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Ceccarelli F, Olivieri G, Dominici L, Celia AI, Cipriano E, Garufi C, Mancuso S, Natalucci F, Orefice V, Perricone C, Pirone C, Pacucci VA, Morello F, Truglia S, Miranda F, Spinelli FR, Alessandri C, Conti F. OP0204 LUPUS COMPREHENSIVE DISEASE CONTROL IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS: APPLICATION OF A NEW INDEX. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4560] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The main outcomes in SLE patients management are represented by the remission achievement and chronic damage prevention. Even though activity and damage are intimately connected, to date indices including both these outcomes are not available.Objectives:In the present study, we aimed at assessing the application of a new index, the Lupus comprehensive disease control (LupusCDC), including disease activity and chronic damage progression.Methods:We performed a longitudinal analysis, including SLE patients according to ACR 1997 criteria, followed-up in the period between January 2014 and December 2018, and with at least one visit per year. Disease activity was assessed by SLE Disease Activity Index 2000 (SLEDAI-2K) and three different remission levels were evaluated, as reported in Table 1 (1).Table 1.Remission levels considered in the study (1).Remission levelDefinitionComplete Remission(CR)No clinical and serological activity (SLEDAI-2K=0) in corticosteroid-free and immunosuppressant-free patients (antimalarials allowed)Clinical remission off-corticosteroids(ClR-GCoff)Serological activity with clinical quiescent disease according to SLEDAI-2K in corticosteroid-free patients (stable immunosuppressive therapy and antimalarials allowed)clinical remission on-corticosteroids(ClR-GCon)Clinical quiescent disease according to SLEDAI-2K in patients on prednisone 1–5 mg/day (stable immunosuppressants and antimalarials allowed)Chronic damage was registered according to SLICC damage index (SDI). All the patients were evaluated at baseline (T0) and every 12 months (T1, T2, T3, T4). At each time-point, we calculated the prevalence of LupusCDC, defined as remission achievement plus absence of chronic damage progression in the previous one year. We calculated this outcome including separately the different remission levels.Results:According with inclusion criteria, 172 SLE patients were evaluated in the present analysis [M/F 16/156, median age 49 years (IQR 16.7), median disease duration 180 months (IQR 156)]. At first assessment, we observed a mean±SD SDI value of 0.7±1.1. In details, 56 patients (32.5%) showed damage in at least one organ/system and the presence of damage was significantly associated with age (p<0.0001, r=0.3) and disease duration (p=0.0003, r=0.3). During the follow-up, we observed a significant increase in SDI values compared with T0 (T1: mean±DS 0.8±1.3, p<0.0001; T2: 0.8±1.4, p<0.0001; T3: 0.9±1.4 p=0.0001; T4: 1.0±1.5 p<0.0001).In figure 1A and 1B we reported the proportion of patients achieving the different levels of remission and LupusCDC, respectively. In particular, the LupusCDC definition including CR was the most frequently detected in all time-points evaluated (T1: 18.0%; T2: 31.9%; T3: 27.9%; T4: 24.4%), with a significant difference at T2 [LupusCDC(CR)versusLupusCDC(ClR-GCoff), p=0.0002; LupusCDC(CR)versusLupusCDC(ClR-GCon) p=0.0002)], T3 [LupusCDC(CR)versusLupusCDC(ClR-GCoff), p=0.03; LupusCDC(CR)versusLupusCDC(ClR-GCon) p=0.006], T4 [LupusCDC(CR)versusLupusCDC(ClR-GCon), p=0.002]. No significant differences were found when comparing the prevalence of different remission levels and the prevalence of LupusCDC including the corresponding remission.Conclusion:In the present analysis we proposed for the first time a new index including disease activity and chronic damage, in order to evaluate the proportion of SLE patients reaching a comprehensive disease control. We found that CR is most frequently associated with the absence of damage progression.References:[1]Zen M et al. Ann Rheum Dis 2017.Disclosure of Interests:Fulvia Ceccarelli: None declared, Giulio Olivieri: None declared, Lorenzo Dominici: None declared, Alessandra Ida Celia: None declared, enrica cipriano: None declared, Cristina Garufi: None declared, Silvia Mancuso: None declared, Francesco Natalucci: None declared, Valeria Orefice: None declared, Carlo Perricone: None declared, Carmelo Pirone: None declared, viviana antonella pacucci: None declared, Francesca Morello: None declared, Simona Truglia: None declared, Francesca Miranda: None declared, Francesca Romana Spinelli Grant/research support from: Pfizer, Consultant of: Novartis, Gilead, Lilly, Sanofi, Celgene, Speakers bureau: Lilly, cristiano alessandri Grant/research support from: Pfizer, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi
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Pavan D, Pitarresi G, Morello F, Monachino F, Sanfilippo A, D’Arienzo A, Camarda L. Does the 5-strand-graft have superior biomechanical behaviour than 4-strand-graft during ACL reconstruction? Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2019.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- D. Pavan
- Department of Orthopaedic Surgery, University of Palermo (Di.Chir.On.S), Palermo, Italy
| | - G. Pitarresi
- Department of Industrial and Digital Innovation (DIID) Chemical, Management, Computer, Mechanical Engineering, Viale delle Scienze ed.8, I-90128 Palermo
| | - F. Morello
- Department of Orthopaedic Surgery, University of Palermo (Di.Chir.On.S), Palermo, Italy
| | - F. Monachino
- Department of Orthopaedic Surgery, University of Palermo (Di.Chir.On.S), Palermo, Italy
| | - A. Sanfilippo
- Department of Orthopaedic Surgery, University of Palermo (Di.Chir.On.S), Palermo, Italy
| | - A. D’Arienzo
- Department of Orthopaedic Surgery, University of Pisa, Pisa, Italy
| | - L. Camarda
- Department of Orthopaedic Surgery, University of Palermo (Di.Chir.On.S), Palermo, Italy
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Camarda L, Bologna E, Pavan D, Morello F, Monachino F, Giacco F, Zingales M. Posterior meniscal root repair: a biomechanical comparison between human and porcine menisci. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2019.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- L. Camarda
- Department of Orthopaedic Surgery, University of Palermo (DiChirOnS), Palermo, Italy
| | - E. Bologna
- Dipartimento di Ingegneria Civile, Ambientale, Aerospaziale, dei Materiali (DICAM), Palermo, Italy
- Bio/NanoMechanics for Medical Sciences Laboratory, Advanced Technology Network (ATeN)-Center, Palermo, Italy
| | - D. Pavan
- Department of Orthopaedic Surgery, University of Palermo (DiChirOnS), Palermo, Italy
| | - F. Morello
- Department of Orthopaedic Surgery, University of Palermo (DiChirOnS), Palermo, Italy
| | - F. Monachino
- Department of Orthopaedic Surgery, University of Palermo (DiChirOnS), Palermo, Italy
| | - F. Giacco
- Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - M. Zingales
- Dipartimento di Ingegneria Civile, Ambientale, Aerospaziale, dei Materiali (DICAM), Palermo, Italy
- Bio/NanoMechanics for Medical Sciences Laboratory, Advanced Technology Network (ATeN)-Center, Palermo, Italy
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Acosta MC, Kundro M, Viloria G, Peressín Paz A, Morello F, Latorre F, Seoane E, Toibaro J, Losso M. The role of brain biopsy in the clinical management of HIV-related focal brain lesions. HIV Med 2018; 19:673-678. [PMID: 30004180 DOI: 10.1111/hiv.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Up to 20% of HIV-related focal brain lesion (FBL) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with FBL, the proportion of diagnoses confirmed by brain biopsies and their aetiologies, and to analyse the proportion of patients in whom the biopsy motivated a change in therapeutic management. METHODS A retrospective cohort study was performed. The data from clinical records of patients with HIV-related FBL admitted between January 2005 and December 2015 were reviewed. RESULTS A total of 137 patients were included in the study. The median age was 39 years [interquartile range (IQR) 33-44.5 years]. The median CD4 count was 54 cells/μL (IQR 21-124 cells/μL). Cerebral brain biopsy was performed in 21.16% of patients (29 of 137); 68.9% of these individuals (20 of 29) were diagnosed by histology, with results of central nervous system (CNS) lymphoma in 20.6% (six of 29), progressive multifocal leucoencephalopathy in 6.8% (two of 29), toxoplasmosis in 6.8% (two of 29), tuberculoma in 6.8% (two of 29), and other diagnoses in 27.6% (eight of 29). In nine patients, the histology was nonspecific. In 75.8% of patients (22 of 29), the result of the biopsy led to a change in the therapeutic management. We did not observe higher rates of mortality related to the procedure. Overall mortality at 30 and 90 days was similar in patients who were and were not biopsied. CONCLUSIONS In this retrospective cohort study, cerebral biopsy was associated with significant adjustments in therapeutic management for a high percentage of patients.
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Affiliation(s)
- M C Acosta
- HIV Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - M Kundro
- HIV Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - G Viloria
- HIV Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - A Peressín Paz
- Neurosurgery Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - F Morello
- Neurosurgery Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - F Latorre
- Neurosurgery Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - E Seoane
- Neurosurgery Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - J Toibaro
- HIV Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
| | - M Losso
- HIV Unit, JM Ramos Mejía Hospital, Buenos Aires, Argentina
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Sala V, Li M, Margaria J, Sciarretta S, Morello F, Sandri M, Mongillo M, Zaglia T, Hirsch E, Ghigo A. Doxorubicin-induced mitochondrial damage activates PI3Kgamma and inhibits protective cardiac autophagy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.101] [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: 10/28/2022]
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Li M, Sala V, Pianca N, Sciarretta S, Morello F, Sandri M, Mongillo M, Zaglia T, Hirsch E, Ghigo A. P318Phosphoinositide 3-kinase gamma inhibition as a novel strategy to reactivate targeted autophagy and limit Doxorubicin-induced cardiotoxicity. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Li
- University of Turin, Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, Turin, Italy
| | - V Sala
- University of Turin, Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, Turin, Italy
| | - N Pianca
- University of Padova, Department of Biomedical Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - S Sciarretta
- Sapienza University of Rome, Department of Medical and Surgical Sciences and Biotechnologies, Latina, Italy
| | - F Morello
- Hospital 'Città della Salute e della Scienza di Torino', S.C. Emergency Medicine, Turin, Italy
| | - M Sandri
- University of Padova, Department of Biomedical Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - M Mongillo
- University of Padova, Department of Biomedical Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - T Zaglia
- University of Padova, Department of Biomedical Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - E Hirsch
- University of Turin, Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, Turin, Italy
| | - A Ghigo
- University of Turin, Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, Turin, Italy
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Li M, Sala V, De Santis M, Cimino J, Cappello P, Pianca N, Martini M, Lazzarini E, Pirozzi F, Tocchetti C, Sandri M, Ameri P, Sciarretta S, Mongillo M, Zaglia T, Morello F, Novelli F, Hirsch E, Ghigo A. PI3Kγ inhibition protects from anthracycline-induced heart failure and reduces tumor growth. Vascul Pharmacol 2018. [DOI: 10.1016/j.vph.2017.12.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Morello F, Li M, Cimino J, De Santis M, Pianca N, Franco I, Sciarretta S, Sandri M, Zaglia T, Mongillo M, Hirsch E, Ghigo A. P6263Phosphoinositide 3-kinase gamma inhibition protects against anthracycline-induced cardiomyopathy by boosting cardiac autophagy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6263] [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: 11/14/2022] Open
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Morello F, Nazerian P, Mueller C, Soeiro A, Leidel B, Salvadeo S, Giachino F, Vanni S, Grimm K, Tavares De Oliveira M, Veglio M, Gualtieri S, Grifoni S, Lupia E. P6021Rule-out of acute aortic syndrome by integration of the aortic dissection detection risk score plus d-dimer: preliminary data from the ADvISED prospective multicenter study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F. Morello
- A.O.U. Città della Salute e della Scienza, Ospedale Molinette, Emergency Department, Torino, Italy
| | | | - C. Mueller
- University Hospital Basel, Cardiovascular Research Institute, Basel, Switzerland
| | - A. Soeiro
- University of São Paulo, Heart Institute, Emergency Care Unit, São Paulo, Brazil
| | - B.A. Leidel
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Department of Emergency Medicine, Berlin, Germany
| | - S. Salvadeo
- Policlinic Foundation San Matteo IRCCS, Emergency Medicine, Pavia, Italy
| | - F. Giachino
- A.O.U. Città della Salute e della Scienza, Ospedale Molinette, Emergency Department, Torino, Italy
| | - S. Vanni
- A.O.U. Careggi, Emergency, Firenze, Italy
| | - K. Grimm
- University Hospital Basel, Cardiovascular Research Institute, Basel, Switzerland
| | | | - M.G. Veglio
- A.O.U. Città della Salute e della Scienza, Ospedale Molinette, Emergency Department, Torino, Italy
| | | | - S. Grifoni
- A.O.U. Careggi, Emergency, Firenze, Italy
| | - E. Lupia
- A.O.U. Città della Salute e della Scienza, Ospedale Molinette, Emergency Department, Torino, Italy
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Lira K, Balarini L, De Lima S, Azevedo A, De Carvalho A, Paschoal V, Myiamoto S, De Souza A, Rocha P, Zanon T, Serrano E, Duque R, Gavi M, Dinis V, Caser L, Salume F, Dalmaso A, Burian A, Pinto L, Brandão, Polito E, Clemente T, Magalhaes E, Rodrigues L, Morello F, De Oliveira K, Thebit M, Bissoli M, Gouvea S, Assis O, De Moura L, Valim V. VACINAÇÃO ANTI‐AMARÍLICA EM PACIENTES COM DOENÇAS REUMÁTICAS IMUNOMEDIADAS: ANÁLISE RETROSPECTIVA. Revista Brasileira de Reumatologia 2017. [DOI: 10.1016/j.rbr.2017.06.119] [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: 11/24/2022] Open
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Abstract
Hypertensive encephalopathy is a syndrome consisting of headache, seizures, visual changes, and other neurologic disturbances in patients with elevated systemic blood pressure. The purpose of this study was to analyse the clinical and neuroradiological findings in nine patients with hypertensive encephalopathy, observed in five years. CT (n = 13), and MR (n = 12), examinations performed in these patients before and after resolution of symptoms were reviewed. Six had the preeclampsia-eclampsia syndrome, and three had hypertensive encephalopathy due to other causes. CT and MR findings in all patients having these examinations were indicative of oedema in the cortex and subcortical white matter in the occipital lobes. Two of the nine patients also had similar findings in the cerebellum and frontal lobes. The findings on the CT and MR studies resolved on follow-up examinations performed after the hypertension was corrected. Our results suggest that the radiological findings associated with hypertensive encephalopathy in the appropriate clinical setting are very useful to achieve an early diagnosis.
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Affiliation(s)
| | - E. Zanella
- Servizio di Radiologia, Ospedale Civile; Arzignano (VI)
| | | | - G. Loro
- Servizio di Radiologia, Ospedale Civile; Arzignano (VI)
| | - L. Simonetti
- Servizio di Neuroradiologia, Ospedale Bellaria; Bologna
| | - M. Leonardi
- Servizio di Neuroradiologia, Ospedale Bellaria; Bologna
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Ceccarelli F, Cipriano E, Perricone C, Leccese I, Massaro L, Miranda F, Morello F, Pacucci V, Orefice V, Pendolino M, Pirone C, Spinelli F, Truglia S, Alessandri C, Valesini G, Conti F. FRI0328 A Complete Remission Lasting at Least One Year Influences The Outcome in Patients Affected by SLE: Results from A Large Monocentric Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4586] [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: 11/04/2022]
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Ceccarelli F, Massaro L, Morello F, Perricone C, Palermo A, Spinelli F, Alessandri C, Chistolini A, Valesini G, Conti F. AB0447 Anti-Phospholipid Positivity in Healthy Subjects: Evaluation of Risk for Thrombotic Event after A 5 Years Follow-Up. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4862] [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: 11/03/2022]
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Spinelli F, Ceccarelli F, Morello F, Massaro L, Alessandri C, Valesini G, Conti F. THU0290 Twelve Months Survival Rate and Causes of Withdrawal of Belimumab in Systemic Lupus Erythematosus in A Real Life Setting. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4333] [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: 11/04/2022]
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Li M, Cimino J, De Santis M, Pianca N, Franco I, Sciarretta S, Morello F, Sandri M, Zaglia T, Mongillo M, Hirsch E, Ghigo A. Inhibition of phosphoinositide 3-kinase γ protects against chemotherapy-induced cardiomyopathy by promoting cardiac autophagy. Vascul Pharmacol 2015. [DOI: 10.1016/j.vph.2015.11.045] [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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Alessandri C, Bartosiewicz I, Pendolino M, Mancini R, Colasanti T, Pecani A, Morello F, Mastrangelo A, Sabatinelli D, Riccieri V, Di Franco M, Ceccarelli F, Perricone C, Conti F, Valesini G. Anti-carbamylated protein antibodies in unaffected first-degree relatives of rheumatoid arthritis patients: lack of correlation with anti-cyclic citrullinated protein antibodies and rheumatoid factor. Clin Exp Rheumatol 2015; 33:824-830. [PMID: 26411477] [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] [Received: 12/24/2014] [Accepted: 05/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To investigate the prevalence of anti-carbamylated protein antibodies (anti-CarP) in the healthy first-degree relatives (HFDRs) of patients with rheumatoid arthritis (RA). METHODS We enrolled 141 HFDRs of 63 patients with RA diagnosed accordingly to the 2010 ACR/EULAR criteria. Fifty-six normal healthy subjects (NHS), sex- and age-matched, served as controls. Anti-CarP IgG, anti-cyclic citrullinated peptide antibody (anti-CCP) IgG and rheumatoid factors (RF) isotypes (IgG, IgA, IgM) were assessed by solid-phase ELISA. RESULTS Anti-CarP were detectable in 13 HFDRs (9.2%), anti-CCP in 9 (6.3%), IgG-RF in 10 (7%), IgA-RF in 17 (12%), and IgM-RF in 13 (9.2%) HFDRs. Twenty-nine (46%) RA patients were positive for anti-CarP, 31 (49.2%) for anti-CCP, and 34 (53.9%) for RF. One NHS (1.7%) resulted positive for anti-CarP, none for anti-CCP and RF. Anti-CarP showed significantly higher serum levels in RA and HFDRs than in NHS (p<0.0001 and p=0.0012, respectively). A significant correlation between anti-CCP and RF were found among RA patients (p=0.0002), whereas no correlations were reported between autoantibodies tested in the HFDRs. CONCLUSIONS Anti-CarP can be found in the sera of HFDRs of RA patients and their prevalence is significantly higher than in NHS. No correlation of anti-CarP with anti-CCP and RF antibodies in RA HFDRs was found.
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Affiliation(s)
- C Alessandri
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
| | - I Bartosiewicz
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - M Pendolino
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - R Mancini
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - T Colasanti
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - A Pecani
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - F Morello
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - A Mastrangelo
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - D Sabatinelli
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - V Riccieri
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - M Di Franco
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - F Ceccarelli
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - C Perricone
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - F Conti
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
| | - G Valesini
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy
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Spinelli F, Barbati C, Massaro L, Ceccarelli F, Morello F, Miranda F, Truglia S, Orefice V, Alessandri C, Conti F, Valesini G. AB0521 Short Term Effect of Belimumab on Endothelial Progenitor Cells in Patients with Systemic Lupus Erythematosus. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4496] [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: 11/04/2022]
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Morello F, Ceccarelli F, Spinelli F, Massaro L, Perricone C, Truglia S, Miranda F, Alessandri C, Conti F, Valesini G. THU0401 Impact of Belimumab Treatment on Quality of Life, Evaluated by Lupusqol Questionnaire, In Patients Affected by Systemic Lupus Erythematosus: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5419] [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: 11/03/2022]
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Perricone C, Ceccarelli F, Morello F, Alessandri C, Spinelli F, Massaro L, Pacucci V, Scirocco C, Priori R, Valesini G, Conti F. THU0397 Safety and Survival of Rituximab Treatment in Systemic Lupus Erythematosus Versus Rheumatoid Arthritis Patients: A 10 Years Observational Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4963] [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: 11/04/2022]
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Bartosiewicz I, Alessandri C, Pendolino M, Mancini R, Colasanti T, Pecani A, Mastrangelo A, Sabatinelli D, Riccieri V, Conti F, Di Franco M, Valesini G, Morello F. FRI0042 Anti-Carbamylated Protein Antibodies in Unaffected First-Degree Relatives of Rheumatoid Arthritis Patients: Lack of Correlation with Anti-Cyclic Citrullinated Protein Antibodies and Rheumatoid Factor. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5009] [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: 11/04/2022]
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21
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Li M, Ghigo A, Cimino J, Franco I, Morello F, Hirsch E. P359Inhibition of phosphoinositide 3-kinase gamma protects against chemotherapy-induced heart failure. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu091.43] [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: 11/14/2022] Open
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22
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Ghigo A, Cimino J, Li M, Morello F, Hirsch E. P624Genetic disruption of the Rac inhibitor ArhGAP15 leads to aortic valve disease in mice. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.52] [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: 11/12/2022] Open
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23
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Vanni S, Jimenez D, Nazerian P, Gigli C, Parisi M, Morello F, Giachino F, Viviani G, Pratesi M, Grifoni S. Prognostic value of plasma lactate in acute pulmonary embolism: the multicentre Thrombo-Embolism Lactate Outcome study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Morello F, Castelli M, Vanni S, Giachino F, Bono A, Forno D, Soardo F, Nazerian P, Betti L, Grifoni S. Validation of the aortic dissection detection risk score in the emergency department. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p268] [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: 11/12/2022] Open
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25
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Nazerian P, Morello F, Vanni S, Castelli M, Veglio MG, Lison D, Saglio E, Bitossi L, Giachino F, Grifoni S. Combined use of a standardized risk score and d-dimer to rule out acute aortic dissection in the emergency department. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht311.5939] [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: 11/13/2022] Open
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26
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Ulla M, Pizzolato E, Lucchiari M, Loiacono M, Morello F, Lupia E, Moiraghi C, Battista S, Mengozzi G. 166 Diagnostic and Prognostic Value of New Biomarkers in the Management of Sespsis in the Emergency Department: The Role of Presepsin. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.06.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Verhovez A, Williams TA, Morello F, Monticone S, Brizzi MF, Dentelli P, Fallo F, Fabris B, Amenta F, Gomez-Sanchez C, Veglio F, Mulatero P. Aldosterone does not modify gene expression in human endothelial cells. Horm Metab Res 2012; 44:234-8. [PMID: 22068811 DOI: 10.1055/s-0031-1291272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The toxic effects of aldosterone on the vasculature, and in particular on the endothelial layer, have been proposed as having an important role in the cardiovascular pathology observed in mineralocorticoid-excess states. In order to characterize the genomic molecular mechanisms driving the aldosterone-induced endothelial dysfunction, we performed an expression microarray on transcripts obtained from both human umbilical vein endothelial cells and human coronary artery endothelial cells stimulated with 10 - 7 M aldosterone for 18 h. The results were then subjected to qRT-PCR confirmation, also including a group of genes known to be involved in the control of the endothelial function or previously described as regulated by aldosterone. The state of activation of the mineralocorticoid receptor was investigated by means of a luciferase-reporter assay using a plasmid encoding a mineralocorticoid and glucocorticoid-sensitive promoter. Aldosterone did not determine any significant change in gene expression in either cell type both in the microarray and in the qRT-PCR analysis. The luciferase-reporter assay showed no activation of the mineralocorticoid receptor following aldosterone stimulation. The status of nonfunctionality of the mineralocorticoid receptor expressed in cultured human umbilical and coronary artery endothelial cells does not allow aldosterone to modify gene expression and provides evidence against either a beneficial or harmful genomic effect of aldosterone on healthy endothelial cells.
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Affiliation(s)
- A Verhovez
- Department of Internal Medicine, University of Torino, Torino, Italy.
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Ciraolo E, Morello F, Hirsch E. Present and future of PI3K pathway inhibition in cancer: perspectives and limitations. Curr Med Chem 2011; 18:2674-85. [PMID: 21649577 DOI: 10.2174/092986711796011193] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/15/2011] [Indexed: 11/22/2022]
Abstract
Phosphoinositide 3-kinases (PI3Ks) control key signaling pathways in cancer cells, leading to cell proliferation, survival, motility and angiogenesis. In several human cancers, activation of PI3Ks results from gain-of-function or over-expression of PI3Ks and/or hyperactivity of up- or downstream players in the pathway. As inhibition of PI3Ks and downstream targets such as mammalian target of rapamycin (mTOR) has been shown to reduce tumor growth in vitro and in preclinical models, several small molecule inhibitors of PI3Ks are currently undergoing clinical trial as novel agents in cancer therapy. These drugs include inhibitors targeting all class I PI3Ks (α, β, γ, δ isoforms), compounds blocking selective PI3K isoforms and dual inhibitors active on both PI3Ks and mTOR. Herein, we summarize the pharmacology and preliminary clinical data of the main PI3K inhibitors undergoing clinical trial. We will also review the preclinical studies documenting the major effects of systemic PI3K inhibition on non-cancer tissues, which have shed light on potential side effects, caveats and limitations for PI3K blockade in patients.
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Affiliation(s)
- E Ciraolo
- Department of Genetics, Biology and Biochemistry, Molecular Biotecnology Center, University of Torino, Torino, Italy
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29
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Morello F, Schiavone D, Mengozzi G, Bertello C, Liew CC, Bisbocci D, Mulatero P, Veglio F. Adrenal endothelin-1 levels are not associated with aldosterone secretion in primary aldosteronism. Eur J Endocrinol 2009; 160:453-8. [PMID: 19073831 DOI: 10.1530/eje-08-0828] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Endothelin-1 (ET-1) may function as an aldosterone secretagogue and, in turn, aldosterone can upregulate ET-1 expression. Hence, the existence of a feedforward loop involving ETs and aldosterone has been speculated in primary aldosteronism (PA). In the present study, we sought to examine ET-1 secretion from the adrenal glands in patients with PA. DESIGN We determined ET-1 levels in blood samples obtained during adrenal venous sampling of patients affected by PA (n=17). Furthermore, we examined the mRNA expression of the ET system in tissue samples from aldosterone-producing adenomas (APAs, n=9) and control normal adrenals (n=3). METHODS Blood ET-1 levels were determined by RIA. Tissue mRNA expression of the ET system was assayed with Affymetrix microarrays. RESULTS ET-1 levels did not differ between inferior vena cava and adrenal vein blood in both bilateral adrenal hyperplasia and APA patients. Moreover, cortisol-normalized ET-1 levels did not show lateralized adrenal ET-1 secretion in APAs. Through gene expression profiling with microarray performed in a distinct set of APA individuals (n=9), we confirmed the adrenal expression of a complete ET system, but we did not detect a significant upregulation of ET components within the APA tissue compared with normal adrenals. CONCLUSIONS The present data argue against the hypothesis of increased ET-1 secretion from APAs and do not support a general role for adrenal ET-1 in the vascular pathophysiology of PA.
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Affiliation(s)
- F Morello
- Fourth Division of Internal Medicine and Hypertension Unit, San Giovanni Battista Hospital of Torino, University of Torino, Torino, Italy.
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30
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Mulatero P, Bertello C, Verhovez A, Testa E, Puglisi E, Morello F, Monticone S, Fallo F, Veglio F. [Role of aldosterone in the metabolic syndrome]. G Ital Nefrol 2006; 23:406-14. [PMID: 17063441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of this review is to summarize the current knowledge regarding metabolic syndrome prevalence and features in primary aldosteronism. We will also discuss the link between aldosterone and the different metabolic changes typical of the metabolic syndrome. Hypertensive patients have a high prevalence of obesity, dyslipidemia and hyperglycaemia. These are risk factors for the metabolic syndrome, and are associated with an increased cardiovascular risk profile. In particular, insulin resistance seems to be the major alteration in patients affected by primary aldosteronism. We will then describe the experimental and clinical evidences of the role of aldosterone in the pathogenesis of insulin resistance. Higher rates of cardiovascular events have been recently reported in primary aldosteronism: they could be partly due to the increased prevalence of the metabolic syndrome in this disorder.
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Affiliation(s)
- P Mulatero
- Divisione di Medicina Interna e Ipertensione, Università di Torino, Torino.
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31
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Morello F, de Bruin TW, Rotter JI, van der Kallen CG, Veglio F, Dzau VJ, Liew CC, Chen YI. Differential Gene Expression of Blood Derived Cell Lines in Familial Combined Hyperlipidemia. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00042] [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: 11/02/2022] Open
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32
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Morello F, de Boer R, Steffensen K, Veglio F, Gustafsson J?, Dzau VJ. LXR?? and LXR?? Regulate Renin Expression In Vitro and In Vivo. High Blood Press Cardiovasc Prev 2005. [DOI: 10.2165/00151642-200512030-00073] [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: 11/02/2022] Open
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33
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Prandini P, Berardinelli A, Fanin M, Morello F, Zardini E, Pichiecchio A, Uggetti C, Lanzi G, Angelini C, Pegoraro E. LAMA2loss-of-function mutation in a girl with a mild congenital muscular dystrophy. Neurology 2004; 63:1118-21. [PMID: 15452315 DOI: 10.1212/01.wnl.0000138498.66940.7f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 11/15/2022] Open
Abstract
The authors report a girl with autosomal recessive congenital muscular dystrophy linked to chromosome 6 (MDC1A) who carries a homozygous out-of-frame deletion in exon 56 of the LAMA2 gene but has a mild phenotype. She is still ambulant at age 13 years, shows white matter abnormalities on MRI, and traces of laminin alpha2 in her muscle biopsy with one of three antibodies used. This patient suggests that modulating factors can be associated with a less severe clinical phenotype in MDC1A.
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Affiliation(s)
- P Prandini
- Neuromuscular Center, Department of Neurosciences, University of Padova, Padova, Italy
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34
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Fallo F, Mulatero P, Vettor R, Scarda A, Della Mea P, Morello F, Veglio F, Williams TA. Bradykinin B2 receptor gene C-58T polymorphism and insulin resistance. A study on obese patients. Horm Metab Res 2004; 36:243-6. [PMID: 15114524 DOI: 10.1055/s-2004-814457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The bradykinin B2 receptor (B2R) gene is a candidate in the pathogenesis of insulin resistance, which often clusters with other abnormalities in metabolic syndrome. We investigated the distribution of the C-58T B2R gene polymorphism within a population of overweight/obese patients (BMI > or = 25 kg/m2) potentially characterised by different levels of insulin resistance. Patients with type 2 diabetes, dyslipidemia and hypertension were excluded in order to distinguish the effect of obesity on insulin sensitivity from that of confounding factors. Ninety-two unrelated adults (41 men and 51 women, aged 33.7 +/- 11.6 years) were recruited by random sampling from a general population evaluated for cardiovascular risk stratification. Measurements included BMI, waist circumference, body composition, blood pressure, serum leptin, and lipid profile. Insulin sensitivity was calculated according to the homeostasis model assessment (HOMA) method. C-58T genotypes--CC (n = 20), CT (n = 47) and TT (n = 25)--were determined by restriction fragment-length polymorphism PCR. Patients subdivided on the basis of C-58T polymorphism, showed no difference in any of the parameters examined, including HOMA index values, after adjustment for age, sex, BMI and waist circumference. The results indicate that the C-58T B2R gene polymorphism is not associated with different levels of insulin resistance within a population of obese patients.
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Affiliation(s)
- F Fallo
- Department of Medical and Surgical Sciences, University of Padova, Italy.
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35
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Abstract
BACKGROUND AND AIM Systematic quantitative resting pulse rate measurements may represent an additional parameter for the study of cardiovascular risk factors in youth as well as in adulthood. The aim of this study was to evaluate resting pulse rate and its distribution curve in order to define reference limits in a sample of adolescents from Turin, Italy. METHODS AND RESULTS The study population consisted of 2230 children aged 12-18 years, who were randomly enrolled from Turin Junior High Schools. All of the participants underwent pulse rate, blood pressure and height measurements. The 5th and 95th percentiles of the pulse rate in boys and girls are reported by age and height. The pulse rate was higher in the girls, but progressively decreased with age and somatic growth in both genders. CONCLUSIONS The present study provides reference blood pressure values by age, gender and height in a sample of male and female adolescents.
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Affiliation(s)
- F Rabbia
- Department of Medicine and Experimental Oncology, University of Turin, Italy.
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36
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Abstract
Involuntary movements of the mouth can present as palatal tremor, which is frequently associated with hypertrophy of the inferior olivary nucleus and can be accompanied by contraction of other muscles of the head. We report the case of a 39-year-old man with autoimmune thyroiditis and diabetes who complained of involuntary rhythmic tremor involving the muscles of the floor of the mouth, which interfered with breathing and swallowing. Cerebrospinal fluid (CSF) examination showed the presence of oligoclonal bands and screening for anti-neuronal antibodies revealed high titres of anti-glutamic acid decarboxylase autoantibodies (GAD-Ab). Tremor responded to treatment with benzodiazepines. The correlation between the tremor and antibody positivity is unclear although an alteration of the gabaergic system mediated by the antibodies may be hypothesised on the basis of an inflammatory CSF profile.
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Affiliation(s)
- M Vianello
- Department of Neurological and Psychiatric Sciences (Second Clinic), University of Padua, Padua, Italy
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37
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Veglio F, Morello F, Morra Di Cella S, Del Colle S, Rabbia F, Mulatero P. Recent advances in diagnosis and treatment of pheochromocytoma. Minerva Med 2003; 94:267-71. [PMID: 14605591] [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: 04/27/2023]
Abstract
Pheochromocytomas are rare tumours of catecholamine-producing chromaffin cells leading to hypertension and symptoms of catecholamine excess. They can be benign or malignant, sporadic or familial tumours. Genetic syndromes associated with pheochromocytoma are MEN II, VHL disease and neurofibromatosis type 1. Usually, pheochromocytomas occur in the adrenal medulla. Clinical manifestations include hypertension (which can be intermittent, stable or in the form of hypertensive peaks) and symptoms related to catecholamine excess such as headache, palpitations and tachycardia, pallor, anxiety and nervousness, nausea, vomiting, weight loss. This clinical syndrome can be mimicked by various hyperkinetic and hyperadrenergic states. When pheochromocytoma is suspected, the first diagnostic step is represented by the measurement of catecholamines and their metabolites (metanephrines) in urine and plasma. Chro-mogranin A measurement can be useful. The clonidine suppression test may be helpful in ruling out other conditions that may elevate catecholamines and metanephrines. Localiza-tion and staging of pheochromocytoma is based on MRI, which is more sensitive than CT scan, and (131)I-MIBG scintiscan. The best therapeutic option for pheochromocytoma is surgery with a laparoscopic approach. An appropriate pre-, intra- and postoperative medical management of the patient is mandatory. In the absence of optimal medical treatment, intraoperative mortality reaches 50%.
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Affiliation(s)
- F Veglio
- Hypertension Unit, Department of Medicine and Experimental Oncology, S. Vito Hospital, University of Turin, Turin, Italy.
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38
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Veglio F, Morello F, Rabbia F, Leotta G, Mulatero P. Recent advances in diagnosis and treatment of primary aldosteronism. Minerva Med 2003; 94:259-65. [PMID: 14605590] [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: 04/27/2023]
Abstract
Primary aldosteronism is the most common form of secondary hypertension. The use of aldosterone/plasma renin activity ratio (ARR) as a screening test has elevated its prevalence up to 10% of hypertensive patients. Idiopathic bilateral adrenal hyperplasia and aldosterone-producing adrenal adenoma are the leading causes of primary aldosteronism. Most patients with this conditions are normokalemic and clinically undistinguishable from essential hypertensives. However, they suffer from anticipated and more severe target organ damage than other hypertensives. Thus, being primary aldosteronism a common, specifically treatable and sometimes surgically cured form of hypertension, a prompt diagnosis is necessary and cannot be overlooked. The measurement of ambulatory ARR represents the screening test and should be performed in the majority of hypertensive patients. ARR higher than a set cutoff suggests the need of a confirmatory test for primary aldosteronism, such as intravenous saline load or fludrocortisone suppression test. If inability to suppress aldosterone is demonstrated, the disease is confirmed. The subtype evaluation is based on adrenal imaging (CT scan) and selective adrenal venous sampling. The latter is the gold standard for the diagnosis of a lateralized aldosterone secretion, as typically observed in aldosterone-producing adenomas. Microadenomas are frequently overlooked by adrenal image. If lateralization is confirmed, unilateral adrenalectomy is the reasonable therapeutic option, leading to a significant reduction of blood pressure, if not normotension. If bilateral aldosterone excess is demonstrated, an aldosterone receptor antagonist should be administered. This article reviews and discusses the new data about prevalence, diagnosis and treatment of primary aldosteronism.
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Affiliation(s)
- F Veglio
- Hypertension Unit, Department of Medicine and Experimental Oncology, S. Vito Hospital, University of Turin, Turin, Italy.
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39
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Abstract
We describe the case of a female patient affected by migraine and untreated adult celiac disease who presented with a state of acute migraine accompanied by multiple neurological deficits, including transient cortical blindness with ischemic CT and MRI alterations, and hypocoagulation due to factor VII deficiency. She was receiving estroprogestin therapy. There was a prompt response to cortisone therapy followed by a state of complete well-being, which also led to the disappearance of migraine attacks after five years of dietary treatment alone.
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Affiliation(s)
- F Morello
- Territorial Neurology and Neurophysiology Service, USSL No. 5, Via Trento 4, I-36071 Arzignano (VI), Italy
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Abstract
Hypertensive encephalopathy is a medical emergency whose clinical manifestations are associated with bilateral parieto-occipital lesions. We describe a case of hypertensive brainstem encephalopathy in which high blood pressure was accompanied only by nuchal headaches of violent onset. T2-weighted magnetic resonance images showed hyperintensity and edema of the pons without any parietooccipital lesions, but with hyperintense lesions at the level of the basal nuclei, insula and temporal lobes. The lesions rapidly regressed once the hypertension had been controlled.
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Affiliation(s)
- F Morello
- Division of Neurology, Civil Hospital, Arzignano (VI), Italy
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Polla B, Cappelli V, Morello F, Pellegrino MA, Boschi F, Pastoris O, Reggiani C. Effects of the beta(2)-agonist clenbuterol on respiratory and limb muscles of weaning rats. Am J Physiol Regul Integr Comp Physiol 2001; 280:R862-9. [PMID: 11171667 DOI: 10.1152/ajpregu.2001.280.3.r862] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to analyze the effects of chronic administration of the beta(2)-agonist clenbuterol (1.5 mg x kg(-1) x day(-1) for 4 wk in the drinking water) on respiratory (diaphragm and parasternal intercostal) and hindlimb (tibialis and soleus) muscles in young rats during postnatal development (21 to 49 postnatal days). The treatment resulted in very little stimulation of muscle growth. Significant slow-to-fast transitions in the expression of myosin heavy chain isoforms and significant increases in the myofibrillar ATPase activity were found in the diaphragm and soleus, whereas tibialis anterior and intercostal muscles did not show any significant fiber-type alteration. Decrease of oxidative enzyme activities and increase of glycolytic enzyme activities were also observed. It is concluded that whereas the growth stimulation is age dependent and only detectable in adult rats, the fiber-type transformation is also present in weaning rats and particularly evident in the soleus and diaphragm. The fiber-type transformation caused by clenbuterol might lead to an enhancement of contractile performance and also to a reduced resistance to fatigue.
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Affiliation(s)
- B Polla
- Hospital San Biagio, 15100 Alessandria, Italy
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43
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Morello F, Swischuk LE, John SD, Angel C. Telescoped jejunum: a complication of Dobhoff catheter placement. Pediatr Radiol 1997; 27:780. [PMID: 9285751 DOI: 10.1007/s002470050230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/05/2023]
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Mignosi U, D'Ambrosio F, Morello F, Vizzaccaro A, Cirillo I. [Castleman's disease. Report of a case]. Radiol Med 1997; 93:806-8. [PMID: 9411540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- U Mignosi
- Servizio di Radiologia, Direttore Generale Ospedale Principale Marina Militare, La Spezia
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45
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Morello F, Moro G, Tibaldo M, Siringo G, Faggin W, Franciosi A. Acute cervical radiculopathy due to vertebral A-V fistula. Ital J Neurol Sci 1992; 13:603-5. [PMID: 1330976 DOI: 10.1007/bf02233405] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We report the case of a 28 year old woman with acute, mainly motor, radiculopathy at C5-C6 on the right side secondary to a congenital vertebral arteriovenous fistula. The finding of a bruit at the side of the neck lent weight to the CT and MRI findings. Angiography was diagnostic. The fistula was embolized successfully.
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Affiliation(s)
- F Morello
- Servizio Autonomo di Neurologia, Ospedale Civile di Arzignano
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46
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Morello F, Cagnin G, Toso V. Hyperproteinorrachia in Eaton-Lambert myasthenic syndrome. Muscle Nerve 1984; 7:754-5. [PMID: 6100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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47
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Cagnin G, Morello F, Galiazzo S, Rizzuto N. [Clinical and biopsy study of 4 cases of chronic recurrent polyradiculoneuritis]. Riv Neurobiol 1984; 30:309-16. [PMID: 6544483] [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: 04/05/2023]
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48
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Toso V, Cagnin G, Morello F, Antonini D, D'Este R. [A case of paraneoplastic myeloneuropathy possibly of deficiency origin]. Riv Neurobiol 1983; 29:249-55. [PMID: 6330864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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49
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Toso V, Carbonin C, Morello F. [Observation of a case of cerebellar atrophy in a patient poisoned by pesticides]. Riv Neurobiol 1982; 28:544-9. [PMID: 7187123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Morello F, Cagnin G, Toso DA. [Case of brucellosis localized in the brain]. Riv Neurobiol 1981; 27:34-9. [PMID: 7346982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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