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51. Die Funktion des Ellenbogengelenkes nach Refixation der rupturierten distalen Bizepssehne

Author

Tinelli, M, Prajitno, J, Münzberg, M, Grützner, PA, and Suda, A

Subjects
ddc: 610, Kraftmessung, distale Bizepssehnenruptur, 610 Medical sciences, Medicine, Bizepssehnenrefixation
Abstract

Fragestellung: Der Riss der distalen Bizepssehne ist ein seltenes Ereignis, dessen Inzidenz innerhalb der letzten Jahre angestiegen ist und hauptsächlich muskelkräftige Männer mittleren Alters betrifft. Frauen sind kaum betroffen. Als Trauma-Ursache werden degenerative Veränderungen[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2013)

Published
2013
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52. European Confederation of Medical Mycology (ECMM) prospective survey of cryptococcosis: Report from Italy

Author

Viviani, Ma, Antinori, S, Cogliati, M, Esposto, Mc, Pinsi, G, Casari, S, Bergamasco, A, De Santis Ml, Ghirga, P, Bonaccorso, C, Jacchetti, G, Niero, F, Ammassari, A, Morace, G, Ossi, C, Montagna, Mt, Angarano, G, Farina, C, Maggiolo, F, Moroni, M, Pierdomenico, S, Michelone, G, Cavanna, C, Viti, F, Carli, T, Barchiesi, F, Agrappi, C, Mena, M, Giola, M, Lombardi, G, Tinelli, M, Ceraminiello, A, Codeluppi, M, Casolari, C, Foresti, S, Bramati, S, Ruggieri, A, Caggese, L, Astolfi, A, Bonora, S, Scotton, Pg, Rigoli, R, Angioni, G, Meneghetti, F, Nullg, Nulldi Perri, UBERTI FOPPA, CATERINA, Viviani, Ma, Antinori, S, Cogliati, M, Esposto, Mc, Pinsi, G, Casari, S, Bergamasco, A, De Santis, Ml, Ghirga, P, Bonaccorso, C, Jacchetti, G, Niero, F, Ammassari, A, Morace, G, UBERTI FOPPA, Caterina, Ossi, C, Montagna, Mt, Angarano, G, Farina, C, Maggiolo, F, Moroni, M, Pierdomenico, S, Michelone, G, Cavanna, C, Viti, F, Carli, T, Barchiesi, F, Agrappi, C, Mena, M, Giola, M, Lombardi, G, Tinelli, M, Ceraminiello, A, Codeluppi, M, Casolari, C, Foresti, S, Bramati, S, Ruggieri, A, Caggese, L, Astolfi, A, Bonora, S, Scotton, Pg, Rigoli, R, Angioni, G, Meneghetti, F, and Nullg, Nulldi Perri

Abstract

Italy is one of the countries participating in a prospective epidemiological survey of cryptococcosis set up in July 1997 by the European Confederation of Medical Mycology (ECMM). Over a 30-month period 156 cases, all caused by Cryptococcus neoformans var. neoformans, were reported by 29 hospitals in 9 regions. An ECMM questionnaire was used to report the clinical presentation and the diagnostic and treatment approach used. Cryptococcosis was associated with HIV infection in 147 cases and was considered indicative of AIDS in 65%. The estimated incidence in the Lombardy region was 0.85/100 in the AIDS population. One isolate from each of 129 patients was serotyped and genotyped. PCR fingerprinting using the primer (GACA)(4) proved to be a more reproducible typing method than the slide agglutination test. Genotypes VN1 (serotype D), VN6 (serotype A) and VN3-VN4 (serotype AD hybrid strains) occurred in Italy at similar levels nationwide, but VN1 (D) was prevalent in the North. In vitro resistance to antifungals was uncommon.

Published
2002

59. Determinants of virologic and immunologic outcomes in chronically HIV-infected subjects undergoing repeated treatment interruptions: The Istituto Superiore di Sanità-Pulsed Antiretroviral Therapy (ISS-PART) study

Author

Palmisano, L., Giuliano, M., Bucciardini, R., Fragola, V., Andreotti, M., Galluzzo, C. M., Pirillo, M. F., Weimer, L. E., Arcieri, R., Germinario, E. A. P., Amici, R., Mancini, M. G., D'Arminio Monforte, A., Castelli, F., Caramello, P., Vella, S., Abrescia, N., Figoni, M., Viglietti, R., Angarano, G., Saracino, A., Anselmo, M., Antinori, A., Sette, P., Zaccarelli, M., Liuzzi, G., Arlotti, M., Martelli, L. T., Ortolani, P., Bassetti, D., Di Biagio, A., Bisio, F., Bellissima, P., Branz, F., Dorigoni, N., Cadeo, G., Vangi, D., Bertelli, D., Bergamasco, A., Caggese, L., Volonterio, A., Orofino, G. C., Carosella, S., Gennero, L., Caremani, M., Tacconi, D., Carosi, G., Tomasoni, L., Patroni, A., Chiodo, F., Borderi, M., Calza, L., Gritti, F., Fasulo, G., Chirianni, A., Gargiulo, M., Colomba, A., Dalle Nogare, E. R., Di Lorenzo, F., Prestileo, T., Bini, T., Cicconi, P., De Lalla, F., Giordani, M. T., De Stefano, C., De Stefano, G., Delia, S., Ciardi, M., Di Perri, G., Sinicco, A., Sales, P., Dini, M., Simeone, M., Esposito, R., Guaraldi, G., Beghetto, B., Fatuzzo, F., La Rosa, R., Ferrari, C., Calzetti, C., Ferraro, T., Cosco, L., Ghinelli, F., Sighinolfi, L., Guadagnino, V., Caroleo, B., Izzi, A., Izzo, C., Franco, A., Lazzarin, A., Castagna, A., Fusetti, G., Leoncini, F., Pozzi, M., Sbaragli, S., Marzetti, M., Magnani, G., Bonazzi, L., Barchi, E., Zoboli, G., Pintus, A., Mandas, A., Soddu, M. L., Zucca, F., Mannucci, P. M., Gringeri, A., Marani Toro, G., Graziani, R. V., Consorti, A., Mazzotta, F., Di Pietro, M., Ble, C., Meneghetti, F., Sasset, L., Cattelan, A. M., Menichetti, F., Savalli, E., Mian, P., Pristera, R., Mignani, E., Artioli, S., Mura, M. S., Mannazzu, M., Narciso, P., Bellagamba, R., Orani, A., Perini, P., Ortona, L., De Luca, A., Murri, R., Pagano, G., Alessandrini, A., Paladini, A., Vinattieri, M. A., Carbonai, S., Pastore, G., Ladina, N., Tateo, M., Piersantelli, N., Penco, G., Petrelli, E., Balducci, M., Pippi, L., Gonnelli, A., Puppo, F., Murdaca, G., Raise, E., Pasquirucci, A., Riccio, G., Bartolacci, V., Carrega, G., Rizzardini, G., Migliorino, G., Russo, R., Casentino, S., Celesia, M., Soranzo, M. L., Macor, A., Salassa, B., Soscia, F., Roberti, L., Di Toro, M. T., Stagno, A., Beltrami, C., Suter, F., Maggiolo, F., Ripamonti, D., Tantimonaco, G., Grisorio, B., Tassara, A., Rossi, P., Tinelli, M., Regazzetti, A., Tirelli, U., Voltaggio, G., Cinelli, R., Toti, M., Baldari, M., Carli, T., Ricciardi, B., Trezzi, M., Vigevani, G. M., Capetti, A., Landonio, S., Vullo, V., Massetti, P., Zauli, T., and Casolari, S.

Subjects
Adult, Male, medicine.medical_specialty, Anti-HIV Agents, medicine.medical_treatment, HIV Infections, Drug resistance, Drug Administration Schedule, law.invention, Randomized controlled trial, Drug Resistance, Multiple, Viral, law, Internal medicine, medicine, Humans, Pharmacology (medical), Protease inhibitor (pharmacology), Structured treatment interruptions, Chemotherapy, Reverse-transcriptase inhibitor, biology, business.industry, HIV, Middle Aged, biology.organism_classification, CD4 Lymphocyte Count, Clinical trial, Chronic infection, Regimen, Infectious Diseases, Immunology, Lentivirus, RNA, Viral, Female, business, medicine.drug
Abstract

Background: Factors influencing the outcome of structured treatment interruptions (STIs) in HIV chronic infection are not fully elucidated. Methods: In ISS-PART, 273 subjects were randomly assigned to arm A (137 assigned to continuous highly active antiretroviral therapy [HAART]) and arm B (136 assigned to 5 STIs of 1, 1, 2, 2, and 3 months'duration, each followed by 3 months of therapy). Main outcome measures were the proportion of subjects with a CD4 count >500 cells/mm 3 , the rate of virologic failure, and the emergence of resistance at 24 months. Results: The proportion of subjects with a CD4 count >500 cells/mm 3 was higher in arm A than in arm B (86.5% vs. 69.1%; P = 0.0075). Pre-HAART CD4 cell count and male gender were independent predictors of a CD4 count >500 cells/mm 3 in arm B. The overall risk of virologic failure was not increased in arm B; however, it was higher in the 38 subjects who had resistance mutations in the rebounding virus. Archived mutations at baseline and the use of a regimen that included an unboosted protease inhibitor (PI), compared with nonnucleoside reverse transcriptase inhibitor-based HAART, independently predicted the emergence of plasma mutations during STI (P = 0.002 for DNA mutations and P = 0.048 for PI-based HAART). Conclusions: Our results suggest that patients with preexisting mutations and treated with unboosted PI-based HAART should not be enrolled in studies of time-fixed treatment interruptions, being at higher risk of developing plasma mutations during STI and virologic failure at therapy reinstitution.

Published
2007

60. Naturally occurring C-terminally truncated STAT5 is a negative regulator of Human Immunodeficiency Virus-type1 expression

Author

Crotti, A., Lusic, M., Lupo, R., Lievens, Patricia, Liboi, Elio Maria, Della Chiara, G., Tinelli, M., Lazzarin, A., Petterson, B. K., Giacca, M., Bovolenta, C., and Poli, G.

Subjects
INFECTED U1 CELLS, MONOCYTE-DERIVED MACROPHAGES, HUMAN-IMMUNODEFICIENCY-VIRUS, FACTOR GM-CSF, T-CELLS, ACUTE MYELOID-LEUKEMIA, COLONY-STIMULATING FACTOR, CONTROLLED-TRIAL, HUMAN-IMMUNODEFICIENCY-VIRUS, COLONY-STIMULATING FACTOR, MONOCYTE-DERIVED MACROPHAGES, ACUTE MYELOID-LEUKEMIA, LONG TERMINAL REPEAT, INFECTED U1 CELLS, FACTOR GM-CSF, T-CELLS, GENE-EXPRESSION, CONTROLLED-TRIAL, LONG TERMINAL REPEAT, GENE-EXPRESSION
Published
2007

64. Valuing Benefits to Inform a Clinical Trial in Pharmacy Do Differences in Utility Measures at Baseline Affect the Effectiveness of the Intervention?

Author

Tinelli, M, Ryan, M, Bond, C, Scott, A, Tinelli, M, Ryan, M, Bond, C, and Scott, A

Abstract

BACKGROUND: The generic health-related quality-of-life (HR-QOL) utility measures the EQ-5D and SF-6D are both commonly used to inform healthcare policy developments. However, their application to pharmacy practice is limited and the optimal method to inform policy developments is unknown. OBJECTIVES: Our objective was to test the sensitivity of the EQ-5D and SF-6D within pharmacy when measuring whether changes in health status or other co-variates at baseline affect the effectiveness of the intervention at follow-up. A further objective was to consider the implications of the findings for pharmacy research and policy. METHODS: The EQ-5D and SF-6D utility measures were employed within a randomized controlled trial (RCT) of community pharmacy-led medicines management for patients with coronary heart disease. The intervention covered a baseline visit with the potential for follow-up. Simultaneous quantile regression assessed the impact of the intervention on both EQ-5D and SF-6D measures at follow-up, controlling for baseline health, appropriateness of treatment, personal characteristics and self-reported satisfaction. RESULTS: No statistically significant difference in HR-QOL across the intervention and control groups at follow-up was reported for either measure. Increased health gain was however associated with the baseline utility score (with the EQ-5D more sensitive for those in worse health) and the appropriateness of treatment, but not patient characteristics or self-reported satisfaction. CONCLUSION: Neither generic measure detected a gain in HR-QOL as a result of the introduction of an innovative pharmacy-based service. This finding supports other work in the area of pharmacy, where health gains have not changed following interventions. Disease-specific utility measures should be investigated as an alternative to generic approaches such as the EQ-5D and SF-6D. Given that the RCT found an increase in self-reported satisfaction, broader measures of benefit that v

Published
2013

67. SHEDDING NEW LIGHT ONTO THE CEILING AND FLOOR? A QUANTILE REGRESSION APPROACH TO COMPARE EQ-5D AND SF-6D RESPONSES

Author

Seymour, J, McNamee, P, Scott, A, Tinelli, M, Seymour, J, McNamee, P, Scott, A, and Tinelli, M

Abstract

An important issue in the measurement of health status concerns the extent to which an instrument displays lack of sensitivity to changes in health status at the extremes of the distribution, known as floor and ceiling effects. Previous studies use relatively simple methods that focus on the mean of the distribution to examine these effects. The aim of this paper is to determine whether quantile regression using longitudinal data improves our understanding of the relationship between quality of life instruments. The study uses EQ-5D and SF-36 (converted to SF-6D values) instruments with both baseline and follow-up data. Relative to ordinary least least-squares (OLS), a first difference model shows much lower association between the measures, suggesting that OLS methods may lead to biased estimates of the association, due to unobservable patient characteristics. The novel finding, revealed by quantile regression, is that the strength of association between the instruments is different across different parts of the health distribution, and is dependent on whether health improves or deteriorates. The results suggest that choosing one instrument at the expense of another is difficult without good prior information surrounding the expected magnitude and direction of health improvement related to a health-care intervention.

Published
2010

71. Single-Nucleotide Polymorphism–Defined Class I and Class III Major Histocompatibility Complex Genetic Subregions Contribute to Natural Long-term Nonprogression in HIV Infection

Author

Guergnon, J., primary, Dalmasso, C., additional, Broet, P., additional, Meyer, L., additional, Westrop, S. J., additional, Imami, N., additional, Vicenzi, E., additional, Morsica, G., additional, Tinelli, M., additional, Zanone Poma, B., additional, Goujard, C., additional, Potard, V., additional, Gotch, F. M., additional, Casoli, C., additional, Cossarizza, A., additional, Macciardi, F., additional, Debré, P., additional, Delfraissy, J. F., additional, Galli, M., additional, Autran, B., additional, Costagliola, D., additional, Poli, G., additional, Theodorou, I., additional, and Riva, A., additional

Published
2012
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75. A short course of pegylated interferon‐α in acute HCV hepatitis

Author

Calleri, G., primary, Cariti, G., additional, Gaiottino, F., additional, De Rosa, F. G., additional, Bargiacchi, O., additional, Audagnotto, S., additional, Quaglia, S., additional, De Blasi, T., additional, Romano, P., additional, Traverso, A., additional, Leo, G., additional, Carbone, R., additional, Del Mastro, B., additional, Tinelli, M., additional, Caramello, P., additional, and Di Perri, G., additional

Published
2006
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78. Valuing benefits to inform a clinical trial in pharmacy : do differences in utility measures at baseline affect the effectiveness of the intervention?

Author

Tinelli M, Ryan M, Bond C, Scott A, Tinelli, Michela, Ryan, Mandy, Bond, Christine, and Scott, Anthony

Abstract

Background: The generic health-related quality-of-life (HR-QOL) utility measures the EQ-5D and SF-6D are both commonly used to inform healthcare policy developments. However, their application to pharmacy practice is limited and the optimal method to inform policy developments is unknown.Objectives: Our objective was to test the sensitivity of the EQ-5D and SF-6D within pharmacy when measuring whether changes in health status or other co-variates at baseline affect the effectiveness of the intervention at follow-up. A further objective was to consider the implications of the findings for pharmacy research and policy.Methods: The EQ-5D and SF-6D utility measures were employed within a randomized controlled trial (RCT) of community pharmacy-led medicines management for patients with coronary heart disease. The intervention covered a baseline visit with the potential for follow-up. Simultaneous quantile regression assessed the impact of the intervention on both EQ-5D and SF-6D measures at follow-up, controlling for baseline health, appropriateness of treatment, personal characteristics and self-reported satisfaction.Results: No statistically significant difference in HR-QOL across the intervention and control groups at follow-up was reported for either measure. Increased health gain was however associated with the baseline utility score (with the EQ-5D more sensitive for those in worse health) and the appropriateness of treatment, but not patient characteristics or self-reported satisfaction.Conclusion: Neither generic measure detected a gain in HR-QOL as a result of the introduction of an innovative pharmacy-based service. This finding supports other work in the area of pharmacy, where health gains have not changed following interventions. Disease-specific utility measures should be investigated as an alternative to generic approaches such as the EQ-5D and SF-6D. Given that the RCT found an increase in self-reported satisfaction, broader measures of benefit that value patient experiences, such as contingent valuation and discrete-choice experiments, should also be considered in pharmacy. [ABSTRACT FROM AUTHOR]

Published
2013
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90. P200 The clinical, utility and economic benefits of securing minimal important difference in asthma control test using a novel tool: the a.b.o.v.e. asthma (achieving-better-outcomes-and-value-for- everybody-in-asthma)

Author

Manfrin, A and Tinelli, M

Abstract

Introduction and ObjectivesAsthma accounts for an economic loss of €72 billion annually in the 28 countries of the European Union with a monetised value of DALYs cost of €38 billion. One of the key priorities in asthma management is achieving asthma control. It is crucial to understand whether providing a minimally clinical important difference (MID) of the asthma control test (ACT) score can bring better clinical, utility and economic outcomes.AimTo test whether the A.B.O.V.E. ASTHMA (Achieving-Better-Outcomes-and-Value-for-Everybody-in-Asthma) tool works in terms of securing the MID in ACT and, in doing so, we can provide positive outcomes for patients, payers, providers and policy makers.MethodsUsing the data obtained from the Italian Medicines Use Review (I-MUR) cluster randomised controlled trial (C-RCT; 2014–2015) involving 1263 asthma patients and 283 pharmacists in Italy, we tested whether A.B.O.V.E. ASTHMA was able to (1) link a clinical outcome (ACT score) to economic and utility dimensions; (2) secure a MID improvement in ACT and the outcomes attached in terms of cost savings for the healthcare provider and gains in health utility (% of being in perfect health).ResultsData from the C-RCT showed that after receiving the A.B.O.V.E. ASTHMA intervention, patients improved their asthma control, assessed by the ACT, shifting from not controlled (RED) towards partially controlled (YELLOW), and fully controlled (GREEN) groups. Asthma control improved in the vast majority of patients (median ACT score was 19 at baseline, 20 at 3 month and 21 at 6 month post intervention). The number of patients who were on MID target and reached the GREEN group at 3 and 6 months were 129 (15.8%) and 162 (19.9%) respectively. The overall annual cost savings per 1000 patients attached to the shift towards the MID target was equal to: 3 46 012 euros (NHS) at 3 months and increased to 4 25 483 euros (NHS) at 6 months (see Table). Health utility gains were equal to 0.9 and 0.29 years in full health, respectively.ConclusionsThe A.B.O.V.E. ASTHMA tool can secure MID in ATC and, in doing so, better outcomes in terms of clinical, utility and economic results.The calculation of the cost-saving for the NHS was estimated for a population of 1000 asthma patientsAbstract P200 Table 1Annual cost savings and utility gains when securing clinical target in asthma control (MID) with A.B.O.V.E. ASTHMA interventionPossible shifts*(current to target scenario)@ 3 months Totaln=1000@ 6 months Totaln=1000Current scenario (ACT)Target scenario(ACT)% of successCost savings NHS (euros)Utility gains(years in full health saved)% of successCost savings NHS(euros)Utility gains(years in full health saved)1RED to RED→5–108–132.6001.6002RED to YELLOW→15–1614–175.41 00 132 (CI 75,099; 130,172) 4.9 (CI 4.85; 4.94)5.51 02 408 (CI 76,806; 133,130) 4.96 (CI 4.91; 5.00)3YELLOW to YELLOW→15–1618–192.2000.9004YELLOW to GREEN→18–1920–2110.52 45 880 (CI 184,410; 319,644) 30.56 (CI 30.29; 30.83)13.83 23 075 (CI 242,306; 419,998) 40.16 (CI 39.80; 40.52)5GREEN to GREEN→20–21≥235.3006.000Total(1+2+3+4+5)31.073 46 012 (CI 259,509; 449,816)35.42(CI 35.11; 35.73)27.824 25 483 (CI 319,112; 553,128)45.12(CI 44.72; 45.52)The calculation of the cost-saving for the NHS was estimated for a population of 1,000 asthma patients.

Published
2017
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91. Nef-specific CD45RA+ CD8+ T cells secreting MIP-1β but not IFN-γ are associated with nonprogressive HIV-1 infection

Author

Goebel Frank D, Vollbrecht Thomas, Santagostino Elena, Stellbrink Hans-J, Lusso Paolo, Bogner Johannes R, Tambussi Giuseppe, Reitmeir Peter, Hoffmann Dieter, Vicenzi Elisa, Ghezzi Silvia, Biswas Priscilla, Allgayer Simone, Heltai Silvia, Kutscher Sarah, Dembek Claudia J, Protzer Ulrike, Draenert Rika, Tinelli Marco, Poli Guido, Erfle Volker, Malnati Mauro, and Cosma Antonio

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Long-term survival of HIV-1 infected individuals is usually achieved by continuous administration of combination antiretroviral therapy (ART). An exception to this scenario is represented by HIV-1 infected nonprogressors (NP) which maintain relatively high circulating CD4+ T cells without clinical symptoms for several years in the absence of ART. Several lines of evidence indicate an important role of the T-cell response in the modulation of HIV-1 infection during the acute and chronic phase of the disease. Results We analyzed the functional and the differentiation phenotype of Nef- and Tat-specific CD8+ T cells in a cohort of HIV-1 infected NP in comparison to progressors, ART-treated seropositive individuals and individuals undergoing a single cycle of ART interruption. We observed that a distinctive feature of NP is the presence of Nef-specific CD45RA+ CD8+ T cells secreting MIP-1beta but not IFN-gamma. This population was present in 7 out of 11 NP. CD45RA+ IFN-gammaneg MIP-1beta+ CD8+ T cells were not detected in HIV-1 infected individuals under ART or withdrawing from ART and experiencing a rebounding viral replication. In addition, we detected Nef-specific CD45RA+ IFN-gammaneg MIP-1beta+ CD8+ T cells in only 1 out of 10 HIV-1 infected individuals with untreated progressive disease. Conclusion The novel antigen-specific CD45RA+ IFN-gammaneg MIP-1beta+ CD8+ T cell population represents a new candidate marker of long-term natural control of HIV-1 disease progression and a relevant functional T-cell subset in the evaluation of the immune responses induced by candidate HIV-1 vaccines.

Published
2010
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92. The intracellular detection of MIP-1beta enhances the capacity to detect IFN-gamma mediated HIV-1-specific CD8 T-cell responses in a flow cytometric setting providing a sensitive alternative to the ELISPOT

Author

Goebel Frank D, Stellbrink Hans J, Bogner Johannes R, Tambussi Giuseppe, Nozza Silvia, Biswas Priscilla, Stadlbauer Birgit, Heltai Silvia, Allgayer Simone, Dembek Claudia J, Kutscher Sarah, Lusso Paolo, Tinelli Marco, Poli Guido, Erfle Volker, Pohla Heike, Malnati Mauro, and Cosma Antonio

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background T-cell mediated immunity likely plays an important role in controlling HIV-1 infection and progression to AIDS. Several candidate vaccines against HIV-1 aim at stimulating cellular immune responses, either alone or together with the induction of neutralizing antibodies, and assays able to measure CD8 and CD4 T-cell responses need to be implemented. At present, the IFN-γ-based ELISPOT assay is considered the gold standard and it is broadly preferred as primary assay for detection of antigen-specific T-cell responses in vaccine trials. However, in spite of its high sensitivity, the measurement of the sole IFN-γ production provides limited information on the quality of the immune response. On the other hand, the introduction of polychromatic flow-cytometry-based assays such as the intracellular cytokine staining (ICS) strongly improved the capacity to detect several markers on a single cell level. Results The cumulative analysis of 275 samples from 31 different HIV-1 infected individuals using an ICS staining procedure optimized by our laboratories revealed that, following antigenic stimulation, IFN-γ producing T-cells were also producing MIP-1β whereas T-cells characterized by the sole production of IFN-γ were rare. Since the analysis of the combination of two functions decreases the background and the measurement of the IFN-γ+ MIP-1β+ T-cells was equivalent to the measurement of the total IFN-γ+ T-cells, we adopted the IFN-γ+ MIP-1β+ data analysis system to evaluate IFN-γ-based, antigen-specific T-cell responses. Comparison of our ICS assay with ELISPOT assays performed in two different experienced laboratories demonstrated that the IFN-γ+ MIP-1β+ data analysis system increased the sensitivity of the ICS up to levels comparable to the sensitivity of the ELISPOT assay. Conclusion The IFN-γ+ MIP-1β+ data evaluation system provides a clear advantage for the detection of low magnitude HIV-1-specific responses. These results are important to guide the choice for suitable highly sensitive immune assays and to build reagent panels able to accurately characterize the phenotype and function of responding T-cells. More importantly, the ICS assay can be used as primary assay to evaluate HIV-1-specific responses without losing sensitivity in comparison to the ELISPOT assay.

Published
2008
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95. Therapeutic strategies for severe COVID-19: a position paper from the Italian Society of Infectious and Tropical Diseases (SIMIT)

Author

Silvia Nozza, Cristina Mussini, Giampiero Carosi, Antonio Cascio, Francesco Mazzotta, Nicola Petrosillo, Marco Falcone, Roberto Parrella, Paolo Grossi, Antonio Chirianni, Carmelo Iacobello, Evangelista Sagnelli, Claudio Maria Mastroianni, Massimo Galli, Marco Tinelli, Marianna Meschiari, Marcello Tavio, Massimo Andreoni, Giovanni Di Perri, V. Portelli, Chiara Iaria, Orlando Armignacco, Caterina Sagnelli, Mussini, C., Falcone, M., Nozza, S., Sagnelli, C., Parrella, R., Meschiari, M., Petrosillo, N., Mastroianni, C., Cascio, A., Iaria, C., Galli, M., Chirianni, A., Sagnelli, E., Iacobello, C., Di Perri, G., Mazzotta, F., Carosi, G., Tinelli, M., Grossi, P., Armignacco, O., Portelli, V., Andreoni, M., Tavio, M., Mussini C., Falcone M., Nozza S., Sagnelli C., Parrella R., Meschiari M., Petrosillo N., Mastroianni C., Cascio A., Iaria C., Galli M., Chirianni A., Sagnelli E., Iacobello C., Di Perri G., Mazzotta F., Carosi G., Tinelli M., Grossi P., Armignacco O., Portelli V., Andreoni M., and Tavio M.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), 030106 microbiology, Coronaviru, practice guidelines as topic, coronavirus, randomized controlled trials as topic, Guidelines, medicine.disease_cause, medical, law.invention, 03 medical and health sciences, 0302 clinical medicine, societies, Randomized controlled trial, law, Pandemic, italy, medicine, pneumonia, 030212 general & internal medicine, Intensive care medicine, humans, Societies, Medical, Coronavirus, therapy, SARS-CoV-2, business.industry, COVID-19, Pneumonia, Therapy, Standard treatment, General Medicine, covid-19, sars-cov-2, societies, medical, standard of care, COVID-19 Drug Treatment, Clinical trial, Infectious Diseases, Position paper, Observational study, business, Human
Abstract

Scope Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, with conflicting results, has led to rapid changes in treatment guidelines. Our aim was to narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and interpretation of the data by experts who are treating patients in the frontline setting. Methods The panel conducted a detailed review of the literature and eventual press releases from randomized clinical trials for each possible available treatment. Inductive PubMed search waws performed for publications relevant to the topic, including all clinical trials conducted. The result was a flowchart with treatment indications for patients with COVID-19. Implications After 6 months of a pandemic situation and before a possible second coronavirus wave descends on Europe, it is important to evaluate which drugs proved to be effective while also considering that results from many randomized clinical trials are still awaited. Indeed, among treatments for COVID-19, only glucocorticoids have resulted in an association with a significant decrease in mortality in published randomized controlled trials. New therapeutic strategies are urgently needed.

Published
2021

96. Bortezomib-induced muscle toxicity in multiple myeloma

Author

Paolo Manganotti, Dominika Nowis, V. Meneghini, Radoslaw Sadowski, Martina Tinelli, Giuliano Tomelleri, Manuela Malatesta, Laura Paoli, Gaetano Vattemi, Matteo Marini, Grzegorz M. Wilczynski, Valeria Guglielmi, Guglielmi, V., Nowis, D., Tinelli, M., Malatesta, M., Paoli, L., Marini, M., Manganotti, P., Sadowski, R., Wilczynski, G. M., Meneghini, V., Tomelleri, G., and Vattemi, G.

Subjects
Male, X-Box Binding Protein 1, 0301 basic medicine, Time Factors, Gastroenterology, Myoblasts, Bortezomib, 0302 clinical medicine, Multiple myeloma, hemic and lymphatic diseases, Myocyte, Prospective Studies, Metabolic myopathy, Cells, Cultured, Aged, 80 and over, Membrane Potential, Mitochondrial, General Medicine, Middle Aged, Endoplasmic Reticulum Stress, 3. Good health, Neurology, 030220 oncology & carcinogenesis, Female, medicine.symptom, medicine.drug, medicine.medical_specialty, Proximal muscle weakness, Antineoplastic Agents, Proteasome inhibitors, Pathology and Forensic Medicine, 03 medical and health sciences, Cellular and Molecular Neuroscience, Muscular Diseases, Muscle toxicity, Internal medicine, Autophagy, medicine, Humans, Myopathy, Aged, business.industry, Muscle weakness, Lipid Metabolism, medicine.disease, Discontinuation, 030104 developmental biology, Gene Expression Regulation, Neurology (clinical), business
Abstract

Multiple myeloma (MM) accounts for ∼13% of all hematologic malignancies. Bortezomib treatment is effective in MM, but can be complicated with neurological side effects. We describe a patient with symptomatic MM who had a reversible metabolic myopathy associated with bortezomib administration and pathologically characterized by excessive storage of lipid droplets together with mitochondrial abnormalities. In a single-center prospective study, 14 out of 24 patients with symptomatic MM were treated with bortezomib and, among these, 7 developed muscular signs and/or symptoms. The myopathy was characterized by a proximal muscle weakness involving lower limbs and was an early complication. Complete resolution of muscle weakness occurred after treatment discontinuation. Conversely, none of the patients who received a treatment without bortezomib developed muscular symptoms. Experimental studies demonstrate that in primary human myoblasts bortezomib at low concentrations leads to excessive storage of lipid droplets together with structural mitochondrial abnormalities, recapitulating the pathologic findings observed in patient's muscle. Our data suggest that patients treated with bortezomib should be monitored for muscular signs and/or symptoms and muscle weakness should alert the clinician to the possibility of myopathy. Bortezomib-induced metabolic myopathy is a potentially reversible entity with important implications for management and treatment of patients with MM.

Published
2017

97. Estimating minimum adult HIV prevalence: A cross-sectional study to assess the characteristics of people living with HIV in Italy

Author

Margherita Busso, Tullio Prestileo, Ermenegildo Francavilla, Marco Anselmo, Francesco Montella, Evangelista Sagnelli, Teresa Santantonio, Massimo Galli, Marcello Saitta, Giuseppe Foti, Cecilia Guariglia, Franco Baldelli, Simona Di Gianbenedetto, Pierluigi Viale, Francesco Castelli, Antonella d'Arminio Monforte, Angelo Pan, Gabriella D’Ettore, Maria Dorrucci, Salvatore Bruno, Tiziana Quirino, Mariangela Raimondo, Alessandro Bartoloni, Vinicio Manfrin, Giovanni Mazzarello, Eugenio Mantia, Raffaele Pempinello, Antonio Traverso, Barbara Suligoi, Fabio Bulla, Pietro Mesina, Alessia Zoncada, Gianfranco Orofino, Oliviero Bosco, Gianmichele Moise, Angelo Salomone Megna, Roberto Ferretto, Mauro Valle, Manuela Colafigli, Claudio Paternoster, S. Artioli, Giovanni Riccio, Stefania Bernardi, Paolo Grossi, Milena Zoppi, Sebastiano Maiuzzo, Giorgio Perboni, Sauro Tini, Giuseppe Ferrea, Nicoletta Ladisa, Enzo M. Farinella, Daniela Francisci, Dino Sgarabotto, Roberto Monarca, Enzo Petrelli, A. Franco, Izzo Cm, Pietro Bellissima, Francesco Ortu, Laura Sighinolfi, Antonio Chirianni, Filippo Bartalesi, Giulio De Stefano, Claudia Colomba, Laura Camoni, Salvatore Galvagna, Benedetto Maurizio Celesia, Andrea Petrucci, Camillo Baretti, Pierluigi Brugnaro, Federica Poletti, Maurilio Chimenti, Camilla Ajassa, Mario Falciano, Rosaria La Sala, Sauro Luchi, V. Portelli, Annamaria Degli Antoni, Francesco Mazzotta, Giuliano Zuccati, Vincenzo Colangeli, Ercole Concia, Giordano Madeddu, Maria Cristina Salfa, Francesca Cattelan, Nicola Acone, Vincenza Regine, Olivia Bargiacchi, Maurizio de Martino, F. Paoletti, Giovanni Cassola, Giuliano Schettino, Carlo De Stefano, Enza Anzalone, D. Aquilini, Giacomo Magnani, Vanni Borghi, Roberta Gastaldi, Alessandra Govoni, Cristina Rossi, Rita Consolini, Gioacchino Angarano, Gloria Taliani, Tommaso Fontana, Sergio Lo Caputo, Davide Vitullo, Pierpaolo Congedo, Emanuela Vaccher, Paolo Viganò, Maria Stella Mura, Claudio Cancellieri, Enrico Girardi, Francesca Savalli, Cecilia Fico, Anna Maria Cattelan, Alessandro Chiodera, Renzo Scaggiante, P. Osimani, Caterina Bramato, Nicola Pietrosillo, Giovanna D'Alessio, Salvatore Bonfante, Vincenzo Vullo, Andrea Gori, Margherita Dalessandro, Domenico Lucchino, Massimo Deseraca, Paolo Tundo, Alfredo Pennica, M. Paoloni, Antonella Castagna, Nicola Serrao, Paolo Costa, Franco Marranconi, Massimo Villa, Pietro Filippini, Maurizio Setti, Eligio Pizzigallo, Marco Tinelli, Mauro Marchili, Domenico Santoro, Cesira Nencioni, Piera Dones, Vincenzo Renda, Alberto Giannetti, Domenico La Rovere, Nicoletta Dorigoni, Guido Palamara, Angelo Iodice, Clara Gabiano, Peter Mian, Luigi Guarnieri, Andrea De Luca, Nicola Tripodi, Giovanni Cristina, Giustino Parruti, Maria Montroni, Loredana Palvarini, Marco Rizzi, Benvenuto Grisorio, Corrado Catalani, Paolo Emilio Manconi, Jacopo Vecchiett, Tiziana Carli, Riccardo Iapoce, Massimo Andreoni, Adriano Lazzarin, Giorgetta Casalino Finocchio, D Sacchini, Mario Gobber, Spartaco Sani, Marco Campus, Rosario La Rosa, Maurizio Mazzeo, Stefano Bonora, Michele Trezzi, Paolo Bassi, Angela La Gala, Alessandro Grimaldi, Dante Di Giammartino, Guido Leo, Gaetano Filice, Antonio Salvo, Paolo Bonfanti, Chiara Pasqualini, Marcello Tavio, Luca Butini, N. Abrescia, Angela Linzalone, Gianpaolo Natalini Ramponi, Pierangelo Rovere, Piero Cortese, Dario Bartolozzi, F. Resta, Miriam Lichtner, Loredana Sarmati, Francesco Cesario, Renato F. Frongillo, Ivano Mezzaroma, Carlo Ferrari, Lorenzo Minoli, Paola Di Stefano, Lucina Titone, Rosa Boncoraglio, Mariana Farenga, Giuliano Rizzardini, Stefano Aviani Barbacci, Andrea Giacometti, Andrea Antinori, Antonio Caterini, Consuelo Geraci, Piergiorgio Chiriacò, Lucio Cosco, Claudio Viscoli, Alfredo Scalzini, Sandro Piga, Massimo Arlotti, Cecilia Occhino, Roberto Luzzati, Paola Sabbatini, Guglielmo Borgia, Umberto Tirelli, Antonio Davi, Letizia Cristiano, Cristina Mussini, Roberto Cauda, Patrizio Vittucci, B. Salassa, Marco Libanore, Maria Pina Sciotti, Isa Picerno, Matteo Bassetti, Benedetto Caroleo, Oswald Moling, Danilo Tacconi, Massimo Puoti, Camoni, Laura, Raimondo, Mariangela, Dorrucci, Maria, Regine V, Salfa MC, CARPHA Study, Group, Lazzarin, Adriano, Castagna, Antonella, Camoni, L, Raimondo, M, Dorrucci, M, Regine, V, Salfa, M, Suligoi, B, Di Giammartino, D, Parruti, G, Di Stefano, P, Paoloni, M, D'Alessandro, M, Grimaldi, A, Sciotti, M, Pizzigallo, E, Vecchiett, J, De Stefano, C, La Gala, A, De Stefano, G, Linzalone, A, Cesario, F, Cosco, L, Caroleo, B, Foti, G, Serrao, N, Lucchino, D, Chirianni, A, Abrescia, N, Pempinello, R, Izzo, C, Borgia, G, Filippini, P, Sagnelli, E, Iodice, A, Megna, A, D'Alessio, G, Acone, N, Mazzeo, M, Sacchini, D, Ferrari, C, Degli Antoni, A, Magnani, G, Mussini, C, Borghi, V, Viale, P, Colangeli, V, Sighinolfi, L, Libanore, M, Govoni, A, Cancellieri, C, Bassi, P, Arlotti, M, Luzzati, R, Bassetti, M, Tirelli, U, Vaccher, E, Moise, G, Palamara, G, Bernardi, S, Falciano, M, Vullo, V, D'Ettore, G, Renda, V, Guariglia, C, Taliani, G, Mezzaroma, I, Paoletti, F, Ajassa, C, Gastaldi, R, Andreoni, M, Sarmati, L, Montella, F, Antinori, A, Giannetti, A, Pietrosillo, N, Girardi, E, Pennica, A, Cauda, R, Colafigli, M, Di Gianbenedetto, S, Caterini, A, Monarca, R, Barbacci, S, Ramponi, G, Marchili, M, Anzalone, E, Lichtner, M, Ferrea, G, Cassola, G, Viscoli, C, Mazzarello, G, Setti, M, Artioli, S, Riccio, G, Finocchio, G, Anselmo, M, Rizzi, M, Scalzini, A, Castelli, F, Quirino, T, Santoro, D, Pan, A, Zoncada, A, Bonfanti, P, Viganò, P, Villa, M, Tinelli, M, Perboni, G, Palvarini, L, Costa, P, Puoti, M, Galli, M, Rizzardini, G, Monforte, A, Lazzarin, A, Castagna, A, Gori, A, Minoli, L, Filice, G, Grossi, P, Giacometti, A, Tavio, M, Montroni, M, Butini, L, Osimani, P, Petrelli, E, Chiodera, A, Vittucci, P, Sabbatini, P, Pasqualini, C, Valle, M, Zoppi, M, Mantia, E, Schettino, G, Deseraca, M, Vitullo, D, Bargiacchi, O, Orofino, G, Bramato, C, Busso, M, Salassa, B, Farenga, M, Bonora, S, Leo, G, Poletti, F, Gobber, M, Cristina, G, Gabiano, C, Mian, P, Moling, O, Paternoster, C, Dorigoni, N, Fontana, T, Angarano, G, Ladisa, N, La Rovere, D, Fico, C, Bulla, F, Santantonio, T, Grisorio, B, Chiriacò, P, Congedo, P, Tundo, P, Resta, F, Cristiano, L, Mura, M, Madeddu, G, Mesina, P, Piga, S, Campus, M, Manconi, P, Ortu, F, Salvo, A, Baretti, C, La Sala, R, Bellissima, P, Bonfante, S, Galvagna, S, Celesia, B, La Rosa, R, Maiuzzo, S, Guarnieri, L, Bruno, S, Picerno, I, Tripodi, N, Farinella, E, Occhino, C, Titone, L, Colomba, C, Prestileo, T, Saitta, M, Dones, P, Boncoraglio, R, Davi, A, Franco, A, Portelli, V, Savalli, F, Geraci, C, Chimenti, M, Luchi, S, Catalani, C, Trezzi, M, Aquilini, D, Sani, S, Nencioni, C, Carli, T, Mazzotta, F, Lo Caputo, S, Zuccati, G, Iapoce, R, Consolini, R, Bartolozzi, D, Bartoloni, A, Bartalesi, F, DE LUCA, A, De Martino, M, Tacconi, D, Tini, S, Baldelli, F, Francisci, D, Frongillo, R, Traverso, A, Francavilla, E, Ferretto, R, Marranconi, F, Manfrin, V, Cortese, P, Rossi, C, Cattelan, F, Petrucci, A, Brugnaro, P, Sgarabotto, D, Scaggiante, R, Cattelan, A, Bosco, O, Concia, E, Rovere, P, Regine, Vincenza, Salfa, Maria Cristina, Suligoi, Barbara, and Luzzati, Roberto

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Immunology, Infectious Diseases, Virology, Settore MED/17 - Malattie Infettive, Epidemiology, Cross-sectional study, Human immunodeficiency virus (HIV), MEDLINE, HIV Infections, medicine.disease_cause, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cross-Sectional Studies, Female, Humans, Italy, Middle Aged, Prevalence, Retrospective Studies, medicine, HIV Infection, HIV, prevalence, Italy, Cross-Sectional Studie, business.industry, Transmission (medicine), HIV, Retrospective cohort study, Hiv prevalence, Northern italy, Anti-Retroviral Agent, business, Viral load, Human, Demography
Abstract

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.

Published
2015

98. Hallmarks of primary headache: part 1 - migraine.

Author

Raggi A, Leonardi M, Arruda M, Caponnetto V, Castaldo M, Coppola G, Della Pietra A, Fan X, Garcia-Azorin D, Gazerani P, Grangeon L, Grazzi L, Hsiao FJ, Ihara K, Labastida-Ramirez A, Lange KS, Lisicki M, Marcassoli A, Montisano DA, Onan D, Onofri A, Pellesi L, Peres M, Petrušić I, Raffaelli B, Rubio-Beltran E, Straube A, Straube S, Takizawa T, Tana C, Tinelli M, Valeriani M, Vigneri S, Vuralli D, Waliszewska-Prosół M, Wang W, Wang Y, Wells-Gatnik W, Wijeratne T, and Martelletti P

Subjects
Humans, Migraine Disorders therapy, Migraine Disorders diagnosis, Migraine Disorders physiopathology
Abstract

Background and Aim: Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features., Main Results: The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities., Conclusions: Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires., (© 2024. The Author(s).)

Published
2024
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99. Treatment methods for cervical intraepithelial neoplasia in England: A cost-effectiveness analysis.

Author

Tinelli M, Athanasiou A, Veroniki AA, Efthimiou O, Kalliala I, Bowden S, Paraskevaidi M, Lyons D, Martin-Hirsch P, Bennett P, Paraskevaidis E, Salanti G, Kyrgiou M, and Naci H

Subjects
Adult, Female, Humans, Middle Aged, Pregnancy, Young Adult, Colposcopy economics, Conization economics, England, Neoplasm Recurrence, Local economics, Premature Birth economics, Premature Birth epidemiology, Treatment Outcome, Cost-Effectiveness Analysis, Uterine Cervical Dysplasia economics, Uterine Cervical Dysplasia surgery, Uterine Cervical Dysplasia therapy, Uterine Cervical Neoplasms economics, Uterine Cervical Neoplasms therapy, Uterine Cervical Neoplasms surgery
Abstract

Objective: To compare the cost-effectiveness of different treatments for cervical intraepithelial neoplasia (CIN)., Design: A cost-effectiveness analysis based on data available in the literature and expert opinion., Setting: England., Population: Women treated for CIN., Methods: We developed a decision-analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10 years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10-year period. The costs calculated were those incurred by the National Health Service (NHS) of England., Main Outcome Measures: Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted., Results: For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost-effective treatment overall at all willingness-to-pay thresholds. For postmenopausal women, LLETZ remained the most cost-effective treatment up to a threshold of £31,500, but laser conisation became the most cost-effective treatment above that threshold., Conclusions: LLETZ is the most cost-effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than £31,500 to avert one CIN2+ recurrence., (© 2024 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Published
2024
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100. Using choice modelling to inform service sustainability for dementia Meeting Centres for people living with dementia in the UK.

Author

Tinelli M, Morton T, Bray J, Henderson C, Frost F, and Evans S

Abstract

Objectives: This study explores the preferences and willingness-to-pay (WTP) of carers for Meeting Centres (MCs) attributes in assisting individuals with mild to moderate dementia., Method: Preferences from 108 carers, gathered through UK-wide MC networks, were collected using a Discrete Choice Experiment survey. The survey incorporated attributes derived from evidence synthesis and lay consultation. A regression model estimated preference weights and marginal WTP for a change in attributes one a time within the MC support 'package.', Results: Carers preferred MCs offering a balanced mix of practical activities and emotional support, along with flexibility without booking requirements and low costs. Social opportunities and the frequency of the meeting were not prioritised. Respondents expressed a WTP of £43 to stay with 'My MC,' the preferred option, compared to transitioning to an alternative in-person MC, all else being equal. Various factors, including attendance modality, the relationship with the supported person, age, and gender, influenced carers' choices., Conclusion: These findings offer valuable insights into carers' preferences, priorities, and WTP within MC support for those with mild to moderate dementia. Understanding these factors can guide the implementation and sustainability of MCs, ensuring alignment with carers' needs and preferences and, ultimately, enhancing support for individuals with dementia.

Published
2024
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