm Hg vs 122±15 mm Hg; p=0.02) positions. During a mean follow-up of 13±7 months, the primary combined end point occurred in seven ‘stop/reduce’ patients (23%): three had syncope, three had presyncope and one had heart failure. Conversely, it occurred in 13 ‘continue’ patients (54%): 10 had syncope, 2 had presyncope and 1 had cerebral transient ischaemic attack. The log-rank p value was 0.02 and the HR was 0.37 (95% CI 0.15 to 0.91). Conclusions Recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy in most elderly patients affected by reflex vasodepressor syncope. Trial registration number NCT01509534; EudraCT2013-004364-63; Results.
Journal of the American Geriatrics Society | 2018
Enrico Mossello; Francesca Tesi; Simona G. Di Santo; Andrea Mazzone; Monica Torrini; Antonio Cherubini; Mario Bo; Massimo Musicco; Angelo Bianchetti; Alberto Ferrari; Nicola Ferrara; Marco Trabucchi; Alessandro Morandi; Giuseppe Bellelli
Delirium is underrecognized in clinical practice. The primary aim of the present multicenter study was to compare the ability of nurses to identify delirium features with a standardized assessment. The secondary aim was to identify predictors of missed or incorrect identifications of delirium by nurses.
Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases | 2013
Andrea Ungar; Martina Rafanelli; Iacopo Iacomelli; Maria Angela Brunetti; Alice Ceccofiglio; Francesca Tesi; Niccolò Marchionni
Aging Clinical and Experimental Research | 2014
Martina Rafanelli; E. Ruffolo; Valentina Maddalena Chisciotti; Maria Angela Brunetti; Alice Ceccofiglio; Francesca Tesi; Alessandro Morrione; Niccolò Marchionni; Andrea Ungar
Heart Rhythm | 2017
Michele Brignole; Régis Guieu; Marco Tomaino; Matteo Iori; Andrea Ungar; Cristina Bertolone; Matthias Unterhuber; Nicola Bottoni; Francesca Tesi; Jean Claude Deharo
International Journal of Cardiology | 2018
Giulia Rivasi; Diana Solari; Martina Rafanelli; Alice Ceccofiglio; Francesca Tesi; Richard Sutton; Michele Brignole; Andrea Ungar
European Geriatric Medicine | 2018
Alice Ceccofiglio; Giulia Peruzzi; Rudi Pecci; Martina Rafanelli; Giulia Rivasi; Francesca Tesi; Angela Riccardi; Gaetano Esposito; Simone Vanni; Andrea Ungar
JACC: Clinical Electrophysiology | 2017
Martina Rafanelli; Giulia Rivasi; D. Solari; Francesca Tesi; Alice Ceccofiglio; F.C. Sacco; S. Venzo; I. Giannini; Michele Brignole; Andrea Ungar
European Geriatric Medicine | 2015
Giulia Rivasi; Martina Rafanelli; G. Toffanello; Alice Ceccofiglio; Francesca Tesi; Niccolò Marchionni; Andrea Ungar