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204. Phenotypic detection of nosocomial mecA-positive coagulase-negative staphylococci from neonates

Author

DE GIUSTI, Maria, Pacifico, Lucia, Tufi, Daniela, Panero, Alessandra, Mancuso, G., Boccia, Antonio, and Chiesa, C.

Subjects
Staphylococcus, Ceftazidime, Polymerase Chain Reaction, Infant, Newborn, Diseases, Agar dilution, Ampicillin, polycyclic compounds, Agar, Pharmacology (medical), METHICILLIN RESISTANCE, Oxacillin, Antibacterial agent, Cross Infection, Staphylococcal Infections, POLYMERASE CHAIN-REACTION, Anti-Bacterial Agents, Blotting, Southern, Intensive Care Units, Phenotype, Infectious Diseases, INFECTIONS, Coagulase, ANTIMICROBIAL SUSCEPTIBILITY, OXACILLIN RESISTANCE, INTENSIVE-CARE, medicine.drug, Microbiology (medical), food.ingredient, Genotype, Penicillin Resistance, POLYMERASE CHAIN-REACTION, METHICILLIN RESISTANCE, ANTIMICROBIAL SUSCEPTIBILITY, OXACILLIN RESISTANCE, INTENSIVE-CARE, INFECTIONS, EPIDERMIDIS, IDENTIFICATION, VANCOMYCIN, AUREUS, Microbial Sensitivity Tests, Penicillins, Biology, Microbiology, food, medicine, Humans, AUREUS, Pharmacology, IDENTIFICATION, SCCmec, Infant, Newborn, EPIDERMIDIS, biochemical phenomena, metabolism, and nutrition, VANCOMYCIN, bacterial infections and mycoses, bacteria, Netilmicin
Abstract

Over a 3-year period, we screened antimicrobial resistance genotype (mecA-positive or -negative) in clinically significant coagulase-negative staphylococci isolated from patients residing in our neonatal intensive care unit. For the 152 study strains, the accuracy of standard methods (agar dilution MIC, disc diffusion and agar screen tests) in detecting oxacillin resistance during 48 h of incubation was evaluated. Using mecA gene PCR and Southern blot hybridization as the gold standard, the differential in MICs of additional antibiotics selected for their relevant clinical use in our setting was also compared with mecA status of the isolates. The frequency of mecA was 48.6% among study strains. When applying the previous (1998) and most current (1999) NCCLS interpretive criteria, the specificities of oxacillin agar dilution MICs in detecting the 78 mecA-negative isolates were 100 and 89.7%, respectively, at 24 h, and 100 and 80.7%, respectively, at 48 h. In this respect, the sensitivities of oxacillin agar dilution MICs in detecting the 74 mecA-positive strains were 75.6 and 97.2%, respectively, at 24 h, and 86.4 and 100%, respectively, at 48 h. When applying the previous and most current NCCLS zone size interpretive criteria, oxacillin zone diameters were in false-susceptible error for 13.5 and 8.1%, respectively, of the 74 mecA-positive strains tested at 24 h, and for 6.7 and 2.7%, respectively, at 48 h. Accordingly, when the 78 mecA-negative strains were considered, oxacillin zone diameters were in false-resistant error for 2.5 and 8.9%, respectively, at 24 h, and for 8.9 and 15.3%, respectively, at 48 h. The oxacillin salt agar screen assay accurately identified all mecA-negative strains at both 24 and 48 h. However, 26 (35.1%) and 7 (9.4%) of the mecA-positive strains were misinterpreted as susceptible by the agar screen test at 24 and 48 h, respectively. Using the presence of mecA as the reference standard for interpreting oxacillin susceptibility results, strains lacking mecA were more likely to be susceptible to ampicillin, ceftazidime, gentamicin, netilmicin and rifampicin than were mecA-positive strains. Vancomycin was the only antibiotic tested for which all strains, regardless of mecA status, remained susceptible.

Published
1999

205. Role of IL-10 in a Neonatal Mouse Listeriosis Model

Author

Genovese, F., Mancuso, G., Cuzzola Maria, Biondo, C., Beninati, C., Delfino, D., and Teti, G.

Subjects
Aging, B-Lymphocytes, Mice, Inbred BALB C, Injections, Subcutaneous, Macrophages, T-Lymphocytes, Immunology, Antibodies, Monoclonal, Listeria monocytogenes, Interleukin-10, sepsis, Disease Models, Animal, Interferon-gamma, Mice, Animals, Newborn, Animals, Immunology and Allergy, listeriosis, Female, Listeriosis
Abstract

This study was undertaken to test the hypothesis that altered IL-10 production plays a role in the increased susceptibility of neonates to listeriosis. Plasma IL-10 levels were measured in neonatal and adult mice at various times after infection with Listeria monocytogenes. Relative to adults, neonatal mice had markedly increased IL-10 levels early in the course of infection with Listeria using a 90% lethal dose. Higher neonatal IL-10 responses were also observed after injecting adults and pups with equal doses of killed organisms. Splenic macrophages from neonates produced higher IL-10 levels than those of adults after in vitro stimulation with killed bacteria, confirming in vivo observations. Moreover, IL-10 blockade had differential effects in neonates and adults infected with live Listeria. In adult mice, anti-IL-10 Abs decreased bacterial burden early in the course of infection, but were no longer effective at 6 days or later after challenge. In the pups, however, the same treatment had beneficial effects both early and late during infection and resulted in increased survival. Collectively, our data suggest that an overproduction of IL-10 by macrophages may at least partially explain the increased susceptibility of neonates to listeriosis, and provide further evidence that cytokine production is different in adults and neonates.

Published
1999

206. Nutritional counselling in overweight and obese children of some school from Palermo

Author

VACCARO, Biagia, TABACCHI, Garden, GAGLIANO, Paolo, MANSUETO, Maria Concetta, DI MAJO, Danila, TRIPOLI, Elisa, GIAMMANCO, Santo, LA GUARDIA, Maurizio, GIAMMANCO, Marco, PATTI G, RIZZO MV, MANCUSO G., VACCARO B, TABACCHI G, GAGLIANO P, PATTI G, MANSUETO MF, RIZZO MV, DI MAJO D, TRIPOLI E, GIAMMANCO S, LA GUARDIA M, GIAMMANCO M, and MANCUSO G

Published
2006

209. Prevalence of overweight and obesity in children from some schools of Palermo

Author

VACCARO, Biagia, GAGLIANO, Paolo, TABACCHI, Garden, MANSUETO, Maria Concetta, GIAMMANCO, Marco, LA GUARDIA, Maurizio, GIAMMANCO, Santo, RIZZO MV, MAMMINA C, MANCUSO G., VACCARO B, GAGLIANO P, TABACCHI G, MANSUETO MF, RIZZO MV, MAMMINA C, GIAMMANCO M, LA GUARDIA M, GIAMMANCO S, and MANCUSO G

Published
2006

212. Risk factors for eating disorders and correlation with the body mass index, in preadolescent girls from some schools of Palermo

Author

GAGLIANO, Paolo, PATTI G, GIAMMANCO, Marco, MANSUETO, Maria Concetta, RIZZO MV, TABACCHI, Garden, VACCARO, Biagia, MANCUSO G, GIAMMANCO, Santo, MAMMINA, Caterina, DI MAJO, Danila, TRIPOLI, Elisa, LA GUARDIA, Maurizio, GAGLIANO P, PATTI G, GIAMMANCO M, MANSUETO MF, RIZZO MV, TABACCHI G, VACCARO B, MANCUSO G, GIAMMANCO S, MAMMINA C, DI MAJO D, TRIPOLI E, and LA GUARDIA M

Published
2006

215. Haemophilus influenzae porin induced Toll-like receptor 2 mediated cytokine production in human monocytes and mouse macrophages

Author

GALDIERO, Marilena, GALDIERO, Massimiliano, FINAMORE E., ROSSANO F., GAMBIZZA M., CATANIA M., TETI G., MIDIRI A., MANCUSO G., Galdiero, Marilena, Galdiero, Massimiliano, Finamore, E., Rossano, F., Gambizza, M., Catania, M., Teti, G., Midiri, A., and Mancuso, G.

Subjects
Porins,Toll-Like Receptor 2, bacteria, complex mixtures
Abstract

The production of proinflammatory cytokines is likely to play a major pathophysiological role in meningitis and other infections caused by Haemophilus influenzae type b (Hib). Previous studies have shown that Hib porin contributes to signaling of the inflammatory cascade. We examined here the role of Toll-like receptors (TLRs) and the TLR-associated adaptor protein MyD88 in Hib porin-induced production of tumor necrosis factor alpha (TNF-*) and interleukin-6 (IL-6). Hib porin-induced TNF-* and IL-6 production was virtually eliminated in macrophages from TLR2- or MyD88-deficient mice. In contrast, macrophages from lipopolysaccharide (LPS)-hyporesponsive C3H/HeJ mice, which are defective in TLR4 function, responded normally to Hib porin. Moreover anti-TLR2 antibodies but not anti-TLR4 antibodies significantly reduced Hib porin-stimulated TNF-* and IL-6 release from the human monocytic cell line THP-1. These data indicate that the TLR2/MyD88 pathway plays an essential role in Hib porin-mediated cytokine production. These findings may be useful in the development of alternative therapies aimed at reducing excessive inflammatory responses during Hib infections.

Published
2004

220. Joint use of cardio-embolic and bleeding risk scores in elderly patients with atrial fibrillation

Author

Marcucci, M, Nobili, A, Tettamanti, M, Iorio, A, Pasina, L, Djade, Cd, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Violi, F, Mannucci, Pm, Reposi, Investigators, Pier, Mm, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, Mg, Bleve, Ma, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, Mc, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, Mr, Laieta, Mt, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, Am, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, Er, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, Al, Puccetti, L, Pasini, Fl, Capecchi, Pl, Bicchi, M, Sabbà, C, Vella, Fs, Marseglia, A, Luglio, Cv, Palasciano, G, Modeo, Me, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, Mr, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis MM, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Dionigi Rossi, P, Damanti, S, Prolo, S, Lilleri, Ms, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, Gr, Miceli, E, Lenti, Mv, Padula, D, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, Mb, Ghelfi, D, Chin, Ws, Carassale, L, Caporotundo, S, Sofia, L, Anastasio, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Guagnano, Mt, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, Nl, Bernasconi, G, Nardo, B, Bianchi, Gb, Giaquinto, S, Benetti, G, Quagliolo, M, Centenaro, Gr, Purrello, Francesco, Di Pino, A, Piro, Salvatore, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Cicardi, M, Magenta, Ag, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca ML, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, Ea, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, Uv, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Zazzetta, Mc, Bertolotti, M, Scotto, Cm, Ferri, Ma, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Carozza, Lm, Pignatti, F., Maura Marcuccia, Alessandro Nobili, Mauro Tettamanti, Alfonso Iorio, Luca Pasina, Codjo D. Djade, Carlotta Franchi, Alessandra Marengoni, Francesco Salerno, Salvatore Corrao, Francesco Violi, Pier Mannuccio Mannucci, REPOSI Investigators1 […, Corinaldesi Roberto, Strocchi Enrico, Borghi Claudio, Bolondi Luigi, Zoli Marco, De Giorgio Roberto, Bernardi Mauro, …], Marcucci, Maura, Nobili, Alessandro, Tettamanti, Mauro, Iorio, Alfonso, Pasina, Luca, Djade, Codjo D., Franchi, Carlotta, Marengoni, Alessandra, Salerno, Francesco, Corrao, Salvatore, Violi, Francesco, Mannucci, Pier o, Zanetti, Michela, Investigators, Reposi, Marcucci, M, Nobili, A, Tettamanti, M, Iorio, A, Pasina, L, Djade, Cd, Franchi, C, Marengoni, A, Salerno, F, Corrao, S, Violi, F, Mannucci, Pm, Reposi, Investigator, Postiglione, Alfredo, PAGANO LEONETTI GIANNI MANNUCCI, Paolo, Pier, Mannuccio, Rizzo, Mr, Djade, C, Mannucci, P, and Annoni, G

Subjects
Registrie, Male, Embolism, Atrial fibrillation, Bleeding risk, Cardioembolic risk, Elderly, Prediction guides, Thromboprophylaxis, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Female, Hemorrhage, Humans, Logistic Models, Platelet Aggregation Inhibitors, Retrospective Studies, Stroke, Warfarin, Registries, Risk Assessment, Internal Medicine, Retrospective Studie, aritmia, bleeding risk score, atrial fibrillation, Aged, 80 and over, Aspirin, education.field_of_study, Elderly, Atrial fibrillation, Prediction guides, Bleeding risk, Cardioembolic risk, Thromboprophylaxis, Cardiovascular disease, cardio-embolic score, Platelet aggregation inhibitor, cardio-embolic scores, bleeding risk scores, elderly, Risk assessment, medicine.drug, Human, medicine.medical_specialty, Logistic Model, Population, CARDIOEMBOLIC RISK, NO, BLEEDING RISK, Internal medicine, medicine, Prediction guide, education, ELDERLY, business.industry, Platelet Aggregation Inhibitor, Settore MED/09 - MEDICINA INTERNA, Anticoagulant, Retrospective cohort study, medicine.disease, Surgery, Thromboprophylaxi, business
Abstract

Background Scores for cardio-embolic and bleeding risk in patients with atrial fibrillation are described in the literature. However, it is not clear how they co-classify elderly patients with multimorbidity, nor whether and how they affect the physician's decision on thromboprophylaxis. Methods Four scores for cardio-embolic and bleeding risks were retrospectively calculated for ≥ 65 year old patients with atrial fibrillation enrolled in the REPOSI registry. The co-classification of patients according to risk categories based on different score combinations was described and the relationship between risk categories tested. The association between the antithrombotic therapy received and the scores was investigated by logistic regressions and CART analyses. Results At admission, among 543 patients the median scores (range) were: CHADS22 (0-6), CHA2DS2-VASc 4 (1-9), HEMORR2HAGES 3 (0-7), HAS-BLED 2 (1-6). Most of the patients were at high cardio-embolic/high-intermediate bleeding risk (70.5% combining CHADS2and HEMORR2HAGES, 98.3% combining CHA2DS2-VASc and HAS-BLED). 50-60% of patients were classified in a cardio-embolic risk category higher than the bleeding risk category. In univariate and multivariable analyses, a higher bleeding score was negatively associated with warfarin prescription, and positively associated with aspirin prescription. The cardio-embolic scores were associated with the therapeutic choice only after adjusting for bleeding score or age. Conclusion REPOSI patients represented a population at high cardio-embolic and bleeding risks, but most of them were classified by the scores as having a higher cardio-embolic than bleeding risk. Yet, prescription and type of antithrombotic therapy appeared to be primarily dictated by the bleeding risk. © 2013 European Federation of Internal Medicine.

Published
2013

221. Comparison of Disease Clusters in Two Elderly Populations Hospitalized in 2008 and 2010

Author

Marengoni, A, Nobili, A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Reposi, Investigators, Pier Mannucci, M, Spirito, V, Noce, D, Bonazzi, J, Lombardo, R, Sparacio, E, Alborghetti, S, De Vittorio, L, Djade, Cd, Paolisso, G, Rizzo, Mr, Laieta, Mt, Roberto, T, Persico, Marcello, Salvatore, T, Sasso, Fc, Utili, R, Durante Mangoni, E, Pinto, D, Fenoglio, L, Brignone, C, Bracco, C, Gasbarrone, L, Porcari, P, Famularo, G, Sajeva, Mr, Maniscalco, G, Gunelli, M, Tirotta, D, Realdi, G, Baritussio, A, Frassoni, F, Delsignore, R, Baroni, Mc, Zardo, M, Volpato, S, Fotini, S, Manfredini, R, Longhini, C, Molino, C, Incasa, E, Guarnieri, G, Zanetti, M, Spalluti, A, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Tuttolomondo, A, Di Sciacca, R, Antonaci, S, Vella, F, Marseglia, A, Centonze, V, Modeo, Me, Palasciano, G, Pugliese, S, Capobianco, C, Murialdo, G, Bovio, M, Pasini, Fl, Capecchi, Pl, Bicchi, M, Nuti, R, Valenti, R, Capodarca, C, Auteri, A, Pasqui, Al, Puccetti, L, Olivieri, O, Stanzial, Am, Agnelli, G, Macura, A, Mannarino, E, Lupattelli, G, Rondelli, P, Serra, Mg, Musca, G, Cuccurullo, O, Cappellini, Md, Fabio, G, Motta, I, Cantoni, F, Fargion, S, Bonara, P, Bulgheroni, M, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Mari, D, Rossi, Pd, Ziglioli, E, Vergani, C, Lilleri, Ms, Podda, M, Selmi, C, Meda, F, Cazzaniga, M, Monti, V, Balduini, Cl, Bertolino, G, Dezzani, L, Cavallo, P, Corazza, Gr, Miceli, E, Secchi, Mb, Wu, Sc, Balsamo, C, Anastasio, L, Sofia, L, Carbone, M, Bertucci, L, Valentia, V, Traisci, G, De Feudis, L, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Ronchi, E, Buratti, A, Tognin, T, Bertolini, D, Liberato, Nl, Bernasconi, G, Nardo, B, Venco, A, Guasti, L, Maroni, L, Castiglioni, L, Vanoli, M, Grignani, G, Casella, G, Mancuso, G, Tavella, R, Persico, R, Cicardi, M, Sandrone, G, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Rozzini, R, Falanga, L, Giordano, A, Menardo, G, Bottone, S, Sferrazzo, E, Tassara, R, Melis, D, Rebella, L, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Di Todaro, F, Nielsen, I, Giusto, L, Semplicini, A, Gottardo, L, Delitala, G, Carta, S, Atzori, S, Rosei, Ea, Rizzoni, D, Castoldi, L, Altomare, E, Serviddio, G, Salvatore, S, Fera, G, Di Luca ML, Renna, D, Picardi, A, Mazzarelli, C, Gentilucci, Uv, De Vincentis, A, Hila, D, Bernardi, M, Li Bassi, S, Santi, L, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Serra, P, Fontana, V, Falcone, M, Violi, F, Basili, S, Perri, L, Silveri, Ng, De Marco, G, Giupponi, B, Landolfi, R, Grieco, A, Gallo, A, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Ballestri, S, Becchi, Ma, Bellettini, E, Bolondi, L, Rasciti, L, Serio, I, Gualandi, S, Romanelli, G, Bonometti, F, Carulli, N, Rondinella, S, Giannico, I, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Sacco, A, Bonelli, A, Dentamaro, G, Micale, G, Delitalia, G, Deidda, S, Cuccuru, Lm, Benetti, G, Quagliolo, M, Centenaro, Gr, Perciccante, A, Coralli, A, Morabito, C, Fava, R, Macchini, L, Realdi, A, Cricco, L, Fiorentini, A, Tofi, C., Marengoni A, Nobili A, Pirali, C, Tettamanti, M, Pasina, L, Salerno, F, Corrao, S, Iorio, A, Marcucci, M, Franchi, C, Mannucci, Pm, Investigators, Reposi, Zanetti, Michela, Marengoni, A., Nobili, A., Pirali, C., Tettamanti, M., Pasina, L., Salerno, F., Corrao, S., Iorio, A., Marcucci, M., Franchi, C., Mannucci, P. M, Rizzo, Mr, Marengoni A, Nobili A, Pirali C, Tettamanti M, Pasina L, Salerno F, Corrao S, Iorio A, Marcucci M, Franchi C, Mannucci PM, REPOSI Investigators [.., Bernardi M, Bolondi L, ], Mannucci, P., and Mansueto, P.

Subjects
Registrie, Male, Aging, Cirrhosis, Settore MED/09 - Medicina Interna, Time Factors, hispitalization, Gerontology, aging populations, atterns of multimorbidity, diseases in the elderly population, Health care, 80 and over, Prevalence, Chronic diseases, Cluster analysis, Hospitalized elderly, Registries, aging population, Aged, 80 and over, education.field_of_study, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Hospitalization, Italy, elderly, disease clusters, Female, hospitalized, Human, medicine.medical_specialty, Time Factor, Anemia, MULTIMORBIDITY, Population, MEDLINE, Malignancy, Diabetes mellitus, Internal medicine, medicine, Multimorbidity, Humans, education, Aged, Chronic Disease, Cluster Analysis, Geriatrics and Gerontology, Cluster Analysi, business.industry, medicine.disease, Physical therapy, disease cluster, business
Abstract

Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter ‘Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.

Published
2013

222. First-line erlotinib followed by second-line cisplatin/gemcitabine chemotherapy in advanced Non Small Cell Lung Cancer. The TORCH randomised trial

Author

Gridelli, C, Ciardiello, F, Gallo, C, Feld, R, Butts, C, Gebbia, V, Maione, P, Morgillo, F, Genestreti, G, Favaretto, A, Leighl, N, Wierzbicki, R, Cinieri, S, Alam, Y, Siena, S, Tortora, Giampaolo, Felletti, R, Riccardi, F, Mancuso, G, Rossi, A, Cantile, F, Tsao, M. S., Saieg, M, da Cunha Santos, G, Piccirillo, Mc, Di Maio, M, Morabito, A, and Perrone, F.

Subjects
NSCLC, Erlotinib, Chemotherapy
Published
2012

224. The role of endosomal toll-like receptors in bacterial recognition

Author

Biondo, C., Mancuso, G., Beninati, C., Iaria, C., Romeo, O., Antonio Cascio, Teti, G., BIONDO, Carmelo, MANCUSO, Giuseppe, BENINATI, Concetta, IARIA, CHIARA, ROMEO, ORAZIO, CASCIO, Antonio, and TETI, Giuseppe

Subjects
Animals, Endosomes, Gram-Positive Bacteria, Signal Transduction, Toll-like receptors
Abstract

BACKGROUND: Infections caused by extracellular Gram positive bacteria are still a major health problems. Better understanding of the mechanisms underlying immune responses to these organisms is key to develop pharmacological agents, including vaccines, to control these infections. OBJECTIVE AND PERSPECTIVES: The objective of this review is to highlight the importance of nucleic acid-sensing, intracellular Toll-like receptors in innate immune recognition and in host defenses against extracellular bacteria. CONCLUSIONS: Toll-like receptors 7 and 9 have a major role in inducing host-protective type I interferon responses in conventional dendritic cells in response to streptococci and other extracellular gram positive bacteria. Moreover an as yet unidentified MyD88-dependent receptor is likely responsible for proinflammatory cytokine induction in response to these pathogens.

Published
2012

226. Intracranial haemorrhage in the Italian population of haemophilia patients with and without inhibitors

Author

Zanon, E, Iorio, A, Rocino, A, Artoni, A, Santoro, R, Tagliaferri, A, Coppola, A, Castaman, G, Mannucci, Pm, Italian Association of Hemophilia Centers, Barillari, G, Dragani, A, Gamba, G, Giuffrida, A, Lapecorella, M, Mancuso, G, Lucia, L, Mazzucconi, Mg, Messina, M, Musso, R, De Martis, F, Rossetti, G, Schinco, P, Spiezia, L, and Valdrè, L

Subjects
Questionnaires, Adult, Male, complications/immunology, Adolescent, Hemophilia A, Hemophilia B, fviii inhibitor, haemophilia a, haemophilia b, intracranial haemorrhage, Cohort Studies, Young Adult, Age Distribution, blood, Risk Factors, Surveys and Questionnaires, Prevalence, Humans, Preschool, Child, Aged, Autoantibodies, Retrospective Studies, Incidence, Infant, Newborn, Infant, Middle Aged, Newborn, epidemiology/prevention /&/ control, Blood Coagulation Factors, Adolescent, Adult, Age Distribution, Aged, Autoantibodies, blood, Blood Coagulation Factors, therapeutic use, Child, Child, Preschool, Cohort Studies, Hemophilia A, complications/immunology, Hemophilia B, complications/immunology, Humans, Incidence, Infant, Infant, Newborn, Intracranial Hemorrhages, epidemiology/prevention /&/ control, Italy, epidemiology, Male, Middle Aged, Prevalence, Questionnaires, Retrospective Studies, Risk Factors, Young Adult, Italy, therapeutic use, Child, Preschool, epidemiology, Intracranial Hemorrhages
Abstract

Intracranial haemorrhage (ICH) is the most serious bleeding symptom in haemophiliacs, resulting in high rates of mortality and disabling sequelae. The Association of Italian Haemophilia Centres carried out a retrospective survey (1987-2008) of ICH occurring in haemophiliacs with the goals to establish: (i) incidence, location of bleeding, death rate and disabling sequels; (ii) risk factors for ICH; and (iii) treatment used during the acute phase of ICH and for recurrence prevention. A total of 112 ICH episodes had occurred in 88 patients (78 haemophilia A, 10 haemophilia B), 24 of whom experienced recurrences. The cumulative hazard of ICH for the whole cohort over the entire follow-up period was 26.7 per 1000 patients, and the annualized rate of ICH was 2.50 events per 1000 patients (95% CI 1.90-3.31). The risk of ICH was higher in the youngest children (24.4 per 1000, 95% CI 12.7-47.0 in the first year of age and 14.9, 95% CI 7.1-31.4 in the second year of age) and then progressively rose again after the age of 40. Univariate, bivariate (age-adjusted) and multivariate analysis investigating the effects of patient characteristics on ICH occurrence showed that haemophilia severity and inhibitor status were strongly associated with ICH [severe vs. mild, HR 3.96 (2.39-6.57); inhibitor vs. non-inhibitor 2.52 (1.46-4.35)]. HCV infection was also associated with the risk of ICH [HR 1.83 (1.25-2.69)]. Therapeutic suggestions based upon our experience to control ICH recurrence are provided.

Published
2011

229. IDENTIFICATION OF FIBRINOGEN BINDING PROTEIN FRAGMENTS USING GENOMIC PHAGE DISPLAY LIBRARIES OF GROUP B STREPTOCOCCUS

Author

Domina, M, Lanza Cariccio, V, Papasergi, S, Mancuso, G, Pietrocola, G, Rindi, S, Colombari, B, Teti, G, Peppoloni, S, Speziale, P, Felici, Franco, and Beninati, C.

Subjects
Fibrinogen Binding Protein (FBP), Virulence factors, Group B Streptococcus (GBS), Phage-display library, Group B Streptococcus (GBS), Virulence factors, Fibrinogen Binding Protein (FBP), Phage-display library
Published
2011

230. A multicenter, randomised, phase 3 trial comparing fixed dose versus toxicity-adjusted dose of cisplatin + etoposide in advanced SCLC patients (pts). The STAD-1 trial

Author

Daniele, G., primary, Morabito, A., additional, Favaretto, A., additional, Filipazzi, V., additional, Rossi, A., additional, Gebbia, V., additional, Castiglione, F., additional, Cavanna, L., additional, Maiello, E., additional, Valmadre, G., additional, Costanzo, R., additional, Manzo, A., additional, Bonanno, L., additional, Piazza, E., additional, Maione, P., additional, Mancuso, G., additional, Di Maio, M., additional, Piccirillo, M.C., additional, Gallo, C., additional, Perrone, F., additional, and Gridelli, C., additional

Published
2015
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231. Heart failure and chronic kidney disease in a registry of internal medicine wards

Author

Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Reboldi, G, Vaudo, G, Pirro, M, Pasqualini, L, Mannarino, E., ANNONI, GIORGIO, ZAZZETTA, SARA, Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Reboldi, G, Vaudo, G, Pirro, M, Pasqualini, L, Mannarino, E., ANNONI, GIORGIO, and ZAZZETTA, SARA

Abstract

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were significantly older (P <' 0.0001) with BMI higher than the patients without those diagnosis (P < 0.02). Patients with a history of CKD showed higher non-fasting glycaemia (140 ± 86 vs. 125 ± 63 mg/dL, P < 0.001). CKD was significantly associated with HF (P < 0.0001). Patients with HF had an estimated GFR lower than patients without HF (P < 0.0001). Comorbidity and severity indices were significantly higher in subjects with HF (P < 0.0001) and CKD (P < 0.0001) than in those without. Multivariable analysis showed a significant association between HF and age (for five years increase OR 1.13, P < 0.009), BMI (for each 3 kg/m2 increase OR 1.15, P < 0.001), GFR (for each decrease of 10 mL/min increase OR 0.92, P < 0.002) and severity index (IS) (for each 0.25 units increase OR 1.43, P < 0.001).Conclusion: HF on admission is strongly associated with CKD, older age, BMI, and SI. These data focus the value of epidemiological studies such REPOSI in identifying and monitoring multimorbidity in elderly.

Published
2014

232. Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI

Author

Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, T, Djade, C, Salerno, F, Corrao, S, Marengoni, A, Marcucci, M, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D’Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, Meroni, M, Cicardi, M, Gidaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Pignatti, F., ANNONI, GIORGIO, ZAZZETTA, SARA, Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, T, Djade, C, Salerno, F, Corrao, S, Marengoni, A, Marcucci, M, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Bassi, S, Santi, L, Agnelli, G, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D’Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, Meroni, M, Cicardi, M, Gidaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Pignatti, F., ANNONI, GIORGIO, and ZAZZETTA, SARA

Abstract

The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.

Published
2014

233. Hepatic steatosis, carotid atherosclerosis and metabolic syndrome: the STEATO Study

Author

Faustina Scavelli, Francesca Parasporo, Antonio Silvano Rotondaro, Maria Belmonte, Claudio Carallo, Mosè Bartone, Ferdinando Laghi, Concetta Irace, G F Mauro, M. Ferraro, Francesco Gullo, Agostino Gnasso, Vitaliano Spagnuolo, Bruno Madafferi, Ferruccio Dell’Aquila, Nicola Brandolino, Antonio Ferrara, Francesco Scopelliti, and Mancuso G

Subjects
Adult, Carotid Artery Diseases, Male, medicine.medical_specialty, Gastroenterology, Transaminase, Insulin resistance, Risk Factors, Carotid artery disease, Diabetes mellitus, Internal medicine, Medicine, Homeostasis, Humans, Aspartate Aminotransferases, Metabolic Syndrome, business.industry, Fatty liver, Alanine Transaminase, Ultrasonography, Doppler, Odds ratio, gamma-Glutamyltransferase, Middle Aged, medicine.disease, Fatty Liver, Endocrinology, Multivariate Analysis, Female, Steatosis, Metabolic syndrome, business
Abstract

Purpose Hepatic steatosis is frequently observed in subjects with metabolic syndrome (MS). In type 2 diabetics, it is independently associated with cardiovascular diseases. In order to confirm and extend this finding, a large group of patients with risk factors for atherosclerosis was studied. Methods Carotid atherosclerosis was investigated by echo-Doppler, and hepatic steatosis by ultrasound and transaminase values. Strict exclusion criteria were chosen in order to avoid secondary forms of fatty liver and interference on transaminase values. Results Among 970 enrolled patients, about 20% were diabetics, half had MS and 76% presented echographic hepatic steatosis. In multivariate analyses, fatty liver and MS were associated with carotid atherosclerosis [odds ratio (95% confidence intervals) 2.15 (1.27–3.63) and 1.72 (1.12–2.64), respectively], whereas HOMA index was not. Aspartate aminotransferase and alanine aminotransferase were not independently associated with carotid atherosclerosis, whereas gamma-glutamyl transferase showed a link with atherosclerosis beyond MS and steatosis presence. The analyses of the 780 non diabetics recruited showed similar results. Conclusions The results of the present study demonstrate that hepatic steatosis measured by echography is associated with carotid atherosclerosis in a large population mostly carrying cardiovascular or metabolic risk factors, independently of MS, cardiovascular diseases, diabetes mellitus and/or insulin resistance.

Published
2009

236. Porins of Pseudomonas aeruginosa induce release of TNF-alpha human leucocytes

Author

CUSUMANO V., TUFANO M. A., MANCUSO G., CARBONE M., FERA M. T., CILIBERTI ANZANI F., RUOCCO E., MERENDINO R. A., TETI G., ROSSANO, FABIO, Cusumano, V., Tufano, M. A., Mancuso, G., Carbone, M., Rossano, Fabio, Fera, M. T., CILIBERTI ANZANI, F., Ruocco, E., Merendino, R. A., and Teti, G.

Published
1997

242. Effects of taxol on TNFα and IL6 production by human peripheral blood cells

Author

LOSI E., CUSUMANO V., MANCUSO G., TOMASELLO F., CHILLENI S., PASTURA G., TRIFILETTI R., TETI G. AND MERENDINO R. A., ROSSANO, FABIO, Losi, E., Rossano, Fabio, Cusumano, V., Mancuso, G., Tomasello, F., Chilleni, S., Pastura, G., Trifiletti, R., and Teti, G. AND MERENDINO R. A.

Published
1996

248. Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

Author

Mannucci, M, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Di Corato, P, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, Dangelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Sofia, L, Anastasio, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Zazzetta, S, Bertolotti, M, Scotto, C, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, DAngelo, D, Pignatti, F., ANNONI, GIORGIO, ZAZZETTA, SARA, Mannucci, M, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Di Corato, P, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Durante Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, Dangelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Sofia, L, Anastasio, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Rossi Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Zazzetta, S, Bertolotti, M, Scotto, C, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, DAngelo, D, Pignatti, F., ANNONI, GIORGIO, and ZAZZETTA, SARA

Abstract

Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in hospital and during the 3-month post-discharge follow-up were explored by logistic regression and propensity score analysis. Among the 1,380 patients enrolled, 171 (15.2 %) were on TP during the hospital stay (162 on low molecular weight heparins, 9 on fondaparinux). The disability Barthel index was the main independent predictor of TP prescription. Rate of fatal and non-fatal VTE and bleeding during and after hospitalization did not differ between TP and non-TP patients. In-hospital and post-discharge mortality was significantly higher in patients on TP, that however was not an independent predictor of mortality. Among elderly medical patients there was a relatively low rate of TP, that was more frequently prescribed to patients with a higher degree of disability and who had an overall higher mortality.

Published
2013

250. Secondary hemophagocytic lymphohistiocytosis in zoonoses. A systematic review

Author

Cascio, Antonio, Pernice, L. M., Barberi, G., Delfino, D., Biondo, C., Beninati, C., Mancuso, G., Rodríguez Morales, Alfonso Javier, Iaria, C., Cascio, Antonio, Pernice, L. M., Barberi, G., Delfino, D., Biondo, C., Beninati, C., Mancuso, G., Rodríguez Morales, Alfonso Javier, and Iaria, C.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome that is often fatal despite treatment. It is caused by a dysregulation in natural killer T-cell function, resulting in activation and proliferation of histiocytes with uncontrolled hemophagocytosis and cytokines overproduction. The syndrome is characterized by fever, hepatosplenomegaly, cytopenias, liver dysfunction, and hyperferritinemia. HLH can be either primary, with a genetic aetiology, or secondary, associated with malignancies, autoimmune diseases, or infections. Zoonotic diseases are an important cause of HLH. Secondary HLH can delay the correct diagnosis of the zoonotic disease, and can contribute to an adverse outcome.

Published
2012

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