Response to a massive SARS-CoV-2 infection in a nursing home transformed into a caring center.
Identifieur interne : 000197 ( Main/Exploration ); précédent : 000196; suivant : 000198Response to a massive SARS-CoV-2 infection in a nursing home transformed into a caring center.
Auteurs : Paolo Agostinis [Italie] ; Valentina Vianello [Italie] ; Elena Dereani [Italie] ; Giuseppe Caruso [Italie] ; Beatrice Montessoro [Italie] ; Marco Taurian [Italie] ; Antonio Di Chiara [Italie] ; Vincenzo Patruno [Italie] ; Francesco Cavallin [Italie] ; Gian Paolo Fadini [Italie] ; Anna Aldovini [États-Unis] ; Anna Baritussio [Italie] ; Francesco Curcio [Italie] ; Carlo Tascini [Italie] ; Aldo Baritussio [Italie]Source :
- Aging clinical and experimental research [ 1720-8319 ] ; 2021.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- chemical : Hydroxychloroquine, RNA, Viral.
- COVID-19, Humans, Nursing Homes, SARS-CoV-2.
Abstract
BACKGROUND
The best policy to follow when nursing homes are massively hit by SARS-CoV2 is unclear.
AIM
To describe COVID-19 containment in a nursing home transformed into a caring center.
METHODS
Physicians and nurses were recruited. The facility was reorganized and connected with the laboratory of the reference hospital. Ultrasound was used to diagnose pneumonia. Patients needing intensive care were transferred to the reference hospital. Hydroxychloroquine/azithromycin/enoxaparin were used initially, while amiodarone/enoxaparin were used at a later phase. Under both regimens, methylprednisolone was added for severe cases. Prophylaxis was done with hydroxychloroquine initially and then with amiodarone.
PERIOD COVERED
March 22-July 31, 2020.
RESULTS
The facility was reorganized in two days. Ninety-two guests of the 121 (76%) and 25 personnel of 118 (21.1%) became swab test positive. Seven swab test negative patients who developed symptoms were considered to have COVID-19. Twenty-seven patients died, 23 swab test positive, 5 of whom after full recovery. Four patients needing intensive care were transferred (3 died). Mortality, peaking in April 2020, was correlated with symptoms, comorbidities, dyspnea, fatigue, stupor/coma, high neutrophil to lymphocyte ratio, C-reactive protein, interleukin-6, pro-calcitonin, and high oxygen need (p ≤ 0.001 for all). Among swab-positive staff, 3 had pneumonia and recovered. Although no comparison could be made between different treatment and prophylaxis strategies, potentially useful suggestions emerged. Mortality compared well with that of nursing homes of the same area not transformed into care centers.
CONCLUSION
Nursing homes massively hit by SARS-CoV-2 can become caring centers for patients not needing intensive care.
DOI: 10.1007/s40520-020-01784-w
PubMed: 33506312
PubMed Central: PMC7840424
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<author><name sortKey="Taurian, Marco" sort="Taurian, Marco" uniqKey="Taurian M" first="Marco" last="Taurian">Marco Taurian</name>
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<author><name sortKey="Di Chiara, Antonio" sort="Di Chiara, Antonio" uniqKey="Di Chiara A" first="Antonio" last="Di Chiara">Antonio Di Chiara</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Medicine, Ospedale Sant'Antonio Abate, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo</wicri:regionArea>
<wicri:noRegion>Tolmezzo</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Patruno, Vincenzo" sort="Patruno, Vincenzo" uniqKey="Patruno V" first="Vincenzo" last="Patruno">Vincenzo Patruno</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pulmonology and Respiratory Medicine, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine</wicri:regionArea>
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<author><name sortKey="Cavallin, Francesco" sort="Cavallin, Francesco" uniqKey="Cavallin F" first="Francesco" last="Cavallin">Francesco Cavallin</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Independent Statistician, Solagna</wicri:regionArea>
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<author><name sortKey="Fadini, Gian Paolo" sort="Fadini, Gian Paolo" uniqKey="Fadini G" first="Gian Paolo" last="Fadini">Gian Paolo Fadini</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Medicine, Section of Diabetes and Metabolic Diseases, University of Padua, Padua</wicri:regionArea>
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<author><name sortKey="Aldovini, Anna" sort="Aldovini, Anna" uniqKey="Aldovini A" first="Anna" last="Aldovini">Anna Aldovini</name>
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<author><name sortKey="Baritussio, Anna" sort="Baritussio, Anna" uniqKey="Baritussio A" first="Anna" last="Baritussio">Anna Baritussio</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua</wicri:regionArea>
<wicri:noRegion>Padua</wicri:noRegion>
</affiliation>
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<author><name sortKey="Curcio, Francesco" sort="Curcio, Francesco" uniqKey="Curcio F" first="Francesco" last="Curcio">Francesco Curcio</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Medicine and Clinical Pathology Institute, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, Udine</wicri:regionArea>
<wicri:noRegion>Udine</wicri:noRegion>
</affiliation>
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<author><name sortKey="Tascini, Carlo" sort="Tascini, Carlo" uniqKey="Tascini C" first="Carlo" last="Tascini">Carlo Tascini</name>
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<wicri:regionArea>Clinical Infectious Diseases, Ospedale Santa Maria Della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine</wicri:regionArea>
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<author><name sortKey="Baritussio, Aldo" sort="Baritussio, Aldo" uniqKey="Baritussio A" first="Aldo" last="Baritussio">Aldo Baritussio</name>
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<wicri:regionArea>Senior Researcher, University of Padua, Padua</wicri:regionArea>
<wicri:noRegion>Padua</wicri:noRegion>
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<series><title level="j">Aging clinical and experimental research</title>
<idno type="eISSN">1720-8319</idno>
<imprint><date when="2021" type="published">2021</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (MeSH)</term>
<term>Nursing Homes (MeSH)</term>
<term>RNA, Viral (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hydroxychloroquine (MeSH)</term>
<term>Maisons de repos (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Hydroxychloroquine</term>
<term>RNA, Viral</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>COVID-19</term>
<term>Humans</term>
<term>Nursing Homes</term>
<term>SARS-CoV-2</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>ARN viral</term>
<term>Humains</term>
<term>Hydroxychloroquine</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>The best policy to follow when nursing homes are massively hit by SARS-CoV2 is unclear.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>AIM</b>
</p>
<p>To describe COVID-19 containment in a nursing home transformed into a caring center.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Physicians and nurses were recruited. The facility was reorganized and connected with the laboratory of the reference hospital. Ultrasound was used to diagnose pneumonia. Patients needing intensive care were transferred to the reference hospital. Hydroxychloroquine/azithromycin/enoxaparin were used initially, while amiodarone/enoxaparin were used at a later phase. Under both regimens, methylprednisolone was added for severe cases. Prophylaxis was done with hydroxychloroquine initially and then with amiodarone.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PERIOD COVERED</b>
</p>
<p>March 22-July 31, 2020.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>The facility was reorganized in two days. Ninety-two guests of the 121 (76%) and 25 personnel of 118 (21.1%) became swab test positive. Seven swab test negative patients who developed symptoms were considered to have COVID-19. Twenty-seven patients died, 23 swab test positive, 5 of whom after full recovery. Four patients needing intensive care were transferred (3 died). Mortality, peaking in April 2020, was correlated with symptoms, comorbidities, dyspnea, fatigue, stupor/coma, high neutrophil to lymphocyte ratio, C-reactive protein, interleukin-6, pro-calcitonin, and high oxygen need (p ≤ 0.001 for all). Among swab-positive staff, 3 had pneumonia and recovered. Although no comparison could be made between different treatment and prophylaxis strategies, potentially useful suggestions emerged. Mortality compared well with that of nursing homes of the same area not transformed into care centers.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>Nursing homes massively hit by SARS-CoV-2 can become caring centers for patients not needing intensive care.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Automated" Owner="NLM"><PMID Version="1">33506312</PMID>
<DateCompleted><Year>2021</Year>
<Month>03</Month>
<Day>02</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>03</Month>
<Day>02</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1720-8319</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>33</Volume>
<Issue>2</Issue>
<PubDate><Year>2021</Year>
<Month>Feb</Month>
</PubDate>
</JournalIssue>
<Title>Aging clinical and experimental research</Title>
<ISOAbbreviation>Aging Clin Exp Res</ISOAbbreviation>
</Journal>
<ArticleTitle>Response to a massive SARS-CoV-2 infection in a nursing home transformed into a caring center.</ArticleTitle>
<Pagination><MedlinePgn>443-450</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s40520-020-01784-w</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The best policy to follow when nursing homes are massively hit by SARS-CoV2 is unclear.</AbstractText>
<AbstractText Label="AIM" NlmCategory="OBJECTIVE">To describe COVID-19 containment in a nursing home transformed into a caring center.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Physicians and nurses were recruited. The facility was reorganized and connected with the laboratory of the reference hospital. Ultrasound was used to diagnose pneumonia. Patients needing intensive care were transferred to the reference hospital. Hydroxychloroquine/azithromycin/enoxaparin were used initially, while amiodarone/enoxaparin were used at a later phase. Under both regimens, methylprednisolone was added for severe cases. Prophylaxis was done with hydroxychloroquine initially and then with amiodarone.</AbstractText>
<AbstractText Label="PERIOD COVERED" NlmCategory="METHODS">March 22-July 31, 2020.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">The facility was reorganized in two days. Ninety-two guests of the 121 (76%) and 25 personnel of 118 (21.1%) became swab test positive. Seven swab test negative patients who developed symptoms were considered to have COVID-19. Twenty-seven patients died, 23 swab test positive, 5 of whom after full recovery. Four patients needing intensive care were transferred (3 died). Mortality, peaking in April 2020, was correlated with symptoms, comorbidities, dyspnea, fatigue, stupor/coma, high neutrophil to lymphocyte ratio, C-reactive protein, interleukin-6, pro-calcitonin, and high oxygen need (p ≤ 0.001 for all). Among swab-positive staff, 3 had pneumonia and recovered. Although no comparison could be made between different treatment and prophylaxis strategies, potentially useful suggestions emerged. Mortality compared well with that of nursing homes of the same area not transformed into care centers.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Nursing homes massively hit by SARS-CoV-2 can become caring centers for patients not needing intensive care.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Agostinis</LastName>
<ForeName>Paolo</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Ospedale Sant'Antonio Abate, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vianello</LastName>
<ForeName>Valentina</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Department of General Surgery, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dereani</LastName>
<ForeName>Elena</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Nursing Home Matteo Brunetti, Paluzza, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Caruso</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Special Continuity Care Units, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Montessoro</LastName>
<ForeName>Beatrice</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Special Continuity Care Units, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Taurian</LastName>
<ForeName>Marco</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Special Continuity Care Units, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Di Chiara</LastName>
<ForeName>Antonio</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Ospedale Sant'Antonio Abate, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Patruno</LastName>
<ForeName>Vincenzo</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonology and Respiratory Medicine, Ospedale Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cavallin</LastName>
<ForeName>Francesco</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Independent Statistician, Solagna, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fadini</LastName>
<ForeName>Gian Paolo</ForeName>
<Initials>GP</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Section of Diabetes and Metabolic Diseases, University of Padua, Padua, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Aldovini</LastName>
<ForeName>Anna</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Medicine and Harvard Medical School, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Baritussio</LastName>
<ForeName>Anna</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">http://orcid.org/0000-0002-6900-6705</Identifier>
<AffiliationInfo><Affiliation>Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Curcio</LastName>
<ForeName>Francesco</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Medicine and Clinical Pathology Institute, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tascini</LastName>
<ForeName>Carlo</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Clinical Infectious Diseases, Ospedale Santa Maria Della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Baritussio</LastName>
<ForeName>Aldo</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Senior Researcher, University of Padua, Padua, Italy. aldo.baritussio@unipd.it.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2021</Year>
<Month>01</Month>
<Day>28</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Germany</Country>
<MedlineTA>Aging Clin Exp Res</MedlineTA>
<NlmUniqueID>101132995</NlmUniqueID>
<ISSNLinking>1594-0667</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber>
<NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="Y">COVID-19</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009735" MajorTopicYN="N">Nursing Homes</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012367" MajorTopicYN="N">RNA, Viral</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="Y">SARS-CoV-2</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Amiodarone</Keyword>
<Keyword MajorTopicYN="N">Elderly patients</Keyword>
<Keyword MajorTopicYN="N">Nursing home</Keyword>
<Keyword MajorTopicYN="N">SARS-CoV-2 infection</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year>
<Month>11</Month>
<Day>04</Day>
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<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>12</Month>
<Day>30</Day>
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<affiliations><list><country><li>Italie</li>
<li>États-Unis</li>
</country>
<region><li>Massachusetts</li>
</region>
</list>
<tree><country name="Italie"><noRegion><name sortKey="Agostinis, Paolo" sort="Agostinis, Paolo" uniqKey="Agostinis P" first="Paolo" last="Agostinis">Paolo Agostinis</name>
</noRegion>
<name sortKey="Baritussio, Aldo" sort="Baritussio, Aldo" uniqKey="Baritussio A" first="Aldo" last="Baritussio">Aldo Baritussio</name>
<name sortKey="Baritussio, Anna" sort="Baritussio, Anna" uniqKey="Baritussio A" first="Anna" last="Baritussio">Anna Baritussio</name>
<name sortKey="Caruso, Giuseppe" sort="Caruso, Giuseppe" uniqKey="Caruso G" first="Giuseppe" last="Caruso">Giuseppe Caruso</name>
<name sortKey="Cavallin, Francesco" sort="Cavallin, Francesco" uniqKey="Cavallin F" first="Francesco" last="Cavallin">Francesco Cavallin</name>
<name sortKey="Curcio, Francesco" sort="Curcio, Francesco" uniqKey="Curcio F" first="Francesco" last="Curcio">Francesco Curcio</name>
<name sortKey="Dereani, Elena" sort="Dereani, Elena" uniqKey="Dereani E" first="Elena" last="Dereani">Elena Dereani</name>
<name sortKey="Di Chiara, Antonio" sort="Di Chiara, Antonio" uniqKey="Di Chiara A" first="Antonio" last="Di Chiara">Antonio Di Chiara</name>
<name sortKey="Fadini, Gian Paolo" sort="Fadini, Gian Paolo" uniqKey="Fadini G" first="Gian Paolo" last="Fadini">Gian Paolo Fadini</name>
<name sortKey="Montessoro, Beatrice" sort="Montessoro, Beatrice" uniqKey="Montessoro B" first="Beatrice" last="Montessoro">Beatrice Montessoro</name>
<name sortKey="Patruno, Vincenzo" sort="Patruno, Vincenzo" uniqKey="Patruno V" first="Vincenzo" last="Patruno">Vincenzo Patruno</name>
<name sortKey="Tascini, Carlo" sort="Tascini, Carlo" uniqKey="Tascini C" first="Carlo" last="Tascini">Carlo Tascini</name>
<name sortKey="Taurian, Marco" sort="Taurian, Marco" uniqKey="Taurian M" first="Marco" last="Taurian">Marco Taurian</name>
<name sortKey="Vianello, Valentina" sort="Vianello, Valentina" uniqKey="Vianello V" first="Valentina" last="Vianello">Valentina Vianello</name>
</country>
<country name="États-Unis"><region name="Massachusetts"><name sortKey="Aldovini, Anna" sort="Aldovini, Anna" uniqKey="Aldovini A" first="Anna" last="Aldovini">Anna Aldovini</name>
</region>
</country>
</tree>
</affiliations>
</record>
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