Author: "Simona, Sestili" - Searchworks@Jio Institute Digital Library Search Results

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41 results on '"Simona, Sestili"'

1. Reduced post-transplant cyclophosphamide doses in haploidentical hematopoietic cell transplantation for elderly patients with hematological malignancies

Author: Rémy Duléry, Claire Goudet, Daniele Mannina, Antonio Bianchessi, Angela Granata, Samia Harbi, Valerio Maisano, Christian Chabannon, Florent Malard, Eolia Brissot, Simona Sestili, Anne Banet, Zoé Van de Wyngaert, Ramdane Belhocine, Stéphane Ederhy, Luca Castagna, Stefania Bramanti, Didier Blaise, Mohamad Mohty, Sabine Fürst, and Raynier Devillier
Subjects: Transplantation, Hematology
Abstract: Although post-transplant cyclophosphamide (PT-Cy) is effective for graft-versus-host disease (GVHD) prophylaxis, it is associated with toxicities, which might be dose-dependent. We compared the outcomes with PT-Cy at 80 mg/kg to those with PT-Cy at 100 mg/kg in elderly patients undergoing haploidentical hematopoietic cell transplantation (HCT). Inclusion criteria included peripheral blood stem cells, hematological malignancy, and age65 years (or age60 years if cardiac event history). Thirty-eight patients received PT-Cy at 80 mg/kg and 55 100 mg/kg, divided in two doses. The cumulative incidences (CI) of acute grade II-IV, acute grade III-IV, and moderate/severe chronic GVHD were 32%, 16%, and 13% with PT-Cy at 80 mg/kg compared to 33%, 13%, and 16% with 100 mg/kg, respectively. In multivariable analysis, reducing PT-Cy dose had no significant impact on GVHD. Neutrophil and platelet engraftments were significantly improved, and CI of BK virus-associated hemorrhagic cystitis was reduced with 80 mg/kg of PT-Cy compared to 100 mg/kg. At 2 years, non-relapse mortality was 16% and 31%, progression-free survival 65% and 49%, overall survival 70% and 56%, and GVHD-free, relapse-free survival 52% and 36% with 80 mg/kg and 100 mg/kg, respectively. Reducing PT-Cy dose to 80 mg/kg is safe and associated with improved hematological recovery and lower CI of hemorrhagic cystitis in elderly patients undergoing haploidentical HCT.
Published: 2022

2. High‐dose post‐transplant cyclophosphamide impairs γδ T‐cell reconstitution after haploidentical haematopoietic stem cell transplantation using low‐dose antithymocyte globulin and peripheral blood stem cell graft

Author: Nicolas Stocker, Béatrice Gaugler, Myriam Labopin, Agathe Farge, Yishan Ye, Laure Ricard, Eolia Brissot, Remy Duléry, Simona Sestili, Giorgia Battipaglia, Clémence Médiavilla, Annalisa Paviglianiti, Anne Banet, Zoe Van De Wyngaert, Tounes Ledraa, Mohamad Mohty, and Florent Malard
Subjects: allogeneic haematopoietic cell transplantation, Epstein–Barr virus, haploidentical haematopoietic cell transplantation, immune reconstitution, post‐transplantation cyclophosphamide, γδ T cell, Immunologic diseases. Allergy, RC581-607
Abstract: Abstract Objectives Haploidentical haematopoietic cell transplantation (Haplo‐HCT) using peripheral blood stem cell (PBSC) grafts and post‐transplant cyclophosphamide (PTCy) is being increasingly used; however, data on immunological reconstitution (IR) are still scarce. Methods This retrospective study evaluated T‐cell immunological reconstitution in 106 adult patients who underwent allogeneic haematopoietic cell transplantation for haematologic malignancies between 2013 and 2016. Results At D30, while conventional T cells reached similar median counts in Haplo‐HCT recipients (n = 19) and controls (n = 87), γδ and Vδ2+ T‐cell median counts were significantly lower in Haplo‐HCT recipients and it persists at least until D360 for Vδ2+ T cells. PTCy induces a significant reduction in early γδ and Vδ2+ T‐cell proliferation at D 7. At one year, the rate of increase in Epstein–Barr virus (EBV) viral load was significantly higher in Haplo‐HCT recipients as compared to controls (61% versus 34%, P = 0.02). In multivariate analysis, a higher γδ T‐cell count (> 4.63 μL−1) at D30 was the only independent parameter significantly associated with a reduced risk of increase in EBV viral load (RR 0.34; 95% CI, 0.15–0.76, P = 0.009). Conclusion Immunological reconstitution of γδ T cells is significantly delayed after Haplo‐HCT using PTCy and low‐dose ATG and is associated with an increased risk of increase in EBV viral load.
Published: 2020
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3. Isocitrate dehydrogenase inhibitors as a bridge to allogeneic stem cell transplant in relapsed or refractory acute myeloid leukaemia

Author: Alexis Genthon, Diana Dragoi, Mara Memoli, Pierre Hirsch, Fabrizia Favale, Ludovic Suner, Michael Chaquin, Pierre Boncoeur, Zora Marjanovic, Agnès Bonnin, Simona Sestili, Remy Dulery, Florent Malard, Eolia Brissot, Anne Banet, Zoe van de Wyngaert, Anne Vekhoff, Francois Delhommeau, Mohamad Mohty, and Ollivier Legrand
Subjects: Leukemia, Myeloid, Acute, Hematopoietic Stem Cell Transplantation, Humans, Hematology, Enzyme Inhibitors, Isocitrate Dehydrogenase
Published: 2022

4. Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Author: Sebastiano, Cicco, D'Abbondanza, Marco, Proietti, Marco, Vincenzo, Zaccone, Chiara, Pes, Federica, Caradio, Mattioli, Massimo, Salvatore, Piano, Alberto Maria Marra, Alessandro, Nobili, Pier Mannuccio Mannucci, Antonello, Pietrangelo, Giorgio, Sesti, Elena, Buzzetti, Andrea, Salzano, Antonio, Cimellaro, Francesco, Perticone, Francesco, Violi, Gino Roberto Corazza, Salvatore, Corrao, Alessandra, Marengoni, Francesco, Salerno, Matteo, Cesari, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Alessio, Novella, Gabriella, Miglio, Alessia Antonella Galbussera, Ilaria, Ardoino, Prisco, Domenico, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Pirro, Matteo, Lupattelli, Graziana, Bianconi, Vanessa, Alcidi, Riccardo, Giotta, Alessia, Massimo, R Mannarino, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Christiano, Argano, Federica, Cavallaro, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Serafini, Giovanni, Angelo, Simili, Mattia, Brunori, Ilaria, Lazzari, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Valeria Di Stefano, Simona, Leoni, Sonia, Seghezzi, Alessandra Danuto Di Mauro, Diletta, Maira, Marta, Mancarella, Tiziano, Lucchi, Paolo Dionigi Rossi, Marta, Clerici, Alessandra Danuta Di Mauro, Giulia, Bonini, Conti, Federica, Silvia, Prolo, Maddalena, Fabrizi, Miriana, Martelengo, Giulia, Vigani, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Lavinia, Pitotti, Donatella, Padula, Valentina, Antoci, Ginevra, Cambiè, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Jacopo, Alberto, Federico, Cattaneo, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Emanuele, Valeriani, Damiani, D'Ardes, Lucia, Esposito, Simona, Sestili, Ermanno, Angelucci, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giovanni, Imbimbo, Giuseppe, Zuccalà, Gabriella, D'Aurizio, Giuseppe, Romanelli, Andrea, Volpini, Daniela, Lucente, Francesca, Manzoni, Annalisa, Pirozzi, Alberto, Zucchelli, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara, Dell'Unto, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Alessandra, Bonfanti, Hajnalka, Szabo, Mazzola, Paolo, Piazzoli, Andrea, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Enrica, Negro, Martino, Brenna, Lucia, Trotta, Giovanni Lorenzo Squintani, Maria Luisa Randi, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Francesco, Ratti, Chiara, Zurlo, Lorenzo, Cerruti, Elisabetta, Cosi, Roberto, Manfredini, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Irene Di Meo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Francesca Giulia Leoni, Valeria De Sando, Sara, Scarduelli, Michela, Cammarosano, Ilenia, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Giuseppe, Re, Andrea, Schilardi, Francesca, Loparco, Luigi, Fenoglio, Andrea, Falcetta, Alessia Valentina Giraudo, Salvatore, D'Aniano, Anna, L Fracanzani, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Felice, Cinque, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Erica, Pagliaro, Eleonora, Semproni, Canetta, Ciro, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Christian, Folli, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Salam, Kassem, Luca, Liberale, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Camillo, Ferrandina, Francesca, Mazzeo, Elena, Spazzini, Giulia, Cono, Giulia, Cesaroni, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Ludovica, Perri, Luigina, Guasti, Francesca, Rotunno, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Francesco, Dentali, Bertolotti, Marco, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Elena, Bigi, Pellegrini, Elisa, Laura, Orlandi, Giulia, Dondi, Lucia, Carulli, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Aleandra, Scozzafava, Valentino, Condoleo, Tania, Falbo, Lidia, Colangelo, Marco, Filice, Elvira, Clausi, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara Del Vecchio, Ilaria, Benzoni, Andrea, Salvi, Leonardi, Roberto, Giampaolo, Damiani, Gianluca, Moroncini, William, Capeci, Giuseppe Pio Martino, Biondi, Lorenzo, Pietro, Pettinari, Monica, Ormas, Emanuele, Filippini, Devis, Benfaremo, Roberto, Romiti, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Samuele, Pignataro, Francesca, Mete, Miriam, Gino, Guido, Moreo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Paolo, Setti, Chiara, Traversa, Camilla, Scarsi, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Marcello Giuseppe Maggio Gian Paolo Ceda, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giovanni, Paoletti, Francesca, Losa, Montalto, GIUSEPPE ALBERT, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Sarah, Morellini, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Tarquini, Roberto, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Volpi, Riccardo, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo, Franco Laghi Pasini, Pier Leopoldo Capecchi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Vittorio, Durante, Daniela, Tirotta, Giovanna, Eusebi, Cattaneo, Marco Natale, Amoruso, MARIA VALENTINA, Paola, Fracasso, Cristina, Fasolino, Moreno, Tresoldi, Enrica, Bozzolo, Sarah, Damanti, Massimo, Porta, Giuseppe, Armentaro, Maria Immacolata Arnone, Milena, Barone, Lorenzo, Bertolino, Sara, Bianco, Nicolò, Binello, Simona, Brancati, Agostino, Buonauro, William, Cordeddu, Curcio, Rosa, Andrea, Dalbeni, Salvatore, D'Agnano, Damiano, D'Ardes, Martina De Feo, Emilia, Donnarumma, Marco, Fei, Carmine Gabriele Gambino, Paolo, Giorgini, Lombardi, Rosa, Giuseppe, Miceli, Paola, Naccarato, Silvia, Noviello, Gaia, Olivieri, Roberta, Parente, Francesca Serena Pignataro, Sonia, Poma, Enrica, Porceddu, Pucci, Giacomo, Marco, Ricchio, Anna, Sabena, Marco, Salice, Claudia, Santarossa, Ambra, Savona, Caterina, Savrié, Roberto, Scicali, Mario, Stabile, Giovanni, Talerico, Michela, Talia, Eliezer Joseph Tassone, Thomas, Teatini, Elisabetta, Tombolini, Matteo, Traversa, Elia, Vettore, Alessandro, Vignal, Luca, Vilardi, Rosanna, Villani, Francesco, Vitale, Cicco, Sebastiano, D Abbondanza, Marco, Proietti, Marco, Zaccone, Vincenzo, Pes, Chiara, Caradio, Federica, Mattioli, Massimo, Piano, Salvatore, Marra, Alberto Maria, Nobili, Alessandro, Mannucci, Pier Mannuccio, Pietrangelo, Antonello, Sesti, Giorgio, Buzzetti, Elena, Salzano, Andrea, Cimellaro, Antonio, Antonio Cimellaro, Salvatore, Corrao, Mario, Barbagallo, Anna, Licata, Giuseppe, Montalto, Paolisso, Giuseppe, Rizzo, Maria Rosaria, and Cimellaro, Antonio - Giovani Internisti Società Italiana di Medicina Interna (GIS-SIMI) and of the REPOSI Investigators
Subjects: cardiovascular events, older patient, hypertension, antihypertensive drugs, older patients, survival, Clinical Biochemistry, antihypertensive drug, General Medicine, Biochemistry, cardiovascular event
Abstract: Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients.
Published: 2023

5. Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Author: Crisafulli, Ernesto, Sartori, Giulia, Vianello, Alice, Busti, Fabiana, Nobili, Alessandro, Mannucci, Pier Mannuccio, Girelli, Domenico Investigators—Domenico Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene Mattioli (Azienda Ospedaliero Universitaria Careggi Firenze, SOD Medicina Interna Interdisciplinare), Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Michele, Zaccari, Massi- miliano Chiuch (Azienda Sanitaria Universitaria Integrata di Trieste, Clinica Medica Generale, e Terapia Medica), Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi (Azienda Ospedaliera della Pro- vincia di Lecco, Ospedale di Merate, Lecco, Medicina, Interna), Matteo, Pirro, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Alessia, Giotta, Mannarino (Azienda Ospedaliera Santa Maria della Misericordia, Massimo R., Perugia, Medicina, Interna, Angiologia Malattie da Arteriosclerosi), Domenico, Girelli, Fabiana, Busti, Giacomo Marchi (Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Medicina Generale e Malattie Aterotrombotiche, e Degenerative), Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica Cacioppo (Azienda Ospedaliera Universitaria Policlinico Giaccone Policlinico di Palermo, Palermo, Unità Operativa di Geriatria, e Lun- godegenza), Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Christiano, Argano, Civico, Federica Cavallaro (A. R. N. A. S., Cristina, Di, Benfratelli, Palermo, UOC Medicina Interna ad Indirizzo Geriatrico- Riabilitativo), Marco, Zoli, Maria Laura Mata- cena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Mattia, Brunori, Ilaria, Lazzari, Orsola-Malpighi, Angelo Simili (Azienda Ospe- daliera Universitaria Policlinico S., Bologna, Unità Operativa di Medicina Interna Zoli), Maria Domenica Cappellini, Gio- vanna Fabio, Margherita Migone De Amicis, Giacomo De Luca, Nata- lia Scaramellini, Valeria Di Stefano, Simona, Leoni, Sonia, Seghezzi, Alessandra Danuto Di Mauro, Diletta, Maira, Marta Mancarella (Fon- dazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Unità Operativa Medicina Interna IA), Tiziano, Lucchi, Paolo Dionigi Rossi, Marta, Clerici, Alessandra Danuta Di Mauro, Giulia, Bonini, Federica, Conti, Silvia, Prolo, Maddalena, Fabrizi, Miriana, Martelengo, Giulia, Vigani, Paola Nicolini (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Geriatria), Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Lavinia, Pitotti, Donatella, Padula, Valentina, Antoci, Ginevra Cambiè (IRCCS Policlinico San Matteo di Pavia, Pavia, Clinica Medica, I, Reparto, 11), Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Jacopo, Alberto, Federico Cattaneo (IRCCS Azienda Ospedaliera Universitaria San Martino-IST di Genova, Gen-, Ova, Clinica di Medicina Interna 2), Luigi, Anastasio, Lucia, Sofia, Maria Carbone (Ospedale Civile Jazzolino di Vibo Valentia, Vibo Val- entia, Medicina, Generale), Francesco, Cipollone, Maria Teresa Guag- nano, Ilaria, Rossi, Emanuele, Valeriani, Damiani, D’Ardes, Lucia, Esposito, Simona, Sestili, Annunziata, Ermanno Angelucci (Ospedale Clinicizzato SS., Chieti, Clinica, Medica), Gerardo, Mancuso, Daniela, Calipari, Mosè Bartone (Ospedale Giovanni Paolo II Lamezia Terme, Catanzaro, Unità Operativa Complessa Medicina Interna), Giuseppe, Delitala, Maria, Berria, Alessandro Delitala (Azienda ospedaliera- universitaria di Sassari, Maurizio, Muscaritoli, Ales- sio Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Gio- vanni Imbimbo (Policlinico Umberto, I, Sapienza Università di Roma, Medicina Interna, e Nutrizione Clinica Policlinico Umberto I), Giuseppe, Zuccalà, Gemelli, Gabriella D’Aurizio (Policlinico Universitario A., Roma, Roma, Unità Operativa Complessa Medicina d'Urgenza, e Pronto Soccorso)Giuseppe Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Francesca, Manzoni, Annalisa, Pirozzi, Alberto Zucchelli (Unità Operativa Complessa di Medicina I, a indirizzo geriatrico, Spedali, Civili, Montichiari, Brescia), Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara Dell’Unto (Università Campus Bio- Medico, Roma, Medicina Clinica-Epatolo- gia), Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Alessandra, Bonfanti, Hajnalka, Szabo, Paolo, Mazzola, Andrea, Piazzoli, Gerardo, Maurizio Corsi (Università degli studi di Milano-Bicocca Ospedale S., Monza, Unità Operativa di Geri- atria), Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica Giofrè (Università degli Studi Magna Grecia, Policlinico Mater Domini, Cat-, Anzaro, Unità Operativa Complessa di Medicina Interna), Maria Grazia Serra, Maria Antonietta Bleve (Azienda Ospedaliera, Lecce, Unità Operativa Complessa Medicina), Antonio, Brucato, Teresa De Falco, Enrica, Negro, Martino, Brenna, Lucia, Trotta, Giovanni Lorenzo Squintani (ASST FatebenefratelliSacco, Maria Luisa Randi, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Francesco, Ratti, Chiara, Zurlo, Lorenzo, Cerruti, Elisabetta Cosi (Azienda Ospe- daliera Università di Padova, Padova, Clinica Medica I), Roberto Man- fredini, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, Giulia Marta Viglione, Caterina Savriè (Azienda OspedalieraUniversitaria Sant'Anna, Ferrara, Unità Operativa Clinica Medica), Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Irene Di Meo (Azienda Ospedaliera Universitaria della Seconda Università degli Studi di Napoli, Napoli, VI Divisione di Medicina Interna, e Malattie Nutrizionali dell'Invecchiamento), Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, 13 Francesca Giulia Leoni, Valeria De Sando, Sara, Scarduelli, Michela, Cammarosano, Orsola-Malpighi, Ilenia Pareo (Azienda Ospedaliera Universitaria Poli- clinico S., Unità Operativa di Medicina Interna Borghi), Carlo, Sabbà, Francesco Saverio Vella, Patrizia Sup- pressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Ema- nuele Amoruso, Carlo, Custodero, Giuseppe, Re, Andrea, Schilardi, Francesca Loparco (Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Frugoni), Medicina Interna Universitaria C., Luigi, Fenoglio, Andrea, Falcetta, Alessia Valentina Giraudo, Salvatore D’Aniano (Azienda Sanitaria Ospedaliera Santa Croce, e Carle di Cuneo, Cuneo, Ademe, Medicina Interna), S. C., Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Felice Cinque (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, UOC Medicina Generale ad Indirizzo Metabolico), Flora, Peyvandi, Raffaella, Rossio, Colombo, Giulia, Pasquale, Agosti, Erica, Pagliaro, Eleonora Semproni (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Medicina Interna, 2, Emato- logia non tumorale, e Coagulopatie), Canetta, Ciro, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Christian Folli (Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Medicina Interna Alta Intensità di Cure), Francesco, Salerno, Giada Pallini (IRCCS Policlinico San Donato, e Università di Milano, San Donato Milanese, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Salam, Kassem, Luca Liberale (IRCCS Ospedale Policlinico San Martino, e Università di Genova, Genova, Clinica Medica, 1, Medicina Interna, e Specialità Mediche), Nicola Lucio Liberato, Tiziana Tognin (ASST di Pavia, UOSD Medicina Interna, Ospedale di Casorate Primo, Pavia), Francesco, Purrello, Antonino Di Pino, Salvatore Piro (Ospedale Garibaldi Nesima, Catania, Giorgia, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano Buf- felli, Camillo, Ferrandina, Francesca, Mazzeo, Elena, Spazzini, Giulia, Cono, Giulia Cesaroni (Ospedale Poliambulanza, Brescia, Medicina Interna, e Geriatria), Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura Sanino (Dipartimento di Scienze Mediche, Università di Torino, Città della Scienza, e della Salute, Torino, Medicina Interna, 2 Unità Indirizzo d'Urgenza), Franc- esco Violi, Ludovica Perri (Policlinico Umberto, I, Prima Clinica Medica), Guasti, Luigina, Rotunno, Francesca, Castiglioni, Luana, Maresca, ANDREA MARIA, Squizzato, Alessandro, Campiotti, Leonardo, Ales- sandra Grossi, Diprizio, ROBERTO DAVIDE, Francesco Dentali (Università degli Studi dell'Insubria, Ospedale di Circolo, e Fondazione Macchi, Varese, Elena, Medicina, e Geriatria), Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Elena, Bigi, Elisa, Pellegrini, Laura, Orlandi, Giulia, Dondi, Lucia Carulli (Università di Modena, e Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Unità Operativa di Geriatria), Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Aleandra, Scozzafava, Valentino, Condoleo, Tania, Falbo, Lidia, Colangelo, Marco Filice, Elvira Clausi (Università Geriatriche), Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vec- chio, Ilaria Benzoni (Dipartimento di Scienze Mediche, e Chirurgiche, Unità Operativa di Medicina Interna, Orsola-Malpighi, Università degli Studi di Bologna/ Azienda Ospedaliero- Universitaria S., Bologna), Andrea, Salvi, Roberto, Leonardi, Giampaolo Damiani (Spedali Civili di Brescia, Medicina Generale), U. O. 3a., Gianluca, Moroncini, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Monica, Ormas, Emanuele, Filippini, Devis, Benfaremo, Roberto Romiti (Clinica Medica, Azienda Ospedaliera Universitaria- Ospedali Riuniti di Ancona), Riccardo, Ghio, Anna Dal Col (Azienda Ospedaliera Università San Martino, Medicina, III), Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo Labbadia (Poli- clinico Umberto, I, SMSC03Medicina Interna F, e Malattie Meta- boliche dell'osso), Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita (Policlinico Campus Biomedico Roma, Medicina, Clinica), Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Emanuele, Samuele Pignataro (Azienda Ospedaliera Universitaria Poli- clinico – V., Catania, Dipartimento di Medicina), Francesca, Mete, Miriam Gino (Ospedale degli Infermi di Rivoli, Medicina Interna)Guido Moreo, Gloria Pina (Clinica San Carlo Casa di Cura Polispecialistica, Paderno, Dugnano, Unità Operativa di Medicina Generale Emilio Bernardelli), Alberto Balle- strero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Paolo, Setti, Chiara, Traversa, Camilla Scarsi (Clinica Di Medicina Interna ad Indirizzo Oncologico, Azienda Ospedaliera Università San Martino di Genova), Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella Gruden (Medicina Interna III, Giovanni Battista Molinette, Ospedale S., Torino), Franco, Berti, Giuseppe, Famularo, Patrizia Tarsitani (Azienda Ospedaliera San Camillo Forlanini, Medicina Interna II), Roberto, Castello, Michela Pasino (Ospedale Civile Maggiore Borgo Trento, Medicina Generale, e Sezione di Decisione Cli- nica), Marcello Giuseppe Maggio Gian Paolo Ceda, Simonetta Mor- ganti, Andrea, Artoni, Margherita Grossi (Azienda Ospedaliero Uni- versitaria di Parma, Clinica Geriatrica), U. O. C., Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giovanni, Paoletti, Francesca Losa (Policlinico Universitario Duilio Casula, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Allergologia ed Immunologia Clinica), Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Angelo Rizzo (Azienda Ospe- daliera Universitaria Policlinico Paolo Giaccone, UOC di Medicina Interna), Francesco, Corica, Giorgio, Basile, Antonino Cata- lano, Federica, Bellone, Martino, Concetto Principato (Azienda Ospedaliera Universitaria Policlinico G., Messina, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella Caruso (Azienda Ospedaliera per l'Emergenza Cannizzaro, Clinica Medica Università di Catania), Patrizia, Mecocci, Carmelinda, Ruggiero, della Misericordia, Virginia Boccardi (Università degli Studi di Perugia-Azienda Ospedaliera S. M., Struttura Complessa di Geriatria), Tiziana, Meschi, Andrea, Ticinesi, Antonio Nouvenne (Azienda Ospedaliera Universitaria di Parma, Medicina Interna e Lungodegenza Critica), U. O., Pietro, Minuz, Luigi, Fondrieschi, Giandomen- ico Nigro Imperiale, Sarah Morellini (Azienda Ospedaliera Universi- taria Verona, Policlinico GB Rossi, Medicina Generale per lo Studio ed il Trattamento dell’Ipertensione Arteriosa), Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia Bellan (Azienda Ospedaliera Universitaria Maggiore della Carità, Medicina Interna 1), Roberto, Quadri, Erica, Larovere, Marco Novelli (Ospedale di Ciriè, Asl, To4, Emilio, Simeone, Rosa, Scurti, Fabio Tolloso (Ospedale Spirito Santo di Pescara, Geriatria), Roberto Tar- quini, Alice, Valoriani, Silvia, Dolenti, Giulia Vannini (Ospedale San Giuseppe, Empoli, USL Toscana Centro, Firenze, Medicina Interna I), Riccardo, Volpi, Pietro, Bocchi, Alessandro Vignali (Azienda Ospe- daliera Universitaria di Parma, Clinica, e Terapia Medica), Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia Aiello (Divisione di Medicina Interna, Multimedica, Ircss, Milano), Antonino Di Pino (Ospedale GaribaldiNesima, – Catania, Medicina Interna), U. O. C., Teresa, Salvatore, Lucio, Monaco, Vanvitelli, Carmen Ricozzi (Policlinico Università della Campania L., UOC Medicina Interna), Alberto, Pilotto, Ilaria, Indiano, Federica Gandolfo (Ente Ospe- daliero Ospedali Galliera Genova, SC Geriatria Dipartimento Cure Geriatriche, Ortogeriatria, e Riabilitazione)Franco Laghi Pasini, Pier Leopoldo Capecchi (Azienda Ospedaliera Universitaria Senese, Siena, Unità Operativa Complessa Medicina 2), Ranuccio, Nuti, Roberto Val- enti, Martina, Ruvio, Silvia, Cappelli, Alberto Palazzuoli (Azienda Ospedaliera Università Senese, Mauro Ber- nardi, Silvia Li Bassi, Luca, Santi, Giacomo Zaccherini (Azienda Ospe- daliera Policlinico Sant’Orsola-Malpighi, Semeiotica Medica Bernardi), Vittorio, Durante, Daniela, Tirotta, Giovanna Eusebi (Ospedale di Cattolica, Rimini, Marco, Cattaneo, Maria Valentina Amoruso, Paola, Fracasso, Cristina Fasolino (Azienda ospedaliera San Paolo, Moreno, Tresoldi, Enrica 13 Internal and Emergency Medicine Internal and Emergency Medicine Bozzolo, Sarah Damanti (IRCCS Ospedale San Raffaele, – Milano, Medicina Generale, e delle Cure Avanzate), Massimo, Porta, Miriam Gino (AOU Città della Salute e della Scienza di Torino, – Torino, and Medicina Interna, 1U).
Subjects: Hospital cure, Chronic obstructive pulmonary disease, Heart failure, Mortality, Multimorbidity, Prognosis
Published: 2023

6. Pulmonary Alveolar Proteinosis After Allogeneic Hematopoietic Stem-Cell Transplantation in Adults

Author: Jean-François Bernaudin, Hélène Salvator, Natacha Maillard, Marie-Thérèse Rubio, Sarah Guenounou, Simona Sestili, Colas Tcherakian, Louise Bondeelle, Laetitia Souchet, Emilie Catherinot, Céline Goyard, Véronique Meignin, Solène Evrard, Elisabeth Longchampt, Marie-Laure Chabi-Charvillat, Eolia Brissot, Anne Fajac, Stéphanie Nguyen, Serge Milin, Anne Bergeron, Louis-Jean Couderc, Claire Givel, Alexandre Chabrol, and Marie Robin
Subjects: Pulmonary and Respiratory Medicine, Pathology, medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine, Hematopoietic stem cell transplantation, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary alveolar proteinosis, medicine.disease, business
Published: 2021

7. Autologous hematopoietic cell transplantation as a part of a sequential multi-phase therapeutic approach (R-COPADM/CYVE/ASCT) as first-line treatment of high-grade B-cell lymphoma: results of a retrospective study with long-term follow-up

Author: Tamim Alsuliman, Nicolas Stocker, Elise Corre, Rémy Dulery, Simona Sestili, Laure Ricard, Florent Malard, Mohamad Mohty, Paul Coppo, and Zora Marjanovic
Subjects: Transplantation, Hematology
Abstract: Patients with high-risk lymphoma have a poor prognosis when treated with standard chemoimmunotherapy. This retrospective study included 23 high-risk lymphoma patients with a median age at diagnosis of 59 (range, 35-68) years. They received 2 cycles of R-COPADM and 2 cycles of CYVE, completed by ASCT for fit patients. With a median follow-up of 46 (range, 3-78) months, three (13%) patients in the cohort died. Nearly half of the patients had an ECOG performance status of 2 or 3. Most patients in the cohort (91%, n = 21) had Ann Arbor stage III-IV disease, and 88% (n = 20) had an IPI of 3 to 5. LDH levels were elevated in 83% (n = 19) of patients. Overall, 30% of patients were identified as having double-expressor lymphoma and 22% as having DHL, while two patients (9%) had THL. The origin of the lymphoma was GC B-cell-like in 15 patients (65%) and ABC-like in 8 patients (35%). Cumulative incidence of relapse at 46 months was 14% (95% CI, 5-37), while overall survival was 87% (95% CI, 64-95) and progression-free survival was 83% (95% CI, 60-93). These results showed the efficacy and an acceptable safety profile of the R-COPADM/CYVE/ASCT regimen in high-risk lymphoma, including patients with DHL.
Published: 2022

8. Reduced Post-Transplant Cyclophosphamide Dose Associated with Antithymocyte Globulin in Peripheral Blood Stem Cell Haploidentical Transplantation

Author: Remy Dulery, Florent Malard, Eolia Brissot, Anne Banet, Simona Sestili, Ramdane Belhocine, Martina Calabrò, Zoé Van De Wyngaert, Agnès Bonnin, Tounes Ledraa, Ollivier Legrand, Myriam Labopin, Elodie Capderou, Ariel Cohen, Stéphane Ederhy, and Mohamad Mohty
Subjects: Immunology, Cell Biology, Hematology, Biochemistry
Published: 2022

9. Thiotepa, busulfan and fludarabine conditioning-regimen is a promising approach for older adult patients with acute lymphoblastic leukemia treated with allogeneic stem cell transplantation

Author: Anne Banet, Ali Bazarbachi, Myriam Labopin, Nicolas Stocker, Rémy Duléry, Florent Malard, Zoé Van de Wyngaert, Alexis Genthon, Mara Memoli, Ollivier Legrand, Agnes Bonnin, Tounes Ledraa, Ramdane Belhocine, Simona Sestili, Jean El-Cheikh, Mohamad Mohty, and Eolia Brissot
Subjects: Adult, Transplantation, Transplantation Conditioning, Adolescent, Hematopoietic Stem Cell Transplantation, Graft vs Host Disease, Hematology, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Young Adult, Leukemia, Myeloid, Acute, Humans, Busulfan, Thiotepa, Vidarabine, Aged, Retrospective Studies
Abstract: For acute lymphoblastic leukemia (ALL) patients, total body irradiation (TBI)- based conditioning regimens are the first choice specially in young population. However, several studies have shown an equivalence in clinical outcomes with thiotepa-based conditioning regimen. We performed a retrospective study to evaluate the outcome of adult ALL patients who received allogeneic hematopoietic stem cell transplantation (allo-HCT) with a thiotepa-busulfan-fludarabine (TBF) myeloablative conditioning regimen with reduced toxicity. Fifty-five patients received a TBF regimen. The median age of the patients was 51 years (range, 17 to 72.4). Most patients had a diagnosis of B-ALL (93%) with 7% having T-ALL. Two - and 5-year overall survival was 73.2% and 64%, respectively. At 2 years, leukemia-free survival and GVHD-free, relapse-free survival were 59.5% and 57.6%, and at 5 years, 53.4% and 51.8%, respectively. The 5-year non-relapse mortality was 15%. The day 180 cumulative incidence (CI) of grade II-IV acute GVHD and grade III-IV acute GVHD were 38.2% and 5.5%, respectively. At 2 years, the CI of chronic GVHD and extensive chronic GVHD was 16.9% and 1.9%, respectively. Our study results do suggest that using TBF as the conditioning regimen in adult ALL patients is a promising option with acceptable toxicity.
Published: 2022

10. Thiotepa-busulfan-fludarabine as a conditioning regimen for patients with myelofibrosis undergoing allogeneic hematopoietic transplantation: a single center experience

Author: Simona Sestili, Agathe Boussaroque, Zoé Van de Wyngaert, Simona Lapusan, Annalisa Paviglianiti, Mara Memoli, Anne Banet, Mohamad Mohty, Clemence Mediavilla, Pierre Hirsch, Remy Dulery, Agnès Bonnin, Ramdane Belhocine, Antonio Bianchessi, Giorgia Battipaglia, Fabrizia Favale, Ollivier Legrand, Florent Malard, Anne Vekhoff, Eolia Brissot, and Tounes Ledraa
Subjects: Adult, Oncology, Cancer Research, medicine.medical_specialty, Transplantation Conditioning, Graft vs Host Disease, ThioTEPA, Single Center, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Myelofibrosis, Busulfan, Aged, business.industry, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, medicine.disease, Fludarabine, Transplantation, Haematopoiesis, Primary Myelofibrosis, 030220 oncology & carcinogenesis, Cohort, business, Thiotepa, Vidarabine, 030215 immunology, medicine.drug
Abstract: We assessed the outcomes associated with thiotepa, busulfan and fludarabine (TBF) conditioning regimen in a cohort of 29 consecutive patients allografted for myelofibrosis (MF). The median age was 56 (range 42-70) years. According to the refined Dynamic International Prognostic Scoring System (DIPSS-plus), 15 (52%) patients were classified as high risk. Graft source was peripheral blood stem cells in 27 patients. Donor type was HLA-matched related (
Published: 2020

11. Low incidence of hyperacute graft-versus-host disease (GVHD) with effective GVHD prophylaxis based on anti-thymocyte globulin

Author: Vera Radici, Nicolas Stocker, Rémy Dulery, Eolia Brissot, Anne Bannet, Zoe van de Wyngaert, Simona Sestili, Ramdane Belhocine, Agnes Bonin, Tounes Ledraa, Mohamad Mohty, and Florent Malard
Subjects: Transplantation Conditioning, Incidence, Hematopoietic Stem Cell Transplantation, Graft vs Host Disease, Humans, Transplantation, Homologous, Hematology, Antilymphocyte Serum
Published: 2022

12. Immune restoration therapy for multidrug-resistant CMV disease in an allogenic stem cell transplant recipient

Author: Olivier Paccoud, Sophie Alain, Joel Gozlan, Sabrine Jarboui, David Boutolleau, Sébastien Hantz, Giorgia Battipaglia, Annalisa Paviglianiti, Rémy Duléry, Florent Malard, Clémence Médiavilla, Simona Sestili, Béatrice Gaugler, Jean-Luc Meynard, Jérôme Pacanowski, Mohamad Mohty, Eolia Brissot, Paccoud, O., Alain, S., Gozlan, J., Jarboui, S., Boutolleau, D., Hantz, S., Battipaglia, G., Pavaglianiti, A., Dulery, R., Malard, F., Mediavilla, C., Sestili, S., Gaugler, B., Meynard, J. -L., Pacanowski, J., Mohty, M., and Brissot, E.
Subjects: gamma delta T cell, Immune Reconstitution, Cytomegalovirus Infections, Artesunate, Cytomegaloviru, Interleukin-2, Cytomegalovirus, Humans, Hematopoietic stem cell transplantation, General Medicine, General Biochemistry, Genetics and Molecular Biology, Transplant Recipients, Stem Cell Transplantation
Published: 2021

13. Stable pulmonary function after haploidentical stem cell transplantation with post-transplant cyclophosphamide: a single center experience

Author: Anne Banet, Zoé Van de Wyngaert, Annalisa Paviglianiti, Tounes Ledraa, Simona Sestili, Mara Memoli, Remy Dulery, Florent Malard, Antonio Bianchessi, Mohamad Mohty, Eolia Brissot, and Ramdane Belhocine
Subjects: Cancer Research, medicine.medical_specialty, Transplantation Conditioning, Cyclophosphamide, Post transplant cyclophosphamide, medicine.medical_treatment, Immunology, Bronchiolitis obliterans, Graft vs Host Disease, Hematopoietic stem cell transplantation, Single Center, Gastroenterology, Biochemistry, Pulmonary function testing, DLCO, Internal medicine, Diffusing capacity, medicine, Humans, Lung, Retrospective Studies, business.industry, Interstitial lung disease, Hematopoietic Stem Cell Transplantation, Cell Biology, Hematology, medicine.disease, Surgery, Transplantation, Oncology, Stem cell, business, medicine.drug
Abstract: Background: Pre- and post-transplant pulmonary function tests (PFT) have been previously analyzed in patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT). A deterioration in pulmonary function could be observed in this setting and accounts for higher morbidity and mortality. Haploidentical allogeneic stem cell transplantation (HAPLO) with post-transplant cyclophosphamide (PTCY) is increasingly used. Limited data exists on evaluation of PFT after HAPLO and the number of patients who underwent HAPLO in previously published studies is negligible. We report the evolution of PFT as well as pre-transplant characteristics and outcomes after HAPLO in the adult setting. Methods: We retrospectively analyzed 80 HAPLO performed in a single center between 2013 and 2019. All patients with available pre- and post-transplant PFT results were included in the study. The Friedman test was used for comparing PFT at baseline, 100 days and 1 year after HAPLO. Results: The median follow up was 32 (range: 12-74) months. CMV serology was positive in 45% and 65% of patients were male. The median age was 58 (range: 16-73) years. The proportion of surviving patients with available PFT at 3 months and 1 year were 86% and 68%, respectively. Diagnosis was acute myeloid leukemia in 51% and disease risk index was intermediate-low in 75% of the cases. Disease status before HAPLO was complete remission in 61%. Graft source was peripheral blood stem cells in 91% of the cases. Conditioning regimen was reduced intensity in 40% and the most frequent chemotherapy regimen was thiotepa, busulfan and fludarabine. Graft-versus- host disease (GvHD) prophylaxis consisted of Cyclosporine A (CsA) and mycophenolate mofetil in all but one patient who received methotrexate and CsA. All patients received PTCY, 64 (80%) at days 3 and 5 after HAPLO, 7 (9%) at days 3 and 4, and 9 (11%) at day 3 only. Seventy-three (91%) patients received anti-thymocyte globulin. In total, 24% of the patients had previously smoked, 8% had type 2 diabetes, and 23% suffered from hypertension. Three patients had a lung infection at baseline, of which one was bacterial and two were possibly aspergillosis. At screening for HAPLO, five (6%) patients had restrictive lung disease, nine (11%) met the criteria for obstructive lung disease, and diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin was impaired in 74% of the patients. The median forced expiratory volume in the first second (FEV1) was 100 (range: 58-146) before HAPLO, 93 (range: 42-10) at 100 days after HAPLO and 99 (range: 32-144) at 1 year. The median forced vital capacity (FVC) was 106 (range: 57-153), 98 (range: 44-148) and 106 (range: 31-153) at pre HSCT, 100 days and 1 year after HAPLO, respectively. FEV1 and FVC were significantly different over time during the 1 year follow up (p=0.01 and p=0.001, respectively). The median FEV1/FVC was 80 (range 51-105) before HAPLO, 77 (range: 54-103) after 3 months, and 75 (range: 43-100) after 1 year. FEV1/FVC, residual volume, and total lung capacity (TLC) remained stable from baseline to 1 year (p=0.27, p=0.84 and p=0.21, respectively). In contrast, DLCO remained impaired during the follow-up period (p Twenty-nine patients had an infectious respiratory complication during the follow-up period. Of these, 19 were bacterial, three were viral, two were fungal and five had no microbial documentation. During the 1-year follow-up period, four patients met the criteria for bronchiolitis obliterans syndrome and two for interstitial lung disease. Of these, only one had died at last follow-up. The cumulative incidence of grade II-IV acute GvHD was 21% (95% CI 14-33%). At 1 year, the cumulative incidence of chronic GvHD was 26% (95% CI 18-39%). Non-relapse mortality was 9% (95% CI 4-18%) at 100 days and 14% (95% CI 8-24%) at 1 year. Relapse incidence was 3% (95% CI 1-10%) and 14% (95% CI 8-24%) at 100 days and 1 year, respectively. Overall survival was 73% (95% CI 62-82%). In all, 22 patients died. Cause of death was relapse of hematological disease in 7 (35%), infection in 7 (35%), GvHD in 2 (9%), multi organ failure in 4 (20%) and other causes in 2. Conclusion: We observed a significantly impaired DLCO at baseline, which remained impaired at 3 months and 1 year after HAPLO, but with a substantial stable pulmonary function at 1 year. Disclosures Malard: Theralos/Mallinckrodt: Honoraria; Sanofi: Honoraria; Keocyt: Honoraria; Astellas: Honoraria; JAZZ pharmaceutical: Honoraria; Biocodex: Honoraria; Janssen: Honoraria.
Published: 2021

14. Early Cardiac Toxicity Associated With Post-Transplant Cyclophosphamide in Allogeneic Stem Cell Transplantation

Author: Anne Banet, Ollivier Legrand, Tounes Ledraa, Simona Lapusan, Annalisa Paviglianiti, Giorgia Battipaglia, Florent Malard, Rosa Adaeva, Clemence Mediavilla, Simona Sestili, Anne Vekhoff, Eolia Brissot, Agnès Bonnin, Razan Mohty, Françoise Isnard, Ramdane Belhocine, Stéphane Ederhy, M. Labopin, Mohamad Mohty, Ariel Cohen, Zoé Van de Wyngaert, Remy Dulery, Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CEREST-TC [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Service de Cardiologie [CHU Saint-Antoine], Gestionnaire, Hal Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Oncology, CVRF, cardiovascular risk factor, medicine.medical_specialty, Standard of care, Cyclophosphamide, Post transplant cyclophosphamide, post-transplant cyclophosphamide, medicine.medical_treatment, [SDV]Life Sciences [q-bio], cardiotoxicity, Hematopoietic stem cell transplantation, CVD, cardiovascular disease, GVHD, graft-versus-host disease, 03 medical and health sciences, HSCT, hematopoietic stem cell transplantation, PT-Cy, post-transplant cyclophosphamide, 0302 clinical medicine, allogeneic stem cell transplantation, Cardiac toxicity, Internal medicine, LVEF, left ventricular ejection fraction, medicine, haploidentical transplantation, Original Research, Cardiotoxicity, LVSD, left ventricular systolic dysfunction, business.industry, HR, hazard ratio, 3. Good health, [SDV] Life Sciences [q-bio], Transplantation, CI, confidence interval, ECE, early cardiac events, surgical procedures, operative, 030220 oncology & carcinogenesis, Stem cell, Cardiology and Cardiovascular Medicine, business, Cy, cyclophosphamide, GRFS, graft-versus-host disease-free, relapse-free survival, left ventricular systolic dysfunction, 030215 immunology, medicine.drug
Abstract: Background Post-transplant cyclophosphamide (PT-Cy) has become a standard of care in haploidentical hematopoietic stem cell transplantation (HSCT) to reduce the risk of graft-versus-host disease. However, data on cardiac events associated with PT-Cy are scarce. Objectives This study sought to assess the incidence and clinical features of cardiac events associated with PT-Cy. Methods The study compared clinical outcomes between patients who received PT-Cy (n = 136) and patients who did not (n = 195), with a focus on early cardiac events (ECE) occurring within the first 100 days after HSCT. All patients had the same systematic cardiac monitoring. Results The cumulative incidence of ECE was 19% in the PT-Cy group and 6% in the no–PT-Cy group (p < 0.001). The main ECE occurring after PT-Cy were left ventricular systolic dysfunction (13%), acute pulmonary edema (7%), pericarditis (4%), arrhythmia (3%), and acute coronary syndrome (2%). Cardiovascular risk factors were not associated with ECE. In multivariable analysis, the use of PT-Cy was associated with ECE (hazard ratio: 2.7; 95% confidence interval: 1.4 to 4.9; p = 0.002]. Older age, sequential conditioning regimen, and Cy exposure before HSCT were also associated with a higher incidence of ECE. Finally, a history of cardiac events before HSCT and ECE had a detrimental impact on overall survival. Conclusions PT-Cy is associated with a higher incidence of ECE occurring within the first 100 days after HSCT. Patients who have a cardiac event after HSCT have lower overall survival. These results may help to improve the selection of patients who are eligible to undergo HSCT with PT-Cy, especially older adult patients and patients with previous exposure to Cy., Central Illustration
Published: 2021

15. Does Ibrutinib impact outcomes of viral infection by SARS-CoV-2 in mantle cell lymphoma patients?

Author: Sylvia Faict, Fella M'hammedi-Bouzina, Anne Banet, Eolia Brissot, Simona Lapusan, Louis Schaeffer, Ollivier Legrand, Remy Dulery, Zoé Van de Wyngaert, Elise Corre, Alexis Genthon, Zora Marjanovic, Souhila Ikhlef, Simona Sestili, Tamim Alsuliman, Mohamad Mohty, Florent Malard, Hematology, and Faculty of Medicine and Pharmacy
Subjects: 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), General Medicine, medicine.disease, Virology, Viral infection, General Biochemistry, Genetics and Molecular Biology, Lymphoma, chemistry.chemical_compound, chemistry, Ibrutinib, medicine, Mantle cell lymphoma, business, Agammaglobulinaemia tyrosine kinase, Letter to the Editor
Published: 2021

16. Gemtuzumab Ozogamicin Combined With Intensive Chemotherapy in Patients With Acute Myeloid Leukemia Relapsing After Allogenic Stem Cell Transplantation

Author: Rosa Adaeva, Souhila Ikhlef, Simona Lapusan, Annalisa Paviglianiti, Simona Sestili, Mohamad Mohty, Remy Dulery, Alexis Genthon, Fella M. ’Hammedi-Bouzina, Eolia Brissot, Ollivier Legrand, Myriam Labopin, Agnès Bonnin, Florent Malard, Elise Corre, Zoé Van de Wyngaert, Zora Marjanovic, Anne Banet, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CCSD, Accord Elsevier, Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: Adult, Oncology, Cancer Research, medicine.medical_specialty, Adolescent, Gemtuzumab ozogamicin, [SDV]Life Sciences [q-bio], CD33, Salvage therapy, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, Antineoplastic Agents, Immunological, 0302 clinical medicine, Recurrence, hemic and lymphatic diseases, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Calicheamicin, Humans, Transplantation, Homologous, Medicine, Aged, business.industry, Myeloid leukemia, Hematology, Middle Aged, Gemtuzumab, 3. Good health, [SDV] Life Sciences [q-bio], Transplantation, Leukemia, Myeloid, Acute, chemistry, 030220 oncology & carcinogenesis, Monoclonal, Toxicity, business, 030215 immunology, medicine.drug
Abstract: Background More than one-third of patients with acute myeloid leukemia (AML) will relapse after allogenic hematopoietic cell transplant (allo-HCT). The main challenge is to overcome disease resistance to achieve a new complete remission while avoiding excessive toxicity. Gemtuzumab ozogamicin (GO), a conjugate of calicheamicin linked to the humanized monoclonal anti-CD33 antibody, has been used for refractory or relapsed AML with promising response rates, but liver toxicity of GO has long been considered a limiting factor. Patients and Methods We included 18 consecutive patients with AML relapsing after a first allo-HCT and treated with fractioned GO (fGO) and intensive chemotherapy. The median age was 40 years (range, 18-65). Results The overall response rate was 72% (13/18), including 7 complete remissions. No death was attributed to treatment toxicity. The main liver toxicity was transient and consisted of transaminase level elevation and hyperbilirubinemia. No cases of veno-occlusive disease were observed after the GO treatment. From the time of salvage treatment initiation, 1- and 2-year OS rates were 54% (95% confidence interval, 28%-74%) and 42% (95% confidence interval, 19%-63%), respectively. Conclusions Our study suggests the feasibility, efficacy, and safety of an fGO-based salvage regimen combined with intensive chemotherapy in patients with CD33+ AML in the case of early relapse after an allo-HCT.
Published: 2020

17. Pulmonary Alveolar Proteinosis After Allogeneic Hematopoietic Stem-Cell Transplantation in Adults: A French Société Francophone de Greffe de Moelle et Thérapie Cellulaire Survey

Author: Helene, Salvator, Colas, Tcherakian, Natacha, Maillard, Serge, Milin, Anne, Bergeron, Louise, Bondeelle, Veronique, Meignin, Stephanie, Nguyen, Laetitia, Souchet, Sarah, Guenounou, Solène M, Evrard, Marie-Therese, Rubio, Marie, Robin, Simona, Sestili, Eolia, Brissot, Anne, Fajac, Emilie, Catherinot, Claire, Givel, Alexandre, Chabrol, Céline, Goyard, Elisabeth, Longchampt, Marie-Laure, Chabi-Charvillat, Jean-Francois, Bernaudin, and Louis-Jean, Couderc
Subjects: Male, Biopsy, Hematopoietic Stem Cell Transplantation, Middle Aged, Periodic Acid-Schiff Reaction, Pulmonary Alveolar Proteinosis, Transplantation, Autologous, Patient Care Management, Respiratory Function Tests, Leukemia, Myeloid, Myelodysplastic Syndromes, Macrophages, Alveolar, Humans, Female, Tomography, X-Ray Computed, Bronchoalveolar Lavage Fluid, Lung, Immunosuppressive Agents, Retrospective Studies
Published: 2020

18. Extracorporeal photopheresis as first line strategy in the treatment of acute graftversus-host disease after haematopoietic stem cell transplantation: a single centre experience

Author: Giorgia Battipaglia, Remy Dulery, Clemence Mediavilla, Zoé Van de Wyngaert, Tounes Ledraa, Florent Malard, Annalisa Paviglianiti, Anne Banet, Eolia Brissot, Mohamad Mohty, Sandra Eder, Simona Sestili, Ramdane Belhocine, Agnes Bonin, Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHRU Brest - Service d'Hématologie (CHU-Brest-Hemato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Gestionnaire, HAL Sorbonne Université 5, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sestili, S., Eder, S., Belhocine, R., Dulery, R., Battipaglia, G., Brissot, E., Mediavilla, C., Banet, A., van de Wyngaert, Z., Paviglianiti, A., Ledraa, T., Bonin, A., Mohty, M., and Malard, F.
Subjects: 0301 basic medicine, [SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, Male, Cancer Research, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, Single Center, Gastroenterology, Graft-versus-host disease, 0302 clinical medicine, Photopheresis, Prednisone, Extracorporeal Photopheresis, Immunology and Allergy, Genetics (clinical), Remission Induction, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Middle Aged, 3. Good health, Treatment Outcome, photopheresis, Oncology, 030220 oncology & carcinogenesis, Acute Disease, hematopoietic stem cell transplantation, Female, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Immunology, acute GVHD, 03 medical and health sciences, Young Adult, Internal medicine, Acute graft versus host disease, medicine, Humans, Transplantation, Homologous, Aged, Retrospective Studies, Transplantation, business.industry, Retrospective cohort study, Cell Biology, medicine.disease, Survival Analysis, 030104 developmental biology, Chronic Disease, business
Abstract: International audience; Background aims: Corticosteroids are the standard first-line treatment for acute graft-versus-host disease (aGVHD), but they are associated with many complications, and less than half of patients have a sustained response.Methods: To improve outcomes, we performed a retrospective study to analyze the efficacy of the addition of extracorporeal photopheresis (ECP) to low-dose corticosteroids in 37 adult patients (median age, 57 years) with skin-predominant aGVHD (grade I, n = 17; grade II, n = 18; and grade III, n = 2). All patients received ECP in combination with 1 mg/kg prednisone (n = 26) or topical steroids (n = 11).Results: Overall response rate was 81% after a median of three ECP procedures (range, 2–8), including 22 complete responses (CR, 59%) and eight very good partial responses (VGPR, 22%). The 11 patients treated with topical corticosteroids achieved CR. Furthermore, 16 (62%) patients reached prednisone withdrawal at a median of 100 days (range, 42–174 days) after its initiation. Eighteen patients developed chronic GVHD (cGVHD); 11 of them (who were in CR of aGVHD) had a new-onset cGVHD, and seven experienced progressive cGVHD (five non-responding and two VGPR patients). A second-line immunosuppressive treatment was initiated in only five (14%) non-responding patients. With a median follow-up of 31 months (range, 6–57 months) 2-year overall survival and non-relapse mortality were 74% and 11%, respectively.Conclusions: Overall, the combination of low-dose corticosteroids and ECP appear to be safe and effective for first-line treatment of skin predominant aGVHD.
Published: 2020

19. High-dose post-transplant cyclophosphamide impairs γδ T-cell reconstitution after haploidentical haematopoietic stem cell transplantation using low-dose antithymocyte globulin and peripheral blood stem cell graft

Author: Simona Sestili, Myriam Labopin, Giorgia Battipaglia, Zoé Van de Wyngaert, Tounes Ledraa, Agathe Farge, Yishan Ye, Eolia Brissot, Anne Banet, Clemence Mediavilla, Laure Ricard, Mohamad Mohty, Nicolas Stocker, Florent Malard, Annalisa Paviglianiti, Remy Dulery, and Béatrice Gaugler
Subjects: lcsh:Immunologic diseases. Allergy, haploidentical haematopoietic cell transplantation, Cyclophosphamide, T cell, Immunology, medicine.disease_cause, Virus, Epstein–Barr virus, post‐transplantation cyclophosphamide, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, General Nursing, γδ T cell, business.industry, immune reconstitution, Transplantation, Haematopoiesis, medicine.anatomical_structure, allogeneic haematopoietic cell transplantation, 030220 oncology & carcinogenesis, Original Article, Stem cell, business, lcsh:RC581-607, Viral load, 030215 immunology, medicine.drug
Abstract: Objectives Haploidentical haematopoietic cell transplantation (Haplo‐HCT) using peripheral blood stem cell (PBSC) grafts and post‐transplant cyclophosphamide (PTCy) is being increasingly used; however, data on immunological reconstitution (IR) are still scarce. Methods This retrospective study evaluated T‐cell immunological reconstitution in 106 adult patients who underwent allogeneic haematopoietic cell transplantation for haematologic malignancies between 2013 and 2016. Results At D30, while conventional T cells reached similar median counts in Haplo‐HCT recipients (n = 19) and controls (n = 87), γδ and Vδ2+ T‐cell median counts were significantly lower in Haplo‐HCT recipients and it persists at least until D360 for Vδ2+ T cells. PTCy induces a significant reduction in early γδ and Vδ2+ T‐cell proliferation at D 7. At one year, the rate of increase in Epstein–Barr virus (EBV) viral load was significantly higher in Haplo‐HCT recipients as compared to controls (61% versus 34%, P = 0.02). In multivariate analysis, a higher γδ T‐cell count (> 4.63 μL−1) at D30 was the only independent parameter significantly associated with a reduced risk of increase in EBV viral load (RR 0.34; 95% CI, 0.15–0.76, P = 0.009). Conclusion Immunological reconstitution of γδ T cells is significantly delayed after Haplo‐HCT using PTCy and low‐dose ATG and is associated with an increased risk of increase in EBV viral load., In this study, immune reconstitution analyses with flow cytometry observed an impaired γ/δ and Vδ2+ T‐cell reconstitution following haploidentical haematopoietic cell transplantation using peripheral blood stem cell grafts and post‐transplant cyclophosphamide (PTCy). PTCy induces a significant reduction in early proliferation of γ/δ and Vδ2+ T‐cell subsets while impaired γ/δ T‐cell recovery was associated with an increased risk of increase in Epstein–Barr virus load.
Published: 2020

20. Thiotepa and antithymocyte globulin-based conditioning prior to haploidentical transplantation with posttransplant cyclophosphamide in high-risk hematological malignancies

Author: Giorgia Battipaglia, Marie-Thérèse Rubio, Eolia Brissot, Myriam Labopin, Tounes Ledraa, Remy Dulery, Françoise Isnard, Anne Vekhoff, Juliana Bastos, Ollivier Legrand, Mohamad Mohty, Simona Sestili, Federica Giannotti, Zinaida Peric, Ramdane Belhocine, Razan Mohty, Annalisa Ruggeri, Simona Lapusan, Clemence Mediavilla, Agnès Bonnin, Florent Malard, Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Peric, Z., Mohty, R., Bastos, J., Brissot, E., Battipaglia, G., Belhocine, R., Sestili, S., Giannotti, F., Vekhoff, A., Ledraa, T., Legrand, O., Lapusan, S., Isnard, F., Labopin, M., Bonnin, A., Mediavilla, C., Rubio, M. -T., Ruggeri, A., Dulery, R., Malard, F., and Mohty, M.
Subjects: medicine.medical_specialty, Transplantation Conditioning, Cyclophosphamide, Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, ThioTEPA, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Refractory, Internal medicine, medicine, Humans, ComputingMilieux_MISCELLANEOUS, Antilymphocyte Serum, Transplantation, Neutrophil Engraftment, Hematologic Neoplasms / therapy, business.industry, Incidence (epidemiology), Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, 3. Good health, Regimen, surgical procedures, operative, 030220 oncology & carcinogenesis, Hematologic Neoplasms, Transplantation, Haploidentical, [SDV.IMM]Life Sciences [q-bio]/Immunology, Stem cell, Neoplasm Recurrence, Local, business, Graft vs Host Disease / prevention & control, Thiotepa, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030215 immunology, medicine.drug
Abstract: We report results of a thiotepa-based conditioning in haploidentical stem cell transplantation (haplo-SCT) with posttransplant cyclophosphamide (PT-CY) and antithymocyte globulin (ATG), for unmanipulated peripheral blood stem cell (PBSC) transplants, in 80 patients with hematological malignancies. Patients in complete remission (CR) received a thiotepa-busulfan-fludarabine (TBF) regimen, while patients with relapsed/refractory (R/R) malignancies received a sequential regimen consisting of thiotepa-etoposide-cyclophosphamide (TEC) and reduced-intensity conditioning (RIC). The median age was 52 (range, 17-72) years, 44% patients had R/R disease at transplant, and the median follow-up was 417 (range, 180-1595) days. The median days to neutrophil engraftment was 17 (range, 12-34). The cumulative incidences (CI) of acute graft-versus-host disease (GVHD) grade III to IV, severe chronic GVHD, nonrelapse mortality (NRM), and relapse were 16%, 16%, 26, and 26%, respectively. The 2-year overall survival (OS) and disease-free survival (DFS) were 53% and 47%, respectively. There were no significant differences between the patients in CR and R/R patients in terms of engraftment, GVHD, NRM, relapse, OS, or DFS. We conclude that thiotepa-based regimen with PT-CY can be modified with PBSC and ATG, still providing low toxicity, protection against GVHD, and low relapse incidence. Particularly encouraging are the results with the modification to sequential regimen in R/R patients.
Published: 2020

21. T-cell-depleted haploidentical stem cell transplantation results improve with time in adults with acute leukemia: A study from the Acute Leukemia Working Party of the European Society of Blood and Marrow Transplantation (EBMT)

Author: Franco Aversa, Donald Bunjes, Simona Sestili, Fabio Ciceri, Philippe Lewalle, Mohamad Mohty, Arnon Nagler, Lothar Kanz, Johan Maertens, Myriam Labopin, Andrea Velardi, and Annalisa Ruggeri
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, Time Factors, Transplantation Conditioning, T-Lymphocytes, Graft vs Host Disease, Gastroenterology, Disease-Free Survival, Lymphocyte Depletion, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Cumulative incidence, Mortality, Survival rate, Acute leukemia, business.industry, Incidence, Incidence (epidemiology), Remission Induction, Hazard ratio, Hematopoietic Stem Cell Transplantation, Myeloid leukemia, Middle Aged, Survival Rate, Transplantation, Leukemia, Myeloid, Acute, Regimen, Oncology, 030220 oncology & carcinogenesis, Transplantation, Haploidentical, Female, Neoplasm Recurrence, Local, business, Follow-Up Studies, 030215 immunology
Abstract: Background T-cell-depleted, haploidentical transplantations (haplos) are commonly offered to patients who have high-risk, acute leukemia in the absence of a human leukocyte antigen (HLA) full-matched donor. Methods To determine the effect of transplantation period, the authors divided 308 adults with de novo, acute leukemia who underwent T-cell-depleted haplo from 2005 to 2015 into 2 groups, according the year in which they underwent transplantation (2005-2011 [n = 191] and 2012-2015 [n = 117]). Results The median age was 41 years in patients who underwent transplantation before 2012 and 46 years in those who underwent transplantation after 2012 (P = .04). Most patients had acute myeloid leukemia (75% vs 69%; P = .26) and were in first complete remission (CR1) (55% vs 64%; P = .12) at the time of transplantation. The cumulative incidence of grade 2, 3, and 4 acute graft-versus-host disease (GvHD) and chronic GvHD were not different between the 2 groups (acute GvHD: 20% vs 22% cumulative incidence in patients who underwent haplo before and after 2012, respectively [P = .67]; chronic GvHD: 19% vs 11% cumulative incidence, respectively; P = .12]. The 2-year relapse incidence was 20%, the nonrelapse mortality (NRM) rate was 48%, and no difference was observed over time (21% vs 19% [P = .72] and 54% vs 38% [P = .11] for patients who underwent haplo before and after 2012, respectively). The main cause of NRM was infection. Haplo after 2012 (hazard ratio [HR], 0.57; P = .01), younger age (HR, 0.82; P = .02), and receipt of a reduced-intensity conditioning (RIC) regimen (HR, 0.53; P = .01) were independently associated with lower NRM. The 2-year overall survival rate was 36% and improved after 2012 (29% vs 47% before 2012; P = .02); and it was higher for patients who underwent transplantation in CR1 (41% vs 29%; P = .01). In multivariate analysis, haplo after 2012 (HR, 0.54; P = .003) and receipt of a RIC regimen (HR, 0.54; P = .005) were independently associated with better overall survival. Similarly, leukemia-free survival and GvHD-free/relapse-free survival (GRFS) improved over time: the leukemia-free survival rate was 31% (25% vs 43% in the groups who underwent transplantation before and after 2012, respectively; P = .05), and the GRFS rate was 24% (19% vs 34%, respectively; P = .09). In addition, leukemia-free survival and GRFS improved among patients who received a RIC regimen. Conclusions The outcome of patients with acute leukemia who underwent T-cell-depleted haplo has improved over time. Cancer 2018;124:2142-50. © 2018 American Cancer Society.
Published: 2018

22. Sequential Conditioning Regimen with Thiotepa in Allogeneic Hematopoietic Cell Transplantation for the Treatment of Refractory Myeloid Malignancies

Author: Michele Wieczorek, Ollivier Legrand, Ramdane Belhocine, Anne Vekhoff, Zoé Van de Wyngaert, Alexis Genthon, Simona Sestili, Nadia Belmoufid, Rémy Duléry, Vera Radici, Agnès Bonnin, Mohamad Mohty, Simona Lapusan, Myriam Labopin, Pierre Fenaux, Florent Malard, Eolia Brissot, Nicolas Stocker, Tounes Ledraa, Mara Memoli, and Anne Banet
Subjects: Myeloid, Hematopoietic cell, business.industry, Immunology, Cell Biology, Hematology, ThioTEPA, Biochemistry, Conditioning regimen, Transplantation, medicine.anatomical_structure, Refractory, medicine, Cancer research, business, medicine.drug
Abstract: Introduction The outcome of conventional allogeneic hematopoietic cell transplantation (HCT) for the treatment of patients with refractory myeloid malignancies remains poor. Thiotepa-based sequential conditioning has shown promising results for various refractory hematological malignancies (Duléry R et al. Biol Blood Marrow Transplant. 2018; 24(5):1013-1021). However, no study has evaluated the outcome of this sequential approach specifically in refractory myeloid malignancies. The optimal dose of chemotherapeutic agents used in the conditioning regimen and the feasibility of this sequential approach in patients aged 60 years and above also need to be assessed. Methods All consecutive patients with refractory myeloid malignancy who underwent allogeneic HCT with a thiotepa-based sequential conditioning regimen in Saint Antoine hospital between April 2013 and October 2020 were included. The sequential approach consisted of a broad spectrum cytoreduction with thiotepa, etoposide, and cyclophosphamide (TEC) from day -15 to -10. Then, after a 3-day rest, a reduced-intensity conditioning (RIC) regimen was administered with fludarabine 150 mg/m 2, intravenous busulfan 6.4 mg/kg and thymoglobulin 5 mg/kg from day -6 to -2. From 2013 to 2018, doses of thiotepa (10 mg/kg), etoposide (400 mg/m 2) and/or cyclophosphamide (1600 mg/m 2) could be reduced in patients older than 60 years or with comorbidities. Since September 2018, the use of a reduced TEC-RIC regimen (thiotepa at 5 mg/kg, etoposide 300 mg/m 2 and cyclophosphamide 1200 mg/m 2 from day -13 to -10) became the new standard of care for all patients. After transplant, patients could receive a hypomethylating agent or targeted therapy to prevent relapse. Prophylactic donor lymphocyte infusions were given to enhance the graft-versus-leukemia effect, in the absence of contraindication. Graft-versus-host disease (GVHD) prophylaxis was cyclosporine A and mycophenolate mofetil for all patients. Post-transplant cyclophosphamide was added in the case of haploidentical HCT. Results Seventy-one patients (median age 61 years, range 15-76) were included. Diagnoses comprised acute myeloblastic leukemia (n=65) and myelodysplastic syndrome/chronic myelomonocytic leukemia (n=6). Donors were haploidentical (n=36), matched related (n=13), unrelated (n=21) and umbilical cord blood (n=1). A reduced TEC-RIC was administrated to 43 (61%) patients, a full dose TEC-RIC to 18 (25%), and a TEC-RIC with a dose reduction only for thiotepa to 10 (14%). With a median follow-up of 45.4 months (95% CI: 36.7-63.6), the 2-year overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM) were 51%, 41%, and 24%, respectively. Patients receiving a reduced TEC-RIC had a lower cumulative incidence of acute and chronic GVHD (acute grade II-IV GVHD: 14%, acute grade III-IV GVHD: 0%, chronic GVHD: 19%) than the other patients (acute grade II-IV GVHD: 29%, acute grade III-IV GVHD: 18%, chronic GVHD: 29%). The outcomes were not significantly different according to the TEC dose in terms of relapse incidence, OS, and PFS, although the NRM was lower with the reduced TEC-RIC (21% versus 28%, p=0.72). Most notably, patients aged 60 years and above had a 2-year OS and PFS of 48% and 39%, respectively, with no significant difference compared to patients younger than 60 years (Figure). Conclusion Our findings endorse the feasibility and efficacy of a thiotepa-based sequential approach for refractory myeloid malignancies undergoing HCT. The dose reduction did not compromise disease control and expanded the transplant option to older patients, ineligible for a higher dose regimen. Thus, a reduced TEC-RIC sequential regimen can be proposed for selected patients older than 60 years and allows promising outcomes for the treatment of refractory myeloid malignancies. Figure 1 Figure 1. Disclosures Duléry: Gilead: Other: travel support and meeting fees; Takeda: Consultancy; Novartis: Honoraria. Malard: Therakos/Mallinckrodt: Honoraria; Biocodex: Honoraria; Astellas: Honoraria; JAZZ pharmaceuticals: Honoraria; Sanofi: Honoraria; Janssen: Honoraria. Legrand: Servier: Consultancy. Fenaux: Abbvie: Honoraria, Research Funding; JAZZ: Honoraria, Research Funding; Celgene/BMS: Honoraria, Research Funding; Novartis: Honoraria, Research Funding; Takeda: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Syros Pharmaceuticals: Honoraria. Labopin: Jazz Pharmaceuticals: Honoraria. Mohty: Sanofi: Honoraria, Research Funding; Pfizer: Honoraria; Novartis: Honoraria; Takeda: Honoraria; Jazz: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Gilead: Honoraria; Celgene: Honoraria, Research Funding; Bristol Myers Squibb: Honoraria; Astellas: Honoraria; Amgen: Honoraria; Adaptive Biotechnologies: Honoraria.
Published: 2021

23. Tolerability and Efficacy of Treatment With Azacytidine as Prophylactic or Preemptive Therapy for Myeloid Neoplasms After Allogeneic Stem Cell Transplantation

Author: Zoé van de Wiegert, Clemence Mediavilla, Mohamad Mohty, Tounes Ledraa, Giorgia Battipaglia, Anne Vekhoff, Eolia Brissot, Agnès Bonnin, Remy Dulery, Abdulhamid Bazarbachi, Simona Lapusan, Annalisa Paviglianiti, Ollivier Legrand, Annalisa Ruggeri, Françoise Isnard, Anne Bannet, Florent Malard, Simona Sestili, Ramdane Belhocine, Carolina Marini, Rosa Adaeva, Myriam Labopin, Marini, C., Brissot, E., Bazarbachi, A., Dulery, R., Sestili, S., Battipaglia, G., Mediavilla, C., Paviglianiti, A., Belhocine, R., Isnard, F., Lapusan, S., Adaeva, R., Bannet, A., van de Wiegert, Z., Vekhoff, A., Ledraa, T., Legrand, O., Labopin, M., Bonnin, A., Ruggeri, A., Malard, F., and Mohty, M.
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, Myeloid, Allogeneic transplantation, Adolescent, Lymphocyte, Posttransplantation, Disease, Prophylaxy, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Acute myeloid leukemia, Myeloproliferative Disorders, business.industry, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, Allografts, Discontinuation, Transplantation, Low burden disease, medicine.anatomical_structure, Oncology, Tolerability, 030220 oncology & carcinogenesis, Hematologic Neoplasms, Azacitidine, Female, Stem cell, business, Myelodysplastic syndrome, 030215 immunology, Follow-Up Studies
Abstract: Introduction/Background Azacytidine (AZA) has been used as a promising treatment for relapse after allogeneic transplantation. A clear benefit has been demonstrated when treating patients with a reduced disease burden, thus a prophylactic and preemptive approach to these patients has emerged. Materials and Methods We retrospectively analyzed patients with myeloid malignancies treated with azacytidine in the posttransplantation setting between September 2013 and April 2018 in a single tertiary care hospital. Of 32 patients analyzed, 21 were treated for prophylactic use and 11 preemptively, with a median follow-up of 20 months. Prophylactic treatment consisted of AZA at 32 mg/m2 for 5 days every 28 days, and preemptive treatment of AZA 75 mg/m2 for 5 or 7 days per cycle. In addition, 10 patients received one or more donor lymphocyte infusions (DLIs). Two patients presented with infectious complications demanding hospitalization, and 13 patients (10 in the prophylactic group and 3 in the preemptive group) presented graft-versus-host disease (GvHD). Of patients who had GvHD, 3 needed treatment discontinuation. Overall, 12 patients suspended treatment, 8 for disease progression and 1 due to patient request. Results In the prophylactic group, all patients are alive at 1 year with an event-free survival (EFS) of 95%, as only 1 patient relapsed. In the preemptive group, 1-year EFS was 54% and 1-year overall survival was 82%. Conclusion Low-dose AZA in posttransplantation patients with myeloid neoplasms is a well-tolerated therapy with the potential to prevent relapse and maintain stable remissions. Randomized prospective trials are needed to determine patient selection and dosage, timing, and duration of treatment.
Published: 2019

24. Thiotepa, Busulfan, and Fludarabine Conditioning Regimen in T Cell-Replete HLA-Haploidentical Hematopoietic Stem Cell Transplantation

Author: Anne Banet, Eolia Brissot, Tounes Ledraa, Florent Malard, Simona Lapusan, Giorgia Battipaglia, Annalisa Ruggeri, Zoé Van de Wyngaert, Rosa Adaeva, Ollivier Legrand, Annalisa Paviglianiti, Marie-Thérèse Rubio, Anne Vekhoff, Federica Giannotti, Juliana Bastos, Françoise Isnard, Mohamad Mohty, Clémence Médiavilla, Simona Sestili, Ramdane Belhocine, Remy Dulery, Dulery, R., Bastos, J., Paviglianiti, A., Malard, F., Brissot, E., Battipaglia, G., Mediavilla, C., Giannotti, F., Banet, A., de Wyngaert, Z. V., Ledraa, T., Belhocine, R., Sestili, S., Adaeva, R., Lapusan, S., Isnard, F., Legrand, O., Vekhoff, A., Rubio, M. -T., Ruggeri, A., Mohty, M., Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospital de São João [Porto], and Sorbonne Université (SU)
Subjects: Male, Transplantation Conditioning, Haploidentical transplantation, medicine.medical_treatment, T-Lymphocytes, Graft vs Host Disease, Hematopoietic stem cell transplantation, Gastroenterology, Graft-versus-host disease, 0302 clinical medicine, Thiotepa/administration & dosage, HLA Antigens, Medicine, Cumulative incidence, ComputingMilieux_MISCELLANEOUS, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, 3. Good health, Fludarabine, Survival Rate, surgical procedures, operative, 030220 oncology & carcinogenesis, Hematologic Neoplasms, Cyclosporine, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Vidarabine/administration & dosage/analogs & derivatives, Vidarabine, medicine.drug, Graft vs Host Disease/metabolism/mortality/pathology/prevention & control, Busulfan/administration & dosage, Adult, medicine.medical_specialty, Adolescent, Hematologic Neoplasms/metabolism/mortality/pathology/therapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, ThioTEPA, Cyclosporine/administration & dosage, Disease-Free Survival, Mycophenolic Acid/administration & dosage, 03 medical and health sciences, Internal medicine, Humans, Busulfan, Aged, Retrospective Studies, Transplantation, Neutrophil Engraftment, business.industry, Myelodysplastic syndromes, Mycophenolic Acid, medicine.disease, T-Lymphocytes/metabolism/pathology, Antithymocyte globulin, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Thiotepa, 030215 immunology, Conditioning
Abstract: We report the outcomes of 51 patients who underwent unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide (PT-Cy) and antithymocyte globulin (ATG), from peripheral blood stem cells (PBSCs) or bone marrow, after receipt of a TBF (thiotepa, busulfan, and fludarabine) conditioning regimen. Their median age was 55 years (range, 16 to 72 years). Hematologic diagnoses included acute leukemias (n = 31), lymphoid neoplasm (n = 12), myeloproliferative neoplasm (n = 5), and myelodysplastic syndromes (n = 3). Thirty-seven patients (73%) were in complete remission. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate for all patients, associated with ATG in 39 patients (76.5%). The median time to neutrophil engraftment was 17 days (range, 12 to 34 days). The cumulative incidences of grade II-IV and grade III-IV acute GVHD were 27.5% and 14%, respectively. In patients receiving a PBSC graft and ATG prophylaxis, grade II-IV aGVHD occurred in 16% of patients. The use of ATG and a lower thiotepa dose (5 mg/kg versus 10 mg/kg) were associated with a reduced cumulative incidence of grade II-IV acute GVHD (P = .03 and .005, respectively). The 2-year cumulative incidence of chronic GVHD was 29% and was significantly reduced to 13% with the lower thiotepa dose (P = .002). After a median follow-up of 25 months (range, 12 to 62 months), the cumulative incidences of nonrelapse mortality, relapse, overall survival (OS), disease-free survival (DFS), and GVHD-free, relapse-free survival (GFRFS) were 20%, 22.5%, 67%, 58%, and 51%, respectively. Pretransplantation disease status (complete remission versus others) was the main factor associated with OS, DFS, and GFRFS. In conclusion, the TBF conditioning regimen is an appealing platform in the haplo-HSCT setting with PT-Cy in terms of engraftment rate, toxicity, and disease control. We found no benefit of a thiotepa dose of 10 mg/kg compared with a dose of 5 mg/kg. ATG reduced the risk of acute GVHD without comprising outcomes.
Published: 2019

25. CD34+-selected stem cell 'Boost' for poor graft function after allogeneic hematopoietic stem cell transplantation

Author: Annalisa Ruggeri, Florent Malard, Mohamad Mohty, Remy Dulery, R Mohty, Giorgia Battipaglia, Eolia Brissot, Simona Sestili, R. Belhocine, C Mediavilla, Mohty, R., Brissot, E., Battipaglia, G., Ruggeri, A., Sestili, S., Mediavilla, C., Belhocine, R., Dulery, R., Mohty, M., and Malard, F.
Subjects: business.industry, medicine.medical_treatment, CD34, CD34+ selected stem cell, General Medicine, Hematopoietic stem cell transplantation, Graft function, General Biochemistry, Genetics and Molecular Biology, Allogeneic hematopoietic stem cell transplantation, medicine, Cancer research, Poor graft function, Stem cell, business, Boost
Published: 2019

26. Implementation of the Frailty Index in hospitalized older patients: Results from the REPOSI register

Author: Matteo, Cesari, Carlotta, Franchi, Laura, Cortesi, Alessandro, Nobili, Ilaria, Ardoino, Pier Mannuccio Mannucci, Mauro, Tettamanti, Luca, Pasina, Francesco, Perticone, Francesco, Salerno, Salvatore, Corrao, Alessandra, Marengoni, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Giovanna, Lanzo, Sarah, Astuto, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Olivieri, Oliviero, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Marta, Mancarella, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Giulia, Bonini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Chiara, Pes, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Gabriella, D'Aurizio, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Hajnalka, Szabo, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Annalisa, Amabile, Elisabetta, Omenetto, Paolo, Scarinzi, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Ilaria, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Pasquale, Agosti, Flavia, Fontana, Francesca, Loparco, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Slivia, Tiraboschi, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Giada, Pallini, Miriam, Valenti, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Francesca, Veltri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Lidia, Colangelo, Tania, Falbo, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Benzoni, Ilaria, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Giampaolo, Damiani, William, Capeci, Mattioli, Massimo, Giuseppe Pio Martino, Biondi, Lorenzo, Monica, Ormas, Pietro, Pettinari, Roberto, Romiti, Silvia, Messina, Federica, Cavallaro, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Sara Carrascosa Garcia, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Cesari M., Franchi C., Cortesi L., Nobili A., Ardoino I., Mannucci P.M., Tettamanti M., Pasina L., Perticone F., Salerno F., Corrao S., Marengoni A., Licata G., Violi F., Corazza G.R., Eldin T.K., Di Blanca M.P.D., Lanzo G., Astuto S., Prisco D., Silvestri E., Cenci C., Emmi G., Biolo G., Guarnieri G., Zanetti M., Fernandes G., Chiuch M., Vanoli M., Grignani G., Casella G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Mannarino E., Lupattelli G., Bianconi V., Paciullo F., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Salvatore T., Sasso F.C., Girelli D., Olivieri O., Matteazzi T., Barbagallo M., Plances L., Alcamo R., Calvo L., Valenti M., Zoli M., Arno R., Pasini F.L., Capecchi P.L., Bicchi M., Palasciano G., Modeo M.E., Peragine M., Pappagallo F., Pugliese S., Gennaro C.D., Postiglione A., Barbella M.R., De Stefano F., Cappellini M.D., Fabio G., Seghezzi S., De Amicis M.M., Mancarella M., Mari D., Rossi P.D., Damanti S., Ottolini B.B., Bonini G., Miceli E., Lenti M.V., Padula D., Murialdo G., Marra A., Cattaneo F., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Davi G., Guagnano M.T., Sestili S., Mancuso G., Calipari D., Bartone M., Meroni M.R., Perin P.C., Lorenzati B., Gruden G., Bruno G., Amione C., Fornengo P., Tassara R., Melis D., Rebella L., Delitala G., Pretti V., Masala M.S., Pes C., Bolondi L., Rasciti L., Serio I., Fanelli F.R., Amoroso A., Molfino A., Petrillo E., Zuccala G., Franceschi F., De Marco G., Chiara C., Marta S., D'aurizio G., Romanelli G., Amolini C., Chiesa D., Picardi A., Gentilucci U.V., Gallo P., Annoni G., Corsi M., Zazzetta S., Bellelli G., Szabo H., Arturi F., Succurro E., Rubino M., Sesti G., Loria P., Becchi M.A., Martucci G., Fantuzzi A., Maurantonio M., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Di Corato P., Agnelli G., Marchesini E., Fabris F., Carlon M., Turatto F., Baritusso A., Amabile A., Omenetto E., Scarinzi P., Manfredini R., Molino C., Pala M., Fabbian F., Boari B., De Giorgi A., Paolisso G., Rizzo M.R., Laieta M.T., Rini G., Mansueto P., Pepe I., Borghi C., Strocchi E., De Sando V., Pareo I., Sabba C., Vella F.S., Suppressa P., Valerio R., Agosti P., Fontana F., Loparco F., Capobianco C., Fenoglio L., Bracco C., Giraudo A.V., Testa E., Serraino C., Fargion S., Bonara P., Periti G., Porzio M., Tiraboschi S., Peyvandi F., Tedeschi A., Rossio R., Monzani V., Savojardo V., Folli C., Magnini M., Conca A., Gobbo G., Pallini G., Balduini C.L., Bertolino G., Provini S., Quaglia F., Dallegri F., Ottonello L., Liberale L., Chin W.S., Carassale L., Caporotundo S., Traisci G., De Feudis L., Di Carlo S., Liberato N.L., Buratti A., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Montrucchio G., Greco E., Tizzani P., Petitti P., Perciccante A., Coralli A., Salmi R., Gaudenzi P., Gamberini S., Semplicini A., Gottardo L., Vendemiale G., Serviddio G., Forlano R., Masala C., Mammarella A., Raparelli V., Basili S., Perri L., Landolfi R., Montalto M., Mirijello A., Vallone C., Bellusci M., Setti D., Pedrazzoli F., Guasti L., Castiglioni L., Maresca A., Squizzato A., Molaro M., Bertolotti M., Mussi C., Libbra M.V., Miceli A., Pellegrini E., Carulli L., Veltri F., Sciacqua A., Quero M., Bagnato C., Colangelo L., Falbo T., De Giorgio R., Serra M., Grasso V., Ruggeri E., Ilaria B., Salvi A., Leonardi R., Grassini C., Mascherona I., Minelli G., Maltese F., Damiani G., Capeci W., Mattioli M., Martino G.P., Biondi L., Ormas M., Pettinari P., Romiti R., Messina S., Cavallaro F., Ghio R., Favorini S., Col A.D., Minisola S., Afeltra A., Alemanno P., Marigliano B., Pipita M.E., Castellino P., Blanco J., Zanoli L., Cattaneo M., Fracasso P., Amoruso M.V., Saracco V., Fogliati M., Bussolino C., Durante V., Eusebi G., Tirotta D., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Scopelliti F., Gasparini F., Cocca M., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Nieves R.D., Alberto M.M., Pedro A.R., Vanessa L.P., Lara T., Xavier C.V., Francesc F., Jesus D.M., Esperanza B.T., Esther D.C.B., Maria S.P., Romero M., Blanca P.L., Cristina L.G.-C., Victoria V.G.M., Saez L., Bosco J., Susana S.B., Marta A.G., Concepcion G.B., Antonio F.M., Hernandez M.G., Borrego M.P., Raquel P.C., Florencia P.R., Beatriz G.O., Sara C.G., Alfonso G.-C.C., Marta P.M., Garcia S.C., Alberto R.C., Antonio A.A., Montserrat G.G., Angel B.R.M., Manuel M.J., Ignacio N.V., Lucia A.S., Alfonso L., David R.B., Iria I.V., Monica R.P., Cesari, M., Franchi, C., Cortesi, L., Nobili, A., Ardoino, I., Mannucci, P. M., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Eldin, T. K., Di Blanca, M. P. D., Lanzo, G., Astuto, S., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Gennaro, C. D., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Cesari, M, Franchi, C, Cortesi, L, Nobili, A, Ardoino, I, Mannucci, P, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, G, Eldin, T, Di Blanca, M, Lanzo, G, Astuto, S, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mancarella, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Bonini, G, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Pallini, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Col, A, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, Monica, R, Franchi, Carlotta, Cortesi, Laura, Nobili, Alessandro, Ardoino, Ilaria, Mannucci, Pier Mannuccio, Tettamanti, Mauro, Pasina, Luca, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thoma, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Zoli, Marco, Arnò, Raffaella, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Gennaro, Carla Di, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D'Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Miceli, Andrea, Pellegrini, Elisa, Carulli, Lucia, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, and Alberto, M. M.
Subjects: Gerontology, Male, Multivariate analysis, Frailty, Internal medicine and geriatric wards, Multimorbidity, Physical and cognitive impairment, Internal Medicine, Psychological intervention, Predictive Value of Test, Severity of Illness Index, 0302 clinical medicine, Interquartile range, Frailty, Internal medicine and geriatric wards, Multimorbidity, Physical and cognitive impairment, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Hospital Mortality, Prospective cohort study, Multivariate Analysi, Aged, 80 and over, Prognosis, Aged, Female, Geriatric Assessment, Hospitalization, Humans, Italy, Multivariate Analysis, Predictive Value of Tests, Regression Analysis, Survival Analysis, Frail Elderly, Predictive value of tests, Survival Analysi, Cohort study, Human, Prognosi, Socio-culturale, Regression Analysi, 03 medical and health sciences, Severity of illness, Survival analysis, business.industry, Internal medicine and geriatric ward, Prospective Studie, business, 030217 neurology & neurosurgery
Abstract: Background Frailty is a state of increased vulnerability to stressors, associated to poor health outcomes. The aim of this study was to design and introduce a Frailty Index (FI; according to the age-related accumulation of deficit model) in a large cohort of hospitalized older persons, in order to benefit from its capacity to comprehensively weight the risk profile of the individual. Methods Patients aged 65 and older enrolled in the REPOSI register from 2010 to 2016 were considered in the present analyses. Variables recorded at the hospital admission (including socio-demographic, physical, cognitive, functional and clinical factors) were used to compute the FI. The prognostic impact of the FI on in-hospital and 12-month mortality was assessed. Results Among the 4488 patients of the REPOSI register, 3847 were considered eligible for a 34-item FI computation. The median FI in the sample was 0.27 (interquartile range 0.21–0.37). The FI was significantly predictive of both in-hospital (OR 1.61, 95%CI 1.38–1.87) and overall (HR 1.46, 95%CI 1.32–1.62) mortality, also after adjustment for age and sex. Conclusions The FI confirms its strong predictive value for negative outcomes. Its implementation in cohort studies (including those conducted in the hospital setting) may provide useful information for better weighting the complexity of the older person and accordingly design personalized interventions.
Published: 2018

27. Risk factors for three-month mortality after discharge in a cohort of non-oncologic hospitalized elderly patients: Results from the REPOSI study

Author: Luca, Pasina, Laura, Cortesi, Mara, Tiraboschi, Alessandro, Nobili, Giovanna, Lanzo, Mauro, Tettamanti, Carlotta, Franchi, Pier Mannuccio Mannucci, Silvia, Ghidoni, Andrea, Assolari, Antonio, Brucato, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Elmo, Mannarino, Graziana, Lupattelli, Vanessa, Bianconi, Francesco, Paciullo, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Alessandra, Marengoni, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Stefano, Carta, Sebastiana, Atzori, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Paola Di Corato, Giancarlo, Agnelli, Emanuela, Marchesini, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Francesco, Salerno, Alessio, Conca, Giulia, Gobbo, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Marco, Bertolotti, Chiara, Mussi, Maria Vittoria Libbra, Andrea, Miceli, Elisa, Pellegrini, Lucia, Carulli, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Andrea, Salvi, Roberto, Leonardi, Chiara, Grassini, Ilenia, Mascherona, Giorgio, Minelli, Francesca, Maltese, Armando, Gabrielli, Massimo, Mattioli, William, Capeci, Giuseppe Pio Martino, Salvatore, Corrao, Silvia, Messina, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Marco, Cattaneo, Paola, Fracasso, Maria Valentina Amoruso, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Nieves Ramirez Duque, Alberto Muela Molinero, Pedro Abad Requejo, Vanessa Lopez Pelaez, Lara, Tamargo, Xavier Corbella Viros, Francesc, Formiga, Jesus Diez Manglano, Esperanza Bejarano Tello, Esther Del Corral Behamonte, Maria Sevil Puras, Manuel, Romero, Blanca Pinilla Llorente, Cristina Lopez Gonzalez-Cobos, Victoria Villalba Garcia, M., Juan Bosco Lopez Saez, Susana Sanz Baena, Marta Arroyo Gallego, Concepcion Gonzalez Becerra, Antonio Fernandez Moyano, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Raquel Pacheco Cuadros, Florencia Perez Rojas, Beatriz Garcia Olid, Sara Carrascosa Garcia, Alfonso Gonzalez-Cruz Cervellera, Marta Peinado Martinez, Alberto Ruiz Cantero, Antonio Albarracín Arraigosa, Montserrat Godoy Guerrero, Miguel Angel Barón Ramos, Jose Manuel Machin, Ignacio Novo Veleiro, Lucia Alvela Suarez, Alfonso, Lopez, David Rubal Bran, Iria Iñiguez Vazquez, and Monica Rios, Prego.
Subjects: Male, Aging, Pediatrics, Health (social science), Bedridden, 030204 cardiovascular system & hematology, Logistic regression, DISEASE, PALLIATIVE CARE, Bedridden Persons, 0302 clinical medicine, Risk Factors, 80 and over, Medicine, 030212 general & internal medicine, Hypoalbuminemia, Prospective Studies, Prospective cohort study, PREDICTORS, Aged, 80 and over, Frailty, Mortality, Prognosis, Aged, Female, Follow-Up Studies, Frail Elderly, Hospital Units, Humans, Internal Medicine, Italy, Logistic Models, Patient Discharge, Absolute risk reduction, CANCER, Severe dementia, Cohort, medicine.medical_specialty, Renal function, Socio-culturale, ILLNESS, VALIDATION, 03 medical and health sciences, SCORE, OLDER PATIENTS, business.industry, Mortality, Bedridden, Prognosis, Frailty, PALLIATIVE CARE, 6-MONTH MORTALITY, OLDER PATIENTS, VALIDATION, DISEASE, SCORE, PREDICTORS, ILLNESS, CANCER, ADULTS, ADULTS, medicine.disease, 6-MONTH MORTALITY, Physical therapy, Geriatrics and Gerontology, business, Gerontology
Abstract: Background Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients. Methods This prospective cohort study was run in 102 Italian internal medicine and geriatric hospital wards. The sample included all patients with three-months follow-up data. Bedridden condition was defined as the inability to walk or stand upright during the whole hospital stay. The following parameters were also recorded: estimated GFR ≤ 29 mL/min/1.73 m2; severe dementia; albuminemia ≪2.5 g/dL; hospital admissions in the six months before the index admission. Results Of 3915 patients eligible for the analysis, three-month follow-up were available for 2058, who were included in the study. Bedridden patients were 112 and the absolute risk difference of mortality at three months was 0.13 (CI 95% 0.08–0.19, p ≪ 0.0001). Logistic regression analysis also adjusted for age, sex, number of drugs and comorbidity index found that bedridden condition (OR 2.10, CI 95% 1.12–3.94), severely reduced kidney function (OR 2.27, CI 95% 1.22–4.21), hospital admission in the previous six months (OR 1.96, CI 95% 1.22–3.14), severe dementia (with total or severe physical dependence) (OR 4.16, CI 95% 2.39–7.25) and hypoalbuminemia (OR 2.47, CI 95% 1.12–5.44) were significantly associated with higher risk of three-month mortality. Conclusions Bedridden status, severely reduced kidney function, recent hospital admissions, severe dementia and hypoalbuminemia were associated with higher risk of three-month mortality in non-oncologic patients after discharge from internal medicine and geriatric hospital wards.
Published: 2018

28. Clinical Severity, Age, and Sex Overcome Cardiometabolic Morbidities but Not Stroke as Predictors of Mortality in Elderly Inpatients: Data From the REgistro POliterapie Società Italiana di Medicina Interna Registry

Author: Salvatore, Corrao, Alessandra, Marengoni, Giuseppe, Natoli, Alessandro, Nobili, Piermannuccio, Mannucci, Francesco, Perticone, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Tommaso, Barnini, Giuseppe, Delitala, Stefano, Carta, Sebastiana, Atzori, Gianfranco, Guarnieri, Michela, Zanetti, Annalisa, Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Laura, Gasbarrone, Giorgio, Maniscalco, Massimo, Gunelli, Daniela, Tirotta, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giancarlo, Agnelli, Emanuela, Marchesini, Elmo, Mannarino, Graziana, Lupattelli, Pamela, Rondelli, Francesco, Paciullo, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Maria Cristina Baroni, Marianna, Zardo, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa, Salvatore, Ferdinando Carlo Sasso, Riccardo, Utili, Emanuele Durante Mangoni, Daniela, Pinto, Oliviero, Olivieri, Anna Maria Stanzial, Renato, Fellin, Volpato, Stefano, Sioulis, Fotini, Mario, Barbagallo, Ligia, Dominguez, Lidia, Plances, Daniela, D’Angelo, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Claudio, Borghi, Enrico, Strocchi, Elisa, Rebecca, Marco, Zoli, Elisa, Fabbri, Donatella, Magalotti, Alberto, Auteri, Anna Laura Pasqui, Luca, Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Carlo, Sabbà, Francesco Saverio Vella, Alessandro, Marseglia, Chiara Valentina Luglio, Giuseppe, Palasciano, Maria Ester Modeo, Annamaria, Aquilino, Raffaele, Pallante, Stefania, Pugliese, Caterina, Capobianco, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi, Fenoglio, Chiara, Brignone, Christian, Bracco, Alessia, Giraudo, Giuseppe, Musca, Olga, Cuccurullo, Luigi, Cricco, Alessandra, Fiorentini, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Silvia, Fargion, Paola, Bonara, Mara, Bulgheroni, Rosa, Lombardi, Marianna, Porzio, Giulia, Periti, Fabio, Magrini, Ferdinando, Massari, Tatiana, Tonella, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Guido, Moreo, Barbara, Ferrari, Luisa, Roncari, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Silvia, Prolo, Maria Sole Lilleri, Giuliana, Micale, Mauro, Podda, Carlo, Selmi, Francesca, Meda, Francesco, Salerno, Silvia, Accordino, Alessio, Conca, Valentina, Monti, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Giovanni, Murialdo, Marta, Bovio, Franco, Dallegri, Luciano, Ottonello, Alessandra, Quercioli, Alessandra, Barreca, Maria Beatrice Secchi, Davide, Ghelfi, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Elisabetta, Bergami, Emanuela, Rizzioli, Carlo, Cagnoni, Luca, Bertone, Antonio, Manucra, Alberto, Buratti, Tiziana, Tognin, Nicola Lucio Liberato, Giordano, Bernasconi, Barbara, Nardo, Giovanni Battista Bianchi, Sabrina, Giaquinto, Giampiero, Benetti, Michela, Quagliolo, Giuseppe Riccardo Centenaro, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Francesco, Gullo, Michele, Cortellaro, Marina, Magenta, Francesca, Perego, Maria Rachele Meroni, Marco, Cicardi, Antonio Gidaro Marina Magenta, Andrea, Sacco, Antonio, Bonelli, Gaetano, Dentamaro, Renzo, Rozzini, Lina, Falanga, Alessandro, Giordano, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Giacomo, Fera, Maria Loreta Di Luca, Donatella, Renna, Antonio, Perciccante, Alessia, Coralli, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giorgio, Menardo, Stefania, Bottone, Elsa, Sferrazzo, Claudio, Ferri, Rinaldo, Striuli, Rosa, Scipioni, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Franco, Ricci, Cosimo, Morabito, Roberto, Fava, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Filippo Rossi Fanelli, Massimo, Delfino, Antonio, Amoroso, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Pietro, Serra, Vincenzo, Fontana, Marco, Falcone, Raffaele, Landolfi, Antonio, Grieco, Antonella, Gallo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Giuseppe, Romanelli, Caterina, Pirali, Claudia, Amolini, Enrico Agabiti Rosei, Damiano, Rizzoni, Luana, Castoldi, Antonio, Picardi, Umberto Vespasiani Gentilucci, Chiara, Mazzarelli, Paolo, Gallo, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Sara, Contini, Marta, Molaro, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Marco, Bertolotti, Chiara, Mussi, Roberto, Scotto, Maria Alice Ferri, Francesca, Veltri, Franco, Arturi, Elena, Succurro, Giorgio, Sesti, Umberto, Gualtieri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Roberto, Corinaldesi, Roberto De Giorgio, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Lorenzo Mauro Carozza, Fabio, Pignatti, Corrao, S., Marengoni, A., Natoli, G., Nobili, A., Mannucci, P., and Perticone, F.
Subjects: Male, Pediatrics, medicine.medical_specialty, REPOSI study, Clinical severity, age, stroke, risk factors, elderly, REPOSI study, Socio-culturale, 030204 cardiovascular system & hematology, Age and sex, elderly, Severity of Illness Index, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Metabolic Diseases, medicine, risk factors, Humans, Clinical severity, Hospital Mortality, Registries, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, Inpatients, business.industry, Age Factors, medicine.disease, age, Italy, Cardiovascular Diseases, Female, Morbidity, Geriatrics and Gerontology, business
Published: 2016

29. Defining aging phenotypes and related outcomes: Clues to recognize frailty in hospitalized older patients

Author: Marcucci, Maura, Carlotta, Franchi, Alessandro, Nobili, Pier Mannuccio Mannucci, Ilaria, Ardoino, Mauro, Tettamanti, Luca, Pasina, Francesco, Perticone, Francesco, Salerno, Salvatore, Corrao, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Olivieri, Oliviero, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Alessandra, Marengoni, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Stefano, Carta, Sebastiana, Atzori, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Roberto, Corinaldesi, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Armando, Gabrielli, Mattioli, Massimo, William, Capeci, Giuseppe Pio Martino, Silvia, Messina, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Marcucci, M., Franchi, C., Nobili, A., Mannucci, P. M., Ardoino, I., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Eldin, T. K., Di Blanca, M. P. D., Djade, C. D., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Vanoli, M., Grignani, G., Casella, G., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Leiter, Sofia, Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Carta, S., Atzori, S., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Sciacqua, A., Quero, M., Bagnato, C., Corinaldesi, R., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Gabrielli, A., Mattioli, M., Capeci, W., Martino, G. P., Messina, S., Ghio, R., Favorini, S., Dal Col, A., Minisola, S., Colangelo, L., Afeltra, A., Alemanno, P., Marigliano, B., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Sofia, L., Marcucci, M, Franchi, C, Nobili, A, Mannucci, P, Ardoino, I, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, G, Eldin, T, Di Blanca, M, Djade, C, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Vanoli, M, Grignani, G, Casella, G, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Carta, S, Atzori, S, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Sciacqua, A, Quero, M, Bagnato, C, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Gabrielli, A, Mattioli, M, Capeci, W, Martino, G, Messina, S, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Colangelo, L, Afeltra, A, Alemanno, P, Marigliano, B, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R
Subjects: Background: Because frailty is a complex phenomenon associated with poor outcomes, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods: Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, physical, cognitive, functional, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results: 2,841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I), those with multimorbidity (II), the functionally independent women with osteoporosis and arthritis (III), and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, 95% CI = 1.15-3.00) than in Cluster I. Conclusions: Using alternative analytical techniques among hospitalized older patients, we could distinguish different frailty phenotypes, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs, Male, Aging, Osteoporosis, we could distinguish different frailty phenotypes, 030204 cardiovascular system & hematology, Logistic regression, 0302 clinical medicine, Internal medicine and geriatric wards, Aging phenotype, 80 and over, Medicine, Cluster analysi, LS4_4, 95% CI = 1.15-3.00) than in Cluster I. Conclusions: Using alternative analytical techniques among hospitalized older patients, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, physical, Outcome, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, Aged, 80 and over, Frailty, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, Cognition, Hospitalization, Phenotype, aging phenotypes, cluster analysis, frailty, internal medicine and geriatric wards, outcomes, Female, 841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I), Human, medicine.medical_specialty, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods: Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, Frail Elderly, Socio-culturale, Aging phenotypes, Cluster analysis, Outcomes, Aged, Humans, Geriatric Assessment, cognitive, 03 medical and health sciences, Multiple correspondence analysis, Internal medicine, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs, Adverse effect, Background: Because frailty is a complex phenomenon associated with poor outcomes, Aging phenotypes, Cluster analysis, Frailty, Internal medicine and geriatric wards, Outcomes, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, business.industry, and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, Settore MED/09 - MEDICINA INTERNA, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results: 2, Odds ratio, medicine.disease, Confidence interval, Internal medicine and geriatric ward, Prospective Studie, functional, Physical therapy, Geriatrics and Gerontology, business
Abstract: Background Because frailty is a complex phenomenon associated with poor outcomes, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, physical, cognitive, functional, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results 2,841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I); those with multimorbidity (II); the functionally independent women with osteoporosis and arthritis (III); and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, 95% CI = 1.15-3.00) than in Cluster I. Conclusions Using alternative analytical techniques among hospitalized older patients, we could distinguish different frailty phenotypes, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs.
Published: 2017

30. Pattern of in-hospital changes in drug use in the older people from 2010 to 2016

Author: Carlotta, Franchi, Ilaria, Ardoino, Alessandro, Nobili, Luca, Pasina, Pier Mannuccio Mannucci, Alessandra, Marengoni, Francesco, Perticone, Mauro, Tettamanti, Francesco, Salerno, Salvatore, Corrao, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Marcucci, Maura, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Giovanna, Lanzo, Sarah, Astuto, Laura, Cortesi, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Marta, Mancarella, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Giulia, Bonini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Chiara, Pes, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Gabriella, D’Aurizio, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Hajnalka, Szabo, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Annalisa, Amabile, Elisabetta, Omenetto, Paolo, Scarinzi, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Ilaria, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Pasquale, Agosti, Flavia, Fontana, Francesca, Loparco, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Slivia, Tiraboschi, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Giada, Pallini, Miriam, Valenti, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Francesca, Veltri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Lidia, Colangelo, Tania, Falbo, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Benzoni, Ilaria, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Giampaolo, Damiani, William, Capeci, Mattioli, Massimo, Giuseppe Pio Martino, Biondi, Lorenzo, Monica, Ormas, Pietro, Pettinari, Roberto, Romiti, Silvia, Messina, Federica, Cavallaro, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Sara Carrascosa Garcia, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Franchi C., Ardoino I., Nobili A., Pasina L., Mannucci P.M., Marengoni A., Perticone F., REPOSI investigators., Barbagallo M., Dominguez Rodríguez L.J., Franchi, C., Ardoino, I., Nobili, A., Pasina, L., Mannucci, P. M., Marengoni, A., Perticone, F., Tettamanti, M., Salerno, F., Corrao, S., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Donatella Di Blanca, M. P., Lanzo, G., Astuto, S., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Li Bassi, S., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Dal Col, A., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Franchi, C, Ardoino, I, Nobili, A, Pasina, L, Mannucci, P, Marengoni, A, Perticone, F, Tettamanti, M, Salerno, F, Corrao, S, Licata, G, Violi, F, Corazza, G, Marcucci, M, Eldin, T, Donatella Di Blanca, M, Lanzo, G, Astuto, S, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, E, Bernardi, M, Li Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mancarella, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Bonini, G, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Pallini, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R
Subjects: Registrie, Male, pharmacoepidemiology, Epidemiology, Discharged alive, 030204 cardiovascular system & hematology, internal medicine and geriatric ward, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, polypharmacy, 0302 clinical medicine, Drug Prescription, Risk Factors, 80 and over, Pharmacology (medical), 030212 general & internal medicine, Registries, At-Risk Population, media_common, Aged, 80 and over, Overtime, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, pharmacoepidemiology, polypharmacy, Pharmacoepidemiology, Hospitalization, Italy, Female, Medical emergency, Human, Drug, medicine.medical_specialty, media_common.quotation_subject, Socio-culturale, Drug Prescriptions, 03 medical and health sciences, Hospital discharge, medicine, Internal Medicine, Humans, Aged, Polypharmacy, Inpatients, business.industry, Risk Factor, medicine.disease, Emergency medicine, Older people, business
Abstract: Purpose: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. Methods: People aged 65years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy). To assess whether or not prevalence of patients in relation to drug use distribution changed overtime, adjusted prevalence ratios (PRs) was estimated with log-binomial regression models. Results: Among 2120 patients recruited in 27 wards continuously participating to data collection, 1882 were discharged alive and included in this analysis. The proportion of patients with very low drug use (0-1 drug) at hospital discharge increased overtime, from 2.7% in 2010 to 9.2% in 2016. Results from a log-logistic adjusted model confirmed the increasing PR of these very low drug users overtime (particularly in 2014 vs 2012, PR 1.83 95% CI 1.14-2.95). Moreover, from 2010 to 2016, there was an increasing number of patients who, on polypharmacy at hospital admission, abandoned it at hospital discharge, switching to the very low drug use group. Conclusion: This study shows that in internal medicine and geriatric wards continuously participating to the REgistro POliterapie Società Italiana di Medicina Interna register, the proportion of patients with a very low drug use at hospital discharge increased overtime, thus reducing the therapeutic burden in this at risk population.
Published: 2017

31. Antipsychotic prescription and mortality in hospitalized older persons

Author: Deborah, Chiesa, Alessandra, Marengoni, Alessandro, Nobili, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Codjo, D Djade, Salvatore, Corrao, Francesco, Salerno, Maura, Marcucci, Giuseppe, Romanelli, Pier Mannuccio Mannucci, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Tommaso, Barnini, Giuseppe, Delitala, Stefano, Carta, Sebastiana, Atzori, Gianfranco, Guarnieri, Michela, Zanetti, Annalisa, Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Laura, Gasbarrone, Giorgio, Maniscalco, Massimo, Gunelli, Daniela, Tirotta, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giancarlo, Agnelli, Emanuela, Marchesini, Elmo, Mannarino, Graziana, Lupattelli, Pamela, Rondelli, Francesco, Paciullo, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Maria Cristina Baroni, Marianna, Zardo, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa, Salvatore, Ferdinando Carlo Sasso, Riccardo, Utili, Emanuele Durante Mangoni, Daniela, Pinto, Oliviero, Olivieri, Anna Maria Stanzial, Fellin, Renato, Volpato, Stefano, Sioulis, Fotini, Mario, Barbagallo, Ligia, Dominguez, Lidia, Plances, Daniela, D’Angelo, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Claudio, Borghi, Enrico, Strocchi, Elisa Rebecca Rinaldi, Marco, Zoli, Elisa, Fabbri, Donatella, Magalotti, Alberto, Auteri, Anna Laura Pasqui, Luca, Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Carlo, Sabbà, Francesco Saverio Vella, Alessandro, Marseglia, Chiara Valentina Luglio, Giuseppe, Palasciano, Maria Ester Modeo, Annamaria, Aquilino, Pallante, Raffaele, Stefania, Pugliese, Caterina, Capobianco, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi, Fenoglio, Chiara, Brignone, Christian, Bracco, Alessia, Giraudo, Giuseppe, Musca, Olga, Cuccurullo, Luigi, Cricco, Alessandra, Fiorentini, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Silvia, Fargion, Paola, Bonara, Mara, Bulgheroni, Rosa, Lombardi, Marianna, Porzio, Giulia, Periti, Fabio, Magrini, Ferdinando, Massari, Tatiana, Tonella, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Guido, Moreo, Barbara, Ferrari, Luisa, Roncari, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Silvia, Prolo, Maria Sole Lilleri, Giuliana, Micale, Mauro, Podda, Carlo, Selmi, Francesca, Meda, Silvia, Accordino, Alessio, Conca, Valentina, Monti, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Giovanni, Murialdo, Marta, Bovio, Franco, Dallegri, Luciano, Ottonello, Alessandra, Quercioli, Alessandra, Barreca, Maria Beatrice Secchi, Davide, Ghelfi, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Elisabetta, Bergami, Emanuela, Rizzioli, Carlo, Cagnoni, Luca, Bertone, Antonio, Manucra, Alberto, Buratti, Tiziana, Tognin, Nicola Lucio Liberato, Giordano, Bernasconi, Barbara, Nardo, Giovanni Battista Bianchi, Sabrina, Giaquinto, Giampiero, Benetti, Michela, Quagliolo, Giuseppe Riccardo Centenaro, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Francesco, Gullo, Michele, Cortellaro, Marina, Magenta, Francesca, Perego, Maria Rachele Meroni, Marco, Cicardi, Antonio Gidaro Marina Magenta, Andrea, Sacco, Antonio, Bonelli, Gaetano, Dentamaro, Renzo, Rozzini, Lina, Falanga, Alessandro, Giordano, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Giacomo, Fera, Maria Loreta Di Luca, Donatella, Renna, Antonio, Perciccante, Alessia, Coralli, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giorgio, Menardo, Stefania, Bottone, Elsa, Sferrazzo, Claudio, Ferri, Rinaldo, Striuli, Rosa, Scipioni, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Franco, Ricci, Cosimo, Morabito, Roberto, Fava, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Filippo Rossi Fanelli, Massimo, Delfino, Antonio, Amoroso, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Pietro, Serra, Vincenzo, Fontana, Marco, Falcone, Raffaele, Landolfi, Antonio, Grieco, Antonella, Gallo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Caterina, Pirali, Claudia, Amolini, Enrico Agabiti Rosei, Damiano, Rizzoni, Luana, Castoldi, Antonio, Picardi, Umberto Vespasiani Gentilucci, Chiara, Mazzarelli, Paolo, Gallo, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Sara, Contini, Marta, Molaro, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Marco, Bertolotti, Chiara, Mussi, Roberto, Scotto, Maria Alice Ferri, Francesca, Veltri, Franco, Arturi, Elena, Succurro, Giorgio, Sesti, Umberto, Gualtieri, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Lorenzo Mauro Carozza, Fabio, Pignatti., Chiesa, D., Marengoni, A., Nobili, A., Tettamanti, M., Pasina, L., Franchi, C., Djade, C., Corrao, S., Salerno, F., Marcucci, M., Romanelli, G., and Mannucci, P.
Subjects: Male, Socio-culturale, Older person, Antipsychotic, Cognition, Economica, Antipsychotics, Hospitalization, Mortality, Older persons, Gerontology, Geriatrics and Gerontology, Psychiatry and Mental Health, Humans, Psychomotor Agitation, Aged, antipsychotics, hospitalization, mortality, older persons, Aged, 80 and over, Mental Disorders, Patient Discharge, antipsychotics, Italy, hospitalization, mortality, older persons, Dementia, Female, Antipsychotic Agents
Abstract: Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie SocietÃ Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score â¥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score
Published: 2017

32. Investigating Antibiotic Exposure and Risk of Severe Acute Graft Versus Host Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Author: Tounes Ledraa, Giorgia Battipaglia, Clemence Mediavilla, Razan Mohty, Florent Malard, Agnès Bonnin, Simona Sestili, Mohamad Mohty, Eolia Brissot, Béatrice Gaugler, and Remy Dulery
Subjects: Cyclophosphamide, Umbilical Cord Blood Transplantation, business.industry, medicine.medical_treatment, Immunology, Cell Biology, Hematology, Hematopoietic stem cell transplantation, medicine.disease, Biochemistry, Transplantation, Graft-versus-host disease, medicine.anatomical_structure, medicine, Anaerobic bacteria, Bone marrow, Stem cell, business, medicine.drug
Abstract: Several studies have shown that alteration of the microbiota, particularly in the gastrointestinal tract, can be associated with graft-versus-host disease (GvHD). Patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT) usually get exposed to antibiotics (ATB), mainly in the peri-transplant period. Moreover, ATB, specifically those that target anaerobic bacteria, can alter the microbiota in a variety of body organs. This, in turn, renders several organs vulnerable to injury making them more prone to developing diseases such as GvHD. In this study, we evaluate whether the use of ATB, characterized by duration, timing and type, in the peri-transplant period, is associated with an increased incidence of acute GvHD (aGvHD) and aGvHD-related mortality. In this retrospective study, we included 318 consecutive patients who underwent allo-SCT including haploidentical and cord blood transplantation between December 2012 and June 2018 at a single center. ATB exposure was collected and classified into 3 groups according to the date of initiation of ATB: from the start of conditioning to day - 1 of allo-SCT (early ATB exposure), from day 0 to neutrophil engraftment (late ATB exposure) and a third group of patients who did not receive ATB (no ATB exposure). ATB were only initiated if a patient develop fever or show signs of infection. Patients did not receive any prophylactic ATB. Exposure was further categorized as primary or adjunct. Primary exposure included the use of 4 classes of ATB: carbapenems, anti-pseudomonal penicillin, 4thand 5thgeneration cephalosporins and fluoroquinolones. Adjunct ATB comprised other ATB and was further divided into 2 groups according to anaerobic coverage. The median age at transplant was 55 years. The stem cell source was peripheral blood in 85%, bone marrow in 10% and cord blood in 5% of the patients. Ninety-nine percent of the patients received cyclosporine A as GvHD prophylaxis and 80% and 7% of the patients received (along with cyclosporine A), mycophenolate mofetil and methotrexate, respectively. In addition, 35% and 89% of the patients received post-transplant cyclophosphamide and anti-thymocyte globulin, respectively, as GvHD prophylaxis. The median time to neutrophil engraftment was 16 days post-transplant. The median follow-up was 85 months. 93.7% of the patients received ATB in the peri-transplant period with 64.5% of them in the early ATB exposure group, and 29.2% of them in the late ATB exposure group. The 2-year overall survival and progression free survival were 74.3% and 63.6% in patients with early ATB exposure, compared to 79.5% and 70.8% in patients with late ATB exposure (p=0.11 and p=0.07 respectively). The 2-year cumulative incidence of non-relapse mortality was 16.5% in patients with early ATB exposure, compared to 15.1% in patients with late ATB exposure (p=0.63). The 180-days cumulative incidence of grade 2-4 and 3-4 aGvHD were 23.8% and 12.2% in patients with early ATB exposure, compared to 27.2% and 5.4% in patients with late ATB exposure (p=0.64 and p=0.06 respectively). In multivariate analysis, including the most important parameters associated with GvHD (stem cell source and donors, conditioning regimen, sex mismatch and patients age), early ATB initiation was the only parameter associated with a significantly higher risk of severe grade 3-4 aGvHD [HR 0.51 (0.28-0.90); p=0.02]. In conclusion, in the absence of any ATB prophylaxis, early initiation of ATB, before graft infusion,is associated with a significantly higher risk of severe grade 3-4 aGvHD. Weighing risk of morbidity and mortality associated with infections versus later on risk of developing aGvHD is essential. Hence, new strategies should be developed to risk stratify patients with fever and thus to avoid early non necessary ATB exposure especially in those who develop fever during anti-thymocyte globulin infusion. Studies evaluating such strategies will be necessary in the next years. Disclosures Mohty: Jazz Pharmaceuticals: Honoraria, Research Funding. Malard:Astellas: Honoraria; JAZZ pharmaceutical: Honoraria; Sanofi: Honoraria; Keocyte: Honoraria; Janssen: Honoraria; Therakos/Mallinckrodt: Honoraria.
Published: 2019

33. Variability in the response to antiplatelet treatment in diabetes mellitus

Author: G. Davi, Simona Sestili, and Natale Vazzana
Subjects: medicine.medical_specialty, Physiology, Pharmacology, Biochemistry, Treatment failure, Diabetes Complications, Diabetes mellitus, Diabetes Mellitus, Humans, Medicine, In patient, Platelet activation, Clinical efficacy, Intensive care medicine, Cause of death, Aspirin, business.industry, Thromboxanes, Thrombosis, Cell Biology, medicine.disease, Treatment Outcome, Pharmacodynamics, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract: Atherothrombosis is a leading cause of death in patients with diabetes mellitus. Among factors contributing to the diabetic prothrombotic state, platelet activation plays a pivotal role. Numerous studies have investigated the benefits of antiplatelet therapy for primary and secondary cardiovascular prevention in diabetic patients. However, there are limited evidences that low-dose aspirin may be effective in this clinical setting. Several disease-specific factors have been identified as potential determinants of aspirin treatment failure. In this review, the main determinants of interindividual variability in response to antiplatelet agents are discussed, with particular emphasis on the pharmacokinetic and pharmacodynamic mechanisms of clinical efficacy and safety of antiplatelet drugs in patients with diabetes mellitus.
Published: 2012

34. Hematopoietic Recovery and Transfusion Needs after Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide in Adult Patients with Hematologic Malignancies

Author: Razan Mohty, Clemence Mediavilla, Eolia Brissot, Annalisa Ruggeri, Florent Malard, Simona Sestili, Mohamad Mohty, Giorgia Battipaglia, Frederica Giannotti, and Remy Dulery
Subjects: Oncology, medicine.medical_specialty, Blood transfusion, Cyclophosphamide, business.industry, medicine.medical_treatment, Immunology, Cell Biology, Hematology, Hematopoietic stem cell transplantation, medicine.disease, Biochemistry, Transplantation, Haematopoiesis, medicine.anatomical_structure, Graft-versus-host disease, Internal medicine, medicine, Bone marrow, Stem cell, business, medicine.drug
Abstract: Introduction: Haploidentical stem cell transplantation (Haplo-SCT) using post-transplant cyclophosphamide is widely used for the treatment of patients with hematologic malignancies especially in patients who lack related or unrelated donors. Several factors were shown to affect hematopoietic recovery after allogeneic hematopoietic stem cell transplantation, including age at transplant, initial diagnosis, stem-cell source, CD34 count in the graft, conditioning regimen intensity, infections, etc. The aim of this study was to evaluate immune reconstitution, neutrophils and platelets recovery, transfusion needs and main transplant outcomes after Haplo-SCT and to identify factors correlated with improved or worsened recovery. Methods: This study included 72 consecutive patients who underwent haploidentical stem cell transplantation between December 2012 and March 2018, in a single center. Graft was either bone marrow (n=21) or peripheral blood stem cells (n=51). Patients were given PT-Cy (50mg/kg/d) for one (n=20) or two days (n=52), cyclosporine, mycophenolate mofetil and ATG for GvHD prophylaxis. Conditioning regimen was reduced toxicity one (RIC) in 69% (n=50) of patients, and a myeloablative one (MAC) in 31% (n=22) of cases . Main transplant outcomes, neutrophil and platelets recovery, and needs for transfusion were evaluated at day +30, day +60 and day +90 after Haplo-SCT. Results: The median CD34+ cells infused was 10.62 x106/kg (range, 1.02-15.06). The median time to neutrophil recovery (>500/µL) was 16 days post-transplant (range, 5-29). The median time to neutrophil count >1000/µL was 17 days post-transplant (range, 5-32). Platelets recovery (>20.000/µL) was observed at a median of 13 days post-transplant (range, 10-193). Platelets recovery (>50.000/µL) was documented at a median of 60 days post-transplant (range, 10-193). Forty-five (63%) and 49 (68%) patients had a platelets count >50.000/µL at days +30 and +60 post-transplant respectively. At day +90 post-transplant, 61 patients were assessable with 56 (92%) of them having a platelets count >50.000/µL. In this series, 61 patients (85%) needed platelets transfusion with a median number of 13 units (range, 2-60), transfused for a median of 26 days (range, 5-198) post-transplant. Similarly, 59 patients (82%) needed RBCs transfusion and received a median of 6 RBCs packs (range, 1-60) for a median duration of 31 days (range, 5-147) post-transplant. 23 patients (32%) had anemia and/or thrombocytopenia requiring the administration of growth factors, either erythropoietin in 14 patients (19%) (Epoetin, n=8 or Darbepoetin, n=6) and/or Thrombopoietin in 15 patients (20%) (Romiplostim, n=13 or Eltrombopag, n=2). In all, 6 patients received unmanipulated CD34+ donor stem cell ("boost" procedure), 5 of them for poor graft function and 1 patient as a consolidation after immunosuppressive therapy for relapse after Haplo-SCT. Such boost proved to be successful in 4 patients while 2patients had an incomplete response with persistent anemia and/or thrombocytopenia. In the multivariable analysis, donor age (>40 years) and CMV reactivation within the first 3 months were shown to meaningfully affect day +90 platelets recovery >100 x109/L (HR 4.86, 95%CI 1.08-21.80, p=0.04 and HR 5.15, 95% CI, 1.22-21.7, p=0.03). Number of CD34, conditioning regimen, stem cell source, donor age and disease status at transplant have no impact on platelet recovery at day +90. Conclusion: In conclusion, our data show that Haplo-SCT is associated with a fast hematopoietic recovery with an acceptable rate of transfusions. While the adverse impact of CMV reactivation on platelet recovery was expected, the relation between donor age (>40 years) and platelets recovery is new. This finding should guide in selection of potential donors for Haplo-SCT. Disclosures Mohty: Celgene: Consultancy, Honoraria; Jazz Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau; Amgen: Consultancy, Honoraria; Takeda: Honoraria, Speakers Bureau; Janssen: Honoraria, Research Funding, Speakers Bureau; Servier: Consultancy; MaaT Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees; Molmed: Consultancy; Bristol Myers: Consultancy, Research Funding; Sanofi: Consultancy, Honoraria, Research Funding, Speakers Bureau.
Published: 2018

35. Achievement of High Concentration of Cyclosporine-a Is Associated with a Low Incidence of Acute Graft-Versus-Host Disease after Haploidentical Hematopoietic Cell Transplantation Using Post-Transplant Cyclophosphamide and Peripheral Blood Stem Cell Graft

Author: Eolia Brissot, Annalisa Ruggeri, Simona Sestili, Florent Malard, Mohamad Mohty, Razan Mohty, Clemence Mediavilla, Giorgia Battipaglia, Remy Dulery, and Nicolas Stocker
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Immunology, Cell Biology, Hematology, Hematopoietic stem cell transplantation, medicine.disease, Biochemistry, Gastroenterology, Granulocyte colony-stimulating factor, Fludarabine, Transplantation, Graft-versus-host disease, medicine.anatomical_structure, Internal medicine, medicine, Bone marrow, Stem cell, business, Busulfan, medicine.drug
Abstract: Background: Allogeneic hematopoietic stem cell transplantation using a related haploidentical donor (Haplo-HCT) using post-transplant high-dose cyclophosphamide (PTCy) is increasingly used for patients lacking a matched related or unrelated donor. However, use ofperipheral blood stem cell graft (PBSC) is associated with an increased risk of acute GvHD (aGvHD) compared to bone-marrow graft. Therefore, while cyclosporine A (CsA) and mycophenolate mofetil (MMF) are traditionally initiated after completion of PT-Cy at day +5, we decided to initiate them at day -3 before transplant and to add a low dose of ATG to reinforce GvHD prophylaxis in those patients. With this background, we analyze retrospectively the impact of early initiation of CsA and of CsA concentration on patients' outcome in all patients who underwent Haplo-HCT with PBSC grafts and PTCy. Patients and Methods: Sixty-one consecutive patients who underwent Haplo-HCT for hematological malignancies between October 2013 and August 2017 were included in this retrospective single-center study. All patients received G-CSF mobilized PBSC as grafts and post-transplantation immunosuppression with CsA and MMF. CsA was administered at a dose of 3mg/kg by continuous intravenous infusion starting from D -3 and changed to twice daily oral dosing as soon as tolerated.MMF was administered at a fixed oral dose of 2g per day starting from day 6 without adjustment. In the absence of GvHD, MMF and CsA were tapered over 4 weeks starting from day 30 and day 60, respectively. CsA blood trough concentrations were monitored 3 times per week during the intravenous treatment and at least once per week after switch to oral dosing. CsA doses were adjusted to achieve blood levels between 200 and 300 ng/mL and to prevent renal dysfunction. The primary endpoint was to determine the impact of the CsA concentration on the risk of grade II-IV and III-IV aGvHD. Results: Median age was 53 (range, 15-72) years, with 16 male patients (26%) receiving a graft from a female donor. Diagnoses were myeloid (64%) or lymphoid malignancies (36%). According to the Disease Risk Index, patients were considered as low-risk, intermediate-risk, high-risk or very-high-risk (respectively 8%, 56%, 31% and 5%). Twenty-five patients (41%) with refractory disease received a sequential conditioning regimen while the remaining (n=36, 59%) received a RIC/RTC regimen based on fludarabine, busulfan and thiotepa. 51 patients (83%) received ATG (2.5-5 mg/Kg total dose) as part of the conditioning regimen. All patients received standard PTCy, nine at D+3 (15%) and 52 at D+3 and D+5 (85%). All patients engrafted at a median of 18 (range: 13-35) days after Haplo-HCT and the median follow-up among surviving patients was 21 (range: 13-53) months. The median concentrations of CsA at 1, 2, 3, and 4 weeks after Haplo-HCT were 272 (range: 114-911), 296 (range: 132-516), 251 (range: 111-485), and 246 (range: 36-375) ng/mL, respectively. At d180, the cumulative incidences (CIs) of grade II-IV and grade III-IV aGvHD were 39% and 18%, respectively. The CIs of chronic GvHD (cGvHD), extensive cGvHD and relapse were 41%, 19% and 35% at 18 months after Haplo-HCT, respectively. At 18 months after the transplant, the OS, PFS and GPFS rates were respectively 60%, 55% and 48%. In univariate analysis, patients having the lowest CsA concentration in the first week after Haplo-HCT had a significantly higher risk of grade II-IV aGvHD (49% vs 18%; P= .02), severe grade III-IV aGvHD (26% vs 0%; P = .03), cGvHD (P= .02) and extensive cGvHD (P= .04). We do not find statistically significant correlation between CsA concentration and relapse incidence, NRM, PFS, GPFS or OS. In multivariate logistic regression analysis, higher CsA concentration (> 301 ng/ mL; the cut-off value defined by ROC analysis) during the first week following Haplo-HCT was the only independent parameter significantly associated with a reduced risk of grade II-IV and grade III-IV aGvHD (respectively P = .04; RR .11; 95% CI, 0.05-0.94; and P < .0001; RR < .001; 95% CI, 0.000007-0.00006). There was no association with extensive cGvHD (P = .14; RR .11; 95% CI, 0.06-1.48). Conclusion: We conclude that achievement of high concentration of CsA early after Haplo-HCT using PBSC graft is associated with a low incidence of aGvHD and that CsA should be initiated at time of transplant with adequate monitoring during the engraftment period to reduce the risk of grade II-IV aGvHD. Disclosures Mohty: MaaT Pharma: Consultancy, Honoraria.
Published: 2018

36. Extracorporeal Photopheresis for First Line Treatment of Acute Graft Versus Host Disease

Author: Florent Malard, Simona Sestili, Remy Dulery, Giorgia Battipaglia, Annalisa Ruggeri, Sandra Eder, Mohamad Mohty, Clemence Mediavilla, Ramdane Belhocine, and Eolia Brissot
Subjects: medicine.medical_specialty, Cyclophosphamide, business.industry, medicine.medical_treatment, Immunology, Salvage therapy, Cell Biology, Hematology, medicine.disease, Single Center, Biochemistry, Transplantation, Regimen, Graft-versus-host disease, Photopheresis, Internal medicine, medicine, Cumulative incidence, business, medicine.drug
Abstract: Background. Extracorporeal photopheresis (ECP) is increasingly used in the treatment of acute and chronic graft versus host disease (aGVHD). It is recognized as an immunomodulatory therapy that can decrease inflammation and allow for immune tolerance. Interesting results have obtained using ECP as salvage therapy in patients with steroid-refractory GVHD after failure of one or more lines of immunosuppressive therapy. With this background, we hypothesized that incorporation of ECP as part of first line treatment for aGVHD may improve response rate and avoid the development of steroid-refractory or steroid-dependent aGVHD, mainly in cases of aGVHD with predominant skin involvement. Patients and methods. Forty consecutive patients who received ECP as part of their first line treatment of aGVHD with skin involvement between 2013 and 2016 were included in this single center analysis. 36 patients (90%) received granulocyte-colony stimulating factor mobilized PBSC as grafts, 3 patients (7.5%) received a bone marrow graft and one patient (2.5%) received an umbilical cord blood graft. Donor was a matched related one for 10 patients, haploidentical for 8 patients, matched unrelated for 16 patients and mismatched unrelated for 6 patients. 4 patients received a reduced intensity conditioning regimen and 36 a myeloablative reduced toxicity conditioning regimen. All patients received a combination of cyclosporine A (CsA) and mycophenolate mofetil for GVHD prophylaxis, except for patients with a matched related donor who received cyclosporine A alone. Patients transplanted with a haploidentical donor, received post-transplant cyclophosphamide (PTCy; 50mg/kg/d at d+3/d+5). ECP was initiated as soon as possible after the diagnosis of aGVHD with predominant skin involvement. The primary endpoint was to determine the best response achieved through the use of ECP for first line treatment of aGVHD. Results. Median age was 57 (range, 22-66) years, with 28 male patients (49%). Diagnoses were myeloid (n=32) or lymphoid malignancies (n=8) and disease status at transplant was complete remission in 23 patients, partial remission in 8 patients, relapse/progression in 8 patients and untreated in 2 patients. Patients developed aGVHD at a median of 31 days after alloHCT (range, 11-129). 5 patients had late onset aGVHD and two patients developed aGVHD after DLI. None of them had an overlap syndrome. aGVHD grade was I in 13 patients, II in 18 patients and III-IV in 9 patients. All patients had skin involvement and 10 patients had gut (n=8) and/or liver (n=5) involvement. All patients, but one, were still receiving CsA at time of aGVHD diagnosis. Systemic corticosteroids were initiated in 29 patients, while 11 patients received only topical dermo-corticoids. ECP was initiated at a median of 9 days (range, 0-83) after the diagnosis of aGVHD. ECP was performed weekly for 26 patients and twice weekly for 14 patients. Overall response rate (ORR) was 80% after a median of 3 (range, 1-9) weeks of treatment, including 24 complete responses (CR, 60%), 6 very good partial responses (VGPR, 15%) and 2 partial responses (PR, 5%). According to aGVHD grade, in patients with grade I aGVHD, the ORR was 92%, including 11 CR and 1 VGPR. In patients with grade II aGVHD, the ORR was 83%, including 8 CR and 7 VGPR/PR. In patients with grade III-IV aGVHD, ORR was 55%, all of them being in CR. In responding patients, 1 patient presented a recurrence of aGVHD and 15 developed chronic GVHD, including 4 overlap syndromes. Median follow-up was 32 months (range, 22-58) among surviving patients. At 24 months after transplant, the OS and PFS rates were respectively 78% (95% CI, 61%-88%) and 56% (range, 39%-70%). The 2-years cumulative incidence of relapse was 33% (95% CI, 19%-49%) and the 2-years cumulative incidence of non-relapse mortality was 10% (95% CI, 3%-22%). Conclusion. ECP is an effective and well-tolerated option for treatment of acute GVHD with predominant skin involvement with a 2 years cumulative incidence of NRM of 10% and an ORR of 80%. Best responses were seen in patients with grade I-II aGVHD, suggesting that ECP should be started as early as possible after the diagnosis of aGVHD. Incorporation of ECP as part of first line treatment for aGVHD may improve response rate and avoid the development of steroid-refractory aGVHD. Prospective randomized trial are warranted to evaluate ECP as adjuvant treatment for first line treatment of skin aGVHD. Disclosures Mohty: Celgene: Consultancy, Honoraria; Takeda: Honoraria, Speakers Bureau; Janssen: Honoraria, Research Funding, Speakers Bureau; Jazz Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau; MaaT Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bristol Myers: Consultancy, Research Funding; Sanofi: Consultancy, Honoraria, Research Funding, Speakers Bureau; Molmed: Consultancy; Servier: Consultancy; Amgen: Consultancy, Honoraria.
Published: 2018

37. [Untitled]

Author: Daria Di Vincenzo, Simona Sestili, and Luciano Di Giovacchino
Subjects: Olive oil quality, Pungency, Chemistry, Organoleptic, General Chemistry, Lower intensity, Ripeness, Industrial and Manufacturing Engineering, Food science, Cultivar, Malaxation, Food Science, Biotechnology, Olive oil
Abstract: Virgin olive oil quality depends on different factors such as olive cultivar, olive tree cultivation and the operations of olive picking, storage and processing. Many investigations concerning these factors were carried out and, in particular, the influence of technological operations of olive processing on oil yields and quality was examined. Leafremoval and olive washing are important operations for the mechanical safety of the olive extracting equipment which operates at high speed and for the organoleptic quality of olive oil. The leaves mixed with olives may increase, in fact, the organoleptic attributes of ‘fresh-cut’ grass or ‘green’, especially if metallic crushers are used to prepare olive paste. Olive crushing has an important influence on organoleptic and nutritional qualities of virgin olive oil. When mill stones are used, the obtained oils have a lower intensity of bitterness and pungency because this crushing method helps to produce oil with a lower content of phenolic substances. When metallic crushers are used oils have, due to the violent action, a higher content of phenolic compounds and are more bitter and pungent. Olive paste malaxation influences the oil yields and also the antioxidant content of oil. With prolonged malaxation oil yields, generally, increase while the phenol content of oils decreases. When ‘difficult’ olive pastes are processed, it is possible to increase oil yields by using technological co-adjuvants such as talc and enzymatic products during the malaxation. The separation of oil from solid and liquid phases of olive paste is performed by using either pressure, percolation or centrifugation systems. All systems may provide good-quality oil if olive fruits are sound and at the correct ripeness, but the centrifugation system helps to avoid or reduce the risk of an organoleptic contamination. The new centrifugal decanters, operating without adding water (or only a minimal amount of water) to olive paste, save heat energy and the oils obtained are more fruity and have a higher content of natural phenolic antioxidants.
Published: 2002

38. Heart failure and chronic kidney disease in a registry of internal medicine wards

Author: Rosa Di Costanzo, Roberto Corinaldesi, Federica Quaglia, Umberto Vespasiani Gentilucci, Giancarlo Agnelli, M. Vanoli, Roberta Forlano, Valeria Savojardo, Luca Bertone, Elisa Fabbri, Antonino Di Pino, Claudia Amolini, Giampiera Bertolino, Paolo Cavallo Perin, Paola Bonara, Tommaso Barnini, Fabrizio Fabris, Paola Di Corato, Maria Rosaria Barbella, Francesco Franceschi, Elisabetta Bergami, Roberto Manfredini, Sonia Seghezzi, Enrico Strocchi, Maria Domenica Cappellini, Antonio Manucra, Alberto Tedeschi, Maurizio Corsi, Gabriella Gruden, Giuseppe Licata, Marianna Zardo, Emanuela Marchesini, Luca Pasina, Maria Ester Modeo, Mosè Bartone, Barbara Nardo, Umberto Gualtieri, Sabbatini Marta, Caterina Cenci, Alessia Coralli, Giorgio Annoni, Lucrezia De Feudis, V. Monti, Pietro Serra, Anna Maria Stanzial, Antonio Bonelli, Gianpaolo Reboldi, Francesco Paciullo, Ferdinando Massari, Graziana Lupattelli, Giorgio Sesti, Silvia Fargion, Angela Sciacqua, Giovanna Fabio, Silvia Di Carlo, Maria Grazia Serra, Emanuele Durante Mangoni, Salvatore Corrao, Maria Angela Becchi, Margherita Migone De Amicis, Francesco Gullo, Silvia Cappelli, Flora Peyvandi, Paolo Gallo, Chiara Mazzarelli, Daniela Calipari, Ferdinando Carlo Sasso, Carlo Cagnoni, Laura Carassale, Donatella Renna, Paola Loria, Davide Ghelfi, Alessandra Quercioli, Maria Teresa Guagnano, Luana Castoldi, Massimo Delfino, Cosimo Morabito, Giuseppe Musca, Francesca Turatto, Silvia Prolo, Lina Falanga, Michela Zanetti, Antonio Perciccante, Francesco Purrello, Marco Cicardi, Maria Beatrice Secchi, Mauro Tettamanti, Maria Rosaria Rizzo, Luigi Anastasio, C. Masala, Andrea Maria Maresca, Elena Silvestri, Domenico Prisco, Filippo Pedrazzoli, Marco Bertolotti, Guido De Marco, Giancarlo Traisci, Maria Carmela Carbone, Filippo Rossi Fanelli, Maria Valenti, Ilenia Pepe, Deborah Melis, Christian Bracco, Giorgio Maniscalco, Antonella Gallo, Daniela D'Angelo, Alfonso Iorio, Gianfranco Martucci, Tatiana Tonella, Ilaria Serio, Wu Sheng Chin, Michela Quagliolo, Cordischi Chiara, Andrea Sacco, Pietro Tizzani, Antonio Mammarella, Donatella Setti, Damiano Rizzoni, Lucia Gottardo, Olga Cuccurullo, Gino Roberto Corazza, Rinaldo Striuli, Elmo Mannarino, Guido Moreo, Luana Castiglioni, G. Vaudo, Teresa Salvatore, Maurizio Bicchi, Raffaella Rossio, Francesco Violi, Donatella Magalotti, Giuseppe Zuccalà, Luca Puccetti, Luigi Fenoglio, Daniela Tirotta, Alessandra Fiorentini, Oliviero Olivieri, Christian Folli, Alberto Buratti, Francesco Saverio Vella, Vincenzo Fontana, Giulia Grignani, Laura Gasbarrone, Sara Zazzetta, Antonio Brucato, Marco Zoli, Michele Cortellaro, Stella Provini, Claudio Borghi, Mario Barbagallo, Rodolfo Tassara, Sara Contini, Elisa Rebecca Rinaldi, Lidia Plances, Stefano Volpato, Alessandra Barreca, Ludovica Perri, Stefania Alborghetti, Chiara Valentina Luglio, Donatella Padula, Codjo Djignefa Djade, Maria Rachele Meroni, Mara Bulgheroni, Giuseppe Riccardo Centenaro, Chiara Bagnato, Salvatore Piro, Nicola Lucio Liberato, Luigi Bolondi, Franco Ricci, Annalisa Spalluti, Luciano Ottonello, Giordano Bernasconi, Antonio Picardi, Michela Carlon, Riccardo Utili, Maria Alice Ferri, Roberto Valenti, Francesca Veltri, Giorgio Menardo, Giuliana Micale, Maria Cristina Baroni, Piergiorgio Gaudenzi, Pallante Raffaele, Simona Sestili, Giuseppe Romanelli, Roberto De Giorgio, L. Rasciti, Franco Arturi, Marta Bovio, Alessandro Squizzato, Leonella Pasqualini, Pier Leopoldo Capecchi, Alfredo Postiglione, Maura Marcucci, Antonio Amoroso, Sarah Damanti, Lucia Sofia, E Mannarino, Francesca Perego, Silvia Caporotundo, Giuseppe Delitala, Gaetano Serviddio, Barbara Ferrari, Lorenzo Mauro Carozza, Raffaella Salmi, Giacomo Fera, Pier Mannuccio Mannucci, Daniela Mari, Pasquale Mansueto, Carlotta Franchi, Silvia Li Bassi, Luca Santi, Michele Quero, Graziella Bruno, Elsa Sferrazzo, Martino Bellusci, Sebastiana Atzori, Mauro Maurantonio, Mauro Bernardi, Maria Sole Lilleri, Maria Loreta Di Luca, Carlo Sabbà, Luigi Cricco, Mancuso G, Alessia Valentina Giraudo, Giovanni Battista Bianchi, Valentina Grasso, Chiara Mussi, Giovanni Murialdo, Chiara Brignone, Marco Pala, Marina Magenta, Franco Dallegri, Giuseppe Montrucchio, Pamela Rondelli, Carlo L. Balduini, P. M. Mannucci, Giampiero Benetti, Fabio Fabbian, Massimo Gunelli, Fabio Pignatti, Emanuela Miceli, Tiziana Tognin, Stefania Pugliese, Franco Laghi Pasini, Francesco Salerno, Alessandra Marengoni, Rosa Scipioni, A. Nobili, Maria Antonietta Bleve, Gianluca Casella, Francesca Meda, Elisabetta Greco, Antonio Gidaro Marina Magenta, Fabio Magrini, Elena Succurro, Emanuela Rizzioli, Valeria Raparelli, Susanna Gamberini, Caterina Pirali, Ligia J. Dominguez, Stefania Basili, Matteo Pirro, Luigi Calvo, Bartolomeo Lorenzati, Ranuccio Nuti, Francesco Perticone, Claudio Ferri, Giovanbattista Rini, Christian Molino, Stefano Carta, Marta Molaro, Francesco De Stefano, Maria Teresa Laieta, Annamaria Aquilino, Sabrina Giaquinto Ospedale, Gaetano Dentamaro, Martina Ruvio, Raffaele Landolfi, Renzo Rozzini, Mauro Serra, Giovanni Davì, Carlo Selmi, Renato Fellin, G. Lupattelli, Silvia Ghidoni, Marco Vincenzo Lenti, Alberto Auteri, Alessandro Giordano, Eleonora Sparacio, Marco Falcone, Roberto Fava, Anna Laura Pasqui, Giuseppe Palasciano, Daniela Di Pinto, Gianfranco Guarnieri, Rosa Lombardi, F. Paciullo, Luigina Guasti, Sioulis Fotini, Maria Magnini, Mauro Podda, Alessandro Marseglia, Silvia Accordino, Enrico Agabiti Rosei, Caterina Capobianco, Alessio Conca, Giuseppe Paolisso, Lara Rebella, Alessandra Fantuzzi, Paolo Rossi, Andrea Semplicini, Gianluigi Vendemiale, Luisa Roncari, Antonio Grieco, Roberto Scotto, Alessandro Nobili, Valter Monzani, Eugenio Ruggeri, Stefania Bottone, Mannucci, P, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Salerno, F, Corrao, S, Marengoni, A, Iorio, A, Marcucci, M, Sparacio, E, Alborghetti, S, Di Costanzo, R, Djade, C, Prisco, D, Silvestri, E, Cenci, C, Barnini, T, Delitala, G, Carta, S, Atzori, S, Guarnieri, G, Zanetti, M, Spalluti, A, Serra, M, Bleve, M, Vanoli, M, Grignani, G, Casella, G, Gasbarrone, L, Maniscalco, G, Gunelli, M, Tirotta, D, Brucato, A, Ghidoni, S, Di Corato, P, Bernardi, M, Li Bassi, S, Santi, L, Agnelli, G, Marchesini, E, Mannarino, E, Lupattelli, G, Rondelli, P, Paciullo, F, Fabris, F, Carlon, M, Turatto, F, Baroni, M, Zardo, M, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Paolisso, G, Rizzo, M, Laieta, M, Salvatore, T, Sasso, F, Utili, R, Mangoni, E, Pinto, D, Olivieri, O, Stanzial, A, Fellin, R, Volpato, S, Fotini, S, Barbagallo, M, Dominguez, L, Plances, L, D'Angelo, D, Rini, G, Mansueto, P, Pepe, I, Licata, G, Calvo, L, Valenti, M, Borghi, C, Strocchi, E, Rinaldi, E, Zoli, M, Fabbri, E, Magalotti, D, Auteri, A, Pasqui, A, Puccetti, L, Pasini, F, Capecchi, P, Bicchi, M, Sabbà, C, Vella, F, Marseglia, A, Luglio, C, Palasciano, G, Modeo, M, Aquilino, A, Raffaele, P, Pugliese, S, Capobianco, C, Postiglione, A, Barbella, M, De Stefano, F, Fenoglio, L, Brignone, C, Bracco, C, Giraudo, A, Musca, G, Cuccurullo, O, Cricco, L, Fiorentini, A, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Fargion, S, Bonara, P, Bulgheroni, M, Lombardi, R, Magrini, F, Massari, F, Tonella, T, Peyvandi, F, Tedeschi, A, Rossio, R, Moreo, G, Ferrari, B, Roncari, L, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Mari, D, Rossi, P, Damanti, S, Prolo, S, Lilleri, M, Micale, G, Podda, M, Selmi, C, Meda, F, Accordino, S, Conca, A, Monti, V, Corazza, G, Miceli, E, Lenti, M, Padula, D, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Murialdo, G, Bovio, M, Dallegri, F, Ottonello, L, Quercioli, A, Barreca, A, Secchi, M, Ghelfi, D, Chin, W, Carassale, L, Caporotundo, S, Anastasio, L, Sofia, L, Carbone, M, Traisci, G, De Feudis, L, Di Carlo, S, Davì, G, Guagnano, M, Sestili, S, Bergami, E, Rizzioli, E, Cagnoni, C, Bertone, L, Manucra, A, Buratti, A, Tognin, T, Liberato, N, Bernasconi, G, Nardo, B, Bianchi, G, Ospedale, S, Benetti, G, Quagliolo, M, Centenaro, G, Purrello, F, Di Pino, A, Piro, S, Mancuso, G, Calipari, D, Bartone, M, Gullo, F, Cortellaro, M, Magenta, M, Perego, F, Meroni, M, Cicardi, M, Magenta, A, Sacco, A, Bonelli, A, Dentamaro, G, Rozzini, R, Falanga, L, Giordano, A, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Montrucchio, G, Greco, E, Tizzani, P, Fera, G, Di Luca, M, Renna, D, Perciccante, A, Coralli, A, Tassara, R, Melis, D, Rebella, L, Menardo, G, Bottone, S, Sferrazzo, E, Ferri, C, Striuli, R, Scipioni, R, Salmi, R, Gaudenzi, P, Gamberini, S, Ricci, F, Morabito, C, Fava, R, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Bolondi, L, Rasciti, L, Serio, I, Masala, C, Mammarella, A, Raparelli, V, Fanelli, F, Delfino, M, Amoroso, A, Violi, F, Basili, S, Perri, L, Serra, P, Fontana, V, Falcone, M, Landolfi, R, Grieco, A, Gallo, A, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Bellusci, M, Setti, D, Pedrazzoli, F, Romanelli, G, Pirali, C, Amolini, C, Rosei, E, Rizzoni, D, Castoldi, L, Picardi, A, Gentilucci, U, Mazzarelli, C, Gallo, P, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Contini, S, Molaro, M, Annoni, G, Corsi, M, Zazzetta, S, Bertolotti, M, Mussi, C, Scotto, R, Ferri, M, Veltri, F, Arturi, F, Succurro, E, Sesti, G, Gualtieri, U, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Carozza, L, Pignatti, F, Reboldi, G, Vaudo, G, Pirro, M, Pasqualini, L, Mannucci, Pier Mannuccio, Nobili, Alessandro, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Iorio, Alfonso, Marcucci, Maura, Sparacio, Eleonora, Alborghetti, Stefania, Di Costanzo, Rosa, Djade, Codjo Djignefa, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Barnini, Tommaso, Delitala, Giuseppe, Carta, Stefano, Atzori, Sebastiana, Guarnieri, Gianfranco, Zanetti, Michela, Spalluti, Annalisa, Serra, Maria Grazia, Bleve, Maria Antonietta, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Gasbarrone, Laura, Maniscalco, Giorgio, Gunelli, Massimo, Tirotta, Daniela, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Bernardi, Mauro, Li Bassi, Silvia, Santi, Luca, Agnelli, Giancarlo, Marchesini, Emanuela, Mannarino, Elmo, Lupattelli, Graziana, Rondelli, Pamela, Paciullo, Francesco, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baroni, Maria Cristina, Zardo, Marianna, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Salvatore, Teresa, Sasso, Ferdinando Carlo, Utili, Riccardo, Mangoni, Emanuele Durante, Pinto, Daniela, Olivieri, Oliviero, Stanzial, Anna Maria, Fellin, Renato, Volpato, Stefano, Fotini, Siouli, Barbagallo, Mario, Dominguez, Ligia, Plances, Lidia, D'Angelo, Daniela, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Licata, Giuseppe, Calvo, Luigi, Valenti, Maria, Borghi, Claudio, Strocchi, Enrico, Rinaldi, Elisa Rebecca, Zoli, Marco, Fabbri, Elisa, Magalotti, Donatella, Auteri, Alberto, Pasqui, Anna Laura, Puccetti, Luca, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Sabbà, Carlo, Vella, Francesco Saverio, Marseglia, Alessandro, Luglio, Chiara Valentina, Palasciano, Giuseppe, Modeo, Maria Ester, Aquilino, Annamaria, Raffaele, Pallante, Pugliese, Stefania, Capobianco, Caterina, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Fenoglio, Luigi, Brignone, Chiara, Bracco, Christian, Giraudo, Alessia, Musca, Giuseppe, Cuccurullo, Olga, Cricco, Luigi, Fiorentini, Alessandra, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Fargion, Silvia, Bonara, Paola, Bulgheroni, Mara, Lombardi, Rosa, Magrini, Fabio, Massari, Ferdinando, Tonella, Tatiana, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Moreo, Guido, Ferrari, Barbara, Roncari, Luisa, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Prolo, Silvia, Lilleri, Maria Sole, Micale, Giuliana, Podda, Mauro, Selmi, Carlo, Meda, Francesca, Accordino, Silvia, Conca, Alessio, Monti, Valentina, Corazza, Gino Roberto, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Murialdo, Giovanni, Bovio, Marta, Dallegri, Franco, Ottonello, Luciano, Quercioli, Alessandra, Barreca, Alessandra, Secchi, Maria Beatrice, Ghelfi, Davide, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Bergami, Elisabetta, Rizzioli, Emanuela, Cagnoni, Carlo, Bertone, Luca, Manucra, Antonio, Buratti, Alberto, Tognin, Tiziana, Liberato, Nicola Lucio, Bernasconi, Giordano, Nardo, Barbara, Bianchi, Giovanni Battista, Ospedale, Sabrina Giaquinto, Benetti, Giampiero, Quagliolo, Michela, Centenaro, Giuseppe Riccardo, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Gullo, Francesco, Cortellaro, Michele, Magenta, Marina, Perego, Francesca, Meroni, Maria Rachele, Cicardi, Marco, Magenta, Antonio Gidaro Marina, Sacco, Andrea, Bonelli, Antonio, Dentamaro, Gaetano, Rozzini, Renzo, Falanga, Lina, Giordano, Alessandro, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Fera, Giacomo, Di Luca, Maria Loreta, Renna, Donatella, Perciccante, Antonio, Coralli, Alessia, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Menardo, Giorgio, Bottone, Stefania, Sferrazzo, Elsa, Ferri, Claudio, Striuli, Rinaldo, Scipioni, Rosa, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Ricci, Franco, Morabito, Cosimo, Fava, Roberto, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Fanelli, Filippo Rossi, Delfino, Massimo, Amoroso, Antonio, Violi, Francesco, Basili, Stefania, Perri, Ludovica, Serra, Pietro, Fontana, Vincenzo, Falcone, Marco, Landolfi, Raffaele, Grieco, Antonio, Gallo, Antonella, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Romanelli, Giuseppe, Pirali, Caterina, Amolini, Claudia, Rosei, Enrico Agabiti, Rizzoni, Damiano, Castoldi, Luana, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Mazzarelli, Chiara, Gallo, Paolo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Contini, Sara, Molaro, Marta, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bertolotti, Marco, Mussi, Chiara, Scotto, Roberto, Ferri, Maria Alice, Veltri, Francesca, Arturi, Franco, Succurro, Elena, Sesti, Giorgio, Gualtieri, Umberto, Perticone, Francesco, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Corinaldesi, Roberto, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Carozza, Lorenzo Mauro, Pignatti, Fabio, Lupattelli, G., Reboldi, G., Paciullo, F., Vaudo, G., Pirro, M., Pasqualini, L., Nobili, A., Mannucci, P. M., Mannarino, E., Mannucci, PM, REPOSI, Investigators, Barbagallo, M, and Dominguez Rodríguez, LJ
Subjects: medicine.medical_specialty, Chronic kidney disease, Elderly, Heart failure, REPOSI, Gerontology, Geriatrics and Gerontology, Humans, Sleep Apnea Syndromes, Noninvasive Ventilation, Renal function, chronic kidney disease, elderly, registry, Tertiary care, Sleep Apnea Syndrome, Internal medicine, Epidemiology, medicine, business.industry, medicine.disease, Heart failure, Elderly, Chronic kidney disease, REPOSI, Icd codes, business, Clinical record, Body mass index, Kidney disease, Human
Abstract: Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were significantly older (P
Published: 2014

39. Plasma levels of soluble CD36, platelet activation, inflammation, and oxidative stress are increased in type 2 diabetic patients

Author: Natale Vazzana, Francesca Santilli, Pål Aukrust, Simona Sestili, Rossella Liani, Gloria Formoso, Bente Halvorsen, Aase Handberg, and Giovanni Davì
Subjects: CD36 Antigens, Male, medicine.medical_specialty, Inflammation, Enzyme-Linked Immunosorbent Assay, Type 2 diabetes, medicine.disease_cause, Biochemistry, Lipid peroxidation, chemistry.chemical_compound, Risk Factors, Physiology (medical), Diabetes mellitus, Internal medicine, medicine, Humans, Platelet, Platelet activation, Aged, Aspirin, Chemistry, Middle Aged, medicine.disease, Atherosclerosis, Platelet Activation, Oxidative Stress, Endocrinology, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Case-Control Studies, Female, medicine.symptom, Oxidative stress, medicine.drug
Abstract: Inflammation, oxidative stress, and platelet activation are involved in type 2 diabetes and its complications. Soluble CD36 (sCD36) has been proposed to early identify diabetics at risk of accelerated atherothrombosis. We aimed at characterizing the platelet contribution to sCD36 in diabetes, by correlating its concentration with the extent of platelet-mediated inflammation and in vivo lipid peroxidation and investigating the effects of low-dose aspirin on these processes. A cross-sectional comparison of sCD36, soluble CD40L (sCD40L) reflecting platelet-mediated inflammation, urinary 11-dehydro-TxB(2), and 8-iso-PGF(2α), in vivo markers of platelet activation and lipid peroxidation, was performed among 200 diabetic patients (94 of them on aspirin 100mg/day) and 47 healthy controls. sCD36 levels (median [IQR]: 0.72 [0.31-1.47] vs 0.26 [0.2-0.37], P=0.003) and urinary 11-dehydro-TxB(2) levels (666 [293-1336] vs 279 [160-396], P≤0.0001) were significantly higher in diabetic patients not on aspirin (n=106) than in healthy subjects. These variables were significantly lower in aspirin-treated diabetics than untreated patients (P0.0001). Among patients not on aspirin, those with long-standing diabetes (1 year) had significantly higher sCD36 levels in comparison to patients with diabetes duration1 year (1.01 [0.62-1.86] vs 0.44 [0.22-1.21], P=0.001). sCD36 linearly correlated with sCD40L (rho=0.447; P=0.0001). On multiple regression analysis, 11-dehydro-TxB(2) (β=0.360; SEM=0.0001, P=0.001), 8-iso-PGF(2α) (β=0.469; SEM=0.0001, P0.0001), and diabetes duration (β=0.244; SEM=0.207, P=0.017) independently predicted sCD36 levels. sCD36, platelet activation, inflammation, and oxidative stress are increased in type 2 diabetes. Future studies are needed to elucidate if the incomplete down-regulation of sCD36 by low-dose aspirin implies that sCD36 may be derived from tissues other than platelets or if additional antiplatelet strategies in diabetes are necessary to interrupt CD36-dependent platelet activation.
Published: 2011

40. Heterogeneity and Peculiarities Of a Small Series Of Patients Affected By Paroxysmal Nocturnal Hemoglobinuria Treated With Eculizumab

Author: Giuseppe Fioritoni, Giuseppina Ricciuti, Paolo Bartolomeo, Antonella Sau, Gaetano La Barba, Simona Sestili, and Stefano Pulini
Subjects: Meningitides, Reticulocytosis, business.industry, Immunology, Cell Biology, Hematology, Eculizumab, medicine.disease, Biochemistry, Hereditary spherocytosis, Complement inhibitor, hemic and lymphatic diseases, Paroxysmal nocturnal hemoglobinuria, medicine, Hemoglobinuria, medicine.symptom, Aplastic anemia, business, medicine.drug
Abstract: Paroxysmal nocturnal hemoglobinuria (PNH) derives from a non malignant clonal expansion of hematopoietic stem cells (HSCs) harbouring somatic mutations of the X-linked PIG-A gene, leading to the complete or partial loss of glycosylphosphatidylinositol membrane-anchored proteins (GPI-APs) from the cell surface of the HSCs and of their mature progeny. The resulting intravascular hemolysis is caused by uncontrolled activation of the complement cascade and determines hemoglobinuria, anemia, fatigue, renal impairment, pulmonary hypertension, smooth muscle dystonias and thromboembolism, with a bad quality of life. Moreover PNH is usually embedded with a various degree of bone marrow (BM) failure syndromes, from mild cytopenias up to aplastic anemia.We describe 5 PNH patients: 3 males and 2 females; median age was 36 year (18-54). All developed PNH after other haematologic disorders. The first one was a rare case occurring after autologous stem cell transplantation(ASCT) for relapsing non-Hodgkin’s lymphoma; the second had experienced an aplastic anemia, successfully treated with immunosuppressive therapy; two were affected by anemia and thrombocytopenia of unspecified nature; in the fifth young patient (18 ys), hereditary spherocytosis had been diagnosed 2 years before, based on erythrocyte membrane protein analysis and splenectomy had been performed. All patients had strong intravascular hemolysis (reticulocytosis, elevated LDH, gross hemosiderinuria); the flow cytometry immunophenotyping study of GPI-APs expression on peripheral blood cells showed large cellular populations of erythrocytes, granulocytes and monocytes which had undetectable expression of GPI-APs, suggesting PNH. According to the previous hematological disorders or therapy (ASCT) in the mentioned series of patients, PNH occurred after 2, 5, 9, 1 and 2 years respectively. Three patients were transfusion dependent. After unsuccessful therapy with prednisone, folate and even cycles of steroid therapy, the terminal complement inhibitor eculizumab (EC) was started. All the patients received vaccination against Neisseria meningitides. EC was infused according to the standard schedule, 600 mg weekly for 4 weeks, followed by 900 mg every other week. EC was started respectively after 7 months, 24 months and 8 years from PNH diagnosis in the first three patients and after 4 months from PNH diagnosis in in the last 2 patients. The intravascular hemolysis was completely controlled in all patients. Only one patient continued but reduced erythrocyte transfusions; she shows significant extravascular hemolysis, building up GPI- C3d coated erythrocytes (DAT ++), and is candidate for splenectomy. Despite the different haematological response all 5 patients experienced a dramatic clinical improvement in the quality of life. In the transplant patient the cytometry showed a progressive reduction and ultimately extinction of the pathological clone; this provided the unique possibility to discontinue treatment after 12 months, then maintaining remission for some years. Probably in this case, EC did not play any direct role in the kinetics of the PNH clone, while the conditions which led to expansion of the clone were somehow unique and possibly related to the ASCT and resulted transient. Our small series, including even 2 rare cases (one pediatric PNH patient and one occurred after ASCT) shows how variable are the clinical and biological spectrum of manifestations in this strange and fascinating disease; moreover its clinical evolution in each single patient remains frequently unpredictable. Disclosures: No relevant conflicts of interest to declare.
Published: 2013

41. C0370 Plasma levels of soluble CD36, platelet activation, inflammation and oxidative stress are increased in type 2 diabetic patients

Author: Francesca Santilli, Aase Handberg, Giovanni Davì, Pål Aukrust, Natale Vazzana, Gloria Formoso, Simona Sestili, Bente Halvorsen, and Rossella Liani
Subjects: medicine.medical_specialty, biology, Chemistry, CD36, Inflammation, Hematology, Plasma levels, medicine.disease_cause, Endocrinology, Internal medicine, biology.protein, medicine, Platelet activation, medicine.symptom, Oxidative stress
Published: 2012

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