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Fedeli L, Betti M, Bicchi S, Benelli M, Quattrocchi M, Gilio M, Rossi F, Busoni S, Taddeucci A, Comeglio M, Maioli M, Lisi C, Meucci F, Vaiano A, Fedele D, Mazzoni L, Bernardi L. Correlation between operator eye lens doses and transcatheter cardiovascular procedure characteristic: multi-parametric linear regression model. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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2
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Betti M, Benelli M, Bicchi S, Fedeli L, Laghai I, Marciello L, Meucci F, Vaiano A, Fedele D, Mazzoni L, Marzano S, Sestini S, Bernardi L. 18F-FDG-PET radiomic assessment for RT treatment strategy in patients with head and neck cancer: a feasibility study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00191-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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3
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Vaiano A, Betti M, Fedele D, Fedeli L, Mazzoni L, Meucci F, Bernardi L. Beam matching of two Elekta linac. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00180-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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4
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Gori G, Fedeli L, Lastrucci A, Betti M, Meucci F, Vaiano A, Fedele D, Mazzoni L, Bernardi L. Couch aluminium activation in high energy LINAC: workers exposure. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00261-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Bicchi S, Betti M, Fedeli L, Vinattieri R, Desideri V, Vaiano A, Meucci F, Fedele D, Mazzoni L, Bernardi L. Chest radiography protocol optimization in neonatal intensive care unit: findings before and after staff training. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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6
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Durkin K, Kelleher J, Stark L, Griffin K, Lynn C, Filigno S, Everhart R, Fedele D, Moffett-Bradford K, Duncan C. 269: Food security and nutritional adherence in adolescents with cystic fibrosis during the COVID-19 pandemic. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01694-5] [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: 10/20/2022]
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7
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Lastrucci A, Fedeli L, Betti M, Meucci F, Serventi E, Vaiano A, Fedele D, Mazzoni L, Ricci R, Gori C, Bernardi L. PO-1780 Evaluation of couch activation in high energy radiation treatment. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08231-1] [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: 10/20/2022]
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8
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Loria D, Aimasso U, Fedele D, Golzio P, Merlo F, Mollo A, De Francesco A. BODY COMPOSITION AND NUTRITIONAL INTAKES IN PATIENTS WITH SHORT BOWEL SYNDROME IN HOME PARENTERAL NUTRITION. Nutrition 2020. [DOI: 10.1016/j.nut.2020.110919] [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: 11/26/2022]
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9
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Bernardi L, Benelli M, Betti M, Fedele D, Mazzoni L, Vaiano A. 158. Retrospective analysys of volumetric modulated arc therapy treatments: Correlation between plans complexity and dosimetric accuracy. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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10
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Villaggi E, Esposito M, Hernández V, Sáez J, Marino C, Bonanno E, Bruschi A, Borzì G, Carbonini C, Consorti R, Fedele D, Moretti E, Nardiello B, Russo S, Vaccara E, Stasi M, Mancosu P. 31. Impact of DVH sharing and experience level in a multicenter SBRT prostate planning study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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11
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Savini A, Fusella M, Esposito M, Ardu V, Benecchi G, Bergantin A, Borzi G, Bresciani S, Cagni E, Carbonini C, Casati M, Clemente S, Consorti R, Cora S, DeMartin E, ElGawhary R, Falco M, Fedele D, Fiandra C, Frassanito M, Garibaldi C, Gasperi G, Giglioli F, Guidi G, Ielo I, Landoni V, Magi S, Malatesta T, Marino C, Masi L, Moretti E, Naccarato S, Nardiello B, Nigro R, Pastore G, Presello M, Ravaglia V, Russo S, Strigari L, Strolin S, Talamonti C, Vaiano A, Vigorito S, Villaggi E, Stasi M, Mancosu P. 161. A crowd-knowledge-based analysis of DVHs in SBRT: First steps towards a national virtual audit. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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12
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Marino C, Carbonini C, Veronese I, Agostinelli S, Aimonetto S, Bagalà P, Barbiero S, Benecchi G, Borzi G, Bresciani S, Broggi S, Cagni E, Casale M, Cilla S, Clemente S, Consorti R, Corletto D, Delana A, Esposito M, Falco M, Fedele D, Fusella M, Garibaldi C, Gasperi C, Giglioli F, Giancaterino S, Iervolino C, Infusino E, Mameli A, Manco L, Masi L, Menghi E, Moretti E, Nardiello B, Paladini L, Panizza D, Pastore G, Radice A, Redaelli I, Rosica F, Russo S, Saiani F, Savini A, Siragusa C, Strigari L, Talamonti C, Vaccara E, Villaggi E, Zucchetti C, Stasi M, Mancosu P. 40. Design of a national survey to assess the technology applied to SBRT. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Villaggi E, Esposito M, Marino C, Hernandez V, Saez J, Bruschi A, Borzì G, Carbonini C, Consorti R, Fedele D, Moretti E, Nardiello B, Russo S, Stasi M, Mancosu P. PO-1012: Can re-planning improve standardization? A multi-institutional SBRT prostate comparison. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31322-7] [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: 11/25/2022]
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Gurrieri L, Giudici F, Fedele D, Dicorato A, Malagoli M, Moroso S, Del Conte G, Zanconati F, Guglielmi A. Does second-line therapy affect the outcome of the patients with cholangiocarcinoma? A single institution experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.028] [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: 11/14/2022] Open
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15
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Parrino S, Sola M, Giulio B, Rosso A, Cinzia O, Alessandra G, Gurrieri L, Stefano M, Dicorato A, Pascoletti G, Fedele D, Ceschia G, Barazzoni R. Evaluating depression in elderly patients with cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx434.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Pasquino M, Stasi M, Mancosu P, Russo S, Villaggi E, Gasperi C, Casale M, Loi G, Strigari L, Miceli R, Raza G, Fedele D, Vaiano A, Falco M, Moretti E, Giglioli F, Nigro R, Talamonti C, Pastore G, Luxardo S, Menghi E, Benecchi G, Clemente S, Marino C, Borzi G, Nardiello B, Ardu V, Paladini L, Cagni E, Russo G, Spiazzi L, Vittorini F. Dosimetric characterization of linac small beams using a plastic scintillator detector: A multicenter study. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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17
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Talamonti C, Russo S, Barone TL, Benecchi G, Borzi G, Bresciani S, Cagni E, Carbonino C, Casale M, Clemente S, Consorti R, D’Alessio V, Dicastro E, Donofrio G, Falco M, Fedele D, Fiandra C, Frassanito C, Gasperi C, Giglioli F, Iervolino C, Infusino E, Linsalata S, Loi G, Lorenzini E, Marino C, Martinotti S, Masi L, Menghi E, Miceli R, Moretti E, Nardiello B, Nigro R, Pastore G, Pressello M, Pimpinella M, Raza G, Rosica F, Ruggeri R, Spiazzi L, Stasi M, Strigari L, Tremolada V, Vaiano A, Vigorito S, Villaggi E, Vittorini F, Mancosu P. Small beam dosimetry: A multi-center multi-detector italian project. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Barbiero S, Matteucci F, Fedele D, Avanzo M. EP-1662: Comparison of VMAT for single fraction lung cancer radiotherapy with and without flattening filter. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32913-9] [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: 10/21/2022]
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Cagni E, Russo S, Botti A, Bresciani S, Bruzzaniti V, Fedele D, Iori M, Naccarato S, Nardiello B, Orsingher L, Reggiori G, Rinaldi A, Ruggieri R, Stasi M, Strigari L, Zani M, Mancosu P. EP-1508: Multicenter study of FFF beams with a new stereotactic diode: can be defined a universal OF curve? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32758-x] [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: 11/26/2022]
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20
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Giglioli F, Strigari L, Marino C, El Gawhary R, Zani M, Fedele D, Landoni V, Quattrocchi M, Falco M, Cagni E, Mancosu P. Lung SABR: A large-scale multi-institutional dosimetric and radiobiological planning comparison. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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21
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Barbiero S, Matteucci F, Fedele D, Avanzo M. Flattening filter free (FFF) rapid arc for single fraction SBRT of the lung reduces treatment time and is dosimetrically equivalent to flattening filter VMAT. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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22
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Cagni E, Russo S, Bresciani S, Bruzzaniti V, Esposito M, Fedele D, Iori M, Naccarato S, Nardiello B, Orsingher L, Raza G, Reggiori G, Rinaldi A, Ruggieri R, Stasi M, Stravato A, Strigari L, Zani M, Mancosu P. Small field characterization of TrueBeam FFF beams with a new stereotactic diode: A multicenter study. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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23
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Clarizio M, Zani M, Delishaj D, Fedele D, Busutti L, Fabrini M. EP-1619: Comparison between two different commercial thermoplastic mask systems in image-guided radiation therapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41611-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Giglioli F, Ragona R, Fiandra C, Pastore G, Landoni V, Borzì G, Menghi E, Villaggi E, Carbonini C, Zani M, Lorenzini E, Malisan M, Redaelli I, Loi G, Ravaglia V, Fedele D, Nigro R, Nardiello B, Frassanito C, Falco M, Cagni E, Ruggieri R, Consorti R, El Gawhary R, Mancosu P. EP-1471: Lung SABR: radiobiological multi planning comparison in a perspective of a multi-institutional study. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41463-x] [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: 11/26/2022]
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25
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Marino C, Esposito M, Strigari L, Fedele D, Fiandra C, Malisan M, Bonanno E, Carbonini C, Nardiello M, Mancosu P. PO-0831: A feasibility multicenter SBRT planning study on prostate cancer over 17 centers. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30949-x] [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: 10/23/2022]
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26
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Falco M, Fedele D, Ponti E, Tolu B, Di Cristino D, D'Andrea M, Bagalà P, Duggento A, Guerrisi M, Santoni R. EP-1266: Impact of the diet and Image Guided Radiotherapy in late rectal toxicity in patients affected by prostate cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Falco MD, D'Andrea M, Fedele D, Barbarino R, Benassi M, Giudice E, Hamoud E, Ingrosso G, Ladogana P, Santarelli F, Tortorelli G, Santoni R. Preliminary experience of a predictive model to define rectal volume and rectal dose during the treatment of prostate cancer. Br J Radiol 2011; 84:819-25. [PMID: 21849366 DOI: 10.1259/bjr/25741415] [Citation(s) in RCA: 4] [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: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to define a method to evaluate the total dose delivered to the rectum during the whole treatment course in six patients undergoing irradiation for prostate cancer using an offline definition of organ motion with images from a cone beam CT (CBCT) scanner available on a commercial linear accelerator. METHODS Patient set-up was verified using a volumetric three-dimensional CBCT scanner; 9-14 CBCT scans were obtained for each patient. Images were transferred to a commercial treatment planning system for offline organ motion analysis. The shape of the rectums were used to obtain a mean dose-volume histogram (<DVH>), which was the average of the DVHs of the rectums as they appeared in each verification CBCT. A geometric model of an average rectum (AR) was produced using the rectal contours delineated on the CBCT scans (DVH(AR)). To check whether the first week of treatment was representative of the whole treatment course, we evaluated the DVHs related to only the first five CBCT scans (<DVH5> and DVH(AR5)). Finally, the influence of a dietary protocol on the goodness of our results was considered. RESULTS In all six patients the original rectal DVH for the planning CT scan showed higher values than all DVHs. CONCLUSION Although the application of the model to a larger set of patients is necessary to confirm this trend, reconstruction of a representative volume of the rectum throughout the entire treatment course seems feasible.
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Affiliation(s)
- M D Falco
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata University General Hospital, Rome, Italy.
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Lapolla A, Dalfrà MG, Ragazzi E, De Cata AP, Fedele D. New International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations for diagnosing gestational diabetes compared with former criteria: a retrospective study on pregnancy outcome. Diabet Med 2011; 28:1074-7. [PMID: 21658125 DOI: 10.1111/j.1464-5491.2011.03351.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [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: 12/01/2022]
Abstract
AIMS The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) Consensus Panel recommends new criteria for diagnosing gestational diabetes. We evaluated the clinical and metabolic characteristics, and pregnancy outcome, in women previously classifiable as 'normal' according to the 4th International Workshop Conference on gestational diabetes criteria, but reclassified as 'abnormal' according to the new recommendations. METHODS Using the new IADPSG criteria, 3953 pregnancies were retrospectively reclassified as 1815 women with normal glucose tolerance and 2138 with gestational diabetes, 112 (2.8%) of whom would have been classified as normal according to the older criteria. RESULTS Of the 2138 women classified as abnormal by the new criteria, the 112 women now reclassified as abnormal were younger and had a lower pre-pregnancy BMI than the 2026 women who had also been classified as abnormal by the previous criteria. The 100-g oral glucose tolerance test showed significantly higher glucose levels in these 112 women than in the 1815 women reclassified as normal (P < 0.0001). Caesarean section was significantly more frequent (P < 0.01) and the ponderal index for the newborn significantly higher in these reclassified women than in those classified as normal (P < 0.0001), and their basal glucose levels correlated significantly with the ponderal index (P < 0.05). CONCLUSION The new criteria for diagnosing gestational diabetes identified a group of women previously classifiable as normal according to the 4th International Workshop Conference criteria, but revealing metabolic characteristics and pregnancy outcomes resembling those of women who would have been considered to have gestational diabetes by the previous criteria.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
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29
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Lapolla A, Mosca A, Fedele D. The general use of glycated haemoglobin for the diagnosis of diabetes and other categories of glucose intolerance: still a long way to go. Nutr Metab Cardiovasc Dis 2011; 21:467-475. [PMID: 21641782 DOI: 10.1016/j.numecd.2011.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 01/31/2011] [Accepted: 02/06/2011] [Indexed: 12/16/2022]
Abstract
Glycated haemoglobin (HbA(1c)) is considered the 'gold standard' for monitoring metabolic control in diabetes. An International Expert Committee recently recommended HbA(1c) as a better method than measurement of glucose to use in the diagnosis of diabetes, based on its strong association with microvascular complications, a lower day-to-day variability and ease of use, not necessarily in the fasting state. These recommendations have been embraced by the American Diabetes Association (ADA), which stated in its Standards of Medical Care in Diabetes 2010 that "A(1c), fasting plasma glucose or the 2 h 75 g oral glucose tolerance test (OGTT) are appropriate for testing diabetes and assessing the risk of future diabetes," and that "a confirmed A(1c) ≥ 6.5% is diagnostic for diabetes." Measuring HbA(1c) has several advantages over glucose measurements, but its exclusive use should only be considered if the test is conducted under standardised conditions and its limitations are taken into due account. The impact of its use on the epidemiology of diabetes and other categories of glucose intolerance, as seen from recent reports, is also discussed.
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Affiliation(s)
- A Lapolla
- Dipartimento di Scienze Mediche e Chirurgiche, Cattedra di Malattie del Metabolismo, Università degli Studi di Padova, Padova, Italy.
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Lapolla A, Dalfrà MG, Fedele D. Diabetes related autoimmunity in gestational diabetes mellitus: is it important? Nutr Metab Cardiovasc Dis 2009; 19:674-682. [PMID: 19541464 DOI: 10.1016/j.numecd.2009.04.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [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] [Received: 09/24/2008] [Revised: 02/06/2009] [Accepted: 04/01/2009] [Indexed: 01/29/2023]
Abstract
Some GDM women show autoantibody positivity during and after pregnancy and pancreatic autoantibodies can appear for the first time in some patients after delivery. Autoantibody positivity is often accompanied by a high frequency of DR3 and DR4 alleles, which are classically related to the development of type 1 diabetes and, although not all studies agree on this point, by an immunological imbalance expressed by the behaviour of the lymphocyte subpopulation, which can be seen as diabetic anomalies overlapping with the immunological changes that occur during pregnancy. It is worth emphasizing that such patients may develop classical type 1 diabetes during and/or after their pregnancy or they may evolve, often some years after their pregnancy, into cases of latent autoimmune diabetes of adulthood (LADA). Autoimmune GDM accounts for a relatively small number of cases (about 10% of all GDM) but the risk of these women developing type 1 diabetes or LADA is very high, so these patients must be identified in order to prevent the severe maternal and fetal complications of type 1 diabetes developing in pregnancy, or its acute onset afterwards. Since women with autoimmune GDM must be considered at high risk of developing type 1 diabetes in any of its clinical forms, these women should be regarded as future candidates for the immunomodulatory strategies used in type 1 diabetes.
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Affiliation(s)
- A Lapolla
- Department of Clinical and Surgical Sciences-Chair of Metabolic Disease, Padova University, Via Giustiniani n 2, 35100 Padova, Italy.
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Sartore G, Reitano R, Barison A, Magnanini P, Cosma C, Burlina S, Manzato E, Fedele D, Lapolla A. The effects of psyllium on lipoproteins in type II diabetic patients. Eur J Clin Nutr 2009; 63:1269-71. [DOI: 10.1038/ejcn.2009.60] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Piarulli F, Sartore G, Ceriello A, Ragazzi E, Reitano R, Nollino L, Cosma C, Fedele D, Lapolla A. Relationship between glyco-oxidation, antioxidant status and microalbuminuria in type 2 diabetic patients. Diabetologia 2009; 52:1419-25. [PMID: 19401824 DOI: 10.1007/s00125-009-1367-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 03/08/2009] [Indexed: 12/26/2022]
Abstract
AIMS/HYPOTHESIS This study examined the relationship, if any, between glucose-induced oxidative stress, antioxidant status and microalbuminuria in patients with type 2 diabetes. METHODS The study involved 99 consecutive type 2 diabetic patients (57 men, 42 women). Patients with persistent microalbuminuria were identified and the following variables evaluated: fasting plasma glucose, HbA(1c), malonyldialdehyde (MDA), pentosidine, AGE, the total radical-trapping antioxidant parameter (TRAP), vitamin E, creatinine, estimated GFR and lipid profile. RESULTS Patients were divided into two groups, i.e. 37 individuals without microalbuminuria (AER <20 microg/min) and 62 with microalbuminuria (AER > or =20 microg/min). The following variables were significantly higher in patients with microalbuminuria than in those without microalbuminuria (mean +/- SD): fasting plasma glucose 9.41 +/- 2.88 vs 8.19 +/- 1.93 mmol/l, p < 0.05; HbA(1c) 7.97 +/- 1.51 vs 7.39 +/- 1.03%, p < 0.05; MDA 1.18 +/- 0.35 vs 1.02 +/- 0.29 micromol/l, p < 0.05; pentosidine 98.5 +/- 24.6 vs 82.9 +/- 20.9 pmol/ml, p < 0.005; and AGE 13.2 +/- 4.8 vs 10.6 +/- 3.8 microg/mg protein, p < 0.01. However, vitamin E and TRAP did not differ between the two groups. Serum creatinine values and estimated GFR were similar in the two groups. Only in patients with microalbuminuria were significant linear correlations seen between AER and both oxidation (HbA(1c) r = 0.33, p < 0.01; MDA r = 0.59, p < 0.001; pentosidine r = 0.48, p < 0.001; and AGE r = 0.44, p < 0.001) and antioxidation variables (vitamin E r = -0.55, p < 0.001; TRAP r = -0.49, p < 0.001). Considering all variables together, multiple regression revealed a correlation between microalbuminuria and vitamin E, TRAP, HbA(1c) and MDA, but not pentosidine or AGE. CONCLUSIONS/INTERPRETATION Our data suggest that microalbuminuria in type 2 diabetic patients might be promoted by an insufficient counter-regulation of the antioxidant system in the event of increased glyco-oxidation/glycation.
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Affiliation(s)
- F Piarulli
- Department of Medical and Surgical Sciences, University of Padova, Via dei Colli 4, Padua, Italy.
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Patella MN, Ghiotto C, Pertile R, Fiduccia P, Bozza F, Pluchinotta A, Zanetti L, Zavagno G, Cavestro M, Fedele D. Effects of a nutritional intervention in overweight/obese breast cancer patients. Mediterr J Nutr Metab 2009. [DOI: 10.1007/s12349-009-0040-z] [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: 10/20/2022]
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Patella M, Ghiotto C, Pertile R, Fiduccia P, Bozza F, Pluchinotta A, Zanetti L, Zavagno G, Cavestro M, Fedele D. Effects of a nutritional intervention in overweight/obese breast cancer patients. Mediterranean Journal of Nutrition and Metabolism 2009. [DOI: 10.3233/s12349-009-0040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M.N. Patella
- Clinical Nutrition Unit, District 2, Unità Locale Socio Sanitariaria 16, Via Avanzo 35, 35100 Padua, Italy. e-mail:
- Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy
| | - C. Ghiotto
- Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy
- Oncological Institute of Veneto (IOV), Padua, Italy
| | - R. Pertile
- Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
| | - P. Fiduccia
- Oncological Institute of Veneto (IOV), Padua, Italy
| | - F. Bozza
- Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy
- Oncological Institute of Veneto (IOV), Padua, Italy
| | - A. Pluchinotta
- Department of Surgery, Hospital of Abano Terme, Abano Terme, Italy
| | - L. Zanetti
- Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy
| | - G. Zavagno
- Mammary Oncological Centre (COM), Hospital of Padova, Padua, Italy
- Oncological Institute of Veneto (IOV), Padua, Italy
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
| | - M. Cavestro
- Clinical Nutrition Unit, District 2, Unità Locale Socio Sanitariaria 16, Via Avanzo 35, 35100 Padua, Italy. e-mail:
| | - D. Fedele
- Clinical Nutrition Unit, District 2, Unità Locale Socio Sanitariaria 16, Via Avanzo 35, 35100 Padua, Italy. e-mail:
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
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Dalfrà MG, Fedele D, Ragazzi E, Cosma C, Bisson T, Masin M, Lapolla A. Elevations of inflammatory cytokines during and after pregnancy in gestational diabetes. J Endocrinol Invest 2009; 32:289-90. [PMID: 19542752 DOI: 10.1007/bf03346470] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Adriani O, Barbarino GC, Bazilevskaya GA, Bellotti R, Boezio M, Bogomolov EA, Bonechi L, Bongi M, Bonvicini V, Bottai S, Bruno A, Cafagna F, Campana D, Carlson P, Casolino M, Castellini G, De Pascale MP, De Rosa G, Fedele D, Galper AM, Grishantseva L, Hofverberg P, Leonov A, Koldashov SV, Krutkov SY, Kvashnin AN, Malvezzi V, Marcelli L, Menn W, Mikhailov VV, Minori M, Mocchiutti E, Nagni M, Orsi S, Osteria G, Papini P, Pearce M, Picozza P, Ricci M, Ricciarini SB, Simon M, Sparvoli R, Spillantini P, Stozhkov YI, Taddei E, Vacchi A, Vannuccini E, Vasilyev G, Voronov SA, Yurkin YT, Zampa G, Zampa N, Zverev VG. New measurement of the antiproton-to-proton flux ratio up to 100 GeV in the cosmic radiation. Phys Rev Lett 2009; 102:051101. [PMID: 19257498 DOI: 10.1103/physrevlett.102.051101] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2008] [Revised: 11/21/2008] [Indexed: 05/27/2023]
Abstract
A new measurement of the cosmic-ray antiproton-to-proton flux ratio between 1 and 100 GeV is presented. The results were obtained with the PAMELA experiment, which was launched into low-Earth orbit on-board the Resurs-DK1 satellite on June 15th 2006. During 500 days of data collection a total of about 1000 antiprotons have been identified, including 100 above an energy of 20 GeV. The high-energy results are a tenfold improvement in statistics with respect to all previously published data. The data follow the trend expected from secondary production calculations and significantly constrain contributions from exotic sources, e.g., dark matter particle annihilations.
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Affiliation(s)
- O Adriani
- Physics Department of University of Florence, I-50019 Sesto Fiorentino, Florence, Italy
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Patella M, Goldin D, Aggujaro M, De Gobbi L, Giarretta R, Michieli E, Pallini P, Ronzani G, Salice E, Fiduccia P, Pertile R, Fedele D. Nutritional concerns of cancer patients and their families. Mediterranean Journal of Nutrition and Metabolism 2009. [DOI: 10.3233/s12349-008-0026-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M.N. Patella
- Dietetics and Clinical Nutrition Unit, ULSS (Unità Locale Socio-Sanitaria) 16, District 2, Via Avanzo 35, 35143 Padua, Italy. e-mail:
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - D. Goldin
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - M. Aggujaro
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - L. De Gobbi
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - R. Giarretta
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - E. Michieli
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - P. Pallini
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - G. Ronzani
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - E. Salice
- Italian Association of Dietetics and Clinical Nutrition (ADI), Veneto Area, Italy
| | - P. Fiduccia
- Istituto Oncologico Veneto (IOV), Padua, Italy
| | - R. Pertile
- Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
| | - D. Fedele
- Dietetics and Clinical Nutrition Unit, ULSS (Unità Locale Socio-Sanitaria) 16, District 2, Via Avanzo 35, 35143 Padua, Italy. e-mail:
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Sartore G, Lapolla A, Reitano R, Zambon S, Romanato G, Marin R, Cosma C, Manzato E, Fedele D. Desaturase activities and metabolic control in type 2 diabetes. Prostaglandins Leukot Essent Fatty Acids 2008; 79:55-8. [PMID: 18771908 DOI: 10.1016/j.plefa.2008.07.001] [Citation(s) in RCA: 13] [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] [Received: 03/28/2008] [Revised: 06/27/2008] [Accepted: 07/11/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to elucidate the effects of a poor glycemic control on fatty acid composition and desaturase activities in type 2 diabetic patients. Plasma phospholipid fatty acid composition and desaturase activities (estimated from fatty acid product to precursor ratios) were measured in 30 type 2 diabetic patients during poor metabolic control and after achieving a good metabolic control. Significant changes were recorded in the percentages of palmitic, stearic, dihomo-gamma-linolenic, docosatetraenoic and docosapentaenoic acid. The delta-5 desaturase activity was significantly higher with poor than with good metabolic control. The changes identified in plasma phospholipid fatty acid composition and the desaturase activity in type 2 diabetic patients go in the opposite direction to those described in similar conditions in type 1 diabetic patients and may be relevant to a better understanding of the role of metabolic control in the progression of chronic complications in type 2 diabetic patients.
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Affiliation(s)
- G Sartore
- Department of Medical and Surgical Sciences, University of Padua, Via Dei Colli, 4, 35143 Padova, Italy.
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Lapolla A, Dalfrà MG, Mello G, Parretti E, Cioni R, Marzari C, Masin M, Ognibene A, Messeri G, Fedele D, Mari A, Pacini G. Early detection of insulin sensitivity and beta-cell function with simple tests indicates future derangements in late pregnancy. J Clin Endocrinol Metab 2008; 93:876-80. [PMID: 18089696 DOI: 10.1210/jc.2007-1363] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [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: 02/12/2023]
Abstract
OBJECTIVE Insulin sensitivity and secretion during early and late pregnancy were assessed in women with normal glucose tolerance and gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS The oral glucose tolerance test (OGTT) was performed in 903 women at 16-20th gestational week, of whom 37 had GDM (GDM1 group), and 859 repeated the OGTT at wk 26-30. At the second test, 55 had GDM (GDM2 group); the others remained normotolerant (ND group). Insulin sensitivity from OGTT (as quantitative insulin sensitivity check index and OGTT insulin sensitivity) and beta-cell function (as the ratio of the areas under the insulin and glucose concentration curves, adjusted for insulin sensitivity) were assessed in both tests. RESULTS In early pregnancy the quantitative insulin sensitivity check index was not different in the three groups, whereas OGTT insulin sensitivity was lowest in GDM2, intermediate in GDM1, and highest in ND. In late pregnancy both indices were reduced in GDM compared with ND and lower than in early pregnancy. In early pregnancy GDM1, but not GDM2, had lower beta-cell function than ND. During the late visit, GDM2 also showed impaired beta-cell function compared with ND; furthermore, the adaptation to the increase to insulin resistance from early to late pregnancy was defective in GDM2. CONCLUSIONS In early pregnancy insulin sensitivity, as assessed from the OGTT but not from fasting measurements, is impaired in women who developed GDM. beta-Cell function impairment is evident only when GDM is manifest and is characterized by inappropriate adaptation to the pregnancy induced increase in insulin resistance.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, Via Giustiniani n 2, 35100 Padova, Italy.
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Piarulli F, Sambataro M, Minicuci N, Scarano L, Laverda B, Baiocchi MR, Baldo-Enzi G, Galasso S, Bax G, Fedele D. Mild peripheral neuropathy prevents both leg muscular ischaemia and activation of exercise-induced coagulation in Type 2 diabetic patients with peripheral artery disease. Diabet Med 2007; 24:1099-104. [PMID: 17888132 DOI: 10.1111/j.1464-5491.2007.02237.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/29/2022]
Abstract
AIM To study the influence of peripheral neuropathy on intermittent claudication in patients with Type 2 diabetes (T2DM). METHODS Twenty-five patients with T2DM were grouped according to the ankle/brachial index (ABI): 10 with ABI > 0.9 without peripheral artery disease (PAD; group T2DM) and 15 with ABI < 0.9 with PAD (group T2DM + PAD). Twelve individuals without T2DM with PAD (group PAD without T2DM) were also enrolled. Tests for peripheral neuropathy were performed in all patients. ABI, rate pressure product, prothrombin fragments 1 + 2 (F1+2), thrombin-anti-thrombin complex (TAT), and d-dimer were measured before and after a treadmill test. During exercise both initial and absolute claudication distance and electrocardiogram readings were recorded. RESULTS We found mild peripheral neuropathy in 20% of group T2DM and 46.7% of group T2DM + PAD (P < 0.01). After exercise, the rate pressure product increased in each group; ABI fell in T2DM + PAD (P < 0.0001) and in PAD without T2DM (P = 0.0005); the fall was greater in the latter group. Initial and absolute claudication distances were similar in PAD patients. In group T2DM + PAD, absolute claudication distance was longer in the subgroup without peripheral neuropathy (P < 0.05), whereas ABI and rate pressure products were similar. F1+2 values at rest were higher in group T2DM + PAD. After exercise, F1+2 values and TAT increased only in group PAD without T2DM. CONCLUSION Only group PAD without T2DM experienced muscular ischaemia, whereas group T2DM + PAD did not. Mild peripheral neuropathy may have prevented them from reaching the point of muscular ischaemia during the treadmill test, because they stopped exercising with the early onset of pain. Reaching a false absolute claudication distance may induce ischaemic preconditioning. These findings suggest a possible protective role of mild peripheral neuropathy in T2DM patients with intermittent claudication, by preventing further activation of coagulation during treadmill testing.
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Affiliation(s)
- F Piarulli
- Department of Medical and Surgical Science, University of Padova, Padova, Italy.
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Lapolla A, Fedele D, Reitano R, Bonfante L, Pastori G, Seraglia R, Tubaro M, Traldi P. Advanced Glycation End Products/Peptides: Anin VivoInvestigation. Ann N Y Acad Sci 2006; 1043:267-75. [PMID: 16037247 DOI: 10.1196/annals.1333.032] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Advanced glycation end products/peptides (AGE/peptides) originate by in vivo enzymatic digestion of nonenzymatically glycated proteins, which are produced by reaction of glucose with primary amino groups present in the protein chain following the Maillard pattern. AGE/peptides are highly reactive species and can interact with tissue and circulating proteins, leading to tissue modification and impaired protein functionality. Serum levels of AGE/peptides are reported to be particularly high in diabetes (in terms of higher production) or in end-stage renal disease (in terms of accumulation). For these reasons, their structural identification is of high interest, giving information on their relationship with the pathological state and allowing the design of possible therapeutic interventions. We report here some preliminary results obtained by liquid chromatography/electrospray ionization/mass spectrometry (LC/ESI/MS) and matrix-assisted laser desorption ionization MS (MALDI-MS) investigations carried out on the low-molecular-weight serum peptide fraction from 10 healthy subjects, 10 patients with poorly controlled diabetes, and 10 patients with end-stage nephropathy.
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Affiliation(s)
- A Lapolla
- Cattedra di Malattie del Metabolismo, Universitá di Padova, Italy
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Piarulli F, Lapolla A, Sartore G, Laverda B, Reitano R, Marin R, Manzato E, Fedele D. We-P11:22 Carotid atherosclerotic plaques in type 2 diabetic patients: Role of glycoxidation. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81378-4] [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: 11/25/2022]
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Lapolla A, Dalfrà MG, Sanzari M, Fedele D, Betterle C, Masin M, Zanchetta R, Faggian D, Masotti M, Nucera V, Plebani M. Lymphocyte subsets and cytokines in women with gestational diabetes mellitus and their newborn. Cytokine 2005; 31:280-7. [PMID: 15979891 DOI: 10.1016/j.cyto.2005.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2004] [Revised: 04/11/2005] [Accepted: 05/10/2005] [Indexed: 01/13/2023]
Abstract
This study aimed to identify potential immunological markers for predicting type 1 diabetes in patients with gestational diabetes mellitus (GDM) and any immunological impairment in their newborn. In 62 GDM patients and 74 women with normal glucose tolerance (NGT), and their babies, we assessed total lymphocytes, T lymphocyte subsets CD3 and CD8 expressing T cell receptor (TCR) alpha/beta or gamma/delta, CD16 and CD19, pancreatic autoantibodies and cytokines (IL-5, IL-2, soluble receptor IL-2). At delivery, umbilical cord blood samples were taken for lymphocyte subpopulations and cytokine measurements. GDM mothers had higher levels of total lymphocytes, CD8 expressing TCR gamma/delta, and lower levels of CD3 expressing TCR alpha/beta than NGT controls. Insulin-treated GDM mothers had lower CD4 and CD4/CD8 ratios, and higher CD8 and IL-5 than diet-treated GDM or controls. Five women were positive for pancreatic autoantibodies, with lower CD4 (p<0.01) and CD4/CD8 ratios (p<0.05), and higher CD8 (p<0.03) and CD19 than GDM and control mothers negative for autoantibodies. GDM newborn had higher CD8 gamma/delta and lower CD16 than NGT babies. There were no significant differences in TNF-alpha concentrations in the cord blood obtained from the GDM and NGT newborn. In conclusion, GDM women and their newborn have lymphocyte subset impairments, which are more important in patients positive for autoantibodies and/or treated with insulin.
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Affiliation(s)
- A Lapolla
- Metabolic Disorders Section, Department of Medical and Surgical Sciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
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Lapolla A, Fedele D, Reitano R, Bonfante L, Guizzo M, Seraglia R, Tubaro M, Traldi P. Mass spectrometric study of in vivo production of advanced glycation end-products/peptides. J Mass Spectrom 2005; 40:969-972. [PMID: 15768376 DOI: 10.1002/jms.842] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Abstract
It has been demonstrated that good metabolic control maintained throughout pregnancy can reduce maternal and fetal complications in diabetes. To achieve good metabolic control, before conception and throughout pregnancy, insulin therapy needs to be optimized, and, in this context, the new insulins currently on the market may help. We therefore review here what is known about the potential benefits and risks related to the use of these new insulins in pregnancy. Clinical and experimental data on insulin lispro strongly suggest that lispro does not have adverse maternal or fetal effects during pregnancy in women with preexisting diabetes, and also that its use in these women results in improved glycemic control, fewer hypoglycemic episodes, and improved patient satisfaction. In women with gestational diabetes mellitus (GDM), the use of insulin lispro is efficient in reducing postprandial hyperglycemia and some neonatal features related to hyperglycemia, thus stressing its usefulness in this condition. As for insulin aspart, clinical data on GDM patients shows the same efficacy as insulin lispro in lowering postprandial hyperglycemia, indicating that insulin aspart may be used in GDM when this condition is characterized by postprandial hyperglycemia. The results of a multicentric study now in progress on the efficacy and safety of insulin aspart in type 1 pregnant diabetic patients will definitely be useful in establishing whether this insulin is safe in pregnancy. For the moment, the use of insulin glargine during pregnancy is not recommended owing to the lack of data on maternal and fetal effects.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, University of Padova, Italy
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Abstract
Levels of plasma pentosidine, a well-known AGE, were measured in type 2 diabetic patients in varying states of metabolic control to verify possible relationships between this parameter and traditional metabolic control parameters such as HbA1c and plasma glucose levels. At baseline, mean values of fasting plasma glucose, HbA1c and pentosidine were significantly higher in diabetic patients than those of controls, confirming patients' poor glycemic control. After ten months, patients with good metabolic control achieved showed near-normal HbA1c levels and reduced but not normalized pentosidine levels. Significant differences were found in the mean percentage decrease in the parameters. Regarding linear correlation, HbA1c levels only showed a positive relationship with plasma glucose values at baseline. Patients affected by chronic complications showed higher levels of pentosidine than those without complications. Thus, pentosidine plasma levels may be used to evaluate very long-term metabolic control in diabetic patients. In addition, a period of ten months of acceptable metabolic control is not enough to normalize pentosidine levels in diabetics, thus emphasizing the need for a longer period of improved metabolic control to reduce both this parameter and the burden of chronic diabetic complications.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, University of Padua, Italy.
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Lapolla A, Tubaro M, Fedele D, Reitano R, Aricò NC, Ragazzi E, Seraglia R, Vogliardi S, Traldi P. A matrix-assisted laser desorption/ionization mass spectrometry study of the non-enzymatic glycation products of human globins in diabetes. Rapid Commun Mass Spectrom 2005; 19:162-168. [PMID: 15593243 DOI: 10.1002/rcm.1759] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The molecular species present in globins from healthy and diabetic subjects with and without chronic complications have been analyzed by matrix-assisted laser desorption/ionization mass spectrometry. The technique demonstrated the presence of glycated and glyco-oxidated species of both alpha- and beta-globins. Their abundances show a good linear relationship with respect to HbA1c values and with the mean daily plasma glucose levels over the 6 weeks preceding the investigation. Interestingly, slightly different behaviour is observed in the data from patients with and without chronic complications; the plots of HbA1c vs. the abundance of glycated and glyco-oxidated species show different slopes and different intercepts with the y-axis. To investigate this aspect the mean abundances of glyco-oxidated species from healthy subjects and from diabetic patients with and without complications were calculated. Higher values were found for the two last sets of samples, but no significant difference was found between them. These data could indicate different individual proclivities to oxidation and/or different oxidation kinetics related to behavioural and environmental factors.
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Affiliation(s)
- A Lapolla
- Dipartimento di Scienze Mediche e Chirurgiche, Malattie del Metabolismo, University of Padova, Via Giustiniani 2, I-35100, Padova, Italy
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Lapolla A, Tubaro M, Reitano R, Aricò NC, Ragazzi E, Seraglia R, Vogliardi S, Traldi P, Fedele D. The complexity of non-enzymatic glycation product sets of human globins. Diabetologia 2004; 47:1712-5. [PMID: 15549235 DOI: 10.1007/s00125-004-1512-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Accepted: 07/12/2004] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS Recently an individual variability in the relationships between mean blood glucose levels and HbA1c has been observed among diabetic patients. The aim of this study was to provide an accurate description and evaluation of glycated and glyco-oxidated globins from diabetic subjects and their relationship with HbA1c and plasma glucose values. METHODS We studied 20 type 2 diabetic and 10 healthy subjects. Plasma samples were analysed by matrix-assisted laser desorption ionisation mass spectrometry. RESULTS The presence of glycated and glyco-oxidated species of both alpha and beta globin was demonstrated. Values for these showed a good linear relationship with HbA1c values and the mean daily plasma glucose values for the 6 weeks preceding the investigation. Trends differed according to whether patients had chronic complications or not, differences being seen in the slopes of the plots relating HbA1c to the abundance of glycated and glyco-oxidated species. CONCLUSIONS/INTERPRETATION The data obtained are consistent with the concept that individuals have a different individual proclivity for oxidation and/or that different oxidation kinetics are related to behavioural and environmental factors. Our data are thus relevant to the analysis of phenotype differences in diabetic patients.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, Metabolic Diseases, University of Padua, Padua, Italy.
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Lapolla A, Dalfrà MG, Masin M, Bruttomesso D, Piva I, Crepaldi C, Tortul C, Dalla Barba B, Fedele D. Analysis of outcome of pregnancy in type 1 diabetics treated with insulin pump or conventional insulin therapy. Acta Diabetol 2003; 40:143-9. [PMID: 14605971 DOI: 10.1007/s00592-003-0103-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2003] [Accepted: 07/02/2003] [Indexed: 11/25/2022]
Abstract
We evaluated the outcome of pregnancies followed between 1990 and 2000 in 93 women with type 1 diabetes, treated with conventional intensive insulin therapy (n=68) or continuous subcutaneous insulin infusion (n=25). We evaluated metabolic control (fasting and 1-hour post-prandial plasma glucose and HbA1c levels), spontaneous or induced abortions, time and mode of delivery, maternal outcome (pregnancy-induced hypertension, preeclampsia, placental insufficiency, hydramnios, hypoglycemic coma, ketoacidosis) and fetal outcome (weight, hypoglycemia, hypocalcemia, hyperbilirubinemia, fetal distress, asphyxia, hyaline membrane disease, polycythemia, shoulder dystocia, malformations). Patients treated with insulin pump more frequently had background retinopathy and clinical neuropathy. No significant differences were observed between the two groups in metabolic control and maternal outcome. Glycemic control, non-optimal in the prepregnancy state, improved significantly during pregnancy, as shown by the progressive reduction in HbA1c levels. As regards fetal outcome, no differences were observed between the two groups in morbidity and especially in malformation rate. Patients with malformed babies did not have optimal metabolic control at conception. Thus, maternal and perinatal outcomes were comparable in patients treated with insulin pump and continuous subcutaneous insulin therapy, and depended on metabolic control. In patients in higher White's class and with more unstable glycemia, we achieved metabolic control and outcomes comparable with those of women of lower White's class and more stable glycemic values using the insulin pump. Our data suggest that insulin pump therapy is useful in problematic, complicated cases of women who want a baby.
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Affiliation(s)
- A Lapolla
- Department of Medical and Surgical Sciences, University of Padua, Via E. Vendramini 7, I-35137, Padua, Italy
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Roselli della Rovere G, Lapolla A, Sartore G, Rossetti C, Zambon S, Minicuci N, Crepaldi G, Fedele D, Manzato E. Plasma lipoproteins, apoproteins and cardiovascular disease in type 2 diabetic patients. A nine-year follow-up study. Nutr Metab Cardiovasc Dis 2003; 13:46-51. [PMID: 12772437 DOI: 10.1016/s0939-4753(03)80167-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [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: 11/28/2022]
Abstract
BACKGROUND AND AIM To evaluate the role of lipoprotein abnormalities as risk factors for macroangiopathy in Type 2 diabetes. METHODS AND RESULTS This prospective nine-year follow-up study involved 113 Type 2 diabetic patients (50 men and 63 women, mean age 66.9 +/- 9.9 years), 37 of whom had clinical signs of coronary heart disease (CHD) and cerebrovascular disease (CVD) at baseline. During the follow-up, 32 patients died: 17 of CHD, five of CVD, and 10 of non-vascular causes. The patients who died because of vascular disease were more frequently smokers, and had baseline symptoms of vascular disease; they were also significantly different from the other patients insofar as they were older, and had higher fasting plasma glucose levels, lower fasting C-peptide levels, and lower apoprotein (apo) AII, apo CII, apo CIII and apo E levels. Univariate analysis showed that baseline symptoms of vascular disease, current smoking, age, high fasting plasma glucose levels, low fasting C-peptide levels, and low apo AII, apo CII, apo CIII and apo E levels [but not cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol or qualitative low-density lipoprotein or HDL abnormalities] were associated with cardiovascular mortality. Multivariate analysis showed that only age, smoking, glycated hemoglobin (HbA1c) and fasting C-peptide levels were significant independent determinants of macrovascular death. CONCLUSIONS In Type 2 normolipidemic diabetic patients, only age, smoking, HbA1c and fasting C-peptide levels are independent vascular risk factors. The differences in apo concentrations between patients with and without vascular disease may reflect qualitative abnormalities in plasma lipoproteins related to vascular disease.
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