1,575 results
Search Results
2. [Italian Society of Pediatric Cardiology (SICP) position paper on the prevention, diagnosis, treatment and follow-up of cardiotoxicity in pediatric patients with cancer].
- Author
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Bennati E, Castaldi B, Derchi ME, Spoto S, Chinali M, Bertorello N, Comparato C, Vairo U, Rinelli G, and Favilli S
- Subjects
- Humans, Child, Italy, Cardiovascular Diseases prevention & control, Cardiology, Follow-Up Studies, Heart Diseases prevention & control, Heart Diseases chemically induced, Heart Diseases diagnosis, Societies, Medical, Cardiotoxicity prevention & control, Cardiotoxicity etiology, Neoplasms drug therapy, Antineoplastic Agents adverse effects, Antineoplastic Agents administration & dosage
- Abstract
The survival of pediatric cancer patients has significantly increased thanks to the improvement of oncological treatments. Therefore, it is of utmost importance to manage short- and long-term cardiovascular complications. In pediatric cardio-oncology, there are no recognized guidelines as in adults. Several recommendations and many indications have been derived from the data obtained in the adult cancer population, resulting in greater discrepancies in the clinical management of patients. The aim of this position paper of the Italian Society of Pediatric Cardiology (SICP) is to collect the main evidence regarding the diagnosis, prevention, treatment and follow-up of cardiotoxicity in children, to provide useful indications for clinical practice, and to promote a network between pediatric centers.
- Published
- 2024
- Full Text
- View/download PDF
3. [ANMCO Position paper: States General 2023 - Digital medicine in cardiology: evidence and state of progress in Italy].
- Author
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Di Fusco SA, Zilio F, Zuin M, Bilato C, Corda M, De Luca L, Di Lenarda A, Di Marco M, Francese GM, Gensini GF, Geraci G, Giubilato S, Iacovoni A, Lucà F, Mazzanti M, Milli M, Navazio A, Orso F, Pascale V, Riccio C, Rocca P, Scicchitano P, Tavazzi L, Tizzani E, Gabrielli D, Colivicchi F, Grimaldi M, and Oliva F
- Subjects
- Humans, Artificial Intelligence, Delivery of Health Care, Italy, Cardiology, General Practice
- Abstract
Technological innovation provides easily accessible tools capable of simplifying healthcare processes. Notably, digital technology application in the cardiology field can improve prognosis, reduce costs, and lead to an overall improvement in healthcare. The digitization of health data, with the use of electronic health records and of electronic health files in Italy, represents one of the fields of application of digital technologies in medicine. The 2023 States General of the Italian Association of Hospital Cardiologists (ANMCO) provided an opportunity to focus attention on the potential benefits and critical issues associated with the implementation of the aforementioned digital tools, artificial intelligence, and telecardiology. This document summarizes key aspects that emerged during the event.
- Published
- 2024
- Full Text
- View/download PDF
4. [ANMCO Position paper: States General 2023 - Role of ANMCO in the setting of clinical research in Cardiology in Italy: current state and future perspectives].
- Author
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Zilio F, Di Fusco SA, Zuin M, Ammirati E, Bilato C, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Maggioni AP, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gabrielli D, Colivicchi F, Grimaldi M, and Oliva F
- Subjects
- Humans, Italy, Cardiology, Cardiovascular Diseases therapy
- Abstract
For over 40 years, clinical research has been one of the most important aims of the Italian Association of Hospital Cardiologists (ANMCO), being an essential tool in pursuing promotion and fulfillment of good clinical practices in prevention, treatment and rehabilitation of cardiovascular diseases. Since 1992, with the creation of the Research Center (now part of the Heart Care Foundation), ANMCO is capable of independently and professionally managing all the aspects related to planning, management, and publication of the results of clinical studies. The other strength of ANMCO is the network built in Cardiology Departments on the whole territory of Italy, a human capital that allows ANMCO to deal with the new scientific challenges, in a context of profound changes in the social, economic, technological, and methodological setting. This document is based on the debate about the state of clinical research in Italy and the role of ANMCO in this setting that took place during the 2023 ANMCO States General.
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- 2024
- Full Text
- View/download PDF
5. [ANMCO Position paper: Reorganization of cardiology in the era of the COVID-19 pandemic].
- Author
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Caldarola P, Murrone A, Roncon L, Di Pasquale G, Tavazzi L, Amodeo V, Aspromonte N, Cipriani M, Di Lenarda A, Domenicucci S, Francese GM, Imazio M, Scotto di Uccio F, Urbinati S, Valente S, Gulizia MM, Colivicchi F, and Gabrielli D
- Subjects
- Cardiovascular Diseases therapy, Health Personnel organization & administration, Humans, Italy, National Health Programs organization & administration, COVID-19, Cardiology organization & administration, Delivery of Health Care organization & administration
- Abstract
The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic, new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.
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- 2021
- Full Text
- View/download PDF
6. [ANMCO Position paper: Timing of coronary angiography in patients with non-ST-elevation acute coronary syndrome].
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Murrone A, Scotto di Uccio F, Amodeo V, Aspromonte N, Caldarola P, Casella G, Cipriani M, De Luca L, Di Lenarda A, Domenicucci S, Francese GM, Imazio M, Roncon L, Urbinati S, Valente S, Di Pasquale G, Gulizia MM, Colivicchi F, and Gabrielli D
- Subjects
- Coronary Angiography, Humans, Italy, Acute Coronary Syndrome diagnostic imaging, Cardiology, Non-ST Elevated Myocardial Infarction diagnostic imaging, Non-ST Elevated Myocardial Infarction therapy
- Abstract
The European Society of Cardiology guidelines on non-ST-elevation acute coronary syndromes suggest different temporal strategies for the angiographic study depending on the risk profile. The scientific evidence underlying the guideline recommendations and the critical issues currently existing in Italy that often do not allow either an extended strategy of revascularization within 24 h or the application of the principle of the same day transfer from a spoke to a hub center are analyzed. The position paper focuses, in particular, on the subgroup of patients with a defined diagnosis of non-ST-elevation myocardial infarction by proposing a timing of coronary angiography/revascularization that takes into account the available scientific evidence and the organizational possibilities of a considerable part of national cardiology services.
- Published
- 2021
- Full Text
- View/download PDF
7. [Position paper of the Italian Society of Cardiology (SIC) on COVID-19 vaccine priority in patients with cardiovascular diseases].
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Indolfi C, Barillà F, Basso C, Ciccone MM, Curcio A, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Romeo F, Sinagra G, and Filardi PP
- Subjects
- Age Factors, Animals, COVID-19 epidemiology, COVID-19 mortality, Cardiology, Coronary Disease complications, Disease Vectors, Heart Failure complications, Heart Transplantation, Heart Valve Diseases complications, Humans, Hypertension, Pulmonary complications, Italy epidemiology, Prognosis, Renal Insufficiency complications, SARS-CoV-2 immunology, Societies, Medical, Vaccines, Synthetic administration & dosage, mRNA Vaccines, COVID-19 prevention & control, COVID-19 Vaccines administration & dosage, Cardiovascular Diseases complications, Consensus
- Abstract
In over a year, the COVID-19 pandemic caused 2.69 million deaths and 122 million infections. Social isolation and distancing measures have been the only prevention available for months. Scientific research has done a great deal of work, developing in a few months safe and effective vaccines against COVID-19. In the European Union, nowadays, four vaccines have been authorized for use: Pfizer-BioNTech, Moderna, ChAdOx1 (AstraZeneca/Oxford), Janssen (Johnson & Johnson), and three others are currently under rolling review.Vaccine allocation policy is crucial to optimize the advantage of treatment preferring people with the highest risk of contagion. These days the priority in the vaccination program is of particular importance since it has become clear that the number of vaccines is not sufficient for the entire Italian population in the short term. Cardiovascular diseases are frequently associated with severe COVID-19 infections, leading to the worst prognosis. The elderly population suffering from cardiovascular diseases is, therefore, to be considered a particularly vulnerable population. However, age cannot be considered the only discriminating factor because in the young-adult population suffering from severe forms of heart disease, the prognosis, if affected by COVID-19, is particularly ominous and these patients should have priority access to the vaccination program. The aim of this position paper is to establish a consensus on a priority in the vaccination of COVID-19 among subjects suffering from different cardiovascular diseases.
- Published
- 2021
- Full Text
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8. [Position paper of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) on driving by patients with cardiac implantable electronic devices].
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Palmisano P, Guerra F, Bisignani G, Forleo GB, Landolina M, Soldati E, Stabile G, Zanotto G, Berisso MZ, De Ponti R, Boriani G, and Ricci RP
- Subjects
- Accidents, Traffic prevention & control, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac therapy, Humans, Italy, Risk, Automobile Driving, Defibrillators, Implantable adverse effects, Pacemaker, Artificial adverse effects
- Abstract
In patients with cardiac implantable electronic devices (CIEDs) (implantable cardioverter-defibrillators [ICDs] and pacemakers [PMs]), the potential risk of suddenly being unable to drive, and hence of causing road accidents, is higher than in the general population. In ICD patients, this risk stems from the possibility that an arrhythmic event leading to loss of consciousness may occur while driving. In PM patients, it may be the result of a device malfunction in a PM-dependent patient. To determine a CIED patient's ability to drive, two variables must be taken into account: (i) the risk of events, which depends on the type of underlying heart disease (ICD patients have a higher risk than PM patients); (ii) the time spent driving and the type of vehicle driven (professional drivers are at higher risk than private drivers). This position paper reports the recommendations of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) regarding driving by patients with CIEDs, on the basis of the available literature and the European reference recommendations.
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- 2020
- Full Text
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9. [ANMCO Position paper: Cardiological outpatient activities in the transition phase of the COVID-19 pandemic].
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Valente S, Colivicchi F, Francese MG, Di Lenarda A, Roncon L, Murrone A, Caldarola P, Bilato C, Amodeo E, Aspromonte N, Cipriani M, Domenicucci S, Imazio M, Scotto di Uccio F, Urbinati S, Gulizia MM, and Gabrielli D
- Subjects
- Ambulatory Care methods, COVID-19, Cardiology, Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy, Cause of Death, Comorbidity, Coronavirus Infections diagnosis, Disease Progression, Female, Humans, Italy epidemiology, Male, Pneumonia, Viral diagnosis, Risk Assessment, Societies, Medical, Survival Analysis, Treatment Outcome, Cardiovascular Diseases epidemiology, Coronavirus Infections epidemiology, Outpatients statistics & numerical data, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology, Transitional Care organization & administration
- Published
- 2020
- Full Text
- View/download PDF
10. [ANMCO Position paper: Pulmonary circulation diseases and COVID-19].
- Author
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Picariello C, Caravita S, Vatrano M, Enea I, Roncon L, De Tommasi E, Imbalzano E, Garascia A, Manes MT, Misuraca L, Urbinati S, Colivicchi F, Gulizia MM, and Gabrielli D
- Subjects
- COVID-19, Cardiology, Communicable Diseases, Emerging epidemiology, Coronavirus Infections diagnosis, Disease Progression, Female, Humans, Incidence, Italy epidemiology, Lung Diseases, Interstitial etiology, Lung Diseases, Interstitial physiopathology, Male, Pneumonia, Viral diagnosis, Pulmonary Circulation physiology, Risk Assessment, Severe Acute Respiratory Syndrome diagnosis, Societies, Medical, Survival Analysis, Venous Thromboembolism mortality, Venous Thromboembolism physiopathology, Cause of Death, Coronavirus Infections epidemiology, Lung Diseases, Interstitial mortality, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology, Severe Acute Respiratory Syndrome epidemiology, Venous Thromboembolism etiology
- Abstract
The new coronavirus disease 2019 (COVID-19), which is causing hundreds of thousands of deaths worldwide, is complex and can present with a multi-organ localization. One of its worst complications is an interstitial pneumonia with acute respiratory failure also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which requires non-invasive or invasive ventilation. A severe coagulopathy with poor prognosis is found in 5-10% of cases. SARS-CoV-2 is manifesting as a multi-dimensional disease and, recently, unique co-existing pathophysiological and clinical aspects are being defined: (i) an increased immune and inflammatory response with the activation of a cytokine storm and consequent coagulopathy, which promote both venous thromboembolic events and in situ thrombosis localized in small arterioles and pulmonary alveolar capillaries; (ii) a high intrapulmonary shunt, which often accounts for the severity of respiratory failure, due to reduced hypoxic pulmonary vasoconstriction with pulmonary neo-angiogenetic phenomena. Furthermore, the high incidence of venous thromboembolism in COVID-19 patients admitted to the intensive care unit and the autoptic findings of in situ micro-thrombosis at the pulmonary vascular level, suggest that in this disease coagulopathy, unlike septic disseminated intravascular coagulation, is driven towards a hyper-thrombogenic state, giving rise to a debate (with ongoing studies) about the preventive use of anticoagulant doses of heparin to reduce mortality. The aim of this position paper from the Italian Association of Hospital Cardiologists (ANMCO) is to highlight the main implications that COVID-19 infection has on the pulmonary circulation from a pathophysiological, clinical and management point of view.
- Published
- 2020
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11. [ANMCO Position paper: Role of cardiology in the management of health needs in the post-COVID-19 era].
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Murrone A, Colivicchi F, Roncon L, Caldarola P, Amodeo V, Urbinati S, Di Lenarda A, Valente S, Aspromonte N, Cipriani M, Domenicucci S, Francese GM, Imazio M, Scotto di Uccio F, Scherillo M, Di Pasquale G, Gulizia MM, and Gabrielli D
- Subjects
- COVID-19, Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy, Coronavirus Infections prevention & control, Female, Health Services Needs and Demand, Humans, Italy, Male, Pandemics prevention & control, Pneumonia, Viral prevention & control, Practice Guidelines as Topic, Risk Assessment, Role, Cardiology methods, Cardiovascular Diseases epidemiology, Communicable Disease Control organization & administration, Coronavirus Infections epidemiology, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology
- Published
- 2020
- Full Text
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12. [Antithrombotic treatments in patients with SARS-CoV-2 infection: from current evidence to reasonable recommendations - A position paper from the Italian Working Group on Atherosclerosis, Thrombosis and Vascular Biology].
- Author
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Patti G, Lio V, Cavallari I, Gragnano F, Riva L, Calabrò P, Di Pasquale G, Pengo V, and Rubboli A
- Subjects
- Atherosclerosis diagnosis, Betacoronavirus, COVID-19, Comorbidity, Coronavirus Infections diagnosis, Evidence-Based Medicine, Female, Humans, Incidence, Italy, Male, Pandemics, Pneumonia, Viral diagnosis, Practice Guidelines as Topic, Risk Assessment, SARS-CoV-2, Thrombosis diagnosis, Thrombosis epidemiology, Treatment Outcome, Atherosclerosis drug therapy, Atherosclerosis epidemiology, Coronavirus Infections epidemiology, Disease Outbreaks statistics & numerical data, Fibrinolytic Agents therapeutic use, Pneumonia, Viral epidemiology, Thrombosis drug therapy
- Abstract
Given the high prevalence of preexisting cardiovascular diseases and the increased incidence of adverse cardiovascular events in patients hospitalized for SARS-CoV-2 infection, the identification of optimal antithrombotic approaches in terms of risk/benefit ratio and outcome improvement appears crucial in this setting. In the present position paper we collected current evidence from the literature to provide practical recommendations on the management of antithrombotic therapies (antiplatelet and anticoagulant) in various clinical contexts prevalent during the SARS-CoV-2 outbreak: in-home management of oral anticoagulant therapy; interactions between drugs used in the SARS-CoV-2 infection and antithrombotic agents; in-hospital management of antithrombotic therapies; diagnosis, risk stratification and treatment of in-hospital thrombotic complications.
- Published
- 2020
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13. [COVID-19 outbreak and Cardiac Surgery: position paper from the COVID-SICCH Task Force of the Italian Society for Cardiac Surgery].
- Author
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Bonalumi G, Di Mauro M, Garatti A, Barili F, Parolari A, and Gerosa G
- Subjects
- COVID-19, Cardiovascular Surgical Procedures methods, Humans, Italy, Pandemics, Risk Assessment, Societies, Medical, Cardiovascular Surgical Procedures standards, Coronavirus Infections complications, Pneumonia, Viral complications, Practice Guidelines as Topic
- Published
- 2020
- Full Text
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14. [About the asbestos and the Position Paper on asbestos of the Italian Society of Occupational Medicine].
- Author
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Barbieri PG, Calisti R, Silvestri S, Calabresi C, Consonni D, Angelini A, Carnevale F, Cavariani F, and Sala O
- Subjects
- Asbestosis epidemiology, Humans, Italy epidemiology, Mesothelioma epidemiology, Occupational Exposure, Asbestos, Occupational Diseases epidemiology
- Abstract
The SIML Position Paper dedicated to asbestos (PPA) is addressed (mainly) to competent practitioners (CP) for the purposes to provide a guidance about a set of items classified as markedly interesting: the actuality of asbestos exposure and the evaluation of the related risk; the diagnosis of the asbestos related diseases; the shape of the risk functions (namely about mesotheliomas); the causal relationship between exposure and disease; the medical surveillance of the workers currently and previously exposed. The scientific literature doesn't acknowledge the idea that nowadays in Italy the frequency of pleural mesotheliomas deriving from environmental asbestos from outdoor sources exposures is really a relevant item. Inside the SIML PPA the chapter concerning industrial hygiene and environmental monitoring themes shows inaccuracies and deficiencies, so resulting of scarce utility for the CPs that should be called for a more cooperative role in front of the employers. The arguments of the diagnosis of the asbestos related diseases is developed with an undue emphasis upon the differential histological diagnosis of asbestosis and, especially, of pleural mesothelioma: nosographic aspects that hardly are posed to the attention of the CP. A similar emphasis is posed towards the shape of the risk function for pleural mesothelioma, a theme absent from the current practice of the CP such as of other occupational practitioners. In conclusion, next to themes of undoubted interest for the PC, the SIML PPA dwells on the scrutiny of some topics representing critical elements of the current contrast between consultants and valuers in the context of criminal prosecutions: subjects having forensic relevance but far from the "application actuality" for the CP invoked in the PPA. A greater transparency, last but not least, was to have been posed, inside the SIML PPA, in the disclosure of the conflict of interests (COIs) of some Authors, declaring their consultancy in favour of companies.
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- 2020
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- View/download PDF
15. [SICI-GISE Position paper: Enhancing radiation safety in the catheterization laboratory].
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Sciahbasi A, Piccaluga E, Andreassi MG, Trianni A, Rosi A, Sarandrea A, Longoni M, Germinal F, Santucci S, Bernardi G, Rigattieri S, La Manna A, Castiglioni B, Limbruno U, Mauro C, Tarantino F, Esposito G, Musumeci G, and Tarantini G
- Subjects
- Humans, Italy, Societies, Medical, Cardiac Catheterization standards, Cardiology, Occupational Exposure prevention & control, Occupational Health standards, Radiation Exposure prevention & control, Radiation Protection standards
- Abstract
The radiation dose received by interventional cardiologists during their activity in the catheterization laboratory is a matter of concern in terms of possible deterministic and stochastic risk. At the same time, very often, the knowledge of the effect and consequences of radiation exposure in the interventional cardiology community is limited. This document endorsed by the Italian Society of Interventional Cardiology (SICI-GISE) provides recommendations for cardiologists' radiation protection. Radiation safety considerations dedicated to women and other staff personnel working in the catheterization laboratory are also discussed.
- Published
- 2019
- Full Text
- View/download PDF
16. [CIPOMO position paper about conflict of interest.]
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- Delivery of Health Care economics, Delivery of Health Care ethics, Humans, Italy, Neoplasms therapy, Quality of Health Care, Conflict of Interest, Delivery of Health Care standards, Health Care Costs, Health Services Accessibility economics
- Abstract
A substantial part of the final cost of health-related products is due to marketing, and the revenue from sales is, at least in some cases, disproportionally higher than the development costs. In this context, financial interests can add to drug pricing and prevail over healthcare issues and equity of access to services. Conflict of interest (COI) is a «condition in which the professional judgment concerning a primary interest (the health of a patient or the reliability of research results or the impartiality of clinical informations) tends to be unduly influenced by a secondary interest (for example an economic gain or a career advantage)». The potential consequences of COI extend from research to guideline drafting, from teaching to clinical decision making. The contiguity of opposing interests can condition the clinician, either consciously or unconsciously. This conditioning, in turn, can have direct consequences on the quality of the provided services, but can also cause insufficient transparency, or distrust of the Health Service. The College of Italian Medical Oncology Directors (CIPOMO) together with all the stakeholders that contribute to the good functioning of cancer care, issues a list of statements that refer to principles of transparency and ethicality in the use of resources. The following recommendations do not intend to establish rules of conduct. Rather, they have the purpose of contributing to awareness of the nature and potential consequences of COI in the clinical community and of promoting constructive reflection within healthcare organizations.
- Published
- 2019
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17. [Cardiac rehabilitation "3.0": from the acute to the chronic stage. A position paper from the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR)].
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Pedretti RFE, Fattirolli F, Griffo R, Ambrosetti M, Angelino E, Brazzo S, Corrà U, Dasseni N, Faggiano P, Favretto G, Febo O, Ferrari M, Giallauria F, Greco C, Iannucci M, La Rovere MT, Mallardo M, Mazza A, Piepoli M, Riccio C, Scalvini S, Tavazzi L, Temporelli PL, and Mureddu GF
- Subjects
- Acute Disease, Ambulatory Care, Cardiac Rehabilitation trends, Chronic Disease, Critical Care, Health Services for the Aged, Humans, Italy, Patient Care Team, Patient Selection, Precision Medicine, Prognosis, Regional Medical Programs, Cardiac Rehabilitation methods, Heart Diseases prevention & control, Heart Diseases rehabilitation
- Abstract
Cardiac rehabilitation (CR) represents a cardiology subspecialty that is devoted to the care of cardiac patients, early and long term after an acute event. CR aims at improving both quality of life and prognosis through risk and prognostic stratification, clinical stabilization and optimization of therapy, management of comorbidities, treatment of disability, and the provision of sustained long-term preventive and rehabilitative services.The mission of CR has changed over time. From being centred on the acute phase, health care of cardiac patients is increasingly involving the long-term chronic phase. The aim of the present position paper is to provide the state of the art of CR in Italy, discussing strengths and weaknesses as well as future perspectives.
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- 2018
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18. [Personalized healthcare in hepatocellular carcinoma. Multi-society Italian position paper.]
- Author
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Trevisani F, Garuti F, and Neri A
- Subjects
- Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular pathology, Humans, Italy, Liver Neoplasms diagnosis, Liver Neoplasms pathology, Patient Care Team organization & administration, Precision Medicine methods, Carcinoma, Hepatocellular therapy, Liver Neoplasms therapy, Practice Guidelines as Topic
- Abstract
Hepatocellular carcinoma (HCC) is a neoplasm characterized by both clinical and biological heterogeneity. Its management requires the expertise of multiple medical specialists and is made complex by the old age of most patients, frequently showing comorbidities. Therefore, HCC management needs a multidisciplinary approach. The aim of this article is to illustrate multi-society recommendations regarding the management of HCC patients, from diagnosis to treatment and follow-up. In particular, in every stage, HCC treatment comprises multiple alternatives and the best option for every patient should be decided by a multidisciplinary team.
- Published
- 2018
- Full Text
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19. [ANMCO Position paper: Diagnostic and therapeutic pathways in patients with hypercholesterolemia and statin intolerance].
- Author
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Gulizia MM, Colivicchi F, Arca M, Abrignani MG, Perna GP, Mureddu GF, Nardi F, and Riccio C
- Subjects
- Algorithms, Anticholesteremic Agents therapeutic use, Clinical Trials as Topic, Humans, Hypercholesterolemia blood, Italy, Risk Assessment, Risk Factors, Cholesterol, LDL blood, Cholesterol, LDL drug effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Hypercholesterolemia drug therapy
- Abstract
Statins are a class of drugs registered and prescribed to lower total and LDL-cholesterol. Clinical trials performed in the last 25 years have shown that these agents are effective in improving cardiovascular outcomes in several different clinical settings. However, in some cases statin treatment may be associated with significant side effects and adverse reactions. The occurrence of such adverse events during statin therapy may cause discontinuation of treatment together with the impossibility of achieving recommended lipid goals. The clinical condition in which patients experience major unacceptable symptoms and/or develop laboratory abnormalities during statin therapy is defined as statin intolerance. This document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolemia and statin intolerance.
- Published
- 2016
- Full Text
- View/download PDF
20. [ANMCO Position paper: Clinical management of hypercholesterolemia in patients with acute coronary syndrome].
- Author
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Colivicchi F, Gulizia MM, Arca M, Abrignani MG, Perna GP, Mureddu GF, Nardi F, and Riccio C
- Subjects
- Acute Coronary Syndrome blood, Anticholesteremic Agents therapeutic use, Cholesterol, LDL blood, Drug Therapy, Combination, Ezetimibe therapeutic use, Humans, Hypercholesterolemia blood, Italy, Treatment Outcome, Acute Coronary Syndrome drug therapy, Cholesterol, LDL drug effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypercholesterolemia drug therapy
- Abstract
LDL-cholesterol (LDL-C) reduction after acute coronary syndromes (ACS) is associated with a significant reduction in ischemic recurrences. Accordingly, international guidelines recommend a reduction of LDL-C below 70 mg/dl in ACS patients. Such a result can be accomplished by using high intensity statins, possibly associated with ezetimibe in selected cases. This document outlines the management strategies that can be consistently implemented in clinical practice in order to achieve and maintain guideline-recommended therapeutic goals.
- Published
- 2016
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21. [Remarks on polyparametric assessment of sudden death risk for primary prevention ICD implantation in patients with left ventricular dysfunction of ischemic and non ischemic etiology. Italian Association of Hospital Cardiologists (ANMCO) Experts Position Paper].
- Author
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Disertori M, Gulizia MM, Casolo G, Delise P, Di Lenarda A, Di Tano G, Lunati M, Mestroni L, Salerno-Uriarte JA, and Tavazzi L
- Subjects
- Humans, Italy, Patient Selection, Practice Guidelines as Topic, Primary Prevention methods, Risk Assessment methods, Sensitivity and Specificity, Ventricular Dysfunction, Left complications, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Ventricular Dysfunction, Left therapy
- Abstract
It is generally recognized that current guidelines, based on ejection fraction criteria, do not allow appropriate selection of patients for implantable cardioverter-defibrillator (ICD) therapy in the primary prevention of sudden death, thus hindering the optimal use of ICD in patients with left ventricular dysfunction of ischemic and nonischemic etiology. Ejection fraction alone has limitations in both sensitivity and specificity. Assessment of the risk for sudden death using a combination of multiple tests (ejection fraction associated with one or more different arrhythmic risk markers) could partially compensate for these limitations. In this position paper, the potential usefulness of a polyparametric assessment using some of the most investigated risk markers of sudden death is discussed, including late gadolinium enhancement cardiac magnetic resonance, programmed ventricular stimulation, T-wave alternans, autonomic tone, biomarkers, and genetic testing.
- Published
- 2015
- Full Text
- View/download PDF
22. [Digital Pen & Paper® technology to manage clinical risk and to prevent medical malpractice claims].
- Author
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Genovese U, Del Sordo S, Gerosa C, Mobilia F, and Raineri M
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- Aged, Cholecystectomy, Laparoscopic methods, Cholelithiasis diagnosis, Cholelithiasis surgery, Documentation methods, Feasibility Studies, Hospitals, University, Humans, Italy, Male, Treatment Outcome, Hospital Information Systems, Liability, Legal, Malpractice legislation & jurisprudence, Medical Records Systems, Computerized
- Abstract
The use of innovative technologies in the health sector can be a key element in clinical risk management. In order to reduce errors in medical recording and to provide medico-legal evidence, Digital Pen & Paper technology has been adopted by medical staff of a hospital in Milan. The Authors introduce the first results of this trial: notable advantages have been reported in compilation, transmission and storage of medical records. Furthermore, this technology could provide evidence in evaluating medical malpractice claims.
- Published
- 2014
23. [Position paper: air pollution and cardiovascular diseases].
- Subjects
- Adult, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Child, Female, Health Policy, Humans, Italy epidemiology, Male, Meta-Analysis as Topic, Pregnancy, Prenatal Exposure Delayed Effects, Vulnerable Populations, Air Pollution adverse effects, Cardiovascular Diseases etiology, Urban Health
- Published
- 2012
24. [Update to the position paper of the Italian Society of Interventional Cardiology (SICI-GISE) on institutional and operator requirements for transcatheter aortic valve implantation (TAVI). Chapter 2: Technical nursing care in TAVI].
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Longoni M, Chiarabelli M, Germinal F, Negrello F, Migliorini M, and Griggio S
- Subjects
- Aortic Valve surgery, Clinical Competence, Humans, Italy, Patient Safety, Quality of Health Care, Transcatheter Aortic Valve Replacement nursing, Transcatheter Aortic Valve Replacement standards, Aortic Valve pathology, Aortic Valve Stenosis surgery, Calcinosis surgery, Transcatheter Aortic Valve Replacement methods
- Abstract
Calcific degenerative aortic stenosis is the most frequent valve disease in the western population. Transcatheter aortic valve implantation procedures are significantly increasing, as they now represent the first choice in inoperable patients and have been shown to be non-inferior to cardiac surgery in patients at high and intermediate surgical risk. In this scenario, it is necessary to define and standardize the technical nursing care to guarantee patient safety and improve quality of care.The purpose of this document is to propose, on the basis on currently available literature, a model for the development of assistance based on shared objectives and clinical competence.
- Published
- 2020
- Full Text
- View/download PDF
25. [Position paper of the Italian Society of Interventional Cardiology (SICI-GISE): Management of patent foramen ovale in patients with cerebral or systemic thromboembolism - 2020].
- Author
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Tarantini G, D'Amico G, Baracchini C, Berni A, Berti S, Chessa M, Esposito G, Gaspardone A, Menozzi A, Meucci F, Musumeci G, Onorato E, Rigattieri S, Saia F, Santoro P, Scacciatella P, Trabattoni D, Fraccaro C, and Pristipino C
- Subjects
- Cardiology, Decision Making, Humans, Intracranial Thrombosis pathology, Italy, Risk Factors, Thromboembolism pathology, Foramen Ovale, Patent therapy, Intracranial Thrombosis complications, Thromboembolism complications
- Abstract
Patent foramen ovale (PFO) is implicated in the pathogenesis of different clinical syndromes in which it plays variable roles. In 2017 and 2018, four randomized clinical trials were published, allowing for the clarification of certain issues pertaining to cryptogenic stroke. Recently, eight European scientific societies collaborated to the writing of an interdisciplinary international position paper on PFO and cryptogenic stroke, based upon best available evidence, with the aim of defining the principles needed to guide decision making. Nonetheless, a tailored approach is not suitably addressed by standard position documents, considering that decisions about optimal management of PFO patients with left circulation thromboembolism are often challenging, mostly due to comorbidities and complex clinical scenarios.A panel of Italian cardiology experts gathered under the auspices of the Italian Society of Interventional Cardiology (SICI-GISE) for comprehensive discussion and consensus development, with the aim of providing practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of PFO in patients with cerebral or systemic thromboembolism. In this position paper, various clinical scenarios in patients with and without high-risk PFO features are presented and discussed, including PFO patients with associated conditions (e.g. hypercoagulable states, deep vein thrombosis/pulmonary embolism, short runs of atrial fibrillation), and special subsets (e.g. patients with risk factors for atrial fibrillation, patients aged ≥65 years, patients who refused percutaneous PFO closure), with the Panel's recommendations being provided for each scenario.
- Published
- 2020
- Full Text
- View/download PDF
26. [HPV vaccination: not only female adolescents and not only prophylactic. Review and position paper of the Italian HPV Study Group (IHSG)].
- Author
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Origoni M, Cristoforoni P, Mariani L, Costa S, Preti M, Sandri MT, Preti EP, Ghelardi A, and Perino A
- Subjects
- Adolescent, Adult, Age Factors, Female, Humans, Italy, Male, Papillomavirus Infections complications, Papillomavirus Infections epidemiology, Uterine Cervical Neoplasms prevention & control, Uterine Cervical Neoplasms virology, Papillomavirus Infections prevention & control, Papillomavirus Vaccines administration & dosage, Vaccination methods
- Abstract
HPV vaccination has been introduced in clinical practice in recent years and represents the most effective strategy of primary prevention of cervical carcinoma and of female genital preneoplastic conditions. One of the major issues of the subject is represented by vaccination coverage of the target population. Since its introduction, HPV vaccine efficacy has been progressively demonstrated also towards extragenital HPV-correlated conditions and in males too. Moreover, even subjects of older age groups or subjects who already had HPV infections have been demonstrated to received benefits from vaccination, due to improvements of their immunological response. Recently, vaccine efficacy has also been investigated in terms of adjuvant administration after treatments of preneoplastic or benign conditions of the female lower genital tract caused by HPVs; preliminary results indicate an interesting and promising field of application. On this basis, in this article an analysis of the state of the art has been performed, with specific regard to the Italian scenario and with the focus of future perspectives of implementation of the HPV vaccination policy. From the available evidences, the Italian HPV Study Group recommends the extension of systematic HPV vaccination to males too, to adult subjects and also after conservative treatment of genital HPV correlated conditions.
- Published
- 2019
- Full Text
- View/download PDF
27. [SICI-GISE Position paper on the standards of cardiac catheterization laboratories in Italy: qualitative and quantitative standards of the Nurses and Allied Professionals Group].
- Author
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Magro B, Chiarabelli M, Barisone M, Girotto E, Ciarma L, Miccoli R, Griggio S, Rivera Di Renzo M, Sevier Azzolina S, Badiali B, Bolla G, Ansaloni P, and Longoni M
- Subjects
- Humans, Italy, Societies, Medical, Allied Health Occupations standards, Cardiac Catheterization standards, Cardiovascular Nursing standards
- Abstract
This document aims to be an integral part of the SICI-GISE position document on standards and guidelines for cardiovascular diagnostic intervention laboratories published in October 2015. It was created with the aim of defining quality and quantitative standards by providing practical support for the structuring of a training course to reach high levels of assistance for nursing and technical personnel working within the catheterization laboratories. The competences detected are the expression of a highly specialized organizational and operational reality that combines technicality with a well-defined clinical assistance need as an expression of a real patient care. The Nurses & Technicians Area of SICI-GISE aimed at issuing a flexible and dynamic document based on technical and operational progress which, in addition to defining qualitative and quantitative standards, describes the underlying knowledge of the professionals of the sector operating in our laboratories. This is the first experience that, through a survey carried out in 2015, has been able to decline qualitative and quantitative data so as to provide resources and skills for measuring and improving assistance outcomes.
- Published
- 2019
- Full Text
- View/download PDF
28. UN INEDITO DI ALESSANDRO PADOA.
- Author
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Borga, Marco, Fenaroli, Giuseppina, and Garibaldi, Antonio C.
- Subjects
MANUSCRIPTS ,AXIOMS ,GEOMETRY ,MATHEMATICAL proofs - Abstract
Some years ago the authors of the present paper found in the Fondo Padoa lying in the Mathematical Library of Genoa University a manuscript of 11 pages by Alessandro Padoa with the title A proposito di un nuovo sistema fondamentale della geometria elementare. It seems to be ready for publication and contains also typographical instruction for printing. Other investigations on Padoa and his rôle in Peano's school led in a series of recent papers to a probably complete list of Padoa's publications where, however, the above mentioned manuscript is not present and, therefore, is likely to be considered an unpublished paper. It's a matter of fact that the whole of Padoa's scientific production has to be integrated by some works that he didn't publish. The unpublished paper under examination deals with the axiomatization of elementary geometry given by Mario Pieri in 1899 in "Della geometria elementare come sistema ipotetico deduttivo. Monografia del punto e del moto", where, as it is well-known, elementary geometry is based on the primitive notions of point and movement and on 20 postulates. Padoa agrees with Pieri's proposal to define segment starting from point and movement; he suggests, however, some modification to the original set of postulates and gives a (partial) proof of their independence. The unpublished paper reveals the interest of Padoa in this subject-matter and, in some sense, his idea of participating in the already consolidated field of research represented by Pieri's results. [ABSTRACT FROM AUTHOR]
- Published
- 2009
29. [Mortality among workers employed in the production of pulp and paper in Apulia].
- Author
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Sivo D, Bisceglia L, de Nichilo G, Bruno S, and Assennato G
- Subjects
- Female, Humans, Italy epidemiology, Male, Paper, Chemical Industry, Occupational Diseases mortality
- Abstract
The authors studied a cohort of 2660 pulp and paper workers in Capitanata, Apulia (Italy). All workers with at least 1 year of employment on January 1 1965 or thereafter until march 30, 2000 where studied. Standardized Mortality Ratios (SMRs) were used to compare the mortality rates of the cohort with those of Apulian population. Ninetyfive percent confidence intervals (CIs) for SMRs were obtained. Cancer risks significantly associated with work where observed: all causes for males (SMR 112.09, 95% CI 104.91-119.77), brain cancer for males (SMR 206.04, 95% CI 103.04-412.01), digestive tract for males (SMR 126.78, CI 100.63-159.73). Association with other malignancies are suggested in this study for Laryngeal and Kidney. These malignancies have been associated with different exposures in the production cycle: biocides (Kidney), Formaldehyde (Kidney, Brain). Unclear is the risk factor for the excess showed in digestive tract cancer.
- Published
- 2003
30. [Pleural mesothelioma in women in the Veneto Region who used to work as rag sorters for textile recycling and paper production].
- Author
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Merler E, Gioffrè F, Rozio L, Bizzotto R, Mion M, and Sarto F
- Subjects
- Aged, Female, Humans, Italy, Mesothelioma pathology, Middle Aged, Occupational Diseases pathology, Paper, Pleural Neoplasms pathology, Textiles, Time Factors, Mesothelioma epidemiology, Occupational Diseases epidemiology, Pleural Neoplasms epidemiology
- Abstract
The paper reports 9 cases of mesothelioma diagnosed by means of histology or cytology that were observed among women resident in the Veneto Region, Northern Italy, whose only activity that could involve exposure to asbestos was as rag sorter. These cases are part of a group of about 260 subjects with mesothelioma whose entire working and residential history has been collected. The women worked as rag sorters between the 1940's and 1960's in textile recycling (8 cases) or (one case) at a paper mill where cotton was used for paper production. The work as rag sorter helps to explain the high proportion of mesotheliomas among women with an occupational exposure to asbestos.
- Published
- 2001
31. [Updated SICI-GISE position paper on institutional and operator requirements for transcatheter aortic valve implantation].
- Author
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Tarantini G, Esposito G, Musumeci G, Fraccaro C, Franzone A, Castiglioni B, La Manna A, Limbruno U, Marchese A, Mauro C, Rigattieri S, Tarantino F, Gandolfo C, Santoro G, Violini R, Airoldi F, Albiero R, Balbi M, Baralis G, Bartorelli AL, Bedogni F, Benassi A, Berni A, Bonzani G, Bortone AS, Braito G, Briguori C, Brscic E, Calabrò P, Calchera I, Cappelli Bigazzi M, Caprioglio F, Castriota F, Cernetti C, Cicala C, Cioffi P, Colombo A, Colombo V, Contegiacomo G, Cremonesi A, D'Amico M, De Benedictis M, De Leo A, Di Biasi M, Di Girolamo D, Di Lorenzo E, Di Mario C, Dominici M, Ettori F, Ferrario M, Fioranelli M, Fischetti D, Gabrielli G, Giordano A, Giudice P, Greco C, Indolfi C, Leonzi O, Lettieri C, Loi B, Maddestra N, Marchionni N, Marrozzini C, Medda M, Missiroli B, My L, Oreglia JA, Palmieri C, Pantaleo P, Paparoni SR, Parodi G, Petronio AS, Piatti L, Piccaluga E, Pierli C, Perkan A, Pitì A, Poli A, Ramondo AB, Reale MA, Reimers B, Ribichini FL, Rosso R, Saccà S, Sacra C, Santarelli A, Sardella G, Satullo G, Scalise F, Siviglia M, Spedicato L, Stabile A, Tamburino C, Tesorio TNM, Tolaro S, Tomai F, Trani C, Valenti R, Valsecchi O, Valva G, Varbella F, Vigna C, Vignali L, and Berti S
- Subjects
- Aortic Valve Stenosis physiopathology, Biomedical Technology trends, Humans, Italy, Severity of Illness Index, Transcatheter Aortic Valve Replacement instrumentation, Aortic Valve Stenosis surgery, Program Development methods, Transcatheter Aortic Valve Replacement methods
- Abstract
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.
- Published
- 2018
- Full Text
- View/download PDF
32. [Determination of PCBs in carbonless copying papers (author's transl)].
- Author
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Belliardo F, Nano GM, Pavan I, and Scansetti G
- Subjects
- Chromatography, Gas methods, Copying Processes, Gas Chromatography-Mass Spectrometry methods, Italy, Polychlorinated Biphenyls toxicity, Paper, Polychlorinated Biphenyls analysis
- Published
- 1979
33. (Un)useful digital technology and literature between printing and voice.
- Author
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Dodi, Carla Alexia
- Subjects
DIGITAL technology ,ELECTRONIC paper ,PODCASTING ,DIGITAL media ,ELECTRONIC books - Abstract
Printed books would be about to die in front of the advantages offered by the digital world. But for 750 million illiterates over 15 worldwide, for two-thirds women (UNESCO, 2017), literature does not go through digital or printing on paper. There is also a disturbing degree of returning or functional illiteracy, significantly affecting a part of European population. Starting from an idea of literature that is above all the art of the word, the article analyzes the (in)utility of digital media compared to the emotional impact and prestige possessed by printed books; the relationship between e-books and printed books in the self-publishing sector; the importance of the human voice as an ancient and very modern means of telling stories and conveying emotions. Recent statistical data (e.g. Pepe Research, 2020) show the success of audiobooks and podcasts in Covid times, in Italy and in the "Westernworld", and for some types of disabilities. The article underlines the need to recompose the competition between digital and printed books into a fruitful collaboration. Finally, it is highlighted that the voice is, still today and everywhere - from the hi-tech world to African storytellers -an extraordinary tool to produce and promote knowledge about literature. [ABSTRACT FROM AUTHOR]
- Published
- 2022
34. [Position paper of the Italian Society of Interventional Cardiology (SICI-GISE): antithrombotic therapy in elderly patients with acute coronary syndrome].
- Author
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Tarantini G, Berti S, De Luca L, De Servi S, Favero L, Ferlini M, La Manna A, Marchese A, Mauro C, Menozzi A, Mojoli M, Paradies V, Varbella F, and Musumeci G
- Subjects
- Aged, Aged, 80 and over, Fibrinolytic Agents adverse effects, Humans, Italy, Treatment Outcome, Acute Coronary Syndrome therapy, Angioplasty, Balloon, Coronary methods, Fibrinolytic Agents therapeutic use, Frail Elderly, Myocardial Infarction therapy
- Abstract
With the ageing of the population in the Western world, an increasing proportion of patients seen in cardiology practice is represented by the elderly. Although approximately one third of patients admitted with acute coronary syndrome (ACS) are >75 years old and the mortality rate in this age group is doubled compared with younger patients, this population is underrepresented in randomized controlled trials and, consequently, clinical guidelines do not always provide clear indications for the management of elderly patients. Therefore, there is an unmet need for clinical guidance regarding this rapidly growing subset of ACS patients, also considering that decisions about optimal antithrombotic treatment strategies in the elderly are often challenging, mostly due to age-related organ dysfunction, the frequency of comorbidities and concomitant medications and an increased risk of both ischemic and bleeding events. A panel of Italian cardiology experts assembled under the auspices of the Italian Society of Interventional Cardiology (SICI-GISE) for comprehensive discussion and consensus development, with the aim to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic therapy in patients with ACS aged ≥75 years. In this position paper, various clinical scenarios in patients with ST-elevation and non-ST-elevation myocardial infarction or unstable angina are presented and discussed, including special subsets (e.g., patients aged ≥85 years, patients with chronic renal disease or previous cerebrovascular events, patients requiring triple therapy or long-term antithrombotic therapy), with the panel's recommendations being provided for each scenario.
- Published
- 2016
- Full Text
- View/download PDF
35. [Position paper of the Italian Society of Invasive Cardiology (SICI-GISE) on indications for coronary angiography in patients with stable angina].
- Author
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Marchese A, Rossini R, Basile M, Bedogni F, Danzi GB, Musumeci G, Paradies V, Piccaluga E, Sardella G, Varbella F, Giordano A, and Berti S
- Subjects
- Aged, Aged, 80 and over, Coronary Artery Disease epidemiology, Humans, Italy, Male, Prevalence, Angina, Stable diagnosis, Coronary Angiography methods, Coronary Artery Disease diagnosis
- Abstract
Available data suggest a steep increase in stable coronary artery disease with age. Its prevalence reaches a peak of almost 12-14% in men aged 65-84 years with an annual mortality ranging from 1.2% to 2.4%. The diagnosis of stable angina is primarily based on history and therefore relies on clinical judgment. In addition, its diagnosis can be extremely challenging because of the frequent transition from unstable to stable angina. Current European guidelines on the management of stable coronary artery disease give increased importance to the pre-test probability, which strongly affects the diagnostic algorithms. Imaging techniques play a greater role in the diagnosis of stable angina than in the past. Conversely, despite recent advances in technology and in the physiological assessment of coronary stenosis, an ever decreasing relevance is conferred to coronary angiography. Another difficult and controversial issue relates to the prognostic benefit of myocardial revascularization. The aim of this position paper is to review the most relevant clinical aspects of the European guidelines on the management of stable coronary artery disease.
- Published
- 2015
- Full Text
- View/download PDF
36. [SICI-GISE position paper on standards and guidelines for diagnostic and catheterization laboratories].
- Author
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Piccaluga E, Marchese A, Varbella F, Sardella G, Danzi GB, Salvi A, Cremonesi A, Merelli A, Ciarma L, Magro B, and Bedogni F
- Subjects
- Acute Coronary Syndrome therapy, Cardiac Catheterization standards, Coronary Artery Disease therapy, Endovascular Procedures methods, Endovascular Procedures standards, Humans, Italy, Standard of Care, Acute Coronary Syndrome diagnosis, Cardiac Catheterization methods, Coronary Artery Disease diagnosis
- Abstract
In the last few years, the activity of cath labs has undergone some notable changes, at present largely focusing on diagnosis and invasive therapy of a broad spectrum of cardiovascular diseases. Technological and pharmacological advances have allowed for procedures to be performed in patients who are increasingly complex, and cath labs have become the preferred venue for endovascular treatment of coronary artery disease, in particular acute coronary syndrome, as well as the treatment of structural heart disease and peripheral vascular disease. This position paper is an update of the 1996 and 2008 versions, given the present level of experience and the situation in Italy. It aims to provide the quality standards required to maintain adequate conditions of know-how and safety, as well as the structural and organizational requirements that are fundamental to obtain the best possible use of human and technological resources. Position papers should be a stimulus and guide for operators in the field as well as for those who govern health policies. This should allow for an improved and more rational allocation of cath labs in Italy, based on the real need for procedures and an optimal distribution and organization of the cardiovascular emergency networks while respecting the minimum standards of care.
- Published
- 2015
- Full Text
- View/download PDF
37. [Position paper on the theoretical basis, practical application and health economic evaluation of the functional assessment of coronary lesions endorsed by the Italian Society of Invasive Cardiology (SICI-GISE)].
- Author
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Bedogni F, Indolfi C, Ribichini F, Verna E, Leone AM, Polimeni A, Bollati M, Biondi-Zoccai G, Testa L, and Berti S
- Subjects
- Adenosine Triphosphate, Cardiac Catheterization economics, Cardiac Catheterization methods, Cardiac Catheterization standards, Clinical Trials as Topic, Collateral Circulation, Coronary Circulation, Coronary Stenosis diagnosis, Coronary Stenosis physiopathology, Diastole, Evidence-Based Medicine, Hemodynamics, Humans, Italy, Multicenter Studies as Topic, Myocardial Contraction, Nitroprusside, Papaverine, Vasodilator Agents, Fractional Flow Reserve, Myocardial, Heart Function Tests economics, Heart Function Tests methods, Heart Function Tests standards
- Abstract
Functional assessment of coronary lesions has become an integral part of routine practice in most cath labs. Such evaluation is performed using a pressure wire that allows measurement of fractional flow reserve (FFR). The latter has received a class I indication with level of evidence A according to the most recent European guidelines on myocardial revascularization for the assessment of angiographically moderate coronary lesions. The present document has the following objectives: 1) to summarize the theoretical basis of FFR; 2) to provide a guideline for vasodilator therapy; 3) to summarize scientific evidence supporting FFR; 4) to provide a model of health economy evaluation focusing on resource sparing associated with the use of FFR.
- Published
- 2015
- Full Text
- View/download PDF
38. [GISE/AIAC position paper on percutaneous left atrial appendage occlusion in patients with nonvalvular atrial fibrillation: recommendations for patient selection, facilities, competences, organizing and training requirements].
- Author
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Berti S, Themistoclakis S, Santoro G, De Ponti R, Danna P, Zecchin M, Bedogni F, and Padeletti L
- Subjects
- Anticoagulants therapeutic use, Atrial Fibrillation complications, Clinical Competence, Humans, Italy, Patient Care Team organization & administration, Patient Selection, Atrial Appendage surgery, Atrial Fibrillation therapy, Septal Occluder Device, Stroke prevention & control
- Abstract
Thromboembolism from the left atrial appendage is the most feared complication in patients with atrial fibrillation (AF). The cornerstone for the management of chronic nonvalvular AF is stroke reduction with oral anticoagulation (OAC). However, poor compliance, maintaining a narrow therapeutic window, and major side effects such as bleeding have severely limited its use, creating a therapeutic dilemma. About 20% of AF patients do not receive OAC due to contraindications and less than half of AF patients are not on OAC due to reluctance of the prescribing physician and/or patient non-compliance. Fortunately, over the past decade, the introduction of percutaneous approaches for left atrial appendage occlusion has offered a viable alternative to the management of nonvalvular AF in patients with OAC contraindication. Occlusion devices such as the Amplatzer Cardiac Plug and Watch man device have shown their noninferiority to OAC for stroke prophylaxis with less bleeding complications, while more recently some new devices have been introduced. The aim of this position paper is to review the most relevant clinical aspects of left atrial appendage occlusion from patient selection to periprocedural and follow-up management. In addition, the importance of a medical team and an organizational environment adequate to optimize all the steps of this procedure is discussed.
- Published
- 2014
- Full Text
- View/download PDF
39. [Part I. End-stage chronic organ failures: a position paper on shared care planning. The Integrated Care Pathway].
- Author
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Gristina GR, Orsi L, Carlucci A, Causarano IR, Formica M, and Romanò M
- Subjects
- Consensus Development Conferences as Topic, Delivery of Health Care, Integrated, Humans, Italy, Practice Guidelines as Topic, Chronic Disease therapy, Critical Care, Critical Pathways, Decision Making, Multiple Organ Failure therapy, Palliative Care, Terminally Ill
- Abstract
In Italy the birth rate decrease together with the continuous improvement of living conditions on one hand, and the health care progress on the other hand, led in recent years to an increasing number of patients with chronic mono- or multi-organ failures and in an extension of their life expectancy. However, the natural history of chronic failures has not changed and the inescapable disease's worsening at the end makes more rare remissions, increasing hospital admissions rate and length of stay. Thus, when the "end-stage" get close clinicians have to engage the patient and his relatives in an advance care planning aimed to share a decision making process regarding all future treatments and related ethical choices such as patient's best interests, rights, values, and priorities. A right approach to the chronic organ failures end-stage patients consists therefore of a careful balance between the new powers of intervention provided by the biotechnology and pharmacology (intensive care), both with the quality of remaining life supplied by physicians to these patients (proportionality and beneficence) and the effective resources rationing and allocation (distributive justice). However, uncertainty still marks the criteria used by doctors to assess prognosis of these patients in order to make decisions concerning intensive or palliative care. The integrated care pathway suggested in this position paper shared by nine Italian medical societies, has to be intended as a guide focused to identify end-stage patients and choosing for them the best care option between intensive treatments and palliative care.
- Published
- 2014
- Full Text
- View/download PDF
40. [Parte III. Ethical and juridical aspects in end-stage chronic organ failures. A position paper on a shared care planning].
- Author
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Barbisan C, Casonato C, Palermo Fabris E, Piccinni M, and Zatti P
- Subjects
- Algorithms, Consensus Development Conferences as Topic, Decision Making, Evidence-Based Medicine, Health Personnel, Humans, Italy, Patient Rights, Chronic Disease therapy, Multiple Organ Failure therapy, Palliative Care ethics, Palliative Care legislation & jurisprudence
- Abstract
The specific target of an experts panel was to assess in terms of law and ethics the compliance of a new specific decision making algorithm described in the position paper proposed by the Gruppo di Lavoro Insufficienze Croniche d'Organo, with the main goal of the position paper consisting in the shared care planning process. The following specific aspects were assessed by the experts: a) the impact on case law and statute law of a new clinical pathway shared by scientific societies in light of good clinical practice and scientific evidence; b) the relevance of all tools useful to identify the appropriateness of care pathways, recognizing responsibilities and decision-making skills related to the end of life choices made by all stakeholders involved (healthcare professionals, patients and their beloved ones); c) the consistency of the healthcare professionals duties proposed in the position paper with the Italian legal order; d) the opportunity to take into account the role of all healthcare providers involved in care relationship; e) the consistency of the definition of patient rights at the end of life as proposed in the position paper with the Italian legal order and the relevance in this context of simultaneous palliative care; f) the relevance of shared care planning and its consistency with the proposed operative tools; g) the relevance of the conscientious objection issue and the compliance of management tools proposed in the position paper with the results of ethical and legal considerations; h) considerations about available resources allocation.
- Published
- 2014
- Full Text
- View/download PDF
41. [Part II. Scientific evidence in end-stage chronic organ failure. A position paper on shared care planning].
- Author
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Gristina GR, Orsi L, Carlucci A, Causarano IR, Formica M, and Romanò M
- Subjects
- Algorithms, Consensus Development Conferences as Topic, Evidence-Based Medicine, Humans, Italy, Societies, Medical, Chronic Disease therapy, Decision Making, Interdisciplinary Communication, Multiple Organ Failure therapy, Terminal Care standards
- Abstract
The therapeutic options related to chronic organ failure are interconnected to the variability of human biological responses and the personal history and choices of the chronically ill patient on one hand, and with the variable human answers to therapies on the other hand. All these aspects may explain the small number and low quality of studies aimed to define the clinical criteria useful in identifying end-stage chronically ill patients, as highlighted through the 2012-2013 Medline survey performed by the task force. These results prevented the grading of scientific evidence. However, taking into account the evidence based medicine definition, the task force believes the clinical reasoning and the individual experience of clinicians as well as the patients and families preferences cannot be replaced "tout court" with a strict methodological research. Accordingly, the working method selected by the task force members was to draw up a set of clinical parameters based on the available scientific literature, submitting it to a peer review process carried out by an expert panel. This paper discusses a set of clinical parameters included in the clinical decision-making algorithm and shared by nine medical societies. For each chronic organ failure these clinical parameters should be intended not as a rigid cutoff system to make a choice between two selected care options (intensive vs palliative), rather as the starting point for a joint and careful consideration regarding the opportunity to adopt the clinical decision-making algorithm care proposed in Part I.
- Published
- 2014
- Full Text
- View/download PDF
42. Valutazione dei prodotti scientifici nell'area giuridica e ruolo delle tecnologie digitali.
- Author
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Caso, Roberto and Pascuzzi, Giovanni
- Subjects
- *
DIGITAL technology , *LEGAL education , *COMPARATIVE studies , *OPEN access publishing , *SCIENTIFIC community , *QUANTITATIVE research - Abstract
In order to evaluate the scientific products of the Italian legal scholarship and make them comparable with the outputs in other scientific areas, some institutional actors have proposed to classify different scientific works (monographs, articles, notes etc.), publishers and journals. Part of learned societies in legal area have published a joint "Document on evaluation" (October 1, 2010) about methods and criteria that should be applied by various institutional organizations for several purposes. The aim of this paper is to offer a critique of that document, as well as to suggest that digital technologies (in particular, Open Access to science) might play a prominent role in the evaluation of products in the legal science field. [ABSTRACT FROM AUTHOR]
- Published
- 2011
43. [Strategies for improving blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy. 2012 Position paper of the Italian Society of Hypertension].
- Author
-
Volpe M, Ambrosioni E, Borghi C, Cottone S, Cuspidi C, De Luca N, Fallo F, Ferri C, Morganti A, Muiesan ML, Sarzani R, Sechi L, Virdis A, Tocci G, Agabiti-Rosei E, Trimarco B, Filippi A, and Mancia G
- Subjects
- Cardiovascular Diseases, Combined Modality Therapy, Humans, Italy, Risk Assessment, Hypertension therapy
- Abstract
Observational studies demonstrate that the proportion of treated hypertensive patients who attain the recommended blood pressure goals (140/90 mmHg) does not exceed 30-40%. Conversely, clinical trials have consistently shown that effective blood pressure control within the recommended targets can be achieved in 70-80% of treated hypertensive patients with different cardiovascular risk profile, especially when appropriate, effective and well tolerated combination therapies are used. In order to bridge the gap between current and optimal blood pressure control rates and to achieve a more effective cardiovascular prevention, the Italian Society of Hypertension has recently developed an interventional strategy that aims to approximate 70% of treated controlled patients by 2015. This ambitious goal can be realistically achieved by the appropriate use of modern aids and tools, also including the implementation of combination therapy, especially if this approach can be simplified into a single pill, now available in Italy. At present, 70-80% of hypertensive patients require combination therapies based on at least two classes of antihypertensive drugs to achieve the recommended blood pressure goals. It is therefore of paramount importance to implement this strategy in routine clinical practice. Among the different combination therapies, the use of combination strategies based on drugs inhibiting the renin-angiotensin system, such as angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, combined with diuretics and/or calcium-channel blockers, have demonstrated to significantly reduce the rates of major cardiovascular events and discontinuations from prescribed therapies, resulting in higher antihypertensive efficacy and better tolerability than monotherapy. The present document of the Italian Society of Hypertension aims to provide main indications for implementing combination therapy in the clinical management of hypertension in order to improve blood pressure control in Italy.
- Published
- 2012
- Full Text
- View/download PDF
44. [Training and accreditation in cardiovascular magnetic resonance imaging: a position paper of the Working Group on Magnetic Resonance Imaging of the Italian Society of Cardiology and of the Working Group on Cardiovascular Imaging of the Italian Association of Hospital Cardiologists].
- Author
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Roghi A, Dellegrottaglie S, and Perna GP
- Subjects
- Humans, Italy, Accreditation, Cardiology education, Diagnostic Techniques, Cardiovascular, Magnetic Resonance Imaging
- Abstract
Cardiovascular magnetic resonance (CMR) imaging has become an established imaging modality requiring the definition of standards for data acquisition, reporting and training, recently addressed by a position statement of the Working Group on Cardiovascular Magnetic Resonance of the European Society of Cardiology (ESC). Taking into account the particular difficulties related to CMR implementation in our country, the Working Group on CMR of the Italian Society of Cardiology and the Working Group on Cardiovascular Imaging of the Italian Association of Hospital Cardiologists have prepared this document with the aim to address the logistic, cultural and training problems inhibiting CMR dissemination. The present paper provides recommendations for the inclusion in the School of Cardiology training curriculum of CMR training as suggested by the ESC training curriculum as well as recommendations concerning cardiovascular and radiological training for certification in CMR. The proposal for the institutional accreditation is discussed, including recommendations for case-load, case-mix, structured training programs, and safety of CMR studies.
- Published
- 2012
- Full Text
- View/download PDF
45. [Risk hypothesis in the use of "non-carbon copy paper"].
- Author
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Maggio M, Benvenuti F, and D'Emilio M
- Subjects
- Humans, Italy, Coloring Agents adverse effects, Copying Processes standards, Occupational Diseases chemically induced, Paper standards, Polychlorinated Biphenyls adverse effects
- Abstract
Some kinds of "carbon less copy-paper" presently used in Italy were examined. The analysis showed the presence on the paper of mycrocapsules containing special inks formed by organic dyes dissolved in mineral oil and, sometimes, polychlorobyfenils. Therefore there is a possible risk for the workers using carbon less copy-paper. It is necessary therefore to complete the research in order to demonstrate this hypothesis also from biological point of view.
- Published
- 1978
46. [Prophylaxis of infective endocarditis. Joint position paper of the Italian Federation of Cardiology and the Italian Society of Infectious and Tropical Diseases].
- Author
-
Cecchi E, De Rosa FG, Chirillo F, Petrelli E, Oreto G, Suter F, Lagioia R, Viale P, Enia F, Bassetti M, Venditti M, Petrosillo N, Utili R, and Imazio M
- Subjects
- Animals, Antibiotic Prophylaxis methods, Endocarditis, Bacterial epidemiology, Endocarditis, Bacterial etiology, Endocarditis, Bacterial mortality, Evidence-Based Medicine, Humans, Italy epidemiology, Risk Assessment, Risk Factors, Societies, Medical, Anti-Bacterial Agents therapeutic use, Endocarditis, Bacterial prevention & control, Practice Guidelines as Topic standards
- Published
- 2009
47. [AIE postion paper on waste management: a consumer opinion].
- Author
-
Tomei F
- Subjects
- Italy, Waste Management
- Published
- 2009
48. [AIE position paper on waste management and health: work in progress].
- Author
-
Bianchi F and Terracini B
- Subjects
- Epidemiology, Italy, Societies, Scientific, Health, Waste Management standards
- Published
- 2008
49. [Waste management and health. Position paper of the Italian Association of Epidemiology].
- Subjects
- Epidemiology, Incineration, Italy, Risk Factors, Societies, Health, Waste Management
- Published
- 2008
50. [Survey to evaluate fees charged and time limits for issuing a medical records's paper copy by hospitals of Lazio Region (Italy)].
- Author
-
Rosati E, Maurici M, Manizzi S, Muzzi A, and Panà A
- Subjects
- Catchment Area, Health, Data Collection, Fees and Charges, Humans, Italy, Time Factors, Copying Processes economics, Hospitals, Private statistics & numerical data, Hospitals, Public statistics & numerical data, Medical Records economics
- Abstract
Aim of the present study was to evaluate the different fees charged for providing paper copies of medical records and time limits for their delivery. The analysis involved all the public and private hospitals in Lazio Region (Italy). The authors administered a short telephone questionnaire to the medical affairs direction of all the hospitals in the survey. In 94.6% of cases (n=106 hospitals) the requested information have been provided. Data analysis showed that average fee charged for issuing copies of medical records was, respectively, 13.90 vs 12.66 euro for inpatient and day hospital. Average time limits for dealing with a request for paper copies of medical records was 24.2 days, less than time established by Italian Law (30 days). The survey showed, however, a huge variability that concerns both the fees and times of issue of medical charts.
- Published
- 2008
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