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13. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Guerra, F., De Ponti, R., D'Onofrio, A., Accogli, M., Bertini, M., Bisignani, G., Forleo, G. B., Landolina, M., Lavalle, C., Notarstefano, P., Ricci, R. P., Zanotto, G., Palmisano, P., Luise, R., De Bonis, S., Pangallo, A., Talarico, A., Maglia, G., Aspromonte, V., Nigro, G., Bianchi, V., Rapacciuolo, A., Ammendola, E., Solimene, F., Stabile, G., Biffi, M., Ziacchi, M., Malpighi, P. S. O., Saporito, D., Casali, E., Turco, V., Malavasi, V. L., Vitolo, M., Imberti, J. F., Anna, A. S., Zardini, M., Placci, A., Quartieri, F., Bottoni, N., Carinci, V., Barbato, G., De Maria, E., Borghi, A., Ramazzini, O. B., Bronzetti, G., Tomasi, C., Boggian, G., Virzi, S., Sassone, B., Corzani, A., Sabbatani, P., Pastori, P., Ciccaglioni, A., Adamo, F., Scaccia, A., Spampinato, A., Patruno, N., Biscione, F., Cinti, C., Pignalberi, C., Calo, L., Tancredi, M., Di Belardino, N., Ricciardi, D., Cauti, F., Rossi, P., Cardinale, M., Ansalone, G., Narducci, M. L., Pelargonio, G., Silvetti, M., Drago, F., Santini, L., Pentimalli, F., Pepi, P., Caravati, F., Taravelli, E., Belotti, G., Rordorf, R., Mazzone, P., Bella, P. D., Rossi, S., Canevese, L. F., Cilloni, S., Doni, L. A., Vergara, P., Baroni, M., Perna, E., Gardini, A., Negro, R., Perego, G. B., Curnis, A., Arabia, G., Russo, A. D., Marchese, P., Dell'Era, G., Occhetta, E., Pizzetti, F., Amellone, C., Giammaria, M., Devecchi, C., Coppolino, A., Tommasi, S., Anselmino, M., Coluccia, G., Guido, A., Rillo, M., Palama, Z., Luzzi, G., Pellegrino, P. L., Grimaldi, M., Grandinetti, G., Vilei, E., Potenza, D., Scicchitano, P., Favale, S., Santobuono, V. E., Sai, R., Melissano, D., Candida, T. R., Bonfantino, V. M., Di Canda, D., Gianfrancesco, D., Carretta, D., Pisano, E. C. L., Medico, A., Giaccari, R., Aste, R., Murgia, C., Nissardi, V., Sanna, G. D., Firetto, G., Crea, P., Ciotta, E., Sgarito, G., Caramanno, G., Ciaramitaro, G., Faraci, A., Fasheri, A., Di Gregorio, L., Campsi, G., Muscio, G., Giannola, G., Padeletti, M., Del Rosso, A., Nesti, M., Miracapillo, G., Giovannini, T., Pieragnoli, P., Rauhe, W., Marini, M., Guarracini, F., Ridarelli, M., Fedeli, F., Mazza, A., Zingarini, G., Andreoli, C., Carreras, G., Zorzi, A., Rossillo, A., Ignatuk, B., Zerbo, F., Molon, G., Fantinel, M., Zanon, F., Marcantoni, L., Zadro, M., and Bevilacqua, M.

Subjects
Cardiac resynchronization therapy, Remote monitoring, Emergency Medicine, Internal Medicine, Ablation, Arrhythmia, Atrial fibrillation, COVID-19, Implantable cardioverter defibrillators, Pacemakers
Abstract

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.

Published
2022

18. FEAR OF SUDDEN DEATH ‘INTERRUPTED‘ BY WEARABLE DEFIBRILLATOR: CASE REPORT

Author

Valecce, R, Carretta, D, D‘Agostino, C, and Bonfantino, M

Abstract

A male patient (pt) 49y,grade II familiarity for sudden cardiac death (SCD).He arrived in the emergency department for worsening dyspnea and he underwent ECG:sinus rhythm and left bundle branch block(QRS duration 170 msec);color Doppler echocardiogram (CDE)showing:Dilated left ventricle, severely and globally hypocontractile(EF30%).Negative cardiac enzymes on laboratory tests.The coronary arteries were normal at angiographic control.The pt did not undergo to cardiac MRI because of claustrophobia.Blood samples were sent for genetic screening for cardiomyopathy.The pt started drug therapy following ESC guidelines.He was transferred to cardiopulmonary rehabilitation department.At the end of the 2 weeks of the rehabilitation cycle, left ventricular systolic dysfunction persisted.The pt was discharged with a wearable defibrillator (WCD) to continue therapy optimization following ESC heart failure guidelines.At the end of 3 months,the pt underwent an echocardiographic recheck which confirmed dilated,severely,and globally hypocontractile left ventricle(EF35%).ICD implantation was indicated, but the pt refused it.Therefore,was prescribed the continuation of SCD protection by WCD.The pt underwent monthly followups,for the next 6 months,reporting no improvement in left ventricular contractile capacity measured by CDE and continuing to refuse biventricular ICD implantation.We noted a correct and consistent wearing of the WCD.After 177 days of wearing,the pt had an episode of loss of consciousness and WCD shock.A remote device check documented ventricular fibrillation at 200 bpm,which was correctly recognized and discontinued.The pt accepted biventricular ICD implantation.At follow–up at 1 month CDE documented improvement in left ventricular contractile capacity(EF 40%),and no arrhythmic events in the absence of symptoms.WCDs have been used extensively in Italy since 2015.This technology provides temporary protection from SCD for pts with an evolving risk profile who are not yet eligible for an ICD.WCD is an effective therapy for the treatment of SCD with a very low complication rate and high pt compliance over time.Our case demonstrates how WCD enabled optimal titration of drug therapy following guidelines and prevented sudden death in young high–risk pts.In addition, our case shows that reduced compliance for definitive ICD implantation due to non–acceptance of the disease,fear of surgery,or subsequent lifestyle changes are not barriers to saving patients from SCD.

Published
2024
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20. Prevalence and correlates of QTc prolongation in Italian psychiatric care: cross-sectional multicentre study

Author

Nosè, M., Bighelli, I., Castellazzi, M., Martinotti, G., Carrà, G., Lucii, C., Ostuzzi, G., Sozzi, F., Barbui, C., Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., Barone, R., Barone, Y., Bartoli, F., Bergamini, C., Bertolini, F., Bolognesi, S., Bordone, A., Bortolaso, P., Bugliani, M., Calandra, C., Calò, S., Cardamone, G., Caroleo, M., Carra, E., Carretta, D., Chiocchi, L., Clerici, M., Corbo, M., Corsi, E., Costanzo, R., Costoloni, G., D'Arienzo, F., Debolini, S., De Capua, A., Di Napoli, W. A., Dinelli, M., Facchi, E., Fargnoli, F., Fiori, F., Franchi, A., Gardellin, F., Gazzoletti, E., Ghio, L., Giacomin, M., Gregis, M., Iovieno, N., Koukouna, D., Lax, A., Lintas, C., Luca, A., Luca, M., Lussetti, M., Madrucci, M., Magnani, N., Magni, L., Manca, E., Martorelli, C., Mattafirri, R., Percudani, M., Perini, G., Petrosemolo, P., Pezzullo, M., Piantanida, S., Pinna, F., Prato, K., Prestia, D., Quattrone, D., Reggianini, C., Restaino, F., Ribolsi, M., Rinosi, G., Rizzo, C., Rizzo, R., Roggi, M., Rossi, G., Rossi, S., Ruberto, S., Santoro, R., Santi, M., Signorelli, M. S., Soscia, F., Staffa, P., Stilo, M., Strizzolo, S., Suraniti, F., Tavian, N., Tortelli, L., Tosoni, F., Valdagno, M., Zanobini, V., Nosè, M, Bighelli, I, Castellazzi, M, Martinotti, G, Carra', G, Lucii, C, Ostuzzi, G, Sozzi, F, Barbui, C, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santoro, R, Santi, M, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, and Zanobini, V

Subjects
Adult, Male, medicine.medical_specialty, Psychotropic drugs, Epidemiology, medicine.medical_treatment, Long QT syndrome, Antidepressant, Drug overdose, Adverse effect, QT interval, Antipsychotic, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Risk Factors, Psychotropic drug, medicine, Prevalence, Humans, cardiovascular diseases, Psychiatry, Settore MED/25 - Psichiatria, Polypharmacy, business.industry, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Public Health, Psychiatry and Mental Health, Original Articles, medicine.disease, 030227 psychiatry, Substance abuse, Long QT Syndrome, Cross-Sectional Studies, Italy, Aripiprazole, Female, business, adverse effect, antipsychotic, psychotropic drugs, Antipsychotic Agents, 030217 neurology & neurosurgery, medicine.drug
Abstract

Aims.In recent years several warnings have been issued by regulatory authorities on the risk of electrocardiogram abnormalities in individuals exposed to psychotropic drugs. As a consequence of these warnings, monitoring of the QT interval corrected for heart rate (QTc) has become increasingly common. This study was conducted to measure the frequency of QTc prolongation in unselected psychiatric patients, and to document the associated factors using a cross-sectional approach.Method.The study was carried out in 35 Italian psychiatric services that are part of the STAR (Servizi Territoriali Associati per la Ricerca) Network, a research group established to produce scientific knowledge by collecting data under ordinary circumstances. During a three-month period, a consecutive unselected series of both in- and out-patients were enrolled if they performed an ECG during the recruitment period and were receiving psychotropic drugs on the day ECG was recorded.Results.During the recruitment period a total of 2411 patients were included in the study. The prevalence of QTc prolongation ranged from 14.7% (men) and 18.6% (women) for the cut-off of 450 ms, to 1.26% (men) and 1.01% (women) for the cut-off of 500 ms. In the multivariate model conducted in the whole sample of patients exposed to psychotropic drugs, female sex, age, heart rate, alcohol and/or substance abuse, cardiovascular diseases and cardiovascular drug treatment, and drug overdose were significantly associated with QTc prolongation. In patients exposed to antipsychotic drugs, polypharmacy was positively associated with QTc prolongation, whereas use of aripiprazole decreased the risk. In patients exposed to antidepressant drugs, use of citalopram, citalopram dose and use of haloperidol in addition to antidepressant drugs, were all positively associated with QTc prolongation.Conclusions.The confirmation of a link between antipsychotic polypharmacy and QTc prolongation supports the current guidelines that recommend avoiding the concurrent use of two or more antipsychotic drugs, and the confirmation of a link between citalopram and QTc prolongation supports the need for routine QTc monitoring. The relatively low proportion of patients with QTc prolongation not only suggests compliance with current safety warnings issued by regulatory authorities, but also casts some doubts on the clinical relevance of QTc prolongation related to some psychotropic drugs.

Published
2016

21. Web- and text-based interventions for smoking cessation: Meta-analysis and meta-regression

Author

Crocamo, C, Carretta, D, Ferri, M, Dias, S, Bartoli, F, Carra', G, CROCAMO, CRISTINA, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BARTOLI, FRANCESCO, CARRA', GIUSEPPE, Crocamo, C, Carretta, D, Ferri, M, Dias, S, Bartoli, F, Carra', G, CROCAMO, CRISTINA, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BARTOLI, FRANCESCO, and CARRA', GIUSEPPE

Abstract

Background: In the past decade, several smoking cessation interventions have been developed and implemented through information and communication technology (ICT). Evidence suggests that they might be suitable for large-scale public health interventions, based on updated communication media characteristics in terms of interplay between technology and graphical user interface, reaching high numbers of individuals. Objectives: We aimed at estimating web/text-based interventions effectiveness as compared with approaches routinely used for general population, that is smoking assessment or non-electronic self-help materials. Methods: A systematic review and meta-analysis was performed searching through PubMed, Embase and PsycInfo databases, as well as references of relevant papers. Heterogeneity and risk of bias were evaluated following standard methods. In addition, we performed meta-regression analyses testing if candidate covariates moderate the overall effect. Results: Slight but significant effectiveness was found for eHealth interventions over control conditions (RR = 1.28, 95% CI: 1.14–1.45). Meta-regressions showed similar findings for web- and text-based interventions. The effect seemed moderated by the follow-up period, being higher at 3 months and lower at 6/7 months follow-up. Conclusions: Our results outline moderate effectiveness of web/text-based interventions. However, a paucity of properly controlled studies and lack of information on several effect modifiers still hamper the development and implementation of smoking cessation interventions through ICT

Published
2018

22. Il disagio giovanile e le patologie emergenti

Author

Cornaggia, CM, Clerici, M, Cornaggia, C, Carretta, D, CORNAGGIA, CESARE MARIA, Carretta, D., Cornaggia, CM, Clerici, M, Cornaggia, C, Carretta, D, CORNAGGIA, CESARE MARIA, and Carretta, D.

Published
2015

23. N/OFQ system in brain areas of nerve-injured mice: Its role in different aspects of neuropathic pain

Author

Palmisano, M, Mercatelli, Daniela, Caputi, F. F, Carretta, D, Romualdi, P, Candeletti, S., M. Palmisano, D. Mercatelli, F.F. Caputi, D. Carretta, P. Romualdi, and S. Candeletti

Subjects
Male, NOP receptor, Amygdala, cingulate cortex, gene expression, neuropathic pain, nociceptin, supraspinal areas, thalamus, Nociceptin, Cingulate cortex, Somatosensory Cortex, Neuropathic pain, Gyrus Cinguli, Sciatic Nerve, Nociceptin Receptor, Supraspinal area, NO, Mice, Behavioral Neuroscience, Opioid Peptides, Thalamus, Genetic, Neurology, Receptors, Opioid, Animals, Neuralgia, Gene expression, Thalamu
Abstract

Several studies showed that chronic pain causes reorganization and functional alterations of supraspinal brain regions. The nociceptin-NOP receptor system is one of the major systems involved in pain control and much evidence also suggested its implication in stress, anxiety and depression. Therefore, we investigated the nociceptin-NOP system alterations in selected brain regions in a neuropathic pain murine model. Fourteen days after the common sciatic nerve ligature, polymerase chain reaction (PCR) analysis indicated a significant decrease of pronociceptin and NOP receptor mRNA levels in the thalamus; these alterations could contribute to the decrease of the thalamic inhibitory function reported in neuropathic pain condition. Nociceptin peptide and NOP mRNA increased in the anterior cingulate cortex (ACC) and not in the somatosensory cortex, suggesting a peculiar involvement of this system in pain regulating circuitry. Similarly to the ACC, an increase of nociceptin peptide levels was observed in the amygdala. Finally, the pronociceptin and NOP mRNAs decrease observed in the hypothalamus reflects the lack of hypothalamus-pituitary-adrenal axis activation, already reported in neuropathic pain models. Our data indicate that neuropathic pain conditions affect the supraspinal nociceptin-NOP system which is also altered in regions known to play a role in emotional aspects of pain.

Published
2017

27. Poster Session Saturday 14 December - AM: 14/12/2013 08:30-12:30 * Location: Poster area

Author

Muraru, D., Addetia, K., Veronesi, F., Corsi, C., Mor-Avi, V., Yamat, M., Weinert, L., Lang, R., Badano, L., Faita, F., Di Lascio, N., Bruno, R., Bianchini, E., Ghiadoni, L., Sicari, R., Gemignani, V., Angelis, A., Ageli, K., Ioakimidis, N., Chrysohoou, C., Agelakas, A., Felekos, I., Vaina, S., Aznaourides, K., Vlachopoulos, C., Stefanadis, C., Nemes, A., Szolnoky, G., Gavaller, H., Gonczy, A., Kemeny, L., Forster, T., Ramalho, A., Placido, R., Marta, L., Menezes, M., Magalhaes, A., Cortez Dias, N., Martins, S., Almeida, A., Pinto, F., Nunes Diogo, A., Botezatu, C.-D., Enache, R., Popescu, B., Nastase, O., Coman, M., Ghiorghiu, I., Calin, A., Rosca, M., Beladan, C., Ginghina, C., Grapsa, J., Cabrita, I., Durighel, G., O'regan, D., Dawson, D., Nihoyannopoulos, P., Pellicori, P., Kallvikbacka-Bennett, A., Zhang, J., Lukaschuk, E., Joseph, A., Bourantas, C., Loh, H., Bragadeesh, T., Clark, A., Cleland, J., Lomax, S., Putzu, P., Diercx, R., Parsons, S., Dicken, B., Vered, Z., Adirevitz, L., Dragu, R., Blatt, A., Karev, E., Malca, Y., Roytvarf, A., Marek, D., Sovova, E., Berkova, M., Cihalik, C., Taborsky, M., Lindqvist, P., Tossavainen, E., Soderberg, S., Gonzales, M., Gustavsson, S., Henein, M., Sonne, C., Bott-Fluegel, L., Hauck, S., Lesevic, H., Hadamitzky, M., Wolf, P., Kolb, C., Bandera, F., Pellegrino, M., Generati, G., Donghi, V., Alfonzetti, E., Castelvecchio, S., Menicanti, L., Guazzi, M., Buchyte, S., Rinkuniene, D., Jurkevicius, R., Smarz, K., Zaborska, B., Jaxa-Chamiec, T., Maciejewski, P., Budaj, A., Santoro, A., Federico Alvino, F., Giovanni Antonelli, G., Roberta Molle, R., Matteo Bertini, M., Stefano Lunghetti, S., Sergio Mondillo, S., Henri, C., Magne, J., Dulgheru, R., Laaraibi, S., Voilliot, D., Kou, S., Pierard, L., Lancellotti, P., Szulik, M., Stabryla-Deska, J., Kalinowski, M., Sliwinska, A., Szymala, M., Lenarczyk, R., Kalarus, Z., Kukulski, T., Yiangou, K., Azina, C., Yiangou, A., Ioannides, M., Chimonides, S., Baysal, S., Pirat, B., Okyay, K., Bal, U., Muderrisoglu, H., Popovic, D., Ostojic, M., Petrovic, M., Vujisic-Tesic, B., Arandjelovic, A., Petrovic, I., Banovic, M., Popovic, B., Vukcevic, V., Damjanovic, S., Velasco Del Castillo, S., Onaindia Gandarias, J., Arana Achaga, X., Laraudogoitia Zaldumbide, E., Rodriguez Sanchez, I., Cacicedo De Bobadilla, A., Romero Pereiro, A., Aguirre Larracoechea, U., Salinas, T., Subinas, A., Elzbieciak, M., Wita, K., Grabka, M., Chmurawa, J., Doruchowska, A., Turski, M., Filipecki, A., Wybraniec, M., Mizia-Stec, K., Varho, V., Karjalainen, P., Lehtinen, T., Airaksinen, J., Ylitalo, A., Kiviniemi, T., Gargiulo, P., Galderisi, M., D' Amore, C., Lo Iudice, F., Savarese, G., Casaretti, L., Pellegrino, A., Fabiani, I., La Mura, L., Perrone Filardi, P., Kim, J. Y., Chung, W., Yu, J., Choi, Y., Park, C., Youn, H., Lee, M., Nagy, A., Manouras, A., Gunyeli, E., Gustafsson, U., Shahgaldi, K., Winter, R., Johnsson, J., Zagatina, A., Krylova, L., Zhuravskaya, N., Vareldzyan, Y., Tyurina, T., Clitsenko, O., Khalifa, E. A., Ashour, Z., Elnagar, W., Jung, I., Seo, H., Lee, S., Lim, D., Mizariene, V., Verseckaite, R., Janenaite, J., Jonkaitiene, R., Sanchez Espino, A., Bonaque Gonzalez, J., Merchan Ortega, G., Bolivar Herrera, N., Ikuta, I., Macancela Quinones, J., Gomez Recio, M., Silva Fazendas Adame, P. R., Caldeira, D., Stuart, B., Almeida, S., Cruz, I., Ferreira, A., Freire, G., Lopes, L., Cotrim, C., Pereira, H., Mediratta, A., Moss, J., Nayak, H., Al Amri, I., Debonnaire, P., Van Der Kley, F., Schalij, M., Bax, J., Ajmone Marsan, N., Delgado, V., Schmidt, F. P., Gniewosz, T., Jabs, A., Munzel, T., Jansen, T., Kaempfner, D., Hink, U., Von Bardeleben, R., Jose, J., George, O., Joseph, G., Adawi, S., Najjar, R., Ahronson, D., Shiran, A., Van Riel, A., Boerlage - Van Dijk, K., De Bruin - Bon, H., Araki, M., Meregalli, P., Koch, K., Vis, M., Mulder, B., Baan, J., Bouma, B., Marciniak, A., Elton, D., Glover, K., Campbell, I., Sharma, R., Batalha, S., Lourenco, C., Oliveira Da Silva, C., Caballero, L., Garcia-Lara, J., Gonzalez-Carrillo, J., Oliva, M., Saura, D., Garcia-Navarro, M., Espinosa, M., Pinar, E., Valdes, M., De La Morena, G., Barreiro Perez, M., Lopez Perez, M., Roy, D., Brecker, S., Venkateshvaran, A., Dash, P. K., Sola, S., Barooah, B., Govind, S. C., Brodin, L. A., Saura Espin, D., Caballero Jimenez, L., Gonzalez Carrillo, J., Oliva Sandoval, M., Lopez Ruiz, M., Garcia Navarro, M., Espinosa Garcia, M., Valdes Chavarri, M., De La Morena Valenzuela, G., Gatti, G., Dell'angela, L., Pinamonti, B., Benussi, B., Sinagra, G., Pappalardo, A., Hernandez, V., Saavedra, J., Gonzalez, A., Iglesias, P., Civantos, S., Guijarro, G., Monereo, S., Ikeda, M., Toh, N., Oe, H., Tanabe, Y., Watanabe, N., Ito, H., Ciampi, Q., Cortigiani, L., Pratali, L., Rigo, F., Villari, B., Picano, E., Yoon, J., Sohn, J., Kim, Y., Chang, H., Hong, G., Kim, T., Ha, J., Choi, B., Rim, S., Choi, E., Tibazarwa, K., Sliwa, K., Wonkam, A., Mayosi, B., Oryshchyn, N., Ivaniv, Y., Pavlyk, S., Lourenco, M. R., Azevedo, O., Moutinho, J., Nogueira, I., Fernandes, M., Pereira, V., Quelhas, I., Lourenco, A., Sunbul, M., Tigen, K., Karaahmet, T., Dundar, C., Ozben, B., Guler, A., Cincin, A., Bulut, M., Sari, I., Basaran, Y., Baydar, O., Kadriye Kilickesmez, K., Ugur Coskun, U., Polat Canbolat, P., Veysel Oktay, V., Umit Yasar Sinan, U., Okay Abaci, O., Cuneyt Kocas, C., Sinan Uner, S., Serdar Kucukoglu, S., Zaroui, A., Mourali, M., Ben Said, R., Asmi, M., Aloui, H., Kaabachi, N., Mechmeche, R., Saberniak, J., Hasselberg, N., Borgquist, R., Platonov, P., Holst, A., Edvardsen, T., Haugaa, K., Eran, A., Yueksel, D., Er, F., Gassanov, N., Rosenkranz, S., Baldus, S., Guedelhoefer, H., Faust, M., Caglayan, E., Matveeva, N., Nartsissova, G., Chernjavskij, A., Ippolito, R., De Palma, D., Muscariello, R., Santoro, C., Raia, R., Schiano-Lomoriello, V., Gargiulo, F., Lipari, P., Bonapace, S., Zenari, L., Valbusa, F., Rossi, A., Lanzoni, L., Canali, G., Molon, G., Campopiano, E., Barbieri, E., Ikonomidis, I., Varoudi, M., Papadavid, E., Theodoropoulos, K., Papadakis, I., Pavlidis, G., Triantafyllidi, H., Anastasiou - Nana, M., Rigopoulos, D., Lekakis, J., Ozen, G., Durmus, E., Kivrak, T., Atas, H., Direskeneli, H., Stevanovic, A., Dekleva, M., Trajic, S., Paunovic, N., Simic, A., Khan, S., Mushemi-Blake, S., Jouhra, F., Dennes, W., Monaghan, M., Melikian, N., Shah, A., Maceira Gonzalez, A. M., Lopez-Lereu, M., Monmeneu, J., Igual, B., Estornell, J., Boraita, A., Kosmala, W., Rojek, A., Bialy, D., Mysiak, A., Przewlocka-Kosmala, M., Popescu, I., Mancas, S., Mornos, C., Serbescu, I., Ionescu, G., Ionac, A., Gaudron, P., Niemann, M., Herrmann, S., Hu, K., Liu, D., Wojciech, K., Frantz, S., Bijnens, B., Ertl, G., Weidemann, F., Cosin-Sales, J., Ruvira, J., Diago, J., Aguilar, J., Cruz, C., Pinho, T., Madureira, A., Lebreiro, A., Dias, C., Ramos, I., Silva Cardoso, J., Julia Maciel, M., De Meester, P., Van De Bruaene, A., Herijgers, P., Voigt, J.-U., Budts, W., Franzoso, F., Voser, E., Wohlmut, C., Kellenberger, C., Valsangiacomo Buechel, E., Carrero, C., Benger, J., Parcerisa, M., Falconi, M., Oberti, P., Granja, M., Cagide, A., Del Pasqua, A., Secinaro, A., Antonelli, G., Iacomino, M., Toscano, A., Chinali, M., Esposito, C., Carotti, A., Pongiglione, G., Rinelli, G., Youssef Moustafa, A., Al Murayeh, M., Al Masswary, A., Al Sheikh, K., Moselhy, M., Dardir, M., Deising, J., Butz, T., Suermeci, G., Liebeton, J., Wennemann, R., Tzikas, S., Van Bracht, M., Prull, M., Trappe, H.-J., Martin Hidalgo, M., Delgado Ortega, M., Ruiz Ortiz, M., Mesa Rubio, D., Carrasco Avalos, F., Seoane Garcia, T., Pan Alvarez-Ossorio, M., Lopez Aguilera, J., Puentes Chiachio, M., Suarez De Lezo Cruz Conde, J., Petrovic, M. T., Giga, V., Stepanovic, J., Tesic, M., Jovanovic, I., Djordjevic-Dikic, A., Piatkowski, R., Kochanowski, J., Scislo, P., Opolski, G., Vareldzhyan, Y., Bombardini, T., Gherardi, S., Leone, O., Michelotto, E., Ciccarone, A., Tarantino, N., Ostuni, V., Rubino, M., Genco, W., Santoro, G., Carretta, D., Romito, R., Colonna, P., Cameli, M., Lunghetti, S., Lisi, M., Curci, V., Cameli, P., Focardi, M., Favilli, R., Mondillo, S., Hoffmann, R., Barletta, G., Von Bardeleben, S., Kasprzak, J., Greis, C., Vanoverschelde, J., Becher, H., Machida, T., Izumo, M., Suzuki, K., Kaimijima, R., Mizukoshi, K., Manabe-Uematsu, M., Takai, M., Harada, T., Akashi, Y., Martin Garcia, A., Arribas-Jimenez, A., Cruz-Gonzalez, I., Nieto, F., Iscar, A., Merchan, S., Martin-Luengo, C., Brecht, A., Theres, L., Spethmann, S., Dreger, H., Baumann, G., Knebel, F., Jasaityte, R., Heyde, B., Rademakers, F., Claus, P., D'hooge, J., Lervik Nilsen, L. C., Lund, J., Brekke, B., Stoylen, A., Giraldeau, G., Duchateau, N., Gabrielli, L., Penela, D., Evertz, R., Mont, L., Brugada, J., Berruezo, A., Sitges, M., Kordybach, M., Kowalski, M., Hoffman, P., Pilichowska, E., Baran, J., Kulakowski, P., Wahi, S., Vollbon, W., Leano, R., Thomas, A., Bricknell, K., Holland, D., Napier, S., Stanton, T., Teferici, D., Qirko, S., Petrela, E., Dibra, A., Bajraktari, G., Bara, P., Sanchis Ruiz, L., Andrea, R., Falces, C., Perez-Villa, F., Sulemane, S., Panoulas, V., Bratsas, A., Tam, F., Abduch, M., Alencar, A., Coracin, F., Barban, A., Saboya, R., Dulley, F., Mathias, W., Vieira, M., Buccheri, S., Mangiafico, S., Arcidiacono, A., Bottari, V., Leggio, S., Tamburino, C., Monte, I. P., Spitzer, E., Beitzke, D., Kaneider, A., Pavo, N., Gottsauner-Wolf, M., Wolf, F., Loewe, C., Mushtaq, S., Andreini, D., Pontone, G., Bertella, E., Conte, E., Baggiano, A., Annoni, A., Cortinovis, S., Fiorentini, C., Pepi, M., Gustafsson, M., Alehagen, U., Dahlstrom, U., Johansson, P., Faden, G., Faggiano, P., Albertini, L., Reverberi, C., Gaibazzi, N., Taylor, R. J., Moody, W., Umar, F., Edwards, N., Townend, J., Steeds, R., Leyva, F., Mihaila, S., Piasentini, E., Peluso, D., Casablanca, S., Naso, P., Puma, L., Iliceto, S., Vinereanu, D., Ciciarello, F. L., Agati, L., Cimino, S., De Luca, L., Petronilli, V., Fedele, F., and Tsverava, M.

Subjects
medicine.medical_specialty, Bundle branch block, business.industry, Left bundle branch block, Speckle tracking echocardiography, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Radial function, Ventricle, Internal medicine, Cardiology, medicine, Radiology, Nuclear Medicine and imaging, In patient, Cardiology and Cardiovascular Medicine, business
Published
2013
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28. Left atrial function measured by cardiac magnetic resonance in patients with heart failure: clinical associations and prognostic value

Author

Muraru, D., Addetia, K., Veronesi, F., Corsi, C., Mor-Avi, V., Yamat, M., Weinert, L., Lang, R., Badano, L., Faita, F., Di Lascio, N., Bruno, R., Bianchini, E., Ghiadoni, L., Sicari, R., Gemignani, V., Angelis, A., Ageli, K., Ioakimidis, N., Chrysohoou, C., Agelakas, A., Felekos, I., Vaina, S., Aznaourides, K., Vlachopoulos, C., Stefanadis, C., Nemes, A., Szolnoky, G., Gavaller, H., Gonczy, A., Kemeny, L., Forster, T., Ramalho, A., Placido, R., Marta, L., Menezes, M., Magalhaes, A., Cortez Dias, N., Martins, S., Almeida, A., Pinto, F., Nunes Diogo, A., Botezatu, C.-D., Enache, R., Popescu, B., Nastase, O., Coman, M., Ghiorghiu, I., Calin, A., Rosca, M., Beladan, C., Ginghina, C., Grapsa, J., Cabrita, I., Durighel, G., O'regan, D., Dawson, D., Nihoyannopoulos, P., Pellicori, P., Kallvikbacka-Bennett, A., Zhang, J., Lukaschuk, E., Joseph, A., Bourantas, C., Loh, H., Bragadeesh, T., Clark, A., Cleland, J., Lomax, S., Putzu, P., Diercx, R., Parsons, S., Dicken, B., Vered, Z., Adirevitz, L., Dragu, R., Blatt, A., Karev, E., Malca, Y., Roytvarf, A., Marek, D., Sovova, E., Berkova, M., Cihalik, C., Taborsky, M., Lindqvist, P., Tossavainen, E., Soderberg, S., Gonzales, M., Gustavsson, S., Henein, M., Sonne, C., Bott-Fluegel, L., Hauck, S., Lesevic, H., Hadamitzky, M., Wolf, P., Kolb, C., Bandera, F., Pellegrino, M., Generati, G., Donghi, V., Alfonzetti, E., Castelvecchio, S., Menicanti, L., Guazzi, M., Buchyte, S., Rinkuniene, D., Jurkevicius, R., Smarz, K., Zaborska, B., Jaxa-Chamiec, T., Maciejewski, P., Budaj, A., Santoro, A., Federico Alvino, F., Giovanni Antonelli, G., Roberta Molle, R., Matteo Bertini, M., Stefano Lunghetti, S., Sergio Mondillo, S., Henri, C., Magne, J., Dulgheru, R., Laaraibi, S., Voilliot, D., Kou, S., Pierard, L., Lancellotti, P., Szulik, M., Stabryla-Deska, J., Kalinowski, M., Sliwinska, A., Szymala, M., Lenarczyk, R., Kalarus, Z., Kukulski, T., Yiangou, K., Azina, C., Yiangou, A., Ioannides, M., Chimonides, S., Baysal, S., Pirat, B., Okyay, K., Bal, U., Muderrisoglu, H., Popovic, D., Ostojic, M., Petrovic, M., Vujisic-Tesic, B., Arandjelovic, A., Petrovic, I., Banovic, M., Popovic, B., Vukcevic, V., Damjanovic, S., Velasco Del Castillo, S., Onaindia Gandarias, J., Arana Achaga, X., Laraudogoitia Zaldumbide, E., Rodriguez Sanchez, I., Cacicedo De Bobadilla, A., Romero Pereiro, A., Aguirre Larracoechea, U., Salinas, T., Subinas, A., Elzbieciak, M., Wita, K., Grabka, M., Chmurawa, J., Doruchowska, A., Turski, M., Filipecki, A., Wybraniec, M., Mizia-Stec, K., Varho, V., Karjalainen, P., Lehtinen, T., Airaksinen, J., Ylitalo, A., Kiviniemi, T., Gargiulo, P., Galderisi, M., D' Amore, C., Lo Iudice, F., Savarese, G., Casaretti, L., Pellegrino, A., Fabiani, I., La Mura, L., Perrone Filardi, P., Kim, J. Y., Chung, W., Yu, J., Choi, Y., Park, C., Youn, H., Lee, M., Nagy, A., Manouras, A., Gunyeli, E., Gustafsson, U., Shahgaldi, K., Winter, R., Johnsson, J., Zagatina, A., Krylova, L., Zhuravskaya, N., Vareldzyan, Y., Tyurina, T., Clitsenko, O., Khalifa, E. A., Ashour, Z., Elnagar, W., Jung, I., Seo, H., Lee, S., Lim, D., Mizariene, V., Verseckaite, R., Janenaite, J., Jonkaitiene, R., Sanchez Espino, A., Bonaque Gonzalez, J., Merchan Ortega, G., Bolivar Herrera, N., Ikuta, I., Macancela Quinones, J., Gomez Recio, M., Silva Fazendas Adame, P. R., Caldeira, D., Stuart, B., Almeida, S., Cruz, I., Ferreira, A., Freire, G., Lopes, L., Cotrim, C., Pereira, H., Mediratta, A., Moss, J., Nayak, H., Al Amri, I., Debonnaire, P., Van Der Kley, F., Schalij, M., Bax, J., Ajmone Marsan, N., Delgado, V., Schmidt, F. P., Gniewosz, T., Jabs, A., Munzel, T., Jansen, T., Kaempfner, D., Hink, U., Von Bardeleben, R., Jose, J., George, O., Joseph, G., Adawi, S., Najjar, R., Ahronson, D., Shiran, A., Van Riel, A., Boerlage - Van Dijk, K., De Bruin - Bon, H., Araki, M., Meregalli, P., Koch, K., Vis, M., Mulder, B., Baan, J., Bouma, B., Marciniak, A., Elton, D., Glover, K., Campbell, I., Sharma, R., Batalha, S., Lourenco, C., Oliveira Da Silva, C., Caballero, L., Garcia-Lara, J., Gonzalez-Carrillo, J., Oliva, M., Saura, D., Garcia-Navarro, M., Espinosa, M., Pinar, E., Valdes, M., De La Morena, G., Barreiro Perez, M., Lopez Perez, M., Roy, D., Brecker, S., Venkateshvaran, A., Dash, P. K., Sola, S., Barooah, B., Govind, S. C., Brodin, L. A., Saura Espin, D., Caballero Jimenez, L., Gonzalez Carrillo, J., Oliva Sandoval, M., Lopez Ruiz, M., Garcia Navarro, M., Espinosa Garcia, M., Valdes Chavarri, M., De La Morena Valenzuela, G., Gatti, G., Dell'angela, L., Pinamonti, B., Benussi, B., Sinagra, G., Pappalardo, A., Hernandez, V., Saavedra, J., Gonzalez, A., Iglesias, P., Civantos, S., Guijarro, G., Monereo, S., Ikeda, M., Toh, N., Oe, H., Tanabe, Y., Watanabe, N., Ito, H., Ciampi, Q., Cortigiani, L., Pratali, L., Rigo, F., Villari, B., Picano, E., Yoon, J., Sohn, J., Kim, Y., Chang, H., Hong, G., Kim, T., Ha, J., Choi, B., Rim, S., Choi, E., Tibazarwa, K., Sliwa, K., Wonkam, A., Mayosi, B., Oryshchyn, N., Ivaniv, Y., Pavlyk, S., Lourenco, M. R., Azevedo, O., Moutinho, J., Nogueira, I., Fernandes, M., Pereira, V., Quelhas, I., Lourenco, A., Sunbul, M., Tigen, K., Karaahmet, T., Dundar, C., Ozben, B., Guler, A., Cincin, A., Bulut, M., Sari, I., Basaran, Y., Baydar, O., Kadriye Kilickesmez, K., Ugur Coskun, U., Polat Canbolat, P., Veysel Oktay, V., Umit Yasar Sinan, U., Okay Abaci, O., Cuneyt Kocas, C., Sinan Uner, S., Serdar Kucukoglu, S., Zaroui, A., Mourali, M., Ben Said, R., Asmi, M., Aloui, H., Kaabachi, N., Mechmeche, R., Saberniak, J., Hasselberg, N., Borgquist, R., Platonov, P., Holst, A., Edvardsen, T., Haugaa, K., Eran, A., Yueksel, D., Er, F., Gassanov, N., Rosenkranz, S., Baldus, S., Guedelhoefer, H., Faust, M., Caglayan, E., Matveeva, N., Nartsissova, G., Chernjavskij, A., Ippolito, R., De Palma, D., Muscariello, R., Santoro, C., Raia, R., Schiano-Lomoriello, V., Gargiulo, F., Lipari, P., Bonapace, S., Zenari, L., Valbusa, F., Rossi, A., Lanzoni, L., Canali, G., Molon, G., Campopiano, E., Barbieri, E., Ikonomidis, I., Varoudi, M., Papadavid, E., Theodoropoulos, K., Papadakis, I., Pavlidis, G., Triantafyllidi, H., Anastasiou - Nana, M., Rigopoulos, D., Lekakis, J., Ozen, G., Durmus, E., Kivrak, T., Atas, H., Direskeneli, H., Stevanovic, A., Dekleva, M., Trajic, S., Paunovic, N., Simic, A., Khan, S., Mushemi-Blake, S., Jouhra, F., Dennes, W., Monaghan, M., Melikian, N., Shah, A., Maceira Gonzalez, A. M., Lopez-Lereu, M., Monmeneu, J., Igual, B., Estornell, J., Boraita, A., Kosmala, W., Rojek, A., Bialy, D., Mysiak, A., Przewlocka-Kosmala, M., Popescu, I., Mancas, S., Mornos, C., Serbescu, I., Ionescu, G., Ionac, A., Gaudron, P., Niemann, M., Herrmann, S., Hu, K., Liu, D., Wojciech, K., Frantz, S., Bijnens, B., Ertl, G., Weidemann, F., Cosin-Sales, J., Ruvira, J., Diago, J., Aguilar, J., Cruz, C., Pinho, T., Madureira, A., Lebreiro, A., Dias, C., Ramos, I., Silva Cardoso, J., Julia Maciel, M., De Meester, P., Van De Bruaene, A., Herijgers, P., Voigt, J.-U., Budts, W., Franzoso, F., Voser, E., Wohlmut, C., Kellenberger, C., Valsangiacomo Buechel, E., Carrero, C., Benger, J., Parcerisa, M., Falconi, M., Oberti, P., Granja, M., Cagide, A., Del Pasqua, A., Secinaro, A., Antonelli, G., Iacomino, M., Toscano, A., Chinali, M., Esposito, C., Carotti, A., Pongiglione, G., Rinelli, G., Youssef Moustafa, A., Al Murayeh, M., Al Masswary, A., Al Sheikh, K., Moselhy, M., Dardir, M., Deising, J., Butz, T., Suermeci, G., Liebeton, J., Wennemann, R., Tzikas, S., Van Bracht, M., Prull, M., Trappe, H.-J., Martin Hidalgo, M., Delgado Ortega, M., Ruiz Ortiz, M., Mesa Rubio, D., Carrasco Avalos, F., Seoane Garcia, T., Pan Alvarez-Ossorio, M., Lopez Aguilera, J., Puentes Chiachio, M., Suarez De Lezo Cruz Conde, J., Petrovic, M. T., Giga, V., Stepanovic, J., Tesic, M., Jovanovic, I., Djordjevic-Dikic, A., Piatkowski, R., Kochanowski, J., Scislo, P., Opolski, G., Vareldzhyan, Y., Bombardini, T., Gherardi, S., Leone, O., Michelotto, E., Ciccarone, A., Tarantino, N., Ostuni, V., Rubino, M., Genco, W., Santoro, G., Carretta, D., Romito, R., Colonna, P., Cameli, M., Lunghetti, S., Lisi, M., Curci, V., Cameli, P., Focardi, M., Favilli, R., Mondillo, S., Hoffmann, R., Barletta, G., Von Bardeleben, S., Kasprzak, J., Greis, C., Vanoverschelde, J., Becher, H., Machida, T., Izumo, M., Suzuki, K., Kaimijima, R., Mizukoshi, K., Manabe-Uematsu, M., Takai, M., Harada, T., Akashi, Y., Martin Garcia, A., Arribas-Jimenez, A., Cruz-Gonzalez, I., Nieto, F., Iscar, A., Merchan, S., Martin-Luengo, C., Brecht, A., Theres, L., Spethmann, S., Dreger, H., Baumann, G., Knebel, F., Jasaityte, R., Heyde, B., Rademakers, F., Claus, P., D'hooge, J., Lervik Nilsen, L. C., Lund, J., Brekke, B., Stoylen, A., Giraldeau, G., Duchateau, N., Gabrielli, L., Penela, D., Evertz, R., Mont, L., Brugada, J., Berruezo, A., Sitges, M., Kordybach, M., Kowalski, M., Hoffman, P., Pilichowska, E., Baran, J., Kulakowski, P., Wahi, S., Vollbon, W., Leano, R., Thomas, A., Bricknell, K., Holland, D., Napier, S., Stanton, T., Teferici, D., Qirko, S., Petrela, E., Dibra, A., Bajraktari, G., Bara, P., Sanchis Ruiz, L., Andrea, R., Falces, C., Perez-Villa, F., Sulemane, S., Panoulas, V., Bratsas, A., Tam, F., Abduch, M., Alencar, A., Coracin, F., Barban, A., Saboya, R., Dulley, F., Mathias, W., Vieira, M., Buccheri, S., Mangiafico, S., Arcidiacono, A., Bottari, V., Leggio, S., Tamburino, C., Monte, I. P., Spitzer, E., Beitzke, D., Kaneider, A., Pavo, N., Gottsauner-Wolf, M., Wolf, F., Loewe, C., Mushtaq, S., Andreini, D., Pontone, G., Bertella, E., Conte, E., Baggiano, A., Annoni, A., Cortinovis, S., Fiorentini, C., Pepi, M., Gustafsson, M., Alehagen, U., Dahlstrom, U., Johansson, P., Faden, G., Faggiano, P., Albertini, L., Reverberi, C., Gaibazzi, N., Taylor, R. J., Moody, W., Umar, F., Edwards, N., Townend, J., Steeds, R., Leyva, F., Mihaila, S., Piasentini, E., Peluso, D., Casablanca, S., Naso, P., Puma, L., Iliceto, S., Vinereanu, D., Ciciarello, F. L., Agati, L., Cimino, S., De Luca, L., Petronilli, V., Fedele, F., and Tsverava, M.

Published
2013
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29. Combinations of QTc-prolonging drugs: towards disentangling pharmacokinetic and pharmacodynamic effects in their potentially additive nature

Author

Meid, A, Bighelli, I, Mächler, S, Mikus, G, Carrà, G, Castellazzi, M, Lucii, C, Martinotti, G, Nosè, M, Ostuzzi, G, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Cinosi, E, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D’Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gastaldon, C, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Paladini, C, Papola, D, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santi, M, Santoro, R, Sepede, G, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, Zanobini, V, Barbui, C, Haefeli, W, A. D. Meid, I. Bighelli, S. Mächler, G. Mikus, G. Carrà, M. Castellazzi, C. Lucii, G. Martinotti, M. Nosè, G. Ostuzzi, T. Acciavatti, A. Adamo, A. Aguglia, C. Albanese, S. Baccaglini, F. Bardicchia, R. Barone, Y. Barone, F. Bartoli, C. Bergamini, F. Bertolini, S. Bolognesi, A. Bordone, P. Bortolaso, M. Bugliani, C. Calandra, S. Calò, G. Cardamone, M. Caroleo, E. Carra, D. Carretta, L. Chiocchi, E. Cinosi, M. Clerici, M. Corbo, E. Corsi, R. Costanzo, G. Costoloni, F. D’Arienzo, S. Debolini, A. De Capua, W. A. Di Napoli, M. Dinelli, E. Facchi, F. Fargnoli, F. Fiori, A. Franchi, F. Gardellin, C. Gastaldon, E. Gazzoletti, L. Ghio, M. Giacomin, M. Gregis, N. Iovieno, D. Koukouna, A. Lax, C. Lintas, A. Luca, M. Luca, M. Lussetti, M. Madrucci, N. Magnani, L. Magni, E. Manca, C. Martorelli, R. Mattafirri, C. Paladini, D. Papola, M. Percudani, G. Perini, P. Petrosemolo, M. Pezzullo, S. Piantanida, F. Pinna, K. Prato, D. Prestia, D. Quattrone, C. Reggianini, F. Restaino, M. Ribolsi, G. Rinosi, C. Rizzo, R. Rizzo, M. Roggi, G. Rossi, S. Rossi, S. Ruberto, M. Santi, R. Santoro, G. Sepede, M. S. Signorelli, F. Soscia, P. Staffa, M. Stilo, S. Strizzolo, F. Suraniti, N. Tavian, L. Tortelli, F. Tosoni, M. Valdagno, V. Zanobini, C. Barbui, W. E. Haefeli, Meid, A, Bighelli, I, Mächler, S, Mikus, G, Carrà, G, Castellazzi, M, Lucii, C, Martinotti, G, Nosè, M, Ostuzzi, G, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Cinosi, E, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D’Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gastaldon, C, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Paladini, C, Papola, D, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santi, M, Santoro, R, Sepede, G, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, Zanobini, V, Barbui, C, Haefeli, W, A. D. Meid, I. Bighelli, S. Mächler, G. Mikus, G. Carrà, M. Castellazzi, C. Lucii, G. Martinotti, M. Nosè, G. Ostuzzi, T. Acciavatti, A. Adamo, A. Aguglia, C. Albanese, S. Baccaglini, F. Bardicchia, R. Barone, Y. Barone, F. Bartoli, C. Bergamini, F. Bertolini, S. Bolognesi, A. Bordone, P. Bortolaso, M. Bugliani, C. Calandra, S. Calò, G. Cardamone, M. Caroleo, E. Carra, D. Carretta, L. Chiocchi, E. Cinosi, M. Clerici, M. Corbo, E. Corsi, R. Costanzo, G. Costoloni, F. D’Arienzo, S. Debolini, A. De Capua, W. A. Di Napoli, M. Dinelli, E. Facchi, F. Fargnoli, F. Fiori, A. Franchi, F. Gardellin, C. Gastaldon, E. Gazzoletti, L. Ghio, M. Giacomin, M. Gregis, N. Iovieno, D. Koukouna, A. Lax, C. Lintas, A. Luca, M. Luca, M. Lussetti, M. Madrucci, N. Magnani, L. Magni, E. Manca, C. Martorelli, R. Mattafirri, C. Paladini, D. Papola, M. Percudani, G. Perini, P. Petrosemolo, M. Pezzullo, S. Piantanida, F. Pinna, K. Prato, D. Prestia, D. Quattrone, C. Reggianini, F. Restaino, M. Ribolsi, G. Rinosi, C. Rizzo, R. Rizzo, M. Roggi, G. Rossi, S. Rossi, S. Ruberto, M. Santi, R. Santoro, G. Sepede, M. S. Signorelli, F. Soscia, P. Staffa, M. Stilo, S. Strizzolo, F. Suraniti, N. Tavian, L. Tortelli, F. Tosoni, M. Valdagno, V. Zanobini, C. Barbui, and W. E. Haefeli

Abstract

Background: Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug–drug interactions. Methods: In a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses. Results: Drugs attributing a ‘known’ risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two versus one QTc-prolonging drug yielded nonsignificant prolongations [exposure-weighted parameter estimates with 95% confidence intervals for ‘known’ risk drugs + 0.93 ms (–8.88;10.75)]. Estimates for the ‘conditional’ risk class increased upon refinement with relative drug exposure and co-administration of a ‘known’ risk drug as a further risk factor. Conclusions: These observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure.

Published
2017

30. First-generation antipsychotics and QTc: any role for mediating variables?

Author

Carrà, G., Crocamo, Cristina, Bartoli, F., Lax, A., Tremolada, Martina, Lucii, C., Martinotti, G., Nosè, M., Bighelli, I., Ostuzzi, G., Castellazzi, M., Clerici, M., Barbui, C., Acciavatti, T., Adamo, A., Aguglia, A., Albanese, C., Baccaglini, S., Bardicchia, F., Barone, R., Barone, Y., Bergamini, C., Bertolini, F., Bolognesi, S., Bordone, A., Bortolaso, P., Bugliani, M., Calandra, C., Calò, S., Cardamone, G., Caroleo, M., Carra, E., Carretta, D., Chiocchi, L., Cinosi, E., Corbo, M., Corsi, E., Costanzo, R., Costoloni, G., D’Arienzo, F., Debolini, S., De Capua, A., Di Napoli, W. A., Dinelli, M., Facchi, E., Fargnoli, F., Fiori, F., Franchi, A., Gardellin, F., Gastaldon, C., Gazzoletti, E., Ghio, L., Giacomin, M., Gregis, M., Iovieno, N., Koukouna, D., Lintas, C., Luca, A., Luca, M., Lussetti, M., Madrucci, M., Magnani, N., Magni, L., Manca, E., Martorelli, C., Mattafirri, R., Paladini, C., Papola, D., Percudani, M., Perini, G., Petrosemolo, P., Pezzullo, M., Piantanida, S., Pinna, F., Prato, K., Prestia, D., Quattrone, D., Reggianini, C., Restaino, F., Ribolsi, M., Rinosi, G., Rizzo, C., Rizzo, R., Roggi, M., Rossi, G., Rossi, S., Ruberto, S., Santi, M., Santoro, R., Sepede, G., Signorelli, M. S., Soscia, F., Sozzi, F., Staffa, P., Stilo, M., Strizzolo, S., Suraniti, F., Tavian, N., Tortelli, L., Tosoni, F., Valdagno, M., Zanobini, V., Carra', G, Crocamo, C, Bartoli, F, Lax, A, Tremolada, M, Lucii, C, Martinotti, G, Nosè, M, Bighelli, I, Ostuzzi, G, Castellazzi, M, Clerici, M, and Barbui, C

Subjects
Adult, Male, QT prolongation, alcohol, antipsychotic agents, drug therapy combination, risk factors, Antipsychotic Agents, Cross-Sectional Studies, Electrocardiography, Female, Heart Rate, Humans, Italy, Long QT Syndrome, Mental Disorders, Middle Aged, Pharmacology (medical), Settore MED/25 - Psichiatria, Neurology, Neurology (clinical), Psychiatry and Mental Health, antipsychotic agent, risk factor
Abstract

Objective: Corrected QT (QTc) interval prolongation is often associated with use of first-generation antipsychotics (FGAs). However, other factors require appropriate consideration, including age and gender, the role of other known medications associated with QTc prolongation, and severe comorbid conditions, such as co-occurring alcohol abuse/dependence. We aimed to study potential mediating roles of different, related, candidate variables on QTc. Methods: We capitalized on data from a large (N = 2366), cross-sectional, national survey, the STAR Network QTc study, using a representative sample of people taking FGAs, and recruited from mental health services across Italy. Results: About one-third of the sample was treated with FGAs, and almost one-tenth of the subjects took a different, additional, drug known to cause QTc prolongation. Our findings confirmed that there is an impact from FGAs, age, gender, alcohol misuse, and concurrent risky drugs on QTc. However, comorbid alcohol abuse/dependence and concurrent risky drugs did not mediate the effect of FGAs on QTc. Conclusions: Our findings showed that FGAs, concurrent risky drugs, and alcohol use disorders prolonged QTc. FGAs had a direct effect on QTc, confirming the need for clinicians to monitor a risk that could lead to sudden unexplained death. Copyright © 2016 John Wiley & Sons, Ltd.

Published
2016

31. Haematological and blood biochemical changes induced by the administration of low doses of Escherichia coli lipopolysaccharide in rabbits

Author

Peñailillo, AK, Sepulveda, MA, Palma, CJ, Espinoza, A, Aguilera, M, Burgos, RA, Carretta, D, Islas, A, and Pérez, R

Subjects
conejos, rabbits, bioquímica sanguínea, hematología, blood biochemistry, lipopolysaccharide, haematology, lipopolisacárido
Abstract

The aim was to investigate the haematological and blood biochemistry changes of adult rabbits after two intravenous administrations of low-doses of E. coli lipopolysacharide (LPS). Six clinically healthy rabbits were distributed through a cross over design to experimental groups: Group 1 (LPS) treated with two intravenous doses of 1 μg/kg bw of E. coli LPS at 6 h intervals. Group 2 (Control) treated with an equivalent volume of saline solution (SS) at similar intervals. Rectal temperature (T°R), serum concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), haemogram, and the activity of enzymes aspartate aminotransferase (AST) and gamma glutamil transferase (GGT) were measured before and after LPS or SS administration. The administration of LPS in rabbits induced significant increases in IL-6 and CRP concentrations. Leukopenia associated to significant decreases of monocytes, lymphocytes and platelet count, with no significant changes in neutrophil count, were observed at 4 and 8 h after LPS administration. There were significant increases in total leukocytes and neutrophils count at 12 and 24 h. No significant changes (P > 0.05) were observed in mean values of PCV, total proteins, albumin and in the activity of enzymes AST and GGT. The administration of low doses of E. coli LPS induces a fast increase in body temperature, haematological and biochemical shifts, which are milder and have a lower intensity and shorter than previous reports in rabbits treated with high doses of LPS. These changes seem to be consistent with an initial inflammatory response induced by a gram-negative infection. El objetivo fue investigar los cambios hematológicos y en la bioquímica sanguínea inducidos por la administración de dosis bajas de lipopolisacárido de Escherichia coli (LPS) en conejos. Seis conejos clínicamente sanos fueron distribuidos en dos grupos experimentales mediante un diseño cruzado: Grupo 1 (LPS) tratado con dos dosis intravenosas de 1 μg/kg de LPS. Grupo 2 (Control) fue tratado con un volumen equivalente de solución salina (SS). Previo y posterior a la administración de LPS se midió temperatura rectal (°C), se determinaron las concentraciones de interleukina 6 (IL-6), proteína C reactiva (PCR), además se realizó hemograma y se midió la actividad de las enzimas aspartato aminotransferasa (AST) y gamma glutamil transferasa (GGT). La administración de LPS produjo aumentos significativos en la temperatura rectal, IL-6 y PCR. A las 4 y 8 h posteriores a la inyección de LPS se observó leucopenia asociada a disminución en el recuento de monocitos, linfocitos y plaquetas, mientras que a las 12 y 24 h el recuento de leucocitos y neutrófilos aumentó significativamente. No se observaron cambios en los promedios de VGA, concentración de proteínas totales y albúmina o en la actividad de las enzimas AST y GGT. Se concluye que las modificaciones hematológicas y de bioquímica sanguínea inducidas por la administración de dosis bajas de LPS son de moderada intensidad y corta duración en comparación a las descritas en conejos tratados con dosis altas de LPS. Estos cambios son consistentes con un estado de respuesta inflamatoria inicial inducida por una infección por Gram negativos.

Published
2016

34. Antipsychotic dose mediates the association between polypharmacy and corrected QT interval

Author

Barbui, C, Bighelli, I, Carrà, G, Castellazzi, M, Lucii, C, Martinotti, G, Nosè, M, Ostuzzi, G, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Cinosi, E, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gastaldon, C, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Paladini, C, Papola, D, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santi, M, Santoro, R, Sepede, G, Signorelli, M, Soscia, F, Sozzi, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, Zanobini, V, Barbui, C, Bighelli, I, Carrà, G, Castellazzi, M, Lucii, C, Martinotti, G, Nosè, M, Ostuzzi, G, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Cinosi, E, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gastaldon, C, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Paladini, C, Papola, D, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santi, M, Santoro, R, Sepede, G, Signorelli, M, Soscia, F, Sozzi, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, and Zanobini, V

Abstract

Antipsychotic (AP) drugs have the potential to cause prolongation of the QT interval corrected for heart rate (QTc). As this risk is dose-dependent, it may be associated with the number of AP drugs concurrently prescribed, which is known to be associated with increased cumulative equivalent AP dosage. This study analysed whether AP dose mediates the relationship between polypharmacy and QTc interval. We used data from a crosssectional survey that investigated the prevalence of QTc lengthening among people with psychiatric illnesses in Italy. AP polypharmacy was tested for evidence of association with AP dose and QTc interval using the Baron and Kenny mediational model. A total of 725 patients were included in this analysis. Of these, 186 (26%) were treated with two or more AP drugs (AP polypharmacy). The mean cumulative AP dose was significantly higher in those receiving AP polypharmacy (prescribed daily dose/defined daily dose = 2.93, standard deviation 1.31) than monotherapy (prescribed daily dose/defined daily dose = 0.82, standard deviation 0.77) (z = -12.62, p < 0.001). Similarly, the mean QTc interval was significantly longer in those receiving AP polypharmacy (mean = 420.86 milliseconds, standard deviation 27.16) than monotherapy (mean = 413.42 milliseconds, standard deviation 31.54) (z = -2.70, p = 0.006). The Baron and Kenny mediational analysis showed that, after adjustment for confounding variables, AP dose mediates the association between polypharmacy and QTc interval. The present study found that AP polypharmacy is associated with QTc interval, and this effect is mediated by AP dose. Given the high prevalence of AP polypharmacy in real-world clinical practice, clinicians should consider not only the myriad risk factors for QTc prolongation in their patients, but also that adding a second AP drug may further increase risk as compared with monotherapy.

Published
2016

35. Building ties in the community for patients with mental illness

Author

Fiorillo,A, Volpe,U, Bhugra, D, Carretta, D, Carra', G, Clerici, M, Heun, R, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CARRA', GIUSEPPE, CLERICI, MASSIMO, Heun, R., Fiorillo,A, Volpe,U, Bhugra, D, Carretta, D, Carra', G, Clerici, M, Heun, R, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CARRA', GIUSEPPE, CLERICI, MASSIMO, and Heun, R.

Published
2016

36. Prevalence and correlates of QTc prolongation in Italian psychiatric care: Cross-sectional multicentre study

Author

Nosè, M, Bighelli, I, Castellazzi, M, Martinotti, G, Carra', G, Lucii, C, Ostuzzi, G, Sozzi, F, Barbui, C, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santoro, R, Santi, M, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, Zanobini, V, CARRA', GIUSEPPE, Barbui, C., Di Napoli, WA, Signorelli, MS, Nosè, M, Bighelli, I, Castellazzi, M, Martinotti, G, Carra', G, Lucii, C, Ostuzzi, G, Sozzi, F, Barbui, C, Acciavatti, T, Adamo, A, Aguglia, A, Albanese, C, Baccaglini, S, Bardicchia, F, Barone, R, Barone, Y, Bartoli, F, Bergamini, C, Bertolini, F, Bolognesi, S, Bordone, A, Bortolaso, P, Bugliani, M, Calandra, C, Calò, S, Cardamone, G, Caroleo, M, Carra, E, Carretta, D, Chiocchi, L, Clerici, M, Corbo, M, Corsi, E, Costanzo, R, Costoloni, G, D'Arienzo, F, Debolini, S, De Capua, A, Di Napoli, W, Dinelli, M, Facchi, E, Fargnoli, F, Fiori, F, Franchi, A, Gardellin, F, Gazzoletti, E, Ghio, L, Giacomin, M, Gregis, M, Iovieno, N, Koukouna, D, Lax, A, Lintas, C, Luca, A, Luca, M, Lussetti, M, Madrucci, M, Magnani, N, Magni, L, Manca, E, Martorelli, C, Mattafirri, R, Percudani, M, Perini, G, Petrosemolo, P, Pezzullo, M, Piantanida, S, Pinna, F, Prato, K, Prestia, D, Quattrone, D, Reggianini, C, Restaino, F, Ribolsi, M, Rinosi, G, Rizzo, C, Rizzo, R, Roggi, M, Rossi, G, Rossi, S, Ruberto, S, Santoro, R, Santi, M, Signorelli, M, Soscia, F, Staffa, P, Stilo, M, Strizzolo, S, Suraniti, F, Tavian, N, Tortelli, L, Tosoni, F, Valdagno, M, Zanobini, V, CARRA', GIUSEPPE, Barbui, C., Di Napoli, WA, and Signorelli, MS

Abstract

Aims. In recent years several warnings have been issued by regulatory authorities on the risk of electrocardiogram abnormalities in individuals exposed to psychotropic drugs. As a consequence of these warnings, monitoring of the QT interval corrected for heart rate (QTc) has become increasingly common. This study was conducted to measure the frequency of QTc prolongation in unselected psychiatric patients, and to document the associated factors using a cross-sectional approach. Method. The study was carried out in 35 Italian psychiatric services that are part of the STAR (Servizi Territoriali Associati per la Ricerca) Network, a research group established to produce scientific knowledge by collecting data under ordinary circumstances. During a three-month period, a consecutive unselected series of both in- and out-patients were enrolled if they performed an ECG during the recruitment period and were receiving psychotropic drugs on the day ECG was recorded. Results. During the recruitment period a total of 2411 patients were included in the study. The prevalence of QTc prolongation ranged from 14.7% (men) and 18.6% (women) for the cut-off of 450 ms, to 1.26% (men) and 1.01% (women) for the cut-off of 500 ms. In the multivariate model conducted in the whole sample of patients exposed to psychotropic drugs, female sex, age, heart rate, alcohol and/or substance abuse, cardiovascular diseases and cardiovascular drug treatment, and drug overdose were significantly associated with QTc prolongation. In patients exposed to antipsychotic drugs, polypharmacy was positively associated with QTc prolongation, whereas use of aripiprazole decreased the risk. In patients exposed to antidepressant drugs, use of citalopram, citalopram dose and use of haloperidol in addition to antidepressant drugs, were all positively associated with QTc prolongation. Conclusions. The confirmation of a link between antipsychotic polypharmacy and QTc prolongation supports the current guidelines that re

Published
2016

37. Impact of a Mobile E-Health Intervention on Binge Drinking in Young People: The Digital-Alcohol Risk Alertness Notifying Network for Adolescents and Young Adults Project

Author

Carra', G, Crocamo, C, Bartoli, F, Carretta, D, Schivalocchi, A, Bebbington, P, Clerici, M, CARRA', GIUSEPPE, CROCAMO, CRISTINA, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, SCHIVALOCCHI, ALESSANDRO, CLERICI, MASSIMO, Carra', G, Crocamo, C, Bartoli, F, Carretta, D, Schivalocchi, A, Bebbington, P, Clerici, M, CARRA', GIUSEPPE, CROCAMO, CRISTINA, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, SCHIVALOCCHI, ALESSANDRO, and CLERICI, MASSIMO

Abstract

Purpose: Binge drinking (BD) is common among young people. E-Health apps are attractive to them and may be useful for enhancing awareness. We aimed to investigate the impact of a publicly available evidence-based e-Health app (Digital-Alcohol Risk Alertness Notifying Network for Adolescents and Young Adults [D-ARIANNA]), estimating current risk of BD by questions, matching identified risk factors, and providing in percent an overall risk score, accompanied by appropriate images showing mostly contributing factors in summary graphics. Methods: A natural, quasi-experimental, pre-/post-test study was conducted. Subjects were recruited in pubs, clubs, discos, or live music events. They were requested to self-administer D-ARIANNA and were re-evaluated after two further weeks. Results: Young (18-24 years) people (N = 590) reported reduced BD at follow-up (18% vs. 37% at baseline). To exclude systematic errors involving those lost at follow-up (14%), the diminution in BD was confirmed in an appropriate generalized estimating equation model with unweighted data on a last observation carried forward basis. Conclusions: Our study provides evidence of population-level benefit at 2 weeks, attained with D-ARIANNA. This can be disseminated easily and economically among young people. However, additional components, including regular feedback and repeated administration by gamification, may be required to make this app suitable for longer term impact.

Published
2016

38. Association between depression and neuropathy in people with type 2 diabetes: a meta-analysis

Author

Bartoli, F, Carra', G, Crocamo, C, Carretta, D, La Tegola, D, Tabacchi, T, Gamba, P, Clerici, M, Carretta, DCLA, Tabacchi, TI, Clerici, M., Bartoli, F, Carra', G, Crocamo, C, Carretta, D, La Tegola, D, Tabacchi, T, Gamba, P, Clerici, M, Carretta, DCLA, Tabacchi, TI, and Clerici, M.

Abstract

Objective: Depression and neuropathy are frequent complications of type 2 diabetes. The current meta-analysis aimed to estimate the association between depression and neuropathy in subjects with type 2 diabetes. Methods: We systematically searched electronic databases for articles published up to February 2015, providing data on the association between depression and neuropathy in individuals with type 2 diabetes. No language restrictions were applied. The meta-analysis generated random-effect odds ratios with 95% confidence intervals (95% CI). Risk of publication bias and heterogeneity were estimated using the Egger test and I2 index, respectively. Leave-one-out analysis was performed. Data were analysed using stata. Results: Thirteen studies were included in the meta-analysis. Data on the association between depression and neuropathy were available for 3898 individuals with type 2 diabetes. Pooled analysis showed an association between depression and neuropathy, with an odds ratio of 2.01 (95% CI: 1.60–2.54; p < 0.001). There was no risk of publication bias (p = 0.064), and heterogeneity was moderate (I2 = 44.5%). Leave-one-out analysis confirmed consistency of the findings. The association appeared partly influenced by age, because studies selecting older people (sample mean age > 65 years) showed a slightly higher estimate for the association. Conclusions: We found an association between depression and neuropathy among people with type 2 diabetes. Because of the cross-sectional nature of included studies, the relationship between these two conditions might be bidirectional. Further research exploring factors that might moderate or mediate this association is needed. Targeted interventions for comorbid depression and neuropathy should be implemented in clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

Published
2016

40. E-health app to reduce binge drinking among adolescents and young adults: the D-ARIANNA Project

Author

Schivalocchi, A, Carretta, D, Bartoli, F, Crocamo, C, Carra', G, SCHIVALOCCHI, ALESSANDRO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BARTOLI, FRANCESCO, CROCAMO, CRISTINA, CARRA', GIUSEPPE, Schivalocchi, A, Carretta, D, Bartoli, F, Crocamo, C, Carra', G, SCHIVALOCCHI, ALESSANDRO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BARTOLI, FRANCESCO, CROCAMO, CRISTINA, and CARRA', GIUSEPPE

Published
2015

41. Psychotic Disorders and Substance Use Disorders

Author

el-Guebaly, N, Carrà, G, Galanter, M, Carretta, D, Clerici, M, Bartoli, F, Carra', G, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, BARTOLI, FRANCESCO, CARRA', GIUSEPPE, el-Guebaly, N, Carrà, G, Galanter, M, Carretta, D, Clerici, M, Bartoli, F, Carra', G, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, BARTOLI, FRANCESCO, and CARRA', GIUSEPPE

Abstract

The comorbidity of psychotic and substance use disorders (SUDs) is a major issue in mental health because of its high frequency and poor prognosis. Moreover, it is often neglected both for the difficulty to assess SUDs in psychotic patients and for scarce attitude to evaluate and treat substance misuse by psychiatric service staff. On the other hand, psychotic patients with SUDs can receive inadequate treatment for psychosis by SUD services for similar reasons. Assessing and treating this comorbidity require the knowledge and the integration of specific tools and interventions that should be tailored toward patients’ clinical condition and that can be difficult to manage in daily clinical practice.

Published
2015

42. Comorbid Anxiety and Alcohol or Substance Use Disorders: An Overview

Author

el-Guebaly N, Carrà G, Galanter M., Bartoli, F, Carretta, D, Clerici, M, Carra', G, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, CARRA', GIUSEPPE, el-Guebaly N, Carrà G, Galanter M., Bartoli, F, Carretta, D, Clerici, M, Carra', G, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, and CARRA', GIUSEPPE

Abstract

The comorbidity between anxiety and alcohol or substance use disorders represents a common and serious clinical challenge, characterized by a high worldwide prevalence. The co-occurrence of these disorders complicates treatment, management, and prognosis of both disorders, but it remains often unrecognized and untreated. Mental health professionals should accurately assess and evaluate the comorbidity, although related etiological links and temporal relationships are still unclear and, probably, heterogeneous and multifactorial. Alcohol and substances may be misused by individuals to self-medicate their anxiety, avoidant, and phobic symptoms, but also anxiety disorders may be consequences of alcohol and/or substance misuse. Integrated treatment appears the most promising approach, but there is paucity of evidence on pharmacological and non-pharmacological treatments addressed to both anxiety and substance use disorders. This chapter provides a comprehensive overview of main epidemiological and clinical issues, etiological/temporal links hypotheses, and treatment options for the comorbidity between anxiety and addictive behaviors.

Published
2015

43. Risk Estimation Modeling and Feasibility Testing for a Mobile eHealth Intervention for Binge Drinking among Young People: The D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults) Project

Author

Carra', G, Crocamo, C, Schivalocchi, A, Bartoli, F, Carretta, D, Brambilla, G, Clerici, M, CARRA', GIUSEPPE, CROCAMO, CRISTINA, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BRAMBILLA, GIULIA, CLERICI, MASSIMO, Carra', G, Crocamo, C, Schivalocchi, A, Bartoli, F, Carretta, D, Brambilla, G, Clerici, M, CARRA', GIUSEPPE, CROCAMO, CRISTINA, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BRAMBILLA, GIULIA, and CLERICI, MASSIMO

Abstract

Binge drinking is common among young people but often relevant risk factors are not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into an eHealth app-D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults)-for young people. Methods: A longitudinal approach with phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios were subsequently pooled through meta-analytic techniques with a random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire and assessed for wording, content, and acceptability in focus groups involving 110 adolescents and young adults. Results: Ten risk factors (5 modifiable) and 2 protective factors showed significant associations with binge drinking and were included in the model. Their weighted coefficients ranged between-0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app as helpful to assess binge drinking risk. Conclusions: We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

Published
2015

45. Prevalence and Correlates of Binge Drinking among Young Adults Using Alcohol: A Cross-Sectional Survey

Author

Bartoli, F, Carretta, D, Crocamo, C, Schivalocchi, A, Brambilla, G, Clerici, M, Carrà, G, Bartoli, F, Carretta, D, Crocamo, C, Schivalocchi, A, Brambilla, G, Clerici, M, and Carrà, G

Abstract

Background. Although binge drinking prevalence and correlates among young people have been extensively studied in the USA and Northern Europe, less is known for Southern Europe countries with relatively healthier drinking cultures. Objective. We aimed at analyzing prevalence and correlates of binge drinking in a representative sample of young adults in Italy. Methods. We conducted a cross-sectional survey among alcohol-consuming young adults. We carried out univariate and multivariate analyses to assess associations between recent binge drinking and candidate variables. Results. We selected 654 subjects, with 590 (mean age: 20.65 ± 1.90) meeting inclusion criteria. Prevalence for recent binge drinking was 38.0%, significantly higher for females than males. Multivariate analysis showed that high alcohol expectancies, large amount of money available during the weekend, interest for parties and discos, female gender, cannabis use, influence by peers, and electronic cigarettes smoking all were significantly associated with recent binge drinking, whereas living with parents appeared a significant protective factor. Conclusions. More than a third of young adults using alcohol are binge drinkers, and, in contrast with findings from Anglo-Saxon countries, females show higher risk as compared with males. These data suggest the increasing importance of primary and secondary prevention programmes for binge drinking. © 2014 Francesco Bartoli et al.

Published
2014

46. Cardiovascular risk factors among people with severe mental illness in Italy: A cross sectional comparative study

Author

Clerici, M, Bartoli, F, Carretta, D, Crocamo, C, Bebbington, P, Carra', G, CLERICI, MASSIMO, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CROCAMO, CRISTINA, CARRA', GIUSEPPE, Clerici, M, Bartoli, F, Carretta, D, Crocamo, C, Bebbington, P, Carra', G, CLERICI, MASSIMO, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CROCAMO, CRISTINA, and CARRA', GIUSEPPE

Abstract

OBJECTIVE: This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people with severe mental illness (SMI), estimating its weight on related risks in Southern Europe, an area with distinct dietary traditions. People with SMI may be more likely than general population to have high prevalence of risk factors for CVDs, due to several reasons, including poor health behaviours and psychopharmacological medications. METHOD: A cross-sectional study has been conducted, comparing inpatients with and without SMI. Univariate and multivariate analyses and logistic regression models have been carried out, exploring the effect of SMI on the prevalence of CVD risk factors. RESULTS: Although obesity and hypertriglyceridemia were more prevalent among people with SMI, controlling for relevant confounders in multivariate analyses we could not detect any significant difference. CONCLUSIONS: People with SMI may not necessarily have higher CVD risk, as compared with general population. Mediterranean healthy dietary habits, universal health coverage, families providing strong support, all are possible explanations for our findings. Further research is needed, exploring different mechanisms, with more detailed biological and genetics measures.

Published
2014

47. The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis

Author

Carra', G, Bartoli, F, Carretta, D, Crocamo, C, Bozzetti, A, Clerici, M, Bebbington, P, CARRA', GIUSEPPE, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BOZZETTI, ALBERTO, CLERICI, MASSIMO, CROCAMO, CRISTINA, Bebbington, P., Carra', G, Bartoli, F, Carretta, D, Crocamo, C, Bozzetti, A, Clerici, M, Bebbington, P, CARRA', GIUSEPPE, BARTOLI, FRANCESCO, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, BOZZETTI, ALBERTO, CLERICI, MASSIMO, CROCAMO, CRISTINA, and Bebbington, P.

Abstract

BACKGROUND: People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). Proposed explanations remain conjectural. Relatively little is known about Mets in SMI in Southern Europe, an area with generally healthy dietary traditions. PURPOSE: To establish prevalence rates of MetS in an Italian sample, and testing hypotheses about putative reasons for the excess in the SMI group. METHODS: We compared the prevalence and correlates of MetS in inpatients with SMI and controls randomly chosen from patients undergoing routine maxillofacial surgery. We employed formal tests of mediation. RESULTS: The MetS prevalence rate was 26.1 % in the SMI group and 15.9 % in the comparison group. After controlling for age, people with SMI were three times more likely to have MetS than their non-SMI counterparts. Smoking and a family history of cardiovascular disease were strongly related to MetS in both groups. However, these factors could not explain the excess of MetS in the SMI group, and we found no effect of antipsychotic dose. CONCLUSIONS: SMI remained prominent in increasing the likelihood of MetS in this low prevalence population, and putative determinants of MetS were common to people with SMI and to controls. Explanations for high MetS rates in SMI may lie in health behaviours other than smoking.

Published
2014

48. Association between depression and non-fatal overdoses among drug users: A systematic review and meta-analysis

Author

Bartoli, F, Carra', G, Brambilla, G, Carretta, D, Crocamo, C, Neufeind, J, Baldacchino, A, Humphris, G, Clerici, M, BARTOLI, FRANCESCO, CARRA', GIUSEPPE, BRAMBILLA, GIULIA, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, CROCAMO, CRISTINA, Bartoli, F, Carra', G, Brambilla, G, Carretta, D, Crocamo, C, Neufeind, J, Baldacchino, A, Humphris, G, Clerici, M, BARTOLI, FRANCESCO, CARRA', GIUSEPPE, BRAMBILLA, GIULIA, CARRETTA, DANIELE CLAUDIO LUIGI AMBROGIO, CLERICI, MASSIMO, and CROCAMO, CRISTINA

Abstract

BACKGROUND: Assessing factors associated with non-fatal overdose is important as these could be useful to identify individuals with substance use disorders at high risk of adverse outcomes and consequences. Depression may play an important role in terms of overdose risk. We aimed to test if drug users suffering from a depressive disorder might have significantly higher risk of non-fatal overdose as compared with drug users without depression. METHODS: We conducted a systematic review and meta-analysis. PubMed, Embase and Web of Knowledge were searched. The pooled analyses were based on prevalence rates, risk difference (RD) and odds ratio (OR), reporting 95% confidence intervals (CIs). The combined estimates were obtained weighting each study according to random effects model for meta-analysis. RESULTS: Seven articles, involving 12,019 individuals, and run in the US, Canada, Sweden, Norway, and Australia, were included. Pooled analyses comparing depressed with not depressed individuals highlighted a RD (95% CIs) for non-fatal overdose of 7.3% (4.8-9.7%) and an OR (95% CIs) of 1.45 (1.17-1.79). The subgroups analyses based on specific characteristics of included studies confirmed the association between depression and overdose. CONCLUSIONS: Depressive disorders seem to be important factors associated to the risk of non-fatal overdose. Longitudinal studies might appropriately clarify causal inference issues. Future research should address the role of depressive disorders as predictors of subsequent non-fatal overdoses

Published
2014

49. N/ OFQ system in brain areas of nerve-injured mice: its role in different aspects of neuropathic pain.

Author

Palmisano, M., Mercatelli, D., Caputi, F. F., Carretta, D., Romualdi, P., and Candeletti, S.

Subjects
ANXIETY, NEUROLOGICAL disorders, EMOTIONS, SOMATOSENSORY cortex, NEURAL circuitry
Abstract

Several studies showed that chronic pain causes reorganization and functional alterations of supraspinal brain regions. The nociceptin- NOP receptor system is one of the major systems involved in pain control and much evidence also suggested its implication in stress, anxiety and depression. Therefore, we investigated the nociceptin- NOP system alterations in selected brain regions in a neuropathic pain murine model. Fourteen days after the common sciatic nerve ligature, polymerase chain reaction ( PCR) analysis indicated a significant decrease of pronociceptin and NOP receptor mRNA levels in the thalamus; these alterations could contribute to the decrease of the thalamic inhibitory function reported in neuropathic pain condition. Nociceptin peptide and NOP mRNA increased in the anterior cingulate cortex ( ACC) and not in the somatosensory cortex, suggesting a peculiar involvement of this system in pain regulating circuitry. Similarly to the ACC, an increase of nociceptin peptide levels was observed in the amygdala. Finally, the pronociceptin and NOP mRNAs decrease observed in the hypothalamus reflects the lack of hypothalamus-pituitary-adrenal axis activation, already reported in neuropathic pain models. Our data indicate that neuropathic pain conditions affect the supraspinal nociceptin- NOP system which is also altered in regions known to play a role in emotional aspects of pain. [ABSTRACT FROM AUTHOR]

Published
2017
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