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Gigantesco A.,Centro Nazionale Of Epidemiologia
Annali dell'Istituto Superiore di Sanita | Year: 2011

Only recently the interest in the quality of life (QoL) has gained prominence in mental health practice with respect to other medical disciplines, such as oncology or cardiology, perhaps because the QoL measures were considered as tautological and largely overlapping with measures of psychopathology. Moreover, most of the recognized components of QoL represent the main areas of psychiatric intervention. For example, psychological functioning impairment represents the main area of psychotherapeutic and psychopharmacological interventions, social functioning impairment the main area of rehabilitation intervention. In addition, measures of QoL in psychiatric patients may be biased by some aspects of the disease, including impaired evaluation capacity or decreased expectations. Nowadays, QoL issues in relation to mental health care are especially relevant with regard to part of evaluation of treatment outcomes. Suggestions for the choice of the most appropriate QoL instruments for research and routine evaluation in mental health care are given.

Marcucci F.,Centro Nazionale Of Epidemiologia | Bellone M.,San Raffaele Scientific Institute | Rumio C.,Humanitas Clinical and Research Center | Corti A.,San Raffaele Scientific Institute
mAbs | Year: 2013

Monoclonal antibodies (mAb) have become a mainstay in tumor therapy. Clinical responses to mAb therapy, however, are far from optimal, with many patients presenting native or acquired resistance or suboptimal responses to a mAb therapy. MAbs exert antitumor activity through different mechanisms of action and we propose here a classification of these mechanisms. in many cases mAbs need to interact with immune cells to exert antitumor activity. We summarize evidence showing that interactions between mAbs and immune cells may be inadequate for optimal antitumor activity. This may be due to insufficient tumor accumulation of mAbs or immune cells, or to low-affinity interactions between these components. The possibilities to improve tumor accumulation of mAbs and immune cells, and to improve the affinity of the interactions between these components are reviewed. We also discuss future directions of research that might further improve the therapeutic efficacy of antitumor mAbs. © 2013 Landes Bioscience.

Vanacore N.,Centro Nazionale Of Epidemiologia | Cocco P.,University of Cagliari | Fadda D.,University of Cagliari | Dosemeci M.,14106 Parkvale Rd.
Amyotrophic Lateral Sclerosis | Year: 2010

Amyotrophic lateral sclerosis (ALS) most likely results from a multifactorial gene-environment interaction. Strenuous physical activity and occupational exposures have been suggested to play a role, and an abnormal response to hypoxia has been proposed in ALS pathogenesis. To test the hypothesis of an excess risk in occupations typically leading to intermittent hypoxia at the tissue level, we accessed a large publicly available database, including death certificates from 24 U.S. states in 19841998. We conducted a case-control analysis of 14,628 deaths due to ALS therein reported and 58,512 controls deceased from other selected causes of death, frequency matched by age, gender and broad geographic area. ALS risk associated with physical activity, and occupations leading to intermittent hypoxia, such as fire fighters and professional athletes, were calculated with unconditional logistic regression, adjusting by age, marital status, residence, and socioeconomic status. Physical activity in general did not show an association with ALS risk. Risk associated with occupation as a professional athlete was elevated (OR 1.81, 99% CI 0.694.78), but not significantly so. Fire fighters showed a significant two-fold excess ALS risk (OR 2.0; 99% CI 1.23.2). Based on our findings and the current clinical, epidemiological and experimental evidence, we suggest that occupational conditions typically leading to intermittent hypoxia, such as fire fighting, might be an ALS risk factor in subjects genetically prone to an abnormal response to hypoxia. © 2010 Informa Healthcare.

Mendis S.,World Health Organization | Thygesen K.,Aarhus University Hospital | Kuulasmaa K.,National Public Health Institute | Giampaoli S.,Centro Nazionale Of Epidemiologia | And 3 more authors.
International Journal of Epidemiology | Year: 2011

Background: WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. Methods: The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory feature; in resource-constrained settings, a typical biomarker pattern cannot be made a compulsory feature as the necessary assays may not be available; the definition must also have provision for diagnosing non-fatal events with incomplete information on cardiac biomarkers and the ECG; to facilitate epidemiologic monitoring definition must recognize fatal events with incomplete or no information on cardiac biomarkers and/or ECG and/or autopsy and/or coronary angiography. Results: Category A definition is the same as ESC/ACC/AHA/WHF definition of MI, and can be applied to settings with no resource constraints. Category B definition of MI is to be applied whenever there is incomplete information on cardiac bio-markers together with symptoms of ischaemia and the development of unequivocal pathological Q waves. Category C definition (probable MI) is to be applied when individuals with MI may not satisfy Category A or B definitions because of delayed access to medical services and/or unavailability of electrocardiography and/or laboratory assay of cardiac biomarkers. In these situations, the term probable MI should be used when there is either ECG changes suggestive of MI or incomplete information on cardiac biomarkers in a person with symptoms of ischaemia with no evidence of a non-coronary reason. Conclusions: This article presents the 2008-09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation. © The Author 2010. Published by Oxford University Press on behalf of the International Epidemiological Association. All rights reserved.

The scientific research on infant feeding is a strange case of "scientific method reversal", in which evidence of the superiority of the biological norm, breastfeeding, compared to breast milk substitutes is desperately sought. Even institutional communication focuses solely on the benefits of breastfeeding. Little or nothing is said on the risk related to not breastfeeding or to the use of breast milk substitutes, in relation to increased likelihood of developing diseases or other undesirable outcomes. Out of the ideological traps, what do new parents need? What is the best communication and information to help them make their own informed choices? And what is the role of the scientific community and the media? Media communication contribute to the social construction of phenomena much more than impact factor. There is no interest to idealize breastfeeding, but good science and good information should be made. The aim of this article is to reflect on recent scientific production on infant feeding and how it is communicated to the public and health professionals.

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