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Bardach A, Alconada T, Palermo C, Rojas-Roque C, Sandoval MM, Gomez J, Pinto T, Ciapponi A. Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis. Infect Dis Ther 2023:10.1007/s40121-023-00814-0. [PMID: 37261611 DOI: 10.1007/s40121-023-00814-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC). METHODS We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies. RESULTS We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data. CONCLUSION The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea. TRIAL REGISTRATION The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).
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Affiliation(s)
- Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Tomás Alconada
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carolina Palermo
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - María Macarena Sandoval
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | | | | | - Agustin Ciapponi
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina.
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Sandoval MM, Bardach A, Rojas-Roque C, Alconada T, Gomez JA, Pinto T, Palermo C, Ciapponi A. Antimicrobial resistance of Neisseria gonorrhoeae in Latin American countries: a systematic review. J Antimicrob Chemother 2023; 78:1322-1336. [PMID: 37192385 PMCID: PMC10232280 DOI: 10.1093/jac/dkad071] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/23/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Detailed information is needed on the dynamic pattern of antimicrobial resistance (AMR) in Neisseria gonorrhoeae in Latin America and the Caribbean (LAC). OBJECTIVES To conduct a systematic review of AMR in N. gonorrhoeae in LAC. METHODS Electronic searches without language restrictions were conducted in PubMed, Embase, Cochrane Library, EconLIT, Cumulative Index of Nursing and Allied Health Literature, Centre for Reviews and Dissemination, and Latin American and Caribbean Literature in Health Sciences. Studies were eligible if published between 1 January 2011 and 13 February 2021, conducted in any LAC country (regardless of age, sex and population) and measured frequency and/or patterns of AMR to any antimicrobial in N. gonorrhoeae. The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO-GASP) for LAC countries and Latin American AMR SurveillanceNetwork databases were searched. AMR study quality was evaluated according to WHO recommendations. RESULTS AMR data for 38, 417 isolates collected in 1990-2018 were included from 31 publications, reporting data from Argentina, Brazil, Colombia, Peru, Uruguay, Venezuela and WHO-GASP. Resistance to extended-spectrum cephalosporins was infrequent (0.09%-8.5%). Resistance to azithromycin was up to 32% in the published studies and up to 61% in WHO-GASP. Resistance to penicillin, tetracycline and ciprofloxacin was high (17.6%-98%, 20.7%-90% and 5.9%-89%, respectively). Resistance to gentamicin was not reported, and resistance to spectinomycin was reported in one study. CONCLUSIONS This review provides data on resistance to azithromycin, potentially important given its use as first-line empirical treatment, and indicates the need for improved surveillance of gonococcal AMR in LAC. Trial registration: Registered in PROSPERO, CRD42021253342.
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Affiliation(s)
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Tomás Alconada
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | | | | | - Carolina Palermo
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
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Javier Balan D, Bardach A, Palermo C, Alconada T, Sandoval M, Nieto Guevara J, Gomez J, Ciapponi A. Economic burden of herpes zoster in Latin America: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2131167. [PMID: 36519226 PMCID: PMC9794010 DOI: 10.1080/21645515.2022.2131167] [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: 12/23/2022] Open
Abstract
This systematic review describes herpes zoster (HZ) economic burden in terms of healthcare resource use and cost outcomes in the Latin America and Caribbean (LAC) region. We searched online databases from 1 January 2000 to 20 February 2020 to identify eligible publications. We identified 23 publications that reported direct costs, indirect costs, and resources associated with HZ and its complications. The primary direct medical resources reported in the different studies were visits to doctors, transportation, days in the hospital, nursing, medication schedules, and physical therapy. Direct total costs per patient ranged from $99.99 to $4177.91. The highest cost was found in Brazil. Direct costs are, in average, 81.39% higher than indirect costs. The cost per patient that includes postherpetic neuralgia treatment is 115% higher on average for the directs and 73% for the indirect costs. Brazil reported a higher total cost per patient than Argentina and Mexico, while for indirect costs per patient, Brazil and Argentina had higher costs than Mexico, respectively. A meta-analysis on the number of days due to HZ hospitalization, performed on non-immunosuppressed patients over 65 years of age from three studies, resulted in a cumulative measure of 4.5 days of hospitalization. In the LAC region, the economic burden of HZ and associated complications is high, particularly among high-risk populations and older age groups. Preventative strategies such as vaccination could help avoid or reduce the HZ-associated disease economic burden in the LAC region.
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Affiliation(s)
- Dario Javier Balan
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Carolina Palermo
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Tomás Alconada
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Macarena Sandoval
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | | | | | - Agustin Ciapponi
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina,CONTACT Agustin Ciapponi Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
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Caldow G, Palermo C, Wilson AN. 'What do doctors think they need to know about nutrition?'-a qualitative study of doctors with formal nutrition training. BMC Nutr 2022; 8:85. [PMID: 35996126 PMCID: PMC9394029 DOI: 10.1186/s40795-022-00577-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Doctors are on the frontline of patient care and in an ideal position to provide nutritional advice, yet can feel ill-equipped to do so. The aim of this study was to explore the nutrition knowledge, skills and practice required for nutrition-competent medical graduates, and their role in providing nutrition advice and care, from the perspective of doctors with formal nutrition training. METHODOLOGY We conducted an exploratory qualitative research study. A purposive sample of 12 medical doctors and students with formal nutrition training across Australia participated in in-depth semi structured interviews. Data were analysed thematically. RESULTS There were four main themes identified: 1. Identifying the role of doctors in nutrition care; 2. Understanding the interrelatedness of the social determinants of health and nutrition status is key; 3. Optimising nutrition care through multidisciplinary collaboration; and 4. Providing evidence-based nutrition care. CONCLUSION This exploratory study suggests that doctors consider that nutrition competent medical graduates require skills in referring to dietitians, an understanding and application of the social determinants of health, and practise applying multidisciplinary and evidence-based nutrition care.
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Affiliation(s)
- G Caldow
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - C Palermo
- Monash Centre for Scholarship in Health Education, Monash University, Melbourne, Australia
| | - A N Wilson
- Maternal, Child and Adolescent Health Program, International Development, Burnet Institute, Melbourne, Australia.
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Previtero M, Simeti G, Lorenzoni G, Torresan F, Jozsa C, Castiello T, Palermo C, Aruta P, Baritussio A, Cecchetto A, Gregori D, Iliceto S, Di Salvo G, Pergola V. Feasibility and reproducibility of right ventricle stress echocardiography and its capability to assess the right ventricle contractile reserve of patient with at least trivial tricuspid regurgitation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.194] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND. Stress echocardiography (SE) is widely used for the assessment of left ventricular (LV) function, diagnostic and prognostic stratification of patients with coronary artery disease and for assessment of mitral and aortic valve disease. However, the assessment of the right ventricle (RV) in general, and in particular in regard to the contractile reserve of the RV in patients with tricuspid valve (TV) disease is an area that has not been previously explored in adult patients. The physiology and function of the RV is different than that of the LV and the use of SE provides the possibility to test both systolic and diastolic function of the RV in response to increased loading conditions. This can potentially be used to assess the RV function prior to surgery and to predict which subset of patients may benefit from intervention on the TV before the RV displays signs of failure
PURPOSE. We therefore propose a study to investigate the potential use of SE for the assessment of RV function in adult patients. The aim is to evaluate the feasibility of RV SE in any patients with more than trivial tricuspid regurgitation (TR) and to assess the presence and degree of RV contractile reserve.
METHODS. We enrolled 81 patients undergoing a phisical or dobutamine SE for CV risk stratification or chest pain. Inclusion criteria were age≥ 18 years, normal baseline RV function (FAC> 35%, TAPSE> 16 mm). Exclusion criteria were presence of RV dysfunction, pulmonary stress hypertension, positive stress test for left myocardial ischemia, presence of moderate or severe valvular disease, grade III or higher diastolic dysfunction at baseline, severe respiratory, renal or hepatic dysfunction. We evaluated the average values of TAPSE, fractional area change (FAC), S wave, sPAP (pulmonary systolic blood pressure), RV strain during baseline and at the peak of the effort. We also assessed the reproducibility of these measurement between two different expert operators (blind analysis).
RESULTS. We were able to measure the RV parameters both during baseline and at the peak of the effort in all patients, demonstrating an excellent feasibility. Differences in parameters collected at baseline and at peak were assessed using paired Wilcoxon signed rank test. All variables showed a statistical significant increase (p < 0.001) at peak compared to the baseline. Average percentage increases at peak were 31.1% for TAPSE, 24,8% for FAC, 50,6% for S wave, 55,2% for PAPS and 39.8 % for RV strain. Bland-Altman method was used to evaluate the agreement between measurements collected by two separate operators and it showed good Intraclass Correlation Coefficients (Figure).
CONCLUSIONS. RV SE proved to be feasible and showed little inter-operator variability in patients with at least trivial TR. It provided valuable informations about RV contractile reserve that may help stratifying the risk of RV failure in patients undergoing TV surgery.
Abstract Figure
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua, Italy
| | - G Simeti
- University of Padova, Dpt of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua, Italy
| | - G Lorenzoni
- University of Padova, Dpt of Statistic, Padua, Italy
| | - F Torresan
- University of Padova, Dpt of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua, Italy
| | - C Jozsa
- Croydon University Hospital, Cardiology Unit, Croydon, United Kingdom of Great Britain & Northern Ireland
| | - T Castiello
- Croydon University Hospital, Cardiology Unit, Croydon, United Kingdom of Great Britain & Northern Ireland
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua, Italy
| | - P Aruta
- University Hospital of Padova, Department of Cardiology, Padua, Italy
| | - A Baritussio
- University Hospital of Padova, Department of Cardiology, Padua, Italy
| | - A Cecchetto
- University Hospital of Padova, Department of Cardiology, Padua, Italy
| | - D Gregori
- University of Padova, Dpt of Statistic, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua, Italy
| | - G Di Salvo
- University of Padova, Department of Women"s and Children"s Health, Padua, Italy
| | - V Pergola
- University Hospital of Padova, Department of Cardiology, Padua, Italy
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Lamendola P, Lanza GA, Melita V, Villano A, Palermo C, Leone D, Lombardo A, Pennestrì F, Crea F, Mercuri EM, Pane M. Duchenne muscular dystrophy: preliminary experience with sacubitril-valsartan in patients with asymptomatic left ventricular dysfunction. Eur Rev Med Pharmacol Sci 2020; 24:9112-9115. [PMID: 32965001 DOI: 10.26355/eurrev_202009_22857] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Duchenne muscular dystrophy (DMD) is an inherited X-linked recessive neuromuscular disease caused by mutations of the dystrophin gene, leading to early and progressive muscle deterioration and dilated cardiomyopathy. The aim of this investigation was to assess whether treatment with sacubitril/valsartan (S/V) is well tolerated and may have beneficial effects in DMD patients with left ventricle (LV) dysfunction. PATIENTS AND METHODS We administered S/V to 3 DMD patients (19-29 yeard old) with LV ejection fraction <35% at echocardiography but no symptoms of heart failure. All patients were on optimal medical therapy. S/V was initiated at a very low dose of 12/13 mg/die, after withdrawal of angiotensin-converting enzyme inhibitor therapy, and slowly titrated to the dose of 49/51 mg twice daily or the maximally tolerated dose. Clinical and echocardiographic follow-up was performed after 3, 6 and 12 months. RESULTS At baseline, the LV ejection fraction was 32±1%. A significant improvement of LV ejection fraction was observed at 3 months (44.0±6.0%; p<0.05), which was maintained at 6 (45.7±5.0%) and 12 (43.3±3.2%) months (p<0.05 for both). No relevant side effects were reported throughout the period of the study. CONCLUSIONS Our preliminary data suggest that, in DMD patients with reduced LV ejection fraction, S/V is safe and may improve LV function.
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Affiliation(s)
- P Lamendola
- Department of Cardiovascular Medicine and 2Department of Pediatrics; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Ottrey E, Palermo C, Huggins CE, Porter J. A longitudinal ethnographic study of hospital staff attitudes and experiences of change in nutrition care. J Hum Nutr Diet 2020; 33:574-583. [DOI: 10.1111/jhn.12734] [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] [Indexed: 12/28/2022]
Affiliation(s)
- E. Ottrey
- Department of Nutrition, Dietetics and Food Monash University Notting Hill VIC Australia
- Dietetics Department Eastern Health Box Hill VIC Australia
| | - C. Palermo
- Department of Nutrition, Dietetics and Food Monash University Notting Hill VIC Australia
| | - C. E. Huggins
- Department of Nutrition, Dietetics and Food Monash University Notting Hill VIC Australia
| | - J. Porter
- Department of Nutrition, Dietetics and Food Monash University Notting Hill VIC Australia
- Allied Health Clinical Research Office Eastern Health Box Hill VIC Australia
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Vijiiac AE, Muraru D, Jarjour F, Kupczynska K, Palermo C, Cecchetto A, Baritussio A, Aruta P, Dorobantu M, Badano LP. P798 Right atrial phasic function and correlation with right ventricular function in patients with reduced left ventricular ejection fraction and no pulmonary hypertension:insights from 3D echocardiography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.454] [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: 11/13/2022] Open
Abstract
Abstract
Background
The right atrium (RA) is a highly dynamic chamber with 3 mechanical functions (reservoir, conduit, booster pump) and prognostic implications in heart failure (HF) and pulmonary hypertension (PH). However, RA function and its interplay with the right ventricular (RV) performance in patients (pts) with reduced left ventricular ejection fraction (LVEF) and without PH remain to be clarified.
Methods
We used three-dimensional echocardiography to study 55 pts (61 ± 14 years, 43 men) with LVEF < 40% no more than mild tricuspid regurgitation (TR), and maximum velocity of the TR jet < 3 m/s. We measured the three-dimensional RA total, passive, active ejection volumes (EV) and the respective emptying fractions (EF). In addition, we compared RV volumes and ejection fraction (RVEF) between patients with normal and abnormal RA function.
Results
Mean LVEF was 30 ± 7%. Mean echo-derived pulmonary vascular resistance was 1.64 ± 0.54 Wood units. 28 pts (51%) had reduced RA reservoir function (total EF = 34 ± 9%), 34 pts (62%) had reduced RA conduit function (passive EF = 15 ± 4%), and 10 pts (18%) had reduced RA pump function (active EF = 11 ± 3%). Pts with reduced RA reservoir function showed larger RV end-systolic volume (RVESV 124 ± 48ml vs. 90 ± 32ml; p = 0.004) and lower RVEF (38 ± 8% vs. 46 ± 6%; p < 0.001) than pts with normal RA function. Pts with reduced RA conduit function showed smaller RV stroke volume (RVSV 65 ± 19 ml vs. 80 ± 22ml; p = 0.009). Pts with impaired RA pump function showed larger RVESV (142 ± 45ml vs. 99 ± 41ml; p = 0.02) and lower RVEF (36 ± 6% vs. 43 ± 8%; p = 0.006).
RVESV was positively correlated with total (r2 = 0.47, p < 0.001), passive (r2 = 0.29, p = 0.03) and active (r2 = 0.39, p = 0.003) RAEV, while it was negatively correlated with total (r2=-0.41, p = 0.002), passive (r2=-0.34, p = 0.01) and active (r2=-0.31, p = 0.02) RAEF. RVSV showed a positive correlation with both total (r2 = 0.4, p = 0.002) and passive (r2 = 0.41, p = 0.002) RAEV. Finally, RVEF was positively correlated with total (r2 = 0.51, p < 0.001), passive (r2 = 0.47, p < 0.001), and active (r2 = 0.36, p = 0.007) RAEF.
Conclusions
RA dysfunction is not uncommon in pts with reduced LVEF, even in the absence of PH. In these pts, RA function is associated with significant changes in RV function. The RA acts as a dynamic modulator of RV pump function by redistributing RV filling and ejection force among reservoir, conduit and pump functions in the setting of altered hemodynamics. The clinical and prognostic significance of RA function in pts with reduced LVEF warrant further studies.
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Affiliation(s)
- A E Vijiiac
- Emergency Clinical Hospital Floreasca, Cardiology Department, Bucharest, Romania
| | - D Muraru
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - F Jarjour
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - K Kupczynska
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - C Palermo
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - A Cecchetto
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - A Baritussio
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - P Aruta
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
| | - M Dorobantu
- Emergency Clinical Hospital Floreasca, Cardiology Department, Bucharest, Romania
| | - L P Badano
- University of Padova, Department of cardiac, vascular and thoracic sciences and public health, Padua, Italy
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Previtero M, Bottigliengo D, Guta AC, Ochoa-Jimenez RC, Figliozzi S, Palermo C, Baritussio A, Cecchetto A, Aruta P, Iliceto S, Badano LP, Muraru D. 47 Identification of threshold values to define right chamber enlargement consistent with severe tricuspid regurgitation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.009] [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: 11/14/2022] Open
Abstract
Abstract
Background
Right ventricle (RV), tricuspid anulus (TA) and right atrium (RA) dilatation, are listed among the supportive signs to grade severe tricuspid regurgitation (TR) according to current EACVI and ESC guidelines. However, at present, there is no cut-off value to define RV, RA and TA dilatation associated to severe TR.
Purpose
Accordingly, we sought to identify the threshold values of RV, RA and TA size associated to severe TR.
Methods
302 patients (59 ± 13 years, 54 % women) with functional TR underwent three- (3D) and two-dimensional (2D) echocardiography to obtain: 3D RV end diastolic volume (RVEDVi) indexed for body surface area (BSA), 3D RV end systolic volume indexed for BSA (RVESVi), 3D RA max volume indexed for BSA (3DRAi), 2D RA systolic volume indexed for BSA (3DRAi), 2D RV basal diameter (2DRVd), 2D RV basal diameter indexed for BSA (2DRVdi), 2D TA measured in the apical 4-chamber view and 2D TA measured in the apical 4-chamber view indexed for BSA. To identify the threshold values of the parameters that discriminate patients with right chamber enlargement associated to severe TR, we selected the probability which returns the best sum of sensitivity and specificity on the ROC curve of the model.
Results
According to EACVI multiparametric approach, 50/302 pts (17%) were found to have severe TR. As shown in Figure, 3DRAi > 45 ml/m2 and 2DRAi > 45 ml/m2 identified patients with RA enlargement associated to severe TR. RVEDVi and RVESVi did not show any predictive value for severe TR. Conversely, 2DRVd > 52 mm (or >30 mm/m2) was associated to severe TR. 2DTA > 42 mm ( or >24 mm/m2) was the selected threshold value for TA dilatation.
Conclusions
Our study provided the threshold values to define the right chamber and TA dilatation associated to severe TR. Implementation of those values in current guidelines can help clinicians to improve their accuracy to identify patients with severe TR.
Abstract 47 Figure.
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | | | - A C Guta
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - R C Ochoa-Jimenez
- Mount Sinai Medical Center, Internal Medicine Department, New York, United States of America
| | - S Figliozzi
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Baritussio
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Cecchetto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - P Aruta
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - L P Badano
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
| | - D Muraru
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
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Previtero M, Ruozi N, Sammarco G, Azzolina D, Tenaglia RM, Palermo C, Aruta P, Iliceto S, Muraru D, Badano LP. P275 Feasibility and accuracy of the automated quantification of two- and three-dimensional left ventricular ejection fraction and its role in the arrhythmic risk stratification of organic heart disease. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.132] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
New automated approaches for left heart chamber quantification based on adaptive analytics algorithms have been introduced for both two- (2DE) and three-dimensional (3DE) echocardiography. These algorithms measure a left ventricular ejection fraction (LVEF) and reduce the intra- and inter-observer variability associated with the conventional manual tracing of LV endocardial borders. However, the clinical utility of these algorithms in the sudden cardiac death (SCD) risk stratification of patients with organic heart disease remains to be clarified.
PURPOSE
We sought to test the feasibility and the accuracy of two automated algorithms that measure 2DE and 3DE LVEF in patients with impaired LV systolic function and to define the cut-off values for fully automated 2DE and 3DE LVEF that could predict major arrhythmic events (MAE). We wanted also to assess the feasibility of replacing manual 2DE and semi-automated (SA) 3DE LVEF with fully-automated (FA) 2DE and 3DE LVEF respectively, in the stratification of high arrhythmic risk patients.
METHODS
We prospectively enrolled 240 patients (63 ± 13 years, 81% men) with both ischemic and non-ischemic cardiomyopathy with 2DE LVEF < 50%, no previous MAE or coronary artery revascularization < 90 days, after at least 3 months of optimal medical therapy for heart failure. MAE were defined as SCD, resuscitated cardiac arrest (CA), ventricular fibrillation, sustained ventricular tachycardia and appropriate ICD shocks. The risk detection cut-off values for 2DE and 3DE FA LVEF were computed using the maximally selected rank statistics method. In order to predict the risk of MAE we created four different risk models, including both clinical characteristics (age, NYHA class, aetiology of the LV dysfunction) and imaging-derived data (2DE manual LVEF, 2DE FA LVEF, 3DE SA LVEF and 3DE FA LVEF), analyzed by a ROC curve.
RESULTS
During a 27 ± 25months follow-up period, 31 patients (13%) presented MAE including SCD (n= 22; 9%), resuscitated CA (n = 3; 1%) and appropriate ICD shocks (n = 6; 2%). Both 2DE and 3DE FA LVEF showed high feasibility (92% and 95%, respectively), and good agreement with conventional LVEF (2DE mean difference 4 ± 7%, and 3DE mean difference 4 ± 7%). We identified two FA LVEF cut-offs for the MAE detection: 2DE <39% (p = 0.006) and 3DE <37% (p = 0.005). The model including the 2DE FA LVEF showed an area under the curve (AUC) larger than the one including conventional 2DE LVEF (0.83 vs 0.80). Conversely, the AUC obtained with FA 3DE LVEF model was slightly lower than the one obtained using SA 3DE LVEF model (0.80 vs 0.84).
CONCLUSIONS
Both 2DE and 3DE FA LVEF are feasible and accurate alternative to the conventional (manual) or SA endocardial border tracing. The use of specific FA 2DE LVEF cut-off values showed a comparable predictive power in the MAE risk stratification compared to the conventional one with the advantage of very low intra- and inter-observer variability.
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - N Ruozi
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - G Sammarco
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Azzolina
- University of Padova, Dpt of Statistic, Padua, Italy
| | - R M Tenaglia
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - P Aruta
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Muraru
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
| | - L P Badano
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
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11
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Previtero M, Guta AC, Ochoa-Jimenez RC, Palermo C, Bottigliengo D, Figliozzi S, Baritussio A, Cecchetto A, Aruta P, Iliceto S, Badano LP, Muraru D. P764 Right ventricular basal diameter, but not volume, can predict severe tricuspid regurgitation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.426] [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: 11/13/2022] Open
Abstract
Abstract
Background
According to current EACVI guidelines, right ventricle (RV), tricuspid anulus (TA) and right atrium (RA) dilatation are supportive signs to identify severe functional tricuspid regurgitation (TR) by echocardiography. However, the ranking by which those parameters should be considered to identify severe TR remains to be clarified.
Purpose
Accordingly, the aim of this study is to compare RV, RA and TA association with severe TR and to rank them in order of importance to predict severe TR.
Methods
302 patients (59 ± 13 years, 54 % women) with functional TR underwent two- and three-dimensional echocardiography. Using the nonparameteric Variable Importance (VIMP) software package, we assessed the relative importance of 6 differerent parameters (indexed by body surface area) to identify severe TR: 3D RV end diastolic volume (RVEDVi), 3D RV end systolic volume (RVESVi), 3D RA max volume (3DRAi), 2D RA systolic volume (3DRAi), 2D RV basal diameter (2DRVdi) and 2D TAi measured in the apical 4-chamber view.
Results
According to EACVI multiparametric approach, 50/302 pts (17%) were found to have severe TR. 3DRAi (VIMP = 0.075) was the most important predictor of severe TR. 2DRVdi (VIMP= 0.005) was the second most important parameter and was the only parameter of RV dilation (RVEDVi= -0.0011 and RVESVi= -0.0012) associated to severe TR. Also, 2DRAi (VIMP= 0.023), and 2D TAi (VIMP= 0.004) showed good predictive ability.
Conclusions
Among the various right heart structures undergoing remodeling in patients with functional TR, RA dilation was the most important predictor of severe TR. Also the RV basal diameter, but not the volumes, was a predictor of severe TR. This underlines the importance of the shape, more than the volume of the RV as a predictor of severe TR.
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A C Guta
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - R C Ochoa-Jimenez
- Mount Sinai Medical Center, Internal Medicine Department, New York, United States of America
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | | | - S Figliozzi
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Baritussio
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Cecchetto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - P Aruta
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - L P Badano
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
| | - D Muraru
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
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Previtero M, Sammarco G, Genovese D, Azzolina D, Tenaglia RM, Ruozi N, Palermo C, Iliceto S, Muraru D, Badano LP. P1581 The global myocardial work index is a powerful predictor of major arrhythmic events in patients with organic heart disease and reduced left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1001] [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: 11/14/2022] Open
Abstract
Abstract
Background
Current guidelines recommend implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death in patients with left ventricular ejection fraction (2DE LVEF) by two-dimensional echocardiography≤ 35%. However, new echocardiography parameters of LV function such as the mechanical dispersion (MD), the LVEF by three-dimensional echocardiography (3DE) and the global myocardial work index (GWI) have been reported to provide a more accurate stratification of the arrhythmic risk, and potentially improve ICD patient selection.
Purpose
We wanted to compare the arrhythmic risk predictive power of the new parameters of LV function with the conventional 2DLVEF.
Material and Methods
we prospectively enrolled 216 patients (63 ± 12 years, 88% men) with organic heart diseases and 2DE LVEF <50%, in whom we re-measured LVEF using 3DE, and obtained MD and GWI using 2DE speckle tracking. Major arrhythmic events were defined as sudden cardiac death, sustained ventricular tachycardia, ventricular fibrillation and appropriate ICD shocks. We assessed the predictive power of 4 different parameters: 2DE LVEF< 35%; 3DE LVEF< 35%; MD > 80 ms; and GWI< 672 mmHg% to identify patients at risk of major arrhythmic events.
Results
During a mean follow-up of 27 ± 24 months, 24 patients (10%) experienced sudden cardiac death, whereas 28 patients (13%) presented major arrhythmic events. The predictive power in terms of major arrhythmic events prediction (Harrel C statistics) improved from 0.67 (95%CI 0.57-0.76) for 2DE LVEF< 35%, to 0.73 (95%CI 0.64-0.82) for 3DE LVEF< 35%, and 0.77 (95%CI 0.68-0.86) for GWI < 672 mm Hg%. Whereas, MD > 80 ms showed a limited predictive power (HCS= 0.53, 95%CI 0.41-0.76)).
Conclusions
GWI< 672 mm Hg% was the most accurate predictor of major arrhythmic events among echocardiography parameters in patients with organic heart disease and LVEF < 50%.
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - G Sammarco
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Genovese
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Azzolina
- University of Padova, Dpt of Statistic, Padua, Italy
| | - R M Tenaglia
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - N Ruozi
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Muraru
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
| | - L P Badano
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
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Jarjour F, Civera S, Vijiiac A, Elnagar B, Palermo C, Torlai Triglia L, Previtero M, Muraru D, Badano LP. P669 Functional remodeling of the left atrium after first acute ST-elevation myocardial infarction: a 3D echocardiography study. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.349] [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: 11/13/2022] Open
Abstract
Abstract
Background
Left atrium (LA) is a dynamic structure which is functionally coupled with the left ventricle and modulates its function in many cardiac conditions. The geometric and functional remodeling of the LA occurring early after myocardial infarction are poorly understood.
Purpose
We sought to evaluate the early changes in LA geometry and function occurring in survivors of a first acute ST-elevation myocardial infarction (STEMI), using three-dimensional echocardiography (3DE).
Methods
LA phasic volumes and strain (both longitudinal and circumferential) were measured using a dedicated automated software package in 54 patients at pre-discharge after STEMI, and in 54 age- and sex-matched healthy volunteers (controls), (figure 1).
Results
In STEMI patients, both maximal (LAV max) and minimal (LAV min) LA volumes were significantly larger than in controls 63 ± 15 vs. 53 ±11 ml; p = 0,002 and 38 ± 15 ml vs. 25 ± 6; p <0.0001 (respectively). Moreover, when compared to controls (Table 1). Both longitudinal (LASr) and circumferential strain reservoirs showed a significant negative correlation with peak cardiac troponin I values (r=-0.344; p = 0.007 and r=-0.357; p = 0.005, respectively) as an estimate of the extent of myocardial damage.
Conclusion
STEMI was associated to significant geometrical and functional remodeling of the LA which was correlated with the extent of myocardial damage.
Table 1 Controls STEMI patients P-value Longitudinal% LASr 21.8 ± 8.4 13.72 ± 8.27 <0.0001 LAScd -12.8 ± 8.48 -6.43 ± 4.74 <0.0001 LASct -9.73 ± 6.04 -7.26 ± 5.87 0.05 Circumferential % LASr-c 27.31 ± 8.07 18.92 ± 9.16 <0.0001 LAScd-c -11.2 ± 5.93 -6.46 ± 5.68 0.0002 LASct-c -16.22 ± 6.33 -12.41 ± 5.94 0.004 LASr longitudinal strain reservoir, LAScd: longitudinal strain conduit, LAScd: longitudinal strain contraction, LASr-c: circumferential strain reservoir, LAScd-c: circumferential strain conduit , LASct-c:circumferential strain contraction
Abstract P669 Figure 1
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Affiliation(s)
- F Jarjour
- Hospital Vila da Serra, Belo Horizonte, Brazil
| | - S Civera
- University of Padova, Cardiology, Padua, Italy
| | - A Vijiiac
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | | | - C Palermo
- University of Padova, Cardiology, Padua, Italy
| | | | - M Previtero
- University of Padova, Cardiology, Padua, Italy
| | - D Muraru
- University of Padova, Cardiology, Padua, Italy
| | - L P Badano
- University of Padova, Cardiology, Padua, Italy
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14
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Previtero M, Guta AC, Ochoa-Jimenez RC, Figliozzi S, Palermo C, Baritussio A, Cecchetto A, Aruta P, Iliceto S, Badano LP, Muraru D. 38 Prognostic validation of partition values obtained with conventional two-dimensional and doppler echocardiography to grade tricuspid regurgitation severity. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Morbidity and mortality associated with severe tricuspid regurgitation (TR) have prompted interest in new corrective transcatheter procedures. However, to properly select patients for interventional procedures, and to assess their effectiveness, a reliable and reproducible grading system of TR severity is mandatory. However, the cut-off values used by current guidelines to differentiate among mild, moderate and severe TR lack clinical validation.
Purpose
We aimed to obtain the threshold values of the currently recommended quantitative echocardiographic parameters used to grade TR severity using pts’ outcome as a reference.
Methods
296 pts, with at least mild TR and complete 2D, 3D and Doppler echocardiographic study, were enrolled and assessed for potential confounders: age, NYHA class, left ventricular ejection fraction, coexistent valvular heart disease and right ventricular (RV) systolic pressure. Average diameter of the vena contracta (VCavg), effective regurgitant orifice area (EROA), regurgitant volume (RVol) and regurgitant fraction (RF) were obtained to grade TR severity. Median follow-up was 47 (17-80) months. The primary composite endpoint was the occurrence of death of any cause or hospitalization for right heart failure (RHF). Survival curves for the composite endpoint were divided in quartiles at median follow-up. Cut-off values for the echo parameters were derived to grade mild (below the 1st quartile), moderate (between 1st and 3rd quartiles), and severe (above the 3r quartile) TR.
Results
33 deaths and 72 hospitalizations for RHF occurred. Event-free rate from death or RHF at the end of follow-up was 14%, 46% and 93% in pts with severe, moderate, and mild TR, respectively. Differences reached statistical significance early (at 1 month), and lasted during the whole follow-up period (Figure). The new threshold values for mild, moderate and severe TR are summarized in Table.
Conclusions
Partition values of quantitative echo-Doppler parameters used to grade mild, moderate and severe TR according to pts’ clinical outcome are significantly lower than those currently reported in guidelines. Further studies are needed to test if these new threshold values for severe TR will translate in earlier referral of pts to valve repair and improved prognosis.
Mild Moderate Severe VCavg <3 mm 3-6 mm >6 mm EROA <0.15 cm² 0.15-0.30 cm² >0.30 cm² R Vol <15 ml 15-30 ml >30 ml RF <25% 25-45% >45%
Abstract 38 Figure.
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Affiliation(s)
- M Previtero
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A C Guta
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - R C Ochoa-Jimenez
- Mount Sinai Medical Center, Internal Medicine Department, New York, United States of America
| | - S Figliozzi
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Baritussio
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Cecchetto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - P Aruta
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padova, Dpt of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - L P Badano
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
| | - D Muraru
- Italian Institute for Auxology IRCCS, San Luca Hospital, University Milano-Bicocca, Milan, Italy
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Ochoa-Jimenez R, Guta AC, Previtero M, Palermo C, Aruta P, Badano LP, Muraru D. 6067Right ventricular global longitudinal strain predicts cardiovascular mortality and heart failure hospitalization in patients with functional tricuspid regurgitation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0117] [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: 11/13/2022] Open
Abstract
Abstract
Background
Functional tricuspid regurgitation (FTR) and its increasing severity are well-known factors associated with increased morbidity and mortality in patients with pulmonary artery hypertension or left heart diseases.
Purpose
To assess the main clinical and echocardiographic determinants of outcome in patients with various causes of FTR.
Methods
A total of 140 patients (pts) (72±14 years, 40% men) with FTR of diverse etiologies underwent complete 2D and additional 3D echocardiography acquisitions and were followed for a median of 5.2 years (interquartile range 2.1 - 6.7 years). Severe FTR was defined by ≥2 parameters: (1) coaptation defect; (2) vena contract ≥7; (3) PISA radius >9 mm; (4) hepatic vein systolic flow reversal. The primary composite outcome was defined as death from cardiovascular causes and hospitalization due to right-sided heart failure (HF).
Results
74 pts (53%) developed the primary composite outcome. Death occurred in 31 pts (22%), while hospitalization due to right-sided HF occurred in 66 pts (47%). At baseline, patients who developed the primary composite outcome, compared to those who did not, had more symptoms, more severe FTR, higher pulmonary systolic pressure (60±27 vs 43±16 mmHg), larger right atrium (69±34 vs 51±22 mL/mm2), right ventricular (RV) basal diameter (29±6 vs 24±4 mm/m2), larger RV end-diastolic (102±45 vs 76±25 mL/m2) and end-systolic (62±37 vs 43±17 mL/m2) volumes, larger tricuspid annulus area (7.7±1.8 vs 6.8±1.8 cm2/m2), lower RV systolic function (RVEF [42±11 vs 46±8%], TAPSE [18±4 vs 21±4], S' [11±3 vs 12±2], RV global longitudinal strain (RVGLS) [16±5 vs 19±4], RV free wall longitudinal strain [19±7 vs 23.5]); all p-values <0.03. There were no significant differences in age, body size or comorbidities. After multivariable Cox regression analysis, FTR grade severity (hazard ratio [HR]=2.95, 95% confidence interval [CI] 2.14–4.06, p<0.001) and RVGLS (HR= 0.91, 95% CI 0.86–0.95) were the only independent predictors of mortality. A cutoff of −17.5 for RVGLS had 57% sensitivity, 73% specificity and a HR of 2.34 (95% CI of 1.42–3.88, p-value=0.001). The Kaplan Meier survival curve showed that patients with an RVGLS ≥ −17.5 had a higher probability of developing the primary composite outcome, especially at an earlier phase of the follow up when compared to those with higher LS (log rank test chi-square = 13.0, p<0.001) (Figure). At the end of follow up, 60% of patients with a RVGLS ≥-17.5 did not developed the primary composite outcome vs 29% in the group with a LS lower than −17.5.
Kaplan-Meier curve of outcome by RVGLS
Conclusions
In patients with FTR, a decreased RVGLS, with a cutoff of −17.5, proved to be an independent prognostic factor for the development of HF hospitalizations and death from cardiovascular causes.
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Affiliation(s)
- R Ochoa-Jimenez
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy, Internal Medicine Department, Mount Sinai St Luke and Mount Sinai West, New York, United States of America
| | - A C Guta
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - M Previtero
- University of Padova, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padova, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - P Aruta
- University of Padova, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - L P Badano
- University of Padova, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - D Muraru
- University of Padova, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
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Vazquez MV, Palermo C, Islas MB, Zapata M, Giussi Bordoni MV, Esteban S, Baum A. Adoption Factors Related to Electronic Vaccine Record in the Public Primary Care Network of Buenos Aires City. Stud Health Technol Inform 2019; 264:2001-2002. [PMID: 31438449 DOI: 10.3233/shti190755] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Electronic Health Record used in the public primary care network of Buenos Aires City has a specific module for the vaccines registration. The present study explores the factors of EHR adoption by nurses. We found 5 barriers and one facilitator for adoption. Barriers are related with organize the flow of patients especially during vaccine campaigns, adapt the work stations and integrate the records with the vaccine central program.
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Affiliation(s)
- M V Vazquez
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - C Palermo
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - M B Islas
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - M Zapata
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - M V Giussi Bordoni
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - S Esteban
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
| | - A Baum
- Health Information Systems Office, Ministry of Health, Buenos Aires City, Argentina
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Bacon R, Long Y, Palermo C, Whelan K. Improving Competency-Based Assessment - an International Perspective. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.251] [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: 11/25/2022]
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Muraru D, Guta AC, Addetia K, Genovese D, Ochoa-Jimenez R, Veronesi F, Aruta P, Palermo C, Prado A, Sammarco G, Tenaglia R, Iliceto S, Lang RM, Badano LP. P1586Accuracy of conventional and 3D echo-derived indices of right chamber and tricuspid annulus size to predict severe functional tricuspid regurgitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1586] [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: 11/14/2022] Open
Affiliation(s)
- D Muraru
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A C Guta
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - K Addetia
- University of Chicago Medicine, Heart & Vascular Center, Chicago, United States of America
| | - D Genovese
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | | | - F Veronesi
- University of Bologna, Department of Electrical, Electronic and Information Engineering, Bologna, Italy
| | - P Aruta
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - C Palermo
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - A Prado
- Private Center of Cardiology, Tucuman, Argentina
| | - G Sammarco
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - R Tenaglia
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - S Iliceto
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
| | - R M Lang
- University of Chicago Medicine, Heart & Vascular Center, Chicago, United States of America
| | - L P Badano
- University of Padua, Department of Cardiac, Thoracic and Vascular Sciences, Padua, Italy
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Blake MR, Backholer K, Hettiarachchi J, Palermo C, Peeters A, Boelsen-Robinson T. The experiences of a large health service food retailer in implementing a healthy food policy. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.321] [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)
- MR Blake
- Monash University, Melbourne, Australia
| | | | | | - C Palermo
- Monash University, Melbourne, Australia
| | - A Peeters
- Deakin University, Melbourne, Australia
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Genovese D, Ermacora D, Cavalli G, Aruta P, Palermo C, Surkova E, Rodriguez-Zanella H, Iliceto S, Badano L, Muraru D. P154Incremental prognostic value of left ventricular ejection fraction measured with three-dimensional echocardiography in a large cohort of patients with various heart diseases. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cherata D, Rodriguez-Zanella H, Muraru D, Palermo C, Cucchini U, Aruta P, Carstea D, Zaharie M, Glodeanu A, Carstea A, Bidviene J, Riccoboni D, Semenzato G, Iliceto S, Badano L. P1438Free wall strain analysis allows identification of subclinical right ventricular dysfunction among patients with early cardiotoxicity. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1438] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Surkova E, Bidviene J, Genovese D, Cavalli G, Aruta P, Palermo C, Rodriguez-Zanella H, Iliceto S, Badano L, Muraru D. P3336Three-dimensional echocardiography right ventricular volumes and ejection fraction predict mortality in unselected patients with various cardiac diseases. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3336] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cherata D, Rodriguez-Zanella H, Riccoboni D, Palermo C, Muraru D, Aruta P, Surkova E, Carstea D, Zaharie M, Glodeanu A, Carstea A, Binotto G, Semenzato G, Iliceto S, Badano L. P160Three-dimensional left ventricular global longitudinal strain is as feasible and accurate as two-dimensional global longitudinal strain for subclinical cardiotoxicity surveillance. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p160] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rodriguez Zanella H, Secco E, Boccalini F, Muraru D, Aruta P, Surkova E, Sammarco G, Genovese D, Cavalli G, Palermo C, Nese A, Iliceto S, Badano L. P1442Age-related increase of left ventricular mechanical dispersion measured with two-dimensional speckle-tracking echocardiography in 254 healthy adults. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1442] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aruta P, Valente L, Ruozi N, Mihaila S, Muraru D, Palermo C, Cucchini U, Rigato I, Rodriguez Zanella H, Surkova E, Bidviene J, Cherata D, Shehatat H, Iliceto S, Badano L. P1362In patients with end stage functional mitral regurgitation, mitral annulus geometry is independent on the ischemic or non-ischemic etiology of left ventricular dysfunction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1362] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Palermo C, Volders E, Gibson S, Kennedy M, Wray A, Thomas J, Hannan-Jones M, Gallegos D, Beck E. Exploring approaches to dietetic assessment of a common task across different universities through assessment moderation. J Hum Nutr Diet 2017; 31:41-46. [PMID: 28730664 DOI: 10.1111/jhn.12499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assessment presents one of the greatest challenges to evaluating health professional trainee performance, as a result of the subjectivity of judgements and variability in assessor standards. The present study aimed to test a moderation procedure for assessment across four independent universities and explore approaches to assessment and the factors that influence assessment decisions. METHODS Assessment tasks designed independently by each of the four universities to assess student readiness for placement were chosen for the present study. Each university provided four student performance recordings for moderation. Eight different academic assessors viewed the student performances and assessed them using the corresponding university assessment instrument. Assessment results were collated and presented back to the assessors, together with the original university assessment results. Results were discussed with assessors to explore variations. The discussion was recorded, transcribed, thematically analysed and presented back to all assessors to achieve consensus on the emerging major learnings. RESULTS Although there were differences in absolute scores, there was consistency (12 out of 16 performances) in overall judgement decisions regarding placement readiness. Proficient communication skills were considered a key factor when determining placement readiness. The discussion revealed: (i) assessment instruments; (ii) assessor factors; and (iii) the subjectivity of judgement as the major factors influencing assessment. CONCLUSIONS Assessment moderation is a useful method for improving the quality of assessment decisions by sharing understanding and aligning standards of performance.
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Affiliation(s)
- C Palermo
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - E Volders
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - S Gibson
- Department of Nutrition and Dietetics, Monash University, Notting Hill, VIC, Australia
| | - M Kennedy
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - A Wray
- Department of Nutrition & Dietetics, Flinders University, Bedford Park, SA, Australia
| | - J Thomas
- Department of Nutrition & Dietetics, Flinders University, Bedford Park, SA, Australia
| | - M Hannan-Jones
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - D Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - E Beck
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
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Amos KJ, Cockrell DJ, Palermo C, Rosehill S, Bearman M. Attributes of the complete dental record: a Delphi approach to standards. Aust Dent J 2017; 62:426-432. [PMID: 28423461 DOI: 10.1111/adj.12521] [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] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adherence to the Dental Board of Australia Guidelines on dental records is not universal and remediation of deficient practise requires clarity in the practical application of standards. The aim of this research is to clarify practical requirements of dental record keeping in New South Wales. METHODS Seventeen experts were invited to participate in an electronically administered series of Delphi questionnaires. Concepts were refined until consensus was reached. RESULTS Two rounds were required to achieve a satisfactory level of consensus (>80%). A high level of consensus was obtained across the two rounds, with 72% and 86% agreement on propositions in the first and second rounds, respectively. Consensus criteria were established in 14 domains to establish attributes of the complete dental record (ACDR). CONCLUSIONS The ACDR may supplement existing national guidelines and are likely to be useful in a remediation context in which clear, unambiguous expectations for conduct are paramount.
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Affiliation(s)
- K J Amos
- Health Professional Education and Research, Monash University, Melbourne, Victoria, Australia
| | - D J Cockrell
- Oral Health, School of Health Sciences, Faculty of Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - C Palermo
- Health Professional Education and Research, Monash University, Melbourne, Victoria, Australia
| | - S Rosehill
- Faculty of Business and Law, University of Newcastle, Newcastle, New South Wales, Australia
| | - M Bearman
- Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Victoria, Australia
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Choi TST, Walker KZ, Lombard CB, Palermo C. Optimising the effectiveness of diabetes education in an East Asian population. Nutr Diet 2017; 74:253-260. [DOI: 10.1111/1747-0080.12339] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/02/2016] [Accepted: 11/18/2016] [Indexed: 11/26/2022]
Affiliation(s)
- T. S. T. Choi
- Department of Nutrition and Dietetics; Monash University; Notting Hill Victoria Australia
| | - K. Z. Walker
- Department of Nutrition and Dietetics; Monash University; Notting Hill Victoria Australia
| | - C. B. Lombard
- Department of Nutrition and Dietetics; Monash University; Notting Hill Victoria Australia
| | - C. Palermo
- Department of Nutrition and Dietetics; Monash University; Notting Hill Victoria Australia
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Alassia L, Palermo C, Recondo F, Giussi M, Stieben A, Baum A, Gonzalez Bernaldo de Quiros F. Managing User Needs During the EHR Implementation in Buenos Aires City: The HelpDesk Role. Stud Health Technol Inform 2017; 245:835-837. [PMID: 29295216] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Enablement, guidance, and proactive preparation for a new IT system implementation has proven to be a smart way to prepare people to embrace change. These activities are closely related to change management approaches which seek to help people understand and adopt specific behaviors. That being said, investing in such activities becomes the cornerstone of the success of the project. Leading IT companies around the world include in their strategy for new services and offering deployments, a proactive HelpDesk service. This not only helps build long lasting/trusted relationships between end users and IT sectors but also helps reduce cost and maximizes the Return of Investment. A streamlined process and easy to use/fluent communication channel between parties are powerful risk management/Quality Assurance and Continuous Improvement tools. In this paper, we address the example of a HelpDesk support team implementation of a city-scaled Electronic Health Records implementation.
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Affiliation(s)
- L Alassia
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
| | - C Palermo
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
| | - F Recondo
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
| | - M Giussi
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
| | - A Stieben
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
| | - A Baum
- Dirección de Informática Clínica, Estadística y Epidemiológica, Health Ministry, Buenos Aires City
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Kanda T, Borizanova A, Borizanova A, Zayat R, Bianco F, Hajdu M, Cherata DA, Ariani R, Sanchez J, Surkova E, Kalcik M, Demkina AE, Di Meglio M, Luszczak JM, Filipiak D, Sanz Sanchez J, Kolesnyk MY, Cersit S, Chokesuwattanaskul R, De Lepper AGW, Hubert A, Tavares Da Silva M, Svetlin Nedkov Tsonev ST, Ahmed A, Fujita M, Iida O, Masuda M, Okamoto S, Ishihara T, Nanto K, Uematsu M, Kinova E, Goudev A, Kinova E, Goudev A, Aljalloud A, Musetti G, Kang HJ, Jansen-Park SH, Goetzenich A, Autschbach R, Hatam N, Cicchitti V, Bucciarelli V, Di Girolamo E, Tonti G, De Caterina R, Gallina S, Vertes V, Meiszterics ZS, Szabados S, Simor T, Faludi R, Muraru D, Palermo C, Romeo G, Aruta P, Binotto G, Semenzato G, Carstea D, Iliceto S, Badano LP, Soesanto AM, Ruiz M, Mesa D, Delgado M, Gutierrez G, Aristizabal CH, Fernandez J, Ferreiro C, Duran E, Anguita M, Castillo JC, Pan M, Arizon JM, Suarez De Lezo J, Bidviene J, Brunello G, Veronesi F, Cavalli G, Sokalskis V, Aruta P, Badano LP, Muraru D, Yesin M, Bayam E, Gunduz S, Gursoy MO, Karakoyun S, Astarcioglu MA, Cersit S, Candan O, Ozkan M, Krylova NS, Poteshkina NG, Kovalevskaya EA, Hashieva FM, Venner C, Huttin O, Guillaumot A, Chaouat A, Chabot F, Juilliere Y, Selton-Suty C, Williams CA, Stuart AG, Pieles GE, Kasprzak JD, Lipiec P, Osa Saez A, Arnau Vives MA, Buendia Fuentes F, Ferre Valverdu M, Quesada Carmona A, Serrano Martinez F, Montero Argudo A, Martinez Dolz L, Rueda Soriano J, Nikitjuk OV, Dzyak GV, Gunduz S, Tabakci M, Gursoy O, Karakoyun S, Bayam E, Kalcik M, Yesin M, Ozkan M, Satitthummanid S, Boonyaratavej S, Herold IHF, Saporito S, Bouwman RA, Mischi M, Korsten HHM, Reesink KD, Houthuizen P, Galli E, Bouzille G, Samset E, Donal E, Pestana G, De Sousa C, Pinto R, Ribeiro V, Vasconcelos M, Almeida PB, Macedo F, Maciel MJ, Manov E, Runev N, Shabani R, Gartcheva M, Donova T, Petrov I, Al-Mallah M. HIT Poster session 1P161E/e'*SV is a better predictor of outcome than E/e' in patients with heart failure with preserved left ventricular ejection fractionP162Subclinical left atrial and left ventricular structural and functional abnormalities in postmenopausal women with abdominal obesityP163Central obesity and hypertension: double burden to the left atrium of postmenopausal womenP164Comparison between 3-D blood pressure pulse analyser and pulsed-wave doppler echocardiography derived hemodynamic parameters in cardiac surgery patients - a pilot studyP165Paced-induced heart electrical activation modifies the orientation of left ventricular flow momentum: novel insights from echocardiographic particle image velocimetryP166Correlations between echocardiographic and CMR-derived parameters of right ventricular size and function in patients with COPDP167Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular myocardial function in patients with cancer therapy-related left ventricular dysfunctionP168Effect of atrial fibrillation to pulmonary hypertension and right ventricular function in patient with severe mitral stenosisP169Evolution of etiologic spectrum and clinical features of mitral regurgitation since 2007 until 2015P170Tricuspid annulus area correlates more with right atrial than right ventricular volumes in patients with different mechanisms of functional tricuspid regurgitation: a 3D echocardiography studyP171The effect of hemolysis on serum lipid levels in patients suffering from severe paravalvular leakageP172Right ventricular dysfunction in patients with hypertrophic cardiomyopathyP173Interest of variations of echocardiographic parameters after initiation of specific therapy in the risk stratification of patients with pulmonary hypertensionP174Comparison of left and right atrial size and function in elite adolescent male football playersP175Do pocket-size imaging devices allow for reliable bedside vascular screening?P176Evolution of tricuspid regurgitation after pulmonary valve replacement for pulmonary regurgitation in repaired tetralogy of fallotP177Effect of perindopril/amlodipine combination on post-exercise E/e' in patients with arterial hypertensionP178Relationship between pulmonary venous flow and prosthetic mitral valve thrombosis P179Mitral valve parameters derived from 3-dimensional transesophageal echocardiography dataset: correlation between qlab and tomtec softwareP180Non-invasive pulmonary transit time: a new parameter for global cardiac performanceP181Assessment of the positive work and mechanical dispersion: new methods to quantify left ventricular function in aortic stenosisP182Atrial function in Takotsubo cardiomyopathy: deformation analysisP183Cardiac syndrome X- proven left ventricular perfusion and kinetic abnormalities by SPECT-CT and pharmacological dobutamine stress testP184Impact of frailty assessment on myocardial perfusion imaging results: a prospective cohort study. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew235] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cueva Recalde JF, Velcea A, Aguiar Rosa S, Surkova E, Bucciarelli V, Kupczynska K, Miskowiec D, Reskovic Luksic V, Verseckaite R, Jillott N, Muraru D, Muraru D, Borizanova A, Caroli S, Guerreiro S, Miskowiec D, Miskowiec D, Mahmoud HM, Peovska Mitevska I, Babukov R, Brecht A, Garcia-Sanchez MJ, Gayan Ordas J, Lacambra Blasco I, Mihaila S, Andronic AA, Marcu S, Vinereanu D, Galrinho A, Branco L, Timoteo A, Cunha P, Lousinha A, Valente B, Pereira Silva T, Oliveira M, Cruz Ferreira R, Aalen J, Samset E, Bidviene J, Aruta P, Romeo G, Sambugaro F, Badano LP, Muraru D, Bianco F, Di Blasio A, Izzicupo P, Ghinassi B, Napolitano G, Di Baldassarre A, Gallina S, Michalski B, Miskowiec D, Kasprzak JD, Lipiec P, Kupczynska K, Michalski B, Simiera M, Lipiec P, Wejner-Mik P, Wierzbowska-Drabik K, Ojrzanowski M, Kasprzak JD, Pasalic M, Separovic Hanzevacki J, Mizariene V, Montvilaite A, Unikaite R, Bieseviciene M, Jurkevicius R, Wilson S, Marotta C, Mihaila S, Calore C, Bidviene J, Surkova E, Romeo G, Aruta P, Palermo C, Badano LP, Marotta C, Mihaila S, Calore C, Aruta P, Romeo G, Surkova E, Bidviene J, Iliceto S, Badano LP, Kinova E, Kundurzhiev T, Goudev A, Bellsham-Revell HR, Bell AJ, Miller OI, Simpson JM, Raposo L, Andrade MJ, Horta E, Reis C, Almeida M, Mendes M, Wejner-Mik P, Kasprzak JD, Qawoq HD, Zycinski P, Wcislo T, Kupczynska K, Lipiec P, Wejner-Mik P, Kasprzak JD, Qawoq HD, Zycinski P, Wcislo T, Kupczynska K, Lipiec P, Abdel Raouf O, Kheir A, Halawa S, Al-Ghamdi M, Ghabashi A, Srbinovska E, Antova E, Bosevski M, Bazilev VV, Bartosh FL, Bathe M, Oertelt-Prigione S, Seeland U, Regitz-Zagrosek V, Baumann G, Stangl K, Stangl V, Knebel F, Dreger H, Barreiro-Perez M, Arribas-Jimenez A, Martin-Garcia A, Diaz-Pelaez E, Rama-Merchan JC, Cruz-Gonzalez I, Sanchez PL. HIT Poster session 2P479Strain concordance in a real-world setting: experience in our laboratory after equipment upgradeP4803D echocardiography is a fast-learning and reliable method for the measurements of left atrial volumesP481Echocardiographic parameters associated with long-term appropriate antiarrhythmic therapies in cardiac resynchronization therapy defibrillator patientsP482Noninvasively measured global wasted myocardial work allows for quantitative assessment of typical left ventricular mechanical dyssynchrony pattern in patients with left bundle branch blockP483The impact of adherence to physical exercise on the improvement of cardiovascular remodeling and metabolic status in healthy untrained postmenopausal womenP484The impact of the latest chamber quantification recommendations on the prediction of left atrial appendage thrombus presenceP485The cardiac-enriched miRNAs plasma levels (miR-1, miR-133a, miR-499) reflect the impaired left ventricular systolic function and correlate with cardiac necrosis markers in early phase of NSTE-ACSP486Acute regional myocardial deformation changes in patients with severe aortic stenosis and preserved ejection fraction after isolated aortic valve replacementP487Left ventricular rotational deformation in asymptomatic patients with chronic aortic regurgitation and normal left ventricular ejection fraction P488The appropriate use of transthoracic echocardiography for the exclusion of infective endocarditisP489In patients with hypertrophic cardiomyopathy, left ventricular mass and shape by three-dimensional echocardiography are related with dynamic obstruction and functional capacityP490Mitral leaflet sizing in hypertrophic cardiomyopathy: impact of method and timingP491Echocardiographic predictors of atrial fibrillation in obese womenP492Echocardiographic risk factors for 30 day mortality after the hybrid procedure for hypoplastic left heart syndromeP493Left ventricular mass is an independent predictor of coronary flow reserve: insights from a single centre stress echo cohortP494Transesophageal echocardigoraphy uner conscious sedation for guiding cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation - the safety and feasibility studyP495Transesophageal echocardigoraphy under conscious sedation for guiding cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation - the safety and feasibility studyP496Three-dimensional trans-esophageal echocardiography assessment of the immediate morphological changes of the mitral annulus after percutaneous mitral edge-to-edge repairP497Clinical value of global and regional longitudinal strain in prediction of myocardial ischemia in asymptomatic diabetes type 2 patientsP499Comparison of prognostic operative risk impact on the global longitudinal strain right ventricle (GLS RV) and tricuspid annular plane systolic excursion (TAPSE) values in patients with ischemic cardioP498Right heart function in early diastolic dysfunction: 2D speckle-tracking echocardiography-based assessment of right atrial and right ventricular functionP500 Comparison of 2D, 3D transesophageal echocardiography and computed tomography during the assessment of left atrial appendage closure. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew246] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mercuri E, Pane M, Palermo C, D'amico A, Messina S, Battini R, Bruno C, Mongini T, Pegoraro E, D'Angelo G, Pini A, Gorni K, Baranello G, Bertini E, Sormani M. The 24-month performance of upper limb (PUL) scale: Changes and steroids correlation in DMD. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.362] [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: 11/27/2022]
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Mercuri E, Coratti G, Messina S, Ricotti V, Baranello G, D'amico A, Pera M, Albamonte E, Palermo C, Sivo S, Mazzone E, Fanelli L, De Sanctis R, Vita G, Battini R, Bertini E, Muntoni F, Pane M. Revised North Star ambulatory assessment for young boys with Duchenne muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.361] [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: 11/25/2022]
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McCaffrey T, Blumfield M, Neville K, Piers L, Kelsall L, Graham V, Bonham M, Palermo C, Walker K, Truby H. Discretionary food consumption in the Victorian Health Monitor survey. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.236] [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: 10/21/2022] Open
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Chung A, Backholer K, Wong E, Palermo C, Keating C, Peeters A. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obes Rev 2016; 17:276-95. [PMID: 26693831 DOI: 10.1111/obr.12360] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [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: 06/05/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
Abstract
Recent obesity trends in children and adolescents suggest a plateau. However, it is unclear whether such trends have been experienced across socioeconomic groups. We analysed whether recent trends in child and adolescent overweight and obesity differ by socioeconomic position (SEP) across economically advanced countries. Eligible studies reported overweight and obesity prevalence in children and/or adolescents (2-18 years), for at least two time points since 1990, stratified by SEP. Socioeconomic differences in trends in child and adolescent overweight and obesity over time were analysed. Differences in trends between SEP groups were observed across a majority of studies. Over half the studies indicated increasing prevalence among low SEP children and adolescents compared to a third of studies among children and adolescents with a high SEP. Around half the studies indicated widening socioeconomic inequalities in overweight and obesity. Since 2000 a majority of studies demonstrated no change or a decrease in prevalence among both high and low SEP groups. However around 40% of studies indicated widening of socioeconomic inequalities post-2000. While our study provides grounds for optimism, socioeconomic inequalities in overweight and obesity continue to widen. These findings highlight the need for greater consideration of different population groups when implementing obesity interventions.
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Affiliation(s)
- A Chung
- Baker IDI Heart and Diabetes Institute, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - K Backholer
- Baker IDI Heart and Diabetes Institute, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - E Wong
- Baker IDI Heart and Diabetes Institute, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - C Palermo
- Department of Nutrition and Dietetics, Monash University, Australia
| | - C Keating
- Baker IDI Heart and Diabetes Institute, Population Health, Deakin University, Melbourne, Australia
| | - A Peeters
- Baker IDI Heart and Diabetes Institute, School of Public Health and Preventive Medicine, Deakin University, Burwood, Australia.,Monash University, Melbourne, Australia
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Palermo C, Davidson ZE, Hay M. A cross-sectional study exploring the different roles of individual and group assessment methods in assessing public health nutrition competence. J Hum Nutr Diet 2016; 29:523-8. [PMID: 26781685 DOI: 10.1111/jhn.12351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Competency in the practice of public health is essential for dietitians, yet little is known about credible and dependable assessment in this field. The present study aimed to investigate the role of individual and group assessment tasks as elements of a public health nutrition competency-based assessment system. METHODS Assessment performance data from 158 dietetics students (three group tasks and one individual task) who had completed a practical placement learning experience in a public health nutrition setting were examined using nonparametric techniques. All 158 students were deemed individually 'competent' on completion of the placement. RESULTS The median mark was significantly lower for the individual compared to the group task, with a greater range of marks achieved in the individual assessment. There was a weak relationship between individual and group marks for the whole cohort (n = 158) (Spearman's rho correlation coefficient = 0.193, P = 0.015). Bland-Altman analysis showed that the mean (SD) agreement between the two assessment tasks was -5.9 (17.7) marks. Systematic bias between the two tasks was also demonstrated, indicating that students with the lowest average mark of the two assessments scored lower on the individual assessment task compared to their group task and those who had a higher average mark scored higher on the individual group assessment compared to their group task. CONCLUSIONS Student performance in public health differs between individual and group assessment. Individual assessment appears to differentiate between students, yet group work is essential for the development of teamwork skills. Both should be considered in the judgement of public health nutrition competency.
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Affiliation(s)
- C Palermo
- Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
| | - Z E Davidson
- Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, VIC, Australia
| | - M Hay
- Office of the Deputy Dean (Education), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
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Muscarella M, Iammarino M, Centonze D, Palermo C. Measurement of Histamine in Seafood by HPLC, CE, and ELISA: Comparison of Three Techniques. Vet Res Commun 2015; 29 Suppl 2:343-6. [PMID: 16244990 DOI: 10.1007/s11259-005-0077-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Muscarella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy.
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Pane M, Mazzone E, Fanelli L, Sanctis RD, Palermo C, Sivo S, D’Amico A, Messina S, Politano L, Battini E, Pedemonte M, Pegoraro E, Berardinelli A, D’Angelo G, Pini A, Baranello G, Mercuri E. T.P.11. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.234] [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: 11/26/2022]
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Pane M, Palermo C, Sivo S, Mazzone E, Fanelli L, Sanctis RD, D’Amico A, Messina S, Politano L, Battini R, Pedemonte M, Pegoraro E, D’Angelo G, Pini A, Baranello G, Mercuri E. T.P.10. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.233] [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: 10/24/2022]
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Mazzone E, Pane M, Sivo S, Palermo C, Sormani M, Messina S, D’Amico A, Vita G, Fanelli L, Berardinelli A, Donati M, Baranello G, Battini R, Pegoraro E, Politano L, Bruno C, Comi G, Bertini E, Mercuri E. T.P.4. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nardiello D, Conte A, Natale A, Lucera A, Palermo C, Centonze D, Del Nobile M. Effects of different packaging systems on microbiological, sensory and peptide profile in fiordilatte cheese. Food Res Int 2014. [DOI: 10.1016/j.foodres.2014.03.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Mazzone E, De Sanctis R, Fanelli L, Bianco F, Main M, van den Hauwe M, Ash M, de Vries R, Fagoaga Mata J, Schaefer K, D'Amico A, Colia G, Palermo C, Scoto M, Mayhew A, Eagle M, Servais L, Vigo M, Febrer A, Korinthenberg R, Jeukens M, de Viesser M, Totoescu A, Voit T, Bushby K, Muntoni F, Goemans N, Bertini E, Pane M, Mercuri E. Hammersmith Functional Motor Scale and Motor Function Measure-20 in non ambulant SMA patients. Neuromuscul Disord 2014; 24:347-52. [PMID: 24491485 DOI: 10.1016/j.nmd.2014.01.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [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: 10/26/2013] [Revised: 12/12/2013] [Accepted: 01/06/2014] [Indexed: 11/29/2022]
Abstract
The aim of this prospective longitudinal multi centric study was to evaluate the correlation between the Hammersmith Functional Motor Scale and the 20 item version of the Motor Function Measure in non ambulant SMA children and adults at baseline and over a 12 month period. Seventy-four non-ambulant patients performed both measures at baseline and 49 also had an assessment 12 month later. At baseline the scores ranged between 0 and 40 on the Hammersmith Motor function Scale and between 3 and 45 on the Motor Function Measure 20. The correlation between the two scales was 0.733. The 12 month changes ranged between -11 and 4 for the Hammersmith and between -11 and 7 for the Motor Function Measure 20. The correlation between changes was 0.48. Our results suggest that both scales provide useful information although they appeared to work differently at the two extremes of the spectrum of abilities. The Hammersmith Motor Function Scale appeared to be more suitable in strong non ambulant patients, while the Motor Function Measures appeared to be more sensitive to capture activities and possible changes in the very weak patients, including more items capturing axial and upper limb activities. The choice of these measures in clinical trials should therefore depend on inclusion criteria and magnitude of expected changes.
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Affiliation(s)
- E Mazzone
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - R De Sanctis
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - L Fanelli
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - F Bianco
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - M Main
- Dubowitz Neuromuscular Centre, Institute of Child Health, University College, London, UK
| | - M van den Hauwe
- Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - M Ash
- Dubowitz Neuromuscular Centre, Institute of Child Health, University College, London, UK
| | - R de Vries
- Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J Fagoaga Mata
- Service of Physical Medicine and Rehabilitation, University Hospital Sant Joan de Deu, Barcelona, Spain
| | - K Schaefer
- University Medical Centre, Freiburg, Germany
| | - A D'Amico
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, and Department of Laboratory Medicine, Unit of Molecular Medicine, Bambino Gesù Hospital, Rome, Italy
| | - G Colia
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, and Department of Laboratory Medicine, Unit of Molecular Medicine, Bambino Gesù Hospital, Rome, Italy
| | - C Palermo
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - M Scoto
- Dubowitz Neuromuscular Centre, Institute of Child Health, University College, London, UK
| | - A Mayhew
- Institute of Genetic Medicine, Newcastle Upon Tyne, UK
| | - M Eagle
- Institute of Genetic Medicine, Newcastle Upon Tyne, UK
| | - L Servais
- Institute of Myology, Groupe hospitalier La Pitié Salpétrière, Paris, France
| | - M Vigo
- Service of Physical Medicine and Rehabilitation, University Hospital Sant Joan de Deu, Barcelona, Spain
| | - A Febrer
- Service of Physical Medicine and Rehabilitation, University Hospital Sant Joan de Deu, Barcelona, Spain
| | | | - M Jeukens
- Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M de Viesser
- Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - A Totoescu
- Institute of Myology, Groupe hospitalier La Pitié Salpétrière, Paris, France
| | - T Voit
- Institute of Myology, Groupe hospitalier La Pitié Salpétrière, Paris, France
| | - K Bushby
- Institute of Genetic Medicine, Newcastle Upon Tyne, UK
| | - F Muntoni
- Dubowitz Neuromuscular Centre, Institute of Child Health, University College, London, UK
| | - N Goemans
- Child Neurology, University Hospitals Leuven, Leuven, Belgium
| | - E Bertini
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, and Department of Laboratory Medicine, Unit of Molecular Medicine, Bambino Gesù Hospital, Rome, Italy
| | - M Pane
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - E Mercuri
- Department of Paediatric Neurology, Catholic University, Rome, Italy.
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Palermo C, Beck EJ, Chung A, Ash S, Capra S, Truby H, Jolly B. Work-based assessment: qualitative perspectives of novice nutrition and dietetics educators. J Hum Nutr Diet 2013; 27:513-21. [DOI: 10.1111/jhn.12174] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Palermo
- Department of Nutrition and Dietetics; Monash University; Notting Hill VIC Australia
| | - E. J. Beck
- University of Wollongong; Wollongong NSW Australia
| | - A. Chung
- Department of Nutrition and Dietetics; Monash University; Notting Hill VIC Australia
| | - S. Ash
- Queensland University of Technology; Brisbane QLD Australia
| | - S. Capra
- The University of Queensland; Brisbane QLD Australia
| | - H. Truby
- Department of Nutrition and Dietetics; Monash University; Notting Hill VIC Australia
| | - B. Jolly
- The University of Newcastle; Newcastle NSW Australia
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De Sanctis R, Bianco F, Mazzone E, Palermo C, Sivo S, Fanelli L, Graziano A, Pane M, Mercuri E. P.2.2 North Star ambulatory assessment in young DMD boys. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.407] [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: 11/28/2022]
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Mazzone E, Bianco F, Main M, van den Hauwe M, Ash M, de Vries R, Fagoaga Mata J, Stein S, De Sanctis R, D'Amico A, Palermo C, Fanelli L, Scoto MC, Mayhew A, Eagle M, Vigo M, Febrer A, Korinthenberg R, de Visser M, Bushby K, Muntoni F, Goemans N, Sormani MP, Bertini E, Pane M, Mercuri E. Six minute walk test in type III spinal muscular atrophy: a 12month longitudinal study. Neuromuscul Disord 2013; 23:624-8. [PMID: 23809874 DOI: 10.1016/j.nmd.2013.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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: 03/18/2013] [Revised: 05/28/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
Abstract
The aim of our longitudinal multicentric study was to establish the changes on the 6min walk test (6MWT) in ambulant SMA type III children and adults over a 12month period. Thirty-eight ambulant type III patients performed the 6MWT at baseline and 12months after baseline. The distance covered in 6min ranged between 75 and 510m (mean 294.91, SD 127) at baseline and between 50 and 611m (mean 293.41m, SD 141) at 12months. The mean change in distance between baseline and 12months was -1.46 (SD 50.1; range: -183 to 131.8m). The changes were not correlated with age or baseline values (p>.05) even though younger patients reaching puberty, had a relatively higher risk of showing deterioration of more than 30m compared to older patients. Our findings provide the first longitudinal data using the 6MWT in ambulant SMA patients.
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Affiliation(s)
- E Mazzone
- Department of Paediatric Neurology, Catholic University, Rome, Italy
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Bianco F, Mazzone E, Di Mauro M, Pane M, Ricotti V, Vasco G, Palermo C, Mercuri E. S.P.10 Upper limb assessment in DMD: An exploratory study and critical review of the existing scales. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.249] [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: 11/24/2022]
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Graziano A, Palermo C, Romeo D, Mazzone E, Baranello G, Bianco F, Santis RD, Pane M, Mercuri E. S.P.25 Sleep disorders in type II SMA. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.300] [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: 10/28/2022]
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Ballestrero A, Garuti A, Cirmena G, Rocco I, Palermo C, Nencioni A, Scabini S, Zoppoli G, Parodi S, Patrone F. Patient-tailored treatments with anti-EGFR monoclonal antibodies in advanced colorectal cancer: KRAS and beyond. Curr Cancer Drug Targets 2012; 12:316-28. [PMID: 22385512 DOI: 10.2174/156800912800190956] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 07/12/2011] [Accepted: 12/22/2011] [Indexed: 11/22/2022]
Abstract
Personalized medicine emphasizes the practice of considering individual patient characteristics as opposed to that centered on standards derived from epidemiological studies which, by definition, do not take into account the variability of individuals within a given population. When applied to oncology, personalized medicine is an even more complex concept because it extends the variability beyond the individual patient to the individual tumor. Indeed, the great genotypic and phenotypic variability (both in primary and metastatic sites of cancer) the development of targeted therapies, and the growing availability of biological assays complicate the scenario of personalized medicine in the oncological field. In this paper we review the results of anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) therapy in metastatic colorectal cancer (mCRC) in the context of tumor biology, delineating the future prospects of patient-tailored medicine in this area. In particular, we deal with EGFR inhibition by Cetuximab, a chimeric mouse human IgG1 mAb, and panitumumab, a fully human IgG2 mAb. We discuss the clinical impact of anti-EGFR mAbs on wild-type (WT) KRAS mCRC, also taking into account the feasibility of novel multi-marker approaches to treatment decision-making, aimed at increasing the predictive power of pre-therapy biomarkers. Experimental topics and fields of ongoing research, such as targeting microRNAs (miRNAs) with novel anticancer drugs and epigenetics in CRC are also addressed.
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Affiliation(s)
- A Ballestrero
- Division of Semeiotics and Medical Methodology, Department of Internal Medicine, University of Genoa, Italy.
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Palermo C, Hughes R, McCall L. An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce. J Hum Nutr Diet 2011; 23:244-53. [PMID: 20642640 DOI: 10.1111/j.1365-277x.2010.01069.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. METHODS An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. RESULTS The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P < 0.05) across a broad range of competency elements. Many participants described re-orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post-intervention. CONCLUSIONS Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.
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Affiliation(s)
- C Palermo
- Department of Nutrition and Dietetics, Monash University, Monash Medical Centre, Clayton, Victoria, Australia.
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Brown T, Boyle MJ, Williams B, Molloy A, McKenna L, Palermo C, Lewis B, Molloy L. Listening styles of undergraduate health students. Educ Health (Abingdon) 2010; 23:424. [PMID: 21290361] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Concerns about poor communication in the medical and other healthcare professions are common in the empirical literature, with studies showing direct relationships between practitioners' effective listening and patients' satisfaction and less risk of litigation. Furthermore, people do not simply listen or not listen, rather they adopt particular listening styles, making the understanding and investigation of practitioner communication a complex topic. The objective of this study was to identify the listening styles of undergraduate health science students enrolled at one Australian university. METHODS A cross-sectional study using a paper-based version of the Listening Styles Profile (LSP-16) was administered to a cohort of students enrolled in undergraduate education programs in eight different health disciplines: emergency health (paramedics), nursing, midwifery, occupational therapy, physiotherapy, nursing/emergency health dual degree, health science and nutrition and dietetics. The LSP-16 is a validated and reliable scale that assesses participants' preferences for each of four distinct listening style constructs. There were 1459 health students eligible for inclusion in the study. Ethics approval was granted. RESULTS A total of 860 students participated in the study (response rate of 58%), of whom 87.2% (n=750) were female. Across the group, a strong preference was shown for the People Listening Style (LS), which is a listening style characterised by a concern for people's feelings and emotions. Otherwise, an unexpected amount of homogeneity in preferred listening style was found within the group of health science students. Female students reported a slightly stronger preference for the People LS, whereas males reported slightly stronger preferences for the Action LS and Content LS. There were no statistical differences in preference for LS by students' age or year level of undergraduate enrolment. CONCLUSION The health professional student participants of this study reported a preference for a range of listening styles, which is appropriate for many healthcare settings. However, a strong preference for the People LS and a moderate preference for the Content LS were evident. This study should be replicated with practicing professionals to establish if the demands of the workplace affect practitioners' listening style(s).
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Affiliation(s)
- T Brown
- Monash University, Melbourne, Victoria, Australia.
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