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Filippone A, Lanza M, Mannino D, Raciti G, Colarossi C, Sciacca D, Cuzzocrea S, Paterniti I. PD1/PD-L1 immune checkpoint as a potential target for preventing brain tumor progression. Cancer Immunol Immunother 2022; 71:2067-2075. [PMID: 35092481 PMCID: PMC9374620 DOI: 10.1007/s00262-021-03130-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 04/13/2021] [Accepted: 12/09/2021] [Indexed: 02/08/2023]
Abstract
Programmed death-1 (PD-1) is a cell surface receptor that functions as a T cell checkpoint and plays a central role in regulating T cell collapse. The binding of PD-1 to its ligand programmed death-ligand 1 (PD-L1) activates downstream signaling pathways and inhibits T cell activation in the perspective of immune system mechanism and regulation in tumor progression. It is well reported that tumors adopt certain immune-checkpoint pathways as a mechanism of resistance against immune cells such as T cells that are specific for tumor antigens. Indeed, the PD-1/PD-L1 pathway controls the induction and maintenance of immune tolerance within the tumor microenvironment. Thus, the PD-1/PD-L1 checkpoint regulation appears to be of extreme importance as well as the immunotherapy targeting that via and the using of PD-1/PD-L1 inhibitors that have changed the scenario of brain cancer treatment and survival. Here, we review the mechanism of action of PD-1 and PD-L1, the PD/PDL-1 signaling pathway involved in the progression of brain tumors, and its application as cancer immunotherapy counteracting tumor escape in central nervous system.
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Affiliation(s)
- A Filippone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, viale Ferdinando Stagno D'Alcontres, 31, 98166, Messina, Italy
| | - M Lanza
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, viale Ferdinando Stagno D'Alcontres, 31, 98166, Messina, Italy
| | - D Mannino
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, viale Ferdinando Stagno D'Alcontres, 31, 98166, Messina, Italy
| | - G Raciti
- IOM Ricerca Srl, via Penninazzo 11, 95029, Catania, Italy
| | - C Colarossi
- Instituto Oncologico del Mediterraneo, via Penninazzo 7, 95029, Catania, Italy
| | - D Sciacca
- Instituto Oncologico del Mediterraneo, via Penninazzo 7, 95029, Catania, Italy
| | - S Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, viale Ferdinando Stagno D'Alcontres, 31, 98166, Messina, Italy
| | - I Paterniti
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, viale Ferdinando Stagno D'Alcontres, 31, 98166, Messina, Italy.
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Oppenheimer J, Abott C, Chang S, Chupp G, Crawford J, Mannino D, Win P. D010 CAPTAIN STUDY: EFFECTS OF BASELINE IGE LEVELS ON TRIPLE THERAPY RESPONSE IN INADEQUATELY CONTROLLED ASTHMA. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.048] [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: 10/19/2022]
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Hanania N, Bailes Z, Barnes N, Gardiner F, Lugogo N, Mannino D, Mehta V, Nyanjom D, Sitz K, Kerstjens H. P206 CAPTAIN STUDY: EFFECTS OF FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL ON FEV1 IMPROVEMENT IN ASTHMA ACCORDING TO AGE. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.103] [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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Oppenheimer J, Brusselle G, Busse W, Fowler A, Jain N, Mannino D, Pavord I, Win P, Zarankaite A, Kerwin E. P202 CAPTAIN STUDY: TREATMENT OUTCOMES FROM FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL ACCORDING TO HISTORY OF SEVERE ASTHMA EXACERBATIONS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.099] [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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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Andreozzi F, Candido R, Corrao S, Fornengo R, Giancaterini A, Ponzani P, Ponziani MC, Tuccinardi F, Mannino D. Clinical inertia is the enemy of therapeutic success in the management of diabetes and its complications: a narrative literature review. Diabetol Metab Syndr 2020; 12:52. [PMID: 32565924 PMCID: PMC7301473 DOI: 10.1186/s13098-020-00559-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022] Open
Abstract
Diabetes mellitus is a chronic disease characterized by high social, economic and health burden, mostly due to the high incidence and morbidity of diabetes complications. Numerous studies have shown that optimizing metabolic control may reduce the risk of micro and macrovascular complications related to the disease, and the algorithms suggest that an appropriate and timely step of care intensification should be proposed after 3 months from the failure to achieve metabolic goals. Nonetheless, many population studies show that glycemic control in diabetic patients is often inadequate. The phenomenon of clinical inertia in diabetology, defined as the failure to start a therapy or its intensification/de-intensification when appropriate, has been studied for almost 20 years, and it is not limited to diabetes care, but also affects other specialties. In the present manuscript, we have documented the issue of inertia in its complexity, assessing its dimensions, its epidemiological weight, and its burden over the effectiveness of care. Our main goal is the identification of the causes of clinical inertia in diabetology, and the quantification of its social and health-related consequences through the adoption of appropriate indicators, in an effort to advance possible solutions and proposals to fight and possibly overcome clinical inertia, thus improving health outcomes and quality of care.
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Affiliation(s)
- F. Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - R. Candido
- Diabetes Center District 3, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - S. Corrao
- Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - R. Fornengo
- SSD of Diabetology and Metabolic Diseases, Hospital of Chivasso, Turin, Italy
| | | | - P. Ponzani
- Operative Unit of Diabetology, “La Colletta” Hospital, Genoa, Italy
| | - M. C. Ponziani
- SSD of Diabetology-Azienda Sanitaria Locale Novara, Novara, Italy
| | - F. Tuccinardi
- Diabetology and Endocrinology Unit “Clinica del Sole” Formia, Formia, Italy
| | - D. Mannino
- Section of Endocrinology and Diabetes, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
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Icardi G, Francia F, Di Bartolo P, Mannino D, Alti E, Purrello F, Sesti G, Sessa A. Multi-disciplinary Consensus Statement Document Vaccinal prevention in adult patients with diabetes mellitus. J Prev Med Hyg 2018; 59:E249-E256. [PMID: 30656226 PMCID: PMC6319117 DOI: 10.15167/2421-4248/jpmh2018.59.4.1124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 11/30/2018] [Indexed: 11/09/2022]
Affiliation(s)
- G. Icardi
- ITALIAN SOCIETY OF HYGIENE, PREVENTIVE MEDICINE AND PUBLIC HEALTH (SItI)
- * Correspondence: Giancarlo Icardi, Department of Health Sciences, University of Genoa, Italy - E-mail:
| | - F. Francia
- ITALIAN SOCIETY OF HYGIENE, PREVENTIVE MEDICINE AND PUBLIC HEALTH (SItI)
| | | | - D. Mannino
- ITALIAN ASSOCIATION OF MEDICAL DIABETOLOGISTS (AMD)
| | - E. Alti
- ITALIAN FEDERATION OF GENERAL PRACTITIONERS (FIMMG)
| | | | - G. Sesti
- ITALIAN SOCIETY OF DIABETOLOGY (SID)
| | - A. Sessa
- ITALIAN SOCIETY OF GENERAL MEDICINE & PRIMARY CARE (SIMG)
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Ahmad O, Shafii A, Mannino D, Choate R, Baz M. Impact of Donor Lung Pathogenic Bacteria on Patient Outcomes in the Immediate Post-transplant Period. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.921] [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: 11/16/2022] Open
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Caputo S, Maran A, Mannino D, Morano S, Lastoria G, Nicoziani P. Safety and effectiveness of insulin detemir in combination with oral antidiabetic agents in an outpatient specialist setting: results of the Italian SOLVE™ observational study. MINERVA ENDOCRINOL 2015; 40:249-258. [PMID: 26551483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The addition of basal insulin to oral antidiabetics (OADs) is described by a large number of guidelines and commonly used in clinical practice as a way to start insulin therapy in patients with type 2 diabetes mellitus in order to maximize compliance and minimise the impact of side effects (mainly hypoglycemia and body weight increase). METHODS SOLVE™ was a 24-week international observational study conducted in 10 countries (including Italy) for the evaluation of the safety and effectiveness of once-daily insulin detemir as add-on therapy in patients with type 2 diabetes mellitus (T2DM) already treated with one or more OADs. The Italian arm of the Solve™ Study aimed to evaluate the safety and the effectiveness of once-daily insulin detemir in combination with OAD agents for the treatment of patients with T2DM in the Italian outpatient specialist setting. The primary endpoint was to assess the incidence of serious adverse drug reactions (SADRs) including in the specific major hypoglycemic events during 24 weeks of once-daily insulin detemir treatment. RESULTS A total of 4625 patients were enrolled in the study by 223 Italian centres for diabetes care. At baseline the mean (±SD) demographic characteristics of the patients were: age 66.5 (±10.0) years, duration of diabetes 13.25 (±8.14) years, weight 78.95 (±15.86) kg and BMI 29.5 (±5.0) kg/m2. At the end of the study, 3 SADRs (of which 2 were major hypoglycemia) were reported in 2 patients (<0.1%). The percentage of patients with at least 1 minor hypoglycemic event during the 4 weeks preceding insulin initiation was 3.6%. Following insulin initiation, 5.7% (as recorded at baseline visit) had at least 1 minor hypoglycemic event, which decreased slightly by the end of the study compared to baseline (4.8%). In addition, before insulin initiation the mean (±SD) glycemic control values were: fasting plasma glucose (FPG) 11.43 (±3.2) mmol/L and HbA1c 9.16% (±1.46). At the end of the study, HbA1c was reduced by 1.35% (±1.57) (P<0.001), FPG was reduced by 3.34 mmol/L (P<0.001) and the percentage of patients with HbA1c<7% was 21.9%. A mean reduction of 0.52 kg of body weight (P<0.001) was observed compared to before insulin initiation; the body weight reduction was more pronounced in patients with higher BMI before insulin initiation (-1.0 kg for 30<BMI<35; -2.1 kg for BMI<35). CONCLUSION In the Italian outpatient setting, once-daily insulin detemir as add-on therapy to OADs was associated with a favourable tolerability profile. The improvement of the glycemic control after initiation with insulin detemir was clinically significant and did not cause an increase in body weight or hypoglycemia.
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Affiliation(s)
- S Caputo
- Unit of Diabetology, Policlinico Gemelli, Catholic University, Rome, Italy -
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Hanson C, Lyden E, Rutten E, Rennard S, Mannino D, Young R. SUN-PP159: The Relationship between Dietary Fiber Intake Low Fev1 in Nhanes. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30310-1] [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: 11/28/2022]
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Turgutalp K, Ozhan O, Akbay E, Tiftik N, Ozcan T, Yilmaz S, Kiykim A, Wu HY, Peng YS, Huang JW, Wu KD, Tu YK, Chien KL, Kacso IM, Moldovan D, Lenghel A, Rusu CC, Gherman Caprioara M, Silva AP, Fragoso A, Pinho A, Silva C, Santos N, Tavares N, Faisca M, Camacho A, Mesquita F, Leao P, Silva AP, Silva C, Santos N, Rato F, Fragoso A, Pinho A, Faisca M, Mesquita F, Leao P, Silva AP, Silva C, Santos N, Rato F, Fragoso A, Pinho A, Faisca M, Mesquita F, Leao P, Oh DJ, Kim HR, Kim SH, Okasha K, Sweilam M, Nagy H, Hassan Rizk M, Kirkpantur A, Afsar B, Chae DW, Chin HJ, Kim S, Fallahzadeh Abarghouei MK, Dormanesh B, Roozbeh J, Kamali-Sarvestani E, Vessal G, Pakfetrat M, Sagheb MM, Imasawa T, Nishimura M, Kawaguchi T, Ishibashi R, Kitamura H, Vlad A, Petrica L, Petrica M, Jianu DC, Gluhovschi G, Ianculescu C, Negru M, Dumitrascu V, Gadalean F, Zamfir A, Popescu C, Giju S, Gluhovschi C, Velciov S, Milas O, Balgradean C, Ursoniu S, Afsar B, Silva AP, Pinho A, Fragoso A, Silva C, Santos N, Faisca M, Mesquita F, Leao P, Soltysiak J, Zachwieja J, Fichna P, Lipkowska K, Skowronska B, Stankiewicz W, Stachowiak-Lewandowska M, Kluska-Jozwiak A, Afghahi H, Prasad N, Bhadauria D, Gupta A, Sharma RK, Gupta A, Kaul A, Jain M, Loboda O, Dudar I, Korol L, Shifris I, Ito K, Ito K, Abe Y, Ogahara S, Yasuno T, Watanabe M, Sasatomi Y, Hisano S, Nakashima H, Saito T, Nogaibayeva A, Tuganbekova S, Taubaldiyeva Z, Bekishev B, Trimova R, Topchii I, Topchii I, Semenovykh P, Galchiskaya V, Efimova N, Scherban T, Yasuda F, Shimizu A, MII A, Fukui M, Postorino M, Alessi E, Dal Moro E, Postorino S, Mannino G, Giandalia A, Mannino D, Pontrelli P, Conserva F, Accetturo M, Papale M, DI Palma AM, Cordisco G, Grandaliano G, Gesualdo L, Kimoto E, Shoji T, Sonoda M, Shima H, Tsuchikura S, Mori K, Emoto M, Ishimura E, Nishizawa Y, Inaba M, Vogel C, Scholbach T, Bergner N, Lioudaki E, Lioudaki E, Stylianou K, Maragkaki E, Stratakis S, Panteri M, Choulaki C, Vardaki E, Ganotakis E, Daphnis E, Iqbal M, Ahmed Z, Mansur M, Iqbal S, Choudhury S, Nahar N, Ali S, Ahmed T, Alam A, Rahman Z, Islam M, Azad Khan A, Ogawa A, Sugiyama H, Kitagawa M, Morinaga H, Inoue T, Takiue K, Kikumoto Y, Uchida HA, Kitamura S, Maeshima Y, Tsuchiyama Y, Makino H, Nazemian F, Jafari M, Zahed NOS, Javidi Dasht Bayaz R, Papale M, DI Paolo S, Vocino G, DI Palma A, Federica C, Rocchetti MT, Grandaliano G, Gesualdo L, Prajitno CW, Ismail G, Ditoiu A, Stanciu S, Herlea V, Motoi O, Striker G, Uribarri J, Vlassara H, Gul B, Oz Gul O, Yildiz A, Eroglu A, Keni N, Ersoy C, Ersoy A, Imamoglu S, Yurtkuran M. Diabetes - Clinical. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs221] [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: 11/13/2022] Open
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Lapolla A, Di Cianni G, Di Benedetto A, Franzetti I, Napoli A, Sciacca L, Torlone E, Tonutti L, Vitacolonna E, Mannino D. Quality of Life, Wishes, and Needs in Women with Gestational Diabetes: Italian DAWN Pregnancy Study. Int J Endocrinol 2012; 2012:784726. [PMID: 22611394 PMCID: PMC3350953 DOI: 10.1155/2012/784726] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/01/2012] [Accepted: 02/01/2012] [Indexed: 11/18/2022] Open
Abstract
The DAWN (Diabetes Attitudes, Wishes and Needs) study is a survey promoted by the International Diabetes Federation to recognize the perceptions and attitudes of people suffering from diabetes mellitus. In this context, we evaluated the quality of life of Italian and immigrant women with gestational diabetes mellitus (GDM). Information was gathered using a structured questionnaire for patients' self-compilation. In a 3-month period, a 51-item questionnaire was submitted to 198 Italians and 88 immigrants (from 27 different foreign nationalities). Italian women were older and had higher education than the immigrants. 60% of the Italians and 38% of the immigrants had a family history of diabetes mellitus. In both groups, the diagnosis of GDM caused anxiety; one-third of women feared their child could contract diabetes at delivery and/or have congenital malformations. Some women had trouble in following treatment regimens: the major concern being dietary advice and blood glucose testing. Most women were satisfied (34%) or highly satisfied (60%) with the quality of care, although the degree of cooperation between diabetes specialists and gynaecologists was considered sometimes unsatisfactory. In order to optimize maternal and foetal outcomes, educational projects and improved communication between patients and the healthcare provider team are recommended.
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Affiliation(s)
- A. Lapolla
- Department of Medicine, University of Padova, Italy
| | - G. Di Cianni
- Department of Diabetes and Metabolic Diseases Livorno, ASl6, Livorno, Italy
- *G. Di Cianni:
| | | | | | - A. Napoli
- Department of Clinical and Molecular Medicine, S. Andrea Hospital, Sapienza University of Rome, Italy
| | - L. Sciacca
- Department of Clinical and Molecular Biomedicine Endocrinology Section, University of Catania, Italy
| | - E. Torlone
- Department of Internal Medicine, Endocrinology and Metabolism, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - L. Tonutti
- Department of Endocrinology and Metabolism, Udine University, Italy
| | - E. Vitacolonna
- Department of Medicine and Ageing, University of Chieti, Italy
| | - D. Mannino
- Department of Endocrinology and Diabetology, Hospital Bianchi Malacrino Morelli, Italy
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Iacopino P, Lombardo MF, Cuzzola M, Irrera G, Spiniello E, Garreffa C, Saccardi R, Piro R, Grossi G, Fiasché M, Mannino D, Verma A, Morabito C, Kasabov N. Hematopoietic stem cells for neovascularization and wound repair. BMC Geriatr 2010. [PMCID: PMC3290146 DOI: 10.1186/1471-2318-10-s1-a109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lapolla A, Di Cianni G, Bruttomesso D, Dalfrà MG, Fresa R, Mello G, Napoli A, Romanelli T, Sciacca L, Stefanelli G, Torlone E, Mannino D. Use of insulin detemir in pregnancy: a report on 10 Type 1 diabetic women. Diabet Med 2009; 26:1181-2. [PMID: 19930001 DOI: 10.1111/j.1464-5491.2009.02852.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [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: 11/29/2022]
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Di Cianni G, Torlone E, Lencioni C, Bonomo M, Di Benedetto A, Napoli A, Vitacolonna E, Mannino D, Lapolla A. Perinatal outcomes associated with the use of glargine during pregnancy. Diabet Med 2008; 25:993-6. [PMID: 18959615 PMCID: PMC2613261 DOI: 10.1111/j.1464-5491.2008.02485.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2008] [Indexed: 11/28/2022]
Abstract
AIMS Insulin glargine (IG), with its non-peaking action profile, might be useful in diabetic pregnancy. However, data on its safety are limited and its use during pregnancy is not recommended. This study focused on the effects of IG on perinatal outcome, particularly to estimate the rate of congenital anomalies and birthweight. METHODS This retrospective study included women with pre-gestational diabetes who used IG before (at least 1 month) and during pregnancy. For all women we recorded data regarding maternal glycaemic control and pregnancy outcome. We also compared women treated with IG throughout pregnancy and women who stopped taking IG at an earlier stage. RESULTS From 27 centres, 107 Type 1 diabetic pregnancies were identified. IG was started 10.3 +/- 6.9 months before conception and in 57.4% of cases was stopped during the first trimester; 42.6% of women continued using it until the end of pregnancy. There were six abortions (four spontaneous and two induced) and five newborns (4.9%) with congenital anomalies. Glycaemic control, birthweight and the prevalence of macrosomia and neonatal morbidity were similar in women who used IG for the full term compared with those who stopped IG earlier during pregnancy. CONCLUSIONS This study, although limited, suggests that IG is safe and effective; the rate of congenital malformations was within the range expected for diabetic pregnancies treated with more traditional forms of insulin. IG used throughout pregnancy did not seem to influence birthweight or increase adverse outcomes.
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Affiliation(s)
- G Di Cianni
- Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy.
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Bonomo M, Lapolla A, Mannino D, Arcangeli A, Di Benedetto A, Di Berardino P, Fresa R, Napoli A, Torlone E, Vero R, Vitacolonna E, Di Cianni G. Care of diabetes in pregnancy in Italy: structural and organizational aspects. Diabet Med 2008; 25:379-80. [PMID: 18215171 DOI: 10.1111/j.1464-5491.2007.02353.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/28/2022]
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Abstract
BACKGROUND The association between obesity and asthma severity remains controversial and limited to small studies. METHODS We determined the association of body mass index (BMI) and asthma severity in the National Asthma Survey. We included adults (age > or = 18 years) who self-reported symptoms of asthma in the past 5 years. A total of 3095 patients were divided into the following BMI categories: 1080 (35%) non-overweight (BMI < 25), 993 (32%) overweight (BMI > or = 25 and < 30) and 1022 (33%) obese (BMI > or = 30). Asthma severity measures included respiratory symptoms, healthcare utilisation, medication use, missed work days and the Global Initiative for Asthma (GINA) severity classification. Models were adjusted for: gender, race, age, education, income, employment status, smoking status, family history of asthma, state of residence and residence in a metropolitan statistical area. RESULTS Compared with non-overweight subjects, obese subjects with asthma were more likely to report continuous symptoms (OR 1.66, 95% CI 1.09 to 2.54), miss more work days (OR 1.35, 95% CI 1.01 to 1.81), use short acting beta agonists (OR 1.36, 95% CI 1.06 to 1.75), use inhaled corticosteroids (OR 1.34, 95% CI 1.01 to 1.79) and use any controller medication according to GINA guidelines (OR 1.37, 95% CI 1.01 to 1.85). Also, obese respondents were less likely to be in asthma remission (OR 0.56, 95% CI 0.38 to 0.82) and were more likely to have severe persistent asthma (GINA IV) (OR 1.42, 95% CI 1.05 to 1.90). CONCLUSIONS In a large, diverse sample of adults with asthma, obesity was associated with measures of asthma severity after adjusting for potential confounders.
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Affiliation(s)
- B Taylor
- Emory University, Atlanta, Georgia, USA
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Napoli A, Colatrella A, Botta R, Di Cianni G, Fresa R, Gamba S, Italia S, Mannino D, Piva I, Suraci C, Tonutti L, Torlone E, Tortul C, Lapolla A. Contraception in diabetic women: an Italian study. Diabetes Res Clin Pract 2005; 67:267-72. [PMID: 15713360 DOI: 10.1016/j.diabres.2004.07.020] [Citation(s) in RCA: 11] [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: 01/13/2004] [Revised: 07/19/2004] [Accepted: 07/23/2004] [Indexed: 11/27/2022]
Abstract
UNLABELLED Over 1 year, a survey on contraception and obstetric history was performed on a cohort of 667 Caucasian fertile diabetic women (446, type 1 and 201, type 2) living in Italy. RESULTS Of these women, 30.4% used hormonal contraceptives, 12.0% intra-uterine device (IUD), 10.7% declared they used no contraception, 47.0% only utilised barrier and/or natural methods. However, irrespective of their previous contraceptive strategy, 7.2% of all the studied population was surgically sterilized during caesarean section. HORMONAL CONTRACEPTION Of these women, 60.4% was prescribed by a gynaecologist, 11.2% by a diabetologist, 15% by both of them and 13.4% by others. The proportion using oral contraception was similar among types 1 and 2 women (29.4% versus 27.8%, chi(2) = ns). SMOKING HABITS Of women taking hormonal contraception, 30.0% were smokers. EDUCATIONAL LEVEL University graduates (37.1%), high school leaves (32.2%), secondary school (28.2%) and primary school leaves (15.5%) used oral contraceptives (OC). OBSTETRIC HISTORY The mean number of deliveries was 1.14 +/- 1.1, of miscarriages was 1.3 +/- 0.7 and of induced abortions 0.17 +/- 0.5. Planning of at least one pregnancy was reported in 29.4% of patients.
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Affiliation(s)
- A Napoli
- Diabetes Unit, Department of Clinical Sciences, Hospital 'S. Andrea', 2nd Faculty of Medicine, University "La Sapienza", Rome, Italy.
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20
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Wilson SR, Yamada EG, Sudhakar R, Roberto L, Mannino D, Mejia C, Huss N. A controlled trial of an environmental tobacco smoke reduction intervention in low-income children with asthma. Chest 2001; 120:1709-22. [PMID: 11713157 DOI: 10.1378/chest.120.5.1709] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
STUDY OBJECTIVES To determine the effectiveness of a cotinine-feedback, behaviorally based education intervention in reducing environmental tobacco smoke (ETS) exposure and health-care utilization of children with asthma. DESIGN Randomized controlled trial of educational intervention vs usual care. SETTING The pediatric pulmonary service of a regional pediatric hospital. PARTICIPANTS ETS-exposed, Medicaid/Medi-Cal-eligible, predominantly minority children who were 3 to 12 years old and who were seen for asthma in the hospital's emergency, inpatient, and outpatient services departments (n = 87). INTERVENTION Three nurse-led sessions employing behavior-changing strategies and basic asthma education and that incorporated repeated feedback on the child's urinary cotinine level. MEASUREMENTS The primary measurements were the urinary cotinine/creatinine ratio (CCR) and the number of acute asthma medical visits. The secondary measurements were number of hospitalizations, smoking restrictions in home, amount smoked, reported exposures of children, and asthma control. RESULTS The intervention was associated with a significantly lower odds ratio (OR) for more than one acute asthma medical visit in the follow-up year, after adjusting for baseline visits (total visits, 87; OR, 0.32; p = 0.03), and a comparably sized but nonsignificant OR for one or more hospitalization (OR, 0.34; p = 0.14). The follow-up CCR measurement and the determination of whether smoking was prohibited inside the home strongly favored the intervention group (n = 51) (mean difference in CCR adjusted for baseline, -0.38; p = 0.26; n = 51) (60; OR [for proportion of subjects prohibiting smoking], 0.24; p = 0.11; n = 60). CONCLUSIONS This intervention significantly reduced asthma health-care utilization in ETS-exposed, low-income, minority children. Effects sizes for urine cotinine and proportion prohibiting smoking were moderate to large but not statistically significant, possibly the result of reduced precision due to the loss of patients to active follow-up. Improving ETS reduction interventions and understanding their mechanism of action on asthma outcomes requires further controlled trials that measure ETS exposure and behavioral and disease outcomes concurrently.
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Affiliation(s)
- S R Wilson
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, CA 94301, USA.
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21
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Yang Q, Khoury MJ, Mannino D. Trends and patterns of mortality associated with birth defects and genetic diseases in the United States, 1979-1992: an analysis of multiple-cause mortality data. Genet Epidemiol 2000; 14:493-505. [PMID: 9358267 DOI: 10.1002/(sici)1098-2272(1997)14:5<493::aid-gepi4>3.0.co;2-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [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: 02/05/2023]
Abstract
Contemporary information on the trends and patterns of mortality associated with birth defects and genetic diseases is lacking in the United States. To study these trends and patterns, we used the Multiple-Cause Mortality Files of the National Center for Health Statistics. From 1979 through 1992, 320,208 deaths in the United States were associated with birth defects and genetic diseases. The age-adjusted mortality rates for people with birth defects declined from about 8.2/100,000 in 1979 to about 6.7/100,000 in 1992, and the mortality rates for people with genetic diseases increased from 2.2/100,000 in 1979 to 2.5/100,000 in 1992. The mortality rate was higher among men than among women and higher among blacks than among whites or other races for both birth defect- and genetic disease-associated deaths. The rate among infants with birth defects was more than 25 times higher than that among other age groups. About half of the children whose deaths were associated with birth defects had cardiovascular system defects, 15% had central nervous system defects, and 12% had chromosomal defects. For deaths associated with genetic diseases, hereditary neurologic or storage disorders were the most common genetic diseases (38%), followed by metabolic disorders (21%), sickle cell and thalassemia (12%). The decline in the rate of mortality from birth defects in the United States probably reflects improvements in medical and surgical care and other factors. Most of the mortality associated with birth defects remains in the pediatric age group (less than 15 years old). The upward trend we detected for the deaths with genetic diseases was most likely related to improved recognition and reporting of some genetic diseases rather than to the increased prevalence.
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Affiliation(s)
- Q Yang
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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22
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Meyer P, Mannino D, Redd S. Air pollution and health: what Georgia physicians should know. J Med Assoc Ga 1999; 88:18-23. [PMID: 10666988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Phillips D, Phillips B, Mannino D. A case study and national database report of progressive systemic sclerosis and associated conditions. J Womens Health (Larchmt) 1998; 7:1099-104. [PMID: 9861587 DOI: 10.1089/jwh.1998.7.1099] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report the case of a 34-year-old white woman with a history of progressive systemic scleroderma (PSS) and diffuse alveolar hemorrhage (DAH) that may be either a rare complication of PSS or induced by D-penicillamine. The DAH progressed to hemoptysis and led to intubation for airway protection. The patient progressed to acute renal failure. Her chest x-ray revealed diffuse bilateral infiltrates. She developed pulmonary fibrosis with secondary pulmonary hypertension. She experienced a brief period of improvement of her respiratory status after steroid treatment. We also report a database of 21,442 decedents with PSS over a 15-year period from 1979 to 1994. Our report demonstrates that of over 21,000 decedents, only 0.2% had pulmonary hemorrhage or hemoptysis or both listed as a cause of death. The data also demonstrate that PSS was the underlying cause of death more frequently in younger people. Age-adjusted mortality rates were higher for blacks than for whites and for women than for men.
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Affiliation(s)
- D Phillips
- Department of Medicine, University of Kentucky College of Medicine, Lexington, USA
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Mannino D, Geiss R, Hodous T, Lapp NL. Suspected hypersensitivity pneumonitis after exposure to a biologic forage inoculant. South Med J 1996; 89:898-901. [PMID: 8790315 DOI: 10.1097/00007611-199609000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 44-year-old farmer had respiratory symptoms and bibasilar pulmonary infiltrates after three exposures to a new biologic forage inoculant. Open lung biopsy revealed chronic interstitial pneumonitis and bronchiolitis obliterans with organizing pneumonia. The patient responded to oral corticosteroids but acutely worsened after an inadvertent reexposure to the forage inoculant. He later recovered, with return of lung function and chest radiograph toward normal. This case suggests that biologic forage inoculants may be associated with hypersensitivity pneumonitis.
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Affiliation(s)
- D Mannino
- Critical Care Medicine, West Virginia University School of Medicine, Morgantown, USA
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Sinks T, Hartle R, Boeniger M, Mannino D, Boyd JE, Fernback J, Hawkins M, Grimes G, Watkins KL, Dill P. Exposure to biogenic silica fibers and respiratory health in Hawaii sugarcane workers. J Occup Med 1994; 36:1329-34. [PMID: 7884574 DOI: 10.1097/00043764-199412000-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We conducted a cross-sectional environmental and medical survey of 355 male sugarcane workers in Hawaii to determine whether exposure to biogenic silica fibers (BSF) affected their respiratory health. Exposures to BSF ranged from nondetectable to more than 0.700 BSF/mL and varied by job and department. Respiratory symptoms, chest radiograph findings, and pulmonary function were not associated with BSF exposures. Cigarette smoking was associated with respiratory symptoms and pulmonary obstruction. Fifteen workers had pleural thickening or pleural plaques and 3 of these workers were exposed to BSF for more than 10 years. BSF exposure does not appear to influence the respiratory health of sugarcane workers; however, further study is warranted.
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Affiliation(s)
- T Sinks
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
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26
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Cucinotta D, Mannino D, Lasco A, Di Cesare E, Musolino C, Alessi R. Premixed insulin at ratio 3/7 and regular + isophane insulins at mixing ratios from 2/8 to 4/6 achieve the same metabolic control. Diabete Metab 1991; 17:49-54. [PMID: 1868960] [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: 12/29/2022]
Abstract
The insulin regimen with two daily injections is still that more frequently used. Often regular and NPH insulins are mixed at different ratios according to the patient's need; however, the mixture preparation can involve several errors. Efficacy, safety and compliance were evaluated comparing a premixture 3/7 (Actraphane HM) with extemporary mixtures of regular + NPH at mixing ratios ranging from 2/8 to 4/6, in a cross-over study of 8 weeks involving 20 insulin dependent diabetics. Metabolic control, hypoglycaemic episodes, insulin dose and proportions were similar with both treatments while a higher compliance was achieved with the premixture. In conclusion, premixture 3/7 and extemporary mixture (from 2/8 to 4/6) obtain the same efficacy and safety but the former shows a higher acceptability.
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Affiliation(s)
- D Cucinotta
- Istituto di Medicina Interna, Università di Messina, Italy
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27
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Massi Benedetti M, Bueti A, Mannino D, Bellomo G, Antonella MA, Calabrese G, Zega G, Brunetti P. Kinetics and metabolic activity of biosynthetic NPH insulin evaluated by the glucose clamp technique. Diabetes Care 1984; 7:132-6. [PMID: 6376009 DOI: 10.2337/diacare.7.2.132] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The glucose clamp technique has been used to evaluate the metabolic activity of NPH biosynthetic insulin in diabetic subjects free from anti-insulin antibodies. After overnight blood glucose normalization with a glucose-controlled insulin infusion system (Biostator), an s.c. injection of NPH insulin was given in the abdominal region. The insulin dose (0.236 +/- 0.05 U/kg body wt) was related to the usual intermediate-acting insulin requirement in the morning. Glucose was clamped at 100 mg/dl by a feedback i.v. glucose infusion. The end of the action of s.c. injected insulin considered conventionally to be the time of the spontaneous rise of blood glucose to 110 mg/dl. Free insulin levels were higher and the length of action was longer after NPH porcine than after NPH biosynthetic human insulin (BHI) (area under the free insulin curve: porcine 1423 +/- 556 mU/L/h; BHI 1045 +/- 338 mU/L/h, P less than 0.05; length of action: porcine 16.0 +/- 3.2 h; BHI 13.7 +/- 0.9 h, P less than 0.05); the glucose requirement was higher after porcine (76.8 +/- 13.5 g) than after BHI (58.5 +/- 14.6 g) without reaching statistical significance. However, the metabolic activity of the bioavailable insulin (index of plasma free insulin activity) was similar for the two insulins (porcine 381 +/- 77.4, BHI 342.8 +/- 54.2 mU/L/g of glucose/h). We conclude that a difference in pharmacokinetics exists between NPH BHI and porcine NPH insulin, which makes the latter metabolically more active. The different behavior does not seem to be related to the insulin molecule itself but could be a consequence of the unequal content of protamine in the two pharmacologic preparations.
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