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Månsson T, Rosso A, Ellström K, Abul-Kasim K, Elmståhl S. Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population. BMC Nephrol 2024; 25:93. [PMID: 38481159 PMCID: PMC10936027 DOI: 10.1186/s12882-024-03528-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Cerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship. METHODS With a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate < 60 ml/min/1,73m2. Associations between chronic kidney disease and magnetic resonance imaging markers of cerebral small vessel disease were explored using logistic regression models adjusted for age and sex. In a secondary analysis, the same calculations were performed with the study sample stratified based on hypertension status. RESULTS In the whole group, adjusted for age and sex, chronic kidney disease was not associated with any markers of cerebral small vessel disease. After stratification by hypertension status and adjusted for age and sex, we observed that chronic kidney disease was associated with cerebral microbleeds (OR 1.93, CI 1.04-3.59, p-value 0.037), as well as with cortical atrophy (OR 2.45, CI 1.34-4.48, p-value 0.004) only in the hypertensive group. In the non-hypertensive group, no associations were observed. CONCLUSIONS In this exploratory cross-sectional study, we observed that chronic kidney disease was associated with markers of cerebral small vessel disease only in the hypertensive subgroup of a general population of older adults. This might indicate that hypertension is an important link between chronic kidney disease and cerebral small vessel disease. Further studies investigating the relationship between CKD, CSVD, and hypertension are warranted.
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Affiliation(s)
- Tomas Månsson
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden.
| | - Aldana Rosso
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
| | - Katarina Ellström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
| | - Kasim Abul-Kasim
- Department of Clinical Sciences in Lund, Division of Diagnostic Radiology, Lund University, 221 85, Lund, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, pl 13, 205 02, Malmö, Sweden
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Svensson M, Elmståhl S, Sanmartin Berglund J, Rosso A. Association of systemic anticholinergic medication use and accelerated decrease in lung function in older adults. Sci Rep 2024; 14:4362. [PMID: 38388652 PMCID: PMC10883995 DOI: 10.1038/s41598-024-54879-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
Older adults are frequently exposed to medicines with systemic anticholinergic properties, which are linked to increased risk of negative health outcomes. The association between systemic anticholinergics and lung function has not been reported. The aim of this study was to investigate if exposure to systemic anticholinergics influences lung function in older adults. Participants of the southernmost centres of the Swedish National study on Aging and Care (SNAC) were followed from 2001 to 2021. In total, 2936 subjects (2253 from Good Aging in Skåne and 683 from SNAC-B) were included. An extensive medical examination including spirometry assessments was performed during the study visits. The systemic anticholinergic burden was described using the anticholinergic cognitive burden scale. The effect of new use of systemic anticholinergics on the annual change in forced expiratory volume (FEV1s) was estimated using mixed models. During follow-up, 802 (27.3%) participants were exposed to at least one systemic anticholinergic medicine. On average, the FEV1s of participants without systemic anticholinergic exposure decreased 37.2 ml/year (95% CI [33.8; 40.6]) while participants with low and high exposure lose 47.2 ml/year (95% CI [42.4; 52.0]) and 43.7 ml/year (95% CI [25.4; 62.0]). A novel association between new use of medicines with systemic anticholinergic properties and accelerated decrease in lung function in older adults was found. The accelerated decrease is comparable to that observed in smokers. Studies are needed to further explore this potential side effect of systemic anticholinergics.
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Affiliation(s)
- Markus Svensson
- Division of Geriatric Medicine, Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden.
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
| | | | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
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Svensson M, Ekström H, Elmståhl S, Rosso A. Association of polypharmacy with occurrence of loneliness and social isolation among older adults. Arch Gerontol Geriatr 2024; 116:105158. [PMID: 37597375 DOI: 10.1016/j.archger.2023.105158] [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] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Polypharmacy is increasing. The longitudinal association of polypharmacy and social isolation has not been previously reported. The aim of this study was to explore longitudinal associations of polypharmacy with loneliness and social isolation among older adults. METHODS Participants aged 60 years and above in southern Sweden were invited for participation. A total of 1526 and 2556 participants were included in the separate analyses for loneliness and social isolation. Polypharmacy was defined as taking five or more medications. Associations of polypharmacy with occurrence of loneliness and social isolation were estimated using logistic regression models. RESULTS During follow-up, 409 and 414 participants developed loneliness and social isolation, respectively. The odds for loneliness occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.37; 95% CI, 1.05-1.78; P = 0.020). For participants without polypharmacy, the probability of developing loneliness was 0.28 (95% CI, 0.25-0.31), while for those with polypharmacy this probability was 25% higher (0.35; 95% CI, 0.30-0.39). The odds for social isolation occurrence were higher for participants with polypharmacy compared to participants without polypharmacy (OR, 1.29; 95% CI, 1.02-1.64; P = 0.036). For participants without polypharmacy, the probability of developing social isolation was 0.16 (95% CI, 0.14-0.18), while for those with polypharmacy this probability was 18% higher (0.19; 95% CI, 0.17-0.22). CONCLUSIONS Polypharmacy was associated with loneliness and social isolation occurrence among older adults. Consideration of loneliness and social isolation are warranted when caring for older adults taking multiple medications.
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Affiliation(s)
- Markus Svensson
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, Malmö 205 02, Sweden.
| | - Henrik Ekström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, Malmö 205 02, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, Malmö 205 02, Sweden
| | - Aldana Rosso
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, Malmö 205 02, Sweden
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Johnson K, Olinder J, Rosso A, Andersson I, Lång K, Zackrisson S. False-positive recalls in the prospective Malmö Breast Tomosynthesis Screening Trial. Eur Radiol 2023; 33:8089-8099. [PMID: 37145147 PMCID: PMC10597871 DOI: 10.1007/s00330-023-09705-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To evaluate the total number of false-positive recalls, including radiographic appearances and false-positive biopsies, in the Malmö Breast Tomosynthesis Screening Trial (MBTST). METHODS The prospective, population-based MBTST, with 14,848 participating women, was designed to compare one-view digital breast tomosynthesis (DBT) to two-view digital mammography (DM) in breast cancer screening. False-positive recall rates, radiographic appearances, and biopsy rates were analyzed. Comparisons were made between DBT, DM, and DBT + DM, both in total and in trial year 1 compared to trial years 2 to 5, with numbers, percentages, and 95% confidence intervals (CI). RESULTS The false-positive recall rate was higher with DBT, 1.6% (95% CI 1.4; 1.8), compared to screening with DM, 0.8% (95% CI 0.7; 1.0). The proportion of the radiographic appearance of stellate distortion was 37.3% (91/244) with DBT, compared to 24.0% (29/121) with DM. The false-positive recall rate with DBT during trial year 1 was 2.6% (95% CI 1.8; 3.5), then stabilized at 1.5% (95% CI 1.3; 1.8) during trial years 2 to 5. The percentage of stellate distortion with DBT was 50% (19/38) trial year 1 compared to 35.0% (72/206) trial years 2 to 5. CONCLUSIONS The higher false-positive recall rate with DBT compared to DM was mainly due to an increased detection of stellate findings. The proportion of these findings, as well as the DBT false-positive recall rate, was reduced after the first trial year. CLINICAL RELEVANCE STATEMENT Assessment of false-positive recalls gives information on potential benefits and side effects in DBT screening. KEY POINTS • The false-positive recall rate in a prospective digital breast tomosynthesis screening trial was higher compared to digital mammography, but still low compared to other trials. • The higher false-positive recall rate with digital breast tomosynthesis was mainly due to an increased detection of stellate findings; the proportion of these findings was reduced after the first trial year.
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Affiliation(s)
- Kristin Johnson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden.
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden.
| | - Jakob Olinder
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Aldana Rosso
- Department of Clinical Sciences, Geriatric Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ingvar Andersson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Kristina Lång
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
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Lång K, Josefsson V, Larsson AM, Larsson S, Högberg C, Sartor H, Hofvind S, Andersson I, Rosso A. Artificial intelligence-supported screen reading versus standard double reading in the Mammography Screening with Artificial Intelligence trial (MASAI): a clinical safety analysis of a randomised, controlled, non-inferiority, single-blinded, screening accuracy study. Lancet Oncol 2023; 24:936-944. [PMID: 37541274 DOI: 10.1016/s1470-2045(23)00298-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Retrospective studies have shown promising results using artificial intelligence (AI) to improve mammography screening accuracy and reduce screen-reading workload; however, to our knowledge, a randomised trial has not yet been conducted. We aimed to assess the clinical safety of an AI-supported screen-reading protocol compared with standard screen reading by radiologists following mammography. METHODS In this randomised, controlled, population-based trial, women aged 40-80 years eligible for mammography screening (including general screening with 1·5-2-year intervals and annual screening for those with moderate hereditary risk of breast cancer or a history of breast cancer) at four screening sites in Sweden were informed about the study as part of the screening invitation. Those who did not opt out were randomly allocated (1:1) to AI-supported screening (intervention group) or standard double reading without AI (control group). Screening examinations were automatically randomised by the Picture Archive and Communications System with a pseudo-random number generator after image acquisition. The participants and the radiographers acquiring the screening examinations, but not the radiologists reading the screening examinations, were masked to study group allocation. The AI system (Transpara version 1.7.0) provided an examination-based malignancy risk score on a 10-level scale that was used to triage screening examinations to single reading (score 1-9) or double reading (score 10), with AI risk scores (for all examinations) and computer-aided detection marks (for examinations with risk score 8-10) available to the radiologists doing the screen reading. Here we report the prespecified clinical safety analysis, to be done after 80 000 women were enrolled, to assess the secondary outcome measures of early screening performance (cancer detection rate, recall rate, false positive rate, positive predictive value [PPV] of recall, and type of cancer detected [invasive or in situ]) and screen-reading workload. Analyses were done in the modified intention-to-treat population (ie, all women randomly assigned to a group with one complete screening examination, excluding women recalled due to enlarged lymph nodes diagnosed with lymphoma). The lowest acceptable limit for safety in the intervention group was a cancer detection rate of more than 3 per 1000 participants screened. The trial is registered with ClinicalTrials.gov, NCT04838756, and is closed to accrual; follow-up is ongoing to assess the primary endpoint of the trial, interval cancer rate. FINDINGS Between April 12, 2021, and July 28, 2022, 80 033 women were randomly assigned to AI-supported screening (n=40 003) or double reading without AI (n=40 030). 13 women were excluded from the analysis. The median age was 54·0 years (IQR 46·7-63·9). Race and ethnicity data were not collected. AI-supported screening among 39 996 participants resulted in 244 screen-detected cancers, 861 recalls, and a total of 46 345 screen readings. Standard screening among 40 024 participants resulted in 203 screen-detected cancers, 817 recalls, and a total of 83 231 screen readings. Cancer detection rates were 6·1 (95% CI 5·4-6·9) per 1000 screened participants in the intervention group, above the lowest acceptable limit for safety, and 5·1 (4·4-5·8) per 1000 in the control group-a ratio of 1·2 (95% CI 1·0-1·5; p=0·052). Recall rates were 2·2% (95% CI 2·0-2·3) in the intervention group and 2·0% (1·9-2·2) in the control group. The false positive rate was 1·5% (95% CI 1·4-1·7) in both groups. The PPV of recall was 28·3% (95% CI 25·3-31·5) in the intervention group and 24·8% (21·9-28·0) in the control group. In the intervention group, 184 (75%) of 244 cancers detected were invasive and 60 (25%) were in situ; in the control group, 165 (81%) of 203 cancers were invasive and 38 (19%) were in situ. The screen-reading workload was reduced by 44·3% using AI. INTERPRETATION AI-supported mammography screening resulted in a similar cancer detection rate compared with standard double reading, with a substantially lower screen-reading workload, indicating that the use of AI in mammography screening is safe. The trial was thus not halted and the primary endpoint of interval cancer rate will be assessed in 100 000 enrolled participants after 2-years of follow up. FUNDING Swedish Cancer Society, Confederation of Regional Cancer Centres, and the Swedish governmental funding for clinical research (ALF).
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Affiliation(s)
- Kristina Lång
- Division of Diagnostic Radiology, Department of Translational Medicine, Lund University, Malmö, Sweden; Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden.
| | - Viktoria Josefsson
- Division of Diagnostic Radiology, Department of Translational Medicine, Lund University, Malmö, Sweden; Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Anna-Maria Larsson
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Larsson
- Department of Technology and Society, Lund University, Lund, Sweden
| | | | - Hanna Sartor
- Division of Diagnostic Radiology, Department of Translational Medicine, Lund University, Malmö, Sweden; Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Solveig Hofvind
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway; Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Ingvar Andersson
- Division of Diagnostic Radiology, Department of Translational Medicine, Lund University, Malmö, Sweden; Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Aldana Rosso
- Division of Diagnostic Radiology, Department of Translational Medicine, Lund University, Malmö, Sweden
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Algotsson C, Rosso A, Elmståhl S, Siennicki-Lantz A. Corrigendum to "Prevalence and functional impact of parkinsonian signs in older adults from the Good Aging in Skåne study" [Parkinsonism Relat. Disord. 111 (2023)]. Parkinsonism Relat Disord 2023:105485. [PMID: 37308400 DOI: 10.1016/j.parkreldis.2023.105485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Charlotte Algotsson
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmo, Lund University, Skåne University Hospital, Malmo, Sweden.
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmo, Lund University, Skåne University Hospital, Malmo, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmo, Lund University, Skåne University Hospital, Malmo, Sweden
| | - Arkadiusz Siennicki-Lantz
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmo, Lund University, Skåne University Hospital, Malmo, Sweden
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Rosso A, Månsson T, Egervall K, Elmståhl S, Overton M. Cognitive decline and risk of dementia in older adults after diagnosis of chronic obstructive pulmonary disease. NPJ Prim Care Respir Med 2023; 33:20. [PMID: 37179395 PMCID: PMC10182997 DOI: 10.1038/s41533-023-00342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Cognitive screening has been proposed for older adults diagnosed with chronic obstructive pulmonary disease (COPD). Therefore, we examined the change over time in cognitive function and the risk of incident dementia in older adults after COPD diagnosis. A sample of 3,982 participants from the population-based cohort study Good Aging in Skåne was followed for 19 years, and 317 incident COPD cases were identified. The cognitive domains of episodic memory, executive function, and language were assessed using neuropsychological tests. Mixed models for repeated measures and a Cox model were implemented. Participants performed, on average, worse over time on all neuropsychological tests after COPD diagnosis in comparison to those without COPD, although statistical significance differences were only observed for episodic memory and language. The groups had a comparable risk of developing dementia. In conclusion, our results indicate that cognitive screening in the early stages of COPD may be of limited clinical relevance.
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Affiliation(s)
- Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
| | - Tomas Månsson
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Karl Egervall
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Marieclaire Overton
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
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Algotsson C, Rosso A, Elmståhl S, Siennicki-Lantz A. Prevalence and functional impact of parkinsonian signs in older adults from the Good Aging in Skåne study. Parkinsonism Relat Disord 2023; 111:105416. [PMID: 37130449 DOI: 10.1016/j.parkreldis.2023.105416] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/05/2023] [Accepted: 04/23/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Mild parkinsonian signs (MPS) have been characterized by several definitions, using the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS). We aimed to investigate the prevalence of MPS and their association with functional level and comorbidities in the oldest old. METHOD Community-dwelling older adults (n = 559, median age 85, range 80-102 years) were examined regarding MPS, possible parkinsonism (PP) and subthreshold parkinsonism (SP) according to four previously used definitions and concerning the impact of parkinsonian signs on cognitive, physical, and autonomic function. MPS, PP and SP are different terms describing a very similar phenomenon and there is no gradation between these. In two of the four definitions more advanced symptoms were categorized as parkinsonism. RESULTS Median UPDRS score in the whole study group was 10 points (range: 0-58) and was predominated by bradykinesia. MPS/PP/SP were present in 17-85%, and parkinsonism in 33-71% of the cohort. Independently of age and gender, MPS/PP/SP and especially parkinsonism, were associated with a higher risk of fear of falling and accomplished falls, with lower: cognition, ADL, physical activity and quality of life, and with urinary incontinence, obstipation and orthostatic intolerance. CONCLUSIONS In a population of older adults above 80 years, MPS are highly prevalent as well as more advanced symptoms defined as parkinsonism, and only 9-17% of the cohort is symptom-free. Predominance of bradykinesia in the oldest old might indicate a need for revision of MPS definitions to improve their sensibility.
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Affiliation(s)
- Charlotte Algotsson
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden.
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
| | - Arkadiusz Siennicki-Lantz
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
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Overton M, Sjögren B, Elmståhl S, Rosso A. Mild Cognitive Impairment, Reversion Rates, and Associated Factors: Comparison of Two Diagnostic Approaches. J Alzheimers Dis 2023; 91:585-601. [PMID: 36463443 PMCID: PMC9912719 DOI: 10.3233/jad-220597] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND As mild cognitive impairment (MCI) is typically used to identify prodromal stages of dementia, it is essential to identify MCI criteria with high diagnostic stability and prediction of dementia. Moreover, further investigation into pinpointing key factors for reversion is required to foresee future prognosis of MCI patients accurately. OBJECTIVE To explore disparities in diagnostic stability by examining reversion rates produced by two operationalizations of the MCI definition: the widely applied Petersen criteria and a version of the Neuropsychological (NP) criteria and to identify cognitive, lifestyle, and health related factors for reversion. METHODS MCI was retrospectively classified in a sample from the Swedish community-based study Good Aging in Skåne with the Petersen criteria (n = 744, median follow-up = 7.0 years) and the NP criteria (n = 375, median follow-up, 6.7 years), respectively. Poisson regression models estimated the effect of various factors on the likelihood of incident reversion. RESULTS Reversion rates were 323/744 (43.4%, 95% confidence intervals (CI): 39.8; 47.0) and 181/375 (48.3% 95% CI: 43.2; 53.5) for the Petersen criteria and NP criteria, respectively. Participants with impairment in a single cognitive domain, regular alcohol consumption, living with someone, older age, and lower body mass index had a higher likelihood of reverting to normal. CONCLUSION Reversion rates were similar for Petersen and NP criteria indicating that one definition is not superior to the other regarding diagnostic stability. Additionally, the results highlight important aspects such as multiple domain MCI, cohabitation, and the role of alcohol on predicting the trajectory of those diagnosed with MCI.
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Affiliation(s)
- Marieclaire Overton
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden,Correspondence to: Marieclaire Overton, Jan Waldenströms gata 35, CRC, Building 28, fl.13,
Skåne University Hospital, SE-205 02, Malmö, Sweden. Tel.: +46 709420138;
E-mail:
| | - Benjamin Sjögren
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
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Svensson M, Rosso A, Elmståhl S, Ekström H. Loneliness, social isolation, and health complaints among older people: A population-based study from the “Good Aging in Skåne (GÅS)” project. SSM Popul Health 2022; 20:101287. [DOI: 10.1016/j.ssmph.2022.101287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
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Rosso A, Rinaldi A, Coluzzi D, Perrelli F, Napoli PA, Villari P. Development of a strategy to control COVID-19 in hard-to-reach migrant communities. Eur J Public Health 2022. [PMCID: PMC9594198 DOI: 10.1093/eurpub/ckac129.663] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Issue/Problem The risk of SARS-Cov-2 infection and its adverse health effects proved to be higher among socially disadvantaged groups, including migants and ethnic minorities. Hard-to-reach (HTR) migrants, such as undocumented people, those living in informal settelments (e.g squats) or roma people have experienced severe barries to access COVID-19 information, testing and vaccination services. Description of the problem During 2020 and 2021, the Migrants'Health Unit of Roma 2 Local Health Unit (ASL) developed different strategies to control the COVID-19 epidemics in HTR communities, addressing both the containment of clusters in informal settelments and access to COVID-19 vaccination for these population. Methods A multicomponent and multidisciplinary strategy was implemented, based on a strong collaboration of different services across the ASL and with Non Governmental Organizations (NGOs). Starting from a mapping of the settlements and the identification of the main critical issues for the control of the epidemic in the target populations, interventions were carried out that included the involvement of NGOS in active surveillance, reporting of suspected cases of COVID-19 to the ASL and information to the communities, and the reorganization of health interventions (eg, swabs, epidemiological investigations, COVID-19 vaccinations) directly in HTR communities’ life places. Results In the period from April 2020 to February 2021, 15 outbreaks were controlled, for a total of over 4500 persons reached, and 265 COVID-19 cases identified. From July to November 2021, vaccinations were offered in outreach or with dedicated vaccination sessions, which reached 1664 people. The intervention model, based on a deep context analysis, strong multisectoral collaboration, community involvement, lays the foundations for the design of public health strategies, not only aimed at HTR populations. Key messages • Controlling COVID-19 in Hard- to- reach migrant populations was possible thanks to a strong collaboration between public health services and NGOs. • Public health interventions addressed complex groups should envisage intersectoral collaborations, reorientation of services in order to meet target groups’ need and community involvement.
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Affiliation(s)
- A Rosso
- Sapienza University of Rome , Rome, Italy
- Migrants’ Health Unit, Local Health Unit Roma 2 , Rome, Italy
| | - A Rinaldi
- Migrants’ Health Unit, Local Health Unit Roma 2 , Rome, Italy
| | - D Coluzzi
- Migrants’ Health Unit, Local Health Unit Roma 2 , Rome, Italy
| | - F Perrelli
- Migrants’ Health Unit, Local Health Unit Roma 2 , Rome, Italy
| | - PA Napoli
- Migrants’ Health Unit, Local Health Unit Roma 2 , Rome, Italy
| | - P Villari
- Sapienza University of Rome , Rome, Italy
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12
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Hedman C, Rosso A, Häggström O, Nordén C, Fürst CJ, Schelin MEC. Sedation in specialized palliative care: A cross-sectional study. PLoS One 2022; 17:e0270483. [PMID: 35802571 PMCID: PMC9269455 DOI: 10.1371/journal.pone.0270483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Palliative sedation is used to relieve refractory symptoms and is part of clinical practice in Sweden. Yet we do not know how frequently this practice occurs, how decision-making takes place, or even which medications are preferentially used. Objectives To understand the current practice of palliative sedation in Sweden. Methods We conducted a retrospective cross-sectional medical record-based study. For 690 consecutive deceased patients from 11 of 12 specialized palliative care units in the southernmost region of Sweden who underwent palliative sedation during 2016, we collected data on whether the patient died during sedation and, for sedated patients, the decision-making process, medication used, and depth of sedation. Results Eight percent of patients were sedated. Almost all (94%) were given midazolam, sometimes in combination with propofol. The proportions of sedation were similar in the patient groups with and without cancer. The largest proportion of the sedated patients died in inpatient care, but 23% died at home, with specialized palliative home care. Among the patients with a decision to sedate, 42% died deeply unconscious, while for those without such a decision the corresponding figure was 16%. In only one case was there more than one physician involved in the decision to use palliative sedation. Conclusion 8% of patients in specialized palliative care received palliative sedation, which is lower than international measures but much increased compared to an earlier Swedish assessment. The level of consciousness achieved often did not correspond to the planned level; this, together with indications of a scattered decision process, shows a need for clear guidelines.
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Affiliation(s)
- Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- The Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden
- R&D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
- * E-mail:
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Ola Häggström
- Unit of Palliative Care Kristianstad, Region Skåne, Kristianstad, Sweden
| | | | - Carl Johan Fürst
- Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- The Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden
| | - Maria E. C. Schelin
- Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- The Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden
- Department of Research and Development, Skåne University Hospital, Lund, Sweden
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13
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Egervall K, Rosso A, Elmståhl S. Association between cardiovascular disease- and inflammation-related serum biomarkers and poor lung function in elderly. Clin Proteomics 2021; 18:23. [PMID: 34583636 PMCID: PMC8480099 DOI: 10.1186/s12014-021-09329-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background Cardiovascular disease (CVD) is a common comorbidity in chronic obstructive pulmonary disease (COPD) and reduced lung function is an important risk factor for CVD and CVD-related death. However, the mechanisms behind the increased risk for CVD in COPD patients are not fully understood. Methods We examined the association between CVD- and inflammation-related serum biomarkers, and pulmonary function in a geriatric population. 266 biomarkers related to CVD and inflammation were analyzed in blood samples from 611 subjects aged 66–86 years who participated in the Good Aging in Skåne study. Serum levels were assessed by a proximity extension assay. Pulmonary function was measured using the lower limit of normality (LLN) spirometry criteria, i.e., forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < LLN. Logistic regression models were implemented and multiple comparisons were accounted for. Results 10.3% of the study participants fulfilled pulmonary function decline criteria according to LLN. Out of the 266 biomarkers, only plasminogen activator, urokinase receptor (PLAUR) was statistically significantly associated with decreased pulmonary function. We could not find a statistically significant association between pulmonary function decline and other biomarkers previously linked to COPD, such as interleukin 6, tumor necrosis factor and surfactant protein D. Conclusion We found that serum levels of PLAUR are associated with pulmonary function decline in older adults. PLAUR is activated following inflammation and promotes matrix metallopeptidase (MMP) activation and extracellular matrix (ECM) degradation. This implies that PLAUR could play a role in the early phase of COPD pathogenesis. Supplementary Information The online version contains supplementary material available at 10.1186/s12014-021-09329-7.
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Affiliation(s)
- K Egervall
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
| | - A Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - S Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
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14
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Rosso A, Juliusson G, Lorenz F, Lehmann S, Derolf Å, Deneberg S, Jädersten M, Antunovic P, Cammenga J, Möllgård L, Wennström L, Ölander E, Ehinger M, Fogelstrand L, Höglund M, Lazarevic VL. Is there an impact of measurable residual disease as assessed by multiparameter flow cytometry on survival of AML patients treated in clinical practice? A population-based study. Leuk Lymphoma 2021; 62:1973-1981. [PMID: 33719843 DOI: 10.1080/10428194.2021.1889539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The Swedish national guidelines for treatment of acute myeloid leukemia (AML) recommend analysis of measurable residual disease (MRD) by multiparameter flow cytometry (MFC) in bone marrow in the routine clinical setting. The Swedish AML registry contains such MRD data in AML patients diagnosed 2011-2019. Of 327 patients with AML (non-APL) with MRD-results reported in complete remission after two courses of intensive chemotherapy 229 were MRD-negative (70%), as defined by <0.1% cells with leukemia-associated immunophenotype in the bone marrow. MRD-results were reported to clinicians in real time. Multivariate statistical analysis adjusted for known established risk factors did not indicate an association between MFC-MRD and overall survival (HR: 1.00 [95% CI 0.61, 1.63]) with a median follow-up of 2.7 years. Knowledge of the importance of MRD status by clinicians and individualized decisions could have ameliorated the effects of MRD as an independent prognostic factor of overall survival.
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Affiliation(s)
- Aldana Rosso
- Department of Clinical Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden.,Diagnostic Radiology, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Gunnar Juliusson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Stem Cell Center, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Fryderyk Lorenz
- Department of Oncology and Hematology, Umeå University Hospital, Umeå, Sweden
| | - Sören Lehmann
- Department of Medical Sciences, Division of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Åsa Derolf
- Department of Hematology, Karolinska University Hospital, Huddinge, Sweden
| | - Stefan Deneberg
- Department of Hematology, Karolinska University Hospital, Huddinge, Sweden
| | - Martin Jädersten
- Department of Hematology, Karolinska University Hospital, Huddinge, Sweden
| | - Petar Antunovic
- Department of Hematology, Linköping University Hospital, Linköping, Sweden
| | - Jörg Cammenga
- Department of Hematology, Linköping University Hospital, Linköping, Sweden
| | - Lars Möllgård
- Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lovisa Wennström
- Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Emma Ölander
- Department of Hematology, Sundsvall Hospital, Sundsvall, Sweden
| | - Mats Ehinger
- Department of Clinical Sciences, Pathology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Linda Fogelstrand
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Martin Höglund
- Department of Medical Sciences, Division of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Vladimir Lj Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Stem Cell Center, Department of Laboratory Medicine, Lund University, Lund, Sweden
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15
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Baccolini V, Rosso A, Di Paolo C, Isonne C, Salerno C, Migliara G, Prencipe GP, Massimi A, Marzuillo C, De Vito C, Villari P, Romano F. What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis. J Gen Intern Med 2021; 36:753-761. [PMID: 33403622 PMCID: PMC7947142 DOI: 10.1007/s11606-020-06407-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 12/07/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. METHODS PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. RESULTS The pooled prevalence of low HL ranged from of 27% (95% CI: 18-38%) to 48% (95% CI: 41-55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (β: 0.87, 95% CI: 0.40-1.35; β: 0.59, 95% CI: 0.25-0.93; and β: 0.72, 95% CI: 0.06-1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (β: 0.61, 95% CI: 0.15-1.08), reading or numeracy comprehensions items (β: 0.77, 95% CI: 0.24-1.31), or a mixed method (β: 0.66, 95% CI: 0.01-1.33) found higher rates of low HL. Refugees had the lowest HL (β: 1.59, 95% CI: 0.26-2.92). Finally, lower quality studies reported higher rates of low HL (β: 0.56, 95% CI: 0.06-1.07). DISCUSSION We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies. PROSPERO REGISTRATION CRD42019133377.
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Affiliation(s)
- V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy. .,Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Local Health Unit Roma 2, Rome, Italy
| | - C Di Paolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Salerno
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G P Prencipe
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Romano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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16
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Michaleas S, Penninga E, Hovgaard D, Dalseg AM, Rosso A, Sarac SB, Jimenez JC, Fernández LLA, Fernández CP, Mangas-SanJuan V, Garcia I, Payares-Herrera C, Sancho-López A, Enzmann H, de Castro Lopes Silva MSS, Duarte S, Pignatti F. EMA Review of Daratumumab (Darzalex) for the Treatment of Adult Patients Newly Diagnosed with Multiple Myeloma. Oncologist 2020; 25:1067-1074. [PMID: 33026700 DOI: 10.1002/onco.13554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/11/2020] [Indexed: 12/24/2022] Open
Abstract
The use of daratumumab in combination with established regimens for the treatment of newly diagnosed multiple myeloma has recently been authorized by the European Medicines Agency based on results from three separate phase III randomized, active controlled, open-label studies that have confirmed enhanced efficacy and tolerability in both transplant-ineligible (MMY3008 and MMY3007) and transplant-eligible (MMY3006) patients, without compromising transplant ability. Trial MMY3008 showed an improvement in progression-free survival (PFS) when daratumumab was added to lenalidomide and dexamethasone compared with lenalidomide and dexamethasone; the median PFS had not been reached in the daratumumab arm and was 31.9 months in the control arm (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.43-0.73; p < .0001). Trial MMY3007 showed an improvement in PFS when daratumumab was added to bortezomib, melphalan, and prednisone compared with bortezomib, melphalan, and prednisone; PFS had not been reached in the daratumumab arm and was 18.1 months in the control arm (HR, 0.5; 95% CI, 0.38-0.65; p < .0001). In trial MMY3006, daratumumab added to bortezomib, thalidomide, and dexamethasone was compared with bortezomib, thalidomide, and dexamethasone as induction and consolidation treatment prior to autologous stem cell transplant. The stringent complete response rate at day 100 after transplant in the daratumumab group was 29% compared with 20% in the control group (odds ratio, 1.60; 1.21-2.12 95% CI; p = .0010). Overall adverse events were manageable, with an increased rate of neutropenia and infections in the daratumumab arms. Regulatory assessment of efficacy and safety results from trials MMY3006, MMY3007, and MMY3008 confirmed a positive benefit-risk ratio leading to an approval of the extensions of indication. IMPLICATIONS FOR PRACTICE: A set of extensions of indication was recently approved for daratumumab (Darzalex) in the setting of newly diagnosed multiple myeloma in combination with established regimens. Results of the MMY3006, MMY3007, and MMY3008 trials have shown enhanced efficacy and a favorable side effect profile of several daratumumab-based combinations in patients both ineligible and eligible for transplant, without compromising transplant ability. The combinations of daratumumab with either lenalidomide and low-dose dexamethasone or bortezomib, melphalan, and prednisone were approved for transplant-ineligible patients. The combination of daratumumab with bortezomib, thalidomide, and dexamethasone was approved for transplant-eligible patients. These combinations are expected to improve the survival outlook for patients with multiple myeloma, without an unacceptable risk of increase in adverse events, and updated information on progression-free survival and overall survival is expected from the above trials.
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Affiliation(s)
| | | | | | | | | | - Sinan B Sarac
- Committee for Medicinal Products for Human Use (CHMP), Amsterdam, The Netherlands
- Danish Medicines Agency, Copenhagen, Denmark
| | - Jorge Camarero Jimenez
- Committee for Medicinal Products for Human Use (CHMP), Amsterdam, The Netherlands
- Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain
| | | | | | - Victor Mangas-SanJuan
- Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia, Valencia, Spain
| | - Isabel Garcia
- Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain
| | - Concepcion Payares-Herrera
- Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain
- Instituto de Investigación Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Aranzazu Sancho-López
- Instituto de Investigación Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Harald Enzmann
- Committee for Medicinal Products for Human Use (CHMP), Amsterdam, The Netherlands
- Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
| | | | - Sílvia Duarte
- Pharmacovigilance Risk Assessment Committee (PRAC), Amsterdam, The Netherlands
- INFARMED - Autoridade Nacional do Medicamento e Produtos de Saúde, I.P, Lisbon, Portugal
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17
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Karim HT, Rosso A, Aizenstein HJ, Bohnen NI, Studenski S, Rosano C. Resting state connectivity within the basal ganglia and gait speed in older adults with cerebral small vessel disease and locomotor risk factors. Neuroimage Clin 2020; 28:102401. [PMID: 32932053 PMCID: PMC7495101 DOI: 10.1016/j.nicl.2020.102401] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/31/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM The basal ganglia are critical for planned locomotion, but their role in age-related gait slowing is not well known. Spontaneous regional co-activation of brain activity at rest, known as resting state connectivity, is emerging as a biomarker of functional neural specialization of varying human processes, including gait. We hypothesized that greater connectivity amongst regions of the basal ganglia would be associated with faster gait speed in the elderly. We further investigated whether this association was similar in strength to that of other risk factors for gait slowing, specifically white matter hyperintensities (WMH). METHODS A cohort of 269 adults (79-90 years, 146 females, 164 White) were assessed for gait speed (m/sec) via stopwatch; brain activation during resting state functional magnetic resonance imaging, WMH, and gray matter volume (GMV) normalized by intracranial volume via 3T neuroimaging; and risk factors of poorer locomotion via clinical exams (body mass index (BMI), muscle strength, vision, musculoskeletal pain, cardiometabolic conditions, depressive symptoms, and cognitive function). To understand whether basal ganglia connectivity shows distinct clusters of connectivity, we conducted a k-means clustering analysis of regional co-activation among the substantia nigra, nucleus accumbens, subthalamic nucleus, putamen, pallidum, and caudate. We conducted two multivariable linear regression models: (1) with gait speed as the dependent variable and connectivity, demographics, WMH, GMV, and locomotor risk factors as independent variables and (2) with basal ganglia connectivity as the dependent variable and demographics, WMH, GMV, and locomotor risk factors as independent variables. RESULTS We identified two clusters of basal ganglia connectivity: high and low without a distinct spatial distribution allowing us to compute an average connectivity index of the entire basal ganglia regional connectivity (representing a continuous measure). Lower connectivity was associated with slower gait, independent of other locomotor risk factors, including WMH; the coefficient of this association was similar to those of other locomotor risk factors. Lower connectivity was significantly associated with lower BMI and greater WMH. CONCLUSIONS Lower resting state basal ganglia connectivity is associated with slower gait speed. Its contribution appears comparable to WMH and other locomotor risk factors. Future studies should assess whether promoting higher basal ganglia connectivity in older adults may reduce age-related gait slowing.
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Affiliation(s)
- H T Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.
| | - A Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - H J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - N I Bohnen
- Departments of Radiology & Neurology, University of Michigan, Ann Arbor, MI, United States; Neurology Service & Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - S Studenski
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
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Pinna S, Piazzi L, Ceccherelli G, Castelli A, Costa G, Curini-Galletti M, Gianguzza P, Langeneck J, Manconi R, Montefalcone M, Pipitone C, Rosso A, Bonaviri C. Macroalgal forest vs sea urchin barren: Patterns of macro-zoobenthic diversity in a large-scale Mediterranean study. Mar Environ Res 2020; 159:104955. [PMID: 32250878 DOI: 10.1016/j.marenvres.2020.104955] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 06/11/2023]
Abstract
The study aimed at contributing to the knowledge of alternative stable states by evaluating the differences of mobile and sessile macro-zoobenthic assemblages between sea urchin barrens and macroalgal forests in coastal Mediterranean systems considering a large spatial scale. Six sites (100 s km apart) were selected: Croatia, Montenegro, Sicily (Italy), Sardinia (Italy), Tuscany (Italy), and Balearic Islands (Spain). A total of 531 taxa, 404 mobile and 127 sessile macro-invertebrates were recorded. Overall, 496 and 201 taxa were found in macroalgal forests and in barrens, respectively. The results of this large-scale descriptive study have met the expectation of lower macrofauna complexity and diversity in barrens rather than in macroalgal forests, and have allowed estimating the differences in levels of diversity and the consistency of variability across Mediterranean sites. Some peculiar patterns in barrens, related to both abundance of specific taxa and to high values of beta diversity, have been evidenced.
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Affiliation(s)
- S Pinna
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy; Fondazione IMC Onlus, Loc Sa Mardini 09170 Torregrande, Oristano, Italy
| | - L Piazzi
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy.
| | - G Ceccherelli
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - A Castelli
- Dipartimento di Biologia, Università di Pisa, Via Derna 1, 56126, Pisa, Italy
| | - G Costa
- Dipartimento di Scienze della Terra, dell'Ambiente e della Vita, Università di Genova, Corso Europa 26, 16132, Genova, Italy
| | - M Curini-Galletti
- Dipartimento di Chimica e Farmacia, Università di Sassari, Via Piandanna 4, 07100, Sassari, Italy
| | - P Gianguzza
- Dipartimento delle Scienze della Terra e del Mare, Università di Palermo, Via Archirafi 2, 90123, Palermo, Italy
| | - J Langeneck
- Dipartimento di Biologia, Università di Pisa, Via Derna 1, 56126, Pisa, Italy
| | - R Manconi
- Dipartimento di Medicina Veterinaria, Università di Sassari, Via Vienna 2, 07100, Sassari, Italy
| | - M Montefalcone
- Dipartimento di Scienze della Terra, dell'Ambiente e della Vita, Università di Genova, Corso Europa 26, 16132, Genova, Italy
| | - C Pipitone
- CNR-IAS, Lungomare Cristoforo Colombo 4521, 90149, Palermo, Italy
| | - A Rosso
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Università di Catania, Corso Italia 57, 95129, Catania, Italy
| | - C Bonaviri
- Dipartimento delle Scienze della Terra e del Mare, Università di Palermo, Via Archirafi 2, 90123, Palermo, Italy
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19
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Zackrisson S, Lång K, Rosso A, Johnson K, Dustler M, Förnvik D, Förnvik H, Sartor H, Timberg P, Tingberg A, Andersson I. One-view breast tomosynthesis vs two-view mammography: a methodological issue - Authors' reply. Lancet Oncol 2020; 20:e7. [PMID: 30614482 DOI: 10.1016/s1470-2045(18)30943-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Sophia Zackrisson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden.
| | - Kristina Lång
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Aldana Rosso
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Kristin Johnson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Magnus Dustler
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden; Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Daniel Förnvik
- Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Hannie Förnvik
- Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Hanna Sartor
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Pontus Timberg
- Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Anders Tingberg
- Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
| | - Ingvar Andersson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Malmö 20502, Sweden
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Rosso A, Martino EDI, Gerovasileiou V. Revision of the genus Setosella (Bryozoa: Cheilostomata) with description of new species from deep-waters and submarine caves of the Mediterranean Sea. Zootaxa 2020; 4728:zootaxa.4728.4.1. [PMID: 32229881 DOI: 10.11646/zootaxa.4728.4.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Indexed: 11/04/2022]
Abstract
The genus Setosella included to date six species. After revision, only four of these species were retained, i.e. S. vulnerata, S. cavernicola, S. folini and S. spiralis. The remaining two species were tentatively placed in Woodipora, W.? antilleana n. comb., and Andreella, A.? fragilis n. comb. On the other hand, scanning electron microscopy examination of Mediterranean material, revealed the presence of three new species previously included in species complexes: S. cyclopensis n. sp. from the open-shelf, S. rossanae n. sp. from submarine caves, and S. alfioi n. sp. from deep-waters. The diagnosis of the genus was amended to include the occurrence of kenozooids in S. cyclopensis n. sp. and S. cavernicola, and of free-living ring-shaped and scorpioid colonies in S. folini and S. alfioi n. sp. All the seven species now in Setosella have present-day representatives; the geographic distribution of the genus is restricted to the NE Atlantic and adjacent seas; its stratigrafic distribution is rejuvenated to the late Tortonian-early Messinian of southern Italy and insular Greece, with only three species occasionally and discontinuously reported. All species are able to produce numerous, subsequent intramural buds and morphological differences seem to be consistently associated with exploitation of particular habitats and substrata.
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Affiliation(s)
- A Rosso
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Corso Italia, Università di Catania, 57, I-95129, Catania, Italy CoNISMa (Consorzio Nazionale Interuniversitario per le Scienze del Mare), URL Catania, Catania, Italy..
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Gandini M, Labate F, Rosso A, Giusto G. Strangulating obstruction of the small intestine by a fibrous band originating on the nephrosplenic ligament. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gandini
- Department of Veterinary Sciences University of Turin Grugliasco, Turin Italy
| | - F. Labate
- Department of Veterinary Sciences University of Turin Grugliasco, Turin Italy
| | - A. Rosso
- Department of Veterinary Sciences University of Turin Grugliasco, Turin Italy
| | - G. Giusto
- Department of Veterinary Sciences University of Turin Grugliasco, Turin Italy
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Rosso A, Massimi A, Adamo G, Baccolini V, Pitini E, Vacchio MR, Marzuillo C, De Vito C, Villari P. A systematic review of factors influencing pregnant women’s future vaccination choices. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Over the last years, vaccine hesitancy has been increasing globally, leading to a decrease in vaccination coverage in several Countries, mostly in Europe. Several systematic reviews were conducted to assess the determinants of hesitancy and of vaccination choices, but none of them focused on pregnant women, which would represent an ideal population to promote correct information on vaccines.
Methods
We conducted a systematic review of studies assessing knowledge and attitudes on paediatric vaccinations, vaccination choices and their determinants among pregnant women. We searched Medline, Scopus and Web of Science, adapting search terms to the different databases, following PRISMA Statement criteria. No time limits were set.
Results
A total of 5,309 records were retrieved. After duplicates removal and title/abstract selection, 15 full texts were included in the narrative synthesis. Most studies (14/15) were quantitative surveys, 2 focused only on specific vaccines (rotavirus and HPV), 4 studies were conducted in European countries (Germany and Italy). The main factors associated with vaccine hesitancy or refusal were the fear of side effects, in particular for the most recent vaccines, the perception of a greater importance of natural immunity and a low perception of utility of vaccines, the lack of trust in health professionals, having obtained information on vaccines not from a doctor, primiparity and a low level of education (for these two last factors, with inconsistent results between studies).
Conclusions
Available evidence shows that the perceived risks and importance of vaccinations and the information received during pregnancy can influence vaccination choices of future mothers, and that the determinants of hesitancy may vary in different contexts. Pregnant women represent a key population for the implementation of interventions aimed at increasing knowledge and acceptance of vaccinations, which should be based on an analysis of the specific context.
Key messages
The perceived risks and importance of vaccinations and the information received during pregnancy can influence vaccination choices of future mothers. Interventions aimed at increasing knowledge and acceptance of vaccinations should be based on an analysis of the specific context.
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Affiliation(s)
- A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Azienda Sanitaria Locale Roma 2, Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Adamo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M R Vacchio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Pitini E, D’Andrea E, Rosso A, Massimi A, Unim B, De Vito C, Marzuillo C, Villari P. Genetic services for Hereditary Cancer: a systematic review of Patient Reported Outcomes studies. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Genetic services for Hereditary Breast and Ovarian Cancer (HBOC) have become part of clinical and public health practice. Nevertheless, the evaluation of such services, including genetic testing and counseling, is challenging as they rarely affect health status measures (e.g. mortality and morbidity). A possible way is using Patient Reported Outcomes (PROs) i.e. subjective reports coming from patients, directly attributable to genetic services. We performed a systematic review to explore the use of PROs in HBOC genetic services.
Methods
We searched Pubmed, Scopus, and ISI Web of Knowledge for observational studies using PROs to assess standard genetic counseling (i.e. in person and individual) for HBOC.
Results
We identified ten surveys from various countries (USA n = 5; Europa n = 6), published between 2000 and 2018 and mainly conducted in Teaching hospitals and Cancer Research and Treatment Institutes (n = 9). The majority assessed pre-test counseling (n = 6) with diagnostic or predictive purpose. The most frequently measured outcomes were patient satisfaction (n = 9), adherence to recommended interventions (n = 3), information sharing with relatives (n = 3); disease risk perception (n = 2), and psychosocial distress (n = 2). Six studies adopted standardized PROs collection tools: the most common were the Genetic Counseling Satisfaction Scale and the Hospital Anxiety and Depression Scale. Questionnaires were mainly administered by post, soon after genetic counseling or up to seven years later. Overall, patients seem satisfied with genetic counseling. Nevertheless, more attention to the psycho-social aspects of genetic testing is needed.
Conclusions
PROs are very promising for the assessment of HBOC genetic services. Their routine use could provide important elements to improve the quality and the patient-centeredness of genetic services. Emerging information and communication technologies will help this process by making it easier collecting patient data.
Key messages
Precision medicine, where medical decisions are tailored to an individual’s characteristics, including the patient’s genetic profile, is becoming a paradigm for chronic diseases, particularly cancer. PROs are expected to be increasingly used as a measure of performance in order to drive the changes in how clinical genetic services, and healthcare in general, are organized, delivered and founded.
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Affiliation(s)
- E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - E D’Andrea
- Harvard TH Chan School of Public Health, Boston, USA
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - B Unim
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Baccolini V, Di Paolo C, Salerno C, Rosso A, Prencipe GP, Isonne C, Marzuillo C, De Vito C, Villari P, Romano F. Prevalence of non-adequate health literacy in Europe: a systematic review and meta-analysis. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.271] [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: 11/14/2022] Open
Abstract
Abstract
Background
Many studies show that a low level of health literacy (HL) is associated with several adverse outcomes. The aim of this systematic review was to estimate the prevalence of non-adequate HL (NAHL) in European countries and outline the main needs for interventions.
Methods
The systematic search was performed in April 2019 and updated in June 2019. PubMed, Embase and Scopus were searched. Articles were considered eligible if they were cross-sectional studies published in English after 2000 and estimating the NAHL prevalence in European countries. Globally, 15490 articles were retrieved. Adapted Newcastle-Ottawa Scale was applied for the quality assessment. Several stratified meta-analyses were carried out. We also performed a meta-regression analysis to test the association between variables and NAHL.
Results
In total, 59 articles of heterogeneous quality were included, providing data for 98 studies to include in the proportion meta-analysis. Overall, quantitative analysis yielded a pooled NAHL prevalence of 40% (95%CI, 36%-43%). Despite the prevalence varied considerably by country, it seemed to follow a geographic gradient, with the northern countries clearly having a lower prevalence than the other European counterparts. The pooled prevalence estimates (PEs) varied significantly according to the different type of HL assessment method applied. Also, high study quality was found to be significantly associated with a reduction of NAHL in the PEs. Grouping the sample in general population, oncology patients, chronic disease patients and refugees, the meta-regression analysis showed a significantly lower prevalence of NAHL in oncology patients.
Conclusions
Although the PEs varied in relation to several factors (e.g. either among population groups, or depending on the HL assessment method), this study shows that more than one in every three surveyed participants had NAHL. Targeted strategies and coordinated policies aiming at improving HL in the Region are needed.
Key messages
Despite several variations, a significant proportion of European population has non-adequate health literacy. Targeted public health strategies of intervention are crucial to address this deficit.
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Affiliation(s)
- V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Di Paolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Salerno
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G P Prencipe
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Romano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Massimi A, Rosso A, De Vito C, Marzuillo C, Baccolini V, Pitini E, Barbato D, Villari P. Are midwives ready to fight vaccine hesitancy? First results from an Italian cross-sectional study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.154] [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: 11/14/2022] Open
Abstract
Abstract
Background
Pregnancy is widely recognized as a ’teachable moment’ since attitudes and beliefs about childhood vaccines are not completely structured. Among healthcare workers (HCWs), midwives play a pivotal role in the maternal care pathway and should have a key role also in promoting opportunities of discussion and correct information about vaccinations.
Methods
We conducted a cross-sectional survey to assess knowledge and attitudes of a sample of Italian midwives towards vaccinations. A questionnaire was designed ad hoc and sent electronically to midwives members of the professional register of Rome.
Results
Preliminary results on data collected from 140 midwives (mean age 37.32, DS ± 11.61; mean years on the job: 11.94 DS ± 12.78) who completed the survey showed a heterogeneous level of knowledge: only 50% of the sample indicated the correct threshold of vaccination coverage for herd immunity, while safety of multiple shots and of the additives contained in vaccines was reported by 61% and 31% of respondents, respectively. Only 41% of midwives had identified the pertussis vaccine as one of the vaccinations recommended during pregnancy. Attitudes were generally positive: 84% of respondents recognized recommended vaccines as effective and 86% as one of the safest health interventions. However, vaccinations against MMR and Varicella were perceived as useful by 86% and 71% of the midwives, while 89% and 77%, respectively, would recommend them to parents (compared to 96% in case of hexavalent). Globally, 79% of respondents would agree with the introduction of mandatory vaccinations for HCWs in maternity wards.
Conclusions
Midwives show some gaps in the knowledge on vaccinations. The final results of this study will be used to build specific and tailored training programs directed to midwives involved in pregnancy management. This may help them to transfer the correct vaccination information for the empowerment and the growth of vaccine literacy.
Key messages
Pregnancy is a strategic teachable moment to influence attitudes regarding childhood vaccinations and healthcare professionals must be trained to be the vehicle of the most accurate information. Specific under- and post-graduate training courses on vaccinations directed to midwives are strongly needed to ensure good level of knowledge on this topic.
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Affiliation(s)
- A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - D Barbato
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Baccolini V, Sindoni A, Adamo G, Rosso A, Massimi A, Pitini E, De Vito C, Marzuillo C, Villari P. Healthcare workers and measles outbreaks in Italy: is it time to act? A systematic review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.071] [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: 11/15/2022] Open
Abstract
Abstract
Background
Despite healthcare workers (HCWs) vaccination against measles is strongly recommended in Europe, many studies showed their low vaccination coverage and a significant involvement in hospital and community outbreaks. The aim of this systematic review was to analyze the available evidence on HCW role in measles outbreaks and identify the epidemiological characteristics of the transmission patterns related to HCW infection.
Methods
PubMed, Scopus and ISI Web of Science were searched to detect the measles outbreaks occurred in Italy and involving at least one HCW. English or Italian records were considered eligible. The quality assessment was performed using the ORION checklist. We also analyzed national or regional measles reports and the Measles outbreaks reporting forms that are annually submitted to the World Health Organization (WHO) of the period 2014-2018.
Results
Twenty-one articles were identified in the literature search and were in general of good quality. Of these, six were regional or Italian reports, two referred to one city, 13 were single outbreak reports. The national data showed that the number of infected HCWs increases with the rise of the total number of cases. A total of 72 descriptions of measles outbreaks were retrieved from the WHO reports. The vast majority was confined to the hospital or started at the hospital and spread in the community. The index cases were mainly patients seeking care for measles-related symptoms but, in the last years, a growing number of infected HCWs was identified as infection source. Similarly, the number of outbreaks with more than one infected HCW recorded a small increase over time.
Conclusions
HCWs play a critical role in measles transmission especially in hospital outbreaks, which are significantly costly and disruptive for the healthcare delivery quality and safety. Vaccination policy aiming at increasing their immunization rate is crucial to limit the virus spread and the economic impact on the institutions.
Key messages
In spite of the remarkable progress, measles elimination in Italy is far from being met and the virus transmission in healthcare settings is increasingly notified. Vaccination policies aiming at increasing HCW immunization coverages are essential.
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Affiliation(s)
- V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Adamo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Rosso A, Massimi A, Baccolini V, Pitini E, Marzuillo C, Vito CD, Villari P. Determinants of the intention to vaccinate with MMR among pregnant women from the City of Rome. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.458] [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: 11/14/2022] Open
Abstract
Abstract
Background
Further to the increase in measles cases reported in Italy since 2016, MMR vaccination became mandatory in 2017, leading to an increase in vaccination coverage in the Country. To guarantee sustained coverage, factors influencing the intention to vaccinate in the population should be better understood.
Methods
We conducted a cross-sectional survey to assess knowledge and attitudes on pediatric vaccinations and intention to vaccinate among pregnant women attending Antenatal Classes in Rome, through distribution of a self-administered questionnaire, which included a specific section on MMR vaccination. Multiple logistic regression analysis was performed to analyze the determinants of the intention to vaccinate with MMR.
Results
A total of 458 pregnant women attending CANs in 36 family health centers and two hospitals answered the survey. Intention to vaccinate with MMR was associated with having received information from a healthcare professional (OR 1.92, 95%CI 1.01-3.63), the perceived importance of vaccines to protect against measles (OR 4.68, 95%CI 2.48- 9.54) and rubella (OR 5.97, 95%CI 2.98-11.95), not believing in news about the risks of MMR vaccine (OR 2.75, 95%CI 1.38-5.50), and the sense of guilt in case the child should contract the disease (OR 2.56, 95%CI 1.16-5.62). Factors negatively associated with the intention to vaccinate were the use of alternative medicine (OR 0.34, 95%CI 0.16- 0.76), believing that MMR vaccine can have serious side effects (OR 0.37, 95%CI 0.00-0.29) and guilt in case of serious side effects (OR 0.40, 95%CI 0.21-0.76).
Conclusions
Fear of MMR side effects is a relevant driver of the intention to vaccinate, coupled with the perceived importance to vaccinate to protect against measles and rubella. Also the source of information plays an important role in shaping ideas on vaccines. Information and communication strategies should be promoted to increase trust in vaccines, with a direct involvement of healthcare workers.
Key messages
Fear of MMR side effects and perceived benefits of the vaccine influence the intention to vaccinate. Information and communication strategies to increase vaccination appectance involving healthcare workers are needed.
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Affiliation(s)
- A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Azienda Sanitaria Locale Roma 2, Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Johnson K, Zackrisson S, Rosso A, Sartor H, Saal LH, Andersson I, Lång K. Tumor Characteristics and Molecular Subtypes in Breast Cancer Screening with Digital Breast Tomosynthesis: The Malmö Breast Tomosynthesis Screening Trial. Radiology 2019; 293:273-281. [PMID: 31478799 DOI: 10.1148/radiol.2019190132] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Kristin Johnson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Sophia Zackrisson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Aldana Rosso
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Hanna Sartor
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Lao H. Saal
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Ingvar Andersson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
| | - Kristina Lång
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Inga Marie Nilssons gata 49, 20502 Malmö, Sweden (K.J., S.Z., A.R., H.S., I.A., K.L.); and Translational Oncogenomics Unit, Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (L.H.S.)
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Sudhop T, Brun NC, Riedel C, Rosso A, Broich K, Senderovitz T. Master protocols in clinical trials: a universal Swiss Army knife? Lancet Oncol 2019; 20:e336-e342. [DOI: 10.1016/s1470-2045(19)30271-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/27/2022]
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Rosso A, Beuck L, Vertino A, Sanfilippo R, Freiwald A. Cribrilinids (Bryozoa, Cheilostomata) associated with deep-water coral habitats at the Great Bahama Bank slope (NW Atlantic), with description of new taxa. Zootaxa 2018; 4524:401-439. [PMID: 30486103 DOI: 10.11646/zootaxa.4524.4.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Indexed: 11/04/2022]
Abstract
Four cribrilinid bryozoans associated with deep-water corals (578-682 m depth) from the Great Bahama Bank slope, are described, two of them are new. The generic allocation of some species prompted us to raise the subgenera Puellina, Cribrilaria, and Glabrilaria to genus rank. The new combination Cribrilaria saginata (Winston, 2005) n. comb. is proposed. Genus Glabrilaria is reported from the NW Atlantic for the first time based on the description of Glabrilaria hirsuta Rosso n. sp. and Glabrilaria polita Rosso n. sp. The new genus Teresaspis Rosso n. gen. is erected, and Teresaspis lineata (Canu Bassler, 1928) n. comb. is proposed as its type species. The new genus Harmelinius Rosso n. gen. is erected for Cribrilina uniserialis (Harmelin, 1978). Both genera have uniserial colonies formed by slightly caudate zooids with extensive gymnocyst and a frontal shield of flattened costae. Teresaspis lineata n. comb., however, has costae with pelmatidia that are connected by few intercostal bridges and separated by intercostal spaces, four orificial costa-like processes with the proximal pair arching above the orifice, hyperstomial acleithral ovicells with a pseudoporous ooecium formed by the distal zooid or a kenozooid, two types of kenozooids (large with costate frontal shield and small with smooth shield and central opesia), and an ancestrula with costate frontal shield. Avicularia are apparently absent in this species. In contrast, the type species of Harmelinius Rosso n. gen. has costae lacking pelmatidia and which are separated by slit-like intercostal spaces. The hyperstomial cleithral ovicells have smooth ooecia with a median suture and without pseudopores, and are formed by a distal kenozooid associated with a small avicularium. Additional paired oral avicularia are occasionally present, as are large kenozooids with a central opesia. Oral spines or spine-like processes are absent. Taxonomy of the above reported cribrilinid genera is discussed in detail together with the geographic distribution of all mentioned taxa.
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Key Words
- Bryozoa, taxonomy, new genera, new species, Holocene, bathyal, species distribution, Cribrilaria, Glabrilaria, Teresaspis, Harmelinius
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Affiliation(s)
- A Rosso
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, University of Catania, Corso Italia 57, 95129, Catania, Italy. CoNISMa (Consorzio Interuniversitario per le Scienze del Mare), Piazzale Flaminio, 9, 00196, Roma, Italy.
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Handing E, Kritchevsky S, Chen H, Rosso A, Manini T, Rejeski J. THE ROLE OF COGNITION AND THE ONSET OF MAJOR MOBILITY DISABILITY IN OLDER ADULTS: RESULTS FROM THE LIFE STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - H Chen
- Wake Forest School of Medicine
| | | | - T Manini
- University of Florida College of Medicine
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Carlson M, Chan T, Adam A, Ahmad O, Roy P, Rosano C, Rosso A, Krakauer J. PILOTING A VIRTUAL REALITY APPLICATION TO PROMOTE EXECUTIVE FUNCTION AND COMMUNITY MOBILITY IN AGING ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Carlson
- Johns Hopkins University, Baltimore, Maryland, United States
| | - T Chan
- Johns Hopkins University, Baltimore, Maryland, United States
| | - A Adam
- Johns Hopkins University, Baltimore, Maryland, United States
| | - O Ahmad
- Johns Hopkins University, Baltimore, Maryland, United States
| | - P Roy
- Johns Hopkins University, Baltimore, Maryland, United States
| | - C Rosano
- Johns Hopkins University, Baltimore, Maryland, United States
| | - A Rosso
- Johns Hopkins University, Baltimore, Maryland, United States
| | - J Krakauer
- Johns Hopkins University, Baltimore, Maryland, United States
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Rosso A, D'Andrea E, Baccolini V, Di Marco M, Di Paolo C, Mele A, Migliara G, Pitini E, Prencipe GP, De Vito C, Villari P. The appropriateness of genetic testing in Europe: a survey of national experts. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Rosso
- Sapienza University of Rome, Rome, Italy
| | - E D'Andrea
- Sapienza University of Rome, Rome, Italy
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | | | - M Di Marco
- Sapienza University of Rome, Rome, Italy
| | - C Di Paolo
- Sapienza University of Rome, Rome, Italy
| | - A Mele
- Sapienza University of Rome, Rome, Italy
| | - G Migliara
- Sapienza University of Rome, Rome, Italy
| | - E Pitini
- Sapienza University of Rome, Rome, Italy
| | | | - C De Vito
- Sapienza University of Rome, Rome, Italy
| | - P Villari
- Sapienza University of Rome, Rome, Italy
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Zackrisson S, Lång K, Rosso A, Johnson K, Dustler M, Förnvik D, Förnvik H, Sartor H, Timberg P, Tingberg A, Andersson I. One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol 2018; 19:1493-1503. [DOI: 10.1016/s1470-2045(18)30521-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
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Rosso A, Pitini E, D'Andrea E, Massimi A, De Vito C, Marzuillo C, Villari P. The Cost-effectiveness of Genetic Screening for Familial Hypercholesterolemia: a Systematic Review. Ann Ig 2018; 29:464-480. [PMID: 28715059 DOI: 10.7416/ai.2017.2178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is a genetic disorder that leads to elevated plasma LDL-cholesterol levels and premature coronary heart disease (CHD). An understanding of the mutations responsible for FH and the effectiveness of statins in lowering the risk of CHD in FH patients has increased interest in genetic screening strategies to improve FH diagnosis. In this study, we aimed to evaluate the cost-effectiveness of such strategies. METHODS We performed a systematic review of full economic evaluations that assessed the cost-effectiveness of FH genetic screening strategies. We used relevant search terms to investigate Medline, Scopus, Web of Science, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Data extraction and assessment of the quality of the studies were performed independently by two reviewers. The key features of the included studies are summarized in a narrative synthesis. RESULTS We included seven economic evaluations that assessed the cost-effectiveness of genetic screening for FH, published mainly in Europe between 2002 and 2015. Most studies had a no-screening strategy as a comparator, focused on relatives of index cases with genetic or clinical diagnosis of FH (cascade screening), considered a lifetime horizon and adopted a health care payer viewpoint. Cascade screening, based on genetic testing of relatives of an index case with confirmed clinical or genetic diagnosis of FH, was shown to be cost-effective in most settings. CONCLUSIONS Our review confirms the cost-effectiveness of cascade genetic screening for the diagnosis of FH. Further research may be needed to assess the cost-effectiveness of cascade screening following the introduction of newly recommended therapeutic regimes and next-generation sequencing.
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Affiliation(s)
- A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - E D'Andrea
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Tosti M, Baglio G, Marceca M, D'Angelo F, Ferrigno L, Eugeni E, Declich S, Pajno C, Marrone R, Rosso A, Geraci S. 7.5-O4Italian guideline on “health checks and protection pathways for migrants on arrival and while hosted in reception centres”. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Tosti
- Istituto Superiore di Sanità, Rome, Italy
| | - G Baglio
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - M Marceca
- Società Italiana di Medicina delle Migrazioni, Italy
| | - F D'Angelo
- Istituto Superiore di Sanità, Rome, Italy
| | - L Ferrigno
- Istituto Superiore di Sanità, Rome, Italy
| | - E Eugeni
- Società Italiana di Medicina delle Migrazioni, Italy
| | - S Declich
- Istituto Superiore di Sanità, Rome, Italy
| | - C Pajno
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - R Marrone
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - A Rosso
- ”La Sapienza” University, Rome, Italy
| | - S Geraci
- Società Italiana di Medicina delle Migrazioni, Italy
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Togliatto G, Trombetta A, Dentelli P, Rosso A, Brizzi MF. Retraction Note to: MIR221/MIR222-driven post-transcriptional regulation of P27KIP1 and P57KIP2 is crucial for high-glucose- and AGE-mediated vascular cell damage. Diabetologia 2018; 61:1236. [PMID: 29427236 DOI: 10.1007/s00125-018-4569-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The authors are retracting this article [1]. Following publication, concerns were raised with respect to some of the western blots and the authors were asked to supply the original unmodified blots.
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Affiliation(s)
- G Togliatto
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - A Trombetta
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - P Dentelli
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - A Rosso
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - M F Brizzi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy.
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Abstract
Background and purpose - The number of patients where shoulder hemiarthroplasty (SHA) is an option is still substantial. Descriptive analyses performed by the Swedish Shoulder Arthroplasty Registry (SSAR) showed that while patients receiving SHA designs, i.e. resurfacing hemi (RH) and stemmed hemi (SH), reported similar shoulder functionality and quality of life, the revision rate for RH (12%) was larger than for SH (6.7%); this difference was studied. Patients and methods - All primary SHA (n = 1,140) for OA reported to SSAR between 1999 and 2009 were analyzed regarding risk factors for revision and PROM outcome, 950 shoulders with primary OA (POA), and 190 secondary OA (SOA). Mean age was 67.4 years (SD 10.8). PROM including WOOS and EQ-5D were collected at 5 years, until December 31, 2014. Results - 76/950 prostheses because of POA and 16/190 prosthesis because of SOA were revised. Age at primary surgery was the main factor that influenced the risk of revision, lower age increased the risk of revision, and was also the explanation for the difference between SH and RH. We also found that SH and RH had similar outcomes measured by PROM, but the POA group had higher scores than the SOA group with a clinically relevant difference of 10% in WOOS. Interpretation - The risk of revision for SH and RH is similar when adjusted for age and does not depend on primary diagnosis or sex. A lower age increases the risk of revision. Patients suffering from POA experience better shoulder functionality than SOA patients irrespective of implant type.
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Affiliation(s)
- Magnus Ödquist
- Ortho Center Stockholm, Löwenströmska sjukhuset, Stockholm,Karolinska Institutet, Department of Clinical Sciences, Danderyds sjukhus AB, Stockholm,Correspondence:
| | - Kristofer Hallberg
- Karolinska Institutet, Department of Clinical Sciences, Danderyds sjukhus AB, Stockholm
| | | | - Björn Salomonsson
- Karolinska Institutet, Department of Clinical Sciences, Danderyds sjukhus AB, Stockholm
| | - Aldana Rosso
- Department of Diagnostic Radiology, Translational Medicine Malmö, Lund University, Malmö,Epidemiology and Centre of Registers South, Skåne University Hospital, Lund, Sweden
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Rosso A, Aragón P, Acevedo F, Doadrio I, García-Barros E, Lobo JM, Munguira ML, Monserrat VJ, Palomo J, Pleguezuelos JM, Romo H, Triviño V, Sánchez-Fernández D. Effectiveness of the Natura 2000 network in protecting Iberian endemic fauna. Anim Conserv 2017. [DOI: 10.1111/acv.12387] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Rosso
- Universidad Pablo de Olavide; Sevilla Spain
| | - P. Aragón
- Departamento de Biogeografía y Cambio Global; Museo Nacional de Ciencias Naturales (CSIC); Madrid Spain
| | - F. Acevedo
- Departamento de Zoología y Antropología Física; Universidad Complutense de Madrid; Madrid Spain
| | - I. Doadrio
- Departamento de Biogeografía y Cambio Global; Museo Nacional de Ciencias Naturales (CSIC); Madrid Spain
| | - E. García-Barros
- Departamento de Biología; Universidad Autónoma de Madrid; Madrid Spain
| | - J. M. Lobo
- Departamento de Biogeografía y Cambio Global; Museo Nacional de Ciencias Naturales (CSIC); Madrid Spain
| | - M. L. Munguira
- Departamento de Biología; Universidad Autónoma de Madrid; Madrid Spain
| | - V. J. Monserrat
- Departamento de Zoología y Antropología Física; Universidad Complutense de Madrid; Madrid Spain
| | - J. Palomo
- Departamento de Biología Animal; Universidad de Málaga; Malaga Spain
| | | | - H. Romo
- Departamento de Biología; Universidad Autónoma de Madrid; Madrid Spain
| | - V. Triviño
- Instituto de Ciencias Ambientales; Universidad de Castilla-La Mancha; Campus Tecnológico de la Fábrica de Armas; Toledo Spain
| | - D. Sánchez-Fernández
- Instituto de Ciencias Ambientales; Universidad de Castilla-La Mancha; Campus Tecnológico de la Fábrica de Armas; Toledo Spain
- Departamento de Ecología de Humedales; Estación Biológica de Doñana (CSIC); Americo Vespucio; Sevilla Spain
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Westborg I, Granstam E, Rosso A, Albrecht S, Karlsson N, Lövestam-Adrian M. Treatment for neovascular age-related macular degeneration in Sweden: outcomes at seven years in the Swedish Macula Register. Acta Ophthalmol 2017; 95:787-795. [PMID: 28834299 DOI: 10.1111/aos.13539] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/25/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To present Swedish Macula Register (SMR) data regarding treatment of neovascular age-related macular degeneration (AMD) in clinical practice since 2008. METHODS A retrospective register-based study was conducted. Evaluation of baseline demographics, visual outcome and number of injections during this period is presented. RESULTS Mean age at diagnosis was 79 ± (SD) 8 years; 65% were female. The proportion of patients with <2 months' duration of symptoms increased from 26% in 2008 to 41% in 2014 (p = 0.001). Mean visual acuity (VA) at baseline increased from 54.3 ± 15.0 early treatment diabetic retinopathy study (ETDRS) letters in 2008 to 57.8 ± 15.6 letters in 2014 (CI95 2.6; 4.3; p < 0.001). Mean VA after 1 year of treatment increased from 57.8 ± 17.7 ETDRS letters for patients who started the treatment in 2008 to 62.8 ± 16.4 ETDRS letters in patients starting treatment in 2014 (CI95 2.67; 4.64; p < 0.001). During all study years, the proportion of patients with an improvement in VA of between 5 and 15 letters was around 30%, while 14% had VA improvement of more than 15 letters. The mean number of injections during the first treatment year increased from 4.3 ± 1.9 in 2008 to 5.9 ± 2.9 in 2014 (CI95 1.40; 1.67; p < 0.001). Seven-year follow-up of 322 eyes showed a mean change of -1 letters from baseline, with a mean of 21 injections for the entire period. CONCLUSION The duration of symptoms before treatment decreased, while VA at baseline and after 1 year of treatment increased over the years and so did the number of injections. Long-term follow-up demonstrated stable VA.
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Affiliation(s)
- Inger Westborg
- Department of Clinical Sciences; Umeå University Hospital; Umeå Sweden
| | - Elisabet Granstam
- Centre for Clinical Research; Uppsala University; County Council of Västmanland; Västerås Sweden
| | - Aldana Rosso
- Department of Radiology; Institution of Translational Medicine; Lund University; Malmö Sweden
| | | | - Niklas Karlsson
- Department of Ophthalmology; Örebro University Hospital; Örebro Sweden
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Affiliation(s)
- Inger Westborg
- Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden
| | - Aldana Rosso
- Centre of Registers South, Skåne University Hospital, Lund, Sweden, and Radiology Diagnostics, Institution of Translational Medicine, Lund University, Malmö, Sweden
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Rosso A, D'Andrea E, Di Marco M, Pitini E, Unim B, Baccolini V, De Vito C, Marzuillo C, Vacchio MR, Barnhoorn F, Zeegers D, Villari P. Interim results of EUPHA network members’ s survey on Public Health Genomics. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - E D'Andrea
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - M Di Marco
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - E Pitini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - B Unim
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - V Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - MR Vacchio
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | | | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Massimi A, Rosso A, Marzuillo C, Vacchio MR, De Vito C, Villari P. Vaccine hesitancy: old defeat or new challenge for public health? A survey on pregnant women in Rome. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Massimi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - MR Vacchio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Flacco ME, Manzoli L, Rosso A, Marzuillo C, Bergamini M, Stefanati A, Villari P, Ricciardi W, Ioannidis JP, Contopoulos-Ioannidis DG. Immunogenicity and safety of the multicomponent meningococcal B vaccine (4CMenB): a meta-analysis. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - A Rosso
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - C Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | | | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - W Ricciardi
- Italian National Institute of Health, Rome, Italy
| | - JP Ioannidis
- Stanford Prevention Research Center, Stanford, United States
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Parrino S, Sola M, Giulio B, Rosso A, Cinzia O, Alessandra G, Gurrieri L, Stefano M, Dicorato A, Pascoletti G, Fedele D, Ceschia G, Barazzoni R. Evaluating depression in elderly patients with cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx434.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- M. Gandini
- Department of Veterinary Sciences; University of Turin; Grugliasco Italy
| | - G. Giusto
- Department of Veterinary Sciences; University of Turin; Grugliasco Italy
| | - V. Caramello
- Department of Veterinary Sciences; University of Turin; Grugliasco Italy
| | - F. Comino
- Department of Veterinary Sciences; University of Turin; Grugliasco Italy
| | - A. Rosso
- Department of Veterinary Sciences; University of Turin; Grugliasco Italy
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Mazzei MM, Sindoni A, Santacaterina A, Platania A, Marino L, Umina V, Girlando A, Ricottone N, D'Agostino A, Marletta F, Tamburo M, Acquaviva G, Spatola C, Privitera G, Frosina P, Garufi G, Bonanno S, Rosso A, Barone V, Corallo A, Sansotta G, Delia P, Donato V, Lopes S, Pisana M, Runco R, Risoleti E, Arcudi A, Rifatto C, Arena G, Potami A, Messina G, Parisi S, Marletta D, Pontoriero A, Iatì G, Pergolizzi S. Radiation therapy utilisation in patients with bone metastases secondary to prostate cancer: A multicenter study. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28657212 DOI: 10.1111/ecc.12681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
- M M Mazzei
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - A Sindoni
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - A Platania
- Radiotherapy Unit, AOOR Papardo, Piemonte, Messina, Italy
| | - L Marino
- Radiotherapy Unit, REM Center, Catania, Italy
| | - V Umina
- Radiotherapy Unit, REM Center, Catania, Italy
| | - A Girlando
- Radiotherapy Unit, Humanitas, Catania, Italy
| | - N Ricottone
- Radiotherapy Unit, Humanitas, Catania, Italy
| | | | | | | | - G Acquaviva
- Radiotherapy Unit, AOOR Papardo, Piemonte, Messina, Italy
| | - C Spatola
- Radiotherapy Unit, University Hospital of Catania, Catania, Italy
| | - G Privitera
- Radiotherapy Unit, University Hospital of Catania, Catania, Italy
| | - P Frosina
- Radiotherapy Unit, "San Vincenzo" Hospital, Taormina, Italy
| | - G Garufi
- Radiotherapy Unit, "San Vincenzo" Hospital, Taormina, Italy
| | - S Bonanno
- Garibaldi-Nesima Hospital, Catania, Italy
| | - A Rosso
- Garibaldi-Nesima Hospital, Catania, Italy
| | - V Barone
- Paternò Arezzo Hospital, Ragusa, Italy
| | - A Corallo
- Paternò Arezzo Hospital, Ragusa, Italy
| | - G Sansotta
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - P Delia
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - V Donato
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Lopes
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - M Pisana
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - R Runco
- University of Messina, Messina, Italy
| | - E Risoleti
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - A Arcudi
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - C Rifatto
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - G Arena
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - A Potami
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - G Messina
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Parisi
- University of Messina, Messina, Italy
| | | | - A Pontoriero
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - G Iatì
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Pergolizzi
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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48
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Abstract
We report on numerical studies of avalanches of an autocatalytic reaction front in a porous medium. The front propagation is controlled by an adverse flow resulting in upstream, static, or downstream regimes. In an earlier study focusing on front shape, we identified three different universality classes associated with this system by following the front dynamics experimentally and numerically. Here, using numerical simulations in the vicinity of the second-order transition, we identify an avalanche dynamics characterized by power-law distributions of avalanche sizes, durations, and lateral extensions. The related exponents agree well with the quenched-Kardar-Parisi-Zhang theory, which describes the front dynamics. However, the geometry of the propagating front differs slightly from that of the theoretical one. We show that this discrepancy can be understood in terms of the nonquasistatic correction induced by the finite front velocity.
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Affiliation(s)
- T Chevalier
- Laboratoire FAST, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
| | - A K Dubey
- Laboratoire FAST, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
| | - S Atis
- Laboratoire FAST, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
| | - A Rosso
- LPTMS, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
| | - D Salin
- Laboratoire FAST, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
| | - L Talon
- Laboratoire FAST, Université Paris-Sud, CNRS, Université Paris-Saclay, F-91405 Orsay, France
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49
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Lazarevic VL, Rosso A, Juliusson G, Antunovic P, Derolf ÅR, Deneberg S, Möllgård L, Uggla B, Wennström L, Wahlin A, Höglund M, Lehmann S, Johansson B. Incidence and prognostic significance of isolated trisomies in adult acute myeloid leukemia: A population-based study from the Swedish AML registry. Eur J Haematol 2017; 98:493-500. [PMID: 28152233 DOI: 10.1111/ejh.12861] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES AND METHODS To ascertain the incidence/clinical implications of isolated autosomal trisomies in adult acute myeloid leukemia (AML), all such cases were retrieved from the Swedish AML Registry. RESULTS Of the 3179 cytogenetically informative AMLs diagnosed January 1997-May 2015, 246 (7.7%) had isolated trisomies. The frequency increased by age (2.4% at age 18-60 years vs. 23% at >60 years; P<.0001); the median age was 69 years. The five most common were +8 (4.0%), +13 (0.9%), +11 (0.8%), +21 (0.7%), and +4 (0.5%). Age and gender, types of AML and treatment, and complete remission and early death rates did not differ between the single trisomy and the intermediate risk (IR) groups or among cases with isolated gains of chromosomes 4, 8, 11, 13, or 21. The overall survival (OS) was similar in the single trisomy (median 1.6 years) and IR groups (1.7 years; P=.251). The OS differed among the most frequent isolated trisomies; the median OS was 2.5 years for +4, 1.9 years for +21, 1.5 years for +8, 1.1 years for +11, and 0.8 years for +13 (P=.013). CONCLUSION AML with single trisomies, with the exception of +13, should be grouped as IR.
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Affiliation(s)
- Vladimir Lj Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Stem Cell Center, Lund University, Lund, Sweden
| | - Aldana Rosso
- Epidemiology and Registry Center in South Sweden, Skåne University Hospital, Lund, Sweden.,Medical Radiology, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Gunnar Juliusson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Stem Cell Center, Lund University, Lund, Sweden
| | - Petar Antunovic
- Department of Hematology, Linköping University Hospital, Linköping, Sweden
| | - Åsa Rangert Derolf
- Department of Medicine, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Deneberg
- Department of Medicine, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Möllgård
- Department of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Bertil Uggla
- Department of Medicine, School of Health and Medical Sciences, Örebro University Hospital, Örebro, Sweden
| | - Lovisa Wennström
- Department of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anders Wahlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Martin Höglund
- Department of Hematology, Academic Hospital, Uppsala, Sweden
| | - Sören Lehmann
- Department of Hematology, Academic Hospital, Uppsala, Sweden
| | - Bertil Johansson
- Department of Clinical Genetics, University and Regional Laboratories Region Skåne, Lund, Sweden.,Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
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50
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Pitini E, Marzuillo C, D’Andrea E, Unim B, Rosso A, De Vito C, Villari P. How should genetic tests be evaluated? Final Results of a systematic review of the existing tools. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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