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Menichelli D, Sciacqua A, Cangemi R, Andreozzi P, Del Sole F, Violi F, Pignatelli P, Pastori D. Atrial fibrillation pattern, left atrial diameter and risk of cardiovascular events and mortality. A prospective multicenter cohort study. Int J Clin Pract 2021; 75:e13771. [PMID: 33078565 DOI: 10.1111/ijcp.13771] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/13/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There are conflicting evidence on the association between atrial fibrillation (AF) pattern, such as persistent/permanent (Pers/Perm) and paroxysmal (PAF) AF and risk of ischemic events. We investigated if left atrial diameter (LAd) may affect the risk of cardiovascular outcomes according to AF pattern. METHODS Prospective multicenter observational including 1,252 non-valvular AF patients (533 PAF and 719 Pers/Perm AF). Study endpoints were cardiovascular events (CVEs), major adverse cardiac events (MACE) and CV death. LA anteroposterior diameter (LAd) was obtained by transthoracic echocardiography. RESULTS Pers/Perm AF patients had a higher proportion of LAd above median than PAF (≥44 mm, 59.5% vs 37.5% respectively, P < .001). In a mean follow-up of 42.2 ± 31.0 months (4,315 patients/year) 179 CVEs (incidence rate [IR] 4.2%/year), 133 MACE (IR 3.1%/year), and 97 CV deaths (IR 2.2%/year) occurred. Compared to patients with LAd below median, those with LAd above the median had a higher rate of CVEs (log-rank test, P < .001), MACE (log-rank test P < .001), and CV death (log-rank test P < .001). Multivariable Cox regression analysis showed that LAd above the median was associated with CVEs, (HR 1.569, 95% CI 1.129-2.180, P = .007) MACE (HR 1.858, 95% CI 1.257-2.745, P = .002) and CV death (HR 2.106, 95% CI 1.308-3.390, P = .002). The association between LAd and outcomes was evident both in PAF and Pers/Perm AF patients. No association between AF pattern and outcomes was found. CONCLUSION LAd is a simple parameter that can be obtained in virtually all AF patients and can provide prognostic information on the risk of CVEs, MACE and CV death regardless of AF pattern.
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Affiliation(s)
- Danilo Menichelli
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Paola Andreozzi
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Del Sole
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Pasquale Pignatelli
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Pastori D, Andreozzi P, Carnevale R, Bartimoccia S, Limaj S, Melandri S, Brunori M, Spallacci G, Violi F, Pignatelli P. Does the Coexistence of Chronic Obstructive Pulmonary Disease and Atrial Fibrillation Affect Nox2 Activity and Urinary Isoprostanes Excretion? Antioxid Redox Signal 2019; 31:786-790. [PMID: 31250672 DOI: 10.1089/ars.2019.7811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF) are characterized by increased oxidative stress, but the impact of the coexistence of COPD and AF on systemic oxidative stress is unclear. We performed a cross-sectional study including 157 outpatients to investigate the Nox2-related oxidative stress in patients with AF and COPD. COPD was defined by an FEV1/FVC <0.70. Oxidative stress was measured by sNox2-dp, a marker of Nox2 activation, and urinary isoprostanes. We divided patients into four groups: Group 0: hypertension (n = 49, controls); Group 1: COPD (n = 42); Group 2: AF (n = 33); and Group 3: COPD and AF (n = 33). Mean age was 68.3 ± 11.0 years, and 46.5% were women. Patients with COPD or AF showed increased levels of sNox2-dp as compared with group 0; sNox2-dp further increased in patients with COPD + AF. In these patients, sNox2-dp was higher than in those with COPD (p < 0.001) or AF (p = 0.003). At multivariable logistic regression analysis, chronic kidney disease, COPD, and AF were associated with sNox2-dp above median. Similar results were observed for urinary isoprostanes. We hypothesize that the coexistence of COPD in AF patients may be associated with an increased systemic oxidative stress by the upregulation of Nox2. Antioxid. Redox Signal. 31, 786-790.
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Affiliation(s)
- Daniele Pastori
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy
| | - Paola Andreozzi
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Simona Bartimoccia
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy
| | - Sandro Limaj
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy
| | - Serena Melandri
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy
| | - Marco Brunori
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Spallacci
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Francesco Violi
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Pasquale Pignatelli
- Department of Internal Medicine and Medical Specialties, I Clinica Medica, Atherothrombosis Centre, Sapienza University, Rome, Italy.,Mediterranea Cardiocentro, Naples, Italy
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Verrusio W, Magro VM, Renzi A, Casciaro B, Andreozzi P, Cacciafesta M. Thyroid hormones, metabolic syndrome and Vitamin D in middle-aged and older euthyroid subjects: a preliminary study. Aging Clin Exp Res 2019; 31:1337-1341. [PMID: 30406357 DOI: 10.1007/s40520-018-1071-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
AIM To explore the relationship between thyroid hormones, Vitamin D (Vit.D) serum concentrations and metabolic syndrome (MetS) in euthyroid subjects. METHODS 123 community-dwelling subjects were enrolled. According to thyroid-stimulating hormone (TSH) values the sample was divided into: (1) group 1 (TSH ≤ 2 mU/L); (2) group 2 (TSH > 2 mU/L). RESULTS Group 2 showed higher percentage of subjects with MetS (p = 0.003) and hypertension (p = 0.031), higher values of waist circumference (WC) (p = 0.007), parathyroid hormone (p = 0.016), glycaemia (p = 0.045), triglycerides (p = 0.034) and free T4 (fT4) (p = 0.013). Correlation analysis showed several weak significant correlations: MetS with TSH (r = 0.202, p = 0.031) and fT3 (r = - 0.206, p = 0.028); THS with body mass index (r = 0.187, p = 0.047) and hypertension (r = 0.199, p = 0.034); Vit.D with WC (r = - 0.185, p = 0.04). CONCLUSIONS Our results showed a possible association between thyroid hormones and MetS. Visceral fat and insulin resistance may be an interesting link between Vit.D and TSH levels.
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D'Alessandro V, Rentería F, Herrera J, Federico A, Barán E, Varas C, Diez G, Cano L, Andreozzi P, Antonioli C, Finocchiaro J, Ditondo J, Nabais I, Palmisciano V, Sirimarco L, Segal E. WS10-5 First report of cystic fibrosis patientś survival from a region of Argentina: data collected by its own Registry. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Verrusio W, Renzi A, Magro VM, Musumeci M, Andreozzi P, Cacciafesta M. Association between epicardial fat thickness and cognitive function in elderly. A preliminary study. Ann Ist Super Sanita 2019; 55:59-62. [PMID: 30968838 DOI: 10.4415/ann_19_01_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Recent studies suggested that the visceral fat could exert a predictive role in the pathogenesis of dementia. The aims of the present study were to evaluate: i) possible differences between groups with different epicardial adipose tissue (EAT) thickness on the included variables; ii) the possible predictive role of the EAT levels on cognitive functioning. METHODS 65 community-dwelling subjects were enrolled and divided into two groups: EAT < 7 mm (n = 36); EAT > 7 mm (n = 29). The metabolic profile was assessed through the evaluation of the biochemical parameters whereas the EAT thickness was measured through the transthoracic echocardiography. The Mini Mental State Examination (MMSE) was also administered. RESULTS The two EAT groups reported several significant differences, included on the MMSE scores. The multiple linear regression analysis showed that the EAT thickness levels and the hypertension had a predictive effect on the MMSE scores. CONCLUSIONS These preliminary findings support the association between EAT thickness levels and cognitive impairment.
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Affiliation(s)
- Walter Verrusio
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Alessia Renzi
- Dipartimento di Psicologia Dinamica e Clinica, Sapienza Università di Roma, Rome, Italy
| | - Valerio Massimo Magro
- Dipartimento di Medicina Interna e Geriatria, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Musumeci
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Paola Andreozzi
- Dipartimento di Medicina Clinica, Sapienza Università di Roma, Rome, Italy
| | - Mauro Cacciafesta
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
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Lai S, Muscaritoli M, Andreozzi P, Sgreccia A, De Leo S, Mazzaferro S, Mitterhofer AP, Pasquali M, Protopapa P, Spagnoli A, Amabile MI, Molfino A. Sarcopenia and cardiovascular risk indices in patients with chronic kidney disease on conservative and replacement therapy. Nutrition 2018; 62:108-114. [PMID: 30875540 DOI: 10.1016/j.nut.2018.12.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/01/2018] [Accepted: 12/05/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is a condition with high cardiovascular mortality associated with emerging risk factors, including sarcopenia. Several mechanisms can affect muscle mass, such as vitamin D deficiency, low protein intake, physical inactivity, metabolic acidosis, and inflammation leading to a worsening of cardiovascular outcomes and cognitive function. We aimed to evaluate the prevalence of sarcopenia in CKD patients on conservative and replacement therapy and the associations between sarcopenia and markers of atherosclerosis, endothelial dysfunction, psychological and cognitive function. METHODS We enrolled CKD patients (stage 3/5 KDIGO [Kidney Disease: Improving Global Outcomes]) and hemodialysis, peritoneal dialysis, and post-kidney transplant patients. Clinical, laboratory and instrumental assessments, including bioimpedance analysis, hand-grip strength, intima media thickness, flow-mediated dilation, and epicardial adipose tissue, were performed in addition to analysis of psychological and cognitive status by the Montreal Cognitive Assessment, Mini-Mental State Examination, and Geriatric Depression Scale. RESULTS A total of 77 patients (43 male) with a mean age of 69.6 ± 9.85 y were studied. According to validated criteria (using bioimpedance analysis and hand-grip strength), the prevalence of sarcopenia was 49.4%. Sarcopenic patients had higher values of intima media thickness (P = 0.032) and epicardial adipose tissue (P = 0.012) and lower flow-mediated dilation (P = 0.002), total cholesterol (P = 0.005), and high-density lipoprotein cholesterol (P = 0.008) with respect to non-sarcopenic patients. We found higher Geriatric Depression Scale scores (P = 0.04) in sarcopenic patients, whereas we did not find differences between the two groups in Mini-Mental State Examination and Montreal Cognitive Assessment score. CONCLUSION Sarcopenia is highly prevalent in CKD/end stage renal disease patients and is associated with changes in early systemic indices of atherosclerosis and endothelial dysfunction, known as markers of worse prognosis.
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Affiliation(s)
- Silvia Lai
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Paola Andreozzi
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Alessandro Sgreccia
- Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric Sciences, Sapienza University of Rome, Italy
| | - Sabrina De Leo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Sandro Mazzaferro
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | | | - Marzia Pasquali
- Nephrology and Dialysis Unit, Policlinico Umberto I, Rome, Italy
| | - Paolo Protopapa
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Alessandra Spagnoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Maria Ida Amabile
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
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Tarantino G, Porcu C, Arciello M, Andreozzi P, Balsano C. Prediction of carotid intima-media thickness in obese patients with low prevalence of comorbidities by serum copper bioavailability. J Gastroenterol Hepatol 2018; 33:1511-1517. [PMID: 29405466 DOI: 10.1111/jgh.14104] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIM Western societies, with growing prevalence, suffer from various metabolic diseases like obesity and hepatic steatosis, better defined as non-alcoholic fatty liver disease, or cardiovascular (CV) diseases that are strictly linked to each other. The association of their occurrence with the altered homeostasis of metals is an intriguing issue. Copper in particular was identified as key player in various metabolic derangements. On these bases, we aimed at investigating the possible association of serum copper levels with an indicator of early CV risk as the intima-media thickness (IMT) of carotid artery and its predictive value in a selected population of obese patients. METHODS We performed a cross-sectional study recruiting 100 obese patients characterized by a low prevalence of comorbidities. Ultrasound investigation for hepatic steatosis and IMT evaluation were performed. Serum samples were collected and then analyzed through atomic absorption spectrometry to evaluate their copper content. Possible correlations between copper bioavailability and biochemical, clinical, and anthropometric characteristics of patients were sought. RESULTS Age negatively predicted copper serum levels of patients (P = 0.009). However, the most interesting finding is the negative prediction of IMT by the copper serum levels (t = -2.23, P = 0.028, least absolute deviations regression). Factor analysis confirmed the aforementioned inverse correlation and highlighted the strong inverse correlation between smoking and copper serum levels. CONCLUSION Our data show that an altered copper bioavailability predicts early atherosclerosis as main CV risk in obese patients with hepatic steatosis detected by ultrasound, shedding some light in this pathological scenario.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Cristiana Porcu
- MeSVA Department, University of L'Aquila, L'Aquila, Italy.,Francesco Balsano Foundation, Rome, Italy
| | - Mario Arciello
- MeSVA Department, University of L'Aquila, L'Aquila, Italy.,Francesco Balsano Foundation, Rome, Italy
| | - Paola Andreozzi
- MeSVA Department, University of L'Aquila, L'Aquila, Italy.,Francesco Balsano Foundation, Rome, Italy
| | - Clara Balsano
- MeSVA Department, University of L'Aquila, L'Aquila, Italy.,Francesco Balsano Foundation, Rome, Italy
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Verrusio W, Andreozzi P, Renzi A, Musumeci M, Gueli N, Cacciafesta M. Association between serum vitamin D and metabolic syndrome in middle-aged and older adults and role of supplementation therapy with vitamin D. Ann Ist Super Sanita 2018; 53:54-59. [PMID: 28361806 DOI: 10.4415/ann_17_01_11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate i) the correlation between vitamin D (vit. D) serum concentrations and metabolic syndrome (MetS); ii) the efficacy of 6 months supplementation therapy with vit. D. METHOD 200 patients were enrolled. Blood analyses and anthropometric measurements were carried out. Patients with hypovitaminosis D received an oral supplement therapy. RESULTS 81% of the sample shows vit. D levels < 30 ng/mL. Rate of MetS was significantly higher in vit. D deficiency group than in vit D insufficiency (p = 0.009) and sufficiency (p = 0.002) groups. Vit. D shows a significant negative correlation with both waist circumference (WC) (ρ - 0.202 p = 0.004) and glycaemia values (FBG) (ρ -0.185 p = 0.009). After the supplementation therapy in a group of 60 subjects a significant increase in vit. D levels (p = 0.001) and a significant reduction in WC values (p = 0.001) were observed. CONCLUSIONS MetS, WC and FBG appeared to be associated vit. D status and it is well-known that central obesity, with the inflammatory alterations thereto correlated that determine insulin resistance, can be considered the "primum movens" for the development of MetS.
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Affiliation(s)
- Walter Verrusio
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Paola Andreozzi
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Alessia Renzi
- Dipartimento di Psicologia Dinamica e Clinica, Sapienza Università di Roma, Rome, Italy
| | - Marco Musumeci
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Nicolò Gueli
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Mauro Cacciafesta
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
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D’Alessandro A, Zito FP, Pesce M, Andreozzi P, Efficie E, Cargiolli M, Maione F, De Palma GD, Cuomo R, Sarnelli G. Specific dyspeptic symptoms are associated with poor response to therapy in patients with gastroesophageal reflux disease. United European Gastroenterol J 2017; 5:54-59. [PMID: 28405322 PMCID: PMC5384555 DOI: 10.1177/2050640616650061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 04/22/2016] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION In patients with gastroesophageal reflux disease (GORD), co-existence of functional dyspepsia (FD) is known to be associated with poor response to proton pump inhibitors (PPIs), but the contribution of specific dyspepsia symptoms has not yet been systematically investigated. OBJECTIVE We aimed to characterize the impact of dyspepsia symptoms on response to PPIs in patients with GORD. METHODS The enrolled subjects were consecutive patients with a diagnosis of GORD. All patients underwent a 24 hour pH-impedance test, while on PPI therapy. Patients were divided into two groups, refractory and responders, according to the persistence of GORD symptoms. A standardized questionnaire for FD was also administered to assess presence of dyspepsia symptoms. RESULTS In the subgroup of refractory patients FD was more prevalent than in responders, with post-prandial fullness, nausea, vomiting, early satiation and epigastric pain being significantly prevalent in refractory GORD patients. In the multivariate analysis only early satiation and vomiting were significantly associated with poor response to PPIs. CONCLUSION Co-existence of FD is associated with refractory GORD. We showed that only early satiation and vomiting are risk factors for poor response to therapy with PPIs. Our findings suggest that symptoms of early satiation and vomiting would help to identify the subset of PPI-refractory GORD patients.
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Affiliation(s)
| | - FP Zito
- Federico II University of Naples, Naples, Italy
| | - M Pesce
- Federico II University of Naples, Naples, Italy
| | - P Andreozzi
- Federico II University of Naples, Naples, Italy
| | - E Efficie
- Federico II University of Naples, Naples, Italy
| | - M Cargiolli
- Federico II University of Naples, Naples, Italy
| | - F Maione
- Federico II University of Naples, Naples, Italy
| | - GD De Palma
- Federico II University of Naples, Naples, Italy
| | - R Cuomo
- Federico II University of Naples, Naples, Italy
| | - G Sarnelli
- Federico II University of Naples, Naples, Italy
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Viscogliosi G, Chiriac IM, Braucci S, Terracina D, Andreozzi P, Ettorre E. Predicting Delirium in Older Patients Hospitalized for Community-Acquired Pneumonia. J Am Med Dir Assoc 2016; 17:1156-1157. [DOI: 10.1016/j.jamda.2016.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 07/29/2016] [Indexed: 11/28/2022]
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Verrusio W, Andreozzi P, Renzi A, Martinez A, Longo G, Musumeci M, Cacciafesta M. Efficacy and safety of spinning exercise in middle-aged and older adults with metabolic syndrome: randomized control trial. Ann Ist Super Sanita 2016; 52:295-300. [PMID: 27364407 DOI: 10.4415/ann_16_02_24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Few studies have been conducted to investigate the effects of spinning exercise on cardio-vascular weal. AIM To assess whether a 6 months spinning training, combined with proper diet, is more effective than standard training programs and diet alone in improving metabolic abnormalities in middle-aged and older adults. DESIGN Randomized clinical trial. SETTING Rehabilitation Unit of our Department. POPULATION Patients with Metabolic Syndrome (MetS) according to the National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria. METHODS Patients were randomly assigned to receive treatment with diet (group A, n = 10), with diet and general gymnastics program (group B, n = 10), with diet and spinning physical training program (group C, n = 10). RESULTS During the study period we observed a significant reduction in blood pressure (group C: systolic blood pressure p = 0.03; diastolic blood pressure p = 0.004 / group B: systolic blood pressure p = 0.001), in lipid profile (group B: plasma total cholesterol p = 0.001; triglycerides p = 0.001 / group C: plasma total cholesterol p = 0.04); in fasting blood glucose (group B: p = 0.01; group C: p = 0.008); in Homeostatic Model Assessment of Insulin Resistance (group B: p = 0.01; group C: p = 0.001); in waist circumference (group C: p = 0.005; group A: p = 0.02; group B: p = 0.04). No patients reported adverse events during follow-up. CONCLUSION Our results confirm the effectiveness of spinning training combined with diet in the management of MetS. CLINICAL REHABILITATION IMPACT The findings provide a preliminary evidence to support that spinning training may represent a useful and safe intervention also in middle-aged and older adults geriatric with multiple CV risk factors.
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Affiliation(s)
- Walter Verrusio
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Paola Andreozzi
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Alessia Renzi
- Dipartimento di Psicologia Dinamica e Clinica, Sapienza Università di Roma, Rome, Italy
| | - Andrea Martinez
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Giovanni Longo
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Marco Musumeci
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
| | - Mauro Cacciafesta
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza Università di Roma, Rome, Italy
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Bruno G, Bagalino A, Andreozzi P, Caporossi A, Benvenuto R, Graf U. Gastroesophageal Reflux: A Role in Exercise-Induced Urticaria-Angioedema Syndrome? Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209600900234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- G. Bruno
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - A. Bagalino
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - P. Andreozzi
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - A.P. Caporossi
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - R. Benvenuto
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - U. Graf
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
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Affiliation(s)
- G. Bruno
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - P. Andreozzi
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - A. Bagalino
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - U. Graf
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
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Andreozzi P, Bagalino A, Caporossi AP, Benvenuto R, Graf U, Bruno G. “Silent” Chronic Infections as the Cause of the Urticaria-Angioedema Syndrome. Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209600900233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] Open
Affiliation(s)
- P. Andreozzi
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - A. Bagalino
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - A. P. Caporossi
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - R. Benvenuto
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - U. Graf
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
| | - G. Bruno
- Istituto I° Clinica Medica, Università degli Studi di Roma “La Sapienza”
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Abstract
Many evidences show that bronchial asthma may be triggered or enhanced by gastroesophageal reflux (GER) even if standardized methods to detect this particular syndrome defined as “gastric asthma” are not available. The Bernstein test suitably modified was performed in 6 adult asthmatic outpatients when they were symptom-free. These subjects were also suffering from recurrent epigastric pain. The patients resulted positive to ultranebulized fog bronchial challenge and all had a moderate- severe alteration of the competency of the lower esophageal sphincter, shown by endoscopy. Functional lung parameters were significantly reduced after esophageal acidification when they were compared to basal values. Is the linkage between GER and asthma important in clinical practice? In asthmatic patients GER represents an important trigger for broncoconstriction through a vagal mediated reflex. The modified Bernstein test represents a reproducible method and may be well used to identify “gastric asthma”, particularly when this picture is “silent”, less evident, or it is not rightly considered. Moreover, its recognition is very relevant to therapeutic problems, also when it is in a subclinical stage. In fact, many “excellent” drugs used for bronchial asthma treatment may have undesirable effects for the gastric tract causing abnormalities such as GER that is so damaging in the development of “gastric asthma”.
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Affiliation(s)
- G. Bruno
- Istituto I Clinica Medica - Fondazione A. Cesalpino, Università “La Sapienza” di Roma - Italy
| | - P. Andreozzi
- Istituto I Clinica Medica - Fondazione A. Cesalpino, Università “La Sapienza” di Roma - Italy
| | - A. Bagalino
- Istituto I Clinica Medica - Fondazione A. Cesalpino, Università “La Sapienza” di Roma - Italy
| | - U. Graf
- Istituto I Clinica Medica - Fondazione A. Cesalpino, Università “La Sapienza” di Roma - Italy
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Andreozzi P, Verrusio W, Viscogliosi G, Summa ML, Gueli N, Cacciafesta M, Albanese CV. Relationship between vitamin D and body fat distribution evaluated by DXA in postmenopausal women. Nutrition 2016; 32:687-92. [DOI: 10.1016/j.nut.2015.12.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/22/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022]
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Magro VM, Verrusio W, Andreozzi P, Cacciafesta M, Gueli N. Right bundle branch and hypothyroidism in an elderly woman: a complex interaction in the risk of syncope. Aging Clin Exp Res 2016; 28:577-8. [PMID: 26289080 DOI: 10.1007/s40520-015-0440-2] [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] [Received: 06/16/2015] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Affiliation(s)
- V M Magro
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - W Verrusio
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00162, Rome, Italy.
| | - P Andreozzi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - M Cacciafesta
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - N Gueli
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
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18
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Viscogliosi G, Chiriac IM, Andreozzi P, Ettorre E. The Metabolic Syndrome Predicts Longitudinal Changes in Clock Drawing Test Performance in Older Nondemented Hypertensive Individuals. Am J Geriatr Psychiatry 2016; 24:359-63. [PMID: 26803584 DOI: 10.1016/j.jagp.2015.09.001] [Citation(s) in RCA: 16] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/26/2015] [Accepted: 09/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study evaluated the metabolic syndrome (MetS) as independent predictor of 1-year longitudinal changes in cognitive function. METHODS 104 stroke- and dementia-free older hypertensive subjects were studied. MetS was defined by NCEP ATP-III criteria. Cognitive function was assessed by the Clock Drawing Test (CDT); 1-year changes in cognitive function were expressed as annual changes in CDT performance. Brain magnetic resonance imaging studies (1.5T) were performed. RESULTS Participants with MetS exhibited greater cognitive decline than those without (-1.78 ± 1.47 versus -0.74 ± 1.44 CDT points, t = 3.348, df = 102, p < 0.001). MetS predicted cognitive decline (β = -0.327, t = -3.059, df = 96, p = 0.003) independently of its components, age, baseline cognition, neuroimaging findings, blood pressure levels, and duration of hypertension. With the exception of systolic blood pressure, none of the individual components of MetS explained 1-year changes in CDT performance. CONCLUSIONS MetS as an entity predicted accelerated 1-year decline in cognitive function, assessed by CDT, in a sample of older hypertensive subjects.
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Affiliation(s)
- Giovanni Viscogliosi
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic, and Geriatric Sciences, "Sapienza" University, Rome, Italy; Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy.
| | | | - Paola Andreozzi
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic, and Geriatric Sciences, "Sapienza" University, Rome, Italy
| | - Evaristo Ettorre
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic, and Geriatric Sciences, "Sapienza" University, Rome, Italy
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Viscogliosi G, Chiriac IM, Andreozzi P, Ettorre E. Markers of Visceral Adiposity for Dementia Risk Assessment. The Epicardial Adipose Tissue (EAT) Thickness. J Am Geriatr Soc 2016; 64:689-91. [PMID: 27000368 DOI: 10.1111/jgs.13983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Paola Andreozzi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
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20
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Diamanti E, Andreozzi P, Anguiano R, Yate L, Gregurec D, Politakos N, Ziolo RF, Donath E, Moya SE. The effect of top-layer chemistry on the formation of supported lipid bilayers on polyelectrolyte multilayers: primary versus quaternary amines. Phys Chem Chem Phys 2016; 18:32396-32405. [DOI: 10.1039/c6cp06258j] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The influence of the surface chemistry of PEMs on the formation of lipid bilayers is studied here for PEMs with different cationic amines as a top layer, and polystyrene sulfonate (PSS) as a polyanion.
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Affiliation(s)
- E. Diamanti
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
| | - P. Andreozzi
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
| | - R. Anguiano
- Departamento de Materiales Avanzados
- Centro de Investigación en Química Aplicada
- 25250 Saltillo
- Mexico
| | - L. Yate
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
| | - D. Gregurec
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
| | - N. Politakos
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
| | - R. F. Ziolo
- Departamento de Materiales Avanzados
- Centro de Investigación en Química Aplicada
- 25250 Saltillo
- Mexico
| | - E. Donath
- Institute of Biophysics and Medical Physics
- Faculty of Medicine
- University of Leipzig
- 04107 Leipzig
- Germany
| | - S. E. Moya
- Soft Matter Nanotechnology Group
- CIC biomaGUNE
- 20009 San Sebastián
- Spain
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21
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Viscogliosi G, Chiriac IM, Andreozzi P, Ettorre E. Executive dysfunction assessed by Clock-Drawing Test in older non-demented subjects with metabolic syndrome is not mediated by white matter lesions. Psychiatry Clin Neurosci 2015; 69:620-9. [PMID: 25781474 DOI: 10.1111/pcn.12296] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 02/25/2015] [Accepted: 03/13/2015] [Indexed: 12/24/2022]
Abstract
AIMS Metabolic syndrome (MetS) has been associated with greater occurrence of white matter hyperintensities (WMH). It remains uncertain whether MetS as a construct is associated with poorer cognitive performances. This study explores whether MetS is associated with poorer performances in global and domain-specific cognitive tests in older non-demented subjects independently of its individual components, WMH severity and other variables. METHODS MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III definition. Brain magnetic resonance studies (1.5T) were performed. Deep and periventricular WMH were graded using the Fazekas scale. Subjects underwent the Mini-Mental State Examination, the Babcock Short Story Recall test and the Clock-Drawing Test (CDT). RESULTS Eighty community-dwellers aged 67-91 years were studied. Subjects with MetS (n = 35) had more severe WMH, and poorer performances on the CDT (P = 0.003) and the Babcock Short Story Recall test (P = 0.027). After multiple adjustment, MetS was inversely associated with CDT scores (B = -1.285; 95% confidence interval = -1.996--0.575; P = 0.001) but not with episodic memory. Results were not affected by WMH severity. Interestingly, none of the individual components of MetS predicted poorer cognitive performances. CONCLUSIONS Impairment in executive functions assessed by CDT may represent an early and specific sign of cognitive decline in older individuals with MetS. Future longitudinal studies are needed to better establish the predictive role of MetS on dementia and to demonstrate the possibility of dementia prevention by targeting MetS.
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Affiliation(s)
- Giovanni Viscogliosi
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy.,Department of Epidemiology, Surveillance and Promotion of Health, National Institute of Health, Rome, Italy
| | | | - Paola Andreozzi
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy
| | - Evaristo Ettorre
- Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy
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22
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Servello A, Camellini C, Cicerchia M, Cerra E, Vigliotta MT, Vulcano A, Giovannelli A, Scatozza R, Selan L, Andreozzi P, Cacciafesta M, Ettorre E. [Physical and psychological stress in a group of Italian caregivers: a new medical emergency? A pilot study]. Ig Sanita Pubbl 2015; 71:489-498. [PMID: 26722826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION this study aimed to evaluate physical and psychological stress in a group of italian caregivers. METHODS 20 subjects were enrolled in the study and divided into 2 groups: 10 healthy controls and 10 caregivers. Every subject underwent an cognitive, clinical and instrumental assessment. RESULTS the statistical analysis showed an increased presence of pathological alterations in caregivers group such as decreased ejection fraction, cognitive impairment and depressed mood. CONCLUSIONS the study shows the figure of a elderly caregiver, predominantly women, who spend many hours in patient care. The caregiver-type takes about four drugs a day and is not involved in screening programs offered by the health service for his age group. Results a high risk of social isolation, emotional fragility and an increased risk of cardiovascular events and cognitive impairment.
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Affiliation(s)
- Adriana Servello
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza, Università di Roma, Italia
| | - Cinzia Camellini
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Manuela Cicerchia
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Elisabetta Cerra
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Maria Teresa Vigliotta
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Achiropita Vulcano
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Agnese Giovannelli
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Rossella Scatozza
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Laura Selan
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza, Università di Roma, Italia
| | - Paola Andreozzi
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Mauro Cacciafesta
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
| | - Evaristo Ettorre
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, Sapienza, Università di Roma, Italia
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Viscogliosi G, Chiriac IM, Pellegrini F, Brutti F, Bellomi C, Andreozzi P, Ettorre E. Depressive symptom clusters and optimistic traits are associated with left ventricular mass increase in older subjects independently of blood pressure levels and hypertension. Geriatr Gerontol Int 2015; 15:1099-101. [DOI: 10.1111/ggi.12501] [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: 11/30/2022]
Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Division of Gerontology; “Sapienza” University of Rome; Rome Italy
- Division of Geriatrics; Casa di Cura “Merry House”; Rome Italy
| | | | | | - Flavio Brutti
- Division of Geriatrics; Casa di Cura “Merry House”; Rome Italy
| | - Carlo Bellomi
- Division of Geriatrics; Casa di Cura “Merry House”; Rome Italy
| | - Paola Andreozzi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Division of Gerontology; “Sapienza” University of Rome; Rome Italy
| | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Division of Gerontology; “Sapienza” University of Rome; Rome Italy
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24
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Maggio R, Viscomi C, Andreozzi P, D'Ettorre G, Viscogliosi G, Barbaro B, Gori M, Vullo V, Balsano C. Normocaloric low cholesterol diet modulates Th17/Treg balance in patients with chronic hepatitis C virus infection. PLoS One 2014; 9:e112346. [PMID: 25532016 PMCID: PMC4273946 DOI: 10.1371/journal.pone.0112346] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 10/01/2014] [Indexed: 02/07/2023] Open
Abstract
UNLABELLED Hepatitis C virus (HCV) infection is associated with hepatic and extrahepatic manifestations, including immunological disorders. Chronic Hepatitis C (CHC) is often characterized by cholesterol and lipid metabolism alterations, leading to hepatic steatosis. Cholesterol metabolism, in fact, is crucial for the viral life cycle. Recent works described that a higher dietary cholesterol intake is associated with the progression of HCV-related liver disease. CHC patients have increased levels of T helper 17 (Th17)-cells, a lymphocytic population involved in the pathogenesis of liver inflammation and autoimmune hepatitis. The balance between Th17 and regulatory T (Treg) cells is crucial for chronic inflammation and autoimmunity. Th17-cell differentiation is deeply influenced by the activation LXRs, nuclear receptors modulating cholesterol homeostasis. Moreover, HCV may affect these nuclear receptors, and cholesterol metabolism, through both direct and indirect mechanisms. On these bases, we hypothesized that modulation of cholesterol levels through Normocaloric Low Cholesterol Diet (NLCD) may represent an innovative strategy to reduce the progression of HCV infection, through the modulation of peripheral Th17/Treg balance. To this end, we performed a pilot study to investigate whether a Normocaloric Low Cholesterol Diet may be able to modulate Th17/Treg balance in patients affected by chronic HCV infection. After 30 days of NLCD CHC patients showed a significant reduction in Th17 cells frequency, which correlated with strong reduction of IL-17 and IL-22 serum levels. At the same time, we appreciated an increase in the percentage of Treg cells, thus improving Treg/Th17 balance. Moreover, we observed an increased expression of LXRs and their target genes: SREBP-1c and ABCA-1. In conclusion, NLCD finely regulates Th17/Treg balance, improving immune system response in CHC patients. This study could pave the way for new treatments of CHC patients, suggesting that change in lifestyle could support the management of these patients, promoting well-being and possibly hindering disease progression. TRIAL REGISTRATION ClinicalTrials.gov NCT02038387.
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Affiliation(s)
- Roberta Maggio
- Laboratory of Molecular Virology and Oncology, Francesco Balsano Foundation, Rome, Italy
- Institute of Molecular Biology and Pathology, National Research Council, Rome, Italy
| | - Carmela Viscomi
- Laboratory of Molecular Virology and Oncology, Francesco Balsano Foundation, Rome, Italy
| | | | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | | | - Barbara Barbaro
- Laboratory of Molecular Virology and Oncology, Francesco Balsano Foundation, Rome, Italy
| | - Manuele Gori
- Laboratory of Molecular Virology and Oncology, Francesco Balsano Foundation, Rome, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Clara Balsano
- Laboratory of Molecular Virology and Oncology, Francesco Balsano Foundation, Rome, Italy
- Institute of Molecular Biology and Pathology, National Research Council, Rome, Italy
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25
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Viscogliosi G, Andreozzi P, Manzon L, Ettorre E, Cacciafesta M. Metabolic Syndrome, Executive Dysfunction, and Late-Onset Depression: Just a Matter of White Matter? J Am Geriatr Soc 2014; 62:1607-9. [PMID: 25116991 DOI: 10.1111/jgs.12960] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Giovanni Viscogliosi
- Division of Gerontology; Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Sapienza University; Rome Italy
| | - Paola Andreozzi
- Predictive Medicine Unit; Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Sapienza University; Rome Italy
| | - Licia Manzon
- Division of Gerontology; Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Sapienza University; Rome Italy
| | - Evaristo Ettorre
- Alzheimer Evaluation Unit; Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Sapienza University; Rome Italy
| | - Mauro Cacciafesta
- Division of Gerontology; Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; Sapienza University; Rome Italy
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26
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Verrusio W, Andreozzi P, Marigliano B, Renzi A, Gianturco V, Pecci MT, Ettorre E, Cacciafesta M, Gueli N. Exercise training and music therapy in elderly with depressive syndrome: a pilot study. Complement Ther Med 2014; 22:614-20. [PMID: 25146063 DOI: 10.1016/j.ctim.2014.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 05/27/2014] [Accepted: 05/28/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Recent studies have thrown doubt on the true effectiveness of anti-depressants in light and moderate depression. The aim of this study is to evaluate the impact of physical training and music therapy on a sample group of subjects affected by light to moderate depression versus subjects treated with pharmacological therapy only. DESIGN AND SETTING Randomized controlled study. Patients were randomized into two groups. Subjects in the pharmacotherapy group received a therapy with antidepressant drugs; the exercise/music therapy group was assigned to receive physical exercise training combined with listening to music. The effects of interventions were assessed by differences in changes in mood state between the two groups. MAIN OUTCOME MEASURES Medically eligible patients were screened with the Hamilton Anxiety Scale and with the Geriatric Depression Scale. We used plasmatic cytokine dosage as a stress marker. RESULTS We recruited 24 subjects (mean age: 75.5 ± 7.4, 11 M/13 F). In the pharmacotherapy group there was a significant improvement in anxiety only (p<0.05) at 6-months. In the exercise/music therapy was a reduction in anxiety and in depression at 3-months and at 6-months (p<0.05). We noted an average reduction of the level of TNF-a from 57.67 (± 39.37) pg/ml to 35.80 (± 26.18) pg/ml. CONCLUSIONS Our training may potentially play a role in the treatment of subjects with mild to moderate depression. Further research should be carried out to obtain more evidence on effects of physical training and music therapy in depressed subjects.
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Affiliation(s)
- W Verrusio
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
| | - P Andreozzi
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - B Marigliano
- Internal Medicine, Campus Bio-medico of Rome, Rome, Italy
| | - A Renzi
- Department of Dynamic and Clinical Psychology, "Sapienza" - University of Rome, Italy
| | - V Gianturco
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - M T Pecci
- "Science of Aging" Interdepartmental Research Center - Sapienza University of Rome, Italy
| | - E Ettorre
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - M Cacciafesta
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - N Gueli
- Department of Cardiovascular, Respiratory, Nephrological, and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
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Abstract
OBJECTIVES the possible therapeutic role of vitamin D in different kind of diseases explains the growing interest in this vitamin due to its pleiotropic effects. This short report shows preliminary results of prevalence of hypovitaminosis D in a group of patients and proposes a oral supplement therapy effective in correcting hypovitaminosis in a short time, without side effects. METHODS 243 patients (aged 26-93; 67 males) were enrolled at this study. We evaluated plasma levels of 25-hydroxyvitamin D [25(OH)D] with the following cut-off values: <10 ng/ml or <0-25 nmol/L (deficient), 10-30 ng/ml or 25-75 nmol/L 30-50 (insufficient) and > 30 ng/ml or > 50 nmol/L (normal). The first 73 patients with hypovitaminosis D received at baseline 25,000 IU (Cholecalciferol) per os twice a month (Tp.A). The next patients (Tp.B) at baseline received a loading dose of 50,000 IU once a week for 8 weeks, followed by a maintenance dose of 25,000 IU twice a month. RESULTS hypovitaminosis D is a widespread condition (i.e., 82.3%) not only in elderly (75.6% of 75 patients aged <65 yrs and 86.5% of 168 subjects aged >65 yrs). Preliminary results at 6 months show that Tp.B is more effective in correcting hypovitaminosis D (baseline 14.4 ± 5.3 ng/ml; 24 wk 43.3 ± 14.7 ng/ml; p<0.0001). CONCLUSION hypovitaminosis D is an important public health problem. We believe it is important to quickly achieve normal Vit. D plasma values in order to produce pleiotropic effects.
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Affiliation(s)
- W Verrusio
- W.Verrusio, M.D. Ph. D. st. tel. +393490745274
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Servello A, Andreozzi P, Bechini F, De Angelis R, Pontecorvo ML, Vulcano A, Cerra E, Vigliotta MT, Artini M, Selan L, Ettorre E. [Effect of AChE and BuChE inhibition by rivastigmin in a group of old-old elderly patients with cerebrovascular impairment (SIVD type)]. Minerva Med 2014; 105:167-174. [PMID: 24727881] [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: 06/03/2023]
Abstract
AIM Vascular dementia (VaD) is defined as a loss of cognitive function resulting from ischemic, hypoperfusive, or hemorrhagic brain lesions due to cerebrovascular disease or cardiovascular pathology. The main types of VaD are: Small Vessel Disease Dementia (sVAD), Large vessel disease dementia, hypoperfusive-ischemic dementia and hemorragic dementia. The sVAD is divided into two main categories: subcortical ischemic vascular dementia (SIVD) and cortical dementia. Currently, no drugs are approved for the treatment of VaD. This study aimed to determine whether rivastigmine, a second generation cholinesterase inhibitor with selectivity for the CNS, with capacity to inhibit both acetylcholinesterase (AChE) and butyryl-cholinesterase (BuChE), slows the rate of cognitive decline associated with VaD. METHODS Study subjects were 27 male and 43 female outpatients aged 80.03±6.53 years, with Mini-Mental State Examination (MMSE) score ranging batween 22 and 12, affected by VaD. They were included in the study if they were undergoing pharmacological treatment with acetylsalicylic acid 100 mg for at least six months. Patients were divided into two groups: one group was treated with ASA 100 mg and rivastigmine patch 9.5 mg (Rivastigmine group), the other just with ASA 100 mg (ASA group). All patients were followed for 6 months, with a first evaluation (T0) and a second examination after six mounths of treatment (T1). RESULTS Statistically data proved as the Rivastigmine group showed constant values at MMSE, compared with patients of the ASA group who experienced decline of their cognitive performances. The same result was found in CDR, ADL, GDS and NPI scales. It is remarkable to underline as Rivastigmine-treated patients had a mean improvement in GDS scales, in comparison with patients of the ASA group who showed a worsening of mood. CONCLUSION Rivastigmine-therapy improves cognitive performance in elderly with SIVD.
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Affiliation(s)
- A Servello
- Dipartimento di Sanità Pubblica e Malattie Infettiva La Sapienza Università di Roma, Roma, Italia -
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Viscogliosi G, Andreozzi P, Ettorre E, Marigliano V. Arterial aging impacts on the risk of late-life depressive and cognitive disorders. Is it time for prevention? Geriatr Gerontol Int 2014; 14:227-8. [DOI: 10.1111/ggi.12118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Paola Andreozzi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Vincenzo Marigliano
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
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Viscogliosi G, Cipriani E, Liguori ML, Marigliano B, Saliola M, Ettorre E, Andreozzi P. Mediterranean dietary pattern adherence: associations with prediabetes, metabolic syndrome, and related microinflammation. Metab Syndr Relat Disord 2013; 11:210-6. [PMID: 23451814 PMCID: PMC3696914 DOI: 10.1089/met.2012.0168] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The adherence to the Mediterranean Diet (Med Diet) seems to reduce the incidence of metabolic syndrome. The present study aimed to explore whether the adherence to the overall Med Diet pattern and to specific Med Diet items is associated with the presence of metabolic syndrome, impaired fasting glucose (IFG), insulin resistance (IR), and microinflammation in subjects free of diabetes and cardiovascular diseases. MEASUREMENTS Each patient underwent clinical assessment. Adherence to the Med Diet was measured by a previously validated 14-item questionnaire. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria; IR was defined by homeostasis model assessment of insulin resistance (HOMA-IR); inflammation was assessed through a high-sensitivity C-reactive protein (hsCRP) assay. RESULTS A total of 120 subjects (64.2% women, mean age 59.8±10.2 years) were enrolled at this study. Subjects with lower Med Diet pattern adherence exhibited higher occurrence of metabolic syndrome and all its components and higher HOMA-IR and hsCRP values (P for all <0.0001). Subjects with metabolic syndrome were less likely to consume olive oil (P=0.002) and vegetables (P=0.023). By multivariable analyses, the overall Med Diet score was found to be strongly and inversely associated with the presence of metabolic syndrome [B=-0.066; 95% confidence interval (CI) -0.105 to -0.028; P=0.001], IFG (B=-0.076; 95% CI -0.114 to -0.038; p<0.0001), high HOMA-IR (B=-0.071; 95% CI -0.108 to -0.034; P<0.0001) and high hsCRP (B=-0.082; 95% CI -0.125 to -0.045; P<0.0001). None of specific Med Diet items independently predicted metabolic syndrome, IFG, and high HOMA-IR. Instead, the consumption of white meat over red meat (B=-0.324; 95% CI -0.467 to -0.178; P<0.0001) was found to be inversely associated with increased hsCRP. CONCLUSIONS The inverse associations between adherence to Med Diet and the prevalence of metabolic syndrome and prediabetes may be due more to the effects of the entire dietary pattern rather than to individual food components. Metabolic syndrome-related microinflammation may further be linked to specific Med Diet components.
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Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University, Rome, Italy.
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Andreozzi P, Viscogliosi G, Colella F, Subic M, Cipriani E, Marigliano B, Verrusio W, Servello A, Ettorre E, Marigliano V. [Predictors of liver fibrosis in patients with non-alcoholic fatty liver disease. The role of metabolic syndrome, insulin-resistance and inflammation]. Recenti Prog Med 2013; 103:570-4. [PMID: 23258240 DOI: 10.1701/1206.13358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION NAFLD (non-alcoholic fatty liver disease) reaches an high prevalence in the general population, and it is closely related to metabolic syndrome (MetS). The entity of metabolic abnormalities and the chronic inflammation seem to play a main role in the development of liver fibrosis. The aim of our study is to determine whether subjects with NAFLD and MetS have higher liver fibrosis degree when compared with NAFLD subjects without MetS, and to investigate the relations between fibrosis, MetS and its single components and inflammation. MATERIALS AND METHODS We considered 24 patients with NAFLD. Those who had viral- and alcohol- related liver disease were excluded. MetS was diagnosed according to NCEP ATP III criteria; inflammatory status was determined through C-reactive protein (PCR) assay. The peripheral insulin-resistance was assessed by calculating HOMA ir. Liver fibrosis was measured by transient elastography (Fibroscan®). RESULTS Subjects with MetS had higher HOMA ir, PCR and Fibroscan® score (log value: 0.92±0.24 KPa vs 0.73±0.2 KPa; p=0.047). The linear correlation analysis showed that Fibroscan® score was related to MetS, number of MetS components, waist circumference, HOMA ir and PCR. However the multivariate regression analysis showed that only HOMA ir (B=0.077; 95%CI: -0.002- 0.157; p=0.05) and PCR (B=0.152; 95% CI: 0.006 - 0.299; p=0.006) were independent predictors of higher Fibroscan® score. CONCLUSION MetS is associated to higher liver fibrosis degree in subjects with NAFLD. The insulin-resistance and inflammation seem to be the main determinants.
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Affiliation(s)
- Paola Andreozzi
- Unita di Medicina Predittiva, Sapienza Universita di Roma, Roma, Italy
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Viscogliosi G, Andreozzi P, Chiriac IM, Cipriani E, Servello A, Marigliano B, Ettorre E, Marigliano V. Depressive symptoms in older people with metabolic syndrome: is there a relationship with inflammation? Int J Geriatr Psychiatry 2013; 28:242-7. [PMID: 22639424 DOI: 10.1002/gps.3817] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 03/21/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate if there is a higher prevalence of depressive symptoms in older people with metabolic syndrome (MetS) compared with those without and whether dedpressive symptoms are independently associated to MetS and its single components and to the inflammatory markers. METHODS Physical parameters, standard blood analytes, high sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were assessed. Fifteen-item Geriatric Depression Scale and mini mental state examination (MMSE) were administered. RESULTS One hundred thirty-three subjects were enrolled. MetS patients (57) exhibited higher prevalence of depressive symptoms (p < 0.0001), worse cognitive function (p < 0.0001), and higher levels of ESR and hsCRP were higher (p < 0.0001). The univariate analysis showed a linear strong correlation of depressive symptoms (p < 0.0001) with the MMSE score (r = -0.422), body mass index (r = 0.414), MetS (r = 0.582), number of MetS components (r = 0.663), fasting blood glucose (r = 0.565), ESR (r = 0.565), hsCRP (r = 0.745), central obesity (r = 0.269; p = 0.002), and high-density lipoprotein cholesterol (r = -0.241; p = 0.005). However, the multivariate analysis showed that only age (B = -0.093; p = 0.032), MetS (B = 1.446; p = 0.025), fasting blood glucose (B = 0.039; p = 0.005), and hsCRP (B = 7.649; p < 0.0001) were independently associated with depressive symptoms. CONCLUSIONS MetS and inflammation are independently associated with depressive symptoms in older people. Inflammation may explain cognitive decline too. Further investigations are needed to better understand the direction of these associations and to determine whether these can be reversible.
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Affiliation(s)
- Giovanni Viscogliosi
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
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Viscogliosi G, Andreozzi P, Marigliano V. Associations of plasma glucose levels and traits of metabolic syndrome with carotid intima media thickness in nondiabetic elderly subjects: are they mediated by insulin resistance? Metab Syndr Relat Disord 2012; 11:41-5. [PMID: 23067236 DOI: 10.1089/met.2012.0087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The independent role of insulin resistance (IR) and high fasting blood glucose (FBG) levels within the normal range on vascular diseases is still under debate. This study was designed to explore whether IR, FBG levels, and the traits of metabolic syndrome are associated with increased carotid intima media thickness (IMT), the early marker of subclinical atherosclerosis, independently of each other in nondiabetic elderly subjects. METHODS Blood analytes and anthropometric measurements were obtained. Carotid IMT was measured by ultrasonography; metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. IR was assessed through homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS At total of 207 subjects aged 68.2±3.6 years were enrolled. Subjects with increased carotid IMT (50.7%) were older (P=0.001), had a higher prevalence of metabolic syndrome (P<0.0001) and all its traits, impaired fasting glucose (IFG) (P<0.0001), and values of HOMA-IR (P<0.0001) than normal subjects. Increased carotid IMT significantly correlated with metabolic syndrome, its traits, IFG, and HOMA-IR. When multivariable regression models were constructed, central obesity [B=0.392; 95% confidence interval (CI) 0.280-0.505; P<0.0001], high-density lipoprotein cholesterol (HDL-C) (B=-0.007; 95% CI -0.013-0.000; P=0.042], hypertension (B=0.475; 95% CI 0.363-0.587; P<0.0001), and IFG (B=0.230; 95% CI 0.092-0.367; P=0.001) were found to be the independent determinants of increased carotid IMT independently of HOMA-IR, but not FBG (B=0.013; 95% CI 0.000-0.026; P=0.050) and HOMA-IR itself. CONCLUSIONS Our results suggest that hypertension, low HDL-C, and central obesity are independently associated with increased carotid IMT in nondiabetic elderly subjects. These associations seem to be not affected by IR. The associations of FBG levels within the normal range and IR with carotid IMT should be investigated further.
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Affiliation(s)
- Giovanni Viscogliosi
- Predictive Medicine Unit, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University, Rome, Italy.
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Viscogliosi G, Andreozzi P, Chiriac IM, Cipriani E, Servello A, Ettorre E, Marigliano V. Screening cognition in the elderly with metabolic syndrome. Metab Syndr Relat Disord 2012; 10:358-62. [PMID: 22784389 DOI: 10.1089/met.2012.0043] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome reaches its highest prevalence in the elderly, and evidence suggests that metabolic syndrome could be an independent risk factor for cognitive impairment. The aims of this study were to detect whether patients with metabolic syndrome have lower cognition and to investigate whether there is a relationship with cognition and single metabolic syndrome components. METHODS We assessed fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides, high-sensitivity C-reactive protein (hsCRP), and anthropometric measurements. Metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The population sample was divided into two groups according to the presence of metabolic syndrome. Cognitive function was investigated through the Mini-Mental State Examination (MMSE). RESULTS We enrolled 159 elderly subjects (mean age, 69.8±4.8 years). Seventy had metabolic syndrome. Metabolic syndrome subjects had higher hsCRP values (P<0.0001) and lower MMSE scores (P<0.0001) than those without metabolic syndrome. MMSE scores were significantly correlated with body mass index (BMI), hsCRP, metabolic syndrome, the number of metabolic syndrome components, and each of them. However, at multivariate regression analysis, only fasting blood glucose [FBG; B=-0.046; 95% confidence interval (CI) -0.066 to -0.028; P<0.0001] and the number of metabolic syndrome components (B=-0.317; 95% CI -0.572 to -0.010; P=0.042) were found to be independent predictors of lower MMSE scores. CONCLUSION We found that subjects with metabolic syndrome have lower MMSE scores than those without, even without symptomatic cognitive impairment, and that the number of metabolic abnormalities is independently associated to lower MMSE scores. We suggest that these patients should always undergo cognitive screening to prevent more severe outcomes.
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Cuomo R, D'Alessandro A, Andreozzi P, Vozzella L, Sarnelli G. Gastrointestinal regulation of food intake: do gut motility, enteric nerves and entero-hormones play together? MINERVA ENDOCRINOL 2011; 36:281-293. [PMID: 22322652] [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: 05/31/2023]
Abstract
The gastrointestinal system can be considered the gateway for food entry in our body. Rather than being a passive player, it is now clear that gut strongly influence the feeding behavior and contribute to maintain energy balance with different signals. The aim of this review is to summarize the current knowledge about the role of gastrointestinal tract in the control of food intake, by focusing on the interplay existing between the enteric nervous system and gastrointestinal hormones and their ability to modulate digestive motility and sensitivity. Also the latest advances about the contribution of gut microbiota and gastrointestinal taste receptors are described. From the reported data it clearly emerges that gut hormones together with nervous signals likely contribute to the regulation of energy balance and modulate food intake through the control of digestive motility and sensations. The close linkage among gastrointestinal hormones, the gut and the central nervous systems appears very intriguing and has induced the development of a new field of research: the gastroendocrinology.
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Affiliation(s)
- R Cuomo
- Department of Clinical and Experimental Medicine, University of Naples Federico II, Naples, Italy.
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Viscogliosi G, Andreozzi P, Chiriac IM, Ettorre E, Vulcano A, Servello A, Marigliano B, Marigliano V. [Vascular depression in the elderly. Does inflammation play a role?]. Recenti Prog Med 2011; 102:261-266. [PMID: 21779108 DOI: 10.1701/893.9844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Vascular depression in the elderly. Does inflammation play a role?Depression is the most common comorbidity in the elderly, and it is a major determinant of disability. The late-onset depression in highly associated to cardiovascular disease. Depressive symptoms may follow vascular brain damage, especially when mood regulating areas are affected. However depression is strongly associated to vascular disease even when there is no manifest brain damage. Recently great attention has been given to chronic inflammation, both related to depression and vascular disease. Both experimental and clinical evidence shows that a rise in the concentrations of proinflammatory cytokines and glucocorticoids in depressed patients is associated with defect in serotonergic function. Chronic inflammation may underlie many forms of depression associated with vascular disease and metabolic syndrome. The importance of the inflammation hypothesis of depression lies is that psychotropic drugs may have central anti-inflammatory action, and that new generation of central anti-inflammatory drugs may be useful in depression treatment.
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Ciacci C, Franceschi F, Purchiaroni F, Capone P, Buccelletti F, Iacomini P, Ranaudo A, Andreozzi P, Tondi P, Gentiloni Silveri N, Gasbarrini A, Gasbarrini G. Effect of beta-glucan, inositol and digestive enzymes in GI symptoms of patients with IBS. Eur Rev Med Pharmacol Sci 2011; 15:637-643. [PMID: 21796867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a very common functional gastrointestinal (GI). Diagnosis of IBS is based on the fulfilment of the Rome III criteria. Common GI symptoms are lower abdominal pain, bloating and disturbed defecation, such as urgent diarrhoea and/or episodes of chronic constipation. Many agents have been employed in the management of IBS, although only few have been demonstrated to show a relevant efficacy. AIM To evaluate the effectiveness of the administration of a mixture of beta-glucan, inositol and digestive enzymes (Biointo) in improving GI symptoms in patients affected by IBS. PATIENTS AND METHODS 50 IBS patients (20 males, 30 females; mean age 51 +/- 19) were treated with Biointo (group A) while another group consisting of 40 IBS patients (15 males, 25 females; mean age 50 +/- 18) did not receive any therapy (group B). RESULTS Biointol administration improved significantly bloating, flatulence and abdominal pain, with a slight increasing of urgency for bowel movements. On the contrary, Biointol did not show any significant effect on the other IBS symptoms. CONCLUSIONS Currently, only few agents used in the management of IBS have been proven to be effective. Biointol administration has shown to improve some IBS symptoms, such as bloating, flatulence and abdominal pain, all connected to the presence of gas inside the intestinal lumen.
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Affiliation(s)
- C Ciacci
- Gastroenterology Unit, University of Salerno, Italy
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Zingone F, Morisco F, Zanetti A, Romanò L, Portella G, Capone P, Andreozzi P, Tortora R, Ciacci C. Long-term antibody persistence and immune memory to hepatitis B virus in adult celiac patients vaccinated as adolescents. Vaccine 2010; 29:1005-8. [PMID: 21129395 DOI: 10.1016/j.vaccine.2010.11.060] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 11/09/2010] [Accepted: 11/16/2010] [Indexed: 12/21/2022]
Abstract
Aim of this study was to investigate the anti-HBs antibody persistence and immune memory to hepatitis B virus in adult celiacs vaccinated as adolescents and the effect of a booster administration in non-protected individuals. Eleven years after primary vaccination, the proportion of vaccinees with titres ≥ 10 mIU/ml and antibody geometric mean concentrations (GMCs) were lower among celiac patients than among controls (68.6% vs 91.7%, p<0.01; GMCs 29.38 mIU/ml vs 250.6 mIU/ml, p<0.001). Participants with anti-HBs below 10 mIU/ml received a booster dose and were retested 2 weeks later to assess the anamnestic response. Post-booster anti-HBs levels were still <10 mIU/ml in 71.4% celiacs and 25% controls (p<0.01). Our findings indicate that the prevalence of seroprotective levels of anti-HBs detected eleven years after primary immunization as well as the frequency of response to a booster dose of vaccine are lower in celiac patients compared to healthy controls.
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Affiliation(s)
- F Zingone
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Italy
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Abstract
BACKGROUND Coeliac disease is a chronic disease with a various clinical presentation, including anxiety and depression. AIM To investigate the quality of sleep in coeliac disease. METHODS The participants were coeliacs at diagnosis; coeliacs on a gluten-free diet at follow-up and healthy volunteers. Participants completed the Pittsburgh Sleep Quality Index (PSQI), SF36, Zung and Fatigue scales and State-Trait Anxiety Inventory (STAI). RESULTS The PSQI score was higher in coeliacs at diagnosis and in a gluten-free diet than in healthy volunteers (P < 0.001). A gluten-free diet did not improve the PSQI score (P = 0.245) in coeliac disease. The other test scores were similar between coeliacs at diagnosis and those on a gluten-free diet, whereas significant differences were found between coeliacs and volunteers. PSQI score was inversely associated with the quality of the physical (r = -0.327, P = 0.002) and mental (r = -0.455, P < 0.001) component scores. The sleep quality scores were related to depression (r = 0.633, P < 0.001), fatigue (r = 0.377, P < 0.001), state anxiety (r = 0.484, P < 0.001) and trait anxiety (r = 0.467, P < 0.001). CONCLUSIONS Sleep disorders are common in coeliac disease not only at diagnosis but also during treatment with a gluten-free diet. Sleep disorders are related to depression, anxiety and fatigue, and inversely related to quality of life scale scores.
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Affiliation(s)
- F Zingone
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Italy
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Loffredo L, Marcoccia A, Pignatelli P, Andreozzi P, Perri L, Martini A, Polimeni L, Cangemi R, Violi F. PO15-398 OXIDATIVE-STRESS MEDIATED ARTERIAL DYSFUNCTION IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71408-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Loffredo L, Marcoccia A, Pignatelli P, Andreozzi P, Borgia MC, Cangemi R, Chiarotti F, Violi F. Oxidative-stress-mediated arterial dysfunction in patients with peripheral arterial disease. Eur Heart J 2007; 28:608-12. [PMID: 17298965 DOI: 10.1093/eurheartj/ehl533] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To investigate the existence of a relationship among flow-mediated dilation (FMD), nitric oxide (NO), and oxidative stress in patients with peripheral arterial disease (PAD), and to assess if the administration of an antioxidant was able to improve arterial dilatation. METHODS AND RESULTS We performed a cross-sectional study comparing FMD, 8-Hydroxy-2-deoxy-2-deoxyguanosine (8-OHdG), a marker of oxidative stress, and nitrite/nitrate (NOx) serum levels in a population of 25 PAD patients and 40 controls. In the second part of the study, 21 PAD patients were randomly allocated to a treatment sequence of 7 days of i.v. infusion of placebo or 6 g/day propionyl-L-carnitine (PLC) in a cross-over design. Compared with controls, patients with PAD had enhanced 8-OHdG serum levels (2.4 +/- 1.2 vs. 4.24 +/- 3.11 ng/mL; P < 0.001), reduced NOx (17.02 +/- 6.11 vs. 11.28 +/- 6.02 microM; P < 0.001), and lowered FMD (10.34 +/- 2.14 vs. 6.69 +/- 2.95; P < 0.001). PLC infusion was associated with an increase of FMD [from 6.6 +/- 0.6 to 11.1 +/- 1.2% (mean +/- SE), P = 0.004] and NOx (from 14.5 +/- 1.4 to 17.1 +/- 1.2 microM; +18%, P = 0.012) and a decrease of 8-OHdG (from 3.62 +/- 0.37 to 2.64 +/- 0.32 ng/mL; -27%, P < 0.001). No changes were observed after placebo treatment. CONCLUSION This study shows that in PAD patients, oxidative stress is implicated in determining reduced FMD.
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Affiliation(s)
- L Loffredo
- IV Divisione di Clinica Medica, Department of Experimental Medicine and Pathology, University of Rome, La Sapienza, Roma 00161, Italy
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Loffredo L, Pignatelli P, Cangemi R, Andreozzi P, Panico MA, Meloni V, Violi F. Imbalance between nitric oxide generation and oxidative stress in patients with peripheral arterial disease: effect of an antioxidant treatment. J Vasc Surg 2006; 44:525-30. [PMID: 16950429 DOI: 10.1016/j.jvs.2006.05.023] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 05/15/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Nitric oxide (NO), a potent vasodilator produced by endothelial cells, is reduced in patients with peripheral arterial disease (PAD), but the mechanism has not been fully elucidated. Because NO is rapidly inactivated by superoxide anion, we speculated that enhanced oxidative stress could lower NO generation. The aim of our study was to investigate if an imbalance between oxidative stress and NO does exist in patients with PAD and if an increase of NO formation could be achieved by an antioxidant treatment. METHODS In a first study, serum levels of nitrite and nitrate (NOx), markers of NO generation, and 8-hydroxy-2-deoxyguanosine (8-OHdG), a marker of oxidative stress and maximal walking distance (MWD), were measured in 40 PAD patients and 40 controls. In a second study, 10 PAD patients were randomly allocated in a crossover design to intravenous propionyl-L-carnitine (6 g/day) or placebo for 7 days, with a washout of 30 days between the two phases of the trial. Serum levels of NOx and 8-OHdG were measured before and after the study. RESULTS Compared with controls, serum levels of 8-OHdG (mean +/- SD) were significantly increased in PAD patients (4.4 +/- 3.1 ng/mL vs 2.4 +/- 1.2 ng/mL; P < .001), and serum levels of NOx were significantly decreased (11.6 +/- 6 microM vs 17 +/- 6.1 microM; P < .001). Levels of 8-OHdG and NOx were inversely correlated (r = -0.879; P < .001). Serum levels 8-OHdG were inversely correlated with MWD (r = -0.48, P = .002). The interventional trial showed no changes in the patients given placebo. Patients treated with propionyl-L-carnitine showed a significant increase of MWD from 101 +/- 31 meters to 129 +/- 35 meters (P = .007) and in NOx from 14.5 +/- 4.5 microM to 17.1 +/- 3.8 microM (P = .007). A significant decrease of 8-OHdG from 3.6 +/- 1.1 ng/mL to 2.6 +/- 1 ng/mL was also found (P = .005.) CONCLUSIONS This study suggests that in PAD patients, the reduction of NO generation could be dependent upon enhanced oxidative stress.
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Affiliation(s)
- Lorenzo Loffredo
- Department of Experimental Medicine and Pathology, IV Divisione di Clinica Medica, University of Rome La Sapienza, Rome, Italy
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Bruno G, Andreozzi P, Graf U, Tega F, Santangelo G, Barucco M, Bruno A, Bracchitta S. Cetirizine, a second-generation H1 antagonist, modulates Rantes and MCP-1 levels in allergic rhinitis. Int J Immunopathol Pharmacol 2002; 15:113-118. [PMID: 12590873 DOI: 10.1177/039463200201500206] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Chemokines and their receptors are involved in several allergic diseases. We measured RANTES and MCP-1 levels in sera of allergic rhinitis patients, and also we evaluated the effect of cetrizine, a second-generation H1 antagonist, on these chemoattractant proteins. 15 subjects were studied (10 males and 5 females; mean age: 26.7 years). They were suffering from perennial or seasonal allergic rhinitis induced by Dermatophagoides pteronyssinus (8 patients) or by grasses (7 patients). RANTES and MCP-1 serum levels were detected with an enzyme immunoassay before and after two weeks of treatment with 10 mg of cetirizine daily, and again after two weeks of washout. Baseline serum levels of RANTES and MCP-1 chemokines were significantly higher (p < 0.02 and p = 0.007, respectively) in allergic patients than in the healthy control group. Cetirizine resulted in a significant decrease in RANTES (p < 0.02) and MCP-1 (p = 0.003) versus baseline values. There is an increase in RANTES and MCP-1 in allergic rhinitis, which is counteracted by cetirizine.
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Affiliation(s)
- G. Bruno
- Allergologia e Immunologia Clinica, Dip Medicina Clinica, Università di Roma, Italy
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Bruno G, Andreozzi P, Magrini L, Santangelo G, Graf U, Angelino A. Serum Tryptase in Allergic Rhinitis: Effect of Cetirizine Treatment. Int J Immunopathol Pharmacol 2001. [DOI: 10.1177/039463200101400305] [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] [Indexed: 01/11/2023] Open
Abstract
Activated mast cells release a large range of potent mediators of allergic inflammation, including proteases. The tryptase serum levels were evaluated in 13 subjects suffering from allergic perennial rhinitis. Moreover, the effects of cetirizine treatment on serum tryptase were studied using the UniCap™ tryptase fluoroenzymeimmunoassay. In allergic patients the serum tryptase values (M±SD: 6.1 ± 2.4 μg/L) were significantly (p < 0.02) higher than the values detected in controls (3.0 ± 1.2 μg/L). In allergic rhinitis, after antihistamine treatment, tryptase values (4.4 ± 1.8 μg/L) decreased significantly (p < 0.001). After two weeks from the cetirizine stop, the tryptase levels increased again (5.5 ± 2.6 μg/l). The results demonstrate that mast cells are constantly activated in perennial allergic rhinitis. The antihistamine treatment is effective in reducing the tryptase release from mast cells, but the mechanism of action of cetirizine is still to understand.
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Affiliation(s)
- G. Bruno
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
- Ospedale Madre G. Vannini, Roma
| | - P. Andreozzi
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
- Ospedale Madre G. Vannini, Roma
| | - L. Magrini
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
| | - G. Santangelo
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
| | - U. Graf
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
| | - A. Angelino
- Dipartimento di Medicina Interna - Fondazione A. Cesalpino, UniversitàT degli Studi “La Sapienza”, Roma
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Bruno G, Andreozzi P, Bracchitta S, Graf U, Santangelo G, Zaino S, Gaston N. Serum tryptase in allergic rhinitis: effect of cetirizine and fluticasone propionate treatment. Clin Ter 2001; 152:299-303. [PMID: 11794849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
PURPOSE A specific reaction against several kinds of inhalant allergens characterizes allergic rhinitis. Mast cells play a crucial role in the allergic inflammation releasing histamine and other mediators. Tryptase is considered to be a specific marker of mast cell activation. This study was devoted to evaluate the serum tryptase in allergic rhinitis and to evaluate the effect of cetirizine and fluticasone propionate on mast cell activation. 13 subjects, suffering from perennial allergic rhinitis induced by Dermatophagoides pteronyssinus, were studied. MATERIALS AND METHODS Tryptase serum levels were detected by the fluoroenzymeimmunoassay (Pharmacia & Upjohn AB, Uppsala, Sweden). Blood samples were taken four times: before starting the study, after two weeks of 10 mg cetirizine treatment once a day, after two weeks of wash-out, and again after 15 days of 100 micrograms intranasal fluticasone propionate therapy twice a day. RESULTS In allergic rhinitis, the basal values of serum tryptase (M +/- SD: 6.1 +/- 2.4 micrograms/l) were significantly higher than in controls (M +/- SD: 3.0 +/- 1.2 micrograms/l). After the antihistamine treatment, tryptase values (M +/- SD: 4.4 +/- 1.8 micrograms/l) decreased significantly (p < 0.001). After the stop of antihistamine treatment, tryptase levels increased (M +/- SD: 5.5 +/- 2.6 micrograms/l, p < 0.001). After the topical corticosteroid treatment, tryptase values decreased again significantly (M +/- SD: 4.5 +/- 3.1 micrograms/l, p < 0.04). CONCLUSIONS All these data seem to confirm the effective action of cetirizine and fluticasone propionate on tryptase serum levels. While the action of corticosteroid is well known, the action of cetirizine is still to define, considering the recent reports on anti-inflammatory effect of the second generation of H1 receptor antagonists. Further studies are necessary to understand if the pharmacological effect on tryptase is a specific one of cetirizine, or if it is common to other anti-H1 molecules.
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Affiliation(s)
- G Bruno
- Dipartimento di Medicina Interna, Fondazione A. Cesalpino, Università degli Studi La Sapienza, Roma, Italia.
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Bruno G, Andreozzi P, Magrini L, Santangelo G, Graf U, Angelino A. Serum tryptase in allergic rhinitis: effect of cetirizine treatment. Int J Immunopathol Pharmacol 2001; 14:147-152. [PMID: 12604015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Activated mast cells release a large range of potent mediators of allergic inflammation, including proteases. The tryptase serum levels were evaluated in 13 subjects suffering from allergic perennial rhinitis. Moreover the effects of cetirizine treatment on serum tryptase were studied using the UniCap™ tryptase fluoroenzymeimmunoassay. In allergic patients the serum tryptase values (M±SD: 6.1 ± 2.4 μg/L) were significantly (p < 0.02) higher than the values detected in controls (3.0 ± 1.2 μg/L). In allergic rhinitis, after antihistamine treatment, tryptase values (4.4 ± 1.8 μg/L) decreased significantly (p < 0.001). After two weeks from the cetirizine stop, the tryptase levels increased again (5.5 ± 2.6 μg/l). The results demonstrate that mast cells are constantly activated in perennial allergic rhinitis. The antihistamine treatment is effective in reducing the tryptase release from mast cells, but the mechanism of action of cetirizine is still to understand.
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Affiliation(s)
- G Bruno
- Dept Internal Medicine, University of Rome, La Sapienza, Rome, Italy
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Abstract
Mast cells play a central role in the pathogenesis of many allergic disorders. They can be activated in different ways. The present study was focused to evaluate the role of mast cells in acquired chronic urticaria-angioedema induced by gastroesophageal reflux. Tryptase, an important marker of mast cell activation, was detected with UniCap Tryptase Fluoroenzymeimmunoassay (Pharmacia & Upjohn AB, Uppsala, Sweden). Eight subjects were studied: four males and four females, aged between 29 and 71 years (mean age: 45 yrs.), suffering from acquired chronic urticaria-angioedema. Results were compared with the results of seven healthy control subjects. Moreover, data were compared with those of 13 subjects (10 males and 3 females, mean age: 24.7 years) suffering from allergic rhinitis. In acquired chronic urticaria-angioedema, serum tryptase levels (mean +/- S.D.: 9.6 +/- 4.3 microg/l) were significantly higher (P < 0.007) than those of the controls (mean +/- S.D.: 3.0 +/- 1.2 microg/l) and higher also than in allergic rhinitis (mean +/- S.D.: 6.1 +/- 2.4 microg/l, P < 0.03). The results underline the central role of mast cells in the inflammation of acquired chronic urticaria-angioedema.
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Affiliation(s)
- G Bruno
- Istituto I Clinica Medica, Fondazione A. Cesalpiolo, Università La Sapienza di Roma, Italy.
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Bruno G, Andreozzi P, Graf U, Santangelo G. Hepatitis C virus: a high risk factor for a second primary malignancy besides hepatocellular carcinoma. Fact or fiction? Clin Ter 1999; 150:413-8. [PMID: 10756661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE Second primary malignancies occur more and more often. But the hepatocellular carcinoma (HCC) linked to a second primary cancer is not frequent. MATERIALS AND METHODS A retrospective study focused on a second primary cancer was performed in 37 patients with HCC, aged between 46 and 81 years, 27 males and 10 females. RESULTS 5 out of them (13.5%), 3 males and 2 females, developed a second primary neoplasm before or after HCC. In 3 cases the second malignancy was a carcinoma of the kidney, of the breast, and the prostate. The fourth patient had a Hodgkin's lymphoma before HCC. The last and most unlucky case, besides HCC, had a basal cell carcinoma, a colorectal cancer, and a bladder carcinoma. The common data of these 5 patients were the presence of anti-HCV antibodies and the positivity of the HCV RNA polymerase reaction. One patient was also HBV positive. CONCLUSION Considering that a large number of virus has been found linked to human cancers, our results brought us to hypothesize that HCV could have played an important role not only in the development of HCC but of the second primary malignancy too. This is likely favoured by constitutional or acquired biological and molecular alterations. Tumor suppressor genes alterations have been reported to be frequently linked to cancers of kidney and breast, of colorectal and skin, of prostate, and lymphoemopoietic tissue. Now just these organs are involved in our patients in addition to the liver. Our results, if confirmed, are of a relevant interest, considering that world-wide HCC is constantly increasing for the spreading of the virus risk-factors.
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Affiliation(s)
- G Bruno
- Istituto I Clinica Medica, Fondazione A. Cesalpino, Università di Roma La Sapienza, Italy
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Abstract
Bronchial asthma is a disease that has been recognized for centuries, which is influenced mainly by genetic and environmental factors. The current interest of bronchial asthma is focused to ascertain the causes and the mechanisms that induce bronchoconstriction. Recently, abnormalities of the esophageal and gastric tracts have become important related areas for research. In predisposed individuals, these abnormalities can trigger or worsen the particular syndrome better known as "gastric asthma." In bronchial asthma the disorder of gastroesophageal reflux (GER) occurs more often than would be expected by chance. The neurogenic mechanism is considered to be the main cause of bronchoconstriction. The diagnosis of gastric asthma is particularly difficult and it should be considered also when GER is less evident or not recognized. In asthmatic patients the recognition of gastric abnormalities is very relevant for therapeutic problems also when GER is in a subclinical stage. In fact, many drugs used in the treatment of bronchial asthma can promote or enhance GER and subsequently they can worsen the symptoms of gastric asthma.
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Affiliation(s)
- G Bruno
- Istituto I Clinica Medica, Fondazione A. Cesalpino, Università La Sapienza di Roma, Rome, Italy
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Abstract
Lipoprotein (a) [Lp(a)] is synthesised by liver cells, and patients with liver cirrhosis (LC) show low serum levels of Lp(a) associated with the degree of liver failure. On the contrary, increased serum levels of Lp(a) have been reported in patients with cancer. In this report, the behaviour of Lp(a) serum levels in patients with hepatocarcinoma (HC), a complication of LC, has been evaluated with the aim to study whether HC cells were able to cause an increase of serum concentrations of this lipoprotein when impaired liver protein synthesis is present. We selected eighteen patients affected by LC + HC, eighteen patients matched for sex, age and degree of liver failure with LC only, and eighteen patients with other cancer types. A significant increase of serum levels of Lp(a) was observed in patients affected by LC + HC or other cancer types compared with healthy subjects. Forty-four percent of LC + HC patients showed Lp(a) values more than 70.4 Units/dl, i.e., the upper limit of values observed in patients with LC only. Lp(a) serum concentrations were significantly associated with serum albumin both in LC and in LC + HC but not in other cancer-type patients. Thus, comparing patients with similar serum albumin concentrations, Lp(a) serum levels were significantly higher in patients with LC + HC than in patients with only LC and quite similar to those observed in patients with other cancer types. In conclusion, HC cells, in vivo, seem able to produce a greater amount of Lp(a) despite the reduced liver protein synthesis typical of LC.
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Affiliation(s)
- S Basili
- Istituto di Terapia Medica, Policlinico Umberto I, Università di Roma La Sapienza, Italy
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