Fabrizio Stocchi

Summary

Country: Italy

Publications

  1. ncbi request reprint The levodopa wearing-off phenomenon in Parkinson's disease: pharmacokinetic considerations
    Fabrizio Stocchi
    Department of Neurology, IRCCS San Raffaele Pisana, via della Pisana 235, 00163, Rome, Italy
    Expert Opin Pharmacother 7:1399-407. 2006
  2. ncbi request reprint The relevance of dopaminergic level in nocturnal disability in Parkinson's disease: implications of continuous dopaminergic stimulation at night to treat the symptoms
    Fabrizio Stocchi
    Institute for Research and Medical Care IRCCS San Raffaele, via della Pisana 235, 00163, Rome, Italy
    J Neural Transm 121:79-83. 2014
  3. doi request reprint Drug safety evaluation of ropinirole prolonged release
    Fabrizio Stocchi
    Institute of Research and Medical Care, IRCCS San Raffaele Roma, via della Pisana 235, 00163 Rome, Italy 39 336 909 255 39 066 789158
    Expert Opin Drug Saf 13:383-9. 2014
  4. pmc Therapy for Parkinson's disease: what is in the pipeline?
    Fabrizio Stocchi
    Institute for Research and Medical Care, IRCCS San Raffaele, via della Pisana 235, 00163, Rome, Italy
    Neurotherapeutics 11:24-33. 2014
  5. ncbi request reprint Optimising levodopa therapy for the management of Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS Neuromed, Pozzilli Is, Via Atnense 18, 66077, Pozzilli Is, Italy
    J Neurol 252:IV43-IV48. 2005
  6. ncbi request reprint Ropinirole 24-hour prolonged release and ropinirole immediate release in early Parkinson's disease: a randomized, double-blind, non-inferiority crossover study
    Fabrizio Stocchi
    Institute of Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
    Curr Med Res Opin 24:2883-95. 2008
  7. doi request reprint Treatment of levodopa-induced motor complications
    Fabrizio Stocchi
    IRCCS San Raffaele, via della Pisana 235, Roma, Italy
    Mov Disord 23:S599-612. 2008
  8. doi request reprint Dopamine receptor agonists in the treatment of advanced Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele, Rome, Italy
    Parkinsonism Relat Disord 15:S54-7. 2009
  9. doi request reprint The hypothesis of the genesis of motor complications and continuous dopaminergic stimulation in the treatment of Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele, Rome, Italy
    Parkinsonism Relat Disord 15:S9-S15. 2009
  10. doi request reprint Continuous dopaminergic stimulation and novel formulations of dopamine agonists
    Fabrizio Stocchi
    Institute of Neurology, Institute for Research and Medical Care IRCCS San Raffaele, via della Pisana 235, 00163 Rome, Italy
    J Neurol 258:S316-22. 2011

Detail Information

Publications51

  1. ncbi request reprint The levodopa wearing-off phenomenon in Parkinson's disease: pharmacokinetic considerations
    Fabrizio Stocchi
    Department of Neurology, IRCCS San Raffaele Pisana, via della Pisana 235, 00163, Rome, Italy
    Expert Opin Pharmacother 7:1399-407. 2006
    ....
  2. ncbi request reprint The relevance of dopaminergic level in nocturnal disability in Parkinson's disease: implications of continuous dopaminergic stimulation at night to treat the symptoms
    Fabrizio Stocchi
    Institute for Research and Medical Care IRCCS San Raffaele, via della Pisana 235, 00163, Rome, Italy
    J Neural Transm 121:79-83. 2014
    ..Dopaminergic treatment may improve some of the nocturnal symptoms in PD. In this paper, the effect of drugs and technique that ensure a more continuous delivery of dopaminergic drugs on sleep problems in PD is reviewed. ..
  3. doi request reprint Drug safety evaluation of ropinirole prolonged release
    Fabrizio Stocchi
    Institute of Research and Medical Care, IRCCS San Raffaele Roma, via della Pisana 235, 00163 Rome, Italy 39 336 909 255 39 066 789158
    Expert Opin Drug Saf 13:383-9. 2014
    ....
  4. pmc Therapy for Parkinson's disease: what is in the pipeline?
    Fabrizio Stocchi
    Institute for Research and Medical Care, IRCCS San Raffaele, via della Pisana 235, 00163, Rome, Italy
    Neurotherapeutics 11:24-33. 2014
    ..In this review, I highlight the obstacles to develop a neuroprotective drug and some of the treatment strategies recently approved or still in clinical trials designed to meet these unmet needs. ..
  5. ncbi request reprint Optimising levodopa therapy for the management of Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS Neuromed, Pozzilli Is, Via Atnense 18, 66077, Pozzilli Is, Italy
    J Neurol 252:IV43-IV48. 2005
    ..It can, therefore, be suggested that the onset of dyskinesia may be prolonged if levodopa is administered in a more continuous manner by administering it as a combination of levodopa/DDCI and COMT inhibitor...
  6. ncbi request reprint Ropinirole 24-hour prolonged release and ropinirole immediate release in early Parkinson's disease: a randomized, double-blind, non-inferiority crossover study
    Fabrizio Stocchi
    Institute of Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
    Curr Med Res Opin 24:2883-95. 2008
    ..This study compares once-daily ropinirole 24-h prolonged release and three-times-daily ropinirole immediate release in patients with early Parkinson's disease...
  7. doi request reprint Treatment of levodopa-induced motor complications
    Fabrizio Stocchi
    IRCCS San Raffaele, via della Pisana 235, Roma, Italy
    Mov Disord 23:S599-612. 2008
    ..Key Words: Advanced PD, dyskinesias, motor fluctuations, levodopa, dopamine agonists, COMT inhibitors, MAO-B inhibitors...
  8. doi request reprint Dopamine receptor agonists in the treatment of advanced Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele, Rome, Italy
    Parkinsonism Relat Disord 15:S54-7. 2009
    ..Dopamine receptor agonists have been extensively used as add-on therapy to L-dopa to treat motor complications. In this article we review the role of dopamine receptor agonists in the treatment of advanced parkinsonian patients...
  9. doi request reprint The hypothesis of the genesis of motor complications and continuous dopaminergic stimulation in the treatment of Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele, Rome, Italy
    Parkinsonism Relat Disord 15:S9-S15. 2009
    ..In this paper, an overview of the different factors inducing motor fluctuations and the role of dopamine receptors stimulation is provided...
  10. doi request reprint Continuous dopaminergic stimulation and novel formulations of dopamine agonists
    Fabrizio Stocchi
    Institute of Neurology, Institute for Research and Medical Care IRCCS San Raffaele, via della Pisana 235, 00163 Rome, Italy
    J Neurol 258:S316-22. 2011
    ..In this paper the role of new formulations of dopamine agonists in the treatment of parkinsonian patients at different stages of the disease is reviewed...
  11. doi request reprint Melevodopa/carbidopa effervescent formulation in the treatment of motor fluctuations in advanced Parkinson's disease
    Fabrizio Stocchi
    Department of Neuroscience, Institute of Neurology, IRCCS San Raffaele Pisana, Roma, Italy
    Mov Disord 25:1881-7. 2010
    ..3%); L/C: 1 patient (1.4%)]. This study failed to meet the primary endpoint (P = 0.07); however, there was a trend in favour of the M/C preparation, which deserves further attention...
  12. doi request reprint PREPARED: Comparison of prolonged and immediate release ropinirole in advanced Parkinson's disease
    Fabrizio Stocchi
    Department of Neurology, Institute of Research and Medical Care, IRCCS San Raffaele Roma, Rome, Italy
    Mov Disord 26:1259-65. 2011
    ..PREPARED was a randomized, parallel-group, double-blind, multicenter study to evaluate the efficacy of adjunctive ropinirole prolonged release (PR) versus immediate release (IR) in patients with advanced Parkinson's disease (PD)...
  13. doi request reprint Initiating levodopa/carbidopa therapy with and without entacapone in early Parkinson disease: the STRIDE-PD study
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele Pisana, Rome, Italy
    Ann Neurol 68:18-27. 2010
    ....
  14. ncbi request reprint AFQ056 in Parkinson patients with levodopa-induced dyskinesia: 13-week, randomized, dose-finding study
    Fabrizio Stocchi
    Istituto di Ricovero e Cura a Carattere Scientifico IRCCS San Raffaele Pisana, Rome, Italy
    Mov Disord 28:1838-46. 2013
    ..AFQ056 demonstrated anti-dyskinetic efficacy in this population without worsening underlying motor symptoms. These results will guide dose selection for future clinical trials...
  15. ncbi request reprint Variation in the dopaminergic response during the day in Parkinson disease
    Alessandra Monge
    Casa Di Cura Villa Margherita Arcugnano VI, Roma, Italy
    Clin Neuropharmacol 27:116-8. 2004
    ..In this study we investigated whether the poor responsiveness to the early afternoon dose of levodopa depends only on peripheral and central levodopa pharmacokinetics or also on pharmacodynamic factors...
  16. ncbi request reprint Factors associated with motor fluctuations and dyskinesia in Parkinson Disease: potential role of a new melevodopa plus carbidopa formulation (Sirio)
    Fabrizio Stocchi
    IRCCS San Raffaele Pisana, Rome and daggerMedical Department, Chiesi Farmaceutici s p a, Parma, Italy
    Clin Neuropharmacol 33:198-203. 2010
    ....
  17. ncbi request reprint Continuous dopaminergic stimulation in early and advanced Parkinson's disease
    Fabrizio Stocchi
    Department of Neuroscience and IRCCS Neuromed Pozzilli IS, University La Sapienza, Rome, Italy
    Neurology 62:S56-63. 2004
    ..Therefore, the development of a simple treatment regimen using an oral formulation of levodopa to provide a more continuous dopaminergic stimulation will represent a significant advance in antiparkinsonian pharmacotherapy...
  18. ncbi request reprint Clinical efficacy of a single afternoon dose of effervescent levodopa-carbidopa preparation (CHF 1512) in fluctuating Parkinson disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele Pisana, Rome, Italy
    Clin Neuropharmacol 30:18-24. 2007
    ..Patients randomized to receive CHF 1512 had a significative shorter latency to "on" than those randomized to LD/CD and a similar "on" duration. The safety profile of CHF 1512 was also comparable with LD/CD...
  19. ncbi request reprint A randomized, double-blind, placebo-controlled trial of safinamide as add-on therapy in early Parkinson's disease patients
    Fabrizio Stocchi
    Department of Neuroscience, IRCCS San Raffaele, Rome, Italy
    Mov Disord 27:106-12. 2012
    ..Exploratory analysis of the primary endpoint for 100 mg/day demonstrated that the addition of safinamide to a stable dose of DA improves motor symptoms in early PD and warrants further investigation...
  20. ncbi request reprint Apomorphine infusion and the long-duration response to levodopa in advanced Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology IRCCS NEUROMED, Pozzilli, Rome, Italy
    Clin Neuropharmacol 26:151-5. 2003
    ..This effect is probably the result of postsynaptic mechanisms. In patients with advanced Parkinson's disease, the long-duration response to levodopa is present although slightly diminished...
  21. ncbi request reprint Dual dopamine agonist treatment in Parkinson's disease
    Fabrizio Stocchi
    Department of Neurological Sciences, IRCCS NEUROMED POZZILLI IS, Viale dell Universita 30, 00185, Rome, Italy
    J Neurol 250:822-6. 2003
    ..5+/-5.3 to 15.5+/-4.7). This open study shows that dual dopamine agonist therapy can be useful in the symptomatic treatment of patients with early or more advanced Parkinson's disease receiving therapy with or without levodopa...
  22. ncbi request reprint Intermittent vs continuous levodopa administration in patients with advanced Parkinson disease: a clinical and pharmacokinetic study
    Fabrizio Stocchi
    Institute of Neurology, IRCCS Neuromed, Pozzilli Is, Italy
    Arch Neurol 62:905-10. 2005
    ..Motor complications can be diminished with a continuous infusion of levodopa...
  23. doi request reprint Use of apomorphine in Parkinson's disease
    Fabrizio Stocchi
    Department of Neurology, IRCCS San Raffaele Pisana, Rome, Italy
    Neurol Sci 29:S383-6. 2008
    ..In this respect, apomorphine administration, via infusion pump, may be a good therapeutic option, aimed at obtaining continuous receptor stimulation, assisting in the management of motor fluctuations in the advanced phase of the disease...
  24. doi request reprint The therapeutic concept of continuous dopaminergic stimulation (CDS) in the treatment of Parkinson's disease
    Fabrizio Stocchi
    Department of Neurology, IRCCS San Raffaele Pisana, Rome, Italy
    Parkinsonism Relat Disord 15:S68-71. 2009
    ..The current challenge is to develop a long-acting formulation of levodopa that simulates the pharmacokinetic pattern seen with infusions of levodopa in attempt to provide comparable benefits with an oral levodopa treatment strategy...
  25. doi request reprint Obstacles to the development of a neuroprotective therapy for Parkinson's disease
    Fabrizio Stocchi
    IRCCS San Raffaele Pisana, Rome, Italy
    Mov Disord 28:3-7. 2013
    ..Advances have been made in each of these areas, thereby increasing the prospects of developing a neuroprotective or disease-modifying therapy in the not-too-distant future. These issues are reviewed in the present article...
  26. ncbi request reprint Are there clinically significant differences between dopamine agonists
    Fabrizio Stocchi
    Institute of Neurology IRCCS Neuromed Is, University La Sapienza, Rome, Italy
    Adv Neurol 91:259-66. 2003
  27. ncbi request reprint When do levodopa motor fluctuations first appear in Parkinson's disease?
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele Pisana, Rome, Italy fabrizio stocchi sanraffaele it
    Eur Neurol 63:257-66. 2010
    ..It is important that early wearing-off is recognized as it has important consequences for the long-term outcome and for the medication regimens to be used...
  28. doi request reprint Emergencies in parkinsonism: akinetic crisis, life-threatening dyskinesias, and polyneuropathy during L-Dopa gel treatment
    Marco Onofrj
    Institute of Neurology, Movement Disorders Center, Department of Oncology and Neuroscience, University G D Annunzio Chieti Pescara, Italy
    Parkinsonism Relat Disord 15:S233-6. 2009
    ..However, hemapheresis was not effective in some reported cases, and recent evidence suggests that Vitamin B12 deficiency or direct high-dose chronic L-Dopa toxicity might play a role in its origin...
  29. pmc Utility of tolcapone in fluctuating Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology, IRCCS San Raffaele Pisana, Roma, Italy
    Clin Interv Aging 1:317-25. 2006
    ..With proper monitoring, tolcapone is an effective, well-tolerated drug useful in the management of patients with fluctuating PD...
  30. doi request reprint Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson's disease
    C Warren Olanow
    Department of Neurology and Neuroscience, Mount Sinai School of Medicine, New York, NY 10029, USA
    Mov Disord 28:1064-71. 2013
    ..The current results suggest that physicians should use the lowest dose of l-dopa that provides satisfactory clinical control to minimize the risk of both dyskinesia and wearing-off...
  31. ncbi request reprint Neuroprotection in Parkinson's disease: clinical trials
    Fabrizio Stocchi
    Department of Neuroscience and Neuromed, University La Sapienza, Rome, Italy
    Ann Neurol 53:S87-97; discussion S97-9. 2003
    ..Currently, this will most likely entail demonstrating that the drug provides benefit for PD patients for both imaging and clinical markers of disease progression...
  32. doi request reprint The concept of continuous dopaminergic stimulation: what we should consider when starting Parkinson's disease treatment
    Fabrizio Stocchi
    Department of Neurology, Institute of Research and Medical Care IRCCS San Raffaele, Rome, Italy
    Neurodegener Dis 7:213-5. 2010
    ..According to patient characteristics, treatment of PD should be started with rasagiline and/or with long-acting DA agonists...
  33. doi request reprint Peripheral blood mononuclear cells from mild cognitive impairment patients show deregulation of Bax and Sod1 mRNAs
    Lucia Gatta
    IRCCS San Raffaele Pisana, Via dei Bonacolsi 81, Rome, Italy
    Neurosci Lett 453:36-40. 2009
    ..In conclusion, our results show that Bax and Sod1 mRNA levels are altered in PBMCs from both MCI and AD patients and indicate these changes as potential biomarkers in the early diagnosis of AD...
  34. ncbi request reprint Correlation between the Overactive Bladder questionnaire (OAB-q) and urodynamic data of Parkinson disease patients affected by neurogenic detrusor overactivity during antimuscarinic treatment
    Giovanni Palleschi
    Department of Neuroscience, Neuro urology unit, Polo Pontino, University of Rome La Sapienza, Latina, Italy
    Clin Neuropharmacol 29:220-9. 2006
    ..Clinical data obtained by the questionnaire were compared with urodynamic outcomes, at basal conditions and after antimuscarinic treatment, to better explorate the questionnaire reliability...
  35. ncbi request reprint COMT inhibitors in Parkinson's disease: can they prevent and/or reverse levodopa-induced motor complications?
    C Warren Olanow
    Department of Neurology, Mount Sinai School of Medicine, New York, New York 10028, USA
    Neurology 62:S72-81. 2004
    ..This article considers the possibility that combining levodopa with entacapone may prevent or reverse motor complications...
  36. ncbi request reprint Drug insight: Continuous dopaminergic stimulation in the treatment of Parkinson's disease
    C Warren Olanow
    Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA
    Nat Clin Pract Neurol 2:382-92. 2006
    ..The current challenge is to develop a long-acting oral formulation of levodopa that provides comparable anti-parkinsonian benefits without motor complications...
  37. ncbi request reprint Levodopa in the treatment of Parkinson's disease: current controversies
    C Warren Olanow
    Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA
    Mov Disord 19:997-1005. 2004
    ..Clinical trials to test this hypothesis are underway. We review current evidence relating to these areas of controversy...
  38. ncbi request reprint Prevention and treatment of motor fluctuations
    Fabrizio Stocchi
    IRCCS NEUROMED Pozzilli 15, Institute of Neuroscience, Viale dell Universita 30, 00185 Rome, Italy
    Parkinsonism Relat Disord 9:S73-81. 2003
    ..Finally, we highlight the increasing importance of treatment strategies that stimulate dopamine receptors in a more continuous, less pulsatile manner as a way of reducing the risk of developing treatment-associated motor complications...
  39. ncbi request reprint Continuous dopamine-receptor treatment of Parkinson's disease: scientific rationale and clinical implications
    C Warren Olanow
    Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA
    Lancet Neurol 5:677-87. 2006
    ..The current challenge is to develop a long-acting oral formulation of levodopa that provides clinical benefits but avoids motor complications...
  40. ncbi request reprint Prospective randomized trial of lisuride infusion versus oral levodopa in patients with Parkinson's disease
    Fabrizio Stocchi
    Institute of Neurology and Neuromed, University La Sapienza, Viale dell Universita 30, 00185 Rome, Italy
    Brain 125:2058-66. 2002
    ..This study indicates that continuous lisuride infusion can be beneficial for patients with advanced Parkinson's disease and reverse established motor fluctuations and dyskinesia...
  41. ncbi request reprint End-of-dose wearing off in Parkinson disease: a 9-question survey assessment
    Mark Stacy
    Division of Neurology, Duke University Medical School, Durham, North Carolina 27705, USA
    Clin Neuropharmacol 29:312-21. 2006
    ..No statistical differences were noted with respect to sex, UPDRS subsection scores, Schwab & England Scale, or Hoehn & Yahr Scale...
  42. ncbi request reprint HLA typing does not predict REM sleep behaviour disorder and hallucinations in Parkinson's disease
    Marco Onofrj
    Department of Oncology and Neuroscience, Movement Disorders Center, Neurophysiopathology, Universita G D Annunzio, via Fonte Romano, 65124 Chieti Pescara, Italy
    Mov Disord 18:337-40. 2003
    ....
  43. ncbi request reprint Pathological gambling in Parkinson's disease
    Fabrizio Stocchi
    Lancet Neurol 4:590-2. 2005
  44. ncbi request reprint Novel parkin mutations detected in patients with early-onset Parkinson's disease
    Aida M Bertoli-Avella
    Genetic Epidemiologic Unit, Department of Clinical Genetics and Department of Epidemiology and Biostatistics, Erasmus MC Rotterdam, The Netherlands
    Mov Disord 20:424-31. 2005
    ..This study confirms the frequent involvement of parkin and the importance of genetic testing in the diagnostic work-up of EOP...
  45. ncbi request reprint A frequent LRRK2 gene mutation associated with autosomal dominant Parkinson's disease
    Alessio Di Fonzo
    Department of Clinical Genetics, Erasmus MC Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands
    Lancet 365:412-5. 2005
    ..The associated phenotype was broad, including early and late disease onset. These findings confirm the association of LRRK2 with neurodegeneration, and identify a common mutation associated with dominantly inherited Parkinson's disease...
  46. ncbi request reprint End-of-dose deterioration in non ergolinic dopamine agonist monotherapy of Parkinson's disease
    Astrid Thomas
    Neurophysiopathology, Movement Disorders Center, Department of Oncology and Neuroscience, University G D Annunzio Chieti Pescara, Ospedale Civile di Pescara, via Fonte Romana, 65124, Pescara, Italy
    J Neurol 253:1633-9. 2006
    ..Our findings provide evidence of WO phenomena in patients with early PD receiving non-ergolinic DA monotherapy...
  47. ncbi request reprint Comprehensive analysis of the LRRK2 gene in sixty families with Parkinson's disease
    Alessio Di Fonzo
    Department of Clinical Genetics, Erasmus MC Rotterdam, Rotterdam, The Netherlands
    Eur J Hum Genet 14:322-31. 2006
    ..These data have implications both for understanding the molecular mechanisms of PD, and for directing the genetic screening in clinical practice...
  48. ncbi request reprint Prevalence of nonmotor symptoms in Parkinson's disease in an international setting; study using nonmotor symptoms questionnaire in 545 patients
    Pablo Martinez-Martin
    Unit of Neuroepidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
    Mov Disord 22:1623-9. 2007
    ....
  49. ncbi request reprint Identification of motor and nonmotor wearing-off in Parkinson's disease: comparison of a patient questionnaire versus a clinician assessment
    Mark Stacy
    Duke University Medical Center, 932 Morreene Road, Durham, NC 27705, USA
    Mov Disord 20:726-33. 2005
    ..The mean number of wearing-off symptoms reported by the 165 subjects indicating wearing-off on the clinical survey was 6.25, with tremor being the most common motor feature and tiredness the most common nonmotor feature...
  50. ncbi request reprint The metric properties of a novel non-motor symptoms scale for Parkinson's disease: Results from an international pilot study
    Kallol Ray Chaudhuri
    National Parkinson Foundation Centre of Excellence, Kings College Hospital, London, United Kingdom
    Mov Disord 22:1901-11. 2007
    ..70). In conclusion, NMSS can be used to assess the frequency and severity of NMS in PD patients across all stages in conjunction with the recently validated non-motor questionnaire...
  51. ncbi request reprint International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study
    Kallol Ray Chaudhuri
    Movement Disorders Unit, Kings College Hospital, University Hospital Lewisham, Guy s King s and St Thomas School of Medicine, London, United Kingdom
    Mov Disord 21:916-23. 2006
    ..Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals...