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Petramala L, Gigante A, Sarlo F, Servello A, Circosta F, Marino L, Ciccarelli A, Cavallaro G, Letizia C. Relevance of obesity-related organ damage and metabolic syndrome classification in cardiovascular and renal risk stratification in patients with essential hypertension. Front Cardiovasc Med 2024; 11:1369090. [PMID: 38606379 PMCID: PMC11008466 DOI: 10.3389/fcvm.2024.1369090] [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: 01/11/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Hypertension is a relevant cardiovascular comorbidity. Adipose tissue represents a metabolically active tissue involved in the regulation of blood pressure and metabolic alterations. In recent decades, several classifications for the metabolic syndrome (MS) have been proposed. Recently, a new syndrome called the "Cardiovascular-kidney-metabolic" (CKM) syndrome was identified, to determine patients at high cardiovascular and metabolic risk. The aim of the study was to compare different classifications in a large population of hypertensive patients. Materials and methods Between September 2022 and August 2023, we consecutively enrolled 772 hypertensive patients (407 men; 365 women; mean age 52.2 ± 15.1 years), evaluating anthropometric, biochemical, and instrumental parameters (transthoracic echocardiogram, carotid echo-Doppler, 24-h ambulatory blood pressure monitoring, fundus oculi). Results Using different classifications we found MS prevalence: Adult Treatment Panel III (ATP-III) 28.8%, International Diabetes Federation (IDF) 31.5%, CKM 40.7%. CKM Classes 3 and 4 showed higher body mass index and waist circumference compared with other groups. Compared with ATP-III and IDF, CKM Class 4 showed higher 24-h systolic blood pressure, lower percentage of controlled hypertension, increased interventricular septum and posterior wall, reduced ejection fraction, and greater prevalence of hypertensive arterial retinal damage. Discussion Visceral obesity and MS are frequent conditions with healthy impact, becoming an important trigger for the development of cardiovascular and metabolic complications. The different MS classifications allow the early identification of patients at high risk of cardiometabolic complications. The new CKM syndrome proves useful to identify individuals at high risk for CKM morbidity and mortality.
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Affiliation(s)
- Luigi Petramala
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Francesca Sarlo
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy
| | - Adriana Servello
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico “Umberto I”, Rome, Italy
| | - Francesco Circosta
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Luca Marino
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico “Umberto I”, Rome, Italy
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
| | - Antonello Ciccarelli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Giuseppe Cavallaro
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Claudio Letizia
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Rome, Italy
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Amadei F, Fozzato S, Prevot LB, Ciccarelli A, Bruno M, Basile G. The posterior interosseus artery flap (piaf) in reconstructive surgery of the hand: strategies of use and medico-legal implications. Clin Ter 2023; 174:498-502. [PMID: 38048112 DOI: 10.7417/ct.2023.5016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background and aim The fascio-cutaneous posterior interosseus artery flap (PIAF) is used in hand reconstruction, especially to repair skin or tissue defects such as burn injuries, open fractures, gunshot wounds or traumatic amputations. The aim of this study is to examine the anatomical features of this flap, to describe the surgical harvesting technique and the difficulties associated with the dissection. Methods From January 2016 to January 2022, we performed PIAF in 10 patients (3 women and 7 men) with a mean age of 28 years (range 22-44). This flap is taken from the back of the forearm, between the extensor carpi ulnaris (ECU) muscle and the extensor digitorum common (EDC) muscle. Results We analyzed retrospectively our patients indicating the failures of this reconstructive surgery, the complications that have arisen and the results using DASH score with the related clinical and medico-legal implications. Conclusions Due to its location and structure, PIAF is one of the most versatile fascio-cutaneous flaps in upper limb reconstructive surgery and can be used to reconstruct parts of the hand, wrist, or elbow, allowing to restore limb function and improve the quality of life of patients even if there could be some medico-legal implications.
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Affiliation(s)
- F Amadei
- Hand and Peripheral Nerve Center, C.O.F. Lanzo Hospital, Italy
| | - S Fozzato
- Trauma Surgery IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - L B Prevot
- Trauma Surgery IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - A Ciccarelli
- Department of Movement, Human and Health Sciences University of Rome Foro Italico, Rome, Italy
| | - M Bruno
- Consultant Hand Surge-ry Villa Stuart Rome
| | - G Basile
- Trauma Surgery IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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Fozzato S, Napoletano G, Ciccarelli A. Could obesity be a risk factor for complications of osteoarthritis elective knee surgery? Acta Biomed 2023; 94:e2023247. [PMID: 37850762 PMCID: PMC10644940 DOI: 10.23750/abm.v94i5.14968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/05/2023] [Indexed: 10/19/2023]
Affiliation(s)
- Stefania Fozzato
- Trauma Surgery Department I.R.C.C.S. Orthopedic Institute Galeazzi, 20161 Milan, Italy.
| | - Gabriele Napoletano
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.
| | - Antonello Ciccarelli
- Department of Movement, Human and Health Sciences University of Rome Foro Italico - 00135 Rome, Italy.
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Pescatori L, Taurone S, Ciccarelli A, Palmieri M, Serraino A, Artico M, Fornai F, Longhitano Y, Zanza C, Tesauro M, Savioli G, Miglietta S, Ciappetta P. Petroclival Clinoidal Folds and Arachnoidal Membranes of the Anteromedial Incisural Space: Clinical Anatomy for Neuro Critical Care. Diagnostics (Basel) 2023; 13:3203. [PMID: 37892024 PMCID: PMC10605941 DOI: 10.3390/diagnostics13203203] [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: 09/11/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
A systematic and narrative literature review was performed, focusing attention on the anatomy of the area located at the junction of the sphenoid and the basal portion of the temporal bone (petrous bone, petrous apex, upper petro-clival region) encircled by the free edge of the tentorium, the insertion of the tentorium itself to the petrous apex and the anterior and posterior clinoid processes that give rise to three distinct dural folds or ligaments: the anterior petroclinoid ligament, the posterior petroclinoid ligament and the interclinoid ligament. These dural folds constitute the posterior portion of the roof of the cavernous sinus denominated "the oculomotor triangle". The main purpose of this review study was to describe this anatomical region, particularly in the light of the relationships between the anterior margin of the free edge of the tentorium and the above-mentioned components of the sphenoid and petrous bone.
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Affiliation(s)
- Lorenzo Pescatori
- Department of Neurosurgery, S. Eugenio Hospital of Rome, 00144 Rome, Italy
| | - Samanta Taurone
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Antonello Ciccarelli
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Mauro Palmieri
- Human Neurosciences Department, A.U.O. “Policlinico Umberto I” Neurosurgery Division, Sapienza University, 00185 Rome, Italy (A.S.)
| | - Alessandra Serraino
- Human Neurosciences Department, A.U.O. “Policlinico Umberto I” Neurosurgery Division, Sapienza University, 00185 Rome, Italy (A.S.)
| | - Marco Artico
- Department of Sensory Organs, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Francesco Fornai
- IRCCS Neuromed, 86077 Pozzilli, Italy;
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Emergency Medicine, Humanitas University Hospital, 20089 Rozzano, Italy
| | - Christian Zanza
- Italian Society of Prehospital Emergency Medicine (SIS 118), 74121 Taranto, Italy
- Post Graduate School of Geriatric Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Manfredi Tesauro
- Post Graduate School of Geriatric Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Gabriele Savioli
- Emergency Department, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy;
| | - Selenia Miglietta
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, “Sapienza” University of Rome, 00185 Rome, Italy;
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Racca F, Longhitano Y, Zanza C, Balzanelli MG, Draisci G, Stoia PA, Gollo E, Maio M, Grattarola C, Astuto M, Ciccarelli A, Racca G, Romenskaya T, Giordano B, Serraino A, Sansone VAM, Gregoretti C, Conti G, Piccolella F, Vaschetto R. Peri-partum respiratory management of pregnant women with neuro-muscular disorders: a prospective observational study (IT-NEUMA-Pregn study). BMC Anesthesiol 2023; 23:342. [PMID: 37833635 PMCID: PMC10571352 DOI: 10.1186/s12871-023-02307-6] [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: 06/08/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Pregnant women with neuromuscular diseases (NMDs) often display respiratory muscle impairment which increases the risk for pulmonary complications (PCs). The aim of this study was to identify pregnant NMDs patients with pulmonary risk factors and to apply in these women non-invasive ventilation (NIV) combined with mechanical insufflation-exsufflation (MI-E) in the peri-partum period. METHODS We conducted a multicenter observational study on women with NMDs undergoing cesarean section or spontaneous labor in a network of 7 national hospitals. In these subjects we applied a protocol for screening and preventing PCs, and we evaluated PCs rate, maternal and neonatal outcome. RESULTS Twenty-four patients out of the 94 enrolled pregnant women were at risk for PCs and were trained or retrained to use NIV and/or MI-E before delivery. After delivery, 17 patients required NIV with or without MI-E. Despite nine out of the 24 women at pulmonary risk developed postpartum PCs, none of them needed reintubation nor tracheostomy. In addition, the average birth weight and Apgar score were normal. Only one patient without pulmonary risk factors developed postpartum PCs. CONCLUSION This study showed the feasibility of applying a protocol for screening and treating pregnant NMDs women with pulmonary risk. Despite a PCs rate of 37% was observed in these patients, maternal and neonatal outcome were favorable.
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Affiliation(s)
- Fabrizio Racca
- Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy
- Division of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christian Zanza
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Post Graduate School of Geriatric Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | | | - Gaetano Draisci
- Institute of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Augusto Stoia
- Anesthesiology and Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda Ca'Granda, Milan, Italy
| | - Evelina Gollo
- Department of Anesthesiology and Intensive Care A.O.U. Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Mariella Maio
- Department of Anesthesiology and Intensive Care A.O.U. Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Claudia Grattarola
- Anesthesiology and Intensive Care Unit, Istituto Giannina Gaslini, Genova, Italy
| | - Marinella Astuto
- Dipartimento Chirurgia Generale e Specialità Medico Chirurgiche, A.O.Universitaria "Policlinico-Vittorio Emanuele", Università Degli Studi Di Catania, Catania, Italy
| | - Antonello Ciccarelli
- Department of Movement, Human, and Health Sciences - Division of Health Sciences, University of Rome "Foro Italico, Rome, Italy
| | - Giulia Racca
- Division of Anesthesia and Critical Care Medicine, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy
| | - Tatsiana Romenskaya
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Benedetta Giordano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Valeria Ada Maria Sansone
- The NEMO Clinical Center in Milan, Neurorehabilitation Unit, University of Milan- ERN for Neuromuscular Diseases, Milan, Italy
| | - Cesare Gregoretti
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
- Fondazione Istituto "G. Giglio" Cefalù, Palermo, Italy
| | - Giorgio Conti
- Institute of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabio Piccolella
- Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy
| | - Rosanna Vaschetto
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
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Basile G, Fozzato S, Bianco Prevot L, Accetta R, Ciccarelli A, Familiari F, Zaami S. Monteggia fracture associated with ipsilateral intercondylar distal humeral fracture with posterior interosseous nerve palsy: case report, medico-legal implications, and methodological assessment analysis. Eur Rev Med Pharmacol Sci 2023; 27:5614-5619. [PMID: 37401299 DOI: 10.26355/eurrev_202306_32800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND The Monteggia fracture, defined as a fracture of the proximal third of the ulnar shaft associated with an anterior or posterior dislocation of the proximal radial epiphysis, is a serious injury accounting for 0.7% of all elbow fractures and dislocations in adults. For adult patients, good results can only be obtained through early diagnosis and adequate surgical treatment. Monteggia fracture-dislocations associated with distal humeral fracture are extremely rare injuries in adults and there are few cases described in the literature. Medico-legal implications arising from such conditions have a host of complexities that cannot be discounted. CASE REPORT This case report revolves around a patient affected by a type I Monteggia fracture-dislocation, according to the Bado classification, associated with an ipsilateral intercondylar distal humeral fracture. To our knowledge, this combination of lesions has never been reported before in adult patients. A positive result was obtained due to early diagnosis, achievement of anatomical reduction, and optimal stabilization with internal fixation which made it possible to achieve early functional recovery. CONCLUSIONS Monteggia fracture-dislocations associated with ipsilateral intercondylar distal humeral fracture are extremely rare in adults. In the case herein reported, a favorable outcome was obtained due to early diagnosis, achievement of anatomical reduction and management with internal fixation with plate and screws, as well as early functional training. Misdiagnosis makes such lesions risky in terms of potentially delayed treatment, increasing the need for surgical interventions and the possibility of high-risk complications and disabling sequelae, with possible medico-legal implications. In the case of unrecognized injuries under urgent circumstances, the injuries may become chronic, making the treatment more complex. The ultimate outcomes of a misdiagnosed Monteggia lesion can lead to very serious functional and aesthetic damage.
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Affiliation(s)
- G Basile
- Department of Trauma Surgery, I.R.C.C.S. Orthopedic Institute Galeazzi, Milan, Italy.
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Fozzato S, Bianco Prevot L, Amadei F, Gallina M, Ciccarelli A, Accetta R, Basile G. Bilateral femur fracture as the first manifestation of multiple myeloma: a case report. Clin Ter 2023; 174:211-214. [PMID: 37199351 DOI: 10.7417/ct.2023.2521] [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] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Abstract The authors aimed to elaborate on an interesting clinical case of a subject that came to our attention following a low-energy traumatic event, producing a bilateral femur fracture. During the instrumental investigations, findings pointing to multiple myeloma were described, in fact later confirmed by the histological and biochemical investigations. In this specific case, unlike manifestations in most patients with MM, the classic correlated pathognomonic symptoms, such as lower back pain, weight loss, recurrent infections, asthenia, were not present. Furthermore, the inflammatory indices, the values of serum calcium, renal function and hemoglobin were completely normal, although numerous bone localizations of disease already coexisted, and these were all unknown to the patient.
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Affiliation(s)
- S Fozzato
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | | | - F Amadei
- Hand and Peripheral Nerve Center, COF Lanzo Hospital, Italy
| | - M Gallina
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - A Ciccarelli
- Department of Movement, Human and Health Sciences University of Rome Foro Italico, Rome, Italy
| | - R Accetta
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - G Basile
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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Liccardi G, Bilo MB, Milanese M, Martini M, Calzetta L, Califano F, Carucci L, Ciccarelli A, Cutajar M, D'Auria P, De Bartolomeis F, Dello Iacono I, Franzese A, Gargano D, Inciso G, Giordano AC, Iannaccone R, Lo Schiavo M, Nappi L, Madonna F, Montera C, Onorati G, Papa A, Pedicini A, Sabatino G, Sacerdoti C, Savoia A, Scopano E, Iannotta MP, Bartiromo M, Del Monaco G, Rogliani P. Face masks during COVID-19 pandemic lockdown and self-reported seasonal allergic rhinitis symptoms. Rhinology 2021; 59:481-484. [PMID: 34459840 DOI: 10.4193/rhin21.202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- G Liccardi
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine. University of Rome "Tor Vergata", Rome, Italy
| | - M B Bilo
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona - Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Italy
| | - M Milanese
- Division of Pulmonology, S.Corona Hospital, Pietra Ligure, Savona, Italy
| | - M Martini
- Global Clinical Development, Chiesi Farmaceutici, Parma, Italy
| | - L Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - F Califano
- Allergy and Clinical Immunology. 'G. Fucito' Hospital and University Hospital, Salerno, Italy
| | - L Carucci
- Department of Translational Medical Sciences and Interdepartmental Center for Research in Basic and Clinical Immunology, Sciences, University of Naples Federico II, Naples, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico 'Loreto Crispi' Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine. Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - P D'Auria
- Regional Environmental Protection Agency Campania Region (ARPAC), Naples, Italy
| | - F De Bartolomeis
- Allergy Unit, High Speciality 'San Giuseppe Moscati' Hospital, Avellino, Italy
| | - I Dello Iacono
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | - A Franzese
- Allergy and Clinical Immunology Unit, ASL Na 3 sud and ASL Na 2 nord, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality 'San Giuseppe Moscati' Hospital, Avellino, Italy
| | - G Inciso
- Allergy Unit, ASL Na 3 (Sanitary District 59), Meta di Sorrento (Naples), Italy
| | - A C Giordano
- Postgraduate School of Internal Medicine. University of Salerno, Salerno, Italy
| | - R Iannaccone
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology.'Fucito' Hospital and University Hospital, Salerno, Italy
| | - L Nappi
- L.N. Center, Scafati (Salerno), Italy
| | - F Madonna
- Allergy Unit. ASL (Sanitary District no. 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology. 'G. Fucito' Hospital and University Hospital, Salerno, Italy
| | - G Onorati
- Regional Environmental Protection Agency Campania Region (ARPAC), Naples, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | | | | | - A Savoia
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli'Hospital, Benevento, Italy
| | - E Scopano
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - M P Iannotta
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - M Bartiromo
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - G Del Monaco
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome, Tor Vergata, Rome, Italy
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Collart C, Ciccarelli A, Ivanovitch K, Rosewell I, Kumar S, Kelly G, Edwards A, Smith JC. The migratory pathways of the cells that form the endocardium, dorsal aortae, and head vasculature in the mouse embryo. BMC Dev Biol 2021; 21:8. [PMID: 33752600 PMCID: PMC7986287 DOI: 10.1186/s12861-021-00239-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
Background Vasculogenesis in amniotes is often viewed as two spatially and temporally distinct processes, occurring in the yolk sac and in the embryo. However, the spatial origins of the cells that form the primary intra-embryonic vasculature remain uncertain. In particular, do they obtain their haemato-endothelial cell fate in situ, or do they migrate from elsewhere? Recently developed imaging techniques, together with new Tal1 and existing Flk1 reporter mouse lines, have allowed us to investigate this question directly, by visualising cell trajectories live and in three dimensions. Results We describe the pathways that cells follow to form the primary embryonic circulatory system in the mouse embryo. In particular, we show that Tal1-positive cells migrate from within the yolk sac, at its distal border, to contribute to the endocardium, dorsal aortae and head vasculature. Other Tal1 positive cells, similarly activated within the yolk sac, contribute to the yolk sac vasculature. Using single-cell transcriptomics and our imaging, we identify VEGF and Apela as potential chemo-attractants that may regulate the migration into the embryo. The dorsal aortae and head vasculature are known sites of secondary haematopoiesis; given the common origins that we observe, we investigate whether this is also the case for the endocardium. We discover cells budding from the wall of the endocardium with high Tal1 expression and diminished Flk1 expression, indicative of an endothelial to haematopoietic transition. Conclusions In contrast to the view that the yolk sac and embryonic circulatory systems form by two separate processes, our results indicate that Tal1-positive cells from the yolk sac contribute to both vascular systems. It may be that initial Tal1 activation in these cells is through a common mechanism. Supplementary Information The online version contains supplementary material available at 10.1186/s12861-021-00239-3.
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Affiliation(s)
- C Collart
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
| | - A Ciccarelli
- Advanced Light Microscopy Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - K Ivanovitch
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - I Rosewell
- Genetic Modification Service, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - S Kumar
- Advanced Light Microscopy Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.,Photonics Group, 606 Blackett Laboratory, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - G Kelly
- Bioinformatics and Biostatistics Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - A Edwards
- Advanced Sequencing Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - J C Smith
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
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Liccardi G, Calzetta L, Berra A, Caiazzo R, Califano F, Ciccarelli A, Cutajar M, D'Amato M, De Bartolomeis F, Dello Iacono I, Gargano D, Lo Schiavo M, Madonna F, Maniscalco M, Milanese M, Montera C, Narducci R, Papa G, Pedicini A, Sabatino G, Sacerdoti C, Savoia A, Stanziola A, Bilò MB, Rogliani P. Unmet needs and relationship between general practitioners (GPs) and allergists living in Campania region (southern Italy). Eur Ann Allergy Clin Immunol 2020; 52:230-234. [PMID: 32374559 DOI: 10.23822/eurannaci.1764-1489.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology. Division of Pulmonology. Unit of Allergology, High Speciality A.Cardarelli Hospital, Naples, Italy.,Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine University of Rome, Tor Vergata, Rome, Italy
| | - A Berra
- Respiratory Allergy Unit. G. Da Procida Hospital, Salerno, Italy
| | - R Caiazzo
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - F Califano
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico Loreto Crispi Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine. Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Disease, Federico II University AO Dei Colli, Naples, Italy
| | - F De Bartolomeis
- Allergy Unit. High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - I Dello Iacono
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - D Gargano
- Allergy Unit. High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit. ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit ICS Maugeri Telese Terme, Benevento, Italy
| | - M Milanese
- Division of Pulmonology, S.Corona Hospital, Pietra Ligure, Savona, Italy
| | - C Montera
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - R Narducci
- Unit of Allergology, San Michele Clinic, Maddaloni, Caserta, Italy
| | - G Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | | | | | - A Savoia
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - A Stanziola
- Department of Respiratory Disease, Federico II University AO Dei Colli, Naples, Italy
| | - M B Bilò
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine University of Rome, Tor Vergata, Rome, Italy
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11
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Asero R, Abbadessa S, Aruanno A, Barilaro G, Barzaghi C, Bignardi D, Bilò MB, Borro M, Bresciani M, Busa M, Buzzulini F, Cavaliere C, Cecchi L, Ciccarelli A, Cortellini G, Cucinelli F, Deleonardi G, Emiliani F, Farsi A, Ferrarini E, Franchini M, Ingrassia A, Lippolis D, Losappio L, Marra AM, Martini M, Masieri S, Mauro M, Mazzolini M, Muratore L, Murzilli F, Nucera E, Pastorello EA, Pinter E, Polillo BR, Pravettoni V, Quercia O, Rizzi A, Russello M, Sacerdoti C, Scala E, Scala G, Scarpa A, Schroeder J, Uasuf CG, Villalta D, Yang B, Mistrello G, Amato S, Lidholm J. Detection of Gibberellin-Regulated Protein (Peamaclein) Sensitization among Italian Cypress Pollen-Sensitized Patients. J Investig Allergol Clin Immunol 2020; 32:40-47. [DOI: 10.18176/jiaci.0542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Fiorilli G, Mariano I, Iuliano E, Giombini A, Ciccarelli A, Buonsenso A, Calcagno G, di Cagno A. Isoinertial Eccentric-Overload Training in Young Soccer Players: Effects on Strength, Sprint, Change of Direction, Agility and Soccer Shooting Precision. J Sports Sci Med 2020; 19:213-223. [PMID: 32132845 PMCID: PMC7039027] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 12/21/2019] [Indexed: 06/10/2023]
Abstract
The isoinertial training method owes its efficacy to an accommodated resistance and optimal individualized eccentric overload. The aim of this study was to assess the effects of a 6-week isoinertial eccentric-overload training program - using a flywheel inertial device during the execution of specific soccer exercises - on explosive and reactive strength, sprint ability, change of direction (COD) performance and soccer shooting precision. Thirty-four junior soccer players were randomly assigned to a plyometric training group (PT) (n = 16, aged 13.36 ± 0.80), which underwent a six-week traditional soccer training program, and a flywheel eccentric overload group (FEO) (n = 18, aged 13.21 ± 1.21), which received additional training consisting of two inertial eccentric-overload training sessions per week. Pre and post intervention tests were carried out to assess explosive and reactive strength, sprint ability, COD ability, agility using the Y-agility test (YT) and soccer shooting precision. The FEO showed significantly higher values than the PT in squat jump height (SJh) (p = 0.01), drop jump height (DJh) (p = 0.003), 7 repeated hop test heights (p = 0.001), the Illinois test (ILL) (p = 0.001), and the Loughborough Soccer Shooting Test (SHOT) (p = 0.02). Finally, the FEO showed significant between-group differences in DJh (p = 0.007), ILL (p = 0.0002), YT (p = 0.002), a linear sprint test (SPRINT) (p = 0.001), and SHOT (p = 0.003). These results confirmed the positive effect of isoinertial training. The use of an isoinertial device to overload multidirectional movements in specific sport conditions leads to greater performance improvements than conventional soccer training. The absence of knowledge of the eccentric overload applied by the isoinertial device, which is different in any exercise repetition, may stimulate the athlete's neural adaptations, improving their soccer skills and in particular their soccer shooting precision.
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Affiliation(s)
- Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Intrieri Mariano
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Enzo Iuliano
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, Italian University of Sport and Movement of Rome "Foro Italico", Rome, Italy
| | - Antonello Ciccarelli
- Department of Movement, Human and Health Sciences, Italian University of Sport and Movement of Rome "Foro Italico", Rome, Italy
| | - Andrea Buonsenso
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Alessandra di Cagno
- Department of Movement, Human and Health Sciences, Italian University of Sport and Movement of Rome "Foro Italico", Rome, Italy
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13
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Mannacio E, Ripani M, Ciccarelli A, Poggini L, Tessitore A. QUALITATIVE ASSESSMENT OF A SEQUENCE OF “ALLEGRO” IN CLASSICAL BALLET DANCERS WITH DIFFERENT TECHNICAL LEVEL. KINSI 2019. [DOI: 10.52165/kinsi.25.2.52-60] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Since training of professional classical ballet dancers is primarily focused on the aesthetic component of performance there is a necessity to assess its qualitative aspects. This study aimed to investigate whether the Performance Competence Evaluation Measure (PCEM) adapted version for classical ballet can be a valid and useful tool: 1) to assess the performance of an “Allegro” sequence; 2) to discriminate between different levels of dancers’ experience. Twenty-four female classical ballet dancers divided in two subgroups [Ballet students (n = 12) and Pre-professional dancers (n = 12)] were recruited to perform a 70 seconds sequence of “Allegro” specifically choreographed. Each performance was assessed by three very experienced judges, which scores were based on a Likert scale (ranging from 1 to 5) to evaluate the following four parameters: 1) Full Body Involvement (FBI); 2) Body Integration and Connectedness (BIC); 3) Articulation of Body Segments (ABS); 4) Movement Skills (MS). The inter-rater reliability values were ranging from good (between 0.6 and 0.8) and very good (over 0.8) for all parameters, while the test-retest reliability showed a very good agreement for all parameters. The Allegro is a dance sequence with greater dynamism that better highlights differences of execution between dancers with different technical levels and the Mann-Whitney test showed significant differences for all parameters (P=0.001) with lower values for the ballet students. In conclusion, the PCEM adapted version for classical ballet showed to be a valid tool: 1) to assess the performance of Allegro; 2) to discriminate between different dancers’ level of experience.
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Affiliation(s)
- Elena Mannacio
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Maurizio Ripani
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Antonello Ciccarelli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | | | - Antonio Tessitore
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
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14
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Valeriani F, Margarucci LM, Gianfranceschi G, Ciccarelli A, Tajani F, Mucci N, Ripani M, Romano Spica V. Artificial-turf surfaces for sport and recreational activities: microbiota analysis and 16S sequencing signature of synthetic vs natural soccer fields. Heliyon 2019; 5:e02334. [PMID: 31517095 PMCID: PMC6728760 DOI: 10.1016/j.heliyon.2019.e02334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/04/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
Synthetic fibres are used in place of the natural grass worldwide, for realizing playgrounds, soccer fields and even domestic gardens or recreational structures. An intensive use of artificial turf is currently observed in sports facilities, due to lower costs, higher sustainability in recycling of materials, and advantages related to athletic practice and performance. However, even if chemical and physical risks were studied, the microbiological component was not fully addressed, especially considering a comprehensive evaluation of the microbiota in synthetic vs natural playground surfaces. Here, we investigated the microbial community present on soccer fields, using Next Generation Sequencing and a 16S amplicon sequencing approach. Artificial and natural turfs show own ecosystems with different microbial profiles and a mean Shannon's diversity value of 2.176 and 2.475, respectively. The bacterial community is significantly different between facilities (ANOSIM: R = 0.179; p < 0.001) and surface materials (ANOSIM: R = 0.172; p < 0.005). The relative abundance of potentially pathogenic bacterial OTUs was higher in synthetic than in natural samples (ANOVA, F = 2.2). Soccer fields are characterized by their own microbiota, showing a different 16S amplicon sequencing signature between natural and artificial turfs.
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Affiliation(s)
- Federica Valeriani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Lory Marika Margarucci
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Gianluca Gianfranceschi
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Antonello Ciccarelli
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Filippo Tajani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Nicolina Mucci
- INAIL, Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements, Rome, Italy
| | - Maurizio Ripani
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
| | - Vincenzo Romano Spica
- University of Rome "Foro Italico", Department of Movement, Human and Health Sciences, Public Health Unit, Rome, Italy
- Corresponding author.
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15
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Mannacio E, Ripani M, Ciccarelli A, Poggini L, Condello G, Tessitore A. ANALYSIS OF CHANGEMENT DE PIED, ECHAPPÉ AND SISSONNE FERMÉ JUMPS IN FEMALE BALLET DANCERS. KINSI 2019. [DOI: 10.52165/kinsi.25.1.45-52] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In classical ballet, jumping should stand more on technique and elegance rather than maximal height. This study aimed to investigate dancers’ ability to perform stable jumps with classical ballet technique. Twenty-two female dancers [divided in two groups: Expert: n=12; Novice, n=10] were recruited to perform three vertical jump protocols: 1) Changement de Pied (CHA), composed by 5 consecutive jumps; 2) Echappé (ECH), composed by two consecutive ‘Echappé’ jumps; and 3) Sissonne Fermé (SF) jumps. Through an Optojump Next system were measured: a) Height (H) of jumps; b) Jumping Point Gap (JPG) and c) Used Area (UA). The CHA analysis showed differences between consecutive jumps for JPG (p=0.003). An approach to significance (p=0.52) and a difference (p=0.42) between groups were found for H and JPG respectively, while no differences were found for UA. The ECH analysis revealed main differences between jumps for H (p< 0.001), JPG (p=0.003) and UA (p< 0.001), post-hoc analysis showed differences (p<0.05) between each jump from the fifth position to the second one and vice versa for H and UA whilst differences between groups emerged only for UA (p=0.001). The SF analysis showed no differences for all parameters. The results showed as in CHA dancers carried out a control on the jump height to maintain their “aplomb” and limit the mediolateral displacement, which was also influenced by the dancers’ experience (NOV group showed higher H and JPG values). The dancers’ skill was also demonstrated by their ability to perform similar jumps in each of the two echappé cycles. Key words: classical ballet, dance, ability, jumps
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Affiliation(s)
- E Mannacio
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - M Ripani
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - A Ciccarelli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | | | - G Condello
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy; Graduate Institute of Sports Training, University of Taipei, Taipei, Taiwan
| | - A Tessitore
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
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16
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Giannini S, Giombini A, Fossati C, Ciccarelli A, Pigozzi F. Mediastinal incidentaloma in a professional football player diagnosed with whole body MRI imaging. MED SPORT 2019. [DOI: 10.23736/s0025-7826.19.03478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Liccardi G, Calzetta L, Apicella G, Baldi G, Berra A, Califano F, Ciccarelli A, Cutajar M, D'Amato M, De Crescenzo G, Di Maro E, Gargano D, Giannattasio D, Inciso G, Lo Schiavo M, Madonna F, Maniscalco M, Montera C, Papa G, Pedicini A, Pio R, Salzillo A, Stanziola A, Rogliani P, Musarra A. Allergy in adolescent population (14-18 years) living in Campania region (Southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2018; 51. [PMID: 30066997 DOI: 10.23822/eurannaci.1764-1489.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Adolescents (Ad) constitute a difficult to manage population among individuals suffering from asthma. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic Ad living in the Campania region (Southern Italy). Sixteen Allergy units or Centers belonging to the Italian Association of Hospital and Territorial Allergologists (AAIITO, Campania region) participated in this cross-sectional study. A case report form (CRF) was specifically designed for this study and commercial allergen extracts used for screening SPTs were provided by ALK-Abelló Group (Milan, Italy). A total of 443 patients were examined (females, f 220, 49.6 %; males, m 223, 50.3%). Dust mites represent the most common sensitizing agents in allergic Ad living in Campania region (Dermatoph. pteronyssinus 67.4% and Dermatoph. farinae 66.5%), followed by Parietaria (58.9%), grasses (45.8%), Artemisia vulgaris (16.7%), Olea Europaea (32.2%), dog dander (17.1%), cat dander (20.0%), Alternaria alternata (8.1%), Cupressus sempervirens (4.9%), Betula pendula (4.7%), other allergens (19.4%). An interesting comparison has been made between clinical data of our Ad with data of elderly patients (E). The role of allergic sensitization is significantly higher in Ad compared to E. Dermatophagoides pteronyssinus is the first sensitizing allergen in Ad and the last in E. Parietaria constitutes the first sensitizing pollen both in Ad and E, the percentage of sensitization is higher in Ad. Another important difference is the higher prevalence of As, as only symptom, in E compared to Ad (19.7% versus 7.6%). In conclusion, our findings confirm the high prevalence and clinical significance of airway allergic sensitization in the adolescents living in Campania region.
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Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy.,Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Apicella
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit. G. Da Procida Hospital, Salerno, Italy
| | - F Califano
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico Loreto Crispi Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento (NA), Italy
| | - M D'Amato
- Department of Respiratory Disease, Federico II University, AO Dei Colli, Naples, Italy
| | - G De Crescenzo
- Allergy and Clinical Immunology Unit, High Speciality Sant'Anna and San Sebastiano Hospital, Caserta, Italy
| | - E Di Maro
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center Mauro Scarlato Hospital, Scafati (SA), Italy
| | - G Inciso
- Allergy Unit, ASL Na 3 (Sanitary District 59), Meta di Sorrento (NA), Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District 12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit ICS Maugeri, Telese Terme, Benevento, Italy
| | - C Montera
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - G Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Allergology Unit, Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Salzillo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Disease, Federico II University, AO Dei Colli, Naples, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - A Musarra
- Allergy Unit, National Healthcare System, Reggio Calabria, Italy
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18
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Liccardi G, Calzetta L, Baldi G, Berra A, Billeri L, Caminati M, Capano P, Carpentieri E, Ciccarelli A, Crivellaro MA, Cutajar M, D'Amato M, Folletti I, Gani F, Gargano D, Giannattasio D, Giovannini M, Lombardi C, Schiavo ML, Madonna F, Maniscalco M, Meriggi A, Micucci C, Milanese M, Montera C, Paolocci G, Parente R, Pedicini A, Pio R, Puggioni F, Russo M, Salzillo A, Scavalli P, Scichilone N, Sposato B, Stanziola A, Steinhilber G, Vatrella A, Rogliani P, Passalacqua G. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study. Clin Mol Allergy 2018. [PMID: 29434523 DOI: 10.1186/s12948-018-0081-z.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The query "are there animals at home?" is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150-20.75%) or indirect contact (103-14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions Only 213 patients (29.46%) would be classified as "exposed to animals" and 510 (70.54%) as "not exposed" according to usual query. Our classification has shown that many "not-exposed" subjects (399-55.19%) were "really exposed". The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.
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Affiliation(s)
- G Liccardi
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.,2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - L Calzetta
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - L Billeri
- 6Department of Laboratory Medicine, University Hospital Padova, Padua, Italy
| | - M Caminati
- 7Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - P Capano
- Unit of Pulmonary Immunology and Respiratory Diseases Ospedale "Santa Maria Della Speranza", Battipaglia, Salerno Italy
| | - E Carpentieri
- Division of Pneumology, "Santa Maria Novella" Hospital, Galatina, Lecce Italy
| | - A Ciccarelli
- Allergy Unit, Loreto Crispi Hospital, Naples, Italy
| | - M A Crivellaro
- 11Unit of Allergy and Occupational Medicine, University Hospital Padova, Padua, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - I Folletti
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - F Gani
- Allergy Unit, S. Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - D Gargano
- 16Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - M Giovannini
- Pulmonary Diseases Department, Mirandola Hospital, Modena, Italy
| | - C Lombardi
- 19Departmental Unit of Allergy, Clinical Immunology and Respiratory Diseases, Fondazione Poliambulanza, Brescia, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri, Telese Terme, Benevento Italy
| | - A Meriggi
- 23Allergy and Immunology Unit, Fondazione "Salvatore Maugeri", Institut of Research and Care, Scientific Institute of Pavia, Pavia, Italy
| | - C Micucci
- Division of Pneumology and Allergology Hospital "Carlo Urbani", Jesi, Ancona Italy
| | - M Milanese
- 25Division of Pneumology, S. Corona Hospital, Pietra Ligure, Savona Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - G Paolocci
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - R Parente
- 26Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Pedicini
- 27Division of Internal Medicine and Allergy, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Puggioni
- Respiratory Diseases Department-IRCCS Humanitas Research and Clinical Center, Rozzano, Milan, Italy
| | - M Russo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - P Scavalli
- Unit of Respiratory Physiopathology, Allergy and Occupational Medicine, ASL Viterbo, Viterbo, Italy
| | - N Scichilone
- 30Biomedical Department of Specialistic and Internal Medicine, University of Palermo, Palermo, Italy
| | - B Sposato
- Pneumology Unit, Azienda Ospedaliera "Misericordia", Grosseto, Italy
| | - A Stanziola
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G Steinhilber
- 32Division of Pneumology, Spedali Civili Brescia, Brescia, Italy
| | - A Vatrella
- 33Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - P Rogliani
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Passalacqua
- 34Allergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Genoa, Italy
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19
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Liccardi G, Calzetta L, Baldi G, Berra A, Billeri L, Caminati M, Capano P, Carpentieri E, Ciccarelli A, Crivellaro MA, Cutajar M, D'Amato M, Folletti I, Gani F, Gargano D, Giannattasio D, Giovannini M, Lombardi C, Schiavo ML, Madonna F, Maniscalco M, Meriggi A, Micucci C, Milanese M, Montera C, Paolocci G, Parente R, Pedicini A, Pio R, Puggioni F, Russo M, Salzillo A, Scavalli P, Scichilone N, Sposato B, Stanziola A, Steinhilber G, Vatrella A, Rogliani P, Passalacqua G. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study. Clin Mol Allergy 2018; 16:3. [PMID: 29434523 PMCID: PMC5796344 DOI: 10.1186/s12948-018-0081-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/22/2018] [Indexed: 12/28/2022] Open
Abstract
Background The query “are there animals at home?” is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150–20.75%) or indirect contact (103–14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions Only 213 patients (29.46%) would be classified as “exposed to animals” and 510 (70.54%) as “not exposed” according to usual query. Our classification has shown that many “not-exposed” subjects (399–55.19%) were “really exposed”. The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.
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Affiliation(s)
- G Liccardi
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.,2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - L Calzetta
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - L Billeri
- 6Department of Laboratory Medicine, University Hospital Padova, Padua, Italy
| | - M Caminati
- 7Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - P Capano
- Unit of Pulmonary Immunology and Respiratory Diseases Ospedale "Santa Maria Della Speranza", Battipaglia, Salerno Italy
| | - E Carpentieri
- Division of Pneumology, "Santa Maria Novella" Hospital, Galatina, Lecce Italy
| | - A Ciccarelli
- Allergy Unit, Loreto Crispi Hospital, Naples, Italy
| | - M A Crivellaro
- 11Unit of Allergy and Occupational Medicine, University Hospital Padova, Padua, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - I Folletti
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - F Gani
- Allergy Unit, S. Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - D Gargano
- 16Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - M Giovannini
- Pulmonary Diseases Department, Mirandola Hospital, Modena, Italy
| | - C Lombardi
- 19Departmental Unit of Allergy, Clinical Immunology and Respiratory Diseases, Fondazione Poliambulanza, Brescia, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri, Telese Terme, Benevento Italy
| | - A Meriggi
- 23Allergy and Immunology Unit, Fondazione "Salvatore Maugeri", Institut of Research and Care, Scientific Institute of Pavia, Pavia, Italy
| | - C Micucci
- Division of Pneumology and Allergology Hospital "Carlo Urbani", Jesi, Ancona Italy
| | - M Milanese
- 25Division of Pneumology, S. Corona Hospital, Pietra Ligure, Savona Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - G Paolocci
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - R Parente
- 26Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Pedicini
- 27Division of Internal Medicine and Allergy, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Puggioni
- Respiratory Diseases Department-IRCCS Humanitas Research and Clinical Center, Rozzano, Milan, Italy
| | - M Russo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - P Scavalli
- Unit of Respiratory Physiopathology, Allergy and Occupational Medicine, ASL Viterbo, Viterbo, Italy
| | - N Scichilone
- 30Biomedical Department of Specialistic and Internal Medicine, University of Palermo, Palermo, Italy
| | - B Sposato
- Pneumology Unit, Azienda Ospedaliera "Misericordia", Grosseto, Italy
| | - A Stanziola
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G Steinhilber
- 32Division of Pneumology, Spedali Civili Brescia, Brescia, Italy
| | - A Vatrella
- 33Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - P Rogliani
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Passalacqua
- 34Allergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Genoa, Italy
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20
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Oro Nobili C, Mannacio E, Ciccarelli A, Tajani F, Ripani M. Analysis of modifications of the plantar parameters after the use of a proprioceptive insole: regular gait. J Sports Med Phys Fitness 2017; 59:65-70. [PMID: 29083125 DOI: 10.23736/s0022-4707.17.07524-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The human foot is the basis of support and propulsion for gait and it provides support and flexibility for effective weight transfer. Therefore a correct distribution of loads and pressures on the surface of the foot is of fundamental importance to ensure a correct walking and maintaining balance in both static and dynamic conditions. The aim of our study was to evaluate the effects of innovative insoles, named regular gait (RG), on plantar pressures distribution during standing position and walking in healthy subjects; therefore, we investigated whether these effects are maintained after insole removing. METHODS Fifty subjects were tested; these were free of foot diseases or damage to the anatomical structures involved in the processes above posture. These subjects underwent rating scales and static and dynamic baropodometric examination before and after using RG. RESULTS The results obtained shown that the RG, for as we have designed, are able to change the distribution of the parameters both in static and dynamic conditions. We have also shown that the best results were obtained only after a month of treatment with RG and that the results obtained persist even in the tests post-treatment without insoles. CONCLUSIONS In conclusion, the data obtained in this study suggest that RG could be efficient in acting on parameters related to maintenance of upright posture and gait. This would allow the treated subjects to improve their posture both while walking and during the maintenance of the upright position.
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Affiliation(s)
- Carlotta Oro Nobili
- Department of Human Movement, Social and Health Sciences, "Foro Italico" University of Rome, Rome, Italy -
| | - Elena Mannacio
- Department of Human Movement, Social and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
| | - Antonello Ciccarelli
- Department of Human Movement, Social and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
| | - Filippo Tajani
- Department of Human Movement, Social and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
| | - Maurizio Ripani
- Department of Human Movement, Social and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
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21
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Ciccarelli A, Calabrò C, Imperatore C, Scala G. Hymenoptera Venom Allergy. A closer collaboration is needed between allergists and emergency physicians. Eur Ann Allergy Clin Immunol 2017; 49:15-17. [PMID: 28120601] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background. Hymenoptera stings are sometimes fatal in venom-allergic patients. Fatalities mostly occur in previously stung subjects, especially those with a history of systemic reactions, and could be avoided if patients were properly informed of the existence of a prevention strategy for insect stings, referred to an allergy follow-up and prescribed auto-injectable epinephrine and/or venom-specific immunotherapy (VIT). We sought to assess knowledge and awareness of Hymenoptera Venom Allergy (HVA) in a small sample of Emergency Physicians in our geographic area. Methods. An eight-point questionnaire on HVA was administered to Emergency Department physicians working in the six largest ED in Naples. Results. Twenty-seven physicians completed the questionnaire. Twenty/27 (74%) were unaware of the classification of Hymenoptera sting reactions, 11/27 (41%) were unaware of the existence of prevention strategies such as VIT, 18/27 (67%) did not refer HVA patients to a specialist follow up. One/27 (4%) prescribed auto-injectable epinephrine and 100% wish better information on the topic. Conclusions. In our survey we found a number of ED physicians whose knowledge of HVA, beyond the emergency treatment, is not satisfactory. A closer collaboration among ED physicians and allergists is urgently needed.
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Affiliation(s)
- A Ciccarelli
- Allergy Unit, Loreto Crispi Hospital, ASL Napoli 1 - Centro, Naples, Italy
| | - C Calabrò
- Allergy Unit, Loreto Crispi Hospital, ASL Napoli 1 - Centro, Naples, Italy
| | - C Imperatore
- Allergy Unit, Loreto Crispi Hospital, ASL Napoli 1 - Centro, Naples, Italy
| | - G Scala
- Allergy Unit, Loreto Crispi Hospital, ASL Napoli 1 - Centro, Naples, Italy. E-mail:
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Massimini M, Palmieri C, De Maria R, Romanucci M, Malatesta D, De Martinis M, Maniscalco L, Ciccarelli A, Ginaldi L, Buracco P, Bongiovanni L, Della Salda L. 17-AAG and Apoptosis, Autophagy, and Mitophagy in Canine Osteosarcoma Cell Lines. Vet Pathol 2016; 54:405-412. [PMID: 28438108 DOI: 10.1177/0300985816681409] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Canine osteosarcoma is highly resistant to current chemotherapy; thus, clarifying the mechanisms of tumor cell resistance to treatments is an urgent need. We tested the geldanamycin derivative 17-AAG (17-allylamino-17-demethoxygeldanamycin) prototype of Hsp90 (heat shock protein 90) inhibitors in 2 canine osteosarcoma cell lines, D22 and D17, derived from primary and metastatic tumors, respectively. With the aim to understand the interplay between cell death, autophagy, and mitophagy, in light of the dual effect of autophagy in regulating cancer cell viability and death, D22 and D17 cells were treated with different concentrations of 17-AAG (0.5 μM, 1 μM) for 24 and 48 hours. 17-AAG-induced apoptosis, necrosis, autophagy, and mitophagy were assessed by transmission electron microscopy, flow cytometry, and immunofluorescence. A simultaneous increase in apoptosis, autophagy, and mitophagy was observed only in the D22 cell line, while D17 cells showed low levels of apoptotic cell death. These results reveal differential cell response to drug-induced stress depending on tumor cell type. Therefore, pharmacological treatments based on proapoptotic chemotherapy in association with autophagy regulators would benefit from a predictive in vitro screening of the target cell type.
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Affiliation(s)
- M Massimini
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - C Palmieri
- 2 School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - R De Maria
- 3 Department of Veterinary Medicine, Animal Pathology, University of Turin, Grugliasco, Italy
| | - M Romanucci
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - D Malatesta
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - M De Martinis
- 4 Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - L Maniscalco
- 3 Department of Veterinary Medicine, Animal Pathology, University of Turin, Grugliasco, Italy
| | - A Ciccarelli
- 5 Faculty of Communication Sciences, University of Teramo, Teramo, Italy
| | - L Ginaldi
- 4 Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Buracco
- 3 Department of Veterinary Medicine, Animal Pathology, University of Turin, Grugliasco, Italy
| | - L Bongiovanni
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - L Della Salda
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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23
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Romanucci M, Massimini M, Ciccarelli A, Malatesta D, Bongiovanni L, Gasbarre A, Della Salda L. HSP32 and HSP90 Immunoexpression, in Relation to Kit Pattern, Grading, and Mitotic Count in Canine Cutaneous Mast Cell Tumors. Vet Pathol 2016; 54:222-225. [PMID: 27627984 DOI: 10.1177/0300985816669405] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Literature data indicate heat shock protein (Hsp) 32 and 90 as potential molecular targets in canine neoplastic mast cells (MCs). However, their immunoexpression patterns in canine mast cell tumors (MCTs) have not been investigated. Thus, the aim of this study was to evaluate the immunohistochemical expression of Hsp32 and Hsp90 in 22 canine cutaneous MCTs, in relation to KIT immunolabeling pattern, histological grade, and mitotic count. All cases showed cytoplasmic labeling of Hsp90, variably associated with nuclear and/or membranous labeling. Relationships of Hsp90 or Hsp32 immunolabeling with KIT pattern, mitotic count, and tumor grade were not observed. However, the reduced Hsp32 immunoexpression observed in most grade III/high-grade MCTs suggests a tendency toward a loss of immunosignal in poorly differentiated MCs. The great heterogeneity in extent and distribution of Hsp90 immunoexpression among the different MCT cases may also partially explain the difficulties in predicting the in vivo biologic activity of Hsp90 inhibitors on canine MCTs.
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Affiliation(s)
- M Romanucci
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - M Massimini
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - A Ciccarelli
- 2 Faculty of Political Sciences, University of Teramo, Teramo, Italy
| | - D Malatesta
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - L Bongiovanni
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - A Gasbarre
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - L Della Salda
- 1 Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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24
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Liccardi G, Baldi G, Berra A, Ciccarelli A, Cutajar M, D'Amato M, D'Angelo R, Gargano D, Giannattasio D, Leone G, Lo Schiavo M, Madonna F, Montera C, Monti R, Parente R, Pedicini A, Pio A, Russo M, Salzillo A, Stanziola A, Vatrella A, Manzi F, Bilò MB. Allergy in urban elderly population living in Campania region (Southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2016; 48:156-160. [PMID: 27425174] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Given the increasing life expectancy observed in Western countries, there is a marked interest to know more about how aging could influence respiratory health. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic elders living in Campania region area (Southern Italy). Fourteen Allergy units or Centres examined a total of 462 patients. In this context 215 (46.53%) had positive skin prick tests (SPTs) to at least one allergen and were diagnosed with respiratory allergy. Parietaria represents the most common sensitizing agent in elders living in Campania region, followed by dust mites, grass pollen and Olea europaea. A relatively high percentage of atopic subjects suffered from respiratory symptoms at a fairly advanced age, namely 8.3% at 60-64 years, 10.2% at 65-70 and 5.7% at > 70 years. In conclusion, the prevalence and clinical significance of airway allergic sensitization in the elderly living in Campania region is more significant than expected in latter stages of life. Physicians should not neglect the role of atopy as a risk factor for the onset of allergic respiratory symptoms even in elderly patients.
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Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy. Phone: +39 081 747 3335-4-3 Fax: + 39 081 747 3331 E-mail:
| | - G Baldi
- Respiratory Medicine Unit. ASL (district 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico "Loreto Crispi", Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Disease, "Federico II" University, AO "Dei Colli", Naples, Italy
| | - R D'Angelo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory physiopathology and allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - G Leone
- Allergy and Clinical Immunology Unit, High Speciality "Sant'Anna and San Sebastiano" Hospital, Caserta, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - R Monti
- Private Center for Allergy Diagnosis, Ischia, Naples, Italy
| | - R Parente
- Department of Medicine and Surgery, University of Salerno, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, "Fatebenefratelli" Hospital, Benevento, Italy
| | - A Pio
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - M Russo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Disease, "Federico II" University, AO "Dei Colli", Naples, Italy
| | - A Vatrella
- Department of Medicine and Surgery, University of Salerno, Italy
| | - F Manzi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - M B Bilò
- Allergy Unit, Department of Immunology, Allergy and Respiratory Diseases. University Hospital Ancona, Italy
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Bongiovanni L, Caposano F, Ciccarelli A, Romanucci M, Malatesta D, Benazzi C, Brachelente C, V.Grieco, Massimini M, Della Salda L. Contribution of Stem Cells to Benign and Malignant Canine Prostate Tissues. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.026] [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: 10/24/2022]
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26
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Romanucci M, Frattone L, Ciccarelli A, Bongiovanni L, Malatesta D, Benazzi C, Brachelente C, Della Salda L. Immunohistochemical expression of heat shock proteins, p63 and androgen receptor in benign prostatic hyperplasia and prostatic carcinoma in the dog. Vet Comp Oncol 2014; 14:337-349. [PMID: 25059752 DOI: 10.1111/vco.12113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 07/24/2013] [Revised: 05/20/2014] [Accepted: 06/24/2014] [Indexed: 11/28/2022]
Abstract
This study compared heat shock proteins Hsp60, Hsp72 and Hsp73, along with p63 and androgen receptor (AR) immunoexpression between 16 cases of benign prostatic hyperplasia (BPH) and 11 prostatic carcinomas (PCa) in dogs. The proportion of Hsp60-positive cells was higher in PCa compared with BPH (P = 0.033), whereas the frequency and intensity of Hsp73 immunostaining did not differ significantly between the two groups. Hsp72-immunostained nuclei formed a discontinuous layer along the basement membrane in BPH, whereas cells in this layer in PCa were negative or weakly positive. Hsp72 nuclear score showed significant positive associations with both p63 (P = 0.016) and AR (P = 0.009) scores. Double immunofluorescence revealed Hsp72-p63 and Hsp72-AR co-expressions in basal cell nuclei. Aberrant cytoplasmic p63 immunolabelling was observed in 3 of 11 PCa cases. These results suggest a role of the combined expression of Hsp72, p63 and AR in basal epithelial cells in canine BPH and PCa.
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Affiliation(s)
- M Romanucci
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - L Frattone
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - A Ciccarelli
- Faculty of Political Sciences, University of Teramo, Teramo, Italy
| | - L Bongiovanni
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - D Malatesta
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - C Benazzi
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - C Brachelente
- Department of Biopathological Sciences and Hygiene of Animal and Food Production, Faculty of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - L Della Salda
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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Scala G, Ciccarelli A, Calabrò C. Adverse reaction to sublingual Parietaria vaccine following an ultra-rush induction. Eur Ann Allergy Clin Immunol 2014; 46:116-118. [PMID: 24853571] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the treatment of respiratory allergies Sublingual Immunotherapy (SLIT) represents a valid alternative to Subcutaneous Immunotherapy (SCIT) for its better safety profile. We describe a case of acute severe asthma following the first maintenance dose of SLIT in a boy allergic to Parietaria pollen. At the initiation of therapy, the patient was in healthy condition and his asthma appeared to be under control. An ultra-rush induction had given no reaction. Despite the good safety profile of SLIT, clinicians should be aware of the risk of adverse effects when prescribing SLIT for respiratory allergies.
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Affiliation(s)
- G Scala
- U.O.S.D. Allergologia e Immunologia Clinica, Loreto Crispi Hospital, Naples, Italy. E-mail:
| | - A Ciccarelli
- U.O.S.D. Allergologia e Immunologia Clinica, Loreto Crispi Hospital, Naples, Italy
| | - C Calabrò
- U.O.S.D. Allergologia e Immunologia Clinica, Loreto Crispi Hospital, Naples, Italy
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Abstract
Survivin is reexpressed in most human breast cancers, where its expression has been associated with tumor aggressiveness, poor prognosis, and poor response to therapy. Survivin expression was evaluated in 41 malignant canine mammary tumors (CMTs) by immunohistochemistry, in relation to histological grade and stage, and correlated with that of some related molecules (β-catenin, caspase 3, heat shock proteins) to understand their possible role in canine mammary tumorigenesis. An increase in nuclear survivin expression, compared with healthy mammary glands, was observed in CMTs, where nuclear immunolabeling was related to the presence of necrosis. No statistically significant relation was found between the expression of the investigated molecules and the histological grade or stage. The present study may suggest an important involvement of survivin in CMT tumorigenesis. Its overexpression in most of the cases evaluated might suggest that targeting survivin in CMTs may be a valid anticancer therapy.
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Affiliation(s)
- L. Bongiovanni
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - M. Romanucci
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - D. Malatesta
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - A. D’Andrea
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - A. Ciccarelli
- Faculty of Political Sciences, University of Teramo, Teramo, Italy
| | - L. Della Salda
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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Liccardi G, Baldi G, Ciccarelli A, Cutajar M, D'Amato M, Gargano D, Giannattasio D, Leone G, Lo Schiavo M, Madonna F, Montera C, Piccolo A, Pio A, Russo M, Stanziola A, D'Amato G. Sensitization to cockroach allergens in the urban atopic populations living in Campania district (southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2014; 46:12-16. [PMID: 24702867] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Although cockroach (CR) is an important cause of allergic sensitization worldwide, only a few data are available in Italy and in a previous study we have observed, in Naples area, a low prevalence of CR sensitization. OBJECTIVES We sought to perform a prospective study for assessing the prevalence of allergic sensitization to CR in a sample of atopic population living in Campania district area (Southern Italy). METHODS Ten Allergy Units or Centres of Campania district participated in this cross-sectional study. Each centre was required to collect the results of at least 100 allergy consultations in consecutive outpatients referred for actual or suspected respiratory allergy. We registered demographic data, type and duration of respiratory symptoms, pets ownership, possible exposure to CR allergens, results of the skin prick tests (SPTs). RESULTS A total of 1477 patients were examined, 985 (66.68%) had a SPTs positivity to at least one allergen. In this context, ninety were sensitized to CR, thus the overall sensitization prevalence in subjects with respiratory allergy was 6.09% ranging between 0-11% and only five patients were mono-sensitized. Thirteen patients reported rhinitis (R) + bronchial asthma (A), twenty-one R + A + conjunctivitis (C), thirty-seven R + C, five only A and eleven individuals only R. Sixty-seven patients exhibited persistent and twenty-three intermittent symptoms. Dust mite constituted the first cause of associated sensitization to CR. CONCLUSIONS The prevalence of allergic sensitization to CR is not negligible in population living in Campania district and shows a higher trend in comparison to that found recently and some years ago in Naples area. Finally, we suggest atopic individuals and especially those highly sensitized to mite allergens or those living in low-income areas to be tested by SPTs / evaluation of serum specific IgE to CR allergens to exclude the occurrence of CR allergic sensitization.
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Affiliation(s)
- G Liccardi
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico "Loreto Crispi", Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Diseases, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory physiopathology and allergy, High Speciality Center "S. Maria Incoronata dell'Olmo" Hospital, Cava dei Tirreni, Salerno, Italy
| | - G Leone
- Allergy and Clinical Immunology Unit, High Speciality "Sant'Anna e San Sebastiano" Hospital, Caserta, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n° 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - A Piccolo
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - M Russo
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Diseases, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G D'Amato
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
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Romanucci M, Berardi I, Ciccarelli A, Bongiovanni L, Malatesta D, Oevermann A, Della Salda L. Immunohistochemical Evaluation of Heat Shock Protein Expression in Normal Canine Nerve and Peripheral Nerve Sheath Tumours. J Comp Pathol 2013; 149:216-20. [DOI: 10.1016/j.jcpa.2012.11.240] [Citation(s) in RCA: 4] [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] [Received: 11/21/2011] [Revised: 10/09/2012] [Accepted: 11/23/2012] [Indexed: 11/16/2022]
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Mantini S, Bruner E, Colaiacomo B, Ciccarelli A, Redaelli A, Ripani M. Preliminary baropodometric analysis of young soccer players while walking: geometric morphometrics and comparative evaluation. J Sports Med Phys Fitness 2012; 52:144-150. [PMID: 22525649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The plantar support and its modifications are widely studied because of their bearing on posture. In particular, past studies have focused on the support modification during specific athletic tasks to highlight the eventual correlations between foot type and the most frequent sport injuries, due to intrinsic and extrinsic components that involve the structural and functional dynamics that act on the plantar vault during static and dynamic condition. These studies have been conducted by analyzing the morphological variation of the footprint during the performance. METHODS In the present study the variation in shape of the baropodometrical footprint of young soccer players, has been analyzed using geometric morphometrics. This approach permits a quantification of the morphological variation of the subjects using Cartesian coordinates placed at specific points on the footprint outline, and to correlate them with physical variables. RESULTS In the present study the young soccer players displayed a narrowing of the footprint due to a transversal variation on the isthmus, when compared to children of the same age who did not play soccer. These results suggest a physiological and biomechanical organization of the foot type in soccer due to the specific athletic tasks involved. CONCLUSION As the foot type, in sport, is strictly associated to recurrent injuries, the result obtained in this study should be considered as indicative for future analysis. In fact, a clear and univocal knowledge of this phenomenon would be useful in the planning of a training protocol to reduce the incidence of sport related injuries.
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Affiliation(s)
- S Mantini
- Department of Health Sciences, Foro Italico University of Rome, Rome, Italy.
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De Vecchis R, Ciccarelli A, Ariano C, Cioppa C, Giasi A, Pucciarelli A, Cantatrione S. In chronic heart failure with marked fluid retention, the i.v. high doses of loop diuretic are a predictor of aggravated renal dysfunction, especially in the set of heart failure with normal or only mildly impaired left ventricular systolic function. Minerva Cardioangiol 2011; 59:543-554. [PMID: 21330961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM In the presence of resistance to oral diuretics in chronic heart failure (CHF) patients with extreme hydrosaline retention, among the proposed therapeutic options the administration of high doses of loop diuretics - either intravenous (i.v.) boluses or i.v. continuous infusion - should first of all be considered. Nevertheless, the use of this therapy may lead to the risk of further aggravation of frequently coexisting renal dysfunction, especially when loop diuretics such as furosemide (FUR), torasemide etc. are administered at excessive doses leading to hypotension, hypoperfusion and/or relative dehydration in patients with decompensated CHF who could have benefit from intensive unloading therapy. The aim of this study was to identify the clinical and hematochemical markers which are able to predict a possible decline or rapid deterioration of renal function implying a rise in serum creatinine (Cr) >25% of its basal value, i.e. the so-called aggravated renal dysfunction (ARD), typically occurring during intensive unloading therapy with i.v. FUR or other loop diuretics, administered to CHF pts with extreme fluid retention. METHODS The protocol of our case-control observational study established to enroll every CHF patient who was demonstrated to develop a rise in Cr suggestive of ARD at the end of i.v. diuretic therapy (VI-VIII day). For each case enrolled, 3 patients at least were selected as controls, matched for age, sex and time elapsed from the beginning of the signs and symptoms of CHF. For the prediction of the dependent variable, represented by ARD diuretic infusion-related, the following independent variables were considered: creatinine clearance (Cr clear) <60 mL/min, Cr clear expressed as a continuous variable (Cr clear continuous), daily dose of i.v. furosemide ≥ 125 mg, left ventricular ejection fraction (LVEF), CHF with normal (≥ 50%) LVEF (HFNEF), urinary sodium concentration (U Na+) ≥ 40 mEq/L, U Na+expressed as a continuous variable (U Na+ continuous), sodium fractional excretion (FE Na+) >2%, urine/plasma concentration ratios for creatinine (U/P cr) <10, for urea (U/P urea) <5 and for osmolality (U/P osmolal) <1.1, mean duration of the symptoms of CHF, history of pre-existing parenchymal renal disease . The values of U Na+, FE Na+, U/P Cr, U/P urea and U/P osmolal were measured after discontinuance of diuretic oral therapy for four days, before the onset of intensive i.v. diuretic administration, so as to identify the patients with pathological values of tubular renal function indexes, known to be not interpretable in the presence of diuretics, suggestive of possible preexisting anatomic renal damage (acute tubular necrosis prior to onset of iv diuretic therapy). RESULTS Nineteen 19 CHF patients with ARD and 60 controls were enrolled. At univariable analysis, Cr clear <60 mL/min, Cr clear continuous, daily dose of iv furosemide ≥ 125 mg, LVEF, HFNEF, FE Na+>2%, Na+≥ 40 mEq/L and U Na+ continuous were shown to be associated with ARD. At multivariate analysis, the role of prognostic indicator of ARD was maintained by daily dose only of iv FUR ≥125 mg (OR: 7.2088 95% CI: 1.3096-39.6802 P=0.0232). By using the 2x2 contingency tables, a qualitative interaction was identified by crossing ARD ‑ outcome variable - against dose of iv FUR ≥ 125 mg/day - exposure variable - and by subsequently stratifying by the HFNEF. Actually, a significant association with ARD was not present in any CHF patient with dilated left ventricle treated with high dosage of iv FUR, whereas a highly significant association with ARD was observed in HFNEF patients (OR: 72 95% CI: 6.601-785.2694 P=0.00001) who had experienced the same high iv fur dose. CONCLUSION In CHF patients with widespread edema refractory to oral diuretic, ARD can be propitiated by high dosages of i.v. FUR, when not associated with other treatments to preserve the effective circulating volume and renal flow. The HFNEF patients appear to be more prone to ARD related to i.v. high dosages of FUR, perhaps because their hemodynamics is more seriously harmed by the drop, FUR-related, in venous return and cardiac preload, as compared to CHF patients with reduced (45-30%) LVEF.
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Affiliation(s)
- R De Vecchis
- Presidio Sanitario Intermedio Elena d'Aosta, Naples, Italy.
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Filippella M, Davì MV, Doveri G, Lillaz E, Ciccarelli A, Massimetti E, Toaiari M, Falconi M, Colao A, Faggiano A. Hyperinsulinemic hypoglycemia associated with ectopic Cushing's syndrome due to a pancreatic endocrine tumor in a Type 2 diabetes mellitus patient: clinical implications of a rare association. J Endocrinol Invest 2011; 34:175-9. [PMID: 20386090 DOI: 10.1007/bf03347062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The coexistence of insulin and ACTH hypersecretion in the same patient is extremely rare. A diabetic patient with a pancreatic endocrine tumor (PET) co-secreting insulin and ACTH is even rarer and has never been described. The combination of these two endocrine syndromes results in a peculiar clinical picture. AIM To determine the cause of glycemic variations in a patient with previously stable diabetes mellitus. SUBJECTS AND METHODS This is a clinical case report from the Endocrinology Unit of Aosta Hospital and Internal Medicine and Surgical Unit of Verona University. A 69-yr-old diabetic patient was hospitalized for recurrent severe hypoglycemic events persistent after withdrawal of anti-diabetic drugs. The causes of hypoglycemia and subsequent resumption of hyperglycemia were investigated. RESULTS An insulin-secreting PET was diagnosed. Diazoxide and octreotide therapy initially was able to control hypoglycemic symptoms, then, a Cushing's syndrome occurred resulting in worsening of diabetes control. ACTH was found to be released by the PET previously diagnosed as an insulin-secreting tumor. The tumor was removed and the histology was consistent with a well differentiated endocrine carcinoma. After surgery, adrenal function was normal and insulin therapy was again necessary to control diabetes. CONCLUSIONS A single PET may be responsible for both a hyperinsulinemic and a Cushing's syndrome. When this rare association occurs, each of the two syndromes may affect the other resulting in a peculiar clinical course. Finally, an insulin-secreting PET has to be kept in mind as a rare cause of hypoglycemia in diabetic patients.
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Affiliation(s)
- M Filippella
- SC Internal Medicine Unit of Diabetology and Endocrinology, Parini Hospital, Aosta, Italy
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De Vecchis R, Ciccarelli A, Ariano C, Pucciarelli A, Cioppa C, Giasi A, Fusco A, Cantatrione S. [Renoprotective effect of small volumes of hypertonic saline solution in chronic heart failure patients with marked fluid retention: results of a case-control study]. Herz 2010; 36:12-7. [PMID: 20978728 DOI: 10.1007/s00059-010-3394-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 09/06/2010] [Accepted: 09/19/2010] [Indexed: 12/20/2022]
Abstract
During intensive therapy of chronic heart failure (CHF) patients with marked fluid retention using high doses of i.v. furosemide the additional effect of agents which might exert osmotic attraction of interstitial fluids has been proposed. They are thought to impede the impairment of renal blood supply and glomerular filtration rate, which may be caused by a combined action of cardiac preload acute reduction, hypotension and neurohormonal activation.We therefore assessed in CHF patients with NYHA class III and BNP values from 900 to 1500 pg/ml, who were treated with i.v. furosemide, the predictors of iatrogenic short term creatinine impairment by means of a case-control observational study from two centers. Patients with CHF had been treated for 6-8 days with intravenous loop diuretics alone or with an additional i.v. administration of other agents (plasma expanders, albumin, mannitol, inotropic support etc.). A rise in serum creatinine ≥ 25% of the basal value was considered as renal impairment.A total of 15 cases and 38 controls were enrolled. At univariate analysis, serum creatinine basal value ≥ 2.2 mg/dl, absence of hypertonic saline solution (HSS) in the therapeutic protocol, hyposodic diet and refractory oligoanuria were associated with an increased risk of worsening renal function precipitated by i.v. diuretic therapy. At multivariate analysis as a predictor of loop diuretic-related renal function impairment, we found a serum creatinine ≥ 2.2 mg/dl at baseline (OR: 63.33, 95% CI: 3.68-1088.73, p=0.0043) and the absence of HSS in the therapeutic regimen (OR: 25.0461, 95% CI: 2.07-302.53, p=0.0113). Moreover, in multivariate analysis ascites had some predictive value of renal deterioration (OR: 13.28, 95% CI: 1.0055-175.41, p=0,0495).
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Affiliation(s)
- R De Vecchis
- Presidio Sanitario Intermedio Elena d'Aosta, Cardiology Unit, via Cagnazzi 29, 80137 Naples, Italy.
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Scala G, Di Rienzo Businco A, Ciccarelli A, Tripodi S. An evidence based overview of sublingual immunotherapy in children. Int J Immunopathol Pharmacol 2009; 22:23-26. [PMID: 19944006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
In light of the current evidence, subcutaneous immunotherapy (SCIT) can be suggested for use in pediatric allergic rhinitis and asthma as treatment and preventive management. Sublingual specific immunotherapy (SLIT) can be suggested for use in children with allergic rhino-conjunctivitis, and seasonal asthma, especially if they are mono-sensitive, for a duration of no less than three years. The earlier treatment begins, the better is the outcome. Further randomized, long-term trials in SLIT for the treatment of perennial asthmatic children are still needed. As regards the choice between the methods of administration (the traditional SCIT or the innovative SLIT), it is up to the physician to find the right equilibrium in the single patient.
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Affiliation(s)
- G Scala
- SSD Allergy and Immunology Clinic, Loreto Crispi Hospital, ASL Naples 1, Naples, Italy.
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Bruner E, Mantini S, Guerrini V, Ciccarelli A, Giombini A, Borrione P, Pigozzi F, Ripani M. Preliminary shape analysis of the outline of the baropodometric foot: patterns of covariation, allometry, sex and age differences, and loading variations. J Sports Med Phys Fitness 2009; 49:246-254. [PMID: 19861931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Baropodometrical digital techniques map the pressures exerted on the foot plant during both static and dynamic loadings. The study of the distribution of such pressures makes it possible to evaluate the postural and locomotory biomechanics together with its pathological variations. This paper is aimed at evaluating the integration between baropodometric analysis (pressure distribution) and geometrical models (shape of the footprints), investigating the pattern of variation associated with normal plantar morphology. METHODS The sample includes 91 individuals (47 males, 44 females), ranging from 5 to 85 years of age (mean and standard deviation = 40 + or - 24).The first component of variation is largely associated with the breadth of the isthmus, along a continuous gradient of increasing/decreasing flattening of the foot plant. This character being dominant upon the whole set of morphological components even in a non-pathological sample, such multivariate computation may represent a good diagnostic tool to quantify its degree of expression in individual subject or group samples. RESULTS Sexual differences are not significant, and allometric variations associated with increasing plantar surface or stature are not quantitatively relevant. There are some differences between adult and young individuals, associated in the latter with a widening of the medial and posterior areas. CONCLUSIONS These results provide a geometrical framework of baropodometrical analysis, suggesting possible future applications in diagnosis and basic research.
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Affiliation(s)
- E Bruner
- National Research Center on Human Evolution (CENIEH), Burgos, Spain
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Morini S, Ciccarelli A, Cerulli C, Giombini A, Di Cesare A, Ripani M. Functional anatomy of trunk flexion-extension in isokinetic exercise: muscle activity in standing and seated positions. J Sports Med Phys Fitness 2008; 48:17-23. [PMID: 18212705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM This study examined the functional differences existing in the trunk flexion-extension movement in standing and seated positions during isokinetic exercises, as well as the influence of position on overload of the lumbar column. METHODS Nine females underwent an isokinetic test at 60 and 180 degrees /s in standing and seated positions. Muscle electrical activity was assessed by means of surface electromyography (EMG). Motion angles related to the different body segments were extrapolated from video images. RESULTS The range of motion for hip movements was statistically significantly higher in the standing position, whereas it was similar for all the other segments studied in both positions. During the first phases of the movement, the lumbar tract showed a more marked lordosis in standing position. Peak torque values were significantly higher for flexion in standing position. Surface EMG showed significant differences in both positions only for the gluteal and biceps femoris muscles. CONCLUSION The seated position allowed made it possible to limit the involvement of the hip muscles, particularly the iliopsoas during flexion, whereas there was little contribution to the trunk extension from hip extensor muscles. In addition, trunk extensors/flexors ratio showed values variable with velocity in standing position. Therefore, if the participation of accessory muscles is avoided, the seated position allows us to more accurately assess these two groups of antagonist muscles, whose balanced ratio is essential in the prevention of spine pathologies. The seated position has also been found to be more suitable in order to limit functional overload of the lumbar column.
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Affiliation(s)
- S Morini
- University Bio-Medical Campus of Rome, Rome, Italy
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Filippella M, Lillaz E, Ciccarelli A, Giardina S, Massimetti E, Navaretta F, Antico A, Veronesi M, Lombardi G, Colao A, Ghigo E, Benso A, Doveri G. Ankle brachial pressure index usefulness as predictor factor for coronary heart disease in diabetic patients. J Endocrinol Invest 2007; 30:721-5. [PMID: 17993762 DOI: 10.1007/bf03350808] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Ankle brachial pressure index (ABPI) is a non-invasive marker of atherosclerosis, helpful to identify subjects at high-risk for coronary heart disease (CHD) among large populations with cardiovascular disease (CVD) risk factors. The diagnostic role of ABPI has been also recognized in patients with diabetes. In the present study, the role of an ABPI score < 0.90 in predicting CHD has been evaluated in a large series of patients with Type 2 diabetes mellitus and compared to other known CVD risk factors. Nine hundred and sixty-nine (mean age was 66.1 yr) consecutive patients with Type 2 diabetes mellitus were evaluated. The patients were followed-up for 18.3+/-5.2 months (range 12- 24) and all events of CHD, defined as myocardial infarction, unstable and resting angina or coronary atherosclerosis at the instrumental investigation (at the coronary angiography and/or perfusion stress testing) were recorded. A rate of 17.5% of CHD events were recorded in diabetic population during the follow-up period. The relative risk of CHD was significantly increased for male patients [odds ratio (OR): 1.6; 95% confidence interval (CI): 1.1-2.2], patients with age > or = 66 yr (OR: 1.8; 95% CI: 1.3-2.5), body mass index (BMI) > 30 (OR: 1.5; 95% CI: 1.1-2.1), waist circumference > 88 cm for females and 102 cm for males (OR: 1.5; 95% CI: 1.0-2.1), proteinuria > or = 30 microg per min (OR: 1.6; 95% CI: 1.1-2.3), LDL-cholesterol > or = 100 mg/dl (OR: 2.1; 95% CI: 1.5-3.0), glycated hemoglobin > 7% (OR: 1.6; 95% CI: 1.1-2.3), insulin therapy (OR: 1.9; 95% CI: 1.3-2.9), and ABPI < 0.90 (OR: 3.7; 95% CI: 2.2- 6.2). BMI was higher in patients with ABPI < 0.90 than in those with ABPI > or = 0.90 (p<0.05). At the multivariate analysis, ABPI < 0.90 was the best factor independently associated with CHD (p<0.001). APBI < 0.90 is strongly associated to CHD in Type 2 diabetic patients. We recommend to use ABPI in diabetic patients and to carefully monitor diabetic subjects with an ABPI lower than 0.90.
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Affiliation(s)
- M Filippella
- Unit of Diabetology and Endocrinology, Regional Hospital of Valle d'Aosta, 11100 Aosta, Italy
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Pasquale L, Caserta L, Rispo A, Biondi V, Rossi M, Ciccarelli A, Raffa M, Bevilacqua G. Endoscopic management of symptomatic choledocholithiasis in pregnancy without the use of radiations. Eur Rev Med Pharmacol Sci 2007; 11:343-346. [PMID: 18074941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report a case of 26-year-old woman at 10th week of gestation with cholestatic jaundice due to a common bile duct (CBD) stone managed by endoscopical retrograde cholangiopancreatography (ERCP). The procedure was successfully carried out without the use of ionizing radiations and under trans-abdominal ultrasonographical (US) control. A few cases are reported in literature in which ERCP was performed without fluoroscopy examination. We believe that ERCP with US guidance is an effective and safe procedure to treat symptomatic choledocholithiasis in pregnant women.
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Affiliation(s)
- L Pasquale
- Gastroenterology Unit, Ariano Irpino Hospital - ASL-AVI, Ariano Irpino, Avellino, Italy
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Abstract
SUMMARYA nutritional characteristic of trypanosomatid protozoa is thatin vitrothey need a haem-compound as a growth factor, which is supplied as haemoglobin, haematin or haemin. Because haemin and related porphyrins are an important source of oxidative stress in biological systems, the effect of haemin on growth, protein content and the antioxidant defence system inTrypanosoma cruziwas evaluated. We have observed that, in epimastigotes grown under different haemin concentrations in the culture medium (0–30 mg/l), 5 mg/l was the haemin concentration yielding optimum growth. Above 15 mg/l there was a clear decrease in growth rate, producing the epimastigote to amastigote transformation. Such morphological change was observed together with a marked injury of the enzymatic machinery of the parasite, leading to diminished protein synthesis as well as lower activity of the antioxidant enzymes (superoxide dismutase, ascorbate peroxidase and trypanothione reductase), reduced total thiol content and a marked increase in the HaemOx-1 activity and expression. The current work demonstrates that there is a correlation between higher haemin concentrations in the culture medium and oxidative damage in the cells. Under these conditions induction of HaemOx-1 would indicate the important role of this enzyme as an antioxidant defence response inTrypanosoma cruzi.
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Affiliation(s)
- A Ciccarelli
- Centro de Investigaciones sobre Porfirinas y Porfirias, CONICET-UBA, Argentina
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41
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Daly AF, Jaffrain-Rea ML, Ciccarelli A, Valdes-Socin H, Rohmer V, Tamburrano G, Borson-Chazot C, Estour B, Ciccarelli E, Brue T, Ferolla P, Emy P, Colao A, De Menis E, Lecomte P, Penfornis F, Delemer B, Bertherat J, Wémeau JL, De Herder W, Archambeaud F, Stevenaert A, Calender A, Murat A, Cavagnini F, Beckers A. Clinical characterization of familial isolated pituitary adenomas. J Clin Endocrinol Metab 2006; 91:3316-23. [PMID: 16787992 DOI: 10.1210/jc.2005-2671] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Familial pituitary adenomas occur rarely in the absence of multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC). OBJECTIVE Our objective was to characterize the clinical and genealogical features of non-MEN1/CNC familial isolated pituitary adenomas (FIPA). DESIGN AND SETTING We conducted a retrospective study of clinical and genealogical characteristics of FIPA cases and performed a comparison with a sporadic population at 22 university hospitals in Belgium, Italy, France, and The Netherlands. RESULTS Sixty-four FIPA families including 138 affected individuals were identified [55 prolactinomas, 47 somatotropinomas, 28 nonsecreting adenomas (NS), and eight ACTH-secreting tumors]. Cases were MEN1/PRKAR1A-mutation negative. First-degree relationships predominated (75.6%) among affected individuals. A single tumor phenotype occurred in 30 families (homogeneous), and heterogeneous phenotypes occurred in 34 families. FIPA cases were younger at diagnosis than sporadic cases (P = 0.015); tumors were diagnosed earlier in the first vs. the second generation of multigenerational families. Macroadenomas were more frequent in heterogeneous vs. homogeneous FIPA families (P = 0.036). Prolactinomas from heterogeneous families were larger and had more frequent suprasellar extension (P = 0.004) than sporadic cases. Somatotropinomas occurred as isolated familial somatotropinoma cases and within heterogeneous FIPA families; isolated familial somatotropinoma cases represented 18% of FIPA cases and were younger at diagnosis than patients with sporadic somatotropinomas. Familial NS cases were younger at diagnosis (P = 0.03) and had more frequently invasive tumors (P = 0.024) than sporadic cases. CONCLUSIONS Homogeneous and heterogeneous expression of prolactinomas, somatotropinomas, NS, and Cushing's disease can occur within families in the absence of MEN1/CNC. FIPA and sporadic cases have differing clinical characteristics. FIPA may represent a novel endocrine neoplasia classification that requires further genetic characterization.
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Affiliation(s)
- A F Daly
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, 4000 Liège, Belgium
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42
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Abstract
BACKGROUND Skin is enlarged and doughy in acromegaly. Alterations have been reported in the structure of the extracellular matrix (ECM) and in the mechanical properties of the dermis. It is recognized that internal tensions in the dermis give rise to active cell-ECM and cell-cell mechanical interactions. This mechanobiological aspect can lead to functional and conformational changes in the cells. Such alterations in connective tissue cells have not been explored so far in acromegaly. The aim of the study was to assess structural changes in the dermal ECM, and in the number and shape of factor XIIIa-positive type I dermal dendrocytes (DDs) in acromegaly. MATERIALS AND METHOD A total of 32 patients with acromegaly (three untreated, 17 with active disease under somatostatin analogues and 12 cured) were examined. Both the maximum and the most recent IGF-1 (insulin-like growth factor) dosages recorded in the patients' files were retrieved. Skin biopsies were taken from their forearms. Histochemistry, immunohistochemistry, morphometry and electron microscopy were used. RESULTS Collagen-bundle coarsening and acidic glycosaminoglycan deposits were found irrespective of the current endocrine status. Dermal dendrocytes were often markedly reduced in numbers, but those present were plump with few dendrites. A negative correlation was found between DD numbers and the maximum IGF-1 dosages recorded in the patients' files. A similar although weaker trend was found with the most recent IGF-1 dosages. CONCLUSIONS Collagen, glycosaminoglycans and DDs appeared affected in acromegaly, even when the hormonal status was controlled after surgery and/or somatostatin analogue treatment. The persisting conformational change of DDs suggests a modification in cellular tensegrity, perhaps initiated by hormonal effects and probably maintained by alterations in the ECM interactions.
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Affiliation(s)
- P Quatresooz
- Department of Dermatopathology, University Hospital of Liège, B-4000 Liège, Belgium
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43
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Abstract
Several experimental and clinical studies have indicate that the heart is an end-organ of GH action. Patients with either childhood- or adulthood-onset GH deficiency (GHD) have abnormalities of cardiac structure and function, such as reduced cardiac mass, impaired diastolic filling and reduced left ventricular response at peak exercise. These cardiovascular abnormalities can be reversed, at least partially, after GH replacement therapy. On the other hand, the chronic overproduction of GH and IGF-I in acromegaly leads to the development of a specific cardiomyopathy. Concentric cardiac hypertrophy occurs in more than two-thirds of patients at diagnosis and is commonly associated with diastolic dysfunction. In later stages, impaired systolic function ending in heart failure can occur if GH/IGF-I excess is not controlled. Additionally, acromegalic cardiomyopathy is complicated by abnormalities of cardiac rhythm and cardiac valves. Successful control of acromegaly is accompanied by a decrease of the left ventricular mass and improvement of cardiac function. These beneficial effects appear earlier in young patients with short disease duration than in elderly patients. In conclusion, GH and IGF-I play a main role in the regulation of cardiac development and performance.
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Affiliation(s)
- A Colao
- Department of Molecular and Clinical Endocrinology and Oncology, 'Federico II' University, via S. Pansini 5, 80131 Naples, Italy.
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44
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Colao A, Pivonello R, Cappabianca P, Auriemma RS, De Martino MC, Ciccarelli A, de Divitiis E, Lombardi G. The use of a GH receptor antagonist in patients with acromegaly resistant to somatostatin analogs. J Endocrinol Invest 2003; 26:53-6. [PMID: 15497660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Pegvisomant, a GH receptor antagonist, is a new pharmaceutical approach to acromegaly. It enables IGF-I levels to return in the age- and sex-reference range in approximately 90% of patients. This new approach is particularly beneficial in those patients who do not experience control of hormone hypersecretion after surgery and/or medical treatment with somatostatin analogs. In our preliminary experience, out of 16 patients unsuccessfully operated on by transsphenoidal surgery and resistant to 40-mg octreotide-LAR or 120-mg lanreotide for at least 6 months, 13 normalized their IGF-I levels within 6 months from treatment beginning. Normalization of IGF-I levels was accompanied by a significant decrease of ring size. We did not observe any increase of tumor remnant in this short period of treatment. In two cases we observed a significant increase of liver transaminases levels. In conclusion, more than 80% of patients with acromegaly unsuccessfully treated by surgery or currently available somatostatin analogs can achieve normal IGF-I levels after short-term treatment with pegvisomant.
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Affiliation(s)
- A Colao
- Departments of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
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45
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Fittipaldi MR, Fonderico F, Vitale G, Ciccarelli A, Lupoli GA, Cascella T, Panico A, Lupoli G. Osteoporosis treatment in elderly hyperthyroid male patients. J Endocrinol Invest 2002; 25:98-100. [PMID: 12508936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- M R Fittipaldi
- Department of Endocrinology and Molecular and Clinic Oncology, University of Naples Federico II, Naples, Italy
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46
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Fonderico F, Fittipaldi MR, Vitale G, Ciccarelli A, Lupoli GA, Panico A, Cascella T, Lupoli G. Medical treatment of male osteoporosis. J Endocrinol Invest 2002; 25:103-5. [PMID: 12508938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- F Fonderico
- Departments of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II, Naples, Italy
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47
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Vitale G, Fonderico F, Martignetti A, Caraglia M, Ciccarelli A, Nuzzo V, Abbruzzese A, Lupoli G. Pamidronate improves the quality of life and induces clinical remission of bone metastases in patients with thyroid cancer. Br J Cancer 2001; 84:1586-90. [PMID: 11401309 PMCID: PMC2363684 DOI: 10.1054/bjoc.2001.1832] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Skeletal metastases from thyroid cancer are poorly responsive to medical or radioiodine treatment. Bone destruction in skeletal metastases results from osteoclast-induced bone resorption. Therefore, a new approach in the therapy of bone metastases consists in using aminobisphosphonates, such as pamidronate, which are potent inhibitors of osteoclastic activity. In the present study, 10 thyroid cancer patients with painful osteolytic bone metastases were administered pamidronate (90 mg, as a 2 hour intravenous infusion) monthly for 12 consecutive cycles. Bone pain, quality of life, performance status, analgesic consumption and disease staging were evaluated before and during the trial. The patients who had been administered pamidronate showed a significant decrease in bone pain (P = 0.0052). Performance status improved nearly significantly (P = 0.051), while the quality of life showed a remarkable amelioration. However, no significant decrease in analgesic consumption was recorded. Partial radiographic response of bone lesions was observed in 2/10 patients. The side effects of pamidronate were mild and transient. In conclusion, monthly infusion of pamidronate is a well-tolerated treatment that induces significant relief from bone pain and improves the quality of life of thyroid cancer patients with symptomatic and osteolytic bone metastases.
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Affiliation(s)
- G Vitale
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Via Pansini 5, 80131, Napoli, Italy
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Abstract
BACKGROUND Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor derived from parafollicular cells. At present, surgery is the most important treatment for MTC. METHODS We describe the current approaches of MTC treatment (surgery, chemotherapy, radiation therapy, and biologic therapy). RESULTS MTC is currently approached surgically in the main part through total thyroidectomy and compartment-oriented microdissection of cervicomediastinal lymph nodes. Substitutive l-thyroxine administration together with close clinical monitoring and the measurement of basal and stimulated serum calcitonin are subsequently performed. Radiotherapy and chemotherapy play a marginal role in advanced MTC. Recently, it has been found that somatostatin analogs and type I interferon are able to control the neuroendocrine symptoms induced by advanced MTC and that they provide clinical benefit by improving the lifestyle of these patients. CONCLUSION Although these agents are poorly active in inducing a shrinkage in tumor mass, the combined use of different biologic agents and cytotoxic drugs needs to be explored in advanced MTC. However, at present, surgery is the only curative treatment for MTC.
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Affiliation(s)
- G Vitale
- Department of Molecular and Clinical Endocrinology and Oncology, School of Medicine, University of Naples Federico II, Naples, Italy
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49
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Vitale G, Tagliaferri P, Caraglia M, Rampone E, Ciccarelli A, Bianco AR, Abbruzzese A, Lupoli G. Slow release lanreotide in combination with interferon-alpha2b in the treatment of symptomatic advanced medullary thyroid carcinoma. J Clin Endocrinol Metab 2000; 85:983-8. [PMID: 10720027 DOI: 10.1210/jcem.85.3.6435] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Somatostatin analogs are promising agents in the treatment of medullary thyroid carcinoma. We have evaluated the effects of the slow release somatostatin analog lanreotide in combination with interferon-alpha2b in seven patients with advanced and symptomatic medullary thyroid carcinoma. The frequency and intensity of daily flushing episodes and bowel movements, the intensity of fatigue, weight, performance status, calcitonin levels, and change in tumor masses were recorded before and during treatment. No objective complete or partial responses were recorded. However, disease stabilization and minor tumor regression were observed in three of seven and two of seven patients, respectively. The number and intensity of bowel movements and flushing episodes decreased in five of six and two of two patients, respectively. Decrease in fatigue and improvement in performance status were observed in five of seven and six of seven patients, respectively. Weight gain was recorded in three of four patients. Plasma levels of calcitonin decreased significantly in six of seven patients. Clinical benefit, evaluated by a structured algorithm, was achieved in six of seven patients and was coupled with a decrease of 50% or more in serum calcitonin levels in three of seven patients. In conclusion, the combination of lanreotide with interferon had a major impact on clinical symptoms and was well tolerated.
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Affiliation(s)
- G Vitale
- Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
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50
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Vitale G, Tagliaferri P, Caraglia M, Rampone E, Ciccarelli A, Abbruzzese A, Bianco A, Lupoli G. A structured algorithm to assess the response to biological therapy in medullary thyroid carcinoma. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81262-3] [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: 10/27/2022]
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