Drug-Drug Interactions of Direct Oral Anticoagulants (DOACs): From Pharmacological to Clinical Practice.

The direct oral anticoagulants (DOACs), dabigatran, rivaroxaban, apixaban, and edoxaban, are becoming the most commonly prescribed drugs for preventing ischemic stroke in patients with non-valvular atrial fibrillation (NVAF) and for the treatment and prevention of venous thromboembolism (VTE). Rivaroxaban was also recently approved for the treatment of patients with a recent acute coronary syndrome (ACS). Their use demonstrated to have a favorable risk-benefit profile, with significant reductions in stroke, intracranial hemorrhage, and mortality compared to warfarin, but with increased gastrointestinal bleeding.

Pharmacokinetic drug interactions of the non-vitamin K antagonist oral anticoagulants (NOACs).

The use of warfarin, the most commonly prescribed oral anticoagulant, is being questioned by clinicians worldwide due to warfarin several limitations (a limited therapeutic window and significant variability in dose-response among individuals, in addition to a potential for drug-drug interactions). Therefore, the need for non-vitamin K antagonist oral anticoagulants (NOACs) with a rapid onset of antithrombotic effects and a predictable pharmacokinetic (PK) and pharmacodynamic (PD) profile led to the approval of five new drugs: the direct factor Xa (F-Xa) inhibitors rivaroxaban, apixaban, edoxaban and betrixaban (newly approved by FDA) and the direct thrombin (factor-IIa) inhibitor dabigatran etexilate. The advantages of NOACs over warfarin are a fixed-dosage, the absence of the need for drug monitoring for changes in anti-coagulation and fewer clinically significant PK and PD drug-drug interactions.

First Results from CUORE: A Search for Lepton Number Violation via 0νββ Decay of ^{130}Te.

The CUORE experiment, a ton-scale cryogenic bolometer array, recently began operation at the Laboratori Nazionali del Gran Sasso in Italy. The array represents a significant advancement in this technology, and in this work we apply it for the first time to a high-sensitivity search for a lepton-number-violating process: ^{130}Te neutrinoless double-beta decay. Examining a total TeO_{2} exposure of 86.

[Knowledge of oral hygiene amongst adolescents in Lombardy, Italy].

The study evaluated oral hygiene knowledge among a group of 12-year-old students in Lombardy, Italy (n=182). Two different questionnaires were administered, respectively to adolescents and to their parents. Results indicate a low level of general knowledge on this topic.

Search for Neutrinoless Double-Beta Decay of (130)Te with CUORE-0.

We report the results of a search for neutrinoless double-beta decay in a 9.8 kg yr exposure of (130)Te using a bolometric detector array, CUORE-0. The characteristic detector energy resolution and background level in the region of interest are 5.

[The "Smoke-free hospital" project: prevalence of smokers in a large hospital in Pavia (Italy) from 2006 to 2010].

This study was conducted in the context of the "Smoke-free Hospital" project and its aims were to describe the prevalence of smokers among employees and patients of the Hospital of Pavia from 2006 to 2010, and to evaluate its determinants. The target population was represented by all employees (healthcare and other staff) and patients (inpatients and outpatients) of the Hospital of Pavia. Data collection took place by means of two self-administered and anonymous questionnaires (one for employees and one for patients).

Process evaluation of European 'Healthy Stadia' program.

Healthy Stadia (HS) is a European public health pilot-program started in 2007 to support sports stadia in promoting the health of people who work and visit sports stadia, as well as inhabitants of the surrounding communities. The aim of this study is to describe the process evaluation of the program, from its beginning in July 2007 to December 2009, in order to assess the feasibility and sustainability of an HS network across Europe. The program involved nine associate partners involved in the coordination of activities at a local level, in the recruitment of stadia, in the development of specific program tasks and in the dissemination of the program at a national level.

["Let's play with the Earth": a project of environmental education for primary school children].

Objective: Raising awareness and knowledge in Pavia Public Primary School students, and indirectly in their parents, about environmental problems like waste recycling and energy saving, developing with games the concept of separate collection of rubbish; creating an environmentally conscious awareness and sense of responsibility towards sustainable behavior.

Design: The educational program lasted six months. Data collection was performed using anonymous questionnaires, administered to "treated" students at the beginning and at the end of the program.

[Evaluation of the efficacy of a school-based program to prevent tobacco smoking among adolescents in Lombardy (Italy)].

The program "Free to choose" was a school-based program aimed at encouraging secondary school students to lead healthy lifestyles and free from tobacco smoke. The project was part of a wider project named "Free from tobacco smoke", implemented in kindergarten, elementary and secondary schools in Lombardy (Italy). The "Free to choose" program was a controlled, non randomized study involving 2,145 subjects aged 16 years, of whom 1,063 participated in the activities laid out by the program (treatment group) and 1,082 only completed the questionnaires (control group).

Good practices and health policy analysis in European sports stadia: results from the 'Healthy Stadia' project.

Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles.

[Surveillance of the health status of the population of the city of Parona (Italy), Phase 2].

This study is part of a prospective study, which started in the year 2000, to monitor the health status of the population of the city of Parona, a previously agricultural area which has been transformed in a prevalently industrial area. This is the second phase of a project regarding the epidemiological surveillance of this population. The aim of the project was to detect changes in the health status of the population, particularly with regard to respiratory diseases associated with air pollution.

Type 1 diabetes risk and autoantibody positivity in Sardinian migrants in the province of Pavia.

Background: Type 1 diabetes is an autoimmune disease. Genetics as well as environmental factors seem to play a role in the pathogenesis of type 1 diabetes.

Aims: We sought to investigate the possible relationship between migration from Sardinia to a low incidence area of type 1 diabetes (Lombardy) and the prevalence of autoantibody positivity.

[Smoking habits among 13-18 year old students in Lombardy].

Objective: to describe the prevalence of smokers among 13- 18-years-old students in Lombardy and to evaluate some related motives.

Design: a survey has been carried out with anonymous questionnaires, distributed at the beginning of the school year 2005-2006.

Setting: the study involved 3,593 classes of the third year of middle school and 2,893 classes of the second and the fifth year of high school, sampled among all the schools of Lombardy.

[Survey on smoking in nursing students].

The study reports the results of a survey about smoking collected by a self-administered questionnaire in nursing students at Pavia University. Responders were 393 (80%: M = 132, F = 261, mean age 24.66 +/- 5.

[Effectiveness of the project "I don't smoke, and you?" against smoking in a secondary school in Italy].

"I don't smoke, and you?" is a project aimed at secondary school students and is part of a wider project called "Free from Smoke", implemented by the Lombardia Region and involving elementary and secondary school students. The project is a controlled non randomized study whose aim is to direct students toward a healthy and smoke-free way of living, by also involving parents and teachers. A total of 11,610 12 year-olds of both sexes were evaluated, 6392 of whom were enrolled in the program and 5218 of whom served as controls and only completed the questionnaire.

[New indications for the prevention of cardiovascular diseases].

Cardiovascular diseases represent the first cause of death and disability in Italy. The main reversible risk factors are high levels of LDL-cholesterol, hypertension, tobacco-smoking, diabetes and/or metabolic syndrome and poor physical activity (at leisure). The prevalence of these risk factors is high in adult Italian population.

Evaluation of outcomes in SPA-treated osteoarthrosic patients.

Introduction: Osteoarthrosis is the most prevalent joints disorder and it is also the most frequent cause of physical disability in the elderly. When surgery is not indicated, symptomatic drugs are generally used. These treatments are frequently associated to balneotherapy.

Major childhood infectious diseases and other determinants associated with type 1 diabetes: a case-control study.

The objective of the study was to evaluate the association between infectious diseases and other events pertaining to childhood medical history and type 1 diabetes. A case-control study was carried out, taking as cases 159 type 1 diabetic patients (0-29 years) recorded from 1988 to 2000 within the population registry of the Pavia province (North Italy). As controls 318 non-diabetic subjects were matched by age and sex.

[Survey among GP's about their smoking habits, opinions and behaviours in smoking prevention in Lombardy (Northern Italy)].

Objective: to analyze smoking habits, opinions on smoking, curriculum and smoking prevention activities carried out by general practitioners in the Lombardy Region (Northern Italy).

Design And Participants: between 2000 and 2002 a questionnaire about tobacco smoke retrieved from the European Project "GPs Empowerment" has been sent to 5348 general practitioners in the Lombardy Region. The questionnaire focuses on the difference of opinions and activity between smoking and non-smoking physicians.

Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes.

Objective: To determine: (a) whether the components of metabolic syndrome (MetS) cluster more frequently than predicted by chance alone and (b) whether increased risk for MetS is associated also with values of each component below, but close to the cutoff points defining MetS.

Research Design And Methods: Anthropometrical and biochemical measurements were performed and a dietary questionnaire was filled-in in 1833 randomly selected non-diabetic subjects, 916 men and 917 women, 20-74 years old, in nine centres in five Mediterranean countries. The prevalence of MetS and of possible combinations of its individual components was measured.

[Prevalence of risk factors for ischemic heart disease in a northern Italian adult population].

The aim of this study is to measure the prevalence of cardiovascular risk factors in Tavazzano (Lodi) inhabitants, in order to implement efficacious and preventive strategies at community level. In 1998 the target population consisted of 2055 adults (males and females) aged 35-64, living in Tavazzano (Lodi province). The examined population was made of 856 subjects (399 males and 457 females), with a participation rate equal to 41,6%.

Diabetes incidence in 0- to 14-year age-group in Italy: a 10-year prospective study.

Objective: The Registry for Type 1 Diabetes Mellitus in Italy (RIDI) Study Group was established to coordinate the registries of type 1 diabetes in Italy. This report is based on 3,606 children younger than 15 years diagnosed with type 1 diabetes and prospectively registered during 1990-1999 by nine centers, covering >35% of the Italian population.

Research Design And Methods: Registries were pooled in four geographic macro-areas: north, central, south, and insular.

[Total and cause-specific mortality trends are analyzed in Pavia Province from 1991 to 2000].

Age-standardized mean two-years mortality rates are compared with those ones of Lombardy region in 1991-1998 period. A decreasing trend of total mortality (-19%) consistent with the regional rates was noticed and a tendency to convergence at the end of the observation period. The reduction is more evident for cardiovascular diseases (-25.

Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD).

Aims/hypothesis: The aim of this study was to compare the nutritional habits of Type 2 diabetic patients among Mediterranean countries and also with those of their background population and with the nutritional recommendations of the Diabetes and Nutrition Study Group.

Methods: We did a cross-sectional study of 1833 non-diabetic subjects and 1895 patients with Type 2 diabetes, in nine centres in six Mediterranean countries. A dietary questionnaire validated against the 3-Day Diet Diary was used.