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1. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: A 2-year observational study in children aged 0-18 years

Author

Rabbone I., Maltoni G., Tinti D., Zucchini S., Cherubini V., Bonfanti R., Scaramuzza A., Lera R., Bobbio A., Piccinno E., Reinstadler P., Felappi B., Prandi E., Gallo F., Frongia AP., Ripoli C., Lo Presti D., Tomaselli L., Cardinale G., Stamati FA., Citriniti F., Suprani T., Graziani V., De Berardinis F., Zampolli M., De Marco R., Cavalli C., Lazzaro N., De Donno V., Toni S., Piccini B., Lenzi L., Mainetti B., Coccioli MS., d'Annunzio G., Minuto N., Aloe S., Lucchesi D., Cirillo S., Sordelli M., Del Vecchio F., Salzano LG., Meschi F., Iughetti L., Predieri B., Franzese A., Mozzillo Enza., Iafusco D., Cadario F., Savastio S., Piredda G., Cardella F., Iovane B., Calcaterra V., Berioli MG., Biagioni M., Randazzo E., Patera I., Schiaffini R., Rutigliano I., Lasagni A., Innaurato S., Gaiero A., Fichera G., Trada M., Guerraggio L., Cauvin V., Franceschi R., Tornese G., Salvatoni A., Marigliano M., Sabbion A., Maffeis C., Arnaldi C., Rabbone, I., Maltoni, G., Tinti, D., Zucchini, S., Cherubini, V., Bonfanti, R., Scaramuzza, A., Lera, R., Bobbio, A., Piccinno, E., Reinstadler, P., Felappi, B., Prandi, E., Gallo, F., Frongia, Ap., Ripoli, C., Lo Presti, D., Tomaselli, L., Cardinale, G., Stamati, Fa., Citriniti, F., Suprani, T., Graziani, V., De Berardinis, F., Zampolli, M., De Marco, R., Cavalli, C., Lazzaro, N., De Donno, V., Toni, S., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, Ms., D'Annunzio, G., Minuto, N., Aloe, S., Lucchesi, D., Cirillo, S., Sordelli, M., Del Vecchio, F., Salzano, Lg., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Iafusco, D., Cadario, F., Savastio, S., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, Mg., Biagioni, M., Randazzo, E., Patera, I., Schiaffini, R., Rutigliano, I., Lasagni, A., Innaurato, S., Gaiero, A., Fichera, G., Trada, M., Guerraggio, L., Cauvin, V., Franceschi, R., Tornese, G., Salvatoni, A., Marigliano, M., Sabbion, A., Maffeis, C., Arnaldi, C., Rabbone, Ivana, Maltoni, Giulio, Tinti, Davide, Zucchini, Stefano, Cherubini, Valentino, Bonfanti, Riccardo, Scaramuzza, Andrea, Lera, Riccardo, Bobbio, Adriana, Piccinno, Elvira, Reinstadler, Petra, Felappi, Barbara, Prandi, Elena, Gallo, Francesco, Frongia, Anna Paola, Ripoli, Carlo, Lo Presti, Donatella, Tomaselli, Letizia, Cardinale, Giuliana, Stamati, Filomena Andreina, Citriniti, Felice, Suprani, Tosca, Graziani, Vanna, De Berardinis, Fiorella, Zampolli, Maria, De Marco, Rosaria, Cavalli, Claudio, Lazzaro, Nicola, De Donno, Valeria, Toni, Sonia, Piccini, Barbara, Lenzi, Lorenzo, Mainetti, Benedetta, Coccioli, Maria Susanna, D’Annunzio, Giuseppe, Minuto, Nicola, Aloe, Monica, Lucchesi, Sonia, Cirillo, Dante, Sordelli, Silvia, Delvecchio, Maurizio, Lombardo, Fortunato, Salzano, Giusy, Meschi, Franco, Iughetti, Lorenzo, Predieri, Barbara, Franzese, Adriana, Mozzillo, Enza, Iafusco, Dario, Cadario, Francesco, Savastio, Silvia, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Biagioni, Martina, Randazzo, Emioli, Patera, Ippolita Patrizia, Schiaffini, Riccardo, Rutigliano, Irene, Lasagni, Anna, Innaurato, Silvia, Gaiero, Alberto, Fichera, Grazziella, Trada, Michela, Guerraggio, Lucia, Cauvin, Vittoria, Franceschi, Roberto, Tornese, Gianluca, Salvatoni, Alessandro, Marigliano, Marco, Sabbion, Alberto, Maffeis, Claudio, and Arnaldi, Claudia

Subjects
Blood Glucose, Male, medicine.medical_specialty, Pediatrics, endocrine system diseases, Diabetic ketoacidosis, Adolescent, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, diabetic ketoacidosis, Patient Education as Topic, Diabetes mellitus, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Child, Type 1 diabetes, diabetes, business.industry, Incidence (epidemiology), Incidence, epidemiology, Infant, Newborn, diabetic ketoacidosi, nutritional and metabolic diseases, Infant, medicine.disease, Diabetes Mellitus, Type 1, Italy, diabete, Child, Preschool, Pediatrics, Perinatology and Child Health, Observational study, Female, business, Prevention campaign
Abstract

ObjectiveAfter a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013–2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign.DesignProspective observational study.SettingMulticentre study throughout Italy.InterventionNational awareness campaign started in November 2015 and held until December 2017.PatientsDuring 2016 and 2017 we collected data on all patients aged 0–18 years with new-onset diabetes.Main outcome measuresDKA (pH ResultsRecords (n=2361) of children with newly diagnosed type 1 diabetes were collected from 58 out of 68 (85.3%) centres of the original survey participants and 100% of the previously surveyed tertiary centres. Overall, DKA was observed in 1124 patients, with an increased rate when compared with the previous survey (47.6% vs 38.5%, p=0.002), and severe DKA in 15.3%. In children below 6 years, DKA was observed in 323 out of 617 (52.5%) and severe DKA in 16.7%; in this age group, occurrence of DKA reduced by 21.3% (p=0.009). DKA treatment according to the ISPED guidelines was adopted in 95% of the centres, with a 27% improvement (p=0.025).ConclusionsDuring a 2-year awareness campaign, DKA at onset of diabetes in children and adolescents 0–18 years is still common and increased when compared with the 2013–2014 survey.

Published
2020

2. Efficacy of self-monitoring blood glucose as a key component of a chronic care model versus usual care in type 2 diabetes patients treated with oral agents: results of a randomized trial

Author

Musacchio, N, Ciullo, I, Scardapane, M, Giancaterini, A, Pessina, L, Maino, S, Gaiofatto, R, Nicolucci, A, Rossi, Mc, Valentini, U, Cimino, A, Agosti, B, Zarra, E, Magri, A, Pellegrini, Ma, Pellarini, L, Sciangula, L, Nappi, F, Ciucci, A, Grassa, B, De Marco, R, Olivo, Es, Trevisan, R, Frosio, I, Morlini, C, Corsi, A, Dodesini, Ar, Grassi, G, Calvi, E, Capello, E, Gramaglia, E, Ramella, V, De Rossi, C, Mengozzi, G, Orsi, E, Lunati, Me, Palmieri, E, Resi, V, Grancini, V, Giarratana, L, Ragonese, M, Slongo, R, Scoponi, C, Tonolo, G, Amadori, G, Becciu, A, Canu, L, Cherchi, S, Paciotti, V, Alfidi, P, Babini, A, Ripani, R, Cantelli, R, Rossi, P, Di Cianni, G, Russo, L, Lemmi, P, Sannino, C, Marconi, S, Di Bartolo, P, Pellicano, F, Scolozzi, P, Annese, S, Lorizzo, F, Coppolino, A, Peditto, Gc, De Feo ME, Piscopo, G, Varriale, A, De Candia, L, Ceci, A, Elia, G, Falzone, G, Schembari, R, Citro, G, Di Mauro, M, D’Urso, C, Caruso, C, on behalf of Self-Care Study Group, Musacchio, N, Ciullo, I, Scardapane, M, Giancaterini, A, Pessina, L, Maino, S, Gaiofatto, R, Nicolucci, A, Rossi, M, Valentini, U, Cimino, A, Agosti, B, Zarra, E, Magri, A, Pellegrini, M, Pellarini, L, Sciangula, L, Nappi, F, Ciucci, A, Grassa, B, De Marco, R, Olivo, E, Trevisan, R, Frosio, I, Morlini, C, Corsi, A, Dodesini, A, Grassi, G, Calvi, E, Capello, E, Gramaglia, E, Ramella, V, De Rossi, C, Mengozzi, G, Orsi, E, Lunati, M, Palmieri, E, Resi, V, Grancini, V, Giarratana, L, Ragonese, M, Slongo, R, Scoponi, C, Tonolo, G, Amadori, G, Becciu, A, Canu, L, Cherchi, S, Paciotti, V, Alfidi, P, Babini, A, Ripani, R, Cantelli, R, Rossi, P, Di Cianni, G, Russo, L, Lemmi, P, Sannino, C, Marconi, S, Di Bartolo, P, Pellicano, F, Scolozzi, P, Annese, S, Lorizzo, F, Coppolino, A, Peditto, G, De Feo, M, Piscopo, G, Varriale, A, De Candia, L, Ceci, A, Elia, G, Falzone, G, Schembari, R, Citro, G, Di Mauro, M, D'Urso, C, and Caruso, C

Subjects
medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, oral antidiabetic agent, Type 2 diabetes, law.invention, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Randomized controlled trial, law, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, hemoglobin A1c lipid, 030212 general & internal medicine, Intensive care medicine, Chronic care, business.industry, Mellitus, General Medicine, medicine.disease, Management, Oral agents, Usual care, Self-monitoring, Empowerment, business
Published
2018

3. Can healthcare utilization data reliably capture cases of chronic respiratory diseases? A cross-sectional investigation in Italy

Author

Biffi, A., Comoretto, R., Arfe, A., Scotti, L., Merlino, L., Vaghi, A., Pesci, A., de Marco, R., Corrao, G., Brignoli, O., Cerveri, I., Guffanti, E., Villa, M., Biffi, A, Comoretto, R, Arfè, A, Scotti, L, Merlino, L, Vaghi, A, Pesci, A, DE MARCO, R, Corrao, G, Brignoli, O, Cerveri, I, Guffanti, E, and Villa, M

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Healthcare utilization database, medicine.medical_specialty, Adolescent, Databases, Factual, Cross-sectional study, Sensitivity and Specificity, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, Young Adult, 0302 clinical medicine, Prevalence, Medicine, Humans, 030212 general & internal medicine, Young adult, Intensive care medicine, Child, Asthma, Aged, Estimation, Aged, 80 and over, COPD, business.industry, Algorithms, Chronic obstructive pulmonary disease, External validation, Infant, Newborn, Uncertainty, Infant, Middle Aged, medicine.disease, respiratory tract diseases, Algorithm, Chronic disease, Cross-Sectional Studies, 030228 respiratory system, Healthcare utilization, Italy, Child, Preschool, Emergency medicine, Chronic Disease, Female, business, Research Article
Abstract

Background Healthcare utilization data are increasingly used for chronic disease surveillance. Nevertheless, no standard criteria for estimating prevalence of high-impact diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are available. In this study an algorithm for recognizing COPD/asthma cases from HCU data is developed and implemented in the HCU databases of the Italian Lombardy Region (about 10 million residents). The impact of diagnostic misclassification for reliably estimating prevalence was also assessed. Methods Disease-specificdrug codes, hospital discharges together with co-payment exemptions when available, and a combination of them according with patient’s age, were used to create the proposed algorithm. Identified cases were considered for prevalence estimation. An external validation study was also performed in order to evaluate systematic uncertainty of prevalence estimates. Results Raw prevalence of COPD and asthma in 2010 was 3.6 and 3.3% respectively. According to external validation, sensitivity values were 53% for COPD and 39% for asthma. Adjusted prevalence estimates were respectively 6.8 and 8.5% for COPD (among person aged 40 years or older) and asthma (among person aged 40 years or younger). Conclusions COPD and asthma prevalence may be estimated from HCU data, albeit with high systematic uncertainty. Validation is recommended in this setting. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0362-6) contains supplementary material, which is available to authorized users.

Published
2017

4. Trends in the prevalence of asthma and allergic rhinitis in Italy between 1991 and 2010

Author

de Marco R, Cappa V, Accordini S, Rava M, Antonicelli L, Bortolami O, Braggion M, Bugiani M, Casali L, Cazzoletti L, Cerveri I, Fois AG, Girardi P, Locatelli F, Marcon A, Marinoni A, Panico MG, Pirina P, Villani S, Zanolin ME, Verlato G, the GEIRD Study Group: de Marco, R., Verlato, G., Zanolin, M., Accordini, S., Bortolami, O., Braggion, M., Cappa, V., Cazzoletti, L., Girardi, P., Locatelli, F., Marcon, A., Montoli, E., Rava, M., Vesentini, R., Ferrari, M., Donatelli, L., Posenato, C., Cascio, V., Perbellini, L., Olivieri, M., D'Amato, J., Donatini, E., Martinelli, M., Pignatti, P., Bombieri, C., Bettin, M., Trabetti, E., Poli, A., Nicolis, M., Sembeni, S., Antonicelli, L., Bonifazi, F., Attena, F., Galdo, V., Cerveri, I., Corsico, A., Albicini, F., Grosso, A., Marinoni, A., Villani, S., Ferretti, V., Casali, L., Miniucchi, A., Briziarelli, L., Marcarelli, M., Panico, M., Pirina, P., Fois, A., Becciu, F., Deledda, A., Spada, V., Bugiani, M., Carosso, A., Piccioni, P., Castiglioni, G., Bono, R., Tassinari, R., Romanazzi, V., Rolla, G., Heffler, E., Migliore, E., BELLIA, Vincenzo, BATTAGLIA, Salvatore, de Marco R, Cappa V, Accordini S, Rava M, Antonicelli L, Bortolami O, Braggion M, Bugiani M, Casali L, Cazzoletti L, Cerveri I, Fois AG, Girardi P, Locatelli F, Marcon A, Marinoni A, Panico MG, Pirina P, Villani S, Zanolin ME, Verlato G, and the GEIRD Study Group: de Marco, R., Verlato, G., Zanolin, M., Accordini, S., Bortolami, O., Braggion, M., Cappa, V., Cazzoletti, L., Girardi, P., Locatelli, F., Marcon, A., Montoli, E., Rava, M., Vesentini, R., Ferrari, M., Donatelli, L., Posenato, C., Cascio, V., Perbellini, L., Olivieri, M., D'Amato, J., Donatini, E., Martinelli, M., Pignatti, P., Bombieri, C., Bettin, M., Trabetti, E., Poli, A., Nicolis, M., Sembeni, S., Antonicelli, L., Bonifazi, F., Attena, F., Galdo, V., Bellia, V., Battaglia, S., Cerveri, I., Corsico, A., Albicini, F., Grosso, A., Marinoni, A., Villani, S., Ferretti, V., Casali, L., Miniucchi, A., Briziarelli, L., Marcarelli, M., Panico, M., Pirina, P., Fois, A., Becciu, F., Deledda, A., Spada, V., Bugiani, M., Carosso, A., Piccioni, P., Castiglioni, G., Bono, R., Tassinari, R., Romanazzi, V., Rolla, G., Heffler, E., and Migliore, E.

Subjects
Male, Pediatrics, Cross-sectional study, 95% CI 1.19-1.59) from 1998-2000 to 2007-2010, but since then there has been no clear temporal pattern. The present study aimed to assess time trends in the prevalence of current asthma, Abstract The prevalence of asthma increased worldwide until the 1990s, temporal trends, Surveys and Questionnaires, Epidemiology, Surveys and Questionnaire, Medicine, asthma-like symptoms and allergic rhinitis in Italian adults from 1990 to 2010. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 yrs) in Italy, Young adult, respectively. The prevalence of current asthma was stable during the 1990s and increased (relative risk 1.38, from 10.1% to 13.9% and from 16.8% to 25.8%, education.field_of_study, Allergic rhinitis, Asthma, Prevalence, Temporal trends, Wheezing, medicine.diagnostic_test, Smoking, the median prevalence of current asthma, allergic rhinitis, asthma, epidemiology, prevalence, temporal trends, wheezing, Italy, Abstract The prevalence of asthma increased worldwide until the 1990s, but since then there has been no clear temporal pattern. The present study aimed to assess time trends in the prevalence of current asthma, asthma-like symptoms and allergic rhinitis in Italian adults from 1990 to 2010. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 yrs) in Italy, in the frame of three multicentre studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993, n=6,031), the Italian Study on Asthma in Young Adults (ISAYA) (1998-2000, n=18,873), and the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007-2010, n=10,494). Time trends in prevalence were estimated using Poisson regression models in the centres that repeated the survey at different points in time. From 1991 to 2010, the median prevalence of current asthma, wheezing and allergic rhinitis increased from 4.1% to 6.6%, from 10.1% to 13.9% and from 16.8% to 25.8%, respectively. The prevalence of current asthma was stable during the 1990s and increased (relative risk 1.38, 95% CI 1.19-1.59) from 1998-2000 to 2007-2010, mainly in subjects who did not report allergic rhinitis. The prevalence of allergic rhinitis has increased continuously since 1991. The asthma epidemic is not over in Italy. During the past 20 yrs, asthma prevalence has increased by 38%, in parallel with a similar increase in asthma-like symptoms and allergic rhinitis, mainly in subjects who did not report allergic rhinitis. The prevalence of allergic rhinitis has increased continuously since 1991. The asthma epidemic is not over in Italy. During the past 20 yrs, symbols, asthma prevalence has increased by 38%, Female, epidemiology, Human, Pulmonary and Respiratory Medicine, Adult, 494). Time trends in prevalence were estimated using Poisson regression models in the centres that repeated the survey at different points in time. From 1991 to 2010, in parallel with a similar increase in asthma-like symptoms and allergic rhinitis, medicine.medical_specialty, Rhinitis, Allergic, Perennial, Population, prevalence, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 031), Settore MED/01 - Statistica Medica, symbols.namesake, Young Adult, Allergic rhiniti, Humans, Respiratory sounds, Poisson regression, education, Respiratory Sounds, Cross-Sectional Studie, allergic rhinitis, business.industry, wheezing, wheezing and allergic rhinitis increased from 4.1% to 6.6%, Rhinitis, Allergic, Seasonal, asthma, in the frame of three multicentre studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993, medicine.disease, 873), Cross-Sectional Studies, n=10, Relative risk, Temporal trend, Respiratory Sound, n=6, n=18, business
Abstract

The prevalence of asthma increased worldwide until the 1990s, but since then there has been no clear temporal pattern. The present study aimed to assess time trends in the prevalence of current asthma, asthma-like symptoms and allergic rhinitis in Italian adults from 1990 to 2010. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 yrs) in Italy, in the frame of three multicentre studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993; n=6,031); the Italian Study on Asthma in Young Adults (ISAYA) (1998-2000; n=18,873); and the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007-2010; n=10,494). Time trends in prevalence were estimated using Poisson regression models in the centres that repeated the survey at different points in time. From 1991 to 2010, the median prevalence of current asthma, wheezing and allergic rhinitis increased from 4.1% to 6.6%, from 10.1% to 13.9% and from 16.8% to 25.8%, respectively. The prevalence of current asthma was stable during the 1990s and increased (relative risk 1.38, 95% CI 1.19-1.59) from 1998-2000 to 2007-2010, mainly in subjects who did not report allergic rhinitis. The prevalence of allergic rhinitis has increased continuously since 1991. The asthma epidemic is not over in Italy. During the past 20 yrs, asthma prevalence has increased by 38%, in parallel with a similar increase in asthma-like symptoms and allergic rhinitis. Copyright©ERS 2012.

Published
2012

5. Do asthma and allergy influence subsequent pet keeping? An analysis of childhood and adulthood

Author

Svanes, C., Zock, J.P., Antò, J.M., Dharmage, S., Norbäck, D., Wjst, M., Heinrich, J., Jarvis, D., de Marco, R., Plana, E., Raherison, C., Sunyer, J., and European Community Respiratory Health Survey II ()

Subjects
Adult, Pediatrics, medicine.medical_specialty, Allergy, Adolescent, Immunology, Disease, Birds, Atopy, Dogs, medicine, Animals, Humans, Immunology and Allergy, Longitudinal Studies, Child, Asthma, selective avoidance, pets, cats, dogs, birds, asthma, atopy, ECRHS, business.industry, Respiratory disease, Age Factors, Infant, Newborn, Infant, Odds ratio, Allergens, Middle Aged, medicine.disease, Europe, El Niño, Animals, Domestic, Child, Preschool, Cats, Hay fever, business, Follow-Up Studies
Abstract

Background: Asthma and allergy might influence the choice of keeping pets, leading to apparent protective effects of pets on allergic disease. Objective: We investigated the effects of asthma and allergy on subsequent pet keeping in childhood and adulthood. Methods: Information about asthma and pet keeping at ages 0 to 4, 5 to 15, 20 to 44, and 26 to 56 years was provided by 9812 subjects participating in the 9-year follow-up of the European Community Respiratory Health Survey. Results: In childhood asthma debut at younger than 5 years was associated with less cat keeping at 5 to 15 years (odds ratio [OR], 0.60; 95% CI, 0.44-0.82), an effect only observed when the parents did not have asthma or allergy (P interaction = .045). Childhood asthma did not influence adult pet ownership, unless there were adult symptoms. Adults less often acquired cats at follow-up if they had 3 or more asthma symptoms (OR, 0.78; 95% CI, 0.64-0.95), were taking asthma medication (OR, 0.48; 95% CI, 0.31-0.74), had hay fever (OR, 0.75; 95% CI, 0.62-0.91), had atopy (OR, 0.75; 95% CI, 0.61-0.91), or had specific IgE to cat (OR, 0.57; 95% CI, 0.39-0.82) at baseline. Adults who already had pets usually continued keeping the same type of pet, except that the presence of 3 or more asthma symptoms was associated with less subsequent dog keeping (OR, 0.69; 95% CI, 0.53-0.89). Pet removal between surveys to reduce allergen was reported by 4.7%. Conclusion: Selective avoidance subsequent to asthma or allergy was observed for childhood cat keeping and adult cat acquisition. Avoidance would produce an apparent protective effect of cats on childhood asthma (large OR, 0.83). Avoidance was generally not observed for dogs or birds. Clinical implications: A part of the protective effects of childhood cats on asthma and allergy can be attributed to selective avoidance. © 2006 American Academy of Allergy, Asthma and Immunology.

Published
2006

6. Differences in Incidence of Reported Asthma Related to Age in Men and Women

Author

de Marco R, Peter Burney, Jordi Sunyer, and Locatelli F

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, Adolescent, Population, Critical Care and Intensive Care Medicine, Age Distribution, Sex Factors, Epidemiology, Humans, Medicine, Sex Distribution, Young adult, Risk factor, Child, education, Retrospective Studies, Asthma, education.field_of_study, business.industry, Incidence, Incidence (epidemiology), Public health, Age Factors, Infant, medicine.disease, respiratory tract diseases, Europe, Case-Control Studies, Child, Preschool, Relative risk, Female, business, Demography
Abstract

Sex differences in asthma prevalence and morbidity, assessed with different methods in different populations, have raised several hypotheses about the different susceptibility to asthma in men and women. However, information on the incidence of asthma by age and sex is limited. The aim of this study was to estimate the age- and sex-specific incidence of asthma from birth to 44 yr of age in men and women across several countries, and to evaluate the main factors influencing asthma incidence in young adults. The data of the European Community Respiratory Health Survey, an international, cross-sectional, population-based survey, which were collected in 16 countries from 1991 to 1993 according to a common protocol, and which pertained to 18,659 subjects, were analyzed retrospectively, using the reported age of the first attack as the onset of asthma. During childhood, girls had a significantly lower risk of developing asthma than did boys (relative risk [RR]: 0.74 and 0.56 in the 0- to 5-yr and 5- to 10-yr age classes, respectively). Around puberty, the risk was almost equal in the two sexes (RR = 0.84; 95% confidence interval [CI]: 0.65 to 1.10 in the 10 to 15-yr age class). After puberty, the risk in women was always significantly higher than that in men (RR: 1.38 to 5.91). This pattern was consistent in all of the 16 countries studied, and was not influenced by recall or cohort effects. When the effects of airway caliber and smoking were studied with a case-control design, the results showed that women's greater susceptibility to asthma in early adulthood was at least partly, explained by their smaller airway caliber (the OR decreased from 2. 04 [95% CI: 1.32 to 3.15] to 1.47 [95% CI: 0.89 to 2.44] after controlling for height-adjusted FEV(1)); while smoking did not increase the risk. This analysis strongly confirms that the incidence of asthma shows a sex reversal during puberty, and suggests that airway caliber, in addition to hormonal factors, could play an important role in explaining the different patterns of asthma incidence in men and women.

Published
2000

7. Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study

Author

Verlato, G, Corsico, A, Villani, S, Cerveri, I, Migliore, E, Accordini, S, Carolei, A, Piccioni, P, Bugiani, M, Lo Cascio, V, Marinoni, A, Poli, A, Ecrhs, de Marco R., Marinoni, ISAYA group Principal researchers: A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Alesina, R., Basso, O., Berrayah, L., Brusotti, R., Fanfulla, F., Moi, P., Frati, C., Karytinos, P., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, Paola, Bono, Roberto, Gigli, G., Giraudo, A., Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Aime, M., Cerutti, A., Chiampo, F., Gallo, W., Sulotto, F., de Marco, R., Verlato, G., Accordini, S., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Campello, C., Rossi, F., Cannistrà, A., Cenci, B., Destefani, E., Girotto, M., Lampronti, G., Martini, C., Tardivo, S., Villani, A., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Allergy, Rhinitis, Allergic, Perennial, temporal trend, Immunology, Logistic regression, asthma, allergic rhinitis, temporal trend, epidemiology, Epidemiology, Prevalence, Immunology and Allergy, Medicine, Humans, Non-response bias, Young adult, Asthma, Response rate (survey), allergic rhinitis, business.industry, Rhinitis, Allergic, Seasonal, Odds ratio, asthma, medicine.disease, Italy, Female, epidemiology, business
Abstract

The prevalence of asthma and allergic rhinitis has increased worldwide during the 1970s and 1980s.This study was aimed at evaluating whether the increasing trend in prevalence persisted during the 1990s in the young adult Italian population.In 1998 to 2000 a screening questionnaire was sent by mail to a general population sample aged 20 to 44 years; nonresponders were contacted again first by mail and then by phone, achieving a final response rate of 78.1% (6876 of 8800). Prevalence estimates, adjusted to correct for nonresponse bias, were compared with those recorded in Italy in 1991 to 1993 during the European Community Respiratory Health Survey, when response rate had been slightly higher (87.6%). Temporal variations in symptom prevalence were analyzed by a logistic regression model, controlling for sex, age, site of residence (urban vs suburban areas), season of response, response rate, and type of contact (mail vs phone).The prevalence of asthma attacks did not vary significantly from 1991 to 1993 (3.6%) to 1998 to 2000 (3.2%) (P =.188). The prevalence of asthma-like symptoms (wheezing, chest tightness, shortness of breath) tended to decrease in the age classes of 32.5 to 45 years, while increasing in the youngest age class (20 to 26 years). A clear-cut increase from 15.4% to 18.3% was observed for the prevalence of allergic rhinitis (P.001), whereas the proportion of people under antiasthmatic treatment increased in suburban areas but not in urban areas (interaction time-site of residence, P.001).Asthma prevalence has not increased during the last decade in Italy. The persistence of an increasing trend in allergic rhinitis prevalence deserves attention.

Published
2003

8. Identification of candidate children for maturity-onset diabetes of the young type 2 (MODY2) gene testing: a seven-item clinical flowchart (7-iF)

Author

Pinelli, M, Acquaviva, F, Barbetti, F, Caredda, E, Cocozza, S, Delvecchio, M, Mozzillo, E, Pirozzi, D, Prisco, F, Rabbone, I, Sacchetti, L, Tinto, N, Toni, S, Zucchini, S, Iafusco, D, Italian Study Group on Diabetes of the Italian Society of Pediatric Endocrinology, Diabetology, Biagioni, M, Carloni, I, Cester, Am, Cherubini, V, Giorgetti, C, Iannilli, A, Bruzzese, M, Mammì, F, Guasti, M, Lenzi, L, Pepe, R, Piccini, B, Benelli, M, Cadario, F, Calcaterra, V, Cerutti, F, Sicignano, S, Mammì, C, Lazzaro, N, Comberiati, P, Scaramuzza, A, Zuccotti, G, Redaelli, F, Gallo, F, Cappa, M, Patera, P, Schiaffini, R, Cardella, F, Salvo, C, De Marco, R, Chessa, M, Frongia, P, Ricciardi, Mr, Ripoli, C, Zedda, Ma, Citriniti, F, Chiarelli, F, Tumini, S, Coccioli, Ms, De Berardinis, F, Santoro, E, DE LUCA, Filippo, Lombardo, Fortunato, Salzano, Giuseppina, Felappi, B, Prandi, E, Frezza, E, Piccinno, E, Torelli, C, Zecchino, C, Galderisi, A, Monciotti, C, Ingletto, D, Kaufmann, P, Pasquino, B, Lera, R, Lucchesi, S, Perrotta, A, Salardi, S, Scipioni, M, Luceri, S, Stamati, F, Pianese, L, Piceno, A, Tomaselli, L, Vergerio, A, Casaburo, F, Cocca, A, Confetto, S, Forgione, E, Pelliccia, C, Picariello, S, Pisani, F, Piscopo, A, Villano, P, Zanfardino, A, Buono, P, Franzese, A, Nugnes, R, Valerio, G, Maffeis, C, Marigliano, M, Chiari, G, Iovene, B, Vanelli, M., Pinelli, Michele, Acquaviva, Fabio, Barbetti, F, Caredda, E, Cocozza, Sergio, Delvecchio, M, Mozzillo, Enza, Pirozzi, Daniele, Prisco, F, Rabbone, I, Sacchetti, Lucia, Tinto, Nadia, Toni, S, Zucchini, S, and Iafusco, D.

Subjects
Genetics and Molecular Biology (all), Pediatrics, medicine.medical_specialty, Science, Cost-Benefit Analysis, Decision tree, Medicine (all), Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Biochemistry, Maturity onset diabetes of the young, Settore MED/13 - Endocrinologia, Quality of life, Surveys and Questionnaires, Glucokinase, medicine, Humans, Genetic Testing, Prospective Studies, Age of Onset, Prospective cohort study, Child, Wasting, Children, Genetic testing, Retrospective Studies, Glycated Hemoglobin, Multidisciplinary, MODY2, medicine.diagnostic_test, business.industry, Decision Trees, Retrospective cohort study, medicine.disease, Test (assessment), Diabetes Mellitus, Type 2, Italy, Child, Preschool, Mutation, Quality of Life, Medicine, Female, medicine.symptom, business, gene testing, Research Article
Abstract

MODY2 is the most prevalent monogenic form of diabetes in Italy with an estimated prevalence of about 0.5-1.5%. MODY2 is potentially indistinguishable from other forms of diabetes, however, its identification impacts on patients' quality of life and healthcare resources. Unfortunately, DNA direct sequencing as diagnostic test is not readily accessible and expensive. In addition current guidelines, aiming to establish when the test should be performed, proved a poor detection rate. Aim of this study is to propose a reliable and easy-to-use tool to identify candidate patients for MODY2 genetic testing. We designed and validated a diagnostic flowchart in the attempt to improve the detection rate and to increase the number of properly requested tests. The flowchart, called 7-iF, consists of 7 binary "yes or no" questions and its unequivocal output is an indication for whether testing or not. We tested the 7-iF to estimate its clinical utility in comparison to the clinical suspicion alone. The 7-iF, in a prospective 2-year study (921 diabetic children) showed a precision of about the 76%. Using retrospective data, the 7-iF showed a precision in identifying MODY2 patients of about 80% compared to the 40% of the clinical suspicion. On the other hand, despite a relatively high number of missing MODY2 patients, the 7-iF would not suggest the test for 90% of the non-MODY2 patients, demonstrating that a wide application of this method might 1) help less experienced clinicians in suspecting MODY2 patients and 2) reducing the number of unnecessary tests. With the 7-iF, a clinician can feel confident of identifying a potential case of MODY2 and suggest the molecular test without fear of wasting time and money. A Qaly-type analysis estimated an increase in the patients' quality of life and savings for the health care system of about 9 million euros per year.

Published
2012

9. Emerging effects of early environmental factors over genetic background for type 1 diabetes susceptibility: Evidence from a nationwide Italian twin study

Author

Nisticò, L, Iafusco, D, Galderisi, A, Fagnani, C, Cotichini, R, Toccaceli, V, Stazi, Ma, Study Group on Diabetes of the Italian Society of Pediatric Endocrinology, Collaborators: Cherubini V, D. i. a. b. e. t. o. l. o. g. y., Iannilli, A, Paparusso, Am, Cavallo, L, Zecchino, C, de Filippo, G, Gargantini, L, Salardi, S, Zucchini, S, Maltoni, G, Pasquino, B, Kaufmann, P, Buzi, F, Prandi, E, Gallo, F, Cicchetti, M, Castaldo, E, Citriniti, F, Chiarelli, F, Tumini, S, Di Stefano, A, Sperlì, D, De Marco, R, Banin, P, Toni, S, Lenzi, L, Del Vecchio, M, Lorini, R, D'Annunzio, G, Ingletto, D, Scaramuzza, A, Zuccotti, Gv, Chiumello, G, Meschi, F, Bonfanti, R, Frontino, G, de Luca, F, Lombardo, F, Salzano, G, Iughetti, L, Franzese, A, Buono, P, De Simone, I, Prisco, F, Cocca, A, Cadario, F, Monciotti, Cm, Savio, V, Cardella, F, Vanelli, M, Chiari, G, Errico, K, Iovane, B, Calcaterra, V, Citro, F, Cantoni, S, Marsciani, A, Cappa, M, Patera, Pi, Schiaffini, R, Sulli, N, Spoletini, M, Cerutti, Franco, Rabbone, I, Sicignano, S, Cauvin, V, Bellizzi, M, Tonini, G, Faleschini, E, Salvatoni, A, Pinelli, L, Maffeis, C, Contreas, G., Nisticò, L, Iafusco, D, Galderisi, A, Fagnani, C, Cotichini, R, Toccaceli, V, Stazi, Ma, and the Study Group on Diabetes of the Italian Society of Pediatric Endocrinology and, Diabetology

Subjects
Adult, Male, Endocrinology, Diabetes and Metabolism, Biochemistry, Endocrinology, Clinical Biochemistry, Biochemistry (medical), medicine.medical_specialty, Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Environment, Female, Humans, Infant, Kaplan-Meier Estimate, Twins, Dizygotic, Twins, Monozygotic, Genetic Predisposition to Disease, type 1 diabetes, Concordance, Population, Twins, Context (language use), Monozygotic, Internal medicine, Diabetes mellitus, Diabetes Mellitus, Dizygotic, medicine, Preschool, education, Type 1 diabetes, education.field_of_study, business.industry, medicine.disease, Twin study, Zygosity, Diabetes and Metabolism, Cohort, Environmental Exposures, business, Type 1
Abstract

Context:The incidence of type 1 diabetes has been increasing over time.Objective:We estimated the genetic and environmental components of type 1 diabetes susceptibility in a twin cohort of recent-onset cases to explore the sources of changing disease epidemiology.Design:We linked the population-based Italian Twin Registry with 14803 type 1 diabetes records from 36 pediatric diabetes care centers throughout Italy, except Sardinia, and identified 173 diabetic twins. Patients were positive for at least one autoantibody to islet cell, glutamate decarboxylase, tyrosine phosphatase, insulin, or zinc transporter 8 and were insulin dependent since their diagnosis. Zygosity was determined by DNA genotyping or by questionnaire.Outcome Measures:We estimated proband-wise concordance, cotwin recurrence risk with Kaplan-Meier method, and genetic and environmental proportions of susceptibility variance by structural equation models.Results:We recruited 104 diabetic twins (53 males) from 88 pairs (34 monozygotic, 54 dizygotic) and one triplet. The mean age at diagnosis was 8.1 yr (range 1.1-20.5 yr), and the median year of diagnosis was 2002. Proband-wise concordances were 45.5 and 16.4% in monozygotic and dizygotic pairs (P = 0.01). Recurrence risks in monozygotic and dizygotic cotwins were 37 and 12% after 10 yr from the proband's diagnosis (P = 0.005). Genetic contribution to type 1 diabetes susceptibility was 40% (95% confidence interval 8-78), and the shared and individual-specific environmental components were 51% (14-77) and 9% (4-19), respectively.Conclusions:In addition to the moderate genetic effects on type 1 diabetes susceptibility, our results draw attention to the substantial shared environmental effects, suggesting that exposures in fetal or early postnatal life may contribute to the increasing incidence of the disease.

Published
2012

10. Operational definitions of asthma in studies on its aetiology

Author

Pekkanen, J, Sunyer, J, Anto, Jm, Burney, Pl, Abramson, M, Kutin, J, Vermeire, P, van Bastelaer, F, Bousquet, J, Neukirch, F, Liard, R, Pin, I, Pison, C, Taytard, A, Magnussen, H, Nowak, D, Wichmann, He, Heinrich, J, Gislason, T, Gislason, D, Prichard, J, Allwright, S, Macleod, D, Bugiani, M, Bucca, Caterina, Romano, Canzio, de Marco, R, Lo Cascio, V, Campello, C, Marinoni, A, Cerveri, I, Casali, L, Rijcken, B, Kremer, A, Crane, J, Lewis, S, Gulsvik, A, Omenaas, E, Soriano, J, Tobías, A, Roca, J, Kogevinas, M, Muniozguren, N, Ramos González, J, Capelastegui, A, Martinez Moratalla, J, Almar, E, Maldonado, J, Pereira, A, Sánchez, J, Payo, F, Huerta, I, Boman, G, Janson, C, Bjornsson, E, Rosenhall, L, Norrman, E, Lundback, B, Lindholm, N, Plaschke, P, Ackermann Liebrich, U, Künzli, N, Perruchoud, A, Burr, M, Layzqll, J, Hall, R, Harrison, B, Stark, J, Chinn, S, Luczynska, C, Jarvis, D, Lai, E, Buist, S, Vollmer, W, and Osborne, M.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, Cross-sectional study, International Cooperation, Asthma, definition, epidemiology, method, risk factor, Sensitivity and Specificity, Severity of Illness Index, Age Distribution, immune system diseases, Risk Factors, Surveys and Questionnaires, Severity of illness, Epidemiology, medicine, Confidence Intervals, Prevalence, Humans, Risk factor, Sex Distribution, Respiratory Sounds, business.industry, Airway Resistance, Odds ratio, Middle Aged, medicine.disease, Prognosis, respiratory tract diseases, Respiratory Function Tests, Cross-Sectional Studies, Dyspnea, Bronchial hyperresponsiveness, Multivariate Analysis, Physical therapy, Female, business, Clinical psychology
Abstract

The most popular way to define asthma based on questionnaires is to use definitions taken from cross-sectional international studies on asthma. These definitions may not, however, be optimal for future studies focusing on risk factors of asthma. The current authors, therefore, compared the performance of different operational definitions of asthma. The European Community Respiratory Health Study I was a cross-sectional study of 21,924 subjects aged between 25-44 yrs in 18 countries. Operational definitions of asthma compared included different combinations of symptoms of asthma and bronchial hyperresponsiveness. A continuous asthma score, ranging from 0-8, was defined as the sum of positive answers to eight main symptom questions. There was no threshold in the associations of asthma symptoms with severity or risk factors of asthma, which would have suggested a dichotomous definition of asthma. Using dichotomous definitions requiring the presence of several asthma symptoms strengthened associations with studied risk factors, and also increased the estimated specificity and positive predictive value. Using a continuous asthma score also improved the power of the analyses. In conclusion, dichotomous definitions of asthma yielding higher odds ratios are achieved by requiring positive responses to several questions on symptoms. However, symptoms of asthma are possibly best analysed as a continuous asthma score.

Published
2005

11. The role of climate on the geographic variability of asthma, allergic rhinitis and respiratory symptoms: results from the Italian study of asthma in young adults

Author

Zanolin, M. E., Pattaro, C., Corsico, A., Bugiani, M., Carrozzi, L., Casali, L., Dallari, R., Ferrari, M., Marinoni, A., Migliore, E., Olivieri, M., Pirina, P., Verlato, G., Villani, S., de Marco, R., Buriani, O., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Cerveri, I., Zoia, M. C., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Ginesu, F., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Giammanco, G., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Accordini, S., Locatelli, F., Cazzoletti, L., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, medicine.medical_specialty, Allergy, Rhinitis, Allergic, Perennial, Climate, Immunology, Geographic pattern, Allergic, Epidemiology, medicine, Prevalence, Immunology and Allergy, Humans, Asthma epidemiology, Asthma prevalence allergy, Latitude, Asthma, Chronic Disease, Cough, Geography, Regression Analysis, Rhinitis, Allergic, Seasonal, Rhinitis, Seasonal, business.industry, Phlegm, Respiratory disease, Odds ratio, medicine.disease, Perennial, respiratory tract diseases, Chronic cough, Etiology, medicine.symptom, business, Demography
Abstract

Background: Variations in the prevalence of respiratory symptoms according to geo-climatic factors could provide important clues to the knowledge of the aetiology of asthma. Methods: Geo-climatic variations in the prevalence of current asthma, allergic rhinitis and chronic cough, and phlegm were assessed on a random sample of 18 873 subjects (response rate = 72.7%) from different climatic regions of Italy. An ecological analysis, supported by robust statistical methods, was employed to investigate potential trends. Results: The prevalence of all symptoms was significantly heterogeneous throughout the peninsula. Only asthma-like symptoms showed a north–south trend: the prevalence increased at a decreasing latitude [odds ratio (OR) varies from 0.92 to 0.96, P

Published
2004

12. Chronic cough and phlegm in young adults

Author

Cerveri, I., Accordini, S., Corsico, A., Zoia, M. C., Carrozzi, L., Cazzoletti, L., Beccaria, M., Marinoni, A., Viegi, G., de Marco, R., Ginesu, F., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Dallari, R., Turrini, E., Foglia, M., Giammanco, G., Pignato, S., Rotondo, A., Cuspilici, A., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Verlato, G., Zanolin, M. E., Locatelli, F., Battisti, L., Pattaro, C., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Pediatrics, medicine.medical_specialty, Chronic Obstructive, Cross-sectional study, Health surveys, Population, chronic obstructive pulmonary disease, cross-sectional studies, health surveys, risk factors, smoking, Pulmonary Disease, Pulmonary Disease, Chronic Obstructive, Sex Factors, Epidemiology, medicine, Prevalence, Chronic obstructive pulmonary disease, Cross-sectional studies, Risk factors, Smoking, Asthma, Chronic Disease, Cough, Cross-Sectional Studies, Female, Humans, Italy, Socioeconomic Factors, Sputum, Young adult, education, education.field_of_study, business.industry, Phlegm, medicine.disease, Obstructive lung disease, respiratory tract diseases, Chronic cough, medicine.symptom, business
Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underline that the presence of chronic cough and sputum production before airflow obstruction offers a unique opportunity to identify subjects at risk of chronic obstructive pulmonary disease for an early intervention. Current epidemiological data on these subjects are scant. Between 1998-2000, the authors evaluated the prevalence and characteristics of these symptoms by a multicentre cross-sectional survey of Italian people aged between 20-44 yrs from the general population (Italian Study on Asthma in Young Adults (ISAYA)). Besides the questions on asthma, more than 18,000 subjects answered the question: "Have you had cough and phlegm on most days for as much as 3 months per year and for at least two successive years?" The adjusted prevalence of subjects with chronic cough and phlegm was 11.9%, being 11.8% in males and 12.0% in females. From these subjects approximately 20% reported coexisting asthma and approximately 30%, predominately females, were nonsmokers. The survey showed that sex (female), smoking and low socioeconomic status were significantly and independently associated with chronic cough and phlegm, current smoking playing the major role. The prevalence of subjects with chronic cough and phlegm is startlingly high among young adults. Further follow-up studies are needed to establish how many of them will go on to develop chronic obstructive pulmonary disease.

Published
2003

13. Incidence and remission of asthma: a retrospective study on the natural history of asthma in Italy

Author

De Marco, R., Locatelli, F., Cerveri, I., Bugiani, M., Marinoni, A., Giammanco, G., Accordini, S., Verlato, G., Zanolin, E., Buriani, O., Carrozzi, L., Dallari, R., Ginesu, F., Poli, A., Struzzo, P., Cavallini, R., Saletti, C., Cellini, M., Faustini, M., De Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., Zanolin, M. E., Cazzoletti, L., Battisti, L., Pattaro, C., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, National Health Programs, Remission, Cross-sectional study, Immunology, Population, Remission, Spontaneous, Rate ratio, Asthma remission, Asthma incidence, Persistence of asthma, Asthma, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Incidence, Infant, Infant, Newborn, Italy, Retrospective Studies, medicine, Immunology and Allergy, Young adult, Preschool, education, education.field_of_study, business.industry, Spontaneous, Incidence (epidemiology), Retrospective cohort study, Newborn, medicine.disease, Natural history, business
Abstract

The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings.This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000.The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis.The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P.001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P.001) and a shorter duration of the disease (5.6 vs 16.1 years, P.001) than patients with current asthma. The probability of remission was strongly (P.001) and inversely related to the age at onset (62.8% and 15.0% in the10- andor =20-years age-at-onset groups, respectively).With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.

Published
2002

14. International assessment of the internal consistency of respiratory symptoms

Author

Sunyer, J., Basagana, X., Burney, P., Anto, J.M., Chinn, S., Luczynska, C., Jarvis, D., Lai, E., Vermeire, Paul, Bousquet, J., Nowak, D., Prichard, J., de Marco, R., Rijcken, B., Alves, J., Boman, G., Kesteloot, H., Nielsen, N., Paoletti, P., and European Community Respiratory Health Survey

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, education.field_of_study, business.industry, International comparisons, Separation (statistics), Population, Critical Care and Intensive Care Medicine, medicine.disease, Cross-cultural studies, Confirmatory factor analysis, Exploratory factor analysis, Surgery, Goodness of fit, medicine, education, business, Demography, Asthma
Abstract

We aimed to assess cross-cultural validity of the reporting of respiratory symptoms in the European Community Respiratory Health Study (ECRHS). A random sample of subjects from the general population (aged 20-44 yr), from 35 centers in 15 countries, answered a questionnaire and underwent allergy tests and airway challenge with methacholine. The overall response rate to the questionnaire was 60% (n = 16,635). Exploratory factor analysis was used to identify how symptoms were grouped (i.e., to specify factor structure), using data from the United Kingdom. Subsequently, a confirmatory factor analysis of the prespecified structure for the United Kingdom was assessed for each country in consecutive nested models, increasing at each step the number of parameters forced to be equal to the United Kingdom, and assessing the goodness of fit. Variables were clustered in the same four groups (factors) in all countries. The four factors, mutually adjusted, were associated with either bronchial responsiveness, atopy, or smoking, which provides coherence for the separation of the four factors. In the confirmatory factor analysis, when the load of each of the symptoms in the corresponding factor was prespecified, all countries except Spain showed an adequate fit; in Spain there were differences in answers concerning asthma treatment. We conclude that the ECRHS multilingual translated respiratory symptoms questionnaire shows high internal consistency, suggesting that international comparisons are not affected by errors due to cross-cultural variations in the reporting of symptoms.

Published
2000

15. Asthmatics and ex-smokers respond early, heavy smokers respond late to mailed surveys in Italy

Author

Verlato, Giuseppe, Melotti, Roberto, Olivieri, Mario, Corsico, Angelo, Bugiani, Massimiliano, Accordini, Simone, Villani, Simona, Migliore, Enrica, Marinoni, Alessandra, Pirina, Pietro, Carrozzi, Laura, Bortolami, Oscar, Rava, Marta, de Marco, Roberto, Accordini, S., Verlato, G., Zanolin, E., Bugiani, M., Buriani, O., Carrozzi, L., Dallari, R., Giammanco, G., Ginesu, F., Marinoni, A., Poli, A., Struzzo, Pierluigi, Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., Salomoni, A., Verlato, Giuseppe, Melotti, Roberto, Olivieri, Mario, Corsico, Angelo, Bugiani, Massimiliano, Accordini, Simone, Villani, Simona, Migliore, Enrica, Marinoni, Alessandra, Pirina, Pietro, Carrozzi, Laura, Bortolami, Oscar, Rava, Marta, de Marco, Roberto, Accordini, S., Verlato, G., Zanolin, E., Bugiani, M., Buriani, O., Carrozzi, L., Dallari, R., Giammanco, G., Ginesu, F., Marinoni, A., Poli, A., Struzzo, Pierluigi, Cavallini, R., Saletti, C., Cellini, M., Faustini, M., de Togni, A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Viegi, G., Pistelli, F., Di Pede, F., Paggiaro, P. L., Santolicandro, A., Giovannetti, P., Pirina, P., Ostera, S., Pinna, G. P., Farre, A., Imparato, S., Turrini, E., Foglia, M., Pignato, S., Rotondo, A., Cuspilici, A., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, P., Bono, R., Gigli, G., Giraudo, A., Brussino, M. C., Bucca, C., Rolla, G., Struzzo, P., Orefice, U., Schneider, M., Chittaro, F., Peresson, D., de Marco, R., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Ferrari, M., Biasin, C., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Male, Questionnaires, Allergy, asthmatics, ex-smokers, survey, Allergic rhinitis, Mail survey, Epidemiology, Prevalence, Smoking habit, Medicine, Respiratory symptoms, Young adult, Response bias, Medicine (all), Respiratory disease, Phlegm, Smoking, Health Survey, Middle Aged, Chronic cough, Italy, Bias (Epidemiology), Female, medicine.symptom, Human, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Logistic Model, Response bia, Young Adult, Allergic rhiniti, Humans, Smoking habits, Asthma, Questionnaire, business.industry, medicine.disease, Health Surveys, Surgery, respiratory tract diseases, Logistic Models, Cough, mail survey, response bias, respiratory symptoms, asthma, allergic rhinitis, smoking habits, Respiratory symptom, Patient Compliance, business, Demography
Abstract

Summary Rationale and objectives Response to mailed epidemiological surveys has decreased in recent decades. Since subjects with respiratory symptoms are usually early responders to surveys performed in Southern Europe, this trend could bias prevalence estimates. The present study aimed at evaluating the impact of non-response bias on prevalence estimates of respiratory symptoms and smoking habits. Methods In 9 centres, participating in the Italian Study on Asthma in Young Adults (ISAYA), random samples of people aged 20–45 years were administered a mailed questionnaire between 1998 and 2000. Non-responders were contacted again first by mail and then by phone. Cumulative response percentage was 30.5%, 52.4% and 72.7% (18,873/25,969), respectively, after the 1st, 2nd and 3rd contact. Results The prevalence of self-reported current asthma, asthma-like symptoms, and chronic cough/phlegm was more than halved from the first contact (5.6%, 17.8%, 14.6% respectively) to the third contact (2.7%, 6.4%, 6.9%). This pattern was less pronounced when considering allergic rhinitis and past asthma, whose prevalence decreased, respectively, from 21.5% to 15.6% and from 3.5% to 2.6%. At the same time the proportion of current smokers increased from 29.2% to 38%, while the proportion of ex-smokers decreased from 16.5% to 10.1%. In a multinomial logistic model current asthma, asthma-like symptoms, chronic cough/phlegm and smoking habits, and to a lower extent past asthma and allergic rhinitis, were significant predictors of late response. Conclusions In Italy when response percentage is low, the prevalence of current asthma, chronic cough/phlegm and ex-smokers is overestimated, while the proportion of current smokers is underestimated.

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16. On-treatment serum albumin level can guide long-term treatment in patients with cirrhosis and uncomplicated ascites

Author

Alessandro Federico, M. Colpani, Paolo Caraceni, Marco Domenicali, Manuel Tufoni, L. Simone, A Alberti, Giovanni Raimondo, A. Risso, Antonietta Sticca, Salvatore Piano, Anna Visani, Francesco Salerno, Giacomo Laffi, Piera Rossi, Paolo Angeli, F. Fidone, Pierluigi Toniutto, Vincenza Calvaruso, Silvia Nardelli, Aldo Airoldi, Sara Massironi, Stefania Gioia, A. Roncadori, Marco Marzioni, Nicola Caporaso, N.M. Castellaneta, Stefano Fagiuoli, Francesco Giuseppe Foschi, Raffaele Cozzolongo, Maria Rendina, Irene Cacciola, Oliviero Riggio, Sergio Neri, Raffaella Viganò, Ferdinando Giannone, Chiara Mazzarelli, Maria Marsico, Giovanni Parrella, Riccardo Guarisco, Chiara Elia, F. Levantesi, M. Cavallin, Alida Andrealli, A. Pecchioli, Loredana Prestianni, Rosanna De Marco, T Gabbani, Elga Neri, S. Boccia, Arianna Lanzi, Giacomo Zaccherini, Marcello Dallio, Giovanni Perricone, Giorgio Ballardini Natascia Celli, Francesco Auriemma, Federica Mirici Cappa, Agnese Antognoli, Annalisa Tortora, Gianfranco Elia, R. Bringiotti, Francesco De Leonardis, Marcello Vangeli, Agostino Rizzotto, Dario Conte, Manuela Merli, Francesca Capretti, Mauro Bernardi, Chiara Pasquale, Pietro Leo, D. Maiorca, M. Zappimbulso, Filomena Morisco, Vincenzo Sangiovanni, Maurizio Baldassarre, Lucia Cesarini, Gianluca Svegliati-Baroni, Maria Guarino, Carmelina Loguercio, Alessandra Galioto, Antonio Mastroianni, Giorgio Maria Saracco, Antonio Gasbarrini, G. Magini, Alba Kostandini, Carlo Alessandria, Josè Petruzzi, Vito Di Marco, Silvano Fasolato, Elisa Negri, Fabio Pugliese, Mario Angelico, Daniela Campion, Caraceni P., Tufoni M., Zaccherini G., Riggio O., Angeli P., Alessandria C., Neri S., Foschi F.G., Levantesi F., Airoldi A., Simone L., Svegliati-Baroni G., Fagiuoli S., Laffi G., Cozzolongo R., Di Marco V., Sangiovanni V., Morisco F., Toniutto P., Gasbarrini A., De Marco R., Piano S., Nardelli S., Elia C., Roncadori A., Baldassarre M., Bernardi M., Domenicali M., Giannone F.A., Antognoli A., Merli M., Pasquale C., Gioia S., Fasolato S., Sticca A., Campion D., Risso A., Saracco G.M., Prestianni L., Fidone F., Maiorca D., Rizzotto A., Cappa F.M., Lanzi A., Neri E., Visani A., Mastroianni A., Perricone G., Alberti A.B., Cesarini L., Mazzarelli C., Vangeli M., Vigano R., Marzioni M., Capretti F., Kostandini A., Magini G., Colpani M., Gabbani T., Marsico M., Zappimbulso M., Petruzzi J., Calvaruso V., Parrella G., Caporaso N., Auriemma F., Guarino M., Pugliese F., Tortora A., Leo P., Angelico M., De Leonardis F., Pecchioli A., Rossi P., Raimondo G., Cacciola I., Elia G., Negri E., Dallio M., Loguercio C., Federico A., Conte D., Massironi S., Natascia Celli G.B., Rendina M., Bringiotti R., Castellaneta N.M., Salerno F., Boccia S., Guarisco R., Galioto A., Cavallin M., Andrealli A., Caraceni, P., Tufoni, M., Zaccherini, G., Riggio, O., Angeli, P., Alessandria, C., Neri, S., Foschi, F. G., Levantesi, F., Airoldi, A., Simone, L., Svegliati-Baroni, G., Fagiuoli, S., Laffi, G., Cozzolongo, R., Di Marco, V., Sangiovanni, V., Morisco, F., Toniutto, P., Gasbarrini, A., De Marco, R., Piano, S., Nardelli, S., Elia, C., Roncadori, A., Baldassarre, M., Bernardi, M., Domenicali, M., Giannone, F. A., Antognoli, A., Merli, M., Pasquale, C., Gioia, S., Fasolato, S., Sticca, A., Campion, D., Risso, A., Saracco, G. M., Prestianni, L., Fidone, F., Maiorca, D., Rizzotto, A., Cappa, F. M., Lanzi, A., Neri, E., Visani, A., Mastroianni, A., Perricone, G., Alberti, A. B., Cesarini, L., Mazzarelli, C., Vangeli, M., Vigano, R., Marzioni, M., Capretti, F., Kostandini, A., Magini, G., Colpani, M., Gabbani, T., Marsico, M., Zappimbulso, M., Petruzzi, J., Calvaruso, V., Parrella, G., Caporaso, N., Auriemma, F., Guarino, M., Pugliese, F., Tortora, A., Leo, P., Angelico, M., De Leonardis, F., Pecchioli, A., Rossi, P., Raimondo, G., Cacciola, I., Elia, G., Negri, E., Dallio, M., Loguercio, C., Federico, A., Conte, D., Massironi, S., Natascia Celli, G. B., Rendina, M., Bringiotti, R., Castellaneta, N. M., Salerno, F., Boccia, S., Guarisco, R., Galioto, A., Cavallin, M., Andrealli, A., Caraceni, P, Tufoni, M, Zaccherini, G, Riggio, O, Angeli, P, Alessandria, C, Neri, S, Foschi, F, Levantesi, F, Airoldi, A, Simone, L, Svegliati-Baroni, G, Fagiuoli, S, Laffi, G, Cozzolongo, R, Di Marco, V, Sangiovanni, V, Morisco, F, Toniutto, P, Gasbarrini, A, De Marco, R, Piano, S, Nardelli, S, Elia, C, Roncadori, A, Baldassarre, M, Bernardi, M, Domenicali, M, Giannone, F, Antognoli, A, Merli, M, Pasquale, C, Gioia, S, Fasolato, S, Sticca, A, Campion, D, Risso, A, Saracco, G, Prestianni, L, Fidone, F, Maiorca, D, Rizzotto, A, Cappa, F, Lanzi, A, Neri, E, Visani, A, Mastroianni, A, Perricone, G, Alberti, A, Cesarini, L, Mazzarelli, C, Vangeli, M, Vigano, R, Marzioni, M, Capretti, F, Kostandini, A, Magini, G, Colpani, M, Gabbani, T, Marsico, M, Zappimbulso, M, Petruzzi, J, Calvaruso, V, Parrella, G, Caporaso, N, Auriemma, F, Guarino, M, Pugliese, F, Tortora, A, Leo, P, Angelico, M, De Leonardis, F, Pecchioli, A, Rossi, P, Raimondo, G, Cacciola, I, Elia, G, Negri, E, Dallio, M, Loguercio, C, Federico, A, Conte, D, Massironi, S, Natascia Celli, G, Rendina, M, Bringiotti, R, Castellaneta, N, Salerno, F, Boccia, S, Guarisco, R, Galioto, A, Cavallin, M, and Andrealli, A

Subjects
Male, 0301 basic medicine, Cirrhosis, ascites, complications, liver cirrhosis, serum albumin, survival, Serum albumin, Survival, Logistic regression, Gastroenterology, Biomarkers, Pharmacological, Ascites, Complications, 0302 clinical medicine, Medicine, biology, Middle Aged, Intention to Treat Analysis, Treatment Outcome, Ascite, Female, 030211 gastroenterology & hepatology, Drug Monitoring, medicine.symptom, medicine.medical_specialty, Settore MED/12 - GASTROENTEROLOGIA, Serum Albumin, Human, 03 medical and health sciences, Serum albumin level, Predictive Value of Tests, Internal medicine, Post-hoc analysis, Humans, In patient, Biological Products, Cirrhosi, Hepatology, business.industry, Albumin, medicine.disease, Long-Term Care, Survival Analysis, 030104 developmental biology, biology.protein, business, Complication
Abstract

Background & Aims: The ANSWER study reported that long-term albumin administration in patients with cirrhosis and uncomplicated ascites improves survival. During treatment, serum albumin increased within a month and remained stable thereafter. In this post hoc analysis, we aimed to determine whether on-treatment serum albumin levels could guide therapy. Methods: Logistic regression was used to assess the association between baseline serum albumin and mortality, as well as to determine on-treatment factors associated with mortality and to predict the achievement of a given on-treatment serum albumin level. Survival was assessed by Kaplan-Meier estimates and second-order polynomial regression. Patients whose on-treatment serum albumin remained below normal were compared with a subset of patients from the control arm matched by principal score. Results: Baseline serum albumin was closely associated with 18-month mortality in untreated patients; albumin treatment almost effaced this relationship. On-treatment serum albumin and MELD-Na at month 1 were the sole independent variables associated with mortality. Second-order polynomial regression revealed that survival improved in parallel with increased 1-month on-treatment serum albumin. Kaplan-Meier estimations showed that any value of 1-month on-treatment serum albumin (0.1 g/dl intervals) in the range 2.5–4.5 g/dl discriminated patient survival. In the normal range of serum albumin, the best discriminant value was 4.0 g/dl. Compared to untreated patients, survival even improved in patients whose on-treatment serum albumin remained below normal. Conclusion: Baseline serum albumin per se should not guide the decision to start albumin therapy. Conversely, 1-month on-treatment serum albumin levels are strongly associated with outcomes and could guide the use of albumin – 4.0 g/dl being the target threshold. However, even patients whose serum albumin remains below normal benefit from long-term albumin administration. Lay summary: The ANSWER study has shown that long-term albumin administration improves survival and prevents the occurrence of major complications in patients with cirrhosis and ascites. This study shows that the achievement of these beneficial effects is related to a significant increase in serum albumin concentration. Even though the best results follow the achievement of a serum albumin concentration of 4 g/dl, a survival benefit is also achieved in patients who fail to normalise serum albumin.

Published
2020

17. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial

Author

Caraceni, Paolo, Riggio, Oliviero, Angeli, Paolo, Alessandria, Carlo, Neri, Sergio, Foschi, Francesco G, Levantesi, Fabio, Airoldi, Aldo, Boccia, Sergio, Svegliati-Baroni, Gianluca, Fagiuoli, Stefano, Romanelli, Roberto G, Cozzolongo, Raffaele, Di Marco, Vito, Sangiovanni, Vincenzo, Morisco, Filomena, Toniutto, Pierluigi, Tortora, Annalisa, De Marco, Rosanna, Angelico, Mario, Cacciola, Irene, Elia, Gianfranco, Federico, Alessandro, Massironi, Sara, Guarisco, Riccardo, Galioto, Alessandra, Ballardini, Giorgio, Rendina, Maria, Nardelli, Silvia, Piano, Salvatore, Elia, Chiara, Prestianni, Loredana, Cappa, Federica Mirici, Cesarini, Lucia, Simone, Loredana, Pasquale, Chiara, Cavallin, Marta, Andrealli, Alida, Fidone, Federica, Ruggeri, Matteo, Roncadori, Andrea, Baldassarre, Maurizio, Tufoni, Manuel, Zaccherini, Giacomo, Bernardi, Mauro, Domenicali, Marco, Giannone, Ferdinando A, Merli, Manuela, Gioia, Stefania, Fasolato, Silvano, Sticca, Antonietta, Campion, Daniela, Risso, Alessandro, Saracco, Giorgio M, Maiorca, Daniela, Rizzotto, Agostino, Lanzi, Arianna, Neri, Elga, Visani, Anna, Mastroianni, Antonio, Alberti, Alberto B, Mazzarelli, Chiara, Vangeli, Marcello, Marzioni, Marco, Capretti, Francesca, Kostandini, Alba, Magini, Giulia, Colpani, Maria, Laffi, Giacomo, Gabbani, Tommaso, Marsico, Maria, Zappimbulso, Marianna, Petruzzi, Josè, Calvaruso, Vincenza, Parrella, Giovanni, Caporaso, Nicola, Auriemma, Francesco, Guarino, Maria, Pugliese, Fabio, Gasbarrini, Antonio, Leo, Pietro, De Leonardis, Francesco, Pecchioli, Alessandra, Rossi, Piera, Raimondo, Giovanni, Negri, Elisa, Dallio, Marcello, Loguercio, Carmelina, Conte, Dario, Celli, Natascia, Bringiotti, Roberto, Castellaneta, Nicola M, Salerno, Francesco, ANSWER Study Investigators, Caraceni, Paolo, Riggio, Oliviero, Angeli, Paolo, Alessandria, Carlo, Neri, Sergio, Foschi, Francesco G, Levantesi, Fabio, Airoldi, Aldo, Boccia, Sergio, Svegliati-Baroni, Gianluca, Fagiuoli, Stefano, Romanelli, Roberto G, Cozzolongo, Raffaele, Di Marco, Vito, Sangiovanni, Vincenzo, Morisco, Filomena, Toniutto, Pierluigi, Tortora, Annalisa, De Marco, Rosanna, Angelico, Mario, Cacciola, Irene, Elia, Gianfranco, Federico, Alessandro, Massironi, Sara, Guarisco, Riccardo, Galioto, Alessandra, Ballardini, Giorgio, Rendina, Maria, Nardelli, Silvia, Piano, Salvatore, Elia, Chiara, Prestianni, Loredana, Cappa, Federica Mirici, Cesarini, Lucia, Simone, Loredana, Pasquale, Chiara, Cavallin, Marta, Andrealli, Alida, Fidone, Federica, Ruggeri, Matteo, Roncadori, Andrea, Baldassarre, Maurizio, Tufoni, Manuel, Zaccherini, Giacomo, Bernardi, Mauro, Domenicali, Marco, Giannone, Ferdinando A, Merli, Manuela, Gioia, Stefania, Fasolato, Silvano, Sticca, Antonietta, Campion, Daniela, Risso, Alessandro, Saracco, Giorgio M, Maiorca, Daniela, Rizzotto, Agostino, Lanzi, Arianna, Neri, Elga, Visani, Anna, Mastroianni, Antonio, Alberti, Alberto B, Mazzarelli, Chiara, Vangeli, Marcello, Marzioni, Marco, Capretti, Francesca, Kostandini, Alba, Magini, Giulia, Colpani, Maria, Laffi, Giacomo, Gabbani, Tommaso, Marsico, Maria, Zappimbulso, Marianna, Petruzzi, Josè, Calvaruso, Vincenza, Parrella, Giovanni, Caporaso, Nicola, Auriemma, Francesco, Guarino, Maria, Pugliese, Fabio, Gasbarrini, Antonio, Leo, Pietro, De Leonardis, Francesco, Pecchioli, Alessandra, Rossi, Piera, Raimondo, Giovanni, Negri, Elisa, Dallio, Marcello, Loguercio, Carmelina, Conte, Dario, Celli, Natascia, Bringiotti, Roberto, Castellaneta, Nicola M, Salerno, Francesco, Caraceni P1, Riggio O2, Angeli P3, Alessandria C4, Neri S5, Foschi FG6, Levantesi F7, Airoldi A8, Boccia S9, Svegliati-Baroni G10, Fagiuoli S11, Romanelli RG12, Cozzolongo R13, Di Marco Vito, Sangiovanni V15, Morisco F16, Toniutto P17, Tortora A18, De Marco R19, Angelico M20, Cacciola I21, Elia G22, Federico A23, Massironi S24, Guarisco R25, Galioto A26, Ballardini G27, Rendina M28, Nardelli S2, Piano S3, Elia C4, Prestianni L5, Cappa FM6, Cesarini L8, Simone L9, Pasquale C2, Cavallin M3, Andrealli A4, Fidone F5, Ruggeri M29, Roncadori A30, Baldassarre M1, Tufoni M1, Zaccherini G1, Bernardi M31, Domenicali M, Giannone FA, Merli M, Gioia S, Fasolato S, Sticca A, Campion D, Risso A, Saracco GM, Maiorca D, Rizzotto A, Lanzi A, Neri E, Visani A, Mastroianni A, Alberti AB, Mazzarelli C, Vangeli M, Marzioni M, Capretti F, Kostandini A, Magini G, Colpani M, Laffi G, Gabbani T, Marsico M, Zappimbulso M, Petruzzi J, Calvaruso Vincenza, Parrella G, Caporaso N, Auriemma F, Guarino M, Pugliese F, Gasbarrini A, Leo P, De Leonardis F, Pecchioli A, Rossi P, Raimondo G, Negri E, Dallio M, Loguercio C, Conte D, Celli N, Bringiotti R, Castellaneta NM, Salerno F., Caraceni P, Riggio O, Angeli P, Alessandria C, Neri S, Foschi FG, Levantesi F, Airoldi A, Boccia S, Svegliati-Baroni G, Fagiuoli S, Romanelli RG, Cozzolongo R, Di Marco V, Sangiovanni V, Morisco F, Toniutto P, Tortora A, De Marco R, Angelico M, Cacciola I, Elia G, Federico A, Massironi S, Guarisco R, Galioto A, Ballardini G, Rendina M, Nardelli S, Piano S, Elia C, Prestianni L, Cappa FM, Cesarini L, Simone L, Pasquale C, Cavallin M, Andrealli A, Fidone F, Ruggeri M, Roncadori A, Baldassarre M, Tufoni M, Zaccherini G, Bernardi M, Domenicali M, Giannone FA, Merli M, Gioia S, Fasolato S, Sticca A, Campion D, Risso A, Saracco GM, Maiorca D, Rizzotto A, Lanzi A, Neri E, Visani A, Mastroianni A, Alberti AB, Mazzarelli C, Vangeli M, Marzioni M, Capretti F, Kostandini A, Magini G, Colpani M, Laffi G, Gabbani T, Marsico M, Zappimbulso M, Petruzzi J, Calvaruso V, Parrella G, Caporaso N, Auriemma F, Guarino M, Pugliese F, Gasbarrini A, Leo P, De Leonardis F, Pecchioli A, Rossi P, Raimondo G, Negri E, Dallio M, Loguercio C, Conte D, Celli N, Bringiotti R, Castellaneta NM, Salerno F., Caraceni, P, Riggio, O, Angeli, P, Alessandria, C, Neri, S, Foschi, F, Levantesi, F, Airoldi, A, Boccia, S, Svegliati-Baroni, G, Fagiuoli, S, Romanelli, R, Cozzolongo, R, Di Marco, V, Sangiovanni, V, Morisco, F, Toniutto, P, Tortora, A, De Marco, R, Angelico, M, Cacciola, I, Elia, G, Federico, A, Massironi, S, Guarisco, R, Galioto, A, Ballardini, G, Rendina, M, Nardelli, S, Piano, S, Elia, C, Prestianni, L, Cappa, F, Cesarini, L, Simone, L, Pasquale, C, Cavallin, M, Andrealli, A, Fidone, F, Ruggeri, M, Roncadori, A, Baldassarre, M, Tufoni, M, Zaccherini, G, Bernardi, M, Domenicali, M, Giannone, F, Merli, M, Gioia, S, Fasolato, S, Sticca, A, Campion, D, Risso, A, Saracco, G, Maiorca, D, Rizzotto, A, Lanzi, A, Neri, E, Visani, A, Mastroianni, A, Alberti, A, Mazzarelli, C, Vangeli, M, Marzioni, M, Capretti, F, Kostandini, A, Magini, G, Colpani, M, Laffi, G, Gabbani, T, Marsico, M, Zappimbulso, M, Petruzzi, J, Calvaruso, V, Parrella, G, Caporaso, N, Auriemma, F, Guarino, M, Pugliese, F, Gasbarrini, A, Leo, P, De Leonardis, F, Pecchioli, A, Rossi, P, Raimondo, G, Negri, E, Dallio, M, Loguercio, C, Conte, D, Celli, N, Bringiotti, R, Castellaneta, N, and Salerno, F

Subjects
Liver Cirrhosis, Male, Time Factors, Cirrhosis, Kaplan-Meier Estimate, law.invention, ascites, 0302 clinical medicine, Hepatorenal syndrome, Randomized controlled trial, Furosemide, law, Ascites, Clinical endpoint, Paracentesis, Diuretics, albumin, decompensated cirrhosi, Mineralocorticoid Receptor Antagonists, Settore MED/12 - Gastroenterologia, Medicine (all), Hazard ratio, General Medicine, Middle Aged, Survival Rate, 030220 oncology & carcinogenesis, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, Quality-Adjusted Life Years, medicine.symptom, Hyponatremia, medicine.medical_specialty, 03 medical and health sciences, Albumins, Internal medicine, medicine, Humans, Survival rate, albumin, Aged, business.industry, cirrhosis, medicine.disease, Clinical trial, albumin, cirrhosis, ascites, liver decompensation, Quality of Life, Hyperkalemia, business, Esophagus Varices, Portal Hypertension, Varicosis
Abstract

Background Evidence is scarce on the efficacy of long-term human albumin (HA) administration in patients with decompensated cirrhosis. The human Albumin for the treatmeNt of aScites in patients With hEpatic ciRrhosis (ANSWER) study was designed to clarify this issue. Methods We did an investigator-initiated multicentre randomised, parallel, open-label, pragmatic trial in 33 academic and non-academic Italian hospitals. We randomly assigned patients with cirrhosis and uncomplicated ascites who were treated with anti-aldosteronic drugs (≥200 mg/day) and furosemide (≥25 mg/day) to receive either standard medical treatment (SMT) or SMT plus HA (40 g twice weekly for 2 weeks, and then 40 g weekly) for up to 18 months. The primary endpoint was 18-month mortality, evaluated as difference of events and analysis of survival time in patients included in the modified intention-to-treat and per-protocol populations. This study is registered with EudraCT, number 2008–000625–19, and ClinicalTrials.gov, number NCT01288794. Findings From April 2, 2011, to May 27, 2015, 440 patients were randomly assigned and 431 were included in the modified intention-to-treat analysis. 38 of 218 patients died in the SMT plus HA group and 46 of 213 in the SMT group. Overall 18-month survival was significantly higher in the SMT plus HA than in the SMT group (Kaplan-Meier estimates 77% vs 66%; p=0·028), resulting in a 38% reduction in the mortality hazard ratio (0·62 [95% CI 0·40–0·95]). 46 (22%) patients in the SMT group and 49 (22%) in the SMT plus HA group had grade 3–4 non-liver related adverse events. Interpretation In this trial, long-term HA administration prolongs overall survival and might act as a disease modifying treatment in patients with decompensated cirrhosis. Funding Italian Medicine Agency. Copyright © 2018 Elsevier Ltd. All rights reserved.

Published
2018

18. Incidence, Predictors, and Clinical Implications of Discontinuing Therapy with Inhaled Long-Acting Bronchodilators among Patients with Chronic Obstructive Pulmonary Disease

Author

I Cerveri, Roberto de Marco, Luca Merlino, Federica Nicotra, Adriano Vaghi, Giovanni Corrao, Andrea Arfè, Arfe, A, Nicotra, F, Cerveri, I, de Marco, R, Vaghi, A, Merlino, L, and Corrao, G

Subjects
Male, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Adrenal Cortex Hormones, Risk Factors, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, 80 and over, COPD, Chronic obstructive pulmonary disease, Incidence (epidemiology), Age Factors, persistence, Middle Aged, Anti-Bacterial Agents, Bronchodilator Agents, Hospitalization, Drug Combinations, Italy, Cohort, Female, Medical Record Linkage, healthcare utilization database, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, long-acting bronchodilators, 03 medical and health sciences, Sex Factors, death, Internal medicine, Humans, Mortality, Intensive care medicine, Aged, business.industry, Proportional hazards model, Odds ratio, medicine.disease, Confidence interval, Discontinuation, hospital admission, 030228 respiratory system, Withholding Treatment, Delayed-Action Preparations, long-acting bronchodilator, discontinuation, business, Follow-Up Studies
Abstract

Incidence, predictors and effect of discontinuation of long-acting bronchodilators on the risk of death or hospital admission among adults with Chronic Obstructive Pulmonary Disease (COPD) were assessed in a large population-based prospective study carried out by linking Italian healthcare utilization databases. Specifically, the cohort of 17,490 beneficiaries of the National Health Service in the Italian Region of Lombardy, aged 40 years or older, who started long-acting bronchodilators therapy during 2005–2008 was followed from first dispensation until 2012. During this period, patients who experienced discontinuation of long-acting bronchodilators were identified. Hospitalizations for COPD and deaths for any cause (composite clinical outcome) were also identified during follow-up. A Cox proportional hazards model was fitted to identify predictors of discontinuation. The case-crossover design was used to assess the implications of treatment discontinuation on the clinical outcome risk. Cumulative incidences of discontinuation were, respectively, 67%, 80%, and 92% at 6 months, 1 year, and 5 years since initial treatment. Significant predictors of discontinuation were female gender, younger age, starting treatment with fixed-dose combination of inhaled bronchodilators and corticosteroids, using antibiotics, inhaled long-acting bronchodilators and corticosteroids and not using short-acting bronchodilators, other respiratory drugs and systemic corticosteroids during follow-up. Odds ratios (95% confidence intervals) for the clinical outcome associated with not discontinuing long-acting bronchodilators was 0.64 (0.50 to 0.82). In conclusion, in the real-life setting, discontinuation of inhaled long-acting bronchodilators in adults with COPD is high even after just 6 months, even though persistence to these drugs reduces the risk of severe outcomes.

Published
2016

19. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

Author

F. De Berardinis, Fortunato Lombardo, G. Zanette, R. Cardani, Ivana Rabbone, C. Zecchino, Barbara Predieri, C. Arnaldi, Barbara Piccini, B. Felappi, Riccardo Bonfanti, D. Lo Presti, B. Mainetti, G. Ignaccolo, F. Stamati, Roberto Franceschi, G. Ponzi, M. S. Coccioli, F. Citriniti, C. Ripoli, F. Chiarelli, Valeria Calcaterra, M. Trada, Giovanni Federico, A. Sabbion, D. Cirillo, Enza Mozzillo, C. Salvo, Francesco Prisco, G. Piredda, Alessandro Salvatoni, Maurizio Delvecchio, R. A. Taccardi, Valentino Cherubini, Gianluca Tornese, G. Morganti, Giulio Maltoni, Nicola Minuto, Giovanni Chiari, S. Zonca, M. Bensa, Franco Meschi, V. De Donno, Martina Biagioni, Silvia Savastio, L. Guerraggio, A. Gualtieri, T. Suprani, A. Franzese, M. G. Berioli, D. Iafusco, Francesco Cadario, Andrea Scaramuzza, A. Favia, Luciano Beccaria, Gian Vincenzo Zuccotti, Sonia Toni, Riccardo Schiaffini, F. Cerutti, N. Lazzaro, Lorenzo Iughetti, B. Pasquino, Francesco Fontana, P. Banin, G. Cardinale, A. Marsciani, Anna Paola Frongia, S. Lucchesi, E. Schieven, R. Lera, R. De Marco, F. Cardella, F. Gallo, Vittoria Cauvin, P. Sogno Valin, E. Prandi, L. Tomaselli, Vanna Graziani, M Bruzzese, Lorenzo Lenzi, F. Mammì, Giuseppe d'Annunzio, Ippolita Patrizia Patera, Stefano Zucchini, C. Maffeis, A. Bobbio, A. Gaiero, V. Castaldo, Alfonso Galderisi, Stefano Tumini, P Buono, C. Monciotti, Elvira Piccinno, D. Pardi, Marco Cappa, Renata Lorini, Marco Marigliano, Zucchini, Stefano, Scaramuzza, Andrea E, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Cherubini, Valentino, Chiari, Giovanni, D'Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Maltoni, Giulio, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Tornese, Gianluca, Rabbone, Ivana, Lera, R., Bobbio, A., Gualtieri, A., Piccinno, E., Zecchino, C., Pasquino, B., Felappi, B., Prandi, E., Gallo, F., Morganti, G., Ripoli, C., Cardinale, G., Ponzi, G., Castaldo, V., Stamati, F., Lo Presti, D., Tomaselli, L., Citriniti, F., Suprani, T., Bensa, M., Graziani, V., De Berardinis, F., Chiarelli, F., De Marco, R., Lazzaro, N., De Donno, V., Banin, P., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, M. S., Minuto, N., Lorini, R., Trada, M., Sogno Valin, P., Beccaria, L., Lucchesi, S., Bruzzese, M., Mammì, F., Cirillo, D., Pardi, D., Taccardi, R. A., Lombardo, F., Zuccotti, G. V., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Prisco, F., Cadario, F., Savastio, S., Piredda, G., Monciotti, C., Galderisi, A., Salvo, C., Calcaterra, V., Berioli, M. G., Federico, G., Favia, A., Zanette, G., Marsciani, A., Schiaffini, R., Cappa, M., Delvecchio, M., Gaiero, A., Ignaccolo, G., Cerutti, F., Fontana, F., Guerraggio, L., Zonca, S., Franceschi, R., Tornese, G., Biagioni, M., Salvatoni, A., Cardani, R., Marigliano, M., Sabbion, A., Maffeis, C., Schieven, E., Arnaldi, C., Zucchini, S., Scaramuzza, A. E., Bonfanti, R., Buono, P., Cardella, F., Cauvin, V., Cherubini, V., Chiari, G., D'Annunzio, G., Frongia, A. P., Iafusco, D., Maltoni, G., Patera, I. P., Toni, S., Tumini, S., Rabbone, I., Mammi, F., Mozzillo, E., and Prisco, Francesco

Subjects
0301 basic medicine, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, Endocrinology, endocrine system diseases, type 1 diabetes, Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetic Ketoacidosis, Female, Health Care Surveys, Humans, Infant, Infant, Newborn, Insulin, Italy, Rehydration Solutions, Retrospective Studies, Treatment Outcome, lcsh:Diseases of the endocrine glands. Clinical endocrinology, ketoacidosis, Retrospective Studie, Medicine, Diabetology, Diabetes and Metabolism, Newly diagnosed diabetes, Research Article, Type 1, Human, medicine.medical_specialty, Article Subject, Referral, Diabetic ketoacidosis, Diabetic Ketoacidosi, 03 medical and health sciences, children, Retrospective survey, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, lcsh:RC648-665, business.industry, Rehydration Solution, nutritional and metabolic diseases, Retrospective cohort study, Newborn, medicine.disease, 030104 developmental biology, Health Care Survey, business
Abstract

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records(n=2453)of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n=1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

Published
2016

20. Socioeconomic inequalities in smoking habits are still increasing in Italy

Author

Giang Nguyen, Alessandro G. Fois, Pietro Pirina, Valeria Bellisario, Simona Villani, Francesco Attena, Roberto de Marco, Leonardo Antonicelli, Pierpaolo Marchetti, Pavilio Piccioni, Gabriele Nicolini, Lamberto Briziarelli, Angelo Corsico, Marcello Ferrari, MariaGrazia Panico, Simone Accordini, Lucio Casali, Lucia Cazzoletti, Roberto Bono, Giuseppe Verlato, Verlato, G, Accordini, S, Nguyen, G, Marchetti, P, Cazzoletti, L, Ferrari, M, Antonicelli, L, Attena, Francesco, Bellisario, V, Bono, R, Briziarelli, L, Casali, L, Corsico, Ag, Fois, A, Panico, M, Piccioni, P, Pirina, P, Villani, S, Nicolini, G, and de Marco, R.

Subjects
trends, medicine.medical_specialty, education.field_of_study, business.industry, Cross-sectional study, Public health, medicine.medical_treatment, Population, Public Health, Environmental and Occupational Health, smoking cessation, socioeconomic status, smoking initiation, smoking cessation, trends, socioeconomic status, Italy, Italy, Environmental health, smoking initiation, Epidemiology, Medicine, Smoking cessation, Biostatistics, Young adult, business, education, Socioeconomic status, Research Article
Abstract

Background: Socioeconomic inequalities in smoking habits have stabilized in many Western countries. This study aimed at evaluating whether socioeconomic disparities in smoking habits are still enlarging in Italy and at comparing the impact of education and occupation. Methods: In the frame of the GEIRD study (Gene Environment Interactions in Respiratory Diseases) 10,494 subjects, randomly selected from the general population aged 20–44 years in seven Italian centres, answered a screening questionnaire between 2007 and 2010 (response percentage = 57.2%). In four centres a repeated cross-sectional survey was performed: smoking prevalence recorded in GEIRD was compared with prevalence recorded between 1998 and 2000 in the Italian Study of Asthma in Young Adults (ISAYA). Results: Current smoking was twice as prevalent in people with a primary/secondary school certificate (40-43%) compared with people with an academic degree (20%), and among unemployed and workmen (39%) compared with managers and clerks (20-22%). In multivariable analysis smoking habits were more affected by education level than by occupation. From the first to the second survey the prevalence of ever smokers markedly decreased among housewives, managers, businessmen and free-lancers, while ever smoking became even more common among unemployed (time-occupation interaction: p = 0.047). At variance, the increasing trend in smoking cessation was not modified by occupation. Conclusion: Smoking prevalence has declined in Italy during the last decade among the higher socioeconomic classes, but not among the lower. This enlarging socioeconomic inequality mainly reflects a different trend in smoking initiation.

Published
2014

21. Measuring contrast sensitivity in aretinopathic patients with insulin dependent diabetes mellitus

Author

A. Franzese, G. Ambrosio, L. Capasso, N. Gasparini, R. De Marco, Adriano Magli, DE MARCO, R., Capasso, L., Magli, A., Franzese, Adriana, Gasparini, A., and Ambrosio, Gennaro

Subjects
Blood Glucose, Male, medicine.medical_specialty, Adolescent, media_common.quotation_subject, Contrast Sensitivity, Random Allocation, Physiology (medical), Diabetes mellitus, Internal medicine, Diabetes Mellitus, medicine, Humans, Contrast (vision), Child, Chromatography, High Pressure Liquid, Glycemic, media_common, Glycated Hemoglobin, Diabetic Retinopathy, business.industry, Puberty, Mean value, Diabetic retinopathy, sensitivity, aretinopathic patients, medicine.disease, Sensory Systems, Ophthalmology, Diabetes Mellitus, Type 1, Endocrinology, Sensory Thresholds, Insulin dependent diabetes, Female, business, Follow-Up Studies, Retinopathy
Abstract

Contrast sensitivity measurements were obtained from 66 patients with Insulin Dependent Diabetes Mellitus (IDDM) and no visible diabetic retinopathy (Group A, n = 30 prepubescent and pubescent subjects; Group B, n = 36 postpubescent subjects). Contrast thresholds were determined for stationary and 6.87 Hz phase-alternating gratings at eight spatial frequencies from 0.18 to 15.7 c/deg. Data from each group of diabetic patients was compared with data from puberty-matched normal subjects. Mean value of the last four determinations of glycohemoglobin Alc (HbAlc) was used as a index of glycemic control. We found that patients with IDDM and no retinopathy had normal contrast sensitivity and that contrast thresholds were not significantly related to sexual maturity, duration of diabetes and glycemic control.

Published
1997

22. Safety and efficacy of infliximab and adalimumab for refractory uveitis in juvenile idiopathic arthritis: 1-year followup data from the Italian Registry

Author

Irene Pontikaki, Stefania Viola, Maria Elisabetta Zannin, Rolando Cimaz, Carolina Birolo, Valeria Gerloni, Fabrizia Corona, Fabio Vittadello, Fulvio Parentin, Riccardo De Marco, Giorgia Martini, Francesco Zulian, Francesco La Torre, Maria Pia Paroli, Fernanda Falcini, Claudia Bracaglia, Elisabetta Miserocchi, Gabriele Simonini, Alison Shardlow, Luciana Breda, Zannin, Me, Birolo, C, Gerloni, Vm, Miserocchi, E, Pontikaki, I, Paroli, Mp, Bracaglia, C, Shardlow, A, Parentin, F, Cimaz, R, Simonini, G, Falcini, F, Corona, F, Viola, S, De Marco, R, Breda, L, La Torre, F, Vittadello, F, Martini, G, and Zulian, F

Subjects
Male, CHILDHOOD, Arthritis, Juvenile, CHILDREN, THERAPY, Monoclonal, Immunology and Allergy, Registries, Child, Humanized, Antibodies, Monoclonal, Anti-tumor necrosis factor agents, Juvenile idiopathic arthritis, Treatment, Uveitis, Adalimumab, Adolescent, Antibodies, Monoclonal, Humanized, Antirheumatic Agents, Arthritis, Juvenile, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infliximab, Italy, Treatment Outcome, Tumor Necrosis Factor-alpha, Treatment efficacy, medicine.drug, medicine.medical_specialty, Immunology, Antibodies, Rheumatology, Refractory, Internal medicine, medicine, Adverse effect, Preschool, business.industry, medicine.disease, Dermatology, Surgery, uveitis, juvenile arthrtritis, ANTI-TUMOR NECROSIS FACTOR AGENTS, TREATMENT, RISK-FACTORS, Physical therapy, business
Abstract

Objective.To evaluate safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of juvenile idiopathic arthritis-related anterior uveitis (JIA-AU).Methods.Starting January 2007, patients with JIA-AU treated with IFX and ADA were managed by a standard protocol and data were entered into the National Italian Registry (NIR). At baseline, all patients were refractory to standard immunosuppressive treatment and/or were corticosteroid-dependent. Data recorded every 3 months included uveitis course, number/type of ocular complications, drug-related adverse events (AE), treatment change or withdrawal, and laboratory measures. Data of patients treated for at least 1 year were retrieved from the NIR and analyzed using descriptive statistics. Treatment efficacy was based on change in uveitis course and in number of ocular complications.Results.Up to December 2009, data for 108 patients with JIA-AU treated with anti-tumor necrosis factor-α agents were recorded in the NIR and data from 91, with at least 12 months’ followup, were included in the study. Forty-eight patients were treated with IFX, 43 with ADA. Forty-seven patients (55.3%) achieved remission of AU, 28 (32.9%) had recurrent AU, and 10 (11.8%) maintained a chronic course. A higher remission rate was observed with ADA (67.4% vs 42.8% with IFX; p = 0.025). Ocular complications decreased from 0.47 to 0.32 per subject. Five patients experienced resolution of structural complications. No patient reported serious AE; 8 (8.8%) experienced 11 minor AE (9 with IFX, 2 with ADA).Conclusion.IFX and ADA appear to be effective and safe for treatment of refractory JIA-related uveitis, with a better performance of ADA in the medium-term period.

Published
2013

23. Boceprevir or telaprevir in hepatitis C virus chronic infection: The Italian real life experience

Author

Antonio Ascione, null CLEO Study Group, Luigi Elio Adinolfi, Pietro Amoroso, Angelo Andriulli, Orlando Armignacco, Tiziana Ascione, Sergio Babudieri, Giorgio Barbarini, Michele Brogna, Francesco Cesario, Vincenzo Citro, Ernesto Claar, Raffaele Cozzolongo, Giuseppe D’Adamo, Emilio D’Amico, Pellegrino Dattolo, Massimo De Luca, Vincenzo De Maria, Massimo De Siena, Giuseppe De Vita, Antonio Di Giacomo, Rosanna De Marco, Giorgio De Stefano, Giulio De Stefano, Sebastiano Di Salvo, Raffaele Di Sarno, Nunzia Farella, Laura Felicioni, Basilio Fimiani, Luca Fontanella, Giuseppe Foti, Caterina Furlan, Francesca Giancotti, Giancarlo Giolitto, Tiziana Gravina, Barbara Guerrera, Roberto Gulminetti, Angelo Iacobellis, Michele Imparato, Angelo Iodice, Vincenzo Iovinella, Antonio Izzi, Alfonso Liberti, Pietro Leo, Gennaro Lettieri, Ileana Luppino, Aldo Marrone, Ettore Mazzoni, Vincenzo Messina, Roberto Monarca, Vincenzo Narciso, Lorenzo Nosotti, Adriano Maria Pellicelli, Alessandro Perrella, Guido Piai, Antonio Picardi, Paola Pierri, Grazia Pietromatera, Francesco Resta, Luca Rinaldi, Mario Romano, Angelo Rossini, Maurizio Russello, Grazia Russo, Rodolfo Sacco, Vincenzo Sangiovanni, Antonio Schiano, Antonio Sciambra, Gaetano Scifo, Filomena Simeone, Annarita Sullo, Pierluigi Tarquini, Paolo Tundo, Alfredo Vallone, Ascione, A, Adinolfi, Luigi Elio, Amoroso, P, Andriulli, A, Armignacco, O, Ascione, T, Babudieri, S, Barbarini, G, Brogna, M, Cesario, F, Citro, V, Claar, E, Cozzolongo, R, D'Adamo, G, D'Amico, E, Dattolo, P, De Luca, M, De Maria, V, De Siena, M, De Vita, G, Di Giacomo, A, De Marco, R, De Stefano, G, Di Salvo, S, Di Sarno, R, Farella, N, Felicioni, L, Fimiani, B, Fontanella, L, Foti, G, Furlan, C, Giancotti, F, Giolitto, G, Gravina, T, Guerrera, B, Gulminetti, R, Iacobellis, A, Imparato, M, Iodice, A, Iovinella, V, Izzi, A, Liberti, 1, Leo, P, Lettieri, G, Luppino, I, Marrone, Aldo, Mazzoni, E, Messina, V1, Monarca, R, Narciso, V, Nosotti, L, Pellicelli, Am, Perrella, A, Piai, G, Picardi, A, Pierri, P, Pietromatera, G, Resta, F, Rinaldi, L, Romano, M, Rossini, A, Russello, M, Russo, G, Sacco, R, Sangiovanni, V, Schiano, A, Sciambra, A, Scifo, G, Simeone, F, Sullo, A, Tarquini, P, Tundo, P, and Vallone, A.

Subjects
viruses, Hepatitis C virus, Observational Study, Antiviral therapy, Boceprevir, Chronic hepatitis, Peg-interferon, Ribavirin, Telaprevir, Hepatology, medicine.disease_cause, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Telaprevi, business.industry, Virology, Peg interferon, Chronic infection, chemistry, Chronic hepatiti, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract

AIM:To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus (HCV) genotype 1 in the real-world settings. METHODS: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-TaqMan2.0 (Roche, LLQ 25 IU/mL). RESULTS: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57 (range 18-78), of whom 18.3% were over 65; mean body mass index 25.6 (range 16-39); genotype 1b (79.4%); diagnosis of cirrhosis (38.2%); and fibrosis F3/4 (71.2%). The following drugs were used: Telaprevir (66.2%) and PEG-IFN-alpha2a (67.6%). Patients were naïve (24.4%), relapsers (30.5%), partial responders (14.8%) and null responders (30.3%). Overall, adverse events (AEs) occurred in 617 patients (73.9%) during the treatment. Anemia was the most frequent AE (52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure (15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age. CONCLUSION: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, non-responders to peginterferon + ribavirin.

Published
2016

24. Visual function before and after photorefractive keratectomy for myopia

Author

Nicola Rosa, Rocco De Marco, G. Ambrosio, Luciano Loffredo, Giovanni Cennamo, Adolfo Sebastiani, Ambrosio, G, Cennamo, Giovanni, De Marco, R, Loffredo, L, Rosa, N, and Sebastiani, A.

Subjects
Adult, medicine.medical_specialty, Adolescent, Light, genetic structures, medicine.medical_treatment, media_common.quotation_subject, Group ii, Vision Disorders, Visual Acuity, Contrast Sensitivity, Cornea, Ophthalmology, Glare testing, Refractive surgery, Myopia, medicine, Humans, Scattering, Radiation, Contrast (vision), Prospective Studies, Vision, Ocular, Dioptre, media_common, business.industry, Glare (vision), Middle Aged, eye diseases, Photorefractive keratectomy, Visual function, Surgery, Laser Therapy, sense organs, business
Abstract

BACKGROUND: To date, Snellen visual acuity and postoperative refraction have been used to evaluate the results of photorefractive keratectomy. However, other parameters, such as contrast sensitivity function and glare, may be affected by refractive surgery and lead to unsatisfactory visual performance. This prospective study is aimed at evaluating the effect of photorefractive keratectomy on contrast sensitivity function and glare. SUBJECTS AND METHODS: Static contrast sensitivity function, dynamic contrast sensitivity function, and glare sensitivity were evaluated in 22 myopic eyes before as well as 1, 3, and 6 months after photorefractive keratectomy. The eyes tested were divided into three groups, according to the amount of myopia: group I, from - 4.00 to - 8.00 diopters (D); group II, from -8.25 to -11.00 D; group ??, from -11.25 to -20.00 D. RESULTS: Both static and dynamic contrast sensitivity function at the intermediate spatial frequencies were altered at 1 month after photorefractive keratectomy, with a trend toward recovery at 3 and 6 months postoperatively. Glare sensitivity was not significantly affected by surgery. CONCLUSIONS: Contrast sensitivity function and glare testing may show abnormalities in the presence of optimal visual and refractive results. These tests may result especially important for the evaluation of new refractive surgical procedures. [J Refract Corneal Surg. 1994;10:129-136.]

Published
1994

25. Diverging trends of chronic bronchitis and smoking habits between 1998 and 2010

Author

Angelo Corsico, Pietro Pirina, Leonardo Antonicelli, Simone Accordini, Isa Cerveri, Alessandro G. Fois, Francesco Attena, Lucio Casali, Roberta Tassinari, Roberto de Marco, Roberto Bono, Marcello Ferrari, Pierpaolo Marchetti, Giuseppe Verlato, Accordini, S, Corsico, Ag, Cerveri, I, Antonicelli, L, Attena, Francesco, Bono, R, Casali, L, Ferrari, M, Fois, A, Marchetti, P, Pirina, P, Tassinari, R, Verlato, G, and de Marco, R.

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic bronchitis, Rhinitis, Allergic, Perennial, Cross-sectional study, Population, Prevalence, cigarette smoking, Young Adult, Internal medicine, Epidemiology, medicine, Humans, Allergic rhinitis, Asthma, Cigarette smoking, Young adult, education, allergic rhinitis, asthma, chronic bronchitis, cigarette smoking, epidemiology, lcsh:RC705-779, education.field_of_study, allergic rhinitis, business.industry, Research, Smoking, lcsh:Diseases of the respiratory system, asthma, medicine.disease, Rhinitis, Allergic, Bronchitis, Chronic, Cross-Sectional Studies, Italy, Relative risk, Physical therapy, chronic bronchitis, Female, epidemiology, allergic rhiniti, business
Abstract

Background No study has been carried out on the time trend in the prevalence of chronic bronchitis (CB) in recent years, despite its clinical and epidemiological relevance. We evaluated the trend in CB prevalence during the past decade among young Italian adults. Methods A screening questionnaire was mailed to general population samples of 20–44 year-old subjects in two cross-sectional surveys: the Italian Study on Asthma in Young Adults (ISAYA) (1998/2000; n = 18,873, 9 centres) and the screening stage of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007/2010; n = 10,494, 7 centres). CB was defined as having cough and phlegm on most days for a minimum of 3 months a year and for at least 2 successive years. The prevalence rates and the risk ratios (RRs) for the association between CB and each potential predictor were adjusted for gender, age, season of response, type of contact, cumulative response rate, and centre. Results CB prevalence was 12.5% (95% CI: 12.1-12.9%) in 1998/2000 and 12.6% (95% CI: 11.7-13.7%) in 2007/2010; it increased among never smokers (from 7.6 to 9.1%, p = 0.003), current light smokers ( Conclusions Despite the significant reduction in current smoking, CB prevalence did not vary among young Italian adults. The temporal pattern of CB prevalence can only be partly explained by the increase of unemployment/premature retirement, asthma and allergic rhinitis, and suggests that other factors could have played a role.

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