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1.
Eur J Prev Cardiol ; 29(15): 1940-1942, 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2188703
2.
Eur Heart J Suppl ; 24(Suppl I): I175-I180, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2115825

ABSTRACT

The immediate repercussions of the pandemic on clinical research were the systematic interruption of ongoing studies and the explosion of tens of thousands of anti-COVID-19 research protocols reported in fragmented, uncoordinated, often technically insufficient international registers, from which almost nothing of significance was produced. In the first two years of intensive research, anti-inflammatory and anticoagulant benefits were identified, while the systemic nature of the viral disease was clearly manifested, but no specific antiviral drugs emerged. Subsequently, monoclonal antibodies and antiviral drugs such as Ritonavir-Boosted Nirmatrelvir (Paxlovid) have given way to more specific therapies, even if surprisingly little used. Finally, the new national Electronic Health Record (EHR-FSE2 Fascicolo Sanitario Elettronico 2 in Italian) was approved as a law, which will integrate the previous one, which is in fact not functional. The systematic, orderly and complete collection of the health data of each citizen constitutes a radical modification of the current National Health System, epidemiology and clinical research.

3.
Eur Heart J Suppl ; 24(Suppl H): H3-H7, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2115668

ABSTRACT

Cardiovascular disease (CVD) is a chronic condition driven by the complex interaction of different risk factors including genetics, lifestyle, environment, etc. which, differently from other pathologies, can be prevented. Treatment of CVD has been inconceivably successful but now it seems that it has reached a plateau suggesting that prevention is the way forward. However, the COVID-19 pandemic has spotted all the limits of the actual health system regarding territorial and, particularly, of preventive medicine. To this end, recently, the SCORE2 risk prediction algorithms, a contemporary model to estimate 10-years risk of CVD in Europe and the new guidelines on prevention have been released. The present review article describes a dream: how prevention of CVD should be addressed in the future. New concepts and paradigms like early genetically personalized and imaging driven risk factors, cardiac risk cartography, measurements of the exposome, estimation of costs of a delayed outcome vs. healthy lifespan, are all addressed. We highlight the importance of technologies and the concept of being engaged in a 'healthy' and not just 'sick' system as it is today. The concept of 'clearing house' with a 'healthcare team' instead of a 'heart team' is described. Finally, we articulate the four points necessary for the dream to come true.

4.
Eur Heart J Suppl ; 23(Suppl E): E161-E167, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1470143

ABSTRACT

The repercussions of the pandemic in progress on clinical research have been the systematic interruption of ongoing research and the explosion of fragmented, uncoordinated, often technically insufficient anti-COVID-19 research. Networks of expert centres have emerged setting up well-structured research, adopting much more efficient and aggressive designs than traditional ones. Adaptive designs, characterized by flexibility and mouldability even in the course of studies, which is essential in an epidemic with thousands of simultaneous studies aimed at the same objectives. Some studies are structured with networks of hospitals around guidance centres, such as RECOVERY (Oxford University, UK) and SOLIDARITY (WHO, 30 countries); others with networks of expert centres mostly organized in a combined model: some expert centres test new molecules in Phase 2 in a limited number of patients, and orient promising ones towards connected networks for Phase 3. Cortisones and tentatively cytokines are acquired in the official recommendation. Another emerging model is the pragmatic trial, also called, more expressively, 'remote' or 'virtual'. So it is in fact: the web replaces the direct link between patients and doctors/research operators (CROs included), behind which there will be omnipresent big-techs.

5.
Eur Heart J Suppl ; 23(Suppl C): C154-C163, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1377966

ABSTRACT

The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic,new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.

6.
Eur J Intern Med ; 92: 24-27, 2021 10.
Article in English | MEDLINE | ID: covidwho-1370510

Subject(s)
COVID-19 , Humans , SARS-CoV-2
7.
G Ital Cardiol (Rome) ; 22(8): 610-619, 2021 Aug.
Article in Italian | MEDLINE | ID: covidwho-1325472

ABSTRACT

The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic, new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.


Subject(s)
COVID-19 , Cardiology/organization & administration , Delivery of Health Care/organization & administration , Cardiovascular Diseases/therapy , Health Personnel/organization & administration , Humans , Italy , National Health Programs/organization & administration
8.
Eur Heart J ; 41(44): 4229-4230, 2020 Nov 21.
Article in English | MEDLINE | ID: covidwho-1043044
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