36 results on '"Pecchioli, S."'
Search Results
2. Development of pollination and in vitro germination techniques to improve the hybridization in Hydrangea spp
- Author
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Venturieri, G.A., Nesi, B., Lazzereschi, S., Pecchioli, S., and Burchi, G.
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0106 biological sciences ,lcsh:Biology (General) ,lcsh:Botany ,food and beverages ,01 natural sciences ,lcsh:QH301-705.5 ,010606 plant biology & botany ,lcsh:QK1-989 - Abstract
Hydrangea is a genus of ornamental plants which is gaining new markets mainly as a fresh or dried cut flower, but it is also important as a pot plant and for landscaping. To expand its market, new hybrids should be developed. To increase the hybridization efficiency, some techniques were developed and tested: i) evaluation of two pollination systems; ii) comparison among fruit-cut systems before in vitro cultivation to develop embryos and to allow the growth of new genotypes; iii) evaluation of seed disinfection systems for in vitro germination; iv) sowing systems using seeds and fruits from stocks cultivated in two environments. To increase inter- and intra-specific hybridization, pollination by dispersion of previously collected pollen on the top of a corymb by a brush was more effective than pollination using the corymb itself as a brush. A longitudinal cut system can be considered the best treatment to be applied on fruits before in vitro cultivation to allow growth of seedlings. Sterilization of seeds can be done by immersion in a solution of commercial bleach for 5 minutes on MS culture medium with PPM®. When stocks are cultivated in greenhouses, in vitro contamination is lower and seeds have a better rate of germination. The results of these experiments were applied in a breeding program on Hydrangea using sexual crosses., Advances in Horticultural Science, Vol 31 No 1 (2017)
- Published
- 2017
3. Micropropagazione di Vaccinium myrtillus L. dell'Appennino Pistoiese
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Nin S., Benelli C., Petrucci W. A., Pecchioli S., Giordani E., and Del Bubba M.
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- 2017
4. Association of Azithromycin and Ventricular Arrhythmia: the ARITMO Project
- Author
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Trifiro G, Oteri A, de Ridder M, Rijnbeek P, Pecchioli S, Mazzaglia G, Bezemer I, Garbe E, Schink T, Poluzzi E, Froslev T, Sturkenboom M, Trifiro, G, Oteri, A, de Ridder, M, Rijnbeek, P, Pecchioli, S, Mazzaglia, G, Bezemer, I, Garbe, E, Schink, T, Poluzzi, E, Froslev, T, and Sturkenboom, M
- Subjects
Electronic Healthcare Database ,Ventricular Arrhythmia ,Case-control ,Azithromycin - Published
- 2014
5. Qualiviva 'La qualità nella filiera florovivaistica nazionale attraverso l'utilizzo e la divulgazione delle schede varietali e di un capitolato unico di appalto per le opere a verde'
- Author
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Ferrini F., Fini A., Di Ferdinando M., Haegi A., Nesi B., Pecchioli S., Lazzareschi S., Resta E., Giurranna F., Della Rocca G., Tattini M., and Rossi P.
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- 2016
6. Antibiotic use varies substantially among adults: a cross-national study from five European Countries in the ARITMO project (vol 43, pg 453, 2015)
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Mor, Ay, Froslev, T, Thomsen, RW, Oteri, Alessandro, Rijnbeek, Peter, Schink, T, Garbe, E, Pecchioli, S, Innocenti, F, Bezemer, I, Poluzzi, E, Sturkenboom, MCJM, Trifiro, Gianluca, Sogaard, M, and Medical Informatics
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- 2016
7. Prevalence and Incidence of Gout in Italy. Analysis of a Primary Care Database
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Cavagna L, Trifiro G, Caporali R, Morabito P, Ferrajolo C, Pecchioli S, Simonetti M, Medea G, Cricelli C, Caputi A, Mazzaglia G, Montecucco C, Cavagna, L, Trifiro, G, Caporali, R, Morabito, P, Ferrajolo, C, Pecchioli, S, Simonetti, M, Medea, G, Cricelli, C, Caputi, A, Mazzaglia, G, and Montecucco, C
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Gout ,Italy ,Prevalence ,Electronic Healthcare Database - Published
- 2013
8. Uso degli antidepressivi in Italia: un’analisi nel contesto della Medicina Generale
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Mazzoleni, F, Simonetti, M, Lapi, F, Pecchioli, S, Trifiro, G, Cricelli, I, Mazzaglia, G, Mazzoleni, F, Simonetti, M, Lapi, F, Pecchioli, S, Trifiro, G, Cricelli, I, and Mazzaglia, G
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Dati clinici elettronici ,Antidepressivi ,Medicina Generale ,Italia - Published
- 2011
9. Aripiprazole Versus Haloperidol in Combination With Clozapine for Treatment-Resistant Schizophrenia in Routine Clinical Care A Randomized, Controlled Trial
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Barbui, C, Accordini, S, Nosè, M, Stroup, S, Purgato, M, Girlanda, F, Esposito, E, Veronese, A, Tansella, M, Cipriani, A, CHAT Clozapine Haloperidol Aripiprazole Trial, Study Group, Losavio, T, Percudani, M, Aldini, F, Appino, Mg, Artioli, P, Barale, F, Beneduce, R, Berardi, D, Bertolazzi, G, Biancosino, B, Bisogno, A, Bivi, R, Bogetto, F, Boso, M, Bozzani, A, Bucolo, P, Casale, M, Cascone, L, Ciammella, L, Cicolini, A, Cipresso, G, Colombo, P, Dal Santo, B, De Francesco, M, Di Lorenzo, G, Di Munzio, W, Erlicher, A, Ferrannini, L, Ferrato, F, Ferro, A, Fragomeno, N, Fricchione Parise, V, Frova, M, Gardellin, F, Garzotto, N, Giambartolomei, A, Giupponi, G, Grassi, L, Grazian, N, Grecu, L, Guerrini, G, Laddomada, F, Lazzarin, E, Lintas, C, Malchiodi, F, Malvini, L, Marchiaro, L, Marsilio, A, Mauri, Mc, Mautone, A, Menchetti, M, Migliorini, G, Mollica, M, Moretti, D, Mulè, S, Nicholau, S, Nosè, F, Occhionero, G, Pacilli, Am, Pecchioli, S, Petrosemolo, P, Piantato, E, Piazza, C, Pontarollo, F, Pycha, R, Quartesan, Roberto, Rillosi, L, Risso, F, Rizzo, R, Rocca, P, Roma, S, Rossattini, M, Rossi, G, Sala, A, Santilli, C, Saraò, G, Sarnicola, A, Sartore, F, Scarone, S, Sciarma, Tiziana, Siracusano, A, Strizzolo, S, Targa, G, Tasser, A, Tomasi, R, Travaglini, R, Valentini, C, Ziero, S., Barbui C., Accordini S., Nosè M., Stroup S., Purgato M., Girlanda F., Esposito E., Veronese A., Tansella M., Cipriani A., CHAT (Clozapine Haloperidol Aripiprazole Trial) Study Group […, Losavio T., Percudani M., Aldini F., Appino M.G., Artioli P., Barale F., Beneduce R., Berardi D., Bertolazzi G., Biancosino B., Bisogno A., Bivi R., Bogetto F., Boso M., Bozzani A., Bucolo P., Casale M., Cascone L., Ciammella L., Cicolini A., Cipresso G., Colombo P., Dal Santo B., De Francesco M., Di Lorenzo G., Di Munzio W., Erlicher A., Ferrannini L., Ferrato F., Ferro A., Fragomeno N., Fricchione Parise V., Frova M., Gardellin F., Garzotto N., Giambartolomei A., Giupponi G., Grassi L., Grazian N., Grecu L., Guerrini G., Laddomada F., Lazzarin E., Lintas C., Malchiodi F., Malvini L., Marchiaro L., Marsilio A., Mauri M.C., Mautone A., Menchetti M., Migliorini G., Mollica M., Moretti D., Mulè S., Nicholau S., Nosè F., Occhionero G., Pacilli A.M., Pecchioli S., Petrosemolo P., Piantato E., Piazza C., Pontarollo F., Pycha R., Quartesan R., Rillosi L., Risso F., Rizzo R., Rocca P., Roma S., Rossattini M., Rossi G., Sala A., Santilli C., Saraò G., Sarnicola A., Sartore F., Scarone S., Sciarma T., Siracusano A., Strizzolo S., Targa G., Tasser A., Tomasi R., Travaglini R., Valentini C., and Ziero S. …]
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Adult ,Male ,medicine.medical_specialty ,antipsychotics ,aripiprazole ,clozapine ,combination strategies ,schizophrenia ,medicine.drug_class ,medicine.medical_treatment ,Drug Resistance ,Atypical antipsychotic ,Quinolones ,Piperazines ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Brief Psychiatric Rating Scale ,medicine ,Haloperidol ,Humans ,Pharmacology (medical) ,humans ,quinolones ,drug resistance ,brief psychiatric rating scale ,antipsychotic agents ,drug therapy, combination ,haloperidol ,piperazines ,adult ,female ,male ,Psychiatry ,Antipsychotic ,Settore MED/25 - Psichiatria ,Clozapine ,combination ,Randomised Controlled Trial ,Aripiprazole ,ATYPICAL ANTIPSYCHOTICS ,TREATMENT RESISTANCE ,drug therapy ,Psychiatry and Mental health ,Tolerability ,Treatment-resistant ,Schizophrenia ,Drug Therapy, Combination ,Female ,Psychology ,Antipsychotic Agents ,medicine.drug - Abstract
This multisite study was conducted to compare the efficacy and tolerability of combination treatment with clozapine plus aripiprazole versus combination treatment with clozapine plus haloperidol in patients with schizophrenia who do not have an optimal response to clozapine. Patients continued to take clozapine and were randomly assigned to receive daily augmentation with aripiprazole or haloperidol. Physicians prescribed the allocated treatments according to usual clinical care. Withdrawal from allocated treatment within 3 months was the primary outcome. Secondary outcomes included severity of symptoms on the Brief Psychiatric Rating Scale and antipsychotic subjective tolerability on the Liverpool University Neuroleptic Side Effect Rating Scale. A total of 106 patients with schizophrenia were randomly assigned to treatment. After 3 months, we found no difference in the proportion of patients who discontinued treatment between the aripiprazole and haloperidol groups (13.2% vs 15.1%, P = 0.780). The 3-month change of the Brief Psychiatric Rating Scale total score was similar in the aripiprazole and haloperidol groups (-5.9 vs -4.4 points, P = 0.523), whereas the 3-month decrease of the Liverpool University Neuroleptic Side Effect Rating Scale total score was significantly higher in the aripiprazole group than in the haloperidol group (-7.4 vs -2.0 points, P = 0.006). These results suggest that augmentation of clozapine with aripiprazole offers no benefit with regard to treatment withdrawal and overall symptoms in schizophrenia compared with augmentation with haloperidol. However, an advantage in the perception of adverse effects with aripiprazole treatment may be meaningful for patients.
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- 2011
10. Angina pectoris: i dati della Medicina Generale italiana e le loro implicazioni per la pratica professionale
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Filippi, A, Pecchioli, S, Simonetti, M, Paolini, I, Mazzaglia, G, Filippi, A, Pecchioli, S, Simonetti, M, Paolini, I, and Mazzaglia, G
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Aderenza ,Angina ,Medicina Generale ,Cardiovascolare - Published
- 2010
11. Homecare for patients with heart failure in Italy
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Filippi, A., Sessa, E., Pecchioli, S., Trifirò, G., Samani, F., Giampiero Mazzaglia, Filippi, A, Sessa, E, Pecchioli, S, Trifirò, G, Samani, F, and Mazzaglia, G
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Aged, 80 and over ,Male ,Heart failure ,Homecare ,Italy ,Surveys and Questionnaires ,Humans ,Female ,Middle Aged ,Home Care Services ,Aged - Abstract
BACKGROUND; Heart failure (HF) represents an important health issue in western countries, especially for the elderly, frail population. A number of HF patients must usually be assisted at home. No information is available about the usual care of HF patients in Italy. The aim of this study was to describe the characteristics of HF patients receiving homecare in the Italian general practice. METHODS: A questionnaire was sent to 320 general practitioners (GPs) involved in the Health Search project. Among these, 148 (46.2%) answered and 376 home-ridden HF patients (60.3% women, median age 85 years) were identified. RESULTS: 257 (57%) patients were in NYHA class III or IV. Multiple relevant concomitant diseases occurred in 326 (86.7%) subjects. Only 140 (37.2%) patients were able to take their pills without any help; caregivers, mainly family members, were required 24 hours a day in 78.7% of cases. The length of homecare was > 1 year in 84.5% of cases. CONCLUSIONS: According to our data, thousands of HF patients are usually assisted at home for long periods in Italy. This is a very old group of subjects with heavy co-morbidity and a high need for continuous, prolonged assistance. Studies specifically aimed at the care of HF patients are needed.
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- 2005
12. Analisi delle prescrizioni di antibiotici per la cistite: uno studio retrospettivo dal database della Società Italiana di Medicina Generale
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Galatti L, Sessa A, Mazzaglia G, Pecchioli S, Rossi A, Schito GC, Nicoletti G, Caputi A, Cricelli C, Galatti, L, Sessa, A, Mazzaglia, G, Pecchioli, S, Rossi, A, Schito, G, Nicoletti, G, Caputi, A, and Cricelli, C
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Antibiotici, cistite, database, Medicina Generale - Published
- 2005
13. La creazione di un campione validato di medici di medicina generale nel database di Health Search
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Sessa, E, Samani, F, Niccolai, C, Pecchioli, S, Ventriglia, G, Mazzaglia, G, Sessa, E, Samani, F, Niccolai, C, Pecchioli, S, Ventriglia, G, and Mazzaglia, G
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database clinici ,validità ,medicina generale - Published
- 2004
14. Un’analisi sull’uso dei FANS in medicina generale nella banca dati Health Search della SIMG
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Mazzaglia G, Pecchioli S, Galatti L, Sessa E, Caputi AP, Mazzaglia, G, Pecchioli, S, Galatti, L, Sessa, E, and Caputi, A
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database clinici ,farmaci anti-infiammatori non steroidei ,medicina generale - Published
- 2004
15. Survey of viruses infecting a Lilium varietal collection in Tuscany
- Author
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Rizzo, D., Nesi, B. STEFANI L., Lazzereschi, S., Pecchioli, S., DELLA BARTOLA, Michele, Materazzi, Alberto, and Grassotti, A.
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- 2011
16. Occurence of Hydrangea ring spot virus in a Hydrangea varietal collection
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Rizzo, D., NESI B., STEFANI L., Antonetti, M., Lazzereschi, S., Pecchioli, S., DELLA BARTOLA, Michele, Materazzi, Alberto, and Grassotti, A.
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- 2011
17. Cryopreservation of shoot tips from dormant buds of Diospyros kaki by one-step vitrification
- Author
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Benelli C., Giordani E., De Carlo A., and Pecchioli S.
- Abstract
The safeguard genetic resources of persimmon in the Mediterranean basin is limited. Some European institutions have contributed, through EC GENRES29 Project 'Conservation of minor fruit tree species', to the safeguarding and conservation of a number of persimmon accessions collected in clonal orchards. Cryopreservation could be an advanced technique to reduce serious implications and risks in the management of germplasm collections and preserve Diospyros kaki cultivars. To optimize cryopreservation procedure for shoot tips from dormant buds of persimmon, mainly used in the Mediterranean area, several experiments were carried out by one-step vitrification method. Vegetative dormant buds were taken, during the winter, from twigs of persimmon cultivars ('Kaki Tipo', 'Jiro', 'Triumph', 'Hiratanenashi' and 'Rojo Brillante'). Shoot tips (2-3 mm) were dissected from sterilized buds and precultured on MS medium (modified with half-strength NH4NO3 and KNO3) with 0.3 M sucrose for 48h. To induce osmodehydration, the shoot tips were loaded in Plant Vitrification Solution 2 (PVS2), for different times (20 min in the first experiment; 30, 60, 90 min in the following experiments) and two treatment temperatures (0°C and 25°C). The explants were rapidly frozen to -196°C by direct immersion in liquid nitrogen (LN). For recovery, they were quickly rewarmed in a waterbath at 40°C for 1 min, then the shoot tips were transferred on the regrowth medium (MS modified with 0.06 M sucrose, 22.2 mM BA, 2 g/l gerlite) and maintained at 24°C with 16h photoperiod. Survival of cryopreserved shoot tips was assessed after 3 weeks. By applying a treatment with PVS2 for 20 min at 25°C on shoots tips from dormant buds, the survival rate observed in cv 'Triumph' (25%), 3 weeks after cryopreservation, is lower than those reported by Matsumoto et al. (2001). In a subsequent experiment on cv 'Kaki Tipo', where we applied a longer exposure time to PVS2, a higher shoot tip survival rate was obtained, in particular with PVS2 treatment for 90 min (73%). The same protocol applied on other cultivars confirmed the effectiveness of this vitrification procedure and with 90 min PVS2 treatment, the survival percentage in three cultivars ('Jiro', 'Triumph' and 'Rojo Brillante') was recorded between 56-80%. Whereas, in cv 'Hiratanenashi', the best survival (86%) was observed with 60 min PVS2 treatment before explant immersion in LN. Molecular assays were performed with fresh material, in vitro-cultured and cryopreserved shoots tips of three persimmon cultivars ('Kaki Tipo', 'Jiro', 'Triumph') in order to validate both the micropropagation procedure and the optimized cryopreservation technique. In our experiments, no morphological deviation was observed in the development of persimmon cryopreserved plantlets.
- Published
- 2009
18. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey
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Ballerini, Andrea, Boccalon, Roberto M., Boncompagni, Giancarlo, Casacchia, Massimo, Margari, Francesco, Minervini, Lina, Righi, Roberto, Russo, Federico, Salteri, Andrea, Frediani, Sonia, Rossi, Andrea, Scatigna, Marco, Barale, F., Bonzano, A., Scioli, R., Bellomo, A., De Giorgi, A., Cammeo, C., Cao, A., Zara, B., Conforti, I., Chillemi, C., Dagnino, L., Ponzoni, M., Della Pietra, F., Benettazzo, M., Esposito, V., Sposito, M., Fato, M., Signorello, G., Fiorenzoni, S., Singali, A., Margari, F., Sicolo, M., Martino, C., Leria, G., Tavoaccini, L., Nigro, G., Russo, V., La Roere, R., Righi, R., Mazzo, M., Rocchetti, R., De Martiis, L., Rodighiero, S., Morello, M., Vescera, M., Pisciotti, D. G., Villari, V., Barzegna, G., Annicchiarico, V., Cosmai, M. G., Rossi, G., Baraldi, E. C., Casacchia, M., Ruggiero, D., Galimberti, P., Fellini, F. A., Francobandiera, G., Gaspari, D., Turati, D., Matacchieri, B., Moscati, G., Mautone, A., DEL CASALE, Monia, Mellado, C., Scaramelli, B., Flilippo, A., Miccichè, M., Minervini, I., Banzato, C., Orengo, S., Alisio, G., Picci, R. L., Venturello, S., D'Aloise, A., Vaira, F., Boccalon, R. M., Cavrini, L., Cogrossi, S., Prato, K., Cremonese, C., Menardi, A., Parisi, M., Mentastro, C., Prosperini, P., Binda, V., Romano, G., Materzanini, A., Crudele, A., Stella, Giuseppe, Petio, C., Fuà, B., Laich, L., Miori, M., Salteri, A., Catania, G., Achena, M., Fara, F. M., Padoani, W., Compagno, S., Pecchioli, S., Moretti, S., Bacchi, L., Vicari, E., Arvizzigno, C., Minunni, P., Rossi, E., Zaiti, M. F., Boncompagni, G., Selleri, M. S., Minnai, G. P., Loche, A. P., Russo, FRANCESCA PAOLA, Antonucci, Annapaola, Chiurco, L., Amendola, R., De Giovanni, M. G., Martano, A., Borsetti, G., Santone, G., Pettolino, A. R., Lisanti, F., Parodi, A., Ciammella, L., Botto, G., Gillotta, S., Florio, G., Fiore, F., Santangelo, E., Fucci, G., Ricci, M., Ciaramella, A., Della Porta, A., Sittinieri, M., D'Asta, L., Triolo, S., Spatola, A., Frediani, S., Rossi, A., Macchi, S., Giovannini, L., Germani, S., Fabbri, Luigi, Fiori, G., Sala, S., Sgarbi, S., Simoni, L., and Zanoli, M.
- Subjects
life habits and psychiatric diagnoses ,Polypharmacy ,Pediatrics ,medicine.medical_specialty ,business.industry ,lcsh:RC435-571 ,psychiatric emergency ,epidemiology ,risk factors ,medicine.disease ,Psychiatry and Mental health ,Epidemiology of child psychiatric disorders ,Schizophrenia ,lcsh:Psychiatry ,Epidemiology ,medicine ,Observational study ,Medical prescription ,Primary Research ,business ,Psychiatry ,Geriatric psychiatry ,Depression (differential diagnoses) - Abstract
Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay. Conclusion Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.
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- 2007
19. Antibiotic and antifungal prescribing for mycosis: a four-year study from an Italian general practice database. Florence, October 2005, p. 113
- Author
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Galatti, L, Mazzaglia, G, Greco, A, Pecchioli, S, Rossi, A, Schito, Gc, Nicoletti, G, Spina, Edoardo, Caputi, Ap, and Cricelli, C.
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- 2005
20. Pharmacological Management of Gout in Italy in the Years 2005-2009: A Nationwide, Population-Based Study
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CARLOMAURIZIO MONTECUCCO, Mazzaglia, G., Caputi, A., Cricelli, C., Medea, G., Simonetti, M., Pecchioli, S., Ferrajolo, C., Morabito, P., Caporali, Roberto, Trifiro, Gianluca, Cavagna, Lorenzo, Cavagna, L, Trifiro, G, Caporali, R, Morabito, P, Ferrajolo, C, Pecchioli, S, Simonetti, M, Medea, G, Cricelli, C, Caputi, A, Mazzaglia, G, and Montecucco, C
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Gout/epidemiology ,Hyperuricemia/epidemiology ,Electronic Healthcare Database ,Primary care
21. Erratum to: Antibiotic use varies substantially among adults: a cross-national study from five European Countries in the ARITMO project
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Mor A, Frøslev T, Reimar Thomsen, Oteri A, Rijnbeek P, Schink T, Garbe E, Pecchioli S, Innocenti F, Bezemer I, Poluzzi E, Mc, Sturkenboom, Trifirò G, and Søgaard M
22. Vitrification/one-step freezing procedure for cryopreservation of persimmon dormant bud
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Carla Benelli, Carlo, A., Giordani, E., Pecchioli, S., Bellini, E., and Kochanova, Z.
23. Use of antihistamines and risk of ventricular tachyarrhythmia: a nested case-control study in five European countries from the ARITMO project
- Author
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Elisabetta Poluzzi, Gianluca Trifirò, Giuseppe Boriani, M. A. J. de Ridder, Serena Pecchioli, F. De Ponti, Ariola Koci, Irene D. Bezemer, Tania Schink, Alessandro Oteri, M. Clo, S. Pilgaard Ulrichsen, M C J M Sturkenboom, Igor Diemberger, Medical Informatics, Poluzzi, Elisabetta, Diemberger, I., De Ridder, M., Koci, A., Clo, M., Oteri, A., Pecchioli, S., Bezemer, I., Schink, T., Pilgaard Ulrichsen, S., Boriani, G., Sturkenboom, M. C. J., De Ponti, F., and Trifirã², G.
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Male ,Ebastine ,030204 cardiovascular system & hematology ,Loratadine ,Antihistamine ,Levocetirizine ,0302 clinical medicine ,Antihistamines ,Arrhythmia ,Case-control study ,Drug safety ,Healthcare databases ,Aged ,Case-Control Studies ,Europe ,Female ,Histamine Antagonists ,Humans ,Middle Aged ,Odds Ratio ,Risk ,Tachycardia, Ventricular ,Pharmacology ,Pharmacology (medical) ,Tachycardia ,Terfenadine ,DRUG ,Desloratadine ,General Medicine ,HYDROXYZINE ,SAFETY ,Anesthesia ,Cohort ,HEART ,medicine.drug ,medicine.medical_specialty ,Healthcare database ,03 medical and health sciences ,Internal medicine ,medicine ,INTERVAL ,business.industry ,Ventricular ,QT PROLONGATION ,Odds ratio ,Nested case-control study ,business ,030217 neurology & neurosurgery - Abstract
Purpose: After regulatory restrictions for terfenadine and astemizole in ‘90s, only scarce evidence on proarrhythmic potential of antihistamines has been published. We evaluate the risk of ventricular tachyarrhythmia (VA) related to the use of individual antihistamines. Methods: A matched case-control study nested in a cohort of new users of antihistamines was conducted within the EU-funded ARITMO project. Data on 1997–2010 were retrieved from seven healthcare databases: AARHUS (Denmark), GEPARD (Germany), HSD and ERD (Italy), PHARMO and IPCI (Netherlands) and THIN (UK). Cases of VA were selected and up to 100 controls were matched to each case. The odds ratio (OR) of current use for individual antihistamines (AHs) was estimated using conditional logistic regression. Results: For agents largely used to prevent allergic symptoms, such as cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine, we found no VA risk. A statistically significant, increased risk of VA was found only for current use of cyclizine in the pooled analysis (ORadj, 5.3; 3.6–7.6) and in THIN (ORadj, 5.3; 95% CI, 3.7–7.6), for dimetindene in GEPARD (ORadj, 3.9; 1.1–14.7) and for ebastine in GEPARD (ORadj, 3.3; 1.1–10.8) and PHARMO (ORadj, 4.6; 1.3–16.2). Conclusions: The risk of VA associated with a few specific antihistamines could be ascribable to heterogeneity in pattern of use or in receptor binding profile.
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- 2017
24. Risk of cardiac valvulopathy with use of bisphosphonates: a population-based, multi-country case-control study
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M. A. J. de Ridder, Gianluca Trifirò, Mees Mosseveld, Preciosa M. Coloma, Miriam C. J. M. Sturkenboom, Serena Pecchioli, Peter R. Rijnbeek, Rosa Gini, Rmc Herings, Irene D. Bezemer, J. van der Lei, Lorenza Scotti, Coloma, P, de Ridder, M, Bezemer, I, Herings, R, Gini, R, Pecchioli, S, Scotti, L, Rijnbeek, P, Mosseveld, M, van der Lei, J, Trifirò, G, Sturkenboom, M, Epidemiology and Data Science, Clinical pharmacology and pharmacy, and Medical Informatics
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Male ,Databases, Factual ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Osteoporosis ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Endocrinology ,0302 clinical medicine ,030212 general & internal medicine ,Healthcare data ,Netherlands ,Aged, 80 and over ,Bone Density Conservation Agents ,Diphosphonates ,Drug Substitution ,Confounding ,Bisphosphonates ,Middle Aged ,Diabetes and Metabolism ,Italy ,Female ,Original Article ,Risk assessment ,Drug-induced valvulopathy ,medicine.medical_specialty ,Cardiac valve disorders ,Cardiac valve regurgitation ,Drug-induced valvular heart disease ,Population based ,Risk Assessment ,Sensitivity and Specificity ,Drug Administration Schedule ,03 medical and health sciences ,Cardiac valve disorder ,Internal medicine ,medicine ,Humans ,Bisphosphonate ,Aged ,business.industry ,Case-control study ,medicine.disease ,United Kingdom ,Case-Control Studies ,business ,Multi country - Abstract
Summary Analyses of healthcare data from 30 million individuals in three countries showed that current use of bisphosphonates may be associated with a small increased risk of cardiac valvulopathy (vs. those not exposed within the previous year), although confounding cannot be entirely ruled out. The observed tendency for decreased valvulopathy risk with cumulative duration of bisphosphonate use >6 months may even indicate a protective effect with prolonged use. Further studies are still needed to evaluate whether bisphosphonates increase or decrease the risk of valvulopathy. Introduction A signal of cardiac valve disorders with use of bisphosphonates was identified in the literature and EudraVigilance database, which contains reports of suspected adverse drug reactions from worldwide sources. The aim of this study was to evaluate the association using population-based healthcare data. Methods This was a case-control study among users of bisphosphonates and other drugs for osteoporosis in six healthcare databases covering over 30 million individuals in Italy, Netherlands and the UK from 1996 to 2012. Prescriptions/dispensations were used to assess drug exposure. Newly diagnosed cases of cardiac valvulopathy were identified via disease codes/free-text search. Controls were matched to each case by age, sex, database and index date. Adjusted odds ratios (ORs) were estimated using conditional logistic regression for the pooled data and meta-analysis of individual database risk estimates. Results A small but statistically significant association was found between exposure to bisphosphonates as a class and risk of valvulopathy. Overall risk was 18 % higher (95 % CI 12–23 %) in those currently exposed to any bisphosphonate (mainly alendronate and risedronate) vs. those not exposed within the previous year. Risk of valve regurgitation was 14 % higher (95 % CI 7–22 %). Decreased valvulopathy risk was observed with longer cumulative duration of bisphosphonate use, compared to use of less than 6 months. Meta-analyses of database-specific estimates confirmed results from pooled analyses. Conclusions The observed increased risks of cardiac valvulopathy with bisphosphonate use, although statistically significant, were quite small and unlikely to be clinically significant. Further studies are still needed to evaluate whether bisphosphonates increase or decrease the risk of valvulopathy and to investigate possible mechanisms for the association. Electronic supplementary material The online version of this article (doi:10.1007/s00198-015-3441-2) contains supplementary material, which is available to authorized users.
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- 2016
25. Use of azithromycin and risk of ventricular arrhythmia
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Giampiero Mazzaglia, Miriam C. J. M. Sturkenboom, Igor Diemberger, Janet Sultana, Peter R. Rijnbeek, Gianluca Trifirò, Irene D. Bezemer, Maria A. J. de Ridder, Trine Frøslev, Mariam Molokhia, Serena Pecchioli, Tania Schink, Alessandro Oteri, Edeltraut Garbe, Elisabetta Poluzzi, Trifirò, G, de Ridder, M, Sultana, J, Oteri, A, Rijnbeek, P, Pecchioli, S, Mazzaglia, G, Bezemer, I, Garbe, E, Schink, T, Poluzzi, E, Frøslev, T, Molokhia, M, Diemberger, I, Sturkenboom, M, Trifirò, Gianluca, De Ridder, Maria, Sultana, Janet, Oteri, Alessandro, Rijnbeek, Peter, Pecchioli, Serena, Mazzaglia, Giampiero, Bezemer, Irene, Garbe, Edeltraut, Schink, Tania, Poluzzi, Elisabetta, Frøslev, Trine, Molokhia, Mariam, Diemberger, Igor, Sturkenboom, Miriam C.J.M., and Medical Informatics
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Male ,TORSADE-DE-POINTES, QT-INTERVAL PROLONGATION, HEALTH-CARE DATABASES, PRECIPITATING FACTORS, CARDIAC-ARRHYTHMIA, ORAL ERYTHROMYCIN, DEATH, EVENTS, EXPERIENCE, MORTALITY ,TORSADE-DE-POINTES ,CARDIAC-ARRHYTHMIA ,Azithromycin ,030204 cardiovascular system & hematology ,Azithromycin/adverse effects ,0302 clinical medicine ,Risk Factors ,QT-INTERVAL PROLONGATION ,030212 general & internal medicine ,HEALTH-CARE DATABASES ,Aged, 80 and over ,education.field_of_study ,Medicine (all) ,Confounding ,PRECIPITATING FACTORS ,DEATH ,General Medicine ,Middle Aged ,Anti-Bacterial Agents ,3. Good health ,Cohort ,Female ,Case-Control Studie ,Human ,medicine.drug ,medicine.medical_specialty ,Population ,EVENTS ,03 medical and health sciences ,Amoxicillin/adverse effect ,Internal medicine ,Anti-Bacterial Agent ,medicine ,Humans ,education ,Amoxicillin/adverse effects ,Aged ,Arrhythmias, Cardiac/chemically induced ,ORAL ERYTHROMYCIN ,business.industry ,Research ,Risk Factor ,MORTALITY ,Case-control study ,Amoxicillin ,Arrhythmias, Cardiac ,Odds ratio ,Anti-Bacterial Agents/adverse effects ,Confidence interval ,Case-Control Studies ,EXPERIENCE ,business - Abstract
BACKGROUND: There are conflicting findings from observational studies of the arrhythrogenic potential of azithromycin. Our aim was to quantify the association between azithromycin use and the risk of ventricular arrhythmia.METHODS: We conducted a nested case-control study within a cohort of new antibiotic users identified from a network of 7 population-based health care databases in Denmark, Germany, Italy, the Netherlands and the United Kingdom for the period 1997-2010. Up to 100 controls per case were selected and matched by age, sex and database. Recency of antibiotic use and type of drug (azithromycin was the exposure of interest) at the index date (occurrence of ventricular arrhythmia) were identified. We estimated the odds of ventricular arrhythmia associated with current azithromycin use relative to current amoxicillin use or nonuse of antibiotics (≥ 365 d without antibiotic exposure) using conditional logistic regression, adjusting for confounders.RESULTS: We identified 14 040 688 new antibiotic users who met the inclusion criteria. Ventricular arrhythmia developed in 12 874, of whom 30 were current azithromycin users. The mean age of the cases and controls was 63 years, and two-thirds were male. In the pooled data analyses across databases, azithromycin use was associated with an increased risk of ventricular arrhythmia relative to nonuse of antibiotics (adjusted odds ratio [OR] 1.97, 95% confidence interval [CI] 1.35-2.86). This increased risk disappeared when current amoxicillin use was the comparator (adjusted OR 0.90, 95% CI 0.48-1.71). Database-specific estimates and meta-analysis confirmed results from the pooled data analysis.INTERPRETATION: Current azithromycin use was associated with an increased risk of ventricular arrhythmia when compared with nonuse of antibiotics, but not when compared with current amoxicillin use. The decreased risk with an active comparator suggests significant confounding by indication.
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- 2017
26. Prescribing pattern of antipsychotic drugs during the years 1996-2010:A population-based database study in Europe with a focus on torsadogenic drugs
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Oteri, Alessandro, Mazzaglia, Giampiero, Pecchioli, Serena, Molokhia, Mariam, Ulrichsen, Sinna Pilgaard, Pedersen, Lars, Poluzzi, Elisabetta, De Ponti, Fabrizio, Garbe, Edeltraut, Schink, Tania, Herings, Ron, Bezemer, Irene D., Sturkenboom, Miriam C. J. M., Trifiro', Gianluca, Oteri, A, Mazzaglia, G, Pecchioli, S, Molokhia, M, Ulrichsen, S, Pedersen, L, Poluzzi, E, De Ponti, F, Garbe, E, Schink, T, Herings, R, Bezemer, I, Sturkenboom, M, Trifiro, G, Oteri, Alessandro, Mazzaglia, Giampiero, Pecchioli, Serena, Molokhia, Mariam, Ulrichsen, Sinna Pilgaard, Pedersen, Lar, Poluzzi, Elisabetta, De Ponti, Fabrizio, Garbe, Edeltraut, Schink, Tania, Herings, Ron, Bezemer, Irene D., Sturkenboom, Miriam C. J. M., Trifirò, Gianluca, and Medical Informatics
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Pharmacology ,Antipsychotic drugs, Population-based study, Torsadogenic potential, Pharmacology (medical), Pharmacology ,musculoskeletal, neural, and ocular physiology ,Journal Article ,cardiovascular system ,Pharmacology (medical) ,Antipsychotic drugs ,Torsadogenic potential ,antipsychotic drug ,Population-based study - Abstract
INTRODUCTION: Antipsychotic drugs (APDs) are used to treat several mental illnesses. Some APDs have long been known to be associated with QT prolongation, potentially leading to torsades de pointes (TdP) and sudden cardiac death (SCD). In 2005, thioridazine was withdrawn because of the risk of SCD, bringing further attention to the arrhythmogenic potential of APDs.AIM: The aim of the current study was to evaluate the use of APDs in five European countries during the years 1996-2010.METHODS: A cohort study was conducted using prescription/dispensing data from seven healthcare databases [the AARHUS University Hospital Database (Denmark), the German Pharmacoepidemiological Research Database (GePaRD) (Germany), Health Search Database/Thales (HSD) and Emilia Romagna Regional Database (ERD) (Italy), PHARMO Database Network and Integrated Primary Care Information (IPCI) (the Netherlands) and The Health Improvement Network (THIN) (the UK), covering a population of 27 million individuals. The annual prescription rate of APDs was measured overall and for individual medications. APDs were classified as torsadogenic according to the Arizona-CERT list. All analyses were stratified by age, gender and calendar year.RESULTS: A total of 559 276 person-years (PYs) of exposure to APDs was captured. The crude annual prescription rate of APD use ranged from 3.0/1000 PYs in ERD to 7.7/1000 PYs in AARHUS. Among APDs with established torsadogenic potential, thioridazine was the most frequently used medication in the UK. Haloperidol was commonly prescribed in Italy and the Netherlands. The use of APDs with torsadogenic potential was much higher in elderly patients.CONCLUSIONS: Substantial use of APDs with torsadogenic potential has been reported in Europe in recent years, in spite of increasing concerns about their arrhythmogenic potential. This use was even greater in elderly patients, who are at higher risk of SCD.
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- 2016
27. Venous thromboembolism in medical patients treated in the setting of primary care: A nationwide case-control study in Italy
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Claudio Cricelli, Giampiero Mazzaglia, Alessandro Filippi, Serena Pecchioli, Claudio Cimminiello, G. Arpaia, Cimminiello, C, Filippi, A, Mazzaglia, G, Pecchioli, S, Arpaia, G, and Cricelli, C
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Medical disease ,Adult ,Male ,medicine.medical_specialty ,Population ,Disease ,Deep vein thrombosi ,Risk Factors ,Internal medicine ,medicine ,Humans ,Intensive care medicine ,education ,Stroke ,Aged ,Retrospective Studies ,Univariate analysis ,education.field_of_study ,COPD ,Primary Health Care ,business.industry ,Pulmonary embolism ,Case-control study ,Venous Thromboembolism ,Hematology ,Case-control ,Middle Aged ,Primary care ,medicine.disease ,Venous thrombosis ,Italy ,Case-Control Studies ,Female ,business - Abstract
Objectives: The risk of venous thrombotic events (VTE) among medical outpatients is still not clear and it remains to be clarified whether medical diseases involve the same risk if managed at home or in hospital. The aim of this study was to evaluate in the setting of outpatient family medicine the relationship between VTE and medical conditions known to be at risk during a hospital stay. Design and setting: The study involved a nationwide retrospective observation according to a nested case-control method; 400 general practitioners throughout Italy constituted the network for data collection. Between 2001 and 2004, all cases recorded as having VTE were entered; ten control patients without VTE, matched by sex, physician, and age, were selected from the database for each case. Results: The eligible population comprised 372,000 patients and 1,624 incident VTE were recorded. Univariate analysis indicated hospitalization (OR 5.02; 95% CI 4.01-6.29), cancer (OR 3.06; 95% CI 2.47-3.79), acute infectious disease (OR 2.93; 95% CI 1.94-4.43), neurological disease (OR 2.60; 95% CI 1.56-4.33), congestive heart failure (CHF) (OR 2.48; 95% CI 1.68-3.69), paralysis (OR 1.87; 95% CI 1.51-2.32), COPD (OR 1.58; 95% CI 1.29-1.95), stroke (OR 1.62; 95% CI 1.24-2.12), superficial venous thrombosis (OR 1.51; 95% CI 1.11-2.04, and rheumatic diseases (OR 1.49; 95% CI 1.28-1.74) as significantly associated with an increased risk for VTE. After adjustment, only transient or definitive paralysis, cancer, acute infectious disease, congestive heart failure, neurological diseases, and previous hospitalization remained associated. Conclusions: This large study indicates that VTE outpatients seen by general practitioners in Italy have a high prevalence of the same medical diseases associated with VTE among patients treated in hospital. (C) 2010 Elsevier Ltd. All rights reserved.
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- 2010
28. Pharmacological treatment after acute myocardial infarction from 2001 to 2006: a survey in Italian primary care
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Serena Pecchioli, Claudio Cricelli, Saffi Ettore Giustini, Gaetano D'Ambrosio, Alessandro Filippi, Giampiero Mazzaglia, Filippi, A, D'Ambrosio, G, Giustini, S, Pecchioli, S, Mazzaglia, G, and Cricelli, C
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Male ,Time Factors ,Follow-Up ,Myocardial Infarction ,Angiotensin-Converting Enzyme Inhibitors ,Cohort Studies ,Antithrombotic ,Secondary Prevention ,Myocardial infarction ,Practice Patterns, Physicians' ,Aged, 80 and over ,Aspirin ,education.field_of_study ,General Medicine ,Middle Aged ,Converting Enzyme-Inhibitor ,Treatment Outcome ,Databases as Topic ,Italy ,Beta-Blocker ,Practice Guidelines as Topic ,Female ,Guideline Adherence ,Cardiology and Cardiovascular Medicine ,Cohort study ,medicine.drug ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Population ,Drug-Use ,Drug Prescriptions ,Fibrinolytic Agents ,Internal medicine ,Vascular-Disease ,medicine ,Humans ,cardiovascular diseases ,Acute Coronary Syndrome ,Medical prescription ,education ,Aged ,Primary Health Care ,business.industry ,Warfarin ,Cardiovascular Agents ,Retrospective cohort study ,medicine.disease ,Drug Utilization ,Retrospective Cohort ,Adherence ,Health Care Surveys ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Angiotensin II Type 1 Receptor Blockers ,Medical Therapy - Abstract
Background Pharmacological preventive therapy after acute myocardial infarction (AMI) is strictly recommended because of its great efficacy. Little is known about long-term utilization of drugs related to cardiovascular secondary prevention in everyday practice. Design A population-based cohort study on the basis of an Italian general practice database. Methods Searching a large primary-care Italian database (Health Search), we selected five cohorts of patients with first occurrence of AMI from 2001 to 2005, respectively, and analyzed prescriptions of antithrombotic agents, beta-blockers, statins and angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) from 2001 to 2006 (follow-up ranging from 1 to 5 years). Results We identified 4764 patients (mean age 67; 35% female) discharged from hospital after first-ever AMI The prescription rate in the first year after AMI was suboptimal (beta-blockers 35.1%, aspirin or warfarin 75.0%,ACE-inhibitors or ARBs 61.6%, statins 52.8%) but showed a continuous improvement from 2001 to 2005. The prescription rate decreased slightly during the follow-up, but showed a complex pattern with a variable but significant number of patients discontinuing or resuming the therapy. Conclusions The prescription of recommended drugs after AMI has increased from 2001 to 2006 in Italy, but the prescription rate remains largely unsatisfactory. Therapeutic continuity is also suboptimal. J Cardiovasc Med 10:714-718 (C) 2009 Italian Federation of Cardiology.
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- 2009
29. Global cardiovascular risk evaluation: pattern of algorithm use and risk modification in 'real life'
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Emiliano Sessa, Giampiero Mazzaglia, Francesco Lapi, Roberto Marchioli, Claudio Cricelli, Ovidio Brignoli, Luigi Palmieri, Simona Giampaoli, Alessandro Filippi, Monica Simonetti, Serena Pecchioli, Filippi, A, Giampaoli, S, Lapi, F, Mazzaglia, G, Palmieri, L, Pecchioli, S, Brignoli, O, Cricelli, C, Simonetti, M, Sessa, E, and Marchioli, R
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Male ,Databases, Factual ,clinical-practice ,Blood Pressure ,030204 cardiovascular system & hematology ,information ,chemistry.chemical_compound ,0302 clinical medicine ,High-density lipoprotein ,Risk Factors ,Medicine ,030212 general & internal medicine ,database ,education.field_of_study ,primary-care ,disease prevention ,General Medicine ,Middle Aged ,Clinical Practice ,Italy ,Cardiovascular Diseases ,barrier ,progetto-cuore ,Female ,Cardiology and Cardiovascular Medicine ,europe ,Algorithm ,guideline ,Algorithms ,Adult ,Population ,heart ,Risk Assessment ,03 medical and health sciences ,In real life ,Humans ,Clinical database ,global cardiovascular risk ,education ,Exercise ,Triglycerides ,Aged ,Creatinine ,Cholesterol ,business.industry ,Cholesterol, HDL ,Risk evaluation ,Blood pressure ,chemistry ,general practitioner ,business - Abstract
AIMS Although calculation of the global cardiovascular risk is strongly recommended, limited data are available regarding the use and the utility of this tool in clinical practice. We aimed at answering the following questions in the setting of Italian general practice: how many patients are evaluated via the cardiovascular risk algorithm; what are their characteristics; and what happens after their evaluation. METHODS We used the Health Search/CSD Longitudinal Patient Database. The software used by about 800 participating GPs allows the calculation of the global cardiovascular risk in automatic. The following data were yearly extracted from the database within 2004-2008: age, sex, and recorded diagnosis of the main cardiovascular and other information encompassing smoking habits, blood pressure, total cholesterol, high density lipoprotein cholesterol (i.e., variables used to calculate cardiovascular risk), BMI, physical activity, triglycerides, glucose and creatinine; wherever available, current cardiovascular therapy and the automatically computed global cardiovascular risk were also extracted. RESULTS In 2008, the observed population, aged 35-69 years, numbered 438 922 individuals; 78 617 (17.9%) had at least one calculation of cardiovascular risk; 20 181 patients were re-evaluated at least once: 61.1% among high-risk patients, 43.8% among moderate-risk patients, and 27.2% among low-risk patients. The level of cardiovascular risk measured at baseline increased in 6863 (34%), decreased in 11 791 (58.4%), and did not change in 1527 (7.6%) individuals. Overall, mean cardiovascular risk decreased over 4 years in 2.25% (SD 6.41%; P
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- 2014
30. Risk of ESRD and death in patients with CKD not referred to a nephrologist: a 7-year prospective study
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Luca De Nicola, Claudio Cricelli, Gaetano Piccinocchi, Monica Simonetti, Roberto Minutolo, Giuseppe Conte, Serena Pecchioli, Paolo Chiodini, Iacopo Cricelli, Francesco Lapi, Elisa Bianchini, Minutolo, Roberto, Lapi, Chiodini, Paolo, Simonetti, M, Bianchini, E, Pecchioli, S, Cricelli, I, Cricelli, C, Piccinocchi, G, Conte, Giuseppe, and DE NICOLA, Luca
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Male ,medicine.medical_specialty ,Time Factors ,Epidemiology ,Critical Care and Intensive Care Medicine ,urologic and male genital diseases ,Risk Assessment ,Interquartile range ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Renal Insufficiency, Chronic ,Intensive care medicine ,Prospective cohort study ,Referral and Consultation ,Aged ,Transplantation ,business.industry ,Hazard ratio ,Original Articles ,Middle Aged ,medicine.disease ,Confidence interval ,female genital diseases and pregnancy complications ,Nephrology ,Disease Progression ,Albuminuria ,Kidney Failure, Chronic ,Female ,medicine.symptom ,Risk assessment ,business ,Dyslipidemia ,Kidney disease - Abstract
Background and objectives Rising prevalence of CKD requires active involvement of general practitioners to limit ESRD and mortality risk. However, the outcomes of patients with CKD exclusively managed by general practitioners are ill defined. Design, setting, participants, & measurements We prospectively evaluated 30,326 adult patients with nondialysis CKD stages 1-5 who had never received consultation in tertiary nephrology care recruited from 700 general practitioner offices in Italy during 2002 and 2003. CKD stages were classified as stages 1 and 2 (GFR >= 60 ml/min per 1.73 m(2) and either albuminuria or an International Classification of Diseases, Ninth Revision, Clinical Modification code for kidney disease), stage 3a (GFR=59-45), stage 3b (GFR=44-30), stage 4 (GFR=29-15), and stage 5 (GFR
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- 2014
31. Epidemiology of gout and hyperuricaemia in Italy during the years 2005-2009: a nationwide population-based study
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Carmen Ferrajolo, Gerardo Medea, Paolo Morabito, Elisa Bianchini, Claudio Cricelli, Achille P. Caputi, Monica Simonetti, Gianluca Trifirò, Serena Pecchioli, Lorenzo Cavagna, Giampiero Mazzaglia, Medical Informatics, Trifirã², Gianluca, Morabito, Paolo, Cavagna, Lorenzo, Ferrajolo, Carmen, Pecchioli, Serena, Simonetti, Monica, Bianchini, Elisa, Medea, Gerardo, Cricelli, Claudio, Caputi, Achille P, Mazzaglia, Giampiero, Trifiro, G, Morabito, P, Cavagna, L, Ferrajolo, C, Pecchioli, S, Simonetti, M, Bianchini, E, Medea, G, Cricelli, C, Caputi, A, and Mazzaglia, G
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Male ,Databases, Factual ,Gout ,Longitudinal Studie ,chemistry.chemical_compound ,Recurrence ,Risk Factors ,Epidemiology ,Prevalence ,Immunology and Allergy ,Longitudinal Studies ,Young adult ,First episode ,Aged, 80 and over ,education.field_of_study ,Incidence (epidemiology) ,Incidence ,Middle Aged ,Hypertensive Patient ,Italy ,epidemiology ,Female ,medicine.symptom ,New-Zealand ,Human ,musculoskeletal diseases ,Adult ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Uric-Acid ,Adolescent ,Pacific Island ,Population ,Immunology ,Hyperuricemia ,Asymptomatic ,General Biochemistry, Genetics and Molecular Biology ,Young Adult ,Age Distribution ,Rheumatology ,Internal medicine ,hyperuricaemia ,medicine ,Primary-Care ,Humans ,Sex Distribution ,education ,Aged ,epidemiology, hyperuricaemia, gout ,Biochemistry, Genetics and Molecular Biology (all) ,Primary Health Care ,business.industry ,Risk Factor ,Nutrition Examination Survey ,nutritional and metabolic diseases ,medicine.disease ,General-Population ,Surgery ,chemistry ,Uric acid ,Soft Drink ,business ,Control Sample Set - Abstract
Objective To assess the epidemiology of gout and hyperuricaemia in the Italian general population during the years 2005–2009. Methods Using the Italian primary care database (Health Search/CSD Longitudinal Patient Database), the prevalence, incidence and recurrence rates of gout and/or hyperuricaemia (serum urate level >360 mmol/l (6 mg/dl)) in outpatients aged ≥18 years during the years 2005–2009 were estimated. Rates together with 95% CI were measured overall and stratified by age, gender and calendar year. The characteristics of patients with newly diagnosed gout and hyperuricaemia were investigated and compared with the general population. Results The prevalence of gout increased from 6.7 per 1000 inhabitants in 2005 to 9.1 per 1000 inhabitants in 2009. It increased with advancing age and was fourfold higher in men. A similar trend was observed for asymptomatic hyperuricaemia (85.4 per 1000 inhabitants in 2005 vs 119.3 per 1000 inhabitants in 2009). The incidence of gout remained stable during the observation years (0.93 per 1000 person years in 2005 vs 0.95 in 2009). Recurrent episode rate was 19.1% during the first year following the first gout attack and 31.6% during the following 5 years. Advanced age, increased levels of uric acid, nephrolithiasis and concomitant use of ciclosporin were the main predictors of recurrence of gout attacks. Conclusion The prevalence of gout and hyperuricaemia increased in Italy from 2005 to 2009. A high recurrence rate for gout attack was observed during the first year following the first episode. Early management of hyperuricaemia in patients at higher risk of recurrent gout attack should be considered in primary care.
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- 2012
32. Opportunistic prostate-specific antigen screening in Italy: 6 years of monitoring from the Italian general practice database
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Giampiero Mazzaglia, Salvatore Campo, Maurizio Cancian, Serena Pecchioli, Gaetano D'Ambrosio, D'Ambrosio, G, Campo, S, Cancian, M, Pecchioli, S, and Mazzaglia, G
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Adult ,Male ,mass screening ,Cancer Research ,medicine.medical_specialty ,family ,Databases, Factual ,General Practice ,Disease ,family practice ,prostatic neoplasms/epidemiology ,urban population/statistics and numerical data ,Prostate cancer ,primary care ,Prostate ,Internal medicine ,Epidemiology ,medicine ,Humans ,prostate-specific antigen ,Longitudinal Studies ,Practice Patterns, Physicians' ,Medical prescription ,Mass screening ,Aged ,Aged, 80 and over ,Gynecology ,physician ,business.industry ,Age Factors ,Public Health, Environmental and Occupational Health ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Confidence interval ,Prostate-specific antigen ,medicine.anatomical_structure ,Italy ,Oncology ,Health Care Surveys ,Computer network management ,epidemiology ,business ,prostatic neoplasms/diagnosi - Abstract
The practice of prostate-specific antigen (PSA) screening has been increasing in Italy despite uncertain scientific evidence and contrary recommendations from most scientific societies. In 2002, a survey of PSA screening diffusion among general practices was performed, looking for screening frequency and age pattern of screened individuals. The objective of this study was to assess whether the features of PSA screening did change after 6 years in the same considered setting. Using the data obtained from 500 Italian general practitioners providing information to the Health Search/CSD Patient database, we selected, for the study purpose 351 091 male individuals. We assumed PSA prescriptions performed during 2005-2008 in individuals without prostate cancer, or benign prostate disease, or urological symptoms history to have a screening purpose. Screening frequency was analyzed in the overall series, by year and by patient's age. Exposure to PSA screening (at least on PSA test in the considered period) of males aged over 50 years raised from 31.4% (confidence interval 95% 31.08-31.70%) during 2002 to 46.4% (confidence interval 95% 46.19-46.68%) during 2008. The highest yearly exposure to PSA screening (55%) and the highest frequency of repeat testing was observed in the 70-79 age range. PSA screening practice has continued to increase in Italy and is often performed in elderly people without any scientific rationale. European Journal of Cancer Prevention 19: 413-416 (c) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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- 2010
33. Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia
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Paola Colombo, Luisa Ciammella, Giancarlo Giupponi, Francesco Barale, Luigi Grassi, Giorgio Di Lorenzo, Maria Frova, Michela Nosè, Gualtiero Guerrini, Liliana Cascone, Francesco Pontarollo, Rodolfo Tomasi, Alfredo Bisogno, Francesca Sartore, Guglielmo Occhionero, Claudio Santilli, Andrea Giambartolomei, Tiziana Sciarma, Marco Menchetti, Matteo Rossattini, Giuseppe Saraò, Farida Ferrato, Gabriele Cipresso, Alessandra Marsilio, Simone Accordini, Anna Maria Pacilli, Francesco Laddomada, Marianna Boso, Giuseppe Migliorini, Lara Malvini, Camilla Lintas, Antonio Ferro, Alessia Cicolini, Luciana Rillosi, Annamarie Tasser, Alberto Siracusano, Mauro Percudani, Roberto Quartesan, Nicoletta Fragomeno, Nicola Garzotto, Flavio Nosè, Corrado Barbui, Raffaella Bivi, Antonio Mautone, Rossella Beneduce, Gerardo Bertolazzi, Andrea Cipriani, Eleonora Esposito, Alberto Bozzani, Stylianos Nicholau, Barbara Dal Santo, Antonio Veronese, Gino Targa, Rossana Travaglini, Ermanna Lazzarin, Francesco Gardellin, Luigi Ferrannini, Stefania Roma, Giuseppe Rossi, Giovanni Rossi, Alessandra Sala, Bruno Biancosino, Massimo Carlo Mauri, Simona Ziero, Domenico Berardi, Roger Pycha, Walter Di Munzio, Serena Mulè, Michele De Francesco, Filippo Bogetto, Arcadio Erlicher, Carlo Piazza, Francesco Risso, Stefania Strizzolo, Marcello Casale, Vincenzo Fricchione Parise, Lorella Grecu, Silvio Scarone, Paola Artioli, Giuseppe Ducci, Raffella Rizzo, Michele Tansella, Natalia Grazian, Livio Marchiaro, Daniele Moretti, Marco Mollica, Paola Rocca, Piera Bucolo, Antonio Sarnicola, Stefania Pecchioli, Ennio Piantato, Francesca Malchiodi, Nosè M, Accordini S, Artioli P, Barale F, Barbui C, Beneduce R, Berardi D, Bertolazzi G, Biancosino B, Bisogno A, Bivi R, Bogetto F, Boso M, Bozzani A, Bucolo P, Casale M, Cascone L, Ciammella L, Cicolini A, Cipresso G, Cipriani A, Colombo P, Dal Santo B, De Francesco M, Di Lorenzo G, Di Munzio W, Ducci G, Erlicher A, Esposito E, Ferrannini L, Ferrato F, Ferro A, Fragomeno N, Parise VF, Frova M, Gardellin F, Garzotto N, Giambartolomei A, Giupponi G, Grassi L, Grazian N, Grecu L, Guerrini G, Laddomada F, Lazzarin E, Lintas C, Malchiodi F, Malvini L, Marchiaro L, Marsilio A, Mauri MC, Mautone A, Menchetti M, Migliorini G, Mollica M, Moretti D, Mulè S, Nicholau S, Nosè F, Occhionero G, Pacilli AM, Pecchioli S, Percudani M, Piantato E, Piazza C, Pontarollo F, Pycha R, Quartesan R, Rillosi L, Risso F, Rizzo R, Rocca P, Roma S, Rossattini M, Rossi G, Sala A, Santilli C, Saraò G, Sarnicola A, Sartore F, Scarone S, Sciarma T, Siracusano A, Strizzolo S, Tansella M, Targa G, Tasser A, Tomasi R, Travaglini R, Veronese A, and Ziero S.
- Subjects
REFRACTORY SCHIZOPHRENIA ,Schizophrenia ,treatment-resistance ,antipsychotics ,medicine.medical_treatment ,Aripiprazole ,piperazines ,Medicine (miscellaneous) ,Antipsychotic Agents ,Clinical Protocols ,Clozapine ,Drug Therapy, Combination ,Government Regulation ,Haloperidol ,Humans ,Italy ,Piperazines ,Prospective Studies ,Quinolones ,Research Design ,Treatment Outcome ,Drug Resistance ,Schizophrenic Psychology ,law.invention ,haloperidol ,Study Protocol ,DOUBLE-BLIND ,Randomized controlled trial ,law ,Pharmacology (medical) ,schizophrenic psychology ,humans ,antipsychotic agents, clinical protocols, clozapine, drug resistance, drug therapy, combination, government regulation, haloperidol, humans, Italy, piperazines, prospective studies, quinolones, research design, schizophrenia, schizophrenic psychology, treatment outcome ,lcsh:R5-920 ,treatment-resistant schizophrenia ,aripiprazole ,clozapine ,ANTIPSYCHOTIC DRUGS ,PRAGMATIC TRIALS ,CLINICAL TRIALS ,AUGMENTATION ,METAANALYSIS ,government regulation ,antipsychotic agents ,research design ,drug therapy ,lcsh:Medicine (General) ,medicine.drug ,medicine.medical_specialty ,Context (language use) ,medicine ,clinical protocols ,Antipsychotic ,Psychiatry ,Settore MED/25 - Psichiatria ,Polypharmacy ,combination ,drug resistance ,business.industry ,medicine.disease ,prospective studies ,Clinical trial ,schizophrenia ,treatment outcome ,quinolones ,business - Abstract
Background One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study. Methods/Design The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome. Discussion The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia. Trial Registration Clincaltrials.gov Identifier: NCT00395915
- Published
- 2009
34. Out of hospital sudden cardiac death in Italy: a population-based case-control study
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Rachele Capocchi, Claudio Cricelli, Francesca Caprari, Alessandro Filippi, Giampiero Mazzaglia, Emiliano Sessa, A. Scivales, Serena Pecchioli, Filippi, A, Sessa, E, Mazzaglia, G, Pecchioli, S, Capocchi, R, Caprari, F, Scivales, A, and Cricelli, C
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Population ,Alcohol abuse ,Coronary Disease ,sudden cardiac death ,Sudden cardiac death ,Risk Factors ,Internal medicine ,Surveys and Questionnaires ,medicine ,Humans ,cardiovascular diseases ,Obesity ,Family history ,education ,Cause of death ,Aged ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Case-control study ,Arrhythmias, Cardiac ,General Medicine ,Middle Aged ,medicine.disease ,Alcoholism ,Death, Sudden, Cardiac ,Italy ,Case-Control Studies ,Multivariate Analysis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Family Practice - Abstract
BACKGROUND Sudden cardiac death (SCD) is a major cause of death in western countries, with coronary heart disease (CHD) being the basis of over 70% of SCD. Incidence in high-CHD risk countries has already been studied, but this information is not available for Mediterranean low-CHD risk countries. Incidence is of paramount importance when cost-effectiveness rate of actions against SCD must be estimated. METHODS We estimated the incidence of SCD and its potential risk associated with clinical variables, by a means of a case-control study in a general practice setting. The enrolled general practitioners (GPs) provided data about the total number of their patients, and identified all their patients who suffered an out-of-hospital SCD during the previous 365 days. Two age-matched and gender-matched controls visiting GPs office after the SCD selection were also selected. We used a structured questionnaire to obtain information about potential risk factors for SCD. Covariates that were univariately associated with SCD were included in the multivariate regression analyses. RESULTS In a population of 297 340 (age greater than 14 years), a total of 230 cases were identified (0.77 per 1000 individuals), mostly occurring at home and among persons with known high cardiovascular risk. In the multivariate analysis only CHD (OR: 1.67; 95% CI: 1.09-2.58), arrhythmia (OR: 2.2; 95% CI: 1.3-3.9), obesity (OR: 2.3; 95% CI: 1.5-3.6), alcohol abuse (OR: 1.8; 95% CI: 1.2-2.7), and family history of CHD (OR 3.1; 95% CI: 1.8-5.3) resulted in a significant association with SCD. CONCLUSIONS The incidence of SCD in Italy is lower than that reported in high-CHD risk population, most of the cases occurring at home and among persons with known high cardiovascular risk. Implementing recommendations for these patients seems to be the most effective strategy to reduce the incidence of SCD.
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- 2008
35. Antibiotic prescribing for acute and recurrent cystitis in primary care: a 4 year descriptive study
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Aurelio Sessa, Achille P. Caputi, Claudio Cricelli, Giuseppe Nicoletti, Gian Carlo Schito, Giampiero Mazzaglia, Serena Pecchioli, Alessandro Rossi, Laura Galatti, Galatti, L, Sessa, A, Mazzaglia, G, Pecchioli, S, Rossi, A, Cricelli, C, Schito, G, Nicoletti, G, and Caputi, A
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Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Antibiotics ,Fosfomycin ,Drug Prescriptions ,Antibiotic prescribing ,Recurrence ,Risk Factors ,Internal medicine ,Cystitis ,medicine ,Humans ,Pharmacology (medical) ,Acute Cystitis ,Practice Patterns, Physicians' ,Medical prescription ,Intensive care medicine ,Aged ,Retrospective Studies ,Antibacterial agent ,Pharmacology ,general practice ,prescribing practice ,business.industry ,Middle Aged ,Drug Utilization ,Anti-Bacterial Agents ,Infectious Diseases ,Acute Disease ,General practice ,Recurrent cystitis ,Female ,Family Practice ,business ,urinary tract infection ,medicine.drug - Abstract
Objectives: To explore the antibiotic prescribing pattern for cystitis and the patient-related variables associated with prescription during a 4 year period among Italian general practitioners (GPs). Methods: We obtained information from the 'Health Search Database' (HSD), an Italian general practice research database. From a total sample of 457 672 eligible patients aged > 16 years registered up to December 2002, we included those whose diagnoses could be classified as acute (uncomplicated and complicated) and recurrent cystitis. Patients' features and prevalence of antibiotic users were assessed. Results: Of 35 129 cases diagnosed during the period 1999-2002, 96.0% of them were acute cystitis (39.2% recorded as uncomplicated). The prevalence of cases with acute complicated and uncomplicated cystitis slightly increased during the 4 year period, whereas it remained stable for recurrent cystitis. Most of the cystitis cases reported no diagnostic tests. More than 70% of patients were prescribed with at least one antibiotic, with a 4-fold increased risk of antibiotic use for acute cystitis throughout the study period. The prevalence of antibiotic users reached 86.2% for both acute uncomplicated and complicated cystitis in 2002, and 81.5% for recurrent cystitis. Fluoroquinolones represented the most common antibiotics being prescribed although they markedly decreased during these years. Fosfomycin trometamol use increased dramatically, becoming the first choice for any type of cystitis. Conclusions: Data indicate an evident rise in antibiotic use mostly related to fosfomycin trometamol. They also indicate that such a prescriptive trend finds confirmation from the available evidence for acute uncomplicated cystitis, although the management of recurrent cystitis could be further improved.
- Published
- 2006
36. Oral anticoagulant therapy in Italy: prescribing prevalence and clinical reasons
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Gianluca Trifirò, Giampiero Mazzaglia, Claudio Cricelli, Serena Pecchioli, Emiliano Sessa, Achille P. Caputi, Alessandro Filippi, Filippi, A, Sessa, E, Trifirò, G, Mazzaglia, G, Pecchioli, S, Caputi, A, and Cricelli, C
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Oral ,Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,Deep vein ,Alternative medicine ,Administration, Oral ,Disease ,Pharmacology ,Drug Prescriptions ,Prescription ,Database ,Databases ,medicine ,Confidence Intervals ,Prevalence ,Humans ,Medical prescription ,General practice ,Oral anticoagulant ,Aged ,Anticoagulants ,Cardiovascular Diseases ,Chi-Square Distribution ,Female ,Italy ,Middle Aged ,Factual ,business.industry ,Atrial fibrillation ,medicine.disease ,Thrombosis ,medicine.anatomical_structure ,Embolism ,Administration ,Emergency medicine ,Population study ,business - Abstract
Background: Oral anticoagulants (OAs) are recommended for many clinical problems and their use requires organised and knowledgeable medical support. Up to our knowledge, there is no data about both the reasons of treatment among OAs’ users and the number of patients prescribed with OAs in Italy. Objectives: To describe the OA use, and the reasons of prescribing among Italian General Practitioners. Methods: We used the Health Search Database owned by the Italian College of General Practitioners to identify the clinical records of patients ≥20 years who had at least one prescription of OAs during the year 2002. Results: Among a study population of 448,495 patients, 3649 subjects (0.81%) had received at least one OAs prescription. Applying such a proportion to the overall Italian population, on the basis of data from Italian Office for National Statistics (ISTAT), we estimated that 376,882 patients would have used OAs during the year 2002 in Italy. The most frequent clinical problem related to the use of OAs was atrial fibrillation (45.6%), followed by cardiac valve disease (14.6%), deep vein thrombosis (12.2%) and peripheral artery embolism (7.7%). Conclusions: Approximately 370,000 patients are prescribed with OAs in Italy and for more than 50% of them life-long therapy is recommended. Atrial fibrillation is the most frequent reason for prescription.
- Published
- 2004
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