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1. Pregnancy e-health: a multicenter Italian cross-sectional study on internet use and decision-making among pregnant women

Author

Bert, F., Gualano, M. R., Brusaferro, Silvio, De Vito, E., de Waure, C., Torre, G. L., Manzoli, L., Messina, G., Todros, T., Torregrossa, M. V., Siliquini, R., Saulle, R., Cristofor, C., Sinatra, I., Carubia, L., Bert, F, Gualano, MR, Brusaferro, S, De Vito, E, de Waure, C, La Torre, G, Manzoli, L, Messina, G, Todros, T, Torregrossa, MV, and Siliquini, R

Subjects
Pediatrics, Gynaecology, Health Promotion, Maternal Health, Cross-sectional study, pregnancy, e-health,study, internet, Epidemiology, Health Behavior, Logistic regression, Choice Behavior, Seekers, Pregnancy, Surveys and Questionnaires, Prevalence, Medicine, health, Telemedicine, Parity, Italy, The Internet, Female, Public Health, Adult, medicine.medical_specialty, Adolescent, Decision Making, Information Seeking Behavior, Socio-culturale, Interviews as Topic, Young Adult, Humans, Life Style, Settore MED/42 - IGIENE GENERALE E APPLICATA, pregnancy, Internet, Descriptive statistics, Consumer Health Information, business.industry, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, medicine.disease, Health promotion, Cross-Sectional Studies, Logistic Models, Family medicine, Multivariate Analysis, Pregnant Women, business
Abstract

Background Our study aimed to estimate the prevalence of pregnancy e-health seekers in a large Italian sample; to explore the factors influencing the choices of the childbearing women regarding their lifestyles after internet consultation; and finally to investigate potential differences between primiparous and multiparous women in internet use to find information about pregnancy. Methods A multicentre survey was carried out in seven Italian cities. Data were collected through a validated questionnaire administered in waiting rooms of outpatient departments by medical doctors. Respondents were questioned about their sociodemographic status, their use of the internet to seek pregnancy information and their consequent choices to modify their lifestyles. Data were analysed using descriptive statistics and logistic regression. Results Almost all women were pregnancy e-health seekers (95%), including those who also received information from healthcare professionals. Indeed, the main reason for searching the web was the need of further knowledge on pregnancy-related topic, over and beyond other key advantages of the net such as anonymity, simplicity and rapidity. A higher likelihood of changing lifestyle after pregnancy e-health was observed among the women who searched institutional websites; declared more confidence in the information retrieved; participated into pregnancy-centred forum online; and were residents in Italy. Conclusions To reduce the likelihood for women of both finding erroneous information or misinterpreting correct ones, healthcare professionals should commit to fill the information gap and guide pregnant women in the online searches. Also, future studies are strongly needed to analyse the quality and accuracy of health information found on the web.

Published
2013

2. http://www.D-MELD.com, the Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation

Author

Avolio, Aw, Agnes, S, Cillo, Umberto, Lirosi, Mc, Romagnoli, R, Baccarani, U, Zamboni, F, Nicolini, D, Donataccio, M, Perrella, A, Ettorre, Gm, Romano, M, Morelli, N, Vennarecci, G, de Waure, C, Fagiuoli, S, Burra, Patrizia, Cucchetti, A., Avolio, A, Agnes, S, Cillo, U, Lirosi, M, Romagnoli, R, Baccarani, U, Zamboni, F, Nicolini, D, Donataccio, M, Perrella, A, Ettorre, G, Romano, M, Morelli, N, Vennarecci, G, de Waure, C, Fagiuoli, S, Burra, P, and Cucchetti, A

Subjects
Internet, Settore MED/18 - CHIRURGIA GENERALE, Graft Survival, Prognosis, ethics, Survival Analysis, outcome analyse, D-MELD, expansion of donor pool, marginal donors, MELD, outcome analyses, selection criteria, Decision Support Techniques, Donor Selection, Liver Transplantation, Logistic Models, Italy, Humans, marginal donor, the unsustainable matches in liver transplantation, ethic, Algorithms
Abstract

Optimization of donor-recipient match is one of the exciting challenges in liver transplantation. Using algorithms obtained by the Italian D-MELD study (5256 liver transplants, 21 Centers, 2002-2009 period), a web-based survival calculator was developed. The calculator is available online at the URL http://www.D-MELD.com. The access is free. Registration and authentication are required. The website was developed using PHP scripting language on HTML platform and it is hosted by the web provider Aruba.it. For a given donor (expressed by donor age) and for three potential recipients (expressed by values of bilirubin, creatinine, INR, and by recipient age, HCV, HBV, portal thrombosis, re-transplant status), the website calculates the patient survival at 90days, 1year, 3years, and allows the identification of possible unsustainable matches (i.e. donor-recipient matches with predicted patient survival less than 50% at 5 years). This innovative approach allows the selection of the best recipient for each referred donor, avoiding the allocation of a high-risk graft to a high-risk recipient. The use of the D-MELD.com website can help transplant surgeons, hepatologists, and transplant coordinators in everyday practice of matching donors and recipients, by selecting the more appropriate recipient among various candidates with different prognostic factors.

Published
2012

3. Balancing donor and recipient risk factors in liver transplantation: the value of D-MELD with particular reference to HCV recipients

Author

Avolio, A, Cillo, U, Salizzoni, M, DE CARLIS, LUCIANO GREGORIO, Colledan, M, Gerunda, G, Mazzaferro, V, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, De Carlis, L, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, De Waure, C., Avolio A.W., Cillo U., Salizzoni M., De Carlis L., Colledan M., Gerunda G.E., Mazzaferro V., Tisone G., Romagnoli R., Caccamo L., Rossi M., Vitale A., Cucchetti A., Lupo L., Gruttadauria S., Nicolotti N., Burra P., Gasbarrini A., Agnes S., Lirosi M.C., Miele L., Pompili M., Siciliano M., Perilli V., Gaspari R., Castagneto M., Tandoi F., Mangoni I., Belli L., Pinna A.D., Cescon M., Gridelli B., Li Petri S., Volpes R., Pinelli D., Fagiuoli S., Montalti R., Regalia E., Rossi G., Antonelli B., Berloco P., Lai Q., Risaliti A., Nicolini D., Valente U., Gelli M., Morelli N., Zamboni F., Tondolo V., Brotzu G., Ettorre G.M., Vennarecci G., Bresadola F., Baccarani U., Toniutto P.L., Manzia T., Anselmo A., Angelico M., Calise F., Scuderi V., Romano M., Rendina M., Barone M., Cuomo O., Perrella A., Santaniello W., Donataccio M., Dalle Ore G., de Ville de J., Monti L., Avolio, A W, Cillo, U, Salizzoni, M, De Carlis, L, Colledan, M, Gerunda, G E, Mazzaferro, Mariapia, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Montalti, Roberto, Avolio, A, DE CARLIS, L, Gerunda, G, Mazzaferro, V, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, and De Waure, C

Subjects
Graft Rejection, Male, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, Hepacivirus, Liver transplantation, Gastroenterology, Liver disease, Postoperative Complications, Retrospective Studie, UNSUSTAINABLE MATCH, Models, Risk Factors, Immunology and Allergy, Health Status Indicators, Age Factor, PROGNOSTIC INDICES, Pharmacology (medical), Health Status Indicator, D-MELD, Liver Transplantation, liver transplantation, Hazard ratio, Graft Survival, donor-recipient match, outcome, prognosis, risk factors, Age Factors, Trapianto epatico, Hepatitis C, Hepatitis B, Statistical, Middle Aged, Prognosis, Tissue Donors, Survival Rate, Italy, HCV, Female, Human, Adult, medicine.medical_specialty, Prognosi, Donor Selection, End Stage Liver Disease, Young Adult, Internal medicine, medicine, Humans, fattori di rischio, Aged, Retrospective Studies, Transplantation, Hepaciviru, Models, Statistical, business.industry, Donor selection, Risk Factor, Settore MED/09 - MEDICINA INTERNA, Odds ratio, medicine.disease, Settore MED/18, Surgery, body regions, Postoperative Complication, business
Abstract

Donor-recipient match is a matter of debate in liver transplantation. D-MELD (donor age × recipient biochemical model for end-stage liver disease [MELD]) and other factors were analyzed on a national Italian database recording 5946 liver transplants. Primary endpoint was to determine factors predictive of 3-year patient survival. D-MELD cutoff predictive of 5-year patient survival 1628). At 3 years, the odds ratio (OR) for death was 2.03 (95% confidence interval [CI], 1.44-2.85) in D-MELD class C versus B. The OR was 0.40 (95% CI, 0.24-0.66) in class A versus class B. Other predictors were hepatitis C virus (HCV; OR = 1.42; 95% CI, 1.11-1.81), hepatitis B virus (HBV; OR = 0.69; 95% CI, 0.51-0.93), retransplant (OR = 1.82; 95% CI, 1.16-2.87) and low-volume center (OR = 1.48; 95% CI, 1.11-1.99). Cox regressions up to 90 months confirmed results. The hazard ratio was 1.97 (95% CI, 1.59-2.43) for D-MELD class C versus class B and 0.42 (95% CI, 0.29-0.60) for D-MELD class A versus class B. Recipient age, HCV, HBV and retransplant were also significant. The 5yrsPS

Published
2011

4. Influenza vaccination coverage among medical residents: an Italian multi center survey

Author

Costantino, C, Mazzucco, W, Azzolini, E, Baldini, C, Bergomi, M, Biafiore, Ad, Bianco, M, Borsari, L, Cacciari, P, Cadeddu, C, Camia, P, Carluccio, E, Conti, A, De Waure, C, Di Gregori, V, Fabiani, Leila, Fallico, R, Filisetti, B, Fiacco, Me, Franco, E, Furnari, R, Galis, V, Gallea, Mr, Gallone, Mf, Gallone, S, Gelatti, U, Gilardi, F, Giuliani, Anna Rita, Grillo, Oc, Lanati, N, Mascaretti, S, Mattei, Antonella, Micò, R, Morciano, L, Nante, N, Napoli, G, Nobile, Cg, Palladino, R, Parisi, S, Passaro, M, Pelissero, G, Quarto, M, Ricciardi, W, Romano, G, Rustico, E, Saponari, A, Schioppa, Fs, Signorelli, C, Siliquini, R, Trabacchi, V, Triassi, M, Varetta, A, Ziglio, A, Zoccali, A, Vitale, F, and Amodio, E.

Subjects
medical residents, Italy, vaccination, multicentre survey, coverage rate
Published
2014

5. [Role of the Web on behaviors and health choices in six Italian cities: results of a multicenter study]

Author

Lovato, E, Bert, F, Bruno, S, Ceruti, M, De Vito, E, La Torre, G, Liguori, G, Manzoli, Lamberto, Messina, G, Minniti, D, Siliquini, R, Langiano, E, Costanzi, L, Di Giovanni, P, Di Onofrio, V, Gallé, F, de Waure, C, Specchia, Ml, D'Addario, M, Di Thiene, D, Nante, N, and Bianco, M.

Subjects
Adult, Male, Internet, Adolescent, Urban Population, Health Behavior, Socio-culturale, Middle Aged, Choice Behavior, Aged, Cross-Sectional Studies, Female, Humans, Italy, Young Adult
Published
2011

6. [The Italian legislation on Health Impact Assessment: the current national and regional regulatory framework]

Author

Bert, F, Ceruti, M, Colombo, A, Lovato, E, Bruno, S, Costa, G, Liguori, G, Manzoli, L, Siliquini, R, de WAURE, C., Specchia, M. L., Ricciardi, W., Versino, E., Scaletti, A., Capunzo, M., Boccia, G., Cavallo, P., Geraci, S., Nante, N., Lupoli, A., Marcarelli, M., DE VITO, Elisabetta, and Del Cimmuto, A.

Subjects
Italy, Humans, Public Health, Environment
Abstract

The scientific literature on HIA is particularly rich in Anglo-Saxon countries (United Kingdom, Canada, New Zealand), in Sweden and in the Netherlands, while in Italy there are not many scientific studies published on this theme. The study conducted showed that in Italy no laws relating to HIA have been enacted yet and that all laws enacted so far considered only EIA. Actually, legislation on environmental impact is in continuous expansion, even if at present, some regions have not yet passed a specified EIA-dealing law. In Italy the protection of health is promoted almost exclusively at a strictly medical level; decisions with strong social and environmental impact are not normally designed with particular regard to health issues. To increase in our country the interest for HIA, it would seem appropriate to discuss the usefulness of introducing health impact assessment in national and regional legislation. A possible law may indeed sensitize non-health decision makers to HIA, bringing Italy among the most innovative countries.

Published
2010

8. Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study

Author

A. Miduri, F Quattrocolo, Francesca Pennino, F. Di Donna, E Olivero, Azzurra Massimi, Maria Rosaria Gualano, C de Waure, Fabrizio Stracci, Ilaria Loperto, P Di Giovanni, Nicola Nante, Antonio Giuliani, Marina Marranzano, Emilia Prospero, LG Sisti, C. Signorelli, Giuseppe Michele Masanotti, Silvana Castaldi, G Voglino, M. Golfera, Roberta Siliquini, Raffaele Squeri, Fabrizio Bert, P Rossello, M P Fantini, M. M. D'Errico, P. Greco, A. Stefanati, Annalisa Rosso, C Genovese, Davide Gori, G Di Martino, E. Buttinelli, G. Zappalà, Gualano, M. R., Bert, F., Voglino, G., Buttinelli, E., D'Errico, M. M., De Waure, C., Di Giovanni, P., Fantini, M. P., Giuliani, A. R., Marranzano, M., Masanotti, G., Massimi, A., Nante, N., Pennino, F., Squeri, R., Stefanati, A., Signorelli, C., Siliquini, R., Castaldi, S., Di Donna, F., Di Martino, G., Genovese, C., Golfera, M., Gori, D., Greco, P., Loperto, I., Miduri, A., Olivero, E., Prospero, E., Quattrocolo, F., Rossello, P., Rosso, A., Sisti, L. G., Stracci, F., Zappalà, G., Gualano, Mr, Bert, F, Voglino, G, Buttinelli, E, D'Errico, Mm, De Waure, C, Di Giovanni, P, Fantini, Mp, Giuliani, Ar, Marranzano, M, Masanotti, G, Massimi, A, Nante, N, Pennino, F, Squeri, R, Stefanati, A, Signorelli, C, Siliquini, R, Gualano, M R, D'Errico, M M, Fantini, M P, and Giuliani, A R

Subjects
Health Knowledge, Attitudes, Practice, Multivariate analysis, Cross-sectional study, Immunology and Microbiology (all), Attitudes, Italy, Mandatory vaccination, Multicentre survey, Pregnancy, Vaccine hesitancy, Molecular Medicine, Veterinary (all), Public Health, Environmental and Occupational Health, Infectious Diseases, Mandatory Programs, Socioeconomic Factor, Heterogeneous-Nuclear Ribonucleoproteins, Health personnel, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Multivariate Analysi, Practice, Immunization Program, Health Knowledge, Mandatory Program, Vaccination, Adolescent, Adult, Cross-Sectional Studies, Female, Health Personnel, Humans, Multivariate Analysis, Pregnant Women, Socioeconomic Factors, Immunization Programs, Public Health, Human, medicine.medical_specialty, Socio-culturale, 03 medical and health sciences, 030225 pediatrics, Socioeconomic status, Cross-Sectional Studie, Mandatory vaccination, Vaccine hesitancy, Pregnancy, Multicentre survey, Italy, General Veterinary, General Immunology and Microbiology, Health professionals, business.industry, Environmental and Occupational Health, Attitude, Family medicine, Heterogeneous-Nuclear Ribonucleoprotein, Healthcare service, business
Abstract

Background: Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools.Methods: In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewee's opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn.Results: Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21-0.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62-4.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46-0.96, p = 0.03; OR: 0.66, CI 95%: 0.46-0.95, p = 0.03, respectively).Conclusion: Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.

Published
2018

9. Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study.

Author

Gualano, M.R., Bert, F., Voglino, G., Buttinelli, E., D'errico, M.M., De Waure, C., Di Giovanni, P., Fantini, M.P., Giuliani, A.R., Marranzano, M., Masanotti, G., Massimi, A., Nante, N., Pennino, F., Squeri, R., Stefanati, A., Signorelli, C., and Siliquini, R.

Subjects
*VACCINATION of children, *ATTITUDES of mothers, *HEALTH attitudes, *ATTITUDE (Psychology), *MEDICAL care, *VACCINE refusal
Abstract

Background Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools. Methods In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewee's opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn. Results Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21–0.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62–4.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46–0.96, p = 0.03; OR: 0.66, CI 95%: 0.46–0.95, p = 0.03, respectively). Conclusion Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened. [ABSTRACT FROM AUTHOR]

Published
2018
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10. Cardiac troponin T and NT-proBNP as diagnostic and prognostic biomarkers of primary cardiac involvement and disease severity in systemic sclerosis: A prospective study

Author

Franca Forni, G. Berardi, Clara Di Mario, Gianfranco Ferraccioli, Elisa Gremese, G. Canestrari, S. L. Bosello, Giacomo De Luca, Francesca Augusta Gabrielli, Chiara de Waure, Bosello, S, De Luca, G, Berardi, G, Canestrari, G, de Waure, C, Gabrielli, Fa, Di Mario, C, Forni, F, Gremese, E, and Ferraccioli, G

Subjects
Male, systemic sclerosis, heart disease, 030204 cardiovascular system & hematology, Severity of Illness Index, Sudden cardiac death, Electrocardiography, 0302 clinical medicine, Risk Factors, Natriuretic Peptide, Brain, Medicine, Prospective Studies, 030212 general & internal medicine, Ejection fraction, biology, troponin, Heart, Middle Aged, Right bundle branch block, Prognosis, Troponin, Myocarditis, Italy, cardiovascular system, Cardiology, Systemic sclerosis, Biomarker (medicine), Female, Adult, medicine.medical_specialty, Heart Diseases, Young Adult, 03 medical and health sciences, Troponin T, Internal medicine, Internal Medicine, Humans, cardiovascular diseases, Risk factor, Aged, Scleroderma, Systemic, business.industry, Biomarkers, NT-proBNP, medicine.disease, Peptide Fragments, Case-Control Studies, Heart failure, biology.protein, business
Abstract

Objectives The aim of our study was to define the role of high-sensitive cardiac troponin T (hs-cTnT) and NT-proBNP in identifying Systemic Sclerosis (SSc) patients with cardiac involvement and at higher risk of cardiac death. Methods Plasma hs-cTnT and NT-proBNP concentrations were measured in 245 SSc-patients. Results hs-cTnT and NT-proBNP levels were higher in SSc-patients than in healthy controls. Hs-cTnT levels were higher than 0.014 ng/ml in 32.3% SSc-patients, while NT-proBNP was above 125 pg/ml in 31.8% of them, irrespective of classical cardiovascular risk factor and of pulmonary arterial hypertension. Elevated hs-cTnT and NT-proBNP were associated with diffuse skin involvement and directly correlated with the skin score. Patients with increased cardiac markers presented a lower left-ventricular ejection fraction (LVEF) and a higher rate of right bundle branch block (RBBB) on electrocardiogram (ECG) compared to patients with normal cardiac enzymes. During the follow-up, 12 SSc-patients experience a disease-related death; 9 of these were directly related to cardiac involvement (sudden cardiac death or heart failure) and the majority of them occurred among patients with increase of at least one cardiac biomarker. Long-term survival was worse in patients with increase of both cardiac biomarkers. Conclusions Evaluation of hs-cTnT and NT-proBNP levels may provide a tool to screen non-invasively SSc-patients for heart involvement. A higher incidence of impaired systolic function, ECG abnormalities and a poor outcome in SSc-patients with elevated cardiac enzymes suggests that they may be valuable screening biomarkers to detect a cardiac damage at early stages and to improve risk stratification.

Published
2019

11. The management of multiple sclerosis by reference centers in south of Italy: a 2011 survey on health demands and needs in Campania region

Author

Daniele Spitaleri, Emilio Lombardi, Walter Di Iorio, Roberta Lanzillo, Mario Alberto Battaglia, Anna Pia Spadera, F. Romano, Giuseppe Orefice, Antonio Gallo, Pasquale Vivo, Francesco Di Nardo, Darko Nedovic, Vincenzo Busillo, Giorgia Teresa Maniscalco, Chiara De Waure, Walter Mazzucco, Walter Ricciardi, Leonardo Sinisi, Maria Petracca, de Waure, Chiara, Di Nardo, Francesco, Mazzucco, Walter, Nedovic, Darko, Battaglia, Mario Alberto, Busillo, Vincenzo, Di Iorio, Walter, Gallo, Antonio, Lanzillo, Roberta, Lombardi, Emilio, Maniscalco, Giorgia Teresa, Orefice, Giuseppe, Petracca, Maria, Romano, Felice, Sinisi, Leonardo, Spadera, Anna Pia, Spitaleri, Daniele, Vivo, Pasquale, Ricciardi, Walter, de Waure, C, Di Nardo, F, Mazzucco, W, Nedovic, D, Battaglia, Ma, Busillo, V, Di Iorio, W, Lanzillo, R, Lombardi, E, Maniscalco, Gt, Orefice, G, Petracca, M, Romano, F, Sinisi, L, Spadera, Ap, Spitaleri, D, Vivo, P, and Ricciardi, W.

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Multiple Sclerosis, Cross-sectional study, Neurological examination, Dermatology, Disease management, Health services needs and demand, Multiple sclerosis, Cross-Sectional Studies, Female, Humans, Italy, Surveys and Questionnaires, Needs Assessment, 2708, Neurology (clinical), Psychiatry and Mental Health, 03 medical and health sciences, 0302 clinical medicine, medicine, Multiple sclerosi, 030212 general & internal medicine, Disease management (health), Glatiramer acetate, Settore MED/42 - IGIENE GENERALE E APPLICATA, Neuroradiology, Expanded Disability Status Scale, medicine.diagnostic_test, business.industry, General Medicine, Management of multiple sclerosis, medicine.disease, Psychiatry and Mental health, Physical therapy, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

This cross-sectional study has investigated the diagnostic and therapeutic management of patients suffering from multiple sclerosis (MS) in the Campania Region (Italy). A survey involving all the reference centers for MS in Campania Region was conducted from March to August 2011. Centers responded to a web-administered questionnaire on management and clinical characteristics of MS patients. In the study period, 3263 patients (mean age 37 years, 66 % females) accessed the centers. Patients received a first diagnosis of MS in 161 cases (4.9 %). About 37 % of the subjects without a previous diagnosis came to the centers on their own initiative. All patients underwent a complete neurological examination and expanded disability status scale. The other most common investigations were magnetic resonance imaging (44.0 %) and evoked potentials (22.1 %). The number of treated patients was 2797 (87.1 %). The most used drugs were interferon β and glatiramer acetate. The time between diagnosis and initiation of therapy exceeded 6 months in 32 % of cases. Second-line drugs were under-used: 16 % of patients who might benefit from them show high clinical and radiological disease activity despite treatment with immunomodulant drugs. The MS care management of the surveyed centers showed consistent margins for improvement in 2011. Even though these data do not represent the current situation, they can be used to monitor improvements in MS care.

Published
2015

12. Influenza vaccination coverage among medical residents: An Italian multicenter survey

Author

Chiara Cadeddu, Francesco Vitale, Valentina Di Gregori, Lucia Borsari, Maria Elena Flacco, Paola Camia, Maria R Gallea, Anita Saponari, Silvia Mascaretti, Paolo Cacciari, Andrea Ziglio, Niccolò Lanati, Anna Rita Giuliani, Walter Ricciardi, Alessia Varetta, Walter Mazzucco, Carlo Signorelli, Elisabetta Franco, Nicola Nante, Michele Quarto, Barbara Filisetti, Roberto Furnari, Rocco Micò, Roberto Fallico, Valeria Trabacchi, Maria Passaro, Serena Gallone, F Schioppa, Maria Triassi, Margherita Bergomi, Manuela Bianco, Elena Azzolini, Eugenia Carluccio, Chiara De Waure, Emanuele Amodio, F Gilardi, Umberto Gelatti, Cesare Baldini, Antonella Mattei, Roberta Siliquini, Claudio Costantino, Angela Zoccali, Leila Fabiani, Carmelo G A Nobile, Giuseppe Napoli, Laura Morciano, Raffaele Palladino, Veronica Galis, Orazio Claudio Grillo, Salvatore Parisi, Gabriele Romano, Alessio Daniele Biafiore, Ennio Rustico, Gabriele Pelissero, Andrea Conti, Maria Filomena Gallone, Costantino, C, Mazzucco, W, Vitale, F, Azzolini, E, Baldini, C, Bergomi, M, Biafiore, A, Bianco, M, Borsari, L, Cacciari, P, Cadeddu, C, Camia, P, Carluccio, E, Conti, A, De Waure, C, Di Gregori, V, Fabiani, L, Fallico, R, Filisetti, B, Flacco, M, Franco, E, Furnari, R, Galis, V, Gallea, M, Gallone, M, Gallone, S, Gelatti, U, Gilardi, F, Giuliani, A, Grillo, O, Lanati, N, Mascaretti, S, Mattei, A, Micò, R, Morciano, L, Nante, N, Napoli, G, Nobile, C, Palladino, R, Parisi, S, Passaro, M, Pelissero, G, Quarto, M, Ricciardi, W, Romano, G, Rustico, E, Saponari, A, Schioppa, F, Signorelli, C, Siliquini, R, Trabacchi, V, Triassi, M, Varetta, A, Ziglio, A, Zoccali, A, Amodio, E, Biafiore, A. D, Amodio, E., Claudio, Costantino, Walter, Mazzucco, Francesco, Vitale, Elena, Azzolini, Cesare, Baldini, Margherita, Bergomi, Alessio Daniele Biafiore, Manuela, Bianco, Lucia, Borsari, Paolo, Cacciari, Chiara, Cadeddu, Paola, Camia, Eugenia, Carluccio, Andrea, Conti, Chiara De Waure, Valentina Di Gregori, Leila, Fabiani, Roberto, Fallico, Barbara, Filisetti, Flacco, Maria E., Elisabetta, Franco, Roberto, Furnari, Veronica, Gali, Gallea, Maria R., Gallone, Maria F., Serena, Gallone, Umberto, Gelatti, Francesco, Gilardi, Giuliani, Anna R., Grillo, Orazio C., Niccol?, Lanati, Silvia, Mascaretti, Antonella, Mattei, Rocco, Mic?, Laura, Morciano, Nicola, Nante, Giuseppe, Napoli, Carmelo, Nobile, Palladino, Raffaele, Salvatore, Parisi, Maria, Passaro, Gabriele, Pelissero, Michele, Quarto, Walter, Ricciardi, Gabriele, Romano, Ennio, Rustico, Anita, Saponari, Schioppa, Francesco S., Carlo, Signorelli, Roberta, Siliquini, Valeria, Trabacchi, Triassi, Maria, Alessia, Varetta, Andrea, Ziglio, Angela, Zoccali, and Emanuele, Amodio

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Attitude of Health Personnel, Immunology, Socio-culturale, Settore MED/42 - Igiene Generale E Applicata, Influenza immunization, medical residents, Physicians, Health care, Influenza, Human, medicine, influenza vaccination, coverage rate, Immunology and Allergy, Humans, Good practice, Coverage rate, Influenza vaccination, Italy, Medical residents, Multicentre survey, Female, Influenza Vaccines, Vaccination, Data Collection, Internship and Residency, multicentre survey, Ethical responsibility, Pharmacology, business.industry, Italy, coverage rate, influenza vaccination, medical residents, multicentre survey, Influenza, Multicenter study, Vaccination coverage, Family medicine, Multicenter survey, business, Research Paper, Human
Abstract

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P < 0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P < 0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future. © 2014 Landes Bioscience.

Published
2014

13. The Italian survival calculator to optimize donor to recipient matching and to identify the unsustainable matches in liver transplantation

Author

Avolio, Alfonso W., Agnes, Salvatore, Cillo, Umberto, Lirosi, Maria C., Romagnoli, Renato, Baccarani, Umberto, Zamboni, Fausto, Nicolini, Daniele, Donataccio, Matteo, Perrella, Alessandro, Ettorre, Giuseppe M., Romano, Marina, Morelli, Nicola, Vennarecci, Giovanni, De Waure, Chiara, Fagiuoli, Stefano, Burra, Patrizia, Cucchetti, Alessandro, Avolio, A.W., Agnes, S., Cillo, U., Lirosi, M.C., Romagnoli, R., Baccarani, U., Zamboni, F., Nicolini, D., Donataccio, M., Perrella, A., Ettorre, G.M., Romano, M., Morelli, N., Vennarecci, G., De Waure, C., Fagiuoli, S., Burra, P., and Cucchetti, A.

Subjects
Transplantation, Internet, Logistic Model, liver transplantation, Prognosi, Graft Survival, ethics, MELD, Donor Selection, Decision Support Techniques, D-MELD, expansion of donor pool, marginal donors, outcome analyses, selection criteria, Algorithm, donor-recipient match, Italy, Survival Analysi, Human
Abstract

Optimization of donor-recipient match is one of the exciting challenges in liver transplantation. Using algorithms obtained by the Italian D-MELD study (5256 liver transplants, 21 Centers, 2002-2009 period), a web-based survival calculator was developed. The calculator is available online at the URL http://www.D-MELD.com. The access is free. Registration and authentication are required. The website was developed using PHP scripting language on HTML platform and it is hosted by the web provider Aruba.it. For a given donor (expressed by donor age) and for three potential recipients (expressed by values of bilirubin, creatinine, INR, and by recipient age, HCV, HBV, portal thrombosis, re-transplant status), the website calculates the patient survival at 90days, 1year, 3years, and allows the identification of possible unsustainable matches (i.e. donor-recipient matches with predicted patient survival less than 50% at 5 years). This innovative approach allows the selection of the best recipient for each referred donor, avoiding the allocation of a high-risk graft to a high-risk recipient. The use of the D-MELD.com website can help transplant surgeons, hepatologists, and transplant coordinators in everyday practice of matching donors and recipients, by selecting the more appropriate recipient among various candidates with different prognostic factors.

Published
2012

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