Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

First integrated tephrochronological record for the last ∼190 kyr from the Fucino Quaternary lacustrine succession, central Italy

We present the first integrated tephrochronological study (major and trace elemental glass composition, Sr and Nd isotope analyses, and 40Ar/39Ar dating) for the last one tenth (∼82 m) of the ∼900 m-thick Quaternary lacustrine succession of the Fucino Basin, the largest and probably only Central Apennine intermountain tectonic depression that hosts a continuous lacustrine succession documenting the Plio-Quaternary sedimentary history up to historical times. Major element glass compositions, determined using a wavelength-dispersive electron microprobe (WDS-EMPA), yielded the geochemical fingerprinting needed for a reliable identification of most of the 23 stratigraphically ordered tephra layers under investigation. These include tephra from Italian volcanoes such as Campi Flegrei, Etna, Colli Albani, Ischia, Vico, Sabatini, and undefined volcanic sources in the Neapolitan area and Latium region. The recognition of key Mediterranean marker tephra layers (e.g. X-5 and X-6) is supported by trace element data acquired by Laser Ablation Inductively Couple Plasma Mass Spectrometry (LA-ICP-MS). The Sr and Nd isotope compositions of selected layers where also determined for circumscribing the volcanic source of distal tephra and for supporting correlations with individual eruptive units. We also propose a new, more expeditious covariation diagram (CaO/FeOtot vs Cl) for identifying the volcanic source of trachytic to phonolitic and tephrytic to phonolitic tephra, that are the most common compositions of pyroclastic rocks from volcanoes of Campania and Latium regions. Finally, we present five new 40Ar/39Ar age determinations, including a new, analytically well-supported, and more precise 40Ar/39Ar age for the widespread Y-7 tephra, and the first 40Ar/39Ar age determinations for one tephra from the Sabatini volcanic district (∼126 ka) and one tephra from Neapolitan volcanic area (Campi Flegrei?; ∼159 ka). These newly dated tephra are widely dispersed (e.g. Monticchio, southern Italy, Adriatic Sea and Lake Ohrid, Macedonia-Abania) and have thus the potential to become important Mediterranean MIS 5 and MIS 6 tephrochronological markers. Altogether the new geochemical data and 40Ar/39Ar ages precisely constrain the chronology of the investigated Fucino succession spanning the last ∼190 ka. In light of these results and by considering that this sedimentary succession possibly extends back to ∼2 Ma, Fucino is likely to provide a very long, continuous tephrostratigraphic record for the Mediterranean area and become a key node in the dense network of tephra correlations of this region

What changed in the Italian internal medicine and geriatric wards during the lockdown

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Comparison between drug therapy-based comorbidity indices and the Charlson Comorbidity Index for the detection of severe multimorbidity in older subjects.

Background: To know burden disease of a patient is a key point for clinical practice and research, especially in the elderly. Charlson's Comorbidity Index (CCI) is the most widely used rating system, but when diagnoses are not available therapy-based comorbidity indices (TBCI) are an alternative. However, their performance is debated. This study compares the relations between Drug Derived Complexity Index (DDCI), Medicines Comorbidity Index (MCI), Chronic Disease Score (CDS), and severe multimorbidity, according to the CCI classification, in the elderly. Methods: Logistic regression and Receiver Operating Characteristic (ROC) analysis were conducted on two samples from Italy: 2579 nursing home residents (Korian sample) and 7505 older adults admitted acutely to geriatric or internal medicine wards (REPOSI sample). Results: The proportion of subjects with severe comorbidity rose with TBCI score increment, but the Area Under the Curve (AUC) for the CDS (Korian: 0.70, REPOSI: 0.79) and MCI (Korian: 0.69, REPOSI: 0.81) were definitely better than the DDCI (Korian: 0.66, REPOSI: 0.74). All TBCIs showed low Positive Predictive Values (maximum: 0.066 in REPOSI and 0.317 in Korian) for the detection of severe multimorbidity. Conclusion: CDS and MCI were better predictors of severe multimorbidity in older adults than DDCI, according to the CCI classification. A high CCI score was related to a high TBCI. However, the opposite is not necessarily true probably because of non-evidence-based prescriptions or physicians' prescribing attitudes. TBCIs did not appear selective for detecting of severe multimorbidity, though they could be used as a measure of disease burden, in the absence of other solutions

Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)

To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry)

Renal Function, Cardiovascular Diseases, Appropriateness of Drug Prescription and Outcomes in Hospitalized Older Patients.

none327noIntroduction: Reduced estimated creatinine clearance (eCrCl) is prevalent in older patients and impacts on drug prescription. In this study, the burden of eCrCl reduction and its associated factors and impact on outcomes were analyzed. Moreover, the rate of inappropriate drug prescription according to eCrCl and its impact on outcomes were described. Methods: Data were obtained from "REgistro POliterapie SIMI" (REPOSI), a prospective observational register enrolling hospitalized patients aged ≥ 65 years. Patients enrolled from 2010-2016 with available data to calculate eCrCl according to the Cockcroft-Gault formula were included in this analysis. Results: A total of 5046 patients were available for analysis. Among these, we found an eCrCl of 45-59 mL/min in 1163 patients (23.0%), an eCrCl of 30-44 mL/min in 1128 (22.4%), an eCrCl of 15-29 mL/min in 702 (13.9%), and an eCrCl < 15 mL/min in 152 (3.0%), with several clinical factors associated with decreasing eCrCl. During follow-up, a progressively higher risk for all-cause death, cardiovascular (CV) death, any death/re-hospitalization, and CV death/re-hospitalization was found across the renal function classes. Among patients with hypertension, diabetes mellitus, atrial fibrillation, coronary artery disease, and heart failure, 476 (10.9%) were inappropriately prescribed medications according to eCrCl. During follow-up, inappropriate prescription was associated with increased risk of all-cause death (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.13-1.97) and any death/re-hospitalization (OR 1.30, 95% CI 1.03-1.63). Conclusions: In older hospitalized patients, impaired eCrCl is prevalent and associated with several factors, polypharmacy in particular. Patients with reduced eCrCl have a higher risk of major clinical outcomes, and > 10% of them are prescribed an inappropriate drug, with a higher risk for major clinical outcomes.noneAntonietta Gigante, Marco Proietti, Enrico Petrillo, Pier Mannuccio Mannucci, Alessandro Nobili, Maurizio Muscaritoli, Antonello Pietrangelo, Francesco Perticone, Francesco Violi, Gino Roberto Corazza, Salvatore Corrao, Alessandra Marengoni, Francesco Salerno, Matteo Cesari, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Laura Cortesi, Gabriella Miglio, Ilaria Ardoino, Alessio Novella, Domenico Prisco, Elena Silvestri, Giacomo Emmi, Alessandra Bettiol, Irene Mattioli, Gianni Biolo, Michela Zanetti, Giacomo Bartelloni, Massimo Vanoli, Giulia Grignani, Edoardo Alessandro Pulixi, Graziana Lupattelli, Vanessa Bianconi, Riccardo Alcidi, Domenico Girelli, Fabiana Busti, Giacomo Marchi, Mario Barbagallo, Ligia Dominguez, Vincenza Beneduce, Federica Cacioppo, Salvatore Corrao, Giuseppe Natoli, Salvatore Mularo, Massimo Raspanti, Marco Zoli, Maria Laura Matacena, Giuseppe Orio, Eleonora Magnolfi, Giovanni Serafini, Angelo Simili, Giuseppe Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia Scaramellini, Matteo Cesari, Paolo Dionigi Rossi, Sarah Damanti, Marta Clerici, Simona Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela Miceli, Marco Vincenzo Lenti, Martina Pisati, Costanza Caccia Dominioni, Roberto Pontremoli, Valentina Beccati, Giulia Nobili, Giovanna Leoncini, Luigi Anastasio, Maria Carbone, Francesco Cipollone, Maria Teresa Guagnano, Ilaria Rossi, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Giuseppe Delitala, Maria Berria, Alessandro Delitala, Alessio Molfino, Enrico Petrillo, Antonella Giorgi, Christian Gracian, Giuseppe Zuccalà, Gabriella D’Aurizio, Giuseppe Romanelli, Alessandra Marengoni, Andrea Volpini, Daniela Lucente, Antonio Picardi, Umberto Vespasiani Gentilucci, Paolo Gallo, Giorgio Annoni, Maurizio Corsi, Giuseppe Bellelli, Alessandra Bonfanti, Franco Arturi, Elena Succurro, Bruno Tassone, Federica Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio Brucato, Teresa De Falco, Fabrizio Fabris, Irene Bertozzi, Giulia Bogoni, Maria Victoria Rabuini, Tancredi Prandini, Roberto Manfredini, Fabio Fabbian, Benedetta Boari, Alfredo De Giorgi, Ruana Tiseo, Giuseppe Paolisso, Maria Rosaria Rizzo, Claudia Catalano, Claudio Borghi, Enrico Strocchi, Eugenia Ianniello, Mario Soldati, Silvia Schiavone, Alessio Bragagni, Carlo Sabbà, Francesco Saverio Vella, Patrizia Suppressa, Giovanni Michele De Vincenzo, Alessio Comitangelo, Emanuele Amoruso, Carlo Custodero, Luigi Fenoglio, Andrea Falcetta, Anna L. Fracanzani, Silvia Tiraboschi, Annalisa Cespiati, Giovanna Oberti, Giordano Sigon, Flora Peyvandi, Raffaella Rossio, Giulia Colombo, Pasquale Agosti, Valter Monzani, Valeria Savojardo, Giuliana Ceriani, Francesco Salerno, Giada Pallini, Fabrizio Montecucco, Luciano Ottonello, Lara Caserza, Giulia Vischi, Nicola Lucio Liberato, Tiziana Tognin, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Renzo Rozzini, Lina Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano Buffelli, Giuseppe Montrucchio, Paolo Peasso, Edoardo Favale, Cesare Poletto, Carl Margaria, Maura Sanino, Francesco Violi, Ludovica Perri, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Leonardo Campiotti, Alessandra Grossi, Roberto Davide Diprizio, Marco Bertolotti, Chiara Mussi, Giulia Lancellotti, Maria Vittoria Libbra, Matteo Galassi, Yasmine Grassi, Francesco Perticone, Maria Perticone, Rosa Battaglia, Marco FIlice, Raffaele Maio, Vincenzo Stanghellini, Eugenio Ruggeri, Sara del Vecchio, Andrea Salvi, Roberto Leonardi, Giampaolo Damiani, William Capeci, Massimo Mattioli, Giuseppe Pio Martino, Lorenzo Biondi, Pietro Pettinari, Salvatore Minisola, Luciano Colangelo, Mirella Cilli, Giancarlo Labbadia, Antonella Afeltra, Benedetta Marigliano, Maria Elena Pipita, Pietro Castellino, Luca Zanoli, Alfio Gennaro, Agostino Gaudio, Valter Saracco, Marisa Fogliati, Carlo Bussolino, Francesca Mete, Miriam Gino, Carlo Vigorito, Antonio Cittadini, Guido Moreo, Silvia Prolo, Gloria Pina, Alberto Ballestrero, Fabio Ferrando, Sergio Berra, Simonetta Dassi, Maria Cristina Nava, Bruno Graziella, Stefano Baldassarre, Salvatore Fragapani, Gabriella Gruden, Giorgio Galanti, Gabriele Mascherini, Cristian Petri, Laura Stefani, Margherita Girino, Valeria Piccinelli, Francesco Nasso, Vincenza Gioffrè, Maria Pasquale, Leonardo Sechi, Cristiana Catena, Gianluca Colussi, Alessandro Cavarape, Andea Da Porto, Nicola Passariello, Luca Rinaldi, Franco Berti, Giuseppe Famularo, Patrizia Tarsitani, Roberto Castello, Michela Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta Morganti, Andrea Artoni, Margherita Grossi, Stefano Del Giacco, Davide Firinu, Giulia Costanzo, Giacomo Argiolas, Giuseppe Montalto, Anna Licata, Filippo Alessandro Montalto, Francesco Corica, Giorgio Basile, Antonino Catalano, Federica Bellone, Concetto Principato, Lorenzo Malatino, Benedetta Stancanelli, Valentina Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella Caruso, Patrizia Mecocci, Carmelinda Ruggiero, Virginia Boccardi, Tiziana Meschi, Andrea Ticinesi, Antonio Nouvenne, Pietro Minuz, Luigi Fondrieschi, Giandomenico Nigro Imperiale, Mario Pirisi, Gian Paolo Fra, Daniele Sola, Mattia Bellan, Massimo Porta, Piero Riva, Roberto Quadri, Erica Larovere, Marco Novelli, Giorgio Scanzi, Caterina Mengoli, Stella Provini, Laura Ricevuti, Emilio Simeone, Rosa Scurti, Fabio Tolloso, Roberto Tarquini, Alice Valoriani, Silvia Dolenti, Giulia Vannini, Riccardo Volpi, Pietro Bocchi, Alessandro Vignali, Sergio Harari, Chiara Lonati, Federico Napoli, Italia Aiello, Raffaele Landolfi, Massimo Montalto, Antonio Mirijello, Francesco Purrello, Antonino Di Pino, Silvia Ghidoni, Teresa Salvatore, Lucio Monaco, Carmen Ricozzi, Alberto Pilotto, Ilaria Indiano, Federica Gandolfo.Gigante, Antonietta; Proietti, Marco; Petrillo, Enrico; Mannuccio Mannucci, Pier; Nobili, Alessandro; Muscaritoli, Maurizio; Pietrangelo, Antonello; Perticone, Francesco; Violi, Francesco; Roberto Corazza, Gino; Corrao, Salvatore; Marengoni, Alessandra; Salerno, Francesco; Cesari, Matteo; Tettamanti, Mauro; Pasina, Luca; Franchi, Carlotta; Cortesi, Laura; Miglio, Gabriella; Ardoino, Ilaria; Novella, Alessio; Prisco, Domenico; Silvestri, Elena; Emmi, Giacomo; Bettiol, Alessandra; Mattioli, Irene; Biolo, Gianni; Zanetti, Michela; Bartelloni, Giacomo; Vanoli, Massimo; Grignani, Giulia; Alessandro Pulixi, Edoardo; Lupattelli, Graziana; Bianconi, Vanessa; Alcidi, Riccardo; Girelli, Domenico; Busti, Fabiana; Marchi, Giacomo; Barbagallo, Mario; Dominguez, Ligia; Beneduce, Vincenza; Cacioppo, Federica; Corrao, Salvatore; Natoli, Giuseppe; Mularo, Salvatore; Raspanti, Massimo; Zoli, Marco; Laura Matacena, Maria; Orio, Giuseppe; Magnolfi, Eleonora; Serafini, Giovanni; Simili, Angelo; Palasciano, Giuseppe; Ester Modeo, Maria; Di Gennaro, Carla; Domenica Cappellini, Maria; Fabio, Giovanna; Migone De Amicis, Margherita; De Luca, Giacomo; Scaramellini, Natalia; Cesari, Matteo; Dionigi Rossi, Paolo; Damanti, Sarah; Clerici, Marta; Leoni, Simona; Danuta Di Mauro, Alessandra; Di Sabatino, Antonio; Miceli, Emanuela; Vincenzo Lenti, Marco; Pisati, Martina; Caccia Dominioni, Costanza; Pontremoli, Roberto; Beccati, Valentina; Nobili, Giulia; Leoncini, Giovanna; Anastasio, Luigi; Carbone, Maria; Cipollone, Francesco; Teresa Guagnano, Maria; Rossi, Ilaria; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Delitala, Giuseppe; Berria, Maria; Delitala, Alessandro; Molfino, Alessio; Petrillo, Enrico; Giorgi, Antonella; Gracian, Christian; Zuccalà, Giuseppe; D’Aurizio, Gabriella; Romanelli, Giuseppe; Marengoni, Alessandra; Volpini, Andrea; Lucente, Daniela; Picardi, Antonio; Vespasiani Gentilucci, Umberto; Gallo, Paolo; Annoni, Giorgio; Corsi, Maurizio; Bellelli, Giuseppe; Bonfanti, Alessandra; Arturi, Franco; Succurro, Elena; Tassone, Bruno; Giofrè, Federica; Grazia Serra, Maria; Antonietta Bleve, Maria; Brucato, Antonio; De Falco, Teresa; Fabris, Fabrizio; Bertozzi, Irene; Bogoni, Giulia; Victoria Rabuini, Maria; Prandini, Tancredi; Manfredini, Roberto; Fabbian, Fabio; Boari, Benedetta; DE GIORGI, Alfredo; Tiseo, Ruana; Paolisso, Giuseppe; Rosaria Rizzo, Maria; Catalano, Claudia; Borghi, Claudio; Strocchi, Enrico; Ianniello, Eugenia; Soldati, Mario; Schiavone, Silvia; Bragagni, Alessio; Sabbà, Carlo; Saverio Vella, Francesco; Suppressa, Patrizia; Michele De Vincenzo, Giovanni; Comitangelo, Alessio; Amoruso, Emanuele; Custodero, Carlo; Fenoglio, Luigi; Falcetta, Andrea; Fracanzani, Anna L.; Tiraboschi, Silvia; Cespiati, Annalisa; Oberti, Giovanna; Sigon, Giordano; Peyvandi, Flora; Rossio, Raffaella; Colombo, Giulia; Agosti, Pasquale; Monzani, Valter; Savojardo, Valeria; Ceriani, Giuliana; Salerno, Francesco; Pallini, Giada; Montecucco, Fabrizio; Ottonello, Luciano; Caserza, Lara; Vischi, Giulia; Lucio Liberato, Nicola; Tognin, Tiziana; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Rozzini, Renzo; Falanga, Lina; Stella Pisciotta, Maria; Baffa Bellucci, Francesco; Buffelli, Stefano; Montrucchio, Giuseppe; Peasso, Paolo; Favale, Edoardo; Poletto, Cesare; Margaria, Carl; Sanino, Maura; Violi, Francesco; Perri, Ludovica; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Campiotti, Leonardo; Grossi, Alessandra; Davide Diprizio, Roberto; Bertolotti, Marco; Mussi, Chiara; Lancellotti, Giulia; Vittoria Libbra, Maria; Galassi, Matteo; Grassi, Yasmine; Perticone, Francesco; Perticone, Maria; Battaglia, Rosa; Filice, Marco; Maio, Raffaele; Stanghellini, Vincenzo; Ruggeri, Eugenio; del Vecchio, Sara; Salvi, Andrea; Leonardi, Roberto; Damiani, Giampaolo; Capeci, William; Mattioli, Massimo; Pio Martino, Giuseppe; Biondi, Lorenzo; Pettinari, Pietro; Minisola, Salvatore; Colangelo, Luciano; Cilli, Mirella; Labbadia, Giancarlo; Afeltra, Antonella; Marigliano, Benedetta; Elena Pipita, Maria; Castellino, Pietro; Zanoli, Luca; Gennaro, Alfio; Gaudio, Agostino; Saracco, Valter; Fogliati, Marisa; Bussolino, Carlo; Mete, Francesca; Gino, Miriam; Vigorito, Carlo; Cittadini, Antonio; Moreo, Guido; Prolo, Silvia; Pina, Gloria; Ballestrero, Alberto; Ferrando, Fabio; Berra, Sergio; Dassi, Simonetta; Cristina Nava, Maria; Graziella, Bruno; Baldassarre, Stefano; Fragapani, Salvatore; Gruden, Gabriella; Galanti, Giorgio; Mascherini, Gabriele; Petri, Cristian; Stefani, Laura; Girino, Margherita; Piccinelli, Valeria; Nasso, Francesco; Gioffrè, Vincenza; Pasquale, Maria; Sechi, Leonardo; Catena, Cristiana; Colussi, Gianluca; Cavarape, Alessandro; Da Porto, Andea; Passariello, Nicola; Rinaldi, Luca; Berti, Franco; Famularo, Giuseppe; Tarsitani, Patrizia; Castello, Roberto; Pasino, Michela; Paolo Ceda, Gian; Giuseppe Maggio, Marcello; Morganti, Simonetta; Artoni, Andrea; Grossi, Margherita; Del Giacco, Stefano; Firinu, Davide; Costanzo, Giulia; Argiolas, Giacomo; Montalto, Giuseppe; Licata, Anna; Alessandro Montalto, Filippo; Corica, Francesco; Basile, Giorgio; Catalano, Antonino; Bellone, Federica; Principato, Concetto; Malatino, Lorenzo; Stancanelli, Benedetta; Terranova, Valentina; Di Marca, Salvatore; Di Quattro, Rosario; La Malfa, Lara; Caruso, Rossella; Mecocci, Patrizia; Ruggiero, Carmelinda; Boccardi, Virginia; Meschi, Tiziana; Ticinesi, Andrea; Nouvenne, Antonio; Minuz, Pietro; Fondrieschi, Luigi; Nigro Imperiale, Giandomenico; Pirisi, Mario; Paolo Fra, Gian; Sola, Daniele; Bellan, Mattia; Porta, Massimo; Riva, Piero; Quadri, Roberto; Larovere, Erica; Novelli, Marco; Scanzi, Giorgio; Mengoli, Caterina; Provini, Stella; Ricevuti, Laura; Simeone, Emilio; Scurti, Rosa; Tolloso, Fabio; Tarquini, Roberto; Valoriani, Alice; Dolenti, Silvia; Vannini, Giulia; Volpi, Riccardo; Bocchi, Pietro; Vignali, Alessandro; Harari, Sergio; Lonati, Chiara; Napoli, Federico; Aiello, Italia; Landolfi, Raffaele; Montalto, Massimo; Mirijello, Antonio; Purrello, Francesco; Di Pino, Antonino; Ghidoni, Silvia; Salvatore, Teresa; Monaco, Lucio; Ricozzi, Carmen; Pilotto, Alberto; Indiano, Ilaria; Gandolfo., Federic