235 results on '"Scondotto, S"'
Search Results
2. The quality of mental health care for people with bipolar disorders in the Italian mental health system. The QUADIM project
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D’avanzo, B, Barbato, A, Monzio Compagnoni, M, Caggiu, G, Allevi, L, Carle, F, Di Fiandra, T, Ferrara, L, Gaddini, A, Sanza, M, Saponaro, A, Scondotto, S, D Tozzi, V, Giordani, C, Corrao, G, Lora, A, D’Avanzo, B, Barbato, A, Monzio Compagnoni, M, Caggiu, G, Allevi, L, Carle, F, Di Fiandra, T, Ferrara, L, Gaddini, A, Sanza, M, Saponaro, A, Scondotto, S, D Tozzi, V, Giordani, C, Corrao, G, and Lora, A
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Healthcare utilization database ,Quality of mental health care ,Public health ,Healthcare research ,Real-world ,Treatment gap ,Bipolar disorder ,Clinical pathway ,Healthcare service ,Mental health care - Abstract
Background: The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods: Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results: 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions: We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health.
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- 2023
3. The quality of mental health care delivered to patients with schizophrenia and related disorders in the Italian mental health system. the QUADIM project: A multi-regional Italian investigation based on healthcare utilisation databases
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Lora, A, Monzio Compagnoni, M, Allevi, L, Barbato, A, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Leogrande, M, Saponaro, A, Scondotto, S, Tozzi, V, Carbone, S, Corrao, G, Lora A., Monzio Compagnoni M., Allevi L., Barbato A., Carle F., D'Avanzo B., Di Fiandra T., Ferrara L., Gaddini A., Leogrande M., Saponaro A., Scondotto S., Tozzi V. D., Carbone S., Corrao G., Lora, A, Monzio Compagnoni, M, Allevi, L, Barbato, A, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Leogrande, M, Saponaro, A, Scondotto, S, Tozzi, V, Carbone, S, Corrao, G, Lora A., Monzio Compagnoni M., Allevi L., Barbato A., Carle F., D'Avanzo B., Di Fiandra T., Ferrara L., Gaddini A., Leogrande M., Saponaro A., Scondotto S., Tozzi V. D., Carbone S., and Corrao G.
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Aims To evaluate the quality of mental health care delivered to patients with schizophrenia and related disorders taken-in-care by mental health services in four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). Methods Thirty-one clinical indicators concerning accessibility, appropriateness, continuity and safety were defined and estimated using healthcare utilisation (HCU) databases, containing data on mental health treatments, hospital admissions, outpatient interventions, lab tests and drug prescriptions. Results A total of 70 586 prevalent patients with schizophrenia and related disorders treated in 2015 were identified, of whom 1752 were newly taken-in-care by the facilities of regional mental health services. For most patients community care was accessible and moderately intensive. However, care pathways were not implemented based on a structured assessment and only half of the patients received psychosocial treatments. One patient out of ten had access to psychological interventions and psychoeducation. Activities specifically addressed to families involved a third of prevalent patients and less than half of new patients. One patient out of six was admitted to a community residential facility, and one out of ten to a General Hospital Psychiatric Ward (GHPW); higher values were identified in new cases. In general hospitals, few patients had a length of stay (LoS) of more than 30 days, while one-fifth of the admissions were followed by readmission within 30 days of discharge. For two-thirds of patients, continuity of community care was met, and six times out of ten a discharge from a GHPW was followed by an outpatient contact within 2 weeks. For cases newly taken-in-care, the continuity of community care was uncommon, while the readiness of outpatient contacts after discharge was slightly more frequent. Most of the patients received antipsychotic medication, but their adherence to long-term treatment was low. Antipsychotic polytherapy was frequent and
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- 2022
4. From contact coverage to effective coverage of community care for patients with severe mental disorders: a real-world investigation from Italy. Methodology and results from the QUADIM project
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Monzio Compagnoni, M., primary, Corrao, G., additional, Barbato, A., additional, D’Avanzo, B., additional, Di Fiandra, T., additional, Carle, F., additional, Ferrara, L., additional, Tozzi, V. D., additional, Gaddini, A., additional, Saponaro, A., additional, Scondotto, S., additional, Chisholm, D., additional, and Lora, A., additional
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- 2023
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5. Using big data and Population Health Management to assess care and costs for patients with severe mental disorders and move toward a value-based payment system
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Tozzi, V, Banks, H, Ferrara, L, Barbato, A, Corrao, G, D'Avanzo, B, Di Fiandra, T, Gaddini, A, Compagnoni, M, Sanza, M, Saponaro, A, Scondotto, S, Lora, A, Tozzi, Valeria D, Banks, Helen, Ferrara, Lucia, Barbato, Angelo, Corrao, Giovanni, D'avanzo, Barbara, Di Fiandra, Teresa, Gaddini, Andrea, Compagnoni, Matteo Monzio, Sanza, Michele, Saponaro, Alessio, Scondotto, Salvatore, Lora, Antonio, Tozzi, V, Banks, H, Ferrara, L, Barbato, A, Corrao, G, D'Avanzo, B, Di Fiandra, T, Gaddini, A, Compagnoni, M, Sanza, M, Saponaro, A, Scondotto, S, Lora, A, Tozzi, Valeria D, Banks, Helen, Ferrara, Lucia, Barbato, Angelo, Corrao, Giovanni, D'avanzo, Barbara, Di Fiandra, Teresa, Gaddini, Andrea, Compagnoni, Matteo Monzio, Sanza, Michele, Saponaro, Alessio, Scondotto, Salvatore, and Lora, Antonio
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Background: Mental health (MH) care often exhibits uneven quality and poor coordination of physical and MH needs, especially for patients with severe mental disorders. This study tests a Population Health Management (PHM) approach to identify patients with severe mental disorders using administrative health databases in Italy and evaluate, manage and monitor care pathways and costs. A second objective explores the feasibility of changing the payment system from fee-for-service to a value-based system (e.g., increased care integration, bundled payments) to introduce performance measures and guide improvement in outcomes. Methods: Since diagnosis alone may poorly predict condition severity and needs, we conducted a retrospective observational study on a 9,019-patient cohort assessed in 2018 (30.5% of 29,570 patients with SMDs from three Italian regions) using the Mental Health Clustering Tool (MHCT), developed in the United Kingdom, to stratify patients according to severity and needs, providing a basis for payment for episode of care. Patients were linked (blinded) with retrospective (2014–2017) physical and MH databases to map resource use, care pathways, and assess costs globally and by cluster. Two regions (3,525 patients) provided data for generalized linear model regression to explore determinants of cost variation among clusters and regions. Results: Substantial heterogeneity was observed in care organization, resource use and costs across and within 3 Italian regions and 20 clusters. Annual mean costs per patient across regions was €3,925, ranging from €3,101 to €6,501 in the three regions. Some 70% of total costs were for MH services and medications, 37% incurred in dedicated mental health facilities, 33% for MH services and medications noted in physical healthcare databases, and 30% for other conditions. Regression analysis showed comorbidities, resident psychiatric services, and consumption noted in physical health databases have considerable impact on tota
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- 2023
6. Assessing the quality of the care offer for people with personality disorders in Italy: the QUADIM project. A multicentre research based on the database of use of Mental Health services
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Sanza, M, Monzio Compagnoni, M, Caggiu, G, Allevi, L, Barbato, A, Campa, J, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Saponaro, A, Scondotto, S, Tozzi, V, Lorusso, S, Giordani, C, Corrao, G, Lora, A, D'avanzo, B, Tozzi, VD, Sanza, M, Monzio Compagnoni, M, Caggiu, G, Allevi, L, Barbato, A, Campa, J, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Saponaro, A, Scondotto, S, Tozzi, V, Lorusso, S, Giordani, C, Corrao, G, Lora, A, D'avanzo, B, and Tozzi, VD
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Background: Italy can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare have been developed by transnational-organisations, there is still no widespread practice of measuring the quality of care pathways delivered to patients with severe mental disorders in a community-oriented system, especially using administrative healthcare databases. The aim of the study is to evaluate the quality of care delivered to patients with personality disorders taken-in-care by mental health services of four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). Methods: A set of thirty-three clinical indicators, concerning accessibility, appropriateness, continuity, and safety of care, was implemented using regional healthcare utilization databases, containing data on mental health treatments and diagnosis, hospital admissions, outpatient interventions and exams and drug prescriptions. RESULTS: 31,688 prevalent patients with personality disorders treated in 2015 were identified, of whom 2,331 newly taken-in-care. One-in-10 patients received a standardized assessment, the treatment discontinuity affected half of the cases. 12.7% of prevalent patients received at least one hospitalization, 10.6% in the newly taken-in-care cohort. 6-out-of-10 patients had contact with community-services within 14 days from hospital discharge. Access to psychotherapy and psychoeducational treatments was low and delivered with a low intensity. The median of psychosocial interventions per person-year was 19.1 and 9.4, respectively, in prevalent and newly taken-in-care cases. Nearly 50% of patients received pharmacological treatments. Conclusions: Healthcare utilization databases were used to systematically evaluate and assess service delivery across regional mental health system
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- 2023
7. Allocation of Users of Mental Health Services to Needs-Based Care Clusters: An Italian Pilot Study
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Barbato, A, D'Avanzo, B, Corrao, G, Di Fiandra, T, Ferrara, L, Gaddini, A, Jarach, C, Monzio Compagnoni, M, Saponaro, A, Scondotto, S, Tozzi, V, Lora, A, Barbato, Angelo, D'Avanzo, Barbara, Corrao, Giovanni, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Jarach, Carlotta Micaela, Monzio Compagnoni, Matteo, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D, Lora, Antonio, Barbato, A, D'Avanzo, B, Corrao, G, Di Fiandra, T, Ferrara, L, Gaddini, A, Jarach, C, Monzio Compagnoni, M, Saponaro, A, Scondotto, S, Tozzi, V, Lora, A, Barbato, Angelo, D'Avanzo, Barbara, Corrao, Giovanni, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Jarach, Carlotta Micaela, Monzio Compagnoni, Matteo, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D, and Lora, Antonio
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In Italy, despite strong community-based mental health services, needs assessment is unsatisfactory. Using the Mental Health Clustering Tool (MHCT) we adopted a multidimensional and non-diagnosis dependent approach to assign mental health services users with similar needs to groups corresponding to resources required for effective care. We tested the MHCT in nine Departments of Mental Health in four Italian regions. After a brief training, 318 professionals assessed 12,938 cases with a diagnosis of schizophrenia, depression, bipolar disorder and personality disorder through the MHCT. 53% of cases were 40–59 years, half were females, 51% had a diagnosis of schizophrenia, 48% of cases were clinically severe. Clusters included different levels of clinical severity and diagnostic groups. The largest cluster was 11 (ongoing recurrent psychosis), with 18.9% of the sample, followed by cluster 3 (non-psychotic disorders of moderate severity). The MHCT could capture a variety of problems of people with mental disorders beyond the traditional psychiatric assessment, therefore depicting service population from a different standpoint. Following a brief training, MHCT assessment proved to be feasible. The automatic allocation of cases made the attribution to clusters easy and acceptable by professionals. To what extent clustering provide a sound base for care planning will be the matter of further research.
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- 2023
8. Small-area deprivation index does not improve the capability of multisource comorbidity score in mortality prediction
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Rea, F, Ferrante, M, Scondotto, S, Corrao, G, Rea, Federico, Ferrante, Mauro, Scondotto, Salvatore, Corrao, Giovanni, Rea, F, Ferrante, M, Scondotto, S, Corrao, G, Rea, Federico, Ferrante, Mauro, Scondotto, Salvatore, and Corrao, Giovanni
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Background: The stratification of the general population according to health needs allows to provide better-tailored services. A simple score called Multisource Comorbidity Score (MCS) has been developed and validated for predicting several outcomes. The aim of this study was to evaluate whether the ability of MCS in predicting 1-year mortality improves by incorporating socioeconomic data (as measured by a deprivation index). Methods: Beneficiaries of the Italian National Health Service who in the index year (2018) were aged 50–85 years and were resident in the Sicily region for at least 2 years were identified. For each individual, the MCS was calculated according to his/her clinical profile, and the deprivation index of the census unit level of the individual’s residence was collected. Frailty models were fitted to assess the relationship between the indexes (MCS and deprivation index) and 1-year mortality. Akaike information criterion and Bayesian information criterion statistics were used to compare the goodness of fit of the model that included only MCS and the model that also contained the deprivation index. The models were further compared by means of the area under the receiver operating characteristic curve (AUC). Results: The final cohort included 1,062,221 individuals, with a mortality rate of 15.6 deaths per 1,000 person-years. Both MCS and deprivation index were positively associated with mortality. The goodness of fit statistics of the two models were very similar. For MCS only and MCS plus deprivation index models, Akaike information criterion were 17,013 and 17,038, respectively, whereas Bayesian information criterion were 16,997 and 17,000, respectively. The AUC values were 0.78 for both models. Conclusion: The present study shows that socioeconomic features as measured by the deprivation index did not improve the capability of MCS in predicting 1-year risk of death. Future studies are needed to investigate other sources of data to enhance the risk
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- 2023
9. Assessment and Monitoring of the Quality of Clinical Pathways in Patients with Depressive Disorders: Results from a Multiregional Italian Investigation on Mental Health Care Quality (the QUADIM Project)
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Monzio Compagnoni, M, Caggiu, G, Allevi, L, Barbato, A, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Giordani, C, Sanza, M, Saponaro, A, Scondotto, S, Tozzi, V, Corrao, G, Lora, A, Monzio Compagnoni, Matteo, Caggiu, Giulia, Allevi, Liliana, Barbato, Angelo, Carle, Flavia, D'Avanzo, Barbara, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Giordani, Cristina, Sanza, Michele, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D, Corrao, Giovanni, Lora, Antonio, Monzio Compagnoni, M, Caggiu, G, Allevi, L, Barbato, A, Carle, F, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Giordani, C, Sanza, M, Saponaro, A, Scondotto, S, Tozzi, V, Corrao, G, Lora, A, Monzio Compagnoni, Matteo, Caggiu, Giulia, Allevi, Liliana, Barbato, Angelo, Carle, Flavia, D'Avanzo, Barbara, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Giordani, Cristina, Sanza, Michele, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D, Corrao, Giovanni, and Lora, Antonio
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Ensuring adequate quality of care to patients with severe mental disorders remains a challenge. The implementation of clinical indicators aimed at assessing the quality of health care pathways delivered is crucial for the improvement of mental health services (MHS). This study aims to evaluate the quality of care delivered to patients who are taken-into-care with depressive disorders by MHS. Thirty-four clinical indicators concerning accessibility, appropriateness, continuity, and safety were estimated using health care utilization databases from four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). A total of 78,924 prevalent patients treated for depressive disorders in 2015 were identified, of whom 15,234 were newly engaged by MHS. During the year of follow-up, access to psychotherapeutic interventions was low, while the intensity was adequate; 5.1% of prevalent patients received at least one hospitalization in a psychiatric ward (GHPW), and 3.3% in the cohort of newly engaged in services. Five-out-of-10 patients had contact with community services within 14 days after GHPW discharge, but less than half of patients were persistent to antidepressant drug therapy. Furthermore, prevalent patients showed an excess of mortality compared to the general population (SMR = 1.35; IC 95%: 1.26–1.44). In conclusion, the quality of health care is not delivered in accordance with evidence-based mental health standards. Evaluation of health interventions are fundamental strategies for improving the quality and equity of health care.
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- 2023
10. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case–control study and epidemiological remarks
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Marinaccio, A., Consonni, D., Mensi, C., Mirabelli, D., Migliore, E., Magnani, C., Di Marzio, D., Gennaro, V., Mazzoleni, G., Girardi, P., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Ascoli, V., Carrozza, F., Angelillo, I. F., Cavone, D., Tumino, R., Melis, M., Curti, S., Brandi, G., Mattioli, S., Iavicoli, S., Dallari, B., Pesatori, A. C., Riboldi, L., Merletti, F., Gangemi, M., Stura, A., Brentisci, C., Gilardetti, M., Benfatto, L., Canessa, P. A., Malacarne, D., Mazzucco, G., Campi, M. G., Fedeli, U., Bressan, V., Gioffre, F., Ballarin, M. N., Chermaz, C., D'Agostin, F., De Michieli, P., Mangone, L., Storchi, C., Sala, O., Badiali, A. M., Cacciarini, V., Giovannetti, L., Martini, A., Calisti, R., Pascucci, C., Stracci, F., Masanotti, G., Davoli, M., Cavariani, F., Ancona, L., Annunziata, A., Menegozzo, S., Napolitano, F., Pelullo, C. P., Vimercati, L., Cascone, G., Frasca, G., Giurdanella, M. C., Martorana, C., Nicita, C., Rollo, C. P., Spata, E., Dardanoni, G., Scondotto, S., Nieddu, V., Pergola, M., Stecchi, S., Marinaccio, A., Consonni, D., Mensi, C., Mirabelli, D., Migliore, E., Magnani, C., Di Marzio, D., Gennaro, V., Mazzoleni, G., Girardi, P., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Ascoli, V., Carrozza, F., Angelillo, I. F., Cavone, D., Tumino, R., Melis, M., Curti, S., Brandi, G., Mattioli, S., Iavicoli, S., Dallari, B., Pesatori, A. C., Riboldi, L., Merletti, F., Gangemi, M., Stura, A., Brentisci, C., Gilardetti, M., Benfatto, L., Canessa, P. A., Malacarne, D., Mazzucco, G., Campi, M. G., Fedeli, U., Bressan, V., Gioffre, F., Ballarin, M. N., Chermaz, C., D'Agostin, F., De Michieli, P., Mangone, L., Storchi, C., Sala, O., Badiali, A. M., Cacciarini, V., Giovannetti, L., Martini, A., Calisti, R., Pascucci, C., Stracci, F., Masanotti, G., Davoli, M., Cavariani, F., Ancona, L., Annunziata, A., Menegozzo, S., Napolitano, F., Pelullo, C. P., Vimercati, L., Cascone, G., Frasca, G., Giurdanella, M. C., Martorana, C., Nicita, C., Rollo, C. P., Spata, E., Dardanoni, G., Scondotto, S., Nieddu, V., Pergola, M., Stecchi, S., Marinaccio A., Consonni D., Mensi C., Mirabelli D., Migliore E., Magnani C., Di Marzio D., Gennaro V., Mazzoleni G., Girardi P., Negro C., Romanelli A., Chellini E., Grappasonni I., Madeo G., Romeo E., Ascoli V., Carrozza F., Angelillo I.F., Cavone D., Tumino R., Melis M., Curti S., Brandi G., Mattioli S., Iavicoli S., Dallari B., Pesatori A.C., Riboldi L., Merletti F., Gangemi M., Stura A., Brentisci C., Gilardetti M., Benfatto L., Canessa P.A., Malacarne D., Mazzucco G., Campi M.G., Fedeli U., Bressan V., Gioffre F., Ballarin M.N., Chermaz C., D'agostin F., De Michieli P., Mangone L., Storchi C., Sala O., Badiali A.M., Cacciarini V., Giovannetti L., Martini A., Calisti R., Pascucci C., Stracci F., Masanotti G., Davoli M., Cavariani F., Ancona L., Annunziata A., Menegozzo S., Napolitano F., Pelullo C.P., Vimercati L., Cascone G., Frasca G., Giurdanella M.C., Martorana C., Nicita C., Rollo C.P., Spata E., Dardanoni G., Scondotto S., Nieddu V., Pergola M., Stecchi S., Marinaccio, Alessandro, Consonni, Dario, Mensi, Carolina, Mirabelli, Dario, Migliore, Enrica, Magnani, Corrado, Di Marzio, Davide, Gennaro, Valerio, Mazzoleni, Guido, Girardi, Paolo, Negro, Corrado, Romanelli, Antonio, Chellini, Elisabetta, Grappasonni, Iolanda, Madeo, Gabriella, Romeo, Elisa, Ascoli, Valeria, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Tumino, Rosario, Melis, Massimo, Curti, Stefania, Brandi, Giovanni, Mattioli, Stefano, and Iavicoli, Sergio
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medicine.medical_specialty ,pericardial and tunica vaginalis testis ,Epidemiology ,Population ,rare disease ,national registry ,medicine.disease_cause ,Epidemiology, Italy, National registry, Rare disease ,Asbestos ,epidemiology, Italy, national registry, rare disease ,NO ,03 medical and health sciences ,0302 clinical medicine ,italy ,medicine ,epidemiology ,Italy ,Mesothelioma ,education ,Gynecology ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,Tunica vaginalis testis ,Case-control study ,case–control study ,Odds ratio ,medicine.disease ,asbestos ,030210 environmental & occupational health ,National registry ,exposure ,mesothelioma ,malignant mesothelioma ,Original Article ,Public aspects of medicine ,RA1-1270 ,business ,Rare disease - Abstract
Objectives: The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods: Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993–2015, incidence rates, survival median period and prognostic factors have been evaluated. A case–control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results: Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85–7.31 and OR 3.42, 95% CI 1.93–6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions: For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.
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- 2020
11. Large-Scale Postmarketing Surveillance of Biological Drugs for Immune-Mediated Inflammatory Diseases Through an Italian Distributed Multi-Database Healthcare Network: The VALORE Project
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Trifiro, G., Isgro, V., Ingrasciotta, Y., Ientile, V., L'Abbate, L., Foti, S. S., Belleudi, V., Poggi, F., Fontana, A., Moretti, U., Lora, R., Sabaini, A., Senesi, I., Sorrentino, C., Puzo, M. R., Padula, A., Fusco, M., Giordana, R., Solfrini, V., Puccini, A., Rossi, P., Del Zotto, S., Leoni, O., Zanforlini, M., Ancona, D., Bavaro, V., Garau, D., Ledda, S., Scondotto, S., Allotta, A., Tuccori, M., Gini, R., Bucaneve, G., Franchini, D., Cavazzana, A., Biasi, V., Spila Alegiani, S., Massari, M., Andretta, I., Tanaglia, M., Carriero, A., Sassano, S., De Sarro, G., Mirarchi, S., Palleria, C., Sarro, C., Balestrieri, M., Rostan, S., Capuano, A., Bernardi, F. F., Trama, U., Russo, A., Fumo, M. G., Addis, A., Musicco, F., Sapigni, E., Mazzetti, I., Podetti, D., Potenza, A. M., Nikitina, V., Ricciardelli, R., Mogheiseh, N., Croce, S., Pettinelli, A., Ejlli, L., Fortino, I., Ercolanoni, M., Mazzone, A., Nisic, A., Schiatti, S., Ludergnani, M., Mancini, M., Patregnani, L., Fabbietti, P., Antonicelli, E., Mangano, A., Campomori, A., Urru, S. A., Costa, G., Guarrera, G. M., Stella, P., Serra, E., Carta, P., Vannacci, A., Lucenteforte, E., Parrilli, M., Convertino, I., De Giorgi, M., Rocchi, R. E., Rossi, M., Scroccaro, G., Deambrosis, P., Grindelli, G., Ferroni, E., Trifiro, G., Isgro, V., Ingrasciotta, Y., Ientile, V., L'Abbate, L., Foti, S. S., Belleudi, V., Poggi, F., Fontana, A., Moretti, U., Lora, R., Sabaini, A., Senesi, I., Sorrentino, C., Puzo, M. R., Padula, A., Fusco, M., Giordana, R., Solfrini, V., Puccini, A., Rossi, P., Del Zotto, S., Leoni, O., Zanforlini, M., Ancona, D., Bavaro, V., Garau, D., Ledda, S., Scondotto, S., Allotta, A., Tuccori, M., Gini, R., Bucaneve, G., Franchini, D., Cavazzana, A., Biasi, V., Spila Alegiani, S., Massari, M., Andretta, I., Tanaglia, M., Carriero, A., Sassano, S., De Sarro, G., Mirarchi, S., Palleria, C., Sarro, C., Balestrieri, M., Rostan, S., Capuano, A., Bernardi, F. F., Trama, U., Russo, A., Fumo, M. G., Addis, A., Musicco, F., Sapigni, E., Mazzetti, I., Podetti, D., Potenza, A. M., Nikitina, V., Ricciardelli, R., Mogheiseh, N., Croce, S., Pettinelli, A., Ejlli, L., Fortino, I., Ercolanoni, M., Mazzone, A., Nisic, A., Schiatti, S., Ludergnani, M., Mancini, M., Patregnani, L., Fabbietti, P., Antonicelli, E., Mangano, A., Campomori, A., Urru, S. A., Costa, G., Guarrera, G. M., Stella, P., Serra, E., Carta, P., Vannacci, A., Lucenteforte, E., Parrilli, M., Convertino, I., De Giorgi, M., Rocchi, R. E., Rossi, M., Scroccaro, G., Deambrosis, P., Grindelli, G., and Ferroni, E.
- Subjects
Male ,medicine.medical_specialty ,Population ,Postmarketing surveillance ,Rate ratio ,REGISTRIES ,Retrospective Studie ,Internal medicine ,BIOSIMILARS ,medicine ,Adalimumab ,Humans ,Pharmacology (medical) ,Original Research Article ,education ,Adverse effect ,ANTI-TNF THERAPY, RHEUMATOID-ARTHRITIS, RISK, PHARMACOVIGILANCE, BIOSIMILARS, EXPERIENCE, REGISTRIES, PSORIASIS, MEDICINES, ACCESS ,Biosimilar Pharmaceuticals ,Retrospective Studies ,RISK ,Delivery of Health Care ,Female ,Infliximab ,Italy ,SARS-CoV-2 ,COVID-19 ,Pharmacology ,education.field_of_study ,PSORIASIS ,business.industry ,Biosimilar ,ANTI-TNF THERAPY ,General Medicine ,medicine.disease ,RHEUMATOID-ARTHRITIS ,PHARMACOVIGILANCE ,MEDICINES ,EXPERIENCE ,Immune-mediated inflammatory diseases ,ACCESS ,business ,Human ,Biosimilar Pharmaceutical ,Biotechnology ,medicine.drug - Abstract
Background Biological drugs have improved the management of immune-mediated inflammatory diseases (IMIDs) despite being associated with important safety issues such as immunogenicity, infections, and malignancies in real-world settings. Objective The aim of this study was to explore the potential of a large Italian multi-database distributed network for use in the postmarketing surveillance of biological drugs, including biosimilars, in patients with IMID. Methods A retrospective cohort study was conducted using 13 Italian regional claims databases during 2010–2019. A tailor-made R-based tool developed for distributed analysis of claims data using a study-specific common data model was customized for this study. We measured the yearly prevalence of biological drug users and the frequency of switches between originator and biosimilars for infliximab, etanercept, and adalimumab separately and stratified them by calendar year and region. We then calculated the cumulative number of users and person-years (PYs) of exposure to individual biological drugs approved for IMIDs. For a number of safety outcomes (e.g., severe acute respiratory syndrome coronavirus 2 [SARS-COV-2] infection), we conducted a sample power calculation to estimate the PYs of exposure required to investigate their association with individual biological drugs approved for IMIDs, considering different strengths of association. Results From a total underlying population of almost 50 million inhabitants from 13 Italian regions, we identified 143,602 (0.3%) biological drug users, with a cumulative exposure of 507,745 PYs during the entire follow-up. The mean age ± standard deviation of biological drug users was 49.3 ± 16.3, with a female-to-male ratio of 1.2. The age-adjusted yearly prevalence of biological drug users increased threefold from 0.7 per 1000 in 2010 to 2.1 per 1000 in 2019. Overall, we identified 40,996 users of biosimilars of tumor necrosis factor (TNF)-α inhibitors (i.e., etanercept, adalimumab, and infliximab) in the years 2015–2019. Of these, 46% (N = 18,845) switched at any time between originator and biosimilars or vice versa. To investigate a moderate association (incidence rate ratio 2) between biological drugs approved for IMIDs and safety events of interest, such as optic neuritis (lowest background incidence rate 10.4/100,000 PYs) or severe infection (highest background incidence rate 4312/100,000 PYs), a total of 43,311 PYs and 104 PYs of exposure to individual biological drugs, respectively, would be required. As such, using this network, of 15 individual biological drugs approved for IMIDs, the association with those adverse events could be investigated for four (27%) and 14 (93%), respectively. Conclusion The VALORE project multi-database network has access to data on more than 140,000 biological drug users (and > 0.5 million PYs) from 13 Italian regions during the years 2010–2019, which will be further expanded with the inclusion of data from other regions and more recent calendar years. Overall, the cumulated amount of person-time of exposure to biological drugs approved for IMIDs provides enough statistical power to investigate weak/moderate associations of almost all individual compounds and the most relevant safety outcomes. Moreover, this network may offer the opportunity to investigate the interchangeability of originator and biosimilars of several TNFα inhibitors in different therapeutic areas in real-world settings. Supplementary Information The online version contains supplementary material available at 10.1007/s40259-021-00498-3.
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- 2021
12. Cost-effectiveness of the adherence with recommendations for clinical monitoring of patients with diabetes
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Corrao, G, Rea, F, Mancia, G, Perseghin, G, Merlino, L, Martini, N, Carbone, S, Carle, F, Bucci, A, Dajko, M, Arca, S, Bellentani, D, Bruno, V, Ceccolini, C, De Feo, A, Lispi, L, Mariniello, R, Masullo, M, Medici, F, Pisanti, P, Visca, M, Zanini, R, Di Fiandra, T, Magliocchetti, N, Romano, G, Cantarutti, A, Pugni, P, Davoli, M, Di Martino, M, Lallo, A, Vittori, P, Vuillermin, G, Bernardo, A, Fusciante, A, Belotti, L, De Palma, R, Di Felice, E, Chiandetti, R, Clagnan, E, Del Zotto, S, Di Lenarda, A, Mariotto, A, Prezza, M, Zanier, L, Fusco, D, Marinacci, C, Lora, A, Spazzafumo, L, Pizzi, S, Simiele, M, Massaro, G, Attolini, E, Lepore, V, Petrarolo, V, De Luca, G, Fantaci, G, Pollina Addario, S, Scondotto, S, Bellomo, F, Braga, M, Di Fabrizio, V, Forni, S, Francesconi, P, Profili, F, Avossa, F, Corradin, M, Vigna, S, Dondi, L, Pedrini, A, Piccinni, C, Cosentino, M, Marvulli, M, Maggioni, A, Corrao G., Rea F., Mancia G., Perseghin G., Merlino L., Martini N., Carbone S., Carle F., Bucci A., Dajko M., Arca S., Bellentani D., Bruno V., Ceccolini C., De Feo A., Lispi L., Mariniello R., Masullo M., Medici F., Pisanti P., Visca M., Zanini R., Di Fiandra T., Magliocchetti N., Romano G., Cantarutti A., Pugni P., Davoli M., Di Martino M., Lallo A., Vittori P., Vuillermin G., Bernardo A., Fusciante A., Belotti L., De Palma R., Di Felice E., Chiandetti R., Clagnan E., Del Zotto S., Di Lenarda A., Mariotto A., Prezza M., Zanier L., Fusco D., Marinacci C., Lora A., Spazzafumo L., Pizzi S., Simiele M., Massaro G., Attolini E., Lepore V., Petrarolo V., De Luca G., Fantaci G., Pollina Addario S., Scondotto S., Bellomo F., Braga M., Di Fabrizio V., Forni S., Francesconi P., Profili F., Avossa F., Corradin M., Vigna S., Dondi L., Pedrini A., Piccinni C., Cosentino M., Marvulli M. G., Maggioni A., Corrao, G, Rea, F, Mancia, G, Perseghin, G, Merlino, L, Martini, N, Carbone, S, Carle, F, Bucci, A, Dajko, M, Arca, S, Bellentani, D, Bruno, V, Ceccolini, C, De Feo, A, Lispi, L, Mariniello, R, Masullo, M, Medici, F, Pisanti, P, Visca, M, Zanini, R, Di Fiandra, T, Magliocchetti, N, Romano, G, Cantarutti, A, Pugni, P, Davoli, M, Di Martino, M, Lallo, A, Vittori, P, Vuillermin, G, Bernardo, A, Fusciante, A, Belotti, L, De Palma, R, Di Felice, E, Chiandetti, R, Clagnan, E, Del Zotto, S, Di Lenarda, A, Mariotto, A, Prezza, M, Zanier, L, Fusco, D, Marinacci, C, Lora, A, Spazzafumo, L, Pizzi, S, Simiele, M, Massaro, G, Attolini, E, Lepore, V, Petrarolo, V, De Luca, G, Fantaci, G, Pollina Addario, S, Scondotto, S, Bellomo, F, Braga, M, Di Fabrizio, V, Forni, S, Francesconi, P, Profili, F, Avossa, F, Corradin, M, Vigna, S, Dondi, L, Pedrini, A, Piccinni, C, Cosentino, M, Marvulli, M, Maggioni, A, Corrao G., Rea F., Mancia G., Perseghin G., Merlino L., Martini N., Carbone S., Carle F., Bucci A., Dajko M., Arca S., Bellentani D., Bruno V., Ceccolini C., De Feo A., Lispi L., Mariniello R., Masullo M., Medici F., Pisanti P., Visca M., Zanini R., Di Fiandra T., Magliocchetti N., Romano G., Cantarutti A., Pugni P., Davoli M., Di Martino M., Lallo A., Vittori P., Vuillermin G., Bernardo A., Fusciante A., Belotti L., De Palma R., Di Felice E., Chiandetti R., Clagnan E., Del Zotto S., Di Lenarda A., Mariotto A., Prezza M., Zanier L., Fusco D., Marinacci C., Lora A., Spazzafumo L., Pizzi S., Simiele M., Massaro G., Attolini E., Lepore V., Petrarolo V., De Luca G., Fantaci G., Pollina Addario S., Scondotto S., Bellomo F., Braga M., Di Fabrizio V., Forni S., Francesconi P., Profili F., Avossa F., Corradin M., Vigna S., Dondi L., Pedrini A., Piccinni C., Cosentino M., Marvulli M. G., and Maggioni A.
- Abstract
Background and aims: To validate a set of indicators for monitoring the quality of care of patients with diabetes in ‘real-life’ practice through its relationship with measurable clinical outcomes and healthcare costs. Methods and results: A population-based cohort study was carried out by including the 20,635 patients, residents in the Lombardy Region (Italy), who in the year 2012 were newly taken-in-care for diabetes. Adherence with clinical recommendations (i.e., controls for glycated haemoglobin, lipid profile, urine albumin excretion and serum creatinine) was recorded during the first year after the patient was taken-in-care, and categorized according whether he/she complied with none or almost none (0 or 1), just some (2) or all or almost all (3 or 4) the recommendations, respectively denoted as poor, intermediate and high adherence. Short- and long-term complications of diabetes, and healthcare cost incurred by the National Health Service, were assessed during follow-up. Compared with patients with poor adherence, those with intermediate and high adherence respectively showed (i) a delay in outcome occurrence of 13 days (95% CI, −2 to 27) and 23 days (9–38), and (ii) a lower healthcare cost of 54 € and 77 €. In average, a gain of 18 Euros and 15 Euros for each day free from diabetic complication by increasing adherence respectively from poor to intermediate and from poor to high were observed. Conclusion: Close control of patients with diabetes through regular clinical examinations must be considered the cornerstone of national guidance, national audits, and quality improvement incentive schemes.
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- 2021
13. Problematic social media use: Associations with health complaints among adolescents
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Marino, C, Lenzi, M, Canale, N, Pierannunzio, D, Dalmasso, P, Borraccino, A, Cappello, N, Lemma, P, Vieno, A, Nardone, P, Spinelli, A, Donati, S, Pizzi, E, Ciardullo, S, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Charrier, L, Sciannameo, V, Gaboardi, M, Santinello, M, Lazzeri, G, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, Weiss, S, Marino C., Lenzi M., Canale N., Pierannunzio D., Dalmasso P., Borraccino A., Cappello N., Lemma P., Vieno A., Nardone P., Spinelli A., Donati S., Pizzi E., Ciardullo S., Andreozzi S., Bucciarelli M., de Mei B., Cattaneo C., Cavallo F., Piraccini G., Berchialla P., Charrier L., Sciannameo V., Gaboardi M., Santinello M., Lazzeri G., Giacchi M. V., Pammolli A., Simi R., Galeone D., Menzano M. T., Vienna A., Colleluori C., Di Giacomo M., Ranalli E., Cauzillo G., Mininni M., Sorrentino G., Azzarito C., Cernuzio A., la Rocca M., Pugliese A., Mazzarella G., Angelini P., Fridel M., Carletti C., Concina F., Ronfani L., Pani P., Cairella G., Bosca L., Pancallo M. T., Ferrando G., Celata C., Coppola L., Lobascio C., Gelmi G., Crottogini L., Velasco V., de Introna S., Giostra G., Ciallella M. L., Colitti M., Paolitto E., Caputo M., Stingi D., Pacella P., Pasquale P., Palmas M. A., Murgia A., Cernigliaro A., Ferro M. P., Scondotto S., Aramini L., Corridori V., Cristofori M., Sorbelli D., Giovannini G., Covarino A. M., Michieletto F., Bino E., Zuccali M. G., Fanolla A., Weiss S., Marino, C, Lenzi, M, Canale, N, Pierannunzio, D, Dalmasso, P, Borraccino, A, Cappello, N, Lemma, P, Vieno, A, Nardone, P, Spinelli, A, Donati, S, Pizzi, E, Ciardullo, S, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Charrier, L, Sciannameo, V, Gaboardi, M, Santinello, M, Lazzeri, G, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, Weiss, S, Marino C., Lenzi M., Canale N., Pierannunzio D., Dalmasso P., Borraccino A., Cappello N., Lemma P., Vieno A., Nardone P., Spinelli A., Donati S., Pizzi E., Ciardullo S., Andreozzi S., Bucciarelli M., de Mei B., Cattaneo C., Cavallo F., Piraccini G., Berchialla P., Charrier L., Sciannameo V., Gaboardi M., Santinello M., Lazzeri G., Giacchi M. V., Pammolli A., Simi R., Galeone D., Menzano M. T., Vienna A., Colleluori C., Di Giacomo M., Ranalli E., Cauzillo G., Mininni M., Sorrentino G., Azzarito C., Cernuzio A., la Rocca M., Pugliese A., Mazzarella G., Angelini P., Fridel M., Carletti C., Concina F., Ronfani L., Pani P., Cairella G., Bosca L., Pancallo M. T., Ferrando G., Celata C., Coppola L., Lobascio C., Gelmi G., Crottogini L., Velasco V., de Introna S., Giostra G., Ciallella M. L., Colitti M., Paolitto E., Caputo M., Stingi D., Pacella P., Pasquale P., Palmas M. A., Murgia A., Cernigliaro A., Ferro M. P., Scondotto S., Aramini L., Corridori V., Cristofori M., Sorbelli D., Giovannini G., Covarino A. M., Michieletto F., Bino E., Zuccali M. G., Fanolla A., and Weiss S.
- Abstract
Objective. Problematic Social Media Use (PSMU) has an addictive potential for young users. The aim of this study was to show the prevalence of PSMU across Italian regions and its association with health complaints. Materials and methods. Data are gathered from the Italian 2018 Health Behaviour in School-aged Children survey using a representative sample of Italian adolescents aged 11, 13 and 15 years (50.6% males). Participants completed self-administered questionnaires assessing PSMU and health complaints. Results. PSMU affects 8.9% adolescents in Italy and the prevalence is quite consistent across regions. 13-year-olds girls showed the highest percentage of PSMU (13%). Problematic users of social media are more likely to report multiple somatic (OR = 1.84 [95% CI 1.82-1.85]) and psychological (OR = 2.60 [95% CI 2.58-2.63]) symptoms. Conclusions. PSMU represents a widespread problem in Italy. National prevention interventions are needed in order to promote a positive use of social media.
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- 2020
14. Dietary habits among Italian adolescents and their relation to socio-demographic characteristics
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Nardone, P, Pierannunzio, D, Ciardullo, S, Lazzeri, G, Cappello, N, Spinelli, A, Donati, S, Pizzi, E, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Borraccino, A, Charrier, L, Dalmasso, P, Lemma, P, Sciannameo, V, Vieno, A, Canale, N, Gaboardi, M, Lenzi, M, Marino, C, Santinello, M, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, Weiss, S, Nardone P., Pierannunzio D., Ciardullo S., Lazzeri G., Cappello N., Spinelli A., Donati S., Pizzi E., Andreozzi S., Bucciarelli M., de Mei B., Cattaneo C., Cavallo F., Piraccini G., Berchialla P., Borraccino A., Charrier L., Dalmasso P., Lemma P., Sciannameo V., Vieno A., Canale N., Gaboardi M., Lenzi M., Marino C., Santinello M., Giacchi M. V., Pammolli A., Simi R., Galeone D., Menzano M. T., Vienna A., Colleluori C., Di Giacomo M., Ranalli E., Cauzillo G., Mininni M., Sorrentino G., Azzarito C., Cernuzio A., la Rocca M., Pugliese A., Mazzarella G., Angelini P., Fridel M., Carletti C., Concina F., Ronfani L., Pani P., Cairella G., Bosca L., Pancallo M. T., Ferrando G., Celata C., Coppola L., Lobascio C., Gelmi G., Crottogini L., Velasco V., de Introna S., Giostra G., Ciallella M. L., Colitti M., Paolitto E., Caputo M., Stingi D., Pacella P., Pasquale P., Palmas M. A., Murgia A., Cernigliaro A., Ferro M. P., Scondotto S., Aramini L., Corridori V., Cristofori M., Sorbelli D., Giovannini G., Covarino A. M., Michieletto F., Bino E., Zuccali M. G., Fanolla A., Weiss S., Nardone, P, Pierannunzio, D, Ciardullo, S, Lazzeri, G, Cappello, N, Spinelli, A, Donati, S, Pizzi, E, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Borraccino, A, Charrier, L, Dalmasso, P, Lemma, P, Sciannameo, V, Vieno, A, Canale, N, Gaboardi, M, Lenzi, M, Marino, C, Santinello, M, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, Weiss, S, Nardone P., Pierannunzio D., Ciardullo S., Lazzeri G., Cappello N., Spinelli A., Donati S., Pizzi E., Andreozzi S., Bucciarelli M., de Mei B., Cattaneo C., Cavallo F., Piraccini G., Berchialla P., Borraccino A., Charrier L., Dalmasso P., Lemma P., Sciannameo V., Vieno A., Canale N., Gaboardi M., Lenzi M., Marino C., Santinello M., Giacchi M. V., Pammolli A., Simi R., Galeone D., Menzano M. T., Vienna A., Colleluori C., Di Giacomo M., Ranalli E., Cauzillo G., Mininni M., Sorrentino G., Azzarito C., Cernuzio A., la Rocca M., Pugliese A., Mazzarella G., Angelini P., Fridel M., Carletti C., Concina F., Ronfani L., Pani P., Cairella G., Bosca L., Pancallo M. T., Ferrando G., Celata C., Coppola L., Lobascio C., Gelmi G., Crottogini L., Velasco V., de Introna S., Giostra G., Ciallella M. L., Colitti M., Paolitto E., Caputo M., Stingi D., Pacella P., Pasquale P., Palmas M. A., Murgia A., Cernigliaro A., Ferro M. P., Scondotto S., Aramini L., Corridori V., Cristofori M., Sorbelli D., Giovannini G., Covarino A. M., Michieletto F., Bino E., Zuccali M. G., Fanolla A., and Weiss S.
- Abstract
Objective. The aim is to describe dietary habits and their association with socio-demographic characteristics in a large nationally representative sample of Italian adolescents aged 11, 13 and 15 years. Materials and methods. Data from the 2018 Italian Health Behaviour in School-aged Children (HBSC) survey on 58,976 adolescents were analysed to determine eating habits. Logistic regression was used to investigate the association between incorrect dietary habits and potential predictors. Results. 38.3% of boys and 48.1% of girls skipped breakfast and 54.1% did not consume fruit and/or vegetables daily. 15.9% of boys and 11.3% of girls drank carbonated-sugary beverages at least once a day. Incorrect dietary habits were more common among boys, adolescents with lower socio-economic conditions, residents in Southern Italy and those spending more time watching TV. Italian adolescents were more likely to have incorrect dietary habits compared with those from most other countries involved in 2018 HBSC. Conclusions. Action is needed to improve dietary habits among adolescents.
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- 2020
15. Cardiovascular Risk After Adjuvant Trastuzumab in Early Breast Cancer: An Italian Population-Based Cohort Study
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Franchi, M, Trama, A, Merlo, I, Minicozzi, P, Tarantini, L, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, De Carlo, I, Scondotto, S, Apolone, G, Corrao, G, Franchi M., Trama A., Merlo I., Minicozzi P., Tarantini L., Garau D., Kirchmayer U., Di Martino M., Romero M., De Carlo I., Scondotto S., Apolone G., Corrao G., Franchi, M, Trama, A, Merlo, I, Minicozzi, P, Tarantini, L, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, De Carlo, I, Scondotto, S, Apolone, G, Corrao, G, Franchi M., Trama A., Merlo I., Minicozzi P., Tarantini L., Garau D., Kirchmayer U., Di Martino M., Romero M., De Carlo I., Scondotto S., Apolone G., and Corrao G.
- Abstract
Background: Although trastuzumab (T) represents the standard of care for the adjuvant treatment of HER2-positive early-stage breast cancer, contrasting results are available about the cardiac toxicity associated to its use. We conducted a multiregional population-based cohort investigation aimed to assess both the short- and long-term cardiovascular (CV) outcomes in women with early breast cancer treated with T-based or standard adjuvant chemotherapy (CT). Materials and Methods: We used health care use databases of six Italian regions, overall accounting for 42% of the Italian population. The study cohort was made by all women surgically treated for breast cancer who started a first-line adjuvant T-based or CT treatment. Patients treated with T were 1:2 matched to those treated with CT based on date of treatment start, age, and presence of CV risk factors. Short- and long-term CV outcomes (heart failure and cardiomyopathy) were measured, respectively, after 1 year and at the end of follow-up. Results: Among 28,599 women who met the inclusion criteria, 6,208 T users were matched to 12,416 CT users. After a mean follow-up of 5.88 years, short- and long-term cumulative CV risk were 0.8% and 2.6% in patients treated with T and 0.2% and 2.8% in those treated with CT, respectively. Adjusted hazard ratios were 4.6 (95% confidence interval [CI], 2.6–8.0) for short-term and 1.2 (95% CI, 0.9–1.6) for long-term CV risk. Discussion: In our large real-world investigation, T-associated cardiotoxicity was limited to the treatment period. The addition of T to adjuvant CT did not result in long-term worsening of CV events. Implications for Practice: Adjuvant trastuzumab-based chemotherapy represents the backbone therapy in patients with HER2-positive early breast cancer. Although well tolerated, cardiovascular events can manifest during or after therapy because of treatment-related toxicities. In this wide multicenter and unselected cohort, long-term symptomatic cardiotoxicity was l
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- 2020
16. Effectiveness and costs associated to adding cetuximab or bevacizumab to chemotherapy as initial treatment in metastatic colorectal cancer: Results from the observational fabio project
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Franchi, M, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, Carlo, I, Scondotto, S, Corrao, G, Franchi M., Garau D., Kirchmayer U., Di Martino M., Romero M., Carlo I. D., Scondotto S., Corrao G., Franchi, M, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, Carlo, I, Scondotto, S, Corrao, G, Franchi M., Garau D., Kirchmayer U., Di Martino M., Romero M., Carlo I. D., Scondotto S., and Corrao G.
- Abstract
Evidence available on the effectiveness and costs of biological therapies for the initial treatment of metastatic colorectal cancer (mCRC) is scarce and contrasting. We conducted a population-based cohort investigation for assessing overall survival and costs associated with their use in a real-world setting. Healthcare utilization databases were used to select patients newly diagnosed with mCRC between 2010 and 2016. Those initially treated with biological therapy (bevacizumab or cetuximab) added to chemotherapy were propensity-score-matched to those treated with standard chemotherapy alone, and were followed up to June 30th, 2018. Kaplan–Meier survival estimates, restricted mean survival time (RMST) and cumulative costs were compared between the two treatment arms. The study cohort included 1896 mCRC patients treated with biological therapy matched to 5678 patients treated with chemotherapy alone. Median overall survival was 21.8 and 20.2 months, respectively. After 84 months of follow-up, RMSTs were 30.9 and 31.9 months (p = 0.193), indicating no differences between the average survival time between treatment arms. Patients treated with biological therapy were associated with higher costs. Cumulative per capita costs were €59,663 and €44,399, respectively. In our study, first-line biological therapy did not improve long-term overall survival and was associated with higher costs as compared to standard chemotherapy.
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- 2020
17. Does the mental health system provide effective coverage to people with schizophrenic disorder? A self-controlled case series study in Italy
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Corrao, G, Barbato, A, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Monzio Compagnoni, M, Saponaro, A, Scondotto, S, Tozzi, V, Carle, F, Lora, A, Tozzi, VD, Corrao, G, Barbato, A, D'Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Monzio Compagnoni, M, Saponaro, A, Scondotto, S, Tozzi, V, Carle, F, Lora, A, and Tozzi, VD
- Abstract
Purpose: To measure indicators of timeliness and continuity of treatments on patients with schizophrenic disorder in ‘real-life’ practice, and to validate them through their relationship with relapse occurrences. Methods: The target population was from four Italian regions overall covering 22 million beneficiaries of the NHS (37% of the entire Italian population). The cohort included 12,054 patients newly taken into care for schizophrenic disorder between January 2015 and June 2016. The self-controlled case series (SCCS) design was used to estimate the incidence rate ratio of relapse occurrences according to mental healthcare coverage. Results: Poor timeliness (82% and 33% of cohort members had not yet started treatment with psychosocial interventions and antipsychotic drug therapy within the first year after they were taken into care) and continuity (27% and 23% of patients were persistent with psychosocial interventions, and antipsychotic drug therapy within the first 2 years after starting the specific treatment) were observed. According to SCCS design, 4794 relapses occurred during 9430 PY (with incidence rate of 50.8 every 100 PY). Compared with periods not covered by mental healthcare, those covered by psychosocial intervention alone, antipsychotic drugs alone and by psychosocial intervention and antipsychotic drugs together were, respectively, associated with relapse rate reductions of 28% (95% CI 4–46%), 24% (17–30%) and 44% (32–53%). Conclusion: Healthcare administrative data may contribute to monitor and to assess the effectiveness of a mental health system. Persistent use of both psychosocial intervention and antipsychotic drugs reduces risk of severe relapse.
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- 2022
18. Development and Validation of a Novel Pre-Pregnancy Score Predictive of Preterm Birth in Nulliparous Women Using Data from Italian Healthcare Utilization Databases
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Merlo, I, Cantarutti, A, Allotta, A, Tavormina, E, Iommi, M, Pompili, M, Rea, F, Agodi, A, Locatelli, A, Zanini, R, Carle, F, Addario, S, Scondotto, S, Corrao, G, Merlo, Ivan, Cantarutti, Anna, Allotta, Alessandra, Tavormina, Elisa Eleonora, Iommi, Marica, Pompili, Marco, Rea, Federico, Agodi, Antonella, Locatelli, Anna, Zanini, Rinaldo, Carle, Flavia, Addario, Sebastiano Pollina, Scondotto, Salvatore, Corrao, Giovanni, Merlo, I, Cantarutti, A, Allotta, A, Tavormina, E, Iommi, M, Pompili, M, Rea, F, Agodi, A, Locatelli, A, Zanini, R, Carle, F, Addario, S, Scondotto, S, Corrao, G, Merlo, Ivan, Cantarutti, Anna, Allotta, Alessandra, Tavormina, Elisa Eleonora, Iommi, Marica, Pompili, Marco, Rea, Federico, Agodi, Antonella, Locatelli, Anna, Zanini, Rinaldo, Carle, Flavia, Addario, Sebastiano Pollina, Scondotto, Salvatore, and Corrao, Giovanni
- Abstract
Background: Preterm birth is a major worldwide public health concern, being the leading cause of infant mortality. Understanding of risk factors remains limited, and early identification of women at high risk of preterm birth is an open challenge. Objective: The aim of the study was to develop and validate a novel pre-pregnancy score for preterm delivery in nulliparous women using information from Italian healthcare utilization databases. Study Design: Twenty-six variables independently able to predict preterm delivery were selected, using a LASSO logistic regression, from a large number of features collected in the 4 years prior to conception, related to clinical history and socio-demographic characteristics of 126,839 nulliparous women from Lombardy region who gave birth between 2012 and 2017. A weight proportional to the coefficient estimated by the model was assigned to each of the selected variables, which contributed to the Preterm Birth Score. Discrimination and calibration of the Preterm Birth Score were assessed using an internal validation set (i.e., other 54,359 deliveries from Lombardy) and two external validation sets (i.e., 14,703 and 62,131 deliveries from Marche and Sicily, respectively). Results: The occurrence of preterm delivery increased with increasing the Preterm Birth Score value in all regions in the study. Almost ideal calibration plots were obtained for the internal validation set and Marche, while expected and observed probabilities differed slightly in Sicily for high Preterm Birth Score values. The area under the receiver operating characteristic curve was 60%, 61% and 56% for the internal validation set, Marche and Sicily, respectively. Conclusions: Despite the limited discriminatory power, the Preterm Birth Score is able to stratify women according to their risk of preterm birth, allowing the early identification of mothers who are more likely to have a preterm delivery.
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- 2022
19. From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy
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Corrao, G, Monzio Compagnoni, M, Barbato, A, D’Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Saponaro, A, Scondotto, S, Tozzi, V, Carle, F, Carbone, S, Chisholm, D, Lora, A, Corrao, Giovanni, Monzio Compagnoni, Matteo, Barbato, Angelo, D’Avanzo, Barbara, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D., Carle, Flavia, Carbone, Simona, Chisholm, Daniel H., Lora, Antonio, Corrao, G, Monzio Compagnoni, M, Barbato, A, D’Avanzo, B, Di Fiandra, T, Ferrara, L, Gaddini, A, Saponaro, A, Scondotto, S, Tozzi, V, Carle, F, Carbone, S, Chisholm, D, Lora, A, Corrao, Giovanni, Monzio Compagnoni, Matteo, Barbato, Angelo, D’Avanzo, Barbara, Di Fiandra, Teresa, Ferrara, Lucia, Gaddini, Andrea, Saponaro, Alessio, Scondotto, Salvatore, Tozzi, Valeria D., Carle, Flavia, Carbone, Simona, Chisholm, Daniel H., and Lora, Antonio
- Abstract
Objectives: To measure the gap between contact and effective coverage of mental healthcare (MHC). Materials and methods: 45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness). Results: 11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse. Conclusion: This study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system.
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- 2022
20. Role of healthcare databases and registries for surveillance of orphan drugs in the real-world setting: the Italian case study
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Crisafulli, S, Sultana, J, Ingrasciotta, Y, Addis, A, Cananzi, P, Cavagna, L, Conter, V, D'Angelo, G, Ferrajolo, C, Mantovani, L, Pastorello, M, Scondotto, S, Trifiro, G, Crisafulli S., Sultana J., Ingrasciotta Y., Addis A., Cananzi P., Cavagna L., Conter V., D'Angelo G., Ferrajolo C., Mantovani L., Pastorello M., Scondotto S., Trifiro G., Crisafulli, S, Sultana, J, Ingrasciotta, Y, Addis, A, Cananzi, P, Cavagna, L, Conter, V, D'Angelo, G, Ferrajolo, C, Mantovani, L, Pastorello, M, Scondotto, S, Trifiro, G, Crisafulli S., Sultana J., Ingrasciotta Y., Addis A., Cananzi P., Cavagna L., Conter V., D'Angelo G., Ferrajolo C., Mantovani L., Pastorello M., Scondotto S., and Trifiro G.
- Abstract
Introduction: Orphan drugs are medicines intended to treat, prevent, or diagnose a rare and serious condition. The collection of pre-marketing safety and efficacy data for orphan drugs is very challenging for several reasons related to the rarity of the diseases. This highlights the need for robust post-marketing evidence generation. Real-world data sources, such as claims databases, electronic healthcare records, and disease and drug registers, have an important role in studying orphan drugs. The availability and usefulness of such resources vary from country to country. Areas covered: A detailed description of the available real-world data sources and their contribution to generating post-marketing evidence on orphan drug benefit-risk profile in Italy is provided. Expert opinion: Despite their considerable potential for rare disease research, the available Italian data sources are currently under-used and require further harmonization of data collection. The establishment of large structured and integrated nationwide data sources, tailored to respond to both research as well as regulatory requirements, is necessary to provide clinically useful information on orphan drugs as well. Such data sources should also be more accessible at the loco-regional, national and international level.
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- 2019
21. Problematic social media use: Associations with health complaints among adolescents
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Marino, C., Lenzi, M., Canale, N., Pierannunzio, D., Dalmasso, P., Borraccino, A., Cappello, N., Lemma, P., Vieno, A., Nardone, P., Spinelli, A., Donati, S., Pizzi, E., Ciardullo, S., Andreozzi, S., Bucciarelli, M., de Mei, B., Cattaneo, C., Cavallo, F., Piraccini, G., Berchialla, P., Charrier, L., Sciannameo, V., Gaboardi, M., Santinello, M., Lazzeri, G., Giacchi, M. V., Pammolli, A., Simi, R., Galeone, D., Menzano, M. T., Vienna, A., Colleluori, C., Di Giacomo, M., Ranalli, E., Cauzillo, G., Mininni, M., Sorrentino, G., Azzarito, C., Cernuzio, A., la Rocca, M., Pugliese, A., Mazzarella, G., Angelini, P., Fridel, M., Carletti, C., Concina, F., Ronfani, L., Pani, P., Cairella, G., Bosca, L., Pancallo, M. T., Ferrando, G., Celata, C., Coppola, L., Lobascio, C., Gelmi, G., Crottogini, L., Velasco, V., de Introna, S., Giostra, G., Ciallella, M. L., Colitti, M., Paolitto, E., Caputo, M., Stingi, D., Pacella, P., Pasquale, P., Palmas, M. A., Murgia, A., Cernigliaro, A., Ferro, M. P., Scondotto, S., Aramini, L., Corridori, V., Cristofori, M., Sorbelli, D., Giovannini, G., Covarino, A. M., Michieletto, F., Bino, E., Zuccali, M. G., Fanolla, A., Weiss, S., Marino, C, Lenzi, M, Canale, N, Pierannunzio, D, Dalmasso, P, Borraccino, A, Cappello, N, Lemma, P, Vieno, A, Nardone, P, Spinelli, A, Donati, S, Pizzi, E, Ciardullo, S, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Charrier, L, Sciannameo, V, Gaboardi, M, Santinello, M, Lazzeri, G, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, and Weiss, S
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Male ,Adolescent ,Problematic use ,Psychosomatic symptom ,Adolescence ,Social media ,Cross-Sectional Studies ,Italy ,Psychosomatic symptoms ,Child ,Female ,Humans ,Internet Addiction Disorder ,Prevalence ,Self Report ,Social Media - Abstract
Objective. Problematic Social Media Use (PSMU) has an addictive potential for young users. The aim of this study was to show the prevalence of PSMU across Italian regions and its association with health complaints. Materials and methods. Data are gathered from the Italian 2018 Health Behaviour in School-aged Children survey using a representative sample of Italian adolescents aged 11, 13 and 15 years (50.6% males). Participants completed self-administered questionnaires assessing PSMU and health complaints. Results. PSMU affects 8.9% adolescents in Italy and the prevalence is quite consistent across regions. 13-year-olds girls showed the highest percentage of PSMU (13%). Problematic users of social media are more likely to report multiple somatic (OR = 1.84 [95% CI 1.82-1.85]) and psychological (OR = 2.60 [95% CI 2.58-2.63]) symptoms. Conclusions. PSMU represents a widespread problem in Italy. National prevention interventions are needed in order to promote a positive use of social media.
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- 2020
22. Dietary habits among Italian adolescents and their relation to socio-demographic characteristics
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Nardone P., Pierannunzio D., Ciardullo S., Lazzeri G., Cappello N., Spinelli A., Donati S., Pizzi E., Andreozzi S., Bucciarelli M., de Mei B., Cattaneo C., Cavallo F., Piraccini G., Berchialla P., Borraccino A., Charrier L., Dalmasso P., Lemma P., Sciannameo V., Vieno A., Canale N., Gaboardi M., Lenzi M., Marino C., Santinello M., Giacchi M. V., Pammolli A., Simi R., Galeone D., Menzano M. T., Vienna A., Colleluori C., Di Giacomo M., Ranalli E., Cauzillo G., Mininni M., Sorrentino G., Azzarito C., Cernuzio A., la Rocca M., Pugliese A., Mazzarella G., Angelini P., Fridel M., Carletti C., Concina F., Ronfani L., Pani P., Cairella G., Bosca L., Pancallo M. T., Ferrando G., Celata C., Coppola L., Lobascio C., Gelmi G., Crottogini L., Velasco V., de Introna S., Giostra G., Ciallella M. L., Colitti M., Paolitto E., Caputo M., Stingi D., Pacella P., Pasquale P., Palmas M. A., Murgia A., Cernigliaro A., Ferro M. P., Scondotto S., Aramini L., Corridori V., Cristofori M., Sorbelli D., Giovannini G., Covarino A. M., Michieletto F., Bino E., Zuccali M. G., Fanolla A., Weiss S., Nardone, P, Pierannunzio, D, Ciardullo, S, Lazzeri, G, Cappello, N, Spinelli, A, Donati, S, Pizzi, E, Andreozzi, S, Bucciarelli, M, de Mei, B, Cattaneo, C, Cavallo, F, Piraccini, G, Berchialla, P, Borraccino, A, Charrier, L, Dalmasso, P, Lemma, P, Sciannameo, V, Vieno, A, Canale, N, Gaboardi, M, Lenzi, M, Marino, C, Santinello, M, Giacchi, M, Pammolli, A, Simi, R, Galeone, D, Menzano, M, Vienna, A, Colleluori, C, Di Giacomo, M, Ranalli, E, Cauzillo, G, Mininni, M, Sorrentino, G, Azzarito, C, Cernuzio, A, la Rocca, M, Pugliese, A, Mazzarella, G, Angelini, P, Fridel, M, Carletti, C, Concina, F, Ronfani, L, Pani, P, Cairella, G, Bosca, L, Pancallo, M, Ferrando, G, Celata, C, Coppola, L, Lobascio, C, Gelmi, G, Crottogini, L, Velasco, V, de Introna, S, Giostra, G, Ciallella, M, Colitti, M, Paolitto, E, Caputo, M, Stingi, D, Pacella, P, Pasquale, P, Palmas, M, Murgia, A, Cernigliaro, A, Ferro, M, Scondotto, S, Aramini, L, Corridori, V, Cristofori, M, Sorbelli, D, Giovannini, G, Covarino, A, Michieletto, F, Bino, E, Zuccali, M, Fanolla, A, and Weiss, S
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Male ,vegetables ,eating behaviour ,Adolescent ,breakfast ,Feeding Behavior ,fruit ,Cross-Sectional Studies ,beverage ,Italy ,Socioeconomic Factors ,Humans ,Female ,Child ,Demography - Abstract
Objective. The aim is to describe dietary habits and their association with socio-demographic characteristics in a large nationally representative sample of Italian adolescents aged 11, 13 and 15 years. Materials and methods. Data from the 2018 Italian Health Behaviour in School-aged Children (HBSC) survey on 58,976 adolescents were analysed to determine eating habits. Logistic regression was used to investigate the association between incorrect dietary habits and potential predictors. Results. 38.3% of boys and 48.1% of girls skipped breakfast and 54.1% did not consume fruit and/or vegetables daily. 15.9% of boys and 11.3% of girls drank carbonated-sugary beverages at least once a day. Incorrect dietary habits were more common among boys, adolescents with lower socio-economic conditions, residents in Southern Italy and those spending more time watching TV. Italian adolescents were more likely to have incorrect dietary habits compared with those from most other countries involved in 2018 HBSC. Conclusions. Action is needed to improve dietary habits among adolescents.
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- 2020
23. Interregional mobility, socio-economic inequality and mortality among cancer patients
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Rubino, C, Ferrante, M, Abbruzzo, A, Fantaci, G, Scondotto, S., Pollice, A, Salvati, N, Schirripa Spagnolo, F, Rubino, C, Ferrante, M, Abbruzzo, A, Fantaci, G, and Scondotto, S.
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patients’ mobility, health outcome, survival analysis, socio-economic inequalities - Abstract
This paper investigates 3-years mortality after discharge in patients residing in Sicily (Italy) diagnosed with cancer among: colon, stomach, liver, and lungs, between 1/1/2010 - 31/12/2011. The effect of mobility and socio-economic status on mortality is evaluated through survival analysis approach. Results shows that out-of-region hospitalization is associated with higher survival time; no association of mortality with socio-economic status appears. The extent of patients’ mobility, and its relation with mortality raises regional policy considerations
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- 2020
24. Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues
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Marinaccio, Alessandro, Binazzi, Alessandra, Bonafede, Michela, Corfiati, Marisa, Di Marzio, Davide, Scarselli, Alberto, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Merler, Enzo, Negro, Corrado, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Cocchioni, Mario, Pascucci, Cristiana, Stracci, Fabrizio, Ascoli, Valeria, Trafficante, Luana, Angelillo, Italo, Musti, Marina, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, Detragiache, E, Merletti, F, Gangemi, M, Stura, A, Brentisci, C, Cammarieri, Diglio G, Macerata, V, Gilardetti, M, Benfatto, L, Bianchelli, M, Mazzucco, G, Consonni, D, Pesatori, AC, Riboldi, L, Bressan, V, Gioffrè, F, Ballarin, MN, Chermaz, C, De Michieli, P, Mangone, L, Storchi, C, Sala, O, Badiali, AM, Cacciarini, V, Giovannetti, L, Martini, A, Calisti, R, La, Rosa F, DʼAlo’, D, Petrucci, MS, Davoli, M, Forastiere, F, Cavariani, F, Romeo, E, Ancona, L, Di Giammarco, A, Menegozzo, S, Canfora, ML, Santoro, M, Viscardi, F, Brangi, A, Cozza, V, Baldassarre, A, Lio, S, Nicita, C, Dardanoni, G, Scondotto, S, Nieddu, V, Pergola, M, and Stecchi, S
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- 2015
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25. Bleeding risk and healthcare resource utilisation in elderly patients treated with edoxaban or vitamin K antagonists for atrial fibrillation in Italy
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Smits, E, primary, Spentzouris, G, additional, Ingrasciotta, Y, additional, Foti, SS, additional, Ferrajolo, C, additional, Pastorello, M, additional, Scondotto, S, additional, Tari, M, additional, and Trifiro, G, additional
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- 2021
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26. [Rt or RDt, that is the question!]
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Giraudo, M. T., Falcone, M., Cadum, E., Deandrea, S., Scondotto, S., Mattaliano, A., Di Pietrantonj, C., Bisceglia, L., Duca, P., Cislaghi, C., and Maria Teresa Giraudo, Manuele Falcone, Ennio Cadum, Silvia Deandrea, Salvatore Scondotto, Andrea Mattaliano, Carlo Di Pietrantonj, Lucia Bisceglia, Piergiorgio Duca, Cesare Cislaghi
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Risk ,Time Factors ,SARS-CoV-2 ,monitoring indexes ,Health Policy ,Incidence ,Decision Making ,Basic Reproduction Number ,COVID-19 ,epidemic development ,swab outcome date ,symptoms onset date ,Humans ,Italy ,Nasopharynx ,Symptom Assessment ,Epidemiological Monitoring ,Pandemics ,COVID-19, swab outcome date, symptoms onset date, monitoring indexes, epidemic development - Abstract
The article compares two of the most followed indices in the monitoring of COVID-19 epidemic cases: the Rt and the RDt indices. The first was disseminated by the Italian National Institute of Health (ISS) and the second, which is more usable due to the lower difficulty of calculation and the availability of data, was adopted by various regional and local institutions. The rationale for the Rt index refers to that for the R0 index, the basic reproduction number, which is used by infectivologists as a measure of contagiousness of a given infectious agent in a completely susceptible population. The RDt index, on the other hand, is borrowed from the techniques of time series analysis for the trend of an event measurement that develops as a function of time. The RDt index does not take into account the time of infection, but the date of the diagnosis of positivity and for this reason it is defined as diagnostic replication index, as it aims to describe the intensity of the development of frequency for cases recognized as positive in the population. The comparison between different possible applications of the methods and the use of different types of monitoring data was limited to four areas for which complete individual data were available in March and April 2020. The main problems in the use of Rt, which is based on the date of symptoms onset, arise from the lack of completeness of this information due both to the difficulty in the recording and to the absence in asymptomatic subjects. The general trend of RDt, at least at an intermediate lag of 6 or 7 days, is very similar to that of Rt, as confirmed by the very high value of the correlation index between the two indices. The maximum correlation between Rt and RDt is reached at lag 7 with a value of R exceeding 0.97 (R2=0.944). The two indices, albeit formally distinct, are both valid; they show specific aspects of the phenomenon, but provide basically similar information to the public health decision-maker. Their distinction lies not so much in the method of calculation, rather in the use of different information, i.e., the beginning of symptoms and the swabs outcome. Therefore, it is not appropriate to make a judgment of preference for one of the two indices, but only to invite people to understand their different potentials so that they can choose the one they consider the most appropriate for the purpose they want to use it for.
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- 2021
27. Bortezomib-based therapy in non-transplant multiple myeloma patients: a retrospective cohort study from the FABIO project
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Franchi, M, Vener, C, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, De Carlo, I, Scondotto, S, Stival, C, Della Porta, M, Passamonti, F, Corrao, G, Franchi, Matteo, Vener, Claudia, Garau, Donatella, Kirchmayer, Ursula, Di Martino, Mirko, Romero, Marilena, De Carlo, Ilenia, Scondotto, Salvatore, Stival, Chiara, Della Porta, Matteo Giovanni, Passamonti, Francesco, Corrao, Giovanni, Franchi, M, Vener, C, Garau, D, Kirchmayer, U, Di Martino, M, Romero, M, De Carlo, I, Scondotto, S, Stival, C, Della Porta, M, Passamonti, F, Corrao, G, Franchi, Matteo, Vener, Claudia, Garau, Donatella, Kirchmayer, Ursula, Di Martino, Mirko, Romero, Marilena, De Carlo, Ilenia, Scondotto, Salvatore, Stival, Chiara, Della Porta, Matteo Giovanni, Passamonti, Francesco, and Corrao, Giovanni
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Introduction: Randomized clinical trials showed that bortezomib, in addition to conventional chemotherapy, improves survival and disease progression in multiple myeloma (MM) patients not eligible for stem cell transplantation. The aim of this retrospective population-based cohort study is the evaluation of both clinical and economic profile of bortezomib-based versus conventional chemotherapy in daily clinical practice.Methods: Healthcare utilization databases of six Italian regions were used to identify adult patients with non-transplant MM, who started a first-line therapy with bortezomib-based or conventional chemotherapy. Patients were matched by propensity score and were followed from treatment start until death, lost to follow-up or study end-point. Overall survival (OS) and restricted mean survival time (RMST) were estimated using the Kaplan-Meier method. Association between first-line treatment and risk of death was estimated by a conditional Cox proportional regression model. Average mean cumulative costs were estimated and compared between groups.Results: In the period 2010-2016, 3509 non-transplant MM patients met the inclusion criteria, of which 1157 treated with bortezomib-based therapy were matched to 1826 treated with conventional chemotherapy. Median OS and RMST were 33.9 and 27.9 months, and 42.9 and 38.4 months, respectively, in the two treatment arms. Overall, these values corresponded to a HR of death of 0.79 (95% CI 0.71-0.89) over a time horizon of 84 months. Average cumulative cost were 83,839 euro and 54,499 euro, respectively, corresponding to an incremental cost-effectiveness ratio of 54,333 euro per year of life gained, a cost coherent with the willingness-to-pay thresholds frequently adopted from Western countries.Conclusions: These data suggested that, in a large cohort of non-transplant MM patients treated outside the experimental setting, first-line treatment with bortezomib-based therapy was associated with a favourable effectiveness
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- 2021
28. Stratification of the risk of developing severe or lethal Covid-19 using a new score from a large Italian population: a population-based cohort study
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Corrao, G, Rea, F, Carle, F, Scondotto, S, Allotta, A, Lepore, V, D'Ettorre, A, Tanzarella, C, Vittori, P, Abena, S, Iommi, M, Spazzafumo, L, Ercolanoni, M, Blaco, R, Carbone, S, Giordani, C, Manfellotto, D, Galli, M, Mancia, G, Corrao, Giovanni, Rea, Federico, Carle, Flavia, Scondotto, Salvatore, Allotta, Alessandra, Lepore, Vito, D'Ettorre, Antonio, Tanzarella, Cinzia, Vittori, Patrizia, Abena, Sabrina, Iommi, Marica, Spazzafumo, Liana, Ercolanoni, Michele, Blaco, Roberto, Carbone, Simona, Giordani, Cristina, Manfellotto, Dario, Galli, Massimo, Mancia, Giuseppe, Corrao, G, Rea, F, Carle, F, Scondotto, S, Allotta, A, Lepore, V, D'Ettorre, A, Tanzarella, C, Vittori, P, Abena, S, Iommi, M, Spazzafumo, L, Ercolanoni, M, Blaco, R, Carbone, S, Giordani, C, Manfellotto, D, Galli, M, Mancia, G, Corrao, Giovanni, Rea, Federico, Carle, Flavia, Scondotto, Salvatore, Allotta, Alessandra, Lepore, Vito, D'Ettorre, Antonio, Tanzarella, Cinzia, Vittori, Patrizia, Abena, Sabrina, Iommi, Marica, Spazzafumo, Liana, Ercolanoni, Michele, Blaco, Roberto, Carbone, Simona, Giordani, Cristina, Manfellotto, Dario, Galli, Massimo, and Mancia, Giuseppe
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Objectives To develop a population-based risk stratification model (COVID-19 Vulnerability Score) for predicting severe/fatal clinical manifestations of SARS-CoV-2 infection, using the multiple source information provided by the healthcare utilisation databases of the Italian National Health Service. Design Retrospective observational cohort study. Setting Population-based study using the healthcare utilisation database from five Italian regions. Participants Beneficiaries of the National Health Service, aged 18-79 years, who had the residentship in the five participating regions. Residents in a nursing home were not included. The model was built from the 7 655 502 residents of Lombardy region. Main outcome measure The score included gender, age and 29 conditions/diseases selected from a list of 61 conditions which independently predicted the primary outcome, that is, severe (intensive care unit admission) or fatal manifestation of COVID-19 experienced during the first epidemic wave (until June 2020). The score performance was validated by applying the model to several validation sets, that is, Lombardy population (second epidemic wave), and the other four Italian regions (entire 2020) for a total of about 15.4 million individuals and 7031 outcomes. Predictive performance was assessed by discrimination (areas under the receiver operating characteristic curve) and calibration (plot of observed vs predicted outcomes). Results We observed a clear positive trend towards increasing outcome incidence as the score increased. The areas under the receiver operating characteristic curve of the COVID-19 Vulnerability Score ranged from 0.85 to 0.88, which compared favourably with the areas of generic scores such as the Charlson Comorbidity Score (0.60). A remarkable performance of the score on the calibration of observed and predicted outcome probability was also observed. Conclusions A score based on data used for public health management accurately predicted the occurrence of
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- 2021
29. Measuring multimorbidity inequality across Italy through the multisource comorbidity score: a nationwide study
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Corrao, G, Rea, F, Carle, F, Di Martino, M, De Palma, R, Francesconi, P, Lepore, V, Merlino, L, Scondotto, S, Garau, D, Spazzafumo, L, Montagano, G, Clagnan, E, Martini, N, Scire', C, Corrao, Giovanni, Rea, Federico, Carle, Flavia, Di Martino, Mirko, De Palma, Rossana, Francesconi, Paolo, Lepore, Vito, Merlino, Luca, Scondotto, Salvatore, Garau, Donatella, Spazzafumo, Liana, Montagano, Giuseppe, Clagnan, Elena, Martini, Nello, SCIRE', CARLO ALBERTO, Corrao, G, Rea, F, Carle, F, Di Martino, M, De Palma, R, Francesconi, P, Lepore, V, Merlino, L, Scondotto, S, Garau, D, Spazzafumo, L, Montagano, G, Clagnan, E, Martini, N, Scire', C, Corrao, Giovanni, Rea, Federico, Carle, Flavia, Di Martino, Mirko, De Palma, Rossana, Francesconi, Paolo, Lepore, Vito, Merlino, Luca, Scondotto, Salvatore, Garau, Donatella, Spazzafumo, Liana, Montagano, Giuseppe, Clagnan, Elena, Martini, Nello, and SCIRE', CARLO ALBERTO
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Background: Multimorbidity is a growing concern for healthcare systems, with many countries experiencing demographic transition to older population profiles. A simple multisource comorbidity score (MCS) has been recently developed and validated. A very large real-world investigation was conducted with the aim of measuring inequalities in the MCS distribution across Italy. Methods: Beneficiaries of the Italian National Health Service aged 50-85 years who in 2018 were resident in one of the 10 participant regions formed the study population (15.7 million of the 24.9 million overall resident in Italy). MCS was assigned to each beneficiary by categorizing the individual sum of the comorbid values (i.e. the weights corresponding to the comorbid conditions of which the individual suffered) into one of the six categories denoting a progressive worsening comorbidity status. MCS distributions in women and men across geographic partitions were compared. Results: Compared with beneficiaries from northern Italy, those from centre and south showed worse comorbidity profile for both women and men. MCS median age (i.e. the age above which half of the beneficiaries suffered at least one comorbidity) ranged from 60 (centre and south) to 68 years (north) in women and from 63 (centre and south) to 68 years (north) in men. The percentage of comorbid population was lower than 50% for northern population, whereas it was around 60% for central and southern ones. Conclusion: MCS allowed of capturing geographic variability of multimorbidity prevalence, thus showing up its value for addressing health policy in order to guide national health planning.
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- 2020
30. Risk of nasopharyngeal cancer in productive sectors and formaldehyde exposure in bakeries industry
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Miligi, L, primary, Massari, S, additional, Paredes Alpaca, R I, additional, Piro, S, additional, Airoldi, C, additional, Ranucci, A, additional, Romeo, E, additional, Scondotto, S, additional, Cenni, A, additional, and Aprea, M C, additional
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- 2020
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31. High resolution data to estimate effects of pollution and temperatures in Italy: The BEEP project
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Cernigliaro, A, primary, Stafoggia, M, primary, Gariazzo, C, primary, Viegi, G, primary, de’ Donato, F, primary, and Scondotto, S, primary
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- 2019
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32. PUK36 DIRECT HEALTHCARE COSTS OF CHRONIC KIDNEY DISEASE MANAGEMENT IN ITALY: HOW MUCH SAVING CAN BE ACHIEVED WITH LARGER BIOSIMILAR UPTAKE?
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Berto, P., primary, Aiello, A., additional, Ingrasciotta, Y., additional, Sultana, J., additional, Formica, D., additional, Ientile, V., additional, Chinellato, A., additional, Tari, D.U., additional, Gini, R., additional, Pastorello, M., additional, Scondotto, S., additional, Cananzi, P., additional, Traversa, G., additional, Genazzani, A., additional, Rossi, M., additional, Santoro, D., additional, and Trifirò, G., additional
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- 2019
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33. In Search of Predictors of Switching Between Erythropoiesis-Stimulating Agents in Clinical Practice: A Multi-Regional Cohort Study
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Ingrasciotta, Y., Belleudi, V., Trotta, F., Addis, A., Fontana, A., Chinellato, A., Ientile, V., Tari, D. U., Roberto, G., Pastorello, M., Scondotto, S., Cananzi, P., Traversa, G., Davoli, M., Rossi, M., Trifiro, G., Caputi, A. P., Bolcato, J., Pirolo, R., Gini, R., Genazzani, A. A., Uomo, I., Addario, S. W. P., and Da Cas, R.
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Male ,medicine.medical_specialty ,Databases, Factual ,Anemia ,Disease ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Internal medicine ,Neoplasms ,medicine ,Humans ,Pharmacology (medical) ,Erythropoiesis ,Renal Insufficiency, Chronic ,Biosimilar Pharmaceuticals ,Aged ,Proportional Hazards Models ,Retrospective Studies ,030203 arthritis & rheumatology ,Pharmacology ,business.industry ,Proportional hazards model ,Retrospective cohort study ,General Medicine ,medicine.disease ,Epoetin Alfa ,Italy ,030220 oncology & carcinogenesis ,Hematinics ,Observational study ,Female ,business ,Biotechnology ,Cohort study ,Kidney disease - Abstract
Switching between different erythropoiesis-stimulating agents (ESAs) during the first year of therapy is frequent (15–20%), much more so toward reference products than biosimilars. The objectives of this study were to investigate the frequency and identify the potential predictors of switching between biosimilar and originator ESAs during the first year of treatment in patients with chronic kidney disease (CKD), or chemotherapy-related anemia from six large Italian geographic areas in the years 2009–2015. A retrospective cohort study was conducted using six Italian regional claims databases (≥ 13 million inhabitants) during 2009–2015. Among incident epoetin users, the frequency of single, multiple, and backward switch during the first year of treatment was evaluated. Using frailty Cox models, potential predictors of first switch were identified. All analyses were stratified by the main indications for use. Among 102,240 incident epoetin users, 15,853 (15.5%) switched to another epoetin during the first year of therapy; only 18% of these switched to biosimilars. Single switch was more common (62.2% of the switchers) than multiple (23.5%) or backward switch (14.3%). In cancer, the cumulative number of transfusions and iron preparations dispensed, as well as hyperparathyroidism, were predictors of switching. In CKD, the cumulative number of transfusions, number of vitamin A/D preparations dispensed, and CKD severity increased the probability of switching. Switching between ESAs was frequent in both CKD and cancer patients. The number of cumulative transfusions and severity of disease seemed to affect the switch.
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- 2019
34. SENTIERI - Studio epidemiologico nazionale dei territori e degli insediamenti esposti a rischio da inquinamento. Quinto Rapporto [SENTIERI: Epidemiological Study of Residents in National Priority Contaminated Sites. Fifth Report]
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Zona, A., Iavarone, I., Buzzoni, C., Conti, S., Santoro, M., Fazzo, L., Pasetto, R., Pirastu, R., Bruno, C., Ancona, C., Bianchi, F., Forastiere, F., Manno, V., Minelli, G., Minerba, A., Minichilli, F., Stoppa, G., Pierini, A., Ricci, P., Scondotto, S., Bisceglia, L., Cernigliaro, A., Ranzi, A., Comba, P., Ferretti, S, Gruppo di lavoro SENTIERI, Gruppo di lavoro AIRTUM-SENTIERI, and Gruppo di lavoro Malformazioni Congenite-SENTIERI
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residential population ,cancer incidence ,children ,congenital anomalies ,health effects ,National Priority Contaminated Sites, environmental exposure, mortality, cancer incidence, hospitalization, congenital anomalies, health effects, residential population, children, young adult, surveillance ,environmental exposure ,surveillance ,Socio-culturale ,young adult ,National Priority Contaminated Sites ,mortality ,hospitalization - Published
- 2019
35. Effectiveness and Safety of Switching Originator and Biosimilar Epoetins in Patients with Chronic Kidney Disease in a Large-Scale Italian Cohort Study
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Belleudi, V., Trotta, F., Addis, A., Ingrasciotta, Y., Ientile, V., Tari, M., Gini, R., Pastorello, M., Scondotto, S., Cananzi, P., Traversa, G., Davoli, M., Trifiro, G., Caputi, A. P., Giorgianni, F., Marciano, I., Chinellato, A., Bolcato, J., Pirolo, R., Roberto, G., Genazzani, A. A., Uomo, I., Addario, S. W. P., Da Cas, R., and Rossi, M.
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Adult ,Male ,medicine.medical_specialty ,Toxicology ,030226 pharmacology & pharmacy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,80 and over ,medicine ,Product Surveillance, Postmarketing ,Humans ,Pharmacology (medical) ,Aged ,Aged, 80 and over, Anemia, Biosimilar Pharmaceuticals, Cohort Studies, Epoetin Alfa, Erythropoietin ,Female, Follow-Up Studies, Humans ,Italy, Male, Medical Record Linkage, Middle Aged, Product Surveillance, Postmarketing, Propensity Score, Renal Insufficiency, Chronic, Retrospective Studies, Treatment Outcome ,Renal Insufficiency ,030212 general & internal medicine ,Original Research Article ,Chronic ,Renal Insufficiency, Chronic ,Propensity Score ,Biosimilar Pharmaceuticals ,Erythropoietin ,Retrospective Studies ,Pharmacology ,Aged, 80 and over ,Proportional hazards model ,business.industry ,Hazard ratio ,Retrospective cohort study ,Biosimilar ,Anemia ,Middle Aged ,Confidence interval ,Product Surveillance ,Postmarketing ,Epoetin Alfa ,Treatment Outcome ,Italy ,Propensity score matching ,Observational study ,Female ,Medical Record Linkage ,business ,Cohort study ,Follow-Up Studies - Abstract
Introduction Real-world data on the comparative effectiveness and safety of switching among different epoetins (including originators and biosimilars) are limited. In light of current debate about interchangeability, prescribers, some patient groups and decision makers are calling for additional post-marketing evidence on the clinical effects of switching between originator and biosimilar epoetins in chronic kidney disease (CKD) patients. Objective The objective of this study was to evaluate the effectiveness and safety of switching versus non-switching and of switching from originator/biosimilar epoetin alpha (ESA α) to any other epoetin in CKD patients. Methods An observational, record-linkage, multi-database, retrospective cohort study was carried out in four Italian geographical areas. All subjects with at least one ESA α dispensing between 1 January 2009 and 31 December 2015 were retrieved. Switching was defined as any transition between originator/biosimilar ESA α to any other epoetin in a series of two consecutive prescriptions up to 2 years. Switchers were matched 1:1 with non-switchers by baseline propensity score and by duration of ESA α treatment. Switchers and non-switchers were followed up from switching date to a maximum of 1 year. Lack of effectiveness and safety of switching versus non-switching were evaluated through Cox regression models (hazard ratio [HR], 95% confidence interval [CI]). A direct comparison between the two switcher categories (switchers from originator/biosimilar ESA α to any other epoetin) was also performed. Results Overall, 14,400 incident users of ESA α for anaemia due to CKD (61.4% originator, 38.6% biosimilar) were available for analysis. During the follow-up, we found no differences on effectiveness (HR 1.02, 95% CI 0.79–1.31 originators; HR 1.16, 95% CI 0.75–1.79 biosimilars) and safety outcomes (HR 1.08, 95% CI 0.77–1.50 originators; HR 1.20, 95% CI 0.66–2.21 biosimilars) between switchers and non-switchers of ESA α. Cumulative probabilities of recording an adverse event, either in terms of lack of effectiveness or safety issue, were the same for two switching categories Conclusions In this large-scale Italian observational multi-database study, switching versus non-switching as well as switching from biosimilar/originator ESA α to any other epoetin in CKD patients is not associated with any effectiveness and safety outcomes. Electronic supplementary material The online version of this article (10.1007/s40264-019-00845-y) contains supplementary material, which is available to authorized users.
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- 2019
36. The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure
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Marinaccio, Alessandro, Corfiati, Marisa, Binazzi, Alessandra, Di Marzio, Davide, Scarselli, Alberto, Ferrante, Pierpaolo, Bonafede, Michela, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Mazzoleni, Guido, Merler, Enzo, Girardi, Paolo, Negro, Corrado, D'Agostin, Flavia, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Pascucci, Cristiana, Calisti, Roberto, Stracci, Fabrizio, Romeo, Elisa, Ascoli, Valeria, Trafficante, Luana, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, Iavicoli, Sergio, Detragiache, E, Merletti, F, Gangemi, M, Stura, A, Brentisci, C, Diglio, Gc, Macerata, V, Gilardetti, M, Lazzarotto, A, Benfatto, L, Bianchelli, M, Mazzucco, G, Campi, M, Malacarne, D, Camposeragno, D, Giorgio, Fd, Canessa, P, Consonni, D, Pesatori, A, Riboldi, L, Bressan, V, Gioffrè, F, Ballarinl, M, Chermaz, C, Michieli, P, Mangone, L, Storchi, C, Sala, O, Badiali, A, Cacciarini, V, Giovannetti, L, Martini, A, Grappasonni, I, Masanotti, G, D'Alo', D, Petrucci, M, Davoli, M, Forastiere, F, Cavariani, F, Ancona, L, Giammarco, Ad, Menegozzo, S, Canfora, M, Santoro, M, Viscardi, F, Brangi, A, Cozza, V, Vimercati, L, Lio, S, Cascone, G, Frasca, G, Giurdanella, M, Martorana, C, Nicita, C, Rollo, P, Spata, E, Dardanoni, G, Scondotto, S, Nieddu, V, Pergola, M, Stecchi, S., Marinaccio, A, Corfiati, M, Binazzi, A, Di Marzio, D, Scarselli, A, Ferrante, P, Bonafede, M, Verardo, M, Mirabelli, D, Gennaro, V, Mensi, C, Schallemberg, G, Mazzoleni, G, Merler, E, Girardi, P, Negro, C, D'Agostin, F, Romanelli, A, Chellini, E, Silvestri, S, Pascucci, C, Calisti, R, Stracci, F, Romeo, E, Ascoli, V, Trafficante, L, Carrozza, F, Angelillo, If, Cavone, D, Cauzillo, G, Tallarigo, F, Tumino, R, Melis, M, Iavicoli, S., Marinaccio, Alessandro, Corfiati, Marisa, Binazzi, Alessandra, Di Marzio, Davide, Scarselli, Alberto, Ferrante, Pierpaolo, Bonafede, Michela, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Mazzoleni, Guido, Merler, Enzo, Girardi, Paolo, Negro, Corrado, D'Agostin, Flavia, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Pascucci, Cristiana, Calisti, Roberto, Stracci, Fabrizio, Romeo, Elisa, Ascoli, Valeria, Trafficante, Luana, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, and Iavicoli, Sergio
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medicine.medical_specialty ,asbestos ,gender ,mesothelioma ,asbestos, gender, mesothelioma ,medicine.disease_cause ,Asbestos ,asbesto ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Medicine ,030212 general & internal medicine ,Mesothelioma ,Workplace ,Modalities ,business.industry ,Incidence (epidemiology) ,Mortality rate ,Environmental and Occupational Health ,Public Health, Environmental and Occupational Health ,medicine.disease ,030220 oncology & carcinogenesis ,Workforce ,Etiology ,Public Health ,Settore SECS-S/01 - Statistica ,business ,Demography - Abstract
IntroductionThe epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register.MethodsIncident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated.ResultsIn the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries.ConclusionsThe consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.
- Published
- 2018
37. Analisi dei determinanti di sovrappeso ed obesità in Italia
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FERRANTE, Mauro, Cernigliaro, A, Immordino, P, Marras, A, Scondotto, S., Ferrante, M, Cernigliaro, A, Immordino, P, Marras, A, and Scondotto, S
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Eccesso ponderale ,Disuguaglianze di Salute ,Settore SECS-S/05 - Statistica Sociale ,Indagini Multiscopo ,Italia - Abstract
Introduzione: Sovrappeso ed obesità rappresentano un problema di crescente interesse nell’ambito dei programmi sanitari nazionali dei Paesi industrializzati, sia perché la prevalenza è in costante aumento, sia perché l’eccesso ponderale è associato al rischio di sviluppare altre patologie quali diabete, malattie cardiovascolari, e alcune forme di tumore. Obiettivi: Descrivere un profilo di prevalenza del sovrappeso e dell’obesità in Italia utilizzando i dati derivanti dall’indagine Multiscopo Istat sulle “Condizioni di Salute e ricorso ai servizi sanitari” per gli anni 2005 e 2013, ed analizzare il contributo che i principali fattori di rischio hanno nel determinare una diversa distribuzione della prevalenza dell’eccesso ponderale sul territorio nazionale.Metodi: Al fine di valutare il grado di associazione tra lo stato ponderale e l’insieme dei potenziali fattori di rischio dell’eccesso ponderale presi in esame, per la stima dei Prevalence Risk Ratio, si è scelto di ricorrere a modelli di Poisson, tenendo conto anche delle variabili previste dal disegno di campionamento dell’indagine. La categoria dei soggetti sottopeso è stata esclusa dalle analisi. Le analisi sono state condotte per il 2005 ed il 2013. Risultati: Dal confronto con i risultati relativi al 2005, nel 2013 è emerso che la prevalenza dei soggetti obesi in Italia ha subito un incremento (da 10,2% a 11,4%). Al contempo, si osserva una modesta riduzione della prevalenza di soggetti in sovrappeso (da 35,4% a 34,7%). I risultati delle analisi, pur confermando il differenziale Nord-Sud, mostrano livelli di eccesso ponderale inferiore in soggetti con più elevati livelli di istruzione, indipendentemente dalla localizzazione territoriale. Analogamente, valori crescenti dell’eccesso ponderale si osservano al crescere dell’età. Il giudizio sulle risorse economiche mostra valori significativi per le femmine in tutte le ripartizioni geografiche ad eccezione delle regioni del Sud e valori non significativi per i maschi in tutte le ripartizioni geografiche. Al contrario, come riportato in letteratura, meno chiara appare la relazione tra fumo ed eccesso ponderale. Conclusioni: I risultati del presente lavoro hanno mostrato un gradiente Nord-Sud in Italia per quanto attiene all’eccesso ponderale. Invero, tale gradiente appare anche per altri aspetti relativi allo stato di salute della popolazione Italiana che sembra pertanto dipendere dalla diversa distribuzione dei fattori di rischio dell’eccesso ponderale nelle regioni Italiane. Bassi livelli di istruzione, ridotta attività fisica e maggiori livelli di deprivazione nelle regioni del Sud rispetto a quelle del Nord, contribuiscono all’acuirsi dei differenziali riscontrati nei livelli di eccesso ponderale. D’altra parte, la recente crisi finanziaria ed i tagli operati nell’ambito del sistema sanitario nazionale possono determinare un peggioramento generale dei principali indicatori di stato di salute ed un aumento delle differenze tra le diverse regioni.
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- 2016
38. Prevalenza di sovrappeso e obesità in Italia: questione meridionale o disagio sociale?
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FERRANTE, Mauro, Cernigliaro, A, Immordino, P, Scondotto, S., Costa, G, Crialesi, R, Migliardi, A, Gargiulo, L, Sebastiani, G, Ruggeri, P, Menniti Ippolito, F, Ferrante, M, Cernigliaro, A, Immordino, P, and Scondotto, S
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Socioeconomic factor ,Italy ,Obesity ,Settore SECS-S/05 - Statistica Sociale ,Overweight ,Life Style - Abstract
Overweight and obesity represent a topic of growing interest for most of the national healthcare plans of developed countries, mainly due to the increasing prevalence of overweight and obesity, and to their presence as a risk factor for many other noncommunicable diseases. The present work aims at providing a profile of overweight and obesity in Italy, and to analyze the impact of different territorial and socioeconomic risk factors. Data derived from Istat survey on “Health conditions and healthcare utilization” 2005 and 2013 are used, and Prevalence Risk Ratio estimates are derived through modified Poisson regression models. The results show higher prevalence of overweight and obesity in the South, which depends mainly from the different distribution of exposed to risk factors, rather than on differences in their mix. From the policy perspective, the results could orient specific prevention actions oriented to high-risk population segments, withouth ignoring the territorial dimension of social inequalities.
- Published
- 2016
39. PREVALENZA DI CADUTE E PREVENZIONE NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO
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Carlino, V., Catanese, G., Alcamo, R., Belvedere, G., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez, L., Barbagallo, M., Gruppo Tecnico Nazionale Passi D’Argento, Carlino, V., Catanese, G., Alcamo, R., Belvedere, G., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez, L., Barbagallo, M., and Gruppo Tecnico Nazionale Passi D’Argento
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Settore MED/09 - Medicina Interna ,invecchiamento, cadute, prevenzione, comorbilità, politerapia - Abstract
L’invecchiamento della popolazione è un fenomeno globale, che si caratterizza soprattutto per la presenza di patologie cronico-degenerative che incidono sulla qualità della vita delle persone anziane e che causano un notevole incremento dei costi per le cure e per l’assistenza. Per fronteggiare tale fenomeno globale, che riguarda da vicino l’Italia, l’Organizzazione Mondiale della Sanità (OMS) ha messo a punto un piano che ha come obiettivo primario “l’invecchiamento attivo” (active ageing), cioè incentivare il passaggio da politiche incentrate sui bisogni delle persone anziane, considerate abitualmente come soggetti passivi, a politiche che riconoscano l’anziano come parte attiva della vita familiare e comunitaria. I tre pilastri su cui si fonda tale strategia sono salute, partecipazione e sicurezza delle persone anziane. A tale modello dell’OMS fa riferimento “Passi d’Argento”, sistema di sorveglianza e di monitoraggio della qualità della vita della popolazione italiana di età superiore a 65 anni, avviato dal Ministero della Salute con la collaborazione della Regione Umbria e del Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS) dell’Istituto Superiore di Sanità e che ha coinvolto 19 tra Regioni e Province Autonome italiane, tra cui la Sicilia.
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- 2015
40. LIVELLI DI ATTIVITÀ FISICA NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO
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Alcamo R, Catanese G, Carlino V, Belvedere G, Cernigliaro A, Scondotto S, Ferro MP, Contoli B, Quarchioni E, Dominguez LJ, Barbagallo M, Gruppo Tecnico Nazionale Passi D’Argento, Alcamo, R., Catanese, G., Carlino, V., Belvedere, G., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez, L., Barbagallo, M., and Gruppo Tecnico Nazionale Passi D’Argento
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Settore MED/09 - Medicina Interna ,invecchiamento, attività fisica, cadute, sarcopenia, sedentarismo, fragilità - Abstract
L’incremento della vita media raggiunto ai nostri giorni presenta nuove sfide, di carattere socio-politico e sanitario, che attendono risposte puntuali e tempestive. Lo stravolgimento demografico, inevitabilmente, si accompagna ad una transizione epidemiologica risultante nella netta prevalenza di patologie cronico-degenerative a genesi multifattoriale, ed in parte secondaria alla presenza di numerosi fattori di rischio modificabili (sedentarietà, cattive abitudini alimentari, fumo ed abuso di alcol) la cui correzione, a tutte le età, è fondamentale per il raggiungimento di un invecchiamento di successo. Ponendo l’attenzione sui benefici dell’incremento dell’attività fisica si può evidenziare come questa, in particolare, è un fattore protettivo, associato alla riduzione dei valori di pressione arteriosa e l’incidenza di coronaropatie; aumenta il colesterolo HDL, riduce il grasso corporeo e viscerale e l’insorgenza del diabete mellito di tipo 2 (riduzione dell’insulino-resistenza); diminuisce le affezioni a carico del distretto osteo-muscolare come artrosi ed osteoporosi (aumenta la massa ossea) limitando l’incidenza delle cadute; tende a contrastare l’insorgenza delle patologie neoplastiche (stimolando la funzione immunitaria); agisce migliorando il tono dell’umore ed evitando l’isolamento sociale. Risultato finale è il mantenimento dell’autosufficienza e dell’autonomia con aumento della longevità in uno stato di benessere psicofisico. L’impegno crescente deve essere quindi la ricerca ed ottimizzazione continua di sistemi finalizzati alla rilevazione dei “bisogni” degli over-65, al fine di mantenere un’idonea qualità di vita anche negli anziani pluripatologici.
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- 2015
41. DEPRESSIONE E RISCHIO DI ISOLAMENTO NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO
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Catanese G, Alcamo R, Carlino V, Belvedere G, Cernigliaro A, Scondotto S, Ferro MP, Contoli B, Quarchioni E, Dominguez LJ, Barbagallo M, Gruppo Tecnico Nazionale Passi d’Argento, Catanese, G., Alcamo, R., Carlino, V., Belvedere, G., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez, L., Barbagallo, M., and Gruppo Tecnico Nazionale Passi d’Argento
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Settore MED/09 - Medicina Interna ,invecchiamento, depressione, isolamento, sorveglianza epidemiologica - Abstract
L’aumento della vita media, e quindi l’invecchiamento della popolazione, si caratterizza per la presenza di patologie cronico-degenerative che influenzano la qualità di vita. Per tale motivo è fondamentale mettere in atto delle risposte globali ed efficaci incentrate sui bisogni delle persone più anziane, in quanto soggetti non passivi, ma aventi il diritto e la responsabilità di partecipare attivamente alla vita della comunità in ogni fase dell’esistenza. A tal proposito il Ministero della Salute, in collaborazione con la regione Umbria e il Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (CNESPS), ha dato vita a “PASSI D’ARGENTO”, un sistema di monitoraggio della qualità di vita della popolazione ultrasessantacinquenne, finalizzato alla programmazione di interventi socio-sanitari mirati ad incidere positiva-mente sulla salute e sulla qualità di vita dei cittadini anziani. La sorveglianza epidemiologica di popolazione “Passi d’Argento”, grazie all’ausilio di una metodologia standardizzata, ha permesso, inoltre, di confrontare lo stato di salute e l’invecchiamento attivo nelle diverse regioni italiane. Tra i problemi e gli aspetti di salute della popolazione con più di 65 anni è stata presa in con-siderazione la depressione, patologia psichiatrica molto frequente che incide sulla disabilità, porta ad un peggioramento delle relazioni sociali con tendenza all’isolamento, e si collega con un aumento dei costi diretti e indiretti per l’intera società. In molti casi è sottostimata in quanto la perdita d’interesse, il sentimento di tristezza e la sensazione di vuoto vengono considerati “tipi-ci” dell’età avanzata. Passi d’Argento ha posto l’attenzione sui sintomi della depressione e sul rischio di isolamento, considerandoli come indicatori che descrivono la condizione di salute della popolazione ultrasessantacinquenne.
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- 2015
42. DIETA GLUTEN-FREE (DGF) IN SOGGETTI CELIACI E QUALITA' DELLA VITA
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Immordino, P, FERRANTE, Mauro, Marras, A, CASUCCIO, Alessandra, Scondotto, S., Immordino, P, Ferrante, M, Marras, A, Casuccio, A, and Scondotto, S.
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Healthcare Survey ,Quality of Life ,Settore SECS-S/05 - Statistica Sociale ,Gluten-Free Diet ,Health Status Indicators ,Settore MED/42 - Igiene Generale E Applicata - Abstract
IntroduzioneLa celiachia è una malattia sistemica autoimmune innescata dall’ingestione di glutine in individui geneticamente predisposti. Nell’adulto le presentazioni atipiche con sintomi extraintestinali e gastrointestinali aspecifici sono sempre più comuni. In particolare, la celiachia può indurre cambiamenti psicologici nell’individuo affetto, influenzando principalmente la percezione del benessere. Una dieta rigorosamente priva di glutine (DGF) da seguire per tutta la vita rappresenta l’unica terapia disponibile. Tuttavia, il rispetto rigoroso di una DGF può potenzialmente influenzare la qualità di vita del celiaco e, d’altra parte, l’ atteggiamento e le aspettative del paziente hanno un impatto sostanziale sul rispetto della DGF. Obiettivi. Analizzare gli effetti della DGF in pazienti celiaci su alcune dimensioni della qualità della vita. MetodiCome caso studio vengono analizzati i dati relativi all’indagine multiscopo Istat sulle condizioni di salute e ricorso ai servizi sanitari 2013. A partire dai soggetti che hanno dichiarato di essere celiaci, è stata analizzata, tramite modelli regressivi, la relazione tra la presenza di una DGF ed alcuni indicatori sulla percezione dello stato di salute, quali indice di stato fisico (PCS), psicologico (MHS) e mentale (MH), al netto di caratteristiche sociodemografiche e comportamentali (titolo di studio, risorse economiche familiari, ripartizione geografica, età, genere ed abitudine al fumo) dei soggetti in studio. RisultatiDall’indagine multiscopo Istat 2013, la percentuale di soggetti che ha dichiarato di essere affetto da celiachia è di circa lo 0.6%. Di questi, il 47.3% circa afferma di osservare una DGF. I risultati delle analisi mostrano un’associazione diretta tra la presenza di una DGF e indice di stato fisico (Beta=1.773, p-value=0.018), mentre non sembra esservi associazione tra l'osservanza di una DGF e indice di stato psicologico (MCS) e mentale (MH). ConclusioniDopo la diagnosi di celiachia, il paziente deve accettare da un lato l’impatto biologico del convivere con una malattia cronica, dall’altro, il bisogno di aderire ad una dieta restrittiva che richiede importanti cambiamenti di stile di vita permanenti con un impatto psicosociale rilevante. Diversi studi hanno dimostrato che tutti questi cambiamenti hanno un impatto negativo sulla qualità della vita dei pazienti. D’altra parte però alcuni autori dimostrano come la qualità della vita, così come i sintomi, migliorino con la terapia dietetica. Il nostro studio conferma una relazione positiva tra DGF e qualità della vita in termini di indice di stato fisico, confermandone l’importanza come unica terapia ad oggi disponibile nella remisione dei sintomi. Tuttavia, sarebbero necessari studi longitudinali volti a determinare se tale effetto sulla qualità della vita sia permanente nel tempo.
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- 2015
43. SOLUZIONI OPERATIVE ED ASPETTI QUALITATIVI PER LA GEOCODIFICA DI POPOLAZIONI IN AMBITO SANITARIO
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FERRANTE, Mauro, Carnà, P., Pontillo, A, Pollina Addario, S, Migliardi, A., Scondotto, S., Ferrante, M, Carnà, P., Pontillo, A, Pollina Addario, S, Migliardi, A., and Scondotto, S.
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Geocoding ,Geographic Information system ,Healthcare management ,Settore SECS-S/05 - Statistica Sociale ,Healthcare evaluation - Abstract
IntroduzioneL'utilizzo dei Geographic Information Systems (GIS) in ambito sanitario, continua a ricevere grande attenzione. La disponibilità di informazioni sulla localizzazione degli individui, consente di effettuare associazioni territoriali sulle cause delle patologie, nonché di indagare aspetti legati alla distribuzione dei servizi sanitari ed all'equità di accesso alle cure. ObiettiviAnalizzare le principali problematiche e le soluzioni operative per la geocodifica di popolazioni e proporre un indice di qualità della geocodifica di cui poter tenere conto in sede di analisi. MetodiCome caso studio vengono illustrate le fasi che hanno portato alla georeferenziazione di indirizzi residenziali di 12 Comuni Siciliani, attraverso l'utilizzo di due procedure di georeferenziazione. Un primo metodo ha utilizzato un record linkage probabilistico tramite un indice basato sulla similarità di Jaccard con tabelle ufficiali degli indirizzi Istat e l'impiego di software per la fase di georeferenziazione degli indirizzi. Il secondo metodo si è basato su un record linkage tramite ricerca fulltext (in Sql) ed ha utilizzato servizi web-based per la georeferenziazione. Dopo aver proposto un indice sintetico di qualità del processo di georeferenziazione, vengono confrontati i risultati derivanti dalle due procedure in termini di copertura e qualità. RisultatiConsiderando livelli alti dell'indice di qualità di georeferenziazione, e grazie all’integrazione dei risultati derivati dalle due procedure, la percentuale di indirizzi geocodificati è risultata circa l’80%. Guardando ai risultati di elevata qualità per entrambe le procedure utilizzate non si rilevano differenze rilevanti in termini di distanza tra le coordinate derivanti dalle due procedure. Tuttavia, i risultati evidenziano migliori performance della procedura che ha fatto ricorso al servizio web-based in termini di copertura (+40% circa di indirizzi geocodificati, rispetto alla procedura software-based), mentre il 9.2% di indirizzi che non sono stati ben georeferenziati con il servizio webbased hanno trovato una corrispondenza tramite procedura software. ConclusioniLa geocodifica di popolazioni può assistere il management sanitario in diversi modi: può aiutare a meglio comprendere la relazione tra esposizioni ambientali e stato di salute, consente di identificare comunità a maggiore rischio di salute, nonché a comprendere le ragioni di natura territoriale che possono avere un'influenza sullo stato di salute degli individui. Dati i limiti insiti in ciascuno dei metodi utilizzati, l'impiego di un indice di qualità di georeferenziazione assieme all'integrazione dei risultati dei due metodi, consente di ottenere un notevole miglioramento dei risultati, e di valutare l'attendibilità del processo di geocodifica in sede di analisi.
- Published
- 2015
44. INDICATORI PER LA VALUTAZIONE DELL'APPROPRIATEZZA DEL PERCORSO NASCITA
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Fantaci, G, FERRANTE, Mauro, Pollina Addario, S, Tavormina, E, Marras, A, Scondotto, S., Fantaci, G, Ferrante, M, Pollina Addario, S, Tavormina, E, Marras, A, and Scondotto, S.
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Hospital outcome ,Sicily ,Healthcare evaluation ,Settore SECS-S/05 - Statistica Sociale ,Neonatal mortality - Abstract
Introduzione:La gravidanza, il parto ed il puerperio sono eventi fisiologici che possono talvolta complicarsi in modo non prevedibile e con conseguenze gravi per la donna, per il nascituro e per il neonato. Gli standard nazionali prevedono la razionalizzazione/riduzione progressiva dei punti nascita con numero di parti inferiore a 1000/anno, e l'abbinamento per pari complessità di attività delle UU.OO. ostetrico-ginecologiche con quelle neonatologiche/pediatriche, riconducendo a due i precedenti tre livelli assistenziali. I punti nascita privi di una copertura di guardia medico-ostetrica, anestesiologica e medico pediatrica attiva h 24, o di risorse umane e di attrezzature adeguate non dovrebbero prendere in carico nascite a rischio. Anche il trasferimento del neonato subito dopo la nascita, in presenza di condizioni predittive di rischio per il neonato al momento del parto, rappresenta un indicatore di cattiva gestione del percorso clinico. Obiettivi: Valutare l’appropriatezza del percorso nascita e la gestione delle fasi assistenziali nelle prime ore dalla nascita con riferimento ai “neonati a rischio”. Metodi: Come caso studio vengono analizzati i dati desunti dal Certificato di Assistenza al Parto (CedAP) e dalle Schede di Dimissione Ospedaliera (SDO). E' stata condotta quindi un'analisi di tipo descrittivo sui volumi dei nati a rischio e trasferiti entro tre giorni dalla nascita per livello di complessità di struttura. La definizione di neonato a rischio viene determinata sulla base di alcuni criteri, basati su: età gestazionale, peso alla nascita, SGA (Small for Gestational Age), età della madre e gravidanza plurima, con valori del rischio definiti da 0 a 3 (nessun fattore di rischio tra quelli selezionati, un fattore, due fattori, oltre due). Tramite processi di record linkage deterministico e probabilistico tra dati desunti da fonte CedAP e SDO, vengono analizzati alcuni aspetti legati alla gestione del neonato a rischio in termini di trasferimenti tra tipologie di strutture ospedaliere, anche alla luce della recente normativa regionale. Risultati: Nel 2013 nella Regione Sicilia sono stati osservati 8.871 (20,3%) parti di neonati con almeno un fattore di rischio tra quelli selezionati. La percentuale di linkage tra CedAP ed almeno una delle due SDO (madre o bambino) è risultata pari al 97.2%. Degli 8.324 neonati a rischio linkati con il flusso SDO, ben il 34,6% è risultato ancora assistito in un punto nascita non di II livello. La percentuale di nati trattati in centri di II livello aumenta all’aumentare del livello di rischio, con valori pari al 75% per neonati con due fattori di rischio e del 78% per neonati con almeno tre fattori di rischio. Con riferimento ai trasferimenti entro tre giorni dalla nascita, dei 568 trasferimenti, il 14.9 % è stato trasferito da punti nascita di II livello, ed il 73.9% da strutture di I livello, mentre l’11% di trasferimenti ha interessato le altre strutture. Conclusioni: L'analisi condotta consente di valutare l'appropriatezza del percorso nascita attraverso alcuni indicatori riguardanti la gestione dei neonati a rischio all'interno della rete assistenziale regionale. Gli indicatori analizzati costituiscono pertanto un utile strumento da impiegare all'interno di programmi di valutazione della qualità dell'assistenza alla gravidanza e al parto.
- Published
- 2015
45. STATO NUTRIZIONALE E ABITUDINI ALIMENTARI NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO
- Author
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Belvedere, G., Alcamo, R., Catanese, G., Carlino, V., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez, L., Barbagallo, M., Gruppo Tecnico Nazionale Passi D’Argento, Belvedere, G., Alcamo, R., Catanese, G., Carlino, V., Cernigliaro, A., Scondotto, S., Ferro, M., Contoli, B., Quarchioni, E., Dominguez Rodriguez, L., Barbagallo, M., and Gruppo Tecnico Nazionale Passi D’Argento
- Subjects
Settore MED/09 - Medicina Interna ,invecchiamento, nutrizione, active-ageing, malattie croniche - Abstract
In Italia l’aumento costante del numero degli anziani è una realtà correlata al miglioramento delle condizioni di vita. Ma ciò porta con sé anche un carico economico e sociale importante in relazione all’aumento delle malattie cronico-degenerative. Per tale motivo l’Organizzazione Mondiale della Sanità ha messo a punto una linea strategica denominata “active ageing” al fine di rafforzare le condizioni per un “invecchiamento attivo” le cui basi sono da costruire ben prima dell’età anziana. L’alimentazione è un cardine imprescindibile nel determinismo dell’invecchiamento di successo.
- Published
- 2015
46. Developing and validating a novel multisource comorbidity score from administrative data: A large population-based cohort study from Italy
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Corrao, G, Rea, F, Di Martino, M, De Palma, R, Scondotto, S, Fusco, D, Lallo, A, Belotti, L, Ferrante, M, Pollina Addario, S, Merlino, L, Mancia, G, Carle, F, Belotti, LMB, Corrao, G, Rea, F, Di Martino, M, De Palma, R, Scondotto, S, Fusco, D, Lallo, A, Belotti, L, Ferrante, M, Pollina Addario, S, Merlino, L, Mancia, G, Carle, F, and Belotti, LMB
- Abstract
Objective To develop and validate a novel comorbidity score (multisource comorbidity score (MCS)) predictive of mortality, hospital admissions and healthcare costs using multiple source information from the administrative Italian National Health System (NHS) databases. Methods An index of 34 variables (measured from inpatient diagnoses and outpatient drug prescriptions within 2 years before baseline) independently predicting 1-year mortality in a sample of 500 000 individuals aged 50 years or older randomly selected from the NHS beneficiaries of the Italian region of Lombardy (training set) was developed. The corresponding weights were assigned from the regression coefficients of a Weibull survival model. MCS performance was evaluated by using an internal (ie, another sample of 500 000 NHS beneficiaries from Lombardy) and three external (each consisting of 500 000 NHS beneficiaries from Emilia-Romagna, Lazio and Sicily) validation sets. Discriminant power and net reclassification improvement were used to compare MCS performance with that of other comorbidity scores. MCS ability to predict secondary health outcomes (ie, hospital admissions and costs) was also investigated. results Primary and secondary outcomes progressively increased with increasing MCS value. MCS improved the net 1-year mortality reclassification from 27% (with respect to the Chronic Disease Score) to 69% (with respect to the Elixhauser Index). MCS discrimination performance was similar in the four regions of Italy we tested, the area under the receiver operating characteristic curves (95% CI) being 0.78 (0.77 to 0.79) in Lombardy, 0.78 (0.77 to 0.79) in Emilia-Romagna, 0.77 (0.76 to 0.78) in Lazio and 0.78 (0.77 to 0.79) in Sicily. conclusion MCS seems better than conventional scores for predicting health outcomes, at least in the general population from Italy. This May offer an improved tool for risk adjustment, policy planning and identifying patients in need of a focused treatment approach in t
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- 2017
47. Distance from the nearest hospital and mortality for acute miocardial infarction (AMI) in Sicily Region (Southern Italy)
- Author
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FERRANTE, Mauro, Scondotto, S, De Luca, G, Fantaci G, Pollina Addario, S., Ferrante, M., Scondotto, S., De Luca, G., Fantaci, G., and Pollina Addario, S.
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Heart attack ,Hospital location ,Settore SECS-S/05 - Statistica Sociale ,GIS - Published
- 2014
48. OKkio alla SALUTE 2014: hours of sleep in Italian 8-9-year-old children
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Lauria, L1, Pizzi, E1, Nardone, P1, Buoncristiano, M1, Bucciarelli, M1, Galeone, D2, Spinelli A1Andreozzi, S, Pediconi, M, Timperi, F, Pizzi, E, Galeone, D, Menzano, M, Vienna, A, Censi, L, Di Giacomo, M, Colleluori, C, Ranalli, E, Ammirati, G, Mininni, M, Sorrentino, G, Azzarito, C, Faillace, F, La Rocca, M, Mazzarella, G, Pizzuti, R, Angelini, P, Fridel, M, Carletti, C, Pani, P, Ronfani, L, Zanier, L, Amadei, P, Cairella, G, Pascali, F, Schiaffino, S, Cereda, D, Pirrone, L, De Introna, S, Giostra, G, Di Nucci, C, Manfredi Selvaggi, T, Valentini, O, Caputo, M, Ferrari, P, Balducci, M, Rosa, G, Stingi, G, Meloni, S, Senis, M, Tanchis, P, Cernigliaro, A, Ferro, M, Scondotto, S, Giacchi, M, Lazzeri, G, Simi, R, Cristofori, M, Giaimo, M, Prandini, S, Covarino, A, D'Alessandro, G, Galesso, R, Michieletto, F, Fanolla, A, Lucchin, L, Weiss, S, Migazzi, M, Grazia, M, Caroli, Anna Maria, Cattaneo, C, De Mei, B, Perri, G, Silvestri, A, Spizzichino, L, Miletto, N, Faragli, G, Vignoli, M, and Piovani, Giovanna
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Male ,Sleep Wake Disorders ,Pediatric Obesity ,Schools ,Child Behavior ,Health Promotion ,Health Surveys ,Body Mass Index ,Italy ,Risk Factors ,Prevalence ,Humans ,Female ,Child ,Sleep ,Students ,Life Style - Published
- 2016
49. La percezione delle mamme sullo stato ponderale e sugli stili di vita dei propri bambini [Maternal perception of their children's weight and lifestyles]
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Spinelli, A., Nardone, P., Buoncristiano, M., Lauria, L., Bucciarelli, M., Andreozzi, S., Pediconi, M., Timperi, F., Pizzi, E., Galeone, D., Menzano, M., Vienna, A., Censi, L., Di Giacomo, M., Colleluori, C., Ranalli, E., Ammirati, G., Mininni, M., Sorrentino, G., Azzarito, C., Faillace, F., La Rocca, M., Mazzarella, G., Pizzuti, R., Angelini, P., Fridel, M., Carletti, C., Pani, P., Ronfani, L., Zanier, L., Amadei, P., Cairella, G., Pascali, F., Schiaffino, S., Cereda, D., Pirrone, L., De Introna, S., Giostra, G., Di Nucci, C., Manfredi Selvaggi, T., Valentini, O., Caputo, M., Ferrari, P., Balducci, M., Rosa, G., Stingi, G., Meloni, S., Senis, M., Tanchis, P., Cernigliaro, A., Ferro, M., Scondotto, S., Giacchi, M., Lazzeri, G., Simi, R., Cristofori, M., Giaimo, M., Prandini, S., Covarino, A., D'Alessandro, G., Galesso, R., Michieletto, F., Fanolla, A., Lucchin, L., Weiss, S., Migazzi, M., Grazia, M., Caroli, M., Cattaneo, C., De Mei, B., Perri, G., Silvestri, A., Spizzichino, L., Miletto, N., Faragli, G., Vignoli, M., and Piovani, G.
- Published
- 2016
50. OKkio alla SALUTE 2014: hours of sleep in Italian 8-9-year-old children [Okkio alla salute 2014: Hours of sleep in 8-9-year-old children in Italy]
- Author
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Lauria, L, Pizzi, E, Nardone, P, Buoncristiano, M, Bucciarelli, M, Galeone, D, Spinelli, A, Andreozzi, S, Pediconi, M, Timperi, F, Menzano, M, Vienna, A, Censi, L, Di Giacomo, M, Colleluori, C, Ranalli, E, Ammirati, G, Mininni, M, Sorrentino, G, Azzarito, C, Faillace, F, La Rocca, M, Mazzarella, G, Pizzuti, R, Angelini, P, Fridel, M, Carletti, C, Pani, P, Ronfani, L, Zanier, L, Amadei, P, Cairella, G, Pascali, F, Schiaffino, S, Cereda, D, Pirrone, L, De Introna, S, Giostra, G, Di Nucci, C, Manfredi Selvaggi, T, Valentini, O, Caputo, M, Ferrari, P, Balducci, M, Rosa, G, Stingi, G, Meloni, S, Senis, M, Tanchis, P, Cernigliaro, A, Ferro, M, Scondotto, S, Giacchi, M, Lazzeri, Giacomo, Simi, Rita, Cristofori, M, Giaimo, M, Prandini, S, Covarino, A, D'Alessandro, G, Galesso, R, Michieletto, F, Fanolla, A, Lucchin, L, Weiss, S, Migazzi, M, Grazia, M, Caroli, M, Cattaneo, C, De Mei, B, Perri, G, Silvestri, A, Spizzichino, L, Miletto, N, Faragli, G, Vignoli, M, and Piovani, G.
- Published
- 2016
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