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Veronese N, Soysal P, Demurtas J, Solmi M, Bruyère O, Christodoulou N, Ramalho R, Fusar-Poli P, Lappas AS, Pinto D, Frederiksen KS, Corbi GM, Karpenko O, Georges J, Durães J, Schlögl M, Yilmaz O, Sieber C, Shenkin SD, Smith L, Reginster JY, Maggi S, Limongi F, Ars J, Barbagallo M, Cherubini A, Quinn T. Physical activity and exercise for the prevention and management of mild cognitive impairment and dementia: a collaborative international guideline. Eur Geriatr Med 2023; 14:925-952. [PMID: 37768499 PMCID: PMC10587099 DOI: 10.1007/s41999-023-00858-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Physical activity and exercise have been suggested as effective interventions for the prevention and management of mild cognitive impairment (MCI) and dementia, but there are no international guidelines. OBJECTIVES To create a set of evidence- and expert consensus-based prevention and management recommendations regarding physical activity (any bodily movement produced by skeletal muscles that results in energy expenditure) and exercise (a subset of physical activity that is planned, structured, repetitive), applicable to a range of individuals from healthy older adults to those with MCI/dementia. METHODS Guideline content was developed with input from several scientific and lay representatives' societies. A systematic search across multidisciplinary databases was carried out until October 2021. Recommendations for prevention and management were developed according to the GRADE and complemented by consensus statements from the expert panels. RECOMMENDATIONS Physical activity may be considered for the primary prevention of dementia. In people with MCI there is continued uncertainty about the role of physical activity in slowing the conversion to dementia. Mind-body interventions have the greatest supporting evidence. In people with moderate dementia, exercise may be used for maintaining disability and cognition. All these recommendations were based on a very low/low certainty of evidence. CONCLUSIONS Although the scientific evidence on the beneficial role of physical activity and exercise in preserving cognitive functions in subjects with normal cognition, MCI or dementia is inconclusive, this panel, composed of scientific societies and other stakeholders, recommends their implementation based on their beneficial effects on almost all facets of health.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
| | - Pinar Soysal
- Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Jacopo Demurtas
- Clinical and Experimental Medicine PhD Program, Università di Modena e Reggio Emilia, Modena - Azienda USL Sud Est Toscana, Grosseto, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization, Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - Nikos Christodoulou
- Department of Psychiatry, University of Thessaly Medical School, Volos, Greece
- World Psychiatric Association, Section of Preventive Psychiatry, University of Nottingham Medical School, Nottingham, UK
| | - Rodrigo Ramalho
- Department of Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Andreas S Lappas
- Faculty of Medicine, Department of Psychiatry, University of Thessaly, Larissa, Greece
- Aneurin Bevan University Health Board, Newport, Wales, UK
| | - Daniel Pinto
- Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, WI, USA
| | - Kristian Steen Frederiksen
- Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Grazia Maria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Olga Karpenko
- Chair of the WPA Preventive Psychiatry Section, Mental-Health Clinic No. 1 Named After N.A. Alexeev, Moscow, Russia
| | | | - João Durães
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | - Mathias Schlögl
- Division of Geriatric Medicine, Clinic Barmelweid, Barmelweid, Switzerland
| | - Ozlem Yilmaz
- Department of Geriatric Medicine, Istanbul Training and Research Hospital, Samatya, Istanbul, Turkey
| | - Cornel Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nuremberg, Germany
- Department of Medicine, Kantonsspital Winterthur, Brauerstrasse 15, Postfach 834, 8401, Winterthur, Zurich, Switzerland
| | - Susan D Shenkin
- Ageing and Health Research Group and Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Federica Limongi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Joan Ars
- RE-FiT Barcelona Research Group, Vall d'Hebron Institute of Research (VHIR) and Parc Sanitari Pere Virgili, Barcelona, Spain
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca Per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Terry Quinn
- Department of Geriatric Medicine, Glasgow Royal Infirmary, Glasgow, UK
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Bencivenga L, Komici K, Paolillo S, Nappi C, Gargiulo P, Assante R, Gambino G, Santillo F, Femminella GD, Corbi GM, Ferrara N, Cuocolo A, Perrone-Filardi P, Rengo G. Cardiac sympathetic innervation and mortality risk scores in patients with heart failure. Eur J Clin Invest 2023; 53:e13948. [PMID: 36576359 DOI: 10.1111/eci.13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION In the risk stratification and selection of patients with heart failure (HF) eligible for implantable cardioverter-defibrillator (ICD) therapy, 123 I-meta-IodineBenzylGuanidine (123 I-mIBG) scintigraphy has emerged as an effective non-invasive method to assess cardiac adrenergic innervation. Similarly, clinical risk scores have been proposed to identify patients with HF at risk of all-cause mortality, for whom the net clinical benefit of device implantation would presumably be lower. Nevertheless, the association between the two classes of tools, one suggestive of arrhythmic risk, the other of all-cause mortality, needs further investigation. OBJECTIVE To test the relationship between the risk scores for predicting mortality and cardiac sympathetic innervation, assessed through myocardial 123 I-mIBG imaging, in a population of patients with HF. METHODS In HF patients undergoing 123 I-mIBG scintigraphy, eight risk stratification models were assessed: AAACC, FADES, MADIT, MADIT-ICD non-arrhythmic mortality score, PACE, Parkash, SHOCKED and Sjoblom. Cardiac adrenergic impairment was assessed by late heart-to-mediastinum ratio (H/M) <1.6. RESULTS Among 269 patients suffering from HF, late H/M showed significant negative correlation with all the predicting models, although generally weak, ranging from -0.15 (p = .013) for PACE to -0.32 (p < .001) for FADES. The scores showed poor discrimination for cardiac innervation, with areas under the curve (AUC) ranging from 0.546 for Parkash to 0.621 for FADES. CONCLUSION A weak association emerged among mortality risk scores and cardiac innervation, suggesting to integrate in clinical practice tools indicative of both arrhythmic and general mortality risks, when evaluating patients affected by HF eligible for device implantation.
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Affiliation(s)
- Leonardo Bencivenga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.,Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Toulouse, France
| | - Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Paola Gargiulo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giuseppina Gambino
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Fabio Santillo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Grazia Maria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Pasquale Perrone-Filardi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Istituti Clinici Scientifici Maugeri SpA Società Benefit, Telese Terme, Italy
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Scarpa A, Marra P, Ralli M, Viola P, Gioacchini FM, Chiarella G, Salzano FA, De Luca P, Ricciardiello F, Cassandro C, Corbi GM. Comparison of different oval window sealing materials in stapes surgery: systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:5521-5533. [PMID: 35857099 PMCID: PMC9649504 DOI: 10.1007/s00405-022-07551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/07/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy. METHODS A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air-bone gap (ABG) closure after surgical intervention. RESULTS Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge's g = 0.04, 95% CI - 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge's g = 0.00, 95% CI - 0.20 0.21). CONCLUSIONS Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
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Affiliation(s)
- Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Pasquale Marra
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Federico Maria Gioacchini
- ENT Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giuseppe Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, 84131 Salerno, Italy
| | | | | | - Grazia Maria Corbi
- Department Medicine and Health Sciences, University of Molise, Campobasso, Italy
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Romano CA, Ravagnani L, Convertini A, Dassisti L, Fanizza AR, Misceo F, Corbi GM, Campobasso CP, Tafuri S, Bianchi FP, Ferrannini L, Ferrara N, Grattagliano I. The aging process in prison: pathologies and health conditions in old inmates. An epidemiological research in Italy. Clin Ter 2020; 171:e340-e345. [PMID: 32614369 DOI: 10.7417/ct.2020.2237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Elderly may suffer from different pathologies during their detention in jail because of their age. Conditions in jails were tough and adapting to that life could be problematic for the elder population. This article aimed to analyse the pathologies and health conditions in a sample of elder inmates from Italy. METHODS The sample was composed by 94 elderly inmates. The research is multicentric. We selected jails from the cities of Bari, Taranto, Foggia, Lecce, Brescia, Bergamo, Cremona and Mantua. The study was conducted by interviewing the prisoners over 60 years of age, in the period between September and December 2017. RESULTS 64% of the sample was in a "Not Optimal" health status. Most of pathologies were Cardiac pathologies (23.4%), Diabetes (12.8 %) and Surgery (9.6%). Statistically significant differences were found for heart disease (p=0.02) and Neoplasia (p=0.025) in the prison of Bari compared to all the other prisons. Statistically significant differences were found for Hypertension in Foggia and Taranto prisons compared to all the other (p=0.023). Furthermore, 18.1% of inmates ended up having an addiction. CONCLUSIONS Our analysis showed that in our sample physical problems were more frequent than psychological one. In fact, in spite of in the literature there was a high prevalence of mental health problems among elderly inmates, we did not find this result. However, stress conditions may increase the risk of pathologies: for example, being in jail and adapt to new hard environment may increase the risk of getting sick. Heart disease pathologies and diabetes were very common in our sample as confirmed by the literature.
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Affiliation(s)
| | | | - A Convertini
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - L Dassisti
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - A R Fanizza
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - F Misceo
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
| | - G M Corbi
- Department Medicine and Health Sciences, University of Molise
| | - C P Campobasso
- Department of Experimental Medicine, University of Naples "L. Vanvitelli"
| | - S Tafuri
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro"
| | - F P Bianchi
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro"
| | - L Ferrannini
- Faculty of medicine and surgery, University of Genova
| | - N Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples
| | - I Grattagliano
- Department of Educational Sciences, Psychology and Communication, University of Bari "Aldo Moro"
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Giordano G, Mondello P, Tambaro R, Perrotta N, D'Amico F, D'Aveta A, Berardi G, Carabellese B, Patriarca A, Corbi GM, DI Marzio L, Licianci A, Berardi D, DI Lullo L, DI Marco R. Biosimilar epoetin α is as effective as originator epoetin-α plus liposomal iron (Sideral®), vitamin B12 and folates in patients with refractory anemia: A retrospective real-life approach. Mol Clin Oncol 2015; 3:781-784. [PMID: 26171179 DOI: 10.3892/mco.2015.555] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 11/13/2014] [Accepted: 03/12/2015] [Indexed: 11/06/2022] Open
Abstract
Several biosimilar versions of recombinant human erythropoietin are currently approved for use in Europe, including a biosimilar epoetin-α. The aim of this the study was to verify that biosimilar epoetin-α is similar in terms of efficacy, safety and cost to originator epoetin-α for the treatment of refractory anemia in patients with myelodysplastic syndrome. A total of 92 patients with myelodysplasia and refractory anemia were investigated. The patients received either originator (group A) or biosimilar (group B) epoetin-α. In addition, they received liposomal iron (Sideral®), calcium levofolinate and vitamin B12. Moreover, the median monthly overall costs were calculated for each group. The results demonstrated that hemoglobin (Hb) levels increased by 1 g/dl after a median time of 5 weeks in group A and 4 weeks in group B. In group A, a Hb level of >12 g/dl was achieved after 12 weeks, while in group B after 10.5 weeks. The median cost of therapy was 1,536 euros/month in group A and 1,354 euros/month in group B. A total of 5 patients required transfusion support in group A and 7 in group B. In conclusion, biosimilar epoetin-α appears to be comparable to originator epoetin-α in terms of efficacy and safety for the treatment of refractory anemia.
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Affiliation(s)
- Giulio Giordano
- General Medicine and Hematology Regional Hospital 'A. Cardarelli', I-86100 Campobasso, Molise, Italy
| | - Patrizia Mondello
- Department of Oncology, G. Martino University Hospital, I-98100 Messina, Messina, Italy
| | - Rosa Tambaro
- G. Pascale Cancer Institute, I-80100 Naples, Campania, Italy
| | - Nicola Perrotta
- Faculty of Pharmacology, G. D'Annunzio University, I-66100 Chieti, Chieti, Italy
| | - Fabio D'Amico
- School of Medicine, University of Molise, I-86100 Campobasso, Molise, Italy
| | - Antonietta D'Aveta
- General Medicine and Hematology Regional Hospital 'A. Cardarelli', I-86100 Campobasso, Molise, Italy
| | - Giuseppe Berardi
- Family Medicine, Regional Health Service, A. Cardelli, I-86100 Campobasso, Molise, Italy
| | - Bruno Carabellese
- Services Department, Cardarelli Hospital, I-86100 Campobasso, Molise, Italy
| | - Andrea Patriarca
- Medicine and Hematology Unit, Public Hospital, I-13900 Biella, Italy
| | - Grazia Maria Corbi
- School of Medicine, University of Molise, I-86100 Campobasso, Molise, Italy
| | - Luigi DI Marzio
- Services Department, Cardarelli Hospital, I-86100 Campobasso, Molise, Italy
| | | | - Donata Berardi
- Faculty of Medicine, University 'La Sapienza', I-00185 Rome, Italy
| | - Liberato DI Lullo
- Department of Oncology, Regional Health Service, A. Cardelli, I-86100 Campobasso, Molise, Italy
| | - Roberto DI Marco
- School of Medicine, University of Molise, I-86100 Campobasso, Molise, Italy
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Corbi GM, Carbone S, Ziccardi P, Giugliano G, Marfella R, Nappo F, Paolisso G, Esposito K, Giugliano D. FFAs and QT intervals in obese women with visceral adiposity: effects of sustained weight loss over 1 year. J Clin Endocrinol Metab 2002; 87:2080-3. [PMID: 11994344 DOI: 10.1210/jcem.87.5.8516] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We evaluated 66 obese patients grouped by waist-to-hip ratio (WHR) into group A (WHR > 0.85, n = 30) and group B (WHR < or = 0.85, n = 36), before and after 1 yr of diet-induced weight loss compared with 25 nonobese women. Before diet, the longest values of QT intervals and the highest levels of FFA and catecholamines were in group A (P < 0.01). In obese women (both groups), the corrected QT (QTc); interval correlated with plasma FFA (P < 0.01) and catecholamine (P < 0.02) concentrations. After 1 yr of diet, at the same levels of body weight reduction, the decrement of the QTc interval (P < 0.02), FFA (P < 0.01) and catecholamine (P < 0.02) levels were significantly greater in-group A than group B. In multivariate analysis, the decline of the QTc interval after weight loss was associated with changes in plasma FFA independently of changes in WHR and plasma catecholamines. Our data suggest that the QTc interval is tightly correlated with plasma FFA levels; shortening of cardiac repolarization times in the course of long-lasting weight reduction may reduce the risk of ventricular electrical instability, especially in women with abdominal adiposity.
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Affiliation(s)
- Grazia Maria Corbi
- Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples 80138, Italy
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