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1. Altered Proteolysis in Fibroblasts of Alzheimer Patients with Predictive Implications for Subjects at Risk of Disease

Author

Alessandra Mocali, Nunzia Della Malva, Claudia Abete, Vito Antonio Mitidieri Costanza, Antonio Bavazzano, Vieri Boddi, Luis Sanchez, Sandra Dessì, Alessandra Pani, and Francesco Paoletti

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Geriatrics, RC952-954.6
Abstract

There is great interest in developing reliable biomarkers to support antemortem diagnosis of late-onset Alzheimer’s disease (AD). Early prediction and diagnosis of AD might be improved by the detection of a proteolytic dysfunction in extracts from cultured AD fibroblasts, producing altered isoelectrophoretic forms of the enzyme transketolase (TK-alkaline bands). The TK profile and apolipoprotein E (APOE) genotype were examined in fibroblasts from 36 clinically diagnosed probable late-onset sporadic AD patients and 38 of their asymptomatic relatives, 29 elderly healthy individuals, 12 neurological non-AD patients, and 5 early-onset AD patients. TK alterations occurred in (i) several probable AD patients regardless of age-of-onset and severity of disease; (ii) all early-onset AD patients and APOE ε4/4 carriers; and (iii) nearly half of asymptomatic AD relatives. Normal subjects and non-AD patients were all negative. Notably, culture conditions promoting TK alterations were also effective in increasing active BACE1 levels. Overall, the TK assay might represent a low-cost laboratory tool useful for supporting AD differential diagnosis and identifying asymptomatic subjects who are at greater risk of AD and who should enter a follow-up study. Moreover, the cultured fibroblasts were confirmed as a useful in vitro model for further studies on the pathogenetic process of AD.

Published
2014
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3. Deep Learning in Automotive Software

Author

Alessandra Mitidieri Costanza, Giuseppe Lami, and Fabio Falcini

Subjects
Engineering, 02 engineering and technology, computer vision, V model, Software development process, Software analytics, ISO/AWI PAS 21448, 0202 electrical engineering, electronic engineering, information engineering, computing methodologies, Social software engineering, Automotive SPICE, vision and scene understanding, business.industry, Software development, W model, software engineering process, 020207 software engineering, ANNs, artificial intelligence, neural networks, 020202 computer hardware & architecture, deep neural networks, software development, Software construction, Personal software process, standards, Software engineering, business, artificial neural networks, Software, ISO 26262, software engineering, Automotive software
Abstract

Deep-learning-based systems are becoming pervasive in automotive software. So, in the automotive software engineering community, the awareness of the need to integrate deep-learning-based development with traditional development approaches is growing, at the technical, methodological, and cultural levels. In particular, data-intensive deep neural network (DNN) training, using ad hoc training data, is pivotal in the development of software for vehicle functions that rely on deep learning. Researchers have devised a development lifecycle for deep-learning-based development and are participating in an initiative, based on Automotive SPICE (Software Process Improvement and Capability Determination), that's promoting the effective adoption of DNN in automotive software. This article is part of a theme issue on Automotive Software.

Published
2017
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4. Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

Author

Aloisi, Gaetano, Marengoni, Alessandra, Morandi, Alessandro, Zucchelli, Alberto, Cherubini, Antonio, Mossello, Enrico, Mario, Bo, Di Santo Simona, Mazzone, Andrea, Trabucchi, Marco, Cappa, Stefano, Fimognari, Filippo, Antonelli Incalzi Raffaele, Gareri, Pietro, Perticone, Francesco, Campanini, Mauro, Montorsi, Marco, Latronico, Nicola, Zambon, Antonella, Bellelli, Giuseppe, Rispoli, Vincenzo, Malara, Alba, Spadea, Fausto, Di Cello Serena, Ceravolo, Francesco, Fabiano, Francesco, Chiaradia, Giuseppe, Gabriele, Amedeo, Lenino, Peluso, Andrea, Taristano, Settembrini, Vincenzo, Capomolla, Domenico, Citrino, Antonella, Scriva, Antonietta, Bruno, Irene, Secchi, Roberto, De Martino Eugenio, Muccinelli, Roberto, Lupi, Gerardo, Paonessa, Patrizio, Fabbri, Andrea, Passuti Maria Teresa, Castellari, Sofia, Andrea, Po, Gaggioli, Guido, Varesi, Massimo, Moneti, Paolo, Capurso, Sebastiano, Latini, Vincenzo, Ghidotti, Stefano, Riccardelli, Francesco, Macchi, Maurizio, Rigo, Rosaria, Claudio, Pascale, Bosio, Angelo, Cerrato, Flavio, Bardelli, Benedetta, Boffelli, Stefano, Cassinadri, Angela, Franzoni, Simone, Spazzini, Elena, Andretto, Daniela, Tonini, Gabriele, Andreani, Laura, Coralli, Mirco, Balotta, Antonio, Cancelliere, Roberto, Ballardini, Giorgio, Simoncelli, Margherita, Mancini, Annarita, Strazzacapa, Mara, Fabio, Stefano, De Filippi Francesco, Giudice, Chiara, Dentizzi, Cosimo, Azzini, Margherita, Cazzadori, Marco, Mastroeni, Valeria, Bertassello, Paolo, Santana, Helena, Benati, Claudia, Nesta, Elisa, Tobaldini, Chiara, Guerini, Fabio, Tambara, Elena, Mombelloni, Paolo, Fontanini, Fulvio, Lassa, Gabriella, Lassa, Pizzorni, Crosio, Oliverio, Martina, Del, Grosso, Luciano, Luca, Giavedoni, Cristina, Bidoli, Giuliano, Mazzei, Bruno, Corsonello, Andrea, Fusco, Sergio, Vena, Silvio, De Vuono Tommaso, Maiuri, Giorgio, Fimognari Filippo Luca, Arone, Andrea, Sgro, Giovanni, Nicolazzo, Rossella, Castegnaro, Eugenio, De Rosa Salvatore, Sechi Bazzano Rossella, Benvenuti, Enrico, Del Lungo Ilaria, Giardini, Sante, Giulietti, Chiara, Di Bari Mauro, Barghini, Eleonora, Paoli, Martina, Fiordelli, Irene, Barucci, Riccardo, Sgrilli, Federica, Bertoletti, Erik, D'Amico, Ferdinando, Caronzolo, Francesco, Grippa, Alessandro, Lombardo, Giuseppina, Pipicella, Tiziana, Saitta, Antonino, Corica, Francesco, Cucinotta, Valeria, Giaritta, Prestipino, Larosa, Daniela, Cucinotta, Domenico, Basile, Giorgio, March, Albert, Nitti Maria Teresa, Felici, Alessandro, Pavan, Silvia, Piazzani, Fabrizio, Lunelli, Alessandra, Dimori, Sergio, Margotta, Alessandro, Soglia, Tiziano, Postacchini, Demetrio, Brunelli, Roberto, Santini, Silvia, Francavilla, Monia, Macchiati, Ilenia, Sorvillo, Francesca, Giuli, Cinzia, Mecocci, Patrizia, Longo, Annalisa, Addesi, Desiree, Rosa Paola Cerra, Bencardino, Giuseppe, Falbo, Tania, Grillo, Nadia, Filice, Marco, Mirella, Filippo, Fanto, Fausto, Isaia, Gianluca, Pezzilli, Stella, Bergamo, Daniele, Furno, Elisabetta, Rrodhe, Sokol, Lucarini, Simonetta, Dijk, Babette, Dall'Acqua, Francesca, Cappelletto, Francesco, Calvani, Donatella, Becheri, Dimitri, Mottino, Giuseppe, Mitidieri, Costanza, Antonio, Vito, Bartalucci, Francesca, Magherini, Lorenza, Malin, Novella, Boni, Franca, Gambardella Paoli Martina Lucia, Valente, Carlo, Bracali, Ilaria, Bracali, Foschini, Alice, Porrino, Paola, Ceci, Giacomo, Bottignole, Giuliana, Tibaldi, Michela, Coppo, Eleonora, Ettore, Evaristo, Camellini, Cinzia, Servello, Adriana, Grassi, Alessandro, Rozzini, Renzo, Tironi, Sara, Grassi Maria Grazia, Troisi, Elio, Caltagirone, Carlo, Franchini, Flaminia, Ratto, Federica, Pavoni, Beatrice, Toniolo, Sofia, Gabutto, Anna, Quazzo, Loredana, Rosatello, Annalisa, Suraci, Domenico, Tagliabue, Benedetta, Perrone, Chiara, Ferrara, Lucia, Castagna, Alberto, Tremolada Maria Luisa, Castoldi, Giuseppe, Barbero, Stefano, Oltramonti, Davide, Piano, Simonetta, Serviddio, Gaetano, Lo Buglio Aurelio, Gurrera, Tiziana, Merlo, Valeria, Rovai, Carla, Cotroneo Antonino Maria, Carlucci, Rosaria, Abbaldo, Anna, Monzani, Fabio, Qasem Ahmad Amedeo, Bini, Giacomo, Tafuto, Silvia, Galli, Giovanni, Bruni Amalia Cecilia, Mancuso, Giovanna, Mancuso, Gerardo, De Luca Giuseppe Massimiliano, Calipari Daniela., Bernardini, Bruno, Corsini, Carla, Ciccarelli, Michele, Dal Farra Sara, Dal, Farra, Cagnin, Annachiara, Fragiacomo, Federica, Pompanin, Sara, Amodio, Piero, Cagnin, Marco, Zurlo, Amedeo, Guerra, Gianluca, Pala, Marco, Menozzi, Luca, Delli Gatti Chiara, Magon, Stefania, Manfredini, Roberto, De Giorgi Alfredo, Fabbian, Fabio, Tiseo, Ruana, Misurati, Elisa, Boari, Benedetta, Molino, Christian, Gallerani, Massimo, Di Francesco Vincenzo, Faccioli, Silvia, Pellizzari, Luca, Fontana, Giorgia, Barbagallo, Giuseppe, Lunardelli Maria Lia, Martini, Emilio, Ferrari, Eleonora, Macchiarulo, Maria, Corneli, Maria, Bacci, Monica, Battaglia, Giuseppe, Anastasio, Luigi, Lo Storto Mario Sostene, Seresin, Chiara, Simonato, Matteo, Loreggian, Michele, Cestonaro, Fausta, Durando, Mario, Latella, Raffaele, Mazzoleni, Marta, Russo, Giuseppe, Ponte, Martino, Valchera, Alessandro, Salustri, Giuseppe, Petritola, Donatella, Costa, Alfredo, Sinforiani, Elena, Cotta Matteo Ramusino, Pizio Renato Nicola, Cester, Alberto, Formilan, Marino, Bonometto, Pietro, Carbone, Pasqualina, Cazzaniga, Ilaria, Appollonio, Ildebrando, Cereda, Diletta, Stabile, Andrea, Xhani, Rubjona, Acampora, Roberto, Tremolizzo, Lucio, Pieruzzi, Federico, Ciaccio, Antonio, Pontecorvi, Valerio, Burti, Cesare, Mokini, Zhirajr, Vitale, Giovanni, Amigoni, Maria, Sparacino, Mariaelena, Bottacchi, Edo, Bucciantini, Elisabetta, Di Giovanni Marco, Franchi, Fabrizio, Lucchetti, Lucio, Mariani, Claudio, Grande, Giulia, Rapazzini, Piero, Mauri, Marco, Romanelli, Giuseppe, Nicosia, Franco, Margola, Alessio, Bonardelli, Stefano, Porcella, Laura, Portolani, Nazario, Concoreggi, Carlo, Grassini, Chiara, Salvi, Andrea, Bianchetti, Luca, Spagnoli, Francesca, Apuzzo, Roberto, Fontanella, Ceraso, Anna, Castelli, Francesco, Fugazza, Luciano, Guerrini, Chiara, De Paduanis Giovanna, Iallonardo, Lucia, Palumbo, Pasquale, Zuliani, Giovanni, Ortolani, Beatrice, Capatti, Eleonora, Soavi, Cecilia, Bianchi, Lara, Francesconi, Daniela, Miselli, Agata, Brombo, Gloria, Romagnoli, Tommaso, Pazzaglini, Chiara, Miselli Maria Agata, Dall'Agata, Marco, Suardi, Teresa, Zaccarini, Cinzia, Riva, Manuela, Mirra, Gianluca, Muti, Ettore, Bottura, Renato, Moretti, Gianpaolo, Secreto, Piero, Bisio, Erika, Cecchettani, Marco, Naldi, Tamara, Pallavicino, Alessandra, Pugliese, Michela, Iozzo Rosaria Cosima, Grassi, Guido, Bombelli, Michele, Delloro, Raffaella, Quarti Trevano Fosca, Giussani Carlo Giorgio, Paterno, Giovanni, Contro, Ernesto, Mannironi, Antonio, Giorli, Elisa, Oberti, Sara, Fierro, Brigida, Piccoli, Tommaso, Giacalone, Fabio, Mandas, Antonella, Serchisu, Luca, Costaggiu, Diego, Pinna, Elisa, Orru, Francesca, Mannai, Martina, Cordioli, Zeno, Pelizzari, Luca, Turcato, Emanuela, Arduini, Pietro, Cacace, Carlo, Chiloiro, Roberta, Cimino, Rosella, Ruberto, Carmen, Ruotolo, Giovanni, Greco, Laura, Dal Santo Pierluigi, Andriolli, Antonino, Burattin, Giuseppe, Rossi, Laura, Andreolli, Antonino, Cervati, Giovanna, Catalano, Giuseppe, Tezza, Fabiana, Pizzardini, Maddalena, Stievano, Laura, Crippa, Patrizia, Aloisio, Paola, Di Monda Tiziana, Malighetti, Alessandro, Galbassini, Gloria, Ivaldi, Claudio, Russo Anna Maria, Bennati, Ettore, Pino, Elisabetta, Zavarise, Gianmaria, Pesci, Alberto, Suigo, Giulia, Faverio, Paola, Gori, Andrea, Perego Sabrina Perego, Zanasi, Massimo, Moniello, Giovanni, Rostagno, Carlo, Cartei, Alessandro, Polidori, Gianluca, Ungar, Andrea, Melis Maria Ramona, Martellini, Eleonora, Torrini, Monica, Giordano, Antonella, Leone, Giovanna, Migliorini, Marta, Caramelli, Francesca, Battiston, Bruno, Berardino, Maurizio, Cavallo, Simona, Masse, Alessandro, Santoro, Anna, Lombardi, Bruna, D'Ippolito, Pierpaolo, Furini, Angela, Villani, Daniele, Raimondi, Clara, Guarneri, Massimo, Paolucci, Stefano, Bassi, Andrea, Coiro, Paola, De Angelis Domenico, Morone, Giovanni, Venturiero, Vincenzo, Palleschi, Lorenzo, Raganato, Paolo, Di Niro Giuseppina, Casini Anna Rosa, Bove, Loredana, Imoscopi, Alessandra, Isaia, Giancarlo, Tibaldi, Vittoria, Calvi, Elisa, Clementi, Carlotta, Zanocchi, Mauro, Agosta, Luca, Criasia, Antonio, Spertino, Elena, Nortarelli, Antonella, Provenzano, Giuseppe, Principato, Pietro, Rizzo, Anita, Cellura, Eleonora, Mari, Daniela, Romano Federica Ylenia, Rosini, Francesca, Mansi, Marta, Rossi, Silvia, Riccardelli, Alex, Inzaghi, Lorenzo, Bonini, Giulia, Rossi, Paolo, Potena, Alfredo, Lichii, Mihaela, Candiani, Tiziana, Grimaldi, William, Bertani, Emiliano, Porta, Alessandra, Calogero, Pietro, Pinto, Daniela, Bernardi, Roberto, Nicolino, Francesco, Galetti, Caterina, Gianstefani, Alice, Corvalli, Giulia, Mulazzani, Lorenzo, Odetti, Patrizio, Monacelli, Fiammetta, Prefumo, Matteo, Canepa, Marta, Minaglia, Cecilia, Paolisso, Giuseppe, Rizzo Maria Rosaria, Prestano, Raffaele, Dalise Anna Maria, Barra, Davide, Dal Bosco Livio, Asprinio, Vincenzo, Dallape, Luciana, Maina, Paola, Perina, Elisa, Bartoli Rossi Isaura, Pluderi, Alice, Maina, Antonella, Pecoraro, Elisabetta, Sciarra, Michela, Prudente, Angela, Mete, Francesca, Ventura, Manuel, Cesari, Luisella, Pernigotti Luigi Maria, Santangelo, Tina, Benini, Lucia, Levato, Francesco, Mhiuta, Victor, Alius, Florin, Davidoaia, Diana, Giardini, Vittorio, Garancini, Mattia, Bellamoli, Claudio, Terranova, Luciano, Bozzini, Claudia, Tosoni, Paolo, Provoli, Emma, Cascone, Luisa, Dioli, Andrea, Ferrarin, Gianfranco, Bucci, Adelmo, Bua, Guido, Fenu, Sara, Bianchi, Giovanna, Casella, Silvia, Romano, Valentina, Poli, Maurizio, Mascherona, Ilenia, Belotti, Gloria, Cavaliere, Sabina, Cuni, Estella, Merciuc, Nina, Oberti, Rosella, Veneziani, Silvia, Capoferri, Emanuela, De Bernardi Elisabetta, Colombo, Katia, Bravi, Marco, Negrinotti, Nicoletta, D'Arcangelo, Paolo, Montenegro, Nicola, Montanari, Roberto, Lamanna, Pierpaolo, Gasperini, Beatrice, Montesi, Isabella, Diotallevi, Stefania, Altobelli, Gaia, Cacinaro, Filippo, Palama, Chiara, Di Emidio Chiara, Scarpini, Elio, Arighi, Andrea, Scrimieri, Antonia, Fumagalli, Giorgio, Basilico, Paola, Migone De Amicis Margherita, Mancarella, Marta, Maira, Diletta, Granata, Antonino, Ranalli, Claudia, Cammilli, Alessandra, Cavallini Maria Chiara, Tricca, Manola, Natella, Daniela, Gabbani, Luciano, Tesi, Francesca, Martella, Letizia, Imbrici, Rosalba, Pacchioni, Maurizio, Gianbattista, Guerrini, Scotuzzi Anna Maria, Sozzi, Ferdinando, Valenti, Luigi, Chiarello, Antonino, Monella, Monia, Pilotto, Alberto, Prete, Camilla, Senesi, Barbara, Meta Anna Cristina, Pendenza, Enrico, Pasqualetti, Giuseppe, Polini, Antonio, Tognini, Sara, Ballino, Elena, Dell'Aquila, Giuseppina, Gasparrini Pina Maria, Marotti, Elisabetta, Migale, Monica, Falsetti, Lorenzo, Salvi, Aldo, Toigo, Gabriele, Ceschia, Giuliano, Rosso, Alessia, Tongiorgi, Chiara, Scarpa, Cristina, De Dominicis Luigino, Pucci, Eugenio, Renzi, Sara, Cartechini, Elisabetta, Tomassini Pia Francesca, Del Gobbo Maurizio, Ugenti, Francesca, Romeo, Pasquale, Nardelli, Anna, Lauretani, Fulvio, Visioli, Sandra, Montanari, Ilaria, Ermini, Francesca, Giordano, Antonio, Pigato, Giorgio, Simeone, Emilio, Colameco, Franco, Cecamore, Antonella, Scurti, Rosa, Lupinetti Maria Cristina, Barbujani, Mario, Perazzi, Beatrice, Giampieri, Marina, Amoruso, Raffaele, Piccinini, Maristella, Ferrari, Camilla, Gambetti, Claudio, Sfrappini, Mario, Semeraro, Letizia, Striuli, Rinaldo, Mariani, Claudia, Pelliccioni, Giuseppe, Marinelli, Donatella, Fabi, Katia, Rossi, Tommaso, Pesallaccia, Martina, Sabbatini, Debora, Gobbi, Beatrice, Cerqua, Raffaella, Tagliani, Giancarla, Schlauser, Elena, Caser, Luciano, Caramello, Elisa, Sandigliano, Franca, Rosso, Giorgio, Bendini, Chiara, Davoli, Maria, Casella, Monica, Prampolini, Raffaella, Scevola, Moreno, Vitale, Enrico, Brugiolo, Roberto, Brugiolo, Fagherazzi, Carlo, Scarpa, Alberto, Zara, Daniela, Bertozzo, Giulia, Granziera, Serena, Barazzuol, Michele, Maugeri, Domenico, Sorace, Rosaria, Anzaldi, Massimiliano, De Gesu Roberto, Morrone, Giuseppe, Davolio, Federica, Fabbo, Andrea, Palmieri, Marina, Forti, Paola, Pirazzoli, Luca, Fabbri, Elisa, Terenzi, Laura, Bergolari, Federica, Wenter, Christian, Ruffini, Ingrid, Insam, Miriam, Abraham, Elisabeth, Kirchlechner, Christine, Lasco, Antonino, Arena Maria Grazia, Parise, Pasquale, Boccali, Andrea, Amici, Serena, Gambacorta, Maurizia, Ferrari, Alberto, Lasagni, Anna, Lovati, Roberto, Giovinazzo, Francesca, Kimak, Elzbieta, Zappa, Paolo, Medici, Francesco, Lo Castro Marika, Mauro, Flavia, De Luca Alessandro, Sancesario, Giuseppe, Martorana, Alessandro, Scaricamazza, Beatrice, Di Lorenzo Francesco, Liguori, Claudio, Vita, Natale, Giomi, Mirna, Forte, Floriana, Padovani, Alessandro, Rozzini, Luca, Caratozzolo, Salvatore, Cottino, Maria, Vitali, Silvia, Marelli, Eleonora, Tripi, Gabriele, Miceli, Salvatore, Urso, Giovanni, Grioni, Giuseppe, Vezzadini, Giuliana, Misaggi, Giulia, Forlani, Chiara, Avanzi, Stefano, Saulle, Serena, Casarini, Claudia, Viggiano, Marilena, Alberto, Luisa, Ghianda, Diego, Giordano, Alessandro, Iemolo, Francesco, Giordano, Antonello, Sanzaro, Enzo, D'Asta, Gabriele, Proietto, Maria, Carnemolla, Anna, Razza, Grazia, Spadaro, Daniela, Bertolotti, Marco, Mussi, Chiara, Neviani, Francesca, Chiesa, Roberto, Guerzoni, Valentina, Morselli, Linda, Venturelli, Francesca, Tarozzi, Adriano, Balestri, Francesca, Mannarino, Giulio, Bigolari, Michela, Natale, Alessia, Grassi, Simona, Bottaro, Cinzia, Stefanelli, Sara, Bovone, Ugo, Tortorolo, Umberto, Quadri, Roberto, Leone, Giuseppe, Ponzetto, Maria, Frasson, Paola, Annoni, Giorgio, Bruni, Adriana, Confalonieri, Roberto, Corsi, Maurizio, Moretti, Daniela, Teruzzi, Fabiola, Umidi, Simona, Mazzola, Paolo, Perego, Sabrina, Persico, Ilaria, Olivieri, Giulia, Bonfanti, Alessandra, Hajnalka, Szabo, Galeazzi, Marianna, Massariello, Francesca, Anzuini, Alessandra, Caffarra, Paolo, Barocco, Federica, Spallazzi, Marco, Ceda Gian Paolo, Morganti, Simonetta, Artoni, Andrea, Chioatto, Paolo, Bortolamei, Sandra, Soattin, Lucia, Beneamino, Borelli, Barilaro, Giuseppe, Bertazzoli, Marco, Rota, Elisabetta, Adobati, Annamaria, Zuccher, Paola, Dal Fabbro Angela, Lo Nigro Ambra, Franchetti, Lorena, Toniolo, Marika, Marcuzzo, Cinzia, Rollone, Marco, Guerriero, Fabio, Sgarlata, Carmelo, Anna, Santoro, Zatti, Giovanni, Piatti, Massimiliano, Graci, Jole, Benati, Giuseppe, Boschi, Federica, Biondi, Mario, Fiumi, Nicoletta, Erika, Tamburini, Locatelli Sergio Mario, Mauri, Sabrina, Beretta, Mauro, Margheritis, Laura, Desideri, Giovanbattista, Liberatore, Ester, Carucci Anna Cecilia, Bonino, Paolo, Caput, Margherita, Antonietti Maria Paola, Polistena, Giuseppe, De la Pierre Franz, Mari, Marcello, Massignani, Paola, Tombesi, Fabio, Selvaggio, Fabio, Verbo, Brunella, Bodoni, Paolo, Marchionni, Niccolo, Sabatini, Tony, Mussio, Eleonora, Magni, Eugenio, Bianchetti, Angelo, Crucitti, Andrea, Titoldini, Giulia, Cossu, Beatrice, Fascendini, Sara, Licini, Cristina, Tomasoni, Angela, Calderazzo, Massimo, Tropiano, Daniela, Lagana, Valentina, Melotti Rita Maria, Lilli, Albina, Buda, Simona, Adversi, Marco, Noro, Gabriele, Turco, Renato, Chiara, Ubezio M., Mantovani Anna Roberta, Viola Maria Cristina, Serrati, Carlo, Pretta, Stefano, Infante, Maria, Gentile, Simona, D'Ambrosio, Viviana, Mazzanti, Paolo, Brambilla, Cristina, Sportelli, Silvia, Platto, Caterina, Faraci, Bianca, Quattrocchi, Daniela, Pisu, Cristina, Sicuro, Francesca, Del Grosso Luciano Luca, Zagnoni, Piergiuseppe, Ghiglia, Stefania, Mosca, Massimiliano, Corazzin, Ileana, Deola, Mariangela, Biagini Carlo Adriano, Bencini, Francesca, Cantini, Claudia, Tonon, Elisabetta, Pierinelli, Silvia, Onofrj, Marco, Thomas, Astrid, Borbone, Filomena, Bonanni, Laura, Cacchio, Gabriella, Comi, Giancarlo, Magnani, Giuseppe, Santangelo, Roberto, Mazzeo, Salvatore, Caso, Francesca, Cecchetti, Giordano, Sant’Angelo, Roberto, Barbieri, Cristina, Giroldi, Liviana, Bandini, Fabio, Masina, Marco, Malservisi, Simona, Cicognani, Annalena, Ricca, Laura, Piccininni, Maristella, Tassinari, Tiziana, Brogi, Davide, Sugo, Annalisa, Filippi, Alessandra, Manfredi, Sonia, Vanni, Valerio, Usai carlo Andrea, Colombo, Enrico, Renna Vera Francesca, Sauchella, Assunta, Prete, Mauro, Bisagni, Pietro, Masini, Roberto, Carrabetta, Salvatore, Barone, Antonella, Razzano, Monica, Imperoli, Giuseppe, Bini, Angela, Serra, Francesco, D’Agostino, Valeria, Gianolla, Federico, Pietrangeli, Lucia, Velardi, Antonella, Di Cello Elisabetta, Rosati, Cristina, Casali, Nadia, Casali, Sessa, Maria, Abruzzi, Luciano, Costanzi, Chiara, Bini, Paolo, Pignata, Michele, Buonaugurio, Enrico, Vollery, Maria, Carrieri, Giovanni, Cioni, Giorgio, Toschi, Andrea, Metra, Marco, Ranieri, Piera, Ceccon, Anna, Magrin, Laura, Marin, Sara, Barbara, Sofia, Ghedini, Laura, Moroni, Matteo, Paragona, Marco, Pallotti Maria Caterina, Rota, Carla, Gottardi, Federica, Tomasoni, Clara, Cappuccio, Melania, Bonini, Giampaolo, Guerini, Stefano, Guerini, Valeria, Merlaj, Lucia, Tovaglieri, Maurizio, Antonio, Grillo, Francesca, Arenare, Mineo, Tonino, Kanah, David, Vianello, Giorgio, Vianello, Piero, Balducci, Ubaldo, Sidoti, Vincenzo, Montanari, Stefano, Murelli Flavio Teodolindo Busonera, Albanese, Paolo, Maselli, Monica, Bolzetta, Francesco, Fabris, Roberto, Durante-Mangoni, Emanuele, Testoni, Michela, Di Stefano Fabio, Seccia, Loredana, Sonzini, Valeria, Fabiano, Maria, Di Giorgio Annabella, De Cosmo Salvatore, Greco, Antonio, D’Onofrio, Grazia, Sancarlo, Daniele, Resta, Gianluca, Girardello, Renzo, Girardello, Minervini, Sergio, Boni, Morena, Vitali, Mariagrazia, Pizzoni, Marina, De Colle Paolo, Frattola, Alessandra, Orlandini, Francesco, La Regina Micaela, Padulo, Filomena, Margheriti, Cristina, Rolano, Dario, Moscatelli, Giancarla, Radaelli, Guido, Montini, Elena, Prete, Cosimo, Novello, Marileda, Bramuzzo, Igor, Bertin, Nicole, Rinaldo, Elena, Paolillo, Ciro, Riccardi, Angela, Benedetti, Claudia, Rizzi, Barbara, Montagna, Francesca, Cutaia, Chiara, Baca, Oliver, Colombo, Mauro, Procino, Giuseppe, Tarara, Rosaria, Dell’Acqua, Davide, Cislaghi, Stefania, Cairati, Marco, Porta, Massimo, Scaglione, Luca, De Feo Martina, Vertolli, Paola, Salvati, Lia, Cinotti, Sandro, De Santis Valentina, Biferi, Erminia, Cheli, Paola, Rebizzo, Romina, Salvatore, Minisola, Luciano, Colangelo, Abete, Pasquale, Liguori, Ilaria, Curcio, Francesca, Spassini, Guglielmo, Engheben, Marco, Rotunno, Sara, Rotunno, Arosio, Paola, Angelini, Claudio, Reggiani, Francesco, Cappelli, Alessandro, Marcheselli, Simona, Fratticci, Lara, Ranzani, Paola, Cesarini, Simonetta, Cerini, Antonella, Gallucci, Fernando, Serra, Emanuela, Sola, Mariolina, Delitala, Alessandro, Pes, Chiara, Lobianco, Giulia, Giani, Alessandro, Famularo, Simone, Sandini, Marta, Pinotti, Enrico, Gianotti, Luca, Battuello, Antonella, Pintore, Giulia, Rossi, Andrea, Rubele, Sofia, Sant, Selena, Vignati, Marco, Clerici, Danila, Rosa, Fabio, Bandirali Maria Pia, Cattaneo, Nicoletta, Boffi, Laura, Avalli, Leonello, Scanziani, Margherita, De Notaris Stefania, Del Santo Pierluigi, Del, Santo, Catalano, Felice, Fogli, Danilo, Di Bella Giovanna, Landi, Francesco, Salini, Sara, Brunetti Maria Angela, Cappa, Giorgetta, Galvagno, Giovanni, Cena, Paola, Bruno, Gerardo, Raspo, Silvio, Semeraro, Pedrotti, Sabrina, Palmieri Vincenzo Ostilio, Palasciano, Giuseppe, Belfiore, Anna, Portincasa, Piero, Sabbà, Carlo, Solfrizzi, Vincenzo, D’Introno, Alessia, Valiani, Vincenzo, Bologna, Carolina, Ciarambino, Tiziana, Magnani, Turelli, Paola, Pazzaglia, Ugo, Rodella, Federica, Piana, Giacomo, Castellano, Maurizio, Garelli, Anna, Garelli, Casella, Elisa, Campana, Federica, Coschigliano Maria Antonietta, Marinangeli, Luigi, Lorico, Fabio, Bazzano, Salvatore, Menculini, Giuseppe, Gelosa, Giorgio, Viviana Ambrogio Teresa, Piras, Valentina, Ciricugno, Andrea, Bollari, Alessandra, Coen, Daniele, Magliola, Renata, Milanesio, Deborah, Muzzulini Carlo Lorenzo, Fogliacco, Paolo, Marinella, Turla, Cotelli Maria Sofia, Bianchi, Marta, Siano, Pietro, Capo, Giuseppe, Napoletano, Rosa, Politi, Cecilia, Mancini, Concetta, Del Buono Corrado, De Bartolomeo Giuseppe, Martinelli, Addolorata, Cefalogli, Carmen, Cozzi, Roberto, Virtuani Angelo Giovanni, Moschettini, Gianfilippo, Mastroianni, Franco, Roglia, Daniela, D'Amico, Gabriella, Palella, Mirella, Endrizzi, Cristina, Trotta, Lucia, Zanetti, Orazio, Terazzi, Emanuela, Sacchetti, Marta, Fleetwood, Thomas, Tondo, Giacomo, Di Fazio Ignazio, Bruni, Andrea, Orsitto, Giuseppe, Fabbro, Emanuela, D’Imporzano, Elena, Casanova, Anna, Bertolio, Serena, Nervo, Silvestri, Roberto, Semproni, Elena, Pintus, Manuela, Aloe, Francesca, Tagliaccica, Angelo., Aloisi G., Marengoni A., Morandi A., Zucchelli A., Cherubini A., Mossello E., Bo M., Di Santo S.G., Mazzone A., Trabucchi M., Cappa S., Fimognari F.L., Incalzi R.A., Gareri P., Perticone F., Campanini M., Montorsi M., Latronico N., Zambon A., Bellelli G., Rispoli V., Malara A., Spadea F., Di Cello S., Ceravolo F., Fabiano F., Chiaradia G., Gabriele A., Lenino P., Andrea T., Settembrini V., Capomolla D., Citrino A., Scriva A., Bruno I., Secchi R., De Martino E., Muccinelli R., Villa Del Sole R.S.A., Lupi G., Paonessa P., Fabbri A., Passuti M.T., Castellari S., Po A., Gaggioli G., Varesi M., Moneti P., Capurso S., Latini V., Ghidotti S., Riccardelli F., Macchi M., Rigo R., Claudio P., Angelo B., Flavio C., Benedetta B., Boffelli S., Cassinadri A., Franzoni S., Spazzini E., Andretto D., Tonini G., Andreani L., Coralli M., Balotta A., Cancelliere R., Ballardini G., Simoncelli M., Mancini A., Strazzacapa M., Fabio S., De Filippi F., Giudice C., Dentizzi C., Azzini M., Cazzadori M., Mastroeni V., Bertassello P., Benati H.S.C., Nesta E., Tobaldini C., Guerini F., Elena T., Mombelloni P., Fontanini F., Gabriella L., Pizzorni C., Oliverio M., Del Grosso L.L., Giavedoni C., Bidoli G., Mazzei B., Corsonello A., Fusco S., Vena S., De Vuono T., Maiuri G., Luca F.F., Andrea A., Giovanni S., Rossella N., Castegnaro E., De Rosa S., Benvenuti E., Del Lungo I., Giardini S., Giulietti C., Mauro D.B., Eleonora B., Martina P., Irene F., Riccardo B., Federica S., Bertoletti E., D'Amico F., Caronzolo F., Grippa A., Lombardo G., Pipicella T., Antonino S., Francesco C., Valeria P.G., Daniela L., Domenico C., Giorgio B., March A., Nitti M.T., Felici A., Pavan S., Piazzani F., Lunelli A., Dimori S., Margotta A., Soglia T., Postacchini D., Brunelli R., Santini S., Francavilla M., Macchiati I., Sorvillo F., Giuli C., Mecocci P., Longo A., Addesi D., Rosa P.C., Bencardino G., Falbo T., Grillo N., Marco F., Mirella F., Fanto F., Isaia G., Pezzilli S., Bergamo D., Furno E., Rrodhe S., Lucarini S., Dijk B., Dall'Acqua F., Calvani D., Becheri D., Giuseppe M., Costanza M., Vito A., Francesca B., Magherini L., Novella M., Franca B., Gambardella P.M.L., Valente C., Ospedale N., Ilaria B., Alice F., Porrino P., Ceci G., Giuliana B., Michela T., Eleonora C., Ettore E., Camellini C., Servello A., Grassi A., Rozzini R., Tironi S., Grassi M.G., Troisi E., Carlo C., Gabriella D.S.S., Flaminia F., Federica R., Beatrice P., Sofia T., Gabutto A., Quazzo L., Rosatello A., Suraci D., Tagliabue B., Perrone C., Ferrara L., Castagna A., Tremolada M.L., Giuseppe C., Stefano B., Davide O., Piano S., Serviddio G., Lo Buglio A., Gurrera T., Merlo V., Rovai C., Cotroneo A.M., Carlucci R., Abbaldo A., Monzani F., Qasem A.A., Bini G., Tafuto S., Galli G., Bruni A.C., Mancuso G., Calipari D., Bernardini B., Corsini C., Michele C., Sara D.F., Cagnin A., Fragiacomo F., Pompanin S., Piero A., Marco C., Zurlo A., Guerra G., Pala M., Menozzi L., Delli Gatti C., Magon S., Roberto M., Alfredo D.G., Fabio F., Ruana T., Elisa M., Christian M., Marco P., Massimo G., Di Francesco V., Faccioli S., Pellizzari L., Giorgia F., Barbagallo G., Lunardelli M.L., Martini E., Ferrari E., Macchiarulo M., Corneli M., Bacci M., Battaglia G., Anastasio L., Lo Storto M.S., Seresin C., Simonato M., Loreggian M., Cestonaro F., Durando M., Latella R., Mazzoleni M., Russo G., Ponte M., Valchera A., Salustri G., Petritola D., Costa A., Sinforiani E., Cotta M.R., Pizio R.N., Cester A., Formilan M., Pietro B., Carbone P., Cazzaniga I., Appollonio I., Cereda D., Stabile A., Xhani R., Acampora R., Tremolizzo L., Federico P., Antonio C., Valerio P., Cesare B., Zhirajr M., Giovanni V., Maria A., Mariaelena S., Bottacchi E., Bucciantini E., Di Giovanni M., Franchi F., Lucchetti L., Mariani C., Grande G., Rapazzini P., Marco M., Romanelli G., Franco N., Alessio M., Nicola L., Laura P., Nazario P., Chiara G., Soccorso P., Andrea S., Luca B., Francesca S., Roberto A., Anna C., Infettive M., Fugazza L., Guerrini C., De Paduanis G., Iallonardo L., Palumbo P., Zuliani G., Ortolani B., Capatti E., Soavi C., Bianchi L., Francesconi D., Miselli A., Gloria B., Tommaso R., Chiara P., Agata M.M., Dall'Agata M., Luca M., Gianluca G., Suardi T., Zaccarini C., Manuela R., Mirra G., Muti E., Bottura R., Gianpaolo M., Secreto P., Bisio E., Cecchettani M., Naldi T., Pallavicino A., Pugliese M., Iozzo R.C., Grassi G., Michele B., Dell'Oro R., Fosca Q.T., Giorgio G.C., Giovanni P., Ernesto C., Mannironi A., Giorli E., Oberti S., Fierro B., Piccoli T., Giacalone F., Mandas A., Serchisu L., Costaggiu D., Pinna E., Orru F., Mannai M., Cordioli Z., Pelizzari L., Turcato E., Arduini P., Cacace C., Chiloiro R., Cimino R., Ruberto C., Giovanni R., Pietro G., Laura G., Alberto C., Carmen R., Dal Santo P., Andriolli A., Burattin G., Rossi L., Antonino C.G.A., Tezza F., Maddalena P., Laura S., Crippa P., Aloisio P., Di Monda T., Malighetti A., Galbassini G., Ivaldi C., Russo A.M., Bennati E., Pino E., Zavarise G., Pesci A., Suigo G., Faverio P., Andrea G., Sabrina P., Zanasi M., Moniello G., Rostagno C., Cartei A., Polidori G., Ungar A., Melis M.R., Martellini E., Enrico M., Monica T., Antonella G., Giovanna L., Migliorini M., Caramelli F., Battiston B., Berardino M., Cavallo S., Alessandro M., Anna S., Lombardi B., D'Ippolito P., Furini A., Villani D., Clara R., Guarneri M., Paolucci S., Bassi A., Coiro P., De Angelis D., Morone G., Venturiero V., Palleschi L., Raganato P., Di Niro G., Rosa C.A., Loredana B., Imoscopi A., Tibaldi V., Bottignole G.G., Calvi E., Clementi C., Zanocchi M., Agosta L., Criasia A., Spertino E., Nortarelli A., Provenzano G., Principato P., Rizzo A., Cellura E., Mari D., Romano F.Y., Rosini F., Mansi M., Rossi S., Riccardelli A., Inzaghi L., Bonini G., Rossi P., Potena A., Lichii M., Candiani T., Grimaldi W., Bertani E., Alessandra P., Calogero P., Pinto D., Bernardi R., Nicolino F., Galetti C., Gianstefani A., Giulia C., Lorenzo M., Odetti P., Monacelli F., Prefumo M., Fiammetta M., Canepa M., Minaglia C., Paolisso G., Rizzo M.R., Prestano R., Dalise A.M., Barra D., Dal Bosco L., Asprinio V., Dallape L., Perina E., Bartoli I.R., Pluderi A., Maina A., Pecoraro E., Sciarra M., Prudente A., Paola M., Francesca M., Manuel V., Luisella C., Maria P.L., Tina S., Benini L., Levato F., Mhiuta V., Alius F., Davidoaia D., Giardini V., Garancini M., Bellamoli C., Terranova L., Bozzini C., Tosoni P., Provoli E., Cascone L., Dioli A., Ferrarin G., Bucci A., Bua G., Fenu S., Bianchi G., Casella S., Romano V., Maurizio P., Mascherona I., Belotti G., Cavaliere S., Cuni E., Merciuc N., Oberti R., Veneziani S., Capoferri E., De Bernardi E., Colombo K., Bravi M., Nicoletta N., D'Arcangelo P., Montenegro N., Montanari R., Lamanna P., Gasperini B., Isabella M., Stefania D., Gaia A., Filippo C., Palama C., Di Emidio C., Scarpini E., Arighi A., Fumagalli G., Basilico P., De Amicis Margherita M., Marta M., Diletta M., Granata A., Ranalli C., Cammilli A., Cavallini M.C., Tricca M., Natella D., Gabbani L., Tesi F., Martella L., Imbrici R., Guerrini G., Scotuzzi A.M., Sozzi F., Valenti L., Chiarello A., Monia M., Pilotto A., Prete C., Senesi B., Meta A.C., Pendenza E., Pasqualetti G., Polini A., Tognini S., Ballino E., Dell'Aquila G., Gasparrini P.M., Marotti E., Migale M., Scrimieri A., Falsetti L., Salvi A., Toigo G., Ceschia G., Rosso A., Tongiorgi C., Scarpa C., De Dominicis L., Pucci E., Renzi S., Cartechini E., Tomassini P.F., Del Gobbo M., Ugenti F., Romeo P., Nardelli A., Lauretani F., Visioli S., Montanari I., Ermini F., Giordano A., Pigato G., Simeone E., Colameco F., Cecamore A., Scurti R., Lupinetti M.C., Barbujani M., Perazzi B., Giampieri M., Amoruso R., Piccinini M., Ferrari C., Gambetti C., Sfrappini M., Semeraro L., Striuli R., Pelliccioni G., Marinelli D., Fabi K., Rossi T., Pesallaccia M., Sabbatini D., Gobbi B., Cerqua R., Tagliani G., Schlauser E., Caser L., Caramello E., Sandigliano F., Rosso G., Ferrari A., Bendini C., Luisa D.M., Casella M., Prampolini R., Scevola M., Vitale E., Roberto B., Carlo F., Sergio F., Alberto S., Daniela Z., Giulia B., Serena G., Maugeri D., Sorace R., Anzaldi M., De Gesu R., Morrone G., Davolio F., Fabbo A., Palmieri M., Zoli M., Forti P., Pirazzoli L., Fabbri E., Terenzi L., Bergolari F., Wenter C., Ruffini I., Insam M., Abraham E., Kirchlechner C., Cucinotta D., Antonino L., Basile G., Grazia A.M., Parise P., Boccali A., Amici S., Gambacorta M., Lasagni A., Lovati R., Giovinazzo F., Kimak E., Zappa P., Medici F., Lo Castro M., Mauro F., De Luca A., Sancesario G., Martorana A., Scaricamazza B., Toniolo S., Di Lorenzo F., Liguori C., Lasco A., Vita N., Giomi M., Forte F., Padovani A., Rozzini L., Ceraso A., Salvatore C., Cottino M., Vitali S., Marelli E., Tripi G., Miceli S., Urso G., Grioni G., Vezzadini G., Misaggi G., Forlani C., Avanzi S., Serena S., Claudia C., Marilena V., Alberto L., Diego G., Alessandro G., Iemolo F., Sanzaro E., D'Asta G., Proietto M., Carnemolla A., Razza G., Spadaro D., Bertolotti M., Mussi C., Neviani F., Roberto C., Valentina G., Linda M., Francesca V., Tarozzi A., Balestri F., Mannarino G., Bigolari M., Natale A., Grassi S., Bottaro C., Stefanelli S., Bovone U., Tortorolo U., Quadri R., Leone G., Ponzetto M., Frasson P., Annoni G., Bruni A., Confalonieri R., Corsi M., Moretti D., Teruzzi F., Umidi S., Mazzola P., Perego S., Persico I., Olivieri G., Bonfanti A., Hajnalka S., Galeazzi M., Massariello F., Anzuini A., Caffarra P., Barocco F., Spallazzi M., Paolo C.G., Simonetta M., Chioatto P., Bortolamei S., Soattin L., Ruotolo G., Beneamino B., Giuseppe B., Bertazzoli M., Rota E., Adobati A., Scarpa A., Granziera S., Zuccher P., Dal Fabbro A., Zara D., Lo Nigro A., Franchetti L., Toniolo M., Marcuzzo C., Rollone M., Guerriero F., Sgarlata C., Masse A., Zatti G., Piatti M., Graci J., Benati G., Boschi F., Biondi M., Fiumi N., Erika T., Locatelli S.M., Mauri S., Beretta M., Margheritis L., Desideri G., Liberatore E., Carucci A.C., Bonino P., Caput M., Antonietti M.P., Polistena G., De La Pierre F., Mari M., Massignani P., Tombesi F., Selvaggio F., Verbo B., Bodoni P., Marchionni N., Sabatini T., Mussio E., Magni E., Bianchetti A., Crucitti A., Titoldini G., Cossu B., Fascendini S., Licini C., Tomasoni A., Calderazzo M., Daniela T., Valentina L., Melotti R.M., Lilli A., Buda S., Adversi M., Noro G., Turco R., Ubezio M.C., Mantovani A.R., Viola M.C., Serrati C., Pretta S., Infante M., Gentile S., D'Ambrosio V., Mazzanti P., Brambilla C., Sportelli S., Platto C., Faraci B., Quattrocchi D., Pernigotti L.M., Pisu C., Sicuro F., Zagnoni P., Ghiglia S., Mosca M., Corazzin I., Deola M., Di Agordo O., Biagini C.A., Bencini F., Cantini C., Tonon E., Pierinelli S., Onofrj M., Thomas A., Filomena B., Bonanni L., Gabriella C., Comi G., Magnani G., Santangelo R., Mazzeo S., Francesca C., Giordano C., Roberto S., Barbieri C., Giroldi L., Bandini F., Masina M., Malservisi S., Cicognani A., Ricca L., Piccininni M., Tassinari T., Brogi D., Sugo A., Alessandra F., Sonia M., Valerio V., Andrea U.C., Enrico C., Vera R.F., Assunta S., Gianmaria Z., Mauro P., Barone A., Razzano M., Giuseppe I., Angela B., Francesco S., D'Agostino V., Federico G., Lucia P., Antonella V., Di Cello E., Cristina C., Nadia C., Maria S., Luciano A., Chiara C., Bini P., Pignata M., Enrico B., Maria V., Giovanni C., Giorgio C., Piera R., Alberto Z., Ceccon A., Magrin L., Marin S., Barbara S., Matteo M., Caterina P.M., Carla R., Federica G., Clara T., Melania C., Giampaolo B., Stefano G., Valeria G., Lucia M., Giovambattista D., Ester L., Cecilia C.A., Maurizio T., Nadia B., Grillo A., Arenare F., Tonino M., David K., Giorgio V.P., Ubaldo B., Vincenzo S., Stefano M., Marino F., Flavio M.T.B., Paolo A., Monica M., Francesco B., Roberto F., Paolo B., Durante-Mangoni E., Testoni M., Di Stefano F., Loredana S., Daniela M., Valeria S., Fabiano M., Di Giorgio A., De Cosmo S., Greco A., D'Onofrio G., Daniele S., Gianluca R., Renzo G., Sergio M., Morena B., Vitali M., Marina P., De Colle P., Cristina S., Orlandini F., La Regina M., Desiree A., Mario B., Paola P., Padulo F., Cristina M., Dario R., Giancarla M., Guido R., Elena M., Marileda N., Igor B., Nicole B., Elena R., Paolillo C., Riccardi A., Claudia B., Barbara R., Silvia V., Oliver B., Mauro C., Eleonora M., Giuseppe P., Rosaria T., Maria C., Dell'Acqua D., Stefania C., Massimo P., Luca S., De Feo M., Paola V., Lia S., Sandro C., De Santis V., Erminia B., Paola C., Romina R., Minisola S., Luciano C., Pasquale A., Ilaria L., Guglielmo S., Marco E., Sara R., Paola A., Claudio A., Francesco R., Alessandro C., Simona M., Lara F., Paola R., Simonetta C., Antonella C., Generoso U., Fernando G., Giuliano C., Emanuela S., Mariolina S., Alessandro D., Giulia L., Famularo S., Sandini M., Pinotti E., Gianotti L., Antonella B., Giulia P., Sante G., Rossi A., Rubele S., Sant S., Marco V., Danila C., Fabio R., Bandirali M.P., Nicoletta C., Laura B., Paolo T., Luciano T., Leonello A., Margherita S., De Notaris S., Del Santo P., Laura R., Fabiana T., Giovanna C., Antonino A., Felice C., Danilo F., Di Bella G., Francesco L., Salini S., Angela B.M., Giorgetta C., Giovanni G., Gerardo B., Silvio R., Letizia S., Davide B., Rosaria R.M., Maria D.A., Raffaele P., Palmieri V.O., Palasciano G., Belfiore A., Portincasa P., Carlo S., D'Introno A., Valiani V., Carolina B., Tiziana C., Paola T., Ugo P., Giacomo P., Castellano M., Anna G., Elisa C., Federica C., Antonietta C.M., Luigi M., Fabio L., Salvatore B., Gelosa G., Viviana A.T., Piras V., Andrea C., Alessandra B., Coen D., Magliola R., Milanesio D., Muzzulini C.L., Paolo F., Marinella T., Sofia C.M., Marta B., Siano P., Capo G., Napoletano R., Cecilia P., Mancini C., Del Buono C., De Bartolomeo G., Addolorata M., Carmen C., Giovanni V.A., Moschettini G., Franco M., Mulli O.F., Daniela R., D'Amico G., Mirella P., Endrizzi C., Trotta L., Ciarambino T., Orazio Z., Emanuela T., Marta S., Thomas F., Giacomo T., Di Fazio I., Andrea B., Giuseppe O., Emanuela F., Serena A., D'Imporzano E., Serena B., Erika N., Elena S., Manuela P., Francesca A., Angelo T., Aloisi, G., Marengoni, A., Morandi, A., Zucchelli, A., Cherubini, A., Mossello, E., Bo, M., Di Santo, S.G., Mazzone, A., Trabucchi, M., Cappa, S., Fimognari, F.L., Incalzi, R.A., Gareri, P., Perticone, F., Campanini, M., Montorsi, M., Latronico, N., Zambon, A., Bellelli, G., Rispoli, V., Malara, A., Spadea, F., Di Cello, S., Ceravolo, F., Fabiano, F., Chiaradia, G., Gabriele, A., Lenino, P., Andrea, T., Settembrini, V., Capomolla, D., Citrino, A., Scriva, A., Bruno, I., Secchi, R., De Martino, E., Muccinelli, R., Villa Del Sole, R.S.A., Lupi, G., Paonessa, P., Fabbri, A., Passuti, M.T., Castellari, S., Po, A., Gaggioli, G., Varesi, M., Moneti, P., Capurso, S., Latini, V., Ghidotti, S., Riccardelli, F., Macchi, M., Rigo, R., Claudio, P., Angelo, B., Flavio, C., Benedetta, B., Boffelli, S., Cassinadri, A., Franzoni, S., Spazzini, E., Andretto, D., Tonini, G., Andreani, L., Coralli, M., Balotta, A., Cancelliere, R., Ballardini, G., Simoncelli, M., Mancini, A., Strazzacapa, M., Fabio, S., De Filippi, F., Giudice, C., Dentizzi, C., Azzini, M., Cazzadori, M., Mastroeni, V., Bertassello, P., Benati, H.S.C., Nesta, E., Tobaldini, C., Guerini, F., Elena, T., Mombelloni, P., Fontanini, F., Gabriella, L., Pizzorni, C., Oliverio, M., Del Grosso, L.L., Giavedoni, C., Bidoli, G., Mazzei, B., Corsonello, A., Fusco, S., Vena, S., De Vuono, T., Maiuri, G., Luca, F.F., Andrea, A., Giovanni, S., Rossella, N., Castegnaro, E., De Rosa, S., Benvenuti, E., Del Lungo, I., Giardini, S., Giulietti, C., Mauro, D.B., Eleonora, B., Martina, P., Irene, F., Riccardo, B., Federica, S., Bertoletti, E., D'Amico, F., Caronzolo, F., Grippa, A., Lombardo, G., Pipicella, T., Antonino, S., Francesco, C., Valeria, P.G., Daniela, L., Domenico, C., Giorgio, B., March, A., Nitti, M.T., Felici, A., Pavan, S., Piazzani, F., Lunelli, A., Dimori, S., Margotta, A., Soglia, T., Postacchini, D., Brunelli, R., Santini, S., Francavilla, M., Macchiati, I., Sorvillo, F., Giuli, C., Mecocci, P., Longo, A., Addesi, D., Rosa, P.C., Bencardino, G., Falbo, T., Grillo, N., Marco, F., Mirella, F., Fantò, F., Isaia, G., Pezzilli, S., Bergamo, D., Furno, E., Rrodhe, S., Lucarini, S., Dijk, B., Dall'Acqua, F., Calvani, D., Becheri, D., Giuseppe, M., Costanza, M., Vito, A., Francesca, B., Magherini, L., Novella, M., Franca, B., Gambardella, P.M.L., Valente, C., Ospedale, N., Ilaria, B., Alice, F., Porrino, P., Ceci, G., Giuliana, B., Michela, T., Eleonora, C., Ettore, E., Camellini, C., Servello, A., Grassi, A., Rozzini, R., Tironi, S., Grassi, M.G., Troisi, E., Carlo, C., Gabriella, D.S.S., Flaminia, F., Federica, R., Beatrice, P., Sofia, T., Gabutto, A., Quazzo, L., Rosatello, A., Suraci, D., Tagliabue, B., Perrone, C., Ferrara, L., Castagna, A., Tremolada, M.L., Giuseppe, C., Stefano, B., Davide, O., Piano, S., Serviddio, G., Lo Buglio, A., Gurrera, T., Merlo, V., Rovai, C., Cotroneo, A.M., Carlucci, R., Abbaldo, A., Monzani, F., Qasem, A.A., Bini, G., Tafuto, S., Galli, G., Bruni, A.C., Mancuso, G., Mancuso, G., Calipari, D., Bernardini, B., Corsini, C., Michele, C., Sara, D.F., Cagnin, A., Fragiacomo, F., Pompanin, S., Piero, A., Marco, C., Zurlo, A., Guerra, G., Pala, M., Menozzi, L., Delli Gatti, C., Magon, S., Roberto, M., Alfredo, D.G., Fabio, F., Ruana, T., Elisa, M., Benedetta, B., Christian, M., Marco, P., Massimo, G., Di Francesco, V., Faccioli, S., Pellizzari, L., Giorgia, F., Barbagallo, G., Lunardelli, M.L., Martini, E., Ferrari, E., Macchiarulo, M., Corneli, M., Bacci, M., Battaglia, G., Anastasio, L., Lo Storto, M.S., Seresin, C., Simonato, M., Loreggian, M., Cestonaro, F., Durando, M., Latella, R., Mazzoleni, M., Russo, G., Ponte, M., Valchera, A., Salustri, G., Petritola, D., Costa, A., Sinforiani, E., Cotta, M.R., Piano, S., Pizio, R.N., Cester, A., Formilan, M., Pietro, B., Carbone, P., Cazzaniga, I., Appollonio, I., Cereda, D., Stabile, A., Xhani, R., Acampora, R., Tremolizzo, L., Federico, P., Antonio, C., Valerio, P., Cesare, B., Zhirajr, M., Giovanni, V., Maria, A., Mariaelena, S., Bottacchi, E., Bucciantini, E., Di Giovanni, M., Franchi, F., Lucchetti, L., Mariani, C., Grande, G., Rapazzini, P., Marco, M., Romanelli, G., Franco, N., Alessio, M., Stefano, B., Nicola, L., Laura, P., Nazario, P., Carlo, C., Chiara, G., Soccorso, P., Andrea, S., Luca, B., Francesca, S., Roberto, A., Marco, F., Anna, C., Francesco, C., Infettive, M., Fugazza, L., Guerrini, C., De Paduanis, G., Iallonardo, L., Palumbo, P., Zuliani, G., Ortolani, B., Capatti, E., Soavi, C., Bianchi, L., Francesconi, D., Miselli, A., Gloria, B., Tommaso, R., Chiara, P., Agata, M.M., Dall'Agata, M., Luca, M., Gianluca, G., Suardi, T., Zaccarini, C., Manuela, R., Mirra, G., Muti, E., Bottura, R., Gianpaolo, M., Secreto, P., Bisio, E., Cecchettani, M., Naldi, T., Pallavicino, A., Pugliese, M., Iozzo, R.C., Grassi, G., Michele, B., Dell'Oro, R., Fosca, Q.T., Giorgio, G.C., Giovanni, P., Ernesto, C., Mannironi, A., Giorli, E., Oberti, S., Fierro, B., Piccoli, T., Giacalone, F., 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Raganato, P., Di Niro, G., Rosa, C.A., Loredana, B., Imoscopi, A., Isaia, G., Tibaldi, V., Bottignole, G.G., Calvi, E., Clementi, C., Zanocchi, M., Agosta, L., Criasia, A., Spertino, E., Nortarelli, A., Provenzano, G., Principato, P., Rizzo, A., Cellura, E., Mari, D., Romano, F.Y., Rosini, F., Mansi, M., Rossi, S., Riccardelli, A., Inzaghi, L., Bonini, G., Rossi, P., Potena, A., Lichii, M., Candiani, T., Grimaldi, W., Bertani, E., Alessandra, P., Calogero, P., Pinto, D., Bernardi, R., Nicolino, F., Galetti, C., Gianstefani, A., Giulia, C., Lorenzo, M., Odetti, P., Monacelli, F., Prefumo, M., Fiammetta, M., Canepa, M., Minaglia, C., Paolisso, G., Rizzo, M.R., Prestano, R., Dalise, A.M., Barra, D., Dal Bosco, L., Asprinio, V., Dallape, L., Perina, E., Bartoli, I.R., Pluderi, A., Maina, A., Pecoraro, E., Sciarra, M., Prudente, A., Paola, M., Francesca, M., Manuel, V., Luisella, C., Maria, P.L., Tina, S., Benini, L., Levato, F., Mhiuta, V., Alius, F., Davidoaia, D., Giardini, V., 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P.M., Marotti, E., Migale, M., Scrimieri A., Falsetti, L., Salvi A., Toigo, G., Ceschia, G., Rosso, A., Tongiorgi, C., Scarpa, C., Maurizio, P., De Dominicis, L., Pucci, E., Renzi, S., Cartechini, E., Tomassini, P.F., Del Gobbo, M., Ugenti, F., Romeo, P., Nardelli, A., Lauretani, F., Visioli, S., Montanari, I., Ermini, F., Giordano, A., Pigato, G., Simeone, E., Colameco, F., Cecamore, A., Scurti, R., Lupinetti, M.C., Barbujani, M., Perazzi, B., Giampieri, M., Amoruso, R., Piccinini, M., Ferrari, C., Gambetti, C., Sfrappini, M., Semeraro, L., Striuli, R., Mariani, C., Pelliccioni, G., Marinelli, D., Fabi, K., Rossi, T., Pesallaccia, M., Sabbatini, D., Gobbi, B., Cerqua, R., Tagliani, G., Schlauser, E., Caser, L., Caramello, E., Sandigliano, F., Rosso, G., Ferrari, A., Bendini, C., Luisa, D.M., Casella, M., Prampolini, R., Scevola, M., Vitale, E., Roberto, B., Carlo, F., Sergio, F., Alberto, S., Daniela, Z., Giulia, B., Serena, G., Michele, B., Maugeri, D., Sorace, R., Anzaldi, M., De Gesu, R., Morrone, G., Davolio, F., Fabbo, A., Palmieri, M., Barbagallo, G., Zoli, M., Forti, P., Pirazzoli, L., Fabbri, E., Terenzi, L., Bergolari, F., Wenter, C., Ruffini, I., Insam, M., Abraham, E., Kirchlechner, C., Cucinotta, D., Antonino, L., Basile, G., Grazia, A.M., Parise, P., Boccali, A., Amici, S., Gambacorta, M., Lasagni, A., Lovati, R., Giovinazzo, F., Kimak, E., Zappa, P., Medici, F., Lo Castro, M., Mauro, F., De Luca, A., Sancesario, G., Martorana, A., Scaricamazza, B., Toniolo, S., Di Lorenzo, F., Liguori, C., Lasco, A., Vita, N., Giomi, M., Forte, F., Padovani, A., Rozzini, L., Ceraso, A., Salvatore, C., Cottino, M., Vitali, S., Marelli, E., Tripi, G., Miceli, S., Urso, G., Grioni, G., Vezzadini, G., Misaggi, G., Forlani, C., Avanzi, S., Serena, S., Claudia, C., Marilena, V., Alberto, L., Diego, G., Alessandro, G., Iemolo, F., Giordano, A., Sanzaro, E., D'Asta, G., Proietto, M., Carnemolla, A., Razza, G., Spadaro, D., Bertolotti, M., Mussi, C., Neviani, F., Roberto, C., Valentina, G., Linda, M., Francesca, V., Tarozzi, A., Balestri, F., Mannarino, G., Bigolari, M., Natale, A., Grassi, S., Bottaro, C., Stefanelli, S., Bovone, U., Tortorolo, U., Quadri, R., Leone, G., Ponzetto, M., Frasson, P., Annoni, G., Bruni, A., Confalonieri, R., Corsi, M., Moretti, D., Teruzzi, F., Umidi, S., Mazzola, P., Perego, S., Persico, I., Olivieri, G., Bonfanti, A., Hajnalka, S., Galeazzi, M., Massariello, F., Anzuini, A., Caffarra, P., Barocco, F., Spallazzi, M., Paolo, C.G., Simonetta, M., Andrea, A., Chioatto, P., Bortolamei, S., Soattin, L., Ruotolo, G., Beneamino, B., Giuseppe, B., Bertazzoli, M., Rota, E., Adobati, A., Scarpa, A., Granziera, S., Zuccher, P., Dal Fabbro, A., Zara, D., Lo Nigro, A., Franchetti, L., Toniolo, M., Marcuzzo, C., Piano, S., Rollone, M., Guerriero, F., Sgarlata, C., Massè, A., Zatti, G., Piatti, M., Graci, J., Benati, G., Boschi, F., Biondi, M., Fiumi, N., Erika, T., Locatelli, S.M., Mauri, S., Beretta, M., Margheritis, L., Desideri, G., Liberatore, E., Carucci, A.C., Bonino, P., Caput, M., Antonietti, M.P., Polistena, G., De La Pierre, F., Mari, M., Massignani, P., Tombesi, F., Selvaggio, F., Verbo, B., Bodoni, P., Marchionni, N., Sabatini, T., Mussio, E., Magni, E., Bianchetti, A., Crucitti, A., Titoldini, G., Cossu, B., Fascendini, S., Licini, C., Tomasoni, A., Calderazzo, M., Daniela, T., Valentina, L., Prampolini, R., Melotti, R.M., Lilli, A., Buda, S., Adversi, M., Noro, G., Turco, R., Ubezio, M.C., Mantovani, A.R., Viola, M.C., Serrati, C., Pretta, S., Infante, M., Gentile, S., D'Ambrosio, V., Mazzanti, P., Brambilla, C., Sportelli, S., Platto, C., Faraci, B., Quattrocchi, D., Pernigotti, L.M., Pisu, C., Sicuro, F., Del Grosso, L.L., Zagnoni, P., Ghiglia, S., Mosca, M., Corazzin, I., Deola, M., Di Agordo, O., Biagini, C.A., Bencini, F., Cantini, C., Tonon, E., Pierinelli, S., Onofrj, M., Thomas, A., Filomena, B., Bonanni, L., Gabriella, C., Comi, G., Magnani, G., Santangelo, R., Mazzeo, S., Giuseppe, M., Francesca, C., Giordano, C., Roberto, S., Barbieri, C., Giroldi, L., Bandini, F., Masina, M., Malservisi, S., Cicognani, A., Ricca, L., Ricca, L., Piccininni, M., Tassinari, T., Brogi, D., Sugo, A., Alessandra, F., Sonia, M., Valerio, V., Andrea, U.C., Enrico, C., Vera, R.F., Assunta, S., Gianmaria, Z., Mauro, P., Pietro, B., Roberto, M., Salvatore, C., Barone, A., Razzano, M., Giuseppe, I., Angela, B., Francesco, S., D'Agostino, V., Federico, G., Lucia, P., Antonella, V., Di Cello, E., Cristina, C., Nadia, C., Maria, S., Luciano, A., Chiara, C., Bini, P., Pignata, M., Enrico, B., Maria, V., Giovanni, C., Giorgio, C., Andrea, T., Marco, M., Piera, R., Alberto, Z., Ceccon, A., Magrin, L., Marin, S., Barbara, S., Marco, M., Laura, G., Matteo, M., Marco, P., Caterina, P.M., Carla, R., Federica, G., Clara, T., Melania, C., Giampaolo, B., Stefano, G., Valeria, G., Lucia, M., Giovambattista, D., Ester, L., Cecilia, C.A., Maurizio, T., Vera, R.F., Nadia, B., Grillo, A., Arenare, F., Tonino, M., David, K., Giorgio, V.P., Ubaldo, B., Vincenzo, S., Stefano, M., Marino, F., Flavio, M.T.B., Paolo, A., Monica, M., Francesco, B., Roberto, F., Paolo, B., Durante-Mangoni, E., Testoni, M., Di Stefano, F., Loredana, S., Daniela, M., Valeria, S., Fabiano, M., Di Giorgio, A., De Cosmo, S., Greco, A., D'Onofrio, G., Daniele, S., Gianluca, R., Renzo, G., Sergio, M., Morena, B., Vitali, M., Marina, P., De Colle, P., Cristina, S., Alessandra, F., Orlandini, F., La Regina, M., Desirée, A., Mirella, F., Mario, B., Paola, P., Padulo, F., Cristina, M., Dario, R., Giancarla, M., Guido, R., Elena, M., Prete, C., Marileda, N., Igor, B., Nicole, B., Elena, R., Paolillo, C., Riccardi, A., Claudia, B., Barbara, R., Francesca, M., Silvia, V., Chiara, C., Oliver, B., Mauro, C., Eleonora, M., Giuseppe, P., Rosaria, T., Maria, C., Dell'Acqua, D., Stefania, C., Marco, C., Massimo, P., Luca, S., De Feo, M., Paola, V., Lia, S., Sandro, C., De Santis, V., Erminia, B., Paola, C., Romina, R., Minisola, S., Luciano, C., Pasquale, A., Ilaria, L., Francesca, C., Guglielmo, S., Marco, E., Sara, R., Paola, A., Claudio, A., Francesco, R., Alessandro, C., Simona, M., Lara, F., Paola, R., Simonetta, C., Antonella, C., Generoso, U., Fernando, G., Giuliano, C., Emanuela, S., Mariolina, S., Alessandro, D., Chiara, P., Giulia, L., Alessandro, G., Famularo, S., Sandini, M., Pinotti, E., Gianotti, L., Antonella, B., Giulia, P., Sante, G., Rossi, A., Rubele, S., Sant, S., Marco, V., Danila, C., Fabio, R., Bandirali, M.P., Nicoletta, C., Laura, B., Paolo, T., Luciano, T., Leonello, A., Margherita, S., De Notaris, S., Del Santo, P., Laura, R., Fabiana, T., Giovanna, C., Antonino, A., Felice, C., Giuseppe, B., Danilo, F., Di Bella, G., Francesco, L., Salini, S., Angela, B.M., Giorgetta, C., Giovanni, G., Paola, C., Gerardo, B., Silvio, R., Letizia, S., Sabrina, P., Davide, B., Rosaria, R.M., Maria, D.A., Raffaele, P., Palmieri, V.O., Palasciano, G., Belfiore, A., Portincasa, P., Carlo, S., Vincenzo, S., D'Introno, A., Valiani, V., Carolina, B., Tiziana, C., Giordano, C., Paola, T., Ugo, P., Federica, R., Giacomo, P., Castellano, M., Anna, G., Elisa, C., Federica, C., Antonietta, C.M., Luigi, M., Fabio, L., Salvatore, B., Giuseppe, M., Gelosa, G., Viviana, A.T., Piras, V., Andrea, C., Alessandra, B., Coen, D., Magliola, R., Milanesio, D., Muzzulini, C.L., Paolo, F., Marinella, T., Sofia, C.M., Marta, B., Siano, P., Capo, G., Napoletano, R., Cecilia, P., Mancini, C., Del Buono, C., De Bartolomeo, G., Addolorata, M., Carmen, C., Roberto, C., Giovanni, V.A., Moschettini, G., Franco M., Mulli, O.F., Daniela, R., D'Amico, G., Mirella, P., Endrizzi, C., Trotta, L., Ciarambino, T., Orazio, Z., Emanuela, T., Marta, S., Thomas, F., Giacomo, T., Di Fazio, I., Andrea, B., Giuseppe, O., Emanuela, F., Serena, A., D'Imporzano, E., Anna, C., Serena, B., Erika, N., Roberto, S., Elena, S., Manuela, P., Francesca, A., Angelo, T., Aloisi, G, Marengoni, A, Morandi, A, Zucchelli, A, Cherubini, A, Mossello, E, Bo, M, Di Santo, S, Mazzone, A, Trabucchi, M, Cappa, S, Fimognari, F, Incalzi, R, Gareri, P, Perticone, F, Campanini, M, Montorsi, M, Latronico, N, Zambon, A, Bellelli, G, and Faverio, P

Subjects
Male, diagnosis, medications, 0302 clinical medicine, prevention, Aged, 80 and over, Delirium, Drug Prescriptions, Female, Hospital Departments, Humans, Prevalence, Polypharmacy, Prescription Drugs, 80 and over, Medicine, LS4_4, 030212 general & internal medicine, Acute hospital, media_common, Confounding, elderly patients, hip fracture, hospitalized patients, prediction rule, risk factor, dementia, events, medications, prevention, diagnosis, risk-factor, risk factor, hip fracture, Psychiatry and Mental Health, medicine.symptom, events, Drug, medicine.medical_specialty, hospitalized-patients, media_common.quotation_subject, MEDLINE, Socio-culturale, elderly-patients, elderly patients, behavioral disciplines and activities, 03 medical and health sciences, Internal medicine, mental disorders, Dementia, Medical prescription, prediction rule, Aged, business.industry, hospitalized patients, medicine.disease, nervous system diseases, dementia, business, 030217 neurology & neurosurgery
Abstract

Objective This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy was defined as a prescription of drugs from 5 or more classes. Results Of 4,133 participants, 969 (23.4%) had delirium. The general prevalence of polypharmacy was higher in patients with delirium (67.6% vs 63.0%, P = .009) but varied according to clinical settings. After adjustment for confounders, polypharmacy was associated with delirium only in patients admitted to surgical units (OR = 2.9; 95% CI, 1.4-6.1). Insulin, antibiotics, antiepileptics, antipsychotics, and atypical antidepressants were associated with delirium, whereas statins and angiotensin receptor blockers exhibited an inverse association. A stronger association was seen between typical and atypical antipsychotics and delirium in subjects free from dementia compared to individuals with dementia (typical: OR = 4.31; 95% CI, 2.94-6.31 without dementia vs OR = 1.64; 95% CI, 1.19-2.26 with dementia; atypical: OR = 5.32; 95% CI, 3.44-8.22 without dementia vs OR = 1.74; 95% CI, 1.26-2.40 with dementia). The absence of antipsychotics among the prescribed drugs was inversely associated with delirium in the whole sample and in both of the hospital settings, but only in patients without dementia. Conclusions Polypharmacy is significantly associated with delirium only in surgical units, raising the issue of the relevance of medication review in different clinical settings. Specific drug classes are associated with delirium depending on the clinical setting and dementia diagnosis, suggesting the need to further explore this relationship.

Published
2019

5. Should we treat HCV carriers with normal ALT levels? The ‘5Ws’ dilemma

Author

O. Dell’ Unto, L. Bellis, M. G. Elmo, Claudio Puoti, Riccardo Guarisco, L. Spilabotti, and O. Mitidieri Costanza

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Ribavirin, Disease progression, Disease, Asymptomatic, Natural history, chemistry.chemical_compound, Infectious Diseases, chemistry, Pegylated interferon, Virology, Liver biopsy, Internal medicine, Immunology, medicine, Liver damage, medicine.symptom, business, medicine.drug
Abstract

Summary. Approximately 30% of patients with chronic HCV infection have persistently normal ALT levels. Although formerly referred to as ‘healthy’ or ‘asymptomatic’ HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological liver damage that may be significant in up to 20% of cases and might progress towards a more severe degree of liver fibrosis. A significant proportion of patients experience periods of increased serum ALT associated with enhanced disease progression. However, controversies still exist in clinical practice regarding the definition of ‘persistent’ ALT normality, the virological and histological features of these subjects, the need for liver biopsy, the role of noninvasive tools for the assessment of liver fibrosis, the natural history and the usefulness of antiviral treatment. The advent of new therapeutic options (pegylated interferon plus ribavirin) has shifted treatment targets towards the eradication of underlying infection, with therapy decision based on age, severity of disease and likelihood of response rather than on aminotransferase levels. This review is aimed at approaching the main unresolved issues on this topic, trying to give evidence-based answers to the more frequently asked questions from patients and their physicians.

Published
2011
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6. Rapid virological response as a predictor of sustained response in HCV-infected patients with persistently normal alanine aminotransferase levels: A multicenter study

Author

A. M. Nicolini, Giorgio Barbarini, L. Bellis, Claudio Puoti, Adriano M. Pellicelli, Mario R. Romano, M. G. Elmo, Lorenzo Nosotti, Antonio Picardi, Olga Mitidieri Costanza, F. Mecenate, O. Dell’ Unto, Riccardo Guarisco, A. Barlattani, L. Spilabotti, Fabrizio Soccorsi, and M.E. Bonaventura

Subjects
medicine.medical_specialty, Hepatology, business.industry, Ribavirin, virus diseases, Gastroenterology, digestive system diseases, Virological response, chemistry.chemical_compound, Infectious Diseases, Pharmacotherapy, chemistry, Virology, Concomitant, Internal medicine, Immunology, Genotype, medicine, Young adult, Alanine aminotransferase, business, Peginterferon alfa-2a, medicine.drug
Abstract

Rapid virological response (RVR) is now considered the strongest predictor of sustained virological response (SVR) in patients with HCV undergoing antiviral treatment, and thus, shorter antiviral treatment for these patients has been suggested. However, no data exist on the predictive value of RVR in HCV carriers with normal ALT values. A total of 137 patients with persistently normal ALT treated with peginterferon alfa 2a and ribavirin were studied. Fifteen patients dropped out early because of side effects, and in 10 patients with HCV-1 treatment was discontinued because of lack of early virological response (EVR). RVR was observed in 68% of the patients (42% patients with HCV-1, 90% HCV-2 and 64% HCV-3). An end-of-treatment response was observed in 86% of the patients (68% HCV-1, 100% HCV-2 and 91% HCV-3). SVR was maintained in 91 patients (46% HCV-1, 97% HCV-2 and 82% HCV-3). Overall, 92% patients with rapid response did obtain HCV eradication vs only 38% of those without rapid response. HCV-1 patients with baseline HCV RNA

Published
2011
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7. HCV carriers with normal alanine aminotransferase levels: Healthy persons or severely ill patients?

Author

Olga Mitidieri Costanza, Orlando Dell' Unto, L. Spilabotti, Riccardo Guarisco, Claudio Puoti, and Lia Bellis

Subjects
medicine.medical_specialty, medicine.diagnostic_test, biology, business.industry, Ribavirin, Hepatitis C virus, Disease, Hepatitis C, medicine.disease, medicine.disease_cause, Asymptomatic, chemistry.chemical_compound, chemistry, Alanine transaminase, Internal medicine, Liver biopsy, Biopsy, Immunology, Internal Medicine, biology.protein, Medicine, medicine.symptom, business
Abstract

Approximately 30% of patients with chronic HCV infection show persistently normal ALT levels. Although formerly referred to as 'healthy' or 'asymptomatic' HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological liver damage that may be significant in up to 20% of patients and might progress toward a more severe degree of liver fibrosis. A significant proportion of patients (> or =20%) experience periods of increased serum ALT (flare) associated with enhanced disease progression. However, controversies still exist in clinical practice regarding the definition of 'persistent' ALT normality, the virological and histological features of these subjects, the need for liver biopsy, the role of non invasive tools for the assessment of liver fibrosis (transient hepatic elastography, fibroscan), and the natural history and optimal management of chronic hepatitis C with normal ALT. The advent of new therapeutic options (pegylated interferons plus ribavirin) has shifted treatment targets toward eradication of underlying infection, with therapy decision based on age, severity of disease and likelihood of response rather than on aminotransferase levels. This review does approach the main unresolved issues on this topic in the form of a dialog between a hepatologist and a patient with HCV infection but normal alanine aminotransferase levels, trying to give evidence-based answers to the more frequently asked questions from patients and their physicians.

Published
2010
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8. Quantitation of tissue polypeptide antigen (TPA) in hepatic and systemic circulation in patients with chronic liver diseases

Author

Orlando Dell' Unto, Olga Mitidieri Costanza, Federica Paglia, L. Spilabotti, Alessandra Galossi, Riccardo Guarisco, Lia Bellis, Claudio Puoti, and Renata Felici

Subjects
Liver Cirrhosis, Male, Pathology, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Hepatic Veins, Chronic liver disease, Severity of Illness Index, Gastroenterology, Pathogenesis, Hepatitis B, Chronic, Predictive Value of Tests, Internal medicine, Hypertension, Portal, medicine, Humans, Prospective Studies, Tissue Polypeptide Antigen, Vein, Aged, integumentary system, Hepatology, business.industry, Vascular disease, Liver Diseases, Liver Neoplasms, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Hepatitis B, medicine.disease, medicine.anatomical_structure, Portal hypertension, Female, business, Venous Pressure, Biomarkers, Liver Circulation
Abstract

Background and Aim: Abnormal serum tissue polypeptide antigen (TPA) values are commonly found in patients with chronic liver damage and liver cirrhosis even in the absence of malignancies. The aim of this study was to compare serum TPA levels in patients with cirrhosis, to examine correlations between TPA levels and the degree of portal hypertension, and to evaluate TPA concentrations in paired hepatic and peripheral blood samples. Methods: A total of 128 patients with chronic liver disease of various severity were studied prospectively. TPA concentrations in hepatic vein and peripheral blood were determined, and Hepatic Vein Pressure Gradient (HVPG) was measured. Results: TPA levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis, and in systemic circulation than in hepatic vein blood. Peripheral but not hepatic TPA levels did correlate with the HVPG. Subjects with clinically significant portal hypertension (HVPG > 10 mmHg) showed significantly higher peripheral TPA levels than those with HVPG

Published
2009
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9. Altered Cholesterol Ester Cycle in Skin Fibroblasts from Patients with Alzheimer's Disease

Author

Christina D. Orru, Anna Laurenzana, Maria Dolores Cannas, Claudia Mulas, Antonio Mitidieri Costanza, Sandra Dessì, Alessandra Pani, Cristina Cellai, Paolo La Colla, Pier Luigi Cocco, A. Bavazzano, Paolo Putzu, Giacomo Diaz, Francesco Paoletti, Fabrizio Angius, Antonella Mandas, Alessandra Mocali, and Claudia Abete

Subjects
Male, medicine.medical_specialty, Genotype, Caveolin 1, Biology, Filipin, chemistry.chemical_compound, Apolipoproteins E, Alzheimer Disease, Internal medicine, medicine, Humans, RNA, Messenger, Receptor, Neprilysin, Aged, Skin, Aged, 80 and over, Amyloid beta-Peptides, Cholesterol, General Neuroscience, General Medicine, Metabolism, Fibroblasts, Middle Aged, Sterol, Psychiatry and Mental health, Clinical Psychology, Endocrinology, chemistry, Case-Control Studies, Imino Furanoses, Female, lipids (amino acids, peptides, and proteins), Cholesterol Esters, Geriatrics and Gerontology, Immunostaining, Lipoprotein
Abstract

Intracellular cholesterol metabolism was reported to modulate amyloid-beta (Abeta) generation in Alzheimer's disease (AD). Results presented herein demonstrated that, like brain cells, cultured skin fibroblasts from AD patients contained more cholesterol esters than fibroblasts from healthy subjects. Particularly, Oil Red-O, Nile Red, and filipin staining highlighted higher levels of neutral lipids which responded to inhibitors of acyl-coenzyme A:cholesterol acyl-transferase (ACAT-1), associated with an increase in free cholesterol. ACAT-1 mRNA levels increased significantly in AD fibroblasts, whereas those of sterol regulatory element binding protein-2, neutral cholesterol ester hydrolase, and ATP-binding cassette transporter member 1 were markedly down-regulated. Instead, mRNA levels of low-density lipoprotein receptor, hydroxy-methyl-glutaryl-coenzyme A reductase, caveolin-1, and amyloid-beta protein precursor (AbetaPP) were virtually unchanged. Notably, mRNA levels of both beta-site AbetaPP-cleaving enzyme 1 (BACE1) and neprilysin were significantly down-regulated. An increase in Abeta(40) and Abeta(42) immunostaining and a decrease in BACE1 active form were also found in AD versus control fibroblasts. Altogether, these findings support the hypothesis that the derangement of cholesterol homeostasis is a systemic alteration involving central but also peripheral cells of AD patients, and point to cholesterol ester levels in AD fibroblasts as an additional metabolic hallmark useful in the laboratory and clinical practice.

Published
2009
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10. Altered Proteolysis in Fibroblasts of Alzheimer Patients with Predictive Implications for Subjects at Risk of Disease

Author

Vito Antonio Mitidieri Costanza, Claudia Abete, Sandra Dessì, A. Bavazzano, Alessandra Pani, Luis Sanchez, Nunzia Della Malva, Francesco Paoletti, Alessandra Mocali, and Vieri Boddi

Subjects
Apolipoprotein E, Aging, Pathology, medicine.medical_specialty, Article Subject, Cognitive Neuroscience, Proteolysis, Disease, lcsh:Geriatrics, Asymptomatic, lcsh:RC321-571, Behavioral Neuroscience, Cellular and Molecular Neuroscience, Genotype, Early prediction, medicine, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, medicine.diagnostic_test, business.industry, Antemortem Diagnosis, Alzheimer's disease, human fibroblasts, altered proteolysis, lcsh:RC952-954.6, Neurology, Immunology, Clinical Study, Neurology (clinical), medicine.symptom, Differential diagnosis, business
Abstract

There is great interest in developing reliable biomarkers to support antemortem diagnosis of late-onset Alzheimer’s disease (AD). Early prediction and diagnosis of AD might be improved by the detection of a proteolytic dysfunction in extracts from cultured AD fibroblasts, producing altered isoelectrophoretic forms of the enzyme transketolase (TK-alkaline bands). The TK profile and apolipoprotein E (APOE) genotype were examined in fibroblasts from 36 clinically diagnosed probable late-onset sporadic AD patients and 38 of their asymptomatic relatives, 29 elderly healthy individuals, 12 neurological non-AD patients, and 5 early-onset AD patients. TK alterations occurred in (i) several probable AD patients regardless of age-of-onset and severity of disease; (ii) all early-onset AD patients and APOEε4/4 carriers; and (iii) nearly half of asymptomatic AD relatives. Normal subjects and non-AD patients were all negative. Notably, culture conditions promoting TK alterations were also effective in increasing active BACE1 levels. Overall, the TK assay might represent a low-cost laboratory tool useful for supporting AD differential diagnosis and identifying asymptomatic subjects who are at greater risk of AD and who should enter a follow-up study. Moreover, the cultured fibroblasts were confirmed as a usefulin vitromodel for further studies on the pathogenetic process of AD.

Published
2014

11. Factors related to the length of in-hospital stay of geriatric patients

Author

A. Di Iorio, E. Benvenuti, A. Mitidieri Costanza, S. Giardini, A. Bavazzano, L. Ferrucci, A. Longo, Stefania Bandinelli, Umberto Senin, T. Palmerio, G. Guizzardi, and G. Abate

Subjects
Aging, medicine.medical_specialty, business.industry, Comorbidity score, Physical function, medicine.disease, Comorbidity, Social support, Internal medicine, medicine, Functional status, Geriatrics and Gerontology, Medical diagnosis, business, Hospital stay, Depressive symptoms
Abstract

The aim of this study was to evaluate factors predicting length of stay in hospital of geriatric patients. Study participants were 402 patients (183 males and 219 females) consecutively admitted to four geriatric wards located in Chieti, Perugia, Pescara and Prato, Italy. Information on potential predictors of length of stay was collected; in particular, we assessed the presence and severity of specific chronic medical conditions, level of physical function, cognitive status, and depressive symptoms. Moreover, information on family and social support was obtained. In general, participants were old, often cognitively impaired and physically disabled. Average length of stay ranged from 9.4±3.3 days (Perugia) to 14.1±7.2 days (Chieti), and was statistically different across centers (p

Published
1999
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12. Should we treat HCV carriers with normal ALT levels? The '5Ws' dilemma

Author

C, Puoti, R, Guarisco, L, Spilabotti, L, Bellis, O, Mitidieri Costanza, O, Dell' Unto, and M G, Elmo

Subjects
Liver, Carrier State, Ribavirin, Humans, Alanine Transaminase, Interferons, Hepatitis C, Chronic, Antiviral Agents
Abstract

Approximately 30% of patients with chronic HCV infection have persistently normal ALT levels. Although formerly referred to as 'healthy' or 'asymptomatic' HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological liver damage that may be significant in up to 20% of cases and might progress towards a more severe degree of liver fibrosis. A significant proportion of patients experience periods of increased serum ALT associated with enhanced disease progression. However, controversies still exist in clinical practice regarding the definition of 'persistent' ALT normality, the virological and histological features of these subjects, the need for liver biopsy, the role of noninvasive tools for the assessment of liver fibrosis, the natural history and the usefulness of antiviral treatment. The advent of new therapeutic options (pegylated interferon plus ribavirin) has shifted treatment targets towards the eradication of underlying infection, with therapy decision based on age, severity of disease and likelihood of response rather than on aminotransferase levels. This review is aimed at approaching the main unresolved issues on this topic, trying to give evidence-based answers to the more frequently asked questions from patients and their physicians.

Published
2012

14. HCV carriers with normal alanine aminotransferase levels: healthy persons or severely ill patients? Dealing with an everyday clinical problem

Author

Claudio, Puoti, Lia, Bellis, Riccardo, Guarisco, Orlando, Dell' Unto, Lucia, Spilabotti, and Olga Mitidieri, Costanza

Subjects
Male, Liver, Carrier State, Disease Progression, Humans, Alanine Transaminase, Female, Hepacivirus, Fibrosis, Hepatitis C
Abstract

Approximately 30% of patients with chronic HCV infection show persistently normal ALT levels. Although formerly referred to as 'healthy' or 'asymptomatic' HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological liver damage that may be significant in up to 20% of patients and might progress toward a more severe degree of liver fibrosis. A significant proportion of patients (or =20%) experience periods of increased serum ALT (flare) associated with enhanced disease progression. However, controversies still exist in clinical practice regarding the definition of 'persistent' ALT normality, the virological and histological features of these subjects, the need for liver biopsy, the role of non invasive tools for the assessment of liver fibrosis (transient hepatic elastography, fibroscan), and the natural history and optimal management of chronic hepatitis C with normal ALT. The advent of new therapeutic options (pegylated interferons plus ribavirin) has shifted treatment targets toward eradication of underlying infection, with therapy decision based on age, severity of disease and likelihood of response rather than on aminotransferase levels. This review does approach the main unresolved issues on this topic in the form of a dialog between a hepatologist and a patient with HCV infection but normal alanine aminotransferase levels, trying to give evidence-based answers to the more frequently asked questions from patients and their physicians.

Published
2009

16. Quantitation of tissue polypeptide antigen (TPA) in hepatic vein Blood and systemic circulation in patients with cirrhosis and HCC

Author

L. Bellis, Federica Paglia, O. Mitidieri Costanza, O. Dell’ Unto, Claudio Puoti, Riccardo Guarisco, R. Felici, L. Spilabotti, and Alessandra Galossi

Subjects
Pathology, medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Tissue Polypeptide Antigen, Gastroenterology, medicine.disease, Systemic circulation, medicine.anatomical_structure, Medicine, In patient, Radiology, business, Vein
Published
2009
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17. Factors related to the length of in-hospital stay of geriatric patients

Author

A, Di Iorio, A, Longo, A, Mitidieri Costanza, T, Palmerio, E, Benvenuti, S, Giardini, A, Bavazzano, G, Guizzardi, U, Senin, S, Bandinelli, L, Ferrucci, and G, Abate

Subjects
Aged, 80 and over, Male, Health Services for the Aged, Comorbidity, Length of Stay, Age Distribution, Italy, Predictive Value of Tests, Chronic Disease, Linear Models, Prevalence, Humans, Female, Cognition Disorders, Hospital Units, Aged
Abstract

The aim of this study was to evaluate factors predicting length of stay in hospital of geriatric patients. Study participants were 402 patients (183 males and 219 females) consecutively admitted to four geriatric wards located in Chieti, Perugia, Pescara and Prato, Italy. Information on potential predictors of length of stay was collected; in particular, we assessed the presence and severity of specific chronic medical conditions, level of physical function, cognitive status, and depressive symptoms. Moreover, information on family and social support was obtained. In general, participants were old, often cognitively impaired and physically disabled. Average length of stay ranged from 9.4 +/- 3.3 days (Perugia) to 14.1 +/- 7.2 days (Chieti), and was statistically different across centers (p0.001). None of the specific medical diagnoses was associated with different length of stay. However, higher comorbidity score (p0.001), living alone (p0.01), lower MMSE score (p = 0.03), and poor functional status (p = 0.05) were all associated with longer length of stay. When these variables were included in a multivariate model predicting length of stay, differences between centers were no longer statistically significant. Findings of this study show that specific medical diagnoses are not adequate instruments to estimate length of stay in geriatric units. Other assessment systems based on extension of the social network, comorbidity, and the cognitive as well as the functional level need to be developed.

Published
1999

19. Should we treat HCV carriers with normal ALT levels? The '5Ws' dilemma.

Author

Puoti, C., Guarisco, R., Spilabotti, L., Bellis, L., Mitidieri Costanza, O., Dell' Unto, O., and Elmo, M. G.

Subjects
HEPATITIS C, LIVER biopsy, HISTOPATHOLOGY, FIBROSIS, ANTIVIRAL agents, DECISION making in clinical medicine, AMINOTRANSFERASES, PATIENTS
Abstract

Summary. Approximately 30% of patients with chronic HCV infection have persistently normal ALT levels. Although formerly referred to as 'healthy' or 'asymptomatic' HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological liver damage that may be significant in up to 20% of cases and might progress towards a more severe degree of liver fibrosis. A significant proportion of patients experience periods of increased serum ALT associated with enhanced disease progression. However, controversies still exist in clinical practice regarding the definition of 'persistent' ALT normality, the virological and histological features of these subjects, the need for liver biopsy, the role of noninvasive tools for the assessment of liver fibrosis, the natural history and the usefulness of antiviral treatment. The advent of new therapeutic options (pegylated interferon plus ribavirin) has shifted treatment targets towards the eradication of underlying infection, with therapy decision based on age, severity of disease and likelihood of response rather than on aminotransferase levels. This review is aimed at approaching the main unresolved issues on this topic, trying to give evidence-based answers to the more frequently asked questions from patients and their physicians. [ABSTRACT FROM AUTHOR]

Published
2012
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23. Characteristics of geriatric patients related to early and late readmissions to hospital

Author

A. Mitidieri Costanza, Umberto Senin, M. Gigante, A. Longo, Luigi Ferrucci, A. Di Iorio, G. Guizzardi, Stefania Bandinelli, S. Capasso, G. Abate, and A. Bavazzano

Subjects
Male, Aging, medicine.medical_specialty, Pediatrics, Multivariate analysis, Time Factors, Logistic regression, Social Environment, Patient Readmission, Social support, Surveys and Questionnaires, Activities of Daily Living, medicine, Humans, Aged, Psychiatric Status Rating Scales, Univariate analysis, business.industry, Medical record, Social environment, medicine.disease, Comorbidity, Italy, Geriatrics, Case-Control Studies, Emergency medicine, Multivariate Analysis, Geriatric Depression Scale, Female, Geriatrics and Gerontology, business
Abstract

The aim of the study was to evaluate which characteristics of geriatric patients account for readmission to hospital, 6 months after discharge. All patients (203 females, 176 males) consecutively admitted over a two-month period to four acute geriatric care units, located in the cities of Chieti, Perugia, Pescara and Prato, participated in the study. Data that could potentially explain early and late readmissions were collected for each patient. Prevalence of diseases and comorbidity were assessed with the Cumulative Illness Rating Scale (CIRS); physical function by self-report (ADL, IADL) and objective (Stand and Walking Speed) measures; cognitive level by MMSE; and depressive symptoms by the Geriatric Depression Scale (GDS). Information on family and social support were also obtained. After discharge, data on hospital readmissions were collected for six months. For each readmitted patient (cases), medical records were reviewed, and supplementary information was obtained from families and general practitioners. Readmissions were classified as "early" (within the first three months), "late" (within the third and sixth month), and "multiple" (2 or more readmissions irrespective of the period). Patients not readmitted (alive at home) were considered as controls. Systematic differences between centers and between periods of readmissions were evaluated using one-way analyses of variance, and Pearson's chi 2 test. Factors related to early, late, and multiple readmission were identified in multivariate logistic regression models. On univariate analysis, patients readmitted over the first three-month period were sicker than controls (CIRS classes 3-4: 52.1% vs 34.1%), had more social problems or behavioral symptoms, and were more functionally impaired (ADL dependencies 3.3 +/- 0.4 vs 2.1 +/- 0.2). Patients who were readmitted between the third and the sixth month after discharge had a significantly higher CIRS total score (p = 0.006). Patients with multiple readmissions had more severe diseases, and more social problems. On multivariate analysis, early readmission was associated with unsatisfactory social conditions, living alone, severity of diseases and cognitive impairment, while late readmission was associated with comorbidity only. Multiple readmissions were related only to social factors, and to hospital admission before the baseline evaluation. The findings of this study suggest that interventions aimed at improving unfavorable social conditions may reduce the rate of rehospitalization in geriatric patients.

26. Factors related to the length of in-hospital stay of geriatric patients.

Author

Di Iorio A, Longo A, Mitidieri Costanza A, Palmerio T, Benvenuti E, Giardini S, Bavazzano A, Guizzardi G, Senin U, Bandinelli S, Ferrucci L, and Abate G

Subjects
Age Distribution, Aged, Aged, 80 and over, Cognition Disorders epidemiology, Comorbidity, Female, Hospital Units statistics & numerical data, Humans, Italy epidemiology, Linear Models, Male, Predictive Value of Tests, Prevalence, Chronic Disease epidemiology, Health Services for the Aged statistics & numerical data, Length of Stay statistics & numerical data
Abstract

The aim of this study was to evaluate factors predicting length of stay in hospital of geriatric patients. Study participants were 402 patients (183 males and 219 females) consecutively admitted to four geriatric wards located in Chieti, Perugia, Pescara and Prato, Italy. Information on potential predictors of length of stay was collected; in particular, we assessed the presence and severity of specific chronic medical conditions, level of physical function, cognitive status, and depressive symptoms. Moreover, information on family and social support was obtained. In general, participants were old, often cognitively impaired and physically disabled. Average length of stay ranged from 9.4 +/- 3.3 days (Perugia) to 14.1 +/- 7.2 days (Chieti), and was statistically different across centers (p < 0.001). None of the specific medical diagnoses was associated with different length of stay. However, higher comorbidity score (p < 0.001), living alone (p < 0.01), lower MMSE score (p = 0.03), and poor functional status (p = 0.05) were all associated with longer length of stay. When these variables were included in a multivariate model predicting length of stay, differences between centers were no longer statistically significant. Findings of this study show that specific medical diagnoses are not adequate instruments to estimate length of stay in geriatric units. Other assessment systems based on extension of the social network, comorbidity, and the cognitive as well as the functional level need to be developed.

Published
1999

27. Characteristics of geriatric patients related to early and late readmissions to hospital.

Author

Di Iorio A, Longo AL, Mitidieri Costanza A, Bandinelli S, Capasso S, Gigante M, Bavazzano A, Guizzardi G, Senin U, Ferrucci L, and Abate G

Subjects
Activities of Daily Living, Aged, Case-Control Studies, Female, Humans, Italy, Male, Multivariate Analysis, Psychiatric Status Rating Scales, Social Environment, Surveys and Questionnaires, Time Factors, Geriatrics statistics & numerical data, Patient Readmission statistics & numerical data
Abstract

The aim of the study was to evaluate which characteristics of geriatric patients account for readmission to hospital, 6 months after discharge. All patients (203 females, 176 males) consecutively admitted over a two-month period to four acute geriatric care units, located in the cities of Chieti, Perugia, Pescara and Prato, participated in the study. Data that could potentially explain early and late readmissions were collected for each patient. Prevalence of diseases and comorbidity were assessed with the Cumulative Illness Rating Scale (CIRS); physical function by self-report (ADL, IADL) and objective (Stand and Walking Speed) measures; cognitive level by MMSE; and depressive symptoms by the Geriatric Depression Scale (GDS). Information on family and social support were also obtained. After discharge, data on hospital readmissions were collected for six months. For each readmitted patient (cases), medical records were reviewed, and supplementary information was obtained from families and general practitioners. Readmissions were classified as "early" (within the first three months), "late" (within the third and sixth month), and "multiple" (2 or more readmissions irrespective of the period). Patients not readmitted (alive at home) were considered as controls. Systematic differences between centers and between periods of readmissions were evaluated using one-way analyses of variance, and Pearson's chi 2 test. Factors related to early, late, and multiple readmission were identified in multivariate logistic regression models. On univariate analysis, patients readmitted over the first three-month period were sicker than controls (CIRS classes 3-4: 52.1% vs 34.1%), had more social problems or behavioral symptoms, and were more functionally impaired (ADL dependencies 3.3 +/- 0.4 vs 2.1 +/- 0.2). Patients who were readmitted between the third and the sixth month after discharge had a significantly higher CIRS total score (p = 0.006). Patients with multiple readmissions had more severe diseases, and more social problems. On multivariate analysis, early readmission was associated with unsatisfactory social conditions, living alone, severity of diseases and cognitive impairment, while late readmission was associated with comorbidity only. Multiple readmissions were related only to social factors, and to hospital admission before the baseline evaluation. The findings of this study suggest that interventions aimed at improving unfavorable social conditions may reduce the rate of rehospitalization in geriatric patients.

Published
1998
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