Publications
182 results found
Petruzzo M, Palladino R, Nardone A, et al., 2018, New diagnostic criteria and the costs for treating multiple sclerosis, 34th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 163-164, ISSN: 1352-4585
Alfano R, Palladino R, Risitano A, et al., 2018, [Network references for rare diseases: state of the art for the paroxysmal nocturnal hemoglobinuria]., Epidemiol Prev, Vol: 42, Pages: 333-343, ISSN: 1120-9763
BACKGROUND: recently, healthcare network models have been proposed to improve general awareness of rare diseases for patients and specific knowledge about diagnosis, treatment, and management for healthcare services. Paroxysmal nocturnal hemoglobinuria (PNH) is a rare haematological disease that still has no framing in an official network. OBJECTIVES: to describe the use of network models in diagnosis, treatment, and management of PNH patients both in Italy and abroad and its impact on patients and healthcare service. DISEGN: literature search was performed using the keywords "Hemoglobinuria", "Network", "PHN", and "Screening" in both MedLine and EMBASE. Search was restricted to the articles published in the last 5 years and written in English, French or Italian language. RESULTS: from the total 251 articles of the initial search, only 21 were finally included in our review. None of the included study explicitly described a network model. In general, we were able to identify two different kind of networks implicitly described in the studies: laboratory networks for diagnostic harmonization or screening of the population at risk of PNH (10/21 studies) and PNH registry as network of clinical information to be use for better understanding of the natural history of the disease and to assess therapeutic effectiveness (11/21 studies). CONCLUSIONS: few network approaches in PNH diagnosis, treatment, and management are described in literature. Despite the scarce application of the networks, our review highlights the positive impact that networks have in both patients and healthcare services.
Moccia M, Albero R, Lanzillo R, et al., 2018, Cardiovascular profile improvement during Natalizumab treatment, Metabolic Brain Disease, Vol: 33, Pages: 981-986, ISSN: 0885-7490
Cardiovascular comorbidities are associated with the risk of MS progression. Thus, we aim to measure variations of cardiovascular risk factors during Natalizumab treatment and their possible clinical associations. Seventy-one relapsing-remitting MS patients treated with Natalizumab were followed-up during a 12.9 ± 6.2 months. Cardiovascular risk factors were recorded on first and last study visits: systolic blood pressure, uric acid, total cholesterol, LDL, HDL, and triglycerides. EDSS progression and relapse occurrence were recorded. At multilevel mixed-effects linear regression models, the population presented with a significant reduction of total cholesterol (Coeff = -7.340; 95%CI = -13.152--1.527; p = 0.013), and of HDL cholesterol (Coeff = -3.473; 95%CI = -6.333--0.613; p = 0.017), and a non-significant reduction of LDL cholesterol (Coeff = -1.872; 95%CI = -8.481-0.736; p = 0.053), and of triglycerides (Coeff = -8.815; 95%CI = -34.011-5.380; p = 0.094). Uric acid levels increased during the study period (Coeff = 0.159; 95%CI = 0.212-0.340; p = 0.038). No significant associations were found with clinical outcomes. Serum lipids decreased and anti-oxidant uric acid increased during Natalizumab treatment. These biomarkers need to be further explored in relation to clinical outcomes on larger cohorts with longer follow-ups.
Moccia M, Palladino R, Carotenuto A, et al., 2018, A 8-year retrospective cohort study comparing Interferon-β formulations for relapsing-remitting multiple sclerosis, MULTIPLE SCLEROSIS AND RELATED DISORDERS, Vol: 19, Pages: 50-54, ISSN: 2211-0348
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- Citations: 8
Jamaludin M, Nazar GP, Palladino R, et al., 2018, Smoke-free legislation and socioeconomic inequalities in smoking-related morbidity and mortality among adults: a systematic review, Publisher: EUROPEAN PUBLISHING, Pages: 148-148, ISSN: 1617-9625
Palladino R, Vamos E, Chang KCM, et al., 2017, Impact of a national diabetes risk assessment and screening programme in England: a quasi-experimental study, Public Health Science Conference, Publisher: ELSEVIER SCIENCE INC, Pages: S65-S65, ISSN: 0140-6736
Palladino R, Vamos E, Chang KCM, et al., 2017, Evaluating the impact of a national diabetes risk assessment and screening programme in England, Publisher: OXFORD UNIV PRESS, Pages: 133-133, ISSN: 1101-1262
Chang K, Lee JT, Vamos E, et al., 2017, Socio-demographic inequalities in the effectiveness of England's NHS Health Check, 10th European Public Health Conference Sustaining resilient and healthy communities, Publisher: Oxford University Press (OUP), ISSN: 1101-1262
Moccia M, Palladino R, Carotenuto A, et al., 2017, A 8-year retrospective cohort study comparing Interferon-β formulations for relapsing-remitting multiple sclerosis, 7th Joint European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS)-Americas-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ACTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 889-889, ISSN: 1352-4585
Chang K, Vamos E, Lee J, et al., 2017, Socio-demographic inequalities in cardiovascular risk management and early detection of vascular conditions by the nhs health check: a difference-in-differences matching analysis, Publisher: BMJ Publishing Group, Pages: A3-A3, ISSN: 0143-005X
Palladino R, Hone T, Filippidis FT, 2017, Changes in support for bans of illicit drugs, tobacco, and alcohol among adolescents and young adults in Europe, 2008–2014, International Journal of Public Health, Vol: 63, Pages: 23-31, ISSN: 0303-8408
Objectives This study assessed the support for bans fortobacco, alcohol, and illicit drugs in adolescents and youngadults across the European Union (EU).Methods Data were analysed for the years 2008, 2011, and2014 for 27 EU member states. 37,253 individuals aged15–24 years were interviewed ascertaining their supportfor banning tobacco, alcohol, cannabis, cocaine, heroin,and ecstasy. Changes over time were assessed using multilevellogistic regression.Results Support for banning heroin, ecstasy, and cocainewas constantly greater than 90%, although support fell overtime. Support for cannabis ban declined (from 67.6% in2008 to 53.7% in 2014) as well as support for alcohol ban(from 8.9% in 2008 to 6.9% in 2014) and tobacco ban(from 17.9% in 2008 to 16.5% in 2014).Conclusions Support for banning substances among EUadolescents and young adults varied, with high support forheroin, cocaine, and ecstasy, but less support for banningcannabis, tobacco, and alcohol. There was reduction insupport of banning all substances between 2008 and 2014,but this varied substantially between European countries.
Moccia M, Annibali V, Lanzillo R, et al., 2017, Oxidative stress in multiple sclerosis: Effect of dietary supplementation with coenzyme Q10, 3rd Congress of the European-Academy-of-Neurology, Publisher: WILEY, Pages: 319-319, ISSN: 1351-5101
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- Citations: 2
Picillo M, Palladino R, Barone P, et al., 2017, The PRIAMO study: urinary dysfunction as a marker of disease progression in early Parkinson's disease, European Journal of Neurology, Vol: 24, Pages: 788-795, ISSN: 1351-5101
Background and purposeNew venues are currently being explored to predict disease progression in Parkinson's disease (PD), such as non-motor subtypes and models merging motor and non-motor symptoms (NMS). By involving a subgroup of 585 patients from the PRIAMO (Parkinson Disease Non-motor Symptoms) study, the present 24-month longitudinal prospective analysis aimed to demonstrate that urinary dysfunction is an early marker of higher motor and non-motor burden as well as lower health-related quality of life.Methods and resultsMultivariable mixed-effect logistic regression models controlling for demographic and clinical variables showed that the following NMS domains were associated with urinary dysfunction: gastrointestinal [odds ratio (OR) 2.57, 95% confidence interval (CI) 1.67–3.97, P < 0.001], cardiovascular (OR 2.22, 95% CI 1.18–4.17, P = 0.013), skin (OR 1.81, 95% CI 1.06–3.08, P = 0.029), sleep (OR 2.06, 95% CI 1.34–3.16, P = 0.001), pain (OR 1.85, 95% CI 1.21–2.83, P = 0.004), fatigue (OR 2.40, 95% CI 1.56–3.68, P < 0.001), apathy (OR 2.79, 95% CI 1.72–4.52, P < 0.001) and respiratory (OR 1.82, 95% CI 1.02–3.23, P = 0.039). Analysis also demonstrated that urinary dysfunction was associated with higher motor disability (coefficient 1.73, 95% CI 0.68–2.78, P = 0.001) and lower health-related quality of life (coefficient −0.05, 95% CI −0.08 to −0.02, P < 0.001, and coefficient −3.49, 95% CI −5.21 to −1.77, P < 0.001) but not with more severe cognitive disability (coefficient −0.34, 95% CI −0.92 to 0.24, P = 0.251).ConclusionsThis is the first prospective longitudinal study involving a large cohort of PD patients demonstrating the relevance of urinary dysfunction as an early marker of higher motor and non-motor disability as well as lower health-related quality of life. These findings support a role for urinary dysfunction as an early marker of more
Lavorgna L, Moccia M, Russo A, et al., 2017, Health-care disparities stemming from sexual orientation of Italian patients with Multiple Sclerosis: A cross-sectional web-based study, MULTIPLE SCLEROSIS AND RELATED DISORDERS, Vol: 13, Pages: 28-32, ISSN: 2211-0348
Lesbian, gay, bisexual and transgender (LGBT) patients might experience unique difficulties and barriers to treatment of chronic diseases related to their sexual orientation. Thus, we investigated concerns experienced by LGBT patients with multiple sclerosis (MS). We conducted a web-based survey using a multi-choice questionnaire published in an Italian social-network (www.smsocialnetwork.com) for MS patients. The survey investigated: socio-demographic factors, lifestyle habits, MS-related health status and LGBT specific issues (e.g. friendliness to their sexual orientation and eventual homophobic behaviors in the MS Center). Among MS patients willing to use psychological services, LGBT patients were associated with a smaller number of psychological consultations, compared to heterosexuals (Coeff.=−0.449; p<0.001; 95%CI=−0.682 to −0.217). LGBT patients were more likely to change MS Center, compared to heterosexuals (OR=2.064; p=0.046; 95%CI=1.011–4.212). The number of MS Center changes was associated with MS Center friendliness (p=0.037; rho=−0.229) and with the occurrence of homophobic behaviors (p=0.036; rho=0.234). LGBT MS patients more frequently changed MS Center and had a reduced use of psychological services, compared to heterosexuals. The attitude towards LGBT MS patients might affect resource utilizations and LGBTs health status.
Moccia M, Palladino R, Lanzillo R, et al., 2017, Healthcare costs for treating relapsing multiple sclerosis and the risk of progression: a retrospective Italian cohort study from 2001 to 2015, PLOS One, Vol: 12, ISSN: 1932-6203
BackgroundDisease modifying treatments (DMTs) are the main responsible for direct medical costs in multiple sclerosis (MS). The current investigation aims at evaluating possible associations between healthcare costs for treating relapsing remitting MS (RRMS) and disease evolution.MethodsThe present cohort study retrospectively included 544 newly diagnosed RRMS patients, prospectively followed up for 10.1±3.3 years. Costs for DMT administration and management were calculated for each year of observation. Following clinical endpoints were recorded: time to first relapse, 1-point EDSS progression, reaching of EDSS 4.0, reaching of EDSS 6.0, and conversion to secondary progressive MS (SP). Covariates for statistical analyses were age, gender, disease duration and EDSS at diagnosis.ResultsAt time varying Cox regression models, 10% increase in annual healthcare costs was associated with 1.1% reduction in 1-point EDSS progression (HR = 0.897; p = 0.018), with 0.7% reduction in reaching EDSS 6.0 (HR = 0.925; p = 0.030), and with 1.0% reduction in SP conversion (HR = 0.902; p = 0.006).ConclusionHigher healthcare costs for treating MS have been associated with a milder disease evolution after 10 years, with possible reduction of long-term non-medical direct and indirect costs.
Moccia M, Quarantelli M, Lanzillo R, et al., 2016, Grey: white matter ratio at diagnosis and the risk of 10-year multiple sclerosis progression, European Journal of Neurology, Vol: 24, Pages: 195-204, ISSN: 1351-5101
Background and purpose: Grey matter (GM) and white matter (WM) are both affected in multiple sclerosis (MS). WM is predominantly involved in inflammatory demyelination of relapsing–remitting MS (RRMS), whereas GM is predominantly involved in neurodegenerative processes of secondary progressive MS. Thus, we investigated the ratio between GM and WM volumes in predicting MS evolution.Methods: The present 10-year retrospective cohort study included 149 patients with newly-diagnosed RRMS, undergoing magnetic resonance imaging for segmentation and brain volumetry. The ratio between GM and normal-appearing WM (NAWM) volumes was calculated for each subject. Outcome measures of interest were Expanded Disability Status Scale (EDSS) progression, reaching EDSS 4.0 and conversion to secondary progressive (SP) MS.Results: During a period of 10.6 ± 2.4 years, a median 1.5 EDSS progression was observed (range 0–5.5), 54 subjects (36.2%) reached EDSS 4.0 and 30 subjects (20.1%) converted to SP. With ordinal logistic regression models, EDSS progression was associated with GM:NAWM ratio (coefficient, −2.918; 95% CI, −4.739–1.097). With Cox regression models, subjects with higher GM:NAWM ratio at diagnosis had a 90% lower rate of reaching EDSS 4.0 (hazard ratio, 0.111; 95% CI, 0.020–0.609) and of converting to secondary progressive MS (hazard ratio, 0.017; 95% CI, 0.001–0.203) compared with subjects with lower GM:NAWM ratio.Conclusions: The GM:NAWM ratio is a predictor of disability progression and of SP conversion in subjects with newly diagnosed RRMS, suggesting that GM and NAWM are variably affected in relation to disease evolution from the early phases of MS.
Palladino R, Lee JT, Hone T, et al., 2016, The great recession and increased cost sharing In European health system, Publisher: Oxford University Press (OUP), ISSN: 1101-1262
Moccia M, Palladino R, Carotenuto A, et al., 2016, Predictors of long-term interferon discontinuation in newly diagnosed relapsing multiple sclerosis, MULTIPLE SCLEROSIS AND RELATED DISORDERS, Vol: 10, Pages: 90-96, ISSN: 2211-0348
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- Citations: 16
Boccia S, Torre I, Santarpia L, et al., 2016, Intestinal microbiota in adult patients with Short Bowel Syndrome: Preliminary results from a pilot study., Clinical Nutrition, ISSN: 1532-1983
INTRODUCTION: Intestinal bacterial flora plays a central role in human intestinal health and disease. Short Bowel Syndrome (SBS), a clinical condition deriving from extensive bowel resections, influence intestinal microbiota (IM) composition in order to reach a new metabolic balance. Little is known about IM in adult patients after wide intestinal resections. MATERIAL AND METHODS: Fecal samples from 12 SBS patients and 16 controls were analyzed in their microbial profile by using both culture-dependent method and quantitative Real-Time PCR (qRT-PCR). RESULTS: The two methods revealed significant lower concentrations of Bacteroidetes (p-value = .02), Firmicutes (p-value = .05), Bifidobacterium (p-value < .01), and Methanobrevibacter Smithii (p-value = .04) in SBS patients than controls. CONCLUSIONS: The significantly different fecal microbiome in SBS patients compared with healthy controls could open new perspectives on the care of their intestinal functions.
Moccia M, Palladino R, Carotenuto A, et al., 2016, Predictors of long-term interferon discontinuation in newly diagnosed relapsing multiple sclerosis, 32nd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 330-330, ISSN: 1352-4585
Moccia M, Palladino R, Lanzillo R, et al., 2016, The expenditure for treating multiple sclerosis and the 10-year risk of disease progression, 32nd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 146-147, ISSN: 1352-4585
Criscuolo C, Lanzillo R, Cianflone A, et al., 2016, Endothelin-1 as a candidate cerebrovascular biomarker in multiple sclerosis, 32nd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS), Publisher: SAGE PUBLICATIONS LTD, Pages: 272-273, ISSN: 1352-4585
Palladino R, Lee JT, Hone T, et al., 2016, The Great Recession And Increased Cost Sharing In European Health Systems, Health Affairs, Vol: 35, Pages: 1204-1213, ISSN: 0278-2715
European health systems are increasingly adopting cost-sharingmodels, potentially increasing out-of-pocket expenditures for patientswho use health care services or buy medications. Government policiesthat increase patient cost sharing are responding to incremental growthin cost pressures from aging populations and the need to invest in newhealth technologies, as well as to general constraints on publicexpenditures resulting from the Great Recession (2007–09). We used datafrom the Survey of Health, Ageing and Retirement in Europe to examinechanges from 2006–07 to 2013 in out-of-pocket expenditures amongpeople ages fifty and older in eleven European countries. Our resultsidentify increases both in the proportion of older European citizens whoincurred out-of-pocket expenditures and in mean out-of-pocketexpenditures over this period. We also identified a significant increaseover time in the percentage of people who incurred catastrophic healthexpenditures (greater than 30 percent of the household income) in theCzech Republic, Italy, and Spain. Poorer populations were less likely thanthose in the highest income quintile to incur an out-of-pocketexpenditure and reported lower mean out-of-pocket expenditures, whichsuggests that measures are in place to provide poorer groups with somefinancial protection. These findings indicate the substantial weakening offinancial protection for people ages fifty and older in European healthsystems after the Great Recession
Moccia M, Palladino R, Lanzillo R, et al., 2016, Predictors of the 10-year direct costs for treating multiple sclerosis, Acta Neurologica Scandinavica, Vol: 135, Pages: 522-528, ISSN: 1600-0404
OBJECTIVES: Disease-modifying treatments (DMTs) constitute the largest direct medical cost for multiple sclerosis (MS). This study aims at investigating predictors of the 10-year economic burden for DMT administration and management. MATERIALS AND METHODS: This study included 537 newly diagnosed, drug naïve relapsing-remitting MS (RRMS) patients, followed up for 10.1±3.3 years. Costs for DMT administration and management were calculated, and referred to each year of observation (annual costs). Possible predictors of disease evolution were categorized into early predictors (age, gender, disease duration, baseline expanded disability status scale (EDSS), 1-point EDSS progression within 2 years, and annualized relapse rate -ARR- within 2 years), and long-term predictors (reaching of EDSS 4.0, conversion to secondary progressive -SP-, ARR, number of DMTs, follow-up duration). Association between predictors and study outcome was explored using mixed-effects log-linear regression models. RESULTS: A 1-point higher EDSS at diagnosis was associated with 13.21% increase in the annual costs (95%CI=4.16-23.04%). Each additional year of age at diagnosis was associated with a 0.74% decrease in the annual costs (95%CI=-1.43 to-0.04%). Female gender was associated with a 12.43% decrease in the annual costs (95%CI=-22.61 to-0.93%). Converting to SP was associated with a 14.26% decrease in the annual costs (95%CI=-14.26 to-2.94%). Each additional year of follow-up was associated with a 3.05% decrease in the annual costs (95%CI=-4.51 to-1.57%). CONCLUSIONS: An estimate of the 10-year costs associated with DMT administration and management can be calculated by analyzing different factors, and might be of particular interest for planning resources needed for treating people with MS.
Lavorgna L, Moccia M, Russo A, et al., 2016, LGBT health-care disparities in Multiple Sclerosis: a cross-sectional web-based study in Italy (Preprint)
<sec> <title>BACKGROUND</title> <p>Lesbian, gay, bisexual and transgender (LGBT) patients might experience unique difficulties and barriers to treatment of chronic diseases related to their sexual orientation.</p> </sec> <sec> <title>OBJECTIVE</title> <p>To investigate health-care disparities experienced by LGBT patients with multiple sclerosis (MS).</p> </sec> <sec> <title>METHODS</title> <p>We conducted a survey on an Italian social-network (www.smsocialnetwork.com) for MS patients, by using standardized multiple-choice questions. The survey investigated: socio-demographic factors, lifestyle habits, MS-related health status and LGBT specific issues (e.g. friendliness to their sexual orientation or homophobic behaviors from the staff of their MS Center).</p> </sec> <sec> <title>RESULTS</title> <p>LGBT patients were associated with a smaller number of psychological consultations, compared to heterosexuals (Coeff.=-0.449; p<0.001; 95%CI=-0.682--0.217). LGBT patients were more likely to change MS Center, compared to heterosexuals (OR=2.064; p=0.046; 95%CI=1.011-4.212). The number of MS Center changes was associated with MS Center friendliness (p=0.037; rho=-0.229) and with the occurrence of homophobic behaviors (p=0.036; rho=0.234).</p> </sec> <sec> <title>CONCLUSIONS</title> <p>LGBT MS patients more frequently changed MS Center and had a reduced use of psychological services, compared to heterosexuals. The at
Palladino R, Caporale O, Nardone A, et al., 2016, Use of Framingham Risk Score as a Clinical Tool for the Assessment of Fitness for Work: Results From a Cohort Study, Journal of Occupational and Environmental Medicine, Vol: 58, Pages: 805-809, ISSN: 1536-5948
OBJECTIVE: The aim of this study is to validate the use of the Framingham Risk Score (FRS) as clinical tool to predict the risk of diagnosis of unsuitability for work in a cohort of Italian workers. METHODS: A cohort of workers has been observed from January 2006 to March 2014. FRS was calculated at each visit. Health surveillance diagnosis of unsuitability for work was selected as outcome. RESULTS: Two thousand eight hundred fifty seven workers were observed, 58.9% were men, mean age was 51.6 (±6.7), the mean FRS was 15.1% (±10.7%). Increased values of FRS at baseline were associated with increased rate of diagnosis of unsuitability for work (Hazard ratio [HR], 11.2, 95%CI, 3.3 to 37.8). CONCLUSIONS: FRS is a strong predictor of diagnosis of unsuitability for work and should be used as a clinical tool for the assessment of fitness for work in health surveillance.
Moccia M, Palladino R, Carotenuto A, et al., 2016, Predictors of long-term interferon discontinuation in newly diagnosed relapsing multiple sclerosis, Publisher: WILEY, Pages: 408-408, ISSN: 1351-5101
Moccia M, Palladino R, Lanzillo R, et al., 2016, The 10-year economic burden for multiple sclerosis treatment, Publisher: WILEY, Pages: 408-408, ISSN: 1351-5101
Erro R, Picillo M, Vitale C, et al., 2016, Clinical clusters and dopaminergic dysfunction in de-novo Parkinson disease, Parkinsonism & Related Disorders, Vol: 28, Pages: 137-140, ISSN: 1353-8020
BACKGROUND: The heterogeneity of PD suggests the existence of different subtypes. While some motor clusters have been consistently identified, little is known about non-motor PD subtypes and motor-non-motor interplay. Research in this regard has produced somewhat contradictory results, which might be biased by the inclusion of treated patients. PATIENTS AND METHODS: We performed a non-hierarchical cluster analysis using both motor and non-motor data on 398 newly diagnosed untreated PD patients enrolled in the Parkinson's Progressive Marker Initiative (PPMI) study. We further evaluated whether dopaminergic dysfunction, as measured by (123)[I]-FP-CIT SPECT scan, could explain, at least partially, the observed difference between the clusters. RESULTS: Three clusters were identified. Group 1 was characterized by the lowest motor and non-motor burden, whereas group 2 and 3 had similar motor disability, but different non-motor involvement, especially with regards to apathy and hallucinations. (123)[I]-FP-CIT binding values paralleled motor disability burden among the 3 clusters, but further multivariate analyses also revealed a negative correlation with depression. DISCUSSION: Our results confirm the motor as well as non-motor heterogeneity of PD, suggesting the existence of 3 different subtypes. Dopaminergic dysfunction only marginally explains the non-motor variability of PD. Identification of such clusters can have important implications for generating novel pathophysiological hypotheses and therapeutic strategies.
Moccia M, Palladino R, Falco A, et al., 2016, Google Trends: new evidence for seasonality of multiple sclerosis, Journal of Neurology Neurosurgery and Psychiatry, Vol: 87, Pages: 1028-1029, ISSN: 1468-330X
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