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3. The potential use of biomarkers in predicting contrast-induced acute kidney injury

Author

Andreucci M, Faga T, Riccio E, Sabbatini M, Pisani A, and Michael A

Subjects
Radiocontrast media, acute renal failure, markers, renal injury., Diseases of the genitourinary system. Urology, RC870-923
Abstract

Michele Andreucci,1 Teresa Faga,1 Eleonora Riccio,2 Massimo Sabbatini,2 Antonio Pisani,2 Ashour Michael,1 1Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, 2Department of Public Health, University of Naples Federico II, Naples, Italy Abstract: Contrast-induced acute kidney injury (CI-AKI) is a problem associated with the use of iodinated contrast media, causing kidney dysfunction in patients with preexisting renal failure. It accounts for 12% of all hospital-acquired kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures. So far, its diagnosis has relied upon the rise in creatinine levels, which is a late marker of kidney damage and is believed to be inadequate. Therefore, there is an urgent need for biomarkers that can detect CI-AKI sooner and more reliably. In recent years, many new biomarkers have been characterized for AKI, and these are discussed particularly with their use in known CI-AKI models and studies and include neutrophil gelatinase-associated lipocalin, cystatin C (Cys-C), kidney injury molecule-1, interleukin-18, N-acetyl-β-d-glucosaminidase, and L-type fatty acid-binding protein (L-FABP). The potential of miRNA and metabolomic technology is also mentioned. Early detection of CI-AKI may lead to early intervention and therefore improve patient outcome, and in future any one or a combination of several of these markers together with development in technology for their analysis may prove effective in this respect. Keywords: radiocontrast media, acute renal failure, markers, renal injury

Published
2016

6. Aquatic Weeds

Author

Sidorkewicj, S., Sabbatini, M. R., Fernández, O. A., Irigoyen, J. H., and Inderjit, editor

Published
2004
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7. Efficacy of a reduced pill burden on therapeutic adherence to calcineurin inhibitors in renal transplant recipients: an observational study

Author

Sabbatini M, Garofalo G, Borrelli S, Vitale S, Torino M, Capone D, Russo L, Pisani A, Carrano R, Gallo R, and Federico S

Subjects
Medicine (General), R5-920
Abstract

Massimo Sabbatini,1 Gianluca Garofalo,1 Silvio Borrelli,2 Sossio Vitale,1 Massimiliano Torino,1 Domenico Capone,3 Luigi Russo,3 Antonio Pisani,1 Rosa Carrano,1 Riccardo Gallo,1 Stefano Federico11Nephrology, Department of Public Health, University Federico II of Naples, 2Department of Nephrology, Second University of Naples, 3Department of Neurosciences, Unit of Clinical Pharmacology, University Federico II of Naples, Naples, ItalyPurpose: The aim of this study was to determine the prevalence of nonadherence in a cohort of renal transplant recipients (RTRs) and to evaluate prospectively whether more intense clinical surveillance and reduced pill number enhanced adherence.Patients and methods: The study was carried out in 310 stable RTRs in whom adherence, life satisfaction, and transplant care were evaluated by specific questionnaires (time 0). The patients under tacrolimus (TAC; bis in die [BID]) were then shifted to once-daily TAC (D-TAC) to reduce their pill burden (Shift group) and were followed up for 6 months to reevaluate the same parameters. Patients on cyclosporin or still on BID-TAC constituted a time-control group.Results: The prevalence of nonadherence was 23.5% and was associated with previous rejection episodes (P

Published
2014

9. New-onset anemia and associated risk of ESKD and death in non-dialysis CKD patients: A multicohort observational study

Author

Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., Grandaliano G. (ORCID:0000-0003-1213-2177), Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Background: Anemia is a common complication of chronic kidney disease (CKD), but its incidence in nephrology settings is poorly investigated. Similarly, the risks of adverse outcomes associated with new-onset anemia are not known. Methods: We performed a pooled analysis of three observational cohort studies including 1031 non-anemic CKD patients with eGFR <60 mL/min/1.73 m2 regularly followed in renal clinics. We estimated the incidence of mild anemia (hemoglobin 11-12 g/dL in women and 11-13 g/dL in men) and severe anemia (hemoglobin <11 g/dL or use of erythropoiesis-stimulating agents) during a 3-year follow-up period. Thereafter we estimated the risk of end-stage kidney disease (ESKD) and all-cause death associated with new-onset mild and severe anemia. Results: The mean age was 63 ± 14 years, 60% were men and 20% had diabetes. The mean estimated glomerular filtration rate (eGFR) was 37 ± 13 mL/min/1.73 m2 and the median proteinuria was 0.4 g/day [interquartile range (IQR) 0.1-1.1]. The incidence of mild and severe anemia was 13.7/100 patients-year and 6.2/100 patients-year, respectively. Basal predictors of either mild or severe anemia were diabetes, lower hemoglobin, higher serum phosphate, eGFR <30 mL/min/1.73 m2 and proteinuria >0.50 g/day. Male sex, moderate CKD (eGFR 30-44 mL/min/1.73 m2) and moderate proteinuria (0.15-0.50 g/day) predicted only mild anemia. The incidence of anemia increased progressively with CKD stages (from 8.77 to 76.59/100 patients-year) and the proteinuria category (from 13.99 to 25.02/100 patients-year). During a median follow-up of 3.1 years, 232 patients reached ESKD and 135 died. Compared with non-anemic patients, mild anemia was associated with a higher adjusted risk of ESKD {hazard ratio [HR] 1.42 [95% confidence interval (CI) 1.02-1.98]} and all-cause death [HR 1.55 (95% CI 1.04-2.32)]. Severe anemia was associated with an even higher risk of ESKD [HR 1.73 (95% CI 1.20-2.51)] and death [HR 1.83 (95% CI 1.05-3.19)].

Published
2022

13. List of contributors

Author

Abdullahi, A., primary, Amini-Nik, S., additional, Azzimonti, B., additional, Barbul, A., additional, Boekema, B.K.H.L., additional, Cannas, M., additional, Clement, A.L., additional, Hinz, B., additional, Jeschke, M.G., additional, Kavalukas, S.L., additional, Kletsas, D., additional, Koh, T.J., additional, Lali, F.V., additional, Lundquist, R., additional, Martin, Y.H., additional, Metcalfe, A.D., additional, Mulder, G., additional, Pins, G.D., additional, Pratsinis, H., additional, Rennekampff, H.O., additional, Rimondini, L., additional, Sabbatini, M., additional, Shupp, J.W., additional, Tejiram, S., additional, Tenenhaus, M., additional, Ulrich, M.M.W., additional, Urao, N., additional, and Vlig, M., additional

Published
2016
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35. Parapelvic cysts, a distinguishing feature of renal Fabry disease

Author

Pisani, A, Petruzzelli Annicchiarico, L, Pellegrino, A, Bruzzese, D, Feriozzi, S, Imbriaco, M, Tedeschi, E, Cocozza, S, De Rosa, D, Mignani, R, Veroux, M, Battaglia, Y, Concolino, D, Sestito, S, Pieruzzi, F, Caroti, L, Manna, R, Zizzo, C, Santangelo, M, Sabbatini, M, Riccio, E, PIERUZZI, FEDERICO UMBERTO EMILIO GUGLIE, Riccio, E., Pisani, A, Petruzzelli Annicchiarico, L, Pellegrino, A, Bruzzese, D, Feriozzi, S, Imbriaco, M, Tedeschi, E, Cocozza, S, De Rosa, D, Mignani, R, Veroux, M, Battaglia, Y, Concolino, D, Sestito, S, Pieruzzi, F, Caroti, L, Manna, R, Zizzo, C, Santangelo, M, Sabbatini, M, Riccio, E, PIERUZZI, FEDERICO UMBERTO EMILIO GUGLIE, and Riccio, E.

Published
2018

36. 'Questo è il mal mio, che toccherà a ridersene a ciascuno ed a me piangerne'. Il ridicolo e la beffa: criteri metateatrali nella commedia del Rinascimento

Author

CAMBIAGHI M,. BELLONI L., CARANDINI S., TAVAZZI V., TAFFON G., TINTERRI A., SABBATINI M., PIGA G., DE MATTEIS T., SABBATINI MARCO, Belloni, Laura, BELLONI LAURA (ORCID:0000-0003-4063-6495), CAMBIAGHI M,. BELLONI L., CARANDINI S., TAVAZZI V., TAFFON G., TINTERRI A., SABBATINI M., PIGA G., DE MATTEIS T., SABBATINI MARCO, Belloni, Laura, and BELLONI LAURA (ORCID:0000-0003-4063-6495)

Abstract

Come ricordano le commedie rinascimentali, l’inganno e la beffa sono parte del teatro quanto della vita vera. Machiavelli ne sintetizza l’essenza ne Il Principe: «colui che inganna troverrà sempre chi si lascerà ingannare» perché secondo le leggi di natura gli uomini sono ‘tanto semplici’ e ‘tanto obediscono alle necessità presenti’ da essere vittime facili e vulnerabili a causa o della loro stupidità o perché i bisogni, i desideri e le necessità impellenti li portano a mostrare il lato più debole. La beffa, come una lente deformante, amplifica tali difetti e imperfezioni fino a renderli estremi, caricaturali, esagerati. Li espone agli occhi del pubblico insieme alla vergogna e all’umiliazione delle vittime. Tuttavia nella commedia il beffato, succube dell’inganno che sfrutta la sue umane debolezze, vien messo in posizione tale da suscitare il riso anche quando la crudeltà dello scherzo risulta estrema. Per quanto grave l’umiliazione, non v’è ombra di patetico o di sofferente nelle sue disavventure. Né la crudeltà né la eventuale rozzezza degli scherzi diminuisce o intacca il risultato comico quando il meccanismo metateatrale bilancia nella commedia il grado di coinvolgimento e di distacco dello spettatore. Abel non ricorda forse che i personaggi nelle commedie non devono convincerci della loro esistenza, ma che tutto quello che devono fare, è farci ridere? Tuttavia, se sul piano narrativo si esalta la comicità pura e leggera, sul piano drammatico e metateatrale, nella breve incursione dietro le quinte, si lascia margine a un sentimento che va oltre il ridicolo: la commedia rinascimentale ama sperimentare nella zona di confine tra ridere e deridere, scherzare e schernire, tra leggerezza e umiliazione passando quasi impercettibilmente dal comico al tragico.

Published
2018

38. Acute Cyclosporine a Nephrotoxicity

Author

Andreucci, V. E., Conte, G., Sabbatini, M., Fuiano, G., Stanziale, P., de Nicola, L., Sepe, V., Balletta, M., Andreucci, Vittorio E., editor, and Dal Canton, Antonio, editor

Published
1989
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39. Use of non-steroidal anti-inflammatory drugs and analgesics in a cohort of hospitalized elderly patients: Results from the REPOSI study

Author

Pasina, L, Cortesi, L, Tettamanti, M, Nobili, A, Mannucci, Pm, Franchi, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, Gr, Marcucci, M, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Vanoli, M, Grignani, G, Casella, G, Bernardi, M, Li Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, R, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, Fc, Girelli, G, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, G, Valenti, V, Zoli, M, Arnò, A, Laghi Pasini, F, Capecchi, Pl, Bicchi, M, Palasciano, P, Modeo, Me, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, Mr, De Stefano, F, Cappellini, Md, Fabio, G, Seghezzi, S, Migone De Amicis, M, Mari, D, Dionigi Rossi, P, Damanti, S, Brignolo Ottolini, B, Miceli, M, Lenti, Mv, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, Mb, Ghelfi, D, Anastasio, A, Sofia, L, Carbone, M, Davì, G, Guagnano, Mt, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, Mr, Cavallo Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, T, Melis, D, Rebella, L, Delitala, D, Pretti, V, Masala, Ms, Bolondi, L, Rasciti, L, Serio, I, Rossi Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccalà, G, Franceschi, F, De Marco, G, Cordischi, C, Sabbatini, M, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Vespasiani Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Delitala, G, Carta, S, Atzori, S, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Manfredini, Roberto, Molino, C, Pala, M, Fabbian, Fabio, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, Mr, Laieta, Mt, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Sabbà, C, Vella, Fs, Suppressa, P, Valerio, R, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, Av, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, Ws, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, Nl, Buratti, A, Tiziana Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Ludovica Perri, P, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, Mv, Miceli, A, Pellegrini, E, Carulli, L, Perticone, F, Sciacqua, A, Quero, M, Bagnato, C, Corinaldesi, R, DE GIORGIO, Roberto, Serra, M, Grasso, V, Ruggeri, E, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Gabrielli, A, Mattioli, M, Capeci, W, Martino, Gp, Messina, S, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Colangelo, L, Afeltra, A, Alemanno, P, Marigliano, B, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, Mv, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, M, Scopelliti, F, Gasparini, F, Cocca, M, Ramirez Duque, N, Muela Molinero, A, Abad Requejo, P, Lopez Pelaez, V, Tamargo, L, Corbella Viros, X, Formiga, F, Diez Manglano, J, Bejarano Tello, E, Del Corral Behamonte, E, Sevil Puras, M, Manuel, R, Pinilla Llorente, B, Lopez Gonzalez Cobos, C, Villalba Garcia, Mv, Sanz Baena, S, Arroyo Gallego, M, Gonzalez Becerra, C, Fernandez Moyano, A, Mercedes Gomez, H, Poyato Borrego, M, Pacheco Cuadros, R, Perez Rojas, F, Garcia Olid, B, Carrascosa Garcia, S, Gonzalez Cruz, C, Peinado Martinez, M, Ruiz Cantero, A, Albarracín Arraigosa, A, Godoy Guerrero, M, Barón Ramos, Ma, Machin, Jm, Novo Veleiro, I, Alvela Suarez, L, Lopez, A, Rubal Bran, D, Iñiguez Vazquez, I, and Rios Prego, M.

Subjects
Male, medicine.medical_specialty, Phamacoepidemiology, Socio-culturale, Pain, Comorbidity, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Elderly, Internal medicine, Internal Medicine, medicine, Humans, Pain Management, 030212 general & internal medicine, Aged, Aged, 80 and over, Analgesics, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Drug Utilization, Hospitalization, Non steroidal anti inflammatory, Italy, Cohort, Polypharmacy, Female, business, Elderly, Non-steroidal anti-inflammatory drugs, Phamacoepidemiology, Non-steroidal anti-inflammatory drugs
Published
2016

41. L'ATTIVITA' DI DONAZIONE D'ORGANI ED IL TRAPIANTO DI RENE IN REGIONE CAMPANIA

Author

Federico, S, Santopietro, A, D'Apice, L, Avella, F, Pagano, F, Caputo, A, Sessa, A, Nullb, nullDi Iorio, Camocardi, A, Carrano, R, Gallo, R, Sabbatini, M, Andreucci, Ve, POLLASTRO, Rosa Maria, DE SANTO, Natale Gaspare, FEDERICO S, SANTOPIETRO A, D'APICE L, AVELLA F, POLLASTRO R.M., PAGANO F, CAPUTO A, SESSA A, DI IORIO B, CAMOCARDI A, CARRANO R, GALLO R, SABBATINI M, DE SANTO NG, ANDREUCCI VE, De Santo NG, Federico, S, Santopietro, A, D'Apice, L, Avella, F, Pollastro, Rosa Maria, Pagano, F, Caputo, A, Sessa, A, Nullb, nullDi Iorio, Camocardi, A, Carrano, R, Gallo, R, Sabbatini, M, DE SANTO, Natale Gaspare, and Andreucci, Ve

Published
2003

42. Setting dialysis start at 6.0 ml/min/1.73 m2 eGFR--a study on safety, quality of life and economic impact

Author

Di Micco, L, Torraca, S, Pota, A, Di Giuseppe, D, Pisani, A, Spinelli, L, de Portu, S, Sabbatini, M, Mantovani, L, Cianciaruso, B, Di Micco L, Torraca S, Pota A, Di Giuseppe D, Pisani A, Spinelli L, de Portu S, Sabbatini M, Mantovani L, Cianciaruso B, Di Micco, L, Torraca, S, Pota, A, Di Giuseppe, D, Pisani, A, Spinelli, L, de Portu, S, Sabbatini, M, Mantovani, L, Cianciaruso, B, Di Micco L, Torraca S, Pota A, Di Giuseppe D, Pisani A, Spinelli L, de Portu S, Sabbatini M, Mantovani L, and Cianciaruso B

Abstract

Background. End-stage renal disease care requires enormous economic resources. A timely dialysis start could reduce the costs of the renal replacement therapy (RRT). Our aim was to measure the time to dialysis in CKD patients, with an estimated glomerular filtration rate (eGFR) ≤11.0 mlmin1.73 m2 (MDRD derived), and to evaluate the safety, economic impact and the quality of life (QoL).Methods. In a prospective, observational study, 70 consecutive CKD patients, stage 5, were screened and 30 patients were selected and followed up monthly, for 24 months or until the start of RRT, set at an eGFR = 6.0 mlmin/ 1.73 m2 or at the occurrence of pre-defined urgent criteria. The SF-36 questionnaire to evaluate the QoL was performed at the first and the last visit.Results. The median time to the start of dialysis was 11.8 (25th and 75th: 5.5-17.3) months. Only seven patients urgently started dialysis, after 8 months (25th and 75th: 4.8-20). The mean monthly cost of care was € 1146 ± 917 per patient. The QoL was similar to that of the general population and did not change at the last assessment.Discussion. This is the first study evaluating the economic impact of intensive conservative management of CKD stage 5 to postpone start of dialysis in tertiary care. This strategy allows us to safely gain a significant amount of time free from dialysis, with good QoL and major savings in the costs of nation's dialysis budget. The present results, however, are applicable only to low comorbidity patients referred to nephrology care and may not be generalized to all patients starting RRT.

Published
2009

46. Antihypertensive Mechanisms of Muzolimine

Author

Russo, D., Cofelice, E., Conte, G., Giunta, A., Maione, S., Romano, G., Sabbatini, M., Testa, A., Veniero, P., Dal Canton, A., Andreucci, V. E., Andreucci, V. E., editor, and Dal Canton, Antonio, editor

Published
1987
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49. The economic impact of moderate stage Alzheimer's disease in Italy: Evidence from the UP-TECH randomized trial

Author

Chiatti, C., Furneri, G., Rimland, J. M., Demma, F., Bonfranceschi, F., Cassetta, L., Masera, F. b, Cherubini, Corsonello, A., Lattanzio, F., Baldassarri, D., Bitti, L., Carosi, A., Sabbatini, M., Paolasini, E., Fiori, T., Fronzi, C., Giacchetta, S., Giacomini, V., Giovagnoli, L., Lattanzi, G., Manca, A. M., Marinelli, I., Pigini, V., Pignotti, M., Proietti, M. C., Quarticelli, A., Rovedi, M., Tasso, L., Valeri, V., Antonioli, A., Barabucci, M., Bassani, M., Bollettini, P., Bruttapasta, M. C., Buccolini, C., Carangella, R., Carboni, F., Ceccolini, D., D'Incecco, P., Di Felice, M., Dini, L., Gioia, G., Di Prima, G., Giusepponi, G., Lanciotti, C., Loffreda, A., Luciani, O., Mariani, L., Mastrorilli, F., Moroni, R., Piatkowska, I., Rucoli, R., Scoccia, G., Teodori, N., Tonelli, T., Angeloni, R., Bratti, R. A., Bonafede, G., Lorenzetti, S., Paci, C., Picciotti, G., Pezzola, D., Rea, V., Scialè, V., Signorino, M., Sorvillo, F., Tomassini, P. F., Ciccola, A., Cionfrini, L., Alessandrini, D., De Santis, A., Formica, B., Tacchi, G., Tortorelli, S., Marchegiani, G., Pozzari, G., Santarelli, G., Bartolucci, D., Caraffa, G., Cavallo, Filippo, Di Furia, L., Lacetera, A., Maffei, C. M., Manzoli, L., Postacchini, D., Bevilacqua, R., Bonfigli, A. R., Bustacchini, S., Capasso, M., Civerchia, P., Di Rosa, M., Giuli, C., Marcellini, M., Marinelli, P., Melchiorre, G., Moraca, M. E., Principi, A., Rocchetti, C., Spazzafumo, L., Vincitorio, D., Bartulewicz, K., Olivetti, P., and Rossi, L.

Subjects
Gerontology, Male, very elderly, cost of illness, Public expenditure, morbidity, residential care, community care, Italian (citizen), cost analysis, Surveys and Questionnaires, Health care, Activities of Daily Living, 80 and over, Medicine, organization and management, caregiver, media_common, Aged, 80 and over, Public sector, Mini Mental State Examination, aged, Alzheimer disease, Article, controlled study, daily life activity, disease severity, economic aspect, female, health care, health care cost, human, Italy, major clinical study, mortality, physical performance, prescription, prevalence, randomized controlled trial, scoring system, social care, socioeconomics, welfare, economics, male, quality of life, questionnaire, statistical model, Activities of Daily Living, Aged, Alzheimer Disease, Caregivers, Cost of Illness, Female, Health Expenditures, Humans, Linear Models, Quality of Life, Alzheimer's disease, community-living, RCT, UP-TECH, Psychiatry and Mental health, Clinical Psychology, Alzheimer’s disease, media_common.quotation_subject, Quality of life (healthcare), Dementia, Medical prescription, Socioeconomic status, business.industry, statistical model, medicine.disease, Geriatrics and Gerontology, business, Welfare
Abstract

Background:There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families.Methods:This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community.Results:The societal burden of AD, composed of public, patient, and informal care costs, was about €20,000/yr. Out of this, the cost borne by the public sector was €4,534/yr. The main driver of public cost was the national cash-for-care allowance (€2,324/yr), followed by drug prescriptions (€1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at €13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure.Conclusion:The burden of AD reflects the structure of Italian welfare. The families predominantly manage AD patients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org (Trial Registration number: NCT01700556).

Published
2015

50. Setting dialysis start at 6.0 ml/min/1.73 m2 eGFR--a study on safety, quality of life and economic impact

Author

Di Micco L, Torraca S, Pota A, Di Giuseppe D, Pisani A, Spinelli L, de Portu S, Sabbatini M, Mantovani L, Cianciaruso B, Di Micco, L, Torraca, S, Pota, A, Di Giuseppe, D, Pisani, A, Spinelli, L, de Portu, S, Sabbatini, M, Mantovani, L, and Cianciaruso, B

Subjects
dyalisis, cost benefit
Abstract

Background. End-stage renal disease care requires enormous economic resources. A timely dialysis start could reduce the costs of the renal replacement therapy (RRT). Our aim was to measure the time to dialysis in CKD patients, with an estimated glomerular filtration rate (eGFR) ≤11.0 mlmin1.73 m2 (MDRD derived), and to evaluate the safety, economic impact and the quality of life (QoL).Methods. In a prospective, observational study, 70 consecutive CKD patients, stage 5, were screened and 30 patients were selected and followed up monthly, for 24 months or until the start of RRT, set at an eGFR = 6.0 mlmin/ 1.73 m2 or at the occurrence of pre-defined urgent criteria. The SF-36 questionnaire to evaluate the QoL was performed at the first and the last visit.Results. The median time to the start of dialysis was 11.8 (25th and 75th: 5.5-17.3) months. Only seven patients urgently started dialysis, after 8 months (25th and 75th: 4.8-20). The mean monthly cost of care was € 1146 ± 917 per patient. The QoL was similar to that of the general population and did not change at the last assessment.Discussion. This is the first study evaluating the economic impact of intensive conservative management of CKD stage 5 to postpone start of dialysis in tertiary care. This strategy allows us to safely gain a significant amount of time free from dialysis, with good QoL and major savings in the costs of nation's dialysis budget. The present results, however, are applicable only to low comorbidity patients referred to nephrology care and may not be generalized to all patients starting RRT.

Published
2009

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