1,721,105 research outputs found
The coexistence of asthma and COPD: some considerations about prevalence and lung function decline
No full textNo abstract availabl
DEFINIZIONE DI UNO SCORE CONTINUO DI GRAVITÀ DELL’ASMA
No full textIntroduzione. Si è ancora lontani da una definizione condivisa di gravità dell’asma. La tendenza è
quella di sintetizzare caratteristiche fisiopatologiche individuali in un numero esiguo di livelli1 che,
per l’eterogeneità della malattia, può causare perdita di informazioni.
Obiettivo. Definire uno score su scala continua che catturi tutti gli aspetti di gravità dell’asma in
soggetti caratterizzati sia dall’attività che dalla non attività della malattia.
Metodi. 334 soggetti (20-64 anni) asmatici identificati in un campione casuale della popolazione
generale di Verona nell’ambito dello studio GEIRD2 (2008-2010). Lo score di gravità è stato ottenuto
mediante un’Analisi delle Componenti Principali non lineare (NLPCA) implementata in due step. Le
informazioni cliniche riguardanti la bronchite cronica, i sintomi asmatiformi riportati negli ultimi 12
mesi, la loro riacutizzazione e l’attività della malattia (asma attiva/non attiva) sono state sintetizzate
nella dimensione “sintomi”. Lo score unidimensionale di gravità dell’asma è stato ottenuto da una
seconda NLPCA, come combinazione non lineare dello score “sintomi” e di due variabili indicanti i
livelli di trattamento farmacologico e di funzionalità respiratoria (FR). La concurrent validity è stata
verificata mediante il confronto con lo score proposto dalle linee guida GINA definito su 4 livelli di
gravità crescente (ottenuti dalla combinazione della
frequenza dei sintomi, della riduzione della FR e
degli step di trattamento)3, e con gli indici sintetici
di stato fisico e psicologico del questionario SF364
(valori bassi = stato peggiore).
Risultati. Lo score di gravità dell’asma è una variabile
continua con distribuzione Quasi-Gamma (0=asma
non attiva, assenza di sintomi, nessun trattamento,
funzionalità respiratoria normale; 16=asma attiva,
massima presenza di sintomi, massimo trattamento,
ostruzione non lieve del flusso respiratorio). È
correlato positivamente con la serie ordinata dei
livelli di gravità come in Figura (ρ-Spearman= 0.82,
p<0.001), e negativamente con gli indici di stato
fisico (ρ-Spearman= -0.22, p<0.001) e psicologico
(ρ-Spearman= -0.18, p=0.001) dell’SF36.
Conclusioni. Lo score di gravità dell’asma proposto è un indicatore sintetico sia delle misurazioni
cliniche e fisiologiche del soggetto sia del trattamento a cui esso è sottoposto e, per la sua natura
continua, ha il vantaggio di essere altamente informativo
Il livello di controllo dell'asma e il suo impatto socio-economico in Europa e in Italia
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Age-period-cohort analysis of asthma incidence in Italy, from 1940 to 2010
No full textBackground: The prevalence of asthma has been rising all over the world. The causes of this epidemic are still not completely known. In this study we aim to estimate the separate effects of age, period and birth cohort on the trends of asthma incidence in Italy.
Methods: Individual information on the history of asthma was collected on 35,375 adults aged 20-64 and born from 1940 to 1989, who were randomly sampled from the general Italian population in 1990/93, 1998/2000 and 2007/10. Overall 3,295 subjects reported asthma from 1,293,801 person-years at risk. Age-specific incidence rates were estimated for both sexes using 5-year age classes in different cohorts and period. Poisson regression models were used to estimate the incidence rates by age, birth cohort and period in males and females.
Results: Age, period and cohort showed significant independent effects (p<0.001) on incidence rates of asthma, which was greater in younger subjects and dramatically increased in recent generations. Males and females had significantly different age-trends of asthma incidence, with males having nearly 50% greater risk to develop asthma in the first decade of life and nearly 40% lower risk after the age of 30 compared with women.
Conclusions: Our results suggest that the trend of asthma is still increasing in Italy, and that more recently born cohorts are at greater risk of developing the disease
A novel score of respiratory health predicts hospitalizations in children
No full textBACKGROUND: Continuous scores have greater power and better predictive value than categorical scores in epidemiological studies.OBJECTIVES: (i) To generate a continuous score that summarize the respiratory health of children, (ii) to evaluate its predictive ability against the risk of hospitalization for respiratory diseasesMETHODS: 3,854 children (3-14 years) were surveyed in 2006 through a parental questionnaire, containing questions about the children's respiratory symptoms and potential risk factors, and hospital discharge records were obtained for the years 2007-9. Children respiratory conditions and symptoms in the previous 12 months were synthetized in a continuous score using a factor analysis with tetrachoric correlation matrix. A Cox regression model was used to evaluate the ability of the score to predict hospital admissions for diseases of respiratory system (ICD-9-CM: 465-519) in children.RESULTS: We identified one factor that explains 93% of common variance of respiratory symptoms and conditions. The children's respiratory health was synthesized in a one-dimensional, continuous score (mean:0.35; range: 0-3) with a quasi-gamma distribution. A unitary increase in the score was associated with 116% greater risk of being hospitalized for respiratory diseases (HR: 2.16, 95%CI:1.66-2.82).CONCLUSIONS: The children's respiratory health score has good ability to predict future respiratory hospitalizations, and might be a promising tool in population studies
Fratture articolari di polso: valutazione radiografica e clinica di una casistica trattata con fissatore esterno
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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