San Giovanni al Natisone, Italy
San Giovanni al Natisone, Italy

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PubMed | University of Leipzig, National School of Management, CIBER ISCIII, National Center for Public Health Protection and 8 more.
Type: Journal Article | Journal: Gaceta sanitaria | Year: 2016

To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach.Representative samples of the adult general population (n=13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated.Health conditions explained a large proportion of full role limitation (PAF=62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability.The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation.


Canu E.,San Raffaele Scientific Institute | Frisoni G.B.,Centro San Giovanni Of Dio Fatebenefratelli | Agosta F.,San Raffaele Scientific Institute | Pievani M.,San Raffaele Scientific Institute | And 3 more authors.
Neurobiology of Aging | Year: 2012

We investigated patterns of white matter (WM) loss in 18 early onset (EO) and 24 late onset (LO) Alzheimer's disease (AD) patients compared with 42 healthy controls (HC), and explored relationships of WM atrophy and apolipoprotein E (ApoE) genotype. Subjects underwent magnetic resonance imaging (MRI). Patterns of WM were assessed using voxel-based morphometry. Compared with healthy controls, LOAD patients had a selective parahippocampal WM loss, while EOAD patients experienced a more widespread pattern of posterior WM atrophy. The distinct regional distribution of WM atrophy reflected the topography of gray matter (GM) loss. ApoE ε4 status was associated with a greater parahippocampal WM loss in both AD groups. The greater WM atrophy in EOAD than LOAD fits with the evidence that EOAD is a more aggressive form of the disease. The ApoE ε4 effect on WM damage in AD is restricted to specific WM regions and does not seem to be related to age of onset. © 2012 Elsevier Inc.


Scafato E.,Instituto Superiore Of Sanita | Gandin C.,Instituto Superiore Of Sanita | Galluzzo L.,Instituto Superiore Of Sanita | Ghirini S.,Instituto Superiore Of Sanita | And 40 more authors.
Aging Clinical and Experimental Research | Year: 2010

Background and aims: The prevalence of the preclinical phase of dementia varies greatly, according to the diagnostic criteria and assessment procedures applied. The purpose of this study was to estimate the prevalence of cognitive impairment according to the Aging-Associated Cognitive Decline (AACD) diagnostic criteria in an Italian elderly population. Methods: In a multicenter community-based prospective study, 4785 Italian subjects aged 65-84 years, randomly selected from the registries of 12 Italian municipalities, were assessed by personal and informant interviews, physical and neurological examinations and an extensive neuropsychological battery. Results: Of these older subjects, 274 (9.2%) fulfilled all the AACD criteria, whereas 561 (18.8%) fulfilled only 3 of them (AACD-3). When the two groups diagnosed according to AACD criteria (AACD and AACD-3) were merged, the prevalence was 28.0% (28.3% for men, 27.6% for women). Two other groups of subjects were also identified: a) Subjects with Qbjective evidence of Cognitive Decline without cognitive complaints (OCD), 508 (17.0%), i.e., subjects with documented neuropsychological deficits, although neither subjects nor informants reported cognitive complaints; and b) Subjects with Cognitive Complaints without objective demonstrable cognitive deficits (CC), 44 (1.5%), i.e., subjects and/or informants reported cognitive complaints without evidence of neuropsychological deficits. Thus, taking into account the additional OCD group, a total of 1343 persons with cognitive impairment without dementia (45.0%) was identified. Conclusions: On the basis of our results, we estimate that 45% of our population-based Italian sample aged 65-84 years had some kind of cognitive deficits without dementia. ©2010, Editrice Kurtis.


Moretti D.V.,Centro San Giovanni Of Dio Fatebenefratelli | Zanetti O.,Centro San Giovanni Of Dio Fatebenefratelli | Binetti G.,Centro San Giovanni Of Dio Fatebenefratelli | Frisoni G.B.,Centro San Giovanni Of Dio Fatebenefratelli
International Journal of Alzheimer's Disease | Year: 2012

We evaluated the relationship between brain rhythmicity and both the cerebrovascular damage (CVD) and amygdalohippocampal complex (AHC) atrophy, as revealed by scalp electroencephalography (EEG) in a cohort of subjects with mild cognitive impairment (MCI). All MCI subjects underwent EEG recording and magnetic resonance imaging. EEGs were recorded at rest. Relative power was separately computed for delta, theta, alpha1, alpha2, and alpha3 frequency bands. In the spectral band power the severity of CVD was associated with increased delta power and decreased alpha2 power. No association of vascular damage was observed with alpha3 power. Moreover, the theta/alpha1 ratio could be a reliable index for the estimation of the individual extent of CV damage. On the other side, the group with moderate hippocampal atrophy showed the highest increase of alpha2 and alpha3 power. Moreover, when the amygdalar and hippocampal volumes are separately considered, within amygdalohippocampal complex (AHC), the increase of theta/gamma ratio is best associated with amygdalar atrophy whereas alpha3/alpha2 ratio is best associated with hippocampal atrophy. CVD and AHC damages are associated with specific EEG markers. So far, these EEG markers could have a prospective value in differential diagnosis between vascular and degenerative MCI. © 2012 D. V. Moretti et al.


Picardi A.,Instituto Superiore Of Sanita | Tarolla E.,Instituto Superiore Of Sanita | De Girolamo G.,Centro San Giovanni Of Dio Fatebenefratelli | Gigantesco A.,Instituto Superiore Of Sanita | And 3 more authors.
Rivista di Psichiatria | Year: 2015

This article describes the activities of a project aimed at developing a system of process and process/outcome indicators suitable to monitor over time the quality of psychiatric care of Italian inpatient and residential psychiatric facilities. This system, named PRISM (Process Indicator System for Mental health), was developed by means of a standardized evaluation made by a panel of experts and a consecutive pilot study in 17 inpatient and 13 residential psychiatric facilities. Materials and methods: A total of 28 indicators were selected from a set of 251 candidate indicators developed by the most relevant and qualified Italian and international authorities. These indicators are derived by data from medical records and information about characteristics of facilities, and they cover processes of care, operational equipment of facilities, staff training and working, relationships with external agencies, and sentinel events. Results: The procedure followed for the development of the indicator system was reliable and innovative. The data collected from the pilot study suggested a favourable benefit-cost ratio between the workload associated with regular use of the indicators into the context of daily clinical activities and the advantages related to the information gathered through regular use of the indicators. Conclusions: The PRISM system provides additional information about the healthcare processes with respect to the information gathered via routine information systems, and it might prove useful for both continuous quality improvement programs and health services research.


PubMed | Centro San Giovanni Of Dio Fatebenefratelli
Type: | Journal: International journal of Alzheimer's disease | Year: 2012

We evaluated the relationship between brain rhythmicity and both the cerebrovascular damage (CVD) and amygdalohippocampal complex (AHC) atrophy, as revealed by scalp electroencephalography (EEG) in a cohort of subjects with mild cognitive impairment (MCI). All MCI subjects underwent EEG recording and magnetic resonance imaging. EEGs were recorded at rest. Relative power was separately computed for delta, theta, alpha1, alpha2, and alpha3 frequency bands. In the spectral band power the severity of CVD was associated with increased delta power and decreased alpha2 power. No association of vascular damage was observed with alpha3 power. Moreover, the theta/alpha1 ratio could be a reliable index for the estimation of the individual extent of CV damage. On the other side, the group with moderate hippocampal atrophy showed the highest increase of alpha2 and alpha3 power. Moreover, when the amygdalar and hippocampal volumes are separately considered, within amygdalohippocampal complex (AHC), the increase of theta/gamma ratio is best associated with amygdalar atrophy whereas alpha3/alpha2 ratio is best associated with hippocampal atrophy. CVD and AHC damages are associated with specific EEG markers. So far, these EEG markers could have a prospective value in differential diagnosis between vascular and degenerative MCI.

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