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Makrydimas G, Damiani G, Jakil C, Cigna V, Orlandi M, Picciotto F, Schillaci G, Cassarà F, Vinciguerra M, Leto F, Giambona A, Maggio A, Nicolaides KH. Reply. Ultrasound Obstet Gynecol 2020; 56:790-791. [PMID: 33136321 DOI: 10.1002/uog.23137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- G Makrydimas
- Department of Obstetrics and Gynecology, Ioannina University Hospital, Ioannina, Greece
| | - G Damiani
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - C Jakil
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - V Cigna
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Orlandi
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Picciotto
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - G Schillaci
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Vinciguerra
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Maggio
- Campus of Hematology Franco and Piera Cutino, AOOR Villa Sofia Cervello, Palermo, Italy
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Makrydimas G, Damiani G, Jakil C, Cigna V, Orlandi M, Picciotto F, Schillaci G, Cassarà F, Vinciguerra M, Leto F, Giambona A, Maggio A, Nicolaides KH. Celocentesis for early prenatal diagnosis of hemoglobinopathy. Ultrasound Obstet Gynecol 2020; 56:672-677. [PMID: 32339311 DOI: 10.1002/uog.22059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/03/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Celocentesis is an invasive technique that can provide prenatal diagnosis of single-gene disorders, from as early as 7 weeks' gestation. The objective of this study was to examine the safety of celocentesis. METHODS In this prospective study, celocentesis was performed for prenatal diagnosis of hemoglobinopathy in 402 singleton pregnancies in which both parents were carriers of β-thalassemia or sickle cell disease trait. We assessed procedure-related maternal discomfort or pain, success of sampling and obtaining results, pregnancy outcome and postnatal follow-up. RESULTS First, celocentesis was carried out at a median gestational age of 8.6 (range, 6.9-9.9) weeks and celomic fluid was successfully aspirated in 99.8% of cases. Second, 67% of women had no or only mild discomfort, 18% had moderate discomfort, 12% had mild-to-moderate pain and 3% had severe pain. Third, prenatal diagnosis from analysis of the celomic fluid was successful in 93.8% cases, and in the last 121 cases, it was always successful. Fourth, in all cases of successful sampling and analysis of celomic fluid, the diagnosis was concordant with results obtained from additional prenatal or postnatal testing. Fifth, in addition to diagnosis of hemoglobinopathy, quantitative fluorescence polymerase chain reaction analysis, which was performed to evaluate maternal contamination using several markers for chromosomes X, Y, 21, 18 and 13, led to the accurate diagnosis of chromosomal aneuploidy. Sixth, in all cases of an affected fetus diagnosed by celocentesis in which the parents chose termination of pregnancy, this was carried out < 10 weeks' gestation. Seventh, in 97.1% (298/307) of the continuing pregnancies there was live birth, in seven (2.3%) there was miscarriage and in two (0.7%) there was loss to follow-up. Eighth, fetal abnormalities were diagnosed in three (1%) cases, including unilateral transverse amputation of the forearm, unilateral moderate hydronephrosis and small-bowel duplication. All neonates were examined by a pediatrician and were found to be phenotypically normal, except for the three cases with a prenatally diagnosed defect. CONCLUSIONS Celocentesis can be used for early prenatal diagnosis of genetic abnormalities, and the procedure-related risk of pregnancy complications appears to be low. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G Makrydimas
- Department of Obstetrics and Gynecology, Ioannina University Hospital, Ioannina, Greece
| | - G Damiani
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - C Jakil
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - V Cigna
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Orlandi
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Picciotto
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - G Schillaci
- UOS Medicina Fetale e Diagnosi Prenatale AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Cassarà
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - M Vinciguerra
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - F Leto
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Giambona
- Laboratory for Molecular Diagnosis of Rare Diseases, AOOR Villa Sofia Cervello, Palermo, Italy
| | - A Maggio
- Campus of Hematology Franco and Piera Cutino, AOOR Villa Sofia Cervello, Palermo, Italy
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Molnar AA, Tarnoki AD, Tarnoki DL, Littvay L, Medda E, Fagnani C, Arnofi A, Farina F, Baracchini C, Meneghetti G, Pucci G, Schillaci G, Stazi MA, Merkely B, Nadasy G. P742Biomechanical properties of the human internal jugular vein wall are heritable. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A A Molnar
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - A D Tarnoki
- Semmelweis University, Department of Radiology, Budapest, Hungary
| | - D L Tarnoki
- Semmelweis University, Department of Radiology, Budapest, Hungary
| | - L Littvay
- Central European University, Budapest, Hungary
| | - E Medda
- Superior Institute of Health, National Center of Epidemiology, Genetic Epidemiology Unit, Rome, Italy
| | - C Fagnani
- Superior Institute of Health, National Center of Epidemiology, Genetic Epidemiology Unit, Rome, Italy
| | - A Arnofi
- Superior Institute of Health, National Center of Epidemiology, Genetic Epidemiology Unit, Rome, Italy
| | - F Farina
- University of Padova, Department of Neurosciences, Padua, Italy
| | - C Baracchini
- University of Padova, Department of Neurosciences, Padua, Italy
| | - G Meneghetti
- University of Padova, Department of Neurosciences, Padua, Italy
| | - G Pucci
- University of Perugia, Department of Internal Medicine, Perugia, Italy
| | - G Schillaci
- University of Perugia, Department of Internal Medicine, Perugia, Italy
| | - M A Stazi
- Superior Institute of Health, National Center of Epidemiology, Genetic Epidemiology Unit, Rome, Italy
| | - B Merkely
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - G Nadasy
- Semmelweis University, Department of Physiology, Budapest, Hungary
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Pasqualini L, Ministrini S, Macura A, Marini E, Leli C, Siepi D, Lombardini R, Kararoudi MN, Scarponi AM, Schillaci G, Pirro M, Mannarino E. Increased Bone Resorption: A Possible Pathophysiological Link Between Hypovitaminosis D and Peripheral Arterial Disease. Eur J Vasc Endovasc Surg 2016; 52:352-9. [PMID: 27432480 DOI: 10.1016/j.ejvs.2016.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 04/24/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE/BACKGROUND Vitamin D deficiency has been associated with the prevalence and severity of peripheral arterial disease (PAD); nevertheless, data on bone turnover in patients with PAD is lacking. The present study investigates a possible relationship between the markers of bone turnover and the presence and severity of PAD. METHODS The study examined 143 patients, with a mean ± SD age of 75.3 ± 8.5 years (range 50.0-93.0 years), of both sexes, admitted to a department of internal medicine. All patients underwent ankle brachial index (ABI) assessment by Doppler velocimetry. Serum levels of 25(OH) vitamin D and two markers of bone turnover, C-terminal telopeptide of type I collagen (sCTX) and bone isoenzyme of alkaline phosphatase, were measured. The differences between patients with normal ABI and patients with PAD were analyzed. Pearson and Spearman correlation coefficients were calculated and independent predictors were identified through a stepwise linear regression analysis. Odds ratios were calculated with a logistic regression model. RESULTS Compared with patients with a normal ABI (≥0.90), patients with PAD (ABI < 0.90) presented with significantly lower levels of 25(OH) vitamin D (12.2 ± 9.6 ng/mL vs. 16.7 ± 8.7 ng/mL; p = .006) and a significantly higher concentration of sCTX (1.1 ± 0.7 ng/mL vs. 0.6 ± 0.4 ng/mL; p < .001). There was a positive correlation between ABI and serum concentration of 25 (OH) vitamin D (r = 0.3; p < .001), whereas ABI was inversely correlated with the concentration of sCTX (r = -0.358; p < .001). At logistic regression analysis, age, cigarette smoking, and both vitamin D and sCTX were independent predictors of an ABI < 0.90. CONCLUSION These results support the hypothesis that hypovitaminosis D and increased bone turnover are risk factors for the presence and severity of PAD. Furthermore, the presence of PAD, even if asymptomatic and diagnosed by a reduced ABI, could identify a population at risk for osteoporosis and osteomalacia.
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Affiliation(s)
- L Pasqualini
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy.
| | - S Ministrini
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - A Macura
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - E Marini
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - C Leli
- Department of Experimental Medicine, Division of Microbiology, University of Perugia, Perugia, Italy
| | - D Siepi
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - R Lombardini
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - M N Kararoudi
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - A M Scarponi
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - G Schillaci
- Department of Medicine, Division of Internal Medicine, University of Perugia, Terni, Italy
| | - M Pirro
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
| | - E Mannarino
- Department of Medicine, Division of Internal Medicine, University of Perugia, Perugia, Italy
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Bartoloni E, Battista F, Alunno A, Cannarile F, Valentini V, Pucci G, Schillaci G, Gerli R. AB0592 Evaluation of Arterial Stiffness in A Cohort of Systemic Sclerosis Patients: A Case-Control Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3501] [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: 11/03/2022]
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Palumbo I, Palumbo B, Fravolini ML, Marcantonini M, Perrucci E, Latini ME, Falcinelli L, Sabalich I, Tranfaglia C, Schillaci G, Mannarino E, Aristei C. Brain natriuretic peptide as a cardiac marker of transient radiotherapy-related damage in left-sided breast cancer patients: A prospective study. Breast 2015; 25:45-50. [PMID: 26547836 DOI: 10.1016/j.breast.2015.10.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/04/2015] [Accepted: 10/10/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Our study evaluated brain natriuretic peptide (BNP) changes over time after adjuvant radiotherapy (RT) in women with left-sided breast cancer investigating its correlation with heart dosimetric parameters. METHODS Forty-three patients underwent clinical cardiac examination, electrocardiogram (ECG), echocardiography and BNP measurement before RT (T0) and 1 (T1), 6 (T6) and 12 months (T12) after. After T12 cardiac assessment was performed annually in each patient. Mean values and standard deviation (SD) of BNP, left ventricular ejection fraction (LVEF), V20, V25, V30, V45 and mean dose were calculated. Normalized BNP (BNPn) was calculated as follows: BNPnT1 = BNPT1/BNPT0, BNPnT6 = BNPT6/BNPT0, BNPnT12 = BNPT12/BNPT0. Absolute BNP and BNPn values were used for data analysis. RESULTS Median follow-up from the end of RT to the last check-up was 87 months (range 37-120 months). Minimum follow-up was 74 months except for two patients, who died at respectively 37 and 47 months after RT. In all patients LVEF did not change significantly (p = 0.22) after RT. BNP increased significantly (p < 0.001), particularly 1 and 6 months after RT. It slightly decreased after 12 months. BNP did not correlate with V20, V25, V30, V45, mean dose and MHD. All BNPn correlated significantly (p < 0.05) with V20, V25, V30, V45, mean dose and MHD. Four patients had a cardiac event; in the only subject who developed myocardial infarction, V20, V25, V30 and V45 were the highest and BNP increased from T1 and persisted high even at T12. CONCLUSION Our results confirm that BNP could be a useful minimally invasive marker of early RT related cardiac impairment.
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Affiliation(s)
- I Palumbo
- Radiation Oncology Section, University of Perugia, Perugia General Hospital, Perugia, Italy.
| | - B Palumbo
- Nuclear Medicine and Health Physics Section, University of Perugia, Perugia, Italy
| | - M L Fravolini
- Department of Engineering, University of Perugia, Italy
| | - M Marcantonini
- Medical Physics Unit, Perugia General Hospital, Perugia, Italy
| | - E Perrucci
- Radiation Oncology Division, Perugia General Hospital, Perugia, Italy
| | - M E Latini
- Radiology Division, Perugia General Hospital, Perugia, Italy
| | - L Falcinelli
- Radiation Oncology Division, Perugia General Hospital, Perugia, Italy
| | - I Sabalich
- Nuclear Medicine and Health Physics Section, University of Perugia, Perugia, Italy
| | - C Tranfaglia
- Nuclear Medicine and Health Physics Section, University of Perugia, Perugia, Italy
| | - G Schillaci
- Internal Medicine Unit, Department of Medicine, University of Perugia, Italy
| | - E Mannarino
- Internal Medicine, Angiology and Arteriosclerosis Diseases Unit, Department of Medicine, University of Perugia, Italy
| | - C Aristei
- Radiation Oncology Section, University of Perugia, Perugia General Hospital, Perugia, Italy
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Giambona A, Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Leto F, Passarello C, Maggio A. Incidence of haemoglobinopathies in Sicily: the impact of screening and prenatal diagnosis. Int J Clin Pract 2015; 69:1129-38. [PMID: 25727926 DOI: 10.1111/ijcp.12628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 11/30/2022] Open
Abstract
BACKGROUND Haemoglobinopathies are a major public health problem in Sicily: it was estimated a frequency of 1/245 couples are at risk of haemoglobinopathies. This paper reviews legislative actions, prevention activities, carrier screening, genetic counselling, foetal sampling and laboratory methodology analysis evolution reporting the results of 30 years of prevention actions to assess the efficiency of our preventative programme in the control of haemoglobinopathies in Sicily. METHODS This programme consisted principally of five phases: legislative actions, public awareness campaign, carrier screening, genetic counselling and prenatal diagnosis. RESULTS These programmes have been very effective, which we can see from a greater public awareness of thalassaemia and its prevention in the target population furthermore by a marked decline in the incidence of thalassaemia major and sickle cell anaemia from 1 in 245 live births in the absence of prevention to 1 in 2000, with a reduction in about 85%. The residual cases were because of a conscious choice by expecting parents in relation to improved life expectancy as well as improved quality of life of the affected patients. CONCLUSION The study suggests that public health authorities should act and invest in a similar programme for prevention of thalassaemia, as well as in relation to the increased survival of patients and the consequent organ complications.
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Affiliation(s)
- A Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Damiani
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Jakil
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Picciotto
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Schillaci
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - V Cigna
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
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Bartoloni E, Baldini C, Schillaci G, Quartuccio L, Priori R, Carubbi F, Bini V, Alunno A, Bombardieri S, De Vita S, Valesini G, Giacomelli R, Gerli R. Cardiovascular disease risk burden in primary Sjögren's syndrome: results of a population-based multicentre cohort study. J Intern Med 2015; 278:185-92. [PMID: 25582881 DOI: 10.1111/joim.12346] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Systemic autoimmune diseases, in particular systemic lupus erythematosus and rheumatoid arthritis, are characterized by a high risk of premature cardiovascular (CV) events. Disease-related characteristics and traditional CV disease risk factors may contribute to atherosclerotic damage. However, there are limited data on the risk of overt CV events in primary Sjögren's syndrome (pSS). METHODS We retrospectively analysed a cohort of patients with 1343 pSS. Disease-related clinical and laboratory data, traditional CV disease risk factors and overt CV events were recorded. Prevalence of traditional CV disease risk factors and of major CV events was compared between a subgroup of 788 female patients with pSS aged from 35 to 74 years and 4774 age-matched healthy women. RESULTS Hypertension and hypercholesterolaemia were more prevalent, whereas smoking, obesity and diabetes mellitus were less prevalent, in women with pSS than in control subjects. Cerebrovascular events (2.5% vs. 1.4%, P = 0.005) and myocardial infarction (MI) (1.0% vs. 0.4%, P = 0.002) were more common in patients with pSS. In the whole population, central nervous system involvement (odds ratio (OR) 5.6, 95% confidence interval (CI) 1.35-23.7, P = 0.02) and use of immunosuppressive therapy (OR 1.9, 95% CI 1.04-3.70, P = 0.04) were associated with a higher risk of CV events. Patients with leucopenia had a higher risk of angina (P = 0.01). CONCLUSIONS pSS is associated with an increased risk of cerebrovascular events and MI. Disease-related clinical and immunological markers may have a role in promoting CV events.
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Affiliation(s)
- E Bartoloni
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
| | - C Baldini
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Schillaci
- Unit of Internal Medicine, Department of Medicine, Terni University Hospital, Terni, Italy
| | - L Quartuccio
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy
| | - R Priori
- Rheumatology Unit, Sapienza University of Rome, Rome, Italy
| | - F Carubbi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - V Bini
- Internal Medicine, Endocrine and Metabolic Sciences Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - A Alunno
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
| | - S Bombardieri
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S De Vita
- Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy
| | - G Valesini
- Rheumatology Unit, Sapienza University of Rome, Rome, Italy
| | - R Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - R Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
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9
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Bartoloni E, Battista F, Alunno A, Pucci G, Valentini V, Cannarile F, Schillaci G, Gerli R. AB0564 Disease Damage is Associated with Increased Aortic Stiffness in Systemic Lupus Erythematosus: A Cross-Sectional Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3258] [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: 11/04/2022]
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10
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Medda E, Fagnani C, Schillaci G, Tarnoki AD, Tarnoki DL, Baracchini C, Meneghetti G, Fanelli F, Alaeddin A, Pucci G, Alviti S, Cotichini R, Brescianini S, Boatta E, Lucatelli P, Nisticò L, Penna L, Salemi M, Toccaceli V, Zini C, Garami Z, Stazi MA. Heritability of arterial stiffness and carotid intima-media thickness: an Italian twin study. Nutr Metab Cardiovasc Dis 2014; 24:511-517. [PMID: 24582685 DOI: 10.1016/j.numecd.2013.10.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/17/2013] [Accepted: 10/22/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Carotid intima-media thickness (IMT) and arterial stiffness parameters, including aortic augmentation index (AIx) and pulse wave velocity (PWV), are independent predictors of stroke and cardiovascular disease. Genetic effects on these traits were never explored in a Mediterranean country. The present study aims to quantify the contribution of genes, environment and age to carotid IMT and aortic Aix and PWV. METHODS AND RESULTS The twin design was used. A total of 348 adult twins from the Italian Twin Register underwent measurements of carotid IMT and aortic PWV and AIx in three university hospitals located in Rome, Padua and Perugia. Carotid IMT was measured by B-mode ultrasound, aortic PWV and AIx by Arteriograph. Genetic modelling was performed to decompose total variance of traits into genetic, shared and unshared environmental and age components. For each phenotype, the best-fitting model included additive genetic, unshared environmental and age effects. For IMT, heritability was 0.32 (95% confidence interval (CI): 0.25-0.38), unshared environmental component was 0.25 (0.18-0.32) and age contribution was 0.44 (0.39-0.49). For AIx and PWV, heritabilities were 0.42 (0.29-0.55) and 0.49 (0.35-0.62), unshared environmental components were 0.31 (0.22-0.44) and 0.37 (0.26-0.51) and age contributions were 0.27 (0.16-0.39) and 0.14 (0.06-0.24), respectively. CONCLUSION This study shows substantial genetic and unshared environmental influences on carotid intima-media thickness and arterial stiffness and confirms the relevant role of age in the aetiology of these traits. Further support is provided for prevention and health promotion strategies based on modifiable factors.
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Affiliation(s)
- E Medda
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - C Fagnani
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy.
| | - G Schillaci
- University of Perugia, Department of Medicine and Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - A D Tarnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - D L Tarnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - C Baracchini
- Department of Neurosciences, School of Medicine, University of Padua, Padua, Italy
| | - G Meneghetti
- Department of Neurosciences, School of Medicine, University of Padua, Padua, Italy
| | - F Fanelli
- Department of Radiological Sciences, La Sapienza University of Rome, Rome, Italy
| | - A Alaeddin
- University of Perugia, Department of Medicine and Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - G Pucci
- University of Perugia, Department of Medicine and Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - S Alviti
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - R Cotichini
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - S Brescianini
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - E Boatta
- Department of Radiological Sciences, La Sapienza University of Rome, Rome, Italy
| | - P Lucatelli
- Department of Radiological Sciences, La Sapienza University of Rome, Rome, Italy
| | - L Nisticò
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - L Penna
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - M Salemi
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - V Toccaceli
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
| | - C Zini
- Department of Radiological Sciences, La Sapienza University of Rome, Rome, Italy
| | - Z Garami
- The Methodist Hospital DeBakey Heart and Vascular Center, Houston, TX, USA
| | - M A Stazi
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Viale Regina Elena 299, 00161 Rome, Italy
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11
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Pucci G, Battista F, de Vuono S, Boni M, Scavizzi M, Ricci MA, Lupattelli G, Schillaci G. Pericardial fat, insulin resistance, and left ventricular structure and function in morbid obesity. Nutr Metab Cardiovasc Dis 2014; 24:440-446. [PMID: 24368081 DOI: 10.1016/j.numecd.2013.09.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 08/25/2013] [Accepted: 09/24/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Morbid obesity is often accompanied by insulin resistance and increased ectopic fat surrounding the heart. We evaluated the relation of epicardial and pericardial fat with insulin resistance and left ventricular (LV) structure and function. METHODS AND RESULTS Epicardial and pericardial fat thicknesses were determined at 2-dimensional echocardiography in 80 morbid obese subjects [age 42 ± 12 years, 31% men, body mass index (BMI) 44.4 ± 7 kg/m(2)]. LV hypertrophy (LV mass ≥51 g/m(2.7)), inappropriately high LV mass for a given cardiac workload (observed vs predicted LV mass >128%), and stress-adjusted LV mid-wall fractional shortening were determined. Pericardial and epicardial fat thicknesses had direct associations with BMI (r = 0.40 and 0.45, both p < 0.01) and waist circumference (r = 0.37 and 0.45, both p < 0.01). Pericardial (partial r = 0.35, p < 0.01), but not epicardial fat thickness (partial r = 0.05, p = n.s.), was correlated with homeostasis model assessment-insulin resistance after adjustment for BMI. Pericardial fat also had a strong negative correlation with mid-wall fractional shortening (p = 0.01) and a positive one with inappropriately high LV mass (p < 0.01), while no such relation was found for epicardial fat (both p = n.s.). Independently of age, male sex, BMI, and anti-hypertensive treatment, pericardial fat thickness had an independent positive association with inappropriately high LV mass (β = 0.29, p = 0.02), and a negative one with stress-adjusted mid-wall fractional shortening (β = -0.26, p = 0.04). CONCLUSIONS Pericardial fat thickness is associated with insulin resistance, inappropriately high LV mass, and LV systolic dysfunction in obese individuals. Findings from this study confirm the existence of a connection between insulin resistance, cardiac ectopic fat deposition and cardiac dysfunction in morbid obesity.
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MESH Headings
- Adipose Tissue/diagnostic imaging
- Adipose Tissue/physiopathology
- Adiposity
- Adult
- Biomarkers/blood
- Body Mass Index
- Cross-Sectional Studies
- Female
- Humans
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/physiopathology
- Insulin Resistance
- Male
- Middle Aged
- Obesity, Morbid/blood
- Obesity, Morbid/complications
- Obesity, Morbid/diagnosis
- Obesity, Morbid/physiopathology
- Pericardium/diagnostic imaging
- Pericardium/physiopathology
- Risk Factors
- Ultrasonography
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Function, Left
- Waist Circumference
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Affiliation(s)
- G Pucci
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - F Battista
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - S de Vuono
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Angiology and Atherosclerosis, Perugia University Hospital, Perugia, Italy
| | - M Boni
- Unit of General Surgery, Foligno Hospital, Italy
| | - M Scavizzi
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Angiology and Atherosclerosis, Perugia University Hospital, Perugia, Italy
| | - M A Ricci
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Angiology and Atherosclerosis, Perugia University Hospital, Perugia, Italy
| | - G Lupattelli
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Angiology and Atherosclerosis, Perugia University Hospital, Perugia, Italy
| | - G Schillaci
- Department of Medicine, University of Perugia, Italy; Unit of Internal Medicine, Terni University Hospital, Terni, Italy.
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12
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Pucci G, Hametner B, Battista F, Anastasio F, Wassertheurer S, Schillaci G. P9.10 EXCESS PRESSURE IS INDEPENDENTLY RELATED TO LV MASS AND CONCENTRIC GEOMETRY IN ESSENTIAL HYPERTENSION. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.198] [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: 10/24/2022] Open
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13
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Bartoloni E, Alunno A, Pirro M, Bistoni O, Schillaci G, Bagaglia F, Luccioli F, Santoboni G, Mirabelli G, Cannarile F, Mannarino E, Gerli R. THU0174 Endothelial microparticles and circulating endothelial progenitor cells in primary sjægren’s syndrome patients: A potential marker of endothelial damage? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2139] [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: 11/04/2022]
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Pirro M, Manfredelli MR, Schillaci G, Helou RS, Bagaglia F, Melis F, Scalera GB, Scarponi AM, Gentile E, Mannarino E. Association between circulating osteoblast progenitor cells and aortic calcifications in women with postmenopausal osteoporosis. Nutr Metab Cardiovasc Dis 2013; 23:466-472. [PMID: 22366195 DOI: 10.1016/j.numecd.2011.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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] [Received: 03/15/2011] [Revised: 07/08/2011] [Accepted: 08/11/2011] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Ectopic artery calcification has been documented in women with postmenopausal osteoporosis, in whom an imbalance in the number of circulating osteoprogenitor cells (OPCs) has been identified. Circulating OPCs form calcified nodules in vitro; however, it remains unknown whether an association exists between the number of circulating OPCs and aortic calcifications. We investigated the relationship between OPCs and aortic calcifications in women with postmenopausal osteoporosis. METHODS AND RESULTS The number of circulating OPCs was quantified by FACS analysis in 50 osteoporotic postmenopausal women. OPCs were defined as CD15-/alkaline-phosphatase(AP)+ cells coexpressing or not CD34. Participants underwent measurement of markers of bone metabolism, bone mineral density and abdominal aortic calcium (AAC) by 64-slice computed tomography. Patients with AAC were older, had lower 25(OH)vitamin D levels and higher circulating CD15-/AP+/CD34- cells than those without AAC. Significant correlates of AAC included age (rho = 0.38 p = 0.006), calcium (rho = 0.35 p = 0.01), 25(OH)vitamin D (rho = -0.31, p = 0.03) and the number of CD15-/AP+/CD34- cells (rho = 0.55 p < 0.001). In regression analyses, the log-transformed number of CD15-/AP+/CD34- cells was associated with the presence (OR = 6.45, 95% CI 1.03-40.1, p = 0.04) and severity (β = 0.43, p < 0.001) of AAC, independent of age, 25(OH)vitamin D, calcium and other potential confounders. Patients with low 25(OH)vitamin D and high CD15-/AP+/CD34- cells had higher median AAC than other patients (1927/μL, 862-2714/μL vs 147/μL, 0-1665/μL, p = 0.003). CONCLUSION In women with postmenopausal osteoporosis, the number of circulating CD15-/AP+/CD34- cells is significantly associated with increased aortic calcifications, that appear to be correlated also with reduced 25(OH)vitamin D levels.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Hospital Santa Maria della Misericordia, Piazzale Menghini, 1, 06129 Perugia, Italy.
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Schillaci G, Battista F, Pucci G. P1.29 CARDIO-ANKLE VASCULAR INDEX, LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AND INAPPROPRIATE LEFT VENTRICULAR MASS. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.058] [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: 11/29/2022] Open
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16
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Pucci G, Battista F, Bilo G, Parati G, Schillaci G. P3.02 MORNING BLOOD PRESSURE SURGE, BLOOD PRESSURE VARIABILITY AND AORTIC STIFFNESS IN ESSENTIAL HYPERTENSION. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.090] [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: 10/26/2022] Open
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17
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Rondelli F, Trastulli S, Avenia N, Schillaci G, Cirocchi R, Gullà N, Mariani E, Bistoni G, Noya G. Is laparoscopic right colectomy more effective than open resection? A meta-analysis of randomized and nonrandomized studies. Colorectal Dis 2012; 14:e447-69. [PMID: 22540533 DOI: 10.1111/j.1463-1318.2012.03054.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [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] [Indexed: 12/12/2022]
Abstract
AIM The aim of this systematic review was to compare laparoscopic and/or laparoscopic-assisted right colectomy (LRC) with open right colectomy (ORC). Many randomized clinical trial have shown that laparoscopic colectomy benefits patients with improved short-term outcomes and comparable overall survival in respect to the open approach. These results, however, could not be applied to right colectomy owing to its wide range of resection and more complicated vascular regional anatomy. METHOD We performed a meta-analysis of the literature in order to compare LRC vs ORC by examining 21 end-points including operative and recovery outcomes, early postoperative mortality and morbidity, and oncological parameters. A subgroup analysis of patients undergoing right colectomy for cancer was carried out. The meta-analysis was conducted following all aspects of the Cochrane Handbook for systematic reviews and Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) statement. The search strategies were developed using the following electronic databases: PubMed, EMBASE, OVID, Medline, Cochrane Database of Systematic Reviews, EBM reviews and CINAHL until March 2011. We included randomized and non randomized studies that compared the LRC vs ORC for benign disease and malignant neoplasm irrespective of publication status. Only studies in English, French, German, Spanish and Italian languages were considered for inclusion. Emergency right colectomies were excluded. To perform the statistical analysis we used the odds ratio (OR) for categorical variables and the weighted mean difference (WMD) for continuous variables. An intention-to-treat analysis was performed. RESULTS Seventeen studies, 15 nonrandomized clinical trials and two randomized clinical trials, involving a total of 1489 patients, were identified. The mean operative time was longer in the group of patients undergoing LRC [weighted mean difference (WMD) = 37.94, 95% CI: 25.01 to 50.88; P < 0.00001]. Intra-operative blood loss (WMD = -96.61; 95% CI: -150.68 to -42.54; P = 0.0005), length of hospital stay (WMD = -2.29; 95% CI: -3.96 to -0.63; P = 0.007) and short-term postoperative morbidity (OR = 0.64; 95% CI: 0.49 to 0.83; P = 0.0009) were significantly in favour of LRC. CONCLUSION Laparoscopic-assisted right colectomy results in less blood loss, a shorter length of hospital stay and lower postoperative short-term morbidity compared with ORC.
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Affiliation(s)
- F Rondelli
- Department of General Surgery, S.Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
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18
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Pirro M, Bocci EB, Di Filippo F, Schillaci G, Mannarino MR, Bagaglia F, Gerli R, Mannarino E. Imbalance between endothelial injury and repair in patients with polymyalgia rheumatica: improvement with corticosteroid treatment. J Intern Med 2012; 272:177-84. [PMID: 22211720 DOI: 10.1111/j.1365-2796.2011.02510.x] [Citation(s) in RCA: 22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Polymyalgia rheumatica (PMR) is a rheumatic disease that is characterized by intense activation of systemic inflammation. Systemic inflammation has been associated with an imbalance between endothelial injury and repair, defined by an increased number of circulating endothelial microparticles (EMPs) and a reduced number of endothelial progenitor cells (EPCs). We investigated the association between inflammation and endothelial injury and repair in patients with PMR and evaluated the effects of corticosteroid therapy on EMP and EPC levels. DESIGN, SETTING AND SUBJECTS We conducted a case-control study in 34 patients with never-treated active PMR and 34 healthy age- and sex-matched controls. Patients with PMR participated in a 1-month intervention open-label study with corticosteroid therapy. Circulating EMPs (CD31+/CD42-) and EPCs (CD34+/KDR+) were quantified by fluorescence-activated cell sorting analysis. RESULTS Patients with PMR had an increased EMP/EPC ratio compared with controls [median (IQR): 6.5 (3.0-11.5) vs. 1.1 (0.7-1.5), P < 0.001], because of both increased EMP and reduced EPC levels. Levels of C-reactive protein (CRP) were associated with an increased EMP/EPC ratio (β = 0.48, P = 0.001), irrespective of traditional cardiovascular risk factors. Corticosteroid therapy led to a significant CRP reduction [from 3.9 (1.5-6.7) to 0.6 (0.2-1.2) mg dL(-1) , P < 0.05], paralleled by a consistent 81% decline in the EMP/EPC ratio. CRP and EMP/EPC ratio reductions were significantly correlated (rho = 0.37, P = 0.04). CONCLUSIONS Polymyalgia rheumatica is associated with a significant imbalance between endothelial injury and repair, which is dependent on the degree of systemic inflammation. Attenuation of inflammation by short-term corticosteroid therapy might have a role in limiting endothelial fragmentation and promote endothelial repair.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
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Lupattelli G, Pirro M, Siepi D, Mannarino MR, Roscini AR, Vaudo G, Pasqualini L, Schillaci G, Mannarino E. Non-cholesterol sterols in different forms of primary hyperlipemias. Nutr Metab Cardiovasc Dis 2012; 22:231-236. [PMID: 20708389 DOI: 10.1016/j.numecd.2010.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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] [Received: 02/07/2010] [Revised: 05/19/2010] [Accepted: 05/21/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS We investigated the behaviour of non-cholesterol sterols, surrogate markers of cholesterol absorption (campesterol and sitosterol) and synthesis (lathosterol), in primary hyperlipemias. METHODS AND RESULTS We studied 53 patients with polygenic hypercholesterolemia (PH), 38 patients with familial combined hyperlipemia (FCH), and 19 age- and sex-matched healthy control subjects. In all participants, plasma sitosterol, campesterol and lathosterol were determined by gas chromatography coupled to mass spectrometry. To correct for the effect of plasma lipid levels, non-cholesterol sterol concentrations were adjusted for plasma cholesterol (10² μmol/mmol cholesterol). Patients with FCH were more frequently men, and had higher body mass index (BMI), fasting glucose, insulin and HOMA-IR. Lathosterol was higher in FCH than in pH or controls (p < 0.05). Campesterol was significantly lower in FCH (p < 0.05), while no differences were found between pH and controls. Sitosterol displayed higher values in pH compared to FCH (p < 0.001) and controls (p < 0.05). Spearman's rank correlations showed positive correlations of lathosterol with BMI, waist circumference, HOMA-IR, triglycerides, apoprotein B, and a negative one with HDL-cholesterol. Sitosterol had a negative correlation with BMI, waist circumference, HOMA-IR, triglycerides, and a positive one with HDL-cholesterol and apoprotein AI. Multivariate regression analyses showed that cholesterol absorption markers predicted higher HDL-cholesterol levels, while HOMA-IR was a negative predictor of sitosterol and BMI a positive predictor of lathosterol. CONCLUSIONS Our findings suggest the occurrence of an increased cholesterol synthesis in FCH, and an increased cholesterol absorption in pH. Markers of cholesterol synthesis cluster with clinical and laboratory markers of obesity and insulin resistance.
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Affiliation(s)
- G Lupattelli
- Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Italy.
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Butlin M, Bozec E, Millet-Amaury E, Pucci G, Battista F, Qasem A, Schillaci G, Boutouyrie P, Avolio A. 5.2 CUFF AND TONOMETER BASED DEVICE FOR ASSESSMENT OF CAROTID TO FEMORAL PULSE WAVE VELOCITY: VALIDATION ACCORDING TO ARTERY SOCIETY GUIDELINES. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.032] [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] Open
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21
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Pucci G, Battista F, Settimi L, Hametner B, Wassertheurer S, Schillaci G. 1.5 BLOOD PRESSURE-INDEPENDENT ASSOCIATION BETWEEN AORTIC CHARACTERISTIC IMPEDANCE AND LEFT VENTRICULAR MASS IN HYPERTENSION. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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22
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Pucci G, Battista F, Notaristefano S, Cavallini C, Mannarino E, Schillaci G. P2.08 CENTRAL-TO-PERIPHERAL BLOOD PRESSURE AMPLIFICATION: INVASIVE VALIDATION OF TWO DEVICES (SPHYGMOCOR AND OMRON HEM9000AI). Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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23
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Pirro M, Schillaci G, Mannarino MR, Scarponi AM, Manfredelli MR, Callarelli L, Leli C, Fabbriciani G, Helou RS, Bagaglia F, Mannarino E. Circulating immature osteoprogenitor cells and arterial stiffening in postmenopausal osteoporosis. Nutr Metab Cardiovasc Dis 2011; 21:636-642. [PMID: 20554181 DOI: 10.1016/j.numecd.2010.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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] [Received: 08/26/2009] [Revised: 11/09/2009] [Accepted: 01/23/2010] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS An increased number of circulating osteoprogenitor cells (OPCs) expressing bone-related proteins and the stem cell marker CD34 have been identified in women with postmenopausal osteoporosis, who also have stiffer arteries than nonosteoporotic subjects. We investigated whether an increased number of circulating OPCs underlies the association of osteoporosis with arterial stiffness. METHODS AND RESULTS The number of circulating OPCs was quantified by FACS analysis in 120 postmenopausal women with or without osteoporosis. OPCs were defined as CD34+/alkaline phosphatase(AP)+ or CD34+/osteocalcin(OCN)+ cells. Participants underwent cardiovascular risk factor assessment, measurement of bone mineral density (BMD), and aortic pulse wave velocity (aPWV) as a measure of arterial stiffness. Osteoporotic women had higher aPWV (9.8 ± 2.8 vs 8.5 ± 1.9 m/s, p = 0.005) and levels of CD34+/AP+ and CD34+/OCN+ cells than nonosteoporotic controls [1045 n/mL (487-2300) vs 510 n/mL (202-940), p < 0.001; 2415 n/mL (1225-8090) vs 1395 n/mL (207-2220), p < 0.001]. aPWV was associated with log-CD34+/AP+ (r = 0.27, p = 0.003), log-CD34+/OCN+ cells (r = 0.38, p < 0.001). In stepwise regression analysis CD34+/OCN+ cells, age, systolic blood pressure and heart rate were significant predictors of aPWV (Model R = 0.62, p < 0.001), independent of cardiovascular risk factors, parathyroid hormone levels and osteoporotic status. CONCLUSION In women with postmenopausal osteoporosis an increased availability of circulating osteoprogenitor cells has a detrimental influence on arterial compliance, which may in part explain the association between osteoporosis and arterial stiffening.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Hospital Santa Maria della Misericordia, Piazzale Menghini 1, Perugia, Italy.
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Pucci G, Gavish B, Battista F, Settimi L, Mannarino E, Schillaci G. 12.02 VARIATIONS OF WAVE REFLECTION INDEXES INDUCED BY ACUTE BLOOD PRESSURE CHANGES AT DIFFERENT ARM HEIGHTS. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.187] [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: 12/01/2022] Open
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Tarnoki A, Tarnoki D, Stazi M, Medda E, Cotichini R, Nistico L, Lucatelli P, Boatta E, Zini C, Fanelli F, Baracchini C, Meneghetti G, Schillaci G, Jermendy G, Osztovits J, Lannert A, Molnar A, Littvay L, Garami Z, Berczi V. P11.30 HERITABILITY OF CENTRAL BLOOD PRESSURE AND PULSE PRESSURE – A TWIN STUDY. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.184] [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: 11/26/2022] Open
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Schillaci G, Gavish B, Pucci G, Settimi L, Mannarino E. P6.03 THE PRESSURE DEPENDENCE OF ARTERIAL STIFFNESS AS A NOVEL VASCULAR MARKER DETERMINED FROM PWV AND BRACHIAL BP TAKEN AT DIFFERENT ARM HEIGHTS. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Schillaci G, Pucci G, Settimi L, Pilati M, Baroni A, Mannarino E. P11.10 PRESSURE-INDEPENDENT ASSOCIATION BETWEEN AORTIC STIFFNESS AND LEFT VENTRICULAR CONCENTRIC GEOMETRY. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.166] [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: 11/28/2022] Open
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Schillaci G, Sarchielli P, Corbelli I, Pucci G, Settimi L, Mannarino MR, Calabresi P, Mannarino E. Aortic stiffness and pulse wave reflection in young subjects with migraine: A case-control study. Neurology 2010; 75:960-6. [PMID: 20837963 DOI: 10.1212/wnl.0b013e3181f25ecd] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Migraine has been associated with an increased risk for ischemic stroke and other cardiovascular (CV) events, including angina, myocardial infarction, and CV death, but the mechanisms that link migraine to CV disease remain uncertain. We hypothesized that aortic pulse wave velocity (PWV), a direct measure of aortic stiffness and an independent predictor of stroke and CV disease, may be increased in young migraineurs with no overt CV disease or major CV risk factors. METHODS We studied 60 subjects with migraine (age 33 ± 8 years, 85% women, blood pressure 119/74 ± 11/9 mm Hg) and 60 age-, sex-, and blood pressure-matched healthy control subjects. In all participants, carotid-femoral PWV and aortic augmentation index were determined by applanation tonometry. Cases and controls were free from overt CV disease, diabetes, and major CV risk factors. RESULTS Subjects with migraine had a higher aortic PWV (7.6 ± 1.2 vs 6.4 ± 1.1 m × s(-1), p < 0.001) and aortic augmentation (heart rate-adjusted augmentation index, 0.17 ± 0.13 vs 0.08 ± 0.15, p < 0.001) than matched control subjects. Migraine patients with aura (n = 17) had higher aortic PWV than those without aura (n = 43; 8.2 ± 1.2 vs 7.4 ± 1.1 m × s(-1), p = 0.027). Age, mean arterial pressure as a measure of distending pressure, and migraine (all p < 0.05) independently predicted aortic PWV when a consistent number of CV risk factors was simultaneously controlled for. CONCLUSIONS Migraine is independently associated with increased aortic stiffness and enhanced pressure wave reflection. This finding, obtained in young subjects without major CV risk factors, may represent one possible mechanism underlying the increased CV risk in migraine patients.
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Affiliation(s)
- G Schillaci
- Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia.
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Schillaci G, Pucci G, Martinelli C, Quirino T, Bonfanti P, De Socio GV. ADVERSE EFFECTS OF HIV INFECTION ON DAY-NIGHT BLOOD PRESSURE VARIABILITY: PP.14.29. J Hypertens 2010. [DOI: 10.1097/01.hjh.0000378955.77231.6d] [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: 11/25/2022]
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Lupattelli G, Pirro M, Siepi D, Mannarino M, Roscini A, Vaudo G, Schillaci G, Mannarino E. P227 NON-CHOLESTEROL STEROLS IN COMMON HYPERCHOLESTEROLEMIA AND FAMILIAL COMBINED HYPERLIPEMIA. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70294-4] [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: 11/30/2022]
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Schillaci G, Rondelli F, Pirro M, Bagaglia F, Pucci G, Noya G, Mannarino E. Endothelial progenitor cells are mobilized after major laparotomic surgery in patients with cancer. Int J Immunopathol Pharmacol 2010; 22:1035-41. [PMID: 20074467 DOI: 10.1177/039463200902200419] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The progression of cancer is largely dependent on neoangiogenesis. Circulating endothelial progenitor cells (EPC) have the ability to form complete vascular structures in vitro and play a crucial role in tumor vasculogenesis. Emerging evidence suggests that surgical injury may induce the mobilization of EPC in animal models, and this might have a negative effect on the prognosis of cancer patients. We studied 20 patients (10 men, 65+/-13 years) undergoing laparotomy for surgical treatment of various forms of abdominal cancer, and 20 age- and sex-matched healthy control subjects. The number of circulating EPC, defined as CD34+/KDR+ cells identified among mononuclear cells isolated from peripheral venous blood, was determined preoperatively and at days 1 and 2 after surgery. Surgery induced a significant increase in circulating EPC levels at day 1 (from 278/mL, interquartile range 171-334, to 558/mL, interquartile range 423-841, p<0.001) and day 2 (709/mL, interquartile range 355-834, p<0.001)compared with baseline values. EPC levels did not change in control subjects. Seven subjects who underwent laparotomic surgery for non-neoplastic disease also showed an increase in EPC levels after surgery (p=0.009 and p=0.028 at day 1 and day 2, respectively). We conclude that patients undergoing elective laparotomic surgery for cancer demonstrate an increase in EPC post-operatively. The potential adverse effects of surgical stress-induced EPC mobilization on tumor and metastasis growth in cancer patients need to be addressed in future studies.
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Affiliation(s)
- G Schillaci
- Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy.
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Pasqualini L, Schillaci G, Innocente S, Pucci G, Coscia F, Siepi D, Lupattelli G, Ciuffetti G, Mannarino E. Lifestyle intervention improves microvascular reactivity and increases serum adiponectin in overweight hypertensive patients. Nutr Metab Cardiovasc Dis 2010; 20:87-92. [PMID: 19473823 DOI: 10.1016/j.numecd.2009.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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] [Received: 09/15/2008] [Revised: 02/28/2009] [Accepted: 03/02/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Obesity and hypoadiponectinemia are often associated with high blood pressure. Moreover, microvascular dysfunction is reported to be an early event in patients with hypertension and may be involved in the pathogenesis of organ damage. METHODS AND RESULTS We investigated the impact of 8-week moderate-intensity aerobic training on adiponectin plasma levels and skin microvascular reactivity in 24 overweight sedentary patients (18 men, age 44+/-6 years, body mass index 28+/-3 kg/m(2)) with never-treated grade 1 essential hypertension. Twenty-four age- and sex-matched hypertensive patients, who were examined twice at 8-week intervals in the absence of exercise training, served as controls. Exercise training was followed by a significant reduction in waist circumference (from 97+/-9 to 95+/-9 cm, p<0.05) and an increase in adiponectin plasma levels (from 11.9+/-3 to 12.5+/-4 mg/L, p<0.05). An inverse correlation was found between adiponectin change and waist circumference change (r=-0.43, p<0.05). The area under the curve after post-occlusive reactive hyperemia at skin laser-Doppler examination increased significantly after aerobic training (from 876+/-539 to 1468+/-925 PU/s, p<0.001). A positive correlation was found between exercise-induced variations of post-occlusive reactive hyperemia and adiponectin plasma levels (r=0.41, p<0.05). Office or 24-h blood pressure values did not change significantly. CONCLUSION In sedentary overweight patients with mild hypertension, moderate aerobic training improves cutaneous microvascular reactivity and adiponectin plasma levels. These changes precede blood pressure reduction and may serve as biomarkers of the efficacy of non-drug treatment in hypertensive patients.
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Affiliation(s)
- L Pasqualini
- Department of Clinical and Experimental Medicine, University of Perugia School of Medicine, Hospital Santa Maria della Misericordia, Perugia, Italy.
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Pucci G, Cheriyan J, Hubsch A, Hickson S, Watson T, Schillaci G, Wilkinson I, McEniery C. 3.2 A COMPARISON OF THE VICORDER APPARATUS WITH SPHYGMOCOR DEVICE FOR THE NON-INVASIVE ASSESSMENT OF AORTIC BLOOD PRESSURE: AN INVASIVE VALIDATION STUDY. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.167] [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: 10/18/2022] Open
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Pucci G, Cheriyan J, Whittaker L, Hickson S, Schillaci G, McEniery C, Wilkinson I. P1.08 THE BRACHIO-TO-RADIAL PULSE PRESSURE AMPLIFICATION AND ITS CONTRIBUTION TO CENTRAL-TO-PERIPHERAL PULSE PRESSURE AMPLIFICATION. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.013] [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: 11/28/2022] Open
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Schillaci G, Pucci G, Gavish B, Hijazi R, Settimi L, Pirro M, Mannarino E. P1.03 BRACHIAL SYSTOLIC AND DIASTOLIC BLOOD PRESSURE AT DIFFERENT ARM HEIGHTS: A NOVEL INDEX OF ARTERIAL FUNCTION. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.008] [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: 11/29/2022] Open
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Schillaci G, Pucci G, De Socio GVL. HIV infection and antiretroviral treatment: a "two-hit" model for arterial stiffness? Am J Hypertens 2009; 22:817-8. [PMID: 19638954 DOI: 10.1038/ajh.2009.113] [Citation(s) in RCA: 4] [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: 11/09/2022] Open
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Mannarino M, Pirro M, Helou R, Schillaci G, Covelli D, Mannarino E. Abstract: P1190 INFLUENCE OF VISCERAL AND SUBCUTANEOUS FAT ON CAROTID INTIMA-MEDIA THICKNESS IN DYSLIPIDEMIC PATIENTS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71217-6] [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: 11/29/2022]
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Pasqualini L, Leli C, De Socio GVL, Mazzolla R, Cavaliere A, Schillaci G, Bistoni F, Mannarino E. Retroperitoneal abscess: an uncommon localization of tubercular infection. Infez Med 2008; 16:230-232. [PMID: 19155690] [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: 05/27/2023]
Abstract
We describe a rare case of a 29-year-old immunocompetent Nigerian male affected by an abdominal abscess due to Mycobacterium tuberculosis infection. Diagnosis was achieved with cultures from surgical drainage. No pulmonary, renal, or gastrointestinal involvement was identified. The patient was successfully treated with standard four-drug antitubercular therapy.
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Affiliation(s)
- L Pasqualini
- Department of Clinical and Experimental Medicine, University of Perugia, Italy
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Pucci G, Mannarino M, Avenia N, Monacelli M, Fabbriciani G, Pirro M, Scarponi A, Mannarino E, Schillaci G. 12.25 Aortic Stiffness: a Reversible Marker of Cardiovascular Risk in Primary Hyperparathyroidism? High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263746] [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] Open
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Schillaci G, Pucci G, Pirro M, Hijazi D, Mannarino M, Vaudo G, Mannarino E. 12.27 Does Ambulatory Blood Pressure Monitoring Provide a Reliable Measure of Arterial Stiffness? High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263748] [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] Open
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Schillaci G, Pucci G, Pirro M, Helou J, Vaudo G, Pasqualini L, Mannarino E. 10.7 QT/RR Slope: a Novel Arrhythmogenic Substrate in Hypertensive Left Ventricular Hypertrophy. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263708] [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] Open
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Pucci G, Mannarino M, Avenia N, Monacelli M, Fabbriciani G, Pirro M, Scarponi A, Schillaci G, Mannarino E. AORTIC STIFFNESS: A REVERSIBLE MARKER OF CARDIOVASCULAR RISK IN PRIMARY HYPERPARATHYROIDISM? ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70602-0] [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: 11/24/2022]
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Pirro M, Vaudo G, Alaeddin A, Bagaglia F, Paoletti L, Razzi R, Mannarino M, Schillaci G, Mannarino E. EFFECTS OF LOW-GRADE SYSTEMIC INFLAMMATION ON ENDOTHELIAL MICROPARTICLE LEVELS IN SUBJECTS AT INCREASED CARDIOVASCULAR RISK. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70658-5] [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: 11/29/2022]
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Pucci G, Mannarino M, Sperandini L, Helou J, Savarese G, Pirro M, Schillaci G, Mannarino E. AORTIC STIFFNESS IN UNTREATED ADULT PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70739-6] [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: 11/28/2022]
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Pasqualini L, Siepi D, Innocente S, Lupattelli G, Sperandini L, Kouadio B, Coscia F, Roscini A, Schillaci G, Mannarino E. LIFESTYLE INTERVENTION IMPROVES ADIPONECTIN LEVELS AND MICROVASCULAR REACTIVITY IN OVERWEIGHT HYPERTENSIVE PATIENTS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70833-x] [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: 11/17/2022]
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Pasqualini L, Schillaci G, Pirro M, Vaudo G, Siepi D, Innocente S, Ciuffetti G, Mannarino E. Renal dysfunction predicts long-term mortality in patients with lower extremity arterial disease. J Intern Med 2007; 262:668-77. [PMID: 17908164 DOI: 10.1111/j.1365-2796.2007.01863.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [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: 12/18/2022]
Abstract
BACKGROUND Patients with renal insufficiency tend to suffer from advanced atherosclerosis and exhibit a reduced life expectancy. OBJECTIVES AND DESIGN This prospective study investigated the relation between renal dysfunction and long-term all-cause and cardiovascular mortality in a population of nonsurgical patients with lower extremity arterial disease (LEAD). SUBJECTS AND METHODS A total of 357 patients with symptomatic LEAD underwent baseline glomerular filtration rate (GFR) estimation by the 4-variable Modification Diet in Renal Diseases equation, and were then followed for 4.2 years (range: 1-17). RESULTS During follow-up, 131 patients died (8.6 deaths per 100 patient-years), 79 of whom (60%) from cardiovascular causes. All-cause death rates were 3.8, 6.6, and 15.5 per 100 patient-years, respectively, in the groups with normal GFR, mild reduction in GFR (60-89 mL min(-1) per 1.73 m2) and chronic kidney disease (CKD; <60 mL min(-1) per 1.73 m2; P < 0.001 by log-rank test). Compared to patients with normal renal function, the risk of all-cause and cardiovascular death was significantly higher in patients with CKD [hazard ratio, respectively, 2.23, 95% confidence interval (CI): 1.16-4.34, P = 0.017; 2.15, 95% CI: 1.05-4.43, P = 0.03]. The association of CKD with all-cause and cardiovascular mortality were independent of age, LEAD severity, cardiovascular risk factors and treatment with angiotensin-converting enzyme (ACE)-inhibitors, hypolipidaemic and antiplatelet drugs. The power of GFR in predicting all-cause death was higher than that of ankle-brachial pressure index (P = 0.029) and Framingham risk score (P < 0.0001). CONCLUSION Chronic kidney disease strongly predicts long-term mortality in patients with symptomatic LEAD irrespective of disease severity, cardiovascular risk factors and concomitant treatments.
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Affiliation(s)
- L Pasqualini
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy.
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Pirro M, Bagaglia F, Menecali C, Mannarino M, Vaudo G, Schillaci G, Mannarino E. WO6-OR-4 THE RELATIONSHIP BETWEEN ENDOTHELIAL PROGENITOR CELLS, THEIR APOPTOTIC MICROPARTICLES AND THE FRAMINGHAM RISK. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)70968-6] [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: 10/23/2022]
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Lupattelli G, Schillaci G, Siepi D, Pucci G, Mannarino M, Helou J, Pirro M, Mannarino E. PO19-580 INVERSE RELATION BETWEEN SERUM ADIPONECTIN AND LEFT VENTRICULAR MASS IN HYPERTENSIVE WOMEN. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71590-8] [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: 10/23/2022]
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