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12 results on '"Claudio Borghi"'

1. Short-term evolocumab-induced tendon xanthomas regression in an elderly patient with homozygous familial hypercholesterolemia

Author

Arrigo F. G. Cicero, Federica Fogacci, Alessio Bragagni, Claudio Borghi, and Cicero AFG, Fogacci F, Bragagni A, Borghi C.

Subjects
Emergency Medicine, Internal Medicine, Evolocumab, tendon xanthomas, homozygous familial hypercholesterolemia
Abstract

Homozygous Familial Hypercholesterolemia (HoFH) is a rare inherited disorder affecting 1 in 160,000 to 1 in 300,000 individuals and resulting in extremely elevated low-densitym lipoprotein cholesterol (LDL-C) levels and premature atherosclerotic cardiovascular disease (ASCVD). Manifestations of ASCVD most notably include fatal and non-fatal myocardial infarction (MI) and occlusive vascular disease requiring surgical or percutaneous revascularization. Deposits of cholesterol in the skin or tendons, or both, called xanthomas, are the hallmark of the disease.

Published
2022

2. Dual RAAS inhibition and cardiorenal disease: is enough really enough?

Author

Daniela Degli Esposti, Maddalena Veronesi, Claudio Borghi, Stefano Bacchelli, and Claudio Borghi , Maddalena Veronesi , Stefano Bacchelli , Daniela Degli Esposti

Subjects
medicine.medical_specialty, Hypertension, Renal, Nephritis, business.industry, Angiotensin-Converting Enzyme Inhibitors, DUAL (cognitive architecture), Kidney, Renin-Angiotensin System, Internal medicine, Emergency Medicine, Internal Medicine, Cardiology, Medicine, Humans, cardiovascular diseases, RAAS, cardiovascular and renal diseases, business, Cardiorenal disease
Abstract

Since the frst appearance of captopril on the market in 1981, the management of cardiovascular and renal diseases relies greatly on the drugs inhibiting the renin angiotensin system (RAAS) [1] that have proven to be efective in the treatment of hypertension, heart failure, acute myocardial infarction and renal disease [1]. Ace-inhibitors (ACEI), angiotensin II receptor inhibitors (ARBs), Direct Renin inhibitors (DRI) and Aldosterone receptors blockers are commonly used in patients with or at risk or cardio-renal disease where they prevent cardiovascular complications and the decline of renal function [2]. All classes of drugs have a comparable antihypertensive efect with no clinically meaningful difference in blood pressure control in comparison with nonRAAS mediated classes of blood pressure lowering drugs and regardless of the methods employed to measure blood pressure [3]. ACEI and ARBs are the most investigated drugs and a large number of studies have been conducted to demonstrate their efcacy in a large population of hypertensive and non-hypertensive patients. The information about DRI is limited to two major trials mainly focused in patients with renal disease while the aldosterone receptors inhibitors have achieved some evidence in the management of resistant hypertension

Published
2020

3. Cost-effectiveness analysis of different hypertension management strategies

Author

Claudio Borghi, Arrigo F G Cicero, Federica Fogacci, and Arrigo F. G. Cicero, Federica Fogacci, Claudio Borghi

Subjects
medicine.medical_specialty, Cost–benefit analysis, business.industry, Cost-Benefit Analysis, MEDLINE, Hypertension management, Cost‑effectiveness, hypertension, cost of the intervention, Cost-effectiveness analysis, Hypertension, Emergency Medicine, Internal Medicine, Medicine, Humans, business, Intensive care medicine, Antihypertensive Agents
Abstract

Despite the availability of a large number of effective and relatively safe antihypertensive drugs, the control of hypertension in general population is suboptimal, reaching the 70% in the best practice settings. In particular, despite its economic power, Europe also ranges among the regions with the lowest rates of hypertension awareness and control worldwide [1]. On the one hand, this redominance reflects the increasing life expectancy in European population, whereas on the other hand, it can be attributed to the sedentary lifestyle and the nutritional habits of wealthy societies, but also to medical inertia, insufficient patient education and contradictory recommendations from different institutions and scientific societies [2]. In this context, the comparative evaluation of the effectiveness of different tools to improve hypertension control is of great interest, especially if the cost of the intervention is also estimated. This is what Chen et al. did in their interesting intervention trial, published in this issue of Internal and Emergency Medicine, where the cost-effectiveness of self-management, traditional management, and mobile app management of high blood pressure was tested in high and low health literacy subjects [3]. The conclusion of the authors was that self-management was the most cost-effective approach, reaching a high blood pressure control rate and low cost for each quality-adjusted life years gained.

Published
2019

4. Uric acid and thrombotic risk: an emerging link

Author

Arrigo F G Cicero, Claudio Borghi, Federica Fogacci, and Cicero AF, Fogacci F, Borghi C.

Subjects
Thrombotic risk, medicine.medical_specialty, business.industry, MEDLINE, Cardiomyopathy, Hyperuricemia, Uric acid, thrombotic risk, emergent risk factor, Cardiomyopathy, Hypertrophic, medicine.disease, Uric Acid, chemistry.chemical_compound, chemistry, Risk Factors, Internal medicine, Thromboembolism, Emergency Medicine, Internal Medicine, medicine, Uric acid, Humans, business
Abstract

A large literature recently supports the role of uric acid (UA)—the end product of the urine nucleotide metabolism— as an emergent risk factor for the development of the cardiovascular diseases [1, 2]. Furthermore, serum UA seems to be a predictor of some pathological conditions associated with an increased risk of thrombotic events, such as arrhythmias [3, 4], heart failure [5], metabolic syndrome [6], type 2 diabetes [7] and chronic kidney disease [8]. To the question of whether serum UA can mediate an increased thrombotic risk, from a theoretical point of view, the answer is yes. In particular, elevated UA has been reported to promote vascular smooth muscle proliferation by increasing expression of the platelet-derived growth factor A-chain [9], up-regulating the expression of platelet-derived growth factor and monocyte chemo-attractant protein-1 and finally inducing cyclo-oxigenase-2, that links UA to inflammation [10] and potentially to platelet hyperreactivity. In the clinical practice, in gouty patients, the risk of venous thromboembolism, deep vein thrombosis, and pulmonary embolism increases gradually before the gout attack, peaking in the year prior to diagnosis and then progressively declines, following the typical serum UA trend [11, 12]. An interesting analysis from the ARIC (Atherosclerosis Risk in Communities) Study, which followed 14,126 subjects for venous thromboembolism occurrence from 1987 to 2011, has recently highlighted that high serum UA concentrations (≥ 8.8 mg/dL) are associated with an increased risk of venous thromboembolism after adjustment for the other risk factors [Hazard Ratio (HR): 2.13, 95% Confidence Interval (CI): 1.47–3.07] [13].

Published
2020

5. Nephrotic range proteinuria and acute heart failure

Author

Matteo Landolfo, Giulia Fiorini, Claudio Borghi, and Matteo Landolfo , Giulia Fiorini , Claudio Borghi

Subjects
Heart Failure, medicine.medical_specialty, Nephrotic Syndrome, business.industry, medicine.disease, Kidney, Proteinuria, Case presentation, Nephrotic syndrome, proteinuria, acute heart failure, Internal medicine, Heart failure, Emergency Medicine, Internal Medicine, medicine, Cardiology, Humans, Female, business, Nephrotic range proteinuria, Aged
Abstract

Case presentation: A 66-year-old woman with mild obesity, systemic hypertension and no history of previous treatment presented to our emergency department (ED) because of progressive exertional dyspnea and bilateral lower limbs swelling. At admission in the ED, arterial pressure was 188/86 mmHg, heart rate was 84 bpm and oxygen blood saturation was 96%. Physical examination confirmed bilateral symmetrical lower limbs pitting edema and bilateral rales at thoracic auscultation. Both laboratory and imaging findings were suggestive of acute decompensated heart failure (HF): BNP was 421 pg/mL and chest X-rays showed signs of congestion, mild pleural effusion and an enlarged cardiac shadow. Cardiac ultrasound revealed left ventricular concentric hypertrophy, mild left atrial enlargement and mild–moderate diastolic dysfunction (LVEF 60%, E/A 0.81, E/Eʹ 17, PAPS 30–40 mmHg). The patient was, thus, treated with intra-venous Furosemide and admitted to our Internal Medicine department with a diagnosis of “acute heart failure with preserved ejection fraction”.

Published
2018

6. Not all that trembles…: a rare case of extrapyramidal impairment

Author

Alessio Bragagni, Claudio Borghi, Matteo Landolfo, and Landolfo M, Bragagni A, Borghi C.

Subjects
Aged, 80 and over, Diagnostic Imaging, Liver Cirrhosis, Male, Pediatrics, medicine.medical_specialty, business.industry, LC, MEDLINE, Diagnosis, Differential, Basal Ganglia Diseases, Rare case, Emergency Medicine, Internal Medicine, porto-systemic shunting computed tomography, Medicine, Humans, business, Neurological impairment
Abstract

An hypertensive and hypercholesterolemic 80-year-old man, with a previous history of peptic ulcer and non-melanoma skin cancer, currently in stable class B Child–Pugh liver cirrhosis (LC) secondary to chronic hepatitis B virus (HBV) infection, was admitted to our emergency department (ED) because of progressive dysarthria and disequilibrium. At admission in the ED, emodynamic was stable (arterial pressure was 110/96 mmHg and heart rate 63 bpm), he was non febrile and alert. The neurological examination was consistent with only mild dysarthria with no lateral deficits and no flapping tremor. Pharmacological history included prazole, carvedilol, atorvastatin, potassium canrenoate, furosemide, lactulose, and entecavir. The recent anamnesis was positive for a hospitalization due to acute hepatic encephalopathy (HE) successfully managed with cathartics, but negative for gastrointestinal bleeding or alteration of the alvus, despite a still high ammonium concentration (156 umol/L). Other laboratory findings were related to mild hepatic failure and portal hypertension (INR 1.72, PLT 66,000/mmc, total bilirubin 1.78 mg/dL, and albumin 2.2 g/dL), in absence of serum electrolyte disorders and any signs of inflammation (WBC 4000/mmc, RCP 0.22 mg/dL). Resting standard 12-lead electrocardiogram (EKG) showed sinus rhythm. First head computed tomography (CT) scan without contrast excluded acute ischemic hypodense lesions, acute or chronic haemorrhagic foci and signs of intracranial hypertension. A definitive diagnosis for the acute neurologic impairment could not be reached, so the patient was admitted to our Internal Medicine department for further investigations

Published
2019

7. Terlipressin infusion induces Tako-Tsubo syndrome in a cirrhotic man with hepato-renal syndrome

Author

Claudio Borghi, Mauro Bernardi, Franco Trevisani, Antonio Di Micoli, Luciana Bastagli, V. Santi, Daniela Degli Esposti, Daniela Buccione, Di Micoli A, Buccione D, Degli Esposti D, Santi V, Bastagli L, Borghi C, Bernardi M, and Trevisani F.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Hepatorenal Syndrome, Cirrhosis, Lypressin, Gastroenterology, Coronary artery disease, Hepatorenal syndrome, Takotsubo Cardiomyopathy, Internal medicine, Ascites, Internal Medicine, medicine, Humans, Myocardial infarction, CIRRHOSIS, Hepatic encephalopathy, Blood urea nitrogen, Aged, business.industry, medicine.disease, AMIODARONE, TAKO-TSUBO SUNDROME, Emergency Medicine, medicine.symptom, business, Terlipressin, hormones, hormone substitutes, and hormone antagonists, medicine.drug
Abstract

Dr. Di Micoli, Dr. Buccione, Prof. Trevisani: TakoTsubo cardiomyopathy (TTC), also known as transient left ventricular apical ballooning syndrome, is a clinical entity characterized by (1) reversible left ventricular apical wall motion abnormalities, (2) typical electrocardiographic changes and (3) relatively minor elevation of troponine, creatinine-kinase (CK) and CK-MB that mimics an acute myocardial infarction (AMI) without any acute obstructive coronary disease [1]. Typically, the left ventricular imbalance almost always recovers in a period of days to weeks, so that the management and prognosis of this condition are clearly different from those of AMI [2]. TTC is generally observed in post-menopausal women without prior history of heart disease or clear risk factors for coronary artery disease, who have often experienced recent emotional or physical stress, non-cardiac surgery or extracardiac diseases [1]. Recently, TTC has also been described in critically ill patients without prior heart disease admitted to a medical intensive care unit for severe non-cardiac diseases, such as sepsis, acute respiratory failure, systemic inflammatory response syndrome, anaphylaxis and trauma injuries [3, 4]. Herein, we report a case of TTC occurring in a cirrhotic man, waiting for liver transplantation (LT), probably favored by the intravenous infusion of terlipressin, a synthetic analog of vasopressin (AVP), for the treatment of hepato-renal syndrome (HRS). A 67-year-old Caucasian man with hepatitis B virusrelated cirrhosis and ascites, waiting for LT, was admitted to our unit because of the onset of hepatic encephalopathy, and the worsening of renal sodium retention. As a candidate for LT, he had undergone clinical, laboratory and instrumental tests aimed at excluding extrahepatic diseases precluding surgery. Myocardial single photon emission computed tomography had excluded ischemic damage, and trans-thoracic echocardiography had ruled out dyskinesia of ventricular segments and documented a normal (65%) left ventricular ejection fraction (LVEF). On admission, the patient presented with peripheral edema, ascites and grade III hepatic encephalopathy. Daily diuresis was around 200 mL. The ongoing therapy included oral diuretics (furosemide 25 mg b.i.d. and spironolactone 100 mg b.i.d.), lamivudine and tenofovir for HBV infection control, norfloxacine (400 mg/day) for secondary prophylaxis of the spontaneous peritoneal peritonitis, lactulose, and periodic albumin infusion. The serum creatinine was 2.2 mg/dL and blood urea nitrogen 0.9 g/dL, while serum electrolyte concentrations were normal (sodium 138 mEq/L, potassium 3.5 mEq/L, calcium 8.9 mg/dL and magnesium 2.6 mEq/L). The hemoglobin level was 10.4 g/dL, platelet count 134.000/lL, leukocytes 8.0 9 10/mmc, serum bilirubin 18.8 mg/dL, albumin 3.4 g/dL, INR 2.11. A. Di Micoli D. Buccione V. Santi L. Bastagli M. Bernardi F. Trevisani Dipartimento di Medicina Clinica, Alma Mater Studiorum-Universita degli Studi di Bologna, Bologna, Italy

Published
2011

8. Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study

Author

Arrigo F G, Cicero, Martino, Morbini, Riccardo, Urso, Martina, Rosticci, Angelo, Parini, Elisa, Grandi, Sergio, D'Addato, Claudio, Borghi, Cicero, Af, Morbini, M, Urso, R, Rosticci, M, Parini, A, Grandi, E, D'Addato, S, and Borghi, C

Subjects
Adult, Male, medicine.medical_specialty, Mean arterial pressure, Apolipoprotein B, Adolescent, Epidemiology, 030204 cardiovascular system & hematology, Pulse Wave Analysis, Logistic regression, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Vascular Stiffness, Internal medicine, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Pulse wave velocity, Aged, Sleep Apnea, Obstructive, biology, business.industry, Snoring, Middle Aged, medicine.disease, respiratory tract diseases, Surgery, Arterial Stiffness, Cardiovascular risk, Italy, Cardiovascular Diseases, Cohort, Emergency Medicine, Cardiology, biology.protein, Arterial stiffness, Female, Self Report, business, Body mass index
Abstract

The correlation of both obstructive sleep apnoea syndrome (OSAS) and snoring with cardiovascular risk is well known, but its investigation is complex and not suitable for studying large cohorts of subjects. Thus, we prospectively evaluated 1476 non-pharmacologically treated subjects selected from the last survey of the Brisighella Heart Study. Snoring and sleep apnoea were investigated asking the subjects if they were aware of snoring during the night, and if this was associated with episodes of apnoea. A full set of clinical and laboratory parameters were evaluated, while augmentation index (AIx), and pulse wave velocity (PWV) were recorded with the Vicorder(®) apparatus. A logistic regression analysis identifies as main independent predictors of AIx age (OR 1.058, 95% CI 1.043-1.065, p < 0.001), Body Mass Index (OR 1.046, 95% CI 1.014-1.079, p = 0.005), and apolipoprotein B (OR 1.014, 95% CI 1.004-1.023, p = 0.001). The main independent predictors of PWV are snoring (OR 1.215, 95% CI 1.083-1.390, p < 0.001), and snoring with apnoea (OR 1.351, 95% CI 1.135-1.598, p = 0.014), age (OR 1.078, 95% CI 1.052-1.089, p < 0.001), serum uric acid [SUA] (OR 1.093, 95% CI 1.026-1.151, p < 0.001) and mean arterial pressure (OR 1.042, 95% CI 1.024-1.056, p < 0.001). In conclusion, in our cohort of overall healthy subjects, self-reported snoring and sleep apnoea are independently associated with a higher PVW, and AIx is statistically significantly higher in snorers with or without sleep apnoea than in non-snorers. Body Mass Index and apolipoprotein B are associated with AIx, while SUA and mean arterial pressure are related to PWV.

Published
2015

9. Inner ear symptoms: can we use them to approach cardiovascular diseases?

Author

Cristina Brandolini, Arrigo F G Cicero, Claudio Borghi, Antonio Pirodda, Pirodda, Antonio, Cicero, Arrigo Francesco Giuseppe, Brandolini, Cristina, and Borghi, Claudio

Subjects
medicine.medical_specialty, business.industry, Epidemiology, Early detection, Hemodynamics, Sensory system, INNER ear, Audiology, Cardiovascular disease, Autonomic Nervous System, Pathophysiology, Highly sensitive, Autonomic nervous system, medicine.anatomical_structure, Cardiovascular Diseases, Ear, Inner, Reflex, Emergency Medicine, Internal Medicine, Medicine, Humans, Blood supply, Inner ear, business, Neuroscience
Abstract

Sensory organs are programmed to detect external stimuli, and inform about possible threats. In general, they are characterized by a complex architecture, a highly energy-requiring function, a peripheral location and a vascular supply depending on a terminal circulation usually under systemic control. Their function may be highly sensitive to more general disorders primarily involving other organs or physiological systems. Consequently, the onset of transient or persistent symptoms of impairment of sensory organs might be the expression of abnormalities in the integrity of more general systems, especially in the elderly population. In the otologic area, despite the availability of evidence supporting the negative impact of some systemic conditions negatively affecting the local blood supply at the labyrinth level, the possibility that the inner ear can reveal the presence of sub-clinical, non-otologic disorders has never been the topic of a constructive investigation. The present review summarizes the preliminary available evidence suggesting a possible negative impact of early systemic hemodynamic changes on the function of the inner ear, as well as the possibility that some audiological symptoms may play some role in the early detection of cardiovascular diseases. In particular, we hypothesize that some cardiovascular diseases may cause an impairment in correct labyrinthine function as a result of a negative interaction between systemic hemodynamic changes, a reflex activation of the autonomic nervous system, and a local vascular response. A multidisciplinary approach to the interpretation of inner ear disorders may increase the possibility of an earlier recognition and understanding of systemic dysfunctions in clinical practice.

Published
2014

10. Hepatic steatosis index and lipid accumulation product as middle-term predictors of incident metabolic syndrome in a large population sample: data from the Brisighella Heart Study

Author

Alessandra Reggi, Giulio Marchesini Reggiani, Arrigo F G Cicero, Sergio D'Addato, Claudio Borghi, Cicero AF, D'Addato S, Reggi A, Reggiani GM, and Borghi C

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Large population, Cohort Studies, Young Adult, Predictive Value of Tests, Risk Factors, Internal medicine, Internal Medicine, medicine, Humans, Young adult, Aged, Aged, 80 and over, Metabolic Syndrome, business.industry, Middle Aged, medicine.disease, Fatty Liver, Endocrinology, Emergency Medicine, Cardiology, Female, Hepatic steatosis index, Steatosis, Metabolic syndrome, business, Lipid Accumulation Product, Cohort study
Published
2012

11. Compliance with therapy in hypertensive patients

Author

Claudio Borghi and Borghi C.

Subjects
therapy, medicine.medical_specialty, business.industry, medicine.disease, compliance, drugs, Compliance (psychology), Hypertension, Emergency Medicine, Internal Medicine, medicine, Humans, Patient Compliance, Medical emergency, business, Intensive care medicine, Antihypertensive Agents
Abstract

not available

Published
2006

12. Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

Author

Mannucci, Pier Mannuccio, Nobili, Alessandro, Pasina, Luca, Tettamanti, Mauro, Franchi, Carlotta, Corrao, Salvatore, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Perticone, Francesco, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Cortesi, Laura, Ardoino, Ilaria, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Zanetti, Michela, Guadagni, Martina, Zaccari, Michele, Vanoli, Massimo, Grignani, Giulia, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Olivieri, Oliviero, Girelli, Domenico, Matteazzi, Thomas, Barbagallo, Mario, Dominguez, Ligia, Cocita, Floriana, Beneduce, Vincenza, Plances, Lidia, Zoli, Marco, Lazzari, Ilaria, Brunori, Mattia, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Palasciano, Giuseppe, Modeo, Maria Ester, Di Gennaro, Carla, Cappellini, Maria Domenica, Maira, Diletta, Di Stefano, Valeria, Fabio, Giovanna, Seghezzi, Sonia, Mancarella, Marta, Rossi, Paolo Dionigi, Damanti, Sarah, Clerici, Marta, Conti, Federica, Miceli, Emanuela, Lenti, Marco Vincenzo, Pisati, Martina, Dominioni, Costanza Caccia, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Cipollone, Francesco, Guagnano, Maria Teresa, Angelucci, Ermanno, Valeriani, Emanuele, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Delitala, Giuseppe, Berria, Maria, Muscaritoli, Maurizio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, D’Aurizio, Gabriella, Romanelli, Giuseppe, Zucchelli, Alberto, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Dell’Unto, Chiara, Annoni, Giorgio, Corsi, Maurizio, Bellelli, Giuseppe, Zazzetta, Sara, Mazzola, Paolo, Szabo, Hajnalka, Bonfanti, Alessandra, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Fabris, Fabrizio, Bertozzi, Irene, Bogoni, Giulia, Rabuini, Maria Victoria, Cosi, Elisabetta, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Tiseo, Ruana, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilenia, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Agosti, Pasquale, Schilardi, Andrea, Loparco, Francesca, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Fargion, Silvia, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Rossio, Raffaella, Ferrari, Barbara, Colombo, Giulia, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Ceriani, Giuliana, Pallini, Giada, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Caserza, Lara, Salam, Kassem, Liberato, Nicola Lucio, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Ferrandina, Camillo, Montrucchio, Giuseppe, Petitti, Paolo, Salmi, Raffaella, Gaudenzi, Piergiorgio, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Grossi, Alessandra, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Dondi, Giulia, Pellegrini, Elisa, Carulli, Lucia, COLANGELO, LIDIA, Falbo, Tania, Stanghellini, Vincenzo, De Giorgio, Roberto, Ruggeri, Eugenio, del Vecchio, Sara, Salvi, Andrea, LEONARDI, ROBERTO, Damiani, Giampaolo, Gabrielli, Armando, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Pettinari, Pietro, Ghio, Riccardo, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Pignataro, Samuele, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Gasparini, Francesca, Prolo, Silvia, Pina, Gloria, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Gruden, Gabriella, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, DI PASQUALE, MARIA GRAZIA, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Passariello, Nicola, Rinaldi, Luca, Berti, Franco, Famularo, Giuseppe, Patrizia, Tarsitani, Castello, Roberto, Pasino, Michela, Ceda, Gian Paolo, Maggio, Marcello Giuseppe, Morganti, Simonetta, Artoni, Andrea, Del Giacco, Stefano, Firinu, Davide, Losa, Francesca, Paoletti, Giovanni, Montalto, Giuseppe, Licata, Anna, Malerba, Valentina, Antonino, Lasco, Basile, Giorgio, Antonino, Catalano, Malatino, Lorenzo, Stancanelli, Benedetta, Terranova, Valentina, Di Marca, Salvatore, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Meschi, Tiziana, Lauretani, Fulvio, Ticinesi, Andrea, Minuz, Pietro, Fondrieschi, Luigi, Pirisi, Mario, Fra, Gian Paolo, Sola, Daniele, Porta, Massimo, Riva, Piero, Quadri, Roberto, Scanzi, Giorgio, Mengoli, Caterina, Provini, Stella, Ricevuti, Laura, Simeone, Emilio, Scurti, Rosa, Tolloso, Fabio, Tarquini, Roberto, Valoriani, Alice, Dolenti, Silvia, Vannini, Giulia, Tedeschi, Alberto, Trotta, Lucia, Volpi, Riccardo, Bocchi, Pietro, Vignali, Alessandro, Harari, Sergio, Lonati, Chiara, Cattaneo, Mara, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viros, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Puras, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobos, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadros, Florencia, Perez Rojas, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, Mannucci, Pier Mannuccio, Nobili, Alessandro, Pasina, Luca, Tettamanti, Mauro, Franchi, Carlotta, Corrao, Salvatore, Marengoni, Alessandra, Salerno, Francesco, Cesari, Matteo, Perticone, Francesco, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Cortesi, Laura, Ardoino, Ilaria, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Zanetti, Michela, Guadagni, Martina, Zaccari, Michele, Vanoli, Massimo, Grignani, Giulia, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Olivieri, Oliviero, Girelli, Domenico, Matteazzi, Thoma, Barbagallo, Mario, Dominguez, Ligia, Cocita, Floriana, Beneduce, Vincenza, Plances, Lidia, Zoli, Marco, Lazzari, Ilaria, Brunori, Mattia, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Palasciano, Giuseppe, Modeo, Maria Ester, Di Gennaro, Carla, Cappellini, Maria Domenica, Maira, Diletta, Di Stefano, Valeria, Fabio, Giovanna, Seghezzi, Sonia, Mancarella, Marta, Rossi, Paolo Dionigi, Damanti, Sarah, Clerici, Marta, Conti, Federica, Miceli, Emanuela, Lenti, Marco Vincenzo, Pisati, Martina, Dominioni, Costanza Caccia, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Cipollone, Francesco, Guagnano, Maria Teresa, Angelucci, Ermanno, Valeriani, Emanuele, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Delitala, Giuseppe, Berria, Maria, Muscaritoli, Maurizio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, D’Aurizio, Gabriella, Romanelli, Giuseppe, Zucchelli, Alberto, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Dell’Unto, Chiara, Annoni, Giorgio, Corsi, Maurizio, Bellelli, Giuseppe, Zazzetta, Sara, Mazzola, Paolo, Szabo, Hajnalka, Bonfanti, Alessandra, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Fabris, Fabrizio, Bertozzi, Irene, Bogoni, Giulia, Rabuini, Maria Victoria, Cosi, Elisabetta, Manfredini, Roberto, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Tiseo, Ruana, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilenia, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Agosti, Pasquale, Schilardi, Andrea, Loparco, Francesca, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Fargion, Silvia, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Rossio, Raffaella, Ferrari, Barbara, Colombo, Giulia, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Ceriani, Giuliana, Pallini, Giada, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Caserza, Lara, Salam, Kassem, Liberato, Nicola Lucio, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Ferrandina, Camillo, Montrucchio, Giuseppe, Petitti, Paolo, Salmi, Raffaella, Gaudenzi, Piergiorgio, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Grossi, Alessandra, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Dondi, Giulia, Pellegrini, Elisa, Carulli, Lucia, Colangelo, Lidia, Falbo, Tania, Stanghellini, Vincenzo, De Giorgio, Roberto, Ruggeri, Eugenio, del Vecchio, Sara, Salvi, Andrea, Leonardi, Roberto, Damiani, Giampaolo, Gabrielli, Armando, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Pettinari, Pietro, Ghio, Riccardo, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Pignataro, Samuele, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Gasparini, Francesca, Prolo, Silvia, Pina, Gloria, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Gruden, Gabriella, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Passariello, Nicola, Rinaldi, Luca, Berti, Franco, Famularo, Giuseppe, Patrizia, Tarsitani, Castello, Roberto, Pasino, Michela, Ceda, Gian Paolo, Maggio, Marcello Giuseppe, Morganti, Simonetta, Artoni, Andrea, Del Giacco, Stefano, Firinu, Davide, Losa, Francesca, Paoletti, Giovanni, Montalto, Giuseppe, Licata, Anna, Malerba, Valentina, Antonino, Lasco, Basile, Giorgio, Antonino, Catalano, Malatino, Lorenzo, Stancanelli, Benedetta, Terranova, Valentina, Di Marca, Salvatore, Mecocci, Patrizia, Ruggiero, Carmelinda, Boccardi, Virginia, Meschi, Tiziana, Lauretani, Fulvio, Ticinesi, Andrea, Minuz, Pietro, Fondrieschi, Luigi, Pirisi, Mario, Fra, Gian Paolo, Sola, Daniele, Porta, Massimo, Riva, Piero, Quadri, Roberto, Scanzi, Giorgio, Mengoli, Caterina, Provini, Stella, Ricevuti, Laura, Simeone, Emilio, Scurti, Rosa, Tolloso, Fabio, Tarquini, Roberto, Valoriani, Alice, Dolenti, Silvia, Vannini, Giulia, Tedeschi, Alberto, Trotta, Lucia, Volpi, Riccardo, Bocchi, Pietro, Vignali, Alessandro, Harari, Sergio, Lonati, Chiara, Cattaneo, Mara, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, Pier Mannuccio Mannucci, Alessandro Nobili, Luca Pasina, REPOSI Collaborators [.., Gino Roberto Corazza, Elena Silvestri, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giacomo Zaccherini, Marco Zoli, Ilaria Lazzari, Mattia Brunori, Claudio Borghi, Enrico Strocchi, Valeria De Sando, Ilenia Pareo, Vincenzo Stanghellini, Roberto De Giorgio, Eugenio Ruggeri, Sara del Vecchio, ], Mannucci, P, Nobili, A, Pasina, L, Dominguez Rodriguez, L, Barbagallo, M, Licata, A, Tettamanti, M, Franchi, C, Corrao, S, Marengoni, A, Salerno, F, Cesari, M, Perticone, F, Licata, G, Violi, F, Corazza, G, Cortesi, L, Ardoino, I, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Olivieri, O, Girelli, D, Matteazzi, T, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Zoli, M, Lazzari, I, Brunori, M, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, di Gennaro, C, Cappellini, M, Maira, D, di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, Rossi, P, Damanti, S, Clerici, M, Conti, F, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Angelucci, E, Valeriani, E, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccala, G, D'Aurizio, G, Romanelli, G, Zucchelli, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Manfredini, R, Fabbian, F, Boari, B, de Giorgi, A, Tiseo, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, de Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Agosti, P, Schilardi, A, Loparco, F, Fenoglio, L, Bracco, C, Giraudo, A, Fargion, S, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Rossio, R, Ferrari, B, Colombo, G, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Salmi, R, Gaudenzi, P, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Grossi, A, Bertolotti, M, Mussi, C, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Colangelo, L, Falbo, T, Stanghellini, V, De Giorgio, R, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Gabrielli, A, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Col, A, Minisola, S, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Pignataro, S, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Patrizia, T, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Giacco, S, Firinu, D, Losa, F, Paoletti, G, Montalto, G, Malerba, V, Antonino, L, Basile, G, Antonino, C, Malatino, L, Stancanelli, B, Terranova, V, di Marca, S, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, Monica, R, DI PASQUALE, MARIA GRAZIA, di Gennaro, Carla, di Stefano, Valeria, de Giorgi, Alfredo, de Sando, Valeria, di Pino, Antonino, Giacco, Stefano Del, and di Marca, Salvatore

Subjects
Male, medicine.medical_specialty, Population ageing, Deprescribing, Inappropriate prescription, Medication reconciliation, Multimorbidity, Polypharmacy, Population, Socio-culturale, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 80 and over, Internal Medicine, Emergency Medicine, medicine, Deprescribing, Inappropriate prescription, Medication reconciliation, Multimorbidity, Polypharmacy, Humans, Registries, 030212 general & internal medicine, Medical prescription, Adverse effect, education, Aged, Aged, 80 and over, Geriatrics, education.field_of_study, business.industry, Patient Discharge, Hospitalization, Female, Italy, Family medicine, business
Abstract

As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration andinevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide register is an ongoing observatory on multimorbidity and polypharmacy in the oldest old, with the goal to improve prescription appropriateness and, thus to avoid potentially inappropriate medications. The main findings of the register, that has accrued so far, 7005 older patients throughout a 10year period, are summarized herewith, with special emphasis on the main patterns of poor prescription appropriateness and related risks of adverse events.

Published
2018

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