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Article ; Online: Socioeconomic inequalities in avoidable mortality in Italy: results from a nationwide longitudinal cohort.

Petrelli, Alessio / Ventura, Martina / Di Napoli, Anteo / Pappagallo, Marilena / Simeoni, Silvia / Frova, Luisa

2024 Volume 24, Issue 1, Page(s) 757

Abstract: Background: Disparities in avoidable mortality have never been evaluated in Italy at the national level. The present study aimed to assess the association between socioeconomic status and avoidable mortality.: Methods: The nationwide closed cohort of ...

Abstract	Background: Disparities in avoidable mortality have never been evaluated in Italy at the national level. The present study aimed to assess the association between socioeconomic status and avoidable mortality. Methods: The nationwide closed cohort of the 2011 Census of Population and Housing was followed up for 2012-2019 mortality. Outcomes of preventable and of treatable mortality were separately evaluated among people aged 30-74. Education level (elementary school or less, middle school, high school diploma, university degree or more) and residence macro area (North-West, North-East, Center, South-Islands) were the exposures, for which adjusted mortality rate ratios (MRRs) were calculated through multivariate quasi-Poisson regression models, adjusted for age at death. Relative index of inequalities was estimated for preventable, treatable, and non-avoidable mortality and for some specific causes. Results: The cohort consisted of 35,708,459 residents (48.8% men, 17.5% aged 65-74), 34% with a high school diploma, 33.5% living in the South-Islands; 1,127,760 deaths were observed, of which 65.2% for avoidable causes (40.4% preventable and 24.9% treatable). Inverse trends between education level and mortality were observed for all causes; comparing the least with the most educated groups, a strong association was observed for preventable (males MRR = 2.39; females MRR = 1.65) and for treatable causes of death (males MRR = 1.93; females MRR = 1.45). The greatest inequalities were observed for HIV/AIDS and alcohol-related diseases (both sexes), drug-related diseases and tuberculosis (males), and diabetes mellitus, cardiovascular diseases, and renal failure (females). Excess risk of preventable and of treatable mortality were observed for the South-Islands. Conclusions: Socioeconomic inequalities in mortality persist in Italy, with an extremely varied response to policies at the regional level, representing a possible missed gain in health and suggesting a reassessment of priorities and definition of health targets.
MeSH term(s)	Male ; Female ; Humans ; Cause of Death ; Educational Status ; Cardiovascular Diseases ; Italy/epidemiology ; Social Class ; Socioeconomic Factors ; Mortality
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-18205-6
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Article ; Online: Comment on "Novel Glutamatergic Modulators for the Treatment of Mood Disorders: Current Status".

Pappagallo, Marco / Inturrisi, Charles E / Manfredi, Paolo L

CNS drugs

2022 Volume 36, Issue 2, Page(s) 203–204

MeSH term(s)	Glutamic Acid ; Humans ; Mood Disorders/drug therapy
Chemical Substances	Glutamic Acid (3KX376GY7L)
Language	English
Publishing date	2022-01-11
Publishing country	New Zealand
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1203800-3
ISSN	1179-1934 ; 1172-7047
ISSN (online)	1179-1934
ISSN	1172-7047
DOI	10.1007/s40263-021-00891-0
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Article ; Online: Esophageal Atresia and Tracheoesophageal Fistula.

Forero Zapata, Laura / Pappagallo, Mariann

The New England journal of medicine

2018 Volume 379, Issue 7, Page(s) e11

MeSH term(s)	Abnormalities, Multiple/diagnostic imaging ; Esophageal Atresia/diagnostic imaging ; Esophageal Atresia/surgery ; Humans ; Infant, Newborn ; Radiography, Thoracic ; Tracheoesophageal Fistula/diagnostic imaging ; Tracheoesophageal Fistula/surgery
Language	English
Publishing date	2018-08-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMicm1801712
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Article ; Online: Male and Female Differences in Homicide Mortality: Results of an Italian Longitudinal Study, 2012-2018.

Ventura, Martina / Di Napoli, Anteo / Petrelli, Alessio / Pappagallo, Marilena / Mirisola, Concetta / Frova, Luisa

Frontiers in public health

2022 Volume 10, Page(s) 919335

Abstract: Introduction: Italy has one of the lowest homicide rates in Europe. However, while it is decreasing overall, the proportion of murdered women is increasing. This study aimed to analyze the demographic and socioeconomic characteristics associated with ... ...

Abstract	Introduction: Italy has one of the lowest homicide rates in Europe. However, while it is decreasing overall, the proportion of murdered women is increasing. This study aimed to analyze the demographic and socioeconomic characteristics associated with homicide mortality in Italy, focusing specifically on male and female differences. Methods: Using a longitudinal design, the Italian 2011 General Census population was followed up to 2018. Deaths from homicide were retrieved by a record linkage with the Causes of Death Register. Age-standardized mortality rates, stratified by sex, citizenship, education, and geographic area of residence were calculated. The association between sociodemographic characteristics and homicide mortality was evaluated using quasi-Poisson regression models. Results: Between 2012 and 2018, 1,940 homicides were recorded in Italy: 53% were females over age 55, 10% were immigrant females, 34% were males aged 40-54 years, 76% had a medium-low education level, and 57% lived in the South and Islands. Foreign citizenship increased a female's risk of dying from homicide (adjusted rate ratio (RRadj): 1.85; 95% CI: 1.54-2.23), while no differences between Italian and immigrant males were found. An inverse association between education and mortality was observed for both sexes, stronger for males (RRadj: 3.68; 95% CI: 3.10-4.36, low vs. high) than for females (RRadj: 1.38; 95%CI: 1.17-1.62, low vs. high). Moreover, a male residing in the South or the Islands had almost 2.5 times the risk of dying from homicide than a resident in the North-West. Finally, old age (over 75) increased a female's risk of being murdered, whereas the highest risk for males was observed for those aged 25-54 years. Conclusions: Male and female differences in homicide mortality profiles by age were expected, but the results by residence, citizenship, and education highlight that living in disadvantaged socioeconomic contexts increases the risk of dying from homicide, suggesting the need to implement specific prevention and intervention strategies.
MeSH term(s)	Educational Status ; Europe ; Female ; Homicide ; Humans ; Italy/epidemiology ; Longitudinal Studies ; Male
Language	English
Publishing date	2022-07-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.919335
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Article: REL-1017 (Esmethadone), A Novel NMDAR Blocker for the Treatment of MDD is Not Neurotoxic in Sprague-Dawley Rats.

Bifari, Francesco / Pappagallo, Marco / Bleavins, Michael / Traversa, Sergio / Folli, Franco / Manfredi, Paolo L

Frontiers in pharmacology

2022 Volume 13, Page(s) 863959

Abstract: REL-1017 (esmethadone; dextromethadone; (S)-methadone) is the opioid-inactive dextro-isomer of the racemic mixture, (R, S)-methadone. REL-1017 acts as a low affinity, low potency N-methyl-D-aspartate receptor (NMDAR) channel blocker with rapid, robust, ... ...

Abstract	REL-1017 (esmethadone; dextromethadone; (S)-methadone) is the opioid-inactive dextro-isomer of the racemic mixture, (R, S)-methadone. REL-1017 acts as a low affinity, low potency N-methyl-D-aspartate receptor (NMDAR) channel blocker with rapid, robust, and sustained therapeutic effects in patients with major depressive disorder (MDD). Systemic administration of NMDAR blockers may cause transient and reversible pathomorphological alterations in brain cortical neurons characterized by cytoplasmic vacuolization, which are called Olney's lesions, and may also lead to irreversible neuronal necrosis. We determined whether REL-1017 administration via oral gavage for 1-4 days to Sprague-Dawley rats could produce Olney's lesions and cortical neuronal death and microgliosis as compared with MK-801, a known neurotoxic potent NMDAR blocker. As previously reported, MK-801 produced Olney's lesions, neuronal necrosis and cortical microgliosis, and impaired behavior and activity. In contrast, administration of REL-1017 at low (20-31.25 mg/kg in females and males), medium (40-62.5 mg/kg) or high (80-110 mg/kg) doses did not cause pathomorphological changes in brain neurons and did not cause impaired behavior and activity. In conclusion, REL-1017 did not produce initial or cumulative neurotoxic effects or other evidence of damage to cortical neurons, further encouraging the development of REL-1017 as a potentially safe novel candidate for rapid treatment of MDD.
Language	English
Publishing date	2022-04-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587355-6
ISSN	1663-9812
ISSN	1663-9812
DOI	10.3389/fphar.2022.863959
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Article: Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017.

Trias-Llimós, Sergi / Barbieri, Magali / Egidi, Viviana / Frova, Luisa / Grippo, Francesco / Meslé, France / Pappagallo, Marilena / Désesquelles, Aline

Demographic research

2023 Volume 49, Issue 2, Page(s) 13–30

Abstract: Background: The increasing prevalence of frailty in aging populations represents a major social and public health challenge which warrants a better understanding of the contribution of frailty to the morbid process.: Objective: To examine frailty- ... ...

Abstract	Background: The increasing prevalence of frailty in aging populations represents a major social and public health challenge which warrants a better understanding of the contribution of frailty to the morbid process. Objective: To examine frailty-related mortality as reported on the death certificate in France, Italy, Spain and the United States in 2017. Methods: We identify frailty at death for the population aged 50 years and over in France, Italy, Spain and the United States. We estimate the proportions of deaths by sex, age group and country with specific frailty-related ICD-codes on the death certificate 1) as the underlying cause of death (UC), 2) elsewhere in Part I (sequence of diseases or conditions or events leading directly to death), and 3) anywhere in Part II (conditions that do not belong in Part I but whose presence contributed to death). Results: The age-standardized proportion of deaths with frailty at ages 50 and over is highest in Italy (25.0%), then in France (24.1%) and Spain (17.3%), and lowest in the United States (14.0%). Cross-country differences are smaller when frailty-related codes are either the underlying cause of the death or reported in Part II. Frailty-related mortality increases with age and is higher among females than males. Dementia is the most frequently reported frailty-related code. Conclusions: Notable cross-country differences were found in the prevalence and the type of frailty-related symptoms at death even after adjusting for differential age distributions.
Language	English
Publishing date	2023-07-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2003725-9
ISSN	2363-7064 ; 1435-9871
ISSN (online)	2363-7064
ISSN	1435-9871
DOI	10.4054/DemRes.2023.49.2
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Article: Incidence, prevalence, and management of opioid bowel dysfunction.

Pappagallo, M

American journal of surgery

2001 Volume 182, Issue 5A Suppl, Page(s) 11S–18S

Abstract: Opioid bowel dysfunction (OBD) is a common adverse effect associated with opioid therapy. OBD is commonly described as constipation; however, it is a constellation of adverse gastrointestinal (GI) effects, which also includes abdominal cramping, bloating, ...

Abstract	Opioid bowel dysfunction (OBD) is a common adverse effect associated with opioid therapy. OBD is commonly described as constipation; however, it is a constellation of adverse gastrointestinal (GI) effects, which also includes abdominal cramping, bloating, and gastroesophageal reflux. The mechanism for these effects is mediated primarily by stimulation of opioid receptors in the GI tract. In patients with pain, uncontrolled symptoms of OBD can add to their discomfort and may serve as a barrier to effective pain management, limiting therapy, or prompting discontinuation. Patients with cancer may have disease-related constipation, which is usually worsened by opioid therapy. However, OBD is not limited to cancer patients. A recent survey of patients taking opioid therapy for pain of noncancer origin found that approximately 40% of patients experienced constipation related to opioid therapy (<3 complete bowel movements per week) compared with 7.6% in a control group. Of subjects who required laxative therapy, only 46% of opioid-treated patients (control subjects, 84%) reported achieving the desired treatment results >50% of the time. Laxatives prescribed prophylactically and throughout opioid therapy may improve bowel movements in many patients. Nevertheless, a substantial number of patients will not obtain adequate relief of OBD because of its refractory nature. Naloxone and other tertiary opioid receptor antagonists effectively reduce the symptoms of constipation in opioid-treated patients. However, because they also act centrally, they may provoke opioid withdrawal symptoms or reverse analgesia in some patients. There are 2 peripherally selective opioid receptor antagonists, methylnaltrexone and ADL 8-2698 (Adolor Corporation, Exton, PA, USA), that are currently under investigation for their use in treating OBD. Early studies confirm that they are effective at normalizing bowel function in opioid-treated patients without entering the central nervous system and affecting analgesia. With a better understanding of the prevalence of OBD and its pathophysiology, a more aggressive approach to preventing and treating OBD is possible and will likely improve the quality of life of patients with pain.
MeSH term(s)	Analgesics, Opioid/adverse effects ; Cathartics/therapeutic use ; Colic/chemically induced ; Constipation/chemically induced ; Constipation/drug therapy ; Constipation/epidemiology ; Data Collection ; Gastroesophageal Reflux/chemically induced ; Humans ; Incidence ; Intestines/drug effects ; Intestines/physiopathology ; Naltrexone/analogs & derivatives ; Naltrexone/therapeutic use ; Narcotic Antagonists/therapeutic use ; Prevalence ; Quaternary Ammonium Compounds ; United States/epidemiology
Chemical Substances	Analgesics, Opioid ; Cathartics ; Narcotic Antagonists ; Quaternary Ammonium Compounds ; methylnaltrexone (0RK7M7IABE) ; Naltrexone (5S6W795CQM)
Language	English
Publishing date	2001-12-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/s0002-9610(01)00782-6
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Article: Aggressive pharmacologic treatment of pain.

Pappagallo, M

Rheumatic diseases clinics of North America

1999 Volume 25, Issue 1, Page(s) 193–213, vii

Abstract: In this article, the author outlines the pharmacology of nociception and discusses the two major classes of drugs used for pain control: opioids and nonopioid analgesics. In order to provide satisfactory pain relief and prevent the possible sequelae of ... ...

Abstract	In this article, the author outlines the pharmacology of nociception and discusses the two major classes of drugs used for pain control: opioids and nonopioid analgesics. In order to provide satisfactory pain relief and prevent the possible sequelae of untreated pain, physicians must possess both knowledge and expertise in the use of opioid and nonopioid analgesics. Opioid analgesics have been underused in the management of pain. Opioids have a higher analgesic potency and wider range of indications than any of the other currently available medications for pain control. The second class of drugs, the nonopioid analgesics and adjuvants, has recently expanded to include new and potentially beneficial medications. This article furthers the understanding on how to use analgesics for a prompt, safe, and effective pharmacologic treatment of acute and chronic pain.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anticonvulsants/therapeutic use ; Antidepressive Agents/therapeutic use ; Chronic Disease ; Humans ; Muscle Relaxants, Central/therapeutic use ; Pain/drug therapy ; Pain/physiopathology
Chemical Substances	Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Anticonvulsants ; Antidepressive Agents ; Muscle Relaxants, Central
Language	English
Publishing date	1999-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	92118-x
ISSN	1558-3163 ; 0889-857X
ISSN (online)	1558-3163
ISSN	0889-857X
DOI	10.1016/s0889-857x(05)70060-0
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Article: Stress Oximetry: Description of a Test to Determine Readiness for Discontinuing Oxygen Therapy in Infants with Chronic Lung Disease.

Hussain, Naveed / Schwenn, Janet / Trzaski, Jennifer / Pappagallo, Mariann

International journal of pediatrics

2018 Volume 2018, Page(s) 8151678

Abstract: Background: In infants with CLD there are no objective tests to monitor an infant's progress towards weaning out of oxygen inhalation therapy (O: Objective: To report the clinical utility of "StressOx" in evaluating readiness for discontinuing O: ... ...

Abstract	Background: In infants with CLD there are no objective tests to monitor an infant's progress towards weaning out of oxygen inhalation therapy (O Objective: To report the clinical utility of "StressOx" in evaluating readiness for discontinuing O Methods: A retrospective review was done of StressOx tests administered at our center from 2002-2008. StressOx was performed based on a consistent clinical protocol in all eligible infants on O Results: There were 279 infants with 899 tests that met inclusion criteria. An average of 3 tests per infant was done, one week apart. The test had a specificity of 97.4% and a positive predictive value of 99.6% in determining success of discontinuing O Conclusions: StressOx appears to be a clinically useful test that may help in determining an infant's ability to successfully wean out of O
Language	English
Publishing date	2018-09-09
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2495026-9
ISSN	1687-9759 ; 1687-9740
ISSN (online)	1687-9759
ISSN	1687-9740
DOI	10.1155/2018/8151678
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Article ; Online: Mortality of people with AIDS in Italy: comparison of AIDS surveillance and multiple cause-of-death registries.

Grippo, Francesco / Grande, Enrico / Zucchetto, Antonella / Frova, Luisa / Pappagallo, Marilena / Pugliese, Lucia / Regine, Vincenza / Serraino, Diego / Taborelli, Martina / Suligoi, Barbara

Annali dell'Istituto superiore di sanita

2022 Volume 58, Issue 2, Page(s) 139–145

Abstract: Aims: To assess whether the use of multiple cause-of-death data could improve reporting of AIDS mortality in Italy.: Method: Population-based, record-linkage study, on 3,975,431 deaths recorded in the National Registry of Causes of Death (RCoD) and 4, ...

Abstract	Aims: To assess whether the use of multiple cause-of-death data could improve reporting of AIDS mortality in Italy. Method: Population-based, record-linkage study, on 3,975,431 deaths recorded in the National Registry of Causes of Death (RCoD) and 4,530 deaths recorded in the National AIDS Registry (RAIDS), during 2006-2012. Results: The record-linkage identified 3,646 AIDS-related deaths present in both registries, 884 deaths in the RAIDS without mention of HIV/AIDS in the RCoD, and 3,796 deaths in the RCoD with mention of HIV/AIDS that were not present in the RAIDS. In the latter, in-depth analysis of multiple cause-of-death allowed the identification of 1,484 deaths that were AIDS-related. On these results, we estimated 6,014 deceased people with AIDS. Of them, 14.7% (884) were not present in the RCoD and 24.7% (1,484) derived from the RCoD only. Conclusions: The integration of different nationwide registries allowed a more comprehensive estimate of the impact of AIDS-associated mortality in Italy.
MeSH term(s)	Acquired Immunodeficiency Syndrome/epidemiology ; Cause of Death ; Humans ; Italy/epidemiology ; Registries
Language	English
Publishing date	2022-06-20
Publishing country	Italy
Document type	Journal Article
ZDB-ID	950344-4
ISSN	2384-8553 ; 0021-2571
ISSN (online)	2384-8553
ISSN	0021-2571
DOI	10.4415/ANN_22_02_10
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