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Dr. Alessandro Pecere
Università del Piemonte Orientale

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0 Health
0 Pharmacovigilance
0 Systematic Review
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Review
Published: 01 June 2021 in Critical Care
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Background Usefulness of noninvasive ventilation (NIV) in weaning patients with non-hypercapnic hypoxemic acute respiratory failure (hARF) is unclear. The study aims to assess in patients with non-hypercapnic hARF, the efficacy of NIV after early extubation, compared to standard weaning. Methods In this individual patient data meta-analysis, we searched EMBASE, Medline and Cochrane Central Register of Controlled Trials to identify potentially eligible randomized controlled trials published from database inception to October 2020. To be eligible, studies had to include patients treated with NIV after early extubation and compared to conventional weaning in adult non-hypercapnic hARF patients. Anonymized individual patient data from eligible studies were provided by study investigators. Using one-step and two-step meta-analysis models we tested the difference in total days spent on invasive ventilation. Results We screened 1605 records. Six studies were included in quantitative synthesis. Overall, 459 participants (mean [SD] age, 62 [15] years; 269 [59%] males) recovering from hARF were included in the analysis (233 in the intervention group and 226 controls). Participants receiving NIV had a shorter duration of invasive mechanical ventilation compared to control group (mean difference, − 3.43; 95% CI − 5.17 to − 1.69 days, p < 0.001), a shorter duration of total days spent on mechanical ventilation (mean difference, − 2.04; 95% CI − 3.82 to − 0.27 days, p = 0.024), a reduced risk of ventilatory associated pneumonia (odds ratio, 0.24; 95% CI 0.08 to 0.71, p = 0.014), a reduction of time spent in ICU (time ratio, 0.81; 95% CI 0.68 to 0.96, p = 0.015) and in-hospital (time ratio, 0.81; 95% CI 0.69 to 0.95, p = 0.010), with no difference in ICU mortality. Conclusions Although primary studies are limited, using an individual patient data metanalysis approach, NIV after early extubation appears useful in reducing total days spent on invasive mechanical ventilation. Trial registration The protocol was registered to PROSPERO database on 12/06/2019 and available at PROSPERO website inserting the study code i.e., CRD42019133837.

ACS Style

Rosanna Vaschetto; Alessandro Pecere; Gavin D. Perkins; Dipesh Mistry; Gianmaria Cammarota; Federico Longhini; Miguel Ferrer; Renata Pletsch-Assunção; Michele Carron; Francesca Moretto; Haibo Qiu; Francesco Della Corte; Francesco Barone-Adesi; Paolo Navalesi. Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials. Critical Care 2021, 25, 1 -11.

AMA Style

Rosanna Vaschetto, Alessandro Pecere, Gavin D. Perkins, Dipesh Mistry, Gianmaria Cammarota, Federico Longhini, Miguel Ferrer, Renata Pletsch-Assunção, Michele Carron, Francesca Moretto, Haibo Qiu, Francesco Della Corte, Francesco Barone-Adesi, Paolo Navalesi. Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials. Critical Care. 2021; 25 (1):1-11.

Chicago/Turabian Style

Rosanna Vaschetto; Alessandro Pecere; Gavin D. Perkins; Dipesh Mistry; Gianmaria Cammarota; Federico Longhini; Miguel Ferrer; Renata Pletsch-Assunção; Michele Carron; Francesca Moretto; Haibo Qiu; Francesco Della Corte; Francesco Barone-Adesi; Paolo Navalesi. 2021. "Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials." Critical Care 25, no. 1: 1-11.

Scholarlyarticle
Published: 09 October 2020 in The Journal of Clinical Endocrinology & Metabolism
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Context A warning has been recently issued by the European Medicine Agency (EMA) regarding a potential increased risk of acute pancreatitis (AP) in methimazole (MMI) users. Objective To investigate the association between MMI and the diagnosis of AP in a population-based study. Materials and Methods A retrospective analysis of administrative health databases was conducted (2013–2018). Relevant data were obtained from: (1) inhabitants registry, (2) hospital discharge records (ICD-9-CM 577.0), and (3) drug claims registry (ATC H03BB02). We evaluated AP risk in MMI users in 18 months of treatment, stratifying results by trimester. Poisson regression was used to estimate the age- and sex-adjusted rate ratios (RR), and the relative 95% confidence intervals (CI), comparing rates of AP between MMI users and nonusers. The absolute risk of AP in MMI users was also calculated. Results A total of 23 087 new users of MMI were identified. Among them, 61 hospitalizations occurred during the study period. An increase in AP risk was evident during the first 3 trimesters of therapy (RR 3.40 [95% CI: 2.12–5.48]; RR 2.40 [95% CI: 1.36–4.23]; RR 2.80 [95% CI: 1.66–4.73]), but disappeared thereafter. The AP absolute risk in MMI users during the first 18 months of treatment was less than 0.4% in all sex and age classes. Conclusions Our results support the EMA warning, suggesting an increased risk of AP associated with MMI use. However, such an increase seems limited to the first months of MMI treatment. Moreover, in absolute terms, the probability of AP is low among patients, well below 1%.

ACS Style

Alessandro Pecere; Marina Caputo; Andrea Sarro; Andrealuna Ucciero; Angelica Zibetti; Gianluca Aimaretti; Paolo Marzullo; Francesco Barone-Adesi. Methimazole Treatment and Risk of Acute Pancreatitis: A Population-based Cohort Study. The Journal of Clinical Endocrinology & Metabolism 2020, 105, e4527 -e4530.

AMA Style

Alessandro Pecere, Marina Caputo, Andrea Sarro, Andrealuna Ucciero, Angelica Zibetti, Gianluca Aimaretti, Paolo Marzullo, Francesco Barone-Adesi. Methimazole Treatment and Risk of Acute Pancreatitis: A Population-based Cohort Study. The Journal of Clinical Endocrinology & Metabolism. 2020; 105 (12):e4527-e4530.

Chicago/Turabian Style

Alessandro Pecere; Marina Caputo; Andrea Sarro; Andrealuna Ucciero; Angelica Zibetti; Gianluca Aimaretti; Paolo Marzullo; Francesco Barone-Adesi. 2020. "Methimazole Treatment and Risk of Acute Pancreatitis: A Population-based Cohort Study." The Journal of Clinical Endocrinology & Metabolism 105, no. 12: e4527-e4530.

Review
Published: 30 July 2020 in Nutrients
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Background: Global dietary patterns have gradually shifted toward a ‘western type’ with progressive increases in rates of metabolic imbalance. Recently, animal and human studies have revealed positive effects of caloric restriction (CR) on many health domains, giving new knowledge for prevention of ill and health promotion; Methods: We conducted a systematic review (SR) of randomized controlled trials (RCTs) investigating the role of CR on health status in adults. A meta-analysis was performed on anthropometric, cardiovascular and metabolic outcomes; Results: A total of 29 articles were retrieved including data from eight RCTs. All included RCTs were at low risk for performance bias related to objective outcomes. Collectively, articles included 704 subjects. Among the 334 subjects subjected to CR, the compliance with the intervention appeared generally high. Meta-analyses proved benefit of CR on reduction of body weight, BMI, fat mass, total cholesterol, while a minor impact was shown for LDL, fasting glucose and insulin levels. No effect emerged for HDL and blood pressure after CR. Data were insufficient for other hormone variables in relation to meta-analysis of CR effects; Conclusion: CR is a nutritional pattern linked to improved cardiometabolic status. However, evidence is limited on the multidimensional aspects of health and requires more studies of high quality to identify the precise impact of CR on health status and longevity.

ACS Style

Silvia Caristia; Marta Vito; Andrea Sarro; Alessio Leone; Alessandro Pecere; Angelica Zibetti; Nicoletta Filigheddu; Patrizia Zeppegno; Flavia Prodam; Fabrizio Faggiano; Paolo Marzullo. Is Caloric Restriction Associated with Better Healthy Aging Outcomes? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2020, 12, 2290 .

AMA Style

Silvia Caristia, Marta Vito, Andrea Sarro, Alessio Leone, Alessandro Pecere, Angelica Zibetti, Nicoletta Filigheddu, Patrizia Zeppegno, Flavia Prodam, Fabrizio Faggiano, Paolo Marzullo. Is Caloric Restriction Associated with Better Healthy Aging Outcomes? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2020; 12 (8):2290.

Chicago/Turabian Style

Silvia Caristia; Marta Vito; Andrea Sarro; Alessio Leone; Alessandro Pecere; Angelica Zibetti; Nicoletta Filigheddu; Patrizia Zeppegno; Flavia Prodam; Fabrizio Faggiano; Paolo Marzullo. 2020. "Is Caloric Restriction Associated with Better Healthy Aging Outcomes? A Systematic Review and Meta-Analysis of Randomized Controlled Trials." Nutrients 12, no. 8: 2290.

Original article
Published: 13 February 2020 in Endocrine
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Unrecognized and untreated hyperthyroidism leads to serious clinical complications with adverse outcomes for patients and increasing costs for the health care system. Hence, adequate knowledge of the epidemiological features of such condition is desirable to plan effective interventions. The aim of our study was to estimate incidence and prevalence of hyperthyroidism in the mildly iodine-deficient Italian Region of Piedmont. A retrospective cohort study was conducted using Administrative Health Databases of the Piedmont Region, Italy (2012–2018). Hyperthyroidism cases were defined as the subjects who had at least one of the following claims: (i) hospital discharge records with hyperthyroidism diagnosis code; (ii) exemption from co-payment for hyperthyroidism; (iii) prescription of one of the following medications: methimazole, propylthiouracil, or potassium perchlorate. The overall prevalence was 756 per 100,000 inhabitants [95% CI 748–764], and the overall incidence was 81 per 100,000-person year [95% CI 80–82]. The prevalence and incidence increased with age and were two-fold higher among women than men. Women also showed two distinct peaks in incidence at the age of 30 and 50; after the age of 60, the trend became similar between sexes. With regard to the geographic distribution, an increasing gradient of incidence was observed from the northern to the south-western areas of the Region. This is the first Italian study based on health databases to estimate the incidence and prevalence of hyperthyroidism in the general population. This approach can represent an inexpensive and simple method to monitor patterns of hyperthyroidism in iodine-deficient areas.

ACS Style

Marina Caputo; Alessandro Pecere; Andrea Sarro; Chiara Mele; Andrealuna Ucciero; Loredana Pagano; Flavia Prodam; Gianluca Aimaretti; Paolo Marzullo; Francesco Barone-Adesi. Incidence and prevalence of hyperthyroidism: a population-based study in the Piedmont Region, Italy. Endocrine 2020, 69, 107 -112.

AMA Style

Marina Caputo, Alessandro Pecere, Andrea Sarro, Chiara Mele, Andrealuna Ucciero, Loredana Pagano, Flavia Prodam, Gianluca Aimaretti, Paolo Marzullo, Francesco Barone-Adesi. Incidence and prevalence of hyperthyroidism: a population-based study in the Piedmont Region, Italy. Endocrine. 2020; 69 (1):107-112.

Chicago/Turabian Style

Marina Caputo; Alessandro Pecere; Andrea Sarro; Chiara Mele; Andrealuna Ucciero; Loredana Pagano; Flavia Prodam; Gianluca Aimaretti; Paolo Marzullo; Francesco Barone-Adesi. 2020. "Incidence and prevalence of hyperthyroidism: a population-based study in the Piedmont Region, Italy." Endocrine 69, no. 1: 107-112.