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Vacca R, Bianchi F. Diversity, integration, and variability of intergenerational relationships in old age: New insights from personal network research. SOCIAL SCIENCE RESEARCH 2024; 119:102991. [PMID: 38609307 DOI: 10.1016/j.ssresearch.2024.102991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 04/14/2024]
Abstract
Relationships between family members from different generations have long been described as a source of solidarity and support in aging populations and, more recently, as a potential risk factor for COVID-19 contagion. Personal or egocentric network research offers a powerful kit of conceptual and methodological tools to study these relationships, but this has not yet been employed to its full potential in the literature. We investigate the heterogeneity, social integration, and individual correlates of intergenerational relationships in old age analyzing highly granular data on the personal networks of 230 older adults (2747 social ties) from a local survey in one of the areas of the world at the forefront of global aging trends (northern Italy). Using information on different layers in broad egocentric networks and on the structure of connectivity among the social contacts of aging people, we propose multiple conceptualizations and measures of intergenerational connectedness. Results show that intergenerational relationships are strongly integrated, but also highly diverse and variable, in older adults' social networks. Different types of intergenerational ties exist in different network layers, with various relational roles, degrees of tie strength, and patterns of association with individual and tie characteristics. We discuss how new and existing personal network data can be leveraged to consider novel questions and hypotheses about intergenerational relationships in contemporary aging families.
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Affiliation(s)
- Raffaele Vacca
- Department of Social and Political Sciences, University of Milan, Italy; Bureau of Economic and Business Research, University of Florida, United States.
| | - Federico Bianchi
- Department of Social and Political Sciences, University of Milan, Italy
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Donghia R, Pesole PL, Castellaneta A, Coletta S, Squeo F, Bonfiglio C, De Pergola G, Rinaldi R, De Nucci S, Giannelli G, Di Leo A, Tatoli R. Age-Related Dietary Habits and Blood Biochemical Parameters in Patients with and without Steatosis-MICOL Cohort. Nutrients 2023; 15:4058. [PMID: 37764841 PMCID: PMC10534690 DOI: 10.3390/nu15184058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Steatosis is now the most common liver disease in the world, present in approximately 25% of the global population. The aim of this study was to study the association between food intake and liver disease and evaluate the differences in blood parameters in age classes and steatosic condition. METHODS The present study included 1483 participants assessed in the fourth recall of the MICOL study. Patients were subdivided by age (>65 years) and administered a validated food frequency questionnaire (FFQ) with 28 food groups. RESULTS The prevalence of steatosis was 55.92% in the adult group and 55.88% in the elderly group. Overall, the results indicated many statistically significant blood parameters and dietary habits. Analysis of food choices with a machine learning algorithm revealed that in the adult group, olive oil, grains, processed meat, and sweets were associated with steatosis, while the elderly group preferred red meat, dairy, seafood, and fruiting vegetables. Furthermore, the latter ate less as compared with the adult group. CONCLUSIONS Many differences were found between the two age groups, both in blood parameters and food intake. The random forest also revealed different foods predicted steatosis in the two groups. Future analysis will be useful to understand the molecular basis of these differences and how different food intake causes steatosis in people of different ages.
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Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Antonino Castellaneta
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Francesco Squeo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Giovanni De Pergola
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Roberta Rinaldi
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Sara De Nucci
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Alfredo Di Leo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
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Marchi S, Fallani E, Salvatore M, Montomoli E, Trombetta CM. The burden of influenza and the role of influenza vaccination in adults aged 50-64 years: A summary of available evidence. Hum Vaccin Immunother 2023; 19:2257048. [PMID: 37778401 PMCID: PMC10760501 DOI: 10.1080/21645515.2023.2257048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023] Open
Abstract
Influenza is a vaccine-preventable disease and a global public health problem. Although most national influenza vaccination recommendations focus on subjects aged ≥65 years, an extensive burden of influenza has also been reported in those aged ≥50 years and is exacerbated by immune system aging. The main purpose of this review is to provide an overview of the burden of influenza and its potential prevention within the 50-64 age-group. These subjects account for a large proportion of the workforce, and play a central economic and social role. Individuals aged 50-64 years had a 3-times higher rate of hospitalization and a 9-fold higher mortality rate attributable to influenza than those aged 18-49-years, generating higher influenza-related hospitalization costs. Available data suggest that including healthy subjects aged 50-64 years in influenza vaccination recommendations would allow a broader population to be reached, reducing the economic and social burden of influenza.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Elettra Fallani
- Seqirus S.r.l., Monteriggioni, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Marco Salvatore
- Seqirus S.r.l., Monteriggioni, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
- VisMederi Research srl, Siena, Italy
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Zuin M, Bilato C, Rigatelli G, Quadretti L, Roncon L. Trends in age-specific and sex-specific pulmonary hypertension mortality in Italy between 2005 and 2017. J Cardiovasc Med (Hagerstown) 2023; 24:289-296. [PMID: 36938812 DOI: 10.2459/jcm.0000000000001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
AIMS Data regarding the pulmonary hypertension (PH)-related mortality and relative trends in the Italian population remain scant. We sought to assess the PH mortality rates and relative trends among the Italian population between 2005 and 2017. METHODS Data regarding the cause-specific mortality and population size by sex in 5-year age groups were extracted from the WHO global mortality database. The age-standardized mortality rates, with relative 95% confidence intervals (CIs), also stratified by sex, were using the direct method. Joinpoint regression analyses were used to identify periods with statistically distinct log linear trends in PH-related death rates. To calculate nationwide annual trends in DCM-related mortality, we assessed the average annual percentage change (AAPC) and relative 95% CIs. RESULTS In Italy, the PH age-standardized annual mortality rate decreased from 2.34 (95% CI: 2.32-2.36) deaths per 100 000 to 1.51 (95% CI: 1.48-1.53) deaths per 100 000 population. Over the entire period, men had higher PH-related mortality rates than women. Moreover, the PH-related mortality trend rose with a seemingly exponential distribution with a similar trend among male and female individuals. Joinpoint regression analysis revealed a linear significant decrease in age-standardized PH-related mortality from 2005 to 2017 [AAPC: -3.1% (95% CI: -3.8 to -2.5), P < 0.001] in the entire Italian population. However, the decline was more pronounced among men [AAPC: -5.0 (95% CI: -6.1 to -3.9), P < 0.001] compared with women [AAPC: -1.5 (95% CI: -2.3 to -0.7), P = 0.001]. CONCLUSION In Italy, the PH-related mortality rates linearly declined from 2005 to 2017.
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Affiliation(s)
- Marco Zuin
- Department of Cardiology, West Vicenza Hospital, Arzignano, Vicenza.,Department of Translational Medicine, University of Ferrara, Ferrara
| | - Claudio Bilato
- Department of Cardiology, West Vicenza Hospital, Arzignano, Vicenza
| | | | - Laura Quadretti
- Department of Cardiology, Casa di Cura Madonna della Slaute, Porto Viro
| | - Loris Roncon
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
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Mazzola P, Spedale V. Commentary: Risk factors for complications in elderly patients aged 85 years and over undergoing endoscopic biliary stone removal. Front Surg 2023; 10:1139745. [PMID: 36925506 PMCID: PMC10011687 DOI: 10.3389/fsurg.2023.1139745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/01/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Paolo Mazzola
- School of Medicine and Surgery, Università Degli Studi di Milano-Bicocca, Monza, MB, Italy.,Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, MB, Italy
| | - Valentina Spedale
- School of Medicine and Surgery, Università Degli Studi di Milano-Bicocca, Monza, MB, Italy.,Nurse Educator Undergraduate Nursing Degree, Fondazione IRCCS San Gerardo dei Tintori, Monza, MB, Italy
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Previtali F, Picco E, Gragnano A, Miglioretti M. The Relationship between Work, Health and Job Performance for a Sustainable Working Life: A Case Study on Older Manual Employees in an Italian Steel Factory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114586. [PMID: 36361464 PMCID: PMC9654428 DOI: 10.3390/ijerph192114586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/17/2022] [Accepted: 10/24/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Supporting and retaining older workers has become a strategic management goal for companies, considering the ageing of the workforce and the prolongation of working lives. The relationship between health and work is especially crucial for older workers with manual tasks, considering the impact of long-standing health impairments in older age. Although different studies investigated the relationship between work ability and job performance, few studies have analysed the impact of workers' capability to balance between health and work demands, including managerial and organisational support (work-health balance). Considering health as a dynamic balance between work and health demands influenced by both individual and environmental factors, we assess the mediator role of work-health balance in the relation between work ability and job performance, both self-reported and assessed by the supervisor. METHODS The study utilises data from a case study of 156 manual workers, who were 50 years old or older and employed in a steel company in Italy. Data were collected inside the company as an organiational initiative to support age diversity. RESULTS The findings show that work-health balance partially mediates the relationship between work ability and self-rated job performance, while it does not mediate the relationship with job performance as rated by the supervisor. Supervisor-rated job performance is positively associated with work ability, while it decreases with the increasing perceived incompatibility between work and health. CONCLUSION A perceived balance between health and work is a strategic factor in increasing manual older workers' job performance. For older workers, not only the perceived capability to work is important but also the organisational health climate and supervisor's support. More studies are needed to verify if managers overlook the importance of health climate and support, as strategic elements that can foster performance for older employees.
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Affiliation(s)
- Federica Previtali
- Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
- Gerontology Research Centre, Tampere University, 33100 Tampere, Finland
- Correspondence:
| | - Eleonora Picco
- Bicocca Center for Applied Psychology–BiCApP, Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Andrea Gragnano
- Bicocca Center for Applied Psychology–BiCApP, Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Massimo Miglioretti
- Bicocca Center for Applied Psychology–BiCApP, Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
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Wu Y, Xu R, Yu W, Wen B, Li S, Guo Y. Economic burden of premature deaths attributable to non-optimum temperatures in Italy: A nationwide time-series analysis from 2015 to 2019. ENVIRONMENTAL RESEARCH 2022; 212:113313. [PMID: 35436452 DOI: 10.1016/j.envres.2022.113313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/21/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Human beings and society are experiencing substantial consequences caused by non-optimum temperatures. However, limited studies have assessed the economic burden of premature deaths attributable to non-optimum temperatures. OBJECTIVES To characterize the association between daily mean temperature and the economic burden of premature deaths. METHODS A total of 3 228 098 deaths were identified from a national mortality dataset in Italy during 2015 and 2019. We used the value of statistical life to quantify the economic losses of premature death. A two-stage time-series analysis was performed to evaluate the economic losses of premature deaths associated with non-optimum temperatures. Attributable burden for non-optimum temperatures compared with minimum risk temperature were estimated. Potential effect modifiers were further explored. RESULTS From 2015 to 2019, the economic loss of premature deaths due to non-optimum temperatures was $525.52 billion (95% CI: $461.84-$580.80 billion), with the attributable fraction of 5.74% (95% CI: 5.04%-6.34%). Attributable economic burden was largely due to moderate cold temperatures ($309.54 billion, 95% CI: $249.49-$357.34 billion). A higher economic burden was observed for people above the age of 65, accounting for 75.97% ($452.42, 95%CI: $406.97-$488.76 billion) of the total economic burden. In particular, higher fractions attributable to heat temperatures were observed for provinces with the lowest level of GDP per capita but the highest level of urbanization. DISCUSSION This study shows a considerable economic burden of premature deaths attributed to non-optimum temperatures. These figures can help inform tailored prevention to tackle the large economic burden imposed by non-optimum temperatures.
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Affiliation(s)
- Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wenhua Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Nepomuceno MR, Klimkin I, Jdanov DA, Alustiza‐Galarza A, Shkolnikov VM. Sensitivity Analysis of Excess Mortality due to the COVID-19 Pandemic. POPULATION AND DEVELOPMENT REVIEW 2022; 48:279-302. [PMID: 35600716 PMCID: PMC9115405 DOI: 10.1111/padr.12475] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Estimating excess mortality is challenging. The metric depends on the expected mortality level, which can differ based on given choices, such as the method and the time series length used to estimate the baseline. However, these choices are often arbitrary, and are not subject to any sensitivity analysis. We bring to light the importance of carefully choosing the inputs and methods used to estimate excess mortality. Drawing on data from 26 countries, we investigate how sensitive excess mortality is to the choice of the mortality index, the number of years included in the reference period, the method, and the time unit of the death series. We employ two mortality indices, three reference periods, two data time units, and four methods for estimating the baseline. We show that excess mortality estimates can vary substantially when these factors are changed, and that the largest variations stem from the choice of the mortality index and the method. We also find that the magnitude of the variation in excess mortality is country-specific, resulting in cross-country rankings changes. Finally, based on our findings, we provide guidelines for estimating excess mortality.
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Raggi A, Monasta L, Beghi E, Caso V, Castelpietra G, Mondello S, Giussani G, Logroscino G, Magnani FG, Piccininni M, Pupillo E, Ricci S, Ronfani L, Santalucia P, Sattin D, Schiavolin S, Toppo C, Traini E, Steinmetz J, Nichols E, Ma R, Vos T, Feigin V, Leonardi M. Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019. J Neurol 2022; 269:2080-2098. [PMID: 34498172 PMCID: PMC9938710 DOI: 10.1007/s00415-021-10774-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Neurological conditions are highly prevalent and disabling, in particular in the elderly. The Italian population has witnessed sharp ageing and we can thus expect a rising trend in the incidence, prevalence and disability of these conditions. METHODS We relied on the Global Burden of Disease 2019 study to extract Italian data on incidence, prevalence and years lived with a disability (YLDs) referred to a broad set of neurological disorders including, brain and nervous system cancers, stroke, encephalitis, meningitis, tetanus, traumatic brain injury, and spinal cord injury. We assessed changes between 1990 and 2019 in counts and age-standardized rates. RESULTS The most prevalent conditions were tension-type headache, migraine, and dementias, whereas the most disabling were migraine, dementias and traumatic brain injury. YLDs associated with neurological conditions increased by 22.5%, but decreased by 2.3% in age-standardized rates. The overall increase in prevalence and YLDs counts was stronger for non-communicable diseases with onset in old age compared to young to adult-age onset ones. The same trends were in the opposite direction when age-standardized rates were taken into account. CONCLUSIONS The increase in YLDs associated with neurological conditions is mostly due to population ageing and growth: nevertheless, lived disability and, as a consequence, impact on health systems has increased. Actions are needed to improve outcome and mitigate disability associated with neurological conditions, spanning among diagnosis, treatment, care pathways and workplace interventions.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Lorenzo Monasta
- S.C.R. Epidemiologia Clinica e Ricerca Sui Servizi Sanitari, IRCCS Materno Infantile “Burlo Garofolo”, Trieste, Italy
| | - Ettore Beghi
- Department of Neurosciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Valeria Caso
- Stroke Unit and Division of Internal and Cardiovascular Medicine, Università di Perugia, Perugia, Italy
| | - Giulio Castelpietra
- Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giorgia Giussani
- Department of Neurosciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience, and Sense Organs, Università di Bari Aldo Moro, Bari, Italy
| | - Francesca Giulia Magnani
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Marco Piccininni
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Elisabetta Pupillo
- Department of Neurosciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Stefano Ricci
- Neurology and Stroke Unit, USL Umbria 1, Gubbio and Cittá di Castello Hospital, Perugia, Italy
| | - Luca Ronfani
- S.C.R. Epidemiologia Clinica e Ricerca Sui Servizi Sanitari, IRCCS Materno Infantile “Burlo Garofolo”, Trieste, Italy
| | - Paola Santalucia
- Neurology and Stroke Unit, Ospedale San Giuseppe-Multimedica, Milan, Italy
| | - Davide Sattin
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Claudia Toppo
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Eugenio Traini
- S.C.R. Epidemiologia Clinica e Ricerca Sui Servizi Sanitari, IRCCS Materno Infantile “Burlo Garofolo”, Trieste, Italy,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jaimie Steinmetz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Emma Nichols
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Rui Ma
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Valery Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, Australia
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
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Mennini FS, Meucci F, Pesarini G, Vandoni P, Lettino M, Sarmah A, Shore J, Green M, Giardina S. Cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in low surgical risk aortic stenosis patients. Int J Cardiol 2022; 357:26-32. [DOI: 10.1016/j.ijcard.2022.03.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 01/07/2023]
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Frailty predicts failure to discharge patients home from a subacute-care unit: a 3-year Italian experience. Aging Clin Exp Res 2022; 34:95-103. [PMID: 34291406 PMCID: PMC8795051 DOI: 10.1007/s40520-021-01908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/05/2021] [Indexed: 12/02/2022]
Abstract
Background The primary purpose of Subacute Care Units (SCU) is to decongest acute hospital wards and facilitate the return of older patients to home. Aims We analyzed the clinical characteristics and outcomes of patients admitted to an Italian SCU, and we explored factors associated with discharge to locations other than home (outcome). Methods This retrospective observational cohort study was conducted at a medium-sized suburban hospital, enrolling all patients consecutively admitted to one SCU from October 2017 to February 2020. We collected demographics, cause of admission, comorbidities, cognition, Barthel Index (BI), nutritional status, Clinical Frailty Scale (CFS), length of stay, and discharge destination. Delirium was screened with the 4AT score. We adopted a multivariable conditional logistic regression model to identify the factors associated with the outcome. Results Frail subjects accounted for 58.6% of 406 patients (mean age 78.2 years, SD 11.6), while 61% were classified as functionally dependent. More than half of patients had relevant comorbidity, approximately 80% had a poor nutritional status, and 25% had pre-existing dementia. The overall prevalence of delirium was 14.5%. Most patients came from a hospital setting; recurrent reasons for admission were infections (70.5%) and heart failure (12.7%). Having a urinary bladder catheter at discharge, being overtly frail (CFS > 8), and low BI score were factors independently associated with not being discharged home. Discussion and conclusion The routine assessment of frailty, as expressed by the CFS, may help redirecting the patients eligible for SCU admission.
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Burden of mental health and substance use disorders among Italian young people aged 10-24 years: results from the Global Burden of Disease 2019 Study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:683-694. [PMID: 35059752 PMCID: PMC8960651 DOI: 10.1007/s00127-022-02222-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 01/06/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE The burden of mental health and substance use disorders among Italian young people have not yet been presented in detail, despite adolescents and young adults aged between 10 and 24 years constitute 14.5% of the Italian population. Therefore, the aim of this study was to provide data on the health burden of mental health and substance use disorders among young people (10-24 years) in Italy between 1990 and 2019. METHODS Ecological study design using data from the Global Burden of Disease Study 2019. Age- and sex-specific prevalence and years lived with disability (YLDs) of mental health and substance use disorders with the uncertainty intervals were reported as well as their percentual changes between 1990 and 2019. RESULTS Prevalence and YLDs rates of mental health and substance use disorders showed negative trends overall between 1990 and 2019. However, diagnoses of attention-deficit/hyperactivity, autism spectrum, conduct and eating (among males) disorders increased as well as cocaine use disorder. The highest levels of disability in terms of YLDs were due to anxiety, depressive, conduct and eating disorders and alcohol use, amphetamine use and opioid use disorders. The disease burden was higher in middle-late adolescence and young adulthood than early adolescence, among females than males for mental health disorders and among males compared to females for substance use disorders. CONCLUSION Findings of the study highlighted disorder-specific patterns of prevalence and YLDs rates and were discussed considering previous research. The public health system should continuously sustain mental health promotion and prevention efforts in young people.
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Use of Focus Groups to Identify Food Safety Risks for Older Adults in the U.S. Foods 2021; 11:foods11010037. [PMID: 35010163 PMCID: PMC8749994 DOI: 10.3390/foods11010037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
Older adults are vulnerable to foodborne illness; however, many do not follow safe food handling guidelines that would reduce their risk of infection. Virtual focus groups were used to explore older adults' food handling and consumption practices and to understand how to apply the Health Belief Model for food safety research with respect to older adults. Thirty-nine adults between the ages of 56 and 80 participated in the study. Most participants reported eating poultry and eggs, whereas few reported eating precut fruit or raw sprouts. The majority were not using a cooking thermometer for all types of poultry and did report washing raw poultry. Participants were generally resistant to the idea of heating deli meats. Most focus group participants did not perceive themselves as being personally susceptible to foodborne illness. They did, however, express food safety concerns related to specific foods, such as melons and bagged salads, and they reported taking precautions to limit health risks from these foods. Regarding the Health Belief Model, our results indicate that the construct of perceived susceptibility could be expanded to include perceived risk, which refers to an individual's belief about the likelihood that a food might be contaminated with a foodborne pathogen. These results should be confirmed among a nationally representative sample of older adults.
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Ni Z, Zhang RC, Pan YL. Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography in elderly patients with a native papilla. Shijie Huaren Xiaohua Zazhi 2021; 29:1286-1291. [DOI: 10.11569/wcjd.v29.i22.1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The diagnosis and treatment of biliary and pancreatic diseases in elderly patients are a challenge for clinicians, while population ageing is becoming a prominent social issue. However, there are few clinical studies on therapeutic endoscopic retrograde cholangiopancreatography in elderly patients.
AIM To evaluate the safety, efficacy, clinical characteristics, and influencing factors related to therapeutic ERCP in patients aged above 80 years.
METHODS Data of 446 elderly patients (aged above 80 years) with a native papilla who underwent therapeutic ERCP form July 2011 to December 2020 were retrospectively analyzed. Their clinical characteristics, procedures of ERCP, and complications after ERCP were evaluated.
RESULTS Mean age of included patients was (83.2 ± 3.3) years old. Significant comorbidities were found in 308 cases. One hundred and twenty-four cases had biliary, pancreatic, or papillary carcinomas. There was no significant difference in post-ERCP complications with regard to comorbidities or timing of ERCP. Overall complications were comparable between patients undergoing difficult and non-difficult cannulation. The incidence of complications in the malignant disease group was higher than that in the benign disease group (15.32% vs 7.86%, P < 0.05). The rate of biliary infection was higher in patients with malignant diseases than in those with benign diseases (6.45% vs 1.57%, P < 0.01). However, the rate of bleeding was higher in patients undergoing urgent ERCP than in those undergoing selective operation (8.33% vs 1.52%, P < 0.05).
CONCLUSION The current study showed that therapeutic ERCP for patients aged 80 years or above is safe and effective. To avoid post-ERCP complications in elderly patients with high risk, detailed peri-ERCP evaluation may be necessary.
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Affiliation(s)
- Zhi Ni
- Department of Gastroenterology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen 361009, Fujian Province, China
| | - Rong-Chun Zhang
- Department of Gastroenterology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen 361009, Fujian Province, China
| | - Yang-Lin Pan
- Department of Gastroenterology, Xijing Hospital of Digestive Diseases, The Air Force Medical University, Xi'an 710032, Shanxi Province, China
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Antonelli-Incalzi R, Blasi F, Conversano M, Gabutti G, Giuffrida S, Maggi S, Marano C, Rossi A, Vicentini M. Manifesto on the Value of Adult Immunization: "We Know, We Intend, We Advocate". Vaccines (Basel) 2021; 9:vaccines9111232. [PMID: 34835163 PMCID: PMC8625332 DOI: 10.3390/vaccines9111232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022] Open
Abstract
Immunization through vaccination is a milestone achievement that has made a tremendous contribution to public health. Historically, immunization programs aimed firstly to protect children, who were disproportionally affected by infectious diseases. However, vaccine-preventable diseases can have significant impacts on adult mortality, health, and quality of life. Despite this, adult vaccinations have historically been overlooked in favor of other health priorities, because their benefits to society were not well recognized. As the general population is aging, the issue of vaccination in older adults is gaining importance. In high-income countries, recommendations for the routine vaccination of older adults have been gradually introduced. The Italian National Immunization Plan is considered to be among the most advanced adult vaccination plans in Europe. However, available data indicate there is low adherence to vaccination recommendations in Italy. The COVID-19 pandemic has exposed the damage that can be caused by an infectious disease, especially among adults and individuals with comorbidities. The aim of this “Manifesto”, therefore, is to provide an overview of the existing evidence on the value of adult vaccination, in the Italian context, with a call to action to healthcare providers and health authorities.
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Affiliation(s)
- Raffaele Antonelli-Incalzi
- Geriatric Unit, Campus Bio-Medico University, 00128 Rome, Italy;
- Italian Society of Gerontology and Geriatrics, 50129 Florence, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Respiratory Unit and Adult Cystic Fibrosis Center, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Michele Conversano
- Department for Public Health, Local Health Unit Taranto, 74121 Taranto, Italy;
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Sandro Giuffrida
- Department of Prevention, Local Health Unit Reggio Calabria, 89124 Reggio Calabria, Italy;
| | - Stefania Maggi
- Aging Branch, Institute of Neuroscience, National Research Council, 35128 Padova, Italy;
| | | | - Alessandro Rossi
- Italian Society of General Medicine and Primary Care, 50142 Florence, Italy;
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Improving Healthy Aging by Monitoring Patients' Lifestyle through a Wearable Device: Results of a Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189806. [PMID: 34574738 PMCID: PMC8469467 DOI: 10.3390/ijerph18189806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022]
Abstract
Population aging is related to a huge growth in healthcare and welfare costs. Therefore, wearable devices could be strategic for minimizing years of disability in old age and monitoring patients’ lifestyles and health. The purpose of this study was to assess the feasibility of using smart devices to monitor patients’ physical activity in a primary care setting. To assess the acceptance of this novel technology from the point of view of both patients and healthcare professionals, two questionnaires (one paper-based and one ex-novo developed) were administered to 11 patients with type 2 diabetes mellitus and a non-compliant behavior towards the therapeutic indications of their general practitioner (GP). Seven participants would continue to use a wearable activity tracker to monitor their health. We observed that 75% of patients reported a device’s characteristics satisfaction level of over 80% of the total score assigned to this dimension. No differences were observed in the questionnaire’s scores between the two professionals categories (GPs and nurses). Three dimensions (equipment characteristics, subjective norm, perceived risks, perceived ease-of-use and facilitating conditions) correlated > 0.5 with the device’s acceptability level. Some weak correlations were observed between healthcare professionals’ perception and patients’ parameters, particularly between the dimensions of collaboration and web interface ease-of-use and patients’ median number of steps and hours of sleep. In conclusion, despite the limited number of subjects involved, a good acceptance level towards these non-medical devices was observed, according to both patients’ and healthcare professionals’ impressions.
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17
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Abstract
Aim: To analyze scientific literature on the development and implementation of the Chronic Care Model (CCM) in treating chronic diseases in the Italy context. Besides, to evaluate the effects of the activities carried out by the operators participating in the CCM on clinical care. Background: Italy is the second country globally for longevity, with 21.4% of citizens over 65 and 6.4% over 80. The CCM fits into this context, a care model aimed primarily at patients suffering from chronic diseases, especially in emergencies, as the recent COVID-19 pandemic. Methods: PubMed, Embase, Scopus, Cinahl, and Cochrane Library scientific databases were consulted, and the records selected as relevant by title and abstract by nine independent scholars, and disagreements were resolved through discussion. Finally, the studies included in this review were selected based on the eligibility criteria. Results: Twenty potentially relevant studies were selected, and after applying the eligibility criteria and screening by the Critical Appraisal Skills Program tool, eight included in this review. The studies showed the effectiveness of CCM for managing patients with heart failure in primary care settings and significant improvements in clinical outcomes, the reduction of inappropriate emergency room access for chronic patients, and the improvement of patients’ overall health with diabetes. The CCM organizational model is effective in improving the management of metabolic control and the main cardiovascular risk factors. Furthermore, this modality also allows doctors to dedicate more space to patients in the disease’s acute phase. Conclusion: The CCM, with its fundamental pillars of empowering self-management of care, could represent a valid alternative to health management. The managers of health services, especially territorial ones, could consider the CCM for the improvement of the treatments offered.
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Nicolini P, Abbate C, Inglese S, Rossi PD, Mari D, Cesari M. Different dimensions of social support differentially predict psychological well-being in late life: opposite effects of perceived emotional support and marital status on symptoms of anxiety and of depression in older outpatients in Italy. Psychogeriatrics 2021; 21:42-53. [PMID: 33230922 DOI: 10.1111/psyg.12633] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/12/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Social support is important to psychological well-being in late life. However, findings in the literature regarding its effects are mixed, less information is available for anxiety than for depressive symptoms, and few studies have been carried out in Italy. Therefore, the aim of this study was to investigate the influence of social support on symptoms of anxiety and of depression in a sample of geriatric outpatients in Italy. METHODS This cross-sectional study consecutively enrolled 299 outpatients without dementia (age ≥ 65, all neuropsychologically tested). Social support was assessed with the ENRICHD Social Support Instrument and by interview. Symptoms of anxiety and of depression were evaluated with short versions of the State-Trait Personality Inventory Trait Anxiety and Geriatric Depression scales. The relationship between social support and psychological well-being was examined by multiple linear regression models with socio-demographic and clinical variables, including cognitive performance, as potential confounders. RESULTS Perceived emotional support was a negative predictor of symptoms of anxiety (standardised beta coefficient (β) -0.288, standard error (SE) 0.074, P < 0.001) and symptoms of depression (β -0.196, SE 0.040, P < 0.001). On the contrary, marital status (i.e. being married) was a positive predictor of symptoms of anxiety (β 0.199, SE 0.728, P = 0.003) and symptoms of depression (β 0.142, SE 0.384, P = 0.035). CONCLUSIONS Different dimensions of social support differentially affect psychological well-being. The protective effect of perceived emotional support is consistent with social cognitive models of health. The harmful effect of being married may be capturing the distress of the pre-bereavement period. Alternatively, it may reflect oppression by gender roles within marriage in a predominantly female sample in a traditional society. Our findings provide insight into the relationship between social support and psychological well-being, and identify potential targets for psychosocial interventions promoting mental health in late life.
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Affiliation(s)
- Paola Nicolini
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Inglese
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo D Rossi
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Mari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
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Pinedo-Torres I, Flores-Fernández M, Yovera-Aldana M, Gutierrez-Ortiz C, Zegarra-Lizana P, Intimayta-Escalante C, Moran-Mariños C, Alva-Diaz C, Pacheco-Barrios K. Prevalence of Diabetes Mellitus and Its Associated Unfavorable Outcomes in Patients With Acute Respiratory Syndromes Due to Coronaviruses Infection: A Systematic Review and Meta-Analysis. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2020; 13:1179551420962495. [PMID: 33177910 PMCID: PMC7592335 DOI: 10.1177/1179551420962495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
Introduction Only 3 types of coronavirus cause aggressive respiratory disease in humans (MERS-Cov, SARS-Cov-1, and SARS-Cov-2). It has been reported higher infection rates and severe manifestations (ICU admission, need for mechanical ventilation, and death) in patients with comorbidities such as diabetes mellitus (DM). For this reason, this study aimed to determine the prevalence of diabetes comorbidity and its associated unfavorable health outcomes in patients with acute respiratory syndromes for coronavirus disease according to virus types. Methods Systematic review of literature in Pubmed/Medline, Scopus, Web of Science, Cochrane, and Scielo until April of 2020. We included cohort and cross-sectional studies with no restriction by language or geographical zone. The selection and extraction were undertaken by 2 reviewers, independently. The study quality was evaluated with Loney's instrument and data were synthesized by random effects model meta-analysis. The heterogeneity was quantified using an I 2 statistic. Funnel plot, Egger, and Begg tests were used to evaluate publication biases, and subgroups and sensitivity analyses were performed. Finally, we used the GRADE approach to assess the evidence certainty (PROSPERO: CRD42020178049). Results We conducted the pooled analysis of 28 studies (n = 5960). The prevalence analysis according to virus type were 451.9 diabetes cases per 1000 infected patients (95% CI: 356.74-548.78; I 2 = 89.71%) in MERS-Cov; 90.38 per 1000 (95% CI: 67.17-118.38) in SARS-Cov-1; and 100.42 per 1000 (95% CI: 77.85, 125.26 I 2 = 67.94%) in SARS-Cov-2. The mortality rate were 36%, 6%, 10% and for MERS-Cov, SARS-Cov-1, and SARS-Cov-2, respectively. Due to the high risk of bias (75% of studies had very low quality), high heterogeneity (I 2 higher than 60%), and publication bias (for MERS-Cov studies), we down rate the certainty to very low. Conclusion The prevalence of DM in patients with acute respiratory syndrome due to coronaviruses is high, predominantly with MERS-Cov infection. The unfavorable health outcomes are frequent in this subset of patients. Well-powered and population-based studies are needed, including detailed DM clinical profile (such as glycemic control, DM complications, and treatment regimens), comorbidities, and SARS-Cov-2 evolution to reevaluate the worldwide prevalence of this comorbidity and to typify clinical phenotypes with differential risk within the subpopulation of DM patients.
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Affiliation(s)
| | | | - Marlon Yovera-Aldana
- Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru.,Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru
| | | | | | - Claudio Intimayta-Escalante
- Sociedad Cientifica de San Fernando. Facultad de Medicina. Universidad Nacional Mayor de San Marcos, Lima, Perú
| | | | - Carlos Alva-Diaz
- Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru.,Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru
| | - Kevin Pacheco-Barrios
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
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20
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Yang J, Hu J, Zhu C. Obesity aggravates COVID-19: A systematic review and meta-analysis. J Med Virol 2020; 93:257-261. [PMID: 32603481 PMCID: PMC7361606 DOI: 10.1002/jmv.26237] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/21/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022]
Abstract
Obesity and COVID‐19 are both worldwide epidemics now. There may be some potential relationships between them, but little is known. This study was done to explore this relationship through literature search, systematic review, and meta‐analysis. Pubmed, Embase, WOS, Cochrane, CNKI, Wanfang, and Sinomed databases were searched to collect literature concerning obesity and COVID‐19. Systematic review and meta‐analysis were conducted after literature screening, quality assessment, and data extraction. A total of 180 articles were initially searched after duplicate removal, and 9 were finally included in our analysis. Results show that severe COVID‐19 patients have a higher body mass index than non‐severe ones (WMD = 2.67; 95% CI, 1.52‐3.82); COVID‐19 patients with obesity were more severely affected and have a worse outcome than those without (OR = 2.31; 95% CI, 1.3‐4.12). Obesity may aggravate COVID‐19. Severe COVID‐19 patients have higher BMI than non‐severe ones. COVID‐19 patients with obesity were more severe than those without. Obesity may aggravate COVID‐19 disease.
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Affiliation(s)
- Jun Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiahui Hu
- School of Preclinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chunyan Zhu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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21
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Zuin M, Cervellati C, Trentini A, Roncon L, Guasti P, Zuliani G. Methylenetetrahydrofolate reductase C667T polymorphism and susceptibility to late-onset Alzheimer's disease in the Italian population. Minerva Med 2020; 112:365-371. [PMID: 32700867 DOI: 10.23736/s0026-4806.20.06801-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study is a meta-analysis of the published studies on the relationship between methylenetetrahydrofolate reductase (MTHFR) C667T polymorphism and the risk of late- onset Alzheimer 's disease (LOAD) in Italian cohorts. EVIDENCE ACQUISITION We conducted a search on the electronic databases PubMed/Medline, Web of Science and Scopus. All cohort and case-control studies investigating the association between MTHFR 677T polymorphism and LOAD in Italian population published any time to May 8, 2020 were included in the analysis. EVIDENCE SYNTHESIS From an initial screening of 136 articles, 4 were included into the systemic review. The pooled analysis based on the co-dominant model revealed that the MTHFR C677T polymorphism was associated with a significant risk of LOAD among Italian cohorts (TC vs. CC: OR=1.20, 95% CI=1.06-1.36, P=0.004, I2=0%). Conversely, the pooled analysis based on the allelic model demonstrated a non-significant relationship between the MTHFR C677T polymorphism and susceptibility to LOAD in Italians (OR: 1.25, 95% CI: 0.99-1.59, P=0.060, I2=14.6%). Moreover, Italian subjects with MTHFR 677TT genotype resulted to have a significantly increased susceptibility to LOAD (OR=1.75, 95% CI=1.23-2.50, P=0.002, I2=0%). CONCLUSIONS The present meta-analysis showed only trend of association between MTHFR C677T polymorphism and LOAD in Italian population; however, it also demonstrated an increased susceptibility of LOAD in patients having MTHFR 677TT genotype. Further studies are needed to establish whether MTHFR polymorphisms can be used as non-invasive biomarker for LOAD.
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Affiliation(s)
- Marco Zuin
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.,Department of Cardiology, Santa Maria delle Misericordia Hospital, Rovigo, Italy
| | - Carlo Cervellati
- Department of Cardiology, Santa Maria delle Misericordia Hospital, Rovigo, Italy - crvcrl@unife
| | - Alessandro Trentini
- Department of Cardiology, Santa Maria delle Misericordia Hospital, Rovigo, Italy
| | - Loris Roncon
- Department of Cardiology, Santa Maria delle Misericordia Hospital, Rovigo, Italy
| | - Patrizia Guasti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giovanni Zuliani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Affiliation(s)
- Richard A. Stein
- Chemical and Biomolecular Engineering, New York University, Tandon School of EngineeringBrooklynNYUSA
- Department of Natural Sciences, LaGuardia Community CollegeLong Island CityNYUSA
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Pasquariello P, Stranges S. Excess mortality from COVID-19: a commentary on the Italian experience. Int J Public Health 2020; 65:529-531. [PMID: 32468219 DOI: 10.1007/s00038-020-01399-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/16/2020] [Accepted: 05/23/2020] [Indexed: 01/12/2023] Open
Affiliation(s)
- Paolo Pasquariello
- Ross School of Business, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201B, London, ON, N6A 5C1, Canada. .,Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg. .,Humanitas University Medical School, Milan, Italy.
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Gray M, Adamo G, Pitini E, Jani A. Precision social prescriptions to promote active ageing in older people. J R Soc Med 2020; 113:143-147. [PMID: 32286116 PMCID: PMC7160795 DOI: 10.1177/0141076819865888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2024] Open
Affiliation(s)
- Muir Gray
- Department of Primary Care, University
of Oxford, Oxford OX2 6GG, UK
| | - Giovanna Adamo
- Dipartimento di Sanita Pubblica e
Malattie Infettive, Universita degli Studi di Roma La Sapienza, Roma 00185,
Italy
| | - Erica Pitini
- Dipartimento di Sanita Pubblica e
Malattie Infettive, Universita degli Studi di Roma La Sapienza, Roma 00185,
Italy
| | - Anant Jani
- Department of Primary Care, University
of Oxford, Oxford OX2 6GG, UK
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Abstract
Assisted living technologies can be of great importance for taking care of elderly people and helping them to live independently. In this work, we propose a monitoring system designed to be as unobtrusive as possible, by exploiting computer vision techniques and visual sensors such as RGB cameras. We perform a thorough analysis of existing video datasets for action recognition, and show that no single dataset can be considered adequate in terms of classes or cardinality. We subsequently curate a taxonomy of human actions, derived from different sources in the literature, and provide the scientific community with considerations about the mutual exclusivity and commonalities of said actions. This leads us to collecting and publishing an aggregated dataset, called ALMOND (Assisted Living MONitoring Dataset), which we use as the training set for a vision-based monitoring approach.We rigorously evaluate our solution in terms of recognition accuracy using different state-of-the-art architectures, eventually reaching 97% on inference of basic poses, 83% on alerting situations, and 71% on daily life actions. We also provide a general methodology to estimate the maximum allowed distance between camera and monitored subject. Finally, we integrate the defined actions and the trained model into a computer-vision-based application, specifically designed for the objective of monitoring elderly people at their homes.
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26
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Petrini E, Caviglia GP, Pellicano R, Saracco GM, Morino M, Ribaldone DG. Risk of drug interactions and prescription appropriateness in elderly patients. Ir J Med Sci 2019; 189:953-959. [DOI: 10.1007/s11845-019-02148-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/15/2019] [Indexed: 12/27/2022]
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DiFrancesco JC, Pina A, Giussani G, Cortesi L, Bianchi E, Cavalieri d'Oro L, Amodio E, Nobili A, Tremolizzo L, Isella V, Appollonio I, Ferrarese C, Beghi E. Generation and validation of algorithms to identify subjects with dementia using administrative data. Neurol Sci 2019; 40:2155-2161. [PMID: 31190251 DOI: 10.1007/s10072-019-03968-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To generate and validate algorithms for the identification of individuals with dementia in the community setting, by the interrogation of administrative records, an inexpensive and already available source of data. METHODS We collected and anonymized information on demented individuals 65 years of age or older from ten general practitioners (GPs) in the district of Brianza (Northern Italy) and compared this with the administrative data of the local health protection agency (Agenzia per la Tutela della Salute). Indicators of the disease in the administrative database (diagnosis of dementia in the hospital discharge records; use of cholinesterase inhibitors/memantine; neuropsychological tests; brain CT/MRI; outpatient neurological visits) were used separately and in different combinations to generate algorithms for the detection of patients with dementia. RESULTS When used individually, indicators of dementia showed good specificity, but low sensitivity. By their combination, we generated different algorithms: I-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests (specificity 97.9%, sensitivity 52.5%); II-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests or brain CT/MRI or neurological visit (sensitivity 90.8%, specificity 70.6%); III-therapy with ChEI/memantine or diagnosis of dementia at discharge or neuropsychological tests or brain CT/MRIMRI and neurological visit (specificity 89.3%, sensitivity 73.3%). CONCLUSIONS These results show that algorithms obtained from administrative data are not sufficiently accurate in classifying patients with dementia, whichever combination of variables is used for the identification of the disease. Studies in large patient cohorts are needed to develop further strategies for identifying patients with dementia in the community setting.
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Affiliation(s)
- Jacopo C DiFrancesco
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy.
| | - Alessandra Pina
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy
| | - Giorgia Giussani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Laura Cortesi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Elisa Bianchi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luca Cavalieri d'Oro
- Epidemiology Unit, Health Protection Agency (Agenzia per la Tutela della Salute - ATS), Monza, Italy
| | - Emanuele Amodio
- Epidemiology Unit, Health Protection Agency (Agenzia per la Tutela della Salute - ATS), Monza, Italy
| | | | - Lucio Tremolizzo
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy
| | - Valeria Isella
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy
| | - Ildebrando Appollonio
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy
| | - Carlo Ferrarese
- Department of Neurology, San Gerardo Hospital, Laboratory of Neurobiology, Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi, 33, 20900, Monza, MB, Italy
| | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Fadini GP, Solini A, Manca ML, Zatti G, Karamouzis I, Di Benedetto A, Frittitta L, Avogaro A. Phenotyping normal kidney function in elderly patients with type 2 diabetes: a cross-sectional multicentre study. Acta Diabetol 2018; 55:1121-1129. [PMID: 30090961 DOI: 10.1007/s00592-018-1194-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/17/2018] [Indexed: 12/26/2022]
Abstract
AIMS Type 2 diabetes (T2D) accelerates the decline in glomerular function; however, some individuals do not develop chronic kidney disease despite advanced age and long-lasting T2D. We aimed to phenotype patients with T2D aged 80 years or older who presented with a fully preserved kidney function. METHODS From an Italian population of 281,217 T2D outpatients, we collected data on demographics, anthropometrics, diabetes duration, HbA1c, fasting plasma glucose, lipids, liver enzymes, estimated glomerular filtration rate (eGFR), albumin excretion rate (AER), chronic complications, and medication use. We primarily compared patients with a fully preserved kidney function (eGFR > 90 ml/min/1.73 m2 and AER < 30 mg/24 h, or G1A1) with those with mild kidney impairment (eGFR 60-90 ml/min/1.73 m2 and AER < 30 mg/24 h, or G2A1). RESULTS N = 113,860 had available data for eGFR and AER, 21,648 of whom were aged ≥ 80. G1A1 (n = 278) and G2A1 (n = 6647) patients represented 1.3 and 30.7% of aged T2D patients, respectively, with an average diabetes duration of 16 years. Differences between the G1A1 and G2A1 groups were entered in a multiple logistic regression analysis with and without imputation of missing data. After adjustment and in both imputed and non-imputed datasets, younger age, lower BMI and lower triglycerides were associated with fully preserved versus mildly impaired kidney function. The comparison between G1A1 and G1A2/3 yielded different results. CONCLUSIONS In a rare population of patients with a fully preserved kidney function despite old age and long-lasting diabetes, lower BMI and triglycerides suggest that protection from lipotoxicity may preserve kidney function over time.
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Affiliation(s)
- G P Fadini
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
| | - A Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - M L Manca
- Department of Mathematics, University of Pisa, Pisa, Italy
| | - G Zatti
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padua, Italy
| | - I Karamouzis
- Ospedale Maggiore di Novara, 28100, Novara, Italy
| | - A Di Benedetto
- Department of Clinical and Experimental Medicine, University of Messina, 98122, Messina, Italy
| | - L Frittitta
- Department of Internal and Special Medicine, University of Catania, 95122, Catania, Italy
| | - A Avogaro
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padua, Italy
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29
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Romanini E, Decarolis F, Luzi I, Zanoli G, Venosa M, Laricchiuta P, Carrani E, Torre M. Total knee arthroplasty in Italy: reflections from the last fifteen years and projections for the next thirty. INTERNATIONAL ORTHOPAEDICS 2018; 43:133-138. [PMID: 30293141 DOI: 10.1007/s00264-018-4165-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE Annual rates of knee arthroplasty are increasing in all developed countries, imposing a significant economic and organizational burden; it is crucial to forecast the future need for knee arthroplasty, to assist stakeholders in planning strategies and investments, especially in a country like Italy, with the largest proportion of elderly citizens in Europe. Few epidemiological studies have been performed worldwide to estimate the demand for future knee replacement, and a variety of methods have been proposed. METHODS We investigated the epidemiology of knee arthroplasty performed in Italy in the last 15 years and projected incidence rates up to the year 2050, utilizing, comparing, and adapting the available methodologies. RESULTS From 2001 to 2016, 812,639 primary TKA were performed in Italy on patients over 40. The total number of surgeries increased by 262% with an average annual growth rate of 6.6%. CONCLUSIONS Adopting the best fitting projection method, an increase of 45% in incidence rate is expected for 2050.
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Affiliation(s)
- Emilio Romanini
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy. .,Artrogruppo, Casa di Cura San Feliciano, Rome, Italy.
| | | | - Ilaria Luzi
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Gustavo Zanoli
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy.,Casa di Cura Santa Maria Maddalena, Occhiobello, RO, Italy
| | | | - Paola Laricchiuta
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Eugenio Carrani
- National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Torre
- GLOBE, Italian Working Group on Evidence Based Orthopaedics, Rome, Italy.,National Centre for Clinical Excellence, Safety and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
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30
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Mazzola P, Floris P, Picone D, Anzuini A, Tsiantouli E, Haas J, Bellelli G, De Filippi F, Annoni G. Functional and clinical outcomes of patients aged younger and older than 85 years after rehabilitation post-hip fracture surgery in a co-managed orthogeriatric unit. Geriatr Gerontol Int 2018; 18:1194-1199. [DOI: 10.1111/ggi.13440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/28/2018] [Accepted: 04/04/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Paolo Mazzola
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
- Clinical Neurosciences Research Area; NeuroMI - Milan Center for Neuroscience; Milan Italy
| | - Patrizia Floris
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
- Acute Geriatrics Unit, Department of Medicine; Sondrio Hospital, ASST of Valtellina and Alto Lario; Sondrio Italy
| | - Domenico Picone
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
| | - Alessandra Anzuini
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
| | - Eleni Tsiantouli
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
- Department of Bone Diseases; Geneva University Hospital; Geneva Switzerland
| | - Justin Haas
- Neuroscience and Mental Health Institute, University of Alberta; Edmonton Canada
| | - Giuseppe Bellelli
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
- Clinical Neurosciences Research Area; NeuroMI - Milan Center for Neuroscience; Milan Italy
| | - Francesco De Filippi
- Acute Geriatrics Unit, Department of Medicine; Sondrio Hospital, ASST of Valtellina and Alto Lario; Sondrio Italy
| | - Giorgio Annoni
- Acute Geriatrics Unit; School of Medicine and Surgery, University of Milano-Bicocca; Monza Italy
- Clinical Neurosciences Research Area; NeuroMI - Milan Center for Neuroscience; Milan Italy
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31
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Galeazzi M, Mazzola P, Valcarcel B, Bellelli G, Dinelli M, Pasinetti GM, Annoni G. Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians' point of view. BMC Gastroenterol 2018. [PMID: 29540171 PMCID: PMC5853060 DOI: 10.1186/s12876-018-0764-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. Methods We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely. The mean age of the study population (n = 363) was 79.9 years old (range 70–95), with 190 subjects aged 70–79 and 173 older than 80. We recorded demographics, Charlson Comorbidity index (CCI), American Society of Anesthesiologists (ASA) physical status classification score, indication for the use of the ERCP procedure, and clinical outcomes. Then, we tested all variables to identify the potential risk factors for complications associated with the procedure. Results The older group (those ≥80 years old) showed significantly more patients with ASA Classes III-IV than the younger one (those ≤79 years old). Interestingly, the CCI was higher in the younger group (p = 0.009). The overall complication rate was 17.3% without inter-group differences. Older age, sex, CCI and intra-ERCP procedures were not related to a higher risk of complications, and the multivariate regression did not identify any of the considered variables to be an independent risk factor for complications. Conclusion ERCP appears as safe in the patients aged 80 years and older, as it is in those aged 70–79 years old in our study, however, a selection bias may affect these findings. A study including a comprehensive geriatric assessment will contribute to shedding light on this issue.
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Affiliation(s)
- Marianna Galeazzi
- University of Milano-Bicocca, School of Medicine and Surgery, U8 Building, Floor 4, Lab 4045, Via Cadore, 48 - 20900, Monza, MB, Italy
| | - Paolo Mazzola
- University of Milano-Bicocca, School of Medicine and Surgery, U8 Building, Floor 4, Lab 4045, Via Cadore, 48 - 20900, Monza, MB, Italy. .,NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences research area, Milan, MI, Italy.
| | | | - Giuseppe Bellelli
- University of Milano-Bicocca, School of Medicine and Surgery, U8 Building, Floor 4, Lab 4045, Via Cadore, 48 - 20900, Monza, MB, Italy.,NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences research area, Milan, MI, Italy.,San Gerardo Hospital ASST Monza, Acute Geriatrics Unit, Monza, MB, Italy
| | - Marco Dinelli
- San Gerardo Hospital ASST Monza, Endoscopy Unit, Monza, MB, Italy
| | - Giulio Maria Pasinetti
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.,James J Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Giorgio Annoni
- University of Milano-Bicocca, School of Medicine and Surgery, U8 Building, Floor 4, Lab 4045, Via Cadore, 48 - 20900, Monza, MB, Italy.,NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences research area, Milan, MI, Italy.,San Gerardo Hospital ASST Monza, Acute Geriatrics Unit, Monza, MB, Italy
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32
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Graffigna G, Barello S, Bonanomi A, Riva G. Factors affecting patients' online health information-seeking behaviours: The role of the Patient Health Engagement (PHE) Model. PATIENT EDUCATION AND COUNSELING 2017; 100:1918-1927. [PMID: 28583722 DOI: 10.1016/j.pec.2017.05.033] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/03/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To identify the variables affecting patients' online health information-seeking behaviours by examining the relationships between patient participation in their healthcare and online health information-seeking behaviours. METHODS A cross-sectional survey of Italian chronic patients (N=352) was conducted on patient's online health information-seeking behaviours and patient participation-related variables. Structural equation modeling analysis was conducted to test the hypothesis. RESULTS This study showed how the healthcare professionals' ability to support chronic patients' autonomy affect patients' participation in their healthcare and patient's online health information-seeking behaviours. However, results do not confirm that the frequency of patients' online health-information seeking behavior has an impact on their adherence to medical prescriptions. CONCLUSION Assuming a psychosocial perspective, we have discussed how patients' engagement - conceived as the level of their emotional elaboration of the health condition - affects the patients' ability to search for and manage online health information. PRACTICE IMPLICATION To improve the effectiveness of patients' online health information-seeking behaviours and to enhance the effectiveness of technological interventions in this field, healthcare providers should target assessing and improving patient engagement and patient empowerment in their healthcare. It is important that health professionals acknowledge patients' online health information-seeking behaviours that they discuss the information offered by patients and guide them to reliable and accurate web sources.
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Affiliation(s)
| | - Serena Barello
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy.
| | - Andrea Bonanomi
- Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
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34
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Mazzola P, Picone D. Healing as a Team. J Am Geriatr Soc 2017; 65:1627. [PMID: 28323329 DOI: 10.1111/jgs.14864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Paolo Mazzola
- School of Medicine and Surgery, Acute Geriatrics Unit, University of Milano-Bicocca, Monza (MB), Italy.,NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences Research Area, Milano (MI), Italy
| | - Domenico Picone
- School of Medicine and Surgery, Acute Geriatrics Unit, University of Milano-Bicocca, Monza (MB), Italy.,NeuroMI - Milan Center for Neuroscience, Clinical Neurosciences Research Area, Milano (MI), Italy
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35
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ÖZTÜRK ZA, ÖZDEMİR S, TÜRKBEYLER İH, DEMİR Z. Quality of life and fall risk in frail hospitalized elderly patients. Turk J Med Sci 2017; 47:1377-1383. [DOI: 10.3906/sag-1610-107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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36
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Lupi SM, Cislaghi M, Rizzo S, Rodriguez Y Baena R. Rehabilitation with implant-retained removable dentures and its effects on perioral aesthetics: a prospective cohort study. Clin Cosmet Investig Dent 2016; 8:105-110. [PMID: 27757052 PMCID: PMC5053264 DOI: 10.2147/ccide.s115384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The onset of perioral wrinkles often prompts patients to request treatment. This aesthetic deterioration linked to aging may be associated with tooth and alveolar bone loss in fully edentulous patients. Purpose To evaluate perioral wrinkles before and after maxillary and mandibular rehabilitation with implant-retained dentures in fully edentulous patients. Methods In this prospective cohort, single-center, blinded study, patients requiring maxillary and mandibular rehabilitation with implant-retained dentures were enrolled. The patients were photographed in the same position before and after oral rehabilitation. Wrinkles were evaluated in the photographs by blinded observers using validated rating scales. The following parameters were analyzed: upper and lower radial lip lines, marionette lines, upper and lower lip fullness, nasolabial folds, corner of the mouth lines, and the labiomental crease. Statistical analysis was performed using the Wilcoxon signed ranks test for paired data, with P<0.05 considered significant. Results Upper and lower implant-retained dentures were applied in 31 patients (15 males; mean ± standard deviation age 62.13±8.69 years, range 47–77 years). The oral rehabilitation procedures significantly improved (P<0.05) the upper and lower radial lip lines, marionette lines, upper and lower lip fullness, the nasolabial folds, and the corner of the mouth lines. Conclusion Maxillary and mandibular rehabilitation with implant-retained dentures in fully edentulous patients improves perioral aesthetics. Patients requiring oral rehabilitation and desiring perioral aesthetic improvement could benefit from treatment with this type of prosthesis.
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Affiliation(s)
- Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Matteo Cislaghi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvana Rizzo
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ruggero Rodriguez Y Baena
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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