1
|
Briganti F, Tortora M, Tortora F, Elefante A, Loiudice G, Marseglia M, Buono G, Rizzuti M, Iodice R, Manganelli F, Diurno F, Numis FG, Ferrara L, Bruno C, Bresciani A, Caranci F, Franco D, Vaiano C, D'Onofrio G, Scala P, Raucci R, Silvestro E. Efficacy of recanalization therapy for ischemic stroke: multicenter hospital network experience. Radiol Med 2023; 128:357-361. [PMID: 36752988 PMCID: PMC10020294 DOI: 10.1007/s11547-023-01599-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/18/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE Stroke is a leading cause of long-term disability with high mortality rate in the first year after the event. In Campania, mechanical thrombectomy treatment significantly increases in the last 3 years, as well as hospitals delivering acute stroke treatments. The aim of this study is to demonstrate how a full opening of our stroke network improves stroke management and stroked patients' survival in Campania. MATERIAL AND METHODS In Federico II University Hospital of Naples acting as a HUB center of 7 peripheral SPOKE hospitals in regional territory, 68 patients with acute ischemic stroke were evaluated with NIHSS and m-RS clinical scores and neuroradiological ASPECT scores, from January 1 to December 31, 2021. At hospital discharge, NIHSS score and three months after m-RS score were re-assessed to evaluate the therapeutic effects. RESULTS Forty-two of 68 patients (63%) admitted to our hub center had ischemic acute stroke at CT evaluation; 29 patients had ASPECT score > 7 (69%), and 6 a score < 7 (14%). At admission, NIHSS score mean value was 10.75, and m-RS score mean value was 0.74. At discharge, NIHSS score mean value was 7.09. After three months, m-RS score mean value was 0.74. DISCUSSION The inter-company agreement between Federico II University and several peripheral hospitals allows an absolute and relative increase in endovascular mechanical thrombectomy and intravenous thrombolysis procedures, with a relative prevalence of mechanical thrombectomy. A regional implementation of the stroke multi-disciplinary care system is hardly needed to ensure the optimum treatment for the largest number of patients, improving patient's outcome.
Collapse
Affiliation(s)
- Francesco Briganti
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Mario Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Fabio Tortora
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Andrea Elefante
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giovanni Loiudice
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Mariano Marseglia
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giuseppe Buono
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Michele Rizzuti
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Rosa Iodice
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Fiore Manganelli
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Francesco Diurno
- ASL Napoli2 Nord: Ospedali Pozzuoli, Frattamaggiore, Giugliano, Italy
| | | | - Luigi Ferrara
- ASL Napoli2 Nord: Ospedali Pozzuoli, Frattamaggiore, Giugliano, Italy
| | - Carlo Bruno
- ASL Napoli2 Nord: Ospedali Pozzuoli, Frattamaggiore, Giugliano, Italy
| | | | - Ferdinando Caranci
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
| | - Donatella Franco
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Vaiano
- ASL Napoli3 Sud: Ospedale di Castellammare, Castellammare di Stabia, Italy
| | - Gaetano D'Onofrio
- ASL Napoli3 Sud: Ospedale di Castellammare, Castellammare di Stabia, Italy
| | - Pasquale Scala
- ASL Napoli3 Sud: Ospedale di Castellammare, Castellammare di Stabia, Italy
| | - Rosa Raucci
- Asl Caserta: Ospedale di Aversa, Aversa, Italy
| | | |
Collapse
|
2
|
Iannuzzi A, Annunziata M, Fortunato G, Giacobbe C, Palma D, Bresciani A, Aliberti E, Iannuzzo G. Case Report: Genetic Analysis of PEG-Asparaginase Induced Severe Hypertriglyceridemia in an Adult With Acute Lymphoblastic Leukaemia. Front Genet 2022; 13:832890. [PMID: 35237305 PMCID: PMC8882989 DOI: 10.3389/fgene.2022.832890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/21/2022] [Indexed: 01/19/2023] Open
Abstract
PEG-Asparaginase (also known as Pegaspargase), along with glucocorticoids (predominantly prednisolone or dexamethasone) and other chemotherapeutic agents (such as cyclophosphamide, idarubicin, vincristine, cytarabine, methotrexate and 6-mercaptopurine) is the current standard treatment for acute lymphoblastic leukaemia in both children and adults. High doses of PEG-asparaginase are associated with side effects such as hepatotoxicity, pancreatitis, venous thrombosis, hypersensitivity reactions against the drug and severe hypertriglyceridemia. We report a case of a 28-year-old male who was normolipidemic at baseline and developed severe hypertriglyceridemia (triglycerides of 1793 mg/dl) following treatment with PEG-asparaginase for acute lymphoblastic leukaemia. Thorough genetic analysis was conducted to assess whether genetic variants could suggest a predisposition to this drug-induced metabolic condition. This genetic analysis showed the presence of a rare heterozygous missense variant c.11G > A-p.(Arg4Gln) in the APOC3 gene, classified as a variant of uncertain significance, as well as its association with four common single nucleotide polymorphisms (SNPs; c.*40C > G in APOC3 and c.*158T > C; c.162-43G > A; c.-3A > G in APOA5) related to increased plasma triglyceride levels. To our knowledge this is the first case that a rare genetic variant associated to SNPs has been related to the onset of severe drug-induced hypertriglyceridemia.
Collapse
|
3
|
Iannuzzi A, Rubba P, Gentile M, Mallardo V, Calcaterra I, Bresciani A, Covetti G, Cuomo G, Merone P, Di Lorenzo A, Alfieri R, Aliberti E, Giallauria F, Di Minno MND, Iannuzzo G. Carotid Atherosclerosis, Ultrasound and Lipoproteins. Biomedicines 2021; 9:biomedicines9050521. [PMID: 34066616 PMCID: PMC8148516 DOI: 10.3390/biomedicines9050521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Carotid artery plaques are considered a measure of atherosclerosis and are associated with an increased risk of atherosclerotic cardiovascular disease, particularly ischemic strokes. Monitoring of patients with an elevated risk of stroke is critical in developing better prevention strategies. Non-invasive imaging allows us to directly see atherosclerosis in vessels and many features that are related to plaque vulnerability. A large body of evidence has demonstrated a strong correlation between some lipid parameters and carotid atherosclerosis. In this article, we review the relationship between lipids and atherosclerosis with a focus on carotid ultrasound, the most common method to estimate atherosclerotic load.
Collapse
Affiliation(s)
- Arcangelo Iannuzzi
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
- Correspondence:
| | - Paolo Rubba
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Marco Gentile
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Vania Mallardo
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Ilenia Calcaterra
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Alessandro Bresciani
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
| | - Giuseppe Covetti
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy; (A.B.); (G.C.)
| | - Gianluigi Cuomo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Pasquale Merone
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Emilio Aliberti
- North Tees University Hospital, Stockton-on Tees TS19 8PE, UK;
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (G.C.); (P.M.); (A.D.L.); (R.A.); (F.G.)
| | - Matteo Nicola Dario Di Minno
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| | - Gabriella Iannuzzo
- Department of Clinical Medicine, Surgery Federico II University, 80131 Naples, Italy; (P.R.); (M.G.); (V.M.); (I.C.); (M.N.D.D.M.); (G.I.)
| |
Collapse
|
4
|
Iannuzzo G, Gentile M, Bresciani A, Mallardo V, Di Lorenzo A, Merone P, Cuomo G, Pacileo M, Sarullo FM, Venturini E, D’Andrea A, Vigorito C, Giallauria F. Inhibitors of Protein Convertase Subtilisin/Kexin 9 (PCSK9) and Acute Coronary Syndrome (ACS): The State-of-the-Art. J Clin Med 2021; 10:1510. [PMID: 33916362 PMCID: PMC8038577 DOI: 10.3390/jcm10071510] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 01/12/2023] Open
Abstract
Acute Coronary Syndrome (ACS) remains one of the most frequent causes of morbidity and mortality in the world. Although the age- and gender-adjusted incidence of ACS is decreasing, the mortality associated with this condition remains high, especially 1-year after the acute event. Several studies demonstrated that PCSK9 inhibitors therapy determine a significant reduction of major adverse cardiovascular events (MACE) in post-ACS patients, through a process of plaque modification, by intervening in lipid metabolism and platelet aggregation and finally determining an improvement in endothelial function. In the EVACS (Evolocumab in Acute Coronary Syndrome) study, evolocumab allows >90% of patients to achieve LDL-C < 55 mg/dL according to ESC/EAS guidelines compared to 11% of patients who only receive statins. In the EVOPACS (EVOlocumab for Early Reduction of low-density lipoprotein (LDL)-cholesterol Levels in Patients With Acute Coronary Syndromes) study, evolocumab determined LDL levels reduction of 40.7% (95% CI: 45.2 to 36.2; p < 0.001) and allowed 95.7% of patients to achieve LDL levels <55 mg/dL. In ODYSSEY Outcome trial, alirocumab reduced the overall risk of MACE by 15% (HR = 0.85; CI: 0.78-0.93; p = 0.0003), with a reduced risk of all-cause mortality (HR = 0.85; CI: 0.73-0.98: nominal p = 0026), and fewer deaths for coronary heart disease (CHD) compared to the control group (HR = 0.92; CI: 0.76-1.11; p = 0.38). The present review aimed at describing the beneficial effect of PCSK9 inhibitors therapy early after ACS in reducing LDL circulating levels (LDL-C) and the risk of major adverse cardiovascular events, which was very high in the first year and persists higher later after the acute event.
Collapse
Affiliation(s)
- Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (M.G.); (V.M.)
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (M.G.); (V.M.)
| | - Alessandro Bresciani
- Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy;
| | - Vania Mallardo
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (M.G.); (V.M.)
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy; (A.D.L.); (P.M.); (G.C.); (C.V.); (F.G.)
| | - Pasquale Merone
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy; (A.D.L.); (P.M.); (G.C.); (C.V.); (F.G.)
| | - Gianluigi Cuomo
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy; (A.D.L.); (P.M.); (G.C.); (C.V.); (F.G.)
| | - Mario Pacileo
- Unit of Cardiology and Intensive Care, “Umberto I” Hospital, Viale San Francesco, 84014 Nocera Inferiore, Italy; (M.P.); (A.D.)
| | - Filippo M. Sarullo
- Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy;
| | - Elio Venturini
- Cardiac Rehabilitation Unit, Azienda USL Toscana Nord-Ovest, Cecina Civil Hospital, 57023 Cecina, Italy;
| | - Antonello D’Andrea
- Unit of Cardiology and Intensive Care, “Umberto I” Hospital, Viale San Francesco, 84014 Nocera Inferiore, Italy; (M.P.); (A.D.)
| | - Carlo Vigorito
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy; (A.D.L.); (P.M.); (G.C.); (C.V.); (F.G.)
| | - Francesco Giallauria
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy; (A.D.L.); (P.M.); (G.C.); (C.V.); (F.G.)
| |
Collapse
|
5
|
Aiezza M, Bresciani A, Guglielmi G, Massa M, Tortori E, Marfella R, Aliberti E, Iannuzzi A. Medication review versus usual care to improve drug therapies in hospitalised older patients admitted to internal medicine wards. Eur J Hosp Pharm 2020. [DOI: 10.1136/ejhpharm-2019-002072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
6
|
Espert M, Bresciani A, Sanz T, Salvador A. Functionality of low digestibility emulsions in cocoa creams. Structural changes during in vitro digestion and sensory perception. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.01.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
7
|
Iannuzzi M, D'Angelillo A, Tortori A, Pazzano D, De Serio L, Covetti G, Bresciani A, Iannuzzi A. Carotid artery diameter and wall stiffness in proteinuric renal disease without severely reduced kidney function. J Clin Ultrasound 2016; 44:175-181. [PMID: 26402850 DOI: 10.1002/jcu.22292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 08/04/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To evaluate the carotid artery diameter, and wall thickness and stiffness in patients with glomerulopathy and proteinuria without severely reduced kidney function. METHODS We compared 30 control subjects to 30 patients with glomerular disease, proteinuria, and glomerular filtration rate > 30 ml/min/1.73 m(2) : membranous glomerulonephritis (n = 13), minimal change disease (n = 2), focal and segmental glomerulosclerosis (n = 3), IgA nephropathy (n = 5), lupus nephritis (n = 5), antiphospholipid antibody nephropathy (n = 1), cryoglobulinemic glomerulonephritis (n = 1). The laboratory evaluations included carotid artery diameter, intima-media thickness, and stiffness measurements. RESULTS Carotid cross-sectional area of intima-media complex was thicker in patients (18.6 ± 1.4 [x ± SEM]) than in controls (14.8 ± 0.6 mm(2) , p = 0.014), as was carotid artery wall stiffness (8.96 ± 0.86 versus 5.65 ± 0.38, [x ± SEM], p < 0.01). This difference remained significant after adjustment for age, sex, and metabolic cardiovascular risk factors: carotid stiffness was 9.19 ± 0.67 (99% confidence interval [CI] 7.40-10.98)] in patients and 4.80 ± 0.75 (99% CI 2.79-7.11) in controls; adjusted mean difference 4.40 (99% CI 1.46-7.34); p <0.001. CONCLUSIONS This study showed, for the first time, signs of altered structural and elastic properties of the arterial wall in patients with proteinuria and glomerular disease without severely reduced kidney function.
Collapse
Affiliation(s)
- MariaRosaria Iannuzzi
- Nephrology and Dialysis Unit, Antonio Cardarelli Hospital, Naples, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Antonio D'Angelillo
- Nephrology and Dialysis Unit, Antonio Cardarelli Hospital, Naples, Via A. Cardarelli 9, 80131, Naples, Italy
| | | | - Dario Pazzano
- Department of Internal Medicine, Unit of Nephrology and Dialysis, University of Messina, Messina, Italy
| | | | - Giuseppe Covetti
- Department of Medicine, Antonio Cardarelli Hospital, Naples, Italy
| | | | | |
Collapse
|
8
|
Marfella R, Sasso FC, Siniscalchi M, Paolisso P, Rizzo MR, Ferraro F, Stabile E, Sorropago G, Calabrò P, Carbonara O, Cinquegrana G, Piscione F, Ruocco A, D'Andrea D, Rapacciuolo A, Petronella P, Bresciani A, Rubino P, Mauro C, Paolisso G. Peri-procedural tight glycemic control during early percutaneous coronary intervention is associated with a lower rate of in-stent restenosis in patients with acute ST-elevation myocardial infarction. J Clin Endocrinol Metab 2012; 97:2862-71. [PMID: 22639289 DOI: 10.1210/jc.2012-1364] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We examined the effects of peri-procedural intensive glycemic control (IGC) during early percutaneous coronary intervention (PCI) on restenosis rate in hyperglycemic patients with ST-segment elevation myocardial infarction (STEMI). RESEARCH DESIGN AND METHODS A total of 165 hyperglycemic patients (glucose ≥ 140 mg/dl) with first STEMI undergoing PCI were studied. Patients were randomized to IGC for almost 24 h after PCI (n = 82; glucose, 80-140 mg/dl) followed by multidose sc insulin during the hospital stay or conventional glycemic control (CGC; n = 83; glucose, 180-200 mg/dl) followed by conventional therapy. Coronary angiography was performed at study entry and at 6-month follow-up. Blood samples for glycemia, hemoglobin A1c, inflammatory markers (C-reactive protein and TNF-α), monocyte chemoattractant-protein-1, and oxidative stress (nitrotyrosine) were collected immediately before and 24 h, 30 and 180 d after PCI. RESULTS After insulin infusion, mean plasma glucose during the peri-procedural period was greater in the CGC group than in the IGC group (CGC, 191 ± 15 mg/dl; IGC, 145 ± 35 mg/dl; P < 0.001). After the insulin infusion period, the levels of markers of oxidative stress (nitrotyrosine), inflammation (C-reactive protein, TNF-α), and monocyte chemoattractant-protein-1 were significantly higher in CGC patients compared with IGC patients. Moreover, ICG during PCI reduces restenosis by half (48 and 24%) at 6 months. During follow-up, there was no difference in mortality rates, glucose, inflammatory and oxidative stress markers among the groups. In-stent restenosis was positively associated with mean plasma glucose levels as well as oxidative stress and inflammatory markers during the insulin infusion period. CONCLUSIONS In hyperglycemic patients with STEMI, optimal peri-procedural glycemic control by reducing oxidative stress and inflammation may improve the outcome after PCI.
Collapse
Affiliation(s)
- Raffaele Marfella
- Department of Geriatrics and Metabolic Diseases, Second University of Naples, 80138 Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Iannuzzi A, Licenziati MR, Acampora C, De Michele M, Iannuzzo G, Chiariello G, Covetti G, Bresciani A, Romano L, Panico S, Rubba P. Carotid artery wall hypertrophy in children with metabolic syndrome. J Hum Hypertens 2007; 22:83-8. [PMID: 17928879 DOI: 10.1038/sj.jhh.1002289] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Preclinical vascular changes (increased stiffness and/or wall thickness) have been observed in children with known metabolic risk factors. Aim of the present study was to evaluate different carotid parameters, representative of vascular health, in children with and without metabolic syndrome (MS). We studied 38 children with MS (mean age 9.6+/-2.6 years; range 6-14 years) and 45 healthy age-matched subjects. Children who met three or more of the following criteria qualified as having the MS: fasting glucose >110 mg dl(-1), fasting triglyceride concentration >100 mg dl(-1), fasting high-density lipoprotein cholesterol concentration <50 mg dl(-1) for females or <45 mg dl(-1) for the males, waist circumference >75th percentile for age and gender and systolic or diastolic blood pressure >90th percentile for age, gender and height. Carotid B-mode ultrasound examinations were performed and intima-media thickness and diameters were measured in all subjects. Arterial geometry was further characterized by calculation of carotid cross-sectional area. Carotid intima-media thickness and lumen diameters were increased in children with MS as compared to children without MS. Moreover, carotid cross-sectional area was significantly higher in the group of children with MS 9.83+/-1.86 mm(2) [mean+/-s.d.] compared with the control group: 7.77+/-1.72 mm(2), P<0.001, even after adjustment for age, gender and height. Carotid hypertrophy is already detectable in children with MS. High-resolution B-mode ultrasound could provide a valuable tool for the cardiovascular risk stratification of children.
Collapse
Affiliation(s)
- A Iannuzzi
- Department of Internal Medicine, A Cardarelli Hospital, Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Migliaresi S, Bresciani A, Ambrosone L, Spera M, Barbarulo D, Lombari V, Pirozzi G, Borgia G, Lombardi ML, Tirri G, Manzo C. Increased serum concentrations of soluble HLA-class I antigens in hepatitis C virus related mixed cryoglobulinaemia. Ann Rheum Dis 2000; 59:20-5. [PMID: 10627422 PMCID: PMC1752989 DOI: 10.1136/ard.59.1.20] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate whether quantitative alterations of both beta(2)microglobulin (beta(2)micro) associated HLA class I heavy chains (sHLA-I) and beta(2) micro free class I heavy chains (sHLA-FHC) in sera of patients with hepatitis C virus (HCV) infection occur and whether they distinguish patients with mixed cryoglobulinaemia (MC). METHODS 83 HCV infected patients were studied and divided into three groups: (A) without cryoglobulinaemia (n=21), (B) with polyclonal MC (n=20), (C) with monoclonal MC (n=42). Serum sHLA-I and sHLA-FHC were measured by double determinant radioimmunoassay using monoclonal antibodies: TP25.99 as catching antibody, and NAMB-1 and HC-10 as revealing antibodies. Western blot identified HLA-I isoforms. RESULTS The serum concentrations of sHLA-I and of sHLA-FHC in HCV infected patients versus controls were respectively 1.3(0.5) microg/ml (mean (SD)) versus 0.8 (0.3) (p<0. 001) and 13.9 (7.1) ng/ml versus 9.2 (5) (p<0.001). sHLA-I were 1.01 (0.4) microg/ml in group A, 1.04 (0.4) microg/ml in group B, and 1. 47 (0.4) microg/ml in group C (p=0.001). Statistical analysis showed a significant difference versus controls for groups B (p<0.02) and C (p<0.001). sHLA-FHC were 12.8 (8.3) ng/ml in group A, 17.2 (7.1) ng/ml in group B, and 12.9 (6.2) ng/ml in group C (p<0.02). A significant difference versus controls for each group was found (p<0. 02, p<0.001, and p<0.02, respectively). Different patterns of sHLA-I isoforms were observed. CONCLUSIONS Increased serum concentrations of sHLA-I and sHLA-FHC characterise HCV infected patients. The highest sHLA-I concentrations seem to distinguish patients with monoclonal MC. In this last condition sHLA could play a part in the HCV escape and in B cell proliferation. The significance of sHLA-FHC is still undefined.
Collapse
Affiliation(s)
- S Migliaresi
- Istituto di Clinica Medica, Reumatologia, Seconda Università degli Studi, Napoli, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Bresciani A, Pirozzi G, Spera M, Lombardi ML, Ambrosone L, Migliaresi S, Ferrone S, Manzo C. Increased level of serum HLA class I antigens in patients with systemic lupus in patients with systemic lupus erythematosus. Correlation with disease activity. Tissue Antigens 1998; 52:44-50. [PMID: 9714473 DOI: 10.1111/j.1399-0039.1998.tb03022.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The level of soluble beta2-mu-associated HLA Class I heavy chains (sHLA-I) and of soluble beta2-mu-free HLA Class I heavy chains (sHLA-FHC) was found to be significantly higher in sera from 58 patients with systemic lupus erythematosus (SLE) than in those from 82 age and sex-matched controls. The level of serum sHLA-I in patients with SLE was significantly correlated to disease activity. Western blotting analysis showed that the 44-kDa isoform represents the major component in the antigens immunoprecipitated by anti-beta2-mu mAb NAMB-1 and by anti-beta2-mu-free HLA Class I heavy chain mAb HC-10 from sera of patients with SLE. These results suggest that the increased serum levels of sHLA-I and of sHLA-FHC in patients with SLE reflect their increased shedding from cell membrane. In view of the ability of sHLA-I and of sHLA-FHC to induce apoptosis of activated T cells, it is suggested that their increased serum levels in patients with SLE is triggered by dysregulation of the immune system leading to T-cell activation. The increased serum levels of sHLA-I and of sHLA-FHC may be used by the immune system to control the pool of activated T cells by inducing apoptosis. If this possibility is proven to be correct, modulation of the serum level of sHLA-I and of sHLA-FHC may be utilized to develop strategies to treat SLE.
Collapse
Affiliation(s)
- A Bresciani
- Servizio di Oncologia Sperimentale C-Immunologia, Istituto Tumori Fondazione Pascale, Napoli, Italy
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Asnis DS, Golub R, Bresciani A. Vibrio cholerae 01 isolated in the gallbladder of a patient presenting with cholecystitis. Am J Gastroenterol 1996; 91:2241-2. [PMID: 8855762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cholera is a topical infection of the intestinal tract and rarely causes extraintestinal disease. The gallbladder has been proposed to be the reservoir of this organism. We present a patient from Bolivia who developed symptoms of acute cholecystitis and whose bile culture grew Vibrio cholerae 01 El tor.
Collapse
Affiliation(s)
- D S Asnis
- Department of Internal Medicine, Flushing Hospital Medical Center, New York, USA
| | | | | |
Collapse
|
13
|
Bresciani A, Pirozzi G, Lombardi M, Mercuro O, Gallo A, Ferrone S, Manzo C. Presence of soluble forms of HLA class I and ICAM-1 in urine of patients with bladder tumor. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)85513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
14
|
Asnis DS, Bresciani A, Ryan M, McArdle P, Mollura JL, Ilardi CF. Cost-effective approach to evaluation of diarrheal illness in hospitals. J Clin Microbiol 1993; 31:1675. [PMID: 8315018 PMCID: PMC265607 DOI: 10.1128/jcm.31.6.1675-.1993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
|