Alberto Donzelli

• MD
• Managing Director at Azienda Sanitaria Locale di Milano

Background The mass vaccination campaign against COVID-19 has been commonly considered the best response to the global COVID-19 pandemic crisis. However, assessment of its real-world effect can be performed by analysis of all-cause mortality by vaccination status. The UK is perhaps the only country which has made publicly available all-cause mortal...

Clarifying and differentiating the causes of diseases is an essential step in any clinical activity, but it takes on particular relevance and complexity in the case that arise following vaccinations. The WHO has proposed a protocol that uses a list of specific questions about vaccine-related adverse events and an algorithm for making a judgement. H...

L'articolo di Eugenio Paci pubblicato su Scienza in rete il 4 settembre ha chiesto un confronto scientifico serio e indipendente sui vaccini contro COVID-19, facendo in particolare riferimento al ‘caso da discutere’ di uno studio sulla provincia di Pescara, con risultati controcorrente sul rapporto tra questi vaccini e mortalità. Paci sosteneva che...

Background The mass vaccination campaign against COVID-19 has been commonly considered the best response to the global COVID-19 pandemic crisis. However, to assess its real-world overall effects, the best way can be the analysis of all-cause mortality by vaccination status. The UK is perhaps the only country which has made publicly available all-ca...

Immortal time bias (ITB) is common in cohort studies and distorts the association estimates between the treated and untreated. We used data from an Italian study on COVID-19 vaccine effectiveness, with a large cohort, long follow-up, and adjustment for confounding factors, affected by ITB, with the aim to verify the real impact of the vaccination c...

The COVID-19 pandemics has had an unprecedented global impact, and the COVID-19 mass vaccination campaign has been commonly regarded as crucial to overcome the pandemics. Since all-cause mortality is the best way to measure the consequences of a health intervention, the present study was devised to analyze the all-cause mortality data of the United...

Immortal-time bias (ITB) is known to be common in cohort studies and distorts the association estimates between treated and untreated groups. We used data from the last of two large studies in an Italian province on COVID-19 vaccines safety and effectiveness incurred this bias, and aligned the entire population on a single index date, to correct th...

As a result of the spread of SARS-CoV-2, a global pandemic was declared. Indiscriminate COVID-19 vaccination has been extended to include age groups and naturally immune people with minimal danger of suffering serious complications due to COVID-19. Solid immuno-histopathological evidence demonstrates that the COVID-19 genetic vaccines can display a...

As a result of the spread of SARS-CoV-2, a global pandemic was declared. Indiscriminate COVID-19 vaccination has been extended to include age groups and naturally immune people with minimal danger of suffering serious complications due to COVID-19. Solid immuno-histopatholog-ical evidence demonstrates that the COVID-19 genetic vaccines can display...

The COVID-19 vaccination prevents COVID-19 specific mortality. Well planned population-based studies, however, are necessary to evaluate the overall effectiveness of vaccination programmes. A study carried out in the province of Pescara is used to illustrate the potential biases that may affect such studies. The Pescara study analysed total and non...

Background: Both natural immunity and vaccine-induced immunity to COVID-19 may be useful to reduce the mortality/morbidity of this disease, but still a lot of controversy exists. Aims: This narrative review analyzes the literature regarding these two immunitary processes and more specifically: (a) the duration of natural immunity; (b) cellular i...

Background: Both natural immunity and vaccine-induced immunity to COVID-19 may be useful to reduce the mortality/morbidity of this disease, but still a lot of controversy exists. Aims: This narrative review analyzes the literature about: a) the duration of natural immunity; b) cellular immunity; c) cross-reactivity; d) the duration of post-vaccinat...

Vaccine surveillance programs are crucial for the analysis of the vaccine’s safety profile and the guidance of health policies. The Epidemiological Observatory of the Italian Apulia Region carried out an active surveillance program of adverse effects following immunization (AEFI) after the first dose of the measles-mumps-rubella-varicella (MMRV) va...

Tra i tanti approcci alla prevenzione del Coronavirus 2019 (COVID-19), il possibile ruolo della nutrizione è stato finora piuttosto sottovalutato. Gli alimenti sono molto ricchi di sostanze con un potenziale effetto benefico sulla salute e alcune di queste potrebbero avere un'azione antivirale o essere importanti nel modulare il sistema immunitario...

Vaccine surveillance programs are crucial for the analysis of the vaccine’s safety profile and the guidance of health policies. The Epidemiological Observatory of the Italian Apulia Region carried out an active surveillance program of adverse effects following immunization (AEFI) after the first dose of the measles-mumps-rubella-varicella (MMRV) va...

To the Editor In their recently published Original Investigation, Schonberg et al¹ correctly reported that “guidelines recommend not screening women 75 years and older at low or average risk regardless of their life expectancy”¹(p837) and that “a threshold of at least a 3% 5-year risk has been recommended to define high risk; however, increasingly...

Systematic reviews have shown a prevalence close to 20% of gastrointestinal symptoms in COVID-19 positive patients, with nearly 40% of patients shedding viral RNA in their faeces, even if it may not be infectious, possibly because of inactivation by colonic fluid.According to current evidence, this virus is primarily transmitted by respiratory drop...

Among the many approaches to Coronavirus disease 2019 (COVID-19) prevention, the possible role of nutrition has so far been rather underestimated. Foods are very rich in substances, with a potential beneficial effect on health, and some of these could have an antiviral action or be important in modulating the immune system and in defending cells fr...

Le linee guida 2019 delle Società europee di cardiologia e dell'aterosclerosi sulla gestione delle dislipidemie hanno aumentato l'aggressività diagnostico-terapeutica e non distinguono prevenzione primaria e secondaria, con parziale eccezione per gli ultra75enni. Raccomandano nuovi target di cLDL: per pazienti a rischio molto alto si raccomanda una...

Among the many approaches to COVID-19 prevention, the possible role of diet has so far been somewhat marginal. Nutrition is very rich in substances with a potential beneficial effect on health and some of these could have an antiviral action or in any case be important in modulating the immune system and in defending cells from the oxidative stress...

La pandemia di COVID-19 ha indotto il Governo a estendere e rafforzare la raccomandazione di vaccinazione antinfluenzale, e varie Regioni ne hanno ordinato l’obbligo per anziani e personale sanitario. Ad oggi, però, le ricerche più valide su anziani hanno dimostrato la sua utilità solo in cardiopatici in fase attiva, mentre per non cardiopatici le...

Pregnant women are increasingly considered a priority group for influenza vaccination, but the evidence in favor relies mainly on observational studies, subject to the “healthy-vaccinee bias”. Propensity score methods—sometimes applied—reduce but cannot eliminate residual confounding. Meta-analyses of observational studies show relative risks far f...

Valid evidence doesn’t support universal influenza vaccination for pregnant women, the LTE objections are unfounded. The observational evidence is less valid than that from RCTs: important safety signals in all the RCTs require high consideration. In RCTs, influenza vaccinated women have mostly local adverse effects, while their offspring show a no...

Pregnant women are a WHO priority group for influenza vaccination, but evidence from observational studies in pregnancy is subject, among others, to the healthy-vaccinee bias, overestimating the vaccine effectiveness and safety. An USA survey adds new evidence that documents this bias. Therefore, it is essential to assess vaccine effectiveness and...

Pregnant women are a World Health Organization (WHO) priority group for influenza vaccination, but evidence of effectiveness and safety for pregnant women comes from observational studies, which are notoriously prone to confounding by indication and healthy-vaccinee bias. The latter type of bias leads to an overestimation of the effectiveness and s...

“Non-specific effects” of vaccines go beyond the specific protective effects against the targeted diseases. They, if real, could theoretically be beneficial, neutral or negative. This article intends to answer the following questions: • Do the non-specific effects of vaccines exist? Almost certainly yes, and they can be important in low-income cou...

A Cochrane review with meta-analysis showed controversial results about the efficacy of PCSK9 antibodies in the prevention of cardiovascular diseases. This review gives the opportunity to test the relation between LDL-C levels and cardiovascular events. The authors analysed the relation between the calculated LDL-C lowering and the risk of all-caus...

To the Editor In their retrospective cohort study of patients with atherosclerotic cardiovascular disease, Rodriguez et al¹ conclude, “High-intensity statins were associated with a small but significant survival advantage compared with moderate-intensity statins, even among older adults. Maximal doses of high-intensity statins were associated with...

To the Editor In the cohort study by Zerbo et al “Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder,”¹ the authors found that “influenza vaccination anytime during pregnancy was not associated with ASD [autism spectrum disorder] risk,” although the adjusted hazard ratio was of borderline s...

To the Editor The population-based analysis of 7 recommendations from the Choosing Wisely campaign by Rosenberg et al1 shows minimal changes equally distributed across desirable decreases, disappointing increases, or null effects. What is not working?In some cases it is the wording of the recommendation itself; eg, “do not routinely prescribe antib...

In their article,(1) Al-Delaimy et al. conclude that smokers who have used electronic cigarettes (e-cigarettes) may be at increased risk for not being able to quit smoking. This conclusion is consistent with other studies-four longitudinal and one cross-sectional-already reported in a review,(2) yet seems at odds with data from experimental studies...

Background: Randomized clinical trials (RCTs) about Ezetimibe's efficacy on patient-oriented outcomes have given discordant results. The aim of this study was to determine the net effect of Ezetimibe and of the widely marketed combination, Ezetimibe+simvastatin, on mortality and morbidity outcomes. Methods and findings: We searched for RCT on Ez...

The first meta-analysis of randomozed control trials (RCTs) in patients "at high-risk of cardiovascular disease", reporting cardiovascular outcomes either as efficacy or safety events, states that influenza vaccine was associated with a lower risk of major adverse cardiovascular events. On the contrary, the published data show that the vaccine was...

The Clinical Pathway (in its complete definition Diagnostic, Clinical and Therapeutic Pathway - Percorso Diagnostico Terapeutico Assistenziale - PDTA), originally started to deal with the newly diagnosed hypertensive patient, developed also recommendations for the first-line drugs in case of specific indications/contraindications and organ damages....

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presente nota affronta due problemi partico-larmente rilevanti nella ricerca scientifica: a) l'indi-viduazione di priorità dal punto di vista del Servizio sanitario nazionale (Ssn) e degli interessi della co-munità dei cittadini e b) la scelta degli sperimenta-tori. Per mantenere le argomentazioni nei limiti defi-niti dal quadro normativo è bene an...

Tra i determinanti maggiori dei comportamenti prescrittivi/erogativi dei professionisti in sanità (e di ciò che ne risulta nei comportamenti delle loro organizzazioni) vi sono etica ed elementi cognitivi, ma anche convenienze/interessi. I comportamenti reali sono molto influenzati dalla percezione di questi ultimi, al di là di quanto correntemente...

Scientific methodology needs unambiguous language in order to share its information with people and cultures without any (or with minimal) distortion. The term 'quality' is unscientific and may cause misunderstanding. The widest and most relevant point of view on health care is that held by society and by the community of citizens/patients intent o...