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Marinelli A, Giaj Levra N, Trachanas K, Costa A, Sicignano G, Cuccia F, Corso M, Alongi F, Molon G. Stereotactic ablative body radiotherapy of ventricular tachycardia. Single italian centre experience. Europace 2022. [DOI: 10.1093/europace/euac053.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ventricular tachycardia (VT) is a life-threatening condition. Usual management of VT is based on anti-arrhythmic drugs or catheter ablation. In this scenario, stereotactic body radiation therapy (SBRT) is arising as an attractive non-invasive alternative for the treatment of VT in some patients (pts).
Purpose
The aim of this study was to assess safety, feasibility and outcomes of SBRT in fragile pts admitted in our centre for VT storms.
Methods
Pts with implantable cardioverter-defibrillator (ICD), presenting with VT storms and not responsive to drugs or suitable for catheter ablation were enrolled for SBRT. All pts underwent a computed tomography (CT) and an 18F-fluorodeoxyglucose positron emission (FDG PET)-CT scan in order to detect a possible area of scar responsible of the VT. All pts had also an electrophysiological study and ventricular programmed stimulation inducing clinical VT while wearing a multi-electrodes ECG vest. Merging the CT scan imagines and the VT 3D reconstruction, we identified the possible circuit of the VT and its exit sites. Treatment planning was performed for a total dose of 21-25 Gy delivered in a single session. For the first year, follow-up (FU) were scheduled every 3 months since the SBRT treatment. Toxicity was prospectively assessed.
Results
From January 2020 to March 2021, we treated 6 (5 males) pts. Mean age was 78±4. NYHA class was II for 3 pts, 2 were class III and only one pts was class IV. Four pts had an ischaemic heart disease background, two had dilated cardiomyopathy (DCM). Mean ejection fraction (EF) was 31±6%. The mean FU was 17 months, with the longest of 23 months. Of these 6 pts, only one died because of end stage heart failure, no VT/VF were recorded on his ICD. This was the pts with DCM and class NYHA IV at the time of procedure. Of the 5 pts remaining, 2/5 reported new therapies delivered by their ICDs. One pts had a single ICD shock during acute urine tract infection and sepsis at one month since SBRT. ICD interrogation documented inappropriate shock on fast conducted atrial fibrillation. No VTs have been recorded after 7 months. The other pts was admitted after 5 months since SBRT. The ICD showed appropriate therapies on VTs. This pts had the biggest scar volume compared to the others (anterior wall of the left ventricle with aneurysmatic apex). On the other 3 pts, no VTs were recorded by ICDs. Of these 3 pts, interestingly, 2 had class NYHA III and the mean EF 28.6±3%. The overall outcome with no appropriate ICD shocks due to VTs is above 70%. No radiotherapy toxicity was documented.
Conclusion
To the best of our knowledge this is one of the biggest groups of pts treated with this technology and the longest FU so far, of a single centre in Italy. SBRT seems to be a safe and feasible approach to treat fragile pts with VTs when not suitable for standard catheter ablation or responsive to medications. It also shows a good outcome even in pts with more advanced heart failure.
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Molon G, Costa A, Bonapace S, Marinelli A, Alongi F, Giaj Levra N, Sicignano G, Cuccia F. C2 STEREOTACTIC ABLATIVE RADIOTHERAPY (STAR) IN PATIENTS WITH ICD AND ARRHYTHMIC STORMS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
The current therapy of recurrent ventricular tachycardia (VT) and arrhythmic storms is the radiofrequency catheter ablation (RFCA). The first experiences of stereotaxic radioablation of arrhythmia (STAR) as an alternative in patients (pts) with defibrillator (ICD) and Arrhythmic Storms are emerging. However, a standardized method for STAR is not yet available and many issues are still under discussion. We present the preliminary results of STAR in the pts of our Center.
Material and method
Pts with ICDs and Arrhythmic Storms, excluded from RFCA, were referred to STAR. Diagnostics performed were Electrophysiological study (EPS) using 3D electroanatomical mapping (3DEAM) using CardioInsightTM vest (Medtronic, Minneapolis, MN), cardio–CT scan and 18F–fluorine–2–deoxy–D–glucose positron emission tomography (18FDG – PET scan) in order to identify the target area of the ventricle. In all pts a sustained monomorphic VT was induced during EPS, and 3DEAM was used to identify the exit point of the VT (Fig. 1). In all cases, a 3 mm thick 4D CT scan was used (Fig. 2) with the aid of an abdominal thermoplastic mask. Each patient was treated with a TrueBeam Linac (Varian Medical Systems, Palo Alto, CA). The prescription of the dose from 21 to 25 Gy in a single delivery. Ethics committee approval was obtained prior to each treatment.
Results
From January 2020 to March 2021, 6 patients (5 M, 1 F), mean age 78 years (58–80) were treated with STAR. The median delivered dose was 25 Gy (range 21–25 Gy). In follow–up (FU) one patient died from end–stage heart failure after 30 days. At a median FU of 13 months, STAR treatment efficacy was observed in 3/5 patients, in whom no defibrillator activation was recorded. 2/5 patients had recurrence of TV, 2 and 6 months after STAR. No severe acute toxicity was recorded after radiotherapy.
Conclusions
Arrhythmic stereotaxic radioablation appears to be a safe and effective therapy in PTS with ICDs and arrhythmic storms. Completely non–invasive diagnostics and therapy make it very interesting and ambitious. Additional data is needed to improve the definition of the target zone and to standardize it in patients not eligible for RFCA.
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Fallara G, Boeri L, Candela L, Costa A, Capogrosso P, Cazzaniga W, Schifano N, Pozzi E, Belladelli F, Cignoli D, Colandrea G, Cornelius J, Mattei A, Montorsi F, Salonia A. Impact of urinary incontinence on sexual function in patients presenting for lower urinary tract symptoms. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fallara G, Capogrosso P, Boeri L, Cazzaniga W, Candela L, Schifano N, Costa A, Pozzi E, Belladelli F, Cignoli D, Raffo M, Matloob R, Cornelius J, Ventimiglia E, Mattei A, Montorsi F, Salonia A. Peyronie's disease in young adults: Symptomatic burden and clinical characteristics. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pozzi E, Fallara G, Candela L, Costa A, Boeri L, Capogrosso P, Schifano N, Cignoli D, Colandrea G, Raffo M, Cornelius J, Mattei A, Montorsi F, Salonia A. Primary organic vs. primary psychogenic erectile dysfunction: a cross-sectional study on patient's characteristics and sexual function from a tertiary referral center. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Capogrosso P, Candela L, Costa A, Cazzaniga W, Fallara G, Cignoli D, Boeri L, Colandrea G, Schifano N, Cornelius J, Abbate C, Dehò F, Mattei A, Montorsi F, Salonia A. Selecting patients for penile doppler ultrasound in clinical practice. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Capogrosso P, Candela L, Cazzaniga W, Costa A, Fallara G, Boeri L, Pozzi E, Belladelli F, Schifano N, Cignoli D, Dehò F, Abbate C, Montorsi F, Salonia A. Are patients really willing to undergo surgery for Peyronie's disease? J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Diéguez I, Costa A, Miró I, March Villalba JA, Del Peral M, Marco Macián A, Vila JJ. En bloc resection vs. Gips procedure in pilonidal sinus surgery. CIRUGIA PEDIATRICA : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE CIRUGIA PEDIATRICA 2022; 35:75-79. [PMID: 35485755 DOI: 10.54847/cp.2022.02.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Pilonidal sinus (PS) is an infectious/inflammatory condition of the sacrococcygeal region, with frequent relapses. There is no clear consensus as to which management technique is best. The most widely used technique is en bloc resection (EBR), but less invasive methods (Gips procedure) are now being developed. OBJECTIVE To compare complications and progression of pediatric patients undergoing PS surgery in our institution using two different surgical techniques. MATERIAL AND METHODS A retrospective study of patients under 16 years of age undergoing PS surgery (EBR/Gips procedure) for the first time from 2014 to 2020 was carried out. Demographic variables, complications in the first month (exudate, wound infection, dehiscence, and bleeding), and result at the end of follow-up were collected. Qualitative variables were expressed as absolute frequency and percentage, whereas quantitative variables were expressed as mean and standard deviation. RESULTS 60 patients underwent surgery. EBR was used in the first group, and the Gips procedure was used in the second group (76.67%, n = 46 vs. 23.33%, n = 14). Both were comparable in terms of sex (32.61% vs. 35.71% male), age (14.04 vs. 13.79 years old), and BMI (26.63 vs. 26.20 kg/m2) at surgery. 6 patients underwent re-intervention (10.87% vs. 7.14%; p = 0.684). Median follow-up time to healing was 6.13 ± 0.98 months vs. 3.31 ± 1.26 months (p < 0.024). The Gips procedure caused no dehiscence, whereas dehiscence rate in EBR was 65.22%. CONCLUSION The Gips procedure is a minimally invasive alternative to EBR. It avoids dehiscence, and time to healing is shorter. Therefore, it should be regarded as the first-line treatment in PS patients.
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Sardinha Abrantes S, Branco R, Landim E, Souto Miranda M, Costa A, Nazaré A. 202 Acute postpartum pulmonary edema – A case report. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meira de Carvalho M, Ferreira A, Costa A, Nazaré A. 201 Trisomy 2 mosaicism as a rare cause of a polymalformed foetus. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Araújo N, Costa A, Lopes-Conceição L, Ferreira A, Carneiro F, Oliveira J, Braga I, Morais S, Pacheco-Figueiredo L, Ruano L, Cruz VT, Pereira S, Lunet N. Androgen deprivation therapy and cognitive decline in the NEON-PC prospective study, during the COVID-19 pandemic. ESMO Open 2022; 7:100448. [PMID: 35344749 PMCID: PMC8898674 DOI: 10.1016/j.esmoop.2022.100448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/25/2022] [Accepted: 02/20/2022] [Indexed: 12/24/2022] Open
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Meira de Carvalho M, Rodrigues M, Ferreira A, Costa A, Nazaré A. 203 Off-label use of femostop® to treat postpartum haemorrhage. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.250] [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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Pereira Amaral P, Rodrigues M, Matos F, Costa A, Nazaré A. 61 Arabin pessary: 5 Years experience of a terciary hospital. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.193] [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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Arros M, Santos I, Henriques M, Rodrigues M, Nascimento S, Landim E, Costa A, Nazaré A. 320 Intrahepatic cholestasis of pregnancy and associated maternal-fetal morbidity –experience of six years (2015-2020) of a terciary hospital. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sardinha Abrantes S, Souto Miranda M, Santos A, Costa A, Nazaré A. 204 1p36 Deletion syndrome – A case report. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kumari R, Janković M, Costa A, Savić A, Konstantinović L, Djordjević O, Vucković A. Short term priming effect of brain-actuated muscle stimulation using bimanual movements in stroke. Clin Neurophysiol 2022; 138:108-121. [DOI: 10.1016/j.clinph.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
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Baumgartner C, Fuchs L, Costa A, Picó-Cortés J, Reinhardt S, Gronin S, Gardner GC, Lindemann T, Manfra MJ, Faria Junior PE, Kochan D, Fabian J, Paradiso N, Strunk C. Effect of Rashba and Dresselhaus spin-orbit coupling on supercurrent rectification and magnetochiral anisotropy of ballistic Josephson junctions. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2022; 34:154005. [PMID: 35051919 DOI: 10.1088/1361-648x/ac4d5e] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
Simultaneous breaking of inversion- and time-reversal symmetry in Josephson junction (JJ) leads to a possible violation of theI(φ) = -I(-φ) equality for the current-phase relation. This is known as anomalous Josephson effect and it produces a phase shiftφ0in sinusoidal current-phase relations. In ballistic JJs with non-sinusoidal current phase relation the observed phenomenology is much richer, including the supercurrent diode effect and the magnetochiral anisotropy (MCA) of Josephson inductance. In this work, we present measurements of both effects on arrays of JJs defined on epitaxial Al/InAs heterostructures. We show that the orientation of the current with respect to the lattice affects the MCA, possibly as the result of a finite Dresselhaus component. In addition, we show that the two-fold symmetry of the Josephson inductance reflects in the activation energy for phase slips.
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Fallara G, Pozzi E, Belladelli F, Corsini C, Raffo M, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Capogrosso P, Boeri L, Cazzaniga W, Matloob R, Mirone V, Dehó F, Montorsi F, Salonia A. Relevance of self-masturbation-related vs. coital erectile function in the real-life management of patients with erectile dysfunction. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Capogrosso P, Ventimiglia E, Fallara G, Costa A, De Angelis M, Colandrea G, Belladelli F, Pellegrino F, Candela L, Pozzi E, Cignoli D, Schifano N, Cazzaniga W, Matloob R, Dehò F, Scattoni V, Salonia A, Montorsi F. Prostate volume is associated with optimal TRIFECTA outcomes after HoLEP – results from a prospective trial (ExpHo). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Belladelli F, Fallara G, Pozzi E, Corsini C, Raffo M, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Capogrosso P, Boeri L, Ventimiglia E, Matloob R, Pagliardini L, Montorsi F, Salonia A. The effect of historical CMV infection on sperm parameters in white-European infertile men: Findings from a real-life cross-sectional study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00885-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Capogrosso P, Ventimiglia E, Fallara G, Costa A, Pellegrino F, Candela L, Pozzi E, Belladelli F, De Angelis M, Colandrea G, Cazzaniga W, Cignoli D, Schifano N, Matloob R, Degò F, Scattoni V, Salonia A, Montorsi F. Risk of orgasmic function impairment after HoLEP – findings of a prospective real-life trial (ExpHo). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boeri L, Pozzi E, Belladelli F, Fallara G, Raffo M, Corsini C, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Ventimiglia E, Capogrosso P, Dehó F, Mirone V, Pagliardini L, Papaleo E, Montorsi F, Salonia A. The impact of different WHO reference criteria for semen analysis in clinical practice: Who will benefit from the new 2021 cutoffs for normal sperm parameters? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Boeri L, Belladelli F, Pozzi E, Fallara G, Raffo M, Corsini C, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Capogrosso P, Ventimiglia E, Pagliardini L, Papaleo E, Mirone V, Dehó F, Montorsi F, Salonia A. Low birth weight is associated with sperm dna fragmentation and assisted reproductive technology outcomes in primary infertile men – results of a cross-sectional study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Saposnik G, Andhavarapu S, Fernández Ó, Kim HJ, Wiendl H, Foss M, Zuo F, Havrdová EK, Celius E, Caceres F, Magyari M, Bermel R, Costa A, Terzaghi M, Kalincik T, Popescu V, Amato MP, Montalban X, Oh J. Factors associated with treatment escalation among MS specialists and general neurologists: Results from an International cojoint study. Mult Scler Relat Disord 2022; 58:103404. [PMID: 35216786 DOI: 10.1016/j.msard.2021.103404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/19/2021] [Accepted: 11/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies in multiple sclerosis (MS) showed that therapeutic inertia (TI) affects 60-90% of neurologists and up to 25% of daily treatment decisions. The objective of this study was to determine the most common factors and attribute levels associated with decisions to treatment escalation in an international study in MS care. METHODS 300 neurologists with MS expertise from 20 countries were invited to participate. Participants were presented with 12 pairs of simulated MS patient profiles described by 13 clinically relevant factors. We used disaggregated discrete choice experiments to estimate the weight of factors and attributes affecting physicians' decisions when considering treatment selection. Participants were asked to select the ideal candidate for treatment escalation from modest to higher-efficacy therapies. RESULTS Overall, 229 neurologists completed the study (completion rate: 76.3%). The top 3 weighted factors associated with treatment escalation were: previous relapses (20%), baseline expanded disability status scale [EDSS] (18%), and MRI activity (13%). Patient demographics and desire for pregnancy had a modest influence (≤ 3%). We observed differences in the weight of factors associated with treatment escalation between MS specialists and non-MS specialists. CONCLUSIONS Our results provide critical information on factors influencing neurologists' treatment decisions and should be applied to continuing medical education strategies.
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Fallara G, Boeri L, Candela L, Costa A, Capogrosso P, Belladelli F, Pozzi E, Raffo M, Corsini C, Cignoli D, Schifano N, Cazzaniga W, Colandrea G, D'Arma A, Matloob R, Mirone V, Montorsi F, Salonia A. Impact of urinary incontinence on sexual function in patients presenting for lower urinary tract symptoms. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00914-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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