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Zanoli L, Gaudio A, Lo Cicero L. Reversibility of Aortic Stiffening During the First Waves of COVID-19. Angiology 2024; 75:105-106. [PMID: 37358839 PMCID: PMC10293861 DOI: 10.1177/00033197231186092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Lorenzo Lo Cicero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Sessa C, Zanoli L, Noto G, Alessandrello I, Galeano D, Giglio E, Giuffrida AE, Distefano G, Ficara V, Messina RM, Musumeci S, Scollo V, Zirino F, Zuppardo C, Morale W. [Contrast Media Toxicity and Its Prevention]. G Ital Nefrol 2023; 40:2023-vol5. [PMID: 38010244] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Intravenous iodinated contrast media are commonly used in clinical practice, ranging from medical imaging to interventional radiology (IR) procedures and endovascular interventions. Compared with patients with normal renal function, nephropathic patients have an increased risk of acute kidney injury (AKI). Nevertheless, this condition cannot represent a limit to diagnostics or endovascular interventions. Despite the literature of the last five years, conflicting management and approaches for nephropathic patients persist, including the use of contrast agents and treatments replacing renal functions, which are often mistakenly considered as part of preventive strategies. Though the issue has been widely discussed, specialists often cope with uncertainty in handling properly the administration of contrast media and renal counselling requests. Furthermore, there is a general difficulty in distinguishing the Post-Contrast Acute Kidney Injury (PC-AKI) from the Contrast-Associated Acute Kidney Injury (CI-AKI). The present review aims to provide an update on the issue and examine strategies to reduce the acute kidney injury risk after the administration of contrast media. These strategies include the early identification of high-risk individuals, the choice of the contrast media and the proper dosage, the suspension of nephrotoxic drugs, the follow-up of the high-risk individuals, and the early identification of AKI.
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Affiliation(s)
- Concetto Sessa
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Luca Zanoli
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT)
| | - Giovanni Noto
- U.O.C. Medicina e Chirurgia d'Accettazione e Urgenza, P.O. Giovanni Paolo II, Ragusa (RG)
| | - Ivana Alessandrello
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Dario Galeano
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Elisa Giglio
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | | | - Giulio Distefano
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Vincenzo Ficara
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | | | - Stella Musumeci
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Viviana Scollo
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Fortunata Zirino
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Carmelo Zuppardo
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
| | - Walter Morale
- U.O.C. Nefrologia e Dialisi, P.O. Maggiore "Nino Baglieri", Modica, Ragusa (RG)
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Castellino N, Scuto S, Zanoli L, Toro MD, Avitabile T, Castellino P, Russo A. Regression of bilateral orbital inflammation with anti-CD20 in a patient with relapsing granulomatosis with polyangiitis: A case report. Eur J Ophthalmol 2023; 33:NP25-NP28. [PMID: 36112868 DOI: 10.1177/11206721221126266] [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] [Indexed: 08/31/2023]
Abstract
PURPOSE To describe a case of bilateral orbital inflammation in a patient with relapsing granulomatosis with polyangiitis as only sign of disease recurrency treated with anti-CD20 antibodies. METHODS A 62-year-old Caucasian man affected by Granulomatosis with polyangiitis (GPA) was admitted to our hospital showing bilateral orbital inflammation as the only signs of disease recurrency. In addition, eye visit detected severe visual loss in the left eye (light perception). Guidelines to manage severe orbital involvement in patients with GPA are lacking. The patient was treated with intravenous rituximab and glucocorticoids. RESULTS Complete regression of inflammatory signs by imaging were observed at three-year of follow-up after the treatment with anti-CD20. However, ocular multimodal imaging showed severe optic nerve damages in the left eye with irreversible visual loss. CONCLUSION Patients affected by GPA with inflammatory orbital involvement may benefit from anti-CD20 antibodies.
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Affiliation(s)
| | - Salvatore Scuto
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Luca Zanoli
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Mario Damiano Toro
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Pietro Castellino
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
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Belluardo G, Frasca L, Sessa C, Galeano D, Zanoli L, Morale W. [Sleep quality of patients in End Stage Renal Disease before and after starting chronic hemodialysis treatment: a longitudinal study]. G Ital Nefrol 2023; 40:2023-vol4. [PMID: 37910215] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Introduction: Sleep disorders are very common in patients with chronic kidney disease, with a prevalence of poor sleep quality of around 40%. Objectives: The purpose of the study is to compare the sleep quality of ESRD patients before hemodialysis (Pre-HD), three months (Post-HD 1) and six months after the start of treatment (Post-HD 2) through the use of the Pittsburgh Sleep Quality Index (PSQI). Methods: Patients in ESRD were recruited from the U.O.C. of Nephrology and Dialysis of the Maggiore Hospital in Modica and biographical and anamnestic data were collected. The PSQI was administered in-person at the Pre-HD stage and by telephone re-test at the three- and six-month follow-up. Results: A total of 71 patients (males=62%, age 68 ± 16) were included. At Pre-HD assessment 93% reported poor sleep quality, the percentage increased to 98% during Post-HD 1 and it partially improved during Post-HD 2 with a prevalence of 95%. Analysis of variance (ANOVA) by repeated measures showed a difference in sleep quality between the three time points. Conclusions: Sleep quality undergoes important changes during the transition from conservative to hemodialysis patient, highlighting a critical period related to the first three months of treatment. More attention to this phase may improve the patient's quality of life and reduce the associated risk of mortality.
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Affiliation(s)
- Giulia Belluardo
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica. Azienda Sanitaria Provinciale di Ragusa, Italia
| | - Letizia Frasca
- Servizio di Psicologia, Modica, Azienda Sanitaria Provinciale di Ragusa, (RG) Italia
| | - Concetto Sessa
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica. Azienda Sanitaria Provinciale di Ragusa, Italia
| | - Dario Galeano
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica. Azienda Sanitaria Provinciale di Ragusa, Italia
| | - Luca Zanoli
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italia
| | - Walter Morale
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica. Azienda Sanitaria Provinciale di Ragusa, Italia
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Di Marco M, Miano N, Marchisello S, Coppolino G, L’Episcopo G, Scilletta S, Spichetti C, Torre S, Scicali R, Zanoli L, Gaudio A, Castellino P, Piro S, Purrello F, Di Pino A. Indirect Effects of the COVID-19 Pandemic on In-Hospital Outcomes among Internal Medicine Departments: A Double-Center Retrospective Study. J Clin Med 2023; 12:5304. [PMID: 37629346 PMCID: PMC10455112 DOI: 10.3390/jcm12165304] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/27/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
The coronavirus disease 19 (COVID-19) emergency led to rearrangements of healthcare systems with a significant impact on those internal medicine departments that had not been converted to COVID-19 wards. A reduced number of departments, indeed, had to cope with the same number of patients along with a lack of management of patients' chronic diseases. We conducted a retrospective study aimed at examiningthe consequences of the COVID-19 pandemic on internal medicine departments that were not directly managing COVID-19 patients. Data from 619 patients were collected: 247 subjects hospitalized in 2019 (pre-COVID-19 era), 178 in 2020 (COVID-19 outbreak era) and 194 in 2021 (COVID-19 ongoing era). We found that in 2020 in-hospital mortality was significantly higher than in 2019 (17.4% vs. 5.3%, p = 0.009) as well as length of in-hospital stay (LOS) (12.7 ± 6.8 vs. 11 ± 6.2, p = 0.04). Finally, we performed a logistic regression analysis of the major determinants of mortality in the entire study population, which highlighted an association between mortality, being bedridden (β = 1.4, p = 0.004), respiratory failure (β = 1.5, p = 0.001), glomerular filtration rate (β = -0.16, p = 0.03) and hospitalization in the COVID-19 outbreak era (β = 1.6, p = 0.005). Our study highlights how the COVID-19 epidemic may have caused an increase in mortality and LOS even in patients not directly suffering from this infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy; (M.D.M.); (N.M.); (S.M.); (G.C.); (G.L.); (S.S.); (C.S.); (S.T.); (R.S.); (L.Z.); (A.G.); (P.C.); (S.P.); (F.P.)
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Noordzij M, Meijers B, Gansevoort RT, Covic A, Duivenvoorden R, Hilbrands LB, Hemmelder MH, Jager KJ, Mjoen G, Nistor I, Parshina E, Pessolano G, Tuglular S, Vart P, Zanoli L, Franssen CFM, van der Net JB, Essig M, du Buf-Vereijken PWG, van Ginneken B, Maas N, van Jaarsveld BC, Bemelman FJ, Klingenberg-Salahova F, Vervloet MG, Nurmohamed A, Vogt L, Abramowicz D, Verhofstede S, Maoujoud O, Malfait T, Fialova J, Lips J, Hengst M, Konings C, Rydzewski A, Oliveira J, Zakharova EV, Lepeytre F, Rabaté C, Rostoker G, Marques S, Azasevac T, Majstorovic GS, Fricke L, Slebe JJP, ElHafeez SA, El-Wakil HS, Verhoeven M, Logan I, Panagoutsos S, Mallamaci F, Postorino A, Cambareri F, Matceac I, Groeneveld JHM, Jousma J, van Buren M, Pereira TA, Arias-Cabrales C, Crespo M, Llinàs-Mallol L, Buxeda A, Tàrrega CB, Redondo-Pachon D, Jimenez MDA, Mendoza-Valderrey A, Martins AC, Mateus C, Alvila G, Laranjinha I, Arroyo D, Castellano S, Rodríguez-Ferrero ML, Lemahieu W, Dirim AB, Demir E, Sever MS, Turkmen A, Şafak S, Hollander DAMJ, Büttner S, Sridharan S, van der Sande FM, Christiaans MHL, Luca MD, Beerenhout C, Adema AY, Stepanov VA, Zulkarnaev AB, Turkmen K, Fliedner A, Åsberg A, Pini S, de Biase C, Kerckhoffs A, van de Logt AE, Maas R, Lebedeva O, Reichert LJM, Verhave J, Marcantoni C, van Gils-Verrij LEA, Battaglia Y, Lentini P, Cabezas-Reina CJ, Roca AM, Nauta F, Goffin E, Kanaan N, Labriola L, Devresse A, Coca A, Naesens M, Kuypers D, Desschans B, Dedinska I, Malik S, Berger SP, Sanders JSF, Özyilmaz A, Ponikvar JB, Pernat AM, Kovac D, Arnol M, Abrahams AC, Molenaar FM, van Zuilen AD, Meijvis SCA, Dolmans H, Esposito P, Krzesinski JM, Barahira JD, Gallieni M, Guglielmetti G, Guzzo G, Luik AJ, van Kuijk WHM, Stikkelbroeck LWH, Hermans MMH, Rimsevicius L, Righetti M, Islam M, Heitink-ter Braak N. Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe - Lessons for the future. Clin Kidney J 2022; 16:662-675. [PMID: 37007687 PMCID: PMC10061429 DOI: 10.1093/ckj/sfac253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Early reports on the pandemic nature of COVID-19 directed the nephrology community to develop infection prevention and control guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave.
Methods
We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between March 1, 2020 and July 31, 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of SARS-CoV-2 in dialysis centres.
Results
Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting.
Conclusions
Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.
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Affiliation(s)
- Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Björn Meijers
- Department of Nephrology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
- Belgium and Department of Microbiology , UZ Leuven, Leuven , , Immunology and Transplantation, KU Leuven, Leuven , Belgium
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Adrian Covic
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Raphaël Duivenvoorden
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center , Nijmegen , The Netherlands
| | - Marc H Hemmelder
- Dept. of Internal Medicine, Div. of Nephrology, Maastricht University Medical Center / CARIM school for cardiovascular disease, University of Maastricht , Maastricht , The Netherlands
| | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam , Medical Informatics, Amsterdam , The Netherlands
- Amsterdam Public Health Research Institute , Quality of Care, Amsterdam , The Netherlands
| | - Geir Mjoen
- Department of Transplantation, Oslo University Hospital , Norway
| | - Ionut Nistor
- Grigore T Popa University of Medicine and Pharmacy , Iasi , , Iasi , Romania
- Romania / Dr Ci Parhon Hospital , Iasi , , Iasi , Romania
| | - Ekaterina Parshina
- Nephrology and Dialysis Department, Saint Petersburg State University Hospital , Saint-Petersburg, Russia
| | - Giuseppina Pessolano
- Division of Nephrology , Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Serhan Tuglular
- Medical Faculty, Department of Internal Medicine, Marmara University , Istanbul , Turkey
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
- Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, University of Groningen , The Netherlands
| | - Luca Zanoli
- Nephrology and dialysis, San Marco Hospital, University of Catania , Catania , Italy
| | - Casper F M Franssen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
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Lentini P, Zanoli L, Ronco C, Benedetti C, Previti A, Laudadio G, Vienna F, Andrighetto S, Fuso V, Gambaro G. The Vascular Disease of Diabetic Kidney Disease. Cardiorenal Med 2022; 13:202-210. [PMID: 36279858 DOI: 10.1159/000527274] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/18/2022] [Accepted: 09/23/2022] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND The incidence of cardiovascular disease (CVD) is increased in patients with diabetic kidney disease (DKD). SUMMARY Aortic stiffness is a well-accepted biomarker for cardiovascular (CV) events in all stages of CKD. The worldwide prevalence of diabetes continues to grow, as does the prevalence of DKD. Insulin resistance, hyperglycaemia, hypertension, and the metabolic abnormalities of type-2 diabetes are all involved in the pathogenesis of CVD. The effect of these toxins on cardiac and vascular function is amplified by the worsening of renal function and the parallel rise of uraemic toxins. KEY MESSAGES In this narrative review, we analysed why arterial stiffening can be considered a vascular mediator between diabetes and cardiac dysfunction, and we discussed the strong CV and nephroprotective effects of sodium-glucose cotransporter type-2 inhibitors.
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Affiliation(s)
- Paolo Lentini
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Luca Zanoli
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Claudio Ronco
- Department of Medicine, University of Padua, Padua, Italy
- San Bortolo Hospital of Vicenza, Department of Nephrology, Dialysis and Transplantation, Vicenza, Italy
- International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital of Vicenza, Vicenza, Italy
| | - Claudia Benedetti
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Antonino Previti
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Giorgio Laudadio
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Federica Vienna
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Sofia Andrighetto
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Valeria Fuso
- Nephrology and dialysis, "San Bassiano Hospital", Bassano del Grappa, Italy
| | - Giovanni Gambaro
- Division of Nephrology and Dialysis, Ospedale Maggiore, Verona, Italy
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Zanoli L, Vancheri C. Lung Dysfunction and Increased Arterial Stiffness: Causality or Epiphenomenon? Angiology 2022; 73:901-902. [PMID: 36063090 DOI: 10.1177/00033197221122838] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Carlo Vancheri
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Colaci M, Zanoli L, Lo Gullo A, Sambataro D, Sambataro G, Aprile ML, Castellino P, Malatino L. The Impaired Elasticity of Large Arteries in Systemic Sclerosis Patients. J Clin Med 2022; 11:jcm11123256. [PMID: 35743327 PMCID: PMC9224949 DOI: 10.3390/jcm11123256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by endothelial dysfunction and fibrosis of skin and visceral organs. In the last decade, attention has been focused on the macrovascular involvement of the disease. In particular, the observation of increased arterial stiffness represented an interesting aspect of the disease, as predictor of cardiovascular risk. (2) Methods: We recruited 60 SSc patients (52 ± 12 years old, 90% females) and 150 age/sex-matched healthy controls in order to evaluate both intima-media thickness of the right common carotid artery and arterial stiffness using the B-mode echography and the SphygmoCor system® tonometer. (3) Results: The carotid-femoral pulse wave velocity (PWV) was higher in SSc patients than in controls (8.6 ± 1.7 vs. 7.8 ± 1.5 m/s; p < 0.001), as was the carotid-radial PWV (7.8 ± 1.1 vs. 6.7 ± 1.4 m/s; p < 0.001). The intima-media thickness was higher in SSc than in controls (654 ± 108 vs. 602 ± 118 µm; p = 0.004). The other parameters measured at carotid (radial strain, Young’s modulus, compliance and distensibility) all indicated that arterial stiffness in tension was more pronounced in SSc. Of interest, the direct correlation between PWV and age corresponded closely in SSc. Moreover, a significant difference between SSc and controls as regards the carotid parameters was evident in younger subjects. (4) Conclusions: SSc patients showed an increased arterial stiffness compared to healthy controls. In particular, an SSc-related pathologic effect was suggested by the more pronounced increase in PWV with age and lower values of carotid elasticity in younger SSc patients than in age-matched controls.
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Affiliation(s)
- Michele Colaci
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, 95126 Catania, Italy; (M.L.A.); (L.M.)
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
- Correspondence:
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
- Internal Medicine Unit, Policlinico Rodolico—S. Marco, 95123 Catania, Italy
| | | | - Domenico Sambataro
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
| | - Gianluca Sambataro
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
| | - Maria Letizia Aprile
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, 95126 Catania, Italy; (M.L.A.); (L.M.)
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
- Internal Medicine Unit, Policlinico Rodolico—S. Marco, 95123 Catania, Italy
| | - Lorenzo Malatino
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, 95126 Catania, Italy; (M.L.A.); (L.M.)
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; (L.Z.); (D.S.); (G.S.); (P.C.)
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Zanoli L, Lentini P, Gaudio A, Castellino P. It Is Time for a Routine Measurement of Aortic Stiffness in Inflammatory Bowel Disease. Turk J Gastroenterol 2022; 33:539-540. [PMID: 35786624 PMCID: PMC9321864 DOI: 10.5152/tjg.2022.21752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/20/2021] [Indexed: 06/15/2023]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Paolo Lentini
- Division of Nephrology and Dialysis, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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11
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Zanoli L, Gaudio A, Mikhailidis DP, Katsiki N, Castellino N, Lo Cicero L, Geraci G, Sessa C, Fiorito L, Marino F, Antonietta Di Rosolini M, Colaci M, Longo A, Montineri A, Malatino L, Castellino P, Aparo P, Arena A, Barchitta M, Castelletti F, Noto MD, Pino AD, Giarrusso O, Isaia I, Lentini P, Magnano San Lio P, Manuele R, Marino E, Morale W, Sciuto A, Scuto SS, Xourafa A, Zocco S. Vascular Dysfunction of COVID-19 Is Partially Reverted in the Long-Term. Circ Res 2022; 130:1276-1285. [DOI: 10.1161/circresaha.121.320460] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/16/2022]
Abstract
Background:
COVID-19 is characterized by severe inflammation during the acute phase and increased aortic stiffness in the early postacute phase. In other models, aortic stiffness is improved after the reduction of inflammation. We aimed to evaluate the mid- and long-term effects of COVID-19 on vascular and cardiac autonomic function. The primary outcome was aortic pulse wave velocity (aPWV).
Methods:
The cross-sectional Study-1 included 90 individuals with a history of COVID-19 and 180 matched controls. The longitudinal Study-2 included 41 patients with COVID-19 randomly selected from Study-1 who were followed-up for 27 weeks.
Results:
Study-1: Compared with controls, patients with COVID-19 had higher aPWV and brachial PWV 12 to 24 (but not 25–48) weeks after COVID-19 onset, and they had higher carotid Young’s elastic modulus and lower distensibility 12 to 48 weeks after COVID-19 onset. In partial least squares structural equation modeling, the higher the hs-CRP (high-sensitivity C-reactive protein) at hospitalization was, the higher the aPWV 12 to 48 weeks from COVID-19 onset (path coefficient: 0.184;
P
=0.04). Moreover, aPWV (path coefficient: −0.186;
P
=0.003) decreased with time. Study-2: mean blood pressure and carotid intima-media thickness were comparable at the end of follow-up, whereas aPWV (−9%;
P
=0.01), incremental Young’s elastic modulus (−17%;
P
=0.03), baroreflex sensitivity (+28%;
P
=0.049), heart rate variability triangular index (+15%;
P
=0.01), and subendocardial viability ratio (+12%;
P
=0.01×10
−4
) were significantly improved. There was a trend toward improvement in brachial PWV (−6%;
P
=0.14) and carotid distensibility (+18%;
P
=0.05). Finally, at the end of follow-up (48 weeks after the onset of COVID-19) aPWV (+6%;
P
=0.04) remained significantly higher in patients with COVID-19 than in control subjects.
Conclusions:
COVID-19-related arterial stiffening involves several arterial tree portions and is partially resolved in the long-term.
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Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital campus, University College London, United Kingdom (D.P.M.)
| | - Niki Katsiki
- Diabetes Center, Division of Endocrinology and Metabolism, First Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece (N.K.)
| | | | - Lorenzo Lo Cicero
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Giulio Geraci
- Internal Medicine, St Elia Hospital, Caltanissetta, Italy (G.G.)
| | - Concetto Sessa
- Nephrology and Dialysis Unit, Giovanni Paolo II Hospital, Ragusa, Italy (C.S.)
| | - Letizia Fiorito
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Francesca Marino
- Infectious Diseases, Giovanni Paolo II Hospital, Ragusa, Italy (F.M., M.A.D.R.)
| | | | - Michele Colaci
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Antonio Longo
- Eye Clinic, University of Catania, Italy. (N.C., A.L.)
| | | | - Lorenzo Malatino
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Italy. (L.Z., A.G., L.LC., L.F., M.C., L.M., P.C.)
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12
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Colaci M, Zanoli L, La Malfa L, Caruso R, De Andres MI, Sambataro D, Sambataro G, Castellino P, Malatino L. Reduction of carotid baroreceptor sensitivity in systemic sclerosis. Clin Exp Rheumatol 2022; 40:1964-1969. [DOI: 10.55563/clinexprheumatol/4j6028] [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] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Michele Colaci
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy.
| | - Luca Zanoli
- Internal Medicine Unit, AOUP G. Rodolico-S. Marco, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Lara La Malfa
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, Catania, Italy
| | - Rossella Caruso
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, Catania, Italy
| | | | - Domenico Sambataro
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Gianluca Sambataro
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Pietro Castellino
- Internal Medicine Unit, AOUP G. Rodolico-S. Marco, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Lorenzo Malatino
- Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy
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13
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Di Pino A, Scicali R, Marchisello S, Zanoli L, Ferrara V, Urbano F, Filippello A, Di Mauro S, Scamporrino A, Piro S, Castellino P, Purrello F, Rabuazzo AM. High glomerular filtration rate is associated with impaired arterial stiffness and subendocardial viability ratio in prediabetic subjects. Nutr Metab Cardiovasc Dis 2021; 31:3393-3400. [PMID: 34625357 DOI: 10.1016/j.numecd.2021.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/08/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS High glomerular filtration rate (HGFR) is associated with cardiovascular damage in the setting of various conditions such as obesity and diabetes. Prediabetes was also associated with increased GFR, however, the association between prediabetes, HGFR and cardiovascular damage has not been investigated. In this study, we investigated the association between HGFR and early markers of cardiovascular disease in subjects with prediabetes. METHODS AND RESULTS Augmentation pressure (Aug), augmentation index (AIx), subendocardial viability ratio (SEVR), pulse wave velocity (PWV), intima-media thickness (IMT) and estimated GFR (eGFR) were evaluated in 230 subjects with prediabetes. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration formula. HGFR was defined as an eGFR above the 75th percentile. Prediabetic subjects were divided into two groups according to presence/absence of HGFR: 61 subjects with HGFR and 169 subjects without HGFR. Subjects with HGFR showed higher Aug, AIx and lower SEVR compared with prediabetic subjects with lower eGFR (14.1 ± 7.2 vs 10.8 ± 6.2, 32.9 ± 12.7 vs 27.6 ± 11.7, 153.5 ± 27.8 vs 162 ± 30.2, p < 0.05). No differences were found in PWV and IMT values between the two groups. Then, we performed multiple regression analysis to test the relationship between Aug, SEVR and several cardiovascular risk factors. In multiple regression analysis Aug was associated with age, systolic blood pressure (BP), HOMA-IR and eGFR; the major determinants of SEVR were systolic BP, HOMA-IR and eGFR. CONCLUSION Subjects with prediabetes and HGFR exhibited an increased Aug, AIx and a reduced SEVR. These alterations are associated with eGFR, insulin resistance and systolic BP.
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Affiliation(s)
- Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Simona Marchisello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Francesca Urbano
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Agnese Filippello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Stefania Di Mauro
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Alessandra Scamporrino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy.
| | - Agata M Rabuazzo
- Department of Clinical and Experimental Medicine, University of Catania, Torre Biologica F. Latteri, S. Sofia Street 89, 9512, Catania, Italy
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14
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Sessa C, Morale W, Zanoli L, Biancone L, Barreca A, Seminara G, Londrino F, Granata A. [Atheroembolic renal disease: risk factors, diagnostics, histology, and therapeutic approaches]. G Ital Nefrol 2021; 38:38-05-2021-07. [PMID: 34713643] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The increase in patients' average age, the enhancement of anticoagulation therapy and the growth of vascular interventions represent the perfect conditions for the onset of atheroembolic renal disease. AERD is observed in patients with diffuse atherosclerosis, generally after a triggering event such as surgery on the aorta, invasive procedures (angiography, catheterization of the left ventricle, coronary angioplasty) and anticoagulant or fibrinolytic therapy. The clinical signs are heterogeneous, a consequence of the occlusion of downstream small arterial vessels by cholesterol emboli coming from atheromatous plaques of the aorta, or one of its main branches. The proximity of the kidneys to the abdominal aorta, and the high flow of blood they receive, make them a major target organ. For this reason, AERD represents a pathological condition that always needs to be taken into account in the nephropathic patient, although its systemic nature makes the diagnosis difficult. This manuscript presents a review of the existing literature on this pathology, to provide an updated summary of the state of the art: risk factors, diagnostics, histology and therapeutic approaches.
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Affiliation(s)
| | - Walter Morale
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica. Azienda Sanitaria Provinciale di Ragusa, Italy
| | - Luca Zanoli
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Luigi Biancone
- Nefrologia Dialisi e Trapianto, AOU città della salute e della Scienza, Torino, Italy
| | - Antonella Barreca
- Anatomia Patologica, AOU città della salute e della Scienza, Torino, Italy
| | - Giuseppe Seminara
- U.O.C di Nefrologia e Dialisi, A.O. per l'Emergenza "Cannizzaro", Catania, Italy
| | - Francesco Londrino
- U.O.C. Nefrologia e Dialisi, ASL Roma 2, A.O. "Sant'Eugenio", Roma, Italy
| | - Antonio Granata
- U.O.C di Nefrologia e Dialisi, A.O. per l'Emergenza "Cannizzaro", Catania, Italy
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15
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Lentini P, Gemelli A, Battaglia Y, Ambrogio A, Esposito R, Zanoli L, Previti A, Dell'Aquila R, Fiorini F. [Home hemodialysis: multicenter observational study]. G Ital Nefrol 2021; 38:38-05-2021-10. [PMID: 34713646] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Home dialysis is a primary objective of Italian Ministry of Health. As stated in the National Chronicity Plan and the Address Document for Chronic Renal Disease, it is mostly home hemodialysis and peritoneal dialysis to be carried out in the patient's home. Home hemodialysis has already been used in the past and today has found new technologies and new applications. The patient's autonomy and the need for a caregiver during the sessions are still the main limiting factors. In this multicenter observational study, 7 patients were enrolled for 24 months. They underwent six weekly hemodialysis sessions of 180' each; periodic medical examinations and blood tests were performed (3, 6, 12, 18 and 24 months). After 3-6 months of home hemodialysis there was already an improvement in the control of calcium-phosphorus metabolism (improvement in phosphorus values, (p <0.01), a reduction in parathyroid hormone (p <0.01)); in the number of phosphorus binders used (p <0.02); in blood pressure control (with a reduction in the number of hypotensive drugs p <0.02). Home hemodialysis, although applicable to a small percentage of patients (10-15%), has improved blood pressure control, calcium-phosphorus metabolism and anemia, reducing the need for rhEPO.
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Affiliation(s)
- Paolo Lentini
- UOC Nefrologia, Ospedale "San Bassiano", Bassano del Grappa (VI), Italy
| | - Alessandro Gemelli
- UOC Nefrologia e Dialisi, Ospedale "Santa Maria della Misericordia", Rovigo, Italy
| | | | - Antonina Ambrogio
- UOC Nefrologia e Dialisi, Ospedale "Santa Maria della Misericordia", Rovigo, Italy
| | - Raffaela Esposito
- UOC Nefrologia e Dialisi, Ospedale "Santa Maria della Misericordia", Rovigo, Italy
| | - Luca Zanoli
- UOC Nefrologia, Università degli Studi di Catania, Catania (CT), Italy
| | - Antonino Previti
- UOC Nefrologia, Ospedale "San Bassiano", Bassano del Grappa (VI), Italy
| | | | - Fulvio Fiorini
- UOC Nefrologia e Dialisi, Ospedale "Santa Maria della Misericordia", Rovigo, Italy
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16
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Gaudio A, Rapisarda R, Xourafa A, Zanoli L, Manfrè V, Catalano A, Signorelli SS, Castellino P. Effects of competitive physical activity on serum irisin levels and bone turnover markers. J Endocrinol Invest 2021; 44:2235-2241. [PMID: 33675533 PMCID: PMC8421288 DOI: 10.1007/s40618-021-01529-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Irisin, a myokine, is a polypeptide derived from the cleavage of the extracellular domain of fibronectin domain-containing protein 5, a receptor that is present on different tissues (skeletal muscle, pericardium, myocardium, and brain), whose functions are not yet fully defined. PURPOSE The main aim of our study was to evaluate the effect of competitive physical activity on serum irisin levels and bone turnover markers. METHODS Fifteen male footballers and an equal number of subjects of the same age and gender, but with a predominantly sedentary lifestyle, had their serum levels of irisin and bone turnover markers measured. Bone mineral status was evaluated in both groups by quantitative bone ultrasound of the calcaneus. In addition, only in footballers, biochemical analyses were repeated after 3 months. RESULTS We did not observe significant differences in the serum levels of calcium, phosphorus, and parathyroid hormone between the two groups. The footballers had significantly higher quantitative bone ultrasound, 25-OH vitamin D, and creatinine values than the controls. There were also no significant differences in the bone alkaline phosphatase, carboxy-terminal telopeptide of type I collagen, osteoprotegerin, sclerostin or Dkk-1 values, while the irisin levels (+ 89%, p < 0.001) and RANKL were significantly higher in the footballers compared to those in the controls. CONCLUSION Our study shows that footballers have significantly higher serum irisin values than the general population. Irisin could be the "trait d'union" between bone health and physical activity.
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Affiliation(s)
- A Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", Via S. Sofia 78, 95123, Catania, Italy.
| | - R Rapisarda
- AOU Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - A Xourafa
- AOU Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - L Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", Via S. Sofia 78, 95123, Catania, Italy
| | - V Manfrè
- Clinica del Mediterraneo, Ragusa, Italy
| | - A Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S S Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", Via S. Sofia 78, 95123, Catania, Italy
| | - P Castellino
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", Via S. Sofia 78, 95123, Catania, Italy
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17
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Zanoli L, Mikhailidis DP. Narrative Review of Carotid disease and the kidney. Ann Transl Med 2021; 9:1210. [PMID: 34430651 PMCID: PMC8350722 DOI: 10.21037/atm-20-5001] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/09/2020] [Indexed: 11/28/2022]
Abstract
Patients with chronic kidney disease (CKD) have an increased cardiovascular (CV) risk that is only in part explained by established risk factors. Carotid arteriosclerosis and atherosclerosis are increased in CKD, play a role in the causation of CV disease in these patients and can affect the progression of renal disease. The arterial stiffening process is evident even in CKD patients with a very mild reduction of glomerular filtration rate (GFR) whereas arterial thickening is evident in more advanced stages. Possible mechanisms include functional and structural alterations of the arterial wall. Arterial stiffness can mediate the effect of CKD on target organs (i.e., brain, kidney and heart). In this review we discuss the arterial phenotype of patients with CKD. This is characterized by increased common carotid artery stiffness and outward remodeling (enlargement and thickening of the arterial wall) and a normal/reduced stiffness paired with an inward remodeling (narrowing of the arterial wall) of muscular arteries. We also discuss the consequences of carotid dysfunction, including the involvement of large elastic arteries stiffness on ventricular-vascular coupling, the mechanisms linking carotid stiffening and increased cardio- and cerebrovascular risk in CKD patients, and the therapeutic options to improve carotid function.
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Affiliation(s)
- Luca Zanoli
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital campus, University College London, London, UK
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18
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Catanzaro R, Selvaggio F, Sciuto M, Zanoli L, Yazdani A, He F, Marotta F. Triglycerides to high-density lipoprotein cholesterol ratio for diagnosing nonalcoholic fatty liver disease. Minerva Gastroenterol (Torino) 2021; 68:261-268. [PMID: 33829728 DOI: 10.23736/s2724-5985.21.02818-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Nonalcoholic Fatty Liver Disease (NAFLD) is a widespread disease in the western world. It can develop into more serious pathological conditions (i.e. liver cirrhosis). Therefore it is important to diagnose it in order to prevent this evolution. For diagnosis it is possible to use both imaging methods and biomarkers, such as the Triglycerides To High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C). Aim of our study is to determine whether TG/HDL-C ratio is significantly associated with NAFLD and Metabolic Syndrome (MetS). METHODS We recruited 231 patients, 131 with and 100 without NAFLD. The Body Mass Index had been calculated and different laboratory parameters had been obtained. TG/HDL-C ratio was calculated for each. RESULTS In our sample HDL-C was not significantly reduced in NAFLD group (p = 0.49), but higher TG and TG/HDL-C ratio were significantly associated with NAFLD: in both p < 0.001. According to receiver operating characteristic curve, the best cut-off of TG/HDL-C in NAFLD population was 1.64 [area under the curve (AUC) 0.675 (95% CI 0.604-0.746), p < 0.001]. TG/HDL-C higher ratio was significantly associated with MetS (p < 0.001). The best cut-off of TG/HDL-C in patients with MetS was 2.48 [AUC 0.871 (95% CI 0.808-0.935), p < 0.001]. CONCLUSIONS We demonstrated that higher TG/HDL-C ratio is associated with NAFLD and MetS. Though nowadays TG/HDL-C ratio is not a criteria for NAFLD diagnosis, we believe that in the future it could be used as a reliable non-invasive marker in routine diagnostics of NAFLD.
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Affiliation(s)
- Roberto Catanzaro
- Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Policlinico Hospital, University of Catania, Catania, Italy -
| | - Federica Selvaggio
- Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Policlinico Hospital, University of Catania, Catania, Italy
| | - Morena Sciuto
- Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Policlinico Hospital, University of Catania, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Azam Yazdani
- Boston University, Harvard Medical School, Boston, MA, USA
| | - Fang He
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu, China
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19
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Gaudio A, Zanoli L, Xourafa A, Rapisarda R, Catalano A, Signorelli SS, Castellino P. Paget's Disease of Bone and Cardiovascular Risk: A Pilot Study. Curr Vasc Pharmacol 2021; 19:423-428. [PMID: 32516100 DOI: 10.2174/1389450121666200609151555] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The association between Paget's disease of bone (PDB) and increased cardiovascular (CV) risk has been suggested, but the literature is conflicting. OBJECTIVE Our study aimed to evaluate two markers of CV risk, namely, common carotid artery intimamedia thickness (cIMT) and the aortic pulse wave velocity (PWV) in patients with PDB. METHODS We enrolled 12 patients with PDB and 58 control subjects, matched for age. The diagnosis of PDB was based on clinical, radiological and biochemical parameters. RESULTS Patients with PDB showed higher PWV values than the controls, whereas cIMT was slightly but not significantly increased. CONCLUSION These findings, although limited by the small study population, represent an original observation that deserves further study. The higher arterial stiffness in PDB could be related to the increased bone turnover or the high levels of oxidative stress that characterize this population.
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Anastasia Xourafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosario Rapisarda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Catania, Italy
| | | | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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20
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Foti PV, Travali M, Farina R, Palmucci S, Coronella M, Spatola C, Puzzo L, Garro R, Inserra G, Riguccio G, Zanoli L, Basile A. Can Conventional and Diffusion-Weighted MR Enterography Biomarkers Differentiate Inflammatory from Fibrotic Strictures in Crohn's Disease? ACTA ACUST UNITED AC 2021; 57:medicina57030265. [PMID: 33803953 PMCID: PMC8000737 DOI: 10.3390/medicina57030265] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
Background and Objectives: To retrospectively assess the value of magnetic resonance enterography (MRE) parameters derived from conventional and diffusion weighted imaging (DWI) sequences to differentiate fibrotic strictures from inflammatory ones in adult patients with Crohn’s disease (CD), using surgical specimens as the histopathological reference standard. Material and Methods: Twenty-three patients with CD who had undergone surgical resection of ileal strictures with full-thickness histopathologic analysis within 3 months from preoperative MRE were included. Two radiologists blinded to histopathology in consensus evaluated the following biomarkers on MRE images matched to resected pathological specimens: T1 ratio, T2 ratio, enhancement pattern, mural thickness, pre-stenotic luminal diameter, and apparent diffusion coefficient (ADC). A blinded pathologist graded stricture histological specimens with acute inflammation score (AIS) and fibrosis score (FS). MRE measurements were correlated with the reference standard. Results: Inflammation and fibrosis coexisted in 78.3% of patients. T2 ratio was reduced in patients with severe fibrosis (p = 0.01). Pre-stenotic bowel dilatation positively correlated with FS (p = 0.002). The ADC value negatively correlated with FS (p < 0.001) and was different between FS grades (p < 0.05). The area under the receiver operating characteristic curve for discriminating between none and mild/moderate–severe bowel wall fibrosis was 0.75 for pre-stenotic bowel dilatation (sensitivity 100%, specificity 44.4%) and 0.97 for ADC (sensitivity 80%, specificity 100%). Conclusions: Inflammation and fibrosis often coexist in CD bowel strictures needing surgery. The combination of parameters derived from conventional MR sequences (T2 ratio, pre-stenotic dilatation) and from DWI (ADC) may provide a contribution to detect and grade bowel fibrosis in adult CD patients.
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Affiliation(s)
- Pietro Valerio Foti
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
- Correspondence: ; Tel.: +39-095-378-2360; Fax: +39-095-378-2368
| | - Mario Travali
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
| | - Renato Farina
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
| | - Stefano Palmucci
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
| | - Maria Coronella
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
| | - Corrado Spatola
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
| | - Lidia Puzzo
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Anatomic Pathology Section, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy; (L.P.); (R.G.)
| | - Rossella Garro
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Anatomic Pathology Section, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy; (L.P.); (R.G.)
| | - Gaetano Inserra
- Department of Clinical and Experimental Medicine, U.O. Medicina Interna, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy; (G.I.); (G.R.)
| | - Gaia Riguccio
- Department of Clinical and Experimental Medicine, U.O. Medicina Interna, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy; (G.I.); (G.R.)
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy;
| | - Antonio Basile
- Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”—Radiology I Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Via Santa Sofia, 78-95123 Catania, Italy; (M.T.); (R.F.); (S.P.); (M.C.); (C.S.); (A.B.)
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21
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Catanzaro R, Aleo A, Sciuto M, Zanoli L, Balakrishnan B, Marotta F. FIB-4 and APRI scores for predicting severe liver fibrosis in chronic hepatitis HCV patients: a monocentric retrospective study. Clin Exp Hepatol 2021; 7:111-116. [PMID: 34027123 PMCID: PMC8122089 DOI: 10.5114/ceh.2021.104543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 09/29/2020] [Accepted: 12/30/2020] [Indexed: 02/07/2023] Open
Abstract
AIM OF THE STUDY Hepatitis C virus (HCV) can cause a chronic liver infection which could then develop into fibrosis, cirrhosis, and hepatocellular carcinoma. Today the diagnosis of liver fibrosis also includes the use of biomarkers. The purpose of our study was to determine the ability of the fibrosis index based on four factors (FIB-4) and aspartate aminotransferase-to-platelet ratio (APRI) to predict the severity of liver fibrosis or cirrhosis. MATERIAL AND METHODS Medical records of 106 patients with HCV-related liver fibrosis were analyzed. All patients underwent clinical examination, blood tests (complete blood count, total bilirubin, etc.) and transient elastography. FIB-4 and APRI were calculated for each patient. RESULTS Twenty-six patients (24.52%) had F4 fibrosis, 80 patients (75.48%) had non-F4 fibrosis (F0-F3). There was a statistically significant difference (p < 0.05) between non-F4 fibrosis patients and F4 fibrosis patients in many parameters, including APRI (F4 fibrosis patients had higher values: 2.06 ±3.22 compared to 0.68 ±0.76 of the non-F4 group; p = 0.044) and FIB-4 (F4 fibrosis patients had higher values: 4.84 ±4.14 compared to 2.29 ±2.90 of the non-F4 group; p = 0.006). Receiver operating characteristic (ROC) curve analysis for APRI and FIB-4 revealed that the area under the curve (AUC) of FIB-4 was 0.855 (CI: 0.813-0.936), while the APRI score had an AUC of 0.767 (CI: 0.79-0.932). CONCLUSIONS In this study, patients with severe fibrosis or cirrhosis were found to have a higher FIB-4 value than APRI in the context of chronic hepatitis C.
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Affiliation(s)
- Roberto Catanzaro
- Department of Clinical and Experimental Medicine – Gastroenterology Section, “Gaspare Rodolico” Policlinico Hospital, University of Catania, Catania, Italy
- Address for correspondence: Prof. Roberto Catanzaro, University of Catania, Italy, e-mail:
| | - Alice Aleo
- Department of Clinical and Experimental Medicine – Gastroenterology Section, “Gaspare Rodolico” Policlinico Hospital, University of Catania, Catania, Italy
| | - Morena Sciuto
- Department of Clinical and Experimental Medicine – Gastroenterology Section, “Gaspare Rodolico” Policlinico Hospital, University of Catania, Catania, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, “Gaspare Rodolico” Policlinico Hospital, University of Catania, Catania, Italy
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22
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De Vincentis A, Vespasiani-Gentilucci U, Costanzo L, Novella A, Cortesi L, Nobili A, Mannucci PM, Incalzi RA, Mannucci PM, Nobili A, Pietrangelo A, Perticone F, Licata G, Violi F, Corazza GR, Corrao S, Marengoni A, Salerno F, Cesari M, Tettamanti M, Pasina L, Franchi C, Franchi C, Cortesi L, Tettamanti M, Miglio G, Tettamanti M, Cortesi L, Ardoino I, Novella A, Prisco D, Silvestri E, Emmi G, Bettiol A, Mattioli I, Biolo G, Zanetti M, Bartelloni G, Vanoli M, Grignani G, Pulixi EA, Lupattelli G, Bianconi V, Alcidi R, Girelli D, Busti F, Marchi G, Barbagallo M, Dominguez L, Beneduce V, Cacioppo F, Corrao S, Natoli G, Mularo S, Raspanti M, Zoli M, Matacena ML, Orio G, Magnolfi E, Serafini G, Simili A, Palasciano G, Modeo ME, Gennaro CD, Cappellini MD, Fabio G, De Amicis MM, De Luca G, Scaramellini N, Cesari M, Rossi PD, Damanti S, Clerici M, Leoni S, Di Mauro AD, Di Sabatino A, Miceli E, Lenti MV, Pisati M, Dominioni CC, Pontremoli R, Beccati V, Nobili G, Leoncini G, Anastasio L, Carbone M, Cipollone F, Guagnano MT, Rossi I, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Delitala A, Muscaritoli M, Molfino A, Petrillo E, Giorgi A, Gracin C, Zuccalà G, D'Aurizio G, Romanelli G, Marengoni A, Volpini A, Lucente D, Picardi A, Gentilucci UV, Bellelli G, Corsi M, Antonucci C, Sidoli C, Principato G, Arturi F, Succurro E, Tassone B, Giofrè F, Serra MG, Bleve MA, Brucato A, De Falco T, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Prandini T, Manfredini R, Fabbian F, Boari B, De Giorgi A, Tiseo R, Paolisso G, Rizzo MR, Catalano C, Borghi C, Strocchi E, Ianniello E, Soldati M, Schiavone S, Bragagni A, Sabbà C, Vella FS, Suppressa P, De Vincenzo GM, Comitangelo A, Amoruso E, Custodero C, Fenoglio L, Falcetta A, Fracanzani AL, Tiraboschi S, Cespiati A, Oberti G, Sigon G, Peyvandi F, Rossio R, Colombo G, Agosti P, Monzani V, Savojardo V, Ceriani G, Salerno F, Pallini G, Montecucco F, Ottonello L, Caserza L, Vischi G, Liberato NL, Tognin T, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Pisciotta MS, Bellucci FB, Buffelli S, Montrucchio G, Peasso P, Favale E, Poletto C, Margaria C, Sanino M, Violi F, Perri L, Guasti L, Castiglioni L, Maresca A, Squizzato A, Campiotti L, Grossi A, Diprizio RD, Bertolotti M, Mussi C, Lancellotti G, Libbra MV, Galassi M, Grassi Y, Greco A, Sciacqua A, Perticone M, Battaglia R, Maio R, Stanghellini V, Ruggeri E, del Vecchio S, Salvi A, Leonardi R, Damiani G, Capeci W, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Cilli M, Labbadia G, Afeltra A, Pipita ME, Castellino P, Zanoli L, Gennaro A, Gaudio A, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Vigorito C, Cittadini A, Moreo G, Prolo S, Pina G, Ballestrero A, Ferrando F, Gonella R, Cerminara D, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Sechi L, Catena C, Colussi G, Cavarape A, Da Porto A, Passariello N, Rinaldi L, Berti F, Famularo G, Tarsitani P, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Grossi M, Del Giacco S, Firinu D, Costanzo G, Argiolas G, Montalto G, Licata A, Montalto FA, Corica F, Basile G, Catalano A, Bellone F, Principato C, Malatino L, Stancanelli B, Terranova V, Di Marca S, Di Quattro R, Malfa LL, Caruso R, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Ticinesi A, Nouvenne A, Minuz P, Fondrieschi L, Imperiale GN, Pirisi M, Fra GP, Sola D, Bellan M, Porta M, Riva P, Quadri R, Larovere E, Novelli M, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Napoli F, Aiello I, Landolfi R, Montalto M, Mirijello A, Purrello F, Di Pino A, del Primario NEC, Ghidoni S, Salvatore T, Monaco L, Ricozzi C, Pilotto A, Indiano I, Gandolfo F. The multifaceted spectrum of liver cirrhosis in older hospitalised patients: analysis of the REPOSI registry. Age Ageing 2021; 50:498-504. [PMID: 32926127 DOI: 10.1093/ageing/afaa150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/20/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. OBJECTIVES To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. METHODS A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. RESULTS LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT. CONCLUSIONS LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
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Affiliation(s)
| | | | - Luisa Costanzo
- Unit of Geriatrics, University Campus Bio-Medico, Rome, Italy
| | - Alessio Novella
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Laura Cortesi
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandro Nobili
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Gaudio A, Xourafa A, Rapisarda R, Gorgone C, Gnoli M, Pedrini E, Sangiorgi L, Catalano A, Zanoli L, Mattina T, Castellino P. Familiar osteopoikilosis: Case report with differential diagnosis and review of the literature. Clin Case Rep 2021; 9:922-926. [PMID: 33598273 PMCID: PMC7869386 DOI: 10.1002/ccr3.3611] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/19/2020] [Accepted: 11/03/2020] [Indexed: 11/11/2022] Open
Abstract
Osteopoikilosis (OP) is a rare autosomal dominant sclerosing bone disease, caused by heterozygous mutations in the LEMD3 gene. It is characterised by numerous focal lamellar bone compact deposits in the spongiosa. In this case report, we describe a famliar case of OP and review the literature.
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | - Anastasia Xourafa
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | - Rosario Rapisarda
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | | | - Maria Gnoli
- Department of Medical Genetics and Rare Orthopaedic DiseasesIRCCS, Istituto Ortopedico RizzoliBolognaItaly
| | - Elena Pedrini
- Department of Medical Genetics and Rare Orthopaedic DiseasesIRCCS, Istituto Ortopedico RizzoliBolognaItaly
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopaedic Diseases & CLIBI LaboratoryIRCCS, Istituto Ortopedico RizzoliBolognaItaly
| | - Antonino Catalano
- Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Luca Zanoli
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
| | | | - Pietro Castellino
- Department of Clinical and Experimental MedicineUniversity of CataniaCataniaItaly
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Zanoli L, Lentini P, Ronco C. Pulsed Tissue Doppler Imaging and Aortic Stiffness. Angiology 2020; 72:401-402. [PMID: 33348991 DOI: 10.1177/0003319720981520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Paolo Lentini
- Nephrology and Dialysis Unit, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Claudio Ronco
- Department of Medicine, 9308University of Padua, Padua, Italy.,San Bortolo Hospital of Vicenza, Department of Nephrology, Dialysis and Transplantation, Vicenza, Italy.,San Bortolo Hospital of Vicenza, International Renal Research Institute of Vicenza (IRRIV), Vicenza, Veneto, Italy
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25
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Sessa C, Castellino P, Battaglia GG, Fatuzzo P, Gaudio A, Granata A, Lentini P, Marcantoni C, Morale W, Musso S, Rapisarda F, Santoro D, Zanoli L. [Therapeutic options to reduce arterial stiffness in chronic kidney disease]. G Ital Nefrol 2020; 37:37-6-2020-06. [PMID: 33295707] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Chronic kidney disease is associated with an increased cardiovascular risk. Several uremic toxins are also vascular toxins and may contribute to the increase of the cardiovascular risk through the development of aortic stiffening. In this process, oxidative stress and endothelial dysfunction play an important role. Considering that aortic stiffness is a known cardiovascular risk factor and a vascular biomarker involved in the development of chronic cardiac dysfunction, and that the reduction of aortic stiffness is associated with an improved survival of patients with end-stage kidney disease, we aim at reviewing the therapeutic options to reduce aortic stiffness and potentially the cardiovascular risk.
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Affiliation(s)
- Concetto Sessa
- U.O.C. Nefrologia e Dialisi, P.O. "Maggiore" di Modica, Ragusa (RG), Italy
| | - Pietro Castellino
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT), Italy
| | | | - Pasquale Fatuzzo
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT), Italy
| | - Agostino Gaudio
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT), Italy
| | - Antonio Granata
- U.O.C di Nefrologia e Dialisi, A.O. per l'Emergenza "Cannizzaro", Catania (CT), Italy
| | - Paolo Lentini
- U.O.C. Nefrologia e Dialisi, Ospedale San Bassiano, Bassano del Grappa (VI), Italy
| | | | - Walter Morale
- U.O.C. Nefrologia e Dialisi, P.O. "Maggiore" di Modica, Ragusa (RG), Italy
| | - Salvatore Musso
- U.O.C. Nefrologia e Dialisi, P.O. "Maggiore" di Modica, Ragusa (RG), Italy
| | - Francesco Rapisarda
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT), Italy
| | - Domenico Santoro
- U.O.C. Nefrologia e Dialisi, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina (ME), Italy
| | - Luca Zanoli
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania (CT); U.O. Nefrologia e Dialisi, A.O.U. Policlinico Catania, Catania (CT), Italy
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Zanoli L, Tuttolomondo A, Geraci G, Castellino P. Bowel resection reduces aortic pulse wave velocity in patients with ulcerative colitis. A longitudinal study. Eur J Intern Med 2020; 82:126-127. [PMID: 32771269 DOI: 10.1016/j.ejim.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
| | | | | | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Zanoli L, Gaudio A, Castellino P. From Arterial to Cardiac Dysfunction. Angiology 2020; 72:301-302. [PMID: 33143453 DOI: 10.1177/0003319720971096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, Policlinico Universitario, 9298University of Catania, Catania, Italy
| | - Agostino Gaudio
- Department of Clinical and Experimental Medicine, Policlinico Universitario, 9298University of Catania, Catania, Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, Policlinico Universitario, 9298University of Catania, Catania, Italy
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Zanoli L, Tuttolomondo A, Inserra G, Cappello M, Granata A, Malatino L, Castellino P. Anxiety, depression, chronic inflammation and aortic stiffness in Crohn's disease: the brain--gut--vascular axis. J Hypertens 2020; 38:2008-2017. [PMID: 32890277 DOI: 10.1097/hjh.0000000000002517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/18/2022]
Abstract
BACKGROUND Patients with Crohn's disease have an increased aortic stiffness, a known cardiovascular risk factor. Anxiety, a key factor of the brain--gut axis in patients with Crohn's disease, is implicated in the pathogenesis and progression of the disease, and is linked with aortic stiffening in other clinical settings. OBJECTIVES Considering that depression is frequently linked to anxiety in Crohn's disease, we performed a mediation analysis to reveal the potential link between anxiety, depression and aortic stiffness in these patients. METHODS Multicentre observational cross-sectional study of 86 consecutive patients with Crohn's disease and 86 matched control individuals. The connections between anxiety, depression, disease duration, aortic pulse wave velocity (aPWV), brachial and central SBP were tested using partial least squares structural equations modelling. RESULTS In patients with Crohn's disease, anxiety (path coefficient: 0.220, P = 0.01) and disease duration (path coefficient: 0.270, P = 0.02) were associated with aPWV that in turn was associated with brachial SBP (path coefficient: 0.184, P = 0.03). These associations were even stronger in patients with active disease. The connection between anxiety and aPWV was in part mediated by central SBP (indirect effect: 0.090, P = 0.01; indirect-to-total effect ratio: 41%) as well as, in a pilot substudy, by sympathetic hyperactivity. Anxiety and depression were highly correlated in patients with Crohn's disease. Consequently, results were confirmed when anxiety was substituted by depression. CONCLUSION The connections of anxiety, depression and chronic inflammation with aPWV and SBP could suggest the first evidence of a brain--gut--vascular axis and new potential targets for therapy in patients with Crohn's disease.
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Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | | | - Gaetano Inserra
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - Maria Cappello
- DIBIMIS, School of Medicine, University of Palermo, Palermo
| | - Antonio Granata
- Nephrology, "St. Giovanni di Dio" Hospital, Agrigento, Italy
| | - Lorenzo Malatino
- Department of Clinical and Experimental Medicine, University of Catania, Catania
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, University of Catania, Catania
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Gaudio A, Xourafa A, Rapisarda R, Zanoli L, Signorelli SS, Castellino P. Hematological Diseases and Osteoporosis. Int J Mol Sci 2020; 21:ijms21103538. [PMID: 32429497 PMCID: PMC7279036 DOI: 10.3390/ijms21103538] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 01/19/2023] Open
Abstract
Secondary osteoporosis is a common clinical problem faced by bone specialists, with a higher frequency in men than in women. One of several causes of secondary osteoporosis is hematological disease. There are numerous hematological diseases that can have a deleterious impact on bone health. In the literature, there is an abundance of evidence of bone involvement in patients affected by multiple myeloma, systemic mastocytosis, thalassemia, and hemophilia; some skeletal disorders are also reported in sickle cell disease. Recently, monoclonal gammopathy of undetermined significance appears to increase fracture risk, predominantly in male subjects. The pathogenetic mechanisms responsible for these bone loss effects have not yet been completely clarified. Many soluble factors, in particular cytokines that regulate bone metabolism, appear to play an important role. An integrated approach to these hematological diseases, with the help of a bone specialist, could reduce the bone fracture rate and improve the quality of life of these patients.
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Affiliation(s)
- Agostino Gaudio
- Correspondence: ; Tel.: +39-095-3781842; Fax: +39-095-378-2376
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Zanoli L, Mikhailidis DP, Bruno RM, Abreu MT, Danese S, Eliakim R, Gionchetti P, Katsanos KH, Kirchgesner J, Koutroubakis IE, Kucharzik T, Lakatos PL, Nguyen GC, Papa A, Vavricka SR, Wilkinson IB, Boutouyrie P. Aortic Stiffening Is an Extraintestinal Manifestation of Inflammatory Bowel Disease: Review of the Literature and Expert Panel Statement. Angiology 2020; 71:689-697. [DOI: 10.1177/0003319720918509] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Current guidelines state that systemic inflammation, together with endothelial dysfunction, calcification, and hypercoagulability, predispose to premature atherosclerosis in patients with inflammatory bowel disease (IBD). We assessed whether IBD can affect aortic stiffness, a well-recognized vascular biomarker and an independent risk factor for cardiovascular (CV) disease (CVD) in several populations. Recent studies reported that aortic stiffness is increased in adults with IBD compared with matched controls. This association is dependent on inflammatory burden and disease duration, and is reduced by antitumor necrosis factor therapy. Considered together, current findings suggest that increased aortic stiffness is an extraintestinal manifestation of IBD. This is clinically relevant since measuring aortic stiffness in patients with IBD could improve risk assessment, especially in those without established CVD. Moreover, effective control of inflammation could lower CV risk in patients with IBD by reducing aortic stiffness. Further longitudinal studies are needed to better clarify (i) the relationship between disease duration and irreversible changes of the arterial wall, (ii) the clinical characteristics of patients with IBD that have an increased arterial stiffness at least in part reversible, and (iii) whether arterial stiffness is useful to evaluate the efficacy of immunosuppressive therapy.
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Affiliation(s)
- Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Italy
- INSERM U970, Department of Pharmacology, Paris, France
| | | | - Rosa Maria Bruno
- INSERM U970, Department of Pharmacology, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Maria T. Abreu
- Department of Medicine, GI Division, University of Miami, FL, USA
| | - Silvio Danese
- Division of Gastroenterology, Istituto Clinico Humanitas, IRCCS in Gastroenterology, Rozzano, Milan, Italy
| | - Rami Eliakim
- Sheba Medical Center, Gastroenterology, Ramat Gan, Israel
| | - Paolo Gionchetti
- Department of Medicine and Surgery, IBD Unit, University of Bologna, Italy
| | - Konstantinos H. Katsanos
- Division of Gastroenterology, Department of Internal Medicine, School of Medical Sciences, University of Ioannina, Greece
| | - Julien Kirchgesner
- Service de Gastroentérologie et Nutrition, Hôpital Saint-Antoine, Paris, France
| | | | - Torsten Kucharzik
- Department of Internal Medicine and Gastroenterology, University Teaching Hospital Lüneburg, Germany
| | - Peter L. Lakatos
- 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary
- Division of Gastroenterology, McGill University, Montreal, Canada
| | | | - Alfredo Papa
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Gemelli, IRCCS, Rome, Italy
- Department of Internal Medicine and Gastroenterology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Ian B. Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, United Kingdom
| | - Pierre Boutouyrie
- INSERM U970, Department of Pharmacology, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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31
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Granata A, Sessa C, Fiorini F, Randone S, Di Nicolò P, Zanoli L, Piranio S. [Management of hemodialysis patient subject to medical-nuclear investigation]. G Ital Nefrol 2020; 37:37-02-2020-11. [PMID: 32281763] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In recent years imaging techniques that use radionuclides have become more and more clinically relevant as they can provide functional information for specific anatomical districts. This has also involved nephrology, where radionuclides are used to study patients with different degrees of renal function failure up to terminal uremia. Although chronic kidney disease, and dialysis in particular, may affect the distribution and the elimination of radiopharmaceuticals, to date there are no consistent data on the risks associated with their use in this clinical context. In addition to the lack of data on the safety of radio-exposure in dialysis patients, there is also a shortage of information concerning the risk for healthcare staff involved in conducting the dialysis sessions performed after a nuclear test. This study, performed on 29 uremic patients who underwent hemodialysis immediately after a scintigraphic examination, assessed the extent of radio-contamination of the staff and of hemodialysis devices such as monitor, kits and dialysate. The data collected has been used to quantify the radiological risk in dialysis after the exposure to the most common radionuclides.
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Affiliation(s)
- Antonio Granata
- U.O.C di Nefrologia, Azienda Ospedaliera per l'Emergenza "Cannizzaro" - Catania, Italia
| | - Concetto Sessa
- U.O.C. Nefrologia e Dialisi, P.O. "Maggiore", Modica (RG), Italia
| | - Fulvio Fiorini
- U.O.C. Nefrologia e Dialisi, PO Santa Maria della Misericordia, Rovigo (RO), Italia
| | | | - Pierpaolo Di Nicolò
- U.O.C. Nefrologia e Dialisi - P.O. "S. Maria della Scaletta", Imola (BO), Italia
| | - Luca Zanoli
- Dipartimento di Medicina Clinica e Sperimentale, Nefrologia, Università degli Studi di Catania (CT), Italia
| | - Salvatore Piranio
- Divisione di Fisica Medica - P.O. "San Giovanni di Dio", Agrigento (AG), Itali
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32
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Giunta R, Ferrario S, Zanoli L, Orlando S, Conti A, Benintende D, Castiglione G, Rapisarda F. [Giant parathyroid adenoma: a rare cause of severe hypercalcemia]. G Ital Nefrol 2020; 37:37-02-2020-9. [PMID: 32281761] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We report the case of a 37-year-old woman that developed severe hypercalcemia due to a parathyroid gland mass. After the initial medical treatment, only a minimal reduction of calcemia was observed and her clinical condition worsened; thus, she required continuous renal replacement therapy (CRRT) that resulted in the normalization of calcium serum level. She then underwent a left thyroid lobectomy with exeresis of the associated parathyroid glands; the histological diagnosis revealed a giant parathyroid adenoma (GPA). CRRT, initially recommended only in case of severe refractory hypercalcemia poorly responsive to pharmacological approaches, is now being evaluated in the first line treatment of life-threatening cases, with or without associated acute kidney injury (AKI).
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Affiliation(s)
- Rosa Giunta
- Sezione di Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario & Scuola di Specializzazione in Nefrologia, Università di Catania, Catania, Italia
| | - Silvia Ferrario
- Sezione di Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario & Scuola di Specializzazione in Nefrologia, Università di Catania, Catania, Italia
| | - Luca Zanoli
- Sezione di Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario & Scuola di Specializzazione in Nefrologia, Università di Catania, Catania, Italia
| | - Silvia Orlando
- Unità di Terapia Intensiva, Ospedale Vittorio Emanuele, AOU Policlinico-Vittorio Emanuele, Catania, Italia
| | - Alessandro Conti
- Unità di Terapia Intensiva, Ospedale Vittorio Emanuele, AOU Policlinico-Vittorio Emanuele, Catania, Italia
| | - Daniela Benintende
- Unità di Terapia Intensiva, Ospedale Vittorio Emanuele, AOU Policlinico-Vittorio Emanuele, Catania, Italia
| | - Giacomo Castiglione
- Unità di Terapia Intensiva, Ospedale Vittorio Emanuele, AOU Policlinico-Vittorio Emanuele, Catania, Italia
| | - Francesco Rapisarda
- Sezione di Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario & Scuola di Specializzazione in Nefrologia, Università di Catania, Catania, Italia
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33
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Cseh D, Climie RE, Offredo L, Guibout C, Thomas F, Zanoli L, Danchin N, Sharman JE, Laurent S, Jouven X, Boutouyrie P, Empana JP. Type 2 Diabetes Mellitus Is Independently Associated With Decreased Neural Baroreflex Sensitivity: The Paris Prospective Study III. Arterioscler Thromb Vasc Biol 2020; 40:1420-1428. [PMID: 32188272 DOI: 10.1161/atvbaha.120.314102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Impaired baroreflex function is an early indicator of cardiovascular autonomic imbalance. Patients with type 2 diabetes mellitus (T2D) have decreased baroreflex sensitivity (BRS), however, whether the neural BRS (nBRS) and mechanical component of the BRS is altered in those with high metabolic risk (HMR, impaired fasting glucose and metabolic syndrome) or with overt T2D, is unknown. We examined this in a community-based observational study, the Paris Prospective Study III (PPS3). Approach and Results: In 7626 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and RR [time elapsed between two successive R waves] intervals) and mechanical BRS were measured by high-precision carotid echotracking. The associations between overt T2D or HMR as compared with subjects with normal glucose metabolism and nBRS or mechanical BRS were quantified using multivariable linear regression analysis. There were 319 subjects with T2D (61±6 years, 77% male), 1450 subjects with HMR (60±6 years, 72% male), and 5857 subjects with normal glucose metabolism (59±6 years, 57% male). Compared with normal glucose metabolism, nBRS was significantly lower in HMR subjects (β=-0.07 [95% CI, -0.12 to -0.01]; P=0.029) and in subjects with T2D (β=-0.18 [95% CI, -0.29 to -0.07]; P=0.002) after adjustment for confounding and mediating factors. Subgroup analysis suggests significant and independent alteration in mechanical BRS only among HMR patients who had both impaired fasting glucose and metabolic syndrome. CONCLUSIONS In this community-based study of individuals aged 50 to 75, a graded decrease in nBRS was observed in HMR subjects and patients with overt T2D as compared with normal glucose metabolism subjects.
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Affiliation(s)
- Domonkos Cseh
- From the Department of Physiology, Semmelweis University, Budapest, Hungary (D.C.)
| | - Rachel E Climie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.E.C.).,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Lucile Offredo
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Catherine Guibout
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Frédérique Thomas
- Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.)
| | - Luca Zanoli
- University of Catania, Catania, Italy (L.Z.)
| | - Nicolas Danchin
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Stéphane Laurent
- Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Xavier Jouven
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Pierre Boutouyrie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
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Zanoli L, Ozturk K, Cappello M, Inserra G, Geraci G, Tuttolomondo A, Torres D, Pinto A, Duminuco A, Riguccio G, Aykan MB, Mulé G, Cottone S, Perna AF, Laurent S, Fatuzzo P, Castellino P, Boutouyrie P. Inflammation and Aortic Pulse Wave Velocity: A Multicenter Longitudinal Study in Patients With Inflammatory Bowel Disease. J Am Heart Assoc 2020; 8:e010942. [PMID: 30712441 PMCID: PMC6405571 DOI: 10.1161/jaha.118.010942] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 12/19/2022]
Abstract
Background Inflammatory bowel disease (IBD) is characterized by a low prevalence of traditional risk factors, an increased aortic pulse‐wave velocity (aPWV), and an excess of cardiovascular events. We have previously hypothesized that the cardiovascular risk excess reported in these patients could be explained by chronic inflammation. Here, we tested the hypothesis that chronic inflammation is responsible for the increased aPWV previously reported in IBD patients and that anti‐TNFa (anti‐tumor necrosis factor‐alpha) therapy reduce aPWV in these patients. Methods and Results This was a multicenter longitudinal study. We enrolled 334 patients: 82 patients with ulcerative colitis, 85 patients with Crohn disease, and 167 healthy control subjects matched for age, sex, and mean blood pressure, from 3 centers in Europe, and followed them for 4 years (range, 2.5–5.7 years). At baseline, IBD patients had higher aPWV than controls. IBD patients in remission and those treated with anti–TNFa during follow‐up experienced an aortic destiffening, whereas aPWV increased in those with active disease and those treated with salicylates (P=0.01). Disease duration (P=0.02) was associated with aortic stiffening as was, in patients with ulcerative colitis, high‐sensitivity C‐reactive protein during follow‐up (P=0.02). All these results were confirmed after adjustment for major confounders. Finally, the duration of anti–TNFa therapy was not associated with the magnitude of the reduction in aPWV at the end of follow‐up (P=0.85). Conclusions Long‐term anti–TNFa therapy reduces aPWV, an established surrogate measure of cardiovascular risk, in patients with IBD. This suggests that effective control of inflammation may reduce cardiovascular risk in these patients.
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Affiliation(s)
- Luca Zanoli
- 1 Nephrology Department of Clinical and Experimental Medicine University of Catania Italy
| | - Kadir Ozturk
- 2 Department of Gastroenterology Gulhane School of Medicine Etlik, Ankara Turkey
| | - Maria Cappello
- 3 DIBIMIS School of Medicine University of Palermo Italy
| | - Gaetano Inserra
- 4 Internal Medicine Department of Clinical and Experimental Medicine University of Catania Italy
| | - Giulio Geraci
- 5 Unit of Nephrology and Hypertension Department of Internal Medicine University of Palermo Italy
| | | | - Daniele Torres
- 3 DIBIMIS School of Medicine University of Palermo Italy
| | - Antonio Pinto
- 3 DIBIMIS School of Medicine University of Palermo Italy
| | - Andrea Duminuco
- 4 Internal Medicine Department of Clinical and Experimental Medicine University of Catania Italy
| | - Gaia Riguccio
- 4 Internal Medicine Department of Clinical and Experimental Medicine University of Catania Italy
| | - Musa B Aykan
- 6 Department of Internal Medicine Gulhane School of Medicine Etlik, Ankara Turkey
| | - Giuseppe Mulé
- 5 Unit of Nephrology and Hypertension Department of Internal Medicine University of Palermo Italy
| | - Santina Cottone
- 5 Unit of Nephrology and Hypertension Department of Internal Medicine University of Palermo Italy
| | - Alessandra F Perna
- 7 First Division of Nephrology Department of Cardiothoracic & Respiratory Sciences University of Campania "Luigi Vanvitelli" Naples Italy
| | - Stephane Laurent
- 8 Department of Pharmacology HEGP Université Paris Descartes AP-HP INSERM U970 Paris France
| | - Pasquale Fatuzzo
- 1 Nephrology Department of Clinical and Experimental Medicine University of Catania Italy
| | - Pietro Castellino
- 4 Internal Medicine Department of Clinical and Experimental Medicine University of Catania Italy
| | - Pierre Boutouyrie
- 8 Department of Pharmacology HEGP Université Paris Descartes AP-HP INSERM U970 Paris France
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35
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Sessa C, Granata A, Gaudio A, Xourafa A, Malatino L, Lentini P, Fatuzzo P, Rapisarda F, Castellino P, Zanoli L. [Vascular dysfunction in Cardiorenal Syndrome type 4]. G Ital Nefrol 2020; 37:37-01-2020-3. [PMID: 32068357] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Cardiorenal Syndrome type 4 (CRS-4) defines a pathological condition in which a primary chronic kidney disease (CKD) leads to a chronic impairment of cardiac function. The pathophysiology of CRS-4 and the role of arterial stiffness remain only in part understood. Several uremic toxins, such as uric acid, phosphates, advanced glycation end-products, asymmetric dimethylarginine, and endothelin-1, are also vascular toxins. Their effect on the arterial wall may be direct or mediated by chronic inflammation and oxidative stress. Uremic toxins lead to endothelial dysfunction, intima-media thickening and arterial stiffening. In patients with CRS-4, the increased aortic stiffness results in an increase of cardiac workload and left ventricular hypertrophy whereas the loss of elasticity results in decreased coronary artery perfusion pressure during diastole and increased risk of myocardial infarction. Since the reduction of arterial stiffness is associated with an increased survival in patients with CKD, the understanding of the mechanisms that lead to arterial stiffening in patients with CRS4 may be useful to select potential approaches to improve their outcome. In this review we aim at discussing current understanding of the pathways that link uremic toxins, arterial stiffening and impaired cardiac function in patients with CRS-4.
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Affiliation(s)
- Concetto Sessa
- U.O.C Nefrologia e Dialisi, P.O. "Maggiore" di Modica, Ragusa
| | - Antonio Granata
- U.O.C di Nefrologia, Azienda Ospedaliera per l'Emergenza "Cannizzaro" - Catania
| | - Agostino Gaudio
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Anastasia Xourafa
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Lorenzo Malatino
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Paolo Lentini
- U.O.C Nefrologia, P.O "San Bassiano", Bassano del Grappa, Vicenza
| | - Pasquale Fatuzzo
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Francesco Rapisarda
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Pietro Castellino
- Medicina Interna, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
| | - Luca Zanoli
- Nefrologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania
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36
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Geraci G, Maria Zammuto M, Vadalà M, Mattina A, Castellucci M, Guarrasi G, Nardi E, Maida C, Zanoli L, Cillino S, Cottone S, Mulè G. Choroidal thickness is associated with renal hemodynamics in essential hypertension. J Clin Hypertens (Greenwich) 2020; 22:245-253. [PMID: 31945274 PMCID: PMC8030072 DOI: 10.1111/jch.13777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/26/2019] [Accepted: 11/17/2019] [Indexed: 01/02/2023]
Abstract
The choroid is the most vascularized structure of the eye and plays a central role in the development of the retinal vascular changes that occur in arterial hypertension. Changes of choroidal thickness (ChT) assessed by optical coherence tomography (OCT) technology could reflect the vascular complications of hypertension. Also, intrarenal hemodynamic damage, associated with endothelial dysfunction, demonstrated to be a good indicator of systemic morphofunctional arterial impairment. The aim of this study is to assess the relationship between ChT and renal hemodynamics in subjects with essential hypertension. Routine laboratory tests, clinical history, and physical examination, including blood pressure assessment, were performed in 90 subjects with essential hypertension. All patients underwent Doppler ultrasonographic evaluation of intra-renal hemodynamics and OCT imaging to assess ChT. When subjects were divided in two groups based on renal resistive index (RRI), group I (RRI ≥ 75% percentile) showed significantly lower values of ChT than group II (RRI < 75% percentile) (P < .001). When divided in two groups based on the ChT median values, patients with lower ChT had significantly higher RRI values than those with ChT above the median values (P < .05). In multivariate model including age, eGFR, and other variables as confounding factors, RRI ≥ 75% was independently associated with ChT. ChT was significantly correlated with renal resistive index in subjects with essential hypertension, confirmed in multivariate analyses. This result could be referred to changes in vascular elastic properties that occur in retinal and intrarenal vascular system probably due to oxidative stress and endothelial dysfunction commonly found in early complications of hypertension.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Maria Vadalà
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
- IRCCS Centro Neurolesi "Bonibo‐Pulejo"MessinaItaly
| | - Massimo Castellucci
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Giulia Guarrasi
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
| | - Carlo Maida
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Luca Zanoli
- Clinical and Experimental MedicineSection of NephrologyUniversity of CataniaCataniaItaly
| | - Salvatore Cillino
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
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Zanoli L, Inserra G, Cappello M, Ozturk K, Castellino P. Aortic Stiffness in Patients With Inflammatory Bowel Disease Reduced After Anti-Tumor Necrosis Factor Therapy. J Am Coll Cardiol 2020; 73:981-982. [PMID: 30819367 DOI: 10.1016/j.jacc.2018.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022]
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Affiliation(s)
- Luca Zanoli
- Department of Clinical & Experimental Medicine, University of Catania 95123, Catania, Italy
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Carlotta F, Raffaella R, Ilaria A, Alessandro N, Mannuccio MP, Mannucci PM, Nobili A, Pietrangelo A, Perticone F, Licata G, Violi F, Corazza GR, Corrao S, Marengoni A, Salerno F, Cesari M, Tettamanti M, Pasina L, Franchi C, Franchi C, Cortesi L, Tettamanti M, Miglio G, Tettamanti M, Cortesi L, Ardoino I, Novella A, Prisco D, Silvestri E, Emmi G, Bettiol A, Caterina C, Biolo G, Zanetti M, Guadagni M, Zaccari M, Chiuch M, Zaccari M, Vanoli M, Grignani G, Pulixi EA, Bernardi M, Bassi SL, Santi L, Zaccherini G, Lupattelli G, Mannarino E, Bianconi V, Paciullo F, Alcidi R, Nuti R, Valenti R, Ruvio M, Cappelli S, Palazzuoli A, Girelli D, Busti F, Marchi G, Barbagallo M, Dominguez L, Cocita F, Beneduce V, Plances L, Corrao S, Natoli G, Mularo S, Raspanti M, Cavallaro F, Zoli M, Lazzari I, Brunori M, Fabbri E, Magalotti D, Arnò R, Pasini FL, Capecchi PL, Palasciano G, Modeo ME, Gennaro CD, Cappellini MD, Maira D, Di Stefano V, Fabio G, Seghezzi S, Mancarella M, De Amicis MM, De Luca G, Scaramellini N, Cesari M, Rossi PD, Damanti S, Clerici M, Conti F, Bonini G, Ottolini BB, Di Sabatino A, Miceli E, Lenti MV, Pisati M, Dominioni CC, Murialdo G, Marra A, Cattaneo F, Pontremoli R, Beccati V, Nobili G, Secchi MB, Ghelfi D, Anastasio L, Sofia L, Carbone M, Cipollone F, Guagnano MT, Valeriani E, Rossi I, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Pes C, Delitala A, Muscaritoli M, Molfino A, Petrillo E, Zuccalà G, D’Aurizio G, Romanelli G, Marengoni A, Zucchelli A, Manzoni F, Volpini A, Picardi A, Gentilucci UV, Gallo P, Dell’Unto C, Annoni G, Corsi M, Bellelli G, Zazzetta S, Mazzola P, Szabo H, Bonfanti A, Arturi F, Succurro E, Rubino M, Tassone B, Sesti G, Interna M, Serra MG, Bleve MA, Gasbarrone L, Sajeva MR, Brucato A, Ghidoni S, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Cosi E, Scarinzi P, Amabile A, Omenetto E, Prandini T, Manfredini R, Fabbian F, Boari B, Giorgi AD, Tiseo R, De Giorgio R, Paolisso G, Rizzo MR, Borghi C, Strocchi E, Ianniello E, Soldati M, Sabbà C, Vella FS, Suppressa P, Schilardi A, Loparco F, De Vincenzo GM, Comitangelo A, Amoruso E, Fenoglio L, Falcetta A, Bracco C, Fracanzani AL, Fargion S, Tiraboschi S, Cespiati A, Oberti G, Sigon G, Peyvandi F, Rossio R, Ferrari B, Colombo G, Agosti P, Monzani V, Savojardo V, Folli C, Ceriani G, Salerno F, Pallini G, Dallegri F, Ottonello L, Liberale L, Caserza L, Salam K, Liberato NL, Tognin T, Bianchi GB, Giaquinto S, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Spazzini E, Ferrandina C, Montrucchio G, Petitti P, Peasso P, Favale E, Poletto C, Salmi R, Gaudenzi P, Violi F, Perri L, Landolfi R, Montalto M, Mirijello A, Guasti L, Castiglioni L, Maresca A, Squizzato A, Campiotti L, Grossi A, Bertolotti M, Mussi C, Lancellotti G, Libbra MV, Dondi G, Pellegrini E, Carulli L, Galassi M, Grassi Y, Perticone F, Perticone M, Battaglia R, FIlice M, Maio R, Stanghellini V, Ruggeri E, del Vecchio S, Salvi A, Leonardi R, Damiani G, Capeci W, Gabrielli A, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Cilli M, Labbadia G, Afeltra A, Marigliano B, Pipita ME, Castellino P, Zanoli L, Pignataro S, Gennaro A, Blanco J, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Cittadini A, Vigorito C, Arcopinto M, Salzano A, Bobbio E, Marra AM, Sirico D, Moreo G, Gasparini F, Prolo S, Pina G, Ballestrero A, Ferrando F, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Scattolin G, Martinelli S, Turrin M, Sechi L, Catena C, Colussi G, Passariello N, Rinaldi L, Berti F, Famularo G, Tarsitani P, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Del Giacco S, Firinu D, Losa F, Paoletti G, Costanzo G, Montalto G, Licata A, Malerba V, Montalto FA, Lasco A, Basile G, Catalano A, Malatino L, Stancanelli B, Terranova V, Di Marca S, Di Quattro R, La Malfa L, Caruso R, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Lauretani F, Ticinesi A, Nouvenne A, Minuz P, Fondrieschi L, Pirisi M, Fra GP, Sola D, Porta M, Riva P, Quadri R, Larovere E, Novelli M, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Tedeschi A, Trotta L, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Cattaneo M, Napoli F. Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients. Eur J Intern Med 2019; 68:e7-e11. [PMID: 31405773 DOI: 10.1016/j.ejim.2019.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022]
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Granata A, Maccarrone R, Zanoli L, Zeiler M, Pace L, Di Lullo L, Battaglia G. FP662NATIVE ARTERO-VENOUS FISTULA DYSFUNCTION: ROLE OF ULTRASOUND-GUIDED PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN THE TREATMENT OF OUTFLOW STENO-THROMBOSIS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp662] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Luca Zanoli
- Policlinico di Catania, Via Santa Sofia 78, 95123 Catania (CT), Italy, Catania, Italy
| | | | - Lillo Pace
- San Giovanni di Dio Hospital, Agrigento, Italy
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Zanoli L, Lentini P, Briet M, Castellino P, House AA, London GM, Malatino L, McCullough PA, Mikhailidis DP, Boutouyrie P. Arterial Stiffness in the Heart Disease of CKD. J Am Soc Nephrol 2019; 30:918-928. [PMID: 31040188 DOI: 10.1681/asn.2019020117] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
CKD frequently leads to chronic cardiac dysfunction. This complex relationship has been termed as cardiorenal syndrome type 4 or cardio-renal link. Despite numerous studies and reviews focused on the pathophysiology and therapy of this syndrome, the role of arterial stiffness has been frequently overlooked. In this regard, several pathogenic factors, including uremic toxins (i.e., uric acid, phosphates, endothelin-1, advanced glycation end-products, and asymmetric dimethylarginine), can be involved. Their effect on the arterial wall, direct or mediated by chronic inflammation and oxidative stress, results in arterial stiffening and decreased vascular compliance. The increase in aortic stiffness results in increased cardiac workload and reduced coronary artery perfusion pressure that, in turn, may lead to microvascular cardiac ischemia. Conversely, reduced arterial stiffness has been associated with increased survival. Several approaches can be considered to reduce vascular stiffness and improve vascular function in patients with CKD. This review primarily discusses current understanding of the mechanisms concerning uremic toxins, arterial stiffening, and impaired cardiac function, and the therapeutic options to reduce arterial stiffness in patients with CKD.
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Affiliation(s)
| | - Paolo Lentini
- Division of Nephrology and Dialysis, St. Bassiano Hospital, Bassano del Grappa, Italy
| | - Marie Briet
- Institut National de la Santé et de la Recherche Médicale U1083, National Center for Scientific Research Joint Research Unit 6214, Centre Hospitalo-Universitaire d'Angers, Université d'Angers, Angers, France
| | - Pietro Castellino
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrew A House
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Gerard M London
- Institut National de la Santé et de la Recherche Médicale U970, Paris, France
| | - Lorenzo Malatino
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Peter A McCullough
- Department of Medicine, Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas
| | | | - Pierre Boutouyrie
- Institut National de la Santé et de la Recherche Médicale U970, Paris, France.,Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; and.,Department of Pharmacology, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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Maccarrone R, Zanoli L, Pace L, Di Stefano G, Basile A, Di Lullo L, Pesce F, Fiorini F, Battaglia GG, Granata A. [The new frontier in endovascular treatment of arteriovenous fistula stenosis: the role of ultrasound-guided percutaneous transluminal angioplasty]. G Ital Nefrol 2019; 36:36-2-2019-8. [PMID: 30983175] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Native arteriovenous fistula is the preferred vascular access because of it does not usually cause infections and seems to be closely related with prolonged patient survival, compared to prosthetic grafts and central venous catheters; it also is cost effective. Venous stenosis is one of the main causes of AVF failure. It is caused by a number of upstream and downstream events. The former group comprises hemodynamic and surgical stressors, inflammatory stimuli and uraemia, while downstream events involve the proliferation of smooth muscle cells and myofibroblasts and the development of neo-intimal hyperplasia. Percutaneous transluminal angioplasty is the gold standard for arteriovenous fistula stenosis. It allows the visualization of the whole vascular circuit and the immediate use of the vascular access for the next dialysis session. Ultrasound-guided percutaneous endovascular angioplasty is a feasible and safe alternative to conventional fluoroscopic technique: it is equally effective in treating arteriovenous fistula stenosis, but it presents the advantage of not using contrast media or ionizing radiation. The aim of this review is to report the latest evidence on cellular and molecular mechanisms that contribute to the development of neo-intimal hyperplasia, as well as the current and future therapeutic perspectives, especially concerning the use of anti-proliferative drugs, and the efficacy of the ultrasound-guided angioplasty in restoring and maintaining the vascular access patency over time.
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Affiliation(s)
- Rosario Maccarrone
- UOC di Nefrologia e Dialisi, P.O. "San Giovanni di Dio", Agrigento, Italia
| | - Luca Zanoli
- Dip. di Medicina Interna, AOU "Policlinico - V. Emanuele" Università di Catania, Catania, Italia
| | - Lillo Pace
- UOC di Radiologia, P.O. "San Giovanni di Dio", Agrigento, Italia
| | - Giulio Di Stefano
- Dip. di Radiologia, AOU "Policlinico - V. Emanuele" Università di Catania, Catania, Italia
| | - Antonio Basile
- Dip. di Radiologia, AOU "Policlinico - V. Emanuele" Università di Catania, Catania, Italia
| | - Luca Di Lullo
- UOC di Nefrologia e Dialisi, P.O. "L. Parodi - Delfino", Colleferro, Roma, Italia
| | - Francesco Pesce
- Dip. di Nefrologia, Dialisi e Trapianto, AOU "A. Moro" Università di Bari, Bari, Italia
| | - Fulvio Fiorini
- UOC di Nefrologia e Dialisi, P.O. "Santa Maria della Misericordia", Rovigo, Italia
| | | | - Antonio Granata
- UOC di Nefrologia e Dialisi, P.O. "San Giovanni di Dio", Agrigento, Italia
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Distefano G, Zanoli L, Basile A, Fatuzzo P, Granata A. Arteriovenous fistula and pre-surgery mapping: Potential role of physical exercise on endothelial function. J Vasc Access 2019; 20:652-658. [DOI: 10.1177/1129729819838180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: The success of the construction of an arteriovenous fistula for haemodialysis is related to the vascular function of the vessels involved in the anastomosis, with particular reference to radial artery distensibility after reactive hyperaemia test and to the fall of resistance index. Only few studies have evaluated the impact of exercise protocols on the endothelial and morphological characteristics of the vessels of the upper limb with inconclusive results. In this pilot longitudinal study, we aimed to evaluate the impact of a standardized exercise protocol on the haemodynamic and resistive index of the arteries of the upper limb of uraemic patients. Methods: A total of 17 uraemic patients planned to construct arteriovenous fistula at the distal third of the forearm were enrolled and followed up for 30 days. All patients performed repeated handgrips for 30 min/day. The arterial parameters were detected before and after an ischaemic stress of 5 min and radial and brachial artery flow-mediated dilation was evaluated as well as radial artery resistance index. Results: Pre-exercise measurements of radial artery diameter and resistance index and brachial artery diameter were not modified by 30 days hand physical exercise, whereas the post-exercise haemodynamic were improved. Consequently, flow-mediated dilation of the radial artery was improved (21% ± 14% vs 30% ± 19%; p = 0.03) and resistance index of the radial artery was reduced ( p = 0.02). Conclusion: Exercise has beneficial effects on endothelial function of the radial artery by resistive index and, potentially, on the outcome of the arteriovenous fistula. Further studies with larger sample size are needed to confirm our preliminary data.
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Affiliation(s)
- Giulio Distefano
- Radiology I Unit, Department of Medical, Surgical Sciences and Advanced Technologies, Catania University Hospital, University of Catania, Catania, Italy
| | - Luca Zanoli
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Basile
- Radiology I Unit, Department of Medical, Surgical Sciences and Advanced Technologies, Catania University Hospital, University of Catania, Catania, Italy
| | - Pasquale Fatuzzo
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Granata
- UOC Nephrology and Dialysis, ‘St. Giovanni di Dio’ Hospital, Agrigento, Italy
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Geraci G, Buccheri D, Zanoli L, Fatuzzo P, Di Natale K, Zammuto MM, Nardi E, Geraci C, Mancia E, Zambelli G, Piraino D, Signorelli SS, Granata A, Cottone S, Mule G. Renal haemodynamics and coronary atherosclerotic burden are associated in patients with hypertension and mild coronary artery disease. Exp Ther Med 2019; 17:3255-3263. [PMID: 30906482 DOI: 10.3892/etm.2019.7279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/01/2018] [Accepted: 02/11/2019] [Indexed: 12/11/2022] Open
Abstract
Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30-80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI) and acceleration time (AT). The carotid intima-media thickness was additionally assessed. A coronary angiography was performed to detect the atherosclerotic burden using the Gensini Score (GS). Based on the GS values, subjects were divided into quintiles (I: ≤9; II: 9-17; III: 17-30; IV: 30-44; and V: GS >44) as well as in subjects with mild (GS ≤30) or severe coronary disease (GS >30). A weak significant difference in PI was identified among quintiles (P=0.041), whereas, RI and AT did not differ significantly. PI was associated with GS in the group with low coronary atherosclerotic burden (GS ≤30; P=0.047), whereas, no association was detected in subjects with GS >30. This association remained following adjustment for age and left ventricular ejection fraction (P=0.025). In conclusion, renal vascular alterations were associated with coronary atherosclerotic burden in patients with hypertension with mild coronary disease.
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Affiliation(s)
- Giulio Geraci
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
| | - Dario Buccheri
- Unit of Interventional Cardiology, Hospital San Giovanni di Dio, I-92100 Agrigento, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, I-95100 Catania, Italy
| | - Pasquale Fatuzzo
- Department of Clinical and Experimental Medicine, University of Catania, I-95100 Catania, Italy
| | - Katia Di Natale
- Department of Interventional Cardiology, Paolo Giaccone University Hospital, I-90100 Palermo, Italy
| | - Marta M Zammuto
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
| | - Emilio Nardi
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
| | - Calogero Geraci
- Unit of Cardiology, S. Elia Hospital, I-93100 Caltanissetta, Italy
| | - Ettore Mancia
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
| | - Giulia Zambelli
- Department of Interventional Cardiology, Paolo Giaccone University Hospital, I-90100 Palermo, Italy
| | - Davide Piraino
- Department of Interventional Cardiology, Paolo Giaccone University Hospital, I-90100 Palermo, Italy
| | - Salvatore S Signorelli
- Department of Clinical and Experimental Medicine, University of Catania, I-95100 Catania, Italy
| | - Antonio Granata
- Department of Nephrology and Dialysis, Hospital San Giovanni di Dio, I-92100 Agrigento, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
| | - Giuseppe Mule
- Unit of Nephrology and Hypertension-European Society of Hypertension Excellence Centre, Paolo Giaccone University Hospital, I-90127 Palermo, Italy
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Zanoli L. Increased Cardiovascular Risk in Patients With Inflammatory Bowel Disease. Clin Gastroenterol Hepatol 2019; 17:799-800. [PMID: 30782324 DOI: 10.1016/j.cgh.2018.08.071] [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] [Received: 08/21/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Luca Zanoli
- Department of Clinical and experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
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Zanoli L, Fatuzzo P, Castellino P. Triglycerides and aortic pulse wave velocity in patients with chronic inflammation. Egypt Heart J 2018; 70:379-380. [PMID: 30591759 PMCID: PMC6303274 DOI: 10.1016/j.ehj.2018.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/25/2022] Open
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Zanoli L, Di Pino A, Terranova V, Di Marca S, Pisano M, Di Quattro R, Ferrara V, Scicali R, Rabuazzo AM, Fatuzzo P, Castellino P, Piro S, Purrello F, Malatino L. Inflammation and ventricular-vascular coupling in hypertensive patients with metabolic syndrome. Nutr Metab Cardiovasc Dis 2018; 28:1222-1229. [PMID: 30348591 DOI: 10.1016/j.numecd.2018.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 05/26/2018] [Revised: 07/29/2018] [Accepted: 08/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) is currently considered to raise the risk for type 2 diabetes and cardiovascular events. It has been suggested that part of this risk excess may be due to a cluster of additional factors associated with MetS. We aimed to investigate the role of inflammation on the ventricular-vascular coupling in patients with MetS. METHODS AND RESULTS We enrolled a total of 227 hypertensive patients (106 with MetS and 121 without MetS) matched for age and gender. Aortic pulse wave velocity (aPWV), intima-media thickness (IMT) and high sensitivity C-reactive protein (CRP) increased according to the number of MetS components. Patients with MetS showed increased aPWV (11.5 ± 3.7 vs. 10.3 ± 2.5 m/s, P = 0.03) compared with controls. In a model adjusted for age, sex, heart rate and mean blood pressure, aPWV resulted increased in patients with CKD (beta 1.29 m/s, 95%CI 0.61-1.96 m/s, P < 0.001) and MetS (beta 0.89 m/s, 95%CI 0.28-1.51 m/s, P = 0.005). After additional adjustment for CRP and IMT, the slope of aPWV was respectively reduced by 16% and 62%, suggesting that inflammation and intima-media thickening could contribute to aortic stiffening in patients with MetS. In these patients, aPWV was also associated with left-ventricular mass index (beta 0.79 g/m2.7, 95%CI 0.05-1.52 g/m2.7, P = 0.05). CONCLUSION MetS is characterized by an inflammation-dependent acceleration in cardiovascular ageing. This pattern of pathophysiological abnormalities may contribute to amplify the burden of cardiovascular risk in patients with MetS.
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Affiliation(s)
- L Zanoli
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - A Di Pino
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - V Terranova
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - S Di Marca
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - M Pisano
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - R Di Quattro
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - V Ferrara
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - R Scicali
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - A M Rabuazzo
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - P Fatuzzo
- Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - P Castellino
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - S Piro
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - F Purrello
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - L Malatino
- Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Geraci G, Zammuto MM, Mattina A, Zanoli L, Geraci C, Granata A, Nardi E, Fatuzzo PM, Cottone S, Mulè G. Para-perirenal distribution of body fat is associated with reduced glomerular filtration rate regardless of other indices of adiposity in hypertensive patients. J Clin Hypertens (Greenwich) 2018; 20:1438-1446. [PMID: 30218482 DOI: 10.1111/jch.13366] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 03/22/2018] [Revised: 07/07/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
Obesity is a well-known risk factor for the development and progression of chronic kidney disease. Recently, para-perirenal ultrasonographic fat thickness (PUFT) has shown to correlate with both total and visceral fat better than body mass index (BMI), waist circumference (WC), and other indices of obesity. Moreover, a local paracrine and mechanical action of the PUFT on kidney has been described in recent studies. Aim of our study was to assess the relationship between glomerular filtration rate (GFR) and PUFT in comparison with other anthropometric and ultrasonographic indices of adiposity. Two hundred and ninety-six hypertensive patients were enrolled. PUFT, cutis-rectis thickness and rectis-aorta thickness were obtained by ultrasonography. Anthropometric measures of adiposity were also measured. Estimated GFR was calculated using the CKD-EPI equation. Higher PUFT values were observed in patients with impaired renal function (P < 0.001), whereas no differences in BMI and WC were shown between groups divided by GFR. PUFT significantly correlated with GFR in all patients (r = -0.284; P < 0.001), with no differences in groups divided by sex, diabetes, or BMI. This association held in multivariate analyses also after correction for confounding factors, including other adiposity indices (P < 0.001). When receiver operating characteristic curves were built to detect a eGFR < 60 mL/minutes per 1.73 m2 , a PUFT value ≤3.725 cm showed a negative predictive value of 94.0%, with the largest area under the curve (AUC: 0.700) among the variables considered. In conclusion, the relationship between PUFT and GFR seems to be more accurate and less influenced by the bias affecting traditional indices of adiposity.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | - Luca Zanoli
- Clinical and Experimental Medicine, Section of Nephrology, University of Catania, Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Antonio Granata
- Unit of Nephrology and Dialysis, San Giovanni di Dio" Hospital, Agrigento, Italy
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | | | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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49
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Proietti M, Antoniazzi S, Monzani V, Santalucia P, Franchi C, Fenoglio LM, Melchio R, Fabris F, Sartori MT, Manfredini R, De Giorgi A, Fabbian F, Biolo G, Zanetti M, Altamura N, Sabbà C, Suppressa P, Bandiera F, Usai C, Murialdo G, Fezza F, Marra A, Castelli F, Cattaneo F, Beccati V, di Minno G, Tufano A, Contaldi P, Lupattelli G, Bianconi V, Cappellini D, Hu C, Minonzio F, Fargion S, Burdick L, Francione P, Peyvandi F, Rossio R, Colombo G, Monzani V, Ceriani G, Lucchi T, Brignolo B, Manfellotto D, Caridi I, Corazza GR, Miceli E, Padula D, Fraternale G, Guasti L, Squizzato A, Maresca A, Liberato NL, Tognin T, Rozzini R, Bellucci FB, Muscaritoli M, Molfino A, Petrillo E, Dore M, Mete F, Gino M, Franceschi F, Gabrielli M, Perticone F, Perticone M, Bertolotti M, Mussi C, Borghi C, Strocchi E, Durazzo M, Fornengo P, Dallegri F, Ottonello LC, Salam K, Caserza L, Barbagallo M, Di Bella G, Annoni G, Bruni AA, Odetti P, Nencioni A, Monacelli F, Napolitano A, Brucato A, Valenti A, Castellino P, Zanoli L, Mazzeo M. Use of oral anticoagulant drugs in older patients with atrial fibrillation in internal medicine wards. Eur J Intern Med 2018; 52:e12-e14. [PMID: 29657108 DOI: 10.1016/j.ejim.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Marco Proietti
- Department of Neuroscience, Laboratory of Quality Assessment of Geriatric Therapies and Services, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Stefania Antoniazzi
- Scientific Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Biomedical and Clinical Sciences, Clinical Pharmacology Unit, ASST Fatebenefratelli - Sacco University Hospital, University of Milan, Milan, Italy
| | - Valter Monzani
- Department of Emergency Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Santalucia
- Scientific Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; IRCCS Centro Neurolesi Bonino Pulejo - Ospedale Piemonte, Messina, Italy
| | - Carlotta Franchi
- Unit of Pharmacoepidemiological Research in Older People, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
| | - Luigi M Fenoglio
- Azienda Ospedaliera Santa Croce e Carle di Cuneo - Medicina Interna, Italy
| | - Remo Melchio
- Azienda Ospedaliera Santa Croce e Carle di Cuneo - Medicina Interna, Italy
| | - Fabrizio Fabris
- Azienda Ospedaliera Universitaria di Padova - Clinica Medica I, Italy
| | | | - Roberto Manfredini
- Azienda Ospedaliero-Universitaria di Ferrara - Arcispedale S. Anna - Clinica Medica, Italy
| | - Alfredo De Giorgi
- Azienda Ospedaliero-Universitaria di Ferrara - Arcispedale S. Anna - Clinica Medica, Italy
| | - Fabio Fabbian
- Azienda Ospedaliero-Universitaria di Ferrara - Arcispedale S. Anna - Clinica Medica, Italy
| | - Gianni Biolo
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara - Clinica Medica, Italy
| | - Michela Zanetti
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara - Clinica Medica, Italy
| | - Nicola Altamura
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara - Clinica Medica, Italy
| | - Carlo Sabbà
- Azienda Ospedaliero-Universitaria Policlinico di Bari - Medicina Interna, Italy
| | - Patrizia Suppressa
- Azienda Ospedaliero-Universitaria Policlinico di Bari - Medicina Interna, Italy
| | | | - Carlo Usai
- Azienda Ospedaliero-Universitaria di Sassari - Medicina Interna, Italy
| | - Giovanni Murialdo
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Francesca Fezza
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Alessio Marra
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Francesca Castelli
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Federico Cattaneo
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Valentina Beccati
- Ospedale Policlinico San Martino, Genova - Clinica di Medicina Interna 2, Italy
| | - Giovanni di Minno
- Azienda Ospedaliera Universitaria Federico II di Napoli - Medicina Interna, Italy
| | - Antonella Tufano
- Azienda Ospedaliera Universitaria Federico II di Napoli - Medicina Interna, Italy
| | - Paola Contaldi
- Azienda Ospedaliera Universitaria Federico II di Napoli - Medicina Interna, Italy
| | - Graziana Lupattelli
- Ospedale "Santa Maria della Misericordia", S. Andrea delle Fratte di Perugia - Medicina Interna, Italy
| | - Vanessa Bianconi
- Ospedale "Santa Maria della Misericordia", S. Andrea delle Fratte di Perugia - Medicina Interna, Italy
| | - Domenica Cappellini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna, Italy
| | - Cinzia Hu
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna, Italy
| | - Francesca Minonzio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna, Italy
| | - Silvia Fargion
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna ad Indirizzo Metabolico, Italy
| | - Larry Burdick
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna ad Indirizzo Metabolico, Italy
| | - Paolo Francione
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna ad Indirizzo Metabolico, Italy
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Ematologia non tumorale e Coagulopatie, Italy
| | - Raffaella Rossio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Ematologia non tumorale e Coagulopatie, Italy
| | - Giulia Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Ematologia non tumorale e Coagulopatie, Italy
| | - Valter Monzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna ad Alta Intensità Di Cura, Italy
| | - Giuliana Ceriani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Medicina Interna ad Alta Intensità Di Cura, Italy.
| | - Tiziano Lucchi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Geriatria, Italy
| | - Barbara Brignolo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano - Geriatria, Italy
| | - Dario Manfellotto
- Ospedale San Giovanni Calibita Fatebenefratelli di Roma - Medicina Interna, Italy
| | - Irene Caridi
- Ospedale San Giovanni Calibita Fatebenefratelli di Roma - Medicina Interna, Italy
| | | | - Emanuela Miceli
- IRCCS Fondazione Policlinico San Matteo di Pavia - Clinica Medica I, Italy
| | - Donatella Padula
- IRCCS Fondazione Policlinico San Matteo di Pavia - Clinica Medica I, Italy
| | - Giacomo Fraternale
- IRCCS Fondazione Policlinico San Matteo di Pavia - Clinica Medica I, Italy
| | - Luigina Guasti
- Ospedale di Circolo e Fondazione Macchi, Azienda Socio-Sanitaria Territoriale Sette-Laghi, Varese, Università degli Studi dell'Insubria Varese - Medicina Interna 1, Italy
| | - Alessandro Squizzato
- Ospedale di Circolo e Fondazione Macchi, Azienda Socio-Sanitaria Territoriale Sette-Laghi, Varese, Università degli Studi dell'Insubria Varese - Medicina Interna 1, Italy
| | - Andrea Maresca
- Ospedale di Circolo e Fondazione Macchi, Azienda Socio-Sanitaria Territoriale Sette-Laghi, Varese, Università degli Studi dell'Insubria Varese - Medicina Interna 1, Italy
| | - Nicola Lucio Liberato
- Azienda Socio-Sanitaria Territoriale di Pavia Ospedale Civile "C. Mira" di Casorate Primo - Medicina Interna, Italy
| | - Tiziana Tognin
- Azienda Socio-Sanitaria Territoriale di Pavia Ospedale Civile "C. Mira" di Casorate Primo - Medicina Interna, Italy
| | - Renzo Rozzini
- Fondazione Poliambulanza Istituto Ospedaliero di Brescia - Geriatria, Italy
| | | | - Maurizio Muscaritoli
- Dipartimento di Medicina Clinica, Sapienza Università di Roma, Policlinico Umberto I di Roma - Medicina Interna e Nutrizione Clinica, Italy
| | - Alessio Molfino
- Dipartimento di Medicina Clinica, Sapienza Università di Roma, Policlinico Umberto I di Roma - Medicina Interna e Nutrizione Clinica, Italy
| | - Enrico Petrillo
- Dipartimento di Medicina Clinica, Sapienza Università di Roma, Policlinico Umberto I di Roma - Medicina Interna e Nutrizione Clinica, Italy
| | - Maurizio Dore
- Ospedale degli Infermi Di Rivoli - Medicina Generale, Italy
| | - Francesca Mete
- Ospedale degli Infermi Di Rivoli - Medicina Generale, Italy
| | - Miriam Gino
- Ospedale degli Infermi Di Rivoli - Medicina Generale, Italy
| | - Francesco Franceschi
- Fondazione Policlinico Universitario "Agostino Gemelli" di Roma - Medicina D'Urgenza e Pronto Soccorso, Italy
| | - Maurizio Gabrielli
- Fondazione Policlinico Universitario "Agostino Gemelli" di Roma - Medicina D'Urgenza e Pronto Soccorso, Italy
| | - Francesco Perticone
- Azienda Ospedaliero Universitaria "Mater Domini" di Catanzaro - Geriatria, Italy
| | - Maria Perticone
- Azienda Ospedaliero Universitaria "Mater Domini" di Catanzaro - Geriatria, Italy
| | - Marco Bertolotti
- Nuovo Ospedale Civile S. Agostino Estense di Modena - Geriatria e Post-Acuzie Geriatria, Italy
| | - Chiara Mussi
- Nuovo Ospedale Civile S. Agostino Estense di Modena - Geriatria e Post-Acuzie Geriatria, Italy
| | - Claudio Borghi
- Azienda Ospedaliero Universitaria - Policlinico S.Orsola-Malpighi di Bologna - Medicina Interna, Italy
| | - Enrico Strocchi
- Azienda Ospedaliero Universitaria - Policlinico S.Orsola-Malpighi di Bologna - Medicina Interna, Italy
| | - Marilena Durazzo
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino - Presidio Molinette, Medicina Interna 3, Italy
| | - Paolo Fornengo
- Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino - Presidio Molinette, Medicina Interna 3, Italy
| | - Franco Dallegri
- Ospedale Policlinico San Martino, Genova - Medicina Interna, Italy
| | | | - Kassem Salam
- Ospedale Policlinico San Martino, Genova - Medicina Interna, Italy
| | - Lara Caserza
- Ospedale Policlinico San Martino, Genova - Medicina Interna, Italy
| | - Mario Barbagallo
- Azienda Ospedaliera Universitaria Policlinico P. Giaccone di Palermo - Geriatria, Italy
| | - Giovanna Di Bella
- Azienda Ospedaliera Universitaria Policlinico P. Giaccone di Palermo - Geriatria, Italy
| | - Giorgio Annoni
- Ospedale S.Gerardo di Monza, Azienda Socio-Sanitaria Territoriale di Monza, Clinica Geriatrica Università degli Studi di Milano-Bicocca - Clinica Geriatrica, Italy
| | - Adriana Antonella Bruni
- Ospedale S.Gerardo di Monza, Azienda Socio-Sanitaria Territoriale di Monza, Clinica Geriatrica Università degli Studi di Milano-Bicocca - Clinica Geriatrica, Italy
| | - Patrizio Odetti
- Ospedale Policlinico San Martino, Genova - Clinica Geriatrica, Italy
| | - Alessio Nencioni
- Ospedale Policlinico San Martino, Genova - Clinica Geriatrica, Italy
| | | | | | - Antonio Brucato
- Ospedale Papa Giovanni XXIII di Bergamo - Medicina Interna, Italy
| | - Anna Valenti
- Ospedale Papa Giovanni XXIII di Bergamo - Medicina Interna, Italy
| | - Pietro Castellino
- Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele" di Catania - Medicina Interna, Italy
| | - Luca Zanoli
- Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele" di Catania - Medicina Interna, Italy
| | - Marco Mazzeo
- Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele" di Catania - Medicina Interna, Italy
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50
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Aliotta R, Zanoli L, Lauretta I, Giunta R, Ferrario S, Rastelli S, Rapisarda S, Rahbari E, Rapisarda F. Pancreatitis Is a Silent Killer in Peritoneal Dialysis With Difficult Diagnostic Approach. Clin Med Insights Case Rep 2018; 11:1179547618765761. [PMID: 29636637 PMCID: PMC5888805 DOI: 10.1177/1179547618765761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 02/26/2018] [Indexed: 12/21/2022]
Abstract
Until 2018, 236 cases of acute pancreatitis have been reported in patients who underwent peritoneal dialysis. Here, we presented a patient with double renal transplantation with chronic renal failure, under renal replacement therapy by peritoneal dialysis, who developed acute pancreatitis with abdominal pain, nausea, vomiting, leukocytosis with neutrophil left shift which is complicated by pancreatic pseudocyst, candida peritonitis, fungal sepsis, overlapping of Acinetobacter baumannii sepsis, and pneumonitis. After the percutaneous cystogastrostomy drainage of pancreatic pseudocyst, changes from peritoneal dialysis to hemodialysis, various thoracentesis, and polyantibiotics therapy, the resolution of the sepsis state was seen. The particular aspect of our case is the various comorbidity risks, severe pancreatitis associated with candida and A baumannii sepsis, and treatment strategy that lead to heal this kind of the high mortality rate condition.
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Affiliation(s)
- Roberta Aliotta
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Luca Zanoli
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Itria Lauretta
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Rosa Giunta
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Silvia Ferrario
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Stefania Rastelli
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Sebastiano Rapisarda
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Elnaz Rahbari
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
| | - Francesco Rapisarda
- Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy
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