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Fantin F, Giani A, Manzato G, Zampieri A, Comellato G, Urbani S, Zoico E, Mazzali G, Zamboni M. Sarcopenia, sarcopenic obesity, and arterial stiffness among older adults. Front Cardiovasc Med 2024; 11:1272854. [PMID: 38404726 PMCID: PMC10885346 DOI: 10.3389/fcvm.2024.1272854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/19/2024] [Indexed: 02/27/2024] Open
Abstract
Background Aging is associated with a higher prevalence of sarcopenia, sarcopenic obesity (SO), and increased arterial stiffening, with possible detrimental effects on morbidity and mortality. The aim of this study was to assess the relationships between sarcopenia, SO, and different indexes of arterial stiffness in older adults. Methods A total of 77 hospitalized patients (mean age 78.68 ± 9.65 years) were evaluated, obtaining anthropometric variables, biochemical samples, handgrip test, and body composition assessment. Arterial stiffness was evaluated by measuring both carotid-femoral pulse wave velocity (cfPWV), a proxy for central stiffness, and cardio-ankle vascular index (CAVI), as well as considering peripheral arteries. The population was sorted into four subgroups: obese, sarcopenic, SO, and controls. Results The highest CAVI (11.31 ± 2.58) was found in sarcopenic patients. SO had the highest value of cfPWV (15.18 ± 8.44 m/s), even after adjustment for significant covariates. In multiple regressions, SO diagnosis resulted as a significant predictor of cfPWV (p = 0.03, R2 = 0.20), and sarcopenia diagnosis resulted as a predictor of CAVI (p = 0.042, R2 = 0.12). Conclusions In conclusion, a positive correlation is found between sarcopenia, SO, and arterial stiffness among older subjects. In particular, greater central arterial stiffness is associated with SO, outlining a remarkable effect on the cardiovascular risk profile.
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Affiliation(s)
- Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Anna Giani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Gisella Manzato
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Annachiara Zampieri
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Gabriele Comellato
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Silvia Urbani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
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Bortolani A, Fantin F, Giani A, Zivelonghi A, Pernice B, Bortolazzi E, Urbani S, Zoico E, Micciolo R, Zamboni M. Predictors of hospital readmission rate in geriatric patients. Aging Clin Exp Res 2024; 36:22. [PMID: 38321332 PMCID: PMC10847193 DOI: 10.1007/s40520-023-02664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/11/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Hospital readmissions among older adults are associated with progressive functional worsening, increased institutionalization and mortality. AIM Identify the main predictors of readmission in older adults. METHODS We examined readmission predictors in 777 hospitalized subjects (mean age 84.40 ± 6.77 years) assessed with Comprehensive Geriatric Assessment (CGA), clinical, anthropometric and biochemical evaluations. Comorbidity burden was estimated by Charlson Comorbidity Index (CCI). Median follow-up was 365 days. RESULTS 358 patients (46.1%) had a second admission within 365 days of discharge. Estimated probability of having a second admission was 0.119 (95%C.I. 0.095-0.141), 0.158 (95%C.I. 0.131-0.183), and 0.496 (95%C.I. 0.458-0.532) at 21, 30 and 356 days, respectively. Main predictors of readmission at 1 year were length of stay (LOS) > 14 days (p < 0.001), albumin level < 30 g/l (p 0.018), values of glomerular filtration rate (eGFR) < 40 ml/min (p < 0.001), systolic blood pressure < 115 mmHg (p < 0.001), CCI ≥ 6 (p < 0.001), and cardiovascular diagnoses. When the joint effects of selected prognostic variables were accounted for, LOS > 14 days, worse renal function, systolic blood pressure < 115 mmHg, higher comorbidity burden remained independently associated with higher readmission risk. DISCUSSION Selected predictors are associated with higher readmission risk, and the relationship evolves with time. CONCLUSIONS This study highlights the importance of performing an accurate CGA, since defined domains and variables contained in the CGA (i.e., LOS, lower albumin and systolic blood pressure, poor renal function, and greater comorbidity burden), when combined altogether, may offer a valid tool to identify the most fragile patients with clinical and functional impairment enhancing their risk of unplanned early and late readmission.
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Affiliation(s)
- Arianna Bortolani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy.
| | - Francesco Fantin
- Section of Geriatric Medicine, Centre for Medical Sciences - CISMed, Department of Psychology and Cognitive Science, University of Trento, Rovereto (TN), Italy
| | - Anna Giani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
| | - Alessandra Zivelonghi
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
| | - Bruno Pernice
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
| | - Elena Bortolazzi
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
| | - Silvia Urbani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Rocco Micciolo
- Centre for Medical Sciences, Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126, Verona, Italy
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Martini A, Fantin F, Cavedon M, Zamboni M, Urbani S, Giani A, Brandimarte P, Rossi AP. Evaluation of the impact on hospitalization risk of an electronic pill-box to promote therapeutic adherence in post-acute care setting: a pilot study. Aging Clin Exp Res 2023; 35:2847-2849. [PMID: 37823996 DOI: 10.1007/s40520-023-02562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023]
Abstract
Literature review reveals that adherence to prescribed therapy at hospital discharge averages around 50%. The purpose of this study was to evaluate adherence to prescribed therapy assessing the relationship between re-hospitalization rate at 30 days and degree of therapeutic adherence in a sample of elderly patients discharged from an acute geriatric ward using an Electronic Medication Packaging device, MePill. The study population (n = 56) was divided in 3 groups, a counseling group (A), a counseling + MePill device group (B) and a control group (C). Group A had 98.1% adherence to therapy, Group B had 100%, and control group had 90%. Analyzing the rate of hospitalization by type of intervention for Group A and C the hospitalization rate was 21% and 27.7%, respectively, whilst for Group B no patient was hospitalized. Participants in Group A and C had the shorter hospitalization-free survival as compared with subjects in Group B.
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Affiliation(s)
- Angela Martini
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale San Lorenzo, Valdagno, Italy
| | - Francesco Fantin
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale Cà Foncello, Verona, Italy
| | | | - Mauro Zamboni
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale Cà Foncello, Verona, Italy
| | - Silvia Urbani
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale Cà Foncello, Verona, Italy
| | - Anna Giani
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale Cà Foncello, Verona, Italy
| | - Piero Brandimarte
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Verona, Ospedale Cà Foncello, Verona, Italy
| | - Andrea Petronio Rossi
- Division of Geriatrics, Department of Medicine, Healthy Aging Center Treviso, Ospedale Cà Foncello, 31100, Treviso, Italy.
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Giani A, Micciolo R, Zoico E, Mazzali G, Zamboni M, Fantin F. Cardio-Ankle Vascular Index and Aging: Differences between CAVI and CAVI0. J Clin Med 2023; 12:6726. [PMID: 37959192 PMCID: PMC10647579 DOI: 10.3390/jcm12216726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Cardio-ankle vascular index (CAVI) and CAVI0 (a mathematical expression derived from CAVI, supposed to be less dependent on blood pressure), can describe arterial stiffness, considering a wide proportion of the arterial tree. The aim of this study was to examine the relationship between CAVI, CAVI0 and aging, looking at the differences between the two arterial stiffness indexes. METHODS A total of 191 patients (68 male, mean age 68.3 ± 14.4 years) referred to the Geriatric Ward and Outpatient Clinic at Verona University Hospital were included and underwent a comprehensive clinical evaluation. CAVI and CAVI0 were obtained for each. RESULTS CAVI0 steeply rises in the elderly age strata, widening the gap between CAVI and CAVI0. An inverse relationship is evident between CAVI0 and DBP in older patients, and CAVI0 is shown to be dependent on age, DBP and age-DBP interaction (R2 = 0.508). Age modifies the effect of DBP on CAVI0, but not on CAVI. CONCLUSIONS The real new findings of our study are that the association between CAVI0 and diastolic blood pressure (DBP) is modified by age, whereas the association between CAVI and DBP is not modified by age. From a clinical point of view, these are very important findings, as DBP decreases with aging, affecting in elderly populations the reliability of CAVI0, which strictly depends on DBP in the formula to calculate it. To monitor the effect of CV therapies, progression of CV diseases and to evaluate clinical outcomes in elderly populations, we suggest using CAVI and not CAVI0.
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Affiliation(s)
- Anna Giani
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37100 Verona, Italy; (A.G.); (M.Z.)
| | - Rocco Micciolo
- Centre for Medical Sciences and Department of Psychology and Cognitive Sciences, University of Trento, 38123 Trento, Italy;
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
| | - Gloria Mazzali
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37100 Verona, Italy; (A.G.); (M.Z.)
| | - Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, 37100 Verona, Italy; (E.Z.); (G.M.)
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Zoico E, Giani A, Saatchi T, Rizzatti V, Mazzali G, Fantin F, Benfari G, Onorati F, Urbani S, Zamboni M. Myocardial Fibrosis and Steatosis in Patients with Aortic Stenosis: Roles of Myostatin and Ceramides. Int J Mol Sci 2023; 24:15508. [PMID: 37958492 PMCID: PMC10648018 DOI: 10.3390/ijms242115508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
Aortic stenosis (AS) involves progressive valve obstruction and a remodeling response of the left ventriculum (LV) with systolic and diastolic dysfunction. The roles of interstitial fibrosis and myocardial steatosis in LV dysfunction in AS have not been completely characterized. We enrolled 31 patients (19 women and 12 men) with severe AS undergoing elective aortic valve replacement. The subjects were clinically evaluated, and transthoracic echocardiography was performed pre-surgery. LV septal biopsies were obtained to assess fibrosis and apoptosis and fat deposition in myocytes (perilipin 5 (PLIN5)), or in the form of adipocytes within the heart (perilipin 1 (PLIN1)), the presence of ceramides and myostatin were assessed via immunohistochemistry. After BMI adjustment, we found a positive association between fibrosis and apoptotic cardiomyocytes, as well as fibrosis and the area covered by PLIN5. Apoptosis and PLIN5 were also significantly interrelated. LV fibrosis increased with a higher medium gradient (MG) and peak gradient (PG). Ceramides and myostatin levels were higher in patients within the higher MG and PG tertiles. In the linear regression analysis, increased fibrosis correlated with increased apoptosis and myostatin, independent from confounding factors. After adjustment for age and BMI, we found a positive relationship between PLIN5 and E/A and a negative correlation between septal S', global longitudinal strain (GLS), and fibrosis. Myostatin was inversely correlated with GLS and ejection fraction. Fibrosis and myocardial steatosis altogether contribute to ventricular dysfunction in severe AS. The association of myostatin and fibrosis with systolic dysfunction, as well as between myocardial steatosis and diastolic dysfunction, highlights potential therapeutic targets.
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Affiliation(s)
- Elena Zoico
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Anna Giani
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Tanaz Saatchi
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Vanni Rizzatti
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Gloria Mazzali
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Francesco Fantin
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Giovanni Benfari
- Division of Cardiology, Department of Medicine, University of Verona, 37126 Verona, Italy
| | - Francesco Onorati
- Division of Cardiac Surgery, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126 Verona, Italy
| | - Silvia Urbani
- Division of Geriatric Medicine, Department of Medicine, University of Verona, 37126 Verona, Italy; (A.G.)
| | - Mauro Zamboni
- Division of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, 37126 Verona, Italy
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Giani A, Xu H, Eriksdotter M, Fantin F, Zamboni M, Bäck M, Religa D. Natural Course of Aortic Stenosis in Older Subjects: Effects of COVID-19. J Am Med Dir Assoc 2023; 24:1594.e1-1594.e9. [PMID: 37696497 DOI: 10.1016/j.jamda.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE Both aortic stenosis (AS) and COVID-19 affect the morbidity and mortality burden among older adults. The aim of the study was to examine whether aortic stenosis (AS) affects the prognosis after SARS-CoV-2 infection and whether COVID-19 affects AS prognosis, in a cohort of older adults hospitalized with and without COVID-19. DESIGN Observational study. SETTING AND PARTICIPANTS Patients admitted to 9 geriatric clinics in Stockholm from March 2020 to November 2021. METHODS AS and COVID-19 diagnoses were identified by electronic health records; the outcomes were mortality at 30 days and any time during a median follow-up of 630 days. The associations between AS, COVID-19, and mortality were assessed by using Royston-Parmar models adjusting for age, sex, comorbidities, and admission waves. RESULTS Among 28,974 patients, 85 had concomitant AS and COVID-19, 529 had only AS, and 5033 had only COVID-19. Both at 30 days and at any time, as compared to patients without, concomitant AS and COVID-19 subjects had a higher mortality rate (438.4 per 100 py, 95% CI 296.2-648.8, and 72.9, 95% CI 53.7-99.0, respectively) and a higher death risk (adjusted HR 5.5, 95% CI 3.7-8.2; and 2.8, 95% CI 2.1-3.9). AS patients presented increased mortality HR both in the presence and absence of COVID-19 at 30 days (1.6, 95% CI 1.1-2.4; and 1.6, 95% CI 1.2-2.2, respectively) and at any time (1.6, 95% CI 1.1-2.1; 1.4, 95% CI 1.2-1.7, respectively). CONCLUSIONS AND IMPLICATIONS AS was a significant mortality risk factor, independent of concomitant COVID-19. Careful AS management should always be pursued, even in acute and post-acute phases of COVID-19.
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Affiliation(s)
- Anna Giani
- Translational Cardiology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Hong Xu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
| | - Magnus Bäck
- Translational Cardiology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology Huddinge, Karolinska University Hospital, Stockholm, Sweden
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
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Zoico E, Saatchi T, Nori N, Mazzali G, Rizzatti V, Pizzi E, Fantin F, Giani A, Urbani S, Zamboni M. Senescent adipocytes as potential effectors of muscle cells dysfunction: An in vitro model. Exp Gerontol 2023; 179:112233. [PMID: 37321332 DOI: 10.1016/j.exger.2023.112233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
Recently, there has been a growing body of evidence showing a negative effect of the white adipose tissue (WAT) dysfunction on the skeletal muscle function and quality. However, little is known about the effects of senescent adipocytes on muscle cells. Therefore, to explore potential mechanisms involved in age-related loss of muscle mass and function, we performed an in vitro experiment using conditioned medium obtained from cultures of mature and aged 3 T3-L1 adipocytes, as well as from cultures of dysfunctional adipocytes exposed to oxidative stress or high insulin doses, to treat C2C12 myocytes. The results from morphological measures indicated a significant decrease in diameter and fusion index of myotubes after treatment with medium of aged or stressed adipocytes. Aged and stressed adipocytes presented different morphological characteristics as well as a different gene expression profile of proinflammatory cytokines and ROS production. In myocytes treated with different adipocytes' conditioned media, we demonstrated a significant reduction of gene expression of myogenic differentiation markers as well as a significant increase of genes involved in atrophy. Finally, a significant reduction in protein synthesis as well as a significant increase of myostatin was found in muscle cells treated with medium of aged or stressed adipocytes compared to controls. In conclusion, these preliminary results suggest that aged adipocytes could influence negatively trophism, function and regenerative capacity of myocytes by a paracrine network of signaling.
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Affiliation(s)
- Elena Zoico
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Tanaz Saatchi
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy.
| | - Nicole Nori
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Vanni Rizzatti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy
| | - Eleonora Pizzi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy
| | - Francesco Fantin
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Anna Giani
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Silvia Urbani
- Department of Medicine, Geriatric Section, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy
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Zamboni M, Mazzali G, Brunelli A, Saatchi T, Urbani S, Giani A, Rossi AP, Zoico E, Fantin F. The Role of Crosstalk between Adipose Cells and Myocytes in the Pathogenesis of Sarcopenic Obesity in the Elderly. Cells 2022; 11:3361. [PMID: 36359757 PMCID: PMC9655977 DOI: 10.3390/cells11213361] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2023] Open
Abstract
As a result of aging, body composition changes, with a decline in muscle mass and an increase in adipose tissue (AT), which reallocates from subcutaneous to visceral depots and stores ectopically in the liver, heart and muscles. Furthermore, with aging, muscle and AT, both of which have recognized endocrine activity, become dysfunctional and contribute, in the case of positive energy balance, to the development of sarcopenic obesity (SO). SO is defined as the co-existence of excess adiposity and low muscle mass and function, and its prevalence increases with age. SO is strongly associated with greater morbidity and mortality. The pathogenesis of SO is complex and multifactorial. This review focuses mainly on the role of crosstalk between age-related dysfunctional adipose and muscle cells as one of the mechanisms leading to SO. A better understanding of this mechanisms may be useful for development of prevention strategies and treatments aimed at reducing the occurrence of SO.
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Affiliation(s)
- Mauro Zamboni
- Geriatrics Division, Department of Surgery, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy
| | - Gloria Mazzali
- Geriatrics Division, Department of Medicine, University of Verona, 37126 Verona, Italy
| | - Anna Brunelli
- Geriatrics Division, Department of Surgery, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy
| | - Tanaz Saatchi
- Geriatrics Division, Department of Surgery, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy
| | - Silvia Urbani
- Geriatrics Division, Department of Surgery, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy
| | - Anna Giani
- Geriatrics Division, Department of Surgery, Dentistry, Pediatric and Gynecology, Healthy Aging Center, University of Verona, 37126 Verona, Italy
| | - Andrea P. Rossi
- Geriatrics Division, Department of Medicine, AULSS2, Ospedale Ca’Foncello, 31100 Treviso, Italy
| | - Elena Zoico
- Geriatrics Division, Department of Medicine, University of Verona, 37126 Verona, Italy
| | - Francesco Fantin
- Geriatrics Division, Department of Medicine, University of Verona, 37126 Verona, Italy
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Kirkham FA, Mills C, Fantin F, Tatsuno I, Nagayama D, Giani A, Zamboni M, Shirai K, Cruickshank JK, Rajkumar C. Are you as old as your arteries? Comparing arterial aging in Japanese and European patient groups using cardio-ankle vascular index. J Hypertens 2022; 40:1758-1767. [PMID: 35943103 DOI: 10.1097/hjh.0000000000003214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most comparisons of arterial stiffness between ethnic groups focus on pulse wave velocity. This study used the cardio-ankle vascular index (CAVI) in European compared to Japanese individuals to investigate how cardiovascular risk factors affect arterial aging across geographic regions. METHODS Four hundred and ninety-four European and 1044 Japanese individuals underwent measurements of CAVI, blood pressure and information on cardiovascular risk factors. Both datasets included individuals with 0-5 cardiovascular risk factors. RESULTS Average CAVI was higher in the Japanese than the European group in every age category, with significant differences up to 75 years for males and 85 for females. The correlation of CAVI with age, controlled for cardiovascular risk factors, was slightly higher in Japanese females (r = 0.594 vs. Europeans r = 0.542) but much higher in European males (r = 0.710 vs. Japanese r = 0.511). There was a significant correlation between CAVI and total cardiovascular risk factors in the Japanese (r = 0.141, P < 0.001) but not the European group. On linear regression, average CAVI was significantly dependent on age, sex, diabetes, BMI, SBP and geographic region. When divided into 'healthy' vs. 'high risk', the healthy group had a steeper correlation with age for Europeans (r = 0.644 vs. Japanese r = 0.472, Fisher's Z P < 0.001), whereas in the high-risk group, both geographic regions had similar correlations. CONCLUSION Japanese patient groups had higher arterial stiffness than Europeans, as measured by CAVI, controlling for cardiovascular risk factors. Europeans had greater increases in arterial stiffness with age in healthy individuals, particularly for males. However, cardiovascular risk factors had a greater impact on the Japanese group.
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Affiliation(s)
| | | | - Francesco Fantin
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | - Ichiro Tatsuno
- Chiba Prefectural University of Health Sciences, Chiba
- Toho University Medical Center, Sakura Hospital, Sakura
| | - Daiji Nagayama
- Nagayama Clinic, Nagayama
- Toho University Medical Center, Sakura Hospital, Sakura
| | - Anna Giani
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Section of Geriatric Medicine, University of Verona, Verona, Italy
| | | | | | - Chakravarthi Rajkumar
- University Hospitals Sussex, NHS Foundation Trust
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
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Giusti I, Carnevali P, Bertoglio CL, Giani A, Achilli P, Grimaldi S, Origi M, Mazzola M, Magistro C, Ferrari G. Laparoscopic right hemicolectomy for hepatic flexure adenocarcinoma with complete mesocolic excision and 3D-CT vascular reconstruction. Tech Coloproctol 2022; 26:1003-1004. [PMID: 35749022 DOI: 10.1007/s10151-022-02639-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/15/2022] [Indexed: 11/25/2022]
Affiliation(s)
- I Giusti
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy.
| | - P Carnevali
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - C L Bertoglio
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - A Giani
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - P Achilli
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - S Grimaldi
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - M Origi
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - M Mazzola
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - C Magistro
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
| | - G Ferrari
- Division of Minimally-Invasive Surgical Oncology, Department of Mininvasive and Oncologic General Surgery, ASST Grande Ospedale Metropolitano di Niguarda, Milan, Italy
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Fantin F, Giani A, Franconi A, Zoico E, Urbani S, Rossi AP, Mazzali G, Zamboni M. Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients. Front Cardiovasc Med 2022; 9:918601. [PMID: 35783827 PMCID: PMC9249084 DOI: 10.3389/fcvm.2022.918601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Arterial stiffness and subendocardial perfusion impairment may play a significant role in heart failure (HF) outcomes. The aim of the study was to examine the main predictors of 30-day readmission in geriatric patients, hospitalized with HF, explore hemodynamical parameters, arterial stiffness indexes, and subendocardial viability ratio (SEVR). In total, 41 hospitalized patients, affected by HF, were included; they underwent clinical evaluation, routine laboratory testing, and echocardiography. At the time of admission, after the achievement of clinical stability (defined as switching from intravenous to oral diuretic therapy), and at discharge, arterial tonometry was performed to evaluate carotid-femoral pulse wave velocity (PWVcf) and SEVR (then corrected for hemoglobin concentration and oxygen saturation). Through the evaluations, a significant progressive decrease in PWVcf was described (17.79 ± 4.49, 13.54 ± 4.54, and 9.94 ± 3.73 m/s), even after adjustment for age, gender, mean arterial pressure (MAP) variation, and left ventricular ejection fraction (LVEF). A significant improvement was registered for both SEVR (83.48 ± 24.43, 97.94 ± 26.84, and 113.29 ± 38.02) and corrected SEVR (12.74 ± 4.69, 15.71 ± 5.30, and 18.55 ± 6.66) values, and it was still significant when adjusted for age, gender, MAP variation, and LVEF. After discharge, 26.8% of patients were readmitted within 30 days. In a multivariate binary logistic regression analysis, PWVcf at discharge was the only predictor of 30-day readmission (odds ratio [OR] 1.957, 95% CI 1.112–3.443). In conclusion, medical therapy seems to improve arterial stiffness and subendocardial perfusion in geriatric patients hospitalized with heart failure. Furthermore, PWVcf is a valid predictor of 30-day readmission. Its feasibility in clinical practice may provide an instrument to detect patients with HF at high risk of rehospitalization.
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Affiliation(s)
- Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
- *Correspondence: Francesco Fantin,
| | - Anna Giani
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Arianna Franconi
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Silvia Urbani
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Andrea P. Rossi
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric, and Gynecology, University of Verona, Verona, Italy
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Giani A, Franconi A, Nicolussi Paolaz S, Zampieri A, Falceri A, Gasparini L, Mattachini E, Santuz B, Zamboni M, Fantin F. P247 ARTERIAL STIFFNESS, SUBENDOCARDIAL PERFUSION AND 30–DAYS READMISSION IN ELDERLY INDIVIDUALS WITH HEART FAILURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.239] [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: 11/12/2022]
Abstract
Abstract
Arterial stiffness and subendocardial perfusion impairment significantly affect cardiovascular morbidity and mortality, playing a relevant role in heart failure. The aim of the present study was to describe the trend of hemodynamical parameters, arterial stiffness indexes and subendocardial viability ratio (SEVR) in geriatric patients, hospitalized with hearth failure, and to define the main predictors of 30–days readmission. A cohort of 41 patients, admitted to the Geriatric ward of Verona University Hospital, affected by heart failure, was included in the study. Each subject underwent clinical evaluation, geriatric comprehensive assessment, routine laboratory testing, and cardiac ultrasound. At the time of admission, after achievement of clinical stability (defined as switching from intravenous to oral diuretic therapy) and at the time of discharge, blood pressure measurement and applanation arterial tonometry (with evaluation of carotid–femoral pulse wave velocity –PWVcf– and SEVR) were also performed. SEVR was corrected for hemoglobin concentration and oxygen saturation. Through the three evaluations, a progressive decrease in PWVcf was described (17.79±4.49 m/s, 13.54±4.54 m/s, 9.94±3.73 m/s respectively, p < 0.001); the trend remained significant even after adjustment for age, gender, mean arterial pressure (MAP) variation and left ventricular ejection fraction (LVEF) (p < 0.001). A significant improvement was registered for both SEVR (83.48±24.43, 97.94±26.84, 113.29±38.02 respectively) and corrected SEVR (12.74±4.69, 15.71±5.30, 18.55±6.66 respectively) values (p < 0.001 for both), and it was still significant when adjusted for age, gender, MAP variation and LVEF (p < 0.001). After discharge, 26.8% of patients was readmitted within 30 days. In a multivariate binary logistic regression analysis, considering 30–days readmission as dependent variable, PWVcf at discharge was the only predictor of readmission (OR 2.004, CI 1.154–3.481, p = 0.014) In conclusion, medical therapy seems to improve arterial stiffness and subendocardial perfusion in geriatric patients hospitalized with hearth failure. Furthermore, PWVcf is a valid predictor of 30–days readmission. Its feasibility and reproducibility in clinical practice, may provide an instrument to detect heart failure patients at high risk of rehospitalization.
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Affiliation(s)
- A Giani
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - A Franconi
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - S Nicolussi Paolaz
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - A Zampieri
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - A Falceri
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - L Gasparini
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - E Mattachini
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - B Santuz
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - M Zamboni
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
| | - F Fantin
- AOUI VERONA – GERIATRIA B – SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA – UNIVERSITÀ DI VERONA, VERONA
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Abstract
BACKGROUND Metabolic Syndrome (MS) is associated to vascular damage, increased arterial stiffness, and impaired myocardial perfusion. Subendocardial viability ratio (SEVR) is a noninvasive estimation of myocardial workload, oxygen supply, and perfusion. The aim of the study was to describe the relation between arterial stiffness, SEVR, and cardio-metabolic risk factors. METHODS A cohort of 55 patients, aged 59.9 ± 10.8 years, was studied; 28 subjects (50.9%) had metabolic syndrome. All patients underwent a clinical evaluation and blood venous sampling, to assess glico-lipid profile. Applanation tonometry was performed, to obtain pulse wave analysis and SEVR values. RESULTS In the overall study population, SEVR showed negative associations with mean (r = -0.301; p = 0.026) and systolic (borderline relation, r = -0.257; p = 0.058) arterial pressure. Metabolic syndrome patients presented lower level of SEVR (p = 0.012), even after adjusting for age, sex, and mean arterial pressure (p = 0.040). Subdividing the study population by the number of metabolic syndrome components, SEVR significantly decreased as the number of Metabolic Syndrome components increased (p for trend 0.005). In a logistic backward regression analysis, both metabolic syndrome and mean arterial pressure resulted significant predictors of SEVR, accounting for 18% of variance. CONCLUSION The reduced SEVR in metabolic syndrome patients could be an important pathophysiological determinant of the increased cardiovascular risk.
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Affiliation(s)
- Francesco Fantin
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
- Francesco Fantin, Department of Medicine, Section of Geriatric Medicine, University of Verona, Piazzale Stefani 1, Verona 37126, Italy.
| | - Anna Giani
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Ludovico Gasparini
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Andrea P Rossi
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Zoico
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Section of Geriatric Medicine, Department of Surgery, Dentistry, Pediatric and Gynecology, University of Verona, Verona, Italy
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Sandini M, Angrisani M, Bassi C, Caccialanza R, Capretti G, Casciani F, Cereda M, Famularo S, Giani A, Gianotti L, Paiella S, Zerbi A. BIOIMPEDANCE VECTOR ANALYSIS (BIVA) PREDICTS MORBIDITY FOLLOWING PANCREATIC RESECTION FOR CANCER. Nutrition 2019. [DOI: 10.1016/j.nut.2019.08.001] [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: 10/25/2022]
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Batista AMM, Figueredo CC, Giani A. Variability in a permanent cyanobacterial bloom: species-specific responses to environmental drivers. FEMS Microbiol Ecol 2019; 94:5115560. [PMID: 30289447 DOI: 10.1093/femsec/fiy197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/02/2018] [Indexed: 11/12/2022] Open
Abstract
Cyanobacterial blooms are characterized by intense growth of one or few species that will dominate the phytoplankton community for periods of few months to an entire year or more. However, even during persistent blooms, important seasonal changes among dominant species can be observed. Pampulha reservoir is a tropical eutrophic reservoir presenting permanent blooms. To identify the main species in this environment, a closer analysis performed by microscopy and 16S-rRNA DGGE revealed Cylindrospermopsis raciborskii as highly dominant throughout the year. The second most abundant group comprised species belonging to the Microcystis genus. They followed a well-defined seasonal pattern described by interesting species-specific ecological trends. During thermal stratification in the rainy/warmer season, C. raciborskii dominated in the water column, while Microcystis spp. were abundant at the end of the dry season, a period characterized by higher total phosphorus concentrations. Phylogenetic analyses confirmed the two dominant taxa and their seasonal trends. The results showed that cyanobacteria major controlling factors were strongly species dependent, shifting from physical/climate related (stratification) to more chemical driven (nutrients/eutrophication). Identifying these drivers is therefore essential for the understanding of the bloom dynamics and the real risks associated with each species, and to eventually adopt the most appropriate and effective management strategies.
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Affiliation(s)
- A M M Batista
- Department of Botany, ICB, Universidade Federal de Minas Gerais, Belo Horizonte 31270-010, Brazil
| | - C C Figueredo
- Department of Botany, ICB, Universidade Federal de Minas Gerais, Belo Horizonte 31270-010, Brazil
| | - A Giani
- Department of Botany, ICB, Universidade Federal de Minas Gerais, Belo Horizonte 31270-010, Brazil
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Fantin F, Giani A, Zoico E, Rossi AP, Mazzali G, Zamboni M. Weight Loss and Hypertension in Obese Subjects. Nutrients 2019; 11:E1667. [PMID: 31330870 PMCID: PMC6682923 DOI: 10.3390/nu11071667] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 02/07/2023] Open
Abstract
Arterial hypertension is strongly related to overweight and obesity. In obese subjects, several mechanisms may lead to hypertension such as insulin and leptin resistance, perivascular adipose tissue dysfunction, renal impairment, renin-angiotensin-aldosterone-system activation and sympathetic nervous system activity. Weight loss (WL) seems to have positive effects on blood pressure (BP). The aim of this review was to explain the mechanisms linking obesity and hypertension and to evaluate the main studies assessing the effect of WL on BP. We analysed studies published in the last 10 years (13 studies either interventional or observational) showing the effect of WL on BP. Different WL strategies were taken into account-diet and lifestyle modification, pharmacological intervention and bariatric surgery. Although a positive effect of WL could be identified in each study, the main difference seems to be the magnitude and the durability of BP reduction over time. Nevertheless, further follow-up data are needed: there is still a lack of evidence about long term effects of WL on hypertension. Hence, given the significant results obtained in several recent studies, weight management should always be pursued in obese patients with hypertension.
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Affiliation(s)
- Francesco Fantin
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy.
| | - Anna Giani
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy
| | - Elena Zoico
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy
| | - Andrea P Rossi
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy
| | - Gloria Mazzali
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy
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Ourak M, Smits J, Esteveny L, Borghesan G, Gijbels A, Schoevaerdts L, Douven Y, Scholtes J, Lankenau E, Eixmann T, Schulz-Hildebrandt H, Hüttmann G, Kozlovszky M, Kronreif G, Willekens K, Stalmans P, Faridpooya K, Cereda M, Giani A, Staurenghi G, Reynaerts D, Vander Poorten EB. Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation. Int J Comput Assist Radiol Surg 2018; 14:301-309. [PMID: 30056592 DOI: 10.1007/s11548-018-1829-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Retinal vein cannulation is an experimental procedure during which a clot-dissolving drug is injected into an obstructed retinal vein. However, due to the fragility and minute size of retinal veins, such procedure is considered too risky to perform manually. With the aid of surgical robots, key limiting factors such as: unwanted eye rotations, hand tremor and instrument immobilization can be tackled. However, local instrument anatomy distance and force estimation remain unresolved issues. A reliable, real-time local interaction estimation between instrument tip and the retina could be a solution. This paper reports on the development of a combined force and distance sensing cannulation needle, and its experimental validation during in vivo animal trials. METHODS Two prototypes are reported, relying on force and distance measurements based on FBG and OCT A-scan fibres, respectively. Both instruments provide an 80 [Formula: see text] needle tip and have outer shaft diameters of 0.6 and 2.3 mm, respectively. RESULTS Both prototypes were characterized and experimentally validated ex vivo. Then, paired with a previously developed surgical robot, in vivo experimental validation was performed. The first prototype successfully demonstrated the feasibility of using a combined force and distance sensing instrument in an in vivo setting. CONCLUSION The results demonstrate the feasibility of deploying a combined sensing instrument in an in vivo setting. The performed study provides a foundation for further work on real-time local modelling of the surgical scene. This paper provides initial insights; however, additional processing remains necessary.
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Affiliation(s)
- M Ourak
- University of Leuven, Leuven, Belgium.
| | - J Smits
- University of Leuven, Leuven, Belgium
| | | | | | - A Gijbels
- University of Leuven, Leuven, Belgium
| | | | - Y Douven
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - J Scholtes
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - E Lankenau
- OptoMedical Technologies GmbH, Lübeck, Germany
| | - T Eixmann
- Medical Laser Center Lübeck GmbH, Lübeck, Germany
| | | | - G Hüttmann
- Medical Laser Center Lübeck GmbH, Lübeck, Germany
| | - M Kozlovszky
- Austrian Center for Medical Innovation and Technology Gmbh, Neustadt, Austria
| | - G Kronreif
- Austrian Center for Medical Innovation and Technology Gmbh, Neustadt, Austria
| | - K Willekens
- University Hospitals Leuven, Leuven, Belgium
| | - P Stalmans
- University Hospitals Leuven, Leuven, Belgium
| | - K Faridpooya
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - M Cereda
- The Eye Clinic, University of Milan, Milan, Italy
| | - A Giani
- The Eye Clinic, University of Milan, Milan, Italy
| | - G Staurenghi
- The Eye Clinic, University of Milan, Milan, Italy
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Giani A, Rossi A. Letter by Giani and Rossi Regarding Article, “Factors Associated With Left Atrial Remodeling in the General Population”. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.117.006472. [DOI: 10.1161/circimaging.117.006472] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anna Giani
- Department of Medicine, University of Verona, Verona, Italy
| | - Andrea Rossi
- Department of Medicine, University of Verona, Verona, Italy
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Paulino MG, Tavares D, Bieczynski F, Pedrão PG, Souza NES, Sakuragui MM, Luquet CM, Terezan AP, Fernandes JB, Giani A, Fernandes MN. Crude extract of cyanobacteria (Radiocystis fernandoi, strain R28) induces liver impairments in fish. Aquat Toxicol 2017; 182:91-101. [PMID: 27886582 DOI: 10.1016/j.aquatox.2016.11.012] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/12/2016] [Accepted: 11/15/2016] [Indexed: 06/06/2023]
Abstract
Radiocystis fernandoi R28 strain is a cyanobacterium which produces mostly the RR and YR microcystin variants (MC-RR and MC-YR, respectively). The effects of crude extract of the R. fernandoi strain R28 were evaluated on the protein phosphatases and on the structure and ultrastructure of the liver of the Neotropical fish, Hoplias malabaricus, after acute and subchronic exposure. Concomitantly, the accumulation of the majority of MCs was determined in the liver and muscle. The fish were exposed to 120.60 MC-RR+MC-LR kg-fish-1 (=100μg MC-LReq kg-fish-1) for 12 and 96h (one single dose, acute exposure) and 30days (one similar dose every 72h, subchronic exposure). MCs did not accumulate in the muscle but, in the liver, MC-YR accumulated after acute exposure and MC-RR and MC-YR accumulation occurred after subchronic exposure. Protein phosphatase 2A (PP2A) activity was inhibited only after subchronic exposure. Acute exposure induced liver hyperemia, hemorrhage, changes in hepatocytes and cord-like disorganization. At the ultrastructural level, the decreasing of glycogen and lipid levels, the swelling of mitochondria and whirling of endoplasmic reticulum suggested hepatocyte necrosis. Subchronic exposure resulted in a complete disarrangement of cord-like hepatocytes, some recovery of mitochondria and whirling endoplasmic reticulum and extensive connective tissues containing fibrous materials in the liver parenchyma. Despite microcystin toxicity and liver alterations, no tumor was induced by MCs. In conclusion, the increased algal mass of R. fernandoi in tropical freshwater, producing mainly MC-RR and MC-YR variants, results in fish liver impairments.
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Affiliation(s)
- M G Paulino
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - D Tavares
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - F Bieczynski
- Center of Applied Ecology of Neuquen, INIBIOMA, UNCo-CONICET- Ruta Provincial 61, km 3, 8371, Junín de los Andes, Neuquén, Argentina
| | - P G Pedrão
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - N E S Souza
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - M M Sakuragui
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - C M Luquet
- Center of Applied Ecology of Neuquen, INIBIOMA, UNCo-CONICET- Ruta Provincial 61, km 3, 8371, Junín de los Andes, Neuquén, Argentina
| | - A P Terezan
- Department of Chemistry, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - J B Fernandes
- Department of Chemistry, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - A Giani
- Department of Botany, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - M N Fernandes
- Department of Physiological Sciences, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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21
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Banci Buonamici F, Guasti A, Belmonte G, Vanzi E, Mazzoni L, De Otto G, Bogi A, Biondi M, Giani A, La Rocca A, Guerrini L, Del Corona A, Manzi P. A software package for data registration and analysis in interventional radiology. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.400] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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22
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Murakami Y, Matsumoto H, Roh M, Giani A, Kataoka K, Morizane Y, Kayama M, Thanos A, Nakatake S, Notomi S, Hisatomi T, Ikeda Y, Ishibashi T, Connor KM, Miller JW, Vavvas DG. Programmed necrosis, not apoptosis, is a key mediator of cell loss and DAMP-mediated inflammation in dsRNA-induced retinal degeneration. Cell Death Differ 2013; 21:270-7. [PMID: 23954861 DOI: 10.1038/cdd.2013.109] [Citation(s) in RCA: 232] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/15/2013] [Accepted: 06/25/2013] [Indexed: 11/09/2022] Open
Abstract
There is no known treatment for the dry form of an age-related macular degeneration (AMD). Cell death and inflammation are important biological processes thought to have central role in AMD. Here we show that receptor-interacting protein (RIP) kinase mediates necrosis and enhances inflammation in a mouse model of retinal degeneration induced by dsRNA, a component of drusen in AMD. In contrast to photoreceptor-induced apoptosis, subretinal injection of the dsRNA analog poly(I : C) caused necrosis of the retinal pigment epithelium (RPE), as well as macrophage infiltration into the outer retinas. In Rip3(-/-) mice, both necrosis and inflammation were prevented, providing substantial protection against poly(I : C)-induced retinal degeneration. Moreover, after poly(I : C) injection, Rip3(-/-) mice displayed decreased levels of pro-inflammatory cytokines (such as TNF-α and IL-6) in the retina, and attenuated intravitreal release of high-mobility group box-1 (HMGB1), a major damage-associated molecular pattern (DAMP). In vitro, poly(I : C)-induced necrosis were inhibited in Rip3-deficient RPE cells, which in turn suppressed HMGB1 release and dampened TNF-α and IL-6 induction evoked by necrotic supernatants. On the other hand, Rip3 deficiency did not modulate directly TNF-α and IL-6 production after poly(I : C) stimulation in RPE cells or macrophages. Therefore, programmed necrosis is crucial in dsRNA-induced retinal degeneration and may promote inflammation by regulating the release of intracellular DAMPs, suggesting novel therapeutic targets for diseases such as AMD.
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Affiliation(s)
- Y Murakami
- 1] Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA [2] Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Matsumoto
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - M Roh
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - A Giani
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - K Kataoka
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Y Morizane
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - M Kayama
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - A Thanos
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - S Nakatake
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Notomi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Hisatomi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Ikeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K M Connor
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - J W Miller
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - D G Vavvas
- Department of Ophthalmology, Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Oldani M, Marchi S, Giani A, Cecchin S, Rigoni E, Persi A, Podavini D, Guerrini A, Nervegna A, Staurenghi G, Bertelli M. Clinical and molecular genetic study of 12 Italian families with autosomal recessive Stargardt disease. Genet Mol Res 2012; 11:4342-50. [DOI: 10.4238/2012.october.9.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Giani A, Sabella P, Eandi CM, Staurenghi G. Spectral-domain optical coherence tomography findings in a case of frosted retinal branch angiitis. Eye (Lond) 2009; 24:943-4. [PMID: 19730449 DOI: 10.1038/eye.2009.228] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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25
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Giani A, Grisan E, De Luca M, Ruggeri A. Detecting false vessel recognitions in retinal fundus analysis. Conf Proc IEEE Eng Med Biol Soc 2007; 2006:4449-52. [PMID: 17946631 DOI: 10.1109/iembs.2006.260608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Automatic tracking of blood vessels in images of retinal fundus is an important and non-invasive procedure for the diagnosis of many diseases. Tracking techniques often present a high rate of false positives. This paper presents six methods to discriminate false detections from true positives, each based on a different model of the vessel. They describe a candidate vessel in terms of its average geometric and grayscale properties considered along the full trajectory of the vessel itself. The rationale is that false vessels are caused by the small scale of the tracking algorithm necessary during the tracking phase. Once tracking has been completed, we can gather information from the full vessel trajectory and solve ambiguities that cannot be fixed during tracking. We apply Fisher linear discriminant analysis to these features to get the desired discrimination. Results on 28 images show satisfactory rejection of false positives and better results when using more complex models.
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Affiliation(s)
- A Giani
- Dept. of Information Eng., Padua Univ., Italy
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26
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Pinto-Coelho RM, Giani A, Morais CA, Carvalho ER, Bezerra-Neto JF. The nutritional status of zooplankton in a tropical reservoir: effects of food quality and community structure. BRAZ J BIOL 2005; 65:313-24. [PMID: 16097735 DOI: 10.1590/s1519-69842005000200016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The temporal variability of energetic reserves of zooplankton in the eutrophic Pampulha reservoir was investigated during two successive annual cycles. The effects of dominance of large filter-feeding cladocerans (Daphnia) and the occurrence of massive blooms of the cyanobacteria Microcystis on the energetic reserves of zooplankton were tested. This study showed that phytoplankton composition has a greater effect on energetic reserves of zooplankton. Some associations between lipid levels and the specific composition of zooplankton were also found. This study also demonstrated that the elementary composition of phosphorus in zooplankton can be used as an estimator of the nutritional status of zooplankton.
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Affiliation(s)
- R M Pinto-Coelho
- Laboratório de Gestão de Reservatórios Tropicais, Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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27
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Corsini E, Giani A, Peano S, Marinovich M, Galli CL. Resistance to silica-induced lung fibrosis in senescent rats: role of alveolar macrophages and tumor necrosis factor-alpha (TNF). Mech Ageing Dev 2004; 125:145-6. [PMID: 15037020 DOI: 10.1016/j.mad.2003.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 11/28/2022]
Abstract
The purpose of the present study was to investigate the effect of aging on silica-induced lung toxicity. In young animals silica induced a significant increase in bronchoalveolar lavage tumor necrosis factor-alpha (TNF), lactate dehydrogenase as well as in cell numbers, which correlate with increased collagen deposition and silicotic nodules formations. In old rats, however, no changes in bronchoalveolar lavage or lung parameters were observed following silica instillation. These in vivo results were also confirmed in vitro, where silica failed to induce TNF release in alveolar macrophages obtained from old animals. This defective response to silica could be explained with defective protein kinase C translocation, due to a reduction in its anchoring protein RACK-1 with aging. Overall, these data indicate that the understanding of the molecular mechanisms undelaying toxicity is crucial to define the influence of age on the toxic response and progression of the disease.
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Affiliation(s)
- E Corsini
- Laboratory of Toxicology, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, Milan 20133, Italy.
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28
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Grasselli G, Viganò L, Capri G, Locatelli A, Tarenzi E, Spreafico C, Bertuzzi A, Giani A, Materazzo C, Cresta S, Perotti A, Valagussa P, Gianni L. Clinical and pharmacologic study of the epirubicin and paclitaxel combination in women with metastatic breast cancer. J Clin Oncol 2001; 19:2222-31. [PMID: 11304775 DOI: 10.1200/jco.2001.19.8.2222] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A pharmacokinetic interaction may cause increased cardiotoxicity of paclitaxel (PTX) and high cumulative dose of doxorubicin. We tested antitumor activity, tolerability, and pharmacokinetics of the lesser cardiotoxic epirubicin (EPI) and PTX (ET combination). PATIENTS AND METHODS Twenty-seven women with untreated metastatic breast cancer, median age of 56 years, and prominent visceral involvement (74%) were studied. Three-weekly EPI (90 mg/m(2)) and PTX (200 mg/m(2) over 3 hours) were given for a maximum nine cycles. EPI was administered 24 hours before PTX (E --> T) in cycle 1, and 15 minutes before PTX (ET) thereafter. EPI, epirubicinol (EOL), EPI-glucuronide (EPI-glu), EOL-glucuronide (EOL-glu), PTX, and 6alpha-OH-PTX were measured in plasma and urine in 14 women. RESULTS Patients received 205 cycles of ET and a median EPI dose of 720 mg/m(2). Grade 4 neutropenia (49% of cycles) was the most frequent toxicity. Cardiac contractility was decreased in five patients. Mild congestive heart failure occurred in two (7.4%). Response rate was 76% (28% complete). Median overall survival was 29 months. On the basis of intrapatient comparison in the first 24 hours of E --> T and ET cycles, PTX did not affect EPI disposition, but significantly increased plasma exposure to EOL (by 137%), EPI-glu (threefold) and EOL-glu (twofold). Urinary excretion of EPI dose went from 8.2% in E --> T to 11.8% in ET cycles. Clearance of PTX was 30% slower in ET than E --> T. ET cycles caused lower neutrophil nadir than E --> T (644 +/- 327 v 195 +/- 91, P <.05) CONCLUSION ET is feasible, devoid of excessive cardiac toxicity, and active. A reciprocal pharmacokinetic interference between the two drugs has pharmacodynamic consequences, and suggests a direct effect of PTX on EPI metabolism requiring ad hoc investigation.
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Affiliation(s)
- G Grasselli
- Division of Medical Oncology A, Division of Radiodiagnostic, Service of Cardiology, and Operation Office, Istituto Nazionale dei Tumori, Milan, Italy
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Boëchat IG, Giani A. Factors affecting biochemical composition of seston in an eutrophic reservoir (Pampulha Reservoir, Belo Horizonte, MG). Rev Bras Biol 2000; 60:63-71. [PMID: 10838925 DOI: 10.1590/s0034-71082000000100009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sestonic biochemical composition (lipids, proteins and carbohydrates) may change with varying environmental fluctuations. These changes and the effects in the nutritional status of algae consists of an actual increasing source of interest. The aims of this work were to establish the relationship between biochemical composition of seston and 1) a range of physical, chemical and climatological factors, and 2) the natural fluctuation in the species composition in phytoplankton assemblages of the Pampulha Reservoir, an urban eutrophic lake located in Belo Horizonte, MG. Seasonal changes in the biochemical composition were observed in this study. None of the considered abiotic factors alone seem to affect the biochemical composition. So the effects could only be understood by interactions among different environmental factors. On the other hand, the dominant algal groups probably have some influence in the observed changes in biochemical composition of seston.
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Affiliation(s)
- I G Boëchat
- Departamento de Biologia Geral, UFMG, Belo Horizonte, Brazil.
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Gianni L, Viganò L, Locatelli A, Capri G, Giani A, Tarenzi E, Bonadonna G. Human pharmacokinetic characterization and in vitro study of the interaction between doxorubicin and paclitaxel in patients with breast cancer. J Clin Oncol 1997; 15:1906-15. [PMID: 9164201 DOI: 10.1200/jco.1997.15.5.1906] [Citation(s) in RCA: 190] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE We performed a pharmacologic investigation of paclitaxel (PTX) infused over 3 hours and bolus doxorubicin (DOX) to assess the role of sequence, interval between drugs, and duration of doxorubicin infusion on paclitaxel and anthracycline plasma disposition. We also explored possible mechanisms of pharmacokinetic interference involving the physiologic role of the multidrug resistance phenotype in anthracycline and taxane biliary excretion. PATIENTS AND METHODS Pharmacokinetics was performed in 80 cycles and 36 women with previously untreated metastatic breast cancer. PTX, DOX, and their metabolites 6 alpha-hydroxyl-PTX (6 alpha OH-PTX) and doxorubicinol (DOL) were measured by high-pressure liquid chromatography (HPLC). Human breast cancer MCF-7 wild-type (WT) and resistant (TH) cell lines were cultured in whole human plasma to study anthracycline retention after treatment with different combinations of PTX, Cremophor EL (CEL) (PEG35 castor oil; BASF, Parsippany, NJ), and DOX. RESULTS Pharmacokinetic interference between PTX and DOX was responsible for nonlinearity of DOX plasma disposition and increased concentrations of DOX and DOL. These effects were PTX dose-dependent, DOX concentration-dependent, and likely a result of interference at the level of liver elimination. In view of the physiologic role of P-glycoproteins (P-gp) in xenobiotic biliary excretion, retention of DOX was assessed in MCF-7 WT and MCF-7 TH cells. Intracellular was significantly higher in MCF-7 WT than MCF-7 TH (P < .05). However, concomitant exposure to DOX, PTX, and CEL caused similar DOX retention in both MCF-7 WT and TH cells. CONCLUSION PTX, as clinically formulated in CEL, is responsible for a nonlinear disposition of DOX and DOL. Nonlinearity is PTX- and DOX-dependent, and possibly caused by competition for biliary excretion of taxanes and anthracyclines mediated by P-gp. Nonlinearity indicates that even minor modifications of dose and infusion duration of DOX and PTX may lead to unpredictable pharmacodynamic consequences. The postulated role of P-gp suggests that CEL is clinically active, and advises caution in designing combinations of PTX with other drugs that are substrate for P-gp.
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Affiliation(s)
- L Gianni
- Division of Medical Oncology, Istituto Nazionale Tumori, Milan, Italy.
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Gianni L, Kearns CM, Giani A, Capri G, Viganó L, Lacatelli A, Bonadonna G, Egorin MJ. Nonlinear pharmacokinetics and metabolism of paclitaxel and its pharmacokinetic/pharmacodynamic relationships in humans. J Clin Oncol 1995; 13:180-90. [PMID: 7799018 DOI: 10.1200/jco.1995.13.1.180] [Citation(s) in RCA: 372] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize and model the disposition of paclitaxel in humans and define a pharmacodynamic relationships between paclitaxel disposition and its toxicity and efficacy. PATIENTS AND METHODS Paclitaxel pharmacokinetics were studied in 55 courses of therapy in 30 patients. Paclitaxel was administered at 135 mg/m2 or 175 mg/m2 by either a 3- or a 24-hour infusion schedule to patients with advanced ovarian cancer (n = 15), or at 225 mg/m2 by 3-hour infusion to patients with advanced breast cancer (n = 15). Paclitaxel and 6 alpha-hydroxylpaclitaxel were quantified by high-performance liquid chromatography (HPLC). Pharmacokinetics were assessed by noncompartmental and model-dependent methods. Pharmacodynamic correlations were evaluated statistically and by regression models. RESULTS Paclitaxel disposition is nonlinear in humans and, on the 3-hour schedule, 6 alpha-hydroxylpaclitaxel was identified in the plasma of all patients treated. The plasma disposition of paclitaxel and 6 alpha-hydroxylpaclitaxel was well described by a model that featured multiple nonlinear processes. Neutropenia was not related to the areas under the curves (AUCs) of paclitaxel or 6 alpha-hydroxylpaclitaxel, or to palitaxel peak concentrations (Cmax). Neutropenia was related to the duration that plasma concentrations were > or = 0.05 mumol/L, a relationship that is well described by a sigmoid maximum response (Emax) model. CONCLUSION The disposition of paclitaxel in humans is nonlinear. Paclitaxel metabolism to 6 alpha-hydroxylpaclitaxel is likely an important detoxification pathway. Myelosuppression is related to the duration that plasma paclitaxel concentrations are > or = 0.05 mumol/L. Trials of new doses and schedules of paclitaxel should take into account its nonlinear disposition to rule out adverse clinical consequences, especially if the drug is administered by short infusion. Our pharmacokinetic model should prove to be a powerful tool in predicting paclitaxel disposition, regardless of dose and schedule, and should facilitate further pharmacodynamic investigations.
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Affiliation(s)
- L Gianni
- Division of Medical Oncology, Instituto Nazinale per lo Studio e la Cura dei Tumori, Milano, Italy
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Salesse A, Giani A, Grosse P, Bougnot G. Etude par spectrométrie de masse de la phase vapeur au cours de la croissance de GaSb par la méthode aux organo-métalliques à partir du triméthylgallium (TMG) et du triméthylantimoine (TMSB) dans l'hydrogène et dans l'hélium. ACTA ACUST UNITED AC 1991. [DOI: 10.1051/jp3:1991187] [Citation(s) in RCA: 3] [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: 11/15/2022]
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Giani A, De Gori V, Masello L. [Study and production of an experimental data base for use in research in preventive medicine]. Quad Sclavo Diagn 1981; 17:10-21. [PMID: 7313064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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