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De Lazzari M, Martini N, Migliore F, Donato F, Babuin L, Tarantini G, Perazzolo Marra M, Cacciavillani L, Bertaglia E, Bortoluzzi A, Cianci V, Corrado D, Iliceto S, Zorzi A. Efficacy and Safety of Isoprenaline during Unstable Third-Degree Atrioventricular Block. J Cardiovasc Dev Dis 2023; 10:475. [PMID: 38132643 PMCID: PMC10744284 DOI: 10.3390/jcdd10120475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/11/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Unstable and symptomatic complete atrioventricular block represents a potentially fatal condition that requires prompt therapy while waiting for definitive pacemaker implantation. Although transcutaneous pacing is included in acute management, it could be a difficult approach due to its painfulness and the occasional failure of mechanical capture. Drug therapy is a feasible choice, and current guidelines encompass the use of atropine, dopamine, or epinephrine. Isoprenaline has never been investigated in this setting, and no specific indication of its use has been provided despite its potentially more favorable pharmacological profile. The study population included a consecutive series of patients who presented to the emergency department because of unstable third-degree atrioventricular block and were treated with either isoprenaline or dopamine infusion while waiting for definitive pacemaker implantation. Asymptomatic patients or those with reversible causes of complete atrioventricular block were excluded. The clinical response to the drug was deemed poor if, despite achieving a full drug dose, patients remained symptomatic and/or with hemodynamic instability, ventricular rate and rhythm did not improve or worsened, including if ventricular arrhythmias or asystolic pauses and/or irrepressible nausea/vomiting occurred. Isoprenaline infusion has proved to be safe and tolerated with no arrhythmia induction or hypotensive issues. Isoprenaline has also proven to be more satisfactory in achieving an effective clinical response in 84% of patients rather than dopamine (31%, p < 0.001), reducing the need for temporary artificial pacing. Our data point out the efficacy and safety of isoprenaline infusion and its greater tolerability over dopamine in the acute management of unstable third-degree AV block while waiting for definitive pacemaker implantation.
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Affiliation(s)
- Manuel De Lazzari
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Nicolò Martini
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Federico Migliore
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Filippo Donato
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Luciano Babuin
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Giuseppe Tarantini
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Martina Perazzolo Marra
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Luisa Cacciavillani
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Emanuele Bertaglia
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Andrea Bortoluzzi
- Emergency Department, Department of Medicine, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (A.B.); (V.C.)
| | - Vito Cianci
- Emergency Department, Department of Medicine, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (A.B.); (V.C.)
| | - Domenico Corrado
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Sabino Iliceto
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
| | - Alessandro Zorzi
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University Hospital of Padua, Via Giustiniani, 2, 35128 Padua, Italy; (M.D.L.); (N.M.); (F.M.); (F.D.); (L.B.); (G.T.); (M.P.M.); (L.C.); (E.B.); (D.C.); (S.I.)
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Cecchetto A, Guarnieri G, Torreggiani G, Vianello A, Baroni G, Palermo C, Bertagna De Marchi L, Lorenzoni G, Bartolotta P, Bertaglia E, Donato F, Aruta P, Iliceto S, Mele D. Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation. J Clin Med 2023; 12:4658. [PMID: 37510773 PMCID: PMC10380208 DOI: 10.3390/jcm12144658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate to severe COVID-19 pneumonia were assessed clinically and by laboratory tests, echocardiography, six-minute walking test (6MWT), and pulmonary function tests. Fifty-one patients reported persistent dyspnea. C-reactive protein (p = 0.025, OR 1.01 (95% CI 1.00-1.02)) at admission, longer duration of hospitalization (p = 0.005, OR 1.05 (95% CI 1.01-1.10)) and higher body mass index (p = 0.001, OR 1.15 (95% CI 1.06-1.28)) were independent predictors of dyspnea. Absolute drop in SpO2 at 6MWT (p = 0.001, OR 1.37 (95% CI 1.13-1.69)), right ventricular (RV) global longitudinal strain (p = 0.016, OR 1.12 (95% CI 1.02-1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (p = 0.034, OR 0.14 (95% CI 0.02-0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period.
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Affiliation(s)
- Antonella Cecchetto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Gabriella Guarnieri
- Respiratory Pathophysiology Division, University of Padua, 35128 Padua, Italy
| | - Gianpaolo Torreggiani
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Andrea Vianello
- Respiratory Pathophysiology Division, University of Padua, 35128 Padua, Italy
| | - Giulia Baroni
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Chiara Palermo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | | | - Giulia Lorenzoni
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Patrizia Bartolotta
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Emanuele Bertaglia
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Filippo Donato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Patrizia Aruta
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Donato Mele
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
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Cecchetto A, Torreggiani G, Guarnieri G, Vianello A, Baroni G, Palermo C, Bertagna De Marchi L, Lorenzoni G, Bartolotta P, Bertaglia E, Donato F, Aruta P, Iliceto S, Mele D. Subclinical Myocardial Injury in Patients Recovered from COVID-19 Pneumonia: Predictors and Longitudinal Assessment. J Cardiovasc Dev Dis 2023; 10:jcdd10040179. [PMID: 37103058 PMCID: PMC10144016 DOI: 10.3390/jcdd10040179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
(1) Background: Emerging data regarding patients recovered from COVID-19 are reported in the literature, but cardiac sequelae have not yet been clarified. To quickly detect any cardiac involvement at follow-up, the aims of the research were to identify: elements at admission predisposing subclinical myocardial injury at follow up; the relationship between subclinical myocardial injury and multiparametric evaluation at follow-up; and subclinical myocardial injury longitudinal evolution. (2) Methods and Results: A total of 229 consecutive patients hospitalised for moderate to severe COVID-19 pneumonia were initially enrolled, of which 225 were available for follow-up. All patients underwent a first follow-up visit, which included a clinical evaluation, a laboratory test, echocardiography, a six-minute walking test (6MWT), and a pulmonary functional test. Of the 225 patients, 43 (19%) underwent a second follow-up visit. The median time to the first follow-up after discharge was 5 months, and the median time to the second follow-up after discharge was 12 months. Left ventricular global longitudinal strain (LVGLS) and right ventricular free wall strain (RVFWS) were reduced in 36% (n = 81) and 7.2% (n = 16) of the patients, respectively, at first the follow-up visit. LVGLS impairment showed correlations with patients of male gender (p 0.008, OR 2.32 (95% CI 1.24-4.42)), the presence of at least one cardiovascular risk factor (p < 0.001, OR 6.44 (95% CI 3.07-14.9)), and final oxygen saturation (p 0.002, OR 0.99 (95% CI 0.98-1)) for the 6MWTs. Subclinical myocardial dysfunction had not significantly improved at the 12-month follow-ups. (3) Conclusions: in patients recovered from COVID-19 pneumonia, left ventricular subclinical myocardial injury was related to cardiovascular risk factors and appeared stable during follow-up.
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Affiliation(s)
- Antonella Cecchetto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Gianpaolo Torreggiani
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Gabriella Guarnieri
- Respiratory Pathophysiology Division, University of Padua, 35128 Padua, Italy
| | - Andrea Vianello
- Respiratory Pathophysiology Division, University of Padua, 35128 Padua, Italy
| | - Giulia Baroni
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Chiara Palermo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | | | - Giulia Lorenzoni
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Patrizia Bartolotta
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Emanuele Bertaglia
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Filippo Donato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Patrizia Aruta
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
| | - Donato Mele
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy
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Abstract
Encephalitis lethargica developed in epidemic from 1919 to 1926 in Europe and throughout the world. From the clinical point of view, the disturbances of consciousness and alertness and the possible outcomes of a postencephalitic Parkinsonism has attracted much attention. For a long time, it was thought that such a disease may still occur sporadically. In this review, the authors examined historical and current pictures of epidemics that may be related to Encephalitis lethargica. The previous Nona and Russian Influenza exhibited frequent neurological symptoms. The Spanish flu, formerly related to Encephalitis lethargica, would appear an epidemic that had its development in a partially overlapping period. The current pandemic linked to COVID-19 sometimes has aspects that can resemble Encephalitis lethargica. Based on historical analysis and the more recent immunological data, it could be suggested that Encephalitis lethargica was an autoimmune encephalitis that arose in a secondary form to the action of a viral agent. It cannot be ruled out that this agent was a coronavirus. From the nosological point of view, the term Encephalitis lethargica should be abolished in designating autoimmune encephalitis pictures that run sporadically.
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Affiliation(s)
- A Di Vito
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy,A Di Vito, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro 88100, Italy.
| | - A Donato
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - J Bria
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - F Donato
- CeRPS Foundation (Research Center on Psychiatry and Social Sciences), Nocera Inferiore, Italy,Giuda Lab, Department of Mechanical, Energy and Management Engineering, University of Calabria, Arcavacata di Rende, Cosenza
| | - G Donato
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Fanelli E, Da Ros Z, Martino I, Azzurro E, Bargione G, Donato F, Lucchetti A. Crowding in the middle of marine food webs: A focus on Raja asterias and other mediterranean batoids. Mar Environ Res 2023; 183:105830. [PMID: 36435173 DOI: 10.1016/j.marenvres.2022.105830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The Mediterranean Sea is among the three biodiversity hotspots of the world where elasmobranchs are severely threatened. Elasmobranchs act as apex or meso-predators within marine food webs and the loss/decline of apex predators determines the mesopredator release, leading in turn to increased predation on smaller prey. However, also several mesopredators (including rays, skates and small sharks) are intensively fished, being of commercial interest, or by-caught, and thus mesopredators increase could not be so evident. We analysed the trophic ecology of an endemic Mediterranean ray, the starry ray Raja asterias, at a seasonal scale from the Adriatic basin, one of the most intensively exploited area of the Mediterranean, by means of stomach contents and stable isotopes analyses. Our results evidenced that starry rays rely on benthic sources including species of local commercial values, such as swimming crabs, small cephalopods, and stomatopods and share the same trophic position with other elasmobranchs (rays, skates, and small sharks) and other mesopredators (e.g., common soles, Norway lobsters and mullets). As all mesopredators are overexploited, as well as their benthic prey are affected by intense trawl-fishing, the whole food webs are disrupted and neither the classical trophic cascade nor the mesopredator release hypothesis could be verified. Conservation measures for these species, such as the release after capture or the application of exclusion grids to the net, should be applied in areas where populations are strongly impacted by trawling.
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Affiliation(s)
- E Fanelli
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy; Stazione Zoologica Anton Dohrn, Naples, Italy.
| | - Z Da Ros
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - I Martino
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - E Azzurro
- Stazione Zoologica Anton Dohrn, Naples, Italy; Institute for Biological Resources and Marine Biotechnologies, National Research Council, Ancona, Italy
| | - G Bargione
- Institute for Biological Resources and Marine Biotechnologies, National Research Council, Ancona, Italy
| | - F Donato
- Institute for Biological Resources and Marine Biotechnologies, National Research Council, Ancona, Italy
| | - A Lucchetti
- Institute for Biological Resources and Marine Biotechnologies, National Research Council, Ancona, Italy
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Dardi F, Ballerini A, Guarino D, Donato F, Bertozzi R, Martini G, Magnani I, Manes A, Palazzini M, Galie' N. A clinical and echocardiographic score to differentiate pulmonary hypertension due to heart failure with preserved ejection fraction from idiopathic pulmonary hypertension: the PH-HFPEF score. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
One of the most challenging differential diagnoses in pulmonary hypertension clinical practice, is the discrimination between idiopathic pulmonary arterial hypertension (IPAH) and pulmonary hypertension due to heart failure with preserved ejection fraction (PH-HFpEF).
Aim
We elaborate a score (considering patient clinical history, demographics, and echocardiographic characteristics) that can predict, noninvasively, PH-HFpEF vs IPAH diagnosis.
Methods
Data were prospectively collected on 466 consecutive patients with a final diagnosis of IPAH or PH-HFpEF referred to a single tertiary pulmonary vascular disease centre. Data included clinical history, demographics, and parameters of an electrocardiogram and a transthoracic echocardiogram. A multivariate regression model was developed to predict a PH-HFpEF diagnosis, and an integer risk score was generated using adjusted regression coefficients of the multivariate logistic regression analysis.
Results
At the multivariate logistic regression a high ratio between left and right ventricular dimensions, a history of atrial fibrillation (AF), a high body mass index (BMI), a reduced mitral deceleration time and a high E-wave at trans-mitral doppler, an advanced age and a high right ventricular fractional area change (FAC) were predictors of PH-HFpEF. The derived PH-HFPEF score is shown in Table 1 and, with a cut-point ≥11, it yielded a specificity/sensitivity, respectively, for the diagnosis of PH-HFpEF, of 100%/49% with an AUC of 0.987.
Conclusions
The PH-HFPEF score can predict PH-HFpEF vs IPAH. The PH-HFPEF score may be used to potentially avoid an invasive diagnostic testing in almost half of PH-HFpEF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Dardi
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - A Ballerini
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - D Guarino
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - F Donato
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - R Bertozzi
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - G Martini
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - I Magnani
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - A Manes
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - M Palazzini
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
| | - N Galie'
- Alma Mater Studiorum, University of Bologna, CardioThoracicVascular Department of IRCCS Sant'Orsola Hospital , Bologna , Italy
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Cipriani A, D’Amico G, Brunetti G, Vescovo GM, Donato F, Gambato M, Dall’Aglio PB, Cardaioli F, Previato M, Martini N, Perazzolo Marra M, Iliceto S, Cacciavillani L, Corrado D, Zorzi A. Electrocardiographic Predictors of Primary Ventricular Fibrillation and 30-Day Mortality in Patients Presenting with ST-Segment Elevation Myocardial Infarction. J Clin Med 2021; 10:jcm10245933. [PMID: 34945229 PMCID: PMC8703328 DOI: 10.3390/jcm10245933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/30/2021] [Revised: 12/12/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
Primary ventricular fibrillation (PVF) may occur in the early phase of ST-elevation myocardial infarction (STEMI) prior to primary percutaneous coronary intervention (PCI). Multiple electrocardiographic STEMI patterns are associated with PVF and short-term mortality including the tombstone, Lambda, and triangular QRS-ST-T waveform (TW). We aimed to compare the predictive value of different electrocardiographic STEMI patterns for PVF and 30-day mortality. We included a consecutive cohort of 407 STEMI patients (75% males, median age 66 years) presenting within 12 h of symptoms onset. At first medical contact, 14 (3%) showed the TW or Lambda ECG patterns, which were combined in a single group (TW-Lambda pattern) characterized by giant R-wave and downsloping ST-segment. PVF prior to primary PCI occurred in 39 (10%) patients, significantly more often in patients with the TW-Lambda pattern than those without (50% vs. 8%, p < 0.001). For the multivariable analysis, Killip class ≥3 (OR 6.19, 95% CI 2.37–16.1, p < 0.001) and TW-Lambda pattern (OR 9.64, 95% CI 2.99–31.0, p < 0.001) remained as independent predictors of PVF. Thirty-day mortality was also higher in patients with the TW-Lambda pattern than in those without (43% vs. 6%, p < 0.001). However, only LVEF (OR 0.86, 95% CI 0.82–0.90, p < 0.001) and PVF (OR 4.61, 95% CI 1.49–14.3, p = 0.042) remained independent predictors of mortality. A mediation analysis showed that the effect of TW-Lambda pattern on mortality was mediated mainly via the reduced LVEF. In conclusion, among patients presenting with STEMI, the electrocardiographic TW-Lambda pattern was associated with both PVF before PCI and 30-day mortality. Therefore, this ECG pattern may be useful for early risk stratification of STEMI.
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Affiliation(s)
- Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Gianpiero D’Amico
- Department of Cardiology, Ospedale dell’Angelo, 30174 Venice, Italy; (G.D.); (G.M.V.); (M.P.)
| | - Giulia Brunetti
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Giovanni Maria Vescovo
- Department of Cardiology, Ospedale dell’Angelo, 30174 Venice, Italy; (G.D.); (G.M.V.); (M.P.)
| | - Filippo Donato
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Marco Gambato
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Pietro Bernardo Dall’Aglio
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Francesco Cardaioli
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Martina Previato
- Department of Cardiology, Ospedale dell’Angelo, 30174 Venice, Italy; (G.D.); (G.M.V.); (M.P.)
| | - Nicolò Martini
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Sabino Iliceto
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Luisa Cacciavillani
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
- Correspondence:
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padova, Italy; (A.C.); (G.B.); (F.D.); (M.G.); (P.B.D.); (F.C.); (N.M.); (M.P.M.); (S.I.); (L.C.); (A.Z.)
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8
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Calore F, Donato F, Manconi S. Dissecting the Inner Galaxy with γ-Ray Pixel Count Statistics. Phys Rev Lett 2021; 127:161102. [PMID: 34723610 DOI: 10.1103/physrevlett.127.161102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/11/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
We combine adaptive template fitting and pixel count statistics in order to assess the nature of the Galactic Center excess in Fermi-LAT data. We reconstruct the flux distribution of point sources well below the Fermi-LAT detection threshold, and measure their radial and longitudinal profiles in the inner Galaxy. We find that all point sources and the bulge-correlated diffuse emission each contributes O(10%) of the total inner Galaxy emission, and disclose a potential subthreshold point-source contribution to the Galactic Center excess.
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Affiliation(s)
- F Calore
- Université Grenoble Alpes, USMB, CNRS, LAPTh, F-74940 Annecy, France
| | - F Donato
- Dipartimento di Fisica, Università di Torino, via P. Giuria, 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, via P. Giuria, 1, I-10125 Torino, Italy
| | - S Manconi
- Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, Sommerfeldstraße 16, 52056 Aachen, Germany
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9
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Carducci AL, Agodi A, Ancona C, Angelini P, Bagordo F, Barbone F, Birbaum L, Carreri V, Casuccio A, Conti A, Conversano M, De Donno A, De Giglio O, Desiante F, Di Pietro A, Dogliotti E, Donato F, Fara GM, Fiore M, Forastiere F, Giammanco G, Izzotti A, Montagna MT, Oliveri Conti G, Petronio MG, Sciacca S, Signorelli C, Testai E, Verani M, Vinceti M, Vitale F, Ferrante M, Adani G, Berghella L, Calia C, Calzolari R, Canale A, Castiglione D, Conti A, Copat C, Cristaldi A, Cuffari G, Coronel Vargas G, De Vita E, De Nard F, Federigi I, Filippini T, Grasso A, Leonardi N, Letzgus M, Lo Bianco G, Mazzucco W, Nicolosi I, Orlandi P, Paladino G, Pizzo S, Pousis C, Raffo M, Rivolta S, Scarpitta F, Trani G, Triggiano F, Tumbarello A, Vecchio V, Zuccarello P, Vassallo M. Impact of the environment on the health: From theory to practice. Environ Res 2021; 194:110517. [PMID: 33271142 DOI: 10.1016/j.envres.2020.110517] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
The Erice 56 Charter titled "Impact of the environment on the health: from theory to practice" was unanimously approved at the end of the 56th course of the "International School of Epidemiology and Preventive Medicine G. D'Alessandro" held from 3rd to November 7, 2019 in Erice - Sicily (Italy) and promoted by the Study Group of "Environment and Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health. The course, that included lectures, open discussions and guided working groups, was aimed to provide a general training on epidemiological and toxicological aspects of the environmental health impact, to be used by public health professionals for risk assessment, without forgetting the risk communications. At the end of the course 12 key points were agreed among teachers and students: they underlined the need of specific training and research, in the perspective of "One Health" and "Global Health", also facing emerging scientific and methodological issues and focusing on communication towards stakeholders. This Discussion highlight the need to improve knowledge of Health and Environment topic in all sectors of health and environmental prevention and management.
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Affiliation(s)
- A L Carducci
- Department of Biology, University of Pisa, Italy
| | - A Agodi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Ancona
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Italy
| | - F Bagordo
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - F Barbone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - L Birbaum
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - V Carreri
- Past-President of Italian Society of Hygiene (SItI), Italy
| | - A Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - M Conversano
- Department of Public Health, ASL, Taranto, Italy
| | - A De Donno
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - O De Giglio
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - F Desiante
- Department of Prevention, Local Health Authority of Taranto, Taranto, Italy
| | - A Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - E Dogliotti
- Department of Environmental and Health. Istituto Superiore di Sanità. Rome, Italy
| | - F Donato
- Department of Medical and Surgical Specialties, Radiological Sciences, And Public Health, University of Brescia, Italy
| | - G M Fara
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - M Fiore
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - F Forastiere
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - G Giammanco
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - A Izzotti
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M T Montagna
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - G Oliveri Conti
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M G Petronio
- Health and Environment-Department of Prevention, Local Health Authority-Empoli, Florence, Italy
| | - S Sciacca
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Signorelli
- University Vita-Salute San Raffaele, Milan, Italy
| | - E Testai
- Istituto Superiore di Sanità, Environment & Health Dept., Rome, Italy
| | - M Verani
- Department of Biology, University of Pisa, Italy
| | - M Vinceti
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - M Ferrante
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy.
| | - G Adani
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - L Berghella
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Calia
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - R Calzolari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - A Canale
- Department of Biology, University of Pisa, Italy
| | - D Castiglione
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - C Copat
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Cristaldi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - G Cuffari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - G Coronel Vargas
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - E De Vita
- Department of Biology, University of Pisa, Italy
| | | | - I Federigi
- Department of Biology, University of Pisa, Italy
| | - T Filippini
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - A Grasso
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - N Leonardi
- University Center for the Protection and Management of Natural Environments and Agrosystems (CUTGANA), University of Catania, Italy
| | | | | | - W Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - I Nicolosi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Orlandi
- Local Health Authority of Rome, Italy
| | - G Paladino
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - S Pizzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - C Pousis
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - M Raffo
- Local Health Authority of Rome, Italy
| | | | - F Scarpitta
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - G Trani
- Central Health Department of the Friuli Venezia Giulia Region, Trieste, Italy
| | - F Triggiano
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | | | - V Vecchio
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Zuccarello
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M Vassallo
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
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10
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Cipriani A, Capone F, Donato F, Molinari L, Ceccato D, Saller A, Previato L, Pesavento R, Sarais C, Fioretto P, Iliceto S, Gregori D, Avogaro A, Vettor R. Cardiac injury and mortality in patients with Coronavirus disease 2019 (COVID-19): insights from a mediation analysis. Intern Emerg Med 2021; 16:419-427. [PMID: 32984929 PMCID: PMC7520162 DOI: 10.1007/s11739-020-02495-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUNDS Patients at greatest risk of severe clinical conditions from coronavirus disease 2019 (COVID-19) and death are elderly and comorbid patients. Increased levels of cardiac troponins identify patients with poor outcome. The present study aimed to describe the clinical characteristics and outcomes of a cohort of Italian inpatients, admitted to a medical COVID-19 Unit, and to investigate the relative role of cardiac injury on in-hospital mortality. METHODS AND RESULTS We analyzed all consecutive patients with laboratory-confirmed COVID-19 referred to our dedicated medical Unit between February 26th and March 31st 2020. Patients' clinical data including comorbidities, laboratory values, and outcomes were collected. Predictors of in-hospital mortality were investigated. A mediation analysis was performed to identify the potential mediators in the relationship between cardiac injury and mortality. A total of 109 COVID-19 inpatients (female 36%, median age 71 years) were included. During in-hospital stay, 20 patients (18%) died and, compared with survivors, these patients were older, had more comorbidities defined by Charlson comorbidity index ≥ 3(65% vs 24%, p = 0.001), and higher levels of high-sensitivity cardiac troponin I (Hs-cTnI), both at first evaluation and peak levels. A dose-response curve between Hs-cTnI and in-hospital mortality risk up to 200 ng/L was detected. Hs-cTnI, chronic kidney disease, and chronic coronary artery disease mediated most of the risk of in-hospital death, with Hs-cTnI mediating 25% of such effect. Smaller effects were observed for age, lactic dehydrogenase, and D-dimer. CONCLUSIONS In this cohort of elderly and comorbid COVID-19 patients, elevated Hs-cTnI levels were the most important and independent mediators of in-hospital mortality.
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Affiliation(s)
- Alberto Cipriani
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy.
| | - Federico Capone
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Filippo Donato
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Leonardo Molinari
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Davide Ceccato
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Alois Saller
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Lorenzo Previato
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Raffaele Pesavento
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Cristiano Sarais
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Paola Fioretto
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Sabino Iliceto
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Dario Gregori
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Angelo Avogaro
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
| | - Roberto Vettor
- Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy
- Azienda Ospedaliera, University of Padua, Via Giustiniani, 2, Padua, 35128, Italy
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11
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Coromilas EJ, Kochav S, Goldenthal I, Biviano A, Garan H, Goldbarg S, Kim JH, Yeo I, Tracy C, Ayanian S, Akar J, Singh A, Jain S, Zimerman L, Pimentel M, Osswald S, Twerenbold R, Schaerli N, Crotti L, Fabbri D, Parati G, Li Y, Atienza F, Zatarain E, Tse G, Leung KSK, Guevara-Valdivia ME, Rivera-Santiago CA, Soejima K, De Filippo P, Ferrari P, Malanchini G, Kanagaratnam P, Khawaja S, Mikhail GW, Scanavacca M, Abrahão Hajjar L, Rizerio B, Sacilotto L, Mollazadeh R, Eslami M, Laleh Far V, Mattioli AV, Boriani G, Migliore F, Cipriani A, Donato F, Compagnucci P, Casella M, Dello Russo A, Coromilas J, Aboyme A, O'Brien CG, Rodriguez F, Wang PJ, Naniwadekar A, Moey M, Kow CS, Cheah WK, Auricchio A, Conte G, Hwang J, Han S, Lazzerini PE, Franchi F, Santoro A, Capecchi PL, Joglar JA, Rosenblatt AG, Zardini M, Bricoli S, Bonura R, Echarte-Morales J, Benito-González T, Minguito-Carazo C, Fernández-Vázquez F, Wan EY. Worldwide Survey of COVID-19-Associated Arrhythmias. Circ Arrhythm Electrophysiol 2021; 14:e009458. [PMID: 33554620 PMCID: PMC7982128 DOI: 10.1161/circep.120.009458] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Supplemental Digital Content is available in the text. Coronavirus disease 2019 (COVID-19) has led to over 1 million deaths worldwide and has been associated with cardiac complications including cardiac arrhythmias. The incidence and pathophysiology of these manifestations remain elusive. In this worldwide survey of patients hospitalized with COVID-19 who developed cardiac arrhythmias, we describe clinical characteristics associated with various arrhythmias, as well as global differences in modulations of routine electrophysiology practice during the pandemic.
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Affiliation(s)
- Ellie J Coromilas
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
| | - Stephanie Kochav
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
| | - Isaac Goldenthal
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
| | - Angelo Biviano
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
| | - Hasan Garan
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
| | - Seth Goldbarg
- New York Presbyterian Queens, Weill Medical College (S.G., J.-H.K., I.Y.)
| | - Joon-Hyuk Kim
- New York Presbyterian Queens, Weill Medical College (S.G., J.-H.K., I.Y.)
| | - Ilhwan Yeo
- New York Presbyterian Queens, Weill Medical College (S.G., J.-H.K., I.Y.)
| | - Cynthia Tracy
- The George Washington University School of Medicine & Health Sciences, The GW Medical Faculty Associates, Washington, DC (C.T., S.A.)
| | - Shant Ayanian
- The George Washington University School of Medicine & Health Sciences, The GW Medical Faculty Associates, Washington, DC (C.T., S.A.)
| | - Joseph Akar
- Section of Cardiovascular Disease, Yale University School of Medicine, New Haven, CT (J.A., A. Singh, S.J.)
| | - Avinainder Singh
- Section of Cardiovascular Disease, Yale University School of Medicine, New Haven, CT (J.A., A. Singh, S.J.)
| | - Shashank Jain
- Section of Cardiovascular Disease, Yale University School of Medicine, New Haven, CT (J.A., A. Singh, S.J.)
| | - Leandro Zimerman
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil (L.Z., M.P.)
| | - Maurício Pimentel
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil (L.Z., M.P.)
| | - Stefan Osswald
- Department of Cardiology & Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland (S.O., R.T., N.S.)
| | - Raphael Twerenbold
- Department of Cardiology & Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland (S.O., R.T., N.S.)
| | - Nicolas Schaerli
- Department of Cardiology & Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland (S.O., R.T., N.S.)
| | - Lia Crotti
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural & Metabolic Sciences, San Luca Hospital, Milan, Italy (L.C., D.F., G.P.).,Department of Medicine & Surgery, University of Milano-Bicocca, Milan, Italy (L.C., D.F., G.P.)
| | - Daniele Fabbri
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural & Metabolic Sciences, San Luca Hospital, Milan, Italy (L.C., D.F., G.P.).,Department of Medicine & Surgery, University of Milano-Bicocca, Milan, Italy (L.C., D.F., G.P.)
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural & Metabolic Sciences, San Luca Hospital, Milan, Italy (L.C., D.F., G.P.).,Department of Medicine & Surgery, University of Milano-Bicocca, Milan, Italy (L.C., D.F., G.P.)
| | - Yi Li
- Wuhan Asia General Hospital, China (Y.L.)
| | - Felipe Atienza
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) (F.A., E.Z.).,CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain (F.A., E.Z.)
| | - Eduardo Zatarain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) (F.A., E.Z.).,CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain (F.A., E.Z.)
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, China (G.T.).,School of Life Sciences. The Hospital Authority of Hong Kong, Hong Kong, China (G.T.).,Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, China (G.T.)
| | - Keith Sai Kit Leung
- Aston Medical School, Aston University, Birmingham, United Kingdom (K.C.K.L.)
| | - Milton E Guevara-Valdivia
- UMAE Hospital de Especialidades Dr. Antonio Fraga Mouret CMN La Raza IMSS, CDMX, Mexico (M.E.G.-V., C.A.R.-S.)
| | - Carlos A Rivera-Santiago
- UMAE Hospital de Especialidades Dr. Antonio Fraga Mouret CMN La Raza IMSS, CDMX, Mexico (M.E.G.-V., C.A.R.-S.)
| | - Kyoko Soejima
- Kyorin University School of Medicine, Tokyo, Japan (K.S.)
| | - Paolo De Filippo
- Electrophysiology & Cardiac Pacing Unit, Cardiology Department, ASST Papa Giovanni XXIII, Bergamo, Italy (P.D.F., P.F., G.M.)
| | - Paola Ferrari
- Electrophysiology & Cardiac Pacing Unit, Cardiology Department, ASST Papa Giovanni XXIII, Bergamo, Italy (P.D.F., P.F., G.M.)
| | - Giovanni Malanchini
- Electrophysiology & Cardiac Pacing Unit, Cardiology Department, ASST Papa Giovanni XXIII, Bergamo, Italy (P.D.F., P.F., G.M.)
| | - Prapa Kanagaratnam
- Imperial College Healthcare NHS Trust, London, United Kingdom (P.K., S. Khawaja, G.W.M.)
| | - Saud Khawaja
- Imperial College Healthcare NHS Trust, London, United Kingdom (P.K., S. Khawaja, G.W.M.)
| | - Ghada W Mikhail
- Imperial College Healthcare NHS Trust, London, United Kingdom (P.K., S. Khawaja, G.W.M.)
| | - Mauricio Scanavacca
- Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil (M.S., A.H., B.R., L.S.)
| | - Ludhmila Abrahão Hajjar
- Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil (M.S., A.H., B.R., L.S.)
| | - Brenno Rizerio
- Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil (M.S., A.H., B.R., L.S.)
| | - Luciana Sacilotto
- Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil (M.S., A.H., B.R., L.S.)
| | - Reza Mollazadeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran (R.M., M.E., V.L.f.)
| | - Masoud Eslami
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran (R.M., M.E., V.L.f.)
| | - Vahideh Laleh Far
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran (R.M., M.E., V.L.f.)
| | | | - Giuseppe Boriani
- University of Modena & Reggio Emilia, Modena, Italy (V.M., G.B.)
| | - Federico Migliore
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.C., F.D.)
| | - Alberto Cipriani
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.C., F.D.)
| | - Filippo Donato
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.C., F.D.)
| | - Paolo Compagnucci
- Cardiology & Arrhythmology Clinic, University Hospital "Ospedali Riuniti," Marche Polytechnic University, Ancona, Italy (P.C., M.C., A.D.R.)
| | - Michela Casella
- Cardiology & Arrhythmology Clinic, University Hospital "Ospedali Riuniti," Marche Polytechnic University, Ancona, Italy (P.C., M.C., A.D.R.)
| | - Antonio Dello Russo
- Cardiology & Arrhythmology Clinic, University Hospital "Ospedali Riuniti," Marche Polytechnic University, Ancona, Italy (P.C., M.C., A.D.R.)
| | - James Coromilas
- Division of Cardiovascular Disease & Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (J.C., A. Aboyme)
| | - Andrew Aboyme
- Division of Cardiovascular Disease & Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (J.C., A. Aboyme)
| | - Connor Galen O'Brien
- Department of Medicine, Division of Cardiology, University of California San Francisco School of Medicine (C.G.O.)
| | | | - Paul J Wang
- Division of Cardiology, Stanford University, CA (F.R., P.J.W.)
| | | | - Melissa Moey
- East Carolina University, Greenville, NC (A.N., M.M.)
| | - Chia Siang Kow
- School of Postgraduate Studies, International Medical University, Kuala Lumpur (C.S.K.)
| | - Wee Kooi Cheah
- Department of Medicine & Clinical Research Center, Taiping Hospital, Perak, Malaysia (W.K.C.)
| | - Angelo Auricchio
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland (A. Auricchio, G.C.)
| | - Giulio Conte
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland (A. Auricchio, G.C.)
| | - Jongmin Hwang
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea (J.H., S.H.)
| | - Seongwook Han
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea (J.H., S.H.)
| | - Pietro Enea Lazzerini
- Department of Medical Sciences, Surgery & Neurosciences, University of Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.).,Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.)
| | - Federico Franchi
- Department of Medical Sciences, Surgery & Neurosciences, University of Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.).,Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.)
| | - Amato Santoro
- Department of Medical Sciences, Surgery & Neurosciences, University of Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.).,Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.)
| | - Pier Leopoldo Capecchi
- Department of Medical Sciences, Surgery & Neurosciences, University of Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.).,Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy (P.E.L., F.F., A. Santoro, P.L.C.)
| | - Jose A Joglar
- University of Texas Southwestern Medical Center, Dallas (J.A.G., A.G.R.)
| | - Anna G Rosenblatt
- University of Texas Southwestern Medical Center, Dallas (J.A.G., A.G.R.)
| | - Marco Zardini
- Division of Cardiology, University Hospital "Ospedale Maggiore," Parma, Italy (M.Z., S.B., R.B.)
| | - Serena Bricoli
- Division of Cardiology, University Hospital "Ospedale Maggiore," Parma, Italy (M.Z., S.B., R.B.)
| | - Rosario Bonura
- Division of Cardiology, University Hospital "Ospedale Maggiore," Parma, Italy (M.Z., S.B., R.B.)
| | - Julio Echarte-Morales
- Department of Cardiology, University Hospital of Leon, Spain (J.E.-M., T.B.-G., C.M.-C., F.F.-V.)
| | - Tomás Benito-González
- Department of Cardiology, University Hospital of Leon, Spain (J.E.-M., T.B.-G., C.M.-C., F.F.-V.)
| | - Carlos Minguito-Carazo
- Department of Cardiology, University Hospital of Leon, Spain (J.E.-M., T.B.-G., C.M.-C., F.F.-V.)
| | - Felipe Fernández-Vázquez
- Department of Cardiology, University Hospital of Leon, Spain (J.E.-M., T.B.-G., C.M.-C., F.F.-V.)
| | - Elaine Y Wan
- Department of Medicine, Division of Cardiology, Columbia University Vagelos College of Physicians & Surgeons (E.J.C., S. Kochav, I.G., A.B., H.G., E.Y.W.)
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12
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Leoncini G, Donato F, Reggiani-Bonetti L, Salviato T, Cadei M, Daperno M, Principi MB, Armuzzi A, Caprioli F, Canavese G, Villanacci V. Diagnostic interobserver variability in Crohn's disease- and ulcerative colitis-associated dysplasia: a multicenter digital survey from the IG-IBD Pathologists Group. Tech Coloproctol 2020; 25:101-108. [PMID: 33025294 DOI: 10.1007/s10151-020-02349-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Crohn's disease (CD) and ulcerative colitis, two forms of inflammatory bowel disease (IBD), are chronic and relapsing conditions of the gastrointestinal tract both characterized by long lasting chronic inflammation and increased risk of dysplasia and colorectal cancer (CRC). The aim of our study was to evaluate the interobserver agreement about IBD-associated dysplasia among pathologists belonging to the Italian Group for Inflammatory Bowel Diseases (IG-IBD P). METHODS The present multicenter survey was performed using telepathology, supported by an open source E-learning platform. Biopsy specimens from 30 colonoscopies and from 20 patients were included. The glass slides of any case, including clinical and endoscopic data, were digitalized and uploaded on the E-learning platform. All the digital slides were grouped in 54 diagnostic "blocks". Blinded histopathological evaluation on all the digital slides was performed by 20 gastrointestinal pathologists. Closed-ended questions about (1) the occurrence of IBD; (2) the classification of IBD (as UC or CD); (3) the presence of active versus quiescent disease; (4) the presence of dysplasia; (5) the possible association of dysplasia with the sites of disease (dysplasia-associated lesion or mass-DALM vs adenoma-like mass-ALM); (6) the grading of dysplasia according to the ECCO guidelines (negative, indefinite, low grade, high grade categories) and (7) the presence of associated serrated features, were proposed in each case. Inter-observer agreement was evaluated by mean agreement percentage and kappa statistic, when suitable. RESULTS The diagnosis of IBD was confirmed in 19 of 20 patients, 17 of 19 being classified as UC, 2 as CD. The mean interobserver agreement percentages about (1) the evidence of IBD, (2) the presence of either UC or CD and (3) the activity grading resulted to be 80%, 69% and 86%, respectively. Dysplasia was detected in 8/20 patients, with moderate agreement between pathologists (mean 72%, k 0.48). Particularly, low grade dysplasia was found in 13 biopsies (combined k 0.38), whereas high grade dysplasia in 8 (combined k 0.47). When the endoscopic and histopathological data were combined, features consistent with DALM were found in 6 of 20 patients with low grade dysplasia and those consistent with ALM in 2 patients with low grade dysplasia in a single biopsy (mean agreement: 86%). An associated serrated pattern was discovered in 4 patients (7 biopsies). CONCLUSIONS Our study showed moderate interobserver agreement about the histopathological detection and classification of IBD-associated dysplasia. Further efforts should be undertaken to integrate the histopathological data with both the ancillary tests and molecular investigations.
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Affiliation(s)
- G Leoncini
- Pathology Unit, ASST del Garda, Desenzano del Garda (BS), Brescia, Italy.
| | - F Donato
- Unit of Hygiene, Epidemiology and Public Health, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - L Reggiani-Bonetti
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - T Salviato
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Cadei
- Institute of Pathology, ASST Spedali Civili, Brescia, Italy
| | - M Daperno
- Gastroenterology Unit, Mauriziano Hospital, Turin, Italy
| | - M B Principi
- Emergency and Organ Transplantation Department, Section of Gastroenterology, AOU Policlinico, Bari, Italy
| | - A Armuzzi
- IBD Unit, Presidio Columbus Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Policlinico di Milano, Milan, Italy
- Department of Pathophysiology, University of Milan, Milan, Italy
- Department of Transplantation, University of Milan, Milan, Italy
| | - G Canavese
- Pathology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - V Villanacci
- Institute of Pathology, ASST Spedali Civili, Brescia, Italy
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13
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von Doetinchem P, Perez K, Aramaki T, Baker S, Barwick S, Bird R, Boezio M, Boggs S, Cui M, Datta A, Donato F, Evoli C, Fabris L, Fabbietti L, Ferronato Bueno E, Fornengo N, Fuke H, Gerrity C, Gomez Coral D, Hailey C, Hooper D, Kachelriess M, Korsmeier M, Kozai M, Lea R, Li N, Lowell A, Manghisoni M, Moskalenko I, Munini R, Naskret M, Nelson T, Ng K, Nozzoli F, Oliva A, Ong R, Osteria G, Pierog T, Poulin V, Profumo S, Pöschl T, Quinn S, Re V, Rogers F, Ryan J, Saffold N, Sakai K, Salati P, Schael S, Serksnyte L, Shukla A, Stoessl A, Tjemsland J, Vannuccini E, Vecchi M, Winkler M, Wright D, Xiao M, Xu W, Yoshida T, Zampa G, Zuccon P. Cosmic-ray antinuclei as messengers of new physics: status and outlook for the new decade. J Cosmol Astropart Phys 2020; 2020:035. [PMID: 34712102 PMCID: PMC8549764 DOI: 10.1088/1475-7516/2020/08/035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The precise measurement of cosmic-ray antinuclei serves as an important means for identifying the nature of dark matter and other new astrophysical phenomena, and could be used with other cosmic-ray species to understand cosmic-ray production and propagation in the Galaxy. For instance, low-energy antideuterons would provide a "smoking gun" signature of dark matter annihilation or decay, essentially free of astrophysical background. Studies in recent years have emphasized that models for cosmic-ray antideuterons must be considered together with the abundant cosmic antiprotons and any potential observation of antihelium. Therefore, a second dedicated Antideuteron Workshop was organized at UCLA in March 2019, bringing together a community of theorists and experimentalists to review the status of current observations of cosmic-ray antinuclei, the theoretical work towards understanding these signatures, and the potential of upcoming measurements to illuminate ongoing controversies. This review aims to synthesize this recent work and present implications for the upcoming decade of antinuclei observations and searches. This includes discussion of a possible dark matter signature in the AMS-02 antiproton spectrum, the most recent limits from BESS Polar-II on the cosmic antideuteron flux, and reports of candidate antihelium events by AMS-02; recent collider and cosmic-ray measurements relevant for antinuclei production models; the state of cosmic-ray transport models in light of AMS-02 and Voyager data; and the prospects for upcoming experiments, such as GAPS. This provides a roadmap for progress on cosmic antinuclei signatures of dark matter in the coming years.
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Affiliation(s)
- P. von Doetinchem
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K. Perez
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - T. Aramaki
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - S. Baker
- Imperial College London, London, SW7 2AZ, U.K
| | - S. Barwick
- Department of Physics & Astronomy, University of California at Irvine, 4129 Frederick Reines Hall, Irvine, CA 92697, U.S.A
| | - R. Bird
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - M. Boezio
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - S.E. Boggs
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Cui
- Purple Mountain Observatory, Yuanhua Road, Qixia District, Nanjing 210033, China
| | - A. Datta
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - F. Donato
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - C. Evoli
- Gran Sasso Science Institute, Viale Francesco Crispi 7, 67100 L’Aquila, Italy
- INFN, Laboratori Nazionali del Gran Sasso, Via G. Acitelli, 22, 67100 Assergi, L’Aquila, Italy
| | - L. Fabris
- Isotope and Fuel Cycle and Technology Division, Oak Ridge National Laboratory, PO BOX 2008, Oak Ridge, TN 37831, U.S.A
| | - L. Fabbietti
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - E. Ferronato Bueno
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - N. Fornengo
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - H. Fuke
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - C. Gerrity
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - D. Gomez Coral
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Physics, National Autonomous University of Mexico, Circuito de la investigación científica, C.U. 04510, Ciudad de México, Mexico
| | - C. Hailey
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - D. Hooper
- Theoretical Astrophysics, Fermi National Accelerator Laboratory, Wilson and Kirk Rds, Batavia, IL 60510, U.S.A
- Department of Astronomy and Astrophysics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
| | - M. Kachelriess
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - M. Korsmeier
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
- Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, 52056 Aachen, Germany
| | - M. Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - R. Lea
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
- Dipartimento di Fisica dell’Universitá Trieste, Via Valerio 2, 34127 Trieste, Italy
| | - N. Li
- CAS Key Laboratory of Theoretical Physics, Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, No.19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - A. Lowell
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Manghisoni
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - I.V. Moskalenko
- Hansen Experimental Physics Laboratory, Stanford University, 452 Lomita Mall, Stanford, CA 94305, U.S.A
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, CA 94305, U.S.A
| | - R. Munini
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - M. Naskret
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Theoretical Physics, University of Wroclaw, pl. M. Borna 9, 50-204 Wroclaw, Poland
| | - T. Nelson
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K.C.Y. Ng
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - F. Nozzoli
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
| | - A. Oliva
- INFN, Sezione di Bologna, Via Irnerio 46, Bologna 40126, Italy
| | - R.A. Ong
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - G. Osteria
- INFN, Sezione di Napoli, Strada Comunale Cinthia, 80126 Naples, Italy
| | - T. Pierog
- Institute for Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V. Poulin
- Laboratoire Univers & Particules de Montpellier, CNRS, Université de Montpellier, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - S. Profumo
- Department of Physics and Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, U.S.A
| | - T. Pöschl
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - S. Quinn
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - V. Re
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - F. Rogers
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - J. Ryan
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - N. Saffold
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - K. Sakai
- NASA-Goddard Space Flight Center), 8800 Greenbelt Rd, Greenbelt, MD 20771, U.S.A
- CRESST, University of Maryland, Baltimore County, MD 21250, U.S.A
| | - P. Salati
- Laboratoire d’Annecy-le-Vieux de Physique Théorique, 9 Chemin de Bellevue, 74940 Annecy, France
| | - S. Schael
- I. Physikalisches Institut, RWTH Aachen University, Sommerfeldstr. 14, 52074 Aachen, Germany
| | - L. Serksnyte
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - A. Shukla
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - A. Stoessl
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - J. Tjemsland
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - E. Vannuccini
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino, Florence, Italy
| | - M. Vecchi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - M.W. Winkler
- The Oskar Klein Centre for Cosmoparticle Physics, Department of Physics, Stockholm University, Alba Nova, 10691 Stockholm, Sweden
| | - D. Wright
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - M. Xiao
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - W. Xu
- Department of Physics, Harvard University, 17 Oxford St, Cambridge, MA, 95129, U.S.A
| | - T. Yoshida
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - G. Zampa
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - P. Zuccon
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
- Department of Physics, University of Trento, Via Sommarive 14, 38123 Povo, Italy
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14
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Cipriani A, Zorzi A, Ceccato D, Capone F, Parolin M, Donato F, Fioretto P, Pesavento R, Previato L, Maffei P, Saller A, Avogaro A, Sarais C, Gregori D, Iliceto S, Vettor R. Arrhythmic profile and 24-hour QT interval variability in COVID-19 patients treated with hydroxychloroquine and azithromycin. Int J Cardiol 2020; 316:280-284. [PMID: 32439366 PMCID: PMC7235573 DOI: 10.1016/j.ijcard.2020.05.036] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/28/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
Background Hydroxychloroquine and azithromycin combination therapy is often prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitoring is warranted because both medications cause corrected QT-interval (QTc) prolongation. Whether QTc duration significantly varies during the day, potentially requiring multiple ECGs, remains to be established. Methods We performed 12‑lead ECGs and 12‑lead 24-h Holter ECG monitoring in all patients aged <80 years admitted to our medical unit for COVID-19, in oral therapy with hydroxychloroquine (200 mg, twice daily) and azithromycin (500 mg, once daily) for at least 3 days. A group of healthy individuals matched for age and sex served as control. Results Out of 126 patients, 22 (median age 64, 82% men) met the inclusion criteria. ECG after therapy showed longer QTc-interval than before therapy (450 vs 426 ms, p = .02). Four patients had a QTc ≥ 480 ms: they showed higher values of aspartate aminotransferase (52 vs 30 U/L, p = .03) and alanine aminotransferase (108 vs 33 U/L, p < .01) compared with those with QTc < 480 ms. At 24-h Holter ECG monitoring, 1 COVID-19 patient and no control had ≥1 run of non-sustained ventricular tachycardia (p = .4). No patients showed “R on T" premature ventricular beats. Analysis of 24-h QTc dynamics revealed that COVID-19 patients had higher QTc values than controls, with no significant hourly variability. Conclusion Therapy with hydroxychloroquine and azithromycin prolongs QTc interval in patients with COVID-19, particularly in those with high levels of transaminases. Because QTc duration remains stable during the 24 h, multiple daily ECG are not recommendable.
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Affiliation(s)
- Alberto Cipriani
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy.
| | - Alessandro Zorzi
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - Davide Ceccato
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Federico Capone
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Matteo Parolin
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Filippo Donato
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - Paola Fioretto
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Raffaele Pesavento
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Lorenzo Previato
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Pietro Maffei
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Alois Saller
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Angelo Avogaro
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Cristiano Sarais
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - Dario Gregori
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - Sabino Iliceto
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - Roberto Vettor
- Department of Medicine, University of Padua Medical School, Padua, Italy
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15
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Barlotta A, Pirillo P, Stocchero M, Donato F, Giordano G, Bont L, Zanconato S, Carraro S, Baraldi E. Metabolomic Profiling of Infants With Recurrent Wheezing After Bronchiolitis. J Infect Dis 2020; 219:1216-1223. [PMID: 30445537 PMCID: PMC7107429 DOI: 10.1093/infdis/jiy659] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022] Open
Abstract
Background Bronchiolitis is associated with a greater risk of developing recurrent wheezing, but with currently available tools, it is impossible to know which infants with bronchiolitis will develop this condition. This preliminary prospective study aimed to assess whether urine metabolomic analysis can be used to identify children with bronchiolitis who are at risk of developing recurrent wheezing. Methods Fifty-two infants <1 year old treated in the emergency department at University Hospital of Padova for acute bronchiolitis were enrolled (77% tested positive for respiratory syncytial virus [RSV]). Follow-up visits were conducted for 2 years after the episode of bronchiolitis. Untargeted metabolomic analyses based on mass spectrometry were performed on urine samples collected from infants with acute bronchiolitis. Data modeling was based on univariate and multivariate data analyses. Results We distinguished children with and those without postbronchiolitis recurrent wheeze, defined as ≥3 episodes of physician-diagnosed wheezing. Pathway overrepresentation analysis pointed to a major involvement of the citric acid cycle (P < .001) and some amino acids (lysine, cysteine, and methionine; P ≤ .015) in differentiating between these 2 groups of children. Conclusion This is the first study showing that metabolomic profiling of urine specimens from infants with bronchiolitis can be used to identify children at increased risk of developing recurrent wheezing.
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Affiliation(s)
- Alessia Barlotta
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Paola Pirillo
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Matteo Stocchero
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Filippo Donato
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Giuseppe Giordano
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Louis Bont
- Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, the Netherlands.,Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - Stefania Zanconato
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Silvia Carraro
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy.,Respiratory Syncytial Virus Network (ReSViNET) Foundation, Zeist, the Netherlands
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16
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AlTurki A, Maj JB, Marafi M, Donato F, Vescovo G, Russo V, Proietti R. The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence. ACTA ACUST UNITED AC 2019; 55:medicina55120767. [PMID: 31801224 PMCID: PMC6956022 DOI: 10.3390/medicina55120767] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/01/2019] [Accepted: 11/23/2019] [Indexed: 12/11/2022]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with implications on long-term outcomes. Metabolic disorders including diabetes mellitus and obesity are independent predictors of atrial fibrillation and present therapeutic targets to reduce both the incidence and duration burden of atrial fibrillation. The presence of pericardial fat in direct contact with cardiac structures, as well the subsequent release of proinflammatory cytokines, may play an important role in this connection. Atrial fibrillation is an independent predictor of cognitive impairment and dementia. While clinical stroke is a major contributor, other factors such as cerebral hypoperfusion and microbleeds play important roles. New evidence suggests that atrial fibrillation and cognitive impairment may be downstream events of atrial cardiomyopathy, which may be caused by several factors including metabolic syndrome, obesity, and obstructive sleep apnea. The mechanisms linking these comorbidities to cognitive impairment are not yet fully elucidated. A clearer understanding of the association of AF with dementia and cognitive impairment is imperative. Future studies should focus on the predictors of cognitive impairment among those with AF and aim to understand the potential mechanisms underlying these associations. This would inform strategies for the management of AF aiming to prevent continued cognitive impairment.
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Affiliation(s)
- Ahmed AlTurki
- Division of Cardiology, McGill University Health Center, Montreal, QC H3G1A4, Canada;
- Correspondence: ; Tel.: +1-514-934-1934; Fax: +1-514-934-8569
| | - Jakub B. Maj
- Division of Cardiology, McGill University Health Center, Montreal, QC H3G1A4, Canada;
| | - Mariam Marafi
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Montreal, QC H3A2B4, Canada;
| | - Filippo Donato
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, 35121 Padua, Italy; (F.D.); (G.V.); (R.P.)
| | - Giovanni Vescovo
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, 35121 Padua, Italy; (F.D.); (G.V.); (R.P.)
| | - Vincenzo Russo
- Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”-Monaldi Hospital, 80131 Naples, Italy;
| | - Riccardo Proietti
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, 35121 Padua, Italy; (F.D.); (G.V.); (R.P.)
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17
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Zani C, Zani D, Donato F, Marullo M, Viola GCV, Lorenzetti S, Montano L. Lifestyle, environmental exposures and male fertility in healthy young men in North Italy. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Human semen quality is affected by metabolic, lifestyle and environmental factors. We planned a randomized controlled trial to evaluate the effects of lifestyle changes on semen quality in healthy young men living in Italian highly polluted areas. We present here some preliminary baseline data on the association between lifestyle and semen quality.
Methods
150 non-smokers, non-alcohol drinkers and non-obese young healthy men, aged 18-22 years, have been assigned to an intervention or control group according to a 1:1 randomization plan. The intervention group follows a 4-month nutritional pathway based on a Mediterranean dietary pattern and receives suggestions on practice of physical activity. All subjects undergo urologic examination, measurement of weight, height and abdominal circumference, an interview on lifestyle variables, and provide blood and semen samples in fasting conditions, at the enrollment and at the end of the intervention and follow-up (after 8 months). Adherence to Mediterranean diet is assessed using the “PREvención con DIeta MEDiterránea” (PREDIMED) tool, and physical activity using the “International Physical Activity Questionnaire” (IPAQ). Automated sperm analysis for all semen parameters is performed on the SQA-V GOLD.
Results
The data of 101 subjects living in a highly industrialized area in North Italy (mean±SD: age: 20.3±1.2 years, BMI: 22.3±2.2) were analyzed. The sperm cell concentration was higher in subjects with IPAQ score > median than those with lower values (68.3±48.6 vs 63.7±47.0 106/mL). Total percent motility was higher in subjects with abdominal circumference < median (50.7±13.6 vs 41.2±18.8, p = 0.004), in subjects with IPAQ score > median (48.2±16.8 vs 44.2±16.8), and in subjects with PREDIMED score > 7 (47.6±18.8 vs 45.0±15.0).
Conclusions
These preliminary data suggest that semen quality is associated with abdominal fat and physical activity in healthy young men.
Key messages
The semen quality is a sensitive marker of the health status and is predictive of disease occurrence. Our study suggests that semen quality is associated with lifestyle aspects in healthy young men.
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Affiliation(s)
- C Zani
- Department of Medical and Surgical Specialties Radiological, University of Brescia, Brescia, Italy
| | - D Zani
- Unit of Urology, Hospital “Città di Brescia”, Brescia, Italy
| | - F Donato
- Department of Medical and Surgical Specialties Radiological, University of Brescia, Brescia, Italy
| | - M Marullo
- Department of Medical and Surgical Specialties Radiological, University of Brescia, Brescia, Italy
| | - G C V Viola
- Department of Medical and Surgical Specialties Radiological, University of Brescia, Brescia, Italy
| | - S Lorenzetti
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health (ISS), Rome, Italy
| | - L Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndro, ASL Salerno “Oliveto Citra Hospital, Salerno, Italy
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18
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Ceretti E, Donato F, Feretti D, Carducci A, Moretti M, Donno AD, Carraro E, Biggeri A, Gelatti U. Monitoring air pollution effects on children for supporting public health policies (MAPEC_LIFE study). Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Children are at high risk of suffering health consequences of air pollution and childhood exposure can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE project, funded by EU Life+ Programme (LIFE12 ENV/IT/000614), aimed to evaluate the association between air pollution exposure and biomarkers of early effect in children and to propose guidance for implementing environmental policies.
Methods
The study was carried out on 6-8-year-old children. Micronucleus (MN) frequency was investigated in buccal cells of children and its association with air pollution exposure was assessed applying multiple Poisson regression mixed models, including socio-demographic and lifestyle factors as confounders. We also dichotomize air pollutants concentration according to the EU Ambient Air Quality Directives and WHO Air Quality Guidelines in all Poisson regression models to assess their risk predictive capacity.
Results
The project involved 1149 children providing buccal cells in winter and spring. 2139 biological samples were included in the analysis (1093 collected in winter, 1046 in spring). The analysis of the association between MN frequency and air quality parameters found positive associations for PM10, PM2.5, benzene, SO2 and ozone. Considering EU Directives, an association was found between MN frequency and PM10 exposure higher than the annual limit value, with an increase of the risk of 17.9% (95%CIs: 0.6-38.1%). Considering WHO Guidelines, the exposures to levels of PM10, benzene and BaP higher than the annual limits were associated with MN frequency, with a risk increase of 22.5%, 27.8% and 59.8% (95%CIs: 3.9-44.3%, 3.8-57.3%, 21.0-111.1%), respectively.
Conclusions
The analyses conducted showed an association between MN frequency in buccal cells of children and levels of some air pollutants, even at concentration below EU and WHO thresholds, which hence seemed to be insufficient for protecting children from this type of damage.
Key messages
Air pollution exposure induced chromosomal damage in buccal cells of children, even at concentration below the law limits. Early biological damage detected might be predictive of the occurrence of future harmful effects in humans, at a population level.
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Affiliation(s)
- E Ceretti
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - F Donato
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - D Feretti
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - A Carducci
- Department of Biology, University of Pisa, Pisa, Italy
| | - M Moretti
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - A De Donno
- Dep of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - E Carraro
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - A Biggeri
- Department of Statistic, Computing and Application, University of Firenze, Firenze, Italy
| | - U Gelatti
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
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Geroin C, Squintani G, Morini A, Donato F, Smania N, Gandolfi MG, Tamburin S, Fasano A, Tinazzi M. Pisa syndrome in Parkinson's disease: electromyographic quantification of paraspinal and non-paraspinal muscle activity. Funct Neurol 2018; 32:143-151. [PMID: 29042003 DOI: 10.11138/fneur/2017.32.3.143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with Parkinson's disease (PD) and Pisa syndrome (PS) may present tonic dystonic or compensatory (i.e. acting against gravity) hyperactivity in the paraspinal and non-paraspinal muscles. Electromyographic (EMG) activity was measured in nine patients with PD and PS, three with PD without PS, and five healthy controls. Fine-wire intramuscular electrodes were inserted bilaterally into the iliocostalis lumborum (ICL), iliocostalis thoracis (ICT), gluteus medius (GM), and external oblique (EO) muscles. The root mean square (RMS) of the EMG signal was calculated and normalized for each muscle. In stance condition, side-to-side muscle activity comparisons showed a higher RMS only for the contralateral ICL in PD patients with PS (p=0.028). Moreover, with increasing degrees of lateral flexion, the activity of the EO and the ICL muscles progressively increased and decreased, respectively. The present data suggest that contralateral paraspinal muscle activity plays a crucial compensatory role and can be dysfunctional in PD patients with PS.
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Abstract
Aims and background We evaluated some standardized criteria for classifying incident cases of liver cancer into either primary liver cancer (PLC) or unspecified liver cancer (ULC) on the basis of the diagnostic examinations performed and their results. Methods A pilot hospital-based study (98 cases) was carried out in Verona, northern Italy, with the main aim of assessing the feasibility of the method. The same procedures were subsequently applied in a population-based study (349 cases) in Brescia, northern Italy. Results Diagnosis was made on histologic data in 38.7% and 41.8% of the hospital based and population-based studies, respectively, with a wide variation among different hospitals. The percentage of cases classified as PLC was 78.6% in the hospital-based study and 78.8% in the population-based study. No differences in the proportion of cases attributed to PLC were found according to patients’ age and sex or hospital of admission. The repeatibility of the procedure was assessed by a cross-panel review of 198 cases, and concordance was found in 91.9% of them. Conclusions An operational method for case definition of PLC based on the results of the diagnostic examinations currently performed and some suggestions for cancer registration are proposed.
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Affiliation(s)
- F Donato
- Cattedra di Igiene, Università di Brescia, Italy
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21
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Alghisi A, Donato F, Lucini L, Marcianò P, Miccichè C, Nardi G, Nardi ME, Pasini M, Spiazzi R. Breast Cancer Screening in an Urban Population in Northern Italy. Tumori 2018; 76:22-5. [PMID: 2321269 DOI: 10.1177/030089169007600105] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A mammographic and clinical screening for breast cancer started in June 1987 in the Health District of Brescia, Northern Italy, including the town and 23 surrounding municipalities. This paper describes the organization and the results of the first 12 months of screening. Of 7791 invited women aged 50–60 years, 5217 (67 %>) agreed to participate. There was a trend for response rates to decline with increasing age and education. Of the 5217 women examined, 66 (1.3%) were referred for biopsy and 64 (1.2%) underwent this procedure. A histologically confirmed malignancy was found in 42 women, corresponding to a prevalence of 8.1/1000. Positive predictive value of the screening was 65.6 %. Among the 42 breast cancers, 4.8% were carcinoma in situ and 42.9 % invasive tumors up to 10 mm in size. According to the p-TNM classification, 92.9 % of all cancers were either TIS or in stage T1, 4.8 % were in T2 and one tumor was classified in T4. Lymph node involvement was assessed in 41 cases, and 71.4% of all cancers detected by screening were negative for lymph node metastasis. In comparison, the classification of tumors found in women of the same age group and living in Brescia, histologically diagnosed in the urban hospitals during 1986, one year before the beginning of the screening, was as follows: 7.1 % carcinoma in situ, and 16.7 % invasive tumors up to 10 mm in size. 38.1%, 2.4% and 2.4% of all tumors were in stages T2, T3 and T4 respectively.
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22
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Zani C, Ceretti E, Grioni S, Viola GCV, Donato F, Feretti D, Festa A, Bonizzoni S, Bonetti A, Monarca S, Villarini M, Levorato S, Carducci A, Verani M, Casini B, De Donno A, Grassi T, Bagordo F, Carraro E, Bonetta S, Bonetta S, Gelatti U. Are 6-8 year old Italian children moving away from the Mediterranean diet? Ann Ig 2016; 28:339-48. [PMID: 27627665 DOI: 10.7416/ai.2016.2114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Mediterranean diet (MD) is considered one of the healthiest dietary models, as it decreases the risk of chronic diseases and may modulate the organism's early response to environmental pollution. In recent decades, Mediterranean countries have been replacing their traditional diet with other less healthy eating habits, especially among children and teenagers. OBJECTIVE The aim of this study was to evaluate the MD and the level of adherence to it in 6-8 year old Italian children, in relation to residence, lifestyle, and social and family contexts. METHODS A questionnaire was administered to the children's parents in two seasons in 5 Italian towns. The diet section contained 116 questions investigating the frequency of consumption of different types of food. The Italian Mediterranean Index (IMI) was calculated according to the intake of 6 typical Mediterranean and 4 non-Mediterranean foods. On the basis of IMI score, MD adherence was classified as low (≤ 3 IMI score), medium (4-5) and high (≥ 6). Total energy load and diet composition in micro- and macronutrients were calculated from consumption frequency. RESULTS Diet analysis was computed on 1164 subjects with two complete questionnaires. Body mass index, calculated for each subject, showed that 28.9% of the children were overweight, the figure varying slightly with area of residence. Our findings showed that 59.0% of the children had a low score for MD adherence. CONCLUSIONS The results of this study showed that most Italian children did not follow the MD and socio-economic characteristics appeared not to be associated with type of diet.
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Affiliation(s)
- C Zani
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - E Ceretti
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - S Grioni
- Epidemiology and Prevention Unit, IRCCS Foundation, Istituto Nazionale dei Tumori, Milan, Italy
| | - G C V Viola
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - F Donato
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - D Feretti
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | - A Festa
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
| | | | - A Bonetti
- Centro Servizi Multisettoriale e Tecnologico - CSMT Gestione S.c.a.r.l., Brescia, Italy
| | - S Monarca
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - M Villarini
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - S Levorato
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - A Carducci
- Department of Biology, University of Pisa, Pisa, Italy
| | - M Verani
- Department of Biology, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Biology, University of Pisa, Pisa, Italy
| | - A De Donno
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - T Grassi
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - F Bagordo
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - E Carraro
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Si Bonetta
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Sa Bonetta
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - U Gelatti
- Department of Medical and Surgical Specialities, Radiological Science and Public Health, University of Brescia, Brescia, Italy
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Romito S, Segatti A, Alessandrini L, Donato F, Squintani G, Moretto G. 32. Phrenic nerve study in infants: Normative data and technical aspects in Verona experience. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.040] [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: 10/22/2022]
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Amantini A, Audenino D, Callegarini C, Carrai R, Celani M, Di Capua M, Donato F, Foresti C, Lanteri P, Lombardi M, Madera L, Marelli A, Megarelli S, Minardi C, Minicucci F, Monetti C, Montalenti E, Motti, Osio M, Piazza O, Politini L, Ricci F, Rota E, Scarpino M, Spalletti M, Valzania F, Vitelli E, Costa P, Grippo A. 78. Diagnostic accuracy of neurophysiological tests (EEG and SEP) in comatose patients after cardiac arrest: Protocol presentation of Italian Multicentric Study (ProNeCA). Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.086] [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: 10/22/2022]
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Segatti A, Alessandrini L, Zanelli S, Santuz P, Biban P, Luciani G, Squintani G, Donato F, Romito S. 117. Phrenic nerve palsy in pediatric heart surgery: The neurophysiological contribution in follow up and decision making. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.125] [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: 10/22/2022]
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26
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Donato F, Turri M, Zanette G, Tugnoli V, Deotto L, Teatini F, Romito S, Moretto G, Squintani G. 63. A study of cortical and spinal excitability in patients affected by multiple sclerosis and spasticity after oromucosal cannabinoid spray (THC/CBD). Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.071] [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: 10/22/2022]
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Turri M, Donato F, Teatini F, Zanette G, Tugnoli V, Deotto L, Moretto G, Squintani G. 17. Pain modulation in patients with Multiple Sclerosis, pain and spasticity after oromucosal cannabinoid spray (THC/CBD): A study with quantitative sensory testing and laser evoked potentials. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.025] [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: 10/22/2022]
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Basaldella F, Donato F, Zuco C, Moretto G, Ottaviani S, Bovi T, Romito S, Squintani G. 116. Atypical AIDP with predominantly sensory involvement and increased duration of SAPs. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.124] [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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Zani C, Donato F, Grioni S, Viola GCV, Ceretti E, Feretti D, Festa A, Bonizzoni S, Bonetti A, Monarca S, Villarini M, Levorato S, Carducci A, Verani M, Casini B, De Donno A, Grassi T, Idolo A, Carraro E, Gilli G, Bonetta S, Gelatti U. Feasibility and reliability of a questionnaire for evaluation of the exposure to indoor and outdoor air pollutants, diet and physical activity in 6-8-year-old children. Ann Ig 2015; 27:646-56. [PMID: 26241109 DOI: 10.7416/ai.2015.2056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The MAPEC-Life project aims to study the biological effects of early exposure to air pollutants on the oral mucosa cells of school-age children in five Italian cities. A questionnaire was created to evaluate the association between outdoor and indoor airborne pollutants, lifestyle, diet and biomarker effects. The feasibility and reliability of the questionnaire were evaluated. METHODS A questionnaire was drawn up to be filled in by the parents of 6-8-year-old children. It consisted of 148 questions on the children's health, physical activity, environmental exposures and the frequency of food consumption at the main meals. First we conducted a questionnaire feasibility study involving 53 volunteer parents. We then performed a reliability study by administering the questionnaire to a further 156 parents and again one month later (test/retest method). The correlations between answers at the first and second administration of the questionnaire were evaluated using the Kappa statistic and Spearman's coefficient. RESULTS After verifying the feasibility of the questionnaire, we conducted a reliability analysis on 132 completed questionnaires. The percentage of agreement between the first and the second responses given was over 70%, all K values being greater than 0.6. The analysis of calories and macronutrients also showed good agreement. CONCLUSIONS The questionnaire drawn up for the study proved to be sufficiently reliable for gathering information about the factors of interest in our study of the relationship between air pollution and early biological effects in children.
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Affiliation(s)
- C Zani
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - F Donato
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - S Grioni
- IRCCS Foundation, National Cancer Institute, Milan, Italy
| | - G C V Viola
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - E Ceretti
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - D Feretti
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - A Festa
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - A Bonetti
- Centro Servizi Multisettoriale e Tecnologico-CSMT Gestione S.c.a.r.l., Brescia, Italy
| | - S Monarca
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - M Villarini
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - S Levorato
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - A Carducci
- Department of Biology, University of Pisa, Pisa, Italy
| | - M Verani
- Department of Biology, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Biology, University of Pisa, Pisa, Italy
| | - A De Donno
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - T Grassi
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - A Idolo
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
| | - E Carraro
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - G Gilli
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - S Bonetta
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - U Gelatti
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Filho C, Jesse C, Donato F, Giacomeli R, Del Fabbro L, da Silva Antunes M, de Gomes M, Goes A, Boeira S, Prigol M, Souza L. Chronic unpredictable mild stress decreases BDNF and NGF levels and Na+,K+-ATPase activity in the hippocampus and prefrontal cortex of mice: Antidepressant effect of chrysin. Neuroscience 2015; 289:367-80. [DOI: 10.1016/j.neuroscience.2014.12.048] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/30/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
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Donato F, Morini A, Zimatore S, Romito S, Alessandrini L, Moretto G, Squintani G. 94. Chronic pure motor axonal plexopathy responsive to immunomodulatory treatment: Clinical, electrophysiological and magnetic resonance imaging correlations. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.113] [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: 11/29/2022]
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Marangone TNFP M, Squintani G, Crovato TNFP M, Donato F, Leopardi F, D’Amico A, Romito S, Moretto G. 64. Predictive value of neurophysiological testing and the importance of multidisciplinary approach in the pelvic floor disorders. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.083] [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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Ceretti E, Bonizzoni S, Bonetti A, Monarca S, Carducci A, De Donno MA, Carraro E, Gelatti U, Covolo L, Donato F, Feretti D, Festa A, Limina RM, Viola GCV, Zani C, Zerbini I, Levaggi R, Mazzoleni G, Furia C. Monitoring air pollution effects in children for supporting public health policy: the MAPEC_LIFE study. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.053] [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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Squintani G, Turri M, Donato F, Tinazzi M, Masotto B, Tramontano V, Talacchi A, Sala F, Moretto G, Valeriani M. Trigeminal laser-evoked potentials: A neurophysiological tool to detect post-surgical outcome in trigeminovascular contact neuralgia. Eur J Pain 2014; 19:253-9. [DOI: 10.1002/ejp.543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/11/2022]
Affiliation(s)
- G. Squintani
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - M. Turri
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences; Section of Clinical Neurology; University of Verona; Italy
| | - F. Donato
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
- Department of Pharmacology; University of Messina; Italy
| | - M. Tinazzi
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences; Section of Clinical Neurology; University of Verona; Italy
| | - B. Masotto
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - V. Tramontano
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - A. Talacchi
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - F. Sala
- Neurosurgery Unit; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - G. Moretto
- Neurology Unit; Department of Neurocience; Azienda Ospedaliera Universitaria Integrata; Verona Italy
| | - M. Valeriani
- Department of Neuroscience; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
- Center for Sensory-Motor Interaction; Aalborg University; Denmark
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Fabrizi F, Donato F, Messa P. Hepatitis C virus infection and glomerular disease. MINERVA UROL NEFROL 2014; 66:139-149. [PMID: 24988205] [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: 06/03/2023]
Abstract
The association between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) is well established and remains an area of intense research. HCV infection is associated with a large spectrum of histo-pathological lesions in both native and transplanted kidneys. The frequency of kidney damage in HCV-infected patients appears low even if is not fully detailed. The most frequent HCV-associated renal lesion is type I membrano-proliferative glomerulonephritis, usually in the context of type II mixed cryoglobulinemia. Various approaches have been tried for the treatment of HCV-related glomerulonephritis, including immunosuppressive therapy (corticosteroids and cytotoxic agents), plasma exchange and antiviral agents. Antiviral treatment of HCV-associated glomerulonephritis has shown encouraging results. Immunosuppressive therapy is particularly recommended for cryoglobulinemic kidney disease. Two distinct approaches should be considered for the treatment of HCV-associated cryoglobulinemic glomerulonephritis according to the level of proteinuria and kidney failure. Some evidence on rituximab therapy for HCV-related cryoglobulinemic glomerulonephritis exists but several questions related to its use need to be addressed.
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Affiliation(s)
- F Fabrizi
- Division of Nephrology, Ospedale Maggiore IRCCS Foundation, Milan, Italy -
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Covolo L, Bibert S, Donato F, Bochud PY, Lagging M, Negro F, Fattovich G. The novel ss469415590 variant predicts virological response to therapy in patients with chronic hepatitis C virus type 1 infection. Aliment Pharmacol Ther 2014; 39:322-30. [PMID: 24308755 DOI: 10.1111/apt.12568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/19/2013] [Accepted: 11/08/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND A novel dinucleotide variant TT/∆G (ss469415590) has been associated with hepatitis C virus clearance. AIM To assess the role of the ss469415590 variant, compared with the known IL28B polymorphisms (rs8099917, rs12979860 and rs12980275) for predicting virological response to therapy in chronic hepatitis C, and its association with the CXCL10 chemokine serum levels - a surrogate marker of interferon-stimulated genes activation. METHODS Multivariate analysis of factors predicting rapid and sustained virological response in 280 consecutive, treatment-naïve, nondiabetic, Caucasian patients with chronic hepatitis C treated with peginterferon alpha and ribavirin. RESULTS In hepatitis C virus genotype 1, the OR (95% CI) for rapid and sustained virological response for the wild-type ss469415590 TT was 9.88 (1.99-48.99) and 7.25 (1.91-27.51), respectively, similar to those found for rs12979860 CC [9.55 (1.93-47.37) and 6.30 (1.71-23.13)] and for rs12980275 AA [9.62 (1.94-47.77] and 7.83 (2.02-30.34)], but higher than for rs8099917 TT [4.8 (1.73-13.33) and 4.75 (2.05-10.98)]. In hepatitis C virus genotype 1, mean (SD) CXCL10 levels in patients with the TT/TT, TT/∆G and ∆G/∆G variants were, respectively, 355.1 (240.6), 434.4 (247.4) and 569.9 (333.3) (P = 0.04). In patients with genotypes 2 and 3 no significant association was found for TT/∆G with viral response. The predictive value of ss469415590 was stronger in patients with advanced fibrosis. CONCLUSIONS The novel IL28B variants at marker ss469415590 predict response to IFN alpha in chronic hepatitis C patients, especially in those with advanced fibrosis. Their determination may be superior to that of known IL28B variants for patient management using IFN-based regimens.
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Affiliation(s)
- L Covolo
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
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Meneghesso C, Riginella E, La Mesa M, Donato F, Mazzoldi C. Life-history traits and population decline of the Atlantic mackerel Scomber scombrusin the Adriatic Sea. J Fish Biol 2013; 83:1249-1267. [PMID: 24111672 DOI: 10.1111/jfb.12223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/30/2013] [Indexed: 06/02/2023]
Abstract
This study investigated demographic structure and reproductive characteristics of the Atlantic mackerel Scomber scombrus, in relation to landing trends in the northern-central Adriatic Sea. Results highlighted the occurrence of only small-sized and young-age individuals, and a marked decline from the 1990s to the present in maximum age (from 8 to 3 years) and total length (L(T); from 420 to 360 mm). Fecundity ranged between 40,000 and 190,000 eggs, and was related to female L(T). High levels of atresia implied lower values of actual fecundity. Sexual maturity was attained by 72·8% of individuals in their first year of life at 200 mm. The reduction in maximum L(T) resulted in a marked decline in the population egg production, while the reduction in maximum age implied that females participated in fewer spawning events.
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Affiliation(s)
- C Meneghesso
- Department of Biology, University of Padova, Via U. Bassi 58/B, 35131 Padova, Italy
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Di Marco V, Covolo L, Calvaruso V, Levrero M, Puoti M, Suter F, Gaeta GB, Ferrari C, Raimondo G, Fattovich G, Santantonio T, Alberti A, Bruno R, Mussini C, Mondelli M, Donato F, Craxì A. Who is more likely to respond to dual treatment with pegylated-interferon and ribavirin for chronic hepatitis C? A gender-oriented analysis. J Viral Hepat 2013; 20:790-800. [PMID: 24168258 DOI: 10.1111/jvh.12106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/02/2013] [Indexed: 12/20/2022]
Abstract
We assessed, in real-life practice, viral, demographic, genetic and metabolic factors influencing the sustained virologic response (SVR), with a gender-oriented analysis, in patients with chronic hepatitis C virus (HCV) treated with pegylated interferon and ribavirin. Six hundred and seventy naïve patients were treated with dual therapy and evaluated by gender and HCV genotype. Associations between baseline variables and SVR were assessed by multivariate logistic regression analysis. Among 362 genotype 1 patients, SVR was achieved in 158 patients (44%), and SVR was independently associated with age less than 50 years (OR 2.12; 95% CI 1.09-4.30; P=0.039) and C/C genotype rs12979860 SNP (OR 2.83; 1.19-6.74; P=0.002) in 163 females, while absence of visceral obesity (OR 2.491; 1.131-5.487; P=0.023), HCV-RNA lower than 400,000 IU/mL (OR 2.66; 1.273-5.558; P=0.009) and C/C genotype rs12979860 SNP (OR 4.969; 2.401-10.283; P<0.001) were independently associated with SVR in 199 males. Combining favourable baseline variables, the probability of obtaining SVR ranged from 27.6% to 84.2% in females, and from 14.3% to 85.7% in males. The rate of SVR was 81.1% in 175 genotype 2 patients, and 69% in 100 genotype 3 patients. Rapid virologic response was the only valid predictor of SVR regardless of other features. In conclusions, in the setting of HCV genotype 1, chronic hepatitis, combining rapid virologic response and predictive factors, which are different for females and males, allows clinicians to single out a group of patients whose likelihood of SVR exceeds 80%. For these patients, triple therapy with first-generation protease inhibitors may be unwarranted.
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Affiliation(s)
- V Di Marco
- Sezione di Gastroenterologia & Epatologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
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Ceretti E, Zerbini I, Viola GCV, Zani C, Limina RM, Donato F, Gelatti U, Lamera R, Capelli M, Pedrazzani R, Repice C, Feretti D. DNA damage in buccal mucosa cells of pre-school children exposed to urban air pollutants. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bianchini F, Hall J, Donato F, Cadet J. Monitoring urinary excretion of 5-hydroxymethyluracil for assessment of oxidative DNA damage and repair. Biomarkers 2013; 1:178-84. [PMID: 23902322 DOI: 10.3109/13547509609079354] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Urinary excretion of oxidized nucleobases and nucleosides has been used as a biomarker of oxidative DNA damage and repair. Most studies have focused on the measurements of 8-oxo-7,8-dihydro-2'-deoxyguanosine; however, the urinary levels of other DNA modifications may represent useful indicators of oxidative stress. We developed a method for the determination of 5-hydroxymethyluraciI (5-HMUra), consisting of the separation of the modified base in urine by HPLC and quantification by GC/MS in the selective ion monitoring mode. This experimental approach was subsequently validated in human samples, with the effect of storage and the inter- and intra-individual variations in 5-HMUra excretion being evaluated. Results showed that 5-HMUra is stable in samples frozen at-80 °C for at least 4 months. Inter-individual variations in 5-HMUra excretion were observed when the results were expressed either as nmoles excreted per kg per day (1.2-2.4) or corrected by creatinine values (7.2-12.2 nmoles 5-HMUra per mmoles creatinine). Intra-individual variability was low, varying slightly at different time collections for several individuals. Differences in the excretion of 5-HMUra in urine collected at three different 8-h intervals during the day were not significant and, in particular, the levels of 5-HMUra calculated from the overnight or the 24-h samples were highly correlated. These results indicate that monitoring urinary levels of 5-HMUra could be a suitable indicator of oxidative damage in human studies.
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Matteelli A, Sulis G, Capelli M, Apostoli A, Toninelli G, D’Aversa FB, Gargiulo F, Salinaro F, Castelli F, Donato F. P3.020 Prevalence of Genital Chlamydia Trachomatis and Neisseria Gonorrhoeae Infections Among Adolescents in Northern Italy. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0480] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Calabresi A, Ferraresi A, Festa A, Scarcella C, Donato F, Vassallo F, Limina R, Castelli F, Quiros-Roldan E. Incidence of AIDS-defining cancers and virus-related and non-virus-related non-AIDS-defining cancers among HIV-infected patients compared with the general population in a large health district of Northern Italy, 1999-2009. HIV Med 2013; 14:481-90. [PMID: 23560682 DOI: 10.1111/hiv.12034] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [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: 02/14/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the incidence of AIDS-defining cancers (ADCs) and virus-related and non-virus-related non-AIDS-defining cancers (NADCs) in HIV-infected patients compared with the general population, and to assess the risk factors associated with these malignancies. METHODS We performed a retrospective cohort study for the period from 1999 to 2009 of HIV-infected patients residing in the Local Health Authority of Brescia (northern Italy). Observed cancers in patients with HIV infection were compared with expected cancers in the population living in the same area using standardized incidence ratios (SIRs). Risk factors were assessed using Poisson regression analysis. RESULTS A total of 5090 HIV-infected patients were included in the study, with 32 390 person-years of follow-up. We recorded 416 tumours in 390 HIV-infected patients. Two hundred of these (48.1%) were ADCs, 138 (33.2%) were non-virus-related NADCs and 78 (18.7%) were virus-related NADCs. An increased risk (SIR = 4.2) of cancers overall was found in HIV-infected patients. A large excess of ADCs (SIR = 31.0) and virus-related NADCs (SIR = 12.3) was observed in HIV-infected patients, while the excess risk for non-virus-related NADCs was small (SIR = 1.6). The highest SIRs were observed for Kaposi sarcoma among ADCs and for Hodgkin lymphoma among virus-related NADCs. Conversely, among non-virus-related NADCs, SIRs for a broad range of malignancies were close to unity. In multivariate analysis, increasing age and CD4 cell count < 50 cells/μL were the only factors independently associated with all cancers. CONCLUSIONS Among HIV-infected people there was an excess of ADCs and also of NADCs, particularly those related to viral infections. Ageing and severe immunodeficiency were the strongest predictors.
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Affiliation(s)
- A Calabresi
- University Division of Infectious and Tropical Diseases, University of Brescia, Brescia Spedali Civili General Hospital, Brescia, Italy
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Casari S, Suligoi B, Camoni L, Pavan A, Macchi L, Capelli M, Paraninfo G, Compostella S, Castelli F, Carosi G, Donato F. Epidemiological and clinical characteristics and behaviours of individuals with newly diagnosed HIV infection: a multicentre study in north Italy. J Prev Med Hyg 2012; 53:190-194. [PMID: 23469586] [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: 06/01/2023]
Abstract
INTRODUCTION We aimed to investigate socio-demographic, clinical and epidemiological characteristics and behaviours of subjects with new HIV diagnosis. METHODS We carried out a multi-centre cross-sectional study comprising 17 infectious diseases units in the Lombardy Region, North Italy. All subjects with a first positive test for HIV infection examined in 2008-09 were interviewed using a structured questionnaire. RESULTS 472 patients were enrolled (mean age 39.8 years, standard deviation [SD] 11.5), mostly males (78%), and born in Italy (77%). The most common routes of HIV transmission were heterosexual intercourse (49%) and sex among men who have sex with men (MSM) (40%). Never/sometimes use of a condom with occasional partners was associated with male gender, heterosexual transmission route, and with >10 sexual partners in their lifetime. 47% had previous HIV negative tests. Having had more than 2 previous HIV negative tests was associated with younger age, MSM transmission route, CD4+ lymphocyte count >350/microl and self-perception of risk. DISCUSSION This study shows that there is a large portion of the adult population, especially heterosexual men aged 45 years and over, who are at high risk of acquiring and transmitting HIV infection and undergoing the HIV diagnostic test late, due to risk behaviours combined with a low perception of being at risk. Compared to people infected by heterosexual contacts, MSM show a greater awareness of being at risk of infection, but this knowledge has a low impact in reducing at-risk behaviours.
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Affiliation(s)
- S Casari
- Department of Infectious Diseases, Spedali Civili General Hospital, Brescia, Italy.
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Fattovich G, Covolo L, Bibert S, Askarieh G, Lagging M, Clément S, Malerba G, Pasino M, Guido M, Puoti M, Gaeta GB, Santantonio T, Raimondo G, Bruno R, Bochud PY, Donato F, Negro F. IL28B polymorphisms, IP-10 and viral load predict virological response to therapy in chronic hepatitis C. Aliment Pharmacol Ther 2011; 33:1162-72. [PMID: 21443535 DOI: 10.1111/j.1365-2036.2011.04635.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [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: 02/06/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma and the identification of the predictors of response to antiviral therapy is an important clinical issue. AIM To determine the independent contribution of factors including IL28B polymorphisms, IFN-gamma inducible protein-10 (IP-10) levels and the homeostasis model assessment of insulin resistance (HOMA-IR) score in predicting response to therapy in chronic hepatitis C (CHC). METHODS Multivariate analysis of factors predicting rapid (RVR) and sustained (SVR) virological response in 280 consecutive, treatment-naive CHC patients treated with peginterferon alpha and ribavirin in a prospective multicentre study. RESULTS Independent predictors of RVR were HCV RNA <400 000 IU/mL (OR 11.37; 95% CI 3.03-42.6), rs12980275 AA (OR 7.09; 1.97-25.56) and IP-10 (OR 0.04; 0.003-0.56) in HCV genotype 1 patients and lower baseline γ-glutamyl-transferase levels (OR=0.02; 0.0009-0.31) in HCV genotype 3 patients. Independent predictors of SVR were rs12980275 AA (OR 9.68; 3.44-27.18), age <40 years (OR=4.79; 1.50-15.34) and HCV RNA <400 000 IU/mL (OR 2.74; 1.03-7.27) in HCV genotype 1 patients and rs12980275 AA (OR=6.26; 1.98-19.74) and age <40 years (OR 5.37; 1.54-18.75) in the 88 HCV genotype 1 patients without a RVR. RVR was by itself predictive of SVR in HCV genotype 1 patients (OR 33.0; 4.06-268.32) and the only independent predictor of SVR in HCV genotype 2 (OR 9.0, 1.72-46.99) or genotype 3 patients (OR 7.8, 1.43-42.67). CONCLUSIONS In HCV genotype 1 patients, IL28B polymorphisms, HCV RNA load and IP-10 independently predict RVR. The combination of IL28B polymorphisms, HCV RNA level and age may yield more accurate pre-treatment prediction of SVR. HOMA-IR score is not associated with viral response.
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Affiliation(s)
- G Fattovich
- Clinic of Gastroenterology, Department of Medicine, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy.
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Donato F, Zani C. [Chronic exposure to organochlorine compounds and health effects in adults: cancer, non-Hodgkin lymphoma. Review of literature]. Ann Ig 2010; 22:357-367. [PMID: 21425646] [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: 05/30/2023]
Abstract
International Agency for Research on Cancer (IARC) has classified 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) as human multisite carcinogen though not associated to specific tumours. Other dioxins and furans are not classified as carcinogenic due to lack of scientific evidence, and polychlorobiphenyls (PCBs) are classified as probable carcinogens. The aim of this research is to focus the association between chronic exposure to organochlorine compounds and cancer in adults. We included cohort studies among occupationally exposed workers or in populations exposed to high levels of these chemicals in the environment, and cohort and case-control studies using measure of internal dose of exposure. Overall, cohort studies among heavy exposed people do not show an increased risk of developing cancer and do not show consistent results as regards in specific sites neoplasms. Among epidemiologic analytical studies with individual measures of exposure, most, though not all, found an association between Non-Hodgkin lymphoma and PCB serum level concentrations. Weak evidence, if any, was available as regards the association between organochlorine compounds and other cancers.
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Affiliation(s)
- F Donato
- Dipartimento di Medicina Sperimentale ed Applicata, Sezione di Igiene, Epidemiologia e Sanità Pubblica, Università degli Studi di Brescia.
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Donato F, Zani C. [Chronic exposure to organochlorine compounds and health effects in adults: diabetes and thyroid diseases]. Ann Ig 2010; 22:185-198. [PMID: 20677670] [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: 05/29/2023]
Abstract
Organochlorine compounds are widely distributed in the world and may persist in both the environment and living organisms. They are fat-soluble compounds and people are usually exposed to them through food, inhalation or dermal contact. They are classified as POPs (persistent organic pollutants), as they persist in the environment for a long time and move up through the food chain. DTT and other synthetic pesticides, polychlorinated dibenzodioxins (PCDD), polychlorinated dibenzofurans (PCDF) and polychlorobyfenils (PCB) are among the most diffused POPs worldwide. Experimental studies show that some of these chemicals have endocrine disruption activity and particularly that they can alter the thyroid function. Furthermore, recent studies in humans show that exposure to some organochlorine compounds may increase the risk of type II diabetes mellitus. This review provides a synthesis of the results of epidemiologic studies regarding the association between organochlorines exposure and thyroid diseases and diabetes. We included published studies with measures of internal dose of exposure (usually, serum concentration) in adults. We retrieved 22 studies for thyroid diseases and 22 on diabetes. Overall, we found contrasting results among the studies, with about half of them showing a statistically significant association between serum concentration of organochlorines and the diseases investigated.
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Affiliation(s)
- F Donato
- Sezione di Igiene, Epidemiologia e Sanità Pubblica, Dipartimento di Medicina Sperimentale ed Applicata, Università degli Studi di Brescia.
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Limina RM, Donato F, Comincini F, Facchi G, Gasparotti C, Festa A, Rosati C, Gelatti U, Scarcella C. [Alcohol consumption among high school students in Brescia, Italy]. Ann Ig 2010; 22:165-175. [PMID: 20476656] [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: 05/29/2023]
Abstract
A random sample of 1,495 high school student of 9th and 13th grade in Brescia, North Italy, were interviewed about their alcohol consumption, knowledge and attitudes using an anonymous self-administered questionnaire. The percentages of students who usually consumed alcoholic beverage, were 39.7% and 30.3% in males and females, respectively, in 9th grade students and were 51.4% and 23.8% in males and females, respectively, in 13th grade students. The frequency of drunkenness during the month previous the interview was, among 9th graders: 6.9% males and 8.7% females; among 13th graders: 20.7% males and 13.3% females. The following variables were positively associated with alcohol consumption: 1) regular smoking; 2) peer alcohol drinking (best friend and partner); 3) parents' alcohol consumption. When comparing the present survey with a previously carried out in 1989, similar results were found as regards alcohol consumption; on the contrary higher prevalence of drunkenness was found in the 2008 survey, that in the 1989 one.
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Affiliation(s)
- R M Limina
- Sezione di Igiene, Epidemiologia e Sanità Pubblica, Facoltà di Medicina e Chirurgia, Università degli Studi di Brescia.
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Zani C, Donato F, Chiesa M, Baiguera C, Gelatti U, Covolo L, Antonini MG, Nasta P, Gatti F, Orizio G, Puoti M. Alcohol and coffee drinking and smoking habit among subjects with HCV infection. Dig Liver Dis 2009; 41:599-604. [PMID: 19185554 DOI: 10.1016/j.dld.2008.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 11/18/2008] [Accepted: 11/20/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS The aims were to estimate among patients with hepatitis C virus (HCV) infection the prevalence of alcohol and coffee intake and smoking habit, the reliability of these self-reported data and the possible change of patients' habit after their first contact with a Viral Hepatitis Service. METHODS 229 patients were initially interviewed personally at the Viral Hepatitis Service and after 6 months they were re-interviewed by phone in regard to their alcohol, coffee drinking and smoking habits. RESULTS Alcohol drinkers were 55.5% of males and 35.3% of females. Most subjects drank coffee daily, both men (90.0%) and women (84.9%). The proportion of current smokers was higher in males (43.6%) than females (26.9%). We found a fair to good reliability of self-reported data regarding patients' habits, alcohol and coffee intake, and number of cigarettes smoked daily. We observed a statistically significant decrease in alcohol and coffee intake and cigarettes smoked between baseline and follow-up interviews. CONCLUSION We found a fairly high proportion of HCV-infected patients who regularly drink alcohol and coffee beverages and smoke cigarettes, especially among males. The reliability of self-reported data on these habits seems satisfactory. More decisive action to modify these habits, especially alcohol intake, is required in these patients.
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Affiliation(s)
- C Zani
- Department of Experimental and Applied Medicine, Institute of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
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Barnett JC, Toluie K, Sterns D, Chandiramani S, Jetton E, Oza A, Pezzali N, Metra M, Covolo L, Curnis A, Gelatti U, Donato F, Dei Cas L, Charlton TA, Mcgrew FA, Johnson EJ, Coppess MA, Hamilton B, Charlton S, Sims JJ, Diaz Escofet M, Arbelo Lainez E, Moreno Djadou B, Garcia Quintana A, Caballero Dorta E, Rios Diaz C, Missorici Corso M, Medina Fernandez-Aceytuno A, Stockburger M, Fateh-Moghadam S, Karhausen T, Doehner W, Nitardy A, Anker SD, Celebi O, Dietz R, Kronborg MB, Nielsen JC, Albertsen AE, Mortensen PT. Abstracts: Cardiac resynchronisation therapy: results and mechanisms. Europace 2009. [DOI: 10.1093/europace/euq246] [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: 11/13/2022] Open
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