Search

Your search keyword '"Mancini I."' showing total 19 results
Start Over Author "Mancini I." Topic business
19 results on '"Mancini I."'

1. The features of acquired thrombotic thrombocytopenic purpura occurring at advanced age

Author

Agosti, P, Mancini, I, Artoni, A, Ferrari, B, Pontiggia, S, Trisolini, Sm, Facchini, L, Peyvandi, F, Capria, S, Codeluppi, K, Rinaldi, E, Pastore, D, Campus, S, Podda, Ra, Caria, C, Caddori, A, Nicolosi, D, Giuffrida, G, Agostini, V, Roncarati, U, Mannarella, C, Fragasso, A, Podda, Gm, Birocchi, S, Cerbone, Am, Tufano, A, Loffredo, G, Menna, G, Pizzuti, M, Ronchi, M, De Fanti, A, Amarri, S, Defina, M, Bocchia, M, Ceru, S, Gattillo, S, Agosti, P., Mancini I., Artoni A., Ferrari B., Pontiggia S., Trisolini S. M., Facchini L., Peyvandi F., and Tufano, A.

Subjects
medicine.medical_specialty, Thrombotic microangiopathy, ADAMTS13 Protein, Hemorrhage, Disease, 030204 cardiovascular system & hematology, Kidney, Adamts13 activity, 03 medical and health sciences, 0302 clinical medicine, Elderly, Older patients, Internal medicine, medicine, Humans, Registries, Acute thrombotic thrombocytopenic purpura management, ADAMTS13, Rare disease, Aged, Acquired Thrombotic Thrombocytopenic Purpura, Purpura, Thrombotic Thrombocytopenic, business.industry, Hematology, Microangiopathic hemolytic anemia, medicine.disease, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Female, business
Abstract

Introduction: Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare life-threatening thrombotic microangiopathy (TMA) affecting more frequently women of 30–50 years of age. There is scarce information on the clinical features of aTTP occurring in the elderly. Our goal was to evaluate the impact of an elderly-onset disease on the expression, severity and management of aTTP. Materials and methods: We performed a cross-sectional study of patients enrolled in the Milan TTP Registry (www.ttpdatabase.org) after a first acute episode of aTTP from January 2002 to March 2018. The aTTP diagnosis was suspected on the basis of the presence of thrombocytopenia and microangiopathic hemolytic anemia with no alternative causes, and was confirmed centrally by a severe plasma deficiency of ADAMTS13 activity (

Published
2020

2. Deepening Trade and Fundamental Rights? Harnessing Data Protection Rights in the Regulatory Cooperation Chapters of EU Trade Agreements

Author

Mancini, I., Weiß, W., Furculita, C., Weiß, W, and Furculita, C

Subjects
QA75, business.industry, media_common.quotation_subject, JN, Fundamental rights, Context (language use), International trade, Pooling data, Negotiation, HV, State (polity), Normative, Data Protection Act 1998, business, media_common
Abstract

The paper explores the descriptive and normative intersection of Data Protection rights and Regulatory Cooperation chapters in the new generation of EU Trade Agreements. While the EU has repeatedly refused to consider data protection as part of trade negotiations, it has sought deeper institutionalised forms of regulatory cooperation: the question then arises as to what extent data protection rights would come across with these mechanisms and the consequences on their protection. In a context of global trade requiring data to flow freely, regulatory cooperation has been advanced as a way to deal with regulatory divergences in data. How should the EU deal with global demands pooling data flows and regulatory cooperation? The paper finds that data protection emerges as a very much cross-cutting issue liable to be affected by Regulatory Cooperation activities. It is argued that the EU should acknowledge this state of play whereby data protection cannot be isolated or only elusively addressed; instead, mechanisms should be secured so as to ensure that data protection, as a fundamental right, is not undermined, and is instead embedded and enhanced in the regulatory cooperation chapters.

Published
2020

3. Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on Atrial Fibrillation

Author

Nieuwlaat R., Prins M. H., Le Heuzey J. -Y., Vardas P. E., Aliot E., Santini M., Cobbe S. M., Widdershoven J. W. M. G., Baur L. H., Levy S., Crijns H. J. G. M., Olsson B., Breithardt G., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M. F., Alonso A., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., Andresen D., McGregor K., Mulder B., Priori S., Ryden L., Vahanian A., Wijns W., Sanofi-Aventis, Grigoryan S. V., Apetyan I., Aroyan S., Camm A. J., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L. A., Davies W., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Capucci A., Borisov B., Petrov V. A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y. A., Ibrahim B. S. S., Tammam K., Saad A., Elghawaby H., Sherif H. Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F. F., Rubio J., Malpartida F., Corona M., Sanchez L. T., Miguel J., Herrera L., Quesada A., Garcia A. J. M., Gonzalez C. S., Juango M. S. A., Berjon-Reyero J., Alegret J. M., Fernandez J. M. C., Carrascosa C., Romero R. A. F., Lara M. G., Sendon J. L. L., de Diego J. J. G., Martin L. S., Irurita M., Guttierez N. H., Rubio J. R. S., Antorrena I., Paves A. B., Salvador A., Orriach M. D., Garcia A. A., Epelde F., Martinez V. B., Sanchez A. B., Galvez C. P., Rivero R. F., Madrid A. H., Baron-Esquivias G., Peinado R., Guindal J. A. G., Vera T. R., Fernandez E. L., Gayan R., Garcia J., Bodegas A., Lopez J. T., Florez J. M., Cabezas C. L., de Castroviejo E. V. R., Bellido J. M., Ruiz M. E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J. C., Lecocq G., Poulain C., Cleland J. G. F. C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N. A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G. -P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G. M., Fioranelli M., Naccarella F., Maranga S. S., Lepera G., Bresciani B., Seragnoli E., Forti M. C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S. M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A. A., op Reimer W. S., de Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D. C. A., Veerhoek M. J., Kamps M., Haan D., van Rijn N., Bootsma A., van den A., Fransen H., Eurlings L., Meeder J., De Boer M. J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A. -M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J. M. F. R., Ferreira R., Freitas A., Morais J. C. A., Pires R., Gomes M. J. V., Gago P., Candeias R. A. C., Nunes L., Sa J. V. M., Ventura M., de Oliveira M., Alves L. B., Bostaca I., Olariu C. T., Dan G. A., Dan A., Podoleanu C., Frigy A., Georgescu G. I. M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D. L., Rancea R., Shubik Y. V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M. I., Makienko N. V., Potpara T., Knezevic S., Randjelovic M., Nieuwlaat R., Prins M.H., Le Heuzey J.-Y., Vardas P.E., Aliot E., Santini M., Cobbe S.M., Widdershoven J.W.M.G., Baur L.H., Levy S., Crijns H.J.G.M., Olsson B., Breithardt G., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J.-J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M.F., Alonso A., Lopez-Sendon J.L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., Andresen D., McGregor K., Mulder B., Priori S., Ryden L., Vahanian A., Wijns W., Sanofi-Aventi, Grigoryan S.V., Apetyan I., Aroyan S., Camm A.J., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L.A., Davies W., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Capucci A., Borisov B., Petrov V.A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y.A., Ibrahim B.S.S., Tammam K., Saad A., Elghawaby H., Sherif H.Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F.F., Rubio J., Malpartida F., Corona M., Sanchez L.T., Miguel J., Herrera L., Quesada A., Garcia A.J.M., Gonzalez C.S., Juango M.S.A., Berjon-Reyero J., Alegret J.M., Fernandez J.M.C., Carrascosa C., Romero R.A.F., Lara M.G., Sendon J.L.L., de Diego J.J.G., Martin L.S., Irurita M., Guttierez N.H., Rubio J.R.S., Antorrena I., Paves A.B., Salvador A., Orriach M.D., Garcia A.A., Epelde F., Martinez V.B., Sanchez A.B., Galvez C.P., Rivero R.F., Madrid A.H., Baron-Esquivias G., Peinado R., Guindal J.A.G., Vera T.R., Fernandez E.L., Gayan R., Garcia J., Bodegas A., Lopez J.T., Florez J.M., Cabezas C.L., de Castroviejo E.V.R., Bellido J.M., Ruiz M.E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J.C., Lecocq G., Poulain C., Cleland J.G.F.C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N.A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G.-P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G.M., Fioranelli M., Naccarella F., Maranga S.S., Lepera G., Bresciani B., Seragnoli E., Forti M.C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S.M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A.A., op Reimer W.S., de Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D.C.A., Veerhoek M.J., Kamps M., Haan D., van Rijn N., Bootsma A., van den A., Fransen H., Eurlings L., Meeder J., De Boer M.J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A.-M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J.M.F.R., Ferreira R., Freitas A., Morais J.C.A., Pires R., Gomes M.J.V., Gago P., Candeias R.A.C., Nunes L., Sa J.V.M., Ventura M., de Oliveira M., Alves L.B., Bostaca I., Olariu C.T., Dan G.A., Dan A., Podoleanu C., Frigy A., Georgescu G.I.M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D.L., Rancea R., Shubik Y.V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M.I., Makienko N.V., Potpara T., Knezevic S., and Randjelovic M.

Subjects
Male, medicine.medical_specialty, Rate control, Heart Diseases, Heart disease, Prognosi, Hemorrhage, Risk Assessment, Anticoagulation, Electrocardiography, Internal medicine, Atrial Fibrillation, Humans, Medicine, Sinus rhythm, Prospective Studies, Mortality, Prospective cohort study, Stroke, Survival rate, Aged, Progression, medicine.diagnostic_test, business.industry, Anticoagulant, Anticoagulants, Atrial fibrillation, Prognosis, medicine.disease, Management, Survival Rate, Prospective Studie, Heart Disease, Treatment Outcome, Heart failure, Disease Progression, Cardiology, Rhythm control, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims: To gain insight in the prognosis and treatment of atrial fibrillation (AF) patients during 1-year follow-up in the Euro Heart Survey (EHS) on AF. Methods and results: The EHS enrolled 5333 AF patients in 2003-2004. One-year follow-up data were available for 80%. Of first detected AF patients, 46% did not have a recurrence during 1 year, paroxysmal AF largely remained paroxysmal AF (80%), and 30% of persistent AF progressed to permanent AF. Many treatment changes occurred since baseline. Oral anticoagulation was started in 19% and discontinued in 16% of all patients. Of patients initially on rhythm control 27% did not receive rhythm control during follow-up, whereas 15% of patients initially on rate control received rhythm control. Mortality was highest in permanent AF (8.2%), but also substantial in first detected AF (5.7%). In multivariable analysis, sinus rhythm at baseline was associated with lower mortality, but no significant effect was observed regarding the application of either rhythm or rate control. Conclusion: The EHS on AF provides unique prospective observational data on AF progression, long-term treatment, prognosis, and determinants of adverse outcome of the total clinical spectrum of AF in a European cardiology-based patient cohort. © The Author 2008.

Published
2008

4. Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe

Author

Malentacchi F, Mancini I, Brandslund I, Vermeersch P, Schwab M, Marc J, van Schaik RH, Siest G, Theodorsson E, Pazzagli M, Di Resta C, European Federation of Clinical Chemistry and Laboratory Medicine (EFLM), European Society of Pharmacogenomics and Personalised Therapy (ESPT) Joint Working Group on Personalized Laboratory Medicine (WG-PLM), Malentacchi, F, Mancini, I, Brandslund, I, Vermeersch, P, Schwab, M, Marc, J, van Schaik, Rh, Siest, G, Theodorsson, E, Pazzagli, M, Di Resta, C, European Federation of Clinical Chemistry and Laboratory Medicine, (EFLM), European Society of Pharmacogenomics and Personalised Therapy (ESPT) Joint Working Group on Personalized Laboratory Medicine, (WG-PLM), and Clinical Chemistry

Subjects
laboratory medicine, medicine.medical_specialty, Clinical Biochemistry, Alternative medicine, Medical laboratory, MEDLINE, Professional Role, laboratory medicine "-omics" technologies personalized medicine REFERENCE VALUES CHALLENGES OPPORTUNITIES STANDARDIZATION INTEGRATION BIOMARKERS INNOVATION PATHOLOGY FUTURE, Surveys and Questionnaires, Health care, Medical Laboratory Science, medicine, Humans, Pharmacology (medical), Precision Medicine, General Pharmacology, Toxicology and Pharmaceutics, Implementation, Schools, Medical, Societies, Medical, Academic Medical Centers, Medical education, Education, Medical, Clinical Laboratory Techniques, business.industry, Teaching, Biochemistry (medical), General Medicine, personalized medicine, Laboratories, Hospital, Precision medicine, Hospitals, Europe, "-omics" technologies, Chemistry, Clinical, Paradigm shift, Health Facilities, Personalized medicine, Laboratories, business
Abstract

Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role in the integration of personalized medicine in routine health care and set the state-of-the-art knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the European Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting the implementation of personalized medicine in the clinical setting. Participants think that the current organization of laboratory medicine needs additional/relevant implementations such as (i) new technological facilities in -omics; (ii) additional training for the current personnel focused on the new methodologies; (iii) incorporation in the laboratory of new competencies in data interpretation and counseling; and (iv) cooperation and collaboration among professionals of different disciplines to integrate information according to a personalized medicine approach. ispartof: Drug Metab Pers Ther vol:30 issue:2 pages:121-128 ispartof: location:Germany status: published

Published
2015

5. Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation

Author

Nieuwlaat R., Capucci A., Lip G. Y. H., Olsson S. B., Prins M. H., Nieman F. H., Lopez-Sendon J., Vardas P. E., Aliot E., Santini M., Crijns H. J. G. M., Andresen D., Camm A. J., Davies W., Levy S., Breithardt G., Cobbe S., Le Heuzey J. -Y., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M. F., Alonso A., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Ryden L., Vahanian A., Wijns W., Sanofi-Aventis, Grigoryan S. V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L. A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B., Petrov V. A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y. A., Ibrahim B. S. S., Tammam K., Saad A., Elghawaby H., Sherif H. Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F. F., Rubio J., Malpartida F., Corona M., Sanchez L. T., Miguel J., Herrera L., Quesada A., Garcia A. J. M., Gonzalez C. S., Juango M. S. A., Berjon-Reyero J., Alegret J. M., Fernandez J. M. C., Carrascosa C., Romero R. A. F., Lara M. G., Sendon J. L. L., de Diego J. J. G., Martin L. S., Irurita M., Guttierez N. H., Rubio J. R. S., Antorrena I., Paves A. B., Salvador A., Orriach M. D., Garcia A. A., Epelde F., Martinez V. B., Sanchez A. B., Galvez C. P., Rivero R. F., Madrid A. H., Baron-Esquivias G., Peinado R., Guindal J. A. G., Vera T. R., Fernandez E. L., Gayan R., Garcia J., Bodegas A., Lopez J. T., Florez J. M., Cabezas C. L., de Castroviejo E. V. R., Bellido J. M., Ruiz M. E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J. C., Lecocq G., Poulain C., Cleland J. G. F. C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N. A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G. -P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G. M., Fioranelli M., Naccarella F., Maranga S. S., Lepera G., Bresciani B., Seragnoli E., Forti M. C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S. M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A. A., op Reimer W. S., de Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D. C. A., Veerhoek M. J., Kamps M., Haan D., van Rijn N., Bootsma A., Baur L., van den A., Fransen H., Eurlings L., Meeder J., De Boer M. J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A. -M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J. M. F. R., Ferreira R., Freitas A., Morais J. C. A., Pires R., Gomes M. J. V., Gago P., Candeias R. A. C., Nunes L., Sa J. V. M., Ventura M., de Oliveira M., Alves L. B., Bostaca I., Olariu C. T., Dan G. A., Dan A., Podoleanu C., Frigy A., Georgescu G. I. M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D. L., Rancea R., Shubik Y. V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M. I., Makienko N. V., Potpara T., Knezevic S., Randjelovic M., Nieuwlaat R., Capucci A., Lip G.Y.H., Olsson S.B., Prins M.H., Nieman F.H., Lopez-Sendon J., Vardas P.E., Aliot E., Santini M., Crijns H.J.G.M., Andresen D., Camm A.J., Davies W., Levy S., Breithardt G., Cobbe S., Le Heuzey J.-Y., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J.-J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M.F., Alonso A., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Simoons M., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Ryden L., Vahanian A., Wijns W., Sanofi-Aventi, Grigoryan S.V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L.A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B., Petrov V.A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y.A., Ibrahim B.S.S., Tammam K., Saad A., Elghawaby H., Sherif H.Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F.F., Rubio J., Malpartida F., Corona M., Sanchez L.T., Miguel J., Herrera L., Quesada A., Garcia A.J.M., Gonzalez C.S., Juango M.S.A., Berjon-Reyero J., Alegret J.M., Fernandez J.M.C., Carrascosa C., Romero R.A.F., Lara M.G., Sendon J.L.L., de Diego J.J.G., Martin L.S., Irurita M., Guttierez N.H., Rubio J.R.S., Antorrena I., Paves A.B., Salvador A., Orriach M.D., Garcia A.A., Epelde F., Martinez V.B., Sanchez A.B., Galvez C.P., Rivero R.F., Madrid A.H., Baron-Esquivias G., Peinado R., Guindal J.A.G., Vera T.R., Fernandez E.L., Gayan R., Garcia J., Bodegas A., Lopez J.T., Florez J.M., Cabezas C.L., de Castroviejo E.V.R., Bellido J.M., Ruiz M.E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J.C., Lecocq G., Poulain C., Cleland J.G.F.C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N.A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G.-P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G.M., Fioranelli M., Naccarella F., Maranga S.S., Lepera G., Bresciani B., Seragnoli E., Forti M.C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S.M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A.A., op Reimer W.S., de Swart E., Lenzen M., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D.C.A., Veerhoek M.J., Kamps M., Haan D., van Rijn N., Bootsma A., Baur L., van den A., Fransen H., Eurlings L., Meeder J., De Boer M.J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A.-M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J.M.F.R., Ferreira R., Freitas A., Morais J.C.A., Pires R., Gomes M.J.V., Gago P., Candeias R.A.C., Nunes L., Sa J.V.M., Ventura M., de Oliveira M., Alves L.B., Bostaca I., Olariu C.T., Dan G.A., Dan A., Podoleanu C., Frigy A., Georgescu G.I.M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D.L., Rancea R., Shubik Y.V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M.I., Makienko N.V., Potpara T., Knezevic S., and Randjelovic M.

Subjects
Adult, Male, medicine.medical_specialty, Oral anticoagulation, Guideline, Risk Assessment, Electrocardiography, Fibrinolytic Agents, Risk Factors, Drug Combination, Antithrombotic, medicine, Humans, Outpatient clinic, Risk factor, Multivariate Analysi, Stroke, Risk stratification, Aged, Antithrombotic therapy, Fibrinolytic Agent, Framingham Risk Score, business.industry, Risk Factor, Atrial fibrillation, Middle Aged, medicine.disease, Drug Combinations, Multivariate Analysis, Practice Guidelines as Topic, Emergency medicine, Physical therapy, Female, Guideline Adherence, Cardiology and Cardiovascular Medicine, business, Cardioversions, Risk assessment, Human
Abstract

Aims To describe guideline adherence and application of different stroke risk stratification schemes regarding antithrombotic therapy in real-life atrial fibrillation (AF) patients and to assess which factors influence antithrombotic management decisions. Methods and results The Euro Heart Survey enrolled 5333 AF patients in 35 countries, in 2003 and 2004. Prescription of antithrombotic drugs, especially oral anticoagulation (OAC), was hardly tailored to the patient's stroke risk profile as indicated by the joint guidelines of the American College of Cardiology, American Heart Association, and the European Society of Cardiology, ACCP guidelines, or CHADS2 and Framingham risk scores. In multivariable analysis, only a limited number of the well-known stroke risk factors triggered OAC prescription. In contrast, less relevant factors, of which clinical type of AF and availability of an OAC monitoring outpatient clinic were the most marked, played a significant role in OAC prescription. Electrical cardioversions and catheter ablations clearly triggered OAC prescription, whereas pharmacological cardioversions even in the presence of stroke risk factors did not. Conclusion Antithrombotic therapy in AF is hardly tailored to the patient's stroke risk profile. Factors other than well-known stroke risk factors were significantly involved in antithrombotic management decisions. To facilitate this tailored treatment, guideline writers and physician educators should focus on providing one uniform and easy to use stroke risk stratification scheme.

Published
2006

6. Diabetes known or newly detected, but not impaired glucose regulation, has a negative influence on 1-year outcome in patients with coronary artery disease: a report from the Euro Heart Survey on diabetes and the heart

Author

Lenzen M., Ryden L., Ohrvik J., Bartnik M., Malmberg K., Scholte Op Reimer W., Simoons M. L., Andresen D., Camm A. J., Davies W., Capucci A., Levy S., Olsson B., Aliot E., Breithardt G., Cobbe S., Le Heuzey J. -Y., Santini M., Vardas P., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M. F., Alonso A., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Vahanian A., Wijns W., Sanofi-Aventis, Grigoryan S. V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L. A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B., Petrov V. A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y. A., Ibrahim B. S. S., Tammam K., Saad A., Elghawaby H., Sherif H. Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F. F., Rubio J., Malpartida F., Corona M., Sanchez L. T., Miguel J., Herrera L., Quesada A., Garcia A. J. M., Gonzalez C. S., Juango M. S. A., Berjon-Reyero J., Alegret J. M., Fernandez J. M. C., Carrascosa C., Romero R. A. F., Lara M. G., Sendon J. L. L., de Diego J. J. G., Martin L. S., Irurita M., Guttierez N. H., Rubio J. R. S., Antorrena I., Paves A. B., Salvador A., Orriach M. D., Garcia A. A., Epelde F., Martinez V. B., Sanchez A. B., Galvez C. P., Rivero R. F., Madrid A. H., Baron-Esquivias G., Peinado R., Guindal J. A. G., Vera T. R., Fernandez E. L., Gayan R., Garcia J., Bodegas A., Lopez J. T., Florez J. M., Cabezas C. L., de Castroviejo E. V. R., Bellido J. M., Ruiz M. E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J. C., Lecocq G., Poulain C., Cleland J. G. F. C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N. A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G. -P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G. M., Fioranelli M., Naccarella F., Maranga S. S., Lepera G., Bresciani B., Seragnoli E., Forti M. C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S. M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A. A., de Swart E., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D. C. A., Veerhoek M. J., Kamps M., Haan D., van Rijn N., Bootsma A., Baur L., van den A., Fransen H., Eurlings L., Meeder J., De Boer M. J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A. -M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J. M. F. R., Ferreira R., Freitas A., Morais J. C. A., Pires R., Gomes M. J. V., Gago P., Candeias R. A. C., Nunes L., Sa J. V. M., Ventura M., de Oliveira M., Alves L. B., Bostaca I., Olariu C. T., Dan G. A., Dan A., Podoleanu C., Frigy A., Georgescu G. I. M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D. L., Rancea R., Shubik Y. V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M. I., Makienko N. V., Potpara T., Knezevic S., Randjelovic M., Lenzen M., Ryden L., Ohrvik J., Bartnik M., Malmberg K., Scholte Op Reimer W., Simoons M.L., Andresen D., Camm A.J., Davies W., Capucci A., Levy S., Olsson B., Aliot E., Breithardt G., Cobbe S., Le Heuzey J.-Y., Santini M., Vardas P., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J.-J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Goncalves L., Grabauskiene V., Asmussen I., Deckers J., Stepinska J., Mareev V., Vasiljevic Z., Riecansky I., Kenda M.F., Alonso A., Lopez-Sendon J.L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Schofield P., Wood D., Battler A., Boersma E., Komajda M., McGregor K., Mulder B., Priori S., Vahanian A., Wijns W., Sanofi-Aventi, Grigoryan S.V., Apetyan I., Aroyan S., Azarapetyan L., Anvari A., Gottsauner-Wolf M., Pfaffenberger S., Aydinkoc K., Kalla K., Penka M., Drexel H., Langer P., Pierard L.A., Legrand V., Blommaert D., Schroeder E., Mancini I., Geelen P., Brugada P., De Zutter M., Vrints C., Vercammen M., Morissens M., Borisov B., Petrov V.A., Marinova M., Assen A., Goudev R., Peychev Y., Stoyanovsky V., Stoynev E., Kranjcevic S., Moutiris J., Ioannides M., Evequoz D., Spacilova J., Novak M., Eisenberger M., Mullerova J., Kautzner J., Riedlbauchova L., Petru` J., Taborsky M., Cappelen H., Sharaf Y.A., Ibrahim B.S.S., Tammam K., Saad A., Elghawaby H., Sherif H.Z., Farouk H., Mielke A., Engelen M., Kirchhof P., Zimmermann P., Aviles F.F., Rubio J., Malpartida F., Corona M., Sanchez L.T., Miguel J., Herrera L., Quesada A., Garcia A.J.M., Gonzalez C.S., Juango M.S.A., Berjon-Reyero J., Alegret J.M., Fernandez J.M.C., Carrascosa C., Romero R.A.F., Lara M.G., Sendon J.L.L., de Diego J.J.G., Martin L.S., Irurita M., Guttierez N.H., Rubio J.R.S., Antorrena I., Paves A.B., Salvador A., Orriach M.D., Garcia A.A., Epelde F., Martinez V.B., Sanchez A.B., Galvez C.P., Rivero R.F., Madrid A.H., Baron-Esquivias G., Peinado R., Guindal J.A.G., Vera T.R., Fernandez E.L., Gayan R., Garcia J., Bodegas A., Lopez J.T., Florez J.M., Cabezas C.L., de Castroviejo E.V.R., Bellido J.M., Ruiz M.E., Savolainen K., Nieminen M., Toivonen L., Syvanne M., Pietila M., Galley D., Beltra C., Gay A., Daubert J.C., Lecocq G., Poulain C., Cleland J.G.F.C., Shelton R., Choudhury A., Abuladze G., Jashi I., Tsiavou A., Giamouzis G., Dagres N., Kostopoulou A., Tsoutsanis D., Stefanadis C., Latsios G., Vogiatzis I., Gotsis A., Bozia P., Karakiriou M., Koulouris S., Parissis J., Kostakis G., Kouris N., Kontogianni D., Athanasios K., Douras A., Tsanakis T., Marketou M., Patsourakos N., Czopf L., Halmosi R., Preda I., Csoti E., Badics A., Strasberg B., Freedberg N.A., Katz A., Zalzstein E., Grosbard A., Goldhammer E., Nahir M., Epstein M., Vider I., Luria D., Mandelzweig L., Aloisi B., Cavallaro A., Antonielli E., Doronzo B., Pancaldo D., Mazzola C., Buontempi L., Calvi V., Giuffrida G., Figlia A., Ippolito F., Gelmini G.-P., Gaibazzi N., Ziacchi V., De Tommasi F., Lombardi F., Fiorentini C., Terranova P., Maiolino P., Albunni M., Pinna-Pintor P., Fumagalli S., Masotti G., Boncinelli L., Rossi D., Santoro G.M., Fioranelli M., Naccarella F., Maranga S.S., Lepera G., Bresciani B., Seragnoli E., Forti M.C., Cortina V., Baciarello G., Cicconetti P., Lax A., Vitali F., Igidbashian D., Scarpino L., Terrazzino S., Tavazzi L., Cantu F., Pentimalli F., Novo S., Coppola G., Zingarini G., Ambrozio G., Moruzzi P., Callegari S., Saccomanno G., Russo P., Carbonieri E., Paino A., Zanetta M., Barducci E., Cemin R., Rauhe W., Pitscheider W., Meloni M., Marchi S.M., Di Gennaro M., Calcagno S., Squaratti P., Quartili F., Bertocchi P., De Martini M., Mantovani G., Komorovsky R., Desideri A., Celegon L., Tarantini L., Catania G., Lucci D., Bianchini F., Puodziukynas A., Kavoliuniene A., Barauskiene V., Aidietis A., Barysiene J., Vysniauskas V., Zukauskiene I., Kazakeviciene N., Georgievska-Ismail L., Poposka L., Vataman E., Grosu A.A., de Swart E., Jansen C., Brons R., Tebbe H., van Hoogenhuyze D.C.A., Veerhoek M.J., Kamps M., Haan D., van Rijn N., Bootsma A., Baur L., van den A., Fransen H., Eurlings L., Meeder J., De Boer M.J., Winter J., Broers H., Werter C., Bijl M., Versluis S., Milkowska M., Wozakowska-Kaplon B., Janion M., Lepska L., Swiatecka G., Kokowicz P., Cybulski J., Gorecki A., Szulc M., Rekosz J., Manczak R., Wnuk-Wojnar A.-M., Trusz-Gluza M., Rybicka-Musialik A., Myszor J., Szpajer M., Cymerman K., Sadowski J., Sniezek-Maciejewska M., Ciesla-Dul M., Gorkiewicz-Kot I., Grodzicki T., Rewiuk K., Kubik L., Lewit J., de Sousa J.M.F.R., Ferreira R., Freitas A., Morais J.C.A., Pires R., Gomes M.J.V., Gago P., Candeias R.A.C., Nunes L., Sa J.V.M., Ventura M., de Oliveira M., Alves L.B., Bostaca I., Olariu C.T., Dan G.A., Dan A., Podoleanu C., Frigy A., Georgescu G.I.M., Arsenescu C., Statescu C., Sascau R., Dimitrascu D.L., Rancea R., Shubik Y.V., Duplyakov D., Shalak M., Danielyan M., Galyavich A., Zakirova V., Hatala R., Kaliska G., Kmec J., Zupan I., Tasie` J., Vokac D., Edvardsson N., Poci D., Gamra H., Denguir H., Sepetoglu A., Arat-Ozkan A., Orynchak M., Paliy E., Vakalyuk I., Malidze D., Prog R., Yabluchansky M.I., Makienko N.V., Potpara T., Knezevic S., Randjelovic M., and Cardiology

Subjects
Blood Glucose, Male, medicine.medical_specialty, Diabetic Angiopathie, Prognosi, Impaired glucose regulation, Euro Heart Survey, Myocardial Infarction, Coronary Artery Disease, Diabete, Follow-Up Studie, Coronary artery disease, Impaired glucose tolerance, SDG 3 - Good Health and Well-being, Internal medicine, Diabetes mellitus, medicine, Humans, Survival analysis, Aged, business.industry, Hazard ratio, Middle Aged, medicine.disease, Impaired fasting glucose, Prognosis, Survival Analysis, Stroke, Endocrinology, Blood sugar regulation, Female, Cardiology and Cardiovascular Medicine, business, Complication, Diabetic Angiopathies, Human, Follow-Up Studies
Abstract

Aims: Although diabetes is known to be a major contributor to cardiovascular diseases, as well as an independent predictor for adverse outcomes in patients with coronary artery disease (CAD), information on the prognosis of patients with CAD and newly diagnosed diabetes or impaired glucose regulation (IGR) is scarce. The objective of this study was to explore 1-year outcome in relation to different glucometabolic states of patients participating in the Euro Heart Survey on diabetes and the heart. Methods and results: In 4676 out of 4961 patients, information on the relation between 1-year outcome and glucometabolic state, which was based on oral glucose tolerance test (OGTT) or fasting glucose plasma, was available. A normal glucose metabolism was identified in 947 patients, IGR (impaired fasting glucose or impaired glucose tolerance) in 1116 patients, and diabetes in 1877 patients of whom 1425 were previously diagnosed and 452 newly diagnosed. In total, 736 patients could not be classified, as no OGTT or fasting plasma glucose was performed. Previously recognized and newly detected diabetes was associated with an increased risk of 1-year mortality when compared with patients with normal glucose regulation [hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.5-3.8 and HR 2.0, 95% CI 1.1-3.6, respectively)]. IGR, however, could not be identified as an independent predictor for 1-year mortality (HR 1.1, 95% CI 0.6-1.9). Conclusion: This study confirmed that patients with CAD and known diabetes are at high risk for mortality and cardiovascular events and demonstrated that patients with newly diagnosed diabetes are at intermediate risk for adverse outcomes. IGR, however, could not be identified as an independent predictor for adverse outcomes during the 1-year follow-up period. © The European Society of Cardiology 2006. All rights reserved.

Published
2006

7. [Lupic nephropathy in childhood: morphologic analysis of 18 cases]

Author

Charles K. Naspitz, Solé D, and Mancini I

Subjects
medicine.medical_specialty, biology, business.industry, Atopic disease, medicine.disease, Immunoglobulin E, Umbilical cord, Viral infection, Gastroenterology, Serum ige, Nephropathy, Atopy, medicine.anatomical_structure, Internal medicine, Pediatrics, Perinatology and Child Health, medicine, biology.protein, Family history, business
Abstract

Serum IgE concentration was determined in 17 newborn and 171 children with ages between 1 and 12 months. In the first group, blood was taken from the umbilical cord, and in the second, we used a periferic blood sample. The selection implied the exclusion of children with any suspicion of atopic disease, family history of atopy and recent viral infection. The serum IgE concentration was determined by enzyme linked immunoabsorbent assay (PRIST). The sex, race ( white and non white) and age were analyzed in the children studied. During a follow-up period (24 months) seven children (3,7%) developed atopic symptoms. The serum IgE concentration of the groups studied was higher than in other studies. The mean IgE in each group was as follows : newborns = 0.24 IU/ml; 1-3 months = 1.57 IU/ml; 4-6 months = 7.72 IU/ml; 7-9 months 12.07 IU/ml; 10-12 months = 12.14 IU/ml.

Published
1996

8. Vaginal metabolites in postmenopausal women with or without vulvo-vaginal atrophy at baseline and after ospemifeme and systemic hormone treatment

Author

Stefania Alvisi, Paolo Casadio, Maria Cristina Meriggiola, Renato Seracchioli, Maurizio Baldassarre, Luca Laghi, Giulia Gava, Claudio Foschi, Ilaria Mancini, Foschi C., Alvisi S., Baldassarre M., Laghi L., Gava G., Mancini I., Casadio P., Seracchioli R., and Meriggiola M.C.

Subjects
Selective Estrogen Receptor Modulators, Genitourinary syndrome, medicine.medical_specialty, Urology, Systemic hormone therapy, Vaginal metabolite, General Biochemistry, Genetics and Molecular Biology, chemistry.chemical_compound, Ospemifene, medicine, Humans, Postmenopausal women, business.industry, Obstetrics and Gynecology, medicine.disease, Hormones, Postmenopause, Dyspareunia, chemistry, Metabolome, Female, Vaginal atrophy, Atrophy, business, Vulvo-vaginal atrophy, Hormone
Abstract

Objectives: Vulvo-vaginal atrophy (VVA) is a highly prevalent chronic condition affecting the lives of postmenopausal women. Ospemifene and systemic hormone therapy (HT) improve vaginal health. This study aims to characterize the vaginal metabolic profile of women with VVA at baseline and after ospemifene and systemic HT. Study design: Sixty postmenopausal women, 32 of whom were affected by VVA, were consecutively enrolled. The vaginal metabolic profile of women with and without VVA at baseline and after three months of ospemifene or HT treatment was assessed. Main outcome measures: The following parameters were evaluated: (i) the Vaginal Health Index; (ii) the Vaginal Maturation Index; and (iii) vaginal metabolic profile, by means of 1H NMR spectroscopy. Results: The vaginal metabolome of postmenopausal women with VVA was different from that of postmenopausal women without VVA, including a more profound decrease in the levels of lactate and several amino acids, typically found in eubiosis, together with an enrichment of molecules derived from anaerobes and gut microbes. After 3 months, ospemifene and HT had modified the vaginal metabolome of the women with VVA, specifically by increasing the levels of beneficial molecules (e.g., lactate, leucine, glycine) and reducing those involved in dysbiosis (e.g., formate). HT improved the vaginal metabolome to a lesser extent. Conclusions: The vaginal metabolic profile of postmenopausal women with VVA differs from that of postmenopausal women without VVA. Our preliminary data show that both ospemifene and HT treatment increase the levels of molecules beneficial for vaginal health and reduce the levels of those involved in dysbiosis. HT improves the vaginal metabolic profile to a lower extent than ospemifene over the course of three months.

Published
2022

9. Knowledge of genito-urinary syndrome of menopause among Italian gynecologists: the DIADEM survey

Author

Stefania Alvisi, Maria Cristina Meriggiola, Angelo Cagnacci, Giulia Gava, Ilaria Mancini, Maurizio Baldassarre, Renato Seracchioli, Alvisi S., Baldassarre M., Gava G., Mancini I., Cagnacci A., Seracchioli R., and Meriggiola M.C.

Subjects
Male, medicine.medical_specialty, Attitude of Health Personnel, medicine.medical_treatment, Urinary system, General Biochemistry, Genetics and Molecular Biology, Electronic mail, Vulva, chemistry.chemical_compound, Ospemifene, Physicians, Surveys and Questionnaires, medicine, Humans, Survey, Response rate (survey), business.industry, Genitourinary system, Attitudes, Genito-urinary syndrome, Menopause, Vulvo-vaginal atrophy, Obstetrics and Gynecology, Syndrome, medicine.disease, Female Urogenital Diseases, Attitude, chemistry, Italy, Gynecology, Family medicine, Vagina, Hormonal therapy, Female, Hormone therapy, Clinical Competence, Atrophy, business
Abstract

Objective The objective of this study was to present an updated picture of the knowledge and attitudes of Italian gynecologists with regard to the genitourinary syndrome of menopause (GSM). Study design An anonymous survey was sent via electronic mail to 3892 gynecologists. The survey consisted of 32 multiple-choice questions divided into four different areas: 1. general demographics of the respondents; 2. knowledge of GSM; 3. most frequently prescribed therapies; and 4. perception of patient compliance and satisfaction with current therapeutic options. Main outcome measures Knowledge of vulvo-vaginal atrophy (VVA) and attitudes of the gynecologists to its management. Results Three hundred and seventy-four out of 3892 invited Italian gynecologists replied to the survey (response rate 9.7 %). Most (84 %) had a good knowledge of GSM and 74 % reported that they investigated it during clinic visits, but most of them underestimated its prevalence. The most frequently prescribed treatment was topical hormonal therapy (60 %), followed by vaginal moisturizers and lubricants (16 %), ospemifene (12 %) and systemic hormone therapy (12 %). According to the clinical experience of respondents, the most effective therapy is local hormonal therapy (36 %), followed by ospemifene (30 %). According to respondents, less than 50 % of patients continue therapy after 12 months, due to the discomfort in vaginal application, the cost of oral therapies and the fear of possible side-effects. Conclusions With the limitation of the low response rate, this study suggests that although Italian gynecologists who answered the survey had some knowledge of GSM, they underestimated its prevalence, did not know its most bothersome symptoms and had inadequate knowledge of the efficacy of treatments, patient compliance and satisfaction.

Published
2021

10. Complete Androgen Insensitivity Syndrome: From Bench to Bed

Author

Diego Peroni, Maria Cristina Meriggiola, Sofia D’Elios, Ilaria Mancini, Giampiero I. Baroncelli, Silvano Bertelloni, Nina Tyutyusheva, Tyutyusheva N., Mancini I., Baroncelli G.I., D'elios S., Peroni D., Meriggiola M.C., and Bertelloni S.

Subjects
0301 basic medicine, Male, AR gene, genetic structures, Physiology, Review, Androgen, lcsh:Chemistry, Exon, 0302 clinical medicine, Complete androgen insensitivity syndrome, androgen receptor, Hormone replacement therapy (male-to-female), Medicine, lcsh:QH301-705.5, Spectroscopy, X chromosome, XY karyotype, Gonad, General Medicine, Androgen-Insensitivity Syndrome, Computer Science Applications, Receptors, Androgen, Androgens, Female, complete androgen insensitivity syndrome, Human, Hormone Replacement Therapy, Karyotype, 030209 endocrinology & metabolism, Bone health, Catalysis, Inorganic Chemistry, 03 medical and health sciences, Humans, bone health, hormonal substitutive therapy, Physical and Theoretical Chemistry, Gonads, Molecular Biology, Gene, Chromosomes, Human, X, business.industry, Organic Chemistry, medicine.disease, Androgen receptor, 030104 developmental biology, lcsh:Biology (General), lcsh:QD1-999, Mutation, gonadal removal, gonadal neoplasia, sense organs, business
Abstract

Complete androgen insensitivity syndrome (CAIS) is due to complete resistance to the action of androgens, determining a female phenotype in persons with a 46,XY karyotype and functioning testes. CAIS is caused by inactivating mutations in the androgen receptor gene (AR). It is organized in eight exons located on the X chromosome. Hundreds of genetic variants in the AR gene have been reported in CAIS. They are distributed throughout the gene with a preponderance located in the ligand-binding domain. CAIS mainly presents as primary amenorrhea in an adolescent female or as a bilateral inguinal/labial hernia containing testes in prepubertal children. Some issues regarding the management of females with CAIS remain poorly standardized (such as the follow-up of intact testes, the timing of gonadal removal and optimal hormone replacement therapy). Basic research will lead to the consideration of new issues to improve long-term well-being (such as bone health, immune and metabolic aspects and cardiovascular risk). An expert multidisciplinary approach is mandatory to increase the long-term quality of life of women with CAIS.

Published
2021

11. A comparison of 5-year administration of cyproterone acetate or leuprolide acetate in combination with estradiol in transwomen

Author

Stefania Alvisi, Giulia Gava, Maria Cristina Meriggiola, Ilaria Mancini, Renato Seracchioli, Gava G., Mancini I., Alvisi S., Seracchioli R., and Meriggiola M.C.

Subjects
Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Transgender Persons, Fasting insulin, Drug Administration Schedule, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, Humans, Testosterone, Prospective Studies, Androgen Antagonist, Prospective cohort study, Adverse effect, Cyproterone Acetate, Bone mineral, Estradiol, business.industry, Cyproterone acetate, Androgen Antagonists, Estrogens, General Medicine, Fertility Agents, Female, Middle Aged, Estrogen, Prolactin, Prospective Studie, Transgender Person, chemistry, 030220 oncology & carcinogenesis, cardiovascular system, Drug Therapy, Combination, Female, Hormone therapy, Cohort Studie, Leuprolide, business, Transsexualism, Human
Abstract

Objective The impact of different combinations of long-term gender-affirming hormone therapy (GAHT) in transwomen (TW) is largely unknown. To assess the effects of 5-year administration of cyproterone acetate (CPA) or leuprolide acetate (Leu) plus transdermal or oral estradiol (E). Design Cohort study based on prospectively collected data. Fifty TW received 50 mg CPA daily orally (n = 25; CPA+E group) or 3.75 mg Leu i.m. monthly (n = 25; Leu+E group) with 1 or 2 mg E daily for 5 years. Reproductive hormones, biochemical and anthropometric parameters, body composition and bone mineral density (BMD) were assessed. Results LH, FSH and total testosterone levels were similarly and significantly suppressed in both groups. Prolactin increased only in the CPA+E group (P = 0.002). Fasting insulin resistance and glucose progressively increased in the CPA+E group only (treatment × time effect P = 0.002 and P = 0.043, respectively). Total cholesterol increased more in the Leu+E group than in the CPA+E group and HDL-cholesterol decreased in the CPA+E group (time × treatment interaction effect, P = 0.007). Lumbar and total body BMD increased in both groups after 3 years. No serious adverse events were recorded. Conclusions Both regimens were effective in suppression of T production. CPA+E worsened the metabolic profile with a slight increase in PRL levels. All subjects presented an increase in BMD regardless of treatment. These preliminary data could have clinical implications in the choice of GAHT, in particular for those TW not requiring gender-affirming surgery.

Published
2020

12. The HLA Variant rs6903608 Is Associated with Disease Onset and Relapse of Immune-Mediated Thrombotic Thrombocytopenic Purpura in Caucasians

Author

Clara Mannarella, Erminia Rinaldi, Katia Codeluppi, Anna Maria Cerbone, Sergio Amarri, Daniela Nicolosi, Michele Pizzuti, Luca Facchini, Alessandro De Fanti, Michela Ronchi, Emanuela Pappalardo, Barbara Ferrari, Monica Bocchia, Gaetano Giuffrida, Vanessa Agostini, Cinzia Caria, Silvia Maria Trisolini, Salvatore Gattillo, Elisa Giacomini, Gian Marco Podda, Aldo Caddori, Saveria Capria, Antonella Tufano, Silvia Cerù, Marzia Defina, Alberto Fragasso, Roberta Gualtierotti, Andrea Artoni, Simona Campus, Flora Peyvandi, Silvia Pontiggia, Umberto Roncarati, Ilaria Mancini, Giuseppe Menna, Domenico Pastore, Frits R. Rosendaal, Simone Birocchi, Mancini, I., Giacomini, E., Pontiggia, S., Artoni, A., Ferrari, B., Pappalardo, E., Gualtierotti, R., Trisolini, S. M., Capria, S., Facchini, L., Codeluppi, K., Rinaldi, E., Pastore, D., Campus, S., Caria, C., Caddori, A., Nicolosi, D., Giuffrida, G., Agostini, V., Roncarati, U., Mannarella, C., Fragasso, A., Podda, G. M., Birocchi, S., Cerbone, A. M., Tufano, A., Menna, G., Pizzuti, M., Ronchi, M., De Fanti, A., Amarri, S., Defina, M., Bocchia, M., Ceru, S., Gattillo, S., Rosendaal, F. R., and Peyvandi, F.

Subjects
medicine.medical_specialty, Thrombotic microangiopathy, ADAMTS13, HLA, autoimmune disease, genotyping, relapse, risk factor, thrombotic thrombocytopenic purpura, Thrombotic thrombocytopenic purpura, lcsh:Medicine, Human leukocyte antigen, 030204 cardiovascular system & hematology, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, hemic and lymphatic diseases, medicine, Risk factor, business.industry, lcsh:R, Absolute risk reduction, General Medicine, Odds ratio, medicine.disease, business, 030215 immunology, Cohort study
Abstract

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare, life-threatening thrombotic microangiopathy caused by severe ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin motifs 13) deficiency, recurring in 30&ndash, 50% of patients. The common human leukocyte antigen (HLA) variant rs6903608 was found to be associated with prevalent iTTP, but whether this variant is associated with disease relapse is unknown. To estimate the impact of rs6903608 on iTTP onset and relapse, we performed a case-control and cohort study in 161 Italian patients with a first iTTP episode between 2002 and 2018, and in 456 Italian controls. Variation in rs6903608 was strongly associated with iTTP onset (homozygotes odds ratio (OR) 4.68 (95% confidence interval (CI) 2.67 to 8.23), heterozygotes OR 1.64 (95%CI 0.95 to 2.83)), which occurred over three years earlier for each extra risk allele (&beta, &minus, 3.34, 95%CI &minus, 6.69 to 0.02). Of 153 survivors (median follow-up 4.9 years (95%CI 3.7 to 6.1)), 44 (29%) relapsed. The risk allele homozygotes had a 46% (95%CI 36 to 57%) absolute risk of relapse by year 6, which was significantly higher than both heterozygotes (22% (95%CI 16 to 29%)) and reference allele homozygotes (30% (95%CI 23 to 39%)). In conclusion, HLA variant rs6903608 is a risk factor for both iTTP onset and relapse. This newly identified biomarker may help with recognizing patients at high risk of relapse, who would benefit from close monitoring or intensified immunosuppressive therapy.

Published
2020

13. Feasibility, Safety, and Satisfaction of Combined Hysterectomy with Bilateral Salpingo-Oophorectomy and Chest Surgery in Transgender and Gender Non-Conforming Individuals

Author

Davide Tarditi, Renato Seracchioli, Alessandra Lami, Luca Contu, Giulia Giacomelli, Paolo Morselli, Stefania Alvisi, Giulia Gava, Ilaria Mancini, Maria Cristina Meriggiola, Mancini I., Tarditi D., Gava G., Alvisi S., Contu L., Morselli P.G., Giacomelli G., Lami A., Seracchioli R., and Meriggiola M.C.

Subjects
medicine.medical_specialty, Health, Toxicology and Mutagenesis, Breast surgery, medicine.medical_treatment, Salpingo-oophorectomy, Personal Satisfaction, gender affirming surgery, Hysterectomy, Transgender Persons, Article, 03 medical and health sciences, chest surgery, 0302 clinical medicine, Hematoma, Retrospective Studie, Transgender, Humans, Medicine, Chest surgery, Retrospective Studies, 030219 obstetrics & reproductive medicine, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, transgender, Bilateral salpingo-oophorectomy, Surgery, Feasibility Studie, 030220 oncology & carcinogenesis, Cohort, Feasibility Studies, Female, business, Complication, transmen, Human
Abstract

The demand for masculinizing breast surgery and hysterectomy with bilateral salpingo-oophorectomy (HBSO) from transmen has increased. With a multidisciplinary approach, these surgeries can be performed in a single session. The objective of this study was to retrospectively evaluate the feasibility, safety, and satisfaction of HBSO and chest surgery in transmen. A cohort of 142 subjects who underwent HBSO alone or combined with chest surgery at Sant’Orsola Hospital was analyzed. Intra and post operation events were evaluated. Subjective post-intervention satisfaction, acceptability, and impact of intervention were assessed via a semi-structured interview. Nineteen transmen underwent HBSO alone and 123 underwent combined surgery. HBSO was performed laparoscopically in 96.5% of transmen (137/142). As expected, length of hospital stay and blood loss were significantly higher in the combined surgery group. A total of 13 intra or post-operative complications occurred in the combined surgery group (10.5%) with thoracic hematoma being the most frequent complication (7.6%). Only one rare complication occurred in the HBSO group (omental herniation through a laparoscopic breach). The overall subjective satisfaction score was 9.9 out of 10 for both groups. Positive changes in all areas of life were reported, with no significant differences. We found that the combined surgery appears to be well tolerated, safe, and feasible in transmen and satisfaction with the combined procedure was high in all subjects.

Published
2021

14. Presentation of a meningioma in a transwoman after nine years of cyproterone acetate and estradiol intake: case report and literature review

Author

Maria Cristina Meriggiola, Valentina Martelli, Irene Coati, Antonino Rotilio, Ilaria Mancini, Renato Seracchioli, and Mancini I, Rotilio A, Coati I, Seracchioli R, Martelli V, Meriggiola MC

Subjects
Adult, Male, medicine.medical_specialty, medicine.drug_class, Endocrinology, Diabetes and Metabolism, Urology, cyproterone acetate, Transgender Persons, Ganglioglioma, Meningioma, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, transsexual, Meningeal Neoplasms, otorhinolaryngologic diseases, medicine, Humans, heterocyclic compounds, cross-sex steroid treatment, Gonadal Steroid Hormones, Adverse effect, neoplasms, Gynecology, Estradiol, medicine.diagnostic_test, business.industry, transwomen, Obstetrics and Gynecology, Cyproterone acetate, Androgen Antagonists, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, nervous system diseases, Regimen, chemistry, Estrogen, 030220 oncology & carcinogenesis, cardiovascular system, Female, Presentation (obstetrics), business, Transsexualism, 030217 neurology & neurosurgery
Abstract

The administration of cyproterone acetate (CPA) and estradiol is a common regimen used by male-to-female transsexuals (transwoman) to adjust their body to their gender identity. Major adverse events are uncommon in these subjects in spite of long-term, high dose cross-sex steroid treatments. We describe the occurrence of a meningioma in a transwoman treated with estrogens and CPA over a period of nine years. The meningioma was revealed during a magnetic resonance imaging (MRI) scan performed as follow-up of a previous surgery for ganglioglioma. CPA intake was discontinued and tumor resection was performed. Histological diagnosis confirmed a strong progesterone receptor-positive and slight estrogen positive meningioma. After surgery, the patient continued her treatment with leuprorelina acetate and estradiol. At one-year follow-up, the MRI scan reveals no recurrence of the tumor. This is the ninth case in literature of a meningioma in a transwoman treated with estrogens and CPA, confirming a possible association between female sex steroids and meningioma. Although there is no still strong evidence of an association between meningioma and CPA, this report may suggest use of alternative treatment for transwomen. This report highlights the importance to record all the cases of meningiomas in high dose CPA-users, in order to improve data.

Published
2017

15. Impaired Lipid Profile is a Risk Factor for the Development of Sexual Dysfunction in Women

Author

Renato Seracchioli, Giulio Marchesini, Simona Moscatiello, Maurizio Baldassarre, Stefania Alvisi, Maria Cristina Meriggiola, Ilaria Mancini, Baldassarre, M, Alvisi, S, Mancini, I, Moscatiello, S, Marchesini, G, Seracchioli, R, and Meriggiola, MC

Subjects
Adult, medicine.medical_specialty, Urology, Endocrinology, Diabetes and Metabolism, Middlesex Hospital Questionnaire, Female sexual dysfunction, Population, 030232 urology & nephrology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Female Sexual Function Index, Internal medicine, Outcome Assessment, Health Care, Prevalence, medicine, Humans, Risk factor, education, Female Sexual Distress Scale, Dyslipidemias, Gynecology, education.field_of_study, 030219 obstetrics & reproductive medicine, Framingham Risk Score, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Sexual Dysfunction, Physiological, Psychiatry and Mental health, Sexual dysfunction, Dyslipidemia, Reproductive Medicine, Cardiovascular Diseases, Female Sexual Dysfunction, Female, Framingham risk score, medicine.symptom, Lipid profile, business, Somatization
Abstract

Introduction Dyslipidemia is a common risk factor for cardiovascular disease which may contribute to sexual dysfunction in women. Aims To assess the impact of dyslipidemia compared with other metabolic alterations on female sexual function. Methods In total, 466 women were enrolled in the study, of which 256 were postmenopausal. Dyslipidemia was defined based on high-density lipoprotein, low-density lipoprotein, or triglycerides levels. Women completed the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), and the Middlesex Hospital Questionnaire (MHQ). Biochemical and anthropometric measurements were performed and the Framingham risk score (FRS) was calculated for each subject. Main Outcome Measurements FSFI, FSDS, and MHQ scores, prevalence of FSD and FRS. Results Median age of the population enrolled was 51.5 (range 42.0–58.0) years. The overall prevalence of FSD, according to FSFI and FSDS scores, was 24%. A significantly higher prevalence of FSFI ( P = .001) and FSDS ( P = .006) pathological scores were found in women with dyslipidemia compared with the control group. The prevalence of FSD was significantly higher in dyslipidemic women ( P = .001). Women with dyslipidemia had significantly higher total scores in areas of depression, somatization, and obsession in the MHQ questionnaire compared with control women. Multivariate analysis showed that dyslipidemia (OR:1.7, CI 1.1–2.9, P = .037), postmenopausal status (OR:2.7, CI 1.5–4.7, P = .001), higher education (OR:0.6; CI 0.3–0.9, P = .038), and somatization (OR:1.7, CI 1.0–2.8, P = .045) were independently associated with FSD. The FRS was higher in dyslipidemic women ( P = .001) and in those with FSD ( P = .001), being associated with an almost doubled risk of developing FSD. Conclusion Our results indicate that dyslipidemia is an independent risk factor for FSD irrespective of postmenopausal status. Also, psychopathological alterations such as somatization are strongly associated with sexual dysfunction. The direct correlation between FSFI score and FRS suggest the importance of cardiovascular integrity in female sexual health.

Published
2016

16. Prevalence of metabolic syndrome and its components in women with and without pelvic organ prolapse and its association with prolapse severity according to the Pelvic Organ Prolapse Quantification system

Author

Maria Cristina Meriggiola, Renato Seracchioli, Ilaria Mancini, Giulia Gava, Stefania Alvisi, and Gava G, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC

Subjects
medicine.medical_specialty, Waist, genetic structures, Urology, 030232 urology & nephrology, Pelvic floor, Gastroenterology, behavioral disciplines and activities, Severity of Illness Index, Pelvic Organ Prolapse, Pelvic floor dysfunction, 03 medical and health sciences, 0302 clinical medicine, Metabolic risk factor, Internal medicine, medicine, Prevalence, Humans, Stage (cooking), Aged, Metabolic Syndrome, Pelvic organ, 030219 obstetrics & reproductive medicine, business.industry, urogenital system, Obstetrics and Gynecology, Odds ratio, Middle Aged, medicine.disease, Confidence interval, body regions, medicine.anatomical_structure, Blood pressure, Cross-Sectional Studies, Female, Metabolic syndrome, business, psychological phenomena and processes
Abstract

INTRODUCTION AND HYPOTHESIS: Data regarding possible associations between metabolic syndrome (MS) and pelvic organ prolapse (POP) are scarce. The primary hypothesis was that the prevalence of MS and its components was higher in postmenopausal women with POP than in age-matched women without POP staged with the Pelvic Organ Prolapse Quantification system (POP-Q). The secondary aim of the study was to analyze the association between MS and its components with POP severity. METHODS: Presence of MS and its components [elevated triglycerides (TG), waist circumference, blood pressure, and fasting glucose (FG) and decreased high-density lipoprotein cholesterol (HDL-C)] were assessed in 122 women with POP (POP-Q stage I-IV) and 77 without (POP-Q 0). Fasting insulin resistance [homeostasis model assessment for fasting insulin resistance (HOMA-IR)] was also assessed. RESULTS: TG levels, FG, and HOMA index were significantly higher in POP-Q stage I-IV compared with POP-Q 0 (p = 0.04, p = 0.0005 and p = 0.04); HDL-C was significantly reduced in POP-Q stage I-IV compared with POP-Q 0 (p = 0.0003). TG levels (p = 0.0315) were significantly higher in POP-Q stage III and IV vs. POP-Q 0; FG and HOMA-IR (p = 0.0015 and p = 0.0204) were significantly higher in POP-Q stage IV vs. POP-Q 0; HDL-C (p = 0.0047) was significantly lower in all stages vs. POP-Q 0. The prevalence of MS was different between groups (p = 0.04) and higher in POP-Q IV. Elevated TG [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.5-9.3, p = 0.004] and reduced HDL-C (OR 2.0, 95% CI 1.1-3.7, p = 0.0241) significantly increased the risk of POP-Q stage ≥III. CONCLUSIONS: MS and its components may be associated with POP. Elevated TG and reduced HDL-C are associated with POP severity.

Published
2018

17. Structure of Epithelial and Stromal Compartments of Vulvar and Vaginal Tissue From Women With Vulvo-Vaginal Atrophy Taking Ospemifene

Author

Renato Seracchioli, Stefania Alvisi, Ilaria Mancini, Martina Gagliardi, Maria Cristina Meriggiola, Giulia Gava, Maurizio Baldassarre, and Alvisi S, Baldassarre M, Gava G, Mancini I, Gagliardi M, Seracchioli R, Meriggiola MC

Subjects
Selective Estrogen Receptor Modulators, Pathology, medicine.medical_specialty, Proliferation index, Urology, Endocrinology, Diabetes and Metabolism, Vaginal Diseases, Connective tissue, 030209 endocrinology & metabolism, Genitourinary Syndrome, Epithelium, Vulva, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, Atrophy, Ospemifene, medicine, Vaginal Proliferation Index, Humans, Longitudinal Studies, Sirius Red, Epithelium Thickne, 030219 obstetrics & reproductive medicine, business.industry, Middle Aged, medicine.disease, Vulvo-Vaginal Atrophy, Psychiatry and Mental health, Tamoxifen, Collagen Fiber, Dyspareunia, medicine.anatomical_structure, Treatment Outcome, Reproductive Medicine, chemistry, Connective Tissue, Vagina, Female, Vaginal atrophy, Vulvar Diseases, business
Abstract

Introduction Vulvo-vaginal atrophy affects the daily lives of most post-menopausal women. We know that ospemifene intake can induce vaginal epithelial improvements within a few weeks; however, direct evidence of the effects of ospemifene on the human vulva and on connective tissue of both the vagina and vulva are lacking. Aim To evaluate the changes induced by ospemifene on epithelium thickness, glycogen content proliferation index, collagen content, and type I/III collagen ratio in vulvar and vaginal tissue of post-menopausal women. Methods 20 women who attended our gynecologic clinic for planned surgery were recruited for the study. 11 subjects were taking ospemifene at the time of inclusion, and 9 subjects who were not taking ospemifene were selected as control group. Vaginal and vulvar biopsies were taken during surgery. Histological features and glycogen content were evaluated by standard hematoxylin-eosin and periodic acid–Schiff staining, total collagen and collagen type I/III ratio were evaluated by hydroxyproline assay and Sirius red staining, while the expression of Ki67 was evaluated by immunohistochemistry. Main Outcome Measure We analyzed histological features of the epithelial and stromal layer of the vaginal and vulvar vestibule mucosa. Results Vaginal and vulvar biopsies from women taking ospemifene showed an increased epithelium thickness, glycogen content, and proliferation index compared with the control group. Collagen content was also higher in women taking ospemifene, while an increased ratio between type I and III collagen fibers was found only at vaginal level. Clinical Implications Our study shows that the effectiveness of ospemifene on vaginal tissue also extends to the vulvar vestibule. Strength & Limitations This study provides direct evidence of the impact of ospemifene on vaginal and vulvar tissue. A specifically designed longitudinal study may further support our findings. Conclusion Ospemifene intake is associated with a marked improvement of various morphological and physiological features of both vaginal and vulvar vestibule epithelium, including the collagen content of the tissues.

Published
2018

18. Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration

Author

Maria Cristina Meriggiola, Ilaria Mancini, Renato Seracchioli, Silvia Cerpolini, Maurizio Baldassarre, Giulia Gava, and Gava G, Mancini I, Cerpolini S, Baldassarre M, Seracchioli R, Meriggiola MC

Subjects
Adult, Male, medicine.medical_specialty, medicine.drug_class, Endocrinology, Diabetes and Metabolism, Physiology, Blood Pressure, 030209 endocrinology & metabolism, androgen, Transgender Persons, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, Humans, Testosterone, Castration, Adverse effect, Retrospective Studies, 030219 obstetrics & reproductive medicine, Anthropometry, business.industry, Androgen, transgender, Blood pressure, testosterone enanthate, Testosterone enanthate, Lean body mass, business, testosterone undecanoate, transmen, Hormone
Abstract

Objective To retrospectively evaluate and compare safety and efficacy of short and long-acting testosterone (T) parenteral formulations over 5 years in transmen. Design and methods Fifty transmen between 21 and 42 years of age were enrolled. Twenty-five received T undecanoate 1000 mg IM (weeks 0 and 6 then every 12-16 weeks), and 25 received T enanthate 250 mg IM (every 3-4 weeks). Hormonal and biochemical parameters, anthropometric characteristics and blood pressure were assessed at baseline and then every 12 months. Body composition was evaluated at baseline and then after 1, 3 and 5 years of T treatment. Global satisfaction was assessed at baseline and after 1 and 5 years. Results Both T formulations led to amenorrhoea in all subjects within 1 year of T administration. Both T treatments led to a similar increase in haemoglobin and haematocrit which always remained within the physiological range. T administration was associated with an increase in total cholesterol, low-density lipoprotein cholesterol and triglycerides and a slight reduction in high-density lipoprotein cholesterol. Coagulative and glucidic profiles and blood pressure did not change significantly in either group. Body weight and BMI showed a slight but not significant increase in both groups, while lean mass rose significantly in both groups. Global satisfaction was increased at years 1 and 5 in both groups. Conclusions Preliminary results from this pilot study suggest that administration of either TU or TE for 5 years in young transmen is both effective and safe. Our study presents the longest follow-up published so far reporting no adverse events and these data are consistent with previous reports with a shorter follow-up.

Published
2018

19. Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition

Author

Bucci, P., Galderisi, S., Mucci, A., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Andriola, I., Bellomo, A., Biondi, M., Cuomo, A., Dell'Osso, L., Favaro, A., Gambi, F., Giordano, G. M., Girardi, P., Marchesi, C., Monteleone, P., Montemagni, C., Niolu, C., Oldani, L., Pacitti, F., Pinna, F., Roncone, R., Vita, A., Zeppegno, P., Maj, M., Patriarca, Sara, Pietrafesa, Daria, Aiello, Carmen, Longo, Luisa, Barone, Marina, Romano, Raffaella, Atti, Anna Rita, Barlati, Stefano, Deste, Giacomo, Valsecchi, Paolo, Carpiniello, Bernardo, Tusconi, Massimo, Puddu, Laura, Signorelli, Maria Salvina, Cannavò, Dario, Minutolo, Giuseppe, Corbo, Mariangela, Montemitro, Chiara, Baroni, Gaia, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Murri, Martino Belvederi, Calcagno, Pietro, Bugliani, Michele, Pizziconi, Giulia, Logozzo, Francesca, Rossi, Rodolfo, Giusti, Laura, Salza, Anna, Malavolta, Maurizio, Orsenigo, Giulia, Grassi, Silvia, De Bartolomeis, Andrea, Gramaglia, Carla, Gattoni, Eleonora, Gambaro, Eleonora, Tenconi, Elena, Ferronato, Luisa, Collantoni, Enrico, Tonna, Matteo, Ossola, Paolo, Gerra, Maria Lidia, Carmassi, Claudia, Cremone, Ivan Mirko, Carpita, Barbara, Buzzanca, Antonio, Girardi, Nicoletta, Frascarelli, Marianna, Del Casale, Antonio, Comparelli, Anna, Corigliano, Valentina, Siracusano, Alberto, Di Lorenzo, Giorgio, Ribolsi, Michele, Corrivetti, Giulio, Bartoli, Luca, Del Buono, Gianfranco, Fagiolini, Andrea, Bolognesi, Simone, Goracci, Arianna, Mancini, Irene, Bava, Irene, Cardillo, Simona, Bucci P., Galderisi S., Mucci A., Rossi A., Rocca P., Bertolino A., Aguglia E., Amore M., Andriola I., Bellomo A., Biondi M., Cuomo A., dell'Osso L., Favaro A., Gambi F., Giordano G.M., Girardi P., Marchesi C., Monteleone P., Montemagni C., Niolu C., Oldani L., Pacitti F., Pinna F., Roncone R., Vita A., Zeppegno P., Maj M., Patriarca S., Pietrafesa D., Aiello C., Longo L., Barone M., Romano R., Atti A.R., Barlati S., Deste G., Valsecchi P., Carpiniello B., Tusconi M., Puddu L., Signorelli M.S., Cannavo D., Minutolo G., Corbo M., Montemitro C., Baroni G., Altamura M., La Montagna M., Carnevale R., Murri M.B., Calcagno P., Bugliani M., Pizziconi G., Logozzo F., Rossi R., Giusti L., Salza A., Malavolta M., Orsenigo G., Grassi S., De Bartolomeis A., Gramaglia C., Gattoni E., Gambaro E., Tenconi E., Ferronato L., Collantoni E., Tonna M., Ossola P., Gerra M.L., Carmassi C., Cremone I.M., Carpita B., Buzzanca A., Girardi N., Frascarelli M., Del Casale A., Comparelli A., Corigliano V., Siracusano A., Di Lorenzo G., Ribolsi M., Corrivetti G., Bartoli L., Del Buono G., Fagiolini A., Bolognesi S., Goracci A., Mancini I., Bava I., Cardillo S., Bucci, P., Galderisi, S., Mucci, A., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Andriola, I., Bellomo, A., Biondi, Maria, Cuomo, Anna, Dell'Osso, L., Favaro, A., Gambi, F., Giordano, G. M., Girardi, P., Marchesi, C., Monteleone, P., Montemagni, C., Niolu, C., Oldani, L., Pacitti, F., Pinna, F., Roncone, R., DE VITA, Anna, Zeppegno, P., Maj, M., Patriarca, Sara, Pietrafesa, Daria, Aiello, Carmen, Longo, Luisa, Barone, Marina, Romano, Raffaella, Atti, Anna Rita, Barlati, Stefano, Deste, Giacomo, Valsecchi, Paolo, Carpiniello, Bernardo, Tusconi, Massimo, Puddu, Laura, Signorelli, Maria Salvina, Cannavò, Dario, Minutolo, Giuseppe, Corbo, Mariangela, Montemitro, Chiara, Baroni, Gaia, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Murri, Martino Belvederi, Calcagno, Pietro, Bugliani, Michele, Pizziconi, Giulia, Logozzo, Francesca, Rossi, Rodolfo, Giusti, Laura, Salza, Anna, Malavolta, Maurizio, Orsenigo, Giulia, Grassi, Silvia, De Bartolomeis, Andrea, Gramaglia, Carla, Gattoni, Eleonora, Gambaro, Eleonora, Tenconi, Elena, Ferronato, Luisa, Collantoni, Enrico, Tonna, Matteo, Ossola, Paolo, Gerra, Maria Lidia, Carmassi, Claudia, Cremone, Ivan Mirko, Carpita, Barbara, Buzzanca, Antonio, Girardi, Nicoletta, Frascarelli, Marianna, Del Casale, Antonio, Comparelli, Anna, Corigliano, Valentina, Siracusano, Alberto, Di Lorenzo, Giorgio, Ribolsi, Michele, Corrivetti, Giulio, Bartoli, Luca, Del Buono, Gianfranco, Fagiolini, Andrea, Bolognesi, Simone, Goracci, Arianna, Mancini, Irene, Bava, Irene, Cardillo, Simona, Biondi, M., Cuomo, A., Vita, A., and Casale, Antonio

Subjects
Male, avolition, Severity of Illness Index, cognitive functioning, 0302 clinical medicine, Cognition, Academic Performance, Medicine, Psychopathology, Depression, primary negative symptoms, Middle Aged, Psychiatric Status Rating Scale, avolition, cognitive functioning, poor emotion expression, premorbid adjustment, primary negative symptoms, poor emotion expression, premorbid adjustment, Psychiatry and Mental Health, Memory, Short-Term, Schizophrenia, Female, Schizophrenic Psychology, medicine.symptom, Psychosocial, Social Adjustment, Clinical psychology, Human, Adult, primary negative symptom, 03 medical and health sciences, Cognition Disorder, Memory, Social cognition, Humans, Cognitive Dysfunction, Cognitive skill, Social Behavior, Aged, Cognition Disorders, Motivation, Psychiatric Status Rating Scales, Settore MED/25 - Psichiatria, Avolition, business.industry, medicine.disease, 030227 psychiatry, Short-Term, business, Neurocognitive, 030217 neurology & neurosurgery
Abstract

Objective The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.

Published
2018

Catalog

Books, media, physical & digital resources
See catalog results