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Russo A, Cascarano L, Dell'Anna AM, Grieco DL, Menga LS, Romanò B, Papanice D, Cataldo A, Foschi N, Russo P, Bassi P, Sollazzi L. Correlation of in-target time for mean arterial pressure and stroke volume with tissue perfusion during major urological surgery: an observational pilot study. Br J Anaesth 2022; 129:e128-e131. [PMID: 36058724 DOI: 10.1016/j.bja.2022.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
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Breccia M, Olimpieri PP, Celant S, Olimpieri O, Pane F, Iurlo A, Summa V, Corradini P, Russo P. Management of chronic myeloid leukaemia patients treated with ponatinib in a real-life setting: A retrospective analysis from the monitoring registries of the Italian Medicines Agency (AIFA). Br J Haematol 2022; 198:965-973. [PMID: 35904979 DOI: 10.1111/bjh.18359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022]
Abstract
Real-world data on daily practice management, treatment modifications and outcome of a large cohort of chronic myeloid leukaemia (CML) patients treated with ponatinib was performed through monitoring Registries of the Italian Medicines Agency (AIFA). Overall, 666 CML subjects were included in the ponatinib registry from February 2015 to December 2020 and were eligible for analysis: 515 in chronic phase (CP), 50 in accelerated phase (AP) and 101 in blast crisis (BC). Median age at baseline was 58.7 years with a predominance of male subjects (57.1%). The median time from diagnosis to start of ponatinib was 2.35 years: 259 (38.9%) subjects had received two previous lines of treatment, 260 (39.0%) three lines and 147 (22.1%) four or more lines. A molecular response [from major molecular response (MMR) to a score of ≤0.01% on the international reporting scale (IS)] was reported for 59% of patients out of 593 patients analysed. With a median follow-up of 14.4 months, 136 subjects (20.4%) required at least one dose reduction due to adverse events (AEs), whereas 309 patients (46.4%) required dose reduction in the absence of any evidence of side effects. Treatment discontinuation occurred in 261 patients (39%). This real-life analysis shows that dose reductions were made primarily as a precaution rather than due to the occurrence of adverse reactions.
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Ceccarelli F, Saccucci M, Natalucci F, Olivieri G, Bruni E, Iacono R, Colasanti T, Di Carlo G, Alessandri C, Uccelletti D, Russo P, Pilloni A, Conti F, Polimeni A. AB0118 PORPHYROMONAS GINGIVALIS AMOUNT IN THE TONGUE BIOFILM IS ASSOCIATED WITH EROSIVE ARTHRITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSeveral data have demonstrated the occurrence of erosive arthritis in Systemic Lupus Erythematosus (SLE) patients. However, few studies have focused on the pathogenic mechanisms involved in this feature. The implication of oral pathogens has been proved in Rheumatoid Arthritis: in particular, Porphyromonas gingivalis (Pg), by inducing citrullination, could trigger autoimmune response.ObjectivesWe evaluated amount of Pg of the tongue in a cohort of SLE patients with arthritis, focusing on the association with the erosive phenotype.MethodsSLE patients with arthritis were enrolled. We evaluated the presence of ACPA and RF by using commercially enzyme-linked immunosorbent assay kits. SLEDAI-2k was applied to assess disease activity and DAS28 to assess joint inflammatory status. Erosive damage was evaluated by ultrasound at level of metacarpophalangeal and proximal interphalangeals joints. All subjects underwent a tongue cytologic swab in order to quantify the amount of Pg (real-time PCR). The bacterium expression was obtained from the ratio between the patient’s DNA amount and that obtained from healthy subjects.ResultsThe present analysis included 33 SLE patients (M/F 3/30; median age 47 years, IQR 17; median disease duration 216 months, IQR 180). Concerning activity at the time of the enrollment, we found a median DAS28 value of 3.8 (IQR 2.8) and a median SLEDAI-2k of 4 (IQR 5). Twelve patients (36.4%) showed US-detected erosive damage in at least one joint, significantly associated with ACPA positivity (p<0.0001). Furthermore, patients with erosive damage showed significantly higher median DAS28 values in comparison with those without [4 (IQR 3.1) versus 3.2 (IQR 2.1), p=0.03]. Moving on the oral pathogen analysis, we found a mean Pg ratio of 19.7±31.1 (median 6.6, IQR 22.3). When dividing patients according to the presence of erosive damage, we found higher Pg amount in SLE patients with this phenotype in comparison with those without (31.4±44.3 versus 12.9±19.2, p=ns; Figure 1A). Thus, we used Pg mean values as threshold, identifying two groups of patients, namely highPg and lowPg. In a receiver operating characteristic curve analysis (ROC), this threshold resulted in the most sensitive and specific one (sensitivity of 85%; specificity of 50%). As reported in Figure 1B, erosive damage was significantly more frequent in highPg patients in comparison with lowPg (60.0% versus 26.0%, p=0.001). Furthermore, highPg patients showed higher prevalence of skin manifestations, serositis and neurological involvement compared to lowPg patients (p=0.005, p=0.03, p=0.0001, respectively).ConclusionThe possible contribution of oral microbiota in SLE erosive arthritis was here evaluated for the first time, finding a significant association between erosive damage and higher expression of Pg at tongue level.Disclosure of InterestsNone declared
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Russo P, Tacconelli E, Olimpieri PP, Celant S, Colatrella A, Tomassini L, Palù G. Mortality in SARS-CoV-2 Hospitalized Patients Treated with Remdesivir: A Nationwide, Registry-Based Study in Italy. Viruses 2022; 14:v14061197. [PMID: 35746668 PMCID: PMC9228114 DOI: 10.3390/v14061197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/26/2022] [Indexed: 12/20/2022] Open
Abstract
Remdesivir is the first drug approved for treatment of COVID-19 but current evidence for recommending its use for the treatment of moderate-to-severe disease is still controversial among clinical guidelines. We performed a nationwide, registry-based study including all Italian hospitalized patients with COVID-19 treated with remdesivir to assess the impact of major confounders on crude 15-day and 29-day mortality. Mortality was calculated using the Kaplan–Meier estimator and the Cox proportional-hazards model was applied to analyze the risks by patient’s baseline features. In total, 16,462 patients treated with remdesivir from 29 October 2020 to 17 December 2020 were entered in the study. Crude 15-day and 29-day mortality were 7.1% (95% CI, 6.7–7.5%) and 11.7% (95% CI, 11.2–12.2%), respectively. Being treated within two days of admission reduced the risk of death by about 40% (HR 1.4, 95% CI, 1.2–1.6). Results from the largest cohort of remdesivir-treated patients suggests that mortality in SARS-CoV-2 hospitalized patients is substantially influenced by the days between SARS-CoV-2 diagnosis and drug prescription. Current recommendations and future clinical trials for remdesivir alone or in combination should carefully consider the target population and timing for best efficacy of treatment.
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Rosano GMC, Celant S, Olimpieri PP, Colatrella A, Onder G, Di Lenarda A, Ambrosio G, Reboldi G, Gensini GF, Colivicchi F, Russo P. Impact of the COVID-19 pandemic on prescription of sacubitril/valsartan in Italy. Eur J Heart Fail 2022; 24:855-860. [PMID: 35303393 PMCID: PMC9087379 DOI: 10.1002/ejhf.2490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/05/2022] [Accepted: 03/16/2022] [Indexed: 12/02/2022] Open
Abstract
AIMS The present study sought to examine the effect of the COVID-19 pandemic and lockdown measures on the prescription of sacubitril/valsartan in patients with heart failure (HF) in Italy. METHODS AND RESULTS Data from Italian Medicines Agency (AIFA) monitoring registries were analysed. The sacubitril/valsartan monitoring registry is based on 6-month prescriptions. A monthly aggregation on new activations throughout the observational period was computed. From March to December 2020, the initiation of new HF patients on sacubitril/valsartan decreased by nearly 40% with prescriptions dropping to values similar to 2018 when the registry was still operated off-line. A slight increase in prescriptions was observed after the lockdown measures were lifted, but prescriptions remained constantly below the pre-lockdown period. CONCLUSION A marked and worrisome decline during the COVID-19 pandemic in the activation of a life-saving treatment such as sacubitril/valsartan was observed. This decline was clearly linked to the lockdown measures instated to counteract the COVID-19 pandemic. Upcoming studies should analyse the occurrence of new cases of HF as well as the severity of patients admitted to hospitals and their mortality compared to pre-pandemic levels.
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Alnuaimi H, Amjad U, Park S, Russo P, Lopresto V, Kundu T. An improved nonlinear ultrasonic technique for detecting and monitoring impact induced damage in composite plates. ULTRASONICS 2022; 119:106620. [PMID: 34673322 DOI: 10.1016/j.ultras.2021.106620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/18/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
An improved technique for sensing damage initiation and progression in thermoplastic resin composite plate specimens is presented in this study. The composite plate specimens are investigated by using a nonlinear ultrasonic (NLU) technique called Sideband Peak Count Index or SPC-I. The technique presented in this paper is an improvement from the previous SPC-I technique. This improved technique provides more reliable and consistent results and can monitor the damage progression over a wide range. In this paper the narrow band SPC-I technique is introduced to replace the conventional wide band SPC-I technique. The method implemented here is improved in three ways. First and foremost the narrow band SPC-I technique is introduced. Secondly, the non-permanently adhered gel coupled Lead-Zirconate-Titanate (PZT) transducers are used to reduce inconsistency in transducer adhesion and manufacturing. Lastly, higher sampling rate equipment is used for better signal resolution and peak counting. The experiments are performed on 4 sets of composite plate specimens fabricated using two composite fiber materials (Glass and Basalt) that have increasing levels of damage. The composite plate specimens were damaged by a falling weight impact machine with increasing impact energy (0 J, 10 J, 20 J and 30 J). The composite plate specimens were examined by propagating a narrow band chirp signal through the specimens using gel coupled transducers in a transmission mode setup. The received signals were recorded and analyzed using the NLU SPC-I technique. The modified SPC-I technique proposed in this paper can reliably and consistently detect both initiation and progression of damage in the composite plate specimens.
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Mettivier G, Ricciardi R, Acampora G, Staffa M, Sarno A, Orientale A, Pilotti I, D’Andria P, Russo P. A machine learning classifier for digital breast tomosynthesis: a first step. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Sarno A, Mettivier G, Bliznakova K, Hernandez A, Boone J, Russo P. Evaluation of glandular dose distribution in 2D and 3D x-ray breast imaging. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00276-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Russo P, Varallo A, Castriconi R, Mazzilli A, Sarno A, Loria A, del Vecchio A, Orientale A, Pilotti I, D’Andria P, Bliznakova K, Mettivier G. Patient-derived 3D printed breast phantoms for mammography and digital breast tomosynthesis. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mettivier G, Tudda A, Nicolini G, Donzelli E, Semperboni S, Bossi M, Cavaletti G, Castriconi R, Mangili P, del Vecchio A, Sarno A, Russo P. Radiation enhancement for kV and MV X-ray irradiation of breast cancer cells incubated with gold nanoparticles. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Valero C, Sarno A, Mettivier G, Stasi M, Russo P. Evaluation of the air kerma distribution at the breast surface in mammography and breast tomosynthesis. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00280-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tucciariello R, Sarno A, Barca P, Del Sarto D, Lamastra R, Mettivier G, Fantacci M, Russo P. Monte Carlo calculation for dedicated mean glandular dose estimates in commercial DBT scanners using homogeneous phantoms. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Gruenwald V, Bex A, Russo P, Tomita Y, Simsek B, Spiridigliozzi J, Chudnovsky A, Motzer R. A phase 3, randomized, double-blind trial of nivolumab or nivolumab plus ipilimumab versus placebo in patients with localized renal cell carcinoma who underwent radical or partial nephrectomy and are at high risk of relapse (CheckMate 914). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03167-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Russo P, Marcellusi A, Zanuzzi M, Carletto A, Fratto ME, Favato G, Staniscia T, Romano F. Drug Prices and Value of Oncology Drugs in Italy. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1273-1278. [PMID: 34452706 DOI: 10.1016/j.jval.2021.04.1278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/23/2021] [Accepted: 04/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The main objective of this study was to evaluate the potential role of efficacy data and other information available at the time of price and reimbursement (P&R) decision-making process within the definition of oncology treatment costs in Italy. METHODS The study included all P&R dossiers submitted to the Italian Medicines Agency between July 2015 and December 2017. It prospectively collected the data of the P&R process starting from dossier submission up to the Italian Health Service reimbursement decision. The cost of treatment per patient was estimated using both the list price ("gross cost") and the confidential net price ("net cost") of drug packages and applied to the median duration of treatment. A 2-sample stage Heckman decomposition model was used to evaluate the potential role of efficacy data and other information available at the time of P&R decision making on the gross and net cost. RESULTS A total of 37 oncology drugs related to 58 therapeutic indications were analyzed. The multivariate model showed that the variation of progression-free survival is the only variable predictor statistically associated with treatment cost, but this effect was observed only when confidential net prices were used (P=.026). CONCLUSIONS Considering the perspective of a developed country having a public healthcare service with a central reimbursement negotiation is determined a relevant reduction in the treatment cost purchased by public payers. This is a useful approach to guarantee the affordability of innovative oncology drugs and to contain public expenditures on healthcare. Furthermore, the negotiation of confidential discounts and agreement clauses in managed entry agreements seemed to reward oncology drugs displaying an added therapeutic benefit.
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Palladini G, Celant S, Milani P, Summa V, Affronti G, Olimpieri PP, Petraglia S, Foli A, Nuvolone M, Merlini G, Russo P. A nationwide prospective registry of bortezomib-based therapy in light chain (AL) amyloidosis. Leuk Lymphoma 2021; 63:205-211. [PMID: 34448427 DOI: 10.1080/10428194.2021.1971215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Until recently, no drug was labeled for AL amyloidosis. In 2011, the Italian Medicines Agency started a program to grant access to upfront bortezomib to patients with AL amyloidosis. All subjects were enrolled in a prospective online registry. Response was evaluated after two cycles to assess the possibility of continuing treatment. A total of 764 patients were included until 2019, and 615 were evaluable. Sixteen percent of patents had advanced (stage-IIIb) heart involvement, and 27% had severe or end-stage renal failure. Bortezomib delivery was possible in stage-IIIb patients at a reduced dose. Bortezomib discontinuation was associated with increasing age, advanced heart involvement and bi-weekly administration. Fifty-nine percent of subjects attained a hematologic response and 14% a cardiac response. Bortezomib-based therapy tends to be discontinued early in elderly patients and in advanced disease. Nevertheless, early response to therapy is possible in this challenging population.
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Russo P, Carletto A, Németh G, Habl C. Medicine price transparency and confidential managed-entry agreements in Europe: findings from the EURIPID survey. Health Policy 2021; 125:1140-1145. [PMID: 34253396 DOI: 10.1016/j.healthpol.2021.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Pricing of pharmaceuticals is an all-time challenge for healthcare systems. Often public payers agree with companies on confidential managed-entry agreements (MEAs) that, e.g. foresee discounts under specific circumstances. The EURIPID Executive Committee surveyed 22 European countries, who all reported the use of confidential agreements between pharmaceutical companies and public payers, confirming that the actual prices paid are typically lower than the published list price. In 68% of the countries, the confidentiality of MEAs is required by non-disclosure clauses between companies and public payers. In some countries (27%) this is even backed up by a specific law. Our study identified legal constraints for the sharing of information on actual prices and confidential agreements among European countries and consequently restrictions in transparency. In conclusion, the EURIPID survey findings suggest that the current possibility to improve the medicines' price transparency across countries is limited and the issue probably requires international institutional engagement, at least to coordinate initiatives toward a greater collaboration among member states.
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Onder G, Olimpieri PP, Celant S, Di Lenarda A, Ambrosio G, Reboldi G, Gensini G, Colatrella A, Palmer K, Gabrielli D, Russo P. Under-prescription of direct oral anticoagulants for treatment of non-valvular atrial fibrillation and venous thromboembolism in the COVID-19 lockdown period. Eur J Prev Cardiol 2021; 29:e149-e152. [PMID: 34151366 PMCID: PMC8344462 DOI: 10.1093/eurjpc/zwab096] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/08/2021] [Accepted: 05/17/2021] [Indexed: 12/25/2022]
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Marcon J, Di Natale R, Weng S, Ghanaat M, Silagy A, Mano R, Blum K, Attalla K, Reznik E, Carlo M, Motzer R, Coleman J, Russo P, Hakimi A, Chen Y. Neutrophil-to-lymphocyte ratio in unclassified renal cell carcinoma is associated with clinical outcome and varies between genomic subgroups. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zanca F, Avanzo M, Colgan N, Crijns W, Guidi G, Hernandez-Giron I, Kagadis GC, Diaz O, Zaidi H, Russo P, Toma-Dasu I, Kortesniemi M. Focus issue: Artificial intelligence in medical physics. Phys Med 2021; 83:287-291. [PMID: 34004585 DOI: 10.1016/j.ejmp.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Hadjigeorgiou C, Molnár D, Hunsberger M, De Henauw S, Moreno LA, Hebestreit A. Cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness in European children and adolescents. Osteoporos Int 2021; 32:853-863. [PMID: 33245373 PMCID: PMC8043938 DOI: 10.1007/s00198-020-05753-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
UNLABELLED In this large perspective cohort among European children and adolescents, we observed that daytime napping was positively associated with bone stiffness, while short or long sleep duration combined with poor sleep quality was associated with less bone stiffness. Our findings are important for obtaining optimal bone stiffness in childhood. INTRODUCTION To examine the cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness index (SI) in European children and adolescents. METHODS Four thousand eight hundred seventy-one children aged 2-11 years from the IDEFICS study and 861 children aged 6-15 years from the subsequent I.Family study were included. Sleep duration (i.e., nocturnal sleep and daytime napping) and sleep quality (i.e., irregularly bedtime routine, have difficulty falling asleep and trouble getting up in the morning) were reported by self-administrated questionnaires. Nocturnal sleep duration was converted into age-specific z-scores, and total sleep duration was classified into short, adequate, and long based on the National Sleep Recommendation. Calcaneal SI of both feet were measured using quantitative ultrasound. Linear mixed-effects models with country as a random effect were used, with adjustments for sex, age, pubertal status, family socioeconomic status, physical activity, screen time, body mass index, and daylight duration. RESULTS Nocturnal sleep duration z-scores were positively associated with SI percentiles among participants with adequate sleep duration at baseline. Moreover, the positive association between daytime napping and SI percentiles was more pronounced in participants with adequate sleep duration at baseline, while at 4-year follow-up was more pronounced in participants with short sleep duration. In addition, extreme sleep duration at baseline predicted lower SI percentiles after 4 years in participants with poor sleep quality. CONCLUSION The positive associations between nocturnal sleep, daytime napping and SI depended on total sleep duration. Long-term detrimental effect of extreme sleep duration on SI only existed in individuals with poor sleep quality.
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Russo P, Pani L, Staniscia T, Romano F, Marzioni M. Impact of reimbursement limits on patient access to direct-acting antivirals in Italy: analysis of data from national registries. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 24:5758-5768. [PMID: 32495912 DOI: 10.26355/eurrev_202005_21368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Hepatitis C virus (HCV) infection is a global epidemic, still highly prevalent in Europe. Given efficacy and safety of HCV therapy by Direct Antiviral Agents (DAA), World Health Organization called for actions to eliminate HCV infection. A limit is represented by access to care, mostly due to the high costs of medicines. In Italy, in 2015, the access to DAA therapy was reimbursed for patients with advanced disease, whereas in 2017 universal access was granted. The aim of this study was to analyse changes in patient recruitment trends treated with DAA with or without limitations to access to therapy. PATIENTS AND METHODS 165,105 patients treated with DAA in Italy from 2015 to December 2018 were analysed. Daily patient treatment rate was obtained by segmented regression of interrupted time series analysis. RESULTS 74,199 patients with advanced disease (62% with cirrhosis) had access to the therapy during the time period from 2015 to 2017. Following the extension of reimbursement criteria, 90,906 additional patients were treated (43.2% with F0-F1 and 22.9% with F2), with an absolute reduction of 59.9% of patients with advanced disease (cirrhosis decreased to 18.5%). Segmented regression of interrupted time series analysis of daily patient treatment rate showed a progressive reduction of patients with advanced disease, offset by those with initial disease. Notably, elimination of restrictions to therapy did not change the overall treatment rate. CONCLUSIONS This study showed that a no-limit reimbursement policy for DAAs prescriptions to HCV infected individuals in Italy widened the types of treated patients, but the process towards elimination of HCV infection was not significantly changed.
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Ricciardi R, Mettivier G, Staffa M, Sarno A, Acampora G, Minelli S, Santoro A, Antignani E, Orientale A, Pilotti I, Santangelo V, D'Andria P, Russo P. A deep learning classifier for digital breast tomosynthesis. Phys Med 2021; 83:184-193. [DOI: 10.1016/j.ejmp.2021.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/04/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022] Open
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Alvarez E, Nair KV, Gorritz M, Bartolome L, Maloney H, Ding Y, Golan T, Wade RL, Kumar R, Su W, Shah R, Russo P. Identification and diagnosis of Secondary Progressive Multiple Sclerosis during the clinical encounter: Results from a physician survey. Mult Scler Relat Disord 2021; 50:102858. [PMID: 33799068 DOI: 10.1016/j.msard.2021.102858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 02/20/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND It is difficult to characterize the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS), due to symptomatic variability across patients. Diagnosis of SPMS is prolonged and often established retrospectively, as it is based on patient clinical history and symptoms. This cross-sectional study aimed to identify MS neurologist reported clinical indicators deemed important in diagnosing SPMS in clinical practice. METHODS A web-based quantitative survey was conducted among MS-treating neurologists across the United States in January 2019. The questionnaire comprised of 17 questions evaluating primary clinical indicators used by neurologists in assessing patient progression to SPMS. Treatment approach and factors influencing treatment decision-making following SPMS diagnosis were also analyzed in the survey. RESULTS Overall, 300 neurologists completed the survey; most of the respondents were general MS-treating neurologists (63%) and from private care setting (58%). The overall respondents as well as MS-focused neurologists ranked patient history (45% and 42%, respectively) and patients' neurological exam (39% and 44%, respectively) as -primary clinical indicators of SPMS diagnosis. 57% of neurologists always or mostly switched disease modifying therapies after progression to SPMS, and mostly considered 3-6 months' assessment interval to diagnose SPMS. CONCLUSION The survey indicated that neurologists are able to recognize signs of SPMS within six months of symptomatic assessment. The diagnosis is primarily based on patient history among MS-treating neurologists. Therefore, continued education to neurologists may facilitate early diagnosis and timely introduction of effective treatment to manage the progression of SPMS.
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Foschi N, Ragonese M, Russo P, Nigro D, Di Gianfrancesco L, Sica S, Tinelli G, Thsomba Y, Bassi P. Synchronous Partial Nephrectomy and Renal Artery Aneurysm Repair in Bilateral Renal Cancers: Case Report and Literature Review. Urol Int 2021; 105:525-530. [PMID: 33601386 DOI: 10.1159/000511755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/19/2020] [Indexed: 11/19/2022]
Abstract
The treatment of renal cancer has changed in the last decades with an increase in application of conservative surgery such as partial nephrectomy (PN) in order to achieve an optimal oncological outcome with the maximum preservation of renal function. The indication for PN is mandatory in case of bilateral tumors or in case of impaired renal function. Renal artery (RA) aneurysm (RAA) is a rare occurrence, and its treatment could be radiological or surgical according to the anatomy of the aneurysm and the clinical characteristics of the patients. Here, we report a case of simultaneous ipsilateral occurrence of renal cancer and RAA in a patient with bilateral renal masses, treated with 1 surgical procedure with good functional and oncological outcomes. This rare occurrence must be known by surgeons treating renal cancers, and it is possible to perform the 2 procedures in 1 surgical step.
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Picola Brau N, Rivero Belenchón I, Mercader Barrull C, Benfante N, Vigués Julià F, Apatov S, Russo P, Coleman J, Touijer K. Multiple partial nephrectomy for multifocal synchronous renal cancer in a solitary kidney. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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