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74 results on '"Health Care Survey"'

1. Workplace Violence Against Physicians Treating COVID-19 Patients in Peru: A Cross-Sectional Study

Author

Dulce Esperanza Alarcón-Yaquetto, Germán Málaga, Agueda Muñoz del Carpio-Toia, Percy Mayta-Tristán, and Lucia Del Carpio

Subjects
family, Cross-sectional study, health care survey, Poison control, intensive care unit, Suicide prevention, Occupational safety and health, 0302 clinical medicine, middle aged, Peru, 030212 general & internal medicine, health service, caregiver, emergency health service, physician, physical violence, adult, 030503 health policy & services, emergency unit, Human factors and ergonomics, female, Workplace Violence, Female, 0305 other medical science, medicine.medical_specialty, hospital subdivisions and components, Leadership and Management, teleconsultation, Article, coronavirus disease 2019, 03 medical and health sciences, male, Physicians, workplace violence, Injury prevention, medicine, cross-sectional study, sex, Humans, controlled study, sexual harassment, human, Pandemics, work experience, Workplace violence, SARS-CoV-2, business.industry, pandemic, health care facility, verbal hostility, COVID-19, Triage, Cross-Sectional Studies, Family medicine, business
Abstract

Background The COVID-19 pandemic is an unprecedented challenge to health systems that has revealed shortcomings and increased unmet demands. Such situations might exacerbate workplace violence (WPV) against physicians, as has been reported in several parts of the world. Methods To identify the frequency and characteristics of WPV suffered by physicians attending COVID-19 patients in Peru, a descriptive, cross-sectional study was conducted with an online survey of 200 physicians. Results Of the survey respondents, 84.5% had suffered some type of WPV; 97.6% of these suffered nonphysical violence. Suffering more than one incident of violence was reported by 75.7% of respondents. The primary aggressor was a patient's family member or caregiver. Violence occurred most frequently in critical areas inside the health service facility, such as COVID-19 triage, tents, and hospital units, although it also occurred during teleconsultations. Multiple shortcomings of the health services were perceived as the main trigger of violence. Being a female physician (odds ratio [OR] = 2.48, 95% confidence interval [CI] = 1.06–5.83) and working in a COVID-19 ICU (OR = 5.84, 95% CI = 1.60–21.28) were the main factors associated with WPV. Conclusion Violence against physicians attending COVID-19 patients in Peru is common. The perceived factors that contribute most to violence are linked to deficiencies in health services.

Published
2021

2. International Impact of COVID-19 on the Diagnosis of Heart Disease

Author

Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Gerd Hinterleitner, Paez D., Yao, Lu, Olga, Morozova, Zhuoran, Xu, Juan, Lopez-Mattei, Purvi, Parwani, Mohammad Nawaz Nasery, Artan, Goda, Ervina, Shirka, Rabie, Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais, Nailli, Mariela, Agolti, Roberto Nicolas Aguero, Maria Del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria Del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana, Zeffiro, Mari, Sakanyan, Scott, Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John, Younger, Gudrun, Feuchtner, Siroos, Mirzaei, Konrad, Weiss, Natallia, Maroz-Vadalazhskaya, Olivier, Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Caroline, M Van De Heyning, Raúl Araujo Ríos, Valentina, Soldat-Stankovic, Sinisa, Stankovic, Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali Jr, Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, E Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello, Zapparoli, Hamid, Naseer, Marina, Garcheva-Tsacheva, Irena, Kostadinova, Youdaline, Theng, Gad, Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine, Zukotynski, Jose, Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas, Pedro, Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Claudia, T Gutierrez Villamil, Claudia, Jaimes, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro, Zuluaga, Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Ana, Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante, Punda, Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis, Rochela, Christoforos, Panagidis, Ioannis, Petrou, Vaclav, Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan, Simanek, Jawdat, Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Zerahn, Bo, Alfredo, Perez, Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez, Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud, Shaaban, Ana Camila Flores, Anne, Poksi, Juhani, Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri, Uusitalo, Matthieu, Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Vania, Tacher, Roman, P Schneider, Harold, Ayetey, George, Angelidis, Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa, Valsamaki, Carla, Gonzalez, Goleat, Gutierrez, Alejandro, Maldonado, Klara, Buga, Ildiko, Garai, Erzsébet, Schmidt, Balint, Szilveszter, Edit, Várady, Nilesh, Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Girijanandan, Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul, Verma, Erwin, Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman, Syawaluddin, Amjed, Albadr, Majid, Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi, Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh, Shalev, Domenico, Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, DELLA TOMMASINA, Veronica, Rexhep, Durmo, Erba, PAOLA ANNA, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania, Zoboli, Dainia, Baugh, Duane, Chambers, Ernest, Madu, Felix, Nunura, Hiroshi, Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya, Yoneyama, Mohammad, Rawashdeh, Daultai, Batyrkhanov, Tairkhan, Dautov, Khalid, Makhdomi, Kevin, Ombati, Faridah, Alkandari, Masoud, Garashi, Tchoyoson Lim Coie, Sonexay, Rajvong, Artem, Kalinin, Marika, Kalnina, Mohamad, Haidar, Renata, Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Donatas, Vajauskas, Christian, Picard, Noor Khairiah, A Karim, Luise, Reichmuth, Anthony, Samuel, Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee, Erick, Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Lilia, M Sierra-Galan, Silvia, Siu, Enrique, Vallejo, Mario, Valles, Marc, Faraggi, Erdenechimeg, Sereegotov, Srdja, Ilic, Nozha, Ben-Rais, Nadia Ismaili Alaoui, Sara, Taleb, Khin Pa Pa Myo, Phyo Si Thu, Ram Kumar Ghimire, Bijoy, Rajbanshi, Peter, Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils, Wagenaar, John, Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua Anthony Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum, Young, Teresa, Cuadra, Hector Bladimir Roque Vanegas, Idrissa Adamou Soli, Djibrillou Moussa Issoufou, Tolulope, Ayodele, Chibuzo, Madu, Yetunde, Onimode, Elen, Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten, Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima, Tag, Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad, Saadullah, Yariela, Herrera, Dora, Lenturut-Katal, Manuel Castillo Vázquez, José, Ortellado, Afroza, Akhter, Dianbo, Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Zhu, Li, Ana, Alfaro, Paz, Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila, Uy, Magdalena, Kostkiewicz, Jolanta, Kunikowska, Nuno, Bettencourt, Guilhermina, Cantinho, Antonio, Ferreira, Ghulam, Syed, Samer, Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie, O'Brien, Ji-In, Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won, Venjamin, Majstorov, Marija, Vavlukis, Barbara Gužic Salobir, Monika, Štalc, Theodora, Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan, Alexey, Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill, Zhuravlev, Mirvat, Alasnag, Subhani, Okarvi, Dragana Sobic Saranovic, Felix, Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew, Andrej, Vondrak, Shereen, Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo, Vangu, Santiago, Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla, Zeidán, Damayanthi, Nanayakkara, Chandraguptha, Udugama, Magnus, Simonsson, Hatem, Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Christel, H Kamani, Nadine, Kawel-Boehm, Robert, Manka, John, O Prior, Axel, Rominger, Jean-Paul, Vallée, Benjapa, Khiewvan, Teerapon, Premprabha, Tanyaluck, Thientunyakit, Ali, Sellem, Kemal Metin Kir, Haluk, Sayman, Mugisha Julius Sebikali, Zerida, Muyinda, Yaroslav, Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna, Satyr, Batool, Albalooshi, Mohamed Ismail Ahmed Hassan, Jill, Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan, Weir-Mccall, Suhny, Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Richard, R Bayer, Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Floyd, W Burke, Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, U Joseph Schoepf, Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T Ahmed Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael, Zgaljardic, Omar, Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando, Mut, Omoa, Djuraev, Gulnora, Rozikhodjaeva, Ha Le Ngoc, Son Hong Mai, Xuan Canh Nguyen, Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Cuocolo, A., Einstein, A, Shaw, L, Hirschfeld, C, Williams, M, Villines, T, Better, N, Vitola, J, Cerci, R, Dorbala, S, Raggi, P, Choi, A, Lu, B, Sinitsyn, V, Sergienko, V, Kudo, T, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Narula, J, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Pacella, S, and Erba, P

Subjects
INCAPS COVID Investigators Group, Heart disease, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Diagnostic Techniques, Cardiovascular, coronavirus, global health, IAEA, Disease, Telehealth, Cardiorespiratory Medicine and Haematology, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, cardiovascular disease, cardiac testing, COVID-19, diagnostic techniques, cardiovascular, health care surveys, heart diseases, humans, international agencies, Pandemic, Global health, 030212 general & internal medicine, COVID-19 Heart Disease, Cause of death, STATEMENT, Heart Disease, International Agencie, Public Health and Health Services, Biomedical Imaging, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Heart Diseases, 03 medical and health sciences, Clinical Research, medicine, Humans, Personal protective equipment, Heart Disease - Coronary Heart Disease, business.industry, International Agencies, medicine.disease, the, coronaviru, Diagnostic Techniques, Good Health and Well Being, Clinical research, Cardiovascular System & Hematology, Health Care Survey, Health Care Surveys, Emergency medicine, Global Health, business
Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Published
2021

3. Impact of the coronavirus disease 2019 (COVID-19) pandemic on the Italian congenital cardiac surgery system: a national survey

Author

Gabriele Scalzo, Luigi Arcieri, Vitali Pak, Federico Brunelli, Guido Oppido, Alessandro Varrica, Alessandro Giamberti, Stefano M. Marianeschi, Salvatore Agati, Lorenzo Galletti, Carlo Pace Napoleone, Giovanni Battista Luciani, Gaetano Palma, Gaetano Gargiulo, Massimo A. Padalino, Giamberti A., Varrica A., Agati S., Gargiulo G., Luciani G.B., Marianeschi S.M., Napoleone C.P., Oppido G., Brunelli F., Palma G., Pak V., Arcieri L., Scalzo G., Padalino M., and Galletti L.

Subjects
Heart disease, Cardiac surgery, Congenital heart disease, Coronavirus disease 2019, Pandemic, COVID-19, Cardiac Surgical Procedures, Cross Infection, Elective Surgical Procedures, Emergencies, Health Care Rationing, Health Care Surveys, Health Policy, Health Services Accessibility, Heart Defects, Congenital, Humans, Infection Control, Italy, Occupational Diseases, Pandemics, Postoperative Complications, Quarantine, 030204 cardiovascular system & hematology, Health care rationing, Congenital, 0302 clinical medicine, Epidemiology, Cardiac Surgical Procedure, Medicine, Infection control, Eacts/137, Heart Defects, Emergencie, Eacts/132, AcademicSubjects/MED00920, General Medicine, Eacts/129, Cardiology and Cardiovascular Medicine, Elective Surgical Procedure, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, 03 medical and health sciences, Health policy, business.industry, medicine.disease, Occupational Disease, 030228 respiratory system, Health Care Survey, Emergency medicine, Surgery, Postoperative Complication, business
Abstract

OBJECTIVES Italy has been one of the countries most severely affected by the coronavirus disease 2019 (COVID-19). The Italian government was forced to introduce quarantine measures quickly, and all elective health services were stopped or postponed. This emergency has dramatically changed the management of paediatric and adult patients with congenital heart disease. We analysed data from 14 Italian congenital cardiac surgery centres during lockdown, focusing on the impact of the pandemic on surgical activity, patients and healthcare providers and resource allocation. METHODS Fourteen centres participated in this study. The period analysed was from 9 March to 4 May. We collected data on the involvement of the hospitals in the treatment of patients with COVID-19 and on limitations on regular activity and on the contagion among patients and healthcare providers. RESULTS Four hospitals (29%) remained COVID-19 free, whereas 10 had a 39% reduction in the number of beds for surgical patients, especially in the northern area. Two hundred sixty-three surgical procedures were performed: 20% elective, 62% urgent, 10% emergency and 3% life-saving. Hospital mortality was 0.4%. Compared to 2019, the reduction in surgical activity was 52%. No patients operated on had positive test results before surgery for severe acute respiratory syndrome coronavirus 2, the virus responsible for COVID-19. Three patients were infected during the postoperative period. Twenty-nine nurses and 12 doctors were infected. Overall, 80% of our infected healthcare providers were in northern centres. CONCLUSIONS Our study shows that the pandemic had a different impact on the various Italian congenital cardiac surgery centres based on the different patterns of spread of the virus across the country. During the lockdown, the system was able to satisfy all emergency clinical needs with excellent results., Starting from Wuhan (China) in December 2019 [1], the disease called coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic with currently over 12 million cases globally (15 June).

Published
2020

4. Perspectives from Italy during the COVID-19 pandemic: nationwide survey-based focus on minimally invasive HPB surgery

Author

Aldrighetti, aEmail Author, L., Boggi, U. b., Falconi, M. c., Giuliante, F. d., Cipriani, F. a., Ratti, Torzilli, G. e., Abu, Hilal, Andrianello, Anselmo, Ardito, Gian, L. B., Banchini, Barabino, Barberis, Bassi, Batignani, Battiston, Belli, Berti, Bianco, Brolese, Brozzetti, Butturini, Calise, Carabott, Capretti, Casadei, Cescon, Cesaretti, Cillo, Cinardi, Colledan, Coppola, Cotsoglou, Crippa, Bona, E. D., Valle, R. D., Angelis, De, Carlis, De, Benedetto, Di, Sebastiano, Di, Dova, Ercolani, Esposito, Giuseppe, M. E., Fabris, Ferrero, Frena, Frigerio, Gianotti, Giuliani, Grazi, Gringeri, Griseri, Gruttadauria, Guglielmi, Izzo, Jovine, Lanza, Malleo, Manzini, Massani, Mazzaferro, Memeo, Minni, Morelli, Nappo, Nardo, Orlando, Partelli, Patriti, Patrone, Percivale, Piccolo, Ravaioli, Reggiani, Risaliti, Rocca, A, Romagnoli, Romano, Russolillo, Ruzzenente, Saladino, Salvia, Santambrogio, Tarchi, Troci, Troisi, Urbani, Veneroni, Vennarecci, Vigano, Viola, Vistoli, Vivarelli, Zanello, Zanus, Zerbi, Italian Association of HepatoBilioPancreatic Surgeons-AICEP, Aldrighetti, L., Boggi, U., Falconi, M., Giuliante, F., Cipriani, F., Ratti, F., Torzilli, G., Abu Hilal, M., Andrianello, S., Anselmo, A., Ardito, F., Gian, L. B., Banchini, F., Barabino, M., Barberis, A., Bassi, C., Batignani, G., Battiston, C., Belli, A., Berti, S., Bianco, P., Brolese, A., Brozzetti, S., Butturini, G., Calise, F., Carabott, K., Capretti, G., Casadei, R., Cescon, M., Cesaretti, M., Cillo, U., Cinardi, N., Colledan, M., Coppola, A., Cotsoglou, C., Crippa, S., Bona, E. D., Valle, R. D., De Angelis, M., De Carlis, L., Di Benedetto, F., Di Sebastiano, P., Dova, L., Ercolani, G., Esposito, A., Giuseppe, M. E., Fabris, A., Ferrero, A., Frena, A., Frigerio, I., Gianotti, L., Giuliani, A., Grazi, G., Gringeri, E., Griseri, G., Gruttadauria, S., Guglielmi, A., Izzo, F., Jovine, E., Lanza, E., Malleo, G., Manzini, L., Massani, M., Mazzaferro, V., Memeo, R., Minni, F., Morelli, L., Nappo, G., Nardo, B., Orlando, F., Partelli, S., Patriti, A., Patrone, R., Percivale, A., Piccolo, G., Ravaioli, M., Reggiani, P., Risaliti, M., Rocca, A., Romagnoli, R., Romano, F., Russolillo, N., Ruzzenente, A., Saladino, E., Salvia, R., Santambrogio, R., Tarchi, P., Troci, A., Troisi, R., Urbani, L., Veneroni, L., Vennarecci, G., Vigano, L., Viola, M., Vistoli, F., Vivarelli, M., Zanello, M., Zanus, G., Zerbi, A., Aldrighetti L., Boggi U., Falconi M., Giuliante F., Cipriani F., Ratti F., Torzilli G., Abu Hilal M., Andrianello S., Anselmo A., Ardito F., Gian L.B., Banchini F., Barabino M., Barberis A., Bassi C., Batignani G., Battiston C., Belli A., Berti S., Bianco P., Brolese A., Brozzetti S., Butturini G., Calise F., Carabott K., Capretti G., Casadei R., Cescon M., Cesaretti M., Cillo U., Cinardi N., Colledan M., Coppola A., Cotsoglou C., Crippa S., Bona E.D., Valle R.D., De Angelis M., De Carlis L., Di Benedetto F., Di Sebastiano P., Dova L., Ercolani G., Esposito A., Giuseppe M.E., Fabris A., Ferrero A., Frena A., Frigerio I., Gianotti L., Giuliani A., Grazi G., Gringeri E., Griseri G., Gruttadauria S., Guglielmi A., Izzo F., Jovine E., Lanza E., Malleo G., Manzini L., Massani M., Mazzaferro V., Memeo R., Minni F., Morelli L., Nappo G., Nardo B., Orlando F., Partelli S., Patriti A., Patrone R., Percivale A., Piccolo G., Ravaioli M., Reggiani P., Risaliti M., Rocca A., Romagnoli R., Romano F., Russolillo N., Ruzzenente A., Saladino E., Salvia R., Santambrogio R., Tarchi P., Troci A., Troisi R., Urbani L., Veneroni L., Vennarecci G., Vigano L., Viola M., Vistoli F., Vivarelli M., Zanello M., Zanus G., and Zerbi A.

Subjects
Future studies, Settore MED/18 - CHIRURGIA GENERALE, Crisis management, Nationwide survey, 0302 clinical medicine, Pandemic, Pancrea, Medicine, Viral, Minimally invasive procedures, Liver Disease, Liver Diseases, COVID-19, Liver, Minimally invasive, Pancreas, Biliary Tract Diseases, Health Care Surveys, Humans, Italy, Pancreatic Diseases, Coronavirus Infections, Minimally Invasive Surgical Procedures, Pandemics, Pneumonia, Viral, 030220 oncology & carcinogenesis, Esophagus Resection, Original Article, 030211 gastroenterology & hepatology, Biliary Tract Disease, Human, Prioritization, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), NO, 03 medical and health sciences, High Volume Hospital, Centralization, LS7_4, Coronavirus Infection, business.industry, Minimally Invasive Surgical Procedure, Pneumonia, Surgery, Health Care Survey, Invasive surgery, Pancreatic Disease, business
Abstract

The safety of minimally invasive procedures during COVID pandemic remains hotly debated, especially in a country, like Italy, where minimally invasive techniques have progressively and pervasively entered clinical practice, in both the hepatobiliary and pancreatic community. A nationwide snapshot of the management of HPB minimally invasive surgery activity during COVID-19 pandemic is provided: a survey was developed and conducted within AICEP (Italian Association of HepatoBilioPancreatic Surgeons) with the final aim of conveying the experience, knowledge, and opinions into a unitary report enabling more efficient crisis management. Results from the survey (81 respondents) show that, in Italian hospitals, minimally invasive surgery maintains its role despite the COVID-19 pandemic, with the registered reduction of cases being proportional to the overall reduction of the HPB surgical activity. Respondents agree that the switch from minimally invasive to open technique can be considered as a valid option for cases with a high technical complexity. Several issues merit specific attention: screening for virus positivity should be universally performed; only expert surgical teams should operate on positive patients and specific technical measures to lower the biological risk of contamination during surgery must be followed. Future studies specifically designed to establish the true risks in minimally invasive surgery are suggested. Furthermore, a standard and univocal process of prioritization of patients from Regional Healthcare Systems is advisable. Electronic supplementary material The online version of this article (10.1007/s13304-020-00815-5) contains supplementary material, which is available to authorized users.

Published
2020

5. Implementation of strategies to prevent and treat postoperative delirium in the post-anesthesia caring unit

Author

Vera von Dossow, Bernhard Zwissler, Thomas Saller, Klaus Hofmann-Kiefer, and Isabel Saller

Subjects
medicine.medical_specialty, Post-anesthesia nursing, Critical Care, Health Informatics, Recovery room, Critical Care and Intensive Care Medicine, behavioral disciplines and activities, Pacu, law.invention, Postoperative complications, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Surveys and Questionnaires, Anesthesiology, Intensive care, mental disorders, medicine, Humans, Anesthesia, Original Research, Response rate (survey), biology, business.industry, Health care survey, Delirium, 030208 emergency & critical care medicine, biology.organism_classification, Intensive care unit, nervous system diseases, Intensive Care Units, Anesthesiology and Pain Medicine, Ambulatory, Emergency medicine, Anxiety, medicine.symptom, business
Abstract

Postoperative delirium is associated with worse outcome. The aim of this study was to understand present strategies for delirium screening and therapy in German Post-Anesthesia-Caring-Units (PACU). We designed a German-wide web-based questionnaire which was sent to 922 chairmen of anesthesiologic departments and to 726 anesthetists working in ambulatory surgery. The response rate was 30% for hospital anesthesiologists. 10% (95%-confidence interval: 8–12) of the anesthesiologists applied a standardised screening for delirium. Even though not on a regular basis, in 44% (41–47) of the hospitals, a recommended and validated screening was used, the Nursing Delirium Screening Scale (NuDesc) or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). If delirium was likely to occur, 46% (43–50) of the patients were examined using a delirium tool. 20% (17–23) of the patients were screened in intensive care units. For the treatment of delirium, alpha-2-agonists (83%, 80–85) were used most frequently for vegetative symptoms, benzodiazepines for anxiety in 71% (68–74), typical neuroleptics in 77% (71–82%) of patients with psychotic symptoms and in 20% (15–25) in patients with hypoactive delirium. 45% (39–51) of the respondents suggested no therapy for this entity. Monitoring of delirium is not established as a standard procedure in German PACUs. However, symptom-oriented therapy for postoperative delirium corresponds with current guidelines.

Published
2020

6. Pulmonary alveolar proteinosis in Korea: analysis of prevalence and incidence via a nationwide population-based study

Author

Hee-Young Yoon, Ji Hyeon Kim, Ye-Jee Kim, and Jin Woo Song

Subjects
Adult, Male, 0301 basic medicine, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Adolescent, National Health Programs, Epidemiology, Population, Comorbidity, Disease, Lung biopsy, Pulmonary Alveolar Proteinosis, Young Adult, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Bronchoscopy, Republic of Korea, Prevalence, medicine, Humans, Sex Distribution, education, Aged, lcsh:RC705-779, education.field_of_study, Insurance claim review, medicine.diagnostic_test, business.industry, Incidence, Incidence (epidemiology), Health care survey, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, Rare diseases, Population based study, 030104 developmental biology, Population Surveillance, Female, business, Pulmonary alveolar proteinosis, 030217 neurology & neurosurgery, Research Article
Abstract

Background Pulmonary alveolar proteinosis (PAP) is a very rare lung disease and its prevalence and incidence remain unclear. The prevalence and incidence of PAP were investigated by using nationwide claims data from the Korean Health Insurance Review and Assessment service. Methods Data were extracted for adults who visited any secondary or tertiary medical institute between 2010 and 2016 with the PAP-related Korean Classification of Disease, 7th edition code J84.0 and the Rare Intractable Disease exempted calculation code V222. To robust case definition, a narrow case definition was made when all following factors were met: 1) more than two PAP-coded visits within 1 year of the first claim, and 2) more than one claim for both chest computed tomography and diagnostic procedures (bronchoscopy or surgical lung biopsy) within 90 days before or after the first claim. Results A total of 182 patients (narrow, n = 82) with PAP-related codes were identified from 2010 to 2016 and 89 new patients (narrow, n = 66) visited medical institutes between 2012 and 2015. The prevalence of PAP was 4.44 (narrow: 2.27) per 106 population, with a peak age of 60–69 years. The incidence of PAP was 0.56 (narrow: 0.41) per 106 population at risk, with a peak age of 50–59 years. Among incident cases, the male-to-female ratio was 1.52 and about two-thirds had comorbidities, dyslipidaemia being the most common. Conclusions The prevalence and incidence of PAP in Korea are low, similar to those in other countries; however, Korean patients with PAP are characterized by older diagnostic age and a lower male-to-female ratio.

Published
2020

7. Experiencia en el desarrollo e implementación de la metodología de grupos relacionados por diagnóstico en un hospital universitario chileno. Evaluación a diez años de funcionamiento

Author

María Alejandra Muñoz D, Valeria Sepúlveda S., and Alfredo Aguila R

Subjects
Hospital days, Gynecology, medicine.medical_specialty, business.industry, Clinical Coding, Managing Information System, General Medicine, Hospital mortality, Bed days, University hospital, 03 medical and health sciences, 0302 clinical medicine, Health Care Survey, Computer equipment, Severity of illness, Medicine, 030212 general & internal medicine, business, Clinical record, Hospital stay
Abstract

Background The Diagnosis Related Groups (DRG) constitute a method of classifying hospital discharges. Aim To report its development and implementation in a Chilean University Hospital and global results of 10 years Material and Methods We included 231,600 discharges from 2007 to 2016. In the development we considered the physical plant, clinical record flow, progressively incorporated human resources and computer equipment for coding and analysis to obtain results. The parameters used were: average stay, average DRG weight, mean of diagnosis and codified procedures, behavior of upper outliers, hospital mortality, distribution by severity and its relationship with other variables. Results The global complexity index was 0.9929. The average of diagnoses coded was 4.35 and of procedures was 7.21. The average stay was 4.56 days, with a downward trend. The top outliers corresponded to 2.25%, with stable hospital days and average DRG weight. The median of hospital mortality was 1.65% with a tendency to decrease and stable DRG mean weight. Seventy two percent had a grade 1 severity, with low median hospital stay. They occupied 40% of bed days. Nine percent had a grade 3 severity with high median hospital stay and accounting for 31.5% of bed days. Conclusions DRG methodology is a valuable information tool for decision making and result assessment in hospital management.

Published
2019

8. Continuous flow insufflation of oxygen compared with manual ventilation during out-of-hospital cardiac arrest: A survey of the paramedics

Author

Alexandra Nadeau, Mathieu Groulx, Pierre-Gilles Blanchard, Marcel Émond, Jessica Harrisson, Douglas Eramian, and Eric Mercier

Subjects
Insufflation, Medicine (General), airway management, Standard of care, business.industry, Continuous flow, medicine.medical_treatment, health care survey, 030208 emergency & critical care medicine, cardiac arrest, General Medicine, 030204 cardiovascular system & hematology, Continuous flow insufflation, Supraglottic airway, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, R5-920, Anesthesia, Medicine, Airway management, Original Research Article, paramedics, Manual ventilation, business
Abstract

Introduction: In 2018, a continuous flow insufflation of oxygen (CFIO) device (b-card™, Vygon (USA)) placed on a supraglottic airway (SGA) became the standard of care to ventilate patients during adult out-of-hospital cardiac arrest (OHCA) care in Quebec–Capitale-Nationale region, Canada. This study aims to assess the paramedics’ perception as well as the disadvantages and the benefits relative to the use of CFIO during OHCA management. Methods: An invitation to complete an online survey (Survey Monkey™) was sent to all 560 paramedics who are working in our region. The survey included 22 questions of which 9 aimed to compare the traditional manual ventilation with a bag to the CFIO using a 5-point Likert-type scale. Results: A total of 244 paramedics completed the survey, of which 189 (77.5%) had used the CFIO device during an OHCA at least once. Most respondents felt that the intervention was faster (70.2%) and easier (86.5%) with the CFIO device compared with manual ventilation. CFIO was also associated with perceived increased patient safety (64.4%) as well as paramedic safety during the evacuation (88.9%) and the ambulance transport (88.9%). Paramedics reported that physical (48.1%) and cognitive (52.9%) fatigue were also improved with CFIO. The main reported barriers were the bending of the external SGA tube and the loss of capnography values. Conclusion: The use of CFIO during adult OHCA care allows a simplified approach and was perceived as safer for the patient and the paramedics compared with manual ventilation. Its impact on patient-centred outcomes needs to be assessed.

Published
2021

9. Coverage of cancer services in Australia and providers’ views on service gaps: findings from a national cross-sectional survey

Author

Caroline Smith, Kate Templeman, Jennifer Hunter, Geoffrey P Delaney, Jane M Ussher, and Suzanne J Grant

Subjects
0301 basic medicine, Cancer Research, Cross-sectional study, Survivorship, Health services financing, 0302 clinical medicine, Cancer Survivors, Neoplasms, Surveys and Questionnaires, Health care, Prevalence, Prospective Studies, Child, Qualitative Research, Multinomial logistic regression, Oncologists, Oncology service, Health care survey, Palliative Care, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Outreach, Oncology, 030220 oncology & carcinogenesis, Respondent, Public Health, Research Article, Specialization, Adult, medicine.medical_specialty, Adolescent, Cancer Care Facilities, lcsh:RC254-282, 03 medical and health sciences, Survivorship curve, Genetics, medicine, Humans, Descriptive statistics, business.industry, Ownership, Australia, Hospices, Private sector, Cross-Sectional Studies, Logistic Models, 030104 developmental biology, Family medicine, Rural Health Services, Business, Delivery of Health Care
Abstract

Background In response to the increasing cancer prevalence and the evolving health service landscape across the public and private health sectors in Australia, this study aimed to map cancer services and identify factors associated with service provision and important service gaps. Methods A prospective, cross-sectional survey was conducted throughout 2016. Extensive search strategies identified Government or privately-owned, hospital or community-based healthcare organisations with dedicated cancer services. One nominated staff member from each organisation answered a purpose specific online/paper questionnaire. Descriptive statistics, standardised rates, and single level and multilevel multinomial logistic regression were used to analyse the data. Analysis was augmented with a qualitative descriptive analysis of open-ended questions. Results From the 295 eligible organisations with a cancer service in Australia, 93.2% participated in the survey. After adjusting for remoteness, for-profit companies were significantly more likely than Government operated services to provide only one or two types of cancer services (e.g. radiotherapy) in a limited range of settings (e.g. day hospital with no in-patient or home care) (p

Published
2019

10. Impact of the COVID-19 pandemic on the selection of chest imaging modalities and reporting systems: a survey of Italian radiologists

Author

Alessandra Farchione, Cristiano Rampinelli, Roberto Iezzi, Andrea Borghesi, Elisa Baratella, Roberto Grassi, Adele Valentini, Maurizio Balbi, Ilaria Pulzato, Giancarlo Cortese, Roberta Polverosi, Stefano Palmucci, Lucio Calandriello, Anna Rita Larici, Chiara Romei, Marco Busso, Nicola Sverzellati, Borghesi, A., Sverzellati, N., Polverosi, R., Balbi, M., Baratella, E., Busso, M., Calandriello, L., Cortese, G., Farchione, A., Iezzi, R., Palmucci, S., Pulzato, I., Rampinelli, C., Romei, C., Valentini, A., Grassi, R., Larici, A. R., Borghesi, Andrea, Sverzellati, Nicola, Polverosi, Roberta, Balbi, Maurizio, Baratella, Elisa, Busso, Marco, Calandriello, Lucio, Cortese, Giancarlo, Farchione, Alessandra, Iezzi, Roberto, Palmucci, Stefano, Pulzato, Ilaria, Rampinelli, Cristiano, Romei, Chiara, Valentini, Adele, Grassi, Roberto, and Larici, Anna Rita

Subjects
medicine.medical_specialty, Consensus, Coronavirus disease 2019 (COVID-19), Chest Radiology, Consensu, Computed tomography, Radiology, Interventional, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, COVID-19, Diagnostic imaging, SARS-CoV-2, Surveys and questionnaires, Radiologists, Pandemic, medicine, Humans, Surveys and questionnaire, Radiology, Nuclear Medicine and imaging, Medical physics, Pandemics, Lung, Societies, Medical, Ultrasonography, Modality (human–computer interaction), Chest imaging, Modalities, Radiology Department, Hospital, medicine.diagnostic_test, business.industry, Interventional radiology, General Medicine, medicine.disease, Pneumonia, Italy, Health Care Survey, Health Care Surveys, Radiologist, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Radiography, Thoracic, Tomography, X-Ray Computed, business, Human
Abstract

Purpose Chest imaging modalities play a key role for the management of patient with coronavirus disease (COVID-19). Unfortunately, there is no consensus on the optimal chest imaging approach in the evaluation of patients with COVID-19 pneumonia, and radiology departments tend to use different approaches. Thus, the main objective of this survey was to assess how chest imaging modalities have been used during the different phases of the first COVID-19 wave in Italy, and which diagnostic technique and reporting system would have been preferred based on the experience gained during the pandemic. Material and Methods The questionnaire of the survey consisted of 26 questions. The link to participate in the survey was sent to all members of the Italian Society of Medical and Interventional Radiology (SIRM). Results The survey gathered responses from 716 SIRM members. The most notable result was that the most used and preferred chest imaging modality to assess/exclude/monitor COVID-19 pneumonia during the different phases of the first COVID-19 wave was computed tomography (51.8% to 77.1% of participants). Additionally, while the narrative report was the most used reporting system (55.6% of respondents), one-third of participants would have preferred to utilize structured reporting systems. Conclusion This survey shows that the participants’ responses did not properly align with the imaging guidelines for managing COVID-19 that have been made by several scientific, including SIRM. Therefore, there is a need for continuing education to keep radiologists up to date and aware of the advantages and limitations of the chest imaging modalities and reporting systems.

Published
2021

11. Latin American ophthalmology practitioner’s perception on current COVID-19 pandemic

Author

Nancy Carolina Quezada del Cid, Verónica Yaneth Burgos Elías, Martin Arturo Zimmermann Paiz, Edison Leonardo Montes Villalva, Evelyn del Busto Wilhelm, Nora Lucía Oliva Castillo, and Ana Marissa Ordoñez Rivas

Subjects
medicine.medical_specialty, Latin Americans, media_common.quotation_subject, MEDLINE, Coronavirus infections, Disease, Surveys and Questionnaires, Ophthalmology, Perception, Pandemic, medicine, Humans, Pandemics, Personal protective equipment, media_common, Response rate (survey), SARS-CoV-2, business.industry, Health care survey, COVID-19, General Medicine, RE1-994, Latin America, SARS-Cov2, Latin America, Anxiety, medicine.symptom, business
Abstract

Purpose: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. Methods: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. Results: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. Conclusion: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.

Published
2021

12. Geographical Distribution, Incidence, Malignancies, and Outcome of 136 Eastern Slavic Patients With Nijmegen Breakage Syndrome and NBN Founder Variant c.657_661del5

Author

Ihor Savchak, Irina A. Tuzankina, E.A. Latysheva, Halyna Makukh, Anastasiia Bondarenko, Mikhail Belevtsev, Inga S. Sakovich, Elena I. Golovataya, Svetlana A. Kulyova, Larysa Kostyuchenko, Jolan E. Walter, Alexander Popa, Dzmitry S. Varabyou, Natalia V. Rumiantseva, Mei-Sing Ong, Alexander G. Beznoshchenko, Svetlana S. Vakhlyarskaya, Mark Ballow, Ekaterina A. Polyakova, Olga E. Pashchenko, Olga Aleinikova, Yuliya Mareika, Svetlana Aleshkevich, Elena V. Vlasova, Olena Kozlova, Svetlana O. Sharapova, Irina V. Naumchik, Nina V. Minakovskaya, Hayane Akopyan, Timur T. Valiev, Alina Fedorova, Tatjana Prokofjeva, Tatiana V. Latysheva, and Irina Kondratenko

Subjects
0301 basic medicine, Pediatrics, GEOGRAPHIC DISTRIBUTION, medicine.medical_treatment, NONHODGKIN LYMPHOMA, LYMPHOPROLIFERATIVE DISORDERS, EASTERN EUROPE, Hematopoietic stem cell transplantation, MAJOR CLINICAL STUDY, ADOLESCENT, lymphomas, risk of malignancies, IMMUNOLOGY, Nijmegen breakage syndrome (NBS), NUCLEAR PROTEIN, 0302 clinical medicine, CHILD, EVENT FREE SURVIVAL, RETROSPECTIVE STUDIES, RETROSPECTIVE STUDY, NBN PROTEIN, HUMAN, Immunology and Allergy, LYMPHOMAS, RISK OF MALIGNANCIES, COGNITIVE DEFECT, EPIDEMIOLOGY, FOUNDER VARIANTS, geographical location, Family history, incidence in East Slavs, Immunodeficiency, MALIGNANT NEOPLASM, Incidence (epidemiology), HUMAN, ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, HEALTH CARE SURVEY, HEMATOPOIETIC STEM CELL TRANSPLANTATION, CLINICAL TRIAL, HUMANS, INCIDENCE IN EAST SLAVS, HEMATOLOGIC NEOPLASMS, FOUNDER EFFECT, FEMALE, LYMPHOPROLIFERATIVE DISEASE, PREVALENCE, SOCIAL ADAPTATION, IMMUNE DEFICIENCY, FOLLOW UP, MENTAL HEALTH, Cohort, HEMATOLOGIC DISEASE, B CELL LYMPHOMA, CANCER SURVIVAL, HODGKIN DISEASE, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, NIJMEGEN BREAKAGE SYNDROME, GENETICS, Genetic counseling, Immunology, COHORT ANALYSIS, CELL CYCLE PROTEINS, Malignancy, founder variants, 03 medical and health sciences, NIJMEGEN BREAKAGE SYNDROME (NBS), QUALITY OF LIFE, ADULT, GEOGRAPHICAL LOCATION, medicine, ARTICLE, CELL CYCLE PROTEIN, CHILD, PRESCHOOL, FOLLOW-UP STUDIES, MALE, business.industry, MORTALITY, ACUTE LYMPHOBLASTIC LEUKEMIA, social adaptation, medicine.disease, NIBRIN, 030104 developmental biology, BURKITT LYMPHOMA, OVERALL SURVIVAL, PRESCHOOL CHILD, NUCLEAR PROTEINS, MULTICENTER STUDY, INFANT, EUROPE, EASTERN, business, lcsh:RC581-607, Nijmegen breakage syndrome, 030215 immunology, INCIDENCE
Abstract

Nijmegen breakage syndrome (NBS) is a DNA repair disorder characterized by combined immunodeficiency and a high predisposition to lymphoid malignancies. The majority of NBS patients are identified with a homozygous five base pair deletion in the Nibrin (NBN) gene (c.657_661del5, p.K219fsX19) with a founder effect observed in Caucasian European populations, especially of Slavic origin. We present here an analysis of a cohort of 136 NBS patients of Eastern Slav origin across Belarus, Ukraine, Russia, and Latvia with a focus on understanding the geographic distribution, incidence of malignancy, and treatment outcomes of this cohort. Our analysis shows that Belarus had the highest prevalence of NBS (2.3 per 1,000,000), followed by Ukraine (1.3 per 1,000,000), and Russia (0.7 per 1,000,000). Of note, the highest concentration of NBS cases was observed in the western regions of Belarus and Ukraine, where NBS prevalence exceeds 20 cases per 1,000,000 people, suggesting the presence of an “Eastern Slavic NBS hot spot.” The median age at diagnosis of this cohort ranged from 4 to 5 years, and delay in diagnosis was more pervasive in smaller cities and rural regions. A total of 62 (45%) patients developed malignancies, more commonly in males than females (55.2 vs. 34.2%; p=0.017). In 27 patients, NBS was diagnosed following the onset of malignancies (mean age: 8 years). Malignancies were mostly of lymphoid origin and predominantly non-Hodgkin lymphoma (NHL) (n=42, 68%); 38% of patients had diffuse large B-cell lymphoma. The 20-year overall survival rate of patients with malignancy was 24%. However, females with cancer experienced poorer event-free survival rates than males (16.6% vs. 46.8%, p=0.036). Of 136 NBS patients, 13 underwent hematopoietic stem cell transplantation (HSCT) with an overall survival of 3.5 years following treatment (range: 1 to 14 years). Indications for HSCT included malignancy (n=7) and immunodeficiency (n=6). Overall, 9% of patients in this cohort reached adulthood. Adult survivors reported diminished quality of life with significant physical and cognitive impairments. Our study highlights the need to improve timely diagnosis and clinical management of NBS among Eastern Slavs. Genetic counseling and screening should be offered to individuals with a family history of NBS, especially in hot spot regions. © Copyright © 2021 Sharapova, Pashchenko, Bondarenko, Vakhlyarskaya, Prokofjeva, Fedorova, Savchak, Mareika, Valiev, Popa, Tuzankina, Vlasova, Sakovich, Polyakova, Rumiantseva, Naumchik, Kulyova, Aleshkevich, Golovataya, Minakovskaya, Belevtsev, Latysheva, Latysheva, Beznoshchenko, Akopyan, Makukh, Kozlova, Varabyou, Ballow, Ong, Walter, Kondratenko, Kostyuchenko and Aleinikova. We thank all doctors for clinical help for patients. We also appreciate the support of patient and their parents for agreeing to take part in this study. TP thanks Sergey?Nikulshin, Marika Grutupa, and Zanna Kovalova. We thank Joseph Dasso for editing this manuscript, primarily for proper English.

Published
2021

13. Counterbalancing COVID-19 with Cancer Surveillance and Therapy: A Survey of Patients with Renal Cell Carcinoma

Author

Dena Battle, Cristiane Decat Bergerot, Michael Staehler, and Sumanta K. Pal

Subjects
Adult, Male, medicine.medical_specialty, Urology, Population, 030232 urology & nephrology, Disease, Anxiety, Frustration, 03 medical and health sciences, 0302 clinical medicine, Renal cell carcinoma, Internal medicine, Pandemic, medicine, Humans, education, Carcinoma, Renal Cell, Pandemics, Qualitative Research, Aged, education.field_of_study, business.industry, SARS-CoV-2, Health care survey, Cancer, COVID-19, Middle Aged, medicine.disease, Kidney Cancer, Kidney Neoplasms, 030220 oncology & carcinogenesis, Localized disease, Health Care Surveys, Population Surveillance, Quality of Life, Female, medicine.symptom, Qualitative study, business, Kidney cancer
Abstract

Background While providers are challenged with treatment decisions during the coronavirus disease 2019 (COVID-19) crisis, decision making ultimately falls in the hands of patients—at present, their perspective is poorly understood. Objective To ascertain renal cell carcinoma (RCC) patients’ perspectives on COVID-19 and understand the associated implications for treatment. Design, setting, and participants An online survey of RCC patients was conducted from March 22 to March 25, 2020, disseminated through social media and patient networking platforms. The survey comprised 45 items, including baseline demographic, clinicopathologic, and treatment-related information. Patients were additionally queried regarding their anxiety level related to COVID-19 and associated implications for their cancer diagnosis. Intervention An online survey study. Outcome measurements and statistical analysis Descriptive statistics with graphical outputs were used to characterize survey results. Results and limitations A total of 539 patients (male:female 39%:58%) from 14 countries responded. Of them, 71% felt that their risk of COVID-19 infection was higher than the general population, and 27% contacted their physician to establish this. Among patients with localized disease (40%), most (42%) had scheduled surveillance scans within 6 wk–65% were unwilling to delay scans. Among patients with metastatic disease, 76% were receiving active therapy. While most patients preferred not to defer therapy (51%), patients receiving immune therapy regimens were less amenable to deferring therapy than those receiving targeted treatment (20% vs 47%). Conclusions Despite high levels of anxiety surrounding COVID-19, many patients with RCC were inclined to adhere to existing schedules of surveillance (localized disease) and systemic treatment (metastatic disease). Patient summary The coronavirus disease 2019 (COVID-19) pandemic has prompted many doctors to develop different treatment strategies for cancer and other chronic conditions. Given the importance of the patient voice in these strategies, we conducted a survey of patients with kidney cancer to determine their treatment preferences. Our survey highlighted that most patients prefer to continue their current strategies of kidney cancer treatment and monitoring., Take Home Message Through an online survey of 539 renal cell carcinoma patients conducted over a 3-d span, we identified that patients have significant anxiety related to coronavirus disease 2019 (COVID-19), which is counterbalanced by a similar level of anxiety related to cancer recurrence or progression. The majority of patients did not want to alter previously designated plans for cancer surveillance or treatment.

Published
2020

14. The Economic Impact and Health-Related Quality of Life of Spinal Muscular Atrophy. An Analysis across Europe

Author

Eduardo F Tizzano, Svenja Litzkendorf, Juan Oliva-Moreno, Isaac Aranda-Reneo, Isabelle Durand-Zaleski, Luz María Peña-Longobardo, Julio López-Bastida, Universidad de Castilla-La Mancha = University of Castilla-La Mancha (UCLM), Leibniz Universität Hannover=Leibniz University Hannover, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Vall d'Hebron University Hospital [Barcelona], Biogen, Lallemant, Christopher, Universidad de Castilla-La Mancha (UCLM), Leibniz University Hannover, and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Gerontology, Total cost, Health Status, Health, Toxicology and Mutagenesis, Health-related quality of life, health care survey, Dewey Decimal Classification::600 | Technik::620 | Ingenieurwissenschaften und Maschinenbau, lcsh:Medicine, Social Welfare, Disease, Economic burden, 0302 clinical medicine, Cost of Illness, cost analysis, Sickness Impact Profile, Surveys and Questionnaires, Germany, Health care, Medicine, Barthel index, 030212 general & internal medicine, Economic impact analysis, Child, health care economics and organizations, spinal muscular atrophy, [SDV.EE]Life Sciences [q-bio]/Ecology, environment, 030503 health policy & services, adult, public health, 1. No poverty, health care cost, Health Care Costs, SMA, health care, Informal care, 3. Good health, informal care, socioeconomic impact, health-related quality of life, Europe, [SDV.EE] Life Sciences [q-bio]/Ecology, environment, female, Caregivers, health care policy, social aspect, economic burden, France, Sick Leave, ddc:620, 0305 other medical science, economic impact, Article, Muscular Atrophy, Spinal, 03 medical and health sciences, Quality of life (healthcare), ddc:690, male, health care utilization, Humans, cross-sectional study, ddc:610, Socioeconomic status, caregiver burden, European Quality of Life 5 Dimensions questionnaire, business.industry, social work, lcsh:R, Public Health, Environmental and Occupational Health, Cost-of-illness, economic aspect, major clinical study, United Kingdom, Cross-Sectional Studies, cost-of-illness, quality of life, adolescent, Dewey Decimal Classification::600 | Technik::690 | Hausbau, Bauhandwerk, social impact, Dewey Decimal Classification::600 | Technik::610 | Medizin, Gesundheit, business
Abstract

Background: this study aimed to estimate the economic impact and health-related quality of life (HRQOL) of patients with spinal muscular atrophy (SMA) in three European countries. It was used a cross-sectional study carried out in France, Germany, and the United Kingdom. Data were collected from July 2015 to November 2015. Healthcare costs (hospitalizations, emergencies, medical tests, drugs used, visits to general practitioners (GPs) and specialists, medical material and healthcare transport), and non-healthcare costs (social services and informal care) were identified and valued. EuroQol instruments, the Zarit interview, and the Barthel Index were also used to reflect the burden and the social impact of the disease beyond the cost of healthcare. Results: we included 86 children with SMA, 26.7% of them had Type I, and 73.3% Type II or III. The annual average cost associated with SMA reaches &euro, 54,295 in the UK, &euro, 32,042 in France and &euro, 51,983 in Germany. The direct non-healthcare costs ranged between 79&ndash, 86% of the total cost and the informal care costs were the main component of these costs. Additionally, people suffering from this disease have a very low health-related quality of life, and there are large differences between countries. Conclusions: SMA has a high socioeconomic impact in terms of healthcare and social costs. It was also observed that the HRQOL of affected children was extremely reduced. The figures shown in this study may help to design more efficient and equitable policies, with special emphasis on the support provided to the families or on non-healthcare aid.

Published
2020

15. COVID-19 and financial toxicity in patients with renal cell carcinoma

Author

Michael Staehler, Cristiane Decat Bergerot, Sumanta K. Pal, David F. Penson, and Dena Battle

Subjects
Male, Coronavirus disease 2019 (COVID-19), Urology, Psycho-Oncology, Antineoplastic Agents, Financial Stress, Disease, Systemic therapy, Frustration, Financial toxicity, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Renal cell carcinoma, Surveys and Questionnaires, Medicine, Humans, In patient, 030212 general & internal medicine, Carcinoma, Renal Cell, Neoplasm Staging, Finance, business.industry, SARS-CoV-2, Health care survey, Cancer, COVID-19, Middle Aged, medicine.disease, Kidney Neoplasms, United States, 030220 oncology & carcinogenesis, COST score, Toxicity, Quality of Life, Anxiety, Female, Original Article, medicine.symptom, Qualitative study, business
Abstract

Purpose To ascertain renal cell carcinoma (RCC) financial toxicity on COVID-19 during the COVID-19 crisis as patients are struggling with therapeutic and financial implications. Methods An online survey was conducted from March 22 to March 25, 2020. It included baseline demographic, clinicopathologic, treatment-related information, anxiety levels related to COVID-19, questions related to financial concerns about COVID-19 as well as the validated 11-item COST measure. Results Five-hundred-and-thirty-nine patients (39%:58% male:female) from 14 countries responded. 23% of the patients did not feel in control of their financial situation but 8% reported being very satisfied with their finances. The median COST score was 21.5 (range 1–44). Metastatic patients who have not started systemic therapy had a COST score (19.8 range 2–41) versus patients on oral systemic therapy had a COST score (23.9 range 4–44). Patients in follow-up after surgery had a median COST score at 20.8 (range 1–40). A low COST scores correlated (p r = 0.108), younger age (r = 0.210), urban living situation (r = 0.68), a lower educational level (r = 0.155), lower income (r = 0.165), higher anxiety about acquiring COVID-19 (r = 0.198), having metastatic disease (r = 0.073) and a higher distress score about cancer progression (r = 0.224). Conclusion Our data highlight severe financial impact of COVID-19. Acknowledging financial hardship and thorough counseling of cancer patients should be part of the conversation during the pandemic. Treatment and surveillance of RCC patients might have to be adjusted to contemplate financial and medical needs.

Published
2020

16. Promoting healthy weight for all young children: a mixed methods study of child and family health nurses’ perceptions of barriers and how to overcome them

Author

Alison Tutt, Rachel Laws, Chris Rossiter, Anne McKenzie, Heilok Cheng, Rosslyn Eames-Brown, Rochelle Seabury, Victoria Blight, Karen J. Campbell, Cathrine Fowler, Kyra Sim, and Elizabeth Denney-Wilson

Subjects
Gerontology, Community health nurses, Breastfeeding, Overweight, Childhood obesity, 03 medical and health sciences, Screen time, 0302 clinical medicine, Nursing, Child and family health nurses, Qualitative research, Global health, Cultural diversity, Medicine, Ethnically diverse populations, 030212 general & internal medicine, Nursing management, Socioeconomic status, General Nursing, lcsh:RT1-120, Obesity management, 030504 nursing, lcsh:Nursing, business.industry, Health care survey, Nursing research, Infant, Pediatric obesity, medicine.disease, Rapid weight gain, medicine.symptom, 0305 other medical science, business, Research Article
Abstract

BackgroundChildhood obesity is a global health concern. Early intervention to help parents adopt best practice for infant feeding and physical activity is critical for maintaining healthy weight. Australian governments provide universal free primary healthcare from child and family health nurses (CFHNs) to support families with children aged up to five years and to provide evidence-based advice to parents. This paper aims to examine factors influencing the child obesity prevention practices of CFHNs and to identify opportunities to support them in promoting healthy infant growth.MethodsThis mixed methods study used a survey (n = 90) and semi-structured interviews (n = 20) with CFHNs working in two local health districts in Sydney, Australia. Survey data were analysed descriptively; interview transcripts were coded and analysed iteratively. Survey and interview questions examined how CFHNs addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behaviour during routine consultations; factors influencing such practices; and how CFHNs could be best supported.ResultsCFHNs frequently advised parents on breastfeeding, introducing solid foods, and techniques for settling infants. They spent less time providing advice on evidence-based formula feeding practices or encouraging physical activity in young children. Although nurses frequently weighed and measured children, they did not always use growth charts to identify those at risk of becoming overweight or obese. Nurses identified several barriers to promoting healthy weight gain in infants and young children, including limited parental recognition of overweight in their children or motivation to change diet or lifestyle; socioeconomic factors (such as the cost of healthy food); and beliefs and attitudes about infant weight and the importance of breastfeeding and physical activity amongst parents and family members.ConclusionsCFHNs require further education and support for their role in promoting optimal child growth and development, especially training in behaviour change techniques to increase parents’ understanding of healthy infant weight gain. Parent information resources should be accessible and address cultural diversity. Resources should highlight the health effects of childhood overweight and obesity and emphasise the benefits of breastfeeding, appropriate formula feeding, suitable first foods, responsiveness to infant feeding cues, active play and limiting screen time.

Published
2020

17. Impact of covid-19 in gynecologic oncology: A nationwide italian survey of the sigo and mito groups

Author

Giuseppe Trojano, G. Salerno, Mezzanzanica Delia, Stefano Greggi, Gabriella Ferrandina, Francesco Raspagliesi, Vito Trojano, Alice Bergamini, Giovanni Scambia, Giorgio Giorda, Giorgio Valabrega, Paolo Scollo, Francesco Sopracordevole, Antonio Chiantera, Gianfranco Zannoni, Ciro Pinelli, Giorgio Bogani, Salvatore Lopez, Pierluigi Benedetti Panici, Fulvio Zullo, Mauro Signorelli, Jvan Casarin, Roberto Angioli, Vito Chiantera, Luca Bocciolone, Antonino Ditto, Antonia Carla Testa, Violante Di Donato, Massimo Franchi, Antonella Savarese, Enrico Vizza, Giovanni Apolone, Enrico Sartori, Mario Malzoni, Sandro Pignata, Innocenza Palaia, Fabio Ghezzi, Fabio Martinelli, Bogani G., Apolone G., Ditto A., Scambia G., Panici P.B., Angioli R., Pignata S., Greggi S., Scollo P., Delia M., Franchi M., Martinelli F., Signorelli M., Lopez S., Di Donato V., Valabrega G., Ferrandina G., Palaia I., Bergamini A., Bocciolone L., Savarese A., Ghezzi F., Casarin J., Pinelli C., Trojano V., Chiantera V., Giorda G., Sopracordevole F., Malzoni M., Salerno G., Sartori E., Testa A., Zannoni G., Zullo F., Vizza E., Trojano G., Chiantera A., and Raspagliesi F.

Subjects
International Cooperation, Computer-assisted web interviewing, COVID-19, Health Care Surveys, SARS-CoV-2 Infection, Surgical Oncology, Betacoronavirus, Coronavirus Infections, Female, Genital Neoplasms, Female, Gynecologic Surgical Procedures, Gynecology, Humans, Infection Control, Italy, Medical Oncology, Pandemics, Pneumonia, Viral, SARS-CoV-2, Societies, Medical, Surveys and Questionnaires, Triage, 0302 clinical medicine, Surgical oncology, Gynecologic Surgical Procedure, Pandemic, Health care, Medicine, Infection control, Viral, Statistics & numerical data, Survey, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, General Medicine, Oncology, 030220 oncology & carcinogenesis, Original Article, Genital Neoplasms, medicine.medical_specialty, Gynecologic oncology, 03 medical and health sciences, Medical, Betacoronaviru, business.industry, Coronavirus Infection, Pneumonia, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Health Care Survey, Family medicine, business, Societies
Abstract

Objective Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. Methods The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. Results Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%-15%), and to perform less radical surgical procedures (20%-25%) during COVID-19 pandemic. Conclusions National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.

Published
2020

18. The search and selection for primary studies in systematic reviews published in dental journals indexed in MEDLINE was not fully reproducible

Author

Nikolaos Pandis, Marco Antonio Alarcón, Luisiana Aranda, Raquel Huivin, and Clovis Mariano Faggion

Subjects
medical literature, medicine.medical_specialty, Evidence-based practice, Abstracting and Indexing, Epidemiology, MEDLINE, health care survey, Information Storage and Retrieval, purl.org/pe-repo/ocde/ford#3.03.09 [https], information processing, Article, 03 medical and health sciences, 0302 clinical medicine, systematic review, Meta-Analysis as Topic, medicine, human, 030212 general & internal medicine, 610 Medicine & health, reproducibility, Selection (genetic algorithm), dentistry, Impact factor, business.industry, Medline, Reproducibility of Results, 030206 dentistry, journal impact factor, Systematic review, priority journal, Dentistry, Family medicine, meta analysis (topic), Regression Analysis, systematic review (topic), Journal Impact Factor, Periodicals as Topic, business, Systematic Reviews as Topic, Medical literature
Abstract

Objectives To evaluate whether the reporting of search strategies and the primary study selection process in dental systematic reviews is reproducible. Study Design and Setting A survey of systematic reviews published in MEDLINE-indexed dental journals from June 2015 to June 2016 was conducted. Study selection was performed independently by two authors, and the reproducibility of the selection process was assessed using a tool consisting of 12 criteria. Regression analyses were implemented to evaluate any associations between degrees of reporting (measured by the number of items positively answered) and journal impact factor (IF), presence of meta-analysis, and number of citations of the systematic review in Google Scholar. Results Five hundred and thirty systematic reviews were identified. Following our 12 criteria, none of the systematic reviews had complete reporting of the search strategies and selection process. Eight (1.5%) systematic reviews reported the list of excluded articles (with reasons for exclusion) after title and abstract assessment. Systematic reviews with more positive answers to the criteria were significantly associated with higher journal IF, number of citations, and inclusion of meta-analysis. Conclusion Search strategies and primary study selection process in systematic reviews published in MEDLINE-indexed dental journals may not be fully reproducible.

Published
2018

19. Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care

Author

Mef Nilbert, Oskar Hagberg, Linn Rosell, and Nathalie Alexandersson

Subjects
Adult, Male, medicine.medical_specialty, Attitude of Health Personnel, Health Personnel, Multidisciplinary team conference, Patient Care Team/organization & administration, Multidisciplinary team, Health informatics, Health administration, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Multidisciplinary approach, Neoplasms, Physicians, Surveys and Questionnaires, Neoplasms/therapy, Medicine, Humans, 030212 general & internal medicine, Competence (human resources), Cross-sectional study, Aged, Patient Care Team, Sweden, Medical education, business.industry, Health Policy, Public health, Nursing research, Health care survey, lcsh:Public aspects of medicine, Patient preferences, lcsh:RA1-1270, Middle Aged, Health Personnel/organization & administration, Clinical trial, Cross-Sectional Studies, Physicians/organization & administration, 030220 oncology & carcinogenesis, Female, business, Tumor board, Research Article
Abstract

Background Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants’ views on the meeting function, including perceived benefits and barriers. Methods In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation. Results The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports. Conclusions Health professionals’ report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented. Electronic supplementary material The online version of this article (10.1186/s12913-018-2990-4) contains supplementary material, which is available to authorized users.

Published
2018

20. Expert clinical management of autoimmune hepatitis in the real world

Author

R. Liberal, Y. S. de Boer, R. J. Andrade, G. Bouma, G. N. Dalekos, A. Floreani, D. Gleeson, G. M. Hirschfield, P. Invernizzi, M. Lenzi, A. W. Lohse, G. Macedo, P. Milkiewicz, B. Terziroli, B. van Hoek, J. M. Vierling, M. A. Heneghan, on behalf of the International Autoimmune Hepatitis Group (IAIHG), A. Pares, A. J. Montano-Loza, A. Granito, A. E. Kremer, C. Schramm, C. Lammert, E. L. R. Cancado, E. Bjornsson, F. Lammert, G. M. Hirschflield, H. Hofer, I. Mackay, J. Neuberger, J. P. H. Drenth, C. M. J. van Nieuwkerk, L. Muratori, M. Swain, M. Heneghan, M. Zeniya, O. Chazouilleres, P. Gines, R. Chapman, T. Berg, H. van Buuren, X. Ma, Gastroenterology and hepatology, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, AII - Inflammatory diseases, Pediatric surgery, Liberal, R, de Boer, Y, Andrade, R, Bouma, G, Dalekos, G, Floreani, A, Gleeson, D, Hirschfield, G, Invernizzi, P, Lenzi, M, Lohse, A, Macedo, G, Milkiewicz, P, Terziroli, B, van Hoek, B, Vierling, J, Heneghan, M, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, R. Liberal, Y. S. de Boer, R. J. Andrade, G. Bouma, G. N. Daleko, A. Floreani, D. Gleeson, G. M. Hirschfield, P. Invernizzi, M. Lenzi, A. W. Lohse, G. Macedo, P. Milkiewicz, B. Terziroli, B. van Hoek, J. M. Vierling, M. A. Heneghan, on behalf of the International Autoimmune Hepatitis Group (IAIHG), A. Pare, A. J. Montano-Loza, A. Granito, A. E. Kremer, C. Schramm, C. Lammert, E. L. R. Cancado, E. Bjornsson, F. Lammert, G. M. Hirschflield, H. Hofer, I. Mackay, J. Neuberger, J.P.H. Drenth, C.M.J. van Nieuwkerk, L. Muratori, M. Swain, M. Heneghan, M. Zeniya, O. Chazouillere, P. Gine, R. Chapman, T. Berg, H. van Buuren, and X. Ma

Subjects
Pediatrics, medicine.medical_specialty, Evidence-based practice, Biopsy, Azathioprine, Autoimmune hepatitis, Tacrolimus, Hepatitis, Immunosuppressive Agent, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, MED/12 - GASTROENTEROLOGIA, medicine, Humans, Pharmacology (medical), Budesonide, Methyltransferase, Hepatology, Thiopurine methyltransferase, biology, business.industry, Gastroenterology, Cyclosporine, Health Care Surveys, Hepatitis, Autoimmune, Immunosuppressive Agents, Methyltransferases, Mycophenolic Acid, Rituximab, medicine.disease, Infliximab, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Health Care Survey, Tacrolimu, 030220 oncology & carcinogenesis, Immunology, biology.protein, 030211 gastroenterology & hepatology, business, Human, medicine.drug, Autoimmune
Abstract

none 55 si First published: 22 December 2016 Background: High-quality data on the management of autoimmune hepatitis (AIH) are scarce. Despite published guidelines, management of AIH is still expert based rather than evidence based. Aim: To survey expert hepatologists, asking each to describe their practices in the management of patients with AIH. Methods: A survey questionnaire was distributed to members of the International AIH Group. The questionnaire consisted of four clinical scenarios on different presentations of AIH. Results: Sixty surveys were sent, out of which 37 were returned. None reported budesonide as a first line induction agent for the acute presentation of AIH. Five (14%) participants reported using thiopurine S-methyltransferase measurements before commencement of thiopurine maintenance therapy. Thirteen (35%) routinely perform liver biopsy at 2 years of biochemical remission. If histological inflammatory activity is absent, four (11%) participants reduced azathioprine, whereas 10 (27%) attempted withdrawal altogether. Regarding the management of difficult-to-treat patients, mycophenolate mofetil is the most widely used second-line agent (n = ~450 in 28 centres), whereas tacrolimus (n = ~115 in 21 centres) and ciclosporin (n = ~112 in 18 centres) are less often reported. One centre reported considerable experience with infliximab, while rescue therapy with rituximab has been tried in seven centres. Conclusions: There is a wide variation in the management of patients with autoimmune hepatitis even among the most expert in the field. Although good quality evidence is lacking, there is considerable experience with second-line therapies. Future prospective studies should address these issues, so that we move from an expert- to an evidence- and personalised-based care in autoimmune hepatitis. mixed R. Liberal; Y. S. de Boer; R. J. Andrade; G. Bouma; G. N. Dalekos; A. Floreani; D. Gleeson; G. M. Hirschfield; P. Invernizzi; M. Lenzi; A. W. Lohse; G. Macedo; P. Milkiewicz; B. Terziroli; B. van Hoek; J. M. Vierling; M. A. Heneghan; on behalf of the International Autoimmune Hepatitis Group (IAIHG); A. Pares; A. J. Montano-Loza; A. Granito; A. E. Kremer; A. Floreani; A. W. Lohse; B. van Hoek; B. Terziroli; C. Schramm; C. Lammert; E. L. R. Cancado; E. Bjornsson; F. Lammert; G. N. Dalekos; G. Bouma; G. M. Hirschflield; G. Macedo; H. Hofer; I. Mackay; J. Neuberger; J. M. Vierling; J.P.H. Drenth; C.M.J. van Nieuwkerk; L. Muratori; M. Lenzi; M. Swain; M. Heneghan; M. Zeniya; O. Chazouilleres; P. Gines; P. Invernizzi; P. Milkiewicz; R. J. Andrade; R. Chapman; T. Berg; H. van Buuren; X. Ma R. Liberal; Y. S. de Boer; R. J. Andrade; G. Bouma; G. N. Dalekos; A. Floreani; D. Gleeson; G. M. Hirschfield; P. Invernizzi; M. Lenzi; A. W. Lohse; G. Macedo; P. Milkiewicz; B. Terziroli; B. van Hoek; J. M. Vierling; M. A. Heneghan; on behalf of the International Autoimmune Hepatitis Group (IAIHG); A. Pares; A. J. Montano-Loza; A. Granito; A. E. Kremer; A. Floreani; A. W. Lohse; B. van Hoek; B. Terziroli; C. Schramm; C. Lammert; E. L. R. Cancado; E. Bjornsson; F. Lammert; G. N. Dalekos; G. Bouma; G. M. Hirschflield; G. Macedo; H. Hofer; I. Mackay; J. Neuberger; J. M. Vierling; J.P.H. Drenth; C.M.J. van Nieuwkerk; L. Muratori; M. Lenzi; M. Swain; M. Heneghan; M. Zeniya; O. Chazouilleres; P. Gines; P. Invernizzi; P. Milkiewicz; R. J. Andrade; R. Chapman; T. Berg; H. van Buuren; X. Ma

Published
2017

21. OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians’ Outpatient Visit Notes

Author

Hannah Chimowitz, Jocelyn Perez, Joann G. Elmore, Catherine M. DesRoches, Kendall Harcourt, Leonor Fernandez, Macda Gerard, Patricia Fitzgerald, Zhiyong Dong, Suzanne G. Leveille, Hannah Shucard, Rebecca Stametz, Sara L. Jackson, Jan Walker, Sigall K. Bell, Thomas H. Payne, Tom Delbanco, and Alan Fossa

Subjects
Male, medicine.medical_specialty, 020205 medical informatics, media_common.quotation_subject, Ambulatory Visit, health care survey, Health Informatics, 02 engineering and technology, 03 medical and health sciences, 0302 clinical medicine, Reading (process), Intervention (counseling), Outpatients, 0202 electrical engineering, electronic engineering, information engineering, medicine, Electronic Health Records, Humans, 030212 general & internal medicine, Patient participation, patient portal, media_common, Patient Access to Records, Original Paper, Health management system, business.industry, Patient portal, electronic health record, Middle Aged, physician-patient relations, Corrigenda and Addenda, United States, Feeling, Family medicine, Female, patient participation, business, Surgical Specialty
Abstract

Background Following a 2010-2011 pilot intervention in which a limited sample of primary care doctors offered their patients secure Web-based portal access to their office visit notes, the participating sites expanded OpenNotes to nearly all clinicians in primary care, medical, and surgical specialty practices. Objective The aim of this study was to examine the ongoing experiences and perceptions of patients who read ambulatory visit notes written by a broad range of doctors, nurses, and other clinicians. Methods A total of 3 large US health systems in Boston, Seattle, and rural Pennsylvania conducted a Web-based survey of adult patients who used portal accounts and had at least 1 visit note available in a recent 12-month period. The main outcome measures included patient-reported behaviors and their perceptions concerning benefits versus risks. Results Among 136,815 patients who received invitations, 21.68% (29,656/136,815) responded. Of the 28,782 patient respondents, 62.82% (18,081/28,782) were female, 72.90% (20,982/28,782) were aged 45 years or older, 76.94% (22,146/28,782) were white, and 14.30% (4115/28,782) reported fair or poor health. Among the 22,947 who reported reading 1 or more notes, 3 out of 4 reported reading them for 1 year or longer, half reported reading at least 4 notes, and 37.74% (8588/22,753) shared a note with someone else. Patients rated note reading as very important for helping take care of their health (16,354/22,520, 72.62%), feeling in control of their care (15,726/22,515, 69.85%), and remembering the plan of care (14,821/22,516, 65.82%). Few were very confused (737/22,304, 3.3%) or more worried (1078/22,303, 4.83%) after reading notes. About a third reported being encouraged by their clinicians to read notes and a third told their clinicians they had read them. Less educated, nonwhite, older, and Hispanic patients, and individuals who usually did not speak English at home, were those most likely to report major benefits from note reading. Nearly all respondents (22,593/22,947, 98.46%) thought Web-based access to visit notes a good idea, and 62.38% (13,427/21,525) rated this practice as very important for choosing a future provider. Conclusions In this first large-scale survey of patient experiences with a broad range of clinicians working in practices in which shared notes are well established, patients find note reading very important for their health management and share their notes frequently with others. Patients are rarely troubled by what they read, and those traditionally underserved in the United States report particular benefit. However, fewer than half of clinicians and patients actively address their shared notes during visits. As the practice continues to spread rapidly in the United States and internationally, our findings indicate that OpenNotes brings benefits to patients that largely outweigh the risks.

Published
2019

22. Sources of Frustration Among Patients Diagnosed With Renal Cell Carcinoma

Author

Paulo Gustavo Bergerot, Daniel J. George, Cristiane Decat Bergerot, Sumanta K. Pal, Hans J. Hammers, Börje Ljungberg, Dena Battle, Eric Jonasch, Michael Staehler, Axel Bex, and Nazli Dizman

Subjects
0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, renal cell carcinoma, frustration, health care survey, qualitative study, fear of cancer recurrence, urologic and male genital diseases, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, Renal cell carcinoma, Internal medicine, Urologi och njurmedicin, medicine, Urology and Nephrology, Original Research, Cancer och onkologi, business.industry, International survey, Cancer, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 030104 developmental biology, 030220 oncology & carcinogenesis, Cancer and Oncology, business
Abstract

Despite numerous therapeutic advances in renal cell carcinoma (RCC), little is known about patients' perspectives on cancer care. An international survey was conducted to identify points of frustration associated with cancer care reported by patients with RCC. Data were obtained from an online survey, conducted from April 1 to June 15, 2017, through social media and patient networking platforms. This survey obtained baseline demographic, clinicopathologic, and treatment-related information. Open-ended questions accessed sources of frustration in cancer-related care and patients' suggestions for amelioration. Responses were categorized and reviewed by independent reviewers. A qualitative analysis was performed and the Kruskal-Wallis test was used to define associations between baseline characteristics and sources of frustration. Among 450 patients surveyed, 71.5% reported sources of frustration, classified as either emotional (48.4%) or practical (23.1%). The most common were fear of recurrence/progression (15.8%), distrust of their cancer care system (12.9%), and lack of appropriate information (9.8%). Female gender and non-clear cell histology were associated with both types of frustration, and older age was linked to practical sources of frustration. Patients suggested solutions included greater compassion among health care practitioners (20.7%), better access to information (15.1%) and research to improve their chances of being cured (14.7%). Sources of frustration related to emotional and practical causes were identified amongst patients with RCC. Certain demographic and clinical characteristics were associated with more sources of frustration. This study provides the first characterization of specific ways to improve the patient experience by addressing common frustrations.

Published
2019

23. Managing chronic myeloid leukemia for treatment-free remission: A proposal from the GIMEMA CML WP

Author

Francesca Lunghi, Gabriele Gugliotta, Chiara Elena, Valentina Giai, Monica Bocchia, Marco Cerrano, Monia Lunghi, Gaetano La Barba, Fausto Castagnetti, Germana Beltrami, Simona Soverini, Paola Fazi, Micaela Bergamaschi, Sara Galimberti, Mario Tiribelli, Claudio Fozza, Antonella Gozzini, Fabrizio Pane, Elena Trabacchi, Massimo Breccia, Mario Annunziata, Isabella Capodanno, Domenico Russo, Serena Rupoli, Sara Barulli, Giovanna Rege-Cambrin, Michele Baccarani, Gianni Binotto, Fausto Palmieri, Roberto Marasca, Bruno Martino, Alessandro Lucchesi, E Abruzzese, Paolo Vigneri, Carmen Fava, Alessandra Iurlo, Francesco Albano, Caterina Musolino, Michele Cedrone, Luigia Luciano, Fabio Stagno, Gianantonio Rosti, Patrizia Pregno, Rosaria Sancetta, Angela Melpignano, Raffaele Spadano, Massimiliano Bonifacio, Luciano Levato, Marzia Salvucci, Vincenzo Accurso, Monica Crugnola, Michele Malagola, Davide Rapezzi, Giovanni Caocci, Mariella D'Adda, Simona Sica, Giuseppe Saglio, Maria Cristina Miggiano, Enrico Montefusco, Simona Tomassetti, Francesco Cavazzini, Baccarani, M., Abruzzese, E., Accurso, V., Albano, F., Annunziata, M., Barulli, S., Beltrami, G., Bergamaschi, M., Binotto, G., Bocchia, M., Caocci, G., Capodanno, I., Cavazzini, F., Cedrone, M., Cerrano, M., Crugnola, M., D'Adda, M., Elena, C., Fava, C., Fazi, P., Fozza, C., Galimberti, S., Giai, V., Gozzini, A., Gugliotta, G., Iurlo, A., la Barba, G., Levato, L., Lucchesi, A., Luciano, L., Lunghi, F., Lunghi, M., Malagola, M., Marasca, R., Martino, B., Melpignano, A., Miggiano, M. C., Montefusco, E., Musolino, C., Palmieri, F., Pregno, P., Rapezzi, D., Rege-Cambrin, G., Rupoli, S., Salvucci, M., Sancetta, R., Sica, S., Spadano, R., Stagno, F., Tiribelli, M., Tomassetti, S., Trabacchi, E., Bonifacio, M., Breccia, M., Castagnetti, F., Pane, F., Russo, D., Saglio, G., Soverini, S., Vigneri, P., Rosti, G., Baccarani M., Abruzzese E., Accurso V., Albano F., Annunziata M., Barulli S., Beltrami G., Bergamaschi M., Binotto G., Bocchia M., Caocci G., Capodanno I., Cavazzini F., Cedrone M., Cerrano M., Crugnola M., D'Adda M., Elena C., Fava C., Fazi P., Fozza C., Galimberti S., Giai V., Gozzini A., Gugliotta G., Iurlo A., la Barba G., Levato L., Lucchesi A., Luciano L., Lunghi F., Lunghi M., Malagola M., Marasca R., Martino B., Melpignano A., Miggiano M.C., Montefusco E., Musolino C., Palmieri F., Pregno P., Rapezzi D., Rege-Cambrin G., Rupoli S., Salvucci M., Sancetta R., Sica S., Spadano R., Stagno F., Tiribelli M., Tomassetti S., Trabacchi E., Bonifacio M., Breccia M., Castagnetti F., Pane F., Russo D., Saglio G., Soverini S., Vigneri P., and Rosti G.

Subjects
Male, Pediatrics, Fusion Proteins, bcr-abl, Chronic myelogenous leukemia, tyrosine kinase inhibitors, additional chromosomal-abnormalities, deep molecular responses, high-dose imatinib, randomized cml, domain mutations, prognostic-significance, cytogenetic response, frontline nilotinib, Pregnancy, chronic myeloid leukemia,management,recommendations,Gimema,treatment-free remission, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, Medicine, Young adult, Disease management (health), Myeloid Neoplasia, Remission Induction, Myeloid leukemia, Disease Management, Hematology, Health Care Costs, Middle Aged, Leukemia, Treatment Outcome, Italy, Retreatment, Treatment strategy, Female, management, Human, Adult, medicine.medical_specialty, Adolescent, Chronic Myeloid Leukemia, Protein Kinase Inhibitor, Socio-culturale, Treatment-Free Remission, Gimema, Myelogenous, Young Adult, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Long term survival, Humans, Protein Kinase Inhibitors, Antineoplastic Combined Chemotherapy Protocol, business.industry, medicine.disease, Health Care Cost, Settore MED/15 - MALATTIE DEL SANGUE, treatment in chronic phase chronic myeloid leukemia, Health Care Survey, Health Care Surveys, recommendations, Disease risk, business
Abstract

Several papers authored by international experts have proposed recommendations on the management of BCR-ABL1+ chronic myeloid leukemia (CML). Following these recommendations, survival of CML patients has become very close to normal. The next, ambitious, step is to bring as many patients as possible into a condition of treatment-free remission (TFR). The Gruppo Italiano Malattie EMatologiche dell’Adulto (GIMEMA; Italian Group for Hematologic Diseases of the Adult) CML Working Party (WP) has developed a project aimed at selecting the treatment policies that may increase the probability of TFR, taking into account 4 variables: the need for TFR, the tyrosine kinase inhibitors (TKIs), the characteristics of leukemia, and the patient. A Delphi-like method was used to reach a consensus among the representatives of 50 centers of the CML WP. A consensus was reached on the assessment of disease risk (EUTOS Long Term Survival [ELTS] score), on the definition of the most appropriate age boundaries for the choice of first-line treatment, on the choice of the TKI for first-line treatment, and on the definition of the responses that do not require a change of the TKI (BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months, ≤0.1% at 12 months, ≤0.01% at 24 months), and of the responses that require a change of the TKI, when the goal is TFR (BCR-ABL1 >10% at 3 and 6 months, >1% at 12 months, and >0.1% at 24 months). These suggestions may help optimize the treatment strategy for TFR.

Published
2019

24. A survey on the experience of 136 Italian urologists in the treatment of erectile dysfunction with PDE5 inhibitors and recommendations for the use of Avanafil in the clinical practice

Author

Alessandro Zucchi, Ferdinando Fusco, Fabio Parazzini, Vincenzo Mirone, Mirone, V., Fusco, F., Parazzini, F., and Zucchi, A.

Subjects
Drug, Adult, Male, medicine.medical_specialty, PDE5 inhibitor, Urology, media_common.quotation_subject, Urologists, Erectile dysfunction, PDE5 inhibitors, Avanafil, Italian survey, Recommendations, Dosage, 030232 urology & nephrology, Alternative medicine, MEDLINE, Avanafil, Recommendations, lcsh:RC870-923, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Dosage, Phosphodiesterase 5 Inhibitor, medicine, Italian survey, Humans, Erectile dysfunction, Dosing, Intensive care medicine, PDE5 inhibitors, media_common, Aged, Dose-Response Relationship, Drug, business.industry, Phosphodiesterase 5 Inhibitors, Recommendation, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Clinical Practice, Pyrimidines, Tolerability, Italy, Pyrimidine, Health Care Survey, Health Care Surveys, 030220 oncology & carcinogenesis, business, medicine.drug, Human
Abstract

Introduction: PDE5 inhibitors are the firstline treatment for erectile dysfunction. Although all these drugs share the same mechanism of action, each agent could have different characteristics in terms of selectivity, pharmacokinetics and tolerability profile. Materials and Methods: This manuscript illustrates a project, undertaken by the Italian Society of Urology in order to obtain a “snapshot” of the experience of Italian urologists with the use of PDE5 inhibitors in the clinical practice. This project included a survey, targeting a sample of 136 Italian urologists experienced in the treatment of ED, and the organization of a conference of experts who, based on the findings of the survey, the scientific literature and the clinical experience, would define some recommendations for the use of PDE5 inhibitors in clinical practice with a particular focus on Avanafil, the most recent drug in this class. Results: The following recommendations on the use of Avanafil were issued: 1) In patients who are candidates for the use of Avanafil, it is advisable to use the 200-mg dose from the first administration; 2) When used at the highest dose (200 mg), Avanafil shows a favourable tolerability profile with an efficacy similar to that of other agents; 3) The patient should be instructed to take Avanafil on an empty stomach, i.e., 30-45 minutes before or 2 hours after a meal; 4) The efficacy window of Avanafil is between 30 minutes and 6 hours after dosing, which qualifies this molecule as a new drug with an intermediate duration of action; 5) Avanafil at a dose of 50-100 mg/day may be a therapeutic option in chronic rehabilitation. Conclusions: Among PDE5 inhibitors, Avanafil is a new agent with an intermediate duration of action, characterized by high efficacy and good tolerability even at the highest dose (200 mg).

Published
2016

25. Oncological care organisation during COVID-19 outbreak

Author

Khalil Zaman, Miguel Martin, Daniele Generali, Massimo Cristofanilli, Marc Peeters, Sabino De Placido, Javier Cortes, Sylvie Rottey, Thomas Ruhstaller, Hope S. Rugo, Concetta Elisa Onesti, Rupert Bartsch, Ahmad Awada, Guy Jerusalem, Sara A. Hurvitz, Jean Pascal Machiels, Volkmar Müller, Fabio Puglisi, Nadia Harbeck, Guy Berchem, Marco Tagliamento, Pierfranco Conte, Mario Campone, Hans Wildiers, Vivianne C. G. Tjan-Heijnen, Institut Català de la Salut, [Onesti CE] Department of Medical Oncology, CHU de Liège, Liege, Belgium. Laboratory of Human Genetics, GIGA Research Institute and University of Liège, Liège, Belgium. [Rugo HS] Department of Medicine and Division of Oncology, University of California San Francisco, Comprehensive Cancer Center, San Francisco, California, USA. [Generali D] UO Patologia Mammaria e Ricerca Traslazionale, Breast Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy. University of Trieste, Trieste, Italy. [Peeters M] Oncology Department, University Hospital Antwerp (UZA), Antwerp, Belgium. [Zaman K] Oncology Department, CHUV - Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. [Wildiers H] Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium. [Cortes J] Servei d’Oncologia, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. IOB Institute of Oncology, Madrid, Spain, Vall d'Hebron Barcelona Hospital Campus, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Unité d'oncologie médicale, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Onesti, Concetta Elisa, Rugo, Hope S, Generali, Daniele, Peeters, Marc, Zaman, Khalil, Wildiers, Han, Harbeck, Nadia, Martin, Miguel, Cristofanilli, Massimo, Cortes, Javier, Tjan-Heijnen, Vivianne, Hurvitz, Sara A, Berchem, Guy, Tagliamento, Marco, Campone, Mario, Bartsch, Rupert, De Placido, Sabino, Puglisi, Fabio, Rottey, Sylvie, Müller, Volkmar, Ruhstaller, Thoma, Machiels, Jean-Pascal, Conte, Pierfranco, Awada, Ahmad, Jerusalem, Guy, Onesti, C. E., Rugo, H. S., Generali, D., Peeters, M., Zaman, K., Wildiers, H., Harbeck, N., Martin, M., Cristofanilli, M., Cortes, J., Tjan-Heijnen, V., Hurvitz, S. A., Berchem, G., Tagliamento, M., Campone, M., Bartsch, R., De Placido, S., Puglisi, F., Rottey, S., Muller, V., Ruhstaller, T., Machiels, J. -P., Conte, P., Awada, A., and Jerusalem, G.

Subjects
Cancer Research, Oncologia, Day care, Medical Oncology, COVID-19 (Malaltia), RECOMMENDATIONS, Assistència sanitària, Neoplasms, Health care, Medicine and Health Sciences, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Medicine, Viral, Health Occupations::Medicine::Internal Medicine::Medical Oncology [DISCIPLINES AND OCCUPATIONS], Cancer, COVID-19, oncological care, Betacoronavirus, Cancer Care Facilities, Coronavirus Infections, Delivery of Health Care, Disinfection, Europe, Health Care Surveys, Humans, Pandemics, Personal Protective Equipment, Pneumonia, Viral, SARS-CoV-2, Triage, United States, Visitors to Patients, Health Care (Public Health) [PUBLIC HEALTH], Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, CANCER, Oncology, Medical emergency, Human, United State, Telemedicine, Cancer Care Facilities/organization & administration, Cancer Care Facilities/statistics & numerical data, Coronavirus Infections/diagnosis, Coronavirus Infections/epidemiology, Coronavirus Infections/prevention & control, Europe/epidemiology, Medical Oncology/statistics & numerical data, Neoplasms/therapy, Pandemics/prevention & control, Pneumonia, Viral/diagnosis, Pneumonia, Viral/epidemiology, Pneumonia, Viral/prevention & control, United States/epidemiology, atención a la salud (salud pública) [SALUD PÚBLICA], SARS-COV-2, lcsh:RC254-282, profesiones sanitarias::medicina::medicina interna::oncología médica [DISCIPLINAS Y OCUPACIONES], Clinical Research, Behavioral and Social Science, Personal protective equipment, Betacoronaviru, Pandemic, Cancer Care Facilitie, Coronavirus Infection, business.industry, Prevention, Généralités, Pneumonia, medicine.disease, Good Health and Well Being, Health Care Survey, Neoplasm, Observational study, Human medicine, business, Patient education
Abstract

Background COVID-19 appeared in late 2019, causing a pandemic spread. This led to a reorganisation of oncology care in order to reduce the risk of spreading infection between patients and healthcare staff. Here we analysed measures taken in major oncological units in Europe and the USA. Methods A 46-item survey was sent by email to representatives of 30 oncological centres in 12 of the most affected countries. The survey inquired about preventive measures established to reduce virus spread, patient education and processes employed for risk reduction in each oncological unit. Results Investigators from 21 centres in 10 countries answered the survey between 10 April and 6 May 2020. A triage for patients with cancer before hospital or clinic visits was conducted by 90.5% of centres before consultations, 95.2% before day care admissions and in 100% of the cases before overnight hospitalisation by means of phone calls, interactive online platforms, swab test and/or chest CT scan. Permission for caregivers to attend clinic visits was limited in many centres, with some exceptions (ie, for non-autonomous patients, in the case of a new diagnosis, when bad news was expected and for terminally ill patients). With a variable delay period, the use of personal protective equipment was unanimously mandatory, and in many centres, only targeted clinical and instrumental examinations were performed. Telemedicine was implemented in 76.2% of the centres. Separated pathways for COVID-19-positive and COVID-19-negative patients were organised, with separate inpatient units and day care areas. Self-isolation was required for COVID-19-positive or symptomatic staff, while return to work policies required a negative swab test in 76.2% of the centres. Conclusion Many pragmatic measures have been quickly implemented to deal with the health emergency linked to COVID-19, although the relative efficacy of each intervention should be further analysed in large observational studies., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

26. Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

Author

Fernando C. Wehrmeister, Ana M. B. Menezes, Larissa Ramirez, Alejandro Casas, Maria Montes de Oca, Maria Victorina Lopez Varela, Laura Mendoza, and Marc Miravitlles

Subjects
Male, Cross-sectional study, Medication Overuse, Adrenergic Beta-2 Receptor Agonists, 0302 clinical medicine, Drug Utilization Review, Adrenal Cortex Hormones, Forced Expiratory Volume, Corticosteroid, Enfermedad pulmonar obstructiva crónica, Practice Patterns, Physicians', Lung, Bronchodilating Agent, COPD, El bloqueo de los receptores muscarínicos agente, General Medicine, Obstructive lung disease, Administration, Drug Therapy, Combination, Human, Respiratory Tract Agent, medicine.medical_specialty, International Journal of Chronic Obstructive Pulmonary Disease, Drug Prescriptions, Article, Medication Adherence, Clinical Practice, 03 medical and health sciences, Drug Therapy, Physicians, Humans, Medication Compliance, Long Acting Drug, Aged, Questionnaire, Nebulizer, Guideline, Monotherapy, medicine.disease, Clinical trial, Cross-Sectional Studies, Latin America, 030228 respiratory system, Health Care Survey, Disease Classification, South And Central America, Agente estimulante beta receptor adrenérgico, Nebulizers And Vaporizers, Medicamentos de acción prolongada, Muscarinic Receptor Blocking Agent, Practice Patterns, Farmacología & terapéutica, Medicamentos de efecto retardado, Prescription, Pulmonary Disease, Chronic Obstructive, Maintenance Therapy, Maintenance therapy, Beta 2 Adrenergic Receptor Stimulating Agent, Inhalational Drug Administration, 030212 general & internal medicine, biology, Lama, Clinical Trial, Bronchodilator Agents, Multicenter Study, Treatment Outcome, Inhalation, Combination, Combination Drug Therapy, Female, Corrigendum, hormones, hormone substitutes, and hormone antagonists, Adult, Chronic Obstructive, Major Clinical Study, Observational Study, Muscarinic Antagonists, Pathophysiology, Pulmonary Disease, Internal medicine, Global Initiative For Chronic Obstructive Lung Disease, Administration, Inhalation, medicine, Medical prescription, Healthcare Disparities, Adrenergic beta-2 Receptor Agonists, Prescription Drug Overuse, Beta Adrenergic Receptor Stimulating Agent, Test Of Adherence To Inhalers Questionnaire, business.industry, Nebulizers and Vaporizers, Chronic Obstructive Lung Disease, Short Acting Drug, Corticosteroides, biology.organism_classification, Cross-Sectional Study, Drug Effect, Health Care Surveys, Patient Compliance, Drug Use, Health Care Disparity, business
Abstract

Alejandro Casas,1 Maria Montes de Oca,2 Ana MB Menezes,3 Fernando C Wehrmeister,3 Maria Victorina Lopez Varela,4 Laura Mendoza,5 Larissa Ramírez,6 Marc Miravitlles7 On behalf of the LASSYC team 1Fundación Neumológica Colombiana, Universidad del Rosario, Bogotá, Colombia; 2Universidad Central de Venezuela, Caracas, Venezuela; 3Federal University of Pelotas, Pelotas, Brazil; 4Universidad de la República, Montevideo, Uruguay; 5Hospital Clínico Universidad de Chile, Santiago de Chile, Chile; 6AstraZeneca, San José, Costa Rica; 7Department of Pneumology, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain Background: Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region.Methods: This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other.Results: In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire.Conclusion: COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence. Keywords: adherence, inhaled therapy, COPD, Latin America

Published
2018

27. Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries

Author

Peter de Jonge, Graham Thornicroft, Nancy A. Sampson, Yanling He, Silvia Florescu, Somnath Chatterji, Josep Maria Haro, Norito Kawakami, Ronald C. Kessler, Ali Al-Hamzawi, Ronny Bruffaerts, Ekaterina Sadikova, Laura Helena Andrade, Viviane Kovess-Masfety, Zhaorui Liu, Elie G. Karam, Alfredo H. Cia, B. E. Pennell, Sergio Aguilar-Gaxiola, Daphna Levinson, Margreet ten Have, María Elena Medina-Mora, Giovanni de Girolamo, Marina Piazza, Sing Lee, Graça Cardoso, Jose Posada-Villa, Jibril Abdulmalik, Zahari Zarkov, Sara Evans-Lacko, Fernando Navarro-Mateu, Jordi Alonso, Oye Gureje, Universitat de Barcelona, and Developmental Psychology

Subjects
Male, SEEKING, global health, surveys, Anxiety, Global Health, 0302 clinical medicine, Belgium, Germany, Peru, middle aged, statistics and numerical data, Medicine, adequate treatment, Young adult, Lebanon, VERSION, Aged, 80 and over, adult, PRIMARY-CARE, CIDI, 3. Good health, health survey, Psychiatry and Mental health, Clinical Psychology, aged, Italy, priority journal, health care quality, Iraq, Anxiety disorder, Health care quality, medicine.medical_specialty, China, EUROPE, alcohol consumption, Argentina, emotion, Nigeria, Colombia, Enquestes, Article, DSM-5, 03 medical and health sciences, DSM-IV, Humans, human, METAANALYSIS, Aged, Quality of Health Care, anxiety disorders, patient attitude, practice guideline, ORGANIZATION, SERVICES, medicine.disease, United States, 030227 psychiatry, psychotherapy, Ansietat, perceived need for care, Serveis sanitaris, very elderly, health care survey, Surveys, Japan, RA0421 Public health. Hygiene. Preventive Medicine, Global health, anxiety disorder, 030212 general & internal medicine, Israel, Bulgaria, Netherlands, alternative medicine, Perceived need for care, Middle Aged, Anxiety Disorders, Health services, PREVALENCE, female, Mental Health, health services, young adult, Female, France, medicine.symptom, Brazil, Adult, mental health care, Adolescent, purl.org/pe-repo/ocde/ford#3.02.24 [https], purl.org/pe-repo/ocde/ford#5.01.00 [https], Young Adult, controlled study, Psychiatry, Mexico, drug use, Portugal, business.industry, Romania, Adequate treatment, Patient Acceptance of Health Care, Mental health, Spain, Health Care Surveys, business
Abstract

Background: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12‐month DSM‐IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received any treatment; and (iii) received possibly adequate treatment. Methods: Data from 23 community surveys in 21 countries of the World Mental Health (WMH) surveys. DSM‐IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM‐IV included posttraumatic stress disorder among anxiety disorders, while it is not considered so in the DSM‐5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or nonmedical professional) for “problems with emotions, nerves, mental health, or use of alcohol or drugs.” Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, complementary alternative medicine or nonmedical care (8+ visits). Results: Of 51,547 respondents (response = 71.3%), 9.8% had a 12‐month DSM‐IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. Of those with 12‐month anxiety only 41.3% perceived a need for care. Lower treatment levels were found for lower income countries. Conclusions: Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment. The U.S. National Comorbidity Survey Replication (NCS‐R) is supported by the National Institute of Mental Health (NIMH; U01‐MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA). SEL (Sara Evans‐Lacko) currently holds a Starting Grant from the European Research Council (337673). The Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust. Dr. Thornicroft is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust. Dr. Thornicroft acknowledges support from the following: the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London Foundation Trust; the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust; the European Union Seventh Framework Programme (FP7/2007‐2013) Emerald project.

Published
2018

28. Relational coordination in interprofessional teams and its effect on patient-reported benefit and continuity of care: a prospective cohort study from rehabilitation centres in Western Norway

Author

Merethe Hustoft, Sturla Gjesdal, Øystein Hetlevik, Eva Biringer, and Jörg Aβmus

Subjects
Male, medicine.medical_specialty, Activities of daily living, medicine.medical_treatment, Interprofessional Relations, education, Health informatics, Rehabilitation Centers, Health administration, 03 medical and health sciences, 0302 clinical medicine, Health care, Activities of Daily Living, Health services research, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Aged, Patient Care Team, Rehabilitation, business.industry, Norway, Health care survey, lcsh:Public aspects of medicine, 030503 health policy & services, Health Policy, Nursing research, Public health, lcsh:RA1-1270, Continuity of Patient Care, Middle Aged, Patient Satisfaction, Patient-reported outcome measures, Family medicine, Health Care Surveys, Continuity of care, Female, 0305 other medical science, business
Abstract

Background Rehabilitation services depend on competent professionals who collaborate effectively. Well-functioning interprofessional teams are expected to positively impact continuity of care. Key factors in continuity of care are communication and collaboration among health care professionals in a team and their patients. This study assessed the associations between team functioning and patient-reported benefits and continuity of care in somatic rehabilitation centres. Methods This prospective cohort study uses survey data from 984 patients and from health care professionals in 15 teams in seven somatic rehabilitation centres in Western Norway. Linear mixed effect models were used to investigate associations between the interprofessional team communication and relationship scores (measured by the Relational Coordination [RC] Survey and patient-reported benefit and personal-, team- and cross-boundary continuity of care. Patient-reported continuity of care was measured using the Norwegian version of the Nijmegen Continuity Questionnaire. Results The mean communication score for healthcare teams was 3.9 (standard deviation [SD] = 0.63, 95% confidence interval [CI] = 3.78, 4.00), and the mean relationship score was 4.1 (SD = 0.56, 95% CI = 3.97, 4.18). Communication scores in rehabilitation teams varied from 3.4–4.3 and relationship scores from 3.6–4.5. Patients treated by teams with higher relationship scores experienced better continuity between health care professionals in the team at the rehabilitation centre (b = 0.36, 95% CI = 0.05, 0.68; p = 0.024). There was a positive association between RC communication in the team the patient was treated by and patient-reported activities of daily living benefit score; all other associations between RC scores and rehabilitation benefit scores were not significant. Conclusion Team function is associated with better patient-reported continuity of care and higher ADL-benefit scores among patients after rehabilitation. These findings indicate that interprofessional teams’ RC scores may predict rehabilitation outcomes, but further studies are needed before RC scores can be used as a quality indicator in somatic rehabilitation. publishedVersion

Published
2018

29. Equity dimensions of the availability and quality of reproductive, maternal and neonatal health services in Zambia

Author

Samantha Straitz, Jonas Mwale, Mary Nambao, Godfrey Biemba, Nadia Akseer, Lily D. Yan, Peter C. Rockers, Davidson H. Hamer, Zulfiqar A Bhutta, Paul Ngwakum, Eleonora Genovese, Kojo Yeboah-Antwi, Bowen Banda, Lawrence Mwananyanda, Julia F. Ross, Yan, L, Mwale, J, Straitz, S, Biemba, G, Bhutta, Z, Ross, J, Mwananyanda, L, Nambao, M, Ngwakum, P, Genovese, E, Banda, B, Akseer, N, Yeboah-Antwi, K, Rockers, P, and Hamer, D

Subjects
Rural Population, Urban Population, Maternal Health, Health Services Accessibility, Multidimensional Poverty Index, 0302 clinical medicine, Retrospective Studie, Pregnancy, Residence Characteristics, 030212 general & internal medicine, Reproductive health, Maternal-Child Health Service, education.field_of_study, Health Equity, Reproduction, Regression analysis, Health equity, Social Cla, Infectious Diseases, Geography, Reproductive Health, Female, 0305 other medical science, Human, Health Facilitie, Maternal-Child Health Services, Reproductive Health Service, Population, Zambia, Social class, 03 medical and health sciences, Environmental health, Humans, Infant Health, education, Poverty, Quality of Health Care, Retrospective Studies, 030505 public health, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, Social Class, Health Care Survey, Residence Characteristic, Health Care Surveys, Parasitology, Reproductive Health Services, Health Facilities, Rural area, business
Abstract

Objective To assess how quality and availability of reproductive, maternal, neonatal (RMNH) services vary by district wealth and urban/rural status in Zambia. Methods We conducted a retrospective analysis of data from the Millennium Development Goal Acceleration Initiative baseline assessment of 117 health facilities in 9 districts. Quality was assessed through a composite score of 23 individual RMNH indicators, ranging from 0 to 1. Availability was evaluated by density of providers and facilities. Districts were divided into wealth groups based on the multidimensional poverty index (MPI). Relative inequity was calculated using the concentration index for quality indicators (positive favours rich, negative favours poor). Multivariable linear regression was performed for the dependent variable composite quality indicator using MPI, urban/rural, and facility level of care as independent variables. Results 13 hospitals, 85 health centres and 19 health posts were included. The RMNH composite quality indicator was 0.64. Availability of facilities and providers was universally low. The concentration index for the composite quality indicator was -0.015 [-0.043, 0.013], suggesting no clustering to favour either rich or poor districts. Rich districts had the highest absolute numbers of health facilities and providers, but lowest numbers per facility per 1 000 000 population. Urban districts had slightly better service quality, but not availability. Using regression analysis, only facility level of care was significantly associated with quality outcome. Conclusions Composite quality of RMNH services did not vary by district wealth, but was slightly higher in urban districts. The availability data suggest that the higher population in richer districts outpaces health infrastructure.

Published
2018

30. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion

Author

Giuseppe Lepore, Riccardo Bonfanti, Lutgarda Bozzetto, Vincenzo Di Blasi, Angela Girelli, Giorgio Grassi, Dario Iafusco, Luigi Laviola, Ivana Rabbone, Riccardo Schiaffini, Daniela Bruttomesso, F. Mammì, M. Bruzzese, M. Schettino, M.G. Nuzzo, V. Di Blasi, R. Fresa, C. Lambiase, D. Iafusco, A. Zanfardino, S. Confetto, L. Bozzetto, G. Annuzzi, A. Alderisio, G. Riccardi, S. Gentile, G. Marino, G. Guarino, S. Zucchini, G. Maltoni, T. Suprani, V. Graziani, M. Nizzoli, S. Acquati, R. Cavani, S. Romano, M. Michelini, E. Manicardi, R. Bonadonna, A. Dei Cas, E. Dall'aglio, M. Papi, S. Riboni, V. Manicardi, V. Pugni, A. Lasagni, M.E. Street, U. Pagliani, C. Rossi, R. Assaloni, B. Brunato, C. Tortul, G. Zanette, P. Li Volsi, M. Zanatta, L. Tonutti, S. Agus, M.A. Pellegrini, P. Ceccano, G. Pozzilli, Beretta Anguissola, R. Buzzetti, C. Moretti C, G. Leto, P. Pozzilli, S. Manfrini, A.R. Maurizi, S. Leotta, M. Altomare, S. Abbruzzese, S. Carletti, C. Suraci, S. Filetti, M.L. Manca Bitti, S. Arcano, M.G. Cavallo, M. De Bernardinis, D. Pitocco, S. Caputo, A. Rizzi, A. Manto, R. Schiaffini, M. Cappa, D. Benevento, S. Frontoni, I. Malandrucco, S. Morano, T. Filardi, D. Lauro, M.A. Marini, E. Castaldo, D. Sabato, F. Tuccinardi, E. Forte, P. Viterbori, C. Arnaldi, N. Minuto, G. d'Annunzio, A. Corsi, R. Rota, C. Scaranna, R. Trevisan, U. Valentini, A. Girelli, S. Bonfadini, E. Zarra, A. Plebani, E. Prandi, B. Felappi, A. Rocca, E. Meneghini, P. Galli, P. Ruggeri, E. Carrai, L. Fugazza, V. Baggi, D. Conti, E. Bosi, A. Laurenzi, A. Caretto, C. Molinari, E. Orsi, V. Grancini, V. Resi, R. Bonfanti, V. Favalli, C. Bonura, A. Rigamonti, M. Bonomo, F. Bertuzzi, B. Pintaudi, O. Disoteo, G. Perseghin, S. Perra, L. Chiovato, P. De Cata, F. Zerbini, E. Lovati, M. Laneri, L. Guerraggio, A.C. Bossi, V. De Mori, M. Galetta, I. Meloncelli, A. Aiello A, S. Di Vincenzo, A. Nuzzi, E. Fraticelli, E. Ansaldi, M. Battezzati, M. Lombardi, M. Balbo, R. Lera, A. Secco, V. De Donno, F. Cadario, S. Savastio, C. Ponzani, G. Aimaretti, I. Rabbone, G. Ignaccolo, D. Tinti, F. Cerutti, F. Bari, F. Giorgino, E. Piccinno, O. Zecchino, M. Cignarelli, O. Lamacchia, G. Picca, S. De Cosmo, A. Rauseo, L. Tomaselli, A. Tumminia, C. Egiziano, A.M. Scarpitta, F. Maggio, F. Cardella, R. Roppolo, V. Provenzano, M. Fleres, A. Scorsone, A. Scatena, G. Gregori, S. Lucchesi, F. Gadducci, S. Di Cianni, S. Pancani, S. Del Prato, M. Aragona, I. Crisci, A. Calianno, B. Fattor, D. Crazzolara, P. Reinstadler, S. Longhi, G. Incelli, S. Rauch, T. Romanelli, M. Orrasch, V. Cauvin, R. Franceschi, C. Lalli, A. Pianta, A. Marangoni, C.N. Aricò, N. Marin, N. Nogara, N. Simioni, A. Filippi, G.L. Gidoni Guarneri, M.L. Contin M.L, A.P. Decata, L. Bondesan, L. Confortin, A. Coracina, S. Lombardi, S. Costa Padova, E. Cipponeri, R. Scotton, S. Galasso, F. Boscari, M.S. Zanon, C. Vinci, G. Lisato, L. Gottardo, E. Bonora, M. Trombetta, C. Negri, C. Brangani, C. Maffeis, A. Sabbion, M. Marigliano, Lepore, Giuseppe, Bonfanti, Riccardo, Bozzetto, Lutgarda, Di Blasi, Vincenzo, Girelli, Angela, Grassi, Giorgio, Iafusco, Dario, Laviola, Luigi, Rabbone, Ivana, Schiaffini, Riccardo, Bruttomesso, Daniela, Lepore, G., Bonfanti, R., Bozzetto, L., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Laviola, L., Rabbone, I., Schiaffini, R., Bruttomesso, D., Mammi, F., Bruzzese, M., Schettino, M., Nuzzo, M. G., Fresa, R., Lambiase, C., Zanfardino, A., Confetto, S., Annuzzi, G., Alderisio, A., Riccardi, G., Gentile, S., Marino, G., Guarino, G., Zucchini, S., Maltoni, G., Suprani, T., Graziani, V., Nizzoli, M., Acquati, S., Cavani, R., Romano, S., Michelini, M., Manicardi, E., Bonadonna, R., Dei Cas, A., Dall'Aglio, E., Papi, M., Riboni, S., Manicardi, V., Pugni, V., Lasagni, A., Street, M. E., Pagliani, U., Rossi, C., Assaloni, R., Brunato, B., Tortul, C., Zanette, G., Li Volsi, P., Zanatta, M., Tonutti, L., Agus, S., Pellegrini, M. A., Ceccano, P., Pozzilli, G., Anguissola, B., Buzzetti, R., Moretti C, C., Leto, G., Pozzilli, P., Manfrini, S., Maurizi, A. R., Leotta, S., Altomare, M., Abbruzzese, S., Carletti, S., Suraci, C., Filetti, S., Manca Bitti, M. L., Arcano, S., Cavallo, M. G., De Bernardinis, M., Pitocco, D., Caputo, S., Rizzi, A., Manto, A., Cappa, M., Benevento, D., Frontoni, S., Malandrucco, I., Morano, S., Filardi, T., Lauro, D., Marini, M. A., Castaldo, E., Sabato, D., Tuccinardi, F., Forte, E., Viterbori, P., Arnaldi, C., Minuto, N., D'Annunzio, G., Corsi, A., Rota, R., Scaranna, C., Trevisan, R., Valentini, U., Bonfadini, S., Zarra, E., Plebani, A., Prandi, E., Felappi, B., Rocca, A., Meneghini, E., Galli, P., Ruggeri, P., Carrai, E., Fugazza, L., Baggi, V., Conti, D., Bosi, E., Laurenzi, A., Caretto, A., Molinari, C., Orsi, E., Grancini, V., Resi, V., Favalli, V., Bonura, C., Rigamonti, A., Bonomo, M., Bertuzzi, F., Pintaudi, B., Disoteo, O., Perseghin, G., Perra, S., Chiovato, L., De Cata, P., Zerbini, F., Lovati, E., Laneri, M., Guerraggio, L., Bossi, A. C., De Mori, V., Galetta, M., Meloncelli, I., Aiello A, A., Di Vincenzo, S., Nuzzi, A., Fraticelli, E., Ansaldi, E., Battezzati, M., Lombardi, M., Balbo, M., Lera, R., Secco, A., De Donno, V., Cadario, F., Savastio, S., Ponzani, C., Aimaretti, G., Ignaccolo, G., Tinti, D., Cerutti, F., Bari, F., Giorgino, F., Piccinno, E., Zecchino, O., Cignarelli, M., Lamacchia, O., Picca, G., De Cosmo, S., Rauseo, A., Tomaselli, L., Tumminia, A., Egiziano, C., Scarpitta, A. M., Maggio, F., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Scorsone, A., Scatena, A., Gregori, G., Lucchesi, S., Gadducci, F., Di Cianni, S., Pancani, S., Del Prato, S., Aragona, M., Crisci, I., Calianno, A., Fattor, B., Crazzolara, D., Reinstadler, P., Longhi, S., Incelli, G., Rauch, S., Romanelli, T., Orrasch, M., Cauvin, V., Franceschi, R., Lalli, C., Pianta, A., Marangoni, A., Arico, C. N., Marin, N., Nogara, N., Simioni, N., Filippi, A., Gidoni Guarneri, G. L., Contin, M. L M. L., Decata, A. P., Bondesan, L., Confortin, L., Coracina, A., Lombardi, S., Costa Padova, S., Cipponeri, E., Scotton, R., Galasso, S., Boscari, F., Zanon, M. S., Vinci, C., Lisato, G., Gottardo, L., Bonora, E., Trombetta, M., Negri, C., Brangani, C., Maffeis, C., Sabbion, A., Marigliano, M., Lepore, G, Bonfanti, R, Bozzetto, L, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Laviola, L, Rabbone, I, Schiaffini, R, Bruttomesso, D, Mammi, F, Bruzzese, M, Schettino, M, Nuzzo, M, Fresa, R, Lambiase, C, Zanfardino, A, Confetto, S, Annuzzi, G, Alderisio, A, Riccardi, G, Gentile, S, Marino, G, Guarino, G, Zucchini, S, Maltoni, G, Suprani, T, Graziani, V, Nizzoli, M, Acquati, S, Cavani, R, Romano, S, Michelini, M, Manicardi, E, Bonadonna, R, Dei Cas, A, Dall'Aglio, E, Papi, M, Riboni, S, Manicardi, V, Pugni, V, Lasagni, A, Street, M, Pagliani, U, Rossi, C, Assaloni, R, Brunato, B, Tortul, C, Zanette, G, Li Volsi, P, Zanatta, M, Tonutti, L, Agus, S, Pellegrini, M, Ceccano, P, Pozzilli, G, Anguissola, B, Buzzetti, R, Moretti C, C, Leto, G, Pozzilli, P, Manfrini, S, Maurizi, A, Leotta, S, Altomare, M, Abbruzzese, S, Carletti, S, Suraci, C, Filetti, S, Manca Bitti, M, Arcano, S, Cavallo, M, De Bernardinis, M, Pitocco, D, Caputo, S, Rizzi, A, Manto, A, Cappa, M, Benevento, D, Frontoni, S, Malandrucco, I, Morano, S, Filardi, T, Lauro, D, Marini, M, Castaldo, E, Sabato, D, Tuccinardi, F, Forte, E, Viterbori, P, Arnaldi, C, Minuto, N, D'Annunzio, G, Corsi, A, Rota, R, Scaranna, C, Trevisan, R, Valentini, U, Bonfadini, S, Zarra, E, Plebani, A, Prandi, E, Felappi, B, Rocca, A, Meneghini, E, Galli, P, Ruggeri, P, Carrai, E, Fugazza, L, Baggi, V, Conti, D, Bosi, E, Laurenzi, A, Caretto, A, Molinari, C, Orsi, E, Grancini, V, Resi, V, Favalli, V, Bonura, C, Rigamonti, A, Bonomo, M, Bertuzzi, F, Pintaudi, B, Disoteo, O, Perseghin, G, Perra, S, Chiovato, L, De Cata, P, Zerbini, F, Lovati, E, Laneri, M, Guerraggio, L, Bossi, A, De Mori, V, Galetta, M, Meloncelli, I, Aiello A, A, Di Vincenzo, S, Nuzzi, A, Fraticelli, E, Ansaldi, E, Battezzati, M, Lombardi, M, Balbo, M, Lera, R, Secco, A, De Donno, V, Cadario, F, Savastio, S, Ponzani, C, Aimaretti, G, Ignaccolo, G, Tinti, D, Cerutti, F, Bari, F, Giorgino, F, Piccinno, E, Zecchino, O, Cignarelli, M, Lamacchia, O, Picca, G, De Cosmo, S, Rauseo, A, Tomaselli, L, Tumminia, A, Egiziano, C, Scarpitta, A, Maggio, F, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Scorsone, A, Scatena, A, Gregori, G, Lucchesi, S, Gadducci, F, Di Cianni, S, Pancani, S, Del Prato, S, Aragona, M, Crisci, I, Calianno, A, Fattor, B, Crazzolara, D, Reinstadler, P, Longhi, S, Incelli, G, Rauch, S, Romanelli, T, Orrasch, M, Cauvin, V, Franceschi, R, Lalli, C, Pianta, A, Marangoni, A, Arico, C, Marin, N, Nogara, N, Simioni, N, Filippi, A, Gidoni Guarneri, G, Contin, M, Decata, A, Bondesan, L, Confortin, L, Coracina, A, Lombardi, S, Costa Padova, S, Cipponeri, E, Scotton, R, Galasso, S, Boscari, F, Zanon, M, Vinci, C, Lisato, G, Gottardo, L, Bonora, E, Trombetta, M, Negri, C, Brangani, C, Maffeis, C, Sabbion, A, and Marigliano, M

Subjects
Blood Glucose, Male, Pediatrics, Acute and chronic complication, Glycated Hemoglobin A, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicine (miscellaneous), Ketosi, Infusions, Subcutaneous, Settore MED/13 - Endocrinologia, Acute and chronic complications, Continuous subcutaneous insulin infusion (CSII), Diabetes mellitus, Metabolic control, Nutrition and Dietetics, Cardiology and Cardiovascular Medicine, 0302 clinical medicine, Endocrinology, Adolescent, Adult, Albuminuria, Biomarkers, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diabetic Retinopathy, Female, Health Care Surveys, Humans, Hypertension, Hypoglycemia, Hypoglycemic Agents, Insulin, Italy, Ketosis, Middle Aged, Risk Factors, Treatment Outcome, Young Adult, Insulin Infusion Systems, 030212 general & internal medicine, Subcutaneous, Diabetic retinopathy, Diabetes and Metabolism, medicine.symptom, Type 2, Human, Type 1, Insulin pump, Infusions, medicine.medical_specialty, Diabetes mellitu, Time Factor, 030209 endocrinology & metabolism, 03 medical and health sciences, medicine, Cross-Sectional Studie, Glycated Hemoglobin, Type 1 diabetes, Hypoglycemic Agent, business.industry, Risk Factor, Biomarker, medicine.disease, Ketoacidosis, Infusions, Subcutaneou, Health Care Survey, Diabetic Nephropathie, business
Abstract

Background and aim: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). Methods and results: Questionnaires investigating the organisation of diabetes care centres, individuals’ clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. 18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. Conclusions: Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. Clinical trial registration number: NCT 02620917 (ClinicalTrials.gov).

Published
2018

31. Entry techniques in laparoscopic radical and partial nephrectomy: A multicenter international survey of contemporary practices

Author

Pierluigi, Bove, Valerio, Iacovelli, Marco, Sandri, Marco, Carilli, Luca, Cindolo, Riccardo, Autorino, Louis R, Kavoussi, Salvatore, Micali, Francesco, Porpiglia, Koon H, Rha, Fernando J, Kim, Stefano, Zaramella, Bove, Pierluigi, Iacovelli, Valerio, Sandri, Marco, Carilli, Marco, Cindolo, Luca, Autorino, Riccardo, Kavoussi, Louis R., Micali, Salvatore, Porpiglia, Francesco, Rha, Koon H., and Kim, Fernando J.

Subjects
medicine.medical_specialty, Urology, medicine.medical_treatment, Concordance, 030232 urology & nephrology, Laparoscopy, Nephrectomy, Health Care Surveys, Humans, Patient Positioning, Retrospective Studies, Surgeons, Nephrology, Settore MED/24 - Urologia, Surgeon, 03 medical and health sciences, 0302 clinical medicine, Cohen's kappa, Port (medical), Retrospective Studie, medicine, Kidney surgery, medicine.diagnostic_test, business.industry, General surgery, International survey, Retrospective cohort study, Health Care Survey, 030220 oncology & carcinogenesis, business, Human
Abstract

Background There is no clear consensus as to the optimal method of entry in laparoscopic renal surgery and no reports have compared them in Urology. To analyze contemporary practice patterns in entry technique and port placement for laparoscopic kidney surgery. Methods We identified 60 high volume urological laparoscopic centers. A purpose-built questionnaire was sent to surgeons. The survey included 22 questions regarding access techniques and port configuration during laparoscopic kidney surgery. Data on were collected and retrospectively analyzed. Concordance among port configurations was assessed using Cohen's Kappa statistics. Results The survey was sent to 60 surgeons and completed by 32 of them. Surgical procedures included were laparoscopic radical nephrectomy (1177 LRN/year) and laparoscopic partial nephrectomy (1047 LPN/year). The transperitoneal route was preferred (85%). Hasson technique was used for the access in 55% of the cases. Patient lateral recumbent position is the most frequently used during the port placement (41%). Although there is a high variability in the port positioning among the surgeons, in more than 90% of cases it was found a specific concordance in triangulation of optics and operating trocars. There were no significant differences between port configuration in LRN and LPN. Limitations include retrospective design and limited sample. Conclusions A standard port configuration has not been previously reported in urological literature. Our study suggests that the transperitoneal approach, the Hasson technique and a specific triangulation of optics and operating trocars have a significant concordance in some high volume laparoscopic urologic centers.

Published
2018

32. The use of human albumin in patients with cirrhosis: a European survey

Author

Mauro Bernardi, Paolo Caraceni, Maurizio Baldassarre, Marco Pavesi, Vicente Arroyo, Caraceni, Paolo, Pavesi, Marco, Baldassarre, Maurizio, Bernardi, Mauro, and Arroyo, Vicente

Subjects
Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Liver Cirrhosi, Serum Albumin, Human, oncotic propertie, 03 medical and health sciences, 0302 clinical medicine, non-oncotic propertie, Chronic liver failure, Internal medicine, medicine, Humans, In patient, survey, Gastroenterologist, Practice Patterns, Physicians', Cirrhosi, Evidence-Based Medicine, Hepatology, Guideline adherence, business.industry, Gastroenterologists, Gastroenterology, Human albumin, Evidence-based medicine, medicine.disease, Decompensated cirrhosis, Europe, Health Care Survey, 030220 oncology & carcinogenesis, Health Care Surveys, human albumin, Practice Guidelines as Topic, complication of cirrhosi, 030211 gastroenterology & hepatology, Guideline Adherence, business, Human
Abstract

Background: The administration of human albumin (HA) in patients with decompensated cirrhosis is still debated. The European Foundation for the Study of Chronic Liver Failure (EF-CLIF) promoted an online survey to assess its use across Europe. Methods: Hepatologists were invited to participate to an electronic questionnaire based on multiple-choice questions divided in 6 different areas. A descriptive statistical analysis was performed to analyze the responses. Results: One hundred-one hepatologists (36% non-EF-CLIF member), belonging to 86 centers (25% non-academic hospitals) completed the survey. The vast majority of participants prescribe HA for the evidence-based indications supported by international guidelines, while a proportion of them consider HA administration useful for other complications currently not supported by solid scientific evidence. Participants show a good level of knowledge about the non-oncotic properties of the molecule, while HA prescription does not appear to be restricted by health authorities in most centers, at least for the evidence-based indications. Conclusions: The present survey indicates that hepatologists across Europe present adherence to international guidelines and highlights the areas where solid scientific data are awaited to achieve a more appropriate HA prescription in patients with decompensated cirrhosis.

Published
2018

33. As Few Pediatricians as Possible and as Many Pediatricians as Necessary?

Author

Laila Burla, Eli Somekh, Leyla Namazova-Baranova, Hilary Hoey, Massimo Pettoello-Mantovani, Aida Mujkić, Mario Trošelj, Alf Nicholson, Ellen Crushell, Vladimir Pilossoff, Julije Meštrović, Jan Janda, Andreas Gerber-Grote, Jana Fruth, Sergey Sargsyans, Jochen H. H. Ehrich, Karoly Illy, Angel Carrasco Sanz, Danielle Jansen, Fügen Çullu, Mehmet Vural, Andreas Werner, Reinhold Kerbl, and Public Health Research (PHR)

Subjects
Male, Adolescent, 03 medical and health sciences, 0302 clinical medicine, Pediatrician, 030225 pediatrics, Outcome Assessment, Health Care, 618.92: Pädiatrie, Medicine, Humans, 030212 general & internal medicine, Pediatricians, Child, Medical education, Health Services Needs and Demand, Primary Health Care, business.industry, Health care survey, Infant, Newborn, Infant, NEED, Europe, Health Planning, Health service need and demand, children, health organization, pediatritions, Child, Preschool, Health Care Surveys, Pediatrics, Perinatology and Child Health, Workforce, Female, business, Delivery of Health Care, Human
Abstract

The status of the pediatric workforce in child healthcare has been discussed for several years, debating oversupply and inefficient services. These debates are influenced by the widely accepted assumption that the future child population will require more pediatric and more general healthcare. The ratio of 4000 children per pediatrician that was regarded to be appropriate in the 1980s has decreased to 1400:1 in recent years.This ongoing trend is supported by our findings from 2013 to 2018 in 16 European countries, irrespective of the underlying child healthcare system.

Published
2018

34. The characteristics, experiences and perceptions of registered massage therapists in New Zealand: Results from a national survey of practitioners

Author

Jill Dunn, David Sibbritt, Jon Adams, Ram Vempati, and Phillip Cottingham

Subjects
integrative medicine, Research design, Stress management, medicine.medical_specialty, Referral, practices, health care survey, massage, perception, Health Professions (miscellaneous), 03 medical and health sciences, 0302 clinical medicine, Health care, medicine, Mainstream, 030212 general & internal medicine, Response rate (survey), Massage, government regulation, business.industry, Research, 030503 health policy & services, Family medicine, referral, Integrative medicine, 0305 other medical science, business, Psychology
Abstract

© 2018, Multimed Inc. All rights reserved. Background: Massage therapy is widely recognized as offering many health benefits, with a growing number of studies finding it has value in stress management, pain reduction, and overcoming physical limitations. However, there are few studies of massage therapists practices and perceptions in New Zealand and internationally. This paper reports the findings from the first national survey examining the characteristics, perceptions, and experiences of New Zealand-based massage therapists on a range of aspects related to their role and practices. Purpose: This study sought to ascertain the characteristics, experiences, and perceptions of massage therapists in New Zealand, particularly in the aspects of: integration of health care; attitudes and practices related to research; and evidence and attitudes to registration. Setting: Massage practice in New Zealand (nationwide survey). Participants: Members of Massage New Zealand (a massage practitioners association). Research Design: Massage practitioners were surveyed online, using a 65-part questionnaire, on a range of characteristics of their practices and their attitudes to research, integration, and registration. Statistical analysis was performed using STATA. Statistical significance was set at 0.05. Main Outcome Measures: Four hundred massage therapists (MTs) were invited to participate and 115 responded, providing a response rate of 29%. MTs valued research (95%) and perceived that it had an impact for their practices (88%). Significant correlations were found for research value and: mean case-load (p = .009) and level of academic qualification (p = .004). The majority of MTs (79%) supported integration with conventional practitioners, and 83% referred clients to general practitioners, with 75% receiving referrals from general practitioners. Ninety-three percent of MTs supported registration, with 67% of those supporting statutory registration. Conclusion: Massage practitioners perceive that they make a significant contribution to health care, but area of practice, such as research, and referral and integration into mainstream health care require more in-depth investigation.

Published
2018

35. Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey

Author

Valgimigli, M, Costa, F, Byrne, R, Haude, M, Baumbach, A, Windecker, S, Aaroe, J, Aasa, M, Abdel-Salam, Am, Alaarag, Af, Accardi, R, Adel, A, Alcazar De La Torre, E, Alejos, R, Alfonso Jimenez, V, Alhashimi, Hmm, Aljeboury, A, Almeida De Sousa, J, Almusawi, A, Alshaikha, M, Altaf, S, Altahmody, Kea, Alvarez Contreras, Lr, Amarasena, N, Amoroso, G, Anderson, R, Ando, G, Andrade, J, Andreou, Ay, Angulo, J, Antonio, T, Aprigliano, G, Aquilina, M, Arafa, Seo, Aramberry, L, Arampatzis, Ca, Araujo, Jj, Asher, E, Ates, I, Athanasias, D, Auer, J, Auffret, V, Ayala, Fj, Baba, C, Baglioni, P, Bagur, R, Balam-Ortiz, E, Balducelli, M, Bam Pas, G, Barbash, Im, Barbosa, Ahp, Barbosa, R, Barnay, P, Barroso, L, Basti, A, Bax, M, Bayet, G, Beijk, Ma, Beltran, R, Berenguer Jofresa, A, Berroth, R, Berti, S, Berumen Dominguez, Le, Bhasin, A, Bhaya, M, Bianco, M, Biasco, L, Bikicki, M, Bonarjee, Vvs, Bonechi, F, Borges Santos, M, Boshev, M, Bouferrouk, A, Bounartzidi, M, Bousoula, E, Brie, D, Brtko, M, Brugaletta, S, Brull, Dj, Buchter, B, Buendia, R, Burzotta, F, Butz, T, Buzzetti, F, Bychowiec, B, Cadeddu, M, Campanile, A, Carneiro, Jg, Carrilho-Ferreira, P, Carrillo Guevara, Je, Carter, Aj, Casal-Heredia, H, Castiglioni, B, Castro Fabiano, L, Cavalcante Silva, R, Cavalcanti De Oliveira, D, Cavalcanti, Rc, Cavazza, C, Centemero, Mp, Chabane, Hk, Chamie, D, Chatzis, D, Chaves, Aj, Cheng, S, Chinchilla, H, Ciabatti, N, Cirillo, P, Citaku, H, Claeys, Mj, Clifford, C, Coceani, M, Coggiola, J, Cohen, Dj, Conway, Dsg, Cornelis, K, Coroleu, Sf, Corral, Jm, Cortese, B, Coskun, U, Costa, Ra, Coste, P, Coufal, Z, Cox, S, Cozma, A, Crean, P, Crenshaw, Mh, Cristian, U, Cruz-Alvarado, Je, Cuculi, F, Cuenza, L, Cyrne Carvalho, H, D'Ascenzo, F, D'Urbano, M, Damonte, A, Dan Florin, F, Dana, A, Dangoisse, V, De Backer, O, De Cock, D, De Vita, M, Debski, A, Delgado, A, Devadathan, S, Dhamrait, S, Di Lorenzo, E, Di Serafino, D, Diego-Nieto, A, Dievart, F, Diez, Jl, Dimitriadis, K, Dina, C, Doerner, O, Donahue, M, Donis, J, Drieghe, B, Drissi, Mf, Du Fretay, H, Dziewierz, A, Echavarria-Pinto, M, Echeverria Romero, Rg, Economou, F, Eftychiou, C, Egdell, R, El Hosieny, A, El Meguid, K, Elabbassi, W, Elesgerli, S, Elghetany, H, Elizondo, Jc, Elkahlout, A, Elrowiny, R, Elserafy, As, Emam, A, Emara, A, Emmanouil, P, Ercilla, J, Erglis, A, Eslam Taha, E, Esmaeil, S, Esposito, G, Ettori, F, Eugenio, N, Everaert, B, Ezquerra Aguilar, W, Falu, R, Farag, E, Farjalla, J, Feldman, L, Feldman, M, Felice, H, Fernandez-Nofrerias, E, Fernandez-Rodriguez, D, Ferranti, F, Ferreira, Q, Ferrone, M, Fleischmann, C, Flessas, D, Formigli, D, Fozilov, H, Fraccaro, C, Freitas, Jo, Fresco, C, Fridrich, V, Furmaniuk, J, Gagnor, A, Galasso, G, Galeazzi, Gl, Galli, S, Galvez Villacorta, V, Gandolfo, C, Garcia, E, Garcia-Blas, S, Garducci, S, Garg, S, Garro, N, Gatto, L, Georgiou, Mg, Ghanem, I, Ghose, T, Giacchi, G, Giang, Pt, Giesler, T, Giovino, M, Girardi, P, Girasis, C, Giunio, L, Giustino, G, Glatthor, C, Glogar, Hd, Golledge, P, Gomez Moreno, J, Gomez Recio, M, Gommeaux, A, Grantalis, G, Greco, F, Grundeken, Mj, Grunert, S, Gudmundsdottir, I, Guenoun, M, Guerios, E, Gupta, R, Gupta, S, Gutierrez, C, Hafeez, I, Halvorsen, S, Hamed Hussein, Ga, Hammoudeh, A, Hansen, Pr, Harb, S, Hawas, Jm, Hayrapetyan, H, Heintzen, Mp, Hengstenberg, C, Herity, N, Hernandez, F, Heyse, A, Hicham, D, Hildick-Smith, D, Hill, J, Hillani, A, Hiltrop, N, Hiramori, A, Hobson, Ar, Homan, Dj, Hooda, A, Ielasi, A, Ierna, S, Iftikhar, Ak, Ilic, I, Imai, Y, Imperadore, F, Indolfi, C, Iorga, V, Ipek, E, Ito, S, Jacksch, R, Jae-Sik, J, James, S, Jamshidi, P, Jerbi, J, Jimenez Quevedo, P, Jimenez-Navarro, M, Jimenez-Santos, M, Jin, Qh, Joksas, V, Jovic, D, Junejo, S, Kallel, R, Kamal, A, Kamiya, H, Kannan, D, Kantaria, M, Kapetanopoulos, A, Kara Ali, B, Karjalainen, Pp, Karthikeyan, Vj, Kato, R, Katsikis, A, Kefer, J, Keta, D, Ketteler, T, Khan, M, Kharlamov, A, Kinani, A, Kinani, T, Kinnaird, T, Kislo, A, Kiviniemi, T, Kleiban, A, Kluck, B, Kocayigit, I, Kokis, A, Komiyama, N, Konstantinos, L, Kordalis, A, Kozak, M, Krecki, R, Kristensen, Sd, Krizanic, F, Krsticevic, L, Kuex, H, Kukreja, N, Kulic, M, Kulikovskikh, Yv, Kulkarni, P, Kumar, N, Kumar Soni, A, Kuzmenko, E, L'Allier, Pl, Langner, O, Lapin, O, Lauer, B, Leclercq, F, Leibundgut, G, Leon Aliz, E, Leon, C, Leon, K, Leoncini, M, Leone, Am, Leroux, L, Lesiak, M, Letilovic, T, Lev, E, Linares Vicente, Ja, Lindsay, S, Loh, Ph, Loncar, G, Loo, B, Lopez, Mb, Lopez-Cuellar, J, Lozano, I, Luigia, P, Lunde, K, Lyczywek, M, Macdougall, D, Mafrici, A, Magni, V, Magro, M, Mainar, V, Makarovic, Z, Malik, N, Maly, M, Mansour, S, Marenco, Re, Maresta, A, Marinho, Ge, Marino, Rl, Marinucci, L, Martins, Hc, Martins, J, Mashayekhi, K, Masood, A, Maurer, E, Mavrogianni, Ad, Mazurek, T, Medina, A, Mehilli, J, Mellwig, Kp, Mendez, M, Mendiz, Oa, Meneses, A, Mercado, La, Mereuta, A, Mezzapelle, G, Milanovic, N, Mohamed, Sm, Mohanad, A, Mohanty, A, Moorthy, N, Morales, Fj, More, R, Moreno Samos, Jc, Moreno-Martinez, Fl, Moscato, F, Mossmann, M, Mrevlje, B, Muller-Eichelberg, A, Musumeci, G, Nadir Khan, M, Najim, S, Nakamura, S, Nakao, F, Naveri, H, Negus, B, Nerla, R, Nguyen, Ht, Niess, Gs, Nikas, Dn, Niroomand, F, Niva, J, Nogueira, Jw, Nombela-Franco, L, Notrica, M, Nouri, B, Nugue, O, Nunes, Gl, Ober, M, Ochoa, J, J. H., O, Ojeda, S, Oktay Tureli, H, Olowe, Y, Oluseun, A, Opolski, G, Ornelas, Ce, Otasevic, P, Ozturk, A, Padilla, F, Pagny, Jy, Paolantonio, D, Papaioannou, Gi, Parodi, G, Patil, Sn, Pavei, A, Pavia, A, Pavlidis, A, Pell, A, Percoco, Gf, Pernasetti, Lv, Pescoller, F, Petropoulakis, P, Piatti, L, Picardi, E, Pieroni, Dm, Pina, J, Pinheiro, Lf, Pinto, Fj, Pipa, Jl, Piroth, Z, Pisano, F, Podbregar, M, Polak, G, Polimeni, A, Postadzhiyan, A, Postu, M, Poulimenos, Le, Pow Chon Long, F, Poyet, R, Pradhan, A, Predescu, Lm, Prida, Xe, Saad, A, Prog, R, Pulikal, Dga, Qiangzhong, Pi, Radu, Md, Rajendran, D, Ram Anil Raj, Mr, Ramazzotti, V, Rapacciuolo, A, Ratib, K, Raungaard, B, Raviola, E, Reppas, E, Reyes, Ja, Rezek, M, Riess, Gj, Rifaie, O, Rigattieri, S, Rissanen, T, Ristic, Ad, Rittger, H, Roberts, J, Rodriguez Saavedra, A, Roik, M, Roshan Rao, K, Routledge, H, Rubboli, A, Rudolph, T, Rudzitis, A, Ruiters, A, Ruiz Ros, Ja, Ruiz-Garcia, J, Ruiz-Nodar, Jm, Sabate, M, Sabnis, G, Sabouret, P, Sacra, C, Saghatelyan, M, Sahin, M, Said, S, Salachas, Aj, Salas Llamas, Jp, Salih, A, Sanchez, Od, Sanchez-Gila, J, Sanchez-Perez, I, Santarelli, A, Sardovski, Sarenac, D, Sarma, J, Sarno, G, Savonitto, S, Sayied Abdullah, A, Schafer, A, Scherillo, M, Schneider, H, Schuhlen, H, Sciahbasi, A, Seca, L, Sedlon, P, Semenka, J, Serra, La, Sesana, M, Sethi, A, Sgueglia, Ga, Shaheen, S, Shahri, H, Sheiban, I, Shyu, Kg, Silva, Cef, Sionis, D, Siqueira, Da, Siqueira, Mj, Smits, P, Sobhy, M, Sokolov, M, Soliman, S, Somani, An, Sridhar, G, Stakos, D, Stasek, J, Stefanini, G, Steigen, Tk, Stewart, Stipal, R, Stochino, Ml, Stoel, Mg, Subla, Rm, Suliman, A, Summaria, F, Stoyanov, N, Syed, Aa, Tanaka, Y, Tashani, A, Tauzin, S, Tawade, N, Tawfik, M, Tayeh, O, Terzic, I, Testa, L, Thevan, B, Thiam, M, Tiecco, F, Tierala, I, Tilea, I, Tilsted, Hh, Tomasik, Ar, Tonev, I, Torres Bosco, A, Tousek, P, Townend, J, Tran Ngoc, T, Triantafyllou, K, Tsigkas, G, Tsioufis, C, Turri, M, Tyligadis, G, Ugo, F, Ultramari, Ft, Urban, P, Uren, N, Uretsky, Bf, Uribe, Ce, Usman, B, Valadez Molina, F, Van Houwelingen, Kg, Vandormael, M, Varvarovsky, I, Vassilis, V, Velasquez, D, Verdoia, M, Vermeersch, P, Vidal-Perez, R, Vinesh, J, Violini, R, Vista, Jh, Vogt, F, Vogt, M, Vokac, D, Vom Dahl, J, Vranckx, P, Wahab, A, Wang, R, Wang, Td, Wani, S, Weisz, Sh, Werner, Gs, Wilkinson, Jr, Wolf, A, Youssef, A, Yumoto, K, Zaderenko, N, Zaghloul Darwish, Am, Zahn, R, Zaro, T, Zavalloni, D, Zbinden, R, Zekanovic, D, Zhang, B, Zhang, C, Zhang, Yj, Zhonghan, N, Zingarelli, A, Zueco, J, Zuhairy, H, Abbate, A, Abdel Hamid, M, Abdelmegid, Maf, Acuna-Valerio, J, Adriaenssens, T, Agostoni, P, Aikot, H, Alameda, M, Alcaraz, H, Almendro-Delia, M, Altug Cakmak, H, Amir, A, Arjomand, A, Assomull, R, Atalar, E, Avramides, D, Aytek Simsek, M, Aznaouridis, K, Azpeitia, Y, Barnabas, C, Barsness, Gw, Bartorelli, Al, Basoglu, A, Benezet, J, Benincasa, S, Berland, J, Berrocal, Dh, Bett, N, Boskovic, S, Brandao, V, Caporale, R, Caprotta, F, Carrabba, N, Cazaux, P, Cheniti, G, Chinchilla Calix, H, Chung, Wy, Cicco, Na, Cieza, T, Clapp, B, Commeau, P, Cuellar, C, De Benedictis, M, De La Torre Hernandez, Jm, De Vroey, F, Degertekin, M, Eberli, Fr, Eggebrecht, H, Ekicibasi, E, Elmaraghi, M, Elod, P, Ergene, Ao, Fadlalla, Vf, Farah, Ma, Fernandez Vina, R, Ferro, A, Fischer, D, Flore, V, Foley, Dp, Gafoor, S, Gallo, S, Gaspardone, A, Gavrilescu, D, Gentiletti, A, Gilard, M, Giovannelli, F, Gonzalez Pacheco, I, Gonzalo, N, Grajek, S, Gurgel De Medeiros, Jp, Haine, S, Hakim, D, Hakim Vista, Jj, Hallani, H, Hamid, M, Helft, G, Heppell, Rm, Hernandez-Enriquez, M, Hlinomaz, O, Ho Choo, E, Huqi, A, Hurtado, Eo, Iakovou, I, Iosseliani, D, Janssens, L, Jean, M, Jensen, Jk, Jesudason, P, Jimenez Diaz, Va, Karchevsky, D, Karpovskii, A, Katsimagklis, G, Kereiakes, D, Kersanova, Nc, Kesavan, S, Khaled, H, Khalil, Sa, Kiatchoosakun, S, Kim, Ks, Kirma, C, Koltowski, L, Konteva, M, Kozinski, L, Kuehn, Cr, Kumar, S, Kyriakakis, Cg, Laanmets, P, Labrunie, A, Ladwiniec, A, Lai, G, Laine, M, Latib, A, Lattuca, B, Lazarevic, Am, Lee, Ks, Legrand, V, Leiva, G, Lester, N, Levchyshyna, O, Livia, G, Londero, Hf, Luha, O, Lupi, A, Lupkovics, G, Maaliki, S, Maeng, M, Mahr, Nc, Mantyla, P, Mariano, E, Marsit, N, Mcdonough, Tj, Medda, M, Mejia Viana, S, Merigo Azpir, Ca, Mitreski, S, Moreno, R, Moreu, J, Muehler, M, Muir, D, Munoz Molina, R, Musilli, N, Myc, J, Nadra, I, Nagy, Cd, Narayanan, A, Neugebauer, P, Nguyen, M, Nick, H, Nicolino, A, Obradovic, Sd, Paizis, I, Panagiotis, P, Park, Sd, Park, Sj, Pasquetto, G, Patel, D, Paunovic, D, Pedon, L, Pereira Machado, F, Pershukov, H, Petrou, E, Pinton, Fa, Preti, G, Puri, R, Pyxaras, Sa, Quintanilla, J, Rhouati, A, Ribeiro De Oliveira, I, Rivetti, L, Rodriguez, Ae, Rotevatn, S, Rubartelli, P, Sachdeva, R, Sanchez-Perez, H, Sangiorgi, G, Santoro, Gm, Saporito, F, Scappaticci, M, Schmermund, A, Schmidt, Je, Schmitz, T, Schneider, Ti, Schuchlenz, H, Sepulveda Varela, P, Shaw, 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M., Alaarag, A. F., Accardi, R., Adel, A., Alcazar De La Torre, E., Alejos, R., Alfonso Jimenez, V., Alhashimi, H. M. M., Aljeboury, A., Almeida De Sousa, J., Almusawi, A., Alshaikha, M., Altaf, S., Altahmody, K. E. A., Alvarez Contreras, L. R., Amarasena, N., Amoroso, G., Anderson, R., Ando, G., Andrade, J., Andreou, A. Y., Angulo, J., Antonio, T., Aprigliano, G., Aquilina, M., Arafa, S. E. O., Aramberry, L., Arampatzis, C. A., Araujo, J. J., Asher, E., Ates, I., Athanasias, D., Auer, J., Auffret, V., Ayala, F. J., Baba, C., Baglioni, P., Bagur, R., Balam-Ortiz, E., Balducelli, M., Bam Pas, G., Barbash, I. M., Barbosa, A. H. P., Barbosa, R., Barnay, P., Barroso, L., Basti, A., Bax, M., Bayet, G., Beijk, M. A., Beltran, R., Berenguer Jofresa, A., Berroth, R., Berti, S., Berumen Dominguez, L. E., Bhasin, A., Bhaya, M., Bianco, M., Biasco, L., Bikicki, M., Bonarjee, V. V. 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E., Cuculi, F., Cuenza, L., Cyrne Carvalho, H., D'Ascenzo, F., D'Urbano, M., Damonte, A., Dan Florin, F., Dana, A., Dangoisse, V., De Backer, O., De Cock, D., De Vita, M., Debski, A., Delgado, A., Devadathan, S., Dhamrait, S., Di Lorenzo, E., Di Serafino, D., Diego-Nieto, A., Dievart, F., Diez, J. L., Dimitriadis, K., Dina, C., Doerner, O., Donahue, M., Donis, J., Drieghe, B., Drissi, M. F., Du Fretay, H., Dziewierz, A., Echavarria-Pinto, M., Echeverria Romero, R. G., Economou, F., Eftychiou, C., Egdell, R., El Hosieny, A., El Meguid, K., Elabbassi, W., Elesgerli, S., Elghetany, H., Elizondo, J. C., Elkahlout, A., Elrowiny, R., Elserafy, A. S., Emam, A., Emara, A., Emmanouil, P., Ercilla, J., Erglis, A., Eslam Taha, E., Esmaeil, S., Esposito, G., Ettori, F., Eugenio, N., Everaert, B., Ezquerra Aguilar, W., Falu, R., Farag, E., Farjalla, J., Feldman, L., Feldman, M., Felice, H., Fernandez-Nofrerias, E., Fernandez-Rodriguez, D., Ferranti, F., Ferreira, Q., Ferrone, M., Fleischmann, C., Flessas, D., Formigli, D., Fozilov, H., Fraccaro, C., Freitas, J. O., Fresco, C., Fridrich, V., Furmaniuk, J., Gagnor, A., Galasso, G., Galeazzi, G. L., Galli, S., Galvez Villacorta, V., Gandolfo, C., Garcia, E., Garcia-Blas, S., Garducci, S., Garg, S., Garro, N., Gatto, L., Georgiou, M. G., Ghanem, I., Ghose, T., Giacchi, G., Giang, P. T., Giesler, T., Giovino, M., Girardi, P., Girasis, C., Giunio, L., Giustino, G., Glatthor, C., Glogar, H. D., Golledge, P., Gomez Moreno, J., Gomez Recio, M., Gommeaux, A., Grantalis, G., Greco, F., Grundeken, M. J., Grunert, S., Gudmundsdottir, I., Guenoun, M., Guerios, E., Gupta, R., Gupta, S., Gutierrez, C., Hafeez, I., Halvorsen, S., Hamed Hussein, G. A., Hammoudeh, A., Hansen, P. R., Harb, S., Hawas, J. M., Hayrapetyan, H., Heintzen, M. P., Hengstenberg, C., Herity, N., Hernandez, F., Heyse, A., Hicham, D., Hildick-Smith, D., Hill, J., Hillani, A., Hiltrop, N., Hiramori, A., Hobson, A. R., Homan, D. J., Hooda, A., Ielasi, A., Ierna, S., Iftikhar, A. K., Ilic, I., Imai, Y., Imperadore, F., Indolfi, C., Iorga, V., Ipek, E., Ito, S., Jacksch, R., Jae-Sik, J., James, S., Jamshidi, P., Jerbi, J., Jimenez Quevedo, P., Jimenez-Navarro, M., Jimenez-Santos, M., Jin, Q. H., Joksas, V., Jovic, D., Junejo, S., Kallel, R., Kamal, A., Kamiya, H., Kannan, D., Kantaria, M., Kapetanopoulos, A., Kara Ali, B., Karjalainen, P. P., Karthikeyan, V. 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C., Martins, J., Mashayekhi, K., Masood, A., Maurer, E., Mavrogianni, A. D., Mazurek, T., Medina, A., Mehilli, J., Mellwig, K. P., Mendez, M., Mendiz, O. A., Meneses, A., Mercado, L. A., Mereuta, A., Mezzapelle, G., Milanovic, N., Mohamed, S. M., Mohanad, A., Mohanty, A., Moorthy, N., Morales, F. J., More, R., Moreno Samos, J. C., Moreno-Martinez, F. L., Moscato, F., Mossmann, M., Mrevlje, B., Muller-Eichelberg, A., Musumeci, G., Nadir Khan, M., Najim, S., Nakamura, S., Nakao, F., Naveri, H., Negus, B., Nerla, R., Nguyen, H. T., Niess, G. S., Nikas, D. N., Niroomand, F., Niva, J., Nogueira, J. W., Nombela-Franco, L., Notrica, M., Nouri, B., Nugue, O., Nunes, G. L., Ober, M., Ochoa, J., Oh, J. H., Ojeda, S., Oktay Tureli, H., Olowe, Y., Oluseun, A., Opolski, G., Ornelas, C. E., Otasevic, P., Ozturk, A., Padilla, F., Pagny, J. Y., Paolantonio, D., Papaioannou, G. I., Parodi, G., Patil, S. N., Pavei, A., Pavia, A., Pavlidis, A., Pell, A., Percoco, G. F., Pernasetti, L. V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. D., Sanchez-Gila, J., Sanchez-Perez, I., Santarelli, A., Sardovski, Sarenac, D., Sarma, J., Sarno, G., Savonitto, S., Sayied Abdullah, A., Schafer, A., Scherillo, M., Schneider, H., Schuhlen, H., Sciahbasi, A., Seca, L., Sedlon, P., Semenka, J., Serra, L. A., Sesana, M., Sethi, A., Sgueglia, G. A., Shaheen, S., Shahri, H., Sheiban, I., Shyu, K. G., Silva, C. E. F., Sionis, D., Siqueira, D. A., Siqueira, M. J., Smits, P., Sobhy, M., Sokolov, M., Soliman, S., Somani, A. N., Sridhar, G., Stakos, D., Stasek, J., Stefanini, G., Steigen, T. K., Stewart, Stipal, R., Stochino, M. L., Stoel, M. G., Subla, R. M., Suliman, A., Summaria, F., Stoyanov, N., Syed, A. A., Tanaka, Y., Tashani, A., Tauzin, S., Tawade, N., Tawfik, M., Tayeh, O., Terzic, I., Testa, L., Thevan, B., Thiam, M., Tiecco, F., Tierala, I., Tilea, I., Tilsted, H. H., Tomasik, A. R., Tonev, I., Torres Bosco, A., Tousek, P., Townend, J., Tran Ngoc, T., Triantafyllou, K., Tsigkas, G., Tsioufis, C., Turri, M., Tyligadis, G., Ugo, F., Ultramari, F. T., Urban, P., Uren, N., Uretsky, B. F., Uribe, C. E., Usman, B., Valadez Molina, F., Van Houwelingen, K. G., Vandormael, M., Varvarovsky, I., Vassilis, V., Velasquez, D., Verdoia, M., Vermeersch, P., Vidal-Perez, R., Vinesh, J., Violini, R., Vista, J. H., Vogt, F., Vogt, M., Vokac, D., Vom Dahl, J., Vranckx, P., Wahab, A., Wang, R., Wang, T. D., Wani, S., Weisz, S. H., Werner, G. S., Wilkinson, J. R., Wolf, A., Youssef, A., Yumoto, K., Zaderenko, N., Zaghloul Darwish, A. M., Zahn, R., Zaro, T., Zavalloni, D., Zbinden, R., Zekanovic, D., Zhang, B., Zhang, C., Zhang, Y. J., Zhonghan, N., Zingarelli, A., Zueco, J., Zuhairy, H., Abbate, A., Abdel Hamid, M., Abdelmegid, M. A. F., Acuna-Valerio, J., Adriaenssens, T., Agostoni, P., Aikot, H., Alameda, M., Alcaraz, H., Almendro-Delia, M., Altug Cakmak, H., Amir, A., Arjomand, A., Assomull, R., Atalar, E., Avramides, D., Aytek Simsek, M., Aznaouridis, K., Azpeitia, Y., Barnabas, C., Barsness, G. W., Bartorelli, A. L., Basoglu, A., Benezet, J., Benincasa, S., Berland, J., Berrocal, D. H., Bett, N., Boskovic, S., Brandao, V., Caporale, R., Caprotta, F., Carrabba, N., Cazaux, P., Cheniti, G., Chinchilla Calix, H., Chung, W. Y., Cicco, N. A., Cieza, T., Clapp, B., Commeau, P., Cuellar, C., De Benedictis, M., De La Torre Hernandez, J. M., De Vroey, F., Degertekin, M., Eberli, F. R., Eggebrecht, H., Ekicibasi, E., Elmaraghi, M., Elod, P., Ergene, A. O., Fadlalla, V. F., Farah, M. A., Fernandez Vina, R., Ferro, A., Fischer, D., Flore, V., Foley, D. P., Gafoor, S., Gallo, S., Gaspardone, A., Gavrilescu, D., Gentiletti, A., Gilard, M., Giovannelli, F., Gonzalez Pacheco, I., Gonzalo, N., Grajek, S., Gurgel De Medeiros, J. P., Haine, S., Hakim, D., Hakim Vista, J. J., Hallani, H., Hamid, M., Helft, G., Heppell, R. M., Hernandez-Enriquez, M., Hlinomaz, O., Ho Choo, E., Huqi, A., Hurtado, E. O., Iakovou, I., Iosseliani, D., Janssens, L., Jean, M., Jensen, J. K., Jesudason, P., Jimenez Diaz, V. A., Karchevsky, D., Karpovskii, A., Katsimagklis, G., Kereiakes, D., Kersanova, N. C., Kesavan, S., Khaled, H., Khalil, S. A., Kiatchoosakun, S., Kim, K. S., Kirma, C., Koltowski, L., Konteva, M., Kozinski, L., Kuehn, C. R., Kumar, S., Kyriakakis, C. G., Laanmets, P., Labrunie, A., Ladwiniec, A., Lai, G., Laine, M., Latib, A., Lattuca, B., Lazarevic, A. M., Lee, K. S., Legrand, V., Leiva, G., Lester, N., Levchyshyna, O., Livia, G., Londero, H. F., Luha, O., Lupi, A., Lupkovics, G., Maaliki, S., Maeng, M., Mahr, N. C., Mantyla, P., Mariano, E., Marsit, N., Mcdonough, T. J., Medda, M., Mejia Viana, S., Merigo Azpir, C. A., Mitreski, S., Moreno, R., Moreu, J., Muehler, M., Muir, D., Munoz Molina, R., Musilli, N., Myc, J., Nadra, I., Nagy, C. D., Narayanan, A., Neugebauer, P., Nguyen, M., Nick, H., Nicolino, A., Obradovic, S. D., Paizis, I., Panagiotis, P., Park, S. D., Park, S. J., Pasquetto, G., Patel, D., Paunovic, D., Pedon, L., Pereira Machado, F., Pershukov, H., Petrou, E., Pinton, F. A., Preti, G., Puri, R., Pyxaras, S. A., Quintanilla, J., Rhouati, A., Ribeiro De Oliveira, I., Rivetti, L., Rodriguez, A. E., Rotevatn, S., Rubartelli, P., Sachdeva, R., Sanchez-Perez, H., Sangiorgi, G., Santoro, G. M., Saporito, F., Scappaticci, M., Schmermund, A., Schmidt, J. E., Schmitz, T., Schneider, T. I., Schuchlenz, H., Sepulveda Varela, P., Shaw, E., Silva Marques, J., Skalidis, E., Slhessarenko, J., Spaulding, C., Stankovic, G., Suwannasom, P., Synetos, A., Szuster, E., Taha, S., Tavano, D., Tebet, M., Thury, A., Toutouzas, K., Triantafyllis, A. S., Tsikaderis, D., Tumscitz, C., Tzanogiorgis, I., Udovichenko, A., Ulrike, N., Unikas, R., Valerio, M. G., Van Mieghem, C., Vandendriessche, T., Vavlukis, M., Vigna, C., Vilar, J. V., Vizzari, G., Voudris, V., Wafa, S., Wagner, D. R., Wichter, T., Wiedemann, S., Williams, P. D., Woody, W., Yding, A., Zachow, G., and Webster, M.

Subjects
Male, medicine.medical_specialty, Time Factors, Percutaneous, Time Factor, Psychological intervention, Alternative medicine, MEDLINE, Practice Patterns, Drug Administration Schedule, acute coronary syndrome, Settore MED/11, Percutaneous Coronary Intervention, Pharmacotherapy, Drug Therapy, Physicians, Surveys and Questionnaires, drug-eluting stent, Humans, Surveys and Questionnaire, Medicine, Practice Patterns, Physicians', health care economics and organizations, clopidogrel, dual antiplatelet therapy (DAPT), stable coronary artery disease, Drug Therapy, Combination, Evidence-Based Medicine, Health Care Surveys, Platelet Aggregation Inhibitors, Practice Guidelines as Topic, Practice Patterns, Physicians, Treatment Outcome, Stents, business.industry, Platelet Aggregation Inhibitor, Coronary stenting, Evidence-based medicine, Middle Aged, Surgery, Clinical trial, Health Care Survey, Combination, Emergency medicine, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting. METHODS AND RESULTS Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (AHA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after AHA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after AHA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAPT should be implemented in selected patients. After AHA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAPT duration, and 40.0% the need for clinical guidance. CONCLUSIONS This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAPT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies.

Published
2015

36. Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys

Author

Alberto Morganti, Massimo Volpe, Andrea Ferrucci, Claudio Borghi, Claudio Ferri, Giuliano Tocci, Giuseppe Mancia, Enrico Agabiti Rosei, Bruno Trimarco, Roberto Pontremoli, Tocci, G., Ferrucci, A., Pontremoli, R., Ferri, C., Rosei, E.A., Morganti, A., Trimarco, B., Mancia, G., Borghi, C., Volpe, M., Tocci, G, Ferrucci, A, Pontremoli, R, Ferri, C, Rosei, E, Morganti, A, Trimarco, B, Mancia, G, Borghi, C, Volpe, M, Rosei, E. A, and Trimarco, Bruno

Subjects
Antihypertensive Agents, Blood Pressure, Guideline Adherence, Health Care Surveys, Humans, Hypertension, Italy, Observational Studies as Topic, Practice Guidelines as Topic, Practice Patterns, Physicians', Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Internal Medicine, Medicine (all), Pediatrics, medicine.medical_specialty, Time Factor, Cardiovascular risk factors, Diastole, population, Practice Patterns, european-society, countries, Medicine, Outpatient clinic, arterial-hypertension, In patient, risk-factors, therapy, disease, Physicians', practice guidelines, business.industry, Risk Factor, Antihypertensive Agent, Blood pressure, Health Care Survey, Observational study, management, discontinuation, Risk assessment, business, Body mass index, Human
Abstract

This analysis is aimed to determine blood pressure (BP) levels and BP control rates in a large population of hypertensive patients in Italy. Data were taken from two large and inclusive cross-sectional surveys, which covered two distinct and subsequent time periods (2000-2005 and 2005-2011, respectively). Observational clinical studies and surveys, which reported average systolic/diastolic clinic BP levels, proportions of treated/untreated and controlled/uncontrolled patients, and prevalence of cardiovascular risk factors in hypertensive patients followed in either outpatient clinics, hypertension centres or general practice, were considered for the analyses. The overall sample included 211 591 hypertensive patients (119 997 (56.7%) women, age 57.0±10.0 years, body mass index 26.9±4.0 kg m(-2), BP levels 146.9±16.7/88.7±9.6 mm Hg). BP levels were 148.2±15.4/87.5±9.3 mm Hg in patients followed by general practitioners (n=168 313, 79.5%), 148.1±17.3/90.1±9.7 mm Hg in those followed by hypertension centres (n=28 180, 13.3%), and 142.4±17.6/86.6±9.8 mm Hg in those followed by outpatient clinics and hospital divisions (n=15 098, 7.1%). Among treated hypertensive patients (n=128 079; 60.5%), 43 008 (33.6%) were reported to have controlled BP levels. Over one decade of observation, we reported that ~60% of hypertensive patients were treated and among these only 33% achieved effective BP control. These findings highlight the need for more effective interventions to improve management of hypertension in Italy.

Published
2015

37. Continuous Subcutaneous Insulin Infusion in Italy: Third National Survey

Author

Bruttomesso D., Laviola L., Lepore G., Bonfanti R., Bozzetto L., Corsi A., Di Blasi V., Girelli A., Grassi G., Iafusco D., Rabbone I., Schiaffini R., Montani V., Colleluori P., Paciotti V., Alfidi P., Grosso J., Tumini S., Cipriano P., Vitacolonna E., Di Vieste G., Minnucci A., Antenucci D., La Penna G., Taraborrelli M., Macerala B., Citro G., De Morelli G., Gnasso A., Irace C., Citriniti F., Lazzaro N., Bruzzese M., Mammi F., De Berardinis F., Santoro E., Corigliano G., Corigliano M., Parillo M., Schettino M., Fresa R., Annuzzi G., Bassi V., Santinelli C., Buono P., Mozzillo E., De Feo E., Esposito K., Petrizzo M., Foglia A., Gatti A., Gentile S., Guarino G., Zanfardino A., Lambiase C., Vitale A., Zucchini S., Maltoni G., Forlani G., Moscatiello S., Suprani T., Bensa M., Tomasi F., Monesi M., Nizzoli M., Acquati S., Chierici G., Milli B., Iughetti L., Predieri B., Cavani R., Romano S., Manicardi V., Michelini M., Cimicchi M. C., Ugolotti D., Zavaroni I., Dei Cas A., Dall'Aglio E., Papi M., Tardio S. M., Calderini M. C., Riboni S., D'Amato L., Zavaroni D., Gastaldi L., Di Bartolo P., Pellicano F., Cirillo A., Graziani V., Di Secli C., Amarri S., Lasagni A., Marsciani A., Pedini A., Pagliani U., Rossi C., Tortul C., Brunato B., Assaloni R., Zanette G., Livolsi P., Petrucco A., Tercelj K., Manca E., Candido R., Tommasi E., Tornese G., Faleschini E., Tonutti L., Agus S., Zanatta M., Rosolen A., Comici A., Graziano F. M., Misischi I., Pozzilli P., Maurizi A. R., Falasca P., Tuccinardi F., Ricciardi G. P., Di Masa P., Ragonese M., Cipolloni L., Buzzetti R., Moretti C., Leto G., Crino A., Bocchini S., Di Perna P., Giuliano M., Frontoni S., Malandrucco I., Pitocco D., Scalpone R., Toscanella F., Cappa M., Ventura C., Bonato V., De Bernardinis M., Cavallo M. G., Leonetti F., Morano S., Mandosi E., Cicconetti E., Ciampittiello G., Marini M. A., Sabato D., Napoli A., Giraudo F., Toscano V., Massimiani F., Fava D., Gargiulo P., Mecca N., Tubili C., Nardone M. R., Morviducci L., Manca-Bitti M. L., Arcano S., Leotta S., Suraci C., Chiaramonte F., Visalli N., Forte E., Palmacci C., Arnaldi C., Tosini D., Querci F., Trevisan R., Bonfadini S., Prandi E., Felappi B., Locatelli F., Fuso V., Rocca A., Meneghini E., Massafra C., Terni T., Elli P., Ruggeri P., Carrai E., Musacchio N., Lovagnini Scher C. A., Marelli G., Vilei V., Richini D., Inversini C., Franzetti I., Bonacina M., Ciucci A., Sciangula L., Duratorre E., Bonomo M., Bertuzzi F., Chebat E., Muratori M., Scaramuzza A., Zuccotti G. V., Bollati P. M., Colapinto P., Orsi E., Palmieri E., Laurenzi A., Molinari C., Frontino G., Veronelli A., Zecchini B., Bianchi A., Torchio G., Lovati E., Ghilardi G., Dagani R., Carugo D., Berra C., Favacchio G., Fochesato E., Pissarelli A., Bucciarelli L., Bulgheroni M., Guerraggio L., Zonca S., Bossi A. C., Berzi D., Mangone I., Cazzaniga E., Rabini R. A., Boemi M., Faloia E., Boscaro M., Sternari G., Iannilli A., Cherubini V., Busciantella Ricci N., Cartechini M. G., Tesei A. M., Maolo G., Galetta M., Vespasiani G., Tinti G., Manfrini S., Aiello A., Di Vincenzo S., Vitale C., Di Caro P., Lera R., Secco A., Lesina A., Romeo F., Origlia C., Giorda C., Chiambretti A. M., Fornengo R., De Donno V., Gallarotti F., Manti R., Marafetti L., Cadario F., Savastio S., Barbieri P., Massucco P., Ali A., Gottero C., Degiovanni M., Bertaina S., Maghenzani G., Tinti D., Fontana F., Giorgino F., Stefanelli G., Cavallo L., Zecchino C., Piccinno E., Ortolani F., Gallo F., Moramarco F., Marino A., Sparasci G., Mileti G., Lamacchia O., Picca G., Coccioli M. S., Micale F., Serra R., Romano I., Savino T., De Cosmo S., Rauseo A., Delvecchio M., Lapolla R., Braione A. F., Papagno G., Baroni M., Melis M., Cossu E., Songini M., Cambuli V. M., Lo Presti D., Timpanaro T. A., Chiavetta A., Garofalo M. R., Tommaselli L., Tumminia A., Scarpitta A. M., Di Benedetto A., Giunta L., Lombardo F., Salzano G., Cardella F., Roppolo R., Provenzano V., Fleres M., Migliorini S., De Luca A., Leopardi A., Beltrami C., Toni S., Guasti G., Lenzi L., Lamanna C., Mannucci E., Lucchesi S., Dicianni G., Aragona M., Del Prato S., Fattor B., Eisath J., Pasquino B., Reinstadler P., Kaufmann P., Incelli G., Rauch S., Romanelli T., Cauvin V., Franceschi R., Soldani C., Scattoni R., Norgiolini R., Celleno R., Torlone E., Bolli G. B., Lalli C., Scarponi M., Bobbio A., Bechaz M., Pianta A., Marangoni A., Arico C. N., Alagona C., Confortin L., Rossi E., Boscolo Bariga A., Nogara A., Bettio M., Frison V., Guidoni G. L., Fongher C., Contin M. L., Cosma A., Vianello S., Bondesan L., Morea A., Volpi A., Coracina A., Panebianco G., Lombardi S., Costa S., Cipponeri E., Vedovato M., Scotton R., Monciotti C. M., Galderisi A., Dalfra M. G., Lapolla A., Zanon M., Lisato G., Mollo F., Calcaterra F., Miola M., Paccagnella A., Sambataro M., Moro E., Trombetta M., Negri C., Sabbion A., Maffeis C., Strazzabosco M., Mesturino C. A., Mingardi R., Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Vitacolonna, E., Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., De Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammi, F., De Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., De Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall'Aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D'Amato, L., Zavaroni, D., Gastaldi, L., Di Bartolo, P., Pellicano, F., Cirillo, A., Graziani, V., Di Secli, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Graziano, F. M., Misischi, I., Pozzilli, P., Maurizi, A. R., Falasca, P., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crino, A., Bocchini, S., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., De Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Napoli, A., Giraudo, F., Toscano, V., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Forte, E., Palmacci, C., Arnaldi, C., Tosini, D., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Lovagnini Scher, C. A., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Carugo, D., Berra, C., Favacchio, G., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Busciantella Ricci, N., Cartechini, M. G., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Tinti, G., Manfrini, S., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., Giorda, C., Chiambretti, A. M., Fornengo, R., De Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Ali, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., De Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., De Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Dicianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Arico, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo Bariga, A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfra, M. G., Lapolla, A., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., Mingardi, R., Bruttomesso, D, Laviola, L, Lepore, G, Bonfanti, R, Bozzetto, L, Corsi, A, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Rabbone, I, Schiaffini, R, Montani, V, Colleluori, P, Paciotti, V, Alfidi, P, Grosso, J, Tumini, S, Cipriano, P, Vitacolonna, E, Di Vieste, G, Minnucci, A, Antenucci, D, La Penna, G, Taraborrelli, M, Macerala, B, Citro, G, De Morelli, G, Gnasso, A, Irace, C, Citriniti, F, Lazzaro, N, Bruzzese, M, Mammi, F, De Berardinis, F, Santoro, E, Corigliano, G, Corigliano, M, Parillo, M, Schettino, M, Fresa, R, Annuzzi, G, Bassi, V, Santinelli, C, Buono, P, Mozzillo, E, De Feo, E, Esposito, K, Petrizzo, M, Foglia, A, Gatti, A, Gentile, S, Guarino, G, Zanfardino, A, Lambiase, C, Vitale, A, Zucchini, S, Maltoni, G, Forlani, G, Moscatiello, S, Suprani, T, Bensa, M, Tomasi, F, Monesi, M, Nizzoli, M, Acquati, S, Chierici, G, Milli, B, Iughetti, L, Predieri, B, Cavani, R, Romano, S, Manicardi, V, Michelini, M, Cimicchi, M, Ugolotti, D, Zavaroni, I, Dei Cas, A, Dall'Aglio, E, Papi, M, Tardio, S, Calderini, M, Riboni, S, D'Amato, L, Zavaroni, D, Gastaldi, L, Di Bartolo, P, Pellicano, F, Cirillo, A, Graziani, V, Di Secli, C, Amarri, S, Lasagni, A, Marsciani, A, Pedini, A, Pagliani, U, Rossi, C, Tortul, C, Brunato, B, Assaloni, R, Zanette, G, Livolsi, P, Petrucco, A, Tercelj, K, Manca, E, Candido, R, Tommasi, E, Tornese, G, Faleschini, E, Tonutti, L, Agus, S, Zanatta, M, Rosolen, A, Comici, A, Graziano, F, Misischi, I, Pozzilli, P, Maurizi, A, Falasca, P, Tuccinardi, F, Ricciardi, G, Di Masa, P, Ragonese, M, Cipolloni, L, Buzzetti, R, Moretti, C, Leto, G, Crino, A, Bocchini, S, Di Perna, P, Giuliano, M, Frontoni, S, Malandrucco, I, Pitocco, D, Scalpone, R, Toscanella, F, Cappa, M, Ventura, C, Bonato, V, De Bernardinis, M, Cavallo, M, Leonetti, F, Morano, S, Mandosi, E, Cicconetti, E, Ciampittiello, G, Marini, M, Sabato, D, Napoli, A, Giraudo, F, Toscano, V, Massimiani, F, Fava, D, Gargiulo, P, Mecca, N, Tubili, C, Nardone, M, Morviducci, L, Manca-Bitti, M, Arcano, S, Leotta, S, Suraci, C, Chiaramonte, F, Visalli, N, Forte, E, Palmacci, C, Arnaldi, C, Tosini, D, Querci, F, Trevisan, R, Bonfadini, S, Prandi, E, Felappi, B, Locatelli, F, Fuso, V, Rocca, A, Meneghini, E, Massafra, C, Terni, T, Elli, P, Ruggeri, P, Carrai, E, Musacchio, N, Lovagnini Scher, C, Marelli, G, Vilei, V, Richini, D, Inversini, C, Franzetti, I, Bonacina, M, Ciucci, A, Sciangula, L, Duratorre, E, Bonomo, M, Bertuzzi, F, Chebat, E, Muratori, M, Scaramuzza, A, Zuccotti, G, Bollati, P, Colapinto, P, Orsi, E, Palmieri, E, Laurenzi, A, Molinari, C, Frontino, G, Veronelli, A, Zecchini, B, Bianchi, A, Torchio, G, Lovati, E, Ghilardi, G, Dagani, R, Carugo, D, Berra, C, Favacchio, G, Fochesato, E, Pissarelli, A, Bucciarelli, L, Bulgheroni, M, Guerraggio, L, Zonca, S, Bossi, A, Berzi, D, Mangone, I, Cazzaniga, E, Rabini, R, Boemi, M, Faloia, E, Boscaro, M, Sternari, G, Iannilli, A, Cherubini, V, Busciantella Ricci, N, Cartechini, M, Tesei, A, Maolo, G, Galetta, M, Vespasiani, G, Tinti, G, Manfrini, S, Aiello, A, Di Vincenzo, S, Vitale, C, Di Caro, P, Lera, R, Secco, A, Lesina, A, Romeo, F, Origlia, C, Giorda, C, Chiambretti, A, Fornengo, R, De Donno, V, Gallarotti, F, Manti, R, Marafetti, L, Cadario, F, Savastio, S, Barbieri, P, Massucco, P, Ali, A, Gottero, C, Degiovanni, M, Bertaina, S, Maghenzani, G, Tinti, D, Fontana, F, Giorgino, F, Stefanelli, G, Cavallo, L, Zecchino, C, Piccinno, E, Ortolani, F, Gallo, F, Moramarco, F, Marino, A, Sparasci, G, Mileti, G, Lamacchia, O, Picca, G, Coccioli, M, Micale, F, Serra, R, Romano, I, Savino, T, De Cosmo, S, Rauseo, A, Delvecchio, M, Lapolla, R, Braione, A, Papagno, G, Baroni, M, Melis, M, Cossu, E, Songini, M, Cambuli, V, Lo Presti, D, Timpanaro, T, Chiavetta, A, Garofalo, M, Tommaselli, L, Tumminia, A, Scarpitta, A, Di Benedetto, A, Giunta, L, Lombardo, F, Salzano, G, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Migliorini, S, De Luca, A, Leopardi, A, Beltrami, C, Toni, S, Guasti, G, Lenzi, L, Lamanna, C, Mannucci, E, Lucchesi, S, Dicianni, G, Aragona, M, Del Prato, S, Fattor, B, Eisath, J, Pasquino, B, Reinstadler, P, Kaufmann, P, Incelli, G, Rauch, S, Romanelli, T, Cauvin, V, Franceschi, R, Soldani, C, Scattoni, R, Norgiolini, R, Celleno, R, Torlone, E, Bolli, G, Lalli, C, Scarponi, M, Bobbio, A, Bechaz, M, Pianta, A, Marangoni, A, Arico, C, Alagona, C, Confortin, L, Rossi, E, Boscolo Bariga, A, Nogara, A, Bettio, M, Frison, V, Guidoni, G, Fongher, C, Contin, M, Cosma, A, Vianello, S, Bondesan, L, Morea, A, Volpi, A, Coracina, A, Panebianco, G, Lombardi, S, Costa, S, Cipponeri, E, Vedovato, M, Scotton, R, Monciotti, C, Galderisi, A, Dalfra, M, Lapolla, A, Zanon, M, Lisato, G, Mollo, F, Calcaterra, F, Miola, M, Paccagnella, A, Sambataro, M, Moro, E, Trombetta, M, Negri, C, Sabbion, A, Maffeis, C, Strazzabosco, M, Mesturino, C, Mingardi, R, Bruttomesso, Daniela, Laviola, Luigi, Lepore, Giuseppe, Bonfanti, Riccardo, Bozzetto, Lutgarda, Corsi, Andrea, Di Blasi, Vincenzo, Girelli, Angela, Grassi, Giorgio, Iafusco, Dario, Rabbone, Ivana, Schiaffini, Riccardo, and Tornese, Gianluca

Subjects
Blood Glucose, Male, Pediatrics, Glucose control, IMPACT, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, CHILDREN, Practice Patterns, Infusions, Subcutaneous, law.invention, Settore MED/13, Endocrinology, Randomized controlled trial, law, Surveys and Questionnaires, Insulin, Practice Patterns, Physicians', Child, Adult, Diabetes Mellitus, Type 1, Female, Guideline Adherence, Health Care Surveys, Humans, Hypoglycemic Agents, Italy, Medical Laboratory Technology, Medicine (all), PUMP THERAPY, Subcutaneous, Diabetes, Diabetes and Metabolism, TERM METABOLIC-CONTROL, Human, Type 1, Infusions, medicine.medical_specialty, Keywords KeyWords Plus:TERM METABOLIC-CONTROL, BOLUS CALCULATOR, PEDIATRIC-PATIENTS, CONTROLLED-TRIAL, CSII, Diabetes mellitus, Diabetes Mellitus, medicine, term metabolic-control, bolus calculator, pump therapy, pediatric-patients, controlled-trial, children, impact CSII, Glucose sensors, Cost-Benefit Analysi, Intensive care medicine, Type 1 diabetes, Physicians', Hypoglycemic Agent, business.industry, medicine.disease, Subcutaneous insulin, Infusions, Subcutaneou, Multicenter study, Health Care Survey, business
Abstract

Background: Continuous subcutaneous insulin infusion (CSII) is increasing worldwide, mostly because of improved technology. The aim of this study was to evaluate the current status of CSII in Italy. Materials and Methods: Physicians from 272 diabetes centers received a questionnaire investigating clinical features, pump technology, and management of patients on CSII. Results: Two hundred seventeen centers (79.8%) joined the study and, by the end of April 2013, gave information about 10,152 patients treated with CSII: 98.2% with type 1 diabetes mellitus, 81.4% adults, 57% female, and 61% with a conventional pump versus 39% with a sensor-augmented pump. CSII advanced functions were used by 68% of patients, and glucose sensors were used 12 days per month on average. Fifty-eight percent of diabetes centers had more than 20 patients on CSII, but there were differences among centers and among regions. The main indication for CSII was poor glucose control. Dropout was mainly due to pump wearability or nonoptimal glycemic control. Twenty-four hour assistance was guaranteed in 81% of centers. A full diabetes team (physician+ nurse + dietician + psychologist) was available in 23% of adult-care diabetes centers and in 53%of pediatric diabetes units. Conclusions: CSII keeps increasing in Italy. More work is needed to ensure uniform treatment strategies throughout the country and to improve pump use.

Published
2015

38. The influential role of personal advice networks on general practitioners’ performance: a social capital perspective

Author

Stefano Calciolari, Laura G. González-Ortiz, Federico Lega, Calciolari, S, González-Ortiz, L, and Lega, F

Subjects
Male, education, Applied psychology, Psychological intervention, Health informatics, Goal, Social Networking, Health administration, 03 medical and health sciences, 0302 clinical medicine, Social capital, Nursing, General Practitioners, Humans, Medicine, 030212 general & internal medicine, Data collection, Primary Health Care, General Practitioner, business.industry, lcsh:Public aspects of medicine, 030503 health policy & services, Health Policy, Nursing research, lcsh:RA1-1270, Hypothesis, Middle Aged, Primary care, Variety (cybernetics), Italy, Health Care Survey, Health Care Surveys, Global Positioning System, Female, Clinical Competence, 0305 other medical science, business, Goals, Human
Abstract

Background In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources embedded in the GPs’ personal advice networks (i.e., social capital) on GPs’ capacity to meet defined objectives. The present study has two goals: (a) to assess the GPs’ personal advice networks according to the social capital framework and (b) to test the influence of such relationships on GPs’ capacity to accomplish organizational goals. Methods The data collection relied on administrative data provided by an Italian local health authority (LHA) and a survey administered to the GPs of the selected LHA. The GPs’ personal advice networks were assessed through an ad-hoc instrument and interpreted as egocentric networks. Multivariate regression analyses assessed two different performance measures. Results Social capital may influence the GPs’ capacity to meet targets, though the influence differs according to the objective considered. In particular, the higher the professional heterogeneity of a GP personal advice network, the lower her/his capacity is to meet targets of prescriptive appropriateness. Conclusions Our findings might help to design more effective primary care reforms depending on the pursued goals. However, further research is needed.

Published
2017

39. Survey of Diagnostic Criteria for Fetal Distress in Latin American and African Countries: Over Diagnosis or Under Diagnosis?

Author

Cecilia D Palacios-Revilla, Maria Paula Cateriano-Alberdi, and Eddy R. Segura

Subjects
medicine.medical_specialty, Latin Americans, Letter, Clinical Biochemistry, Health care quality, lcsh:Medicine, South and Central America, 03 medical and health sciences, 0302 clinical medicine, Nursing, Fetal distress, medicine, Clinical protocol, 030212 general & internal medicine, bibliographic database, Fetus distress, 030219 obstetrics & reproductive medicine, business.industry, Health care survey, lcsh:R, Disease classification, Paediatrics Section, General Medicine, medicine.disease, clinical practice, Clinical Practice, Bibliographic database, Family medicine, Africa, business, Over diagnosis, Human
Abstract

Cartas al editor

Published
2017

40. Prophylactic antibiotic use in pediatric patients undergoing urinary tract catheterization: a survey of members of the Society for Pediatric Urology

Author

Elizabeth B. Yerkes, Ilina Rosoklija, Emilie K. Johnson, and Alexander P. Glaser

Subjects
Adult, Male, medicine.medical_specialty, medicine.drug_class, Attitude of Health Personnel, Urinary system, medicine.medical_treatment, Urology, Antibiotics, Population, 030232 urology & nephrology, lcsh:RC870-923, Pediatrics, Urinary catheterization, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, medicine, Humans, 030212 general & internal medicine, Antibiotic prophylaxis, Practice Patterns, Physicians', Intensive care medicine, education, Child, Societies, Medical, education.field_of_study, Urinary tract infection, business.industry, Health care survey, General Medicine, Antibiotic Prophylaxis, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Pediatric urology, Reproductive Medicine, Hypospadias, Child, Preschool, Health Care Surveys, Female, Catheter-related infection, business, Urinary Catheterization, Research Article
Abstract

Background Current organizational guidelines regarding use of antibiotics during urinary tract catheterization are based on limited evidence and are not directly applicable to the pediatric urology population. We seek to improve understanding of this population by first evaluating current practices. This study aims to investigate practice patterns and attitudes of pediatric urologists regarding the use of antibiotics in the setting of urinary tract catheterization. Methods An online survey was sent to members of the Society for Pediatric Urology. Questionnaire sections included demographics, general questions about antibiotic use with catheterization, and specific clinical scenarios. Descriptive statistics were used, and chi-square analysis was performed to examine associations between demographics and specific responses. Results Of 448 pediatric urologists surveyed, 154 (34%) responded to the survey. A majority of surveyed urologists (78%) prescribe daily prophylactic antibiotics with a hypospadias stent in place, but extensive variation in use of antibiotics was reported with other catheters and tubes. Extensive variation in practice patterns was also reported for three case scenarios regarding antibiotic prophylaxis with catheterization. Urologists > 50 years of age and fellowship-trained urologists were more likely to prescribe antibiotics for hypospadias stents (p = 0.02, p = 0.03), but no other significant associations between demographic characteristics and antibiotic use were found. Conclusions There is substantial variation in practice patterns among surveyed pediatric urologists regarding prophylactic antibiotic use with urinary catheterization. This variation, combined with a lack of objective data and increasing pressure to decrease infectious complications and combat antibiotic resistance, highlights the need for development of management guidelines for this unique population. Electronic supplementary material The online version of this article (10.1186/s12894-017-0268-5) contains supplementary material, which is available to authorized users.

Published
2017

41. Doctors' experience of coordination across care levels and associated factors. A cross-sectional study in public healthcare networks of six Latin American countries

Author

Amparo Susana Mogollón-Pérez, Irene Garcia-Subirats, Pierre De Paepe, Angelica Ivonne Cisneros, Ingrid Vargas, Isabella Samico, Pamela Eguiguren, Fernando Bertolotto, María Cecilia Muruaga, Adriana Huerta, María Luisa Vázquez, and Jean-Pierre Unger

Subjects
Male, Health (social science), Latin Americans, Cross-sectional study, Health Worker, Satisfaction, 0302 clinical medicine, Administración de servicios de salud, Surveys and Questionnaires, Health care, Administración hospitalaria, 030212 general & internal medicine, Salary, Cooperative Behavior, Chile, Doctor Patient Relation, media_common, General Practitioner, Quality Of Health Care, Health services research, Atención primaria en salud, Care Integration, Integrated Delivery Systems, Middle Aged, Health Services, Health Survey, 3. Good health, Female, Health Services Research, Public Health, 0305 other medical science, Care Coordination, Brazil, Human, Adult, Employment, medicine.medical_specialty, Secondary Health Care, media_common.quotation_subject, education, Argentina, Health-Care Surveys, Follow Up, Colombia, Public healthcare, Secondary Care, 03 medical and health sciences, History and Philosophy of Science, Nursing, Perception, Physicians, parasitic diseases, medicine, Humans, Mexico [North America], Mexico, 030505 public health, Consultation, Primary Health Care, business.industry, Questionnaire, Public health, Cross-Sectional Study, Logistic Regression Analysis, Cross-Sectional Studies, Latin America, Health Care Survey, Family medicine, Coordination, Latino People, Uruguay, Patient Care, Skill, business, Model
Abstract

Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination. © 2017 The Authors

Published
2017

42. Follow-up of Antihypertensive Therapy Improves Blood Pressure Control: Results of HYT (HYperTension survey) Follow-up

Author

Wim Makel, Istemi Nalbantgil, N. Koylan, Y. Korkut, Fosca Quarti-Trevano, Francesco Fici, Guido Grassi, Gino Seravalle, N. Cagla, Fici, F, Seravalle, G, Koylan, N, Nalbantgil, I, Cagla, N, Korkut, Y, Quarti-Trevano, F, Makel, W, and Grassi, G

Subjects
Male, Time Factors, Turkey, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, 030204 cardiovascular system & hematology, Dihydropyridine calcium channel blocker, 0302 clinical medicine, Angiotensin II receptors blocker, Edema, Medicine, 030212 general & internal medicine, ACE-inhibitor, Incidence (epidemiology), Angiotensin Receptor Antagonist, Dihydropyridine, Middle Aged, Calcium Channel Blockers, Antihypertensive Agent, Treatment Outcome, Anesthesia, ACE-inhibitors, Ankle edema, Hypertension, Drug Therapy, Combination, Female, medicine.symptom, Calcium Channel Blocker, Cardiology and Cardiovascular Medicine, medicine.drug, Human, Time Factor, Angiotensin II receptors blockers, Angiotensin Receptor Antagonists, 03 medical and health sciences, Diabetes mellitus, Heart rate, Internal Medicine, Humans, Adverse effect, Antihypertensive Agents, Aged, Cross-Sectional Studie, business.industry, Angiotensin-Converting Enzyme Inhibitor, medicine.disease, Dihydropyridine calcium channel blockers, Regimen, Cross-Sectional Studies, Blood pressure, Blood pressure control, Health Care Survey, Health Care Surveys, business
Abstract

Introduction: Although improved during the past few years, blood pressure control remains sub optimal. Aim: The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. Methods: From the 4993 patients with uncontrolled blood pressure, (BP ? 140/90 or ?140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. Results: At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p < 0.05 vs 35.3% at baseline), whereas in diabetes was 32.5 and 37.9% respectively (p < 0.05 vs 20% at baseline). No differences in heart rate were observed. No differences in control rate were observed between the different CCBs regimen. The incidence of drugs related adverse events was 3.6%. Conclusions: These findings provide evidence that: (a) the follow-up of hypertensive patients under therapy increase the rate of blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen; (c) lipophilic CCBs induce less ankle edema. © 2017, Springer International Publishing Switzerland.

Published
2017

43. Outcome of aplastic anemia in adolescence: a survey of the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation

Author

Hubert Schrezenmeier, Alicia Rovó, Sujith Samarasinghe, Austin G. Kulasekararaj, Judith C. W. Marsh, Régis Peffault de Latour, Britta Hoechsmann, Carlo Dufour, Antonio M. Risitano, Gérard Socié, André Tichelli, Marta Pillon, Mahmoud Aljurf, Rosi Oneto, Christina Peters, Genny Franceschetto, Andrea Bacigalupo, Jakob Passweg, Elisa Carraro, Dufour, Carlo, Pillon, Marta, Passweg, Jakob, Socié, Gerard, Bacigalupo, Andrea, Franceschetto, Genny, Carraro, Elisa, Oneto, Rosi, Risitano, ANTONIO MARIA, de Latour, Regis Peffault, Tichelli, André, Rovo, Alicia, Peters, Christina, Hoechsmann, Britta, Samarasinghe, Sujith, Kulasekararaj, Austin G., Schrezenmeier, Hubert, Aljurf, Mahmoud, and Marsh, Judith

Subjects
Graft Rejection, Male, medicine.medical_specialty, Transplantation Conditioning, Adolescent, Prognosi, Anemia, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, Young Adult, Internal medicine, medicine, Humans, Cumulative incidence, Aplastic anemia, Child, Hematologic Neoplasm, Bone Marrow Transplantation, business.industry, Incidence, Hematopoietic Stem Cell Transplantation, Anemia, Aplastic, Immunosuppression, Articles, Hematology, Prognosis, medicine.disease, Surgery, Patient Outcome Assessment, Treatment Outcome, surgical procedures, operative, medicine.anatomical_structure, Health Care Survey, Health Care Surveys, Hematologic Neoplasms, Savior sibling, Female, Bone marrow, business, Human
Abstract

We analyzed the outcome of 537 adolescents (age 12-18 years) with idiopathic aplastic anemia included in the database of the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation comparing: i) matched family donor hematopoietic stem cell transplantation performed as first-line treatment with ii) front-line immunosuppressive therapy not followed by subsequent transplant given for failure and with iii) hematopoietic stem cell transplantation performed after failed front-line immunosuppressive therapy. Overall survival was 86% in the matched family donor hematopoietic stem cell transplantation group, 90% in patients given front-line immunosuppressive alone (those who did not fail this treatment and who did not receive subsequent rescue with hematopoietic stem cell transplantation) and 78% in subjects who underwent hematopoietic stem cell transplantation post failed front-line immunosuppressive therapy (P=0.14). Event-free survival in the same groups was respectively 83%, 64% and 71% (P=0.04). Cumulative incidence of rejection was 8% in matched family donor hematopoietic stem cell transplantation and 9% in transplants post failed front-line immunosuppression (P=0.62). Cumulative incidence of acute graft-versus-host disease was 12% in matched family donor transplants and 18% in transplants post failed immunosuppression (P=0.18). Chronic graft-versus-host disease was higher in matched family donor hematopoietic stem cell transplantation (8%) than in transplants post failed immunosuppressive therapy (20%) (P=0.0009). Cumulative incidence of post-therapy malignancies was 0.7% in matched family donor transplantations, 7% in transplantations post failed immunosuppression and 21% after front-line immunosuppression (P=0.0017). In the whole cohort, under multivariate analysis, the diagnosis to treatment interval of two months or under positively affected overall survival whereas up-front immunosuppression alone (with no subsequent rescue transplants) negatively affected event-free survival. In transplanted patients an interval from diagnosis to treatment of 2 months or under, bone marrow as source of cells and first-line matched family donor transplants provided a significant advantage in overall and event-free survival. Aplastic anemia in adolescents has a very good outcome. If a matched family donor is available, hematopoietic stem cell transplantation using bone marrow cells is the first choice treatment. If such a donor is not available, immunosuppressive treatment may still be an acceptable second choice, also because, in case of failure, hematopoietic stem cell transplantation is a very good rescue option.

Published
2014

44. Reducing Mortality in Acute Kidney Injury Patients: Systematic Review and International Web-Based Survey

Author

Giovanni, Landoni, Tiziana, Bove, Andrea, Székely, Marco, Comis, Reitze N, Rodseth, Daniela, Pasero, Martin, Ponschab, Marta, Mucchetti, Maria L, Azzolini, Fabio, Caramelli, Gianluca, Paternoster, Giovanni, Pala, Luca, Cabrini, Daniele, Amitrano, Giovanni, Borghi, Antonella, Capasso, Claudia, Cariello, Anna, Carpanese, Paolo, Feltracco, Leonardo, Gottin, Rosetta, Lobreglio, Lorenzo, Mattioli, Fabrizio, Monaco, Francesco, Morgese, Mario, Musu, Laura, Pasin, Antonio, Pisano, Agostino, Roasio, Gianluca, Russo, Giorgio, Slaviero, Nicola, Villari, Annalisa, Vittorio, Mariachiara, Zucchetti, Fabio, Guarracino, Andrea, Morelli, Vincenzo, De Santis, Paolo A, Del Sarto, Antonio, Corcione, Marco, Ranieri, Gabriele, Finco, Alberto, Zangrillo, Rinaldo, Bellomo, Landoni, G., Bove, T., Székely, A., Comis, M., Rodseth, R.N., Pasero, D., Ponschab, M., Mucchetti, M., Azzolini, M.L., Caramelli, F., Paternoster, G., Pala, G., Cabrini, L., Amitrano, D., Borghi, G., Capasso, A., Cariello, C., Carpanese, A., Feltracco, P., Gottin, L., Lobreglio, R., Mattioli, L., Monaco, F., Morgese, F., Musu, M., Pasin, L., Pisano, A., Roasio, A., Russo, G., Slaviero, G., Villari, N., Vittorio, A., Zucchetti, M., Guarracino, F., Morelli, A., De Santis, V., Del Sarto, P.A., Corcione, A., Ranieri, M., Finco, G., Zangrillo, A., Bellomo, R., Landoni, G, Bove, T, Székely, A, Comis, M, Rodseth, Rn, Pasero, D, Ponschab, M, Mucchetti, M, Azzolini, Ml, Caramelli, F, Paternoster, G, Pala, G, Cabrini, L, Amitrano, D, Borghi, G, Capasso, A, Cariello, C, Carpanese, A, Feltracco, P, Gottin, L, Lobreglio, R, Mattioli, L, Monaco, F, Morgese, F, Musu, M, Pasin, L, Pisano, A, Roasio, A, Russo, G, Slaviero, G, Villari, N, Vittorio, A, Zucchetti, M, Guarracino, F, Morelli, A, De Santis, V, Del Sarto, Pa, Corcione, A, Ranieri, M, Finco, G, Zangrillo, A, and Bellomo, R

Subjects
renal failure, short term survival, patient monitoring, medicine.medical_treatment, health care survey, acute renal injury, hetastarch, bacterial peritoniti, Comorbidity, hemodynamic monitoring, health belief, law.invention, hemofiltration, contrast induced nephropathy, burn patient, law, consensu, burn, web vote, angiography, randomized controlled trial (topic), hepatorenal syndrome, physician, continuous hemodiafiltration, article, Acute kidney injury, Acute Kidney Injury, continuous infusion, Intensive care unit, human immunoglobulin, clinical practice, vasopressin, acute kidney failure, multiple myeloma, perioperative hemodynamic optimization, priority journal, human albumin, meta analysis (topic), nadroparin, multicenter study (topic), sepsi, Cardiology and Cardiovascular Medicine, renal replacement therapy, Reducing mortality in acute kidney injury patients: systematic review and international web-based surve, radiation injury, Human, medicine.drug, medicine.medical_specialty, consensus conference, Contrast-induced nephropathy, self report, anesthesia, survival, Perioperative Care, acute kidney failure, acute renal injury, anesthesia, consensus, consensus conference, critical care, mortality, renal failure, survival, web vote, terlipressin, critically ill patient, acute kidney failure, Monitoring, Intraoperative, acetylcysteine, Hemofiltration, medicine, Humans, systematic review, acute kidney failure, fenoldopam, furosemide, Hemodynamic, Renal replacement therapy, Intensive care medicine, plasmapheresi, Internet, continuous hemofiltration, liver cirrhosi, Septic shock, business.industry, hepatorenal syndrome type 1, Hemodynamics, Perioperative, citric acid, bleeding, medicine.disease, mortality, web vote, Acute Kidney Injury, fluid balance, heart surgery, drug efficacy, critical care, early intervention, Anesthesiology and Pain Medicine, hemodialysi, consensus, Health Care Surveys, septic shock, Terlipressin, business, periangiography hemofiltration
Abstract

"OBJECTIVE: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting.. . DESIGN AND SETTING: Systematic literature review and international web-based survey.. . PARTICIPANTS: More than 300 physicians from 62 countries.. . INTERVENTIONS: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality.. . MEASUREMENTS AND MAIN RESULTS: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically ill patients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically ill patients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions.. . CONCLUSION: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.. . "

Published
2013

45. Diabetes, pre-diabetes and their risk factors in Malta : a study profile of national cross-sectional prevalence study

Author

Neville Calleja, Julian Mamo, Sarah Cuschieri, Nikolai Paul Pace, and Josanne Vassallo

Subjects
Cross-sectional study, Epidemiology, health care survey, Non-insulin-dependent diabetes -- Malta, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Health care, medicine, 030212 general & internal medicine, Original Research Article, Disease burden, Non-insulin-dependent diabetes -- Prevention, Data collection, Medical care surveys -- Malta, business.industry, Malta, Public Health, Environmental and Occupational Health, Type 2 Diabetes Mellitus, Evidence-based medicine, medicine.disease, Obesity, diabetes mellitus, Cross-sectional studies, Optometry, business, evidence-based medicine
Abstract

Type 2 diabetes mellitus constitutes a global epidemic and a major burden on health care systems across the world. Prevention of this disease is essential, and the development of effective prevention strategies requires validated information on the disease burden and the risk factors. Embarking on a nationally representative cross-sectional study is challenging and costly. Few countries undertake this process regularly, if at all. This paper sets out the evidence-based protocol of a recent cross-sectional study that was conducted in Malta. Data collection took place from November 2014 to January 2016. This study presents up-to-date national data on diabetes and its risk factors (such as obesity, smoking, physical activity and alcohol intake) that will soon be publicly available. This protocol was compiled so that the study can be replicated in other countries. The protocol contains step-by-step descriptions of the study design, including details on the population sampling, the permissions required and the validated measurement tools used., peer-reviewed

Published
2016

46. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

Author

F. De Berardinis, Fortunato Lombardo, G. Zanette, R. Cardani, Ivana Rabbone, C. Zecchino, Barbara Predieri, C. Arnaldi, Barbara Piccini, B. Felappi, Riccardo Bonfanti, D. Lo Presti, B. Mainetti, G. Ignaccolo, F. Stamati, Roberto Franceschi, G. Ponzi, M. S. Coccioli, F. Citriniti, C. Ripoli, F. Chiarelli, Valeria Calcaterra, M. Trada, Giovanni Federico, A. Sabbion, D. Cirillo, Enza Mozzillo, C. Salvo, Francesco Prisco, G. Piredda, Alessandro Salvatoni, Maurizio Delvecchio, R. A. Taccardi, Valentino Cherubini, Gianluca Tornese, G. Morganti, Giulio Maltoni, Nicola Minuto, Giovanni Chiari, S. Zonca, M. Bensa, Franco Meschi, V. De Donno, Martina Biagioni, Silvia Savastio, L. Guerraggio, A. Gualtieri, T. Suprani, A. Franzese, M. G. Berioli, D. Iafusco, Francesco Cadario, Andrea Scaramuzza, A. Favia, Luciano Beccaria, Gian Vincenzo Zuccotti, Sonia Toni, Riccardo Schiaffini, F. Cerutti, N. Lazzaro, Lorenzo Iughetti, B. Pasquino, Francesco Fontana, P. Banin, G. Cardinale, A. Marsciani, Anna Paola Frongia, S. Lucchesi, E. Schieven, R. Lera, R. De Marco, F. Cardella, F. Gallo, Vittoria Cauvin, P. Sogno Valin, E. Prandi, L. Tomaselli, Vanna Graziani, M Bruzzese, Lorenzo Lenzi, F. Mammì, Giuseppe d'Annunzio, Ippolita Patrizia Patera, Stefano Zucchini, C. Maffeis, A. Bobbio, A. Gaiero, V. Castaldo, Alfonso Galderisi, Stefano Tumini, P Buono, C. Monciotti, Elvira Piccinno, D. Pardi, Marco Cappa, Renata Lorini, Marco Marigliano, Zucchini, Stefano, Scaramuzza, Andrea E, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Cherubini, Valentino, Chiari, Giovanni, D'Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Maltoni, Giulio, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Tornese, Gianluca, Rabbone, Ivana, Lera, R., Bobbio, A., Gualtieri, A., Piccinno, E., Zecchino, C., Pasquino, B., Felappi, B., Prandi, E., Gallo, F., Morganti, G., Ripoli, C., Cardinale, G., Ponzi, G., Castaldo, V., Stamati, F., Lo Presti, D., Tomaselli, L., Citriniti, F., Suprani, T., Bensa, M., Graziani, V., De Berardinis, F., Chiarelli, F., De Marco, R., Lazzaro, N., De Donno, V., Banin, P., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, M. S., Minuto, N., Lorini, R., Trada, M., Sogno Valin, P., Beccaria, L., Lucchesi, S., Bruzzese, M., Mammì, F., Cirillo, D., Pardi, D., Taccardi, R. A., Lombardo, F., Zuccotti, G. V., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Prisco, F., Cadario, F., Savastio, S., Piredda, G., Monciotti, C., Galderisi, A., Salvo, C., Calcaterra, V., Berioli, M. G., Federico, G., Favia, A., Zanette, G., Marsciani, A., Schiaffini, R., Cappa, M., Delvecchio, M., Gaiero, A., Ignaccolo, G., Cerutti, F., Fontana, F., Guerraggio, L., Zonca, S., Franceschi, R., Tornese, G., Biagioni, M., Salvatoni, A., Cardani, R., Marigliano, M., Sabbion, A., Maffeis, C., Schieven, E., Arnaldi, C., Zucchini, S., Scaramuzza, A. E., Bonfanti, R., Buono, P., Cardella, F., Cauvin, V., Cherubini, V., Chiari, G., D'Annunzio, G., Frongia, A. P., Iafusco, D., Maltoni, G., Patera, I. P., Toni, S., Tumini, S., Rabbone, I., Mammi, F., Mozzillo, E., and Prisco, Francesco

Subjects
0301 basic medicine, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, Endocrinology, endocrine system diseases, type 1 diabetes, Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetic Ketoacidosis, Female, Health Care Surveys, Humans, Infant, Infant, Newborn, Insulin, Italy, Rehydration Solutions, Retrospective Studies, Treatment Outcome, lcsh:Diseases of the endocrine glands. Clinical endocrinology, ketoacidosis, Retrospective Studie, Medicine, Diabetology, Diabetes and Metabolism, Newly diagnosed diabetes, Research Article, Type 1, Human, medicine.medical_specialty, Article Subject, Referral, Diabetic ketoacidosis, Diabetic Ketoacidosi, 03 medical and health sciences, children, Retrospective survey, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, lcsh:RC648-665, business.industry, Rehydration Solution, nutritional and metabolic diseases, Retrospective cohort study, Newborn, medicine.disease, 030104 developmental biology, Health Care Survey, business
Abstract

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records(n=2453)of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n=1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

Published
2016

47. The management of gout in different clinical specialties in Turkey: a patient-based survey

Author

Bunyamin Kisacik, Rıdvan Mercan, ÖmerNuri Pamuk, Soner Senel, Şafak Şahin, Mehmet Ali Balcı, Kemal Üreten, Mehmet Engin Tezcan, Arif Kaya, Ahmet Mesut Onat, Ayse Balkarli, Veli Cobankara, Gozde Yildirim Cetin, Mehmet Akif Ozturk, Abdurrahman Tufan, Mehmet Sayarlioglu, Adem Kucuk, Gezmiş Kimyon, Kevser Gok, Ondokuz Mayıs Üniversitesi, and Kırıkkale Üniversitesi

Subjects
Male, Gout, Turkey, health care survey, rheumatology, Turkey (republic), 0302 clinical medicine, Patient Admission, Life style modifications, Surveys and Questionnaires, Health care, nonsteroid antiinflammatory agent, physiotherapist, middle aged, antibiotic therapy, antibiotic agent, 030212 general & internal medicine, steroid therapy, antigout agent, internist, adult, steroid, clinical trial, General Medicine, orthopedic specialist, Management, aged, female, priority journal, orthopedics, medicine.drug, musculoskeletal diseases, Physical Therapy Specialty, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, lifestyle, Referral, Allopurinol, sex difference, Specialty, patient referral, colchicine, Article, Gout Suppressants, 03 medical and health sciences, uric acid, Internal medicine, medicine, Internal Medicine, Humans, human, procedures, Medical prescription, Life Style, paramedical personnel, physiotherapy, 030203 arthritis & rheumatology, long term care, Primary Health Care, business.industry, questionnaire, health care facility, medicine.disease, major clinical study, Rheumatology, Long-term care, hospital admission, multicenter study, general practitioner, Physical therapy, lifestyle modification, business
Abstract

mercan, ridvan/0000-0003-1537-2192; Tezcan, Mehmet Engin/0000-0002-1753-4936; TUFAN, Abdurrahman/0000-0001-6244-9362 WOS: 000388826200020 PubMed: 27722972 Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 +/- 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications. Forty patients were referred to another center without any treatment (12.8 %), and referral rate is most common among the primary care physicians (28.8 %). Colchicine was more commonly used for attack prophylaxis than allopurinol. Ninety-two patients had never been treated with allopurinol (28.8 %). Allopurinol prescription was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. Recommendation of diet and life style modifications was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. The rates of life style modification recommendation and long-term allopurinol prescription were 83.7 and 77.6 %, respectively, among the rheumatologists. Both acute and chronic management of gout is suboptimal in Turkey especially among the primary care physicians and orthopedists. Moreover, chronic treatment is even suboptimal among rheumatologists.

Published
2016

48. Investigation of Sleep Quality and Sleep Disorders in Students of Medicine

Author

Mustafa Öztürk, Yücel Kurt, Mustafa Saygin, Mehmet Has, Mehmet Ali Yağlı, Sadettin Çalışkan, Önder Öztürk, Uluğ Bey Hayri, Taner Gonca, and Ahmet Akkaya

Subjects
multivariate logistic regression analysis, obesity, medicine, health care survey, physical activity, Overweight, Sleep medicine, regression analysis, middle aged, Pittsburgh Sleep Quality Index, comparative study, Original Investigation, sleep disorder, Cerrahi, Sleep disorder, exercise, sleep time, Epworth Sleepiness Scale, adult, Apnea, Sleep disorders, sleep quality, female, medical student, risk factor, health insurance, young adult, Analysis of variance, medicine.symptom, Pitssburg, Pulmonary and Respiratory Medicine, medicine.medical_specialty, analysis of variance, Berlin sleep questionnaire, hypertension, Epworth, alcohol consumption, Article, smoking, male, genetic difference, cross-sectional study, controlled study, human, Psychiatry, business.industry, questionnaire, Epworth sleepiness scale, apnea, medicine.disease, Obesity, Medical students, major clinical study, body mass, sensitivity and specificity, business, Body mass index, snoring, Demography
Abstract

OBJECTIVES: This study was performed on Suleyman Demirel University medical students to determine the quality of sleep and to investigate factors that affect of sleep quality.MATERIAL AND METHODS: Suleyman Demirel University Medical students at 1, 2, 3, 4, 5 and 6 classes included to this crosssectional analytical study (n= 720). Refused to fill to the survey (188), and students were not come to faculty (195), applied survey to 337 students (46.8%). Epworth sleepiness scale (ESS), Pittsburgh (PSQI) and Berlin sleep questionnaires, and 13 pieces closed and open-ended socio-demographic questions were conduct a questionnare under observation. The collected data were analyzed by using descriptive statistics, chi-square, two independent groups t test, Pearson and Spearman's correlation, Mann-Whitney U, Kruskal-Wallis and ANOVA tests.RESULTS: 337 students participated in the study, 42.1% were male, 57.9% were female, mean age was 21.3 ± 2.1 years. Depending on Body mass index (BMI) 31 were poor, 212 normal, 53 overweight, and 4 obese students. In 118 students (35.3%), and these students have a chronic disease associated with 15.6% used the drug because of illness and 38 percent of students (11.6%) were smokers. 18.1 ± 16.1 min for pupils in times of falling asleep, sleep duration per night. 6.6 ± 1.3h, the mean departure time was 7.7 ± 1.8. Scale with a total score of Pittsburgh class (p= 0.000), age (p= 0.003), BMI (p= 0.015) had a significant correlation between. Pittsburgh PUKI scores and without a significant difference in gender (p= 0.054), the use of stimulant substances (p= 0.032), weight (p= 0.021) and snoring (p= 0.002) with no significant difference were found. ESS total score and gender (p= 0.025), drug use (p= 0.035) and sports activities (p= 0.038). Ten students had snoring (3.0%), 5 students (1.5%) had witnessed apnea. Snoring 17.2% to in ESS > 10 points on it. Pittsburgh, the mean scores of those who witnessed apnea (14.0 ± 5.3), witnessed apnea, according to non-students (10.2 ± 6.4) were higher (p= 0.191).The effects PSQI and ESS results on the term were statistically significant by the multivariate regression analysis [F(10.602)= 4.56; p< 0.05; Wilkis Lamda 0.864, partial n2= 0.07]. To estimate of the value of PSQI by the stepwise regression analysis was performed; age and fall asleep properties has been included of the model (R2= 89%, p< 0.05). To estimate of the value of PSQI by the stepwise regression analysis was performed; fall asleep property has been included of the model in the the male gender (R2= 80%, p< 0.05). To estimate of the value of ESS by the stepwise regression analysis was performed; term property has been included of the model (R2= 65%, p< 0.05).CONCLUSION: Medical school students participating in our study, although female-male ratio close to each other, we found that higher ESS and Pittsburgh scores in female more than male. In this case may be related to physiological, genetic, environmental, cultural and psychological differences.

Published
2016

49. Necessity and Readiness for Smoking Cessation Intervention in Dental Clinics in Japan

Author

Miki Ojima, Takashi Hanioka, and Hideo Tanaka

Subjects
Adult, Male, medicine.medical_specialty, National Health and Nutrition Examination Survey, Epidemiology, Attitude of Health Personnel, medicine.medical_treatment, health care survey, Dentists, Psychological intervention, Young Adult, Japan, Surveys and Questionnaires, medicine, Humans, Young adult, Aged, Response rate (survey), business.industry, dentist, Dental Clinics, Behavior change, Smoking, Questionnaire, General Medicine, Middle Aged, smoking cessation, Family medicine, Others, Needs assessment, Smoking cessation, Original Article, Female, patient, business, Needs Assessment
Abstract

Background: The necessity and readiness for smoking cessation intervention in dental clinics was assessed by investigating smoking status and stage of behavior change in patients and the attitudes of dentists toward the effects of smoking on their patients, respectively.Methods: A self-administered questionnaire was mailed to 1022 dentists randomly selected from the Japanese Dental Association database. The questionnaire survey consisted of 1 section for dentists and 1 for patients aged 20 years or older and was scheduled to be completed at the dentists’ clinics on a designated day in February 2008.Results: The response rate to the questionnaire was 78.2% from among target dental clinics and 73.7% and 74.7% for patient and dentist questionnaires, respectively. Data from 11 370 patients and 739 dentists were analyzed. The overall smoking prevalence among the patients (25.1%) was similar to that reported by the National Health and Nutrition Examination Survey, and young female patients had a markedly higher smoking prevalence. More than 70% of patients who smoked were interested in quitting. Although the prevalence of current smoking among dentists (27.1%) was significantly higher than that reported among Japanese physicians (15.0%), approximately 70% of dentists were concerned about the effects of smoking on patient health and prohibited smoking inside their clinic.Conclusions: Many smokers who were interested in quitting, particularly young women, visited dental clinics, and most dentists believed that smoking was harmful for their patients. These results indicate that smoking cessation intervention in dental settings is necessary and that dentists are ready to provide such interventions.

Published
2012

50. Different Aspects of Self-Reported Quality of Life in 450 German Melanoma Survivors

Author

Eckhard W. Breitbart, Sandra Nolte, Ron Pritzkuleit, Alexander Katalinic, and Annika Waldmann

Subjects
Cancer Research, medicine.medical_specialty, skin neoplasms, health care survey, MEDLINE, Disease, population based, lcsh:RC254-282, Article, German, Stable Disease, Quality of life, Internal medicine, Global health, medicine, otorhinolaryngologic diseases, melanoma, Reference population, neoplasms, business.industry, Melanoma, social sciences, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, language.human_language, humanities, Surgery, Oncology, quality of life, language, business
Abstract

The present study was aimed at assessing quality of life (QoL) in a total of 450 melanoma patients who filled out the EORTC QLQ-C30 (Q1, 15 months post diagnosis) as part of the OVIS Study. Follow-up questionnaires (Q2) were administered two years after Q1. The analyses presented herein were based on the following assumptions: QoL of melanoma patients is worse than that of a German reference population. Further, both tumor location and tumor stage have an influence on self-reported QoL, with patients with tumors located on face, head, neck, and advanced tumor stage (T3/T4) reporting the worst QoL levels. Finally, patients’ QoL improves over time based on the theory of disease adaptation. In contrast to the above assumptions, with the exception of global health/QoL scores, differences between OVIS and the reference population were below the minimal clinical important difference of ten points. Furthermore, no clinically meaningful differences were found between patients after stratifying our data by tumor location and tumor stage. Finally, no clinically relevant changes were seen between Q1 and Q2 across all scales of the EORTC QLQ-C30. However, when data were stratified by patients with stable disease versus those with progression, clinically relevant differences were found between Q1 and Q2 predominantly in women in the latter group regarding emotional function, insomnia, dyspnoea, and fatigue. The lack of clinically meaningful differences across strata (tumor location, tumor stage), time, and patients compared to a reference population is surprising. However, it is possible that the instrument used, a generic QoL instrument, is generally not sensitive enough to detect differences in melanoma patients. Our findings may further be explained by the fact that all patients included in our sample had been diagnosed well before Q1, i.e., main illness adaptation processes may have occurred before study entry.

Published
2011

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