Alba Malara

ANASTE Humanitas

Objective: Chloroquine (CQ) and hydroxychloroquine (HCQ) were used as off-label treatments for SARS-CoV-2 infection during the first pandemic waves. The urgency of combatting COVID-19 led to the dissemination of medical recommendations with a scarce awareness of possible drug–drug interactions. This issue primarily concerned people already taking m...

Nurses play an important role in interprofessional pharmaceutical care. Curricula related to pharmaceutical care, however, vary a lot. Mapping the presence of pharmaceutical care related domains and competences in nurse educational programs can lead to a better understanding of the extent to which curricula fit expectations of the labour market. Th...

Polypharmacy is common in older adults, particularly among those living in long-term care facilities. This condition represents a marker of clinical complexity and might directly affect the immunological response. However, there are limited data on the association of polypharmacy with vaccine immunogenicity. This study evaluated the immune response...

Background: The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in re...

Background Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the t...

Background and objectives: Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim o...

Background In older patients, prevention of acute respiratory tract infections (RTIs) is challenging. Experimental studies have consistently underlined an immune-potentiating effect of the bacterial lysates product OM85, on both cellular and humoral responses. Objective This work aimed to assess the potential efficacy of OM-85 for RTIs’ prevention...

Despite the reported sex-related variations in the immune response to vaccination, whether the effects of SARS-CoV-2 vaccination differ by sex is still under debate, especially considering old vulnerable individuals, such as long-term care facilities (LTCFs) residents. This study aimed to evaluate COVID-19 infections, adverse events, and humoral re...

Background Various models have been proposed to predict frailty, including those based on clinical criteria and phenotypes. However, a simple biomarker associated with frailty has been not been identified. The aim of the current study is to evaluate the relationship between FT3/FT4 ratio value and the degree of frailty among three different cohorts...

Objectives Nursing home (NH) residents have been significantly affected by the COVID-19 pandemic. Studies addressing the immune responses induced by COVID-19 vaccines in NH residents have documented a good post-vaccination antibody response and the beneficial effect of a third booster vaccine dose. Less is known about vaccine-induced activation of...

Background: COVID-19 has disproportionately affected older adults. Yet, healthcare trajectories experienced by older persons hospitalized for COVID-19 have not been investigated. This study aimed at estimating the probabilities of transitions between severity states in older adults admitted in COVID-19 acute wards and at identifying the factors as...

Background Safe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of...

Objective: Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTC...

Background Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population. Aims The present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to t...

Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 6...

Dementia was one of the conditions focused on in an EU (European Union) project called “PARADISE” (Psychosocial fActors Relevant to brAin DISorders in Europe) that later produced a measure called PARADISE 24, developed within the biopsychosocial model proposed in the International Classification of Functioning Disability and Health (ICF). The aims...

Covid-19 may have a heterogeneous onset, especially in older age. However, whether and how Covid-19 signs and symptoms may present and aggregate together according to sociodemographic and health factors is unclear, as well as their prognostic value. This work included 981 Covid-19 inpatients who participated in the GeroCovid Observational study. Si...

A third dose of mRNA COVID-19 vaccine dose restores high levels of anti-Spike IgG in nursing home residents. A longer interval between first and third dose does not impair immunogenicity.

Background In older and multimorbid patients, chronic conditions may affect the prognostic validity of computed tomography (CT) findings in COVID-19. This study aims at assessing to which extent CT findings have prognostic implications in COVID-19 older patients. Methods Hospitalized COVID-19 patients aged 60 years or more enrolled in the multicen...

The COVID-19 pandemic has changed routine care practice for older persons, especially in those with frailty living in long term care (LTC) facilities. Due to the high mortality rates of Nursing home (NH) residents during the first wave of the COVID-19 pandemic, priority for COVID-19 vaccinations was given to this vulnerable population. However, the...

Background and aimsAtrial fibrillation (AF) is often complicated by disabling conditions in the elderly. COVID-19 has high mortality in older people. This study aimed at evaluating the relationship of pre-infection AF with characteristics and survival of older COVID-19 patients.Methods We retrospectively analyzed inpatients aged ≥ 60 years enrolled...

Italy was one of the first western countries to embrace the first wave of COVID-19 and undergo detrimental outcomes in older adults in different clinical settings, especially in those with comorbidity and frailty. In addition, older nursing home (NH) residents had significantly higher mortality rates most likely due to the increased susceptibility...

Objectives: The spread of COVID-19 has undeniably unsettled the social, psychological and emotional life of the entire world population. Particular attention should be paid to older adults with dementia, given their vulnerability to emotional stressors. The aim of this retrospective study is to evaluate the impact of the first wave quarantine relat...

Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC...

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients' care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective st...

Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European count...

Funding Acknowledgements Type of funding sources: None. OnBehalf the GeroCovid Investigators Introduction. Atrial fibrillation (AF), the arrhythmia most frequently diagnosed in older patients, associates with serious, thrombo-embolic, complications and high mortality. COVID-19 severely affects aged subjects, determining an important prothrombotic...

Funding Acknowledgements Type of funding sources: None. OnBehalf the GeroCovid Investigators Introduction. Atrial fibrillation (AF) is the most frequent arrhythmia diagnosed in elderly patients. It often associates with disabling complications, such as stroke and systemic embolism. COVID-19 severely affects older subjects, who show a particularly...

Introduction: Atrial fibrillation (AF), the most frequent arrhythmia of older patients, associates with serious thrombo-embolic complications and high mortality. COVID-19 severely affects aged subjects, determining an important prothrombotic status. Aim of this study was to evaluate mortality-related factors in older AF patients with COVID-19. Me...

Background Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To dat...

Background : Despite the growing evidence on Covid-19, there are still many gaps in the understanding of this disease, especially in individuals in advanced age. We describe the study protocol of GeroCovid Observational, a multi-purpose, multi-setting and multicenter initiative that aims at investigating: risk factors, clinical presentation and out...

Following the rapid spread of a new Coronavirus identified in China, on 30.01.2020, the World Health Organization (WHO) declares a state of public health emergency of international importance and in Italy health surveillance measures are promptly strengthened. The aim of the study is to describe the surveillance system for the spread of the epidemi...

Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoin...

Objectives Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design This is a cross-sectional study nested in the “Delirium Day” study, a nationwide Italian poin...

Pain is under-detected and under -treated in the elderly. This study inves􏱙gates the prevalence of pain in elderly people ad- mi􏱚ed to Long Term Care Facili􏱙es of the Na- 􏱙onal Associa􏱙on of Third Age Structures (ANASTE) and it evaluates the associa􏱙on be- tween pain, mood and quality of life.

Background: Pain is under-detected and undertreated in people with dementia. The present study investigates the prevalence of pain in people with dementia hospitalized in nursing homes that are members of National Association of Third Age Residences (ANASTE) Calabria, and evaluates the association among pain, mood, and behavioral and psychological...

The Behavioural and Psychological Symptoms of Dementia (BPSD) are the biggest predictors of stress experienced by caregivers, they are correlated with high levels of burden of care. The level of stress is a multidimensional construct observable and expressed by physical, psychological, social and economic variables. The Relative Stress Scale (RSS),...

PROFILES OF ICF DISABILITY IN ALZHEIMER AND VASCULAR DEMENTIA A. Malara, G. Sgrò, F. Ceravolo, G. Curinga, G.F. Renda, F. Spadea, V. Rispoli

Backgrounds: The International Classification of Functioning, Disability and Health (ICF) is a suitable tool to standardize the status of health and disability. A previous study, carried out on 546 subjects included in the database ANASTE (National Association of Nursing Home for Third Age) Calabria, showed that 78.43% of the patients suffered from...

The interaction between dementia and nutritional state is very complex and not yet fully understood. The aim of the present study was to assess the interaction between cognitive impairment and nutritional state in a cohort of residential elderly in relationship with functional condition of patients and their load of assistance in long-term-care fac...

The studio di intervento nel decadimento vascolare lieve (IDEALE study) was an open multicenter Italian study, the aim of which was to assess the effectiveness and safety of oral citicoline in elderly people with mild vascular cognitive impairment. The study was performed in 349 patients. The active or citicoline group was composed of 265 patients...

Objectives: This paper describes the preliminary results of a project funded by Scientific Coordination ANASTE Calabria on experimentation of RUG-III (Resource Utilization Groups-version III) classification system as a method for measuring time, care needs and case mix of nursing homés residents. Methods: RUG-III uses a subset of MDS/RAI assessment...

Objectives: This paper describes the preliminary results of a project funded by Scientific Coordination ANASTE Calabria on experimentation of RUG-III (Resource Utilization Groups-version III) classification system as a method for measuring time, care needs and case mix of nursing homés residents. Methods: RUG-III uses a subset of MDS/RAI assessment...

To verify whether platelet responsiveness to leptin is associated with metabolic syndrome risk factors. Cross-sectional study. We studied 169 consecutive patients, mean age=43.6+/-9.9 years, with overweight (N=57) or obesity (N=112). Cluster analysis was used to generate three clusters based on platelet responsiveness to increasing doses of leptin....

Magnesium sulphate has well known antiplatelet properties. Its effect on leptin-dependent platelet aggregation has not been studied previously. Thus, we performed this ex vivo study to investigate whether magnesium sulphate is able to inhibit leptin-dependent aggregation of human platelets. We obtained platelet rich plasma (PRP) from venous blood s...

To investigate the role of phospholipase C (PLC), phospholipase A(2) (PLA(2)), calcium, and protein kinase C (PKC) in mediating leptin-enhanced aggregation of human platelets. In vitro, ex vivo study. Outpatient's Service for Prevention and Treatment of Obesity at the University Hospital of Messina, Italy. In total, 14 healthy normal-weight male (a...

To investigate the effects of leptin on platelet aggregation and platelet free calcium (Ca(2+)) concentrations, and the role of the long form of leptin receptor (ObRb) and the phospholipase C (PLC) in mediating leptin effects on platelet function. Cross-sectional, clinical study. Outpatient's Service for Prevention and Treatment of Obesity at the U...

Dear Sir:We have read with great interest the paper by Ozata et al.(1). Their results are in contrast with recent evidence sug-gesting that leptin may promote human platelet aggregation(2). We performed this study to investigate the role of leptinin the regulation of platelet aggregation in humans.Our study consisted of 14 healthy men (age 25 to 35...

We performed this study to investigate whether alpha- and beta-adrenergic agonists are able to regulate intracellular free magnesium concentrations [Mg2+]i in platelets from healthy and obese individuals. Twenty-six informed-consent men (14 healthy and 12 obese) were enrolled in the study. We measured fasting plasma glucose, insulin, epinephrine an...

We performed this cross-sectional case control study to investigate the association between low serum magnesium levels and cognitive impairment in hypertensive hospitalized patients. The study was carried out in general medical care units at 81 hospitals participating in the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study throughout I...

We performed this study to investigate whether changes in plasma glucose, insulin, and norepinephrine concentrations during an oral glucose tolerance test (OGTT) are associated with changes in plasma leptin levels in normotensive and hypertensive obese women. Plasma insulin, glucose, norepinephrine, and leptin concentrations were evaluated at the b...

We performed this case control study to evaluate the risk of hypoglycemia associated with the use of antihypertensive drugs in older hospitalized diabetic patients treated with sulfonylureas and/or insulin. All diabetic patients admitted during 4 months in 1988, month in 1991, 4 months in 1993 and 4 months in 1995 (n = 3477, mean age 71.4 +/- 0.2 y...

We measured plasma and platelet magnesium concentrations, plasma epinephrine and norepinephrine, and plasma aldosterone and renin concentrations in normotensive (NT-Ob, n = 19, BMI 35.7 +/- 7.4 kg/m2, WHR 0.92 +/- 0.05) and hypertensive (HT-Ob, n = 11, BMI 35.2 +/- 3.6 kg/m2, WHR 0.93 +/- 0.07) obese subjects, and in a group of age- and sex-matched...

We performed this case–control study to evaluate the risk of hypoglycemia associated with the use of antihypertensive drugs in older hospitalized diabetic patients treated with sulfonylureas and/or insulin. All diabetic patients admitted during 4 months in 1988, 1 month in 1991, 4 months in 1993 and 4 months in 1995 (n = 3477, mean age 71.4 0.2 yea...

This was a study of the action of continuous intrathecal clonidine infusion on the locus coeruleus in the regulation of cerebral blood flow (CBF) by means of a test of the activation of the locus coeruleus (cold pressure test, CPT). The effects on CBF of intrathecal clonidine used for analgesic purposes in a patient with a chronic painful benign sy...

Introduction. The present study was made to determine diagnostic accuracy of Power Doppler Imaging (PDT) in the distinguishing of internal carotid artery pseudo-occlusion from complete occlusion. Power Doppler is a ultrasonic technique based oo the analysis of total integrated doppler power tcpectrum, and its signal depends principally from red cel...

Introduction. The fetal variant of the cerebral posterior artery is a Willis' circle variant in form characterized by its origin from internal carotid artery instead of basilar artery, associated with hypoplasia of its PI segment. This functional bifurcation is present in 10-15 % of population, and it has been always considered as phistological and...