Papers by Valentina Di Gregori
Body: Background Low birth weight, preterm birth and rapid infant growth seem to be associated wi... more Body: Background Low birth weight, preterm birth and rapid infant growth seem to be associated with increased risks of childhood asthma. We examined the association of birth and infant growth characteristics with the risks of preschool wheezing and school age asthma using data from 147,252 subjects of 31 European cohort studies. Methods Studies were eligible if they included children from 1989 onwards, had
European Journal of Clinical Microbiology & Infectious Diseases, Feb 2, 2019
The emergence and spread of antimicrobial resistance is one of the major global issues currently ... more The emergence and spread of antimicrobial resistance is one of the major global issues currently threatening the health and wealth of nations, with effective guidelines and intervention strategies urgently required. Such guidelines and interventions should ideally be targeted at individuals, communities, and nations, requiring international coordination for maximum effect. In this respect, the European Joint Programming Initiative on Antimicrobial Resistance Transnational Working Group 'Antimicrobial Resistance-Rapid Diagnostic Tests' (JPIAMR AMR-RDT) is proposing to consider a 'mix-and-match' package for the implementation of point-of-care testing (PoCT), which is described in this publication. The working group was established with the remit of identifying barriers and solutions to the development and implementation of rapid infectious disease PoCT for combatting the global spread of antimicrobial resistance. It constitutes a multi-sectoral collaboration between medical, technological, and industrial opinion leaders involved in in vitro diagnostics development, medical microbiology, and clinical infectious diseases. The mix-and-match implementation package is designed to encourage the implementation of rapid infectious disease and antimicrobial resistance PoCT in transnational medical environments for use in the fight against increasing antimicrobial resistance.
PubMed, Jul 26, 2021
Background Multiple hereditary exostoses (MHE) also known as Multiple Osteochondromas is a rare b... more Background Multiple hereditary exostoses (MHE) also known as Multiple Osteochondromas is a rare benign bone tumour disease, characterized by multiple osteocartilaginous masses. The knee is one of the most affected sites. Anterior cruciate ligament (ACL) surgery is the most common and generally most successful surgical knee procedure; however, the association between MHE and ACL reconstruction is very rare and may represent a challenging procedure because of the anatomical anomaly related to presence of multiple masses around the knee. Here, we present a case report of ACL reconstruction in a patient affected by multiple exostoses. Case report The patient was a 30-year-old woman affected by MHE, with an ACL tear arising after knee trauma. As the patient complained of pain, swelling and the knee "giving way", she successfully underwent arthroscopic-assisted ACL reconstruction using quadrupled hamstring tendon grafts, with femoral suspension and double tibial fixations. Conclusion Symptomatic ACL tears in a patient affected by MHE should be considered for arthroscopic reconstruction, which requires that particular attention be paid to tendons harvesting, tunnel placement and the choice of graft fixation system, given the presence of multiple masses around the knee.
European journal of public health, Oct 1, 2015
European Journal of Public Health, 2015
Il numero di parti effettuati con taglio cesareo (TC) \ue8 un fenomeno sanitario in continuo aume... more Il numero di parti effettuati con taglio cesareo (TC) \ue8 un fenomeno sanitario in continuo aumento in molti paesi del mondo, nonostante questo incremento non sia associato a miglioramenti nella mortalit\ue0 e morbidit\ue0 materna e perinatale. In Italia il ricorso alla pratica del TC ha raggiunto livelli allarmanti, sia per il numero di interventi effettuati sia per la variabilit\ue0 rilevata tra le diverse regioni e aziende sanitarie. Sulla base di queste considerazioni, il Sistema Nazionale per le Linee Guida dell\u2019Istituto Superiore di Sanit\ue0 (SNLG-ISS) ha sviluppato raccomandazioni per la pratica clinica relativamente al ricorso al TC. La Linea Guida \ue8 stata pubblicata nel Gennaio 2010. La riduzione del numero di TC rimane tra gli obiettivi individuati dal Documento preliminare informativo sui contenuti del nuovo Piano sanitario nazionale 2010-2012. L\u2019indicatore pi\uf9 frequentemente utilizzato per la valutazione dei servizi ostetrici \ue8 la proporzione totale di parti cesarei. Nel 2008 la proporzione italiana di TC totali \ue8 pari al 39.19%, mostrando una certa tendenza alla stabilizzazione o alla riduzione nella maggior parte delle regioni. Tale tendenza \ue8 legata ad una riduzione della proporzione di TC primari, accompagnata per\uf2 da un aumento della proporzione di TC ripetuti. Poich\ue9 ad un TC primario seguir\ue0, con una probabilit\ue0 molto elevata, un TC ripetuto, nonostante dal 2007 al 2008 si osservi una riduzione nel numero di TC primari, la proporzione di TC ripetuti \ue8 ancora in aumento, mentre il numero complessivo di TC \ue8 in via di stabilizzazione. Continua ad essere importante, pertanto, tenere distinti i due indicatori (TC primari e TC ripetuti) nei confronti tra regioni e concentrarsi sull\u2019individuazione dei determinanti, clinici e non clinici, dei TC primari
PubMed, Nov 1, 2013
Aim of this study is to assess differences and similarities in official European and Italian Mini... more Aim of this study is to assess differences and similarities in official European and Italian Ministry of Health policy documents referring to the subject "Breast Unit". The T-Lab software package for textual analysis was used to analyze the documents. This instrument permits the identification of the most frequent used words and the semantic network associated with "Breast Unit". Results show that the European document gives more emphasis to the concept of "integrated care", delivered by a multi-professional team that meets the clinical, psychological and informational needs of the patient. The Italian document gives more prominence to themes related to the clinical content of the interventions and managerial aspects through the use of clinical guidelines.
High blood pressure & cardiovascular prevention, May 1, 2009
ABSTRACT Recent evidence suggests a strong relationship between angiotensin 1 (AT1) receptor gene... more ABSTRACT Recent evidence suggests a strong relationship between angiotensin 1 (AT1) receptor gene expression and low-density lipoprotein cholesterol (LDL-C) plasma level. This article comparatively evaluates blood pressure-modulating effects and metabolic and haemodynamic actions of an antihypertensive treatment directly interacting (telmisartan) versus non-interacting (bisoprolol) with the AT1 receptor in statin-treated hypercholesterolaemic patients.Sixteen untreated hypertensive hypercholesterolaemic patients (aged 57.4 ± 7 years) were enrolled according to a randomized, single-blind, crossover design with a prospective randomized, open-label, blinded evaluation of the primary endpoint. All of the patients were allocated to treatment with simvastatin 20 mg/day for 2 weeks, and then randomly assigned to treatment with either telmisartan (40-80 mg/day) or bisoprolol (5-10 mg/day) whose daily dose was doubled after 2 weeks if blood pressure control was unsatisfactory. After a cumulative period of 4 weeks, the antihypertensive drugs were withdrawn for a washout period of 2 weeks when the patients were treated with simvastatin alone. They were then allocated to the alternative antihypertensive treatment (bisoprolol or telmisartan) for a cumulative period of 4 additional weeks with a dosage adjustment at week 2. The following were measured in each patient: lying and standing systolic blood pressure (SBP) and diastolic blood pressure (DBP); heart rate; 24-hour SBP and DBP by ambulatory blood pressure measurement; baseline forearm blood flow (FBF); and forearm vascular resistance (FVR), post-ischaemic FBF and FVR, lipid profile and fasting plasma glucose.After 2 weeks of treatment with simvastatin, baseline and post-ischaemic FBF increased (both p < 0.05), while baseline and post-ischaemic FVR decreased (both p < 0.05). Both antihypertensive treatments were associated with a significant reduction in SBP (p < 0.005), DBP (p < 0.05) and mean blood pressure (MBP) [p < 0.05]. Standing DBP and MBP were reduced more in the telmisartan than in the bisoprolol group (p < 0.05). Basal and post-ischaemic FBF were significantly increased (p < 0.05 and p < 0.005, respectively) and basal and post-ischaemic FVR were significantly decreased (both p < 0.005) only in the telmisartan-treated group. LDL-C plasma level significantly improved in both treatment groups (p < 0.05), while plasma triglycerides significantly decreased only in the telmisartan-treated group (p < 0.05).From the result of this preliminary study carried out on a small sample of hypercholesterolaemic hypertensive patients, it appears that the association with telmisartan and simvastatin could exert positive effects on a large quantity of vascular functionality parameters, after just a short treatment. This observation has not been confirmed in bisoprolol-treated patients.Received for publication on 27 February 2008; accepted for publication 15 January 2009.
Human Vaccines & Immunotherapeutics, Dec 30, 2013
Clinical and Experimental Hypertension, Apr 1, 2010
There is a vast disagreement in relation to the possible beneficial effects of omega-3 polyunsatu... more There is a vast disagreement in relation to the possible beneficial effects of omega-3 polyunsaturated fatty acids (omega-3 PUFA) supplementation in patients with diabetes and cardiovascular disease. The conflicting results between the various original studies and meta-analyses could be partially explained as a result of variable supplementation dosage and duration, either of which may modify the effects of omega-3 PUFA on cardio-metabolic biomarkers. Meta-analyses are limited usually by the inability to draw inferences regarding dosage, duration and the interaction of dosage and duration of omega-3 PUFA intake. Even so, almost all endpoints in the so-called "negative" meta-analyses leaned toward a trend for benefit with a near 10% reduction in cardiovascular outcomes and a borderline statistical significance. Many trials included in these meta-analyses tested an insufficient daily dose of omega-3 PUFA of less than 1000 mg. Probably, the consistent cardiovascular effects of omega-3 PUFA supplements could be expected only with daily doses above 2000 mg.
PubMed, Dec 1, 2014
Introduction: A few number of literature specifically addresses vaccination uptake among Public H... more Introduction: A few number of literature specifically addresses vaccination uptake among Public Health Residents (PHRs). Influenza vaccine attitudes and risk perceptions of PHRs across Italy were studied, contributing to literature on influenza vaccination uptake predictors, in particular among young physicians. Methods: An online survey was conducted in 25 Schools of Public Health in Italy in 2011-2012. Results were analysed using prevalence and logistic regression methods. Results: A total of 365 Italian public health residents were included in the study. Vaccination uptake was confirmed by 22.2 and 33.2% of PHRs in 2010-2011 and 2011-2012, respectively. For the 2010-2011 influenza season, vaccination was associated with male sex (adj-OR 3.43; 95% CI = 1.5-7.84) and vaccination history (adj-OR 29.44; 95% CI = 6.4-135.04). For the 2011-2012 season, vaccination was significantly associated with having had between one and three influenza vaccinations in the previous five years (adj-OR 11.56; 95% CI = 6.44-20.75) or more than three (adj-OR 13643; 95% CI = 30.8-604.7) and with individual participation in general population vaccination campaigns (adj-OR 1.85; 95% CI = 1.01-3.41). Discussion: Italian residents in public health have no confidence and a low personal risk perception about vaccinations therefore taking no measures to protect patients, general population and themselves. Annual influenza vaccination acceptance is associated with influenza vaccine uptake in the previous years and personal involvement in general population vaccination campaigns. These factors should be considered for the design of future campaigns targeting public health residents.
Introduction Income inequality has been found to be associated, in cross-national comparisons, wi... more Introduction Income inequality has been found to be associated, in cross-national comparisons, with several health indicators such as life expectancy and infant mortality. Recent studies suggest that in high income countries child wellbeing may depend more on income equality than on absolute national income. The aim of the study was to analyse the relationship between income inequality and infant mortality in the twenty-seven countries of European Union (EU). Methods: Gini coefficient (income inequality) and infant mortality rate (IMR) for the year 2004 for each country were extracted from Eurostat database and per capita gross domestic product (GDP) for the same year was extracted from Health for All-Europe database. Spearman correlation coefficients were calculated to analyse the relationship between GDP and Gini and infant mortality. Multivariate linear regression was used to analyse the relationship between income inequality and infant mortality after controlling for per-capita income. Results: In EU countries, IMR was negatively correlated with GDP (ρ=- 0.57, p=0.0016) and positively correlated with Gini coefficient (ρ= 0.3980, p=0.039). Multivariate linear regression showed that the coefficient for GDP (β= -0.6; P= 0.002) is still strongly associated with IMR, while Gini coefficient was unrelated to it (β=0,001; p=0.99). A scatter-plot of IMR versus GDP suggested that all the countries with a GDP over 14,000 Euro per capita have a IMR rate less than or equal to five deaths per 1000. In Italy IMR was negatively correlated with GDP and positively correlated with Gini coefficient, but correlations were not significant. When the median familiar income was included in the multivariate regression model the relation was significantly negative, indicating that the higher the income, the lower is the IMR. Conclusion Differently from other studies conducted in developed countries, our results suggest that, in EU and in Italy, IMR correlates more on economic growth than richness distribution
Occupational and Environmental Medicine, Jun 1, 2014
labour. The 3-rd group consisted of 2078 workers, hard manual labour without influence of bone-se... more labour. The 3-rd group consisted of 2078 workers, hard manual labour without influence of bone-seeking toxic factors (metalworker, painters, moulders etc.). The 4-th group-3240 workers and employees of auxiliary departments not subjected to the influence of unfavourable industrial factors (engineer, command, economists etc.). The observed were divided into four age groups and three working experience groups. Results In the observed population the prevalence of SPS was 9,6 (95% CI 8,9-10,7), among male-8,6 (7,8-9,4), among female-1,9 (10,5-13,5). The highest rates of SPS were aged 40 to 49 years-11,0 (9,6-12,4) and older than 50 years-11,9 (10,5-13,3). The highest prevalence index of SPS were registered in the B first group-32, 9% (workers exposed to toxic effects of fluoride and physical strain), the lowest-in the 3-rd group-6,9% (without the impact of toxic action). Rate of shoulder pain prevalence is authentically higher among the workers of hard manual labour and under the toxic influence of fluoride. The prevalence of SP in the 3rd group was similar to the index of the 4th group. Conclusions The highest RR of SPS progress was observed in the 1st group in the relation to 4th (5,6) and 3rd groups (5,2), at the same time etiological fraction (EF) was 77.5% and 78,7%, it indicates very high influence of labour conditions on prevalence of SPS. Influence without the manual labour index of RR and EF is much higher in the 2nd group, than in 3rd and 4th groups. It's worth noting that the highest prevalence of SPS was found among patients with broncho-pulmonary system diseases-24,8 (20,1-29,4), it is higher than among patients with neck pain-23,4 (21,5-25,3). Among the analysed "nonmanufactoring" data co-morbid pathology of the respiratory system and neck pain increase the risk of the shoulder pain syndrome development. The relative risk of SPS was higher among patients with neck pain (7,0) than with comorbidity of broncho-pulmonary system (2,6).
Fundamental & Clinical Pharmacology, Oct 1, 2009
Arterial hypertension is one of the most relevant independent cardiovascular diseases risk factor... more Arterial hypertension is one of the most relevant independent cardiovascular diseases risk factors and recent studies show that the maintenance of normal blood pressure (BP) level, even if not in frankly hyper-tensive subjects, is associated to a significant reduced incidence of cardiovascular events [1]. The linear relationship between plasma cholesterol levels and BP, independent of age and body mass index, has been reported by many different epidemiological surveys, both in general population [2] and also in patients with
European Journal of Public Health, 2013
ABSTRACT Francesco SonciniF Soncini, G Silvestrini, A Poscia, V Ciorba, A Conti, C Murru, A Rinal... more ABSTRACT Francesco SonciniF Soncini, G Silvestrini, A Poscia, V Ciorba, A Conti, C Murru, A Rinaldi, A Zoccali, E Azzolini, C Baldini, L Bandini, I Bernardini, D Boemo, V Burrai, P Camia, F Campanella, A Caruana, C Costantino, E D'Andrea, V Di Gregori, E D'Ippolito, S Ferioli, R Furnari, E Garavelli, F Gilardi, Gb Giraldi, G Goi, G Gregoraci, A Guaccero, R Guerra, G La Maestra, E La Rosa, G Licitra, F Lucaroni, C Marcantoni, F Marra, M Martinese, T Marzulli, A Montante, F Napolitano, C Nioteni, R Palladino, S Parisi, M Passaro, M Pastori, P Pelullo, F Puggelli, C Ravaioli, S Reggiani, R Santoru, S Sironi, A Soumelis, T Tanini, D Tedesco, P Tricarico, S Vallorani, V Vighi, F Zazzara, A Ziglio and R ZuccoItalian Public Health Residents Committee of the Italian Society of Hygiene, Preventive Medicine and Public HealthContact: francescosoncini{at}hotmail.comLarge gaps in care quality resulting from ineffective communication between health providers, patients, and other health care organizations have been documented. Research suggests that effective, empathic communication positively influences health outcomes. Many studies focused on the assessment of clinicians empathy, while there is still a lack of evidence on the role and level of empathy for public health medical doctors, especially during their postgraduate education. The aim of this study was to assess empathy level of …
Ridisegnare l'assistenza primaria base di un moderno SSN. Due anni di assistenza primaria nella C... more Ridisegnare l'assistenza primaria base di un moderno SSN. Due anni di assistenza primaria nella Città di Milano A
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Papers by Valentina Di Gregori