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Onagbiye S, Guddemi A, Baruwa OJ, Alberti F, Odone A, Ricci H, Gaeta M, Schmid D, Ricci C. Association of sedentary time with risk of cardiovascular diseases and cardiovascular mortality: A systematic review and meta-analysis of prospective cohort studies. Prev Med 2024; 179:107812. [PMID: 38081421 DOI: 10.1016/j.ypmed.2023.107812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023]
Abstract
Given the high prevalence of cardiovascular disease (CVD), we meta-analysed CVD relative risk (RR) in relation to high vs. low categories of self-reported and objectively assessed sedentary behaviours from cohort studies; in a sub-sample (n = 4 studies), the theoretical substitution of one hour spent sedentary with the same amount of time spent in light-intense physical activity was evaluated. Based on 19 studies (60,526 fatal and non-fatal CVD, 1,473,354 individuals and 13,559,139 persons-year) we estimated a 30% increased CVD risk for high vs. low categories of sedentary behaviour (RR = 1.29, confidence interval (CI) = 1.22;1.37). Every hour spent sedentary corresponds to a 5% increased fatal and non-fatal CVD risk (RR = 1.05, CI = 1.02;1.07). Dose-response meta-analysis revealed that sedentary behaviour is statistically significantly associated to fatal and non-fatal CVD risk following a J-shaped relation. Substituting one hour spent sedentary with physical activity of light intensity reduced the risk of fatal and non-fatal CVD events by one-fifth (RR =0.84, CI = 0.73;0.97). In meta-regression analysis, potential influential factors such as age, sex, and medical condition did not essentially alter the results.
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Affiliation(s)
- S Onagbiye
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa; Health & Exercise Science, Frederick Community College, MD, USA; Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, USA
| | - A Guddemi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - O J Baruwa
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa; UMIT TIROL - University for Health Sciences and Technology, Tirol, Austria
| | - F Alberti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - A Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - H Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
| | - M Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - D Schmid
- Division for Quantitative Methods in Public Health and Health Services Research, UMIT TIROL - University for Health Sciences and Technology, Hall i. Tirol, Austria
| | - C Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa.
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Vigezzi GP, Guddemi A, Bucci D, Colucci S, La Fauci D, Calsolaro R, Foglia E, Chiesa R, Bertoglio L, Odone A. HTA supporting clinical practice: the case of surgical repair of thoracoabdominal aortic aneurysms. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Thoracoabdominal aortic aneurysms (TAAAs) are defined as those aortic aneurysms involving renovisceral arteries. They account for around 10% of aortic aneurysms, and their treatment is burdened by considerable mortality and morbidity. Open surgical repair has been practised as the standard of care since the 1950s. In 2001 endovascular repair was introduced to reduce treatment invasiveness, and the technology is still evolving. The potential benefits of endovascular repair over open surgery should be carefully weighed in a multidimensional framework.
Methods
We applied the Health Technology Assessment (HTA) framework (EUnetHTA core model with 9 dimensions) to conduct a report comparing the two technologies. A multidisciplinary working group was established. We derived and pooled: i) secondary data derived from systematic literature reviews, and ii) original data from IRCCS San Raffaele Hospital, Milan, a national referral centre for TAAA (qualitative and economic data).
Results
Endovascular repair resulted superior to the traditional open surgery in terms of efficacy and safety, as justified by the meta-analysis we performed. Despite the higher costs, a significant impact on budget and slightly lower cost-effectiveness, the endovascular protheses’ adoption could provide conspicuous benefits in terms of social and ethical dimensions without affecting long-term organisational and legal aspects.
Conclusions
The multi-criteria decision analysis carried out from a hospital point of view shows that there is no significant difference (final score endovascular repair 0.68 vs open surgery 0.63) between the two procedures considering all the dimensions. Still, the endovascular repair is slightly superior to the open surgery in terms of safety, effectiveness, social, ethical, legal, and organisational impact. From the policy maker’s point of view, technologies with a score superior to 0.6 are equally valuable, and the final decision should be left to the clinicians.
Key messages
• Further research is needed to compare endovascular prostheses and open surgery’s long-term population benefits, balancing clinical, economic, organisational and patient-related outcomes.
• HTA methodology offers substantial support to compare in-use technologies, informing clinicians’ and decision-makers’ choices to strengthen healthcare provision equity and preparedness.
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Affiliation(s)
- GP Vigezzi
- Department of Public Health, University of Pavia , Pavia, Italy
- Ca’ della Paglia College, Ghislieri Foundation , Pavia, Italy
| | - A Guddemi
- Department of Public Health, University of Pavia , Pavia, Italy
| | - D Bucci
- School of Medicine, Vita-Salute San Raffaele University , Milan, Italy
| | - S Colucci
- School of Medicine, Vita-Salute San Raffaele University , Milan, Italy
| | - D La Fauci
- Administrative Direction, IRCCS San Raffaele Hospital , Milan, Italy
- HTA Commission, IRCCS San Raffaele Hospital , Milan, Italy
| | - R Calsolaro
- Department of Public Health, University of Pavia , Pavia, Italy
| | - E Foglia
- LIUC Business School, LIUC Carlo Cattaneo University , Castellanza, Italy
| | - R Chiesa
- Division of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University , Milan, Italy
| | - L Bertoglio
- Division of Vascular Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University , Milan, Italy
| | - A Odone
- Department of Public Health, University of Pavia , Pavia, Italy
- HTA Commission, IRCCS San Raffaele Hospital , Milan, Italy
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Mastrooeni F, D'amico A, Novella G, Isgrò A, Guddemi A, Paganelli A, Tallarigo C. Due casi di fibrosi retroperitoneale con risposta favorevole alla terapia corticosteroidea. Urologia 1997. [DOI: 10.1177/039156039706401s07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Retroperitoneal fibrosis is rare and is usually treated with exploratory laparotomy. Satisfactory response to corticosteroid therapy has been shown, however, in cases with early retroperitoneal disease, while those with late disease show no improvement. Two cases are reported of patients with retroperitoneal fibrosis treated successfully with long-term corticosteroid therapy.
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Affiliation(s)
- F. Mastrooeni
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - A. D'amico
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - G. Novella
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - A. Isgrò
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - A. Guddemi
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - A. Paganelli
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - C. Tallarigo
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
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