STATO NUTRIZIONALE E ABITUDINI ALIMENTARI NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO

In Italia l’aumento costante del numero degli anziani è una realtà correlata al miglioramento delle condizioni di vita. Ma ciò porta con sé anche un carico economico e sociale importante in relazione all’aumento delle malattie cronico-degenerative. Per tale motivo l’Organizzazione Mondiale della Sanità ha messo a punto una linea strategica denominata “active ageing” al fine di rafforzare le condizioni per un “invecchiamento attivo” le cui basi sono da costruire ben prima dell’età anziana. L’alimentazione è un cardine imprescindibile nel determinismo dell’invecchiamento di successo.

A dietary pattern score and risk of developing type 2 diabetes in the sun project

Introduction: Numerous diabetes risk models and scores have been developed, but most are rarely used or are not focused on diet or do not fully capture the overall dietary pattern. Objectives: To develop a friendly, plausible, self-administered, and complete diabetes dietary score (DDS), emphasizing the powerful role of optimal food patterns to decrease the risk of developing type 2 diabetes (T2DM). Method / Design: We assessed 17,292 participants of the prospective SUN cohort initially free of diabetes. They were followed-up for a mean of 9.2 years. A validated 136-item FFQ was administered at baseline. Vegetables, fruit, whole-cereals, nuts, coffee, low-fat dairy, fiber, PUFA, and alcohol…

Ecocolordoppler epiaortico e transcranico nelle diagnosi differenziale delle demenze

INTERVENTI DI POTATURA VERDE PER LA GESTIONE DELLA MATURAZIONE DELL’UVA NELLA CV MERLOT IN AMBIENTE CALDO ARIDO

Considering the predicted scenarios of climate change for the near future, Mediterranean vineyards, may face substantial shifts in precipitation, atmospheric conditions and temperature, resulting in higher winter rainfall, together with drier and hotter summers. All potentially contributing to an uncoupling of technological and phenolic ripeness in Vitis vinifera grapevines, due to berry ripening taking place in the hottest month of the year, resulting in wines with high alcohol content and low titratable acidity. A reduced sugar accumulation rate in the berry may delay berry maturation and subsequently counteract these effects. The aim of this study was to delay berry maturation in cv Merl…

Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study

Abstract Background and aims Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA 2 DS 2 -VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA 2 DS 2 -VASc score. Methods We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography. Results VD was reported in 351 (17.3%) patients while CP was detected in 16.6% patients. Ad…

ANORESSIA SENILE

Malgrado l’elevata e crescente prevalenza del sovrappeso, il principale problema nutrizionale nell’anziano è rappresentato dalla malnutrizione per difetto spesso secondaria a riduzione dell’introito alimentare ed alla perdita di motivazione all’assunzione di cibo. Ciò fa pensare alla presenza nell’età senile di problemi correlati alla regolazione del bilancio energetico ed al controllo del senso della fame e della sazietà. L’anoressia conseguente all’invecchiamento rappresenta una causa comune di malnutrizione che è associata ad un aumento della mortalità e della disabilità funzionale.

A comprehensive fracture prevention strategy in older adults : The European union geriatric medicine society (EUGMS) statement

Published also in Aging Clinical and Experimental Research, Vol.28, No.4, WOS: 000379034800030 Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects …

THU0349 A Double-Blind, Randomised, Parallel Group, Active Controlled, Multicentre Study to Assess the Therapeutic Non-Inferiority of Skp-021, A 0.3% Ketoprofen Patch, versus Diclofenac Sodium Patch in Patients with Acute Inflammatory Musculoskeletal Injuries

Background NSAIDs are the first choice for management of acute musculoskeletal pain. Acute musculoskeletal pain is often associated with trauma, surgery, musculoskeletal injuries like strains, sprains and over-use injuries Objectives The primary study endpoint was the estimate of the non-inferiority of the Test drug (Ketoprofen) vs. the Reference drug (Diclofenac). This was performed by assessment of the proportion of responders (response: 50% or more reduction of baseline VAS % (95%CI) at the end of treatment) in the two treatment groups. Methods This phase III, randomised, blinded, active-control and non-inferiority study involved 697 adults with acute muskuloskeletal pain. Participants w…

GEANT4 simulation of the neutron background of the C6D6 set-up for capture studies at n_TOF

The neutron sensitivity of the C6D6 detector setup used at n_TOF facility for capture measurements has been studied by means of detailed GEANT4 simulations. A realistic software replica of the entire n_TOF experimental hall, including the neutron beam line, sample, detector supports and the walls of the experimental area has beeni mplemented in the simulations. The simulations have been analyzed in the same manner as experimental data, in particular by applying the Pulse Height Weighting Technique. The simulations have been validated against a measurement of the neutron background performed with anatC sample, showing an excellent agreement above 1 keV. At lower energies, an additional compo…

IL TESTAMENTO BIOLOGICO NEL PAZIENTE AFFETTO DA DEMENZA: CONSIDERAZIONI BIOETICHE E SUGGERIMENTI NELLA PRATICA CLINICA

La demenza rappresenta oggi una delle principali priorità del sistema sanitario, in termini sia clinici che assistenziali, con un importante impatto sulla popola-zione mondiale. Un recente report redatto dalla comunità scientifica ha evidenziato come circa 46 milioni di soggetti hanno ricevuto diagnosi di demenza nel corso del 2015. Il trend intrapreso suggerisce che questa cifra possa aumentare progressivamente in futuro: è stimato che circa 130 milioni di persone saranno affette da demenza nei prossimi quarant’anni. Nonostante la cruda sincerità di tali numeri, il progresso delle conoscenze cliniche nel campo delle demenze non sempre ha progredito di pari passo con il miglioramento dei mo…

PREVALENZA DI CADUTE E PREVENZIONE NELLA POPOLAZIONE SICILIANA ULTRASESSANTACINQUENNE. SISTEMA DI SORVEGLIANZA PASSI D’ARGENTO

L’invecchiamento della popolazione è un fenomeno globale, che si caratterizza soprattutto per la presenza di patologie cronico-degenerative che incidono sulla qualità della vita delle persone anziane e che causano un notevole incremento dei costi per le cure e per l’assistenza. Per fronteggiare tale fenomeno globale, che riguarda da vicino l’Italia, l’Organizzazione Mondiale della Sanità (OMS) ha messo a punto un piano che ha come obiettivo primario “l’invecchiamento attivo” (active ageing), cioè incentivare il passaggio da politiche incentrate sui bisogni delle persone anziane, considerate abitualmente come soggetti passivi, a politiche che riconoscano l’anziano come parte attiva della vit…

Neutron measurements for advanced nuclear systems: The n_TOF project at CERN

A few years ago, the neutron time-of-flight facility n_TOF was built at CERN to address some of the urgent needs of high-accuracy nuclear data for Accelerator Driven Systems and other advanced nuclear energy systems, as well as for nuclear astrophysics and fundamental nuclear physics. Thanks to the characteristics of the neutron beam, and to state-of-the-art detection and acquisition systems, high quality neutron cross-section data have been obtained for a variety of isotopes, many of which radioactive. Following an important upgrade of the spallation target and of the experimental area, a new measurement campaign has started last year. After a brief review of the most important results obt…

Safety of rofecoxib in subjects with a history of adverse cutaneous reactions to aspirin and/or non-steroidal anti-inflammatory drugs

Background: Adverse reactions to non-steroidal anti-inflammatory drugs (NSAID)s are frequent, and the need to identify a safe alternative drug is a common problem in clinical practice. Objective: To assess the tolerability ofrofecoxib, a drug that specifically inhibits COX-2, in a group of NSAID-sensitive patients. Methods: One-hundred and four subjects (29 males and 75 females, mean age 35.6 ± 14.1) were enrolled. All subjects had experienced one or more episode characterized by cutaneous symptoms (erythema, and/or urticaria angioedema) following the assumption of NSAIDs; 92 subjects experienced reactions to only one NSAID (single intolerance: SI) and 12 subjects had reactions to multiple …

Invecchiamento in salute e dieta mediterranea

Analysis of genetic markers for the optimization of an individualized approach to osteoporosis.

Aim of this study: Osteoporosis is a systemic skeletal disease characterized by compromised bone structure and resistance and by an increased risk of fracture especially in postmenopausal women. Multiple factors including hormonal, environmental and genetic factors are involved in osteoporosis development and clinical outcome. It has been shown that Klotho and insulin-like growth factor-1 (IGF-1) have a significant effect on aging and osteoporosis risk. Actually, Insulin-like growth factor-1 (IGF-1) is a critical polypeptide that plays an important role in the regulation of bone metabolism, which promotes bone cell growth, differentiation, cell cycle progression. Klotho modulates aging in m…

IPERSENSIBILITÀ AL GLUTINE NELL’ANZIANO. PRESENTAZIONE DI UN CASO CLINICO

La celiachia è una malattia immunomediata scatenata dall’ingestione di glutine che, in soggetti geneticamente predisposti, determina un processo infiammatorio intestinale con conseguente malassorbimento e manifesta-zioni extraintestinali. Fino ad alcuni anni fa era considerata una patologia rara, tipica dell’età infantile; lo scenario epidemiologico della celiachia, oggi, è totalmente cambiato, grazie anche all’introduzione di test sierologici ad elevata sensibilità e specificità come gli anticorpi anti-endomisio (EMA) e gli anticorpi anti-transglutaminasi tissutale (tTG). Studi epidemiologici basati sull’impiego dei test sierologici hanno dimostrato che la diagnosi di celiachia viene sempr…

AB0427 Clinical and laboratory findings in patients with late-onset sle and correlations with il6 concentrations

Background Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease that usually develops in women aged 18-50 years. It is known that age at onset modifies the clinical manifestations of SLE, and so the elderly may form a specific patient subgroup. It is now well established that the serum levels of the cytokines interleukin (IL) 6 and IL10 are increased in patients with SLE (1). Objectives The primary aim was to compare the type of clinical involvement and autoantibodies in patients with late-onset (LO) or early-onset (EO) SLE. The second aim was to compare IL6 levels in the two patient groups and their possible correlations with clinical and immunological manifestations. Meth…

GRUPPO DI PSICOTERAPIA CON SOGGETTI DEFINITI MILD COGNITIVE IMPAIRMENT

Il particolare momento di vita legato ai continui cambiamenti psico-socio-cultarali impone a tutti coloro che si occupano di relazioni d’aiuto, un ripensamento che riguardi i dispositivi di cura, sì da riuscire a dare risposte in termini terapici alle nuove sofferenze portate dai nostri pazienti. Il seguente lavoro prova a chiarire come tale pensiero critico abbia prodotto dei risultati all’interno del servizio centro UVA n° 6 del Policlinico di Palermo - reparto di Geriatria.

Leisure-time physical activity for health promotion in elderly: initial evidence from the ‘‘Passiata Day’’ model

Purpose: Falls prevention interventions are a priority for public health systems in order to reduce falls-related high costs. The University Hospital of Palermo promoted the ‘‘Passiata Day’’ model, an initiative of the Department of Geriatrics that provided a 1-h walk for once a week in a park of Palermo. It was guided by a graduate in physical education and a medical doctor. The aim of this study was to evaluate posturographic parameters in a sample of elderly including a group of subjects that had been walking regularly in the ‘‘Passiata Day’’ model for 6 months and a group of sedentary elderly subjects. Methods: A number of 109 older people were recruited at the University Hospital of Pa…

Significance of magnesium in insulin resistance, metabolic syndrome, and diabetes – recommendations of the Association of Magnesium Research e.V.

Magnesium (Mg) depletion is an important and highly prevalent condition in patients with diabetes or precursor states of type-2 diabetes like metabolic syndrome. Mg deficiency increases the risk of developing type-2 diabetes. These recommendations compile present data on the physiology of Mg in carbohydrate metabolism and pathophysiological consequences of Mg depletion for diabetics. Diabetes patients and candidates benefit from four categories of Mg effects: insulin-sensitizing effect, calcium antagonism, stress-regulating and endotheli-um-stabilizing effects. Clinical data with Mg co-medication show improvement of insulin resistance/blood glucose level and reduced long-term vascular damag…

Taste loss in hospitalized multimorbid elderly subjects

ED Toffanello,1 EM Inelmen,1 A Imoscopi,1 E Perissinotto,2 A Coin,1 F Miotto,1 LM Donini,3 D Cucinotta,4 M Barbagallo,5 E Manzato,1 G Sergi11Department of Medical and Surgical Sciences, Geriatrics Division and University of Padova, Padova, 2Department of Environmental Medicine and Public Health, University of Padua, Padua, Italy; 3Department of Medical Physiopathology (Food Science Section), University of Roma, La Sapienza, Roma, 4S Orsola Malpighi Hospital, Bologna, 5Geriatric Unit, Department of Internal Medicine and Emerging Diseases, University of Palermo, Palermo, ItalyBackground: Loss of the sense of taste is common among older people. Morbidities and polypharmacy may contribute to th…

Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study

Chronic obstructive pulmonary disease (COPD) increases the risk of mortality in non-valvular atrial fibrillation (NVAF) patients. Data on the relationship of COPD to major cardiovascular events (MACE) in AF have not been defined. The aim of the study is to assess the predictive value of COPD on incident MACE in NVAF patients over a 3-year follow-up. In the Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study (ARAPACIS) cohort, we evaluate the impact of COPD on the following clinical endpoints: MACE (including vascular death, fatal/non-fatal MI and stroke/TIA), cardiovascular (CV) death and all-cause mortality. Among 2027 NVAF patients, pati…

Recent results in nuclear astrophysics at the n_TOF facility at CERN

The neutron time of flight (n_TOF) facility at CERN is a spallation source characterized by a white neutron spectrum. The innovative features of the facility, in the two experimental areas, (20 m and 185 m), allow for an accurate determination of the neutron cross section for radioactive samples or for isotopes with small neutron capture cross section, of interest for Nuclear Astrophysics. The recent results obtained at n_TOF facility are presented.

TERIPARATIDE NEL TRATTAMENTO DELL’IPOPARATIROIDISMO CRONICO GRAVE RESISTENTE A TERAPIA CON CALCIO E VITAMINA D

L’ipocalcemia post-operatoria è la più frequente tra le complicanze della chirurgia tiroidea. Si manifesta in un’elevata percentuale di pazienti nel periodo post-operatorio immediato come ipoparatiroidismo transito-rio, e rimane in modo permanente soltanto nei pazienti che hanno subito una paratiroidectomia accidentale durante la tiroidectomia conformando un quadro di vero ipoparatiroidismo. Nella forma definitiva raggiunge un’incidenza compresa tra 0,2 e 32% a seconda del-le casistiche. Il rischio di sviluppare ipocalcemia post-operatoria dipende principalmente dall’indicazione chirurgica (i.e., rischio superiore per malattia di Graves, inferiore in caso di carcinoma tiroideo e di gozzo no…

MEDITERRANEAN DIET AND LIFESTYLE: A PROVED APPROACH TO HEALTHY LONGEVITY

Aging is a multifactorial and progressive process, universal and irreversible, that takes place at different levels, affecting practically all-living organisms. Human life expectancy increased extraordinarily during the last century worldwide. Currently, there is growing evidence that there are modifiable factors that contribute to ageing per se, and particularly to longevity (i.e. diet, physical and mental activity). These factors may interact with the ageing process and may alter the susceptibility of an individual to develop age-associated diseases. There is currently much promise in research that provides information about the underlying biology of ageing and longevity, which has unveil…

Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

Abstract Background Gastrointestinal bleeding (GIB) is burdened by high mortality rate that increases with aging. Elderly patients may be exposed to multiple risk factors for GIB. We aimed at defining the impact of GIB in elderly patients. Methods Since 2008, samples of elderly patients (age ≥ 65 years) with multimorbidity admitted to 101 internal medicine wards across Italy have been prospectively enrolled and followed-up (REPOSI registry). Diagnoses of GIB, length of stay (LOS), mortality rate, and possible risk factors, including drugs, index of comorbidity (Cumulative Illness Rating Scale [CIRS]), polypharmacy, and chronic diseases were assessed. Adjusted multivariate logistic regressio…

Calcium intake in the Mediterranean region

A deficiency in calcium intake, is considered an important risk factor for the development of osteoporosis. Since the human body cannot produce calcium, individuals are recommended to maintain an adequate daily intake. The aim of the “Calcium Intake in the Mediterranean Region” Study is to evaluate the mean calcium intake in men and women between 40 and 80 residing in various areas of the Mediterranean basin. Enrolled subjects have been asked to fill out a self-administered questionnaire to evaluate the mean daily calcium intake from food, principle risk factors for osteoporosis were registered. A dual- energy X-ray absorptiometry (DEXA) has also been carried out to evaluate bone mineral de…

Diagnosi differenziale tra sindrome neurologica alterna e idrocefalo normoteso: un caso clinico

L’idrocefalo consiste in una dilatazione del sistema ventricolare dovuta ad un disturbo della circolazione liquorale. Nell’anziano l’idrocefalo è di frequente riscontro in associazione a demenza, come forma ex vacuo. L’idrocefalo normoteso colpisce prevalentemente soggetti d’età superiore ai 65 anni con un esordio clinico subdolo, che spesso è causa di ritardo nella diagnosi. Le sindromi neurologiche alterne sono espressione di lesioni di varia natura a carico del tronco encefalico, caratterizzate dalla coesistenza di un deficit neurologico centrale controlaterale alla lesione ed un deficit neurologico periferico omolateralmente alla lesione. Descriviamo il caso di un paziente di sesso masc…

Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

none 327 si Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in …

Ageing, lifestyle modifications, and cardiovascular disease in developing countries.

Developing countries face the double menace of still prevalent infectious diseases and increasing cardiovascular disease (CVD) with epidemic proportions in the near future, linked to demographic changes (expansion and ageing), and to urbanisation and lifestyle modifications. It is estimated that the elderly population will increase globally (over 80% during the next 25 years), with a large share of this rise in the developing world because of expanding populations. Increasing longevity prolongs the time exposure to risk factors, resulting in a greater probability of CVD. As a paradox, increased longevity due to improved social and economical conditions associated with lifestyle changes in t…

Magnesium and muscle performance in older persons: the InCHIANTI study.

Background: The role of magnesium in maintaining muscle integrity and function in older adults is largely unknown. Objective: We aimed to investigate the relation between serum magnesium concentrations and muscle performance in older subjects. Design: Data are from the baseline examination conducted between September 1998 and March 2000 of the InCHIANTI (aging in the Chianti area) study, a prospective epidemiologic survey of risk factors for late-life disability. From among 1453 randomly selected community residents completing a home interview, 1138men(46%) and women (aged 66.7 15.2 y; x SD) with complete data on muscle performance and serum magnesium who were not severely cognitively compr…

MALATTIA OSSEA DI PAGET NELL’ANZIANO: UNA POSSIBILITÀ DIAGNOSTICA DA NON TRASCURARE

La malattia ossea di Paget è una delle principali alte-razioni del metabolismo scheletrico, seconda per frequenza solo all’osteoporosi. È caratterizzata da un di-sordine focale e progressivo del rimaneggiamento osseo, nel quale il tessuto osseo normale viene rimosso e sostituito con tessuto osseo patologico. La malattia è di solito diagnosticata in soggetti di età superiore ai 55 anni con una maggiore prevalenza nel sesso maschile. Sulla base di reperti autoptici, si è stimato che possa colpire fino al 4% dei soggetti di età superiore ai 50 anni e la probabilità che compaia aumenta con l’età con un’incidenza di circa il 10% nei soggetti molto anziani. I segni clinici vengono solitamente esp…

Manuale di metodologia epidemiologica per la promozione della salute e la prevenzione della disabilità

Experimental neutron capture data of 58Ni from the CERN n_TOF facility

The $^{58}$Ni $(n,\gamma)$ cross section has been measured at the neutron time of flight facility n_TOF at CERN, in the energy range from 27 meV up to 400 keV. In total, 51 resonances have been analyzed up to 122 keV. Maxwellian averaged cross sections (MACS) have been calculated for stellar temperatures of kT$=$5-100 keV with uncertainties of less than 6%, showing fair agreement with recent experimental and evaluated data up to kT = 50 keV. The MACS extracted in the present work at 30 keV is 34.2$\pm$0.6$_\mathrm{stat}\pm$1.8$_\mathrm{sys}$ mb, in agreement with latest results and evaluations, but 12% lower relative to the recent KADoNIS compilation of astrophysical cross sections. When in…

Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study

<b><i>Objective:</i></b> Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.<b><i></i></b>The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). <b><i>Materials and Methods:</i></b> We analyzed Registry of Polytherapies Societa Italiana di Medicina I…

Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study

The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC-OS) is a prospective, observational study of women with osteoporosis in Europe and Canada. At baseline, patients with gastrointestinal symptoms reported lower adherence to osteoporosis treatment, treatment satisfaction, and health-related quality of life, than those without gastrointestinal symptoms. INTRODUCTION: The aim of the study was to examine gastrointestinal (GI) symptoms and the association between GI symptoms and treatment adherence, treatment satisfaction, and health-related quality of life (HRQoL) among osteoporotic women in Europe and Canada. METHODS: Baseline results are re…

DISTURBI COMPORTAMENTALI E SINDROME DA OVERLAPPING PER POLITERAPIA ANTIPSICOTICA

I disturbi comportamentali delle demenze (BPSD) accompagnano la storia naturale di queste malattie sin dall’esordio, con vesti diverse che vanno dalle sindromi nevrotiche a quelle psicotiche vere e proprie. Si distinguono alterazioni dell’umore in senso ansioso-depressivo, del ritmo sonno-veglia, facile irritabilità e sintomi psicotici veri e propri con deliri e allucinazioni, disturbi di personalità e agitazione psicomotoria, comportamenti specifici quali aggressività, vocalizzi persistenti e perseverazioni. La prevalenza è elevata e variabile a seconda della tipologia della demenza, del momento storico della sua evoluzione, del setting in cui il paziente è gestito; la loro entità non semp…

Allucinazioni visive tra demenza e psicosi.

Le allucinazioni possono comparire in corso di varie patologie (psicosi, delirium, demenza, emicrania, neoplasia, epilessia) o possono essere altresì indotte da farmaci. Esse sono percezioni involontarie e ricorrenti di immagini in assenza di un corrispondente stimolo fisico esterno. Possono essere classificate in semplici o complesse. Si definisce allucinazione semplice quella in cui è attivata una singola modalità sensoriale e quindi la percezione non richiede un’elaborazione cognitiva per essere decodificata (ad es. vedere un oggetto in una stanza); complessa è invece l’allucinazione in cui sono attivate più modalità sensoriali (es. vedere un leone sentendo che ruggisce) o in cui la perc…

Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AIMS: Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases. METHODS: MASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients. STAKEHOLDERS: Incl…

Tumore gastrointestinale stromale indifferenziato (GIST)e pregressa Billroth II in paziente anziano: solo casualità?

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.

Abstract Background The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for…

PARATHYROID HORMONE INCREASES AFTER ORAL PEPTONES ADMINISTRATION IN OBESE SUBJECTS TREATED WITH ROUX-EN-Y GASTRIC BYPASS SURGERY: ROLE OF PHOSPHATE ON THE RAPID CONTROL OF PARATHYROID HORMONE RELEASE

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App

Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 1…

CASE REPORT: UN CASO DI DEMENZA A CORPI DI LEWY

La demenza a corpi di Lewy (Dementia with Lewy Bodies, DLB) rappresenta la seconda più comune causa di demenza su base degenerativa nella popolazione anziana dopo la demenza di Alzheimer. La prevalenza della DLB oscilla tra lo 0 e il 30,5% nei pazienti affetti da demenza. La DLB è caratterizzata dall’accumulo all’interno delle cellule neuronali e gliali di aggregati insolubili di alfa-sinucleina denominati corpi di Lewy. L’età di esordio clinico della DLB oscilla dai 50 agli 85 anni, con un media di 68 anni. Nella DLB la compromissione della sfera cognitiva si caratterizza tipicamente per la presenza di episodi di disorientamento e confusione mentale in un contesto di progressivo deficit co…

Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

Abstract Background Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements. Methods Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results Seventy-two percent of patients admitted to …

2016 Antiaging Medicine

• The factors best demonstrated to delay aging are fruit and vegetables, exercise, not smoking, drinking one or two glasses of alcohol daily, and fish consumption. • Vitamin D replacement, in persons with low 25[OH] vitamin D levels, decreases hip fractures, improves muscle strength, enhances function, and decreases mortality. • Antiaging medicine has been hijacked by charlatans who promote unproven or dangerous remedies to a naïve aging public. • Too often animal studies that produce longevity are directly ap-plied to humans before appropriate clinical trials have been carried out. • There is no evidence that hormones or megadoses of vitamins prolong life. • Numerous products of varying qu…

MALNUTRIZIONE E FRAGILITÀ NELL’ANZIANO: UN CASO COMPLESSO DI MULTIMORBILITÀ E COMORBILITÀ

La malnutrizione è un problema di rilevante importanza nell’anziano. Numerosi studi hanno dimostrato che la prevalenza della malnutrizione è compresa tra il 20 e il 60% nei pazienti anziani al momento dell’ammissione in un reparto ospedaliero e tra il 30 e il 50% nei pazienti che accedono alle nursing-home; alcuni studi hanno stimato un dato di prevalenza di malnutrizione pari all’85% nei pazienti anziani confinati in casa, ospedalizzati o istituzionalizzati. Nell’anziano lo stato di nutrizione influenza notevolmente l’evoluzione del quadro clinico e condiziona l’esito dei trattamenti e dei programmi di riabilitazione. Il cambiamento più frequente delle abitudini alimentari dell’anziano è r…

The Italian observational study on severe osteoporosis (ISSO): 24-month results on incidence of fractures and adherence to treatment

Objective To estimate the proportion of patients with very severe osteoporosis (those covered by the reimbursement criteria of the Italian National Health Service) experiencing new vertebral and non-vertebral fragility fractures in the first 24 months of a new anti-osteoporosis treatment. Methods Prospective observational study in men and post-menopausal women (aged > 21 years) initiating anti-osteoporosis treatment for very severe osteoporosis. Eligibility was based on teriparatide (TPD) reimbursement criteria in Italy: Incident of vertebral or hip fracture during anti-resorptive treatment (minimum 1 year), or at least three prevalent severe vertebral fractures, or two prevalent severe ver…