Oreste Capelli - Academia.edu (original) (raw)
Papers by Oreste Capelli
Diabetes Research and Clinical Practice, 2017
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced ... more Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. Allergic rhinitis affects approximately 20-30% of the population worldwide and its prevalence is increasing. Isolated AR is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. Bronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. A state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests (SPTs) are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy (AIT) for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of AIT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in adults and in pediatric patients. The long lasting effect of AIT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of AIT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of AIT. Allergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.
PLOS ONE, Oct 17, 2014
†<p>56 physicians who had not prescribed tamsulosin or terazosin could not be included in t... more †<p>56 physicians who had not prescribed tamsulosin or terazosin could not be included in the calculation since this is a ratio.</p>§<p>300 physicians who had not prescribed risedronate or ibandronate could not be included in the calculation since this is a ratio.</p><p>TEA trial: differences in DDD per 1000 patients of prescribed drugs (intervention vs control: 1605 included GPs).</p
InTech eBooks, Apr 27, 2012
Journal of Cardiovascular Medicine, 2019
Aim To assess the feasibility and effectiveness of a lowcomplexity, low-cost model of caregiver e... more Aim To assess the feasibility and effectiveness of a lowcomplexity, low-cost model of caregiver education in primary care, targeted to reduce hospitalizations of heart failure patients. Methods A cluster-randomized, controlled, open trial was proposed to general practitioners, who were invited to identify patients with heart failure, exclusively managed at home and continuously attended by a caregiver. Participating general practitioners were then randomized to: usual treatment; caregiver education (educational session for recognizing early symptoms/signs of heart failure, with recording in a diary of a series of patient parameters, including body weight, blood pressure, heart rate). The patients were observed at baseline and during a 12-month follow-up. Results Three hundred and thirteen patients were enrolled (163 in the intervention, 150 in the usual care group), 63% women, mean age 85.3 W 7.7 years. At the end of the 12month follow-up, a trend towards a lower incidence of hospitalizations was observed in the intervention group (hazard ratio 0.73; 95% CI 0.53-1.01 P U 0.061). Subgroup analysis showed that for patients with persistent/ permanent atrial fibrillation, age less than 90 years or Barthel score equal to or greater than 50 a significant lower hospital admission rate occurred in the intervention group (hazard ratio 0.63; 95% CI 0.39-0.99; P U 0.048, hazard ratio 0.66; 95% CI 0.45-0.97; P U 0.036 and hazard ratio 0.61; 95% CI 0.41-0.89; P U 0.011, respectively). Conclusion Caregivers training for early recognition of symptoms/signs of worsening heart failure may be effective in reducing hospitalizations, although the benefit was evident only in specific patient subgroups (with persistent/permanent atrial fibrillation, age <90 years or Barthel score >-50), with only a positive trend in the whole cohort. Trial registration ClinicalTrials.gov Identifier: NCT03389841.
Recenti Progressi in Medicina, 2009
i cultori di scienze, fra i medici pratici, taluni han l'inclinazione intellettuale a trovare suf... more i cultori di scienze, fra i medici pratici, taluni han l'inclinazione intellettuale a trovare sufficiente qualunque mediocre spiegazione, mentre altri durano gran fatica ad acquietarsi.
Authors' original file for figure 2
Diabetes Research and Clinical Practice, 2017
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced ... more Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. Allergic rhinitis affects approximately 20-30% of the population worldwide and its prevalence is increasing. Isolated AR is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. Bronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. A state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests (SPTs) are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy (AIT) for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of AIT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in adults and in pediatric patients. The long lasting effect of AIT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of AIT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of AIT. Allergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.
International Journal of Integrated Care, 2014
In the last years some RCT have demonstrated the efficacy of "integrated models of care" in the m... more In the last years some RCT have demonstrated the efficacy of "integrated models of care" in the management of chronic diseases such as depression and dementia. Since 1999 the Regional Government of Emilia-Romagna deliberated the "Regional Dementia Project" (D.G.R. 2581/1999) , an act that provides funds for the organization of Health and Social Welfare services in the community for people with dementia. The main strategies and tools of Dementia Project are: a) ensure good and timely diagnosis; b) global approach to PWD and his familiy (social and healt services integrated); c) qualify existing network service (not only separate net for PWD); d) improve and support caregivers The design includes specialized outpatient clinics with competencies for diagnosis and care planning. A targeted project of the Public Health Agency of Modena has been implemented to involve the family physician in dementia screening and followup, by means of accreditation courses, promotion of uniform screening instruments and structured annul following up of the patients with epidemiological reporting; the family physician is seen as pivotal in providing a continuum of care over the long natural history of the disease. The main outcome of this agreement is to improve the quality of life and health of demented individuals and their carers, permitting people with dementia to remain at home as long as possible, and to promote the management of dementia patients by the primary care physicians (PCP). The specialized referral clinics offer diagnostic competencies and consult for specific problems. The protocol consists of two phases: in the first phase, when the PCP suspects a diagnosis of dementia, he/she administers simple, standardized screening tests, such as the Symptom of Dementia Screener (S.D.S.) and provides an assessment of somatic morbidity and functional World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. The introduction of a measurable indicator of appropriateness of care to patients with dementia by GI can become a tool for assessment of the quality of care in the context of primary care.
Diabetes Research and Clinical Practice, 2017
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced ... more Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. Allergic rhinitis affects approximately 20-30% of the population worldwide and its prevalence is increasing. Isolated AR is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. Bronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. A state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests (SPTs) are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy (AIT) for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of AIT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in adults and in pediatric patients. The long lasting effect of AIT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of AIT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of AIT. Allergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.
PLOS ONE, Oct 17, 2014
†<p>56 physicians who had not prescribed tamsulosin or terazosin could not be included in t... more †<p>56 physicians who had not prescribed tamsulosin or terazosin could not be included in the calculation since this is a ratio.</p>§<p>300 physicians who had not prescribed risedronate or ibandronate could not be included in the calculation since this is a ratio.</p><p>TEA trial: differences in DDD per 1000 patients of prescribed drugs (intervention vs control: 1605 included GPs).</p
InTech eBooks, Apr 27, 2012
Journal of Cardiovascular Medicine, 2019
Aim To assess the feasibility and effectiveness of a lowcomplexity, low-cost model of caregiver e... more Aim To assess the feasibility and effectiveness of a lowcomplexity, low-cost model of caregiver education in primary care, targeted to reduce hospitalizations of heart failure patients. Methods A cluster-randomized, controlled, open trial was proposed to general practitioners, who were invited to identify patients with heart failure, exclusively managed at home and continuously attended by a caregiver. Participating general practitioners were then randomized to: usual treatment; caregiver education (educational session for recognizing early symptoms/signs of heart failure, with recording in a diary of a series of patient parameters, including body weight, blood pressure, heart rate). The patients were observed at baseline and during a 12-month follow-up. Results Three hundred and thirteen patients were enrolled (163 in the intervention, 150 in the usual care group), 63% women, mean age 85.3 W 7.7 years. At the end of the 12month follow-up, a trend towards a lower incidence of hospitalizations was observed in the intervention group (hazard ratio 0.73; 95% CI 0.53-1.01 P U 0.061). Subgroup analysis showed that for patients with persistent/ permanent atrial fibrillation, age less than 90 years or Barthel score equal to or greater than 50 a significant lower hospital admission rate occurred in the intervention group (hazard ratio 0.63; 95% CI 0.39-0.99; P U 0.048, hazard ratio 0.66; 95% CI 0.45-0.97; P U 0.036 and hazard ratio 0.61; 95% CI 0.41-0.89; P U 0.011, respectively). Conclusion Caregivers training for early recognition of symptoms/signs of worsening heart failure may be effective in reducing hospitalizations, although the benefit was evident only in specific patient subgroups (with persistent/permanent atrial fibrillation, age <90 years or Barthel score >-50), with only a positive trend in the whole cohort. Trial registration ClinicalTrials.gov Identifier: NCT03389841.
Recenti Progressi in Medicina, 2009
i cultori di scienze, fra i medici pratici, taluni han l'inclinazione intellettuale a trovare suf... more i cultori di scienze, fra i medici pratici, taluni han l'inclinazione intellettuale a trovare sufficiente qualunque mediocre spiegazione, mentre altri durano gran fatica ad acquietarsi.
Authors' original file for figure 2
Diabetes Research and Clinical Practice, 2017
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced ... more Allergic rhinitis (AR) is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. Allergic rhinitis affects approximately 20-30% of the population worldwide and its prevalence is increasing. Isolated AR is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. Bronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. A state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests (SPTs) are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy (AIT) for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of AIT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in adults and in pediatric patients. The long lasting effect of AIT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of AIT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of AIT. Allergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.
International Journal of Integrated Care, 2014
In the last years some RCT have demonstrated the efficacy of "integrated models of care" in the m... more In the last years some RCT have demonstrated the efficacy of "integrated models of care" in the management of chronic diseases such as depression and dementia. Since 1999 the Regional Government of Emilia-Romagna deliberated the "Regional Dementia Project" (D.G.R. 2581/1999) , an act that provides funds for the organization of Health and Social Welfare services in the community for people with dementia. The main strategies and tools of Dementia Project are: a) ensure good and timely diagnosis; b) global approach to PWD and his familiy (social and healt services integrated); c) qualify existing network service (not only separate net for PWD); d) improve and support caregivers The design includes specialized outpatient clinics with competencies for diagnosis and care planning. A targeted project of the Public Health Agency of Modena has been implemented to involve the family physician in dementia screening and followup, by means of accreditation courses, promotion of uniform screening instruments and structured annul following up of the patients with epidemiological reporting; the family physician is seen as pivotal in providing a continuum of care over the long natural history of the disease. The main outcome of this agreement is to improve the quality of life and health of demented individuals and their carers, permitting people with dementia to remain at home as long as possible, and to promote the management of dementia patients by the primary care physicians (PCP). The specialized referral clinics offer diagnostic competencies and consult for specific problems. The protocol consists of two phases: in the first phase, when the PCP suspects a diagnosis of dementia, he/she administers simple, standardized screening tests, such as the Symptom of Dementia Screener (S.D.S.) and provides an assessment of somatic morbidity and functional World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. The introduction of a measurable indicator of appropriateness of care to patients with dementia by GI can become a tool for assessment of the quality of care in the context of primary care.