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Lonati D, Schicchi A, Crevani M, Buscaglia E, Scaravaggi G, Maida F, Cirronis M, Petrolini VM, Locatelli CA. Foodborne Botulism: Clinical Diagnosis and Medical Treatment. Toxins (Basel) 2020; 12:toxins12080509. [PMID: 32784744 PMCID: PMC7472133 DOI: 10.3390/toxins12080509] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 07/14/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022] Open
Abstract
Botulinum neurotoxins (BoNTs) produced by Clostridia species are the most potent identified natural toxins. Classically, the toxic neurological syndrome is characterized by an (afebrile) acute symmetric descending flaccid paralysis. The most know typical clinical syndrome of botulism refers to the foodborne form. All different forms are characterized by the same symptoms, caused by toxin-induced neuromuscular paralysis. The diagnosis of botulism is essentially clinical, as well as the decision to apply the specific antidotal treatment. The role of the laboratory is mandatory to confirm the clinical suspicion in relation to regulatory agencies, to identify the BoNTs involved and the source of intoxication. The laboratory diagnosis of foodborne botulism is based on the detection of BoNTs in clinical specimens/food samples and the isolation of BoNT from stools. Foodborne botulism intoxication is often underdiagnosed; the initial symptoms can be confused with more common clinical conditions (i.e., stroke, myasthenia gravis, Guillain–Barré syndrome—Miller–Fisher variant, Eaton–Lambert syndrome, tick paralysis and shellfish or tetrodotoxin poisoning). The treatment includes procedures for decontamination, antidote administration and, when required, support of respiratory function; few differences are related to the different way of exposure.
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Affiliation(s)
- Davide Lonati
- Correspondence: ; Tel.: +39-0382-26261; Fax: +39-0382-24605
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Gallelli L, Siniscalchi A, Palleria C, Mumoli L, Staltari O, Squillace A, Maida F, Russo E, Gratteri S, De Sarro G, Working Group G. Adverse Drug Reactions Related to Drug Administration in Hospitalized Patients. Curr Drug Saf 2017. [DOI: 10.2174/1574886312666170616090640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Luca Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Antonio Siniscalchi
- Department of Neurology, Annunziata Hospital, Via F. Migliori, 1 - 87100 Cosenza, Italy
| | - Caterina Palleria
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Laura Mumoli
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Orietta Staltari
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Aida Squillace
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Francesca Maida
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Emilio Russo
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - Santo Gratteri
- Department of Medical and Surgical Sciences, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, MaterDomini Hospital, Catanzaro, Italy
| | - G&SP Working Group
- Department of Neurology, Annunziata Hospital, Via F. Migliori, 1 - 87100 Cosenza, Italy
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Leporini C, Piro R, Ursini F, Maida F, Palleria C, Arturi F, Pavia M, De Sarro G, Russo E. Monitoring safety and use of old and new treatment options for type 2 diabetic patients: a two-year (2013-2016) analysis. Expert Opin Drug Saf 2017; 15:17-34. [PMID: 27718744 DOI: 10.1080/14740338.2016.1246531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To compare patients' and physicians' perceptions regarding effectiveness and tolerability of non-insulin hypoglycemic drugs in a cohort of type 2 diabetic patients; to verify whether a possible tridimensional link between effectiveness, tolerability, and adherence affects long-term therapeutic outcomes. METHODS A two-year observational study was performed in 1389 Type 2 diabetic patients by involving general practitioner clinics and Diabetes Centers. A decimal scale and the Morisky questionnaire were used, respectively, to assess effectiveness and tolerability perceptions, and medication adherence. RESULTS Physicians perceived therapy as more efficacious compared to their patients: perceived effectiveness was steady for physicians during the study whereas patients' perception not significantly decreased (mean score from >8 to 7.84 ± 1.69). Physicians assigned higher tolerability scores compared to patients but only at the beginning of the study; interestingly, physicians' tolerability perception was poorer than patients' perception at last follow-up (mean score = 7.57 ± 1.40 vs. 7.88 ± 1.84). Favorable (score >7) patients' perceptions about treatment effectiveness and tolerability were associated with higher adherence. Patients showed medium adherence across the study. CONCLUSIONS A mutual relationship between clinical effectiveness, adverse drug reactions, and adherence has been established, significantly impacting the clinical management of diabetic patients. A careful monitoring of this link by clinicians appears therefore necessary.
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Affiliation(s)
- Christian Leporini
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Rosanna Piro
- b 'S Francesco di Paola' Hospital , Diabetology and Metabolic Diseases Unit , Paola , Italy
| | - Francesco Ursini
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Francesca Maida
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Caterina Palleria
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Franco Arturi
- c Department of Medical and Surgical Sciences, Internal Medicine Unit of 'Mater Domini' University Hospital , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Maria Pavia
- d Department of Health Sciences, Medical School , University of Catanzaro 'Magna Græcia', Campus of Germaneto , Catanzaro , Italy
| | - Giovambattista De Sarro
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
| | - Emilio Russo
- a School of Medicine and Surgery, Department of Health Sciences, Clinical Pharmacology and Pharmacovigilance Unit , 'Magna Graecia' University of Catanzaro , Catanzaro , Italy
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Palleria C, Leporini C, Maida F, Succurro E, De Sarro G, Arturi F, Russo E. Potential effects of current drug therapies on cognitive impairment in patients with type 2 diabetes. Front Neuroendocrinol 2016; 42:76-92. [PMID: 27521218 DOI: 10.1016/j.yfrne.2016.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/13/2016] [Accepted: 07/22/2016] [Indexed: 02/07/2023]
Abstract
Type 2 diabetes mellitus is a complex metabolic disease that can cause serious damage to various organs. Among the best-known complications, an important role is played by cognitive impairment. Impairment of cognitive functioning has been reported both in type 1 and 2 diabetes mellitus. While this comorbidity has long been known, no major advances have been achieved in clinical research; it is clear that appropriate control of blood glucose levels represents the best current (although unsatisfactory) approach in the prevention of cognitive impairment. We have focused our attention on the possible effect on the brain of antidiabetic drugs, despite their effects on blood glucose levels, giving a brief rationale on the mechanisms (e.g. GLP-1, BDNF, ghrelin) that might be involved. Indeed, GLP-1 agonists are currently clinically studied in other neurodegenerative diseases (i.e. Parkinson's and Alzheimer's disease); furthermore, also other antidiabetic drugs have proven efficacy in preclinical studies. Overall, promising results are already available and finding new intervention strategies represents a current need in this field of research.
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Affiliation(s)
- Caterina Palleria
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Christian Leporini
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Francesca Maida
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, Internal Medicine Unit of "Mater Domini", University Hospital, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100 Catanzaro, Italy
| | - Giovambattista De Sarro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, Internal Medicine Unit of "Mater Domini", University Hospital, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100 Catanzaro, Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Italy.
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Gallelli L, Maida F, Staltari O, Rende P, Russo E, Caroleo B, De Sarro G. Recurrence of atrial fibrillation after switching from brand to generic atenolol. J Pharmacol Pharmacother 2015; 6:39-41. [PMID: 25709353 PMCID: PMC4319249 DOI: 10.4103/0976-500x.149146] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/31/2014] [Accepted: 06/28/2014] [Indexed: 11/04/2022] Open
Abstract
Beta blockers are the initial treatment for rate control of supraventricular tachyarrhythmia in patients without a history of myocardial infarction or left ventricular dysfunction. In this article we report the recurrence of atrial fibrillation after switching to the generic formulation of atenolol.
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Affiliation(s)
- Luca Gallelli
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesca Maida
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Orietta Staltari
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Pierandrea Rende
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Benedetto Caroleo
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
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De Fazio P, Gaetano R, Caroleo M, Cerminara G, Maida F, Bruno A, Muscatello MR, Moreno MJJ, Russo E, Segura-García C. Rare and very rare adverse effects of clozapine. Neuropsychiatr Dis Treat 2015; 11:1995-2003. [PMID: 26273202 PMCID: PMC4532211 DOI: 10.2147/ndt.s83989] [Citation(s) in RCA: 48] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Clozapine (CLZ) is the drug of choice for the treatment of resistant schizophrenia; however, its suitable use is limited by the complex adverse effects' profile. The best-described adverse effects in the literature are represented by agranulocytosis, myocarditis, sedation, weight gain, hypotension, and drooling; nevertheless, there are other known adverse effects that psychiatrists should readily recognize and manage. This review covers the "rare" and "very rare" known adverse effects of CLZ, which have been accurately described in literature. An extensive search on the basis of predefined criteria was made using CLZ and its combination with adverse effects as keywords in electronic databases. Data show the association between the use of CLZ and uncommon adverse effects, including ischemic colitis, paralytic ileus, hematemesis, gastroesophageal reflux disease, priapism, urinary incontinence, pityriasis rosea, intertriginous erythema, pulmonary thromboembolism, pseudo-pheochromocytoma, periorbital edema, and parotitis, which are influenced by other variables including age, early diagnosis, and previous/current pharmacological therapies. Some of these adverse effects, although unpredictable, are often manageable if promptly recognized and treated. Others are serious and potentially life-threatening. However, an adequate knowledge of the drug, clinical vigilance, and rapid intervention can drastically reduce the morbidity and mortality related to CLZ treatment.
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Affiliation(s)
- Pasquale De Fazio
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Raffaele Gaetano
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Mariarita Caroleo
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Gregorio Cerminara
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Francesca Maida
- Department of Health Sciences, School of Specialization in Pharmacology, University "Magna Graecia", Catanzaro, Italy
| | - Antonio Bruno
- Department of Neurosciences, School of Specialization in Psychiatry, University of Messina, Messina, Italy
| | - Maria Rosaria Muscatello
- Department of Neurosciences, School of Specialization in Psychiatry, University of Messina, Messina, Italy
| | - Maria Jose Jaén Moreno
- Department of Social Health Sciences, Radiology and Physical Medicine, University of Cordoba, Cordoba, Spain
| | - Emilio Russo
- Department of Health Sciences, School of Specialization in Pharmacology, University "Magna Graecia", Catanzaro, Italy
| | - Cristina Segura-García
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
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Perna F, De Masi AL, Maida F. [Roundish opacity in the left pulmonary medial lobe]. Arch Monaldi 1984; 39:101-4. [PMID: 6532350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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