Papers by Fabio Vittadello
European Urology Supplements, 2006
We present hereby an update on the clinical value and role of uCyt+/ImmunoCytäas a non-invasive t... more We present hereby an update on the clinical value and role of uCyt+/ImmunoCytäas a non-invasive tool for detection of recurrent urothelial carcinoma. MATERIAL & METHODS: Between January 2002 and October 2004 942 patients, with a mean age of 72.6 years (range 32-87 years) were enrolled in this prospective study. Patients were mostly under follow-up for superfi cial urothelial cancer (UC) confi ned to the mucosa and lamina propria stage pTa, pT1, pTis (carcinoma in situ) for a mean 15.62 months (range 4-28). Voided urinary cytology and the uCyt+/ImmunoCyttest (Diagnocure Inc.) of all patients were performed on liquid based cytology (ThinPrepâ, Cytyc Corp.). Patients underwent subsequent cystoscopy when cytology or uCyt+/ImmunoCyt resulted positive and evaluation of any suspicious lesion by biopsy was performed. Altogether 1,991 uCyt+/ImmunoCytanalyses were performed. RESULTS: 298 of patients with adequate samples were found to have histologically proven UC. The sensitivity of cytology increased from 8.3% for G1 to 75.3% in G3 tumours, whereas for uCyt+/ImmunoCyt it was 79.3% for G1, 84.1% for G2 and 92.1% for G3 tumours, respectively. Combining cytology and uCyt+/ ImmunoCyt sensitivity was 79.3% for G1, 90.9% for G2 and 98.9% for G3. CONCLUSIONS: Our data confi rm the clinical usefulness of uCyt+/ImmunoCyt TM in the follow-up of patients with recurrent UC. Cytology as a non invasive tool escorted by uCyt+/ImmunoCyt could reduce the morbidity and cost of follow-up patients with a low risk of recurrence avoiding superfl uous cystoscopies. However, additional studies are necessary to establish and compare the morbidity and cost of each method.
Journal of Interprofessional Care
This paper presents a study that aimed to validate a translation of a multiple-group measurement ... more This paper presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.
Journal of Interprofessional Care
Pathologica, 2019
Objectives. To obtain a picture of the work done in Italian anatomical pathology centres in 2014,... more Objectives. To obtain a picture of the work done in Italian anatomical pathology centres in 2014, and evaluate differences between the various centres in terms of the workloads of medical and non-medical staff. Methods. A self-administered questionnaire designed by a SIAPEC working group was e-mailed to 256 centres and subsequently collected by the Anatomical Pathology Service of Bolzano. QlikView software was used to prepare the final database and check the quality of the data, which were processed using version 18.0 of SPSS for Windows statistical software. Results. The questionnaire was completed by 120 of the centres (46.9%), which were staffed by a mean number of 6.6 physicians (range 1-24), 1.6 biologists (range 0-7), 10.8 laboratory technicians (range 2-47) and 2.2 administrative personnel (range 0-9). During 2014, the centres carried out a mean of 15,000 histology examinations (range 3,215-50,680), almost 11,700 immunohistochemistry examinations (range 0-54,359), and a mean of 1,471 molecular biology examinations (range 0-31,322) relating to a mean of 704 patients (range 0-9,434), and a mean of 16,509 cytology examinations (range 0-150,000) relating to 13,383 patients (range 0-120,000). Each centre physician issued a mean of 2,444 histology examinations reports (range 613-11,000); the ratio between the number of immunohistochemistry examinations and the number of histology examinations was 0.8 (range 0-2.7); and each laboratory technician had a mean overall annual workload of 3,072 histology, molecular biology and cytology examinations (range 793-9,882/year). These values varied widely among the participating centres. The mean ratio between the number of histology examinations carried out and the number of physicians was 1,982.77:1 a year In the small centres (< 10,000 histology cases/year), 2,627:1 a year in the medium-sized centres (10-24,999 histology cases/year), and 2,881.34:1 in the large centres (> 25,000 histology cases/year). There were significant differences between the small and medium-sized centres (p = 0.004) and between the small and large centres (p = 0.001), but not between the medium-sized and large centres. The ratio between the total number of histology, molecular biology and cytology examinations and the number of laboratory technicians was 1,963.34 in the small centres (< 10,000 examinations/year), 2,717.11 in the medium-sized centres (10,000-24,999 examinations/year), and 3,531.56 in the large centres (≥ 25,000 examinations/year). There were significant differences between the small and large centres (p = 0.001) and between the medium-sized and large centres (p = 0.004), but not between the small and medium-sized centres. Conclusions. The data collected by means of this survey provide an important, albeit partial, point of reference concerning the status of Italian anatomical pathology centres and their recent, everyday working situation.
Annals of the Rheumatic Diseases, 2015
Conclusions: Overall, ADA is well-tolerated in these pts with active pJIA. No new safety signals ... more Conclusions: Overall, ADA is well-tolerated in these pts with active pJIA. No new safety signals were observed, and based on this interim analysis, the known safety profile of ADA remains unchanged.
Annals of the Rheumatic Diseases, 2013
Background Chronic non-bacterial osteomyelitis (CNO) is a rare characterized by inflammatory bone... more Background Chronic non-bacterial osteomyelitis (CNO) is a rare characterized by inflammatory bone lesions with no detectable infectious agents. It may be unifocal (U-CNO) or multifocal (M-CNO) and have a monophasic, relapsing or persistent course. The typical presentation of CNO is local bone pain with or without fever or other local signs of inflammation (1). Imaging evaluation (bone scintiscan and MRI) is very important to identify and evaluate lesions but, to date, no validated outcome measure has been identified (2). Objectives to define the role of MRI in detecting disease activity in patients with CNO. Methods Patients with CNO, lasting longer than 6 month, were prospectively followed every 3-4 months. MRI were performed at diagnosis, at the time of clinical relapse or at least yearly in all patients. Clinically, active disease was considered when patient complained bone pain and needed analgesic or second line therapy to control symptoms. Active bone lesions on MRI were those in which BME was associated with soft tissue inflammation (STI, edema and/or perilesional effusion). As resulted in sports medicine studies, BME alone was not considered a parameter of activity (3). A single radiologist, blinded on patients’ clinical status, reviewed all MRI. Sensitivity, specificity and predictive value for disease activity detection of MRI were calculated by comparing radiological evaluation with clinical status of the patients at different time points. Results 13 CNO patients entered the study. 8 had UF-CNO, 5 had MF-CNO, mean age at disease onset 10,8 years (range 2,33-18,5), 54% were female. Disease duration at diagnosis was longer in patients with UF-CNO (14,2 vs 10,1 months). Localized bone pain was the leading symptom at onset in all patients; systemic symptoms, such as fever and fatigue, were more frequent in MF-CNO. 38,5% presented associated skin disease and 61,5% positive family history for autoimmune disease. At onset WBC was normal, CRP and ESR were elevated in 69,2%, especially in MF-CNO. After median 3 years follow up, 46% of patients had no symptoms and were off-therapy. At disease onset, all patients were evaluated by MRI then, during the follow-up, 12 patients repeated MRI once (T1) and 6 twice (T2). At disease onset, all 13 MRI showed BME with STI. Of the 18 follow up MRI, 4 (22%) completely normalized, 6 (33%) showed only BME, 8 (44%) showed pathological changes. Time n Sensitivity Specificity + Predictive value – Predictive value T1 12 0,83 1,00 1,00 0,86 T2 6 1,00 1,00 1,00 1,00 Sensitivity of the MRI ranged between 0.83 and 1.00, specificity 1.00, positive predictive value was 1,00 while negative predictive value ranged between 0.86 and 1.00. Conclusions Despite the small sample, MRI resulted to be a sensitive, specific and predictive tool for monitoring CNO. Once validated in a larger cohort of patients, these preliminary findings will allow including MRI among the most reliable outcome measures for CNO. References Girschick HJ, et al. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis. 2005; 64:279. G. Khanna, et al. Imaging of Chronic Recurrent Multifocal Osteomyelitis. Radiogaphics 2009; 29:1159. Kornaat PR, et al. Bone marrow edema-like signal in the athlete. Eur J Radiol. 2008;67:49. Disclosure of Interest None Declared
Italian Journal of Pediatrics
Background Studies published on gender-related differences in the gambling behavior of adolescent... more Background Studies published on gender-related differences in the gambling behavior of adolescents have focused mainly on psychological and social factors. The aim of this study was to develop separate risk factor models for male and female adolescents, considering the environmental, psychological, behavioral and socio-economic factors related to their gambling. Methods A survey was conducted through a questionnaire developed on a dedicated web site in 2014 on a representative sample of the Italian 15–19-years-old population, including 34,922 students attending 438 secondary schools. The SOGS-RA questionnaire was used to measure gambling behavior. To verify the risk factors associated with gambling a logistic regression stratified by gender was performed. Results In our representative sample of Italian adolescents nationwide, the prevalence of each level of gambling was higher in males than in females. The logistic regression stratified by gender found that for both genders, gamblin...
Ocular Immunology and Inflammation, 2021
Objective: To evaluate the long-term efficacy of methotrexate (MTX) monotherapy in patients with ... more Objective: To evaluate the long-term efficacy of methotrexate (MTX) monotherapy in patients with juvenile idiopathic arthritis-associated uveitis (JIA-U). Methods: We analyzed a cohort of patients with JIA-U treated with MTX monotherapy, divided into two groups depending on whether MTX was started before (on-MTX group) or after uveitis diagnosis (MTX-naïve group). The primary endpoint was the time between uveitis inactivity and first relapse. Results: 84 patients entered the study. The median duration of remission on MTX monotherapy resulted 8.2 months. The on-MTX group showed a significant longer time interval between arthritis and uveitis onset and higher need for biologic agents (bDMARD). During follow-up, 40 patients (47.6%) needed bDMARD due to poor control of uveitis. Clinical remission off medication was achieved in 11.9% of patients, all belonging to the MTX-naïve group. Conclusions: MTX monotherapy, although effective in early stages of JIA-U, showed poor disease control in the long term.
Healthcare, 2020
The aim of our study was to evaluate the disposition of individuals with type 2 diabetes mellitus... more The aim of our study was to evaluate the disposition of individuals with type 2 diabetes mellitus (DM2) toward changing their nutritional and physical activity habits and associated factors—particularly their perceptions about interacting and communicating with four health professions. Working with a local patients’ association, we invited 364 individuals with DM2, all at least 18 years old, to complete a paper-based survey with questions addressing their experiences of interacting and communicating with general practitioners, nurses, dieticians and diabetologists and about their readiness to change targeted habits, their health literacy and their clinical status. Of the 109 questionnaires collected, 100 were eligible for descriptive and inferential statistical analysis. Regarding nutritional habits, the highest percentage of participants were at the maintenance stage (26%), whereas regarding physical activity habits the highest percentage of participants were at the preparation sta...
European Archives of Oto-Rhino-Laryngology, 2021
Objective The aim of the study was to evaluate the impact of the COVID-19 pandemic on new diagnos... more Objective The aim of the study was to evaluate the impact of the COVID-19 pandemic on new diagnoses of head and neck cancer (HNC) in South Tyrol, northern Italy in terms of the number of new diagnoses and worsening disease stage due to diagnostic delay. Methods Patients were divided into two groups: the control group with a first diagnosis of HNC in 10 months before the national lockdown (March 9th, 2020) and the study group with a first diagnosis of HNC in 10 months after lockdown. Results A total of 124 patients were included in the study. Before the spread of COVID-19, 79 new diagnoses of HNCs were registered, while in the period after the lockdown, 45 new cancers cases were diagnosed and the difference was statistically significant (p = 0.01278). Early clinical T-stage results showed 52 cases in the control group and 21 in the study group, again with a significant difference (p = 0.03711). Advanced T-stage results showed 27 cases in the control group and 24 in the study group. Conclusions This study highlights the impact of the COVID-19 pandemic on HNCs, showing a statistically significant difference in the number of diagnoses before and after the lockdown which was related to the spread of the SARS-CoV-2 virus, and with a relevant decrease in early cT-staged HNCs.
Ageing and Society, 2020
Healthy ageing is a public health problem globally. In Europe, the dependency ratio of the elderl... more Healthy ageing is a public health problem globally. In Europe, the dependency ratio of the elderly is expected to increase by 21.6 per cent to 51.2 per cent in 2070. The World Health Organization (WHO) study on healthy ageing started in 2002 as a concept whereby all people of all ages should be able to live in a healthy, safe and socially inclusive way. The aim of this study is to present preliminary results of the project Identification of Determinants of Healthy Ageing in Italy (IDAGIT) that aimed to collect data on the active and healthy ageing of the Italian population aged over 18 using the conceptual framework of the WHO's ageing model. To link the determinants of the IDAGIT studies to those of the WHO model, we performed a confirmatory factor analysis which reported these variables as significant (in order of factor loading): smoking, cognition score, comorbidity, outdoor built environment, participation, working expertise and income. Considering comorbidity, 83.8 per cen...
Annals of the Rheumatic Diseases, 2015
Conclusions: In conclusion, we present a rare case of infantile systemic lupus erythematosus. To ... more Conclusions: In conclusion, we present a rare case of infantile systemic lupus erythematosus. To our best knowledge we are the first to describe a successful treatment with systemic hydroxychloroquine in a patient with iSLE. Since the induced therapy with hydroxychloroquine the patient did not suffer from skin rash or other systemic symptoms any more. References: [1] Zulian F, Pluchinotta F, Martini G et al. Severe clinical course of systemic lupus erythematosus in the first year of life.
Conclusion: Despite intensive counseling, the majority of men did not return for any postoperativ... more Conclusion: Despite intensive counseling, the majority of men did not return for any postoperative spermiogram. However, the absolute failure rate was low (0.3%) and postoperative complications (occurring in 12%) were minor and selflimiting.
Journal of the American Academy of Dermatology, 2012
Background: Recent studies report that methotrexate (MTX) is beneficial in the treatment of juven... more Background: Recent studies report that methotrexate (MTX) is beneficial in the treatment of juvenile localized scleroderma (JLS) but little is known about its long-term effectiveness. Objective: We assessed the therapeutic role of MTX in children with JLS who were followed up for a prolonged period. Methods: A cohort of patients with JLS, previously enrolled in a double-blind, randomized controlled trial and treated with oral MTX (15 mg/m 2 /wk) and prednisone (1 mg/kg/d, maximum 50 mg) for the first 3 months, were prospectively followed up. Lesions were evaluated clinically, with infrared thermography, and by a computerized skin score. Response to treatment was defined as: (1) no new lesions; (2) skin score rate less than 1; and (3) decrease in lesion temperature by at least 10% compared with baseline. Clinical remission (CR) on medication was defined when response was maintained, on treatment, for at least 6 months, and complete CR when response was maintained, without treatment, for at least 6 months. Results: Of 65 patients treated with MTX, 48 (73.8%) were responders, 10 (15.4%) relapsed by 24 months since MTX start, and 7 (10.8%) were lost to follow-up. Among the responders, 35 (72.9%) maintained CR for a mean of 25 months and 13 (27.1%) were in CR on medication. Adverse effects seen in 28 patients (48.3%) were generally mild and never required treatment discontinuation. Limitations: The use of objective measures not widely available, such as infrared thermography and computerized skin score, makes it difficult to compare data from previous studies.
British Journal of Ophthalmology, 2007
Acta Ophthalmologica, 2009
Aim of the present study was to validate a statistical model to predict a severe course of anteri... more Aim of the present study was to validate a statistical model to predict a severe course of anterior uveitis (AU) in patients with juvenile idiopathic arthritis (JIA). Methods: Consecutive patients with newly diagnosed uveitis have been followed for at least 1 year with a standardized protocol. For each patient, demographic, clinical and laboratory characteristics, including time interval between arthritis and uveitis onset, a 2-globulins level at arthritis onset, number of uveitis relapses ⁄ year, ocular complications and therapy and visual acuity, have reported. The validation procedure included the assessment of sensitivity, specificity and efficiency of previously published statistical model (Zulian et al.
The state of interprofessional collaboration in
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Papers by Fabio Vittadello