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1. Using Patient Profiles To Guide The Choice Of Antihistamines In The Primary Care Setting In Malaysia: Expert Consensus And Recommendations

Author

Baharudin A, Abdul Latiff AH, Woo K, Yap FBB, Tang IP, Leong KF, Chin WS, and Wang DY

Subjects
antihistamines, primary care, patient profiling, malaysia, Therapeutics. Pharmacology, RM1-950
Abstract

Abdullah Baharudin,1 Amir Hamzah Abdul Latiff,2 Kent Woo,3 Felix Boon-Bin Yap,4 Ing Ping Tang,5 Kin Fon Leong,6 Wai Seong Chin,7 De Yun Wang8 1Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 3Allergy and Immunology Clinic, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 4Department of Dermatology, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia; 5Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kuching, Sarawak, Malaysia; 6Department of Dermatology, Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 7Pediatric Clinic, Dr Chin’s Child Specialist Clinic, Kuala Lumpur, Malaysia; 8Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeCorrespondence: Abdullah BaharudinDepartment of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, MalaysiaEmail baharudin@usm.myAbstract: H1-antihistamines are recognized to be effective for conditions such as allergic rhinitis and chronic spontaneous urticaria. However, management of such conditions in the real-world primary care setting may be challenging due to diverse patient-specific considerations, the wide range of antihistamines available, choice of other treatment modalities, and the complexity of interpreting specialist treatment algorithms. Despite regular updates to international guidelines, regional/national surveys of healthcare professionals show a clear gap between guidelines and real-world practice, particularly at the primary care level. This article thus presents the consensus opinion of experts from relevant specialties in Malaysia – allergology, pediatrics, otorhinolaryngology, and dermtology – on harmonizing the use and choice of antihistamines in primary care. Patient profiling is recommended as a tool to guide primary care practitioners in prescribing the appropriate antihistamine for each patient. Patient profiling is a three-step approach that involves 1) identifying the individual’s needs; 2) reviewing patient-specific considerations; and 3) monitoring treatment response and referral to specialists in more severe or difficult-to-treat cases. Concurrently, guidelct 3ines should be reviewed and updated periodically to include recommendations that are easily actionable for primary care practitioners.Keywords: antihistamines, primary care, patient profiling, Malaysia

Published
2019

2. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study

Author

Bertolotti, M, Franchi, C, Rocchi, Mb, Miceli, A, Libbra, Mv, Nobili, A, Lancellotti, G, Carulli, L, Mussi, C, Reposi, Investigators, Mannucci, Pm, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, Gr, Marcucci, M, Eldin, Tk, Di Blanca MP, Lanzo, G, Astuto, S, Ardoino, I, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, Fc, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Pasini, Fl, Capecchi, Pl, Bicchi, M, Palasciano, G, Modeo, Me, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, Mr, De Stefano, F, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis MM, Mancarella, M, Mari, D, Rossi, Pd, Damanti, S, Ottolini, Bb, Bonini, G, Miceli, E, Lenti, Mv, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davì, G, Guagnano, Mt, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, Mr, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, Ms, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, Fr, Amoroso, A, Molfino, A, Petrillo, E, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, Uv, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, Mr, Laieta, Mt, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabbà, C, Vella, Fs, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, Av, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Salerno, Mm, Conca, A, Gobbo, G, Pallini, G, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, Ws, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, Nl, Buratti, A, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Pellegrini, E, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, Gp, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Col, Ad, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, Me, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, Mv, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffrè, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dc, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lg, Victoria, Vg, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gc, Marta, Pm, Garcia, Sc, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Ángel, Br, Manuel, Mj, Ignacio, Nv, Lucía, As, Alfonso, L, David, Rb, Iria, Iv, Monica, R. P., Bertolotti, Marco, Franchi, Carlotta, Rocchi, Marco B. L., Miceli, Andrea, Libbra, M. Vittoria, Nobili, Alessandro, Lancellotti, Giulia, Carulli, Lucia, Mussi, Chiara, On behalf of REPOSI Investigators [.., Mannucci, Pier Mannuccio, Tettamanti, Mauro, Pasina, Luca, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marcucci, Maura, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Ardoino, Ilaria, Cortesi, Laura, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thoma, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Di Gennaro, Carla, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D’Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Ferrari, Barbara, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Salerno, Maria Magnini Francesco, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Libbra, Maria Vittoria, Pellegrini, Elisa, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego.., ], Bertolotti, M, Franchi, C, Rocchi, M, Miceli, A, Libbra, M, Nobili, A, Lancellotti, G, Carulli, L, Mussi, C, Annoni, G, Monica, Rios Prego, Reposi, Investigator, Bertolotti, M., Franchi, C., Rocchi, M. B. L., Miceli, A., Libbra, M. V., Nobili, A., Lancellotti, G., Carulli, L., Mussi, C., Mannucci, P. M., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Di Blanca, M. P. D., Lanzo, G., Astuto, S., Ardoino, I., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Ferrari, B., Monzani, V., Savojardo, V., Folli, C., Salerno, M. M. F., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Pellegrini, E., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., and Monica, R. P.

Subjects
Male, medicine.medical_specialty, Logistic Model, Lipid-Lowering Agents, Population, Socio-culturale, Older Hospitalized Patients, 030204 cardiovascular system & hematology, Geriatrics and Gerontology, Pharmacology (medical), 03 medical and health sciences, 0302 clinical medicine, Internal medicine, 80 and over, Prevalence, medicine, Humans, 030212 general & internal medicine, Medical prescription, Intensive care medicine, Omega 3 fatty acid, education, Adverse effect, Aged, Hypolipidemic Agents, Aged, 80 and over, Polypharmacy, Geriatrics, education.field_of_study, Hypolipidemic Agent, business.industry, Geriatrics and Gerontology, Pharmacology (medical), Hospitalization, Logistic Models, Cohort, Female, business, Human, Cohort study
Abstract

BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. RESULTS: 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. CONCLUSIONS: In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen

Published
2017

3. Use of non-steroidal anti-inflammatory drugs and analgesics in a cohort of hospitalized elderly patients: Results from the REPOSI study

Author

Pasina, L, Cortesi, L, Tettamanti, M, Nobili, A, Mannucci, Pm, Franchi, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, Gr, Marcucci, M, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Vanoli, M, Grignani, G, Casella, G, Bernardi, M, Li Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, R, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, Fc, Girelli, G, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, G, Valenti, V, Zoli, M, Arnò, A, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Palasciano, P, Modeo, Me, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, Mr, De Stefano, F, Cappellini, Md, Fabio, G, Seghezzi, S, Migone De Amicis, M, Mari, D, Dionigi Rossi, P, Damanti, S, Brignolo Ottolini, B, Miceli, M, Lenti, Mv, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, Mb, Ghelfi, D, Anastasio, A, Sofia, L, Carbone, M, Davì, G, Guagnano, Mt, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, Mr, Cavallo Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, T, Melis, D, Rebella, L, Delitala, D, Pretti, V, Masala, Ms, Bolondi, L, Rasciti, L, Serio, I, Rossi Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccalà, G, Franceschi, F, De Marco, G, Cordischi, C, Sabbatini, M, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Vespasiani Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Delitala, G, Carta, S, Atzori, S, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Manfredini, Roberto, Molino, C, Pala, M, Fabbian, Fabio, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, Mr, Laieta, Mt, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Sabbà, C, Vella, Fs, Suppressa, P, Valerio, R, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, Av, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, Ws, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, Nl, Buratti, A, Tiziana Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Ludovica Perri, P, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, Mv, Miceli, A, Pellegrini, E, Carulli, L, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Corinaldesi, R, DE GIORGIO, Roberto, Serra, M, Grasso, V, Ruggeri, E, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Gabrielli, A, Mattioli, M, Capeci, W, Martino, Gp, Messina, S, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Colangelo, L, Afeltra, A, Alemanno, P, Marigliano, B, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, Mv, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, M, Scopelliti, F, Gasparini, F, Cocca, M, Ramirez Duque, N, Muela Molinero, A, Abad Requejo, P, Lopez Pelaez, V, Tamargo, L, Corbella Viros, X, Formiga, F, Diez Manglano, J, Bejarano Tello, E, Del Corral Behamonte, E, Sevil Puras, M, Manuel, R, Pinilla Llorente, B, Lopez Gonzalez Cobos, C, Villalba Garcia, Mv, Sanz Baena, S, Arroyo Gallego, M, Gonzalez Becerra, C, Fernandez Moyano, A, Mercedes Gomez, H, Poyato Borrego, M, Pacheco Cuadros, R, Perez Rojas, F, Garcia Olid, B, Carrascosa Garcia, S, Gonzalez Cruz, C, Peinado Martinez, M, Ruiz Cantero, A, Albarracín Arraigosa, A, Godoy Guerrero, M, Barón Ramos, Ma, Machin, Jm, Novo Veleiro, I, Alvela Suarez, L, Lopez, A, Rubal Bran, D, Iñiguez Vazquez, I, and Rios Prego, M.

Subjects
Male, medicine.medical_specialty, Phamacoepidemiology, Socio-culturale, Pain, Comorbidity, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Elderly, Internal medicine, Internal Medicine, medicine, Humans, Pain Management, 030212 general & internal medicine, Aged, Aged, 80 and over, Analgesics, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Drug Utilization, Hospitalization, Non steroidal anti inflammatory, Italy, Cohort, Polypharmacy, Female, business, Elderly, Non-steroidal anti-inflammatory drugs, Phamacoepidemiology, Non-steroidal anti-inflammatory drugs
Published
2016

4. Gender-differences in disease distribution and outcome in hospitalized elderly: data from the REPOSI study

Author

S. Corrao, P. Santalucia, C. Argano, C. D. Djade, E. Barone, M. Tettamanti, L. Pasina, C. Franchi, T. K. Eldin, A. Marengoni, F. Salerno, M. Marcucci, P. M. Mannucci, A. Nobili, R. E. P. collaborators, Mannucci M, Nobili A, Tettamanti M, Pasina L, Franchi C, Salerno F, Corrao S, Marengoni A, Marcucci M, Sparacio E, Alborghetti S, Di Costanzo R, Djignefa Djade C, 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, Bassi SL, Santi L, Agnelli G, Iorio A, 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, Rinaldi ER, Fabbri E, Auteri A, Pasqui AL, Puccetti L, Laghi Pasini F, 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, Rossi PD, 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, Anastasio L, Carbone M, Traisci G, De Feudis L, Davì G, 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, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, 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, Rasciti L, 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 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, Corsi M, Zazzetta S, Bertolotti M, Mussi C, Scotto R, 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, Serra M, Grasso V, Ruggeri E, Carozza LM, Pignatti F), BERNARDI, MAURO, BORGHI, CLAUDIO, STROCCHI, ENRICO, ZOLI, MARCO, MAGALOTTI, DONATELLA, BOLONDI, LUIGI, SERIO, ILARIA, CORINALDESI, ROBERTO, DE GIORGIO, ROBERTO, S. Corrao, P. Santalucia, C. Argano, C. D. Djade, E. Barone, M. Tettamanti, L. Pasina, C. Franchi, T. K. Eldin, A. Marengoni, F. Salerno, M. Marcucci, P. M. Mannucci, A. Nobili, and R. E. P. collaborator, Mannucci M, Nobili A, Tettamanti M, Pasina L, Franchi C, Salerno F, Corrao S, Marengoni A, Marcucci M, Sparacio E, Alborghetti S, Di Costanzo R, Djignefa Djade C, 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, Bernardi M, Bassi SL, Santi L, Agnelli G, Iorio A, 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, Laghi Pasini F, 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, Rossi PD, 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, Anastasio L, Carbone M, Traisci G, De Feudis L, Davì G, 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, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, 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, 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 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, Corsi M, Zazzetta S, Bertolotti M, Mussi C, Scotto R, 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), Corrao S., Santalucia P., Argano, C., Djade, C. D., Barone, E., Tettamanti, M., Pasina, L., Franchi, C., Kamal Eldin, T., Marengoni, A., Salerno, F., Marcucci, M., Mannucci, P. M., Nobili, A., Zanetti, Michela, Corrao, S, Santalucia, P, Argano, C, Djade, Cd, Barone, E, Tettamanti, M, Pasina, L, Franchi, C, Kamal Eldin, T, Marengoni, A, Salerno, F, Marcucci, M, Mannucci, Pm, Nobili, Rizzo, Mr, Paolisso, G, Reposi, Investigators, Djade, C, Mannucci, P, Nobili, A, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djignefa 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, 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, 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, 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, Laghi 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, Carbone, M, 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, 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, Corrao, S., Santalucia, P., Djade, C.D., Mannucci, P.M., Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Iorio, Alfonso, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Sabbà, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Conca, Alessio, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, and Facolta' di MEDICINA e CHIRURGIA

Subjects
Gerontology, Male, Activities of daily living, Settore MED/09 - Medicina Interna, Geriatric Medicine, Comorbidity, Disease distribution, Elderly, Sex-gender difference, In-hospital mortality, Retrospective Studie, Activities of Daily Living, gender, 80 and over, Depression (differential diagnoses), Aged, 80 and over, education.field_of_study, hospitalized elderly, Depression, Mortality rate, Medicine (all), gender, hospitalization, elderly, Hospitalization, Italy, outcome, Geriatric Depression Scale, Female, Inpatient, Human, Population, Gender-difference, sex-gender differences, Follow-Up Studie, Cognition Disorder, medicine, Internal Medicine, Aged, Chronic Disease, Cognition Disorders, Follow-Up Studies, Geriatric Assessment, Humans, Morbidity, Retrospective Studies, Sex Distribution, Inpatients, education, business.industry, Settore MED/09 - MEDICINA INTERNA, Retrospective cohort study, medicine.disease, Gender-differences, disease distribution, Mood disorders, elderly, in-hospital mortality, business
Abstract

none 330 Women live longer and outnumber men. On the other hand, older women develop more chronic diseases and conditions such as arthritis, osteoporosis and depression, leading to a greater number of years of living with disabilities. The aim of this study was to describe whether or not there are gender differences in the demographic profile, disease distribution and outcome in a population of hospitalized elderly people.Retrospective observational study including all patients recruited for the REPOSI study in the year 2010. Analyses are referred to the whole group and gender categorization was applied.A total of 1380 hospitalized elderly subjects, 50.5\% women and 49.5\% men, were considered. Women were older than men, more often widow and living alone or in nursing homes. Disease distribution showed that malignancy, diabetes, coronary artery disease, chronic kidney disease and chronic obstructive pulmonary disease were more frequent in men, but hypertension, osteoarthritis, anemia and depression were more frequent in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment evaluated by the Short Blessed Test (SBT), mood disorders by the Geriatric Depression Scale (GDS) and disability in daily life measured by Barthel Index (BI) were worse in women. In-hospital and 3-month mortality rates were higher in men.Our study showed a gender dimorphism in the demographic and morbidity profiles of hospitalized elderly people, emphasizing once more the need for a personalized process of healthcare. none S. Corrao;P. Santalucia;C. Argano;C. D. Djade;E. Barone;M. Tettamanti;L. Pasina;C. Franchi;T. K. Eldin;A. Marengoni;F. Salerno;M. Marcucci;P. M. Mannucci;A. Nobili; and R. E. P. collaborators; Mannucci M; Nobili A; Tettamanti M; Pasina L; Franchi C; Salerno F; Corrao S; Marengoni A; Marcucci M; Sparacio E; Alborghetti S; Di Costanzo R; Tettamanti M; Djignefa Djade C; 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; Bernardi M; Bassi SL; Santi L; Agnelli G; Iorio A; Marcucci M; 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; Laghi Pasini F; 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; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno 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; Anastasio L; Carbone M; Traisci G; De Feudis L; Davì G; 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; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; 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; Delitala G; Carta S; Atzori S; 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 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; Corsi M; Zazzetta S; Bertolotti M; Mussi C; Scotto R; 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) S. Corrao;P. Santalucia;C. Argano;C. D. Djade;E. Barone;M. Tettamanti;L. Pasina;C. Franchi;T. K. Eldin;A. Marengoni;F. Salerno;M. Marcucci;P. M. Mannucci;A. Nobili; and R. E. P. collaborators; Mannucci M; Nobili A; Tettamanti M; Pasina L; Franchi C; Salerno F; Corrao S; Marengoni A; Marcucci M; Sparacio E; Alborghetti S; Di Costanzo R; Tettamanti M; Djignefa Djade C; 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; Bernardi M; Bassi SL; Santi L; Agnelli G; Iorio A; Marcucci M; 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; Laghi Pasini F; 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; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno 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; Anastasio L; Carbone M; Traisci G; De Feudis L; Davì G; 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; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; 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; Delitala G; Carta S; Atzori S; 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 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; Corsi M; Zazzetta S; Bertolotti M; Mussi C; Scotto R; 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)

Published
2014

5. Prevalence and Risk Factors Associated with Use of QT-Prolonging Drugs in Hospitalized Older People

Author

Franchi, C, Ardoino, I, Rossio, R, Nobili, A, Biganzoli, Em, Marengoni, A, Marcucci, M, Pasina, L, Tettamanti, M, Corrao, S, Mannucci, Pm, Salerno, F, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, Tk, Djade, Cd, 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, Porzio, M, Periti, G, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, Pd, 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, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, 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, Marina, 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, 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, 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, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, 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., Franchi, C., Ardoino, I., Rossio, R., Nobili, A., Biganzoli, E. M., Marengoni, A., Marcucci, M., Pasina, L., Tettamanti, M., Corrao, S., Mannucci, P. M, Rizzo, Mr, Mannucci, P. M., Zanetti, M., Reposi, Investigators, Biganzoli, E., Mannucci, P., Mansueto, P., Franchi, Chiara, Nobili, Andrea, Marcucci, Marianna, and Tettamanti, Massimo

Subjects
Male, TORSADES-DE-POINTES, INTERVAL PROLONGATION, PATIENT, CIPROFLOXACIN, COHORT, DEATH, MULTIMORBIDITY, AMIODARONE, MORTALITY, AIFA, Amiodarone, 030204 cardiovascular system & hematology, CIPROFLOXACIN, Logistic regression, Electrocardiography, 0302 clinical medicine, Risk Factors, Torsades de Pointes, Atrial Fibrillation, 80 and over, Prevalence, Pharmacology (medical), 030212 general & internal medicine, Aged, Aged, 80 and over, Female, Humans, Long QT Syndrome, Middle Aged, Patient Discharge, Hospitalization, media_common, Torsades de Pointe, Geriatrics and Gerontology, Medicine (all), DEATH, Cohort, Hospitalized Older People, medicine.drug, Human, Drug, medicine.medical_specialty, media_common.quotation_subject, MULTIMORBIDITY, Torsades de pointes, PATIENT, 03 medical and health sciences, Pharmacotherapy, Internal medicine, INTERVAL PROLONGATION, medicine, TORSADES-DE-POINTES, COHORT, Medical prescription, AIFA, business.industry, MORTALITY, Risk Factor, Settore MED/09 - MEDICINA INTERNA, Odds ratio, medicine.disease, QT-Prolonging Drug, Physical therapy, business
Abstract

Aims: The objective of this study was to evaluate the prevalence of the prescription of QT-prolonging drugs at hospital admission and discharge and the risk factors associated with their use in older people (aged 65Âyears and older). Methods: Data were obtained from the REPOSI (REgistro POliterapie SIMI [Società Italiana di Medicina Interna]) registry, which enrolled 4035 patients in 2008 (nÂ=Â1332), 2010 (nÂ=Â1380), and 2012 (nÂ=Â1323). Multivariable logistic regression was performed to determine the risk factors independently associated with QT-prolonging drug use. QT-prolonging drugs were classified by the risk of Torsades de Pointes (TdP) (definite, possible, or conditional) according to the Arizona Center for Education and Research on Therapeutics (AzCERT) classification. Specific drug combinations were also assessed. Results: Among 3906 patients prescribed at least one drug at admission, 2156 (55.2Â%) were taking at least one QT-prolonging drug. Risk factors independently associated with the use of any QT-prolonging drugs were increasing age (odds ratio [OR] 1.02, 95Â% CI 1.01–1.03), multimorbidity (OR 2.69, 95Â% CI 2.33–3.10), hypokalemia (OR 2.79, 95Â% CI 1.32–5.89), atrial fibrillation (OR 1.66, 95Â% CI 1.40–1.98), and heart failure (OR 3.17, 95Â% CI 2.49–4.05). Furosemide, alone or in combination, was the most prescribed drug. Amiodarone was the most prescribed drug with a definite risk of TdP. Both the absolute number of QT-prolonging drugs (2890 vs. 3549) and the number of patients treated with them (2456 vs. 2156) increased at discharge. Among 1808 patients not prescribed QT-prolonging drugs at admission, 35.8Â% were prescribed them at discharge. Conclusions: Despite their risk, QT-prolonging drugs are widely prescribed to hospitalized older persons. The curriculum for both practicing physicians and medical students should be strengthened to provide more education on the appropriate use of drugs in order to improve the management of hospitalized older people.

Published
2016

6. Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

Author

Marcucci, M., Iorio, A., Nobili, A., Tettamanti, M., Pasina, L., Djade, Cd, Marengoni, A., Salerno, F., Corrao, S., Mannucci, Pm, Reposi, Investigators, Mannucci, M., Franchi, C., Sparacio, E., Alborghetti, S., Di Costanzo, R., Prisco, D., Silvestri, E., Cenci, C., Barnini, T., Delitala, G., Carta, S., Atzori, S., Guarnieri, G., Zanetti, M., Spalluti, A., Serra, Mg, Bleve, Ma, 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, 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 Piro, 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., Dangelo, 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, 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., Rossi, Pd, 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., Di Carlo, S., Traisci, G., Feudis, L., Davì, G., 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, Benetti, G., Quagliolo, M., Centenaro, Gr, Purrello, Francesco Salvatore, Antonino Di Pino, Piro S., 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., Violi, F., Basili, S., Perri, L., Serra, P., Fontana, V., Falcone, M., Landolfi, R., Grieco, A., Gallo, A., Zuccalà, G., Franceschi, F., 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., Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Carozza, Lm, Pignatti, F., Maura, Marcucci, Alfonso, Iorio, Alessandro, Nobili, Mauro, Tettamanti, Luca, Pasina, Codjo Djignefa, Djade, Alessandra, Marengoni, Francesco, Salerno, Salvatore, Corrao, Pier Mannuccio, Mannucci, Zanetti, Michela, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, 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, Marcucci, M., Iorio, A., Nobili, A., Tettamanti, M., Pasina, L., Djade, C., Marengoni, A., Salerno, F., Corrao, S., Mannucci, P., Mansueto, P., Djade, Cd, Mannucci, Pm, Reposi, Investigator, Postiglione, Alfredo, Marcucci M, Iorio A, Nobili A, Tettamanti M, Pasina L, Djade CD, Marengoni A, Salerno F, Corrao S, Mannucci PM, Mannucci M, Franchi C, Sparacio E, Alborghetti S, Di Costanzo R, Prisco D, Silvestri E, Cenci C, Barnini T, Delitala G, Carta S, Atzori S, Guarnieri G, Zanetti M, Spalluti A, Serra MG, Bleve MA, 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 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, DAngelo 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, Rossi PD, 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, Di Carlo S, Traisci G, De Feudis L, Davì G, 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, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, 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, 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 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, and Pignatti F

Subjects
Male, TVP, Settore MED/09 - Medicina Interna, Comorbidity, Logistic regression, Fondaparinux, VENOUS THROMBOEMBOLISM, THROMBOPROPHYLAXIS, Medical Patients, Medical patients, Thromboprophylaxis, Venous thromboembolism, Aged, Aged, 80 and over, Area Under Curve, Female, Hospital Mortality, Hospitalization, Humans, Logistic Models, Propensity Score, Venous Thromboembolism, Internal Medicine, Emergency Medicine, Thromboprophylaxis, Venous thromboembolism, Medical patients, 80 and over, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, prophylaxis, venous thromboembolism, elderly, medicine.drug, medicine.medical_specialty, multimorbidity, Barthel index, MEDLINE, elderly patients, Internal medicine, medicine, Medical prescription, Intensive care medicine, business.industry, prophylaxi, Elderly, medical patients, thromboprophylaxis, medicine.disease, Propensity score matching, business
Abstract

none 327 si 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. mixed Marcucci M; Iorio A; Nobili A; Tettamanti M; Pasina L; Djade CD; Marengoni A; Salerno F; Corrao S; Mannucci PM; 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; Tettamanti M; Djade CD; Prisco D; Silvestri E; Cenci C; Barnini T; Delitala G; Carta S; Atzori S; Guarnieri G; Zanetti M; Spalluti A; Serra MG; Bleve MA; 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; Iorio A; Marcucci M; 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; DAngelo 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; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno 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; Di Carlo S; Traisci G; De Feudis L; Davì G; 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; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; 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; Delitala G; Carta S; Atzori S; 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 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 Marcucci M; Iorio A; Nobili A; Tettamanti M; Pasina L; Djade CD; Marengoni A; Salerno F; Corrao S; Mannucci PM; 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; Tettamanti M; Djade CD; Prisco D; Silvestri E; Cenci C; Barnini T; Delitala G; Carta S; Atzori S; Guarnieri G; Zanetti M; Spalluti A; Serra MG; Bleve MA; 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; Iorio A; Marcucci M; 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; DAngelo 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; Rossi PD; Damanti S; Prolo S; Lilleri MS; Cricco L; Fiorentini A; Micale G; Podda M; Selmi C; Meda F; Salerno 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; Di Carlo S; Traisci G; De Feudis L; Davì G; 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; Benetti G; Quagliolo M; Centenaro GR; Purrello F; Di Pino A; Piro S; 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; Delitala G; Carta S; Atzori S; 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 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

Published
2013

7. Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Author

Corrao, S, Argano, C, Nobili, A, Marcucci, M, Djade, Cd, Tettamanti, M, Pasina, L, Franchi, C, Marengoni, A, Salerno, F, Violi, F, Mannucci, Pm, Perticone, F, Sparacio, E, Alborghetti, S, Di Costanzo, R, 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, Iorio, A, 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, Rossi, Pd, 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, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, 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, F, Di Pino, A, Piro, S, 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, Luigina, Castiglioni, Luana, Maresca, ANDREA MARIA, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, Ma, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, 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., Corrao S, Argano C, Nobili A, Marcucci M, Djade CD, Tettamanti M, Pasina L, Franchi C, Marengoni A, Salerno F, Violi F, Mannucci PM, Perticone F, REPOSI Investigator, Bernardi M, Borghi,C, Strocchi E, Rinaldi ER, Zoli M, Bolondi L, Corrao, S, Argano, C, Nobili, A, Marcucci, M, Djade, C. D, Tettamanti, M, Pasina, L, Franchi, C, Marengoni, A, Salerno, F, Violi, F, Mannucci, P. M, Perticone, F, Reposi, Investigator, Zanetti, Michela, Djade, CD, Mannucci, PM, Perticone, F. Mansueto, P, REPOSI Investigators, Corrao, S., Argano, C., Nobili, A., Marcucci, M., Djade, C. D., Tettamanti, M., Pasina, L., Franchi, C., Marengoni, A., Salerno, F., Violi, F., Mannucci, P. M., Rizzo, Mr, Paolisso, G, Mannucci, P, 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, 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, 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, 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, Giaquinto, 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, 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, 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, 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, and Pignatti, F

Subjects
Male, Settore MED/09 - Medicina Interna, REPOSI study, Kidney, Disability Evaluation, Retrospective Studie, Risk Factors, hospitalized patient, Atrial Fibrillation, 80 and over, Odds Ratio, LS4_4, Renal Insufficiency, Chronic, Multivariate Analysi, Stroke, Aged, 80 and over, Medicine (all), Brain, Atrial fibrillation, Female, atrial microembolism, Human, Glomerular Filtration Rate, medicine.medical_specialty, Socio-culturale, Renal function, elderly, Cognition Disorder, Internal medicine, Thromboembolism, medicine, Internal Medicine, Humans, Renal insufficiency, chronic, Heart Atria, Intensive care medicine, Aged, Anticoagulants, Dementia, Cognition Disorders, Multivariate Analysis, Renal Insufficiency, Chronic, Retrospective Studies, business.industry, Risk Factor, Settore MED/09 - MEDICINA INTERNA, Anticoagulant, Retrospective cohort study, Odds ratio, medicine.disease, Blood pressure, Heart failure, Aged, Anticoagulants, Atrial fibrillation, Dementia, Renal insufficiency, chronic, Stroke, hospitalized patients, business, Kidney disease
Abstract

Background It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables and mortality. Results Among the 1384 patients enrolled, 321 had AF. Patients with AF were older, had worse CI and disability and higher rates of stroke, hypertension, heart failure, and CKD, and less than 50% were on anticoagulant therapy. Among patients with AF, those with worse CI and those with lower estimated glomerular filtration rate (eGFR) had a higher mortality risk (odds ratio 1.13, p = 0.006). Higher disability levels, older age, higher systolic blood pressure, and higher eGFR were related to lower probability of oral anticoagulant prescription. Lower mortality rates were found in patients on oral anticoagulant therapy. Conclusions Elderly hospitalized patients with AF are more likely affected by CI and CKD, two conditions that expose them to a higher mortality risk. Oral anticoagulant therapy, still underused and not optimally enforced, may afford protection from thromboembolic episodes that probably concur to the high mortality.

Published
2015

8. Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Author

Rossio, R, Franchi, C, Ardoino, I, Djade, Cd, Tettamanti, M, Pasina, L, Salerno, F, Marengoni, A, Corrao, S, Marcucci, M, Peyvandi, F, Biganzoli, Em, Nobili, A, Mannucci, Pm, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, Tk, 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, Iorio, A, 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, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Sabbà, C, Vella, Fs, Marseglia, A, Luglio, Cv, Palasciano, G, Modeo, Me, Aquilino, A, 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, Tedeschi, A, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, Pd, 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, Anastasio, L, Sofia, L, Carbone, M, Di Carlo, S, Traisci, G, De Feudis, L, Davì, G, 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, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, Mr, Cicardi, M, Gidaro, A, 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, 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, Ea, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, Uv, Mazzarelli, C, Gallo, P, Guasti, Luigina, Castiglioni, Luana, Maresca, ANDREA MARIA, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, 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., Rossio, Raffaella, Franchi, Carlotta, Ardoino, Ilaria, Djade, Codjo D., Tettamanti, Mauro, Pasina, Luca, Salerno, Francesco, Marengoni, Alessandra, Corrao, Salvatore, Marcucci, Maura, Peyvandi, Flora, Biganzoli, Elia M., Nobili, Alessandro, Mannucci, Pier Mannuccio, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Zanetti, Michela, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Iorio, Alfonso, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Sabbà, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Tedeschi, Alberto, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Conca, Alessio, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Raffaella Rossio, Carlotta Franchi, Ilaria Ardoino, Codjo D. Djade, Mauro Tettamanti, Luca Pasina, Francesco Salerno, Alessandra Marengoni, Salvatore Corrao, Maura Marcucci, Flora Peyvandi, Elia M. Biganzoli, Alessandro Nobili, Pier Mannuccio Mannucci, REPOSI Investigators [.., Mauro Bernardi, Claudio Borghi, Marco Zoli, Luigi Bolondi, Roberto Corinaldesi, Roberto De Giorgio, ], Rossio, R, Franchi, C, Ardoino, I, Djade, C, Tettamanti, M, Pasina, L, Salerno, F, Marengoni, A, Corrao, S, Marcucci, M, Peyvandi, F, Biganzoli, E, Nobili, A, Mannucci, P, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Eldin, T, 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, 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, Durante 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, Laghi Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, 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, Tedeschi, A, 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, 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, Giaquinto, 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, 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, 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, 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, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, DOMINGUEZ RODRIGUEZ, Ligia Juliana, and Reposi, Investigators

Subjects
Male, Antibiotic regimen, Guidelines adherence, Settore MED/09 - Medicina Interna, Antibiotics, Logistic regression, Elderly, Community-acquired pneumonia, 80 and over, Elderly people, Age Factor, Hospital Mortality, Aged, 80 and over, Treatment regimen, Medicine (all), Age Factors, Optimal management, Mortality, Pneumonia, Re-hospitalization, Aged, Anti-Bacterial Agents, Female, Humans, Logistic Models, Practice Guidelines as Topic, Treatment Outcome, Guideline Adherence, Hospitalization, Internal Medicine, Human, medicine.medical_specialty, Logistic Model, medicine.drug_class, Socio-culturale, antibiotic treatment, guidelines, pneumonia, elderly, Internal medicine, Anti-Bacterial Agent, medicine, elderly, pmeumonia, antibiotics, guidelines adherence, mortality, re-hospitalization, pmeumonia, Intensive care medicine, business.industry, Settore MED/09 - MEDICINA INTERNA, Antibiotic, medicine.disease, business
Abstract

none 22 no Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia. none Raffaella Rossio; Carlotta Franchi; Ilaria Ardoino; Codjo D. Djade; Mauro Tettamanti; Luca Pasina; Francesco Salerno; Alessandra Marengoni; Salvatore Corrao; Maura Marcucci; Flora Peyvandi; Elia M. Biganzoli; Alessandro Nobili; Pier Mannuccio Mannucci; REPOSI Investigators [...; Mauro Bernardi; Claudio Borghi; Marco Zoli; Luigi Bolondi; Roberto Corinaldesi; Roberto De Giorgio;...] Raffaella Rossio; Carlotta Franchi; Ilaria Ardoino; Codjo D. Djade; Mauro Tettamanti; Luca Pasina; Francesco Salerno; Alessandra Marengoni; Salvatore Corrao; Maura Marcucci; Flora Peyvandi; Elia M. Biganzoli; Alessandro Nobili; Pier Mannuccio Mannucci; REPOSI Investigators [..; Mauro Bernardi; Claudio Borghi; Marco Zoli; Luigi Bolondi; Roberto Corinaldesi; Roberto De Giorgio;..]

Published
2015

9. Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly

Author

Franchi, C, Salerno, F, Conca, A, Djade, Cd, Tettamanti, M, Pasina, L, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, Pm, Nobili, A, Reposi, Investigators, Sparacio, E, Alborghetti, S, Di Costanzo, R, 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, Iorio, A, 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, Rossi, Pd, Damanti, S, Prolo, S, Lilleri, Ms, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, 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, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, 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, Marina 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, 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, 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, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, 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., 337. Franchi C, Salerno F, Conca A, Djade CD, Tettamanti M, Pasina L, Corrao S, Marengoni A, Marcucci M, Mannucci PM, Nobili A. REPOSI Investigator, Bernardi M, Borghi C, Strocchi E, Zoli M, Bolondi L, Corinaldesi R, De Giorgio R, Franchi C, Salerno F, Conca, A, Djade, Cd, Tettamanti, M, Pasina, L, Corrao, S, Marengoni, A, Marcucci, M, Mannucci, Pm, Nobili, A, Zanetti, Michela, Franchi, Carlotta, Salerno, Francesco, Conca, Alessio, Djade, Codjo D., Tettamanti, Mauro, Pasina, Luca, Corrao, Salvatore, Marengoni, Alessandra, Marcucci, Maura, Mannucci, Pier Mannuccio, Nobili, Alessandro, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Iorio, Alfonso, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Mr, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, SabbÃ&nbsp, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davã¬, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosã, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, ZuccalÃ&nbsp, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Franchi, C, Salerno, F, Djade, C, Mannucci, P, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Attori, S, Guarnieri, G, Zanetti, M, Spallati, 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, Iorio, A, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Maciullo, 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, 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, Laghi 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, Girando, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, Migone 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, Monti, A, 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, Guelfi, 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, Giaquinto, 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, Gigaro, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Cavallo Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzoni, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferruzzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, R, 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, Agabiti Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Vespasiani 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, Franchi, C., Salerno, F., Conca, A., Djade, C., Tettamanti, M., Pasina, L., Corrao, S., Marengoni, A., Marcucci, M., Mannucci, P., Nobili, A., and Mansueto, P.

Subjects
Male, Kidney Disease, Settore MED/09 - Medicina Interna, hyperuricemia, Comorbidities, chemistry.chemical_compound, Cardiovascular Disease, gout, elderly, Allopurinol, Elderly, Gout, Hyperuricemia, Outcomes, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Chronic Disease, Comorbidity, Female, Hospital Mortality, Hospitalization, Humans, Kidney Diseases, Length of Stay, Treatment Outcome, Uric Acid, Internal Medicine, Medicine (all), 80 and over, Medicine, Age Factor, Outcome, OUTCOMES, comorbidity, Cohort, Comorbiditie, Human, medicine.drug, musculoskeletal diseases, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, allopurinol, NO, gout, Gout, allopurinol, hyperuricemia, comorbidities, outcomes, elderly, Internal medicine, Risk factor, Intensive care medicine, Adverse effect, ELDERLY, gout, allopurinol, hyperuricemia, comorbidities, outcomes, elderly, business.industry, nutritional and metabolic diseases, medicine.disease, chemistry, Uric acid, business
Abstract

Background: Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a prospective registry, the prevalence of gout/hyperuricemia and its association with these and other clinical parameters was evaluated in an Italian cohort of elderly patients acutely admitted to internal medicine or geriatric wards. Methods: While the prevalence of gout was calculated by counting patients with this diagnosis hyperuricemia was inferred in patients taking allopurinol at hospital admission or discharge, on the assumption that this drug was only prescribed owing to the finding of high serum levels of uric acid. A series of clinical and demographic variables were evaluated for their association with gout/hyperuricemia. Results: Of 1380 patients, 139 (10%) had a diagnosis of gout or were prescribed allopurinol. They had more co-morbidities (7.0 vs 5.6; P < 0.0001) and consumed more drugs (6.8 vs 5.0; < b 0.0001). The CIRS (co-morbidity index) was worse in these patients (OR 1.28 95% CI 1.15-1.41). Multivariable regression analysis showed that only renal and heart failures were independently associated with gout/allopurinol intake. Moreover, this combined event was associated with an increased risk of adverse events during hospitalization (OR 1.66, 95% CI 1.16-2.36), but not with the risk of re-hospitalization, length of hospital stay or death. Conclusions: Gout/allopurinol intake has a high prevalence in elderly patients acutely admitted to hospital and are associated with renal and cardiovascular diseases, an increased rate of adverse events and a high degree of drug consumption. In contrast, this finding did not affect the length of hospitalization nor hospital mortality.

Published
2014

10. Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

Author

Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, 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, 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, Durante 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, Giaquinto, 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, 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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, Iorio A, 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, Rossi PD, 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, Anastasio L, Sofia L, Carbone M, Traisci G, De Feudis L, Di Carlo S, Davì G, 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 F, Di Pino A, Piro S, 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, 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 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, GIORGIO, Corsi M, ZAZZETTA, SARA, Bertolotti M, Mussi C, Scotto R, 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., Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, 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, 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, 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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, Giaquinto, 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, 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, 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, Mannucci PM, Nobili A, Tettamanti M, Pasina L, Franchi C, Salerno F, Corrao S, Marengoni A, Marcucci M, Sparacio E, Alborghetti S, Di Costanzo R, Djade CD, 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, Iorio A, 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, Rossi PD, 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, Anastasio L, Sofia L, Carbone M, Traisci G, De Feudis L, Di Carlo S, Davì G, 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 F, Di Pino A, Piro S, 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, 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 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, GIORGIO, Corsi M, ZAZZETTA, SARA, Bertolotti M, Mussi C, Scotto R, 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, and Pignatti F.

Abstract

Background: It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF. Methods: We retrospectively analyzed the data collected on elderly patients in 66 Italian hospitals, in the frame of the REPOSI project. We analyzed the clinical characteristics of patients with AF and different degrees of CI. Multivariate logistic analysis was used to explore the relationship between variables and mortality. Results: Among the 1384 patients enrolled, 321 had AF. Patients with AF were older, had worse CI and disability and higher rates of stroke, hypertension, heart failure, and CKD, and less than 50% were on anticoagulant therapy. Among patients with AF, those with worse CI and those with lower estimated glomerular filtration rate (eGFR) had a higher mortality risk (odds ratio 1.13, p = 0.006). Higher disability levels, older age, higher systolic blood pressure, and higher eGFR were related to lower probability of oral anticoagulant prescription. Lower mortality rates were found in patients on oral anticoagulant therapy. Conclusions: Elderly hospitalized patients with AF are more likely affected by CI and CKD, two conditions that expose them to a higher mortality risk. Oral anticoagulant therapy, still underused and not optimally enforced, may afford protection from thromboembolic episodes that probably concur to the high mortality.

Published
2015

11. 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

12. Gender-differences in disease distribution and outcome in hospitalized elderly: Data from the REPOSI study

Author

Corrao, S, Santalucia, P, Argano, C, Djade, C, Barone, E, Tettamanti, M, Pasina, L, Franchi, C, Kamal Eldin, T, Marengoni, A, Salerno, F, Marcucci, M, Mannucci, P, Nobili, A, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djignefa 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, 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, Durante 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, Laghi 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, Carbone, M, 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, 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, Mannucci M, Nobili A, Tettamanti M, Pasina L, Franchi C, Salerno F, Corrao S, Marengoni A, Marcucci M, Sparacio E, Alborghetti S, Di Costanzo R, Djignefa Djade C, 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, Bernardi M, Bassi SL, Santi L, Agnelli G, Iorio A, 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, Laghi Pasini F, 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, Rossi PD, 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, Anastasio L, Carbone M, Traisci G, De Feudis L, Davì G, 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, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, 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, 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 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, Corsi M, Bertolotti M, Mussi C, Scotto R, 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., ANNONI, GIORGIO, ZAZZETTA, SARA, Corrao, S, Santalucia, P, Argano, C, Djade, C, Barone, E, Tettamanti, M, Pasina, L, Franchi, C, Kamal Eldin, T, Marengoni, A, Salerno, F, Marcucci, M, Mannucci, P, Nobili, A, Mannucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djignefa 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, 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, Durante 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, Laghi 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, Carbone, M, 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, 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, Mannucci M, Nobili A, Tettamanti M, Pasina L, Franchi C, Salerno F, Corrao S, Marengoni A, Marcucci M, Sparacio E, Alborghetti S, Di Costanzo R, Djignefa Djade C, 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, Bernardi M, Bassi SL, Santi L, Agnelli G, Iorio A, 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, Laghi Pasini F, 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, Rossi PD, 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, Anastasio L, Carbone M, Traisci G, De Feudis L, Davì G, 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, Benetti G, Quagliolo M, Centenaro GR, Purrello F, Di Pino A, Piro S, 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, 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 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, Corsi M, Bertolotti M, Mussi C, Scotto R, 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., ANNONI, GIORGIO, and ZAZZETTA, SARA

Abstract

Background and purpose Women live longer and outnumber men. On the other hand, older women develop more chronic diseases and conditions such as arthritis, osteoporosis and depression, leading to a greater number of years of living with disabilities. The aim of this study was to describe whether or not there are gender differences in the demographic profile, disease distribution and outcome in a population of hospitalized elderly people. Methods Retrospective observational study including all patients recruited for the REPOSI study in the year 2010. Analyses are referred to the whole group and gender categorization was applied. Results A total of 1380 hospitalized elderly subjects, 50.5% women and 49.5% men, were considered. Women were older than men, more often widow and living alone or in nursing homes. Disease distribution showed that malignancy, diabetes, coronary artery disease, chronic kidney disease and chronic obstructive pulmonary disease were more frequent in men, but hypertension, osteoarthritis, anemia and depression were more frequent in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment evaluated by the Short Blessed Test (SBT), mood disorders by the Geriatric Depression Scale (GDS) and disability in daily life measured by Barthel Index (BI) were worse in women. In-hospital and 3-month mortality rates were higher in men. Conclusions Our study showed a gender dimorphism in the demographic and morbidity profiles of hospitalized elderly people, emphasizing once more the need for a personalized process of healthcare. © 2014 European Federation of Internal Medicine.

Published
2014

14. The influence of exposure to inorganic arsenic and other arsenic species on early renal impairment among young adults in Taiwan.

Author

Chin WS, Hung WL, Say YH, Chien LC, Chen YC, Lo YP, and Liao KW

Abstract

Chronic kidney disease (CKD) poses a significant global public health challenge, with environmental toxins potentially contributing to its prevalence. In Taiwan, where arsenic (As) contamination is endemic in certain areas, assessing its impact on renal health is crucial due to the country's high rates of unexplained CKD. This cross-sectional study assessed associations between urinary As species and early renal impairment biomarkers-the microalbumin-to-creatinine ratio (ACR) and β2-microglobulin (B2MG)-in 248 young Taiwanese adults (aged 20-29 years). We measured urinary As species (including arsenite [As 3+ ], arsenate [As 5+ ], monomethylarsonic acid [MMA], and dimethylarsinic acid [DMA]) and early renal impairment biomarkers (urinary microalbumin and B2MG levels). Median concentrations of urinary As 3+ , As 5+ , MMA, DMA, inorganic As (iAs), and the sum of inorganic and methylated As species (iSumAs) were 1.43, 1.02, 3.79, 31.53, 2.82, and 39.22 μg/g creatinine (Cre.), respectively. We also evaluated the first methylation ratio (FMR) and the second methylation ratio (SMR). After adjusting for potential confounding factors, a multivariate linear regression showed significant associations between B2MG and urinary As 5+ (β = 0.299, 95% confidence interval [CI]: 0.113-0.485) and iAs (β = 0.281, 95% CI: 0.061-0.502) concentrations. A generalized additive model revealed non-linear relationships among As 5+ , iAs, and B2MG concentrations. Moreover, there were elevated risks associated with the highest tertile of B2MG concentrations compared to the highest tertile of urinary As 5+ (odds ratio [OR] = 2.366, 95% CI: 1.196-4.682), MMA (OR = 1.917, 95% CI: 1.002-3.666), DMA (OR = 1.952, 95% CI: 1.015-3.753), and iSumAs (OR = 2.302, 95% CI: 1.182-4.483). These results indicated that exposure to As was associated with early renal impairment, particularly evidenced by increased urinary B2MG concentrations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Published
2024
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15. Long-term exposure to NO 2 and PM 2.5 and the occurrence of chronic kidney disease among patients with type 2 diabetes in Taiwan.

Author

Chin WS, Guo YL, Chang YK, Huang LF, and Hsu CC

Subjects
Humans, Taiwan epidemiology, Female, Middle Aged, Male, Longitudinal Studies, Incidence, Aged, Air Pollution statistics & numerical data, Air Pollution adverse effects, Environmental Monitoring, Adult, Diabetes Mellitus, Type 2 epidemiology, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic chemically induced, Particulate Matter analysis, Air Pollutants analysis, Nitrogen Dioxide analysis, Environmental Exposure statistics & numerical data
Abstract

Background: Individuals diagnosed with type 2 diabetes (T2D) frequently exhibit chronic kidney disease (CKD) which may be caused by environmental hazards such as exposure to air pollutants. However, limited research has explored the effects of prolonged exposure to air pollutants on CKD development in this population. This study examines the relationship between long-term exposure to air pollutants and CKD incidence in a longitudinal cohort of individuals with type 2 diabetes in Taiwan METHODS: Between 2003 and 2005, we recruited 1316 T2D patients (693 females [52.66 %]; mean age 56.16 ± 8.97 years). Patients were followed until December 31, 2012, with at least two clinical visits. Baseline demographics, medical history, and biomarker levels were collected. The development of CKD was determined by eGFR level < 60 mL/min/1.73 m 2 . Monthly averages of nitrogen dioxide (NO 2 ) and fine particulate matter [PM ≤ 2.5 μm in aerodynamic diameter (PM 2.5 )] were acquired from 72 ambient air monitoring stations. The kriging method was employed to estimate the exposure levels to PM 2.5, NO 2, temperature, and relative humidity in the participants' residential areas. Cox regression with time-dependent covariates regression was applied to assess the impact of long-term exposure to air pollutants and CKD risk., Results: Of 992 patients with normal renal function at baseline, 411 (41.43 %) experienced CKD occurrence over a median follow-up period of 5.45 years. The incidence of CKD was 93.96 cases per 1000 person-years. In multivariable adjusted models, patients exposed to PM 2.5 levels above the third quartile of (>33.44 μg/m 3 ) and NO 2 levels above the fourth quartile (>22.55 ppb) were found to have an increased risk of CKD occurrence compared to lower exposure levels., Conclusions: This longitudinal study highlights the increased risk of CKD in individuals with type 2 diabetes due to prolonged exposure to NO 2 and PM 2.5 , emphasizing the need for tailored air quality management strategies for this high-risk population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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16. Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan.

Author

Liao KW, Lee WJ, Lin SC, Tsao YN, Lin HY, Liu C, and Chin WS

Subjects
Infant, Female, Humans, Infant, Newborn, Infant Formula chemistry, Cadmium analysis, Taiwan, Lead analysis, Milk, Human chemistry, Manganese analysis, Risk Assessment methods, Environmental Monitoring methods, Arsenic analysis, Metals, Heavy analysis
Abstract

During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn., (© 2024 Institute of Food Technologists.)

Published
2024
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17. Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[ 18 F]FDG PET/CT.

Author

Chuang PJ, Wang HP, Tien YW, Chin WS, Hsieh MS, Chen CC, Hong TC, Ko CL, Wu YW, and Cheng MF

Subjects
Humans, Male, Female, Middle Aged, Aged, Positron Emission Tomography Computed Tomography methods, Fluorodeoxyglucose F18, Radiopharmaceuticals, Retrospective Studies, Tomography, X-Ray Computed methods, Positron-Emission Tomography, Endoscopy, Ampulla of Vater diagnostic imaging, Common Bile Duct Neoplasms diagnostic imaging
Abstract

Objective: We aimed to investigate whether 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[ 18 F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy., Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[ 18 F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test., Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in early-phase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy., Conclusion: Adding 2-[ 18 F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2024 The Korean Society of Radiology.)

Published
2024
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18. Click Chemistry in Lithium-Metal Batteries.

Author

Hu J, Wang W, Zhou B, Sun J, Chin WS, and Lu L

Abstract

Lithium-metal batteries (LMBs) are considered the "holy grail" of the next-generation energy storage systems, and solid-state electrolytes (SSEs) are a kind of critical component assembled in LMBs. However, as one of the most important branches of SSEs, polymer-based electrolytes (PEs) possess several native drawbacks including insufficient ionic conductivity and so on. Click chemistry is a simple, efficient, regioselective, and stereoselective synthesis method, which can be used not only for preparing PEs with outstanding physical and chemical performances, but also for optimizing the stability of solid electrolyte interphase (SEI) layer and elevate the cycling properties of LMBs effectively. Here it is primarily focused on evaluating the merits of click chemistry, summarizing its existing challenges and outlining its increasing role for the designing and fabrication of advanced PEs. The fundamental requirements for reconstructing artificial SEI layer through click chemistry are also summarized, with the aim to offer a thorough comprehension and provide a strategic guidance for exploring the potentials of click chemistry in the field of LMBs., (© 2023 Wiley-VCH GmbH.)

Published
2024
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19. The occurrence and probabilistic risk of exposure to parabens from bottled and hand-shaken teas in the general adult population of Taiwan.

Author

Chin WS, Chang CH, Say YH, Chuang YN, Wang JN, Kao HC, and Liao KW

Subjects
Adult, Humans, Chromatography, Liquid, Taiwan, Tea, Parabens, Tandem Mass Spectrometry
Abstract

Parabens (PBs) are esters of p-hydroxybenzoic acid, and there are growing concerns due to their potential to disrupt endocrine function and their wide use as preservatives in foodstuffs, including beverages. The consumption of bottled and hand-shaken teas is gradually replacing traditional tea consumption through brewing. However, no study has reported PB concentrations in different types of teas or packaging and their associated health risks. Our aim was to determine the concentration of PBs (methyl- (MetPB), ethyl- (EthPB), propyl- (PropPB), butyl-paraben (ButPB)) in green, black, and oolong teas in two varieties of products (bottled and hand-shaken teas), using UPLC-MS/MS. Additionally, we estimated the health risks associated with tea consumption in the general adult population of Taiwan. A Monte Carlo simulation was applied to estimate the distribution of daily PB intake through bottled (n = 79) and hand-shaken (n = 71) tea consumption. Our findings revealed geometric mean concentrations in bottled green/black/oolong teas were 714.1/631.2/532.1 ng/L for MetPB, 95.2/ 30.5/14.9 ng/L for EthPB, 77.9/28.3/non-detected (ND) ng/L for PropPB, and 69.3/26.6/ND ng/L for ButPB. Hand-shaken green/black/oolong teas exhibited concentrations of 867.5/2258/1307 ng/L for MetPB, 28.5/28.8/14.5 ng/L for EthPB, 25.4/18.3/17.8 ng/L for PropPB, and 30.3/18.0/15.5 ng/L for ButPB. The median MetPB concentrations in hand-shaken black (2333 ng/L) and oolong teas (1215 ng/L) were significantly higher than those in bottled black (595.4 ng/L) and oolong teas (489.3 ng/L). Conversely, median concentrations of EthPB, PropPB, and ButPB in bottled teas were significantly higher than those in hand-shaken teas. MetPB was the predominant PB, constituting 73.2-91.9% in bottled teas and 85-94% in hand-shaken teas. Our results showed no health risks associated with bottled or hand-shaken tea consumption based on reference doses. However, the study highlights the importance of continued vigilance given the potential chronic exposure to PBs from various sources, necessitating ongoing concern despite the absence of immediate risks from tea consumption., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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20. Urinary heavy metals and attention-deficit/hyperactivity symptoms of preschool children: a mixed-exposure analysis.

Author

Huang CC, Pan SC, Chin WS, Hsu JF, and Guo YL

Subjects
Humans, Child, Preschool, Lead analysis, Manganese analysis, Cadmium analysis, Nickel analysis, Environmental Exposure adverse effects, Environmental Exposure analysis, Chromium analysis, Arsenic analysis, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit Disorder with Hyperactivity chemically induced, Metals, Heavy analysis, Environmental Pollutants toxicity, Neurotoxicity Syndromes
Abstract

The neurotoxic effects of certain heavy metals are well established, but only a few studies have investigated the joint effect of concurrent exposure to multiple ones. The study aims to evaluate the association between mixed exposure to neurotoxic metals and the psychosocial behavior of preschool children. Using a stratified sampling strategy, we recruited participants from 105 kindergartens in 41 townships of Taiwan and excluded those with blood lead levels ≥ 3.5 µg/L. The first-morning void urines were collected and analyzed for cadmium, manganese, arsenic, chromium, lead, and nickel concentrations using inductively coupled plasma mass spectrometry. We applied the parentally reported Strengths and Difficulties Questionnaire (SDQ) and Swanson, Nolan, and Pelham IV (SNAP-IV) scales to evaluate the psychosocial behaviors. Multiple linear regressions were utilized to evaluate the associations between each heavy metal and the outcomes, while the mixed effect of concurrent exposure was estimated by using a Quantile g-computation approach. A total of 977 preschool children were included in the study, and the mean (SD) age was 5.7 (0.7) years old. In single pollutant models, we observed adverse effects of urinary manganese, nickel, arsenic, and lead on the specific subsets of SDQ. Furthermore, the combined effect of six heavy metals significantly affected the hyperactivity/inattention symptoms (beta = 0.46, 95% CI: 0.13-0.78, with all metals increased by one quartile), and chromium and lead were the two major contributors. Similar detrimental effects of urinary cadmium and lead were also observed in the SNAP-IV subsets, although the joint effect analysis was not significant. The study provided evidence that concurrent exposure to multiple heavy metals may exert increased risks of hyperactivity/inattention in children compared to single pollutant exposure. Further studies are needed to verify our findings regarding mixed exposure to multiple neurotoxic metals., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2023
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21. Risk of type 2 diabetes after diagnosed gestational diabetes is enhanced by exposure to PM2.5.

Author

Pan SC, Huang CC, Chen BY, Chin WS, and Guo YL

Subjects
Pregnancy, Female, Humans, Particulate Matter adverse effects, Particulate Matter analysis, Microtubule-Associated Proteins analysis, Diabetes, Gestational epidemiology, Diabetes Mellitus, Type 2 epidemiology, Air Pollutants adverse effects, Air Pollutants analysis, Air Pollution adverse effects, Air Pollution analysis, Ozone adverse effects, Ozone analysis
Abstract

Background: Air pollution and gestational diabetes mellitus (GDM) are both associated with increased diabetes mellitus (DM) occurrence. However, whether air pollutants modify the effects of GDM on the occurrence of DM has been unknown. This study aims to determine whether the effect of GDM on DM development can be modified by exposure to ambient air pollutants., Methods: Women with one singleton birth delivery during 2004-14 according to the Taiwan Birth Certificate Database (TBCD) were included as the study cohort. Those newly diagnosed as having DM 1 year or later after childbirth were identified as DM cases. Controls were selected among women without DM diagnosis during follow-up. Personal residence was geocoded and linked with interpolated concentrations of air pollutants into township levels. Conditional logistic regression was used to determine the odds ratio (OR) of pollutant exposure and GDM, adjusting for age, smoking and meteorological variables., Results: There were 9846 women who were newly diagnosed as having DM over a mean follow-up period of 10.2 years. We involved them and the 10-fold matching controls involved in our final analysis. The OR (odds ratio) (95% confidence interval, 95% CI) of DM occurrence per interquartile range increased in particulate matter (PM) smaller than or equal to 2.5 µm (PM2.5) and ozone (O3) was 1.31 (1.22-1.41) and 1.20 (1.16-1.25), respectively. The effects of PM exposure on DM development were significantly higher in the GDM group (OR: 2.46, 95% CI: 1.84-3.30) than in the non-GDM group (OR: 1.30, 95% CI: 1.21-1.40)., Conclusions: Exposure to high levels of PM2.5 and O3 elevates the risk of DM. GDM acted synergistically in DM development with exposure to PM2.5 but not with that to O3., (© The Author(s) 2023; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Published
2023
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22. The effect of cumulative noise exposure on distortion product otoacoustic emissions.

Author

Lin IF, Tsai PJ, Wu JL, Chin WS, Lin CY, and Guo YL

Subjects
Humans, Male, Cross-Sectional Studies, Noise adverse effects, Audiometry, Pure-Tone, Auditory Threshold, Otoacoustic Emissions, Spontaneous, Hearing Loss, Noise-Induced diagnosis, Hearing Loss, Noise-Induced etiology
Abstract

Objective: This study aimed to identify the characteristics of distortion product otoacoustic emissions (DPOAEs) that can be used to differentiate noise-induced hearing loss (NIHL) from age-related hearing loss. A potential index to detect NIHL was defined in terms of its susceptibility to cumulative noise exposure but not to age., Design: In this cross-sectional cohort study, a job-exposure matrix was used to calculate the cumulative noise exposure. Multivariate linear regression models were used to examine how age and cumulative noise exposure associated with DPOAEs at individual frequencies after adjusting for hypertension, dyslipidaemia, tobacco use and alcohol consumption., Study Sample: The pure-tone audiometry and DPOAEs data collected from 239 male workers in a steel factory., Results: DPOAEs and DPOAE signal-to-noise ratios (SNRs) at all frequencies were found to be correlated with age, and those at 2, 3, 4 and 6 kHz were correlated with both age and noise exposure. The difference between DPOAE SNR at 1 and 3 kHz showed significant correlation with noise exposure but not with age., Conclusions: The results showed that this DPOAE index, the DPOAE SNR at 1 kHz minus the DPOAE SNR at 3 kHz, could add values to audiometric evaluation of NIHL.

Published
2023
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23. Monitoring and evaluating the dietary risk of trace elements content in bottled and hand-shaken tea in Taiwan.

Author

Chin WS, Chien LC, Kao HC, Chuang YN, and Liao KW

Subjects
Humans, Aged, Taiwan, Tea, Beverages, Risk Assessment, Trace Elements analysis, Camellia sinensis
Abstract

Tea is the most frequently consumed beverage worldwide and is obtained from the leaves Camellia sinensis. The traditional way of tea consumption through brewing is gradually being replaced by the consumption of bottled and hand-shaken tea. Despite the different ways of tea consumption, trace elements accumulation and contamination of tea leaves have caused concerns. However, limited studies have reported trace element concentrations in different types of tea in bottled or hand-shaken tea and their health risks. This study aimed to determine the level of trace elements (V, Cr, Co, As, Cd, Pb, Mn, and Zn) in green tea, black tea, and Oolong tea in two varieties of products (bottled and hand-shaken tea). The health risks associated with tea consumption in various age subgroups among Taiwan's general population were also estimated. A Monte Carlo simulation was applied to estimate the distribution of daily trace elements intake through bottled and hand-shaken tea consumption. As to the non-carcinogenic risks, the Monte Carlo simulation showed that hand-shaken green tea had a higher percentage of hazard index (HI) >1 (1.08%~6.05%) among all age groups. As to carcinogenic risks, the Monte Carlo simulation showed that the risks of As exposure from bottled Oolong tea and hand-shaken black, green, and Oolong teas in the 90th percentile in >18 to ≤65 and >65-year-old groups were higher than 10 -6 . The current study findings provided some information about trace elements of both bottled and hand-shaken tea and human health risks in the general population of Taiwan., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2023
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24. Long-Term Exposure to Air Pollution and the Occurrence of Metabolic Syndrome and Its Components in Taiwan.

Author

Chen YC, Chin WS, Pan SC, Wu CD, and Guo YL

Subjects
Adult, Humans, Taiwan epidemiology, Obesity, Abdominal chemically induced, Blood Glucose, Environmental Exposure analysis, Particulate Matter analysis, Obesity chemically induced, Nitrogen Dioxide analysis, Metabolic Syndrome epidemiology, Metabolic Syndrome chemically induced, Air Pollution adverse effects, Air Pollution analysis, Air Pollutants analysis, Hypertension chemically induced
Abstract

Background: Metabolic syndrome (MetS), a major contributor to cardiovascular and metabolic diseases, has been linked with exposure to air pollution. However, the relationship between air pollutants and the five components of MetS [abdominal obesity, elevated triglyceride, decreased high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and elevated fasting blood glucose levels], has not been clearly described., Objective: We examined the association between long-term exposure to air pollutants and the occurrence of MetS and its components by using a longitudinal cohort in Taiwan., Methods: The MJ Health Research Foundation is a medical institute that conducts regular physical examinations. The development of MetS, based on a health examination and the medical history of an MJ cohort of 93,771 participants who were enrolled between 2006 and 2016 and had two or more examinations, was compared with estimated exposure to air pollutants in the year prior to health examination. The exposure levels to fine particulate matter [PM with an aerodynamic diameter of ≤ 2.5 μ m ( PM 2.5 )] and nitrogen dioxide ( NO 2 ) in the participants' residential areas were estimated using a hybrid Kriging/land-use regression (LUR) model executed using the XGBoost algorithm and a hybrid Kriging/LUR model, respectively. Cox regression with time-dependent covariates was conducted to estimate the effects of annual air pollutant exposure on the risk of MetS and its components., Results: During the average follow-up period of 3.4 y, the incidence of MetS was 38.1/1,000 person-years. After mutual adjustment and adjustments for potential covariates, the results indicated that every 10 - μ g / m 3 increase in annual PM 2.5 concentration was associated with an increased risk of abdominal obesity [ adjusted hazard ratio  ( aHR ) = 1.07 ; 95% confidence interval (CI): 1.01, 1.14], hypertriglyceridemia ( aHR = 1.17 ; 95% CI: 1.11, 1.23), low HDL-C ( aHR = 1.09 ; 95% CI: 1.02, 1.17), hypertension ( aHR = 1.15 ; 95% CI: 1.09, 1.21), and elevated fasting blood glucose ( aHR = 1.15 ; 95% CI: 1.10, 1.20). Furthermore, PM 2.5 and NO 2   may increase the risk of developing MetS among people who already "have" some components of MetS., Discussion: Our findings suggest that in apparently healthy adults undergoing physical examination, exposure to PM 2.5 and NO 2 might be associated with the occurrence of MetS and its components. https://doi.org/10.1289/EHP10611.

Published
2023
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25. [Safety Climate in Hospitals: From Science to Policy-The Progress of Needlestick Prevention in Taiwan].

Author

Wu HC, Ou YS, Chin WS, Wang LJ, Chen YC, Lin TT, and Shiao SJ

Subjects
Hospitals, Humans, Organizational Culture, Policy, Taiwan, Needlestick Injuries prevention & control, Occupational Stress
Abstract

In hospitals, safety climate refers to the safety policies and regulations established by medical institutions and the measures taken to ensure medical personnel feel safe while working at these institutions. Safety climate can directly affect the overall work performance of medical personnel and indirectly affect patient care quality, which in turn impacts the rate of occupational hazards. Common occupational hazards in the medical workplace include contracting infectious diseases, overwork, irregular circadian rhythm due to working shifts, changes in sleep patterns and dietary habits, musculoskeletal discomfort, workplace violence, workplace stress, and needlestick injuries. This paper was developed to explore the history of promoting needlestick prevention in Taiwan, and discusses how to use the results of empirical research as scientific evidence and critical proofs to advocate for needlestick prevention and to establish related policies. In addition, the process of how improvements to the hospital safety climate and the prevention of occupational hazard incidents mutually influence and complement each other was examined. Future studies are encouraged to explore this topic to further elucidate the sources of workplace stress and to devise methods to ameliorate their influence on workplace stress in medical institutions. The results of these studies may be referenced by relevant government agencies and medical institutions when developing policies promoting safe environments in hospitals that improve the safe-work perceptions of nursing personnel and create comfortable and friendly medical environments.

Published
2022
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26. Living proximity to petrochemical industries and the risk of attention-deficit/hyperactivity disorder in children.

Author

Huang CC, Pan SC, Chin WS, Chen YC, Wu CD, Hsu CY, Lin P, Chen PC, and Guo YL

Subjects
Benzene toxicity, Child, Cohort Studies, Humans, Proportional Hazards Models, Time Factors, Attention Deficit Disorder with Hyperactivity chemically induced, Attention Deficit Disorder with Hyperactivity epidemiology
Abstract

Evidence regarding the negative neurodevelopmental effects of compound exposure to petrochemicals remains limited. We aimed to evaluate the association between exposure to petrochemical facilities and generated emissions during early life and the risk of attention-deficit/hyperactivity disorder (ADHD) development in children. We conducted a population-based birth cohort study using the 2004 to 2014 Taiwanese Birth Certificate Database and verified diagnoses of ADHD using the National Health Insurance Database. The level of petrochemical exposure in each participant's residential township was evaluated using the following 3 measurements: distance to the nearest petrochemical industrial plant (PIP), petrochemical exposure probability (accounting for monthly prevailing wind measurements), and monthly benzene concentrations estimated using kriging-based land-use regression models. We applied Cox proportional hazard models to evaluate the association. During the study period, 48,854 out of 1,863,963 children were diagnosed as having ADHD. The results revealed that residents of townships in close proximity to PIPs (hazard ratio [HR] = 1.20, 95% confidence interval [CI]: 1.16-1.23, <3 vs. ≥10 km), highly affected by petrochemical-containing prevailing winds (HR = 1.12, 95% CI: 1.08-1.16, ≥40% vs. <10%), and with high benzene concentrations (HR = 1.26, 95% CI: 1.23-1.29, ≥0.75 vs. <0.55 ppb) were consistently associated with the increased risk of ADHD development in children. The findings of the sensitivity analysis remained robust, particularly for the 2004 to 2009 birth cohort and for models accounting for a longer duration of postnatal exposure. This work provided clear evidence that living near petrochemical plants increases the risk of ADHD development in children. Further studies are warranted to confirm our findings., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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27. Enhancing the capability of Klebsiella pneumoniae to produce 1, 3-propanediol by overexpression and regulation through CRISPR-dCas9.

Author

Wang X, Zhang L, Liang S, Yin Y, Wang P, Li Y, Chin WS, Xu J, and Wen J

Subjects
Fermentation, Glycerol metabolism, Propylene Glycol metabolism, Propylene Glycols metabolism, Clustered Regularly Interspaced Short Palindromic Repeats, Klebsiella pneumoniae genetics
Abstract

Klebsiella pneumoniae is a common strain of bacterial fermentation to produce 1, 3-propanediol (1, 3-PDO). In general, the production of 1, 3-PDO by wild-type K. pneumoniae is relatively low. Therefore, a new gene manipulation of K. pneumoniae was developed to improve the production of 1, 3-PDO by overexpressing in the reduction pathway and attenuating the by-products in the oxidation pathway. Firstly, dhaB and/or dhaT were overexpressed in the reduction pathway. Considering the cost of IPTG, the constitutive promoter P32 was selected to express the key gene. By comparing K.P. pET28a-P32-dhaT with the original strain, the production of 1, 3-PDO was increased by 19.7%, from 12.97 to 15.53 g l -1 (in a 250 ml shaker flask). Secondly, three lldD and budC regulatory sites were selected in the by-product pathway, respectively, using the CRISPR-dCas9 system, and the optimal regulatory sites were selected following the 1, 3-PDO production. As a result, the 1, 3-PDO production by K.P. L1-pRH2521 and K.P. B3-pRH2521 reached up to 19.16 and 18.74 g l -1 , which was increased by 47.7% and 44.5% respectively. Overexpressing dhaT and inhibiting expression of lldD and budC were combined to further enhance the ability of K. pneumoniae to produce 1, 3-PDO. The 1, 3-PDO production by K.P. L1-B3-PRH2521-P32-dhaT reached 57.85 g l -1 in a 7.5 l fermentation tank (with Na + neutralizer), which is higher than that of the original strain. This is the first time that the 1, 3-PDO production was improved in K. pneumoniae by overexpressing the key gene and attenuating by-product synthesis in the CRISPR-dCas9 system. This study reports an efficient approach to regulate the expression of genes in K. pneumoniae to increase the 1, 3-PDO production, and such a strategy may be useful to modify other strains to produce valuable chemicals., (© 2022 The Authors. Microbial Biotechnology published by Society for Applied Microbiology and John Wiley & Sons Ltd.)

Published
2022
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28. Exposure to Air Pollution and Survival in Follow-Up after Hepatocellular Carcinoma.

Author

Chin WS, Pan SC, Huang CC, Chen PJ, and Guo YL

Abstract

Introduction: Air pollutants are classified as carcinogens by the International Agency for Research on Cancer. Long-term exposure to ambient particulate matter with an aerodiameter of 2.5 μm or lower (PM 2.5 ) has been reported to be linked with increased mortality due to hepatocellular carcinoma (HCC). However, the effects of air pollutants other than PM 2.5 on HCC-related mortality have not been fully investigated. Accordingly, we conducted this study to assess the effect of long-term exposure to air pollutants (PM 2.5 and nitrogen dioxide [NO 2 ]) on HCC-related mortality., Method: In 2005, the Taiwan Liver Cancer Network (TLCN) was established by the National Research Program for Genomic Medicine to recruit liver cancer patients from 5 major medical centers in northern, central, and southern Taiwan. The TLCN had successfully recruited 9,344 patients by the end of 2018. In this study, we included 1,000 patients randomly sampled from the TLCN to assess the effect of exposure to air pollutants on HCC mortality after HCC diagnosis. Daily averages of PM 2.5 and NO 2 concentrations were retrieved from 77 air quality-monitoring stations and interpolated to the townships of patients' residences by using the Kriging method. The effect of air pollutants on HCC survival was assessed using a Cox proportional hazards model., Results: A total of 940 patients were included in the analysis. After adjusting for potential confounders and mutually adjusting for co-pollutants, we observed that the hazards ratio (95% confidence interval) for HCC-related mortality for every 1-μg/m 3 increase in PM 2.5 concentration was 1.11 (1.08-1.14) and that for every 1-ppb increase in NO 2 concentration was 1.08 (1.03-1.13)., Conclusion: Our study suggests that long-term exposure to PM 2.5 and NO 2 was associated with decreased survival time in patients with HCC in Taiwan., Competing Interests: Prof. Chen is an Associate Editor of Liver Cancer. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.)

Published
2022
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29. Proximity to petrochemical industrial parks and risk of chronic glomerulonephritis.

Author

Chin WS, Pan SC, Huang CC, Chen YC, Hsu CY, Lin P, Chen PC, and Guo YL

Subjects
Adult, Aged, Case-Control Studies, Humans, Industry, Middle Aged, Odds Ratio, Young Adult, Environmental Exposure analysis, Glomerulonephritis chemically induced, Glomerulonephritis epidemiology
Abstract

This study determined whether individuals residing near petrochemical industrial parks (PIPs) have a higher risk of chronic glomerulonephritis (CGN). We performed population-based 1:4 case-control study by using Taiwan's National Health Insurance Research Database from 2000 to 2016. The subjects were aged 20-65 years, residing in western Taiwan, and did not have a history of any renal or urinary system disease in 2000. The case cohort included those who had at least three outpatient visits or one hospitalization between 2001 and 2016 with codes for CGN as per International Classification of Diseases (ICD)-Ninth and Tenth Revisions. Controls were randomly sampled age-, sex-, and urbanization-matched individuals without renal and urinary system diseases. Petrochemical exposure was evaluated by the distance to the nearest PIP of the residential township, and petrochemical exposure probability was examined considering the monthly prevailing wind direction. Conditional logistic regression was used to determine the association between petrochemical exposure and CGN risk. A total of 320,935 subjects were included in the final analysis (64,187 cases and 256,748 controls). After adjustment for potential confounders, living in townships within a 3-km radius of PIPs was associated with a higher risk of CGN (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.28-1.37). Compared with townships more than 20 km away from PIPs, those within 10 km of PIPs were associated with significantly increased risks of CGN in a dose-dependent manner. When prevailing wind was considered, townships with high exposure probability were associated with a significantly increased risk of CGN. We found that those residing near PIPs or with high petrochemical exposure probability had a higher risk of CGN. These findings highlight the need for monitoring environmental nephrotoxic substances and the renal health of residents living near PIPs., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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30. Occupational and Non-occupational Injuries Can Result in Prolonged Augmentation of Psychiatric Disorders.

Author

Chin WS, Liao SC, Pan SC, and Guo YL

Subjects
Adult, Humans, Incidence, Middle Aged, National Health Programs, Young Adult, Mental Disorders epidemiology, Occupational Injuries epidemiology
Abstract

Background: The long-term effects of occupational injury (OI) on psychiatric diseases are unclear. This study assessed and compared the effects of OI, no injury (control), and non-OI (NOI) on the development of psychiatric diseases., Methods: We used Taiwan's National Health Insurance Research Database to investigate the incidence of psychiatric disorders in OI, NOI, and control groups. The subjects were aged 20-50 years, actively employed in 2000, and did not have history of injury or psychiatric disorders. All subjects were followed from 2000 and were classified into OI, NOI, and control groups according to occurrence of target injury later on. Individuals in each group were matched by age, sex, insurance premium before the index date, and year of the index date. Psychiatric disease-free days were compared among the groups using survival analysis and Cox regression., Results: We included a total of 12,528 patients for final analysis, with 4,176 in each group. Compared with the control group, the OI group had an increased occurrence of trauma and stress-related disorder, depressive disorders, anxiety disorders, and alcohol and other substance dependence. These increases were similar to those in the NOI group. Elevated cumulative incidence rate of any psychiatric disorders was observed among those with OI or NOI up to 10 years after injury., Conclusion: We confirmed that OI and NOI induced psychiatric disorders. These findings highlight the need for workers' compensation mechanisms to consider long-term psychological care among injured workers.

Published
2022
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31. Rapid and sensitive SERS detection of melamine in milk using Ag nanocube array substrate coupled with multivariate analysis.

Author

Li L and Chin WS

Abstract

In this study, a facile Ag nanocube (NC) array substrate was fabricated for rapid SERS detection of melamine in milk. This easily-prepared substrate exhibited high Raman enhancement factor (~1.02 × 10 5 ) and good reproducibility with ~10.75% spot-to-spot variation in Raman intensity. Our proposed method can detect melamine as low as 0.01 ppm in standard solutions and 0.5 ppm in real milk samples after a simple one-step solvent extraction. Two multivariate analysis tools including partial least squares and support vector machines (SVM) were explored to develop reliable regression models for quantitative SERS analysis of melamine. By comparison, SVM regression models exhibited better predictive performance, especially in liquid milk, with root mean square error (RMSE) of calibration = 5.5783, coefficient of determination (R 2 ) of calibration = 0.9807, RMSE of prediction = 1.9636, and R 2 of prediction = 0.9736. Hence, this study offers a rapid and sensitive detection of adulterant melamine in milk samples., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Published
2021
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32. Maternal proximity to petrochemical industrial parks and risk of premature rupture of membranes.

Author

Huang CC, Pan SC, Chin WS, Chen YC, Hsu CY, Lin P, and Guo YL

Subjects
Case-Control Studies, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Odds Ratio, Pregnancy, Fetal Membranes, Premature Rupture chemically induced, Fetal Membranes, Premature Rupture epidemiology, Premature Birth chemically induced, Premature Birth epidemiology
Abstract

Background: Living near petrochemical industries has been reported to increase the risks of adverse birth outcomes, such as low birth weight and preterm delivery. However, evidence regarding the role of petrochemical exposure in pregnancy complications remains limited. This study evaluated the association between maternal proximity to petrochemical industrial parks (PIPs) during pregnancy and the occurrence of premature rupture of membranes (PROM)., Methods: We performed a population-based 1:3 case-control study by using the 2004-2014 Taiwanese Birth Certificate Database. Birth records reported as stillbirth or bearing congenital anomalies were excluded. Cases were newborns reported to have PROM, whereas controls were randomly sampled from those without any pregnancy complications by matching birth year and urbanization index of the residential township. The proximity to PIPs was evaluated by calculating the distance to the nearest PIP of the maternal residential township during pregnancy. Furthermore, petrochemical exposure opportunity, accounting for monthly prevailing wind direction, was quantified during the entire gestational period. We applied conditional logistic regression models to evaluate the associations., Results: In total, 29371 PROM cases were reported during the study period, with a corresponding 88113 healthy controls sampled. The results revealed that living within a 3-km radius of PIPs during pregnancy would increase the risk of PROM (odds ratio [OR] = 1.76, 95% CI: 1.66-1.87). Furthermore, compared with the lowest exposed group, those with high petrochemical exposure opportunity had a significantly increased risk of PROM occurrence (OR = 1.69-1.75). The adverse effects remained robust in the subgroup analysis for both term- and preterm-PROM., Conclusions: The results of the present work provide evidence that living near PIPs during pregnancy would increase the risk of PROM, and additional studies are warranted to confirm our findings., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2021
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33. Biogenic Synthesis of Silver Nanoparticles with High Antimicrobial and Catalytic Activities using Sheng Di Huang (Rehmannia glutinosa).

Author

Yong DWY, Lieu ZZ, Cao X, Yong XE, Wong JZL, Cheong YS, Browder LK, and Chin WS

Subjects
Aminophenols chemistry, Anti-Infective Agents chemistry, Catalysis, Green Chemistry Technology, Nitrophenols chemistry, Plants, Medicinal chemistry, Plants, Medicinal metabolism, Rehmannia metabolism, Anti-Infective Agents chemical synthesis, Metal Nanoparticles chemistry, Plant Extracts chemistry, Rehmannia chemistry, Silver chemistry
Abstract

Silver nanoparticles (AgNPs) are widely sought after for a variety of biomedical and environmental applications due to their antimicrobial and catalytic properties. We present here a green and simple synthesis of AgNPs utilizing traditional Chinese medicinal herbs. The screening of 20 aqueous herb extracts shows that Sheng Di Huang (Rehmannia glutinosa) had the most promising potential in producing AgNPs of 30±6 nm, with narrow size distribution and high crystallinity. The antimicrobial activities of these AgNPs conducted on E. coli cells were found to be superior in comparison to poly(vinylpyrrolidone)-capped AgNPs synthesized using common chemical method. Additionally, the AgNPs obtained possess excellent catalytic performance in the reduction of 4-nitrophenol to 4-aminophenol. We compared the phytochemical and FTIR spectral analyses of the herb extract before and after synthesis, in order to elucidate the phytochemicals responsible for the reduction of Ag + ions and the capping of the AgNPs produced., (© 2020 Wiley-VCH GmbH.)

Published
2021
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34. Short sleep and chronic neck and shoulder discomfort in nurses.

Author

Chin WS, Chen YC, Lin TT, Guo YL, and Shiao JSC

Subjects
Adult, Chronic Pain etiology, Cross-Sectional Studies, Female, Humans, Middle Aged, Neck Pain etiology, Occupational Diseases etiology, Shoulder Pain etiology, Sleep, Taiwan epidemiology, Time Factors, Chronic Pain epidemiology, Neck Pain epidemiology, Nursing Staff, Hospital statistics & numerical data, Occupational Diseases epidemiology, Shoulder Pain epidemiology
Abstract

Objective: Short sleep duration is common among nurses. Sleep restriction has been associated with musculoskeletal discomfort. However, studies on the effect of short sleep duration on chronic neck and shoulder discomfort in nurses have been lacking. The aim of this study was to determine whether short sleep duration is related to chronic neck and shoulder discomfort., Methods: We conducted a cross-sectional survey of female nurses in secondary referral health centers in Taiwan. We applied stratified sampling based on region (north, central, south, and east) to select representative centers for this study. A self-administered structured questionnaire, including demographic data, the psychological working environment, and musculoskeletal symptoms, was administered to nurses. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of average sleeping hours per working day on chronic neck and shoulder discomfort., Results: A total of 1602 (78.9%) questionnaires were eligible for final analysis. The prevalence rates of chronic neck and shoulder discomfort were 33.9% and 34.7%, respectively. Population attributable risk estimation revealed that a sleep duration of <7 hours per working day was the most crucial factor for chronic neck and shoulder discomfort in the nurses, accounting for 8.8% of chronic neck discomfort and 8.6% of chronic shoulder discomfort respectively., Conclusion: Our study found that sleep duration on working days was associated with chronic neck and shoulder discomfort in female nurses. Further interventions are warranted for maintaining nurses' sleep hygiene., (© 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Published
2021
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35. Ambient air pollution and asthma onset in Taiwanese adults.

Author

Wu TJ, Chen CH, Chen BY, Chin WS, and Guo YL

Subjects
Adult, Asian People, Cross-Sectional Studies, Environmental Monitoring methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prevalence, Retrospective Studies, Schools, Surveys and Questionnaires, Taiwan epidemiology, Air Pollution adverse effects, Asthma epidemiology, Asthma etiology, Environmental Exposure adverse effects, Nitrogen Dioxide adverse effects
Abstract

Background: Ambient nitrogen dioxide is associated with asthma occurrence in adults in Western countries. However, two recent large-scale studies have provided inconclusive results regarding this association. Moreover, the association remains unknown in an Asian population., Objective: We aimed to investigate the association between ambient air pollution exposure and incident adult asthma., Methods: From 2016 to 2017, we conducted a cross-sectional self-administered questionnaire survey with retrospective follow-up of incident asthma cases among schoolchildren's parents from 41 schools within 1 km of air monitoring stations distributed throughout the main island of Taiwan. To estimate participants' exposure, air pollution data of air monitoring stations within 1 km of schools from where participants were sampled were inputted into the proximity model. We used mixed logistic regression models to determine the association between air pollution exposure and asthma onset within five years prior to the survey., Results: The questionnaire was completed for a total of 11 585 participants out of 13 424 candidates (response rate, 86.3%). Among 9131 participants aged from 26 to 50 years, 101 were diagnosed with asthma within the five years prior to the survey. The prevalence of incident asthma cases was 2.2 per 1000 person-years. Those exposed to higher ambient nitrogen dioxide (odds ratio = 1.20 per interquartile [5.7 ppb] of nitrogen dioxide, 95% CI = 1.02-1.42) were more likely to develop adult-onset asthma., Conclusion: In an Asian population, exposure to higher ambient nitrogen dioxide is associated with increased prevalence of incident asthma cases among adults aged 26-50 years., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Published
2020
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36. Rapid Fabrication of a Flexible and Transparent Ag Nanocubes@PDMS Film as a SERS Substrate with High Performance.

Author

Li L and Chin WS

Abstract

Flexible and transparent surface-enhanced Raman scattering (SERS) substrates have long been sought-after for nondestructive detection of analytes on nonplanar surfaces, but there is still a lack of one convenient and robust way to fabricate such SERS substrates rapidly. Herein, we demonstrate the fabrication of a high-performance SERS substrate consisting of plasmonic Ag nanocube (Ag NC) arrays anchored onto a flexible transparent poly(dimethylsiloxane) (PDMS) membrane. Through a simple organic/water interfacial self-assembly method, arrays of presynthesized Ag NCs are obtained and directly retrieved onto the PDMS membrane without the aid of rigid substrates (e.g., Si wafers or glass slides). The plasmonic Ag NC arrays can produce strong electromagnetic enhancement, achieving high SERS enhancement factor (∼3.43 × 10 6 ) and ideal detection capability for methylene blue (MB) and Rhodamine 6G (R6G) at respective trace amounts of 10 -10 and 10 -9 M. Moreover, without the need to transfer from substrate to substrate, the regular Ag NC arrays are kept intact, thereby yielding a good reproducibility (RSD ∼12%). We demonstrate further that our as-fabricated SERS substrate displays ideal selectivity toward different kinds of analyte molecules (R6G, crystal violet (CV), and MB) based on principal component analysis. The PDMS membrane owns excellent transparency and flexibility; thus, the substrate enables the conformal contact with nonplanar surfaces and allows the penetration of a laser to reach the analytes from the reverse side of the substrate. This thus facilitates in situ SERS detection of trace residual crystal violet on fish skin, with limit of detection (LOD) reaching 0.6 ppm. This fabrication method reported here is economical and easily implemented. The robust Ag NCs@PDMS could be readily prepared and stored to meet diverse SERS sensing applications, especially for in situ detection of analytes on irregular nonplanar surfaces.

Published
2020
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37. Association between air pollution exposure and diabetic retinopathy among diabetics.

Author

Pan SC, Huang CC, Chin WS, Chen BY, Chan CC, and Guo YL

Subjects
Air Pollutants, Humans, Particulate Matter, Air Pollution, Diabetes Mellitus, Diabetic Retinopathy, Environmental Exposure
Abstract

Background: Exposure to air pollution has been linked to adverse effects on vascular diseases. However, the effects of air pollution exposure on diabetic retinopathy (DR), a vascular disease, have not been studied., Objective: To determine the association of ambient air pollution exposure with DR risk., Methods: Patients newly diagnosed as having diabetes mellitus (DM) during 2003-2012 from Longitudinal Health Insurance Database 2005), a subset of National Health Insurance Research Database, were included as the study cohort. Newly diagnosed DR patients one year or later after DM diagnosis were identified as cases. Kriging was used to interpolate yearly concentrations of air pollutants at township levels and linked with every individual's residence in each year; average concentrations during the follow-up period were then calculated as personal exposure. Conditional logistic regressions with adjustments for age at DM diagnosis and comorbidities were applied., Results: Of newly diagnosed DM cases during 2003-2012, 579 were newly diagnosed as having DR over a mean follow-up period of 5.6 years. The Odds ratio (95% confidence interval) of DR occurrence for every 10-μg/m 3 increase in particulate matter with ≤2.5 and 2.5-10-μm diameter was 1.29 (1.11-1.50) and 1.37 (1.17-1.61), respectively., Conclusion: In patients with DM, the higher particulate matter exposure, the higher is the DR risk., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article to disclose., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2020
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38. Modulation of the doping level of PEDOT:PSS film by treatment with hydrazine to improve the Seebeck coefficient.

Author

Yemata TA, Zheng Y, Kyaw AKK, Wang X, Song J, Chin WS, and Xu J

Abstract

As the most popular conducting polymer, poly(3,4 ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) is widely used for a variety of applications, including thermoelectrics. This paper reports the modulation of the doping level by treatment with hydrazine to improve the Seebeck coefficient of PEDOT:PSS films. PEDOT:PSS films were first treated with formic acid followed by hydrazine, leading to a significant increase in the Seebeck coefficient from 17.5 to 42.7 μV K -1 , about 2.5 times higher than that of the pristine film partially at the expense of electrical conductivity. An optimum power factor of 93.5 μW K -2 m -1 , being 2.4 times that of the one treated with only formic acid, was achieved. The substantial improvement in the Seebeck coefficient and the power factor is collectively attributed to the removal of the PSS, and more importantly, the reduction of the doping level of PEDOT by the hydrazine treatment, which is evidenced clearly by UV-vis-NIR spectroscopy, XPS and Raman spectroscopy., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Published
2020
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39. Improved Thermoelectric Properties and Environmental Stability of Conducting PEDOT:PSS Films Post-treated With Imidazolium Ionic Liquids.

Author

Yemata TA, Zheng Y, Kyaw AKK, Wang X, Song J, Chin WS, and Xu J

Abstract

Poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) is one of the most popular conducting polymers and widely used as polymer thermoelectric materials, and its thermoelectric performance could be improved by a variety of post-treatment processes. This paper reported two series of post-treatment methods to enhance the thermoelectric performance. The first series method included pre-treatment of PEDOT:PSS film with formamide, followed by imidazolium-based ionic liquids. The second series method included pre-treatment of PEDOT:PSS film with formamide, followed by sodium formaldehyde sulfoxylate, and finally imidazolium-based ionic liquids. Two series of post-treatment methods significantly improved the power factor of PEDOT:PSS when compared to that of PEDOT:PSS treated with formamide only. For example, using the first series post-treatment method with 40 vol.% ionic liquid 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl) amide, the Seebeck coefficient of the PEDOT:PSS film increased from 14.9 to 28.5 μV/K although the electrical conductivity reduced from 2,873 to 1,701 S/cm, resulting in a substantial improvement in the overall power factor from 63.6 to 137.8 μW/K 2 m. The electrical conductivity enhancement in the formamide-treatment process was in part ascribed to the removal of the insulating PSS component. Further treatment of PEDOT:PSS film with ionic liquid caused dedoping of PEDOT and hence increased in Seebeck coefficient. In contrast, second series post-treatment method led to the reduction in electrical conductivity from 2,873 to 641 S/cm but a big improvement in the Seebeck coefficient from 14.9 to 61.1 μV/K and thus the overall power factor reached up to ~239.2 μW/K 2 m. Apart from the improvement in electrical conductivity, the increase in Seebeck coefficient is on account of the substantial dedoping of PEDOT polymer to its neutral form and thus leads to the big improvement of its Seebeck coefficient. The environmental stability of ionic liquid-treated PEDOT:PSS films were examined. It was found that the ionic liquid treated PEDOT:PSS retained more than 70% Seebeck coefficient and electrical conductivity at 75% RH humidity and 70°C for 480 h. The improved long-term TE stability is attributed to the strong ionic interaction between sulfonate anions and bulky imidazolium cations that effectively block the penetration of water and lessen the tendency to take up water from the air., (Copyright © 2020 Yemata, Zheng, Kyaw, Wang, Song, Chin and Xu.)

Published
2020
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40. Patient-Nurse Ratio is Related to Nurses' Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction.

Author

Chen YC, Guo YL, Chin WS, Cheng NY, Ho JJ, and Shiao JS

Subjects
Adult, Burnout, Professional etiology, Cross-Sectional Studies, Female, Humans, Intention, Male, Middle Aged, Nurses statistics & numerical data, Taiwan, Young Adult, Burnout, Professional epidemiology, Job Satisfaction, Nurses psychology, Workload statistics & numerical data
Abstract

In healthcare settings, nurses' workload, burnout, and job satisfaction are associated to the patient-nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient-nurse ratio on nurses' intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient-nurse ratio (ADPNR), nurses' personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient-nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Published
2019
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41. Effects of PM 2.5 on Skeletal Muscle Mass and Body Fat Mass of the Elderly in Taipei, Taiwan.

Author

Chen CH, Huang LY, Lee KY, Wu CD, Chiang HC, Chen BY, Chin WS, Pan SC, and Guo YL

Subjects
Aged, Aged, 80 and over, Body Composition drug effects, Cross-Sectional Studies, Electric Impedance, Environmental Exposure adverse effects, Exercise physiology, Female, Hand Strength physiology, Humans, Male, Taiwan, Adipose Tissue drug effects, Muscle, Skeletal drug effects, Particulate Matter pharmacology
Abstract

Loss of skeletal muscle mass is common with aging and can cause morbidity and mortality in the elderly. The effects of particulate air pollution on skeletal muscle mass is not known. The study aims to assess the chronic effects of ambient fine particulates (PM 2.5 ) on the body composition of the elderly. From October 2015 to November 2016, a cross-sectional survey on 530 elderly (age > = 65 years) was conducted in the Taipei Basin, Taiwan. The body composition was measured by bioelectrical impedance analysis (InBody 120). One year exposure to air pollution was estimated using the Kriging method at the participant's residence. Multiple linear regression analysis, after adjustments for demographics and co-pollutants, was used to examine the effects of PM 2.5 on body composition indices and force of handgrip. Changes in body composition for an interquartile (1.4 μm/m 3 ) increase in PM 2.5 concentration included a 0.4 kg (95% confidence interval (CI): -0.31, -0.58; p < 0.0001) decrease in skeletal muscle mass (2.0%) and a 0.7 kg (95% CI: 0.47, 0.91; p < 0.0001) increase in body fat mass (3.6%). While PM 2.5 reduced fat free mass in the upper extremities and trunk, but not in the lower extremities, it increased body fat mass in the three parts. There was no significant effect of PM 2.5 on handgrip force. Higher physical activity (versus lower than median) was associated with less detrimental effect of PM 2.5 on skeletal muscle mass and body fat mass (p values for interaction term: 0.009 and 0.013, respectively). Long-term PM 2.5 exposure is associated with decreased skeletal muscle mass and increased body fat mass in the elderly, which can be ameliorated by physical activity.

Published
2019
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42. Long-Term Effects of Psychological Symptoms after Occupational Injury on Return to Work: A 6-Year Follow-Up.

Author

Chu PC, Chin WS, Guo YL, and Shiao JS

Subjects
Adult, Female, Follow-Up Studies, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Surveys and Questionnaires, Occupational Injuries psychology, Return to Work psychology
Abstract

Psychological factors may compromise return to work among workers with occupational injuries, and little is known about the long-term consequences of psychological symptoms relating to return to work. The study examined the impact of psychological symptoms on return to work as well as exploring factors associated with return to work among injured workers. A total of 572 workers who experienced occupational injuries were recruited in this prospective cohort study. Surveys of the psychological symptoms using the 5-item Brief Symptom Rating Scale (BSRS-5) were conducted at 3 and 12 months after the injury. All of the workers were invited to join the study at year 6 after the injury. Sociodemographic factors, psychological symptoms, injury severity, and return-to-work status were collected. Approximately 10% of injured workers could not return to work even 6 years after the injury. Severe psychological symptoms within 1 year after the injury presented a significant risk factor for not returning to work 6 years after the injury (adjusted OR = 0.7, 95% CI: 0.5⁻0.8). Furthermore, age, education level, length of hospitalization, and injury-induced changes in appearance had significant independent influence on return to work as well. These findings highlight the importance of the effects of mental health within 1 year post injury on return to work, and support the concept of early screening, detection, and intervention in at-risk occupational injured workers with severe psychological symptoms.

Published
2019
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43. Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan.

Author

Chin WS, Chen YC, Ho JJ, Cheng NY, Wu HC, and Shiao JSC

Subjects
Adult, Burnout, Professional epidemiology, Cross-Sectional Studies, Female, Humans, Logistic Models, Middle Aged, Nursing Research, Prevalence, Risk Factors, Surveys and Questionnaires, Taiwan epidemiology, Burnout, Professional psychology, Nurses psychology, Self Report, Suicidal Ideation, Workplace psychology
Abstract

Purpose: Nurses are exposed to a poor psychological work environment; this may cause poor mental health, which is a risk factor for suicidal ideation. We investigated the association between psychological work environment and suicidal ideation among hospital nurses in Taiwan., Design: We conducted a cross-sectional survey in Taiwan female nurses using stratified sampling by region (north, central, south, and east) to select representative centers for this study., Methods: A self-report questionnaire including items on demographic data, the psychological work environment, and suicidal ideation was sent to nurses working in hospitals. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of the psychological work environment on suicidal ideation., Findings: A total of 2,734 eligible questionnaires (76.8%) were returned. The prevalence of suicidal ideation was 18.3%, and higher risk was found to be associated with the educational level of junior college or below, higher personal burnout, higher client-related burnout, and always feeling stressed at work. Estimation of population attributable risk showed that higher personal burnout, client-related burnout, and always feeling stressed at work were the most crucial factors among nurses, accounting for 19.4%, 8.6%, and 10.5% of suicidal ideation, respectively., Conclusions: A considerable proportion of nurses developed suicidal ideation. A poor psychological work environment was a relevant factor for suicidal ideation., Clinical Evidence: This study provides relevant knowledge for nursing management levels in preventing the development of suicidal ideation among nurses. Not only for nurses' mental health, but for patient safety and care quality, further studies in improving nurses' psychological work environment are warranted., (© 2018 Sigma Theta Tau International.)

Published
2019
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45. Suicidality 6 Years After Occupational Injury.

Author

Chin WS, Guo YL, Liao SC, Lin KH, Kuo CY, Chen CC, and Shiao JSC

Subjects
Adult, Female, Humans, Male, Middle Aged, Prevalence, Psychiatric Status Rating Scales, Risk Factors, Taiwan epidemiology, Time Factors, Young Adult, Occupational Injuries epidemiology, Suicidal Ideation, Suicide statistics & numerical data, Suicide, Attempted statistics & numerical data
Abstract

Objective: Suicide attempts can result from traumatic events, including those caused by occupational injury. However, literature on the long-term prevalence rates of suicidality after occupational injury is relatively lacking. This study investigated the long-term prevalence of suicidality after occupational injury., Methods: Between February 1 and August 31, 2009, 4,403 workers in Taiwan sustained occupational injuries and were hospitalized for 3 days or longer. Surveys were conducted at 3 and 12 months after occupational injury, and 2,308 workers responded to either survey. They were invited to join the follow-up at 6 years after occupational injury, using the Brief Symptom Rating Scale (BSRS-5), Posttraumatic Symptom Checklist (PTSC), and 1 question on suicidal ideation. Workers with a high score on the BSRS-5 or PTSC were invited to participate in an in-depth psychiatric evaluation using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI)., Results: The estimated MINI-diagnosed suicidality rates at 3 months, 12 months, and 6 years after occupational injury were 5.4%, 4.8%, and 9.5%, respectively. Injured workers who reported that the injury majorly affected their physical appearance, experienced additional occupational injury requiring hospitalization for > 3 days, had unstable employment, and had lower income in the past 1 year than that before occupational injury had a higher risk of suicidal ideation. Injury majorly affecting the physical appearance, unstable employment, and lower income than that before occupational injury were the most crucial factors. These factors accounted for 12.7%, 13.2%, and 19.0% of suicidal ideation among the injured workers., Conclusions: The suicidality rate increased at 6 years after occupational injury. The relevant factors for suicidal ideation were injury severity and work instability. Periodic monitoring of psychological and physical health and economic stability are warranted., (© Copyright 2018 Physicians Postgraduate Press, Inc.)

Published
2018
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46. Machine-Learning Energy Gaps of Porphyrins with Molecular Graph Representations.

Author

Li Z, Omidvar N, Chin WS, Robb E, Morris A, Achenie L, and Xin H

Abstract

Molecular functionalization of porphyrins opens countless new opportunities in tailoring their physicochemical properties for light-harvesting applications. However, the immense materials space spanned by a vast number of substituent ligands and chelating metal ions prohibits high-throughput screening of combinatorial libraries. In this work, machine-learning algorithms equipped with the domain knowledge of chemical graph theory were employed for predicting the energy gaps of >12 000 porphyrins from the Computational Materials Repository. Among a variety of graph-based molecular descriptors, the electrotopological-state index, which encodes electronic and topological structure information, captures the energy gaps of porphyrins with a prediction RMSE < 0.06 eV. Importantly, feature sensitivity analysis suggests that the carbon structural motif in methine bridges connected to the anchor group predominantly influences the energy gaps of porphyrins, consistent with the spatial distribution of their frontier molecular orbitals from quantum-chemical calculations.

Published
2018
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47. Effects of long-term exposure to CO and PM 2.5 on microalbuminuria in type 2 diabetes.

Author

Chin WS, Chang YK, Huang LF, Tsui HC, Hsu CC, and Guo YL

Subjects
Aged, Air Pollutants analysis, Carbon Monoxide analysis, China epidemiology, Diabetes Mellitus, Type 2 urine, Environmental Exposure analysis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Particulate Matter analysis, Air Pollutants adverse effects, Albuminuria epidemiology, Carbon Monoxide adverse effects, Diabetes Mellitus, Type 2 epidemiology, Environmental Exposure adverse effects, Particulate Matter adverse effects
Abstract

Objective: No study has examined the effects of air pollutants on albuminuria in type 2 diabetes. Therefore, the present study investigated this association., Methods: This follow-up study enrolled 812 patients with type 2 diabetes between 2003 and 2012. The urinary albumin-to-creatinine ratio (ACR) was recorded annually. Exposure to the air pollutants CO, NO 2 , O 3 , SO 2 , and PM 2.5 was interpolated from 72 air-quality monitoring stations to residences by using the kriging method. The association between air pollutants and ACR increase was assessed using mixed-effect model with random intercepts for 36 clinics., Results: The study objects (mean age: 55.4 years) were followed for 3 or more years (average period: 5.4 years). ACR increase was found to be positively associated with the male sex, baseline hemoglobin A1c, and exposure to CO and PM 2.5 , and negatively associated with waist circumference through multiple linear regression. Annually urine albumin/creatinine ratio increase was estimated by the final model, Patients exposed to higher levels of CO (e.g., third quartile, 1025 ppb) and lower levels of CO (e.g., first quartile, 850 ppb) had an annual ACR increase of 3.73 and 3.54 mg/g, respectively. Patients exposed to higher levels of PM 2.5 (e.g., third quartile, 38.8 μg/M3) and lower levels of PM 2.5 (e.g., first quartile, 27.7 μg/M3) had an annual ACR increase of 3.96 and 3.17 mg/g, respectively., Conclusions: Exposure to high CO and PM 2.5 levels increased albuminuria in type 2 diabetes., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

Published
2018
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48. Quality of life at 6 years after occupational injury.

Author

Chin WS, Guo YL, Liao SC, Wu HC, Kuo CY, Chen CC, and Shiao JS

Subjects
Adult, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Occupational Injuries psychology, Quality of Life psychology
Abstract

Purpose: Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain., Methods: Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury., Results: A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains., Conclusion: At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.

Published
2018
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49. Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries.

Author

Chin WS, Shiao JS, Liao SC, Kuo CY, Chen CC, and Guo YL

Subjects
Adult, Anxiety Disorders epidemiology, Depressive Disorder, Major epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Occupational Injuries epidemiology, Stress Disorders, Post-Traumatic epidemiology, Taiwan epidemiology, Anxiety Disorders etiology, Depressive Disorder, Major etiology, Employment statistics & numerical data, Hospitalization statistics & numerical data, Occupational Injuries complications, Stress Disorders, Post-Traumatic etiology
Abstract

The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.

Published
2017
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50. Hydrocarbon bio-jet fuel from bioconversion of poplar biomass: life cycle assessment.

Author

Budsberg E, Crawford JT, Morgan H, Chin WS, Bura R, and Gustafson R

Abstract

Background: Bio-jet fuels compatible with current aviation infrastructure are needed as an alternative to petroleum-based jet fuel to lower greenhouse gas emissions and reduce dependence on fossil fuels. Cradle to grave life cycle analysis is used to investigate the global warming potential and fossil fuel use of converting poplar biomass to drop-in bio-jet fuel via a novel bioconversion platform. Unique to the biorefinery designs in this research is an acetogen fermentation step. Following dilute acid pretreatment and enzymatic hydrolysis, poplar biomass is fermented to acetic acid and then distilled, hydroprocessed, and oligomerized to jet fuel. Natural gas steam reforming and lignin gasification are proposed to meet hydrogen demands at the biorefineries. Separate well to wake simulations are performed using the hydrogen production processes to obtain life cycle data. Both biorefinery designs are assessed using natural gas and hog fuel to meet excess heat demands., Results: Global warming potential of the natural gas steam reforming and lignin gasification bio-jet fuel scenarios range from CO2 equivalences of 60 to 66 and 32 to 73 g MJ(-1), respectively. Fossil fuel usage of the natural gas steam reforming and lignin gasification bio-jet fuel scenarios range from 0.78 to 0.84 and 0.71 to 1.0 MJ MJ(-1), respectively. Lower values for each impact category result from using hog fuel to meet excess heat/steam demands. Higher values result from using natural gas to meet the excess heat demands., Conclusion: Bio-jet fuels produced from the bioconversion of poplar biomass reduce the global warming potential and fossil fuel use compared with petroleum-based jet fuel. Production of hydrogen is identified as a major source of greenhouse gas emissions and fossil fuel use in both the natural gas steam reforming and lignin gasification bio-jet simulations. Using hog fuel instead of natural gas to meet heat demands can help lower the global warming potential and fossil fuel use at the biorefineries.

Published
2016
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