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1. Clinical management of older, frail patients with atrial fibrillation. The proposal of a multidisciplinary working group

Author

Marchionni, N, Fumagalli, S, Bo, M, Boccanelli, A, Boriani, G, Rubboli, A, Violi, F, Di Pasquale, G, Beer, B, Colonna, P, Manetti, L, Pilleri, A, Purificato, F, Ruotolo, G, Sciacqua, A, Taberini, L, Turcato, E, Bozzato, S, Catanzariti, D, Felici, M, Florio, C, Fontana, F, Giomi, A, Masala, R, Mascia, G, Nassiacos, D, Nesti, M, Okoye, C, Pestelli, G, Bassi, V, Curci, S, D'Avino, M, Doimo, S, Faustino, M, Gemmiti, M, Pignatelli, P, Sarli, G, Stefanoni, P, Ciccone, M, Diemberger, I, Gragnano, F, Serafini, F, Marchionni N., Fumagalli S., Bo M., Boccanelli A., Boriani G., Rubboli A., Violi F., Di Pasquale G., Beer B., Colonna P., Manetti L. L., Pilleri A., Purificato F., Ruotolo G., Sciacqua A., Taberini L., Turcato E., Bozzato S., Catanzariti D., Felici M., Florio C., Fontana F., Giomi A., Masala R., Mascia G., Nassiacos D., Nesti M., Okoye C., Pestelli G., Bassi V., Curci S., D'Avino M., Doimo S., Faustino M., Gemmiti M. P., Pignatelli P., Sarli G., Stefanoni P., Ciccone M., Diemberger I., Gragnano F., Serafini F., Marchionni, N, Fumagalli, S, Bo, M, Boccanelli, A, Boriani, G, Rubboli, A, Violi, F, Di Pasquale, G, Beer, B, Colonna, P, Manetti, L, Pilleri, A, Purificato, F, Ruotolo, G, Sciacqua, A, Taberini, L, Turcato, E, Bozzato, S, Catanzariti, D, Felici, M, Florio, C, Fontana, F, Giomi, A, Masala, R, Mascia, G, Nassiacos, D, Nesti, M, Okoye, C, Pestelli, G, Bassi, V, Curci, S, D'Avino, M, Doimo, S, Faustino, M, Gemmiti, M, Pignatelli, P, Sarli, G, Stefanoni, P, Ciccone, M, Diemberger, I, Gragnano, F, Serafini, F, Marchionni N., Fumagalli S., Bo M., Boccanelli A., Boriani G., Rubboli A., Violi F., Di Pasquale G., Beer B., Colonna P., Manetti L. L., Pilleri A., Purificato F., Ruotolo G., Sciacqua A., Taberini L., Turcato E., Bozzato S., Catanzariti D., Felici M., Florio C., Fontana F., Giomi A., Masala R., Mascia G., Nassiacos D., Nesti M., Okoye C., Pestelli G., Bassi V., Curci S., D'Avino M., Doimo S., Faustino M., Gemmiti M. P., Pignatelli P., Sarli G., Stefanoni P., Ciccone M., Diemberger I., Gragnano F., and Serafini F.

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in elderly people. Older patients with AF have several comorbidities and should be treated with complex therapeutic schemes. Arrhythmia complications are also common at an advanced age. Accordingly, AF can be considered a marker of frailty. Few indications can be found concerning the management of frail older subjects in current guidelines. The Frailty in Atrial Fibrillation Survey Study (FAST) was designed to overcome the gap of knowledge about this extremely vulnerable subset of patients. A multidisciplinary team composed by cardiologists, geriatricians and internists participated in the project. In a first phase, a survey was conducted aiming at clarifying specialty-related differences in definition and oral anticoagulant therapy (OAT) management of frail individuals. In the second phase, specific chapters were prepared about AF and frailty epidemiology, the network for the management of the arrhythmia, the diagnostic strategies for AF (including a minimum data set of tools derived from the geriatric multidimensional assessment), OAT and the choice between a rate or a rhythm control strategy. For each chapter, up-to-date evidence and current guideline recommendations were presented and discussed among the 47 Italian centers participating in the project. In the last phase of FAST, the results of the survey and the final draft of the chapters were merged into the present document. A lack of homogeneity in frailty definition existed. The integration among cardiologists, geriatricians and internists can represent the most effective tool to get through these differences improving the management of frail older patients.

Published
2021

2. The methodology of the Italian HBSC 2010 study (Health Behaviour in School-aged Children)

Author

Lazzeri, G, Giacchi, M, Dalmasso, P, Vieno, A, Nardone, P, Lamberti, A, Spinelli, A, Cavallo, F, Lemma, P, Berchialla, P, Colombini, S, Zambon, A, Charrier, L, Borraccino, A, Pilato, V, Rossi, S, Pammolli, A, Santinello, M, Chieco, F, Lenzi, M, Baglio, G, Galeone, D, Spizzichino, L, Menzano, M, Scotti, M, Silani, M, Teti, S, Ciglia, A, Di Giacomo, M, Spinosa, S, Ammirati, G, Cauzillo, G, Sorrentino, G, Azzarito, C, La Rocca, M, Pizzuti, R, Mazzarella, G, Di Martino, E, Angelini, P, Fridel, M, Bavcar, A, Castronuovo, G, Pascali, F, Celata, C, Tosi, M, Velasco, V, Bonfanti, M, Coppola, L, Giostra, G, Ciallella, M, Caputo, M, Viesti, E, Rosa, G, Anelli, S, Meloni, S, Senis, M, Masala, R, Cernigliaro, A, Rizzo, S, Giannoni, A, Cristofori, M, Covarino, A, D'Alessandro, G, Piffer, S, Fanolla, A, Weiss, S, Lazzeri G., Giacchi M. V., Dalmasso P., Vieno A., Nardone P., Lamberti A., Spinelli A., Cavallo F., Lemma P., Berchialla P., Colombini S., Zambon A., Charrier L., Borraccino A., Pilato V., Rossi S., Pammolli A., Santinello M., Chieco F., Lenzi M., Baglio G., Galeone D., Spizzichino L., Menzano M. T., Scotti M. T., Silani M. T., Teti S., Ciglia A., Di Giacomo M., Spinosa S., Ammirati G., Cauzillo G., Sorrentino G., Azzarito C., La Rocca M., Pizzuti R., Mazzarella G., Di Martino E., Angelini P., Fridel M., Bavcar A., Castronuovo G. C. E., Pascali F., Celata C., Tosi M., Velasco V., Bonfanti M., Coppola L., Giostra G., Ciallella M. L., Caputo M., Viesti E., Rosa G., Anelli S., Meloni S., Senis M. L., Masala R., Cernigliaro A., Rizzo S., Giannoni A. M., Cristofori M., Covarino A. M., D'alessandro G., Piffer S., Fanolla A., Weiss S., Lazzeri, G, Giacchi, M, Dalmasso, P, Vieno, A, Nardone, P, Lamberti, A, Spinelli, A, Cavallo, F, Lemma, P, Berchialla, P, Colombini, S, Zambon, A, Charrier, L, Borraccino, A, Pilato, V, Rossi, S, Pammolli, A, Santinello, M, Chieco, F, Lenzi, M, Baglio, G, Galeone, D, Spizzichino, L, Menzano, M, Scotti, M, Silani, M, Teti, S, Ciglia, A, Di Giacomo, M, Spinosa, S, Ammirati, G, Cauzillo, G, Sorrentino, G, Azzarito, C, La Rocca, M, Pizzuti, R, Mazzarella, G, Di Martino, E, Angelini, P, Fridel, M, Bavcar, A, Castronuovo, G, Pascali, F, Celata, C, Tosi, M, Velasco, V, Bonfanti, M, Coppola, L, Giostra, G, Ciallella, M, Caputo, M, Viesti, E, Rosa, G, Anelli, S, Meloni, S, Senis, M, Masala, R, Cernigliaro, A, Rizzo, S, Giannoni, A, Cristofori, M, Covarino, A, D'Alessandro, G, Piffer, S, Fanolla, A, Weiss, S, Lazzeri G., Giacchi M. V., Dalmasso P., Vieno A., Nardone P., Lamberti A., Spinelli A., Cavallo F., Lemma P., Berchialla P., Colombini S., Zambon A., Charrier L., Borraccino A., Pilato V., Rossi S., Pammolli A., Santinello M., Chieco F., Lenzi M., Baglio G., Galeone D., Spizzichino L., Menzano M. T., Scotti M. T., Silani M. T., Teti S., Ciglia A., Di Giacomo M., Spinosa S., Ammirati G., Cauzillo G., Sorrentino G., Azzarito C., La Rocca M., Pizzuti R., Mazzarella G., Di Martino E., Angelini P., Fridel M., Bavcar A., Castronuovo G. C. E., Pascali F., Celata C., Tosi M., Velasco V., Bonfanti M., Coppola L., Giostra G., Ciallella M. L., Caputo M., Viesti E., Rosa G., Anelli S., Meloni S., Senis M. L., Masala R., Cernigliaro A., Rizzo S., Giannoni A. M., Cristofori M., Covarino A. M., D'alessandro G., Piffer S., Fanolla A., and Weiss S.

Abstract

Italy has participated in the Health Behaviour in School-aged Children (HBSC) study since 2000. These surveys collect data every four years on the well-being and health behaviour of boys and girls aged 11, 13 and 15. Until 2007, the coordination group of the University of Turin, Siena and Padua directly sent the questionnaires to each sampled school to collect the data. The sample of about 4500 students was nationally representative. In 2008 the HBSC became part of the project "Surveys on behavioral risks in children aged 6-17 years", coordinated by the National Institute of Health (ISS) and promoted by the Ministry of Health, in collaboration with the Ministry of Education, University and Research. For the first time, in 2010, the survey was conducted by health workers in collaboration with teachers in all regions with a representative sample, not just at the national level, but also at regional level. In the 2,504 sampled schools, 77,113 students (25,079 eleven-year-old, 26,048 thirteen-year-old and 25,986 fifteen-year-old) completed an anonymous questionnaire. Knowledge of the health-related behaviour of school-aged adolescents may help monitoring and enable policies for young people to be formulated and implemented.

Published
2013

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