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Atherosclerosis is associated with a higher risk of hepatic steatosis in HIV-infected patients. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2017; 58:E219-E224. [PMID: 29123368 PMCID: PMC5668931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
INTRODUCTION Cardiovascular Diseases (CD) have emerged as a leading cause of morbidity and mortality in HIV population. Some studies have reported higher carotid Intima Media Thickness (c-IMT), a measure of subclinical atherosclerosis (AT), in this cohort of patients. METHODS Here, we evaluate the role of Hepatic Steatosis (HS) as likely marker for AT in 128 HIV-infected patients without hepatitis C infection. c-IMT has been detected non-invasively by carotid ultrasonography to assess the progression of AT. HS has been evaluated using a process based on vibration-controlled transient elastography (Fibroscan) by a novel ultrasonic controlled attenuation parameter (CAP). The cut-off value for defining the presence of significant HS was CAP > 259 dBm-1. RESULTS AT has been detected in 26 patients (20.3%), whereas steatosis of grade 2 (S2) in 31 (24.2%). The variables statistically related to AT were age, obesity, diabetes, hypertension and S2. In the multivariate analysis, AT was only associated (p < 0.001) with age and S2. The optimal cut-off value indicated by ROC curve for predicting AT was CAP > 250 dB/m-1. DISCUSSION Our results highlight the presence of AT in HIVinfected persons and its association with fatty liver disease; therefore, HS assessment in HIV population results crucial to predict AT and CD.
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Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3078.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women. CLIN EXP OBSTET GYN 2016; 43:198-202. [PMID: 27132409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed. MATERIALS AND METHODS A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered. RESULTS The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.0 19) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2. CONCLUSIONS The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.
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Management of cutaneous discomfort in patients with scleroderma: a clinical trial. Reumatismo 2013; 65:240-7. [DOI: 10.4081/reumatismo.2013.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/08/2013] [Accepted: 11/07/2013] [Indexed: 11/22/2022] Open
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Efficacy of a Dermoxen® lenitiva for pruritus genitalis in a randomized, double blind trial. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2013; 17:2668-2674. [PMID: 24142616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Pruritus can be defined as an unpleasant cutaneous sensation associated with the immediate desire to scratch. In particular external intimate zone could be hit by pruritus genitalis because of several reasons (bacterial infection, fungal infection, stress, bad intimate behavior, synthetic intimate clothes). AIM The aim of the study was to compare the efficacy of Dermoxen® Lenitiva cream versus a methylprednisolone aceponate 0.1% based cream in treating pruritus of the external genitalia. PATIENTS AND METHODS Independent, randomized, double-blind, controlled trial in two University affiliated Italian Hospitals. 80 women, affected by aspecific pruritus genitalis with negative vaginal swab for bacterial or fungal infections or other pathogenic causes of itching, were selected and blindly treated by Dermoxen® Lenitiva cream or methylprednisolone aceponate 0.1% based cream. The main outcome measures were: the reduction of sensation of pruritus, evaluated by a visual analog scale (VAS) pain score, and improvement of intimate wellness sensation, and comfort during sexual intercourse, frequency and severity of adverse reactions. RESULTS Significant reduction of itching sensation was verified for each treatment. CONCLUSIONS Based on our results, DermoXen® Lenitiva vaginal cream showed efficacy so as methylprednisolone aceponate 0.1% based cream for itching treatment on external female genitalia and improved intimate comfort and comfort in sexual intercourse.
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Molecular approaches in the diagnosis of sepsis in neutropenic patients with haematological malignances. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2012; 53:104-108. [PMID: 23240170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Sepsis is a major cause of significant morbidity and mortality in neutropenic patients. Blood culture remains the gold standard in the microbiological diagnosis of bacterial or fungal bloodstream infections, but it has clear limits of rapidity and sensitivity. The objective of the study was to compare the real-time polymerase chain reaction (RT-PCR) with automated blood cultures (BC) method in detection in whole blood of pathogens in febrile neutropenic patients with hematological malignancies. METHODS A total of 166 consecutive febrile neutropenic patients were enrolled. Blood samples for cultures and SeptiFast testing were obtained at the onset of fever, before the implementation of empirical antibiotic therapy. RESULTS Forty (24.1%) samples out of the 166 blood samples tested, were positive by at least one method. Twenty-three (13.9%) samples were positive by blood culture and 38 (22.9%) by multiplex real-time PCR. The analysis of concordance evidenced a low correlation between the two methods (n = 21; 52.5%), mainly due to samples found negative by culture but positive with the Septi-Fast assay. Sensitivity, specificity, and positive and negative predictive values of RT-PCR were 91.3%, 88.1%, 55.3%, and 98.4%, respectively, compared with BC. DISCUSSION Multiplex real-time PCR assay improved detection of the most bacteria associated with febrile neutropenia episodes. Further studies are needed to assess the real advantages and clinical benefits that molecular biology tests can add in diagnosis of sepsis.
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Abstract
OBJECTIVE The aim of the study was to evaluate the interleukin-17 (IL-17) plasma level in HIV-1-infected patients and its relation to central obesity. METHODS Eighty-four HIV-1-infected patients [42 with visceral obesity (group A) and 42 without visceral obesity (group B)] and 46 HIV-negative subjects [23 with visceral obesity (group C) and 23 without visceral obesity (group D)] were enrolled in the study. Sonographic measurements of perirenal fat diameter/body mass index (PRFD/BMI) were used to assess visceral adipose tissue thickness. RESULTS HIV-1-infected patients had higher plasma levels of IL-17 than HIV-negative subjects [837.8 ± 260 pg/mL (mean ± standard deviation) vs. 395.3 ± 138.6 pg/mL, respectively; P<0.001]. Furthermore, HIV-1-infected patients with a diagnosis of visceral obesity had lower levels of IL-17 than HIV-infected lean patients (756.9 ± 282.9 pg/mL vs. 918.7 ± 208.4 pg/mL, respectively; P<0.01). IL-17 (r= -0.21; P=0.03) and waist circumference (r=0.48; P<0.001) were significantly associated with visceral adipose tissue thickness. A negative correlation of IL-17 (r= -0.23; P<0.001) with PRFD/BMI was found. CONCLUSIONS This study suggests a linear negative association between IL-17 and visceral adipose tissue thickness.
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Abstract
A serological survey was performed to determine the prevalence of antibodies against human bocavirus in an Apulian population. Anti-hBoV IgG antibodies were analysed in 1206 inhabitants (age range, 1month-84years) using a standardized ELISA test based on the use of recombinant hBoV VP2 virus-like particles. In total, 1075 (89.1%) of 1206 participants (mean age 32±24.8years) displayed anti-hBoV-IgG. The seroprevalence increased significantly (p<0.0001) in children from 2-4years (64.2%) to 5-9years (96.4%). A similar trend was observed in both male and female subjects. In conclusion, our results show that hBoV infection is common in this population, especially in children.
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Caesarean section in the world: a new ecological approach. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2011; 52:161-173. [PMID: 22442920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION This study aimed to estimate the most recent caesarean section rates in the world and examine the association between these rates and old and new indicators of health care. METHODS Authors analyzed the Caesarean Section (CS) rates, also in geo-economic and economic groups, and correlated them to maternal and neonatal mortality, to births attended by skilled health personnel and to births among adolescents. Analysis of covariance and piecewise regressions were used for the statistical analysis. RESULTS In 47.2% of the countries, the CS rate exceeded 15%. Countries of Latin America and the Caribbean along with Europe, North America and Oceania had the highest values. The analysis showed an inverse association between CS rates and Maternal Mortality (MMR) and Neonatal Mortality (NMR) for all geographical areas except for Europe. The greatest association was observed in lower-middle-income countries. In developing countries only 50% of cases, occur in medical facilities and only half of these are seen by medical, nursing and obstetrical staff. Age of the mother appears to influence the outcome and choice of delivery type. Countries where an high ABR rate is present have low CS use. CONCLUSIONS To best evaluate the consequences of the increasing rate of CS, it would be useful to identify the most sensitive outcome indicators.
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Susceptibility to varicella-zoster among pregnant women in the province of Lecce, Italy. J Clin Virol 2011; 53:72-6. [PMID: 22074933 DOI: 10.1016/j.jcv.2011.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/21/2011] [Accepted: 10/14/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND Varicella is predominantly a childhood disease, considered a mild self-limiting disease that can have serious complications for a pregnant woman and her developing fetus. OBJECTIVES We investigated the susceptibility to varicella-zoster Virus (VZV) among pregnant women in the province of Lecce. STUDY DESIGN A cross-sectional study was carried out in Departments of Gynecology and Obstetrics of the Province of Lecce, where 539 pregnant women were recruited, and face-to-face interviews were conducted. Varicella IgG tests were performed. RESULTS The prevalence of varicella susceptibility among pregnant mothers was 10.6%. The prevalence of IgG antibodies increases significantly with increasing age, from 62.5% in the age group 15-19 years to 94.4% in the age group 40-49 years. DISCUSSION In the Italian National Vaccination Plan 2005-2007, varicella vaccine is only recommended for childbearing women. A safe and effective vaccine is available and no abnormalities have been observed among infants born to susceptible women who received varicella vaccines during pregnancy. Such a high number of susceptible women indicates that preventive and informative programs should be introduced, even among those who do not plan to become pregnant. Routine counselling, varicella IgG antibody screening and varicella vaccination should be considered if they have no history of the infection, to reduce the risk of fetal complications and the cost of healthcare associated with the infection.
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Human metapneumovirus and human bocavirus associated with respiratory infection in Apulian population. Virology 2011; 417:64-70. [PMID: 21636105 PMCID: PMC7173056 DOI: 10.1016/j.virol.2011.04.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 04/04/2011] [Accepted: 04/25/2011] [Indexed: 01/11/2023]
Abstract
We have studied the occurrence of hBoV, hMPV and InfA-B in an Apulian population with respiratory tract infections. During influenza season 2008-2009, 116 oropharingeal swabs were collected from patients affected by Influenza-Like Illness (ILI). The PCR products of hMPV M and HBoV NP-1 genes were sequenced. 78 out of 116 samples were positive for at least one respiratory virus; hBoV was detected in 53, hMPV in 22 and InfA-B in 41 out of 116 swabs. A high rate of hBoV infection in adult (18.9%) and elderly (26.4%) subjects was found. The co-infection rate was higher for hMPV (18/22 cases, 81.8%) compared to hBoV (26/53 cases, 49.1%), and InfA-B (25/41 cases, 61.0%). Co-infections were common in children. hBoV positive samples shared a high level of genetic similarity with the hBoV1 genotype, and hMPV positive samples clustered with A2 subgroup. Our results suggest that hBoV and hMPV play a role in ILI.
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Kidney tubular function and serum phosphate levels in HIV-1-infected patients treated with tenofovir: preliminary results. J Int AIDS Soc 2010. [PMCID: PMC3113090 DOI: 10.1186/1758-2652-13-s4-p83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Altered phosphate metabolism in HIV-1-infected patients: another feature of metabolic syndrome? J Int AIDS Soc 2010. [PMCID: PMC3113084 DOI: 10.1186/1758-2652-13-s4-p78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Low serum phosphate levels are related to increased cardiovascular risk in HIV-1 infected patients. J Int AIDS Soc 2010. [PMCID: PMC3113071 DOI: 10.1186/1758-2652-13-s4-p66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Outcome of acute type A aortic dissection: single-center experience from 1998 to 2007. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2009; 50:152-158. [PMID: 20411648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Acute aortic dissection (AAD) is a serious disease of the aorta with high mortality and morbidity, which requires emergency surgical treatment in order to close the site of the dissection and direct blood flow into the true lumen. Improvements in surgical technique have led to better management of patients with reduced operative mortality, although it still remains high. The aim of this study is to evaluate early and late outcomes of the surgical treatment of acute type A aortic dissection at the hospital of Lecce between 1998 and 2007. We also aim to establish a correlation between these outcomes and pre-operative conditions, surgical procedures and location of the site of the tear. METHODS From 1998 to 2007, 100 patients (69 males and 31 females, average age 62.2 +/- 12.3 years, range 22-85 years) underwent surgery for acute AAD at the center. Surgical techniques included replacement of the ascending aorta (Asc Ao) with or without valve replacement (including five patients who underwent the Bentall/De Bono procedure) and replacement of the Asc Ao with or without arch or hemiarch replacement. RESULTS In-hospital mortality was 22%, with different results between surgery for replacement of the aorta and for aorta with valve replacement (respectively, 16% and 23%). Different mortality rates were found between the distal surgical treatments, with rates of 20.8% and 18.2% respectively between replacements of the Asc Ao and of Asc Ao with arch/hemiarch, although they were not statistically significant. A different mortality rate that was subject to the patient's preoperative condition has also been found (33.3% of mortality in patients in unstable or high-risk condition vs 13.8% in patients in stable condition). The peak reached 43.5% mortality in patients taken to the operating room while in shock or cardiac tamponade. The location of the site of the tear is another factor that distinguishes mortality rates, which are 17.8% if localized at the proximal ascending aorta and 22.2% in the aortic arch. Assessment of the outcome (10 years after surgery), has shown that four patients died several years later but for reasons unrelated to the surgery. CONCLUSIONS The surgery of dissection is still an intervention with a relatively high in-hospital mortality risk, and whose outcome, which has been steady in the last 20 years, can be predicted according to the preoperative condition of the patient. This underlines the need to reduce the time of diagnosis indicating immediate surgical treatment.
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Phase 1A safety assessment of intravenous amitriptyline. THE JOURNAL OF PAIN 2007; 8:549-55. [PMID: 17512256 PMCID: PMC2001298 DOI: 10.1016/j.jpain.2007.02.433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 02/01/2007] [Accepted: 02/22/2007] [Indexed: 10/23/2022]
Abstract
UNLABELLED The antidepressant amitriptyline is used as an adjuvant in the treatment of chronic pain. Among its many actions, amitriptyline blocks Na+ channels and nerves in several animal and human models. As perioperative intravenous lidocaine has been suggested to decrease postoperative pain, amitriptyline, because of its longer half-life time, might be more useful than lidocaine. However, the use of intravenous amitriptyline is not approved by the US Food and Drug Administration. We therefore investigated the adverse effects of preoperative intravenous amitriptyline in a typical phase 1A trial. After obtaining written Food and Drug Administration and institutional review board approval, we obtained written consent for preoperative infusion of amitriptyline in an open-label, dose-escalating design (25, 50, and 100 mg, n=5 per group). Plasma levels of amitriptyline/nortriptyline were determined, and adverse effects were recorded in a predetermined symptom list. Infusion of 25 and 50 mg amitriptyline appears to be well tolerated; however, the study was terminated when 1 subject in the 100-mg group developed severe bradycardia. Intravenous infusion of amitriptyline (25 to 50 mg over 1 hour) did not create side effects beyond dry mouth and drowsiness, or dizziness, in 2 of our 10 otherwise healthy participants receiving the 25- to 50-mg dose. An appropriately powered future trial is necessary to determine a potential role of amitriptyline in decreasing postoperative pain. PERSPECTIVE Amitriptyline potently blocks the persistently open Na+ channels, which are known to be instrumental in various pain states. As this occurs at very low plasma concentrations, a single preoperative intravenous infusion of amitriptyline could provide long-lasting pain relief and decrease the incidence of chronic pain.
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Abstract
BACKGROUND The objective of this study was to evaluate, within the Italian National Influenza Epidemiological and Virological Surveillance, the rate of vaccination coverage, the incidence of Influenza Like-Illness (ILI), the incidence of Acute Respiratory Illness (ARI), and to identify the virus strains circulating in Apulia from 1999 to 2003. METHODS Vaccination coverage rates were calculated based on the number of doses administered to individuals > 65 years of age. Every week, sentinel physicians reported ILI and ARI cases having occurred among their patients. Voluntary general practitioners (GPs) and paediatricians (Ps) collected oropharyngeal swab samples from patients suspected with ILI. Influenza viruses were isolated and identified by cell culture (MDCK cells) and RT-PCR. Virological surveillance was carried out by the ISS, in collaboration with a network of peripheral laboratories. RESULTS In Apulia, vaccination coverage progressively increased to 68.6% during the 2002-2003 season. The analysis of ILI cases showed higher incidence rates during the 1999-2000 and 2002-2003 seasons. ARI rates appeared to have a more constant trend. ILI and ARI incidence rates were higher in the 0-14 year age group. CONCLUSION The increase in vaccination coverage rates and implementation of the network of clinical, and epidemiological and virological surveillance are fundamental for the control and prevention of influenza.
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[Anti-HEV seroprevalence in the area of Lecce]. ANNALI DI IGIENE : MEDICINA PREVENTIVA E DI COMUNITA 2003; 15:199-205. [PMID: 12910873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Hepatitis E virus (HEV) is the causative agent of an enterically transmitted viral hepatitis associated with inadequate hygienic conditions. Hepatitis E is endemic in developing countries where it occurs both in sporadic and epidemic form. Outbreaks have been reported in different areas of the world. The aim of the present work was to assess the seroprevalence of HEV infection in the general population and in different risk groups in the area of Lecce. The presence of anti-HEV antibodies was ascertained by qualitative ELISA (Abbott HEV EIA) and Western Blot (Recomblot HEV IgG/IgM, Mikrogen). The prevalence of anti-HEV in the general population was 2.9% while in intravenous drug users, hemodialized patients and immigrants the seroprevalence rates were 0.7%, 4.3% and 15.3% respectively. Our data show a circulation of HEV at low level in the area of Lecce which is endemic for hepatitis A. Higher seroprevalence rates were found in hemodialized patients and remarkably in immigrants coming from endemic areas like Turkey.
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[Seroepidemiologic survey on varicella-zoster infection in the Province of Lecce]. ANNALI DI IGIENE : MEDICINA PREVENTIVA E DI COMUNITA 2001; 13:93-100. [PMID: 11414108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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[Scanning electron microscopy (SEM) and x-ray microanalysis of enamel during the transitional post-secretory phase of ameloblasts]. ARCHIVIO ITALIANO DI ANATOMIA E DI EMBRIOLOGIA. ITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGY 1988; 93:133-53. [PMID: 3240027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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[Preliminary study with scanning electron microscopy of the first layer of enamel]. ARCHIVIO ITALIANO DI ANATOMIA E DI EMBRIOLOGIA. ITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGY 1986; 91:197-209. [PMID: 3566414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Premiere contribution à l'étude taxonomique du genre «Centaurea» de la Sicile sur la base des données polliniques, traitées par l'analyse informatique. ACTA ACUST UNITED AC 1984. [DOI: 10.1080/00837792.1984.10670306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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