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Nardi C, Magnini A, Calistri L, Cavigli E, Peired AJ, Rastrelli V, Carlesi E, Zantonelli G, Smorchkova O, Cinci L, Orlandi M, Landini N, Berillo E, Lorini C, Mencarini J, Colao MG, Gori L, Luzzi V, Lazzeri C, Cipriani E, Bonizzoli M, Pieralli F, Nozzoli C, Morettini A, Lavorini F, Bartoloni A, Rossolini GM, Matucci-Cerinic M, Tomassetti S, Colagrande S. Doubts and concerns about COVID-19 uncertainties on imaging data, clinical score, and outcomes. BMC Pulm Med 2023; 23:472. [PMID: 38007479 PMCID: PMC10675953 DOI: 10.1186/s12890-023-02763-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND COVID-19 is a pandemic disease affecting predominantly the respiratory apparatus with clinical manifestations ranging from asymptomatic to respiratory failure. Chest CT is a crucial tool in diagnosing and evaluating the severity of pulmonary involvement through dedicated scoring systems. Nonetheless, many questions regarding the relationship of radiologic and clinical features of the disease have emerged in multidisciplinary meetings. The aim of this retrospective study was to explore such relationship throughout an innovative and alternative approach. MATERIALS AND METHODS This study included 550 patients (range 25-98 years; 354 males, mean age 66.1; 196 females, mean age 70.9) hospitalized for COVID-19 with available radiological and clinical data between 1 March 2021 and 30 April 2022. Radiological data included CO-RADS, chest CT score, dominant pattern, and typical/atypical findings detected on CT examinations. Clinical data included clinical score and outcome. The relationship between such features was investigated through the development of the main four frequently asked questions summarizing the many issues arisen in multidisciplinary meetings, as follows 1) CO-RADS, chest CT score, clinical score, and outcomes; 2) the involvement of a specific lung lobe and outcomes; 3) dominant pattern/distribution and severity score for the same chest CT score; 4) additional factors and outcomes. RESULTS 1) If CT was suggestive for COVID, a strong correlation between CT/clinical score and prognosis was found; 2) Middle lobe CT involvement was an unfavorable prognostic criterion; 3) If CT score < 50%, the pattern was not influential, whereas if CT score > 50%, crazy paving as dominant pattern leaded to a 15% increased death rate, stacked up against other patterns, thus almost doubling it; 4) Additional factors usually did not matter, but lymph-nodes and pleural effusion worsened prognosis. CONCLUSIONS This study outlined those radiological features of COVID-19 most relevant towards disease severity and outcome with an innovative approach.
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Affiliation(s)
- Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Andrea Magnini
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Edoardo Cavigli
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Anna Julie Peired
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Vieri Rastrelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Edoardo Carlesi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giulia Zantonelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Olga Smorchkova
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Cinci
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Martina Orlandi
- Department of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Nicholas Landini
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy
| | - Edoardo Berillo
- Department of Clinical and Experimental Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Jessica Mencarini
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Maria Grazia Colao
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Leonardo Gori
- Department of Clinical and Experimental Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Valentina Luzzi
- Department of Clinical and Experimental Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Chiara Lazzeri
- Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Elisa Cipriani
- Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Manuela Bonizzoli
- Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Filippo Pieralli
- Intermediate Care Unit, University Hospital Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Carlo Nozzoli
- Internal Medicine Unit 1, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Alessandro Morettini
- Internal Medicine Unit 2, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Federico Lavorini
- Department of Experimental and Clinical Medicine, Division of Pulmonology, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Sara Tomassetti
- Department of Clinical and Experimental Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
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Morandi A, Cipriani E, Parolini F, Consonni D, Calderini E, Franzini S, Leva E. The coagulation profile as a marker for acute appendicitis in the paediatric population: Retrospective study. Afr J Paediatr Surg 2020; 17:59-63. [PMID: 33342835 PMCID: PMC8051619 DOI: 10.4103/ajps.ajps_52_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Appendicitis is the commonest and most frequently misdiagnosed acute abdominal surgical illness in the paediatric population worldwide. The aim of this study is to evaluate the role of coagulation profile in acute appendicitis (AA) in children. MATERIALS AND METHODS we retrospectively collected data of patients submitted to appendectomy from 2011 to 2017. According to histopathology, patients were divided into three groups: not histologically confirmed AA (NAA), simple AA (SAA) and complicated AA (CAA). White blood cell (WBC) count, relative neutrophilia (Neutr%), C-reactive protein (CRP), prothrombin time ratio (PTratio), activated partial thromboplastin time ratio (APTTratio) and fibrinogen (Fib) were compared among groups. RESULTS Three hundred and seven patients were included: 57 NAA, 184 SAA and 66 CAA. WBC was significantly different among groups: CAA (mean 16.67 × 103/ml), SAA (14.73 × 103/ml, P= 0.01) and NAA (10.85 × 103/ml, P< 0.0001). Significant differences were found for Neutr% (mean CAA 81.14 vs. SAA 77.03 P= 0.006, vs. NAA 63.86 P< 0.0001) and CRP (mean NAA 2.56, SAA 3.26, CAA 11.58, P< 0.0001). PTratio and Fib increased with the severity of AA receiver operator characteristic curves were similar for CRP (0.739), Fib (0.726), WBC (0.746) and Neutr% (0.754), while for PTratio and aPTTratio were 0.634 and 0.441, respectively. CONCLUSIONS extrinsic coagulation pathway is altered in AA, especially in CAA. Coagulation can be useful in the diagnostic and perioperative anaesthetic management of AA in children. Fib seems to have the highest accuracy.
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Affiliation(s)
- Anna Morandi
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Filippo Parolini
- Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy
| | - Dario Consonni
- Department of Epidemiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Edoardo Calderini
- Department of Anesthesia and Pediatric Intensive Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Franzini
- Department of Anesthesia and Pediatric Intensive Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pediatric Anaestesia and Intensive Care, Hôpital Universitaire Necker Enfants Malades, Paris, France
| | - Ernesto Leva
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan; Università Degli Studi of Milan, Italy
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Panigada M, Spinelli E, Cucino A, Cipriani E, De Falco S, Panarello G, Occhipinti G, Arcadipane A, Sales G, Fanelli V, Brazzi L, Novembrino C, Consonni D, Pesenti A, Grasselli G. Antithrombin supplementation during extracorporeal membrane oxygenation: study protocol for a pilot randomized clinical trial. Trials 2019; 20:349. [PMID: 31186035 PMCID: PMC6558738 DOI: 10.1186/s13063-019-3386-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 04/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Normal levels of plasma antithrombin (AT) activity might decrease heparin requirements to achieve an adequate level of anticoagulation during treatment with extracorporeal membrane oxygenation (ECMO). Acquired AT deficiency during ECMO is common, but formal recommendations on target, timing, and rate of AT supplementation are lacking. Thus, we conceived a pilot trial to evaluate the feasibility and safety of prolonged AT supplementation in patients requiring veno-venous ECMO for respiratory failure. METHODS Grifols Antithrombin Research Awards (GATRA) is a prospective, randomized, single blinded, multicenter, controlled two-arm trial. Patients undergoing veno-venous ECMO will be randomized to either receive AT supplementation to maintain a functional AT level between 80 and 120% (AT supplementation group) or not (control group) for the entire ECMO course. In both study groups, anticoagulation will be provided with unfractionated heparin following a standardized protocol. The primary endpoint will be the dose of heparin required to maintain the ratio of activated partial thromboplastin time between 1.5 and 2. Secondary endpoints will be the adequacy of anticoagulation and the incidence of hemorrhagic and thrombotic complications. DISCUSSION GATRA is a pilot trial that will test the efficacy of a protocol of AT supplementation in decreasing the heparin dose and improving anticoagulation adequacy during ECMO. If positive, it might provide the basis for a future larger trial aimed at verifying the impact of AT supplementation on a composite outcome endpoint including hemorrhagic events, transfusion requirements, and mortality. TRIAL REGISTRATION ClinicalTrials.gov, NCT03208270 . Registered on 5 July 2017.
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Affiliation(s)
- Mauro Panigada
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Elena Spinelli
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Cucino
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elisa Cipriani
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano De Falco
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giovanna Panarello
- Department of Anesthesiology and Intensive Care, ISMETT IRCCS (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), UPMC, Palermo, Italy
| | - Giovanna Occhipinti
- Department of Anesthesiology and Intensive Care, ISMETT IRCCS (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), UPMC, Palermo, Italy
| | - Antonio Arcadipane
- Department of Anesthesiology and Intensive Care, ISMETT IRCCS (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), UPMC, Palermo, Italy
| | - Gabriele Sales
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Vito Fanelli
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cristina Novembrino
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Pesenti
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giacomo Grasselli
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Abstract
Fourteen explanted Dynesys® spinal devices were analyzed for biostability and compared with a reference, never implanted, control. Both poly(carbonate-urethane) (PCU) spacers and polyethylene-terephthalate (PET) cords were analyzed. The effect of implantation was evaluated through the observation of physical alterations of the device surfaces, evaluation of the chemical degradation and fluids absorption on the devices and examination of the morphological and mechanical features. PCU spacers exhibited a variety of surface damage mechanisms, the most significant being abrasion and localized, microscopic surface cracks. Evidence of oxidation and chain scission were detected on PCU spacers ATR-FTIR. ATR-FTIR, DSC and hardness measurements also showed a slight heterogeneity in the composition of PCU. The extraction carried out on the PCU spacers revealed the presence of extractable polycarbonate segments. One spacer and all PET cords visually exhibited the presence of adherent biological material (proteins), confirmed by the ATR-FTIR results. GC/MS analyses of the extracts from PET cords revealed the presence of biological fluids residues, mainly cholesterol derivatives and fatty acids, probably trapped into the fiber network. No further chemical alterations were observed on the PET cords. Although the observed physical and chemical damage can be considered superficial, greater attention must be paid to the chemical degradation mechanisms of PCU and to the effect of byproducts on the body.
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Affiliation(s)
- E Cipriani
- Dipartimento di Chimica and NIS Centre of Excellence, University of Torino, Via Pietro Giuria 7, 10125 Torino, Italy
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Viscogliosi G, Cipriani E, Liguori ML, Marigliano B, Saliola M, Ettorre E, Andreozzi P. Mediterranean dietary pattern adherence: associations with prediabetes, metabolic syndrome, and related microinflammation. Metab Syndr Relat Disord 2013; 11:210-6. [PMID: 23451814 PMCID: PMC3696914 DOI: 10.1089/met.2012.0168] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [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: 11/13/2022] Open
Abstract
BACKGROUND The adherence to the Mediterranean Diet (Med Diet) seems to reduce the incidence of metabolic syndrome. The present study aimed to explore whether the adherence to the overall Med Diet pattern and to specific Med Diet items is associated with the presence of metabolic syndrome, impaired fasting glucose (IFG), insulin resistance (IR), and microinflammation in subjects free of diabetes and cardiovascular diseases. MEASUREMENTS Each patient underwent clinical assessment. Adherence to the Med Diet was measured by a previously validated 14-item questionnaire. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria; IR was defined by homeostasis model assessment of insulin resistance (HOMA-IR); inflammation was assessed through a high-sensitivity C-reactive protein (hsCRP) assay. RESULTS A total of 120 subjects (64.2% women, mean age 59.8±10.2 years) were enrolled at this study. Subjects with lower Med Diet pattern adherence exhibited higher occurrence of metabolic syndrome and all its components and higher HOMA-IR and hsCRP values (P for all <0.0001). Subjects with metabolic syndrome were less likely to consume olive oil (P=0.002) and vegetables (P=0.023). By multivariable analyses, the overall Med Diet score was found to be strongly and inversely associated with the presence of metabolic syndrome [B=-0.066; 95% confidence interval (CI) -0.105 to -0.028; P=0.001], IFG (B=-0.076; 95% CI -0.114 to -0.038; p<0.0001), high HOMA-IR (B=-0.071; 95% CI -0.108 to -0.034; P<0.0001) and high hsCRP (B=-0.082; 95% CI -0.125 to -0.045; P<0.0001). None of specific Med Diet items independently predicted metabolic syndrome, IFG, and high HOMA-IR. Instead, the consumption of white meat over red meat (B=-0.324; 95% CI -0.467 to -0.178; P<0.0001) was found to be inversely associated with increased hsCRP. CONCLUSIONS The inverse associations between adherence to Med Diet and the prevalence of metabolic syndrome and prediabetes may be due more to the effects of the entire dietary pattern rather than to individual food components. Metabolic syndrome-related microinflammation may further be linked to specific Med Diet components.
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Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University, Rome, Italy.
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Andreozzi P, Viscogliosi G, Colella F, Subic M, Cipriani E, Marigliano B, Verrusio W, Servello A, Ettorre E, Marigliano V. [Predictors of liver fibrosis in patients with non-alcoholic fatty liver disease. The role of metabolic syndrome, insulin-resistance and inflammation]. Recenti Prog Med 2013; 103:570-4. [PMID: 23258240 DOI: 10.1701/1206.13358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION NAFLD (non-alcoholic fatty liver disease) reaches an high prevalence in the general population, and it is closely related to metabolic syndrome (MetS). The entity of metabolic abnormalities and the chronic inflammation seem to play a main role in the development of liver fibrosis. The aim of our study is to determine whether subjects with NAFLD and MetS have higher liver fibrosis degree when compared with NAFLD subjects without MetS, and to investigate the relations between fibrosis, MetS and its single components and inflammation. MATERIALS AND METHODS We considered 24 patients with NAFLD. Those who had viral- and alcohol- related liver disease were excluded. MetS was diagnosed according to NCEP ATP III criteria; inflammatory status was determined through C-reactive protein (PCR) assay. The peripheral insulin-resistance was assessed by calculating HOMA ir. Liver fibrosis was measured by transient elastography (Fibroscan®). RESULTS Subjects with MetS had higher HOMA ir, PCR and Fibroscan® score (log value: 0.92±0.24 KPa vs 0.73±0.2 KPa; p=0.047). The linear correlation analysis showed that Fibroscan® score was related to MetS, number of MetS components, waist circumference, HOMA ir and PCR. However the multivariate regression analysis showed that only HOMA ir (B=0.077; 95%CI: -0.002- 0.157; p=0.05) and PCR (B=0.152; 95% CI: 0.006 - 0.299; p=0.006) were independent predictors of higher Fibroscan® score. CONCLUSION MetS is associated to higher liver fibrosis degree in subjects with NAFLD. The insulin-resistance and inflammation seem to be the main determinants.
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Affiliation(s)
- Paola Andreozzi
- Unita di Medicina Predittiva, Sapienza Universita di Roma, Roma, Italy
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Viscogliosi G, Andreozzi P, Chiriac IM, Cipriani E, Servello A, Marigliano B, Ettorre E, Marigliano V. Depressive symptoms in older people with metabolic syndrome: is there a relationship with inflammation? Int J Geriatr Psychiatry 2013; 28:242-7. [PMID: 22639424 DOI: 10.1002/gps.3817] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 03/21/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate if there is a higher prevalence of depressive symptoms in older people with metabolic syndrome (MetS) compared with those without and whether dedpressive symptoms are independently associated to MetS and its single components and to the inflammatory markers. METHODS Physical parameters, standard blood analytes, high sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were assessed. Fifteen-item Geriatric Depression Scale and mini mental state examination (MMSE) were administered. RESULTS One hundred thirty-three subjects were enrolled. MetS patients (57) exhibited higher prevalence of depressive symptoms (p < 0.0001), worse cognitive function (p < 0.0001), and higher levels of ESR and hsCRP were higher (p < 0.0001). The univariate analysis showed a linear strong correlation of depressive symptoms (p < 0.0001) with the MMSE score (r = -0.422), body mass index (r = 0.414), MetS (r = 0.582), number of MetS components (r = 0.663), fasting blood glucose (r = 0.565), ESR (r = 0.565), hsCRP (r = 0.745), central obesity (r = 0.269; p = 0.002), and high-density lipoprotein cholesterol (r = -0.241; p = 0.005). However, the multivariate analysis showed that only age (B = -0.093; p = 0.032), MetS (B = 1.446; p = 0.025), fasting blood glucose (B = 0.039; p = 0.005), and hsCRP (B = 7.649; p < 0.0001) were independently associated with depressive symptoms. CONCLUSIONS MetS and inflammation are independently associated with depressive symptoms in older people. Inflammation may explain cognitive decline too. Further investigations are needed to better understand the direction of these associations and to determine whether these can be reversible.
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Affiliation(s)
- Giovanni Viscogliosi
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
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Cipriani E, Zanetti M, Brunella V, Costa L, Bracco P. Thermoplastic polyurethanes with polycarbonate soft phase: Effect of thermal treatment on phase morphology. Polym Degrad Stab 2012. [DOI: 10.1016/j.polymdegradstab.2012.06.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Viscogliosi G, Andreozzi P, Chiriac IM, Cipriani E, Servello A, Ettorre E, Marigliano V. Screening cognition in the elderly with metabolic syndrome. Metab Syndr Relat Disord 2012; 10:358-62. [PMID: 22784389 DOI: 10.1089/met.2012.0043] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome reaches its highest prevalence in the elderly, and evidence suggests that metabolic syndrome could be an independent risk factor for cognitive impairment. The aims of this study were to detect whether patients with metabolic syndrome have lower cognition and to investigate whether there is a relationship with cognition and single metabolic syndrome components. METHODS We assessed fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides, high-sensitivity C-reactive protein (hsCRP), and anthropometric measurements. Metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The population sample was divided into two groups according to the presence of metabolic syndrome. Cognitive function was investigated through the Mini-Mental State Examination (MMSE). RESULTS We enrolled 159 elderly subjects (mean age, 69.8±4.8 years). Seventy had metabolic syndrome. Metabolic syndrome subjects had higher hsCRP values (P<0.0001) and lower MMSE scores (P<0.0001) than those without metabolic syndrome. MMSE scores were significantly correlated with body mass index (BMI), hsCRP, metabolic syndrome, the number of metabolic syndrome components, and each of them. However, at multivariate regression analysis, only fasting blood glucose [FBG; B=-0.046; 95% confidence interval (CI) -0.066 to -0.028; P<0.0001] and the number of metabolic syndrome components (B=-0.317; 95% CI -0.572 to -0.010; P=0.042) were found to be independent predictors of lower MMSE scores. CONCLUSION We found that subjects with metabolic syndrome have lower MMSE scores than those without, even without symptomatic cognitive impairment, and that the number of metabolic abnormalities is independently associated to lower MMSE scores. We suggest that these patients should always undergo cognitive screening to prevent more severe outcomes.
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Dal Grande M, Zanderigo C, Coato F, Menegolli S, Cipriani E, Pancheri V, Malesani F, Perbellini L. [Sudden death caused by freon 22?]. Med Lav 1992; 83:361-4. [PMID: 1461194] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Case report of a plumber's fatal work accident. Investigations on the causes of death made at post mortem showed that the worker had absorbed a large quantity of freon 22 (chlorodifluoromethane) which is known to be a narcotic agent and capable of inducing cardiac arrhythmia. It is believed freon inhalation was the cause of loss of consciousness with consequent death from drowning in the water issuing from the pipes. It is concluded that preventive measures need to be reinforced by adequate information to the workforce on the risks connected to this type of gas.
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Affiliation(s)
- M Dal Grande
- ULSS 26 della Regione Veneto, Servizio di Prevenzione Igiene e Sicurezza negli Ambienti di Lavoro (S.P.I.S.A.L.), Bussolengo
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Bishop RF, Cipriani E, Lund JS, Barnes GL, Hosking CS. Estimation of rotavirus immunoglobulin G antibodies in human serum samples by enzyme-linked immunosorbent assay: expression of results as units derived from a standard curve. J Clin Microbiol 1984; 19:447-52. [PMID: 6325495 PMCID: PMC271092 DOI: 10.1128/jcm.19.4.447-452.1984] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A method for estimating rotavirus immunoglobulin G (IgG) antibodies by assay of human serum samples at a single serum dilution was studied. Antibody was measured by enzyme-linked immunosorbent assay (ELISA). The optical density of the reaction with a 1:100 dilution of each serum was expressed as ELISA units of antirotavirus IgG by reference to a standard curve. This standard curve was obtained by incorporation in each assay of five dilutions of a serum containing an arbitrary number of units of antirotavirus IgG. Test serum samples found to contain high amounts of antirotavirus IgG were reassayed at a 1:1,000 dilution. There was good correlation between antirotavirus IgG ELISA units in 45 serum samples and endpoint titers of the same samples (Spearman rank correlation coefficient rs, 0.95). Seroconversion during rotavirus infection was defined as an increase in antirotavirus IgG ELISA units per milliliter of greater than 28% (2 X intra-run coefficient of variation of the assay) in consecutive serum samples from the same child. Paired serum samples from nine children with diarrhea not due to rotavirus infection showed no seroconversions. Paired samples from eight children with rotavirus infection showed seroconversions. Estimation of antirotavirus IgG ELISA units in serum is simple, rapid, reproducible, and economical of serum samples. Standardization of results could be achieved by worldwide distribution of a standard serum. Its use would facilitate epidemiological surveys to evaluate potential rotavirus vaccines.
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Abstract
To determine whether rotavirus infection in newborn babies conferred immunity to postneonatal rotavirus infection, we studied 81 babies at birth and kept them under clinical and serologic study for three years. During the first 14 days of life, 44 of the infants excreted rotavirus, and 37 did not. Fifty-five per cent of those with neonatal infection and 54 per cent of those without it had rotavirus infection during the next three years. Symptoms associated with postneonatal rotavirus infection were significantly less frequent and less severe in the infants who had had neonatal infection (P = 0.003) than in those who had not. Thirty-eight per cent of the former group (9 of 24 infants) had symptoms of mild (3 infants) or moderate (6) severity during the first postneonatal infection. In contrast, 85 per cent of the latter group (17 of 20 infants) had mild (3), moderate (6), or severe (8) symptoms. We conclude that neonatal rotavirus infection does not confer immunity against reinfection but does protect against the development of clinically severe disease during reinfection.
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Breda M, Ciani R, Celeste G, Domenici R, Cipriani E. [Histofunctional aspects of the rat adrenals following administration of ethinyl estradiol (histological study)]. Boll Soc Ital Biol Sper 1978; 54:105-10. [PMID: 737046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cipriani E, Howard JE. Some observations on the effect of hypercapnea on ricketic cartilage calcification. Johns Hopkins Med J 1973; 132:88-94. [PMID: 4684172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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