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Russo C, Walicka M, Caponnetto P, Cibella F, Maglia M, Alamo A, Campagna D, Frittitta L, Di Mauro M, Caci G, Krysinski A, Franek E, Polosa R. Efficacy and Safety of Varenicline for Smoking Cessation in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2217709. [PMID: 35727580 PMCID: PMC9214580 DOI: 10.1001/jamanetworkopen.2022.17709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Evidence of effective smoking cessation interventions in patients with diabetes is limited. The unique behavioral and metabolic characteristics of smokers with type 2 diabetes warrants a randomized clinical trial of the smoking cessation drug varenicline. OBJECTIVE To evaluate the efficacy and safety of varenicline in patients with type 2 diabetes with an intention to quit smoking. DESIGN, SETTING, AND PARTICIPANTS This multicenter, double-blind, placebo-controlled randomized clinical trial recruited patients from 6 outpatient clinics in 5 hospitals in Catania, Italy. Patients with type 2 diabetes, who were smoking at least 10 cigarettes a day, and who intended to quit smoking were screened for eligibility. Eligible patients were randomized to either varenicline or placebo treatment. The trial consisted of a 12-week treatment phase followed by a 40-week follow-up, nontreatment phase. Intention-to-treat data analysis was performed from December 2020 to April 2021. INTERVENTIONS Varenicline, 1 mg, twice daily or matched placebo administered for 12 weeks. Patients in both treatment groups also received smoking cessation counseling. MAIN OUTCOMES AND MEASURES The primary efficacy end point of the study was the continuous abstinence rate (CAR) at weeks 9 to 24. Secondary efficacy end points were the CAR at weeks 9 to 12 and weeks 9 to 52 as well as 7-day point prevalence of abstinence at weeks 12, 24, and 52. RESULTS A total of 300 patients (mean [SD] age, 57.4 [0.8] years; 117 men [78.0%] in varenicline group and 119 men [79.3%] in placebo group) were randomized to receive varenicline (n = 150) or placebo (n = 150). The CAR at weeks 9 to 24 was significantly higher for the varenicline than placebo group (24.0% vs 6.0%; odds ratio [OR], 4.95; 95% CI, 2.29-10.70; P < .001). The CARs at weeks 9 to 12 (31.3% vs 7.3%; OR, 5.77; 95% CI, 2.85-11.66; P < .001) and weeks 9 to 52 (18.7% vs 5.3%; OR, 4.07; 95% CI, 1.79-9.27; P < .001) as well as the 7-day point prevalence of abstinence at weeks 12, 24, and 52 were also significantly higher for the varenicline vs placebo group. The most frequent adverse events occurring in the varenicline group compared with the placebo group were nausea (41 [27.3%] vs 17 [11.4%]), insomnia (29 [19.4%] vs 19 [12.7%]), abnormal dreams (19 [12.7%] vs 5 [3.4%]), anxiety (17 [11.4%] vs 11 [7.3%]), and irritability (14 [9.4%] vs 8 [5.4%]). Serious adverse events were infrequent in both groups and not treatment-related. CONCLUSIONS AND RELEVANCE Results of this trial showed that inclusion of varenicline in a smoking cessation program is efficacious in achieving long-term abstinence without serious adverse events. Varenicline should be routinely used in diabetes education programs to help patients with type 2 diabetes stop smoking. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01387425.
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Affiliation(s)
- Cristina Russo
- Ambulatorio di Diabetologia, Unità Operativa Complessa (UOC) Medicina Interna E D'Urgenza, Policlinico Universitario, Azienda Ospedaliero Universitaria (AOU) Policlinico-G. Rodolico-San Marco, Catania, Italy
| | - Magdalena Walicka
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior (MSWIA), Warsaw, Poland
- Dipartimento di Medicina Clinica e Sperimentale, Università Di Catania, Catania, Italy
| | - Pasquale Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo, AOU Policlinico-G. Rodolico-San Marco, dell'Università Di Catania, Catania, Italy
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Palermo, Italy
| | - Marilena Maglia
- Centro per la Prevenzione e Cura del Tabagismo, AOU Policlinico-G. Rodolico-San Marco, dell'Università Di Catania, Catania, Italy
| | - Angela Alamo
- Centro Diabetologico, UOC Andrologia Ed Endocrinologia, Policlinico Universitario, AOU, Catania, Italy
| | - Davide Campagna
- Ambulatorio di Diabetologia, Unità Operativa Complessa (UOC) Medicina Interna E D'Urgenza, Policlinico Universitario, Azienda Ospedaliero Universitaria (AOU) Policlinico-G. Rodolico-San Marco, Catania, Italy
- UOC Medicina e Chirurgia d'Accettazione e Urgenza, University Teaching Hospital, G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Lucia Frittitta
- Centro per il Diabete e l'Obesità, UOC Endocrinologia, Ospedale Garibaldi Nesima, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction, Dipartimento Di Medicina Clinica E Sperimentale, Università di Catania, Catania, Italy
| | - Maurizio Di Mauro
- Center of Excellence for the Acceleration of Harm Reduction, Dipartimento Di Medicina Clinica E Sperimentale, Università di Catania, Catania, Italy
- Ambulatorio di Diabetologia, Ospedale V. Emanuele, AOU Policlinico-Vittorio Emanuele, Catania, Italy
| | - Grazia Caci
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Arkadiusz Krysinski
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior (MSWIA), Warsaw, Poland
| | - Edward Franek
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior (MSWIA), Warsaw, Poland
| | - Riccardo Polosa
- Ambulatorio di Diabetologia, Unità Operativa Complessa (UOC) Medicina Interna E D'Urgenza, Policlinico Universitario, Azienda Ospedaliero Universitaria (AOU) Policlinico-G. Rodolico-San Marco, Catania, Italy
- Dipartimento di Medicina Clinica e Sperimentale, Università Di Catania, Catania, Italy
- Centro per la Prevenzione e Cura del Tabagismo, AOU Policlinico-G. Rodolico-San Marco, dell'Università Di Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction, Dipartimento Di Medicina Clinica E Sperimentale, Università di Catania, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
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Federico A, Mazzarella C, Spina A, Dallio M, Romeo M, Masarone M, Persico M, Gravina AG, Luzza F, Abenavoli L, Di Mauro M, Loguercio C. Alcoholic Consumption of Young Italians During the SARS-CoV-2 Pandemic. Rev Recent Clin Trials 2022; 17:126-135. [PMID: 35657052 DOI: 10.2174/1574887117666220602100325] [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: 02/23/2022] [Revised: 03/25/2022] [Accepted: 04/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The international health emergency caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which, at the end of 2019, hit the world, forced the governments of all countries to adopt stringent restrictive measures to contain the spread of the virus. Several studies have revealed worsening levels of anxiety, depression and perceived stress related to these restrictions and the resulting lifestyle changes. Some studies have also confirmed the presence of a relationship between SARS-CoV-2-related emotional distress and drinking behavior. Indeed, is a wellknown fact that alcohol consumption is one of the behavioral strategies used to reduce negative emotional states. However, it was documented that young people developed different responses to alcohol use during the pandemic than adults. OBJECTIVE The aim of this work was to investigate the consumption habits of young Italians and how the consumption and purchase of alcoholic beverages have changed following the pandemic. New ways of drinking alcohol were also interesting to observe, such as online. METHODS Young people between 18 and 35 years old were subjected to an anonymous questionnaire of 22 questions on the adoption of forms of behavior at risk through alcohol consumption, the quantity and occasions of preferential consumption, and on the methods and quantities of alcoholic beverage purchase, before and during the SARS-CoV-2 pandemic. The subjects who declared themselves "non-drinkers" were not included in the statistical survey. RESULTS About 33% of the enrolled "drinkers" (268/823), adopted risky forms of alcoholic behavior. Males reported a higher average habit of drinking wine or alcohol (M = 1.9953 ± 1.39743, F = 1.7373 ± 1.36688, p <0.005); an increased frequency of drinking (M = 2.3025 ± 0.80610 F = 2.0494 ± 0.75043 p <0.001); a higher average number of drinks consumed (M = 1.5182 ± 0.85646, F = 1.2618 ± 0.53292, p <0.001) and binge drinking to the greatest extent (M = 1.1933 ± 0.96522 F = 0.8176 ± 0.85446 p <0.001). Education and employment were significantly correlated with the frequency of alcohol consumption (r = 0.107 p <0.005 and r = 0.120 p = 0.001 respectively). Subjects reported buying alcoholic beverages during the pandemic with a frequency of "less than once a month" (N = 291, 35.36%) and mainly in shops (N = 556, 67.56%), while before the pandemic they mainly bought alcohol once a week (N = 431, 52.37%) and predominantly in bars / clubs (N = 619, 75.21%). New ways of drinking alcohol such as online drinking, have not been significantly identified. CONCLUSION A change in alcohol consumed and alcohol purchased before and during the SARSCoV- 2 pandemic was revealed.
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Affiliation(s)
- Alessandro Federico
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Chiara Mazzarella
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Annamaria Spina
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Marcello Dallio
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Mario Romeo
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Mario Masarone
- Department of Medicine and Surgery, "Scuola Medica Salernitana", University of Salerno, Via Allende, 84081, Baronissi, Salerno, Italy
| | - Marcello Persico
- Department of Medicine and Surgery, "Scuola Medica Salernitana", University of Salerno, Via Allende, 84081, Baronissi, Salerno, Italy
| | - Antonietta Gerarda Gravina
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - Francesco Luzza
- Department of Health Science, University Magna Graecia, Campus Germaneto, Catanzaro 88100, Italy
| | - Ludovico Abenavoli
- Department of Health Science, University Magna Graecia, Campus Germaneto, Catanzaro 88100, Italy
| | | | - Carmelina Loguercio
- Hepatogastroenterology Division, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
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Spina A, Mazzarella C, Dallio M, Romeo M, Pellegrino R, Durante T, Romano M, Loguercio C, Di Mauro M, Federico A, Gravina AG. The Lesson from the First Italian Lockdown: Impacts on Anxiety and Depressive Symptoms and Sleep Quality in Patients with Remission of Inflammatory Bowel Disease. Rev Recent Clin Trials 2022; 17:109-119. [PMID: 35346015 DOI: 10.2174/1574887117666220328125720] [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: 10/11/2021] [Revised: 12/30/2021] [Accepted: 01/31/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND During the COVID-19 pandemic in Italy, decisions were taken to adopt restrictive legislative measures, such as the first half of the 2020 lockdown. In those months, patients with inflammatory bowel disease experienced social isolation and reduced access to health care. OBJECTIVE We aimed to evaluate, in this condition, the presence of remission subgroups that were most impacted by the lockdown. METHODS During the first Italian lockdown, we recruited patients with remission of inflammatory bowel disease by administering an online questionnaire including patient demographics, the Beck Anxiety Questionnaire Inventory, the Beck Depression Inventory questionnaire, and the Pittsburg Sleep Quality Index, all validated standardized questionnaires for anxiety symptom levels, depression, and sleep quality. RESULTS Our results showed how female patients (p<0.0001) with Crohn's disease (p<0.001) experienced worse levels of anxiety symptoms. Female patients (p<0.0001) between 50 and 60 years of age (p=0.013) with Crohn's disease (p=0.047) experienced worse levels of depressive symptoms. Females also experienced significantly worse sleep levels (p<0.001). We found a correlation between the number of sleeping hours (p<0.001) and the time taken to fall asleep (p<0.001) and the Beck Anxiety Questionnaire Inventory,which showed a linear worsening of the number of minutes it took to fall asleep, and the Beck Depression Inventory questionnaire. CONCLUSION Among patients with remission of inflammatory bowel disease, female patients, patients with Crohn's disease, and people aged between 50 and 70 years should be considered for screening for anxiety and depression disorders and an assessment of sleep quality.
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Affiliation(s)
- Annamaria Spina
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Chiara Mazzarella
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Marcello Dallio
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Mario Romeo
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Raffaele Pellegrino
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Tommaso Durante
- Mental Health Department, S. Pio Hospital, via dell'Angelo, Benevento, 82100, Italy
| | - Marco Romano
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Carmelina Loguercio
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Maurizio Di Mauro
- Director-General, Azienda Ospedaliera dei Colli, via Leonardo Bianchi, 80131, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine, Hepatogastroenterology Unit, University of Campania "Luigi Vanvitelli", via Pansini, 5, Naples, 80138, Italy
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Krysinski A, Russo C, John S, Belsey JD, Campagna D, Caponnetto P, Vudu L, Lim CW, Purrello F, Di Mauro M, Iqbal F, Fluck D, Franek E, Polosa R, Sharma P. International randomised controlled trial evaluating metabolic syndrome in type 2 diabetic cigarette smokers following switching to combustion-free nicotine delivery systems: the DIASMOKE protocol. BMJ Open 2021; 11:e045396. [PMID: 33906842 PMCID: PMC8088261 DOI: 10.1136/bmjopen-2020-045396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Reducing exposure to cigarette smoke is an imperative for public health and for patients with diabetes. Increasingly, combustion-free nicotine delivery systems (C-F NDS) such as e-cigarettes and heated tobacco products are substituting conventional cigarettes and accelerating the downward trends in smoking prevalence. However, there is limited information about the long-term health impact in patients with diabetes who use C-F NDS. This randomised trial of type 2 diabetic cigarette smokers will test the hypothesis that following a switch from conventional cigarettes to C-F NDS a measurable improvement in metabolic syndrome (MetS) factors will be shown over the course of 2 years. METHODS AND ANALYSIS The study is multicentre and thus will take place in five locations in four countries in an ambulatory setting. A total of 576 patients with diabetes will be randomised (1:2 ratio) to either a control arm (Study Arm A), in which they will be offered referral to smoking cessation programmes or to an intervention arm (Study Arm B) assigned to C-F NDS use. Participants will be at least 23 years old and of any gender. Patient recruitment will start in February 2021 and is expected to be completed by December 2021. Primary outcome measures include fasting plasma glucose, blood pressure, triglycerides, high-density lipoprotein and waist circumference, while secondary feature absolute change in the sum of the individual factors of MetS and change in each individual factor of MetS measured at each study time point. ETHICS AND DISSEMINATION The approval of research ethics committee (REC) regarding the trial protocol, informed consent forms and other relevant documents is required to commence the study. Substantial amendments to the study protocol cannot be implemented until the REC grants a favourable opinion. The results of the study are intended to be published as articles in high quality peer-reviewed journals and disseminated through conference papers. TRIAL REGISTRATION NUMBER NCT04231838. Pre-results stage.
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Affiliation(s)
- Arkadiusz Krysinski
- Polish Academy of Sciences, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, CK MSW, Warszawa, Poland
| | - Cristina Russo
- Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
| | - Sarah John
- School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Davide Campagna
- U O C. MCAU, University Teaching Hospital 'Policlinico-Vittorio Emanuele', University of Catania, Catania, Italy
| | - Pasquale Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Universita degli Studi di Catania Scuola di Facolta di Medicina, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Sicilia, Italy
| | - Lorina Vudu
- Endocrinology, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, The Republic of Moldova
| | - Chong Wei Lim
- Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
| | - Francesco Purrello
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Sicilia, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Sicilia, Italy
| | - Maurizio Di Mauro
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Sicilia, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Sicilia, Italy
| | - Farrukh Iqbal
- The University of Lahore University College of Medicine and Dentistry, Lahore, Pakistan
| | - David Fluck
- Cardiology, Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, CK MSW, Warszawa, Poland
- Mossakowski Medical Research Centre, Polska Akademia Nauk, Warszawa, Poland
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Sicilia, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Sicilia, Italy
| | - Pankaj Sharma
- Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
- Institute of Cardiovascular Research, Royal Holloway University of London, Egham, Surrey, UK
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Di Pietro C, Caruso S, Battaglia R, Iraci Sareri M, La Ferlita A, Strino F, Bonaventura G, Di Mauro M, Barcellona ML, Perciavalle V, Purrello M, Cianci A. MiR-27a-3p and miR-124-3p, upregulated in endometrium and serum from women affected by Chronic Endometritis, are new potential molecular markers of endometrial receptivity. Am J Reprod Immunol 2018; 80:e12858. [DOI: 10.1111/aji.12858] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/27/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Cinzia Di Pietro
- Biology and Genetics Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties; University of Catania; Catania Italy
| | - Rosalia Battaglia
- Biology and Genetics Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Marco Iraci Sareri
- Department of General Surgery and Medical Surgical Specialties; University of Catania; Catania Italy
| | - Alessandro La Ferlita
- Biology and Genetics Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Fabrizio Strino
- Biology and Genetics Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Gabriele Bonaventura
- Biochemistry Section; Department of Pharmaceutical Science; University of Catania; Catania Italy
| | - Maurizio Di Mauro
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
| | - Maria Luisa Barcellona
- Biochemistry Section; Department of Pharmaceutical Science; University of Catania; Catania Italy
| | - Vincenzo Perciavalle
- Physiology Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Michele Purrello
- Biology and Genetics Section; Department of Biomedical and Biotechnological Sciences; University of Catania; Catania Italy
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties; University of Catania; Catania Italy
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Condorelli RA, Calogero AE, Di Mauro M, La Vignera S. PCOS and diabetes mellitus: from insulin resistance to altered beta pancreatic function, a link in evolution. Gynecol Endocrinol 2017. [PMID: 28644709 DOI: 10.1080/09513590.2017.1342240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Rosita A Condorelli
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Aldo E Calogero
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Maurizio Di Mauro
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
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Condorelli RA, Calogero AE, Di Mauro M, Mongioì LM, Russo GI, Morgia G, La Vignera S. Effects of tadalafil treatment combined with physical activity in patients with low onset hypogonadism: results from a not-randomized single arm phase 2 study. Aging Male 2016; 19:155-160. [PMID: 27152882 DOI: 10.1080/13685538.2016.1177717] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To investigate a possible relation between penile Doppler ultrasound examination (PDUE) parameters and efficacy of chronic therapy with tadalafil (TAD) combined with a protocol of aerobic physical activity (PA) in patients with late onset hypogonadism (LOH). METHODS The study evaluated 30 patients consecutively enrolled with LOH and erectile dysfunction which present contraindication to hormonal replacement therapy for concomitant prostate disease. These patients were subjected to a combined protocol with phosphodiesterase V selective inhibitors (TAD 5 mg daily) and aerobic PA. RESULTS After three months, we observed significant improvements in erectile function [IIEF-5, median (IQR) = 13.0 (7.0-18.0) versus 6.0 (5.0-6.75); p < 0.01] and of the main metabolic [homeostatic model assessment index, median (IQR) = 2.5 (1.62-3.37) versus 3.0 (2.0-3.75); p < 0.01; body mass index, median (IQR) = 27.0 (24.0-28.75) versus 27.5 (24.0-29.5)] and vascular parameters [peak systolic velocity, median (IQR) = 29.5 (24.25-31.0) versus 28.0 (23.0-24.25); acceleration time, median (IQR) = 114 (105.25-134.0) versus 115.0 (106.5-134.0)], assessed by PDUE. CONCLUSION PA in association with phosphodiesterase V inhibitors could compensate the effects of hypogonadism on erectile function and facilitate the clinical response to these drugs even in the absence of adequate serum concentrations of total testosterone.
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Affiliation(s)
- Rosita A Condorelli
- a Department of Clinical and Experimental Medicine - CRAMD (Research Centre of Motor Activity and Metabolic Rehabilitation in Diabetes) , University of Catania , Catania , Italy
| | - Aldo E Calogero
- a Department of Clinical and Experimental Medicine - CRAMD (Research Centre of Motor Activity and Metabolic Rehabilitation in Diabetes) , University of Catania , Catania , Italy
| | - Maurizio Di Mauro
- b CRAMD (Research Centre of Motor Activity and Metabolic Rehabilitation in Diabetes), University of Catania , Catania , Italy , and
| | - Laura M Mongioì
- a Department of Clinical and Experimental Medicine - CRAMD (Research Centre of Motor Activity and Metabolic Rehabilitation in Diabetes) , University of Catania , Catania , Italy
| | - Giorgio I Russo
- c Department of Urology , University of Catania , Catania , Italy
| | - Giuseppe Morgia
- c Department of Urology , University of Catania , Catania , Italy
| | - Sandro La Vignera
- a Department of Clinical and Experimental Medicine - CRAMD (Research Centre of Motor Activity and Metabolic Rehabilitation in Diabetes) , University of Catania , Catania , Italy
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Maran A, Tschoepe D, Di Mauro M, Fisher WA, Loeffler K, Vesper I, Bloethner S, Mast O, Weissmann J, Amann-Zalán I, Moritz A, Parkin CG, Kohut T, Cranston I. Use of an integrated strip-free blood glucose monitoring system increases frequency of self-monitoring and improves glycemic control: Results from the ExAct study. J Clin Transl Endocrinol 2014; 1:161-166. [PMID: 29159096 PMCID: PMC5684965 DOI: 10.1016/j.jcte.2014.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/18/2014] [Accepted: 08/26/2014] [Indexed: 11/25/2022] Open
Abstract
Aims We investigated the impact of using an integrated, strip-free system compared to the use of single-strip systems on testing frequency and glycemic control in individuals with insulin-treated diabetes. Methods This multinational, comparative, cluster-randomized, observational study included 311 patients with type 1 and insulin-treated type 2 diabetes who were performing SMBG at suboptimal frequencies. Sites were cluster-randomized to “integrated strip-free” system (EXP group) or any “single-strip” system (CNL group). Testing frequency and HbA1c were measured at baseline, 12 weeks and 24 weeks. Results At week 24, the EXP group showed an increase in SMBG frequency from baseline of 4.17 tests/week (95% CI 2.76, 5.58) compared with an increase of 0.53 tests/week (95% CI −0.73, 1.79) among CNL patients, resulting in a between-group difference of 3.63 tests/week (p < 0.0002). Mixed-effects models for repeated measurements (MMRM) controlling for baseline frequency of testing, country and clinical site confirmed a higher SMBG testing frequency in the EXP group compared to the CNL group, with a between-group difference of 2.70 tests/week (p < 0.01). Univariate analysis showed greater HbA1c reductions in the EXP group than CNL group: −0.44% (95% CI −0.59, −0.29) vs. −0.13% (95% CI −0.27, 0.01), respectively, p < 0.0002. MMRM analyses confirmed these HbA1c reductions. A greater percentage of EXP than CNL patients achieved HbA1c reductions of ≥0.5%: 45.1% vs. 29.1%, respectively, p < 0.01. Conclusions The use of an integrated, strip-free SMBG system improved testing adherence and was associated with improvements in glycemic control.
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Condorelli RA, Calogero AE, Favilla V, Morgia G, Johnson EO, Castiglione R, Salemi M, Mongioí L, Nicoletti C, Duca Y, Di Mauro M, Vicari E, La Vignera S. Arterial erectile dysfunction: different severities of endothelial apoptosis between diabetic patients "responders" and "non responders" to sildenafil. Eur J Intern Med 2013; 24:234-40. [PMID: 23357410 DOI: 10.1016/j.ejim.2013.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 12/23/2012] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The low pharmacological response to phosphodiesterase type 5 inhibitors represents an expression of higher endothelial damage in certain categories of patients with erectile dysfunction and high cardiovascular risk. The present study evaluated this objective in type 2 diabetic patients with erectile dysfunction, classified as "non responders" to Sildenafil. METHODS Eighteen "responder" and twelve "non responder" type 2 diabetic patients were evaluated, relatively to different levels of endothelial damage, through the diagnostic use of a new immunophenotype of circulating endothelial progenitor cells (CD45neg/CD34pos/CD144pos) and endothelial microparticles (CD45neg/CD144pos/Annexin Vpos), recently developed and published by our group. RESULTS "Non responder" patients showed a significant higher severity [8.0±3.0 (International Index of Erectile Function-abbreviated version with 5 questions) vs 14.0±3.0] and duration (10.0±2.0 vs 7.0±2.0 years) of erectile dysfunction, higher level of penile arterial insufficiency (peak systolic velocity=13.0±16.0 vs 28.0±26.0cm/s; acceleration time=153±148 vs 125±128 mm/s) and finally a significant higher level of endothelial apoptosis [0.15±0.13 vs 0.05±.0.03% (serum concentrations of endothelial microparticles)] associated with higher serum concentrations of circulating late immunophenotype of endothelial progenitor cells (0.40±0.35 vs 0.12±.0.10%). CONCLUSIONS The results of this study corroborate the clinical value of the low clinical response to phosphodiesterase type 5 inhibitors in the treatment of erectile dysfunction in the patients with high cardiovascular risk profile, such as diabetics. In addition, the markers used in this study confirm their potential application in clinical practice as useful indicators of endothelial alteration. However, in the future we will have to assess a larger number of patients and for a longer period of observation in order to better understand the causal and temporal relations.
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Affiliation(s)
- Rosita A Condorelli
- Section of Endocrinology, Andrology and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Italy
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La Vignera S, Condorelli RA, Di Mauro M, D'Agata R, Vicari E, Calogero AE. Seminal vesicles and diabetic neuropathy: ultrasound evaluation. J Androl 2011; 32:478-483. [PMID: 21164143 DOI: 10.2164/jandrol.110.011676] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of the study was to evaluate the ultrasound characteristics of the seminal vesicles (SV) of infertile patients with diabetes and neuropathy, and possible changes in relation to duration of diabetes. Sixty infertile patients with type 2 diabetes and symptomatic neuropathy were selected. Patients were divided into 3 groups according to duration of diabetes (group A ≤ 5 years, group B between 5 and 15 years, and group C ≥ 15 years). A pathological control group of 20 infertile patients without diabetes and a real control group of 20 healthy fertile men were selected and compared. Patients underwent prostate-vesicular transrectal ultrasonography and sperm analysis. The following ultrasound parameters were recorded: 1) body anteroposterior diameter (APD); 2) fundus APD; 3) parietal thickness of the right and left SVs; 4) number of polycyclic areas within both SVs; 5) fundus-to-body ratio; 6) difference of the parietal thickness between the right and the left SVs; and 7) pre-ejaculatory and postejaculatory APD difference. All patients with diabetes had a significantly (P < .05) higher fundus-to-body ratio compared with controls. Group C had a significantly (P < .05) higher fundus-to-body ratio compared with other diabetes groups. There was no significant difference (P > .05) relative to the number of polycyclic areas in patients with diabetes and controls. All patients with diabetes had a significantly lower (P < .05) preejaculatory and postejaculatory difference in body SV APD compared with controls. Group A and group B had a similar preejaculatory and postejaculatory difference in body SV APD, whereas this difference was significantly (P < .05) lower in group C. In conclusion, infertile patients with diabetes and neuropathy have peculiar SV ultrasound features suggestive of functional atony, and duration of disease is associated with worse changes in ultrasound findings.
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Affiliation(s)
- Sandro La Vignera
- Section of Endocrinology, Andrology and Internal Medicine, Master in Andrological, Human Reproduction, andBiotechnology Sciences, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.
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La Vignera S, Lanzafame F, Di Mauro M, Condorelli R, Vicari E. Spermatic and ultrasound characterization of young diabetic patients. Arch Ital Urol Androl 2009; 81:245-247. [PMID: 20608150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
AIM Different authors showed clear correlations between diabetic disease and male reproductive damage (es. rate of nuclear DNA fragmentation, mithocondrial DNA mutations, increased of enzymatic glication products, etc...). The aim of this observational study carried out on a selected group of diabetic patients (average age 36) with primary infertility was to determine reactive oxygen species (ROS) production in sperm in connection with duration of disease, glicemic control and seminal vescicular emptying in the post ejaculatory. METHODS All diabetic patients enrolled (20) were submitted to two consecutive spermiograms, ROS sperm analysis and transrectal ultrasound evaluation before and after ejaculation, performed according to standard conventional methods. RESULTS Diabetic patients with better glicometabolic compensation (HBAI C < 7%) and duration of disease <5 years showed spermatic rate of ROS production significantly lower regarding the group with worse glicemic control and greater duration of disease. Diabetic patients with altered vescicular emptying in the post ejaculatory showed spermatic rate of ROS production significantly higher regarding patients with normal vescicular emptying. CONCLUSION The degree of oxidative stress in sperm of diabetic patients follows the course of the other chronic complications, getting worse in connection with duration of disease and glicemic control. Altered vescicular emptying in the post ejaculatory could be an important mechanism for initiation of this higher response.
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Affiliation(s)
- Sandro La Vignera
- Section of Endocrinology, Andrology and Internal Medicine, Departement of Biomedical Sciences-University of Catania, Ospedale Garibaldi-Centro, Catania, Italy.
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Calabrese V, Mancuso C, Sapienza M, Puleo E, Calafato S, Cornelius C, Finocchiaro M, Mangiameli A, Di Mauro M, Stella AMG, Castellino P. Oxidative stress and cellular stress response in diabetic nephropathy. Cell Stress Chaperones 2008; 12:299-306. [PMID: 18229449 DOI: 10.1379/csc-270.1] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Oxidative stress has been suggested to play a main role in the pathogenesis of type 2 diabetes mellitus and its complications. As a consequence of this increased oxidative status, a cellular-adaptive response occurs requiring functional chaperones, antioxidant production, and protein degradation. This study was designed to evaluate systemic oxidative stress and cellular stress response in patients suffering from type 2 diabetes-induced nephropathy and in age-matched healthy subjects. Systemic oxidative stress has been evaluated by measuring advanced glycation end-products (pentosidine), protein oxidation (protein carbonyls [DNPH]), and lipid oxidation (4-hydroxy-2-nonenal [HNE] and F2-isoprostanes) in plasma, lymphocytes, and urine, whereas the lymphocyte levels of the heat shock proteins (Hsps) heme oxygenase-1 (HO-1), Hsp70, and Hsp60 as well as thioredoxin reductase-1 (TrxR-1) have been measured to evaluate the systemic cellular stress response. We found increased levels of pentosidine (P < 0.01), DNPH (P < 0.05 and P < 0.01), HNE (P < 0.05 and P < 0.01), and F2-isoprostanes (P < 0.01) in all the samples from type 2 diabetic patients with nephropathy with respect to control group. This was paralleled by a significant induction of cellular HO-1, Hsp60, Hsp70, and TrxR-1 (P < 0.05 and P < 0.01). A significant upregulation of both HO-1 and Hsp70 has been detected also in lymphocytes from type 2 diabetic patients without uraemia. Significant positive correlations between DNPH and Hsp60, as well as between the degree of renal failure and HO-1 or Hsp70, also have been found in diabetic uremic subjects. In conclusion, patients affected by type 2 diabetes complicated with nephropathy are under condition of systemic oxidative stress, and the induction of Hsp and TrxR-1 is a maintained response in counteracting the intracellular pro-oxidant status.
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Affiliation(s)
- Vittorio Calabrese
- Department of Chemistry, Faculty of Medicine, University of Catania, 95100 Catania, Italy
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Calabrese V, Mancuso C, Sapienza M, Guagliano E, Puleo E, Calafato S, Finocchiaro M, Mangiameli A, Di Mauro M, Giuffrida Stella AM, Castellino P. OXIDATIVE STRESS, AND CELLULAR STRESS RESPONSE IN DIABETIC NEPHROPATHY. Cell Stress Chaperones 2005. [DOI: 10.1379/csc-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Li Volsi G, Licata F, Fretto G, Mauro MD, Santangelo F. Influence of serotonin on the glutamate-induced excitations of secondary vestibular neurons in the rat. Exp Neurol 2001; 172:446-59. [PMID: 11716569 DOI: 10.1006/exnr.2001.7804] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The excitatory responses evoked by glutamate and its agonists in secondary vestibular neurons of the rat were studied during microiontophoretic application of 5-hydroxytryptamine (5-HT). Ejection of 5-HT modified neuronal responsiveness to glutamate in 86% of the studied units, the effect being a depression of the excitatory responses in two-thirds of cases and an enhancement in the remaining third. 5-HT was also effective in modifying 94% of the responses evoked by N-methyl-d-aspartate (NMDA), inducing a depressive effect in 76% of cases and an enhancement in the remaining ones. Quisqualate-evoked effects were depressed and enhanced by 5-HT in about the same number of cases; in contrast, kainate-evoked responses were enhanced. The depressive action of 5-HT was mimicked by application of alpha-methyl-5-hydroxytryptamine (alpha-Me-5-HT), a 5-HT(2) receptor agonist, whereas the enhancing effect could be evoked by application of 8-hydroxy-2(di-n-propylamino)tetralin (8-OH-DPAT), a selective 5-HT(1A) receptor agonist. The 5-HT(2) receptor antagonist ketanserin was able to reduce, but not to block totally, the depressive action of 5-HT on glutamate- or NMDA-evoked responses. No significant difference was detected between neuronal responses in the lateral and the superior vestibular nucleus. These results indicate that 5-HT is able to modulate the responsiveness of secondary vestibular neurons to excitatory amino acids. Its action is mostly depressive, involves 5-HT(2) receptors, and is exerted on NMDA receptors. A minor involvement of other 5-HT receptors (at least 5-HT(1A)) and other glutamate receptors (for quisqualate and kainate) in the modulatory action of 5-HT is plausible.
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Affiliation(s)
- G Li Volsi
- Department of Physiological Sciences, University of Catania, Catania, Italy.
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