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Caccamo M, Luciano G, Rapisarda T, Marino VM, Pasta C, Natalello A, Mangione G, Valenti B, Campione A, Marino G, Pauselli M. Cocoa by-product inclusion in dairy sheep diet: effect on sensory, volatile and antioxidant properties of cheese. J Dairy Sci 2024:S0022-0302(24)00756-2. [PMID: 38642650 DOI: 10.3168/jds.2023-24428] [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: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/22/2024]
Abstract
The possibility of inclusion of agro-industrial by-products in the diet of small ruminants represents both an economical and an environmental strategy for reducing waste management by industries and the cost of feeding as well as the impact of livestock farming. Large amounts of wastes from the cocoa industry are annually produced with a considerable part represented by cocoa bean shells, considered a suitable ingredient to be included in the diet of ruminants within the limits established by European legislation. The aim of this study was to assess the effect of including cocoa bean shells in the diet of dairy sheep on the sensory, volatile, and antioxidant properties of cheese. To this purpose, 20 Comisana lactating ewes were randomly assigned to 2 experimental groups: control (CTRL) and cocoa bean shells (CBS), and received alfalfa hay ad libitum and 800g of conventional (CTRL) or experimental (CBS) concentrate containing 11.7% CBS to partially replace corn and barley of the CTRL concentrate. Bulk milk collected from each group was used to produce a total of 15 cheeses per group, obtained in 5 different days of cheese-making (3 cheeses a day per group). After 60 d of aging, each cheese of each experimental group was sampled for the analyses. The results on chemical composition revealed a greater monounsaturated fatty acids content and an increase in the nutritional indices suggesting a favorable role of cocoa bean shells dietary inclusion on the nutritive value of the cheese. The cheese sensory profile was affected by the cocoa bean shells inclusion, with more pronounced appearance, odor, aroma, and taste attributes in the product. The volatile profile showed only a few significant differences, mainly related to the cheese ripening process, and no differences were found in α-tocopherol contents in cheese fat between the 2 groups. Therefore, the coca bean shells inclusion in the diet of dairy sheep allowed to obtain a good quality cheese, without altering the characteristics associated with the typical profiles of sheep cheese. Furthermore, the use of this by-product could contribute to decrease feed costs and waste management, representing a good practice for increasing the sustainability of dairy products.
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Affiliation(s)
- M Caccamo
- Consorzio per la Ricerca nel settore della Filiera Lattiero-Casearia e dell'agroalimentare (CoRFiLaC), Regione Siciliana, 97100 Ragusa, Italy
| | - G Luciano
- Department Di3A, University of Catania, via Santa Sofia 100, 95123 Catania, Italy
| | - T Rapisarda
- Consorzio per la Ricerca nel settore della Filiera Lattiero-Casearia e dell'agroalimentare (CoRFiLaC), Regione Siciliana, 97100 Ragusa, Italy
| | - V M Marino
- Consorzio per la Ricerca nel settore della Filiera Lattiero-Casearia e dell'agroalimentare (CoRFiLaC), Regione Siciliana, 97100 Ragusa, Italy
| | - C Pasta
- Consorzio per la Ricerca nel settore della Filiera Lattiero-Casearia e dell'agroalimentare (CoRFiLaC), Regione Siciliana, 97100 Ragusa, Italy
| | - A Natalello
- Department Di3A, University of Catania, via Santa Sofia 100, 95123 Catania, Italy..
| | - G Mangione
- Department Di3A, University of Catania, via Santa Sofia 100, 95123 Catania, Italy
| | - B Valenti
- Department DSA3, University of Perugia, Borgo XX Giugno 74, 06121 Perugia, Italy
| | - A Campione
- Department DSA3, University of Perugia, Borgo XX Giugno 74, 06121 Perugia, Italy
| | - G Marino
- Consorzio per la Ricerca nel settore della Filiera Lattiero-Casearia e dell'agroalimentare (CoRFiLaC), Regione Siciliana, 97100 Ragusa, Italy
| | - M Pauselli
- Department DSA3, University of Perugia, Borgo XX Giugno 74, 06121 Perugia, Italy
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2
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Zatelli MC, Faggiano A, Argentiero A, Danesi R, D'Oronzo S, Fogli S, Franchina T, Giorgino F, Marrano N, Giuffrida D, Gori S, Marino G, Mazzilli R, Monami M, Montagnani M, Morviducci L, Natalicchio A, Ragni A, Renzelli V, Russo A, Sciacca L, Tuveri E, Aimaretti G, Avogaro A, Candido R, Di Maio M, Silvestris N, Gallo M. Endocrine-metabolic assessment checklist for cancer patients treated with immunotherapy: A proposal by the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE) and Italian Society of Pharmacology (SIF) multidisciplinary group. Cancer Treat Rev 2024; 126:102734. [PMID: 38604051 DOI: 10.1016/j.ctrv.2024.102734] [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: 01/24/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Immunotherapy with immune checkpoint inhibitors (ICI) is increasingly employed in oncology. National and international endocrine and oncologic scientific societies have provided guidelines for the management of endocrine immune-related adverse events. However, guidelines recommendations differ according to the specific filed, particularly pertaining to recommendations for the timing of endocrine testing. In this position paper, a panel of experts of the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF) offers a critical multidisciplinary consensus for a clear, simple, useful, and easily applicable endocrine-metabolic assessment checklist for cancer patients on immunotherapy.
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Affiliation(s)
- Maria Chiara Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical & Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | | | - Romano Danesi
- Oncology and Haematology Dept, University of Milano "La Statale", Milano, Italy.
| | - Stella D'Oronzo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy.
| | - Stefano Fogli
- Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Tindara Franchina
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
| | - Francesco Giorgino
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
| | - Nicola Marrano
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
| | - Dario Giuffrida
- Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, Catania, Italy.
| | - Stefania Gori
- Oncologia Medica, IRCCS Ospedale Don Calabria-Sacro Cuore di Negrar, Verona, Italy.
| | - Giampiero Marino
- Internal Medicine Department, Ospedale dei Castelli, Asl Roma 6, Ariccia, RM Italy.
| | - Rossella Mazzilli
- Endocrinology Unit, Department of Clinical & Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Matteo Monami
- Diabetology, Careggi Hospital and University of Florence, Italy.
| | - Monica Montagnani
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Pharmacology, University of Bari Aldo Moro, Bari, Italy.
| | - Lelio Morviducci
- Diabetology and Nutrition Unit, Department of Medical Specialties, ASL Roma 1 - S. Spirito Hospital, Rome, Italy.
| | - Annalisa Natalicchio
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
| | - Alberto Ragni
- Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria, Italy.
| | - Valerio Renzelli
- Diabetologist and Endocrinologist, Italian Association of Clinical Diabetologists, Rome, Italy.
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania Catania, Italy.
| | - Enzo Tuveri
- Diabetology, Endocrinology and Metabolic Diseases Service, ASL-Sulcis, Italy.
| | - Gianluca Aimaretti
- Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
| | - Angelo Avogaro
- Department of Medicine, Section of Diabetes and Metabolic Diseases, University of Padova, Padova, Italy.
| | - Riccardo Candido
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy.
| | | | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
| | - Marco Gallo
- Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria, Italy.
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Renzelli V, Gallo M, Morviducci L, Marino G, Ragni A, Tuveri E, Faggiano A, Mazzilli R, Natalicchio A, Zatelli MC, Montagnani M, Fogli S, Giuffrida D, Argentiero A, Danesi R, D’Oronzo S, Gori S, Franchina T, Russo A, Monami M, Sciacca L, Cinieri S, Colao A, Avogaro A, Di Cianni G, Giorgino F, Silvestris N. Polybrominated Diphenyl Ethers (PBDEs) and Human Health: Effects on Metabolism, Diabetes and Cancer. Cancers (Basel) 2023; 15:4237. [PMID: 37686512 PMCID: PMC10486428 DOI: 10.3390/cancers15174237] [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: 07/25/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
There is increasing evidence of the role of endocrine disruptors (EDs) derived from commonly employed compounds for manufacturing and processing in altering hormonal signaling and function. Due to their prolonged half-life and persistence, EDs can usually be found not only in industrial products but also in households and in the environment, creating the premises for long-lasting exposure. Polybrominated diphenyl ethers (PBDEs) are common EDs used in industrial products such as flame retardants, and recent studies are increasingly showing that they may interfere with both metabolic and oncogenic pathways. In this article, a multidisciplinary panel of experts of the Italian Association of Medical Diabetologists (AMD), the Italian Society of Diabetology (SID), the Italian Association of Medical Oncology (AIOM), the Italian Society of Endocrinology (SIE) and the Italian Society of Pharmacology (SIF) provides a review on the potential role of PBDEs in human health and disease, exploring both molecular and clinical aspects and focusing on metabolic and oncogenic pathways.
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Affiliation(s)
- Valerio Renzelli
- Italian Association of Clinical Diabetologists, 00192 Rome, Italy;
| | - Marco Gallo
- Endocrinology and Metabolic Diseases Unit, AO SS Antonio e Biagio e Cesare Arrigo of Alessandria, 15121 Alessandria, Italy;
| | - Lelio Morviducci
- Diabetology and Nutrition Unit, Department of Medical Specialities, ASL Roma 1, S. Spirito Hospital, 00193 Rome, Italy;
| | - Giampiero Marino
- Internal Medicine Department, Ospedale dei Castelli, Asl Roma 6, 00040 Ariccia, Italy;
| | - Alberto Ragni
- Endocrinology and Metabolic Diseases Unit, AO SS Antonio e Biagio e Cesare Arrigo of Alessandria, 15121 Alessandria, Italy;
| | - Enzo Tuveri
- Diabetology, Endocrinology and Metabolic Diseases Service, ASL-Sulcis, 09016 Iglesias, Italy;
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical & Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (A.F.); (R.M.)
| | - Rossella Mazzilli
- Endocrinology Unit, Department of Clinical & Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy; (A.F.); (R.M.)
| | - Annalisa Natalicchio
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, 70121 Bari, Italy; (A.N.); (F.G.)
| | - Maria Chiara Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Monica Montagnani
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Pharmacology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Stefano Fogli
- Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.F.); (R.D.)
| | - Dario Giuffrida
- Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, 95029 Catania, Italy;
| | - Antonella Argentiero
- Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
| | - Romano Danesi
- Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.F.); (R.D.)
| | - Stella D’Oronzo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Stefania Gori
- Oncologia Medica, IRCCS Ospedale Don Calabria-Sacro Cuore di Negrar, 37024 Verona, Italy;
| | - Tindara Franchina
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, 98122 Messina, Italy; (T.F.); (N.S.)
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, 90133 Palermo, Italy;
| | - Matteo Monami
- Diabetology, Careggi University Hospital, University of Florence, 50134 Florence, Italy;
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, 95124 Catania, Italy;
| | - Saverio Cinieri
- Medical Oncology Division, Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, 72100 Brindisi, Italy;
| | - Annamaria Colao
- Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, 80138 Naples, Italy;
- UNESCO Chair, Education for Health and Sustainable Development, Federico II University, 80131 Naples, Italy
| | - Angelo Avogaro
- Department of Medicine, Section of Diabetes and Metabolic Diseases, University of Padova, 35122 Padova, Italy;
| | | | - Francesco Giorgino
- Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, 70121 Bari, Italy; (A.N.); (F.G.)
| | - Nicola Silvestris
- Medical Oncology Unit, Department of Human Pathology “G. Barresi”, University of Messina, 98122 Messina, Italy; (T.F.); (N.S.)
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Marino G, Alfieri N, Tessitore IV, Barba M, Manodoro S, Frigerio M. Hematocolpos due to imperforate hymen: a case report and literature systematic review. Int Urogynecol J 2023; 34:357-369. [PMID: 35713674 DOI: 10.1007/s00192-022-05270-x] [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: 04/04/2022] [Accepted: 06/03/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Hematocolpos is a rare condition, where menstrual blood fills the vagina, instead of being expelled, due to a series of uterovaginal pathologies, the most frequent of which is the imperforate hymen. To date, few cases of hematocolpos have been reported in the literature. METHODS We report a case of hematometrocolpos due to imperforate hymen initially misdiagnosed as constipation and subsequently as ovarian mass; moreover, the present study undertakes a systematic review of studies on hematometrocolpos due to imperforate hymen to synthesize available knowledge on epidemiology, diagnosis, and management about this rare condition. RESULTS A total of 35 studies, describing 61 patients, were identified. The presence of hematocolpos should be suspected in premenarchal patients complaining of low abdominal pain, abdominal swelling, and urinary retention. Genital examination disclosing a tender, pale hymen and ultrasound represent a useful tool for diagnosis. The goal of the management is to timely perform hymenotomy to drain the hematocolpos, followed by hymenectomy to prevent recurrence. Follow-up is needed to diagnose possible recurrences. CONCLUSIONS In the case of an adolescent girl complaining of genital pain associated with primary amenorrhea, hematocolpos due to imperforate hymen should be suspected.
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Affiliation(s)
- G Marino
- University of Milano-Bicocca, Monza, Italy
| | | | | | - M Barba
- University of Milano-Bicocca, Monza, Italy
| | - S Manodoro
- ASST Santi Paolo e Carlo, San Paolo University Hospital, Milano, Italy
| | - Matteo Frigerio
- ASST Monza, San Gerardo University Hospital, via G.B. Pergolesi, 33, Monza, IT, Italy.
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Gentile S, Guarino G, Della Corte T, Marino G, Satta E, Pasquarella M, Romano C, Alfarone C, Giordano L, Loiacono F, Capece M, Lamberti R, Strollo F. Why Do So Many People with Type 2 Diabetes Who Take Insulin Have Lipohypertrophy? Fate or Educational Deficiencies? Diabetes Ther 2023; 14:179-191. [PMID: 36472805 PMCID: PMC9735184 DOI: 10.1007/s13300-022-01341-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Cutaneous lipohypertrophy (LH) is a thickened, "rubbery" lesion in the subcutaneous tissue following multiple injections performed at the same site, i.e., an incorrect injection technique. It is widespread, averaging 47% of insulin patients worldwide, and has severe direct and indirect consequences. Direct consequences consist mainly of poor metabolic control and frequent hypoglycemic events (HYPOs), and indirect ones of markedly increased healthcare costs related to hospital access due to acute events and long-term disease complications. This observation also holds for Italy, despite the National Health System organization expecting every patient with diabetes to undergo a series of visits by different care team members, each performing a specific treatment/education task. Indeed, the recent literature points to poor awareness of LH relevance and metabolic consequences among doctors from general and diabetic hospital wards, with educational deficiencies on correct injection practice in nurses too. The aim was to establish if, to what extent, and by whom they had received training on correct insulin injection techniques, and how many initially received notions had persisted over time. METHODS We investigated the possible causes of such a failure from the point of view of 1160 insulin-requiring subjects with type 2 diabetes (T2DM), reporting for the first time to specialized diabetic structures through a validated questionnaire and, in the same patients, we searched for LH by inspection/palpation according to international guidelines, further confirmed by ultrasound scans. We then analyzed differences in education and injecting behavior between subjects classified as LH+ or LH- depending on the presence or absence of LH lesions. RESULTS We documented significant educational gaps, with 50% of patients failing to refer to healthcare professionals and relying on their peers with diabetes, thought to be more experienced in 15% of the cases. Seventy-five percent of LH- patients received education from healthcare providers, while 90% of LH+ learned from another patient or could not remember how they knew, and 68% of LH+ versus 52% of LH- (p < 0.01) patients had failed to receive training on injection techniques by healthcare providers. All of this enabled the most disabling features of diabetes from the very beginning of the disease history. CONCLUSIONS This study documents, from the patients' point of view, that educational gaps are significant and that, even in initially trained subjects, education on correct injection techniques has a fleeting effect if not regularly recalled. Therefore, to rehabilitate LH+ patients as soon as possible and prevent LH- patients from inadvertently slipping into the other group, there is an urgent need to educate doctors and nurses repeatedly on the importance of correctly injecting insulin to improve patients' knowledge and skills.
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Affiliation(s)
- Sandro Gentile
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, University ''Luigi Vanvitelli'', Naples, Campania, Italy
| | - Giuseppina Guarino
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, University ''Luigi Vanvitelli'', Naples, Campania, Italy
| | - Teresa Della Corte
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, University ''Luigi Vanvitelli'', Naples, Campania, Italy
| | - Giampiero Marino
- Department of Internal Medicine, University ''Luigi Vanvitelli'', Naples, Campania, Italy
| | - Ersilia Satta
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Polyspecialistic Nephrologic Center CNP Srl, Fratta Maggiore, Italy
| | | | | | | | - Laura Giordano
- Emodialysis Center Srl, Nefrocenter Network, Naples, Italy
| | | | - Maurizio Capece
- Vomero Center Crisci Bersabea and C SNC, Nefrocenter Network, Naples, Italy
| | | | - Felice Strollo
- Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy.
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6
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Rifici C, Sfacteria A, Di Giorgio S, Giambrone G, Marino G, Mazzullo G. Mast Cell Tumour and Mammary Gland Carcinoma Collision Tumour. Case report and literature review. J HELL VET MED SOC 2022. [DOI: 10.12681/jhvms.27639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Collision tumours are the coexistence, at the same venue, of distinct tumours not macroscopically distinguishable and consisting of two independent cell populations without histological admixture. In human medicine, collision tumours in different anatomical sites have been described. In the veterinary literature, few cases exist so far. A 12-year-old female Labrador with a mammary gland nodular lesion was presented for clinical examination. The nodule was surgically removed and underwent histological and immunohistochemical analysis. Histopathological examination revealed two distinct malignant tumours: a mammary gland carcinoma and a cutaneous mast cells tumour. To the author's knowledge, the paper reports the first case of a collision tumour composed of mammary gland neoplasia and mast cell tumour. The rising interest in collision tumours suggests widening their knowledge and setting up a multimodal approach that includes surgery and targeted therapy.
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7
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Jorstad SG, Marscher AP, Raiteri CM, Villata M, Weaver ZR, Zhang H, Dong L, Gómez JL, Perel MV, Savchenko SS, Larionov VM, Carosati D, Chen WP, Kurtanidze OM, Marchini A, Matsumoto K, Mortari F, Aceti P, Acosta-Pulido JA, Andreeva T, Apolonio G, Arena C, Arkharov A, Bachev R, Banfi M, Bonnoli G, Borman GA, Bozhilov V, Carnerero MI, Damljanovic G, Ehgamberdiev SA, Elsässer D, Frasca A, Gabellini D, Grishina TS, Gupta AC, Hagen-Thorn VA, Hallum MK, Hart M, Hasuda K, Hemrich F, Hsiao HY, Ibryamov S, Irsmambetova TR, Ivanov DV, Joner MD, Kimeridze GN, Klimanov SA, Knött J, Kopatskaya EN, Kurtanidze SO, Kurtenkov A, Kuutma T, Larionova EG, Leonini S, Lin HC, Lorey C, Mannheim K, Marino G, Minev M, Mirzaqulov DO, Morozova DA, Nikiforova AA, Nikolashvili MG, Ovcharov E, Papini R, Pursimo T, Rahimov I, Reinhart D, Sakamoto T, Salvaggio F, Semkov E, Shakhovskoy DN, Sigua LA, Steineke R, Stojanovic M, Strigachev A, Troitskaya YV, Troitskiy IS, Tsai A, Valcheva A, Vasilyev AA, Vince O, Waller L, Zaharieva E, Chatterjee R. Rapid quasi-periodic oscillations in the relativistic jet of BL Lacertae. Nature 2022; 609:265-268. [PMID: 36071186 DOI: 10.1038/s41586-022-05038-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022]
Abstract
Blazars are active galactic nuclei (AGN) with relativistic jets whose non-thermal radiation is extremely variable on various timescales1-3. This variability seems mostly random, although some quasi-periodic oscillations (QPOs), implying systematic processes, have been reported in blazars and other AGN. QPOs with timescales of days or hours are especially rare4 in AGN and their nature is highly debated, explained by emitting plasma moving helically inside the jet5, plasma instabilities6,7 or orbital motion in an accretion disc7,8. Here we report results of intense optical and γ-ray flux monitoring of BL Lacertae (BL Lac) during a dramatic outburst in 2020 (ref. 9). BL Lac, the prototype of a subclass of blazars10, is powered by a 1.7 × 108 MSun (ref. 11) black hole in an elliptical galaxy (distance = 313 megaparsecs (ref. 12)). Our observations show QPOs of optical flux and linear polarization, and γ-ray flux, with cycles as short as approximately 13 h during the highest state of the outburst. The QPO properties match the expectations of current-driven kink instabilities6 near a recollimation shock about 5 parsecs (pc) from the black hole in the wake of an apparent superluminal feature moving down the jet. Such a kink is apparent in a microwave Very Long Baseline Array (VLBA) image.
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Affiliation(s)
- S G Jorstad
- Institute for Astrophysical Research, Boston University, Boston, MA, USA. .,Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia.
| | - A P Marscher
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
| | - C M Raiteri
- INAF, Osservatorio Astrofisico di Torino, Torino, Italy
| | - M Villata
- INAF, Osservatorio Astrofisico di Torino, Torino, Italy
| | - Z R Weaver
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
| | - H Zhang
- NASA Postdoctoral Program Fellow, Greenbelt, MD, USA.,NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - L Dong
- Department of Physics, Purdue University, West Lafayette, IN, USA
| | - J L Gómez
- Instituto de Astrofísica de Andalucía (CSIC), Granada, Spain
| | - M V Perel
- St. Petersburg State University, St. Petersburg, Russia
| | - S S Savchenko
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia.,Special Astrophysical Observatory, Russian Academy of Sciences, Nizhnii Arkhyz, Russia.,Pulkovo Observatory, St. Petersburg, Russia
| | - V M Larionov
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia.,Pulkovo Observatory, St. Petersburg, Russia
| | - D Carosati
- EPT Observatories, Tijarafe, La Palma, Spain.,INAF, TNG Fundación Galileo Galilei, La Palma, Spain
| | - W P Chen
- Graduate Institute of Astronomy, National Central University, Taoyuan, Taiwan
| | - O M Kurtanidze
- Abastumani Observatory, Mt. Kanobili, Abastumani, Georgia.,Engelhardt Astronomical Observatory, Kazan Federal University, Tatarstan, Russia.,Zentrum für Astronomie der Universität Heidelberg, Landessternwarte, Heidelberg, Germany
| | - A Marchini
- Astronomical Observatory, Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy
| | - K Matsumoto
- Astronomical Institute, Osaka Kyoiku University, Kashiwara, Japan
| | | | - P Aceti
- Osservatorio Astronomico Città di Seveso, Seveso, Italy.,Department of Aerospace Science and Technology, Politecnico di Milano, Milano, Italy
| | - J A Acosta-Pulido
- Instituto de Astrofísica de Canarias and Dpto. de Astrofísica, Universidad de La Laguna, Tenerife, Spain
| | - T Andreeva
- Institute of Applied Astronomy, Russian Academy of Sciences, St. Petersburg, Russia
| | - G Apolonio
- Department of Physics and Astronomy, Brigham Young University, Provo, UT, USA
| | - C Arena
- Gruppo Astrofili Catanesi (GAC), Catania, Italy
| | - A Arkharov
- Pulkovo Observatory, St. Petersburg, Russia
| | - R Bachev
- Institute of Astronomy and National Astronomical Observatory, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - M Banfi
- Osservatorio Astronomico Città di Seveso, Seveso, Italy
| | - G Bonnoli
- Instituto de Astrofísica de Andalucía (CSIC), Granada, Spain.,Astronomical Observatory, Department of Physical Sciences, Earth and Environment, University of Siena, Siena, Italy.,INAF-Osservatorio Astronomico di Brera, Merate, Italy
| | - G A Borman
- Crimean Astrophysical Observatory RAS, Bakhchisaray, Crimea
| | - V Bozhilov
- Department of Astronomy, Faculty of Physics, University of Sofia, Sofia, Bulgaria
| | - M I Carnerero
- INAF, Osservatorio Astrofisico di Torino, Torino, Italy
| | | | - S A Ehgamberdiev
- Ulugh Beg Astronomical Institute, Tashkent, Uzbekistan.,National University of Uzbekistan, Tashkent, Uzbekistan
| | - D Elsässer
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany.,Department of Physics, TU Dortmund University, Dortmund, Germany
| | - A Frasca
- INAF-Osservatorio Astrofisico di Catania, Catania, Italy
| | | | - T S Grishina
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - A C Gupta
- Aryabhatta Research Institute of Observational Sciences (ARIES), Nainital, India
| | - V A Hagen-Thorn
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - M K Hallum
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
| | - M Hart
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
| | - K Hasuda
- Department of Physical Sciences, Aoyama Gakuin University, Tokyo, Japan
| | - F Hemrich
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - H Y Hsiao
- Graduate Institute of Astronomy, National Central University, Taoyuan, Taiwan
| | - S Ibryamov
- Department of Physics and Astronomy, Faculty of Natural Sciences, University of Shumen, Shumen, Bulgaria
| | - T R Irsmambetova
- Sternberg Astronomical Institute, M.V. Lomonosov Moscow State University, Moscow, Russia
| | - D V Ivanov
- Institute of Applied Astronomy, Russian Academy of Sciences, St. Petersburg, Russia
| | - M D Joner
- Department of Physics and Astronomy, Brigham Young University, Provo, UT, USA
| | - G N Kimeridze
- Abastumani Observatory, Mt. Kanobili, Abastumani, Georgia
| | | | - J Knött
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - E N Kopatskaya
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - S O Kurtanidze
- Abastumani Observatory, Mt. Kanobili, Abastumani, Georgia.,Zentrum für Astronomie der Universität Heidelberg, Landessternwarte, Heidelberg, Germany
| | - A Kurtenkov
- Institute of Astronomy and National Astronomical Observatory, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - T Kuutma
- Centro de Estudios de Física del Cosmos de Aragón, Teruel, Spain
| | - E G Larionova
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - S Leonini
- Montarrenti Observatory, Siena, Italy
| | - H C Lin
- Graduate Institute of Astronomy, National Central University, Taoyuan, Taiwan
| | - C Lorey
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - K Mannheim
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany.,Lehrstuhl für Astronomie, Universität Würzburg, Würzburg, Germany
| | - G Marino
- Gruppo Astrofili Catanesi (GAC), Catania, Italy.,Wild Boar Remote Observatory, Florence, Italy
| | - M Minev
- Department of Astronomy, Faculty of Physics, University of Sofia, Sofia, Bulgaria
| | | | - D A Morozova
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - A A Nikiforova
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia.,Pulkovo Observatory, St. Petersburg, Russia
| | - M G Nikolashvili
- Abastumani Observatory, Mt. Kanobili, Abastumani, Georgia.,Zentrum für Astronomie der Universität Heidelberg, Landessternwarte, Heidelberg, Germany
| | - E Ovcharov
- Department of Astronomy, Faculty of Physics, University of Sofia, Sofia, Bulgaria
| | - R Papini
- Wild Boar Remote Observatory, Florence, Italy
| | - T Pursimo
- Nordic Optical Telescope, Santa Cruz de Tenerife, Spain.,Department of Physics and Astronomy, Aarhus University, Aarhus C, Denmark
| | - I Rahimov
- Institute of Applied Astronomy, Russian Academy of Sciences, St. Petersburg, Russia
| | - D Reinhart
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - T Sakamoto
- Department of Physical Sciences, Aoyama Gakuin University, Tokyo, Japan
| | - F Salvaggio
- Gruppo Astrofili Catanesi (GAC), Catania, Italy.,Wild Boar Remote Observatory, Florence, Italy
| | - E Semkov
- Institute of Astronomy and National Astronomical Observatory, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | | | - L A Sigua
- Abastumani Observatory, Mt. Kanobili, Abastumani, Georgia
| | - R Steineke
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - M Stojanovic
- Astronomical Observatory Belgrade, Belgrade, Serbia
| | - A Strigachev
- Institute of Astronomy and National Astronomical Observatory, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Y V Troitskaya
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - I S Troitskiy
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - A Tsai
- Graduate Institute of Astronomy, National Central University, Taoyuan, Taiwan
| | - A Valcheva
- Department of Astronomy, Faculty of Physics, University of Sofia, Sofia, Bulgaria
| | - A A Vasilyev
- Astronomical Institute, St. Petersburg State University, St. Petersburg, Russia
| | - O Vince
- Astronomical Observatory Belgrade, Belgrade, Serbia
| | - L Waller
- Hans-Haffner-Sternwarte, Naturwissenschaftliches Labor für Schüler am FKG, Würzburg, Germany
| | - E Zaharieva
- Department of Astronomy, Faculty of Physics, University of Sofia, Sofia, Bulgaria
| | - R Chatterjee
- Department of Physics, Presidency University, Kolkata, India
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8
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Marino G, Rigattieri S, Giovannelli F, Tommasino A, Berni A, Volpe M. P86 IN–HOSPITAL OUTCOMES OF PORTICO TRANSCATHETER AORTIC VALVE IMPLANTATION WITH THE FLEXNAV AS COMPARED TO THE FIRST–GENERATION DELIVERY SYSTEM. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.083] [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: 11/14/2022]
Abstract
Abstract
Introduction
technological advancements in transcatheter heart valve platforms, along with increasing operator experience and careful patient selection, are essential to reach high standards of efficacy and safety in transcatheter aortic valve replacement (TAVR). Aim of this study was to evaluate the performance of the new version of the Portico valve delivery system (FlexNav) as compared to the first–generation device.
Materials and Methods
we report the results of a single–center, observational study on patients with severe aortic valve stenosis undergoing TAVR with the Portico valve at our Institution. Consecutive patients treated with the new FlexNav delivery system (DS), available since May, 2020, were compared with patients treated with the first–generation delivery system (1st Gen–DS). In–hospital outcomes were self–adjudicated according to the Valve Academic Research Consortium–3 definition.
Results
50 patients were included in this study; 22 were treated with the FlexNav–DS and the remaining with the 1st Gen–DS. Clinical characteristics were similar between group, expect for older age (82.6 ± 3.6 vs 80.7 ± 3.8; p = 0.07) and higher prevalence of female gender (68.2% vs 39.3%; p = 0.04) in FlexNav–DS group as compared to 1st Gen–DS group, respectively. We observed similar rates of procedural success but higher rate of moderate–to–severe paravalvular leak in 1st Gen–DS as compared to FlexNav–DS group (28.6% vs 4.6%; p = 0.03); major vascular complications were reduced, although not significantly, in the FlexNav–DS as compared to 1st Gen–DS group (4.5% vs 10.7%; p = 0.64).
Conclusion
Our data suggest that the FlexNav DS, thanks to lower profile and enhanced stability during valve deployment, has the potential to allow for to better procedural and clinical results of TAVR with the Portico valve as compared to the 1st Gen–DS.
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Affiliation(s)
- G Marino
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
| | - S Rigattieri
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
| | - F Giovannelli
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
| | - A Tommasino
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
| | - A Berni
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
| | - M Volpe
- UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA, UOC CARDIOLOGICA CLINICA E RIABILITATIVA, PO SAN FILIPPO NERI, ASL ROMA 1, ROMA; UOC CARDIOLOGIA, AOU SANT‘ANDREA, ROMA; UOC CARDIOLOGIA, DIPARTIMENTO DI MEDICINA CLINICA E MOLECOLARE, SAPIENZA UNIVERSITÀ DI ROMA, AOU SANT‘ANDREA, ROMA
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9
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Gentile S, Guarino G, Della Corte T, Marino G, Satta E, Pasquarella M, Romano C, Alfrone C, Giordano L, Loiacono F, Capece M, Lamberti R, Strollo F. The Economic Burden of Insulin Injection-Induced Lipohypertophy. Role of Education: The ISTERP-3 Study. Adv Ther 2022; 39:2192-2207. [PMID: 35306633 PMCID: PMC9056437 DOI: 10.1007/s12325-022-02105-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
Abstract
Introduction The history of insulin-induced skin lipohypertrophy (LH) runs parallel to that of insulin's 100 years, and an average of 47% of insulin-treated patients still suffer from it today. The metabolic and economic effects of LH are significant, with hypoglycemia being the most striking. The objective of the study was to perform a 52-week follow-up of 713 insulin-treated patients with type 2 diabetes (T2DM) and LH to detect any differences in the occurrence of hypoglycemic events (HYPOs) and related healthcare costs as well as in LH rates and injection habits between an intensive education intervention group (IG) and control group (CG) provided with a single educational session at the starting point. Methods All participants were trained in accurately self-monitoring blood glucose and recording all HYPOs for 6 months, which allowed baseline recordings before they were randomized into the IG, comprising 395 insulin-treated subjects undergoing repeated, structured multimodal education on correct injection techniques as a longstanding behavioral rehabilitation strategy, and the CG, comprising 318 subjects receiving the same structured, multimodal educational session, but only initially. Results Changes in LH rate and size and in performance were large in the IG and only slight and transient in the CG. A striking difference in the rate of decrease of HYPOs was also apparent between groups. Indeed, estimated costs of health interventions for severe and symptomatic HYPOs, which were on the order of €70,000 and €9300, respectively, in the two groups at baseline decreased by 5.9 times and 13.7 times, respectively, at the end of follow-up in the IG and by only approximately half in the CG. Full details of the changes occurring as a result of intensive education are provided in the text. Conclusions The effect of only initial education in the CG was not significant, thus providing evidence of the virtual worthlessness of a single training session on injection techniques, typical of worldwide daily clinical practice, and easily explaining the extremely high prevalence of LH in insulin-treated patients. Conversely, highly positive effects on LH prevalence and size as well as costs expected from decreased HYPO rate were obtained in the IG. To our knowledge, ours is the first 18-month randomized trial in the field. If our experimental model were to be used as an effective, longstanding behavioral rehabilitation strategy and therefore adapted to real-world settings universally, LH prevalence and costs related to their clinical consequences would be drastically reduced. However, only with a strong, relentless commitment of universities, scientific societies, and patient associations can we achieve this ambitious goal, which would provide great institutional savings and improved quality of life for people with diabetes. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02105-5.
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Affiliation(s)
- Sandro Gentile
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Guarino
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Teresa Della Corte
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Ersilia Satta
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Polyspecialistic Nephrologic Center CNP Srl, Fratta Maggiore, Italy
| | | | | | | | - Laura Giordano
- Emodialysis Center Srl, Nefrocenter Network, Naples, Italy
| | | | - Maurizio Capece
- Vomero Center Crisci Bersabea & C SNC, Nefrocenter Network, Naples, Italy
| | | | - Felice Strollo
- Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy.
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10
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Pietrantonio F, Rosiello F, Pascucci M, Alessi E, Ciamei A, Cipriano E, Di Berardino A, Laurelli G, Porzano A, Delli Castelli M, Marino G, Onesti E, Montagnese F, Rainone M, Ruggeri M. Device therapy for the major complications detection and early treatment of patients with natural and iatrogenic comorbidities admitted to internal medicine wards. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3103] [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: 11/13/2022] Open
Abstract
Abstract
Background
Whith advances in devices miniaturization and wireless technologies, wereable “on body” ECG patch devices are unobtrusive and easy to use. Continuous ECG monitoring in the short term is indicated in patients who, due to age, comorbidities and polytherapy, are at greater risk of arrhythmias. Since 2017, a randomized-open label study is being conducted at the admission of acute patients in Internal Medicine Unit for 72 hours with continuous monitoring of vital parameters and the 5 leads-ECG (VP-ECG CM) trace by the mean of a tele-cardiology program.
Purpose
Objective of this study is to perform a cost-effectiveness evaluation of the VP-ECG CM program in inpatient settings.
Methods
Data were used in order to evaluate costs, the program effectiveness and the QALY gains using wireless monitoring compared to nurses traditional one. Costs were estimated by mean of the identification, measuring and valorization of the resources uptake. Cost drivers included: time spent by personnel, cost of the device, consumables, medical treatments, diagnostic exams and complications. The perspective of the Italian National Health Service was adopted. The incremental analysis was performed in order to present the cost per complication avoided and the cost per QALY gained. Net monetary benefit was also calculated. Either a deterministic and probabilistic analysis were performed by means of a bootstrap simulation allowing for re-sampling. A cost-effectiveness-acceptability curve was estimated, considering a cost-effectiveness threshold of €35,000/QALY.
Results
On 143 patients, arrhythmias and acute coronary syndrome were detected 4.3% in the experimental arm and 1.9% in the control arm, whilst 29,5% major complications were detected in the experimental arm vs 43.5% in the control and reduction in the number of sudden deaths (16% control and 9.3% experimental). Time spent by nurses in the control arm (58 minutes/day/patient) was the most relevant cost driver and allowed a saving ranging €54–90/patient. This saving overwhelmed the costs for the equipment whilst the other costs remained unchanged, thus allowing for the VP-ECG CM to be dominant versus the standard of care. One way and multiway sensitivity analyses confirmed the robustness of our results with p-value 0,05 involved in the bootstrap presenting dominance of the VP-ECG CM.
Conclusions
Notwithstanding the concerns of a loss of control in patient management, telemedicine (digital health infrastructure and driver) could perform healthcare transformation enabling physicians to increase the volume of patients seen, reduce the time to diagnosis, improve efficiency and efficacy of disease management, and reduce unnecessary clinic visits and hospital admissions. The miniaturized technologies can improve patient adherence, and the detection, characterization and monitoring of cardiac arrhythmias – readily digitalized markers and phenotypes of cardiovascular disease.
Funding Acknowledgement
Type of funding sources: None. Wireless Monitoring Study flowchart
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Affiliation(s)
- F Pietrantonio
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - F Rosiello
- Sapienza University, Microbiology, Infectious Disease and Public Health, Rome, Italy
| | - M Pascucci
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - E Alessi
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - A Ciamei
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - E Cipriano
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - A Di Berardino
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - G Laurelli
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - A Porzano
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | | | - G Marino
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - E Onesti
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - F Montagnese
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - M Rainone
- Castelli Hospital, Internal Medicine Department, Ariccia, Italy
| | - M Ruggeri
- Italian Superior Health Institute, National Centre of Health Technology Assessment, Rome, Italy
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11
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Gentile S, Guarino G, Della Corte T, Marino G, Satta E, Pasquarella M, Romano C, Alfrone C, Giordano L, Loiacono F, Capace M, Lamberti R, Strollo F. The Durability of an Intensive, Structured Education-Based Rehabilitation Protocol for Best Insulin Injection Practice: The ISTERP-2 Study. Diabetes Ther 2021; 12:2557-2569. [PMID: 34383261 PMCID: PMC8385007 DOI: 10.1007/s13300-021-01108-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 06/03/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Studies on the durability of an intensive, structured education protocol on best insulin injection practice are missing for people with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the durability of an intensive, structured education-based rehabilitation protocol on best insulin injection practice in well-trained subjects from our previous intensive, multimedia intervention study registered as the ISTERP-1 study. A total of 158 subjects with T2DM from the well-trained group of the 6-month-long ISTERP-1 study, all of whom had successfully attained lower glucose levels compared to baseline levels with lower daily insulin doses and with less frequent and severe hypoglycemic episodes, participated in the present investigation involving an additional 6-month follow-up period, called the ISTERP-2 study. METHODS Participants were randomized into an intervention group and a control group, depending on whether they were provided or not provided with further education refresher courses for 6 months. At the end of the 6 months, the two groups were compared in terms of injection habits, daily insulin dose requirement, number of severe or symptomatic hypoglycemic events, and glycated hemoglobin (HbA1c) levels. RESULTS Despite being virtually superimposable at baseline, the two groups behaved quite differently during the follow-up. The within-group analysis of observed parameters showed that the subjects in the intervention group maintained and even improved the good behavioral results learned during the ISTERP-1 study by further reducing both the rate of injection technique errors (p < 0.001) and size of lipohypertrophic lesions at injection sites (p < 0.02). Conversely, those in the control group progressively abandoned best practice, except for the use of ice-cold insulin and, consequently, had significantly higher HbA1c levels and daily insulin dose requirements at the end of the follow-up than at baseline (p < 0.05). In addition, as expected from all the above, the rate of hypoglycemic episodes also decreased in the intervention group (p < 0.05), resulting in a significant difference between groups after 6 months (p < 0.02). CONCLUSION Our data provide evidence that intensive, structured education refresher courses have no outstanding durability, so that repeated refresher courses, at least at 6-month intervals, are needed to have positive effects on people with T2DM, contributing not only to prevention but also to long-term rehabilitation. TRIAL REGISTRATION Trial Registration no. 118 bis/15.04.2018.
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Affiliation(s)
- Sandro Gentile
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Guarino
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Teresa Della Corte
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - Ersilia Satta
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
- Polispecialistic Nephrological Center CNP Srl, Fratta Maggiore, Italy
| | | | | | | | - Laura Giordano
- Emodialysis Center Srl, Nefrocenter Network, Naples, Italy
| | | | - Maurizio Capace
- Vomero Center Crisci Bersabea & C SNC, Nefrocenter Network, Naples, Italy
| | | | - Felice Strollo
- Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy.
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12
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Catone G, Meligrana M, Marino G, Vullo C. Constant rate infusion of tramadol in isoflurane-anesthetized pigs undergoing experimental surgery. Pol J Vet Sci 2021; 23:589-593. [PMID: 33480502 DOI: 10.24425/pjvs.2020.135805] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to investigate the effect of tramadol (TM) (2 mg/kg) administered intramuscularly (IM) followed by a constant rate infusion (CRI) of TM (2 mg/kg/h) in pigs. Sixteen pigs undergoing experimental surgery were premedicated IM with a combination of alfaxalone (5 mg/kg) and midazolam (0.5 mg/kg). Anaesthesia was induced with propofol (2 mg/kg) intravenously (IV) and maintained with isoflurane. Pigs were randomly assigned to one of the two following groups: Group 1 (n=8): received a loading dose of TM (2 mg/kg) followed by a CRI of TM (2 mg/kg/h); Group 2 (n=8): a loading dose of TM (2 mg/kg) followed by a CRI of lactated Ringer's solution (2 ml/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), haemoglobin oxygen saturation (SpO2), fraction of inspired oxygen (FIO2), end-tidal concentration of isoflurane (FEISO), end-tidal carbon dioxide concentration (FECO2), pH, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2) and bicarbonate concentration (HCO3-) were recorded immediately after loss of righting reflex (T=0 min) and at 15-min intervals over a period of 60 min. Continuous data were analysed using a repeated- -measure analysis of variance (ANOVA) and a p-value ⟨0.05 was considered significant. HR, RR and FEISO were significantly lower (p⟨0.05) in Group 1 at T30 and T45, which corresponded to the time of the most intense surgical stimulation. The results suggest that the TM infusion minimizes the HR and RR response, slightly reducing isoflurane requirements and determining a superior perioperative analgesia.
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Affiliation(s)
- G Catone
- Department of Veterinary Science, Polo Universitario dell'Annunziata, University of Messina, Via Palatucci, Messina, 98168, Italy
| | - M Meligrana
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circionvallazione 93-95, Matelica (MC), 62024, Italy
| | - G Marino
- Department of Veterinary Science, Polo Universitario dell'Annunziata, University of Messina, Via Palatucci, Messina, 98168, Italy
| | - C Vullo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Polo Papardo, University of Messina, Viale F. Stagno d'Alcontres 31, Messina, 98166, Italy
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Gentile S, Guarino G, Della Corte T, Marino G, Satta E, Pasquarella M, Romano C, Alfrone C, Strollo F. Role of Structured Education in Reducing Lypodistrophy and its Metabolic Complications in Insulin-Treated People with Type 2 Diabetes: A Randomized Multicenter Case-Control Study. Diabetes Ther 2021; 12:1379-1398. [PMID: 33738775 PMCID: PMC8099954 DOI: 10.1007/s13300-021-01006-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/15/2021] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION It is essential to use the correct injection technique (IT) to avoid skin complications such as lipohypertrophy (LH), local inflammation, bruising, and consequent repeated unexplained hypoglycemia episodes (hypos) as well as high HbA1c (glycated hemoglobin) levels, glycemic variability (GV), and insulin doses. Structured education plays a prominent role in injection technique improvement. The aim was to assess the ability of structured education to reduce (i) GV and hypos, (ii) HbA1c levels, (iii) insulin daily doses, and (iv) overall healthcare-related costs in outpatients with T2DM who were erroneously injecting insulin into LH. METHODS 318 patients aged 19-75 years who had been diagnosed with T2DM for at least 5 years, were being treated with insulin, were routinely followed by a private network of healthcare centers, and who had easily seen and palpable LH nodules were included in the study. At the beginning of the 6-month run-in period (T-6), all patients were trained to perform structured self-monitoring of blood glucose and to monitor symptomatic and severe hypos (SyHs and SeHs, respectively). After that (at T0), the patients were randomly and equally divided into an intervention group who received appropriate IT education (IG) and a control group (CG), and were followed up for six months (until T+6). Healthcare cost calculations (including resource utilization, loss of productivity, and more) were carried out based on the average NHS reimbursement price list. RESULTS Baseline characteristics were the same for both groups. During follow-up, the intra-LH injection rate for the CG progressively decreased to 59.9% (p < 0.001), a much smaller decrease than seen for the IG (1.9%, p < 0.001). Only the IG presented significant decreases in HbA1c (8.2 ± 1.2% vs. 6.2 ± 0.9%; p < 0.01), GV (247 ± 61 mg/dl vs. 142 ± 31 mg/dl; p < 0.01), insulin requirement (- 20.7%, p < 0.001), and SeH and SyH prevalence (which dropped dramatically from 16.4 to 0.6% and from 83.7 to 7.6%, respectively; p < 0.001). In the IG group only, costs-including those due to the reduced insulin requirement-decreased significantly, especially those relating to SeHs and SyHs, which dropped to €25.8 and €602.5, respectively (p < 0.001). CONCLUSION Within a 6-month observation period, intensive structured education yielded consistently improved metabolic results and led to sharp decreases in the hypo rate and the insulin requirement. These improvements resulted in a parallel drop in overall healthcare costs, representing a tremendous economic advantage for the NHS. These positive results should encourage institutions to resolve the apparently intractable problem of LH by financially incentivizing healthcare teams to provide patients with intensive structured education on proper injection technique. TRIAL REGISTRATION Trial registration no. 118/15.04.2018, approved by the Scientific and Ethics Committee of Campania University "Luigi Vanvitelli," Naples, Italy, and by the institutional review board (IRB Min. no. 9926 dated 05.05.2018).
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Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy.
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy.
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | - Teresa Della Corte
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | - Ersilia Satta
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | | | - Carmine Romano
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | - Carmelo Alfrone
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
| | - Felice Strollo
- Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy
- Nefrocenter Research Network and Nyx Start-Up, Naples, Italy
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Gentile S, Guarino G, Della Corte T, Marino G, Satta E, Romano C, Alfrone C, Lmberti C, Strollo F. Bruising: A Neglected, Though Patient-Relevant Complication of Insulin Injections Coming to Light from a Real-Life Nationwide Survey. Diabetes Ther 2021; 12:1143-1157. [PMID: 33687646 PMCID: PMC7994491 DOI: 10.1007/s13300-021-01026-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/08/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Despite the availability of sophisticated devices and suitable recommendations on how to best perform insulin injections, lipohypertrophy (LH) and bruising (BR) frequently occur as a consequence of improper injection technique. AIM The purpose of this nationwide survey was to check literature-reported LH risk factors or consequences for any association with BR METHOD: This was a cross-sectional, observational, multicenter study based on the identification of skin lesions at all patient-reported insulin injection sites in 790 subjects with diabetes. General and injection habit-related elements were investigated as possible BR risk factors. RESULTS While confirming the close relationship existing between LH and a full series of factors including missed injection site rotation, needle reuse, long-standing insulin treatment, frequent hypoglycemic events (hypos), and great glycemic variability (GV), the observed data could find no such association with BR, which anyhow came with high HbA1c levels, missed injection site rotation, and long-standing insulin treatment. CONCLUSION BR most likely depends on the patient's habit of pressing the injection pen hard onto the skin. Despite being worrisome and affecting quality of life, BR seems to represent a preliminary stage of LH but does not affect the rate of hypos and GV. TRIAL REGISTRATION 207/19.09.2017.
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Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy.
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy.
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | - Teresa Della Corte
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | - Ersilia Satta
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | - Carmine Romano
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | | | - Clelia Lmberti
- Nefrocenter Research Network & Nyx Start-Up, Naples, Italy
| | - Felice Strollo
- Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy
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Gentile S, Guarino G, Della Corte T, Marino G, Fusco A, Corigliano G, Colarusso S, Piscopo M, Improta MR, Corigliano M, Martedi E, Oliva D, Russo V, Simonetti R, Satta E, Romano C, Vaia S, Strollo F. Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes. Diabetes Ther 2021; 12:107-119. [PMID: 33219928 PMCID: PMC7843727 DOI: 10.1007/s13300-020-00954-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The number of older adults with insulin-treated diabetes mellitus (DM) is steadily increasing worldwide. Errors in the insulin injection technique can lead to skin lipohypertrophy (LH), which is the accumulation of fat cells and fibrin in the subcutaneous tissue. While lipohypertrophic lesions/nodules (LHs) due to incorrect insulin injection techniques are very common, they are often flat and hardly visible and thus require thorough deep palpation examination and ultrasonography (US) for detection. Detection is crucial because such lesions may eventually result in poor diabetes control due to their association with unpredictable insulin release patterns. Skin undergoes fundamental structural changes with aging, possibly increasing the risk for LH. We have therefore investigated the effect of age on the prevalence of LHs and on factors potentially associated with such lesions. METHODS A total of 1227 insulin-treated outpatients with type 2 DM (T2DM) referred to our diabetes centers were consecutively enrolled in the study. These patients underwent a thorough clinical and US evaluation of the skin at injection sites, as previously described, with up to 95% concordance betweenthe clinical and US screening techniques. Of these 1227 patients, 718 (59%) had LH (LH+) and 509 (41%) were LH-free (LH-). These patients were then assigned to two age class groups (≤ 65 years and > 65 years), and several clinical features, diabetes complication rates, and injection habits were investigated. RESULTS Comparison of the two age subgroups revealed that 396 (48%) and 322 (79%) patients in the younger and older groups, respectively, had LHs (p < 0.001). Compared to the younger subgroup, the older subgroup displayed a higher LH rate in the abdomen (52.9 vs. 38.3%; p < 0.01) and a lower rate in the arms (25.4 vs. 35.8%; p < 0.05), thighs (26.7 vs. 33.4%; p < 0.05), and buttocks (4.9 vs. 26.2%; p < 0.01). In older subjects, the most relevant parameters were: habit of injecting insulin into LH nodules (56 vs. 47% [younger subjects]; p < 0.01), rate of post-injection leakage of insulin from injection site (drop-leaking rate; 47 vs. 39% [younger subjects]; p < 0.05), and rate of painful injections (5 vs. 16% [younger subjects]; p < 0.001). Multivariate analysis showed a stronger association between LH and poor habits, as well as between several clinical parameters, among which the most relevant were hypoglycemic events and glycemic variability. DISCUSSION The higher rate of post-injection drop-leaking and pain-free injections might find an explanation in skin changes typically observed in older adults, including lower thickness, vascularity and elasticity, and a more prominent fibrous texture, all of which negatively affect tissue distensibility. Consequently, in addition to the well-known association between aging skin impaired drug absorption rate, aging skin displays a progressively decreasing ability to accommodate large volumes of insulin-containing fluid. CONCLUSIONS The strong association between LH rate and hypoglycemic events plus glycemic variability suggests the need (1) to take specific actions to prevent and control the high risk of acute cardiovascular events expected to occur in older subjects in the case of hypoglycemic events, and (2) to identify suitable strategies to fulfill the difficult task of performing effective educational programs specifically targeted to the elderly. TRIAL REGISTRATION Trial registration number 172-11:12.2019, Scientific and Ethical Committee of Campania University "Luigi Vanvitelli", Naples, Italy).
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Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University “Luigi Vanvitelli”, Naples, Italy
- Diabetes Unit AID Stabia, Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University “Luigi Vanvitelli”, Naples, Italy
| | - Teresa Della Corte
- Department of Internal Medicine, Campania University “Luigi Vanvitelli”, Naples, Italy
- Nutrition, Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University “Luigi Vanvitelli”, Naples, Italy
| | - Alessandra Fusco
- Diabetes Unit, Italian Association for Diabetes (AID) Napoli, Naples, Italy
| | - Gerardo Corigliano
- Diabetes Unit, Italian Association for Diabetes (AID) Napoli, Naples, Italy
| | | | | | | | - Marco Corigliano
- Diabetes Unit, Italian Association for Diabetes (AID) Napoli, Naples, Italy
| | | | - Domenica Oliva
- Diabetes Unit, AID Cava dè Tirreni, Cava dè Tirreni, Italy
| | - Viviana Russo
- Diabetes Unit, Italian Association for Diabetes (AID) Napoli, Naples, Italy
| | | | - Ersilia Satta
- Dialysis Unit, Nefrocenter Research Network, Naples, Italy
| | - Carmine Romano
- Dialysis Unit, Nefrocenter Research Network, Naples, Italy
| | - Sebastiano Vaia
- Neuropsicology Unit, Nefrocenter Research Network, Naples, Italy
| | - Felice Strollo
- Diabetes, Endocrinology and Metabotic Disease, IRCCS San Raffaele Pisana, Rome, Italy
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16
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Gentile S, Guarino G, Corte TD, Marino G, Fusco A, Corigliano G, Colarusso S, Piscopo M, Improta MR, Corigliano M, MartedÌ E, Oliva D, Russo V, Simonetti R, Satta E, Romano C, Alfarone C, Vetrano A, Martino C, Lamberti C, Vecchiato A, Cozzolino G, Brancario C, Strollo F. Insulin-Induced Skin Lipohypertrophy in Type 2 Diabetes: a Multicenter Regional Survey in Southern Italy. Diabetes Ther 2020; 11:2001-2017. [PMID: 32683659 PMCID: PMC7435140 DOI: 10.1007/s13300-020-00876-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Received: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Lipohypertrophies (LHs) due to incorrect insulin injection techniques have been described in the literature for decades. Their rate averages 38%, but this is still controversial because of the vast range reported by different publications, most of which fail to describe the selected detection protocol and therefore are not entirely reliable. We still need to identify the real LH rate, and only consistently using a standardized method in a large cohort of insulin-treated (IT) patients make this possible. METHODS Our group performed thorough clinical skin examinations on patients suffering from type 2 diabetes mellitus (T2DM): 1247 IT T2DM outpatients were examined according to a standardized protocol, previously published elsewhere, as well as an ultrasound scan of the same skin areas to assess the degree of concordance between the two methods and to evaluate the demographic, clinical, and behavioral risk factors (RF) as well as metabolic consequences of identified LHs. RESULTS The concordance between the two methods was 99%. Identified risk factors for LHs were needle reuse, failure to rotate injection sites, and ice-cold insulin injections. High HbA1c values, wide glycemic variability, and longstanding proneness to hypoglycemia with a high rate of ongoing hypoglycemic events proved to be significantly associated with LHs, too; the same applied to cardiovascular and renal complications as well as to living alone and being retired. CONCLUSIONS Based on a strict well-structured methodology, our data confirmed what has already been reported in the literature on factors leading to, or associated with, LHs and, for the first time in adults, indicated cryotrauma from ice-cold insulin injections and specific social conditions as factors facilitating LH occurrence. HCPs should therefore plan a yearly clinical examination of all injection sites to improve patient quality of life through better glucose control and a reduced rate of hypoglycemic events. TRIAL REGISTRATION Trial registration no. 127-11.01.2019, approved by the Scientific and Ethics Committee of Campania University "Luigi Vanvitelli," Naples, Italy.
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Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli" and Nefrocenter Research, Naples, Italy.
- Diabetes Unit AID Castellammare di Stabia, Castellammare di Stabia, Italy.
- Nefrocenter Research and Nyx Start-Up, Naples, Italy.
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli" and Nefrocenter Research, Naples, Italy
| | - Teresa Della Corte
- Department of Internal Medicine, Campania University "Luigi Vanvitelli" and Nefrocenter Research, Naples, Italy
- Diabetes Unit AID Castellammare di Stabia, Castellammare di Stabia, Italy
- Diabetes Unit AID Portici, Portici, Italy
- Diabetes Unit AID Cava de' Tirreni, Cava de' Tirreni, Italy
- Endocrinology and Diabetes, San Raffaele Termini Pisana Research Institute, Rome, Italy
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli" and Nefrocenter Research, Naples, Italy
| | | | | | | | | | - Maria Rosaria Improta
- Diabetes Unit AID Castellammare di Stabia, Castellammare di Stabia, Italy
- Diabetes Unit AID Portici, Portici, Italy
- Diabetes Unit AID Cava de' Tirreni, Cava de' Tirreni, Italy
- Endocrinology and Diabetes, San Raffaele Termini Pisana Research Institute, Rome, Italy
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | - Marco Corigliano
- Diabetes Unit AID Napoli, Napoli, Italy
- Diabetes Unit AID Benevento, Benevento, Italy
- Diabetes Unit AID Nola, Nola, Italy
- Diabetes Unit AID Castellammare di Stabia, Castellammare di Stabia, Italy
- Diabetes Unit AID Portici, Portici, Italy
- Diabetes Unit AID Cava de' Tirreni, Cava de' Tirreni, Italy
- Endocrinology and Diabetes, San Raffaele Termini Pisana Research Institute, Rome, Italy
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | | | - Domenica Oliva
- Diabetes Unit AID Cava de' Tirreni, Cava de' Tirreni, Italy
- Endocrinology and Diabetes, San Raffaele Termini Pisana Research Institute, Rome, Italy
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | | | | | - Ersilia Satta
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
| | | | | | | | - Carmine Martino
- Diabetes Unit AID Castellammare di Stabia, Castellammare di Stabia, Italy
| | - Clelia Lamberti
- Diabetes Unit, AID Nocera Inferiore, Nocera Inferiore, Italy
| | | | | | | | - Felice Strollo
- Endocrinology and Diabetes, San Raffaele Termini Pisana Research Institute, Rome, Italy
- Nefrocenter Research and Nyx Start-Up, Naples, Italy
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van Zwieten A, Wong G, Ruospo M, Palmer SC, Teixeira-Pinto A, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo M, Loy CT, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GF, Cagnazzo A, Antinoro R, Sambati M, Donatelli C, Dambrosio N, Saturno C, Marangelli A, Pedone F, Matera G, Benevento M, Papagni S, Alicino F, Latassa G, Molino A, Grippaldi F, Bertino D, Montalto G, Messina S, Campo S, Nasisi P, Failla A, Bua A, Pagano S, Marino G, Sanfilippo N, Rallo D, Maniscalco A, Capostagno C, Randazzo G, Fici M, Lupo A, Fichera R, D'angelo A, Di Toro Mammarella R, Meconizzi M, Boccia E, Mantuano M, Flammini A, Moscardelli L. Associations of Cognitive Function and Education Level With All-Cause Mortality in Adults on Hemodialysis: Findings From the COGNITIVE-HD Study. Am J Kidney Dis 2019; 74:452-462. [DOI: 10.1053/j.ajkd.2019.03.424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/08/2019] [Indexed: 12/24/2022]
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Raygoza-Sánchez KY, Rocha-Mendoza I, Segovia P, Krasavin AV, Marino G, Cesca T, Michieli N, Mattei G, Zayats AV, Rangel-Rojo R. Polarization dependence of second harmonic generation from plasmonic nanoprism arrays. Sci Rep 2019; 9:11514. [PMID: 31395922 PMCID: PMC6687713 DOI: 10.1038/s41598-019-47970-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/25/2019] [Indexed: 11/09/2022] Open
Abstract
The second order nonlinear optical response of gold nanoprisms arrays is investigated by means of second harmonic generation (SHG) experiments and simulations. The polarization dependence of the nonlinear response exhibits a 6-fold symmetry, attributed to the local field enhancement through the excitation of the surface plasmon resonances in bow-tie nanoantennas forming the arrays. Experiments show that for polarization of the input light producing excitation of the plasmonic resonances in the bow-tie nanoantennas, the SHG signal is enhanced; this despite the fact that the linear absorption spectrum is not dependent on polarization. The results are confirmed by electrodynamic simulations which demonstrate that SHG is also determined by the local field distribution in the nanoarrays. Moreover, the maximum of SHG intensity is observed at slightly off-resonance excitation, as implemented in the experiments, showing a close relation between the polarization dependence and the structure of the material, additionally revealing the importance of the presence of non-normal electric field components as under focused beam and oblique illumination.
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Affiliation(s)
- K Y Raygoza-Sánchez
- Maestría y Posgrado en Ciencias, Universidad Autónoma de Baja California, Carretera Transpeninsular 3917, 22860, Ensenada, B.C., Mexico.,Optics Department, Centro de Investigación Científica y de Educación Superior de Ensenada, Carretera Ensenada-Tijuana, No. 3918, Zona Playitas, 22860, Ensenada, B.C., Mexico
| | - I Rocha-Mendoza
- Optics Department, Centro de Investigación Científica y de Educación Superior de Ensenada, Carretera Ensenada-Tijuana, No. 3918, Zona Playitas, 22860, Ensenada, B.C., Mexico
| | - P Segovia
- Researcher of Cátedras CONACYT Centro de Investigación Científica y de Educación Superior de Ensenada, Carretera Ensenada-Tijuana, No. 3918, Zona Playitas, 22860, Ensenada, B.C., Mexico
| | - A V Krasavin
- Department of Physics and London Centre for Nanotechnology King's College London, Strand, London, WC2R 2LS, UK
| | - G Marino
- Department of Physics and London Centre for Nanotechnology King's College London, Strand, London, WC2R 2LS, UK
| | - T Cesca
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università degli Studi di Padova, Via Marzolo 8, 35131, Padova, Italy
| | - N Michieli
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università degli Studi di Padova, Via Marzolo 8, 35131, Padova, Italy
| | - G Mattei
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università degli Studi di Padova, Via Marzolo 8, 35131, Padova, Italy
| | - A V Zayats
- Department of Physics and London Centre for Nanotechnology King's College London, Strand, London, WC2R 2LS, UK
| | - R Rangel-Rojo
- Optics Department, Centro de Investigación Científica y de Educación Superior de Ensenada, Carretera Ensenada-Tijuana, No. 3918, Zona Playitas, 22860, Ensenada, B.C., Mexico.
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Martín-Arévalo E, Lupiáñez J, Narganes-Pineda C, Marino G, Colás I, Chica AB. The causal role of the left parietal lobe in facilitation and inhibition of return. Cortex 2019; 117:311-322. [PMID: 31185374 DOI: 10.1016/j.cortex.2019.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/19/2019] [Revised: 04/12/2019] [Accepted: 04/30/2019] [Indexed: 11/26/2022]
Abstract
Following non-informative peripheral cues, responses are facilitated at the cued compared to the uncued location at short cue-target intervals. This effect reverses at longer intervals, giving rise to Inhibition of Return (IOR). The integration-segregation hypothesis (Lupiáñez, 2010) suggests that peripheral cues always produce an onset-detection cost regardless the behavioral cueing effect that is measured - either facilitation or IOR. In the present study, we used transcranial magnetic stimulation (TMS) to investigate the causal contribution of this detection cost to performance. We used a cueing paradigm with a target discrimination task that was preceded by a non-informative peripheral cue. The presence-absence of a central intervening event was manipulated. Online TMS to the left superior parietal lobe (compared to an active vertex stimulation) lead to an overall more positive effect (faster responses for cued as compared to uncued trials), by putatively impairing the detection cost contribution to performance. The data revealed a strong association between overall RT and the TMS effect, and also between overall RT and the integrity of the first branch of the left superior longitudinal fascicule. These results have critical implications not only for the open debate about the mechanism/s underlying spatial orienting effects, but also for the growing literature demonstrating that white matter connectivity is crucial for explaining inter-individual behavioral variability.
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Affiliation(s)
- E Martín-Arévalo
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.
| | - J Lupiáñez
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - C Narganes-Pineda
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - G Marino
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - I Colás
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Ana B Chica
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
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Gentile S, Strollo F, Della Corte T, Marino G, Guarino G. Insulin related lipodystrophic lesions and hypoglycemia: Double standards? Diabetes Metab Syndr 2018; 12:813-818. [PMID: 29703450 DOI: 10.1016/j.dsx.2018.04.023] [Citation(s) in RCA: 9] [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: 03/01/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
Lipohypertophy (LH) is the most common skin complication of incorrect injection technique which does not only represent an aesthetic defect but also severely disrupts insulin pharmacokinetics/pharmacodynamics. As a consequence of that, hormone release is delayed and unexplained/unpredictable hypoglycemia occurs, both deteriorating metabolic control while negatively affecting adherence to treatment and quality of life. The economic burden due to unwanted intra-LH injections is accounted for by inappropriately high insulin requirements, increased emergency-related hospitalizations, and loss of work days. Greater attention has to be paid by diabetes care teams to education programs with periodic refreshers to achieve better metabolic control and reduce the economic burden of diabetes.
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Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy; Coordinator of the Study Group on Injection Technique of AMD (Medical Association of Diabetology), Italy.
| | - Felice Strollo
- Endocrinology and Diabetes, San Raffaele Termini Institute, Rome, Italy
| | - Teresa Della Corte
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy
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21
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Gastaldi B, Marino G, Assef Y, Silva Sofrás FM, Catalán CAN, González SB. Nutraceutical Properties of Herbal Infusions from Six Native Plants of Argentine Patagonia. Plant Foods Hum Nutr 2018; 73:180-188. [PMID: 30062579 DOI: 10.1007/s11130-018-0680-3] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Six native plants of South America traditionally consumed in the Patagonian region (southern Argentina and Chile), namely: Adesmia boronioides Hook. f., Apium australe Thouars, Buddleja globosa Hope, Drimys andina (Reiche) R. Rodr. & Quezada, Dysphania multifida L. and Solidago chilensis Meyen were investigated to determine the nutraceutical properties of infusions of their aerial parts. The infusions were characterized in terms of their antioxidant activity, phenolic and flavonoid content, profile of phenolic compounds, general toxicity and cytotoxicity on two different human cell lines: T84 (derived from colon cancer) and HTR8/SVneo (not derived from cancer). Twenty-nine compounds, mainly phenolic acids and flavonoids, were identified. This is the first analysis of phenolic compounds in infusions from native plants of Patagonia. D. andina, B. globosa and S. chilensis showed high levels of antioxidants, even higher than those of Green Tea. The content of phenolic compounds correlated significantly with the antioxidant activity of the samples analyzed. The toxicity test indicated that the use of A. australe, B. globosa and D. multifida seems safe, but a moderate consumption is suggested for A. boronioides, D. andina and S. chilensis until more exhaustive and long-term results are available. Moreover, A. boronioides and S. chilensis showed anticancer potential due to their antiproliferative activity on human cancer cell lines.
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Affiliation(s)
- Bruno Gastaldi
- Departamento de Química, Facultad de Ciencias Naturales y Ciencias de Salud, Universidad Nacional de la Patagonia San Juan Bosco (UNPSJB), Esquel, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - G Marino
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Y Assef
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Centro de Investigación Esquel de Montaña y Estepa Patagónica (CIEMEP), Esquel, Argentina
| | - F M Silva Sofrás
- Departamento de Química, Facultad de Ciencias Naturales y Ciencias de Salud, Universidad Nacional de la Patagonia San Juan Bosco (UNPSJB), Esquel, Argentina
| | - C A N Catalán
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Instituto de Química del Noroeste Argentino (INQUINOA-CONICET), Instituto de Química Orgánica, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - S B González
- Departamento de Química, Facultad de Ciencias Naturales y Ciencias de Salud, Universidad Nacional de la Patagonia San Juan Bosco (UNPSJB), Esquel, Argentina
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22
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Secco GB, Sertoli MR, Scarpati D, Marino G, Fardelli R, Nobile MT, Corvò R. Preoperative Chemotherapy and Radiotherapy in the Management of Epidermoid Carcinoma of the Anal Canal. Tumori 2018; 73:151-5. [PMID: 3107181 DOI: 10.1177/030089168707300211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sixteen patients affected by epidermoid carcinoma of the anal canal were treated preoperatively by means of an i.v. infusion of mitomycin C (15 mg/m2) on day 1 and 5-fluorouracil (750 mg/m2) days 1 to 5, followed by radiotherapy (3000 R in 3 weeks). Four to 6 weeks after the end of radiotherapy the response to the preoperative treatment was evaluated by means of biopsy. A reduction of the neoplastic mass was observed in 13 of the 16 patients. An evident correlation exists between the stage of the tumor and 1) the response to preoperative treatment, 2) local recurrence, and 3) long-term survival. In fact: 3/4 T1 patients reached a complete response (CR), and 1/4 T1, 5/5 T2 and 4/7 T3 patients achieved a partial response (PR); only 3/7 T3 patients never responded to preoperative treatment. After the initial surgery, only T2 (3/5) and T3 (4/7) patients underwent a second operation for a recurrence. Overall survival at 42 months was 62.5 % (T1, 100 %; T2, 80 %; T3, 28.5 2%).
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23
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Fazio E, Ferlazzo A, Cristarella S, Medica P, Marino G, Quartuccio M. The stress response of Ragusano donkey (Equus asinus) to different semen collection techniques. Pol J Vet Sci 2018; 20:669-676. [PMID: 29611652 DOI: 10.1515/pjvs-2017-0084] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to characterize the stress response of donkeys to different semen collection techniques, comparing the physiological patterns of hormonal (adrenocorticotropic hormone: ACTH, cortisol) and biochemical variables (creatinine, total protein, urea, aspartate aminotransferase: AST, alanine aminotransferase: ALT), and routine seminal parameters and sexual behaviour. Twenty two healthy Ragusano donkeys were used and were randomly assigned to one of 2 groups based on different semen collection techniques. Group A was designated as the experimental group and included 16 donkeys submitted to semen collection by an artificial vagina (AV) "on the ground"; group B was designated as the control group, and included 6 donkeys submitted to semen collection by AV during the mount. The semen collection was performed in October, once a day for 10 consecutive days. Blood samples were collected in baseline conditions, before the onset of the treatments and within 30 min after, from the jugular vein of each subject. Two-way ANOVA showed a significant effect of semen collection technique and time points in group A for ACTH (p=0.0084), cortisol (p=0.0004) and creatinine (p=0.0131), with lower values after semen collection than before. A significant effect of semen collection technique and time points in group B for ACTH (p<0.0001) and cortisol (p<0.0001) was observed, with higher values after semen collection than before. The comparison between groups A and B values over different time points showed a significant effect after semen collection for ACTH (p<0.0001), cortisol (p<0.0001) and creatinine (p<0.0001), with the highest values in group B. This study provides the physiological evidence that semen collection on the ground in healthy donkeys could be used as an alternative strategy to induce a positive animal approach and economical advantages.
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Affiliation(s)
- E Fazio
- Department of Veterinary Sciences Unit of Veterinary Physiology University of Messina, 98168 Messina, Italy
| | - A Ferlazzo
- Department of Veterinary Sciences Unit of Veterinary Physiology University of Messina, 98168 Messina, Italy
| | - S Cristarella
- Department of Veterinary Sciences Unit of Physiopathology and Clinic of Reproduction University of Messina, 98168 Messina, Italy
| | - P Medica
- Department of Veterinary Sciences Unit of Veterinary Physiology University of Messina, 98168 Messina, Italy
| | - G Marino
- Department of Veterinary Sciences Unit of Physiopathology and Clinic of Reproduction University of Messina, 98168 Messina, Italy
| | - M Quartuccio
- Department of Veterinary Sciences Unit of Physiopathology and Clinic of Reproduction University of Messina, 98168 Messina, Italy
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24
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Lepore G, Bonfanti R, Bozzetto L, Di Blasi V, Girelli A, Grassi G, Iafusco D, Laviola L, Rabbone I, Schiaffini R, Bruttomesso D, Mammì F, Bruzzese M, Schettino M, Nuzzo M, Di Blasi V, Fresa R, Lambiase C, Iafusco D, Zanfardino A, Confetto S, Bozzetto L, Annuzzi G, Alderisio A, Riccardi G, Gentile S, Marino G, Guarino G, Zucchini S, Maltoni G, Suprani T, Graziani V, Nizzoli M, Acquati S, Cavani R, Romano S, Michelini M, Manicardi E, Bonadonna R, Dei Cas A, Dall'aglio E, Papi M, Riboni S, Manicardi V, Manicardi E, Manicardi E, Pugni V, Lasagni A, Street M, Pagliani U, Rossi C, Assaloni R, Brunato B, Tortul C, Zanette G, Li Volsi P, Zanatta M, Tonutti L, Agus S, Pellegrini M, Ceccano P, Pozzilli G, Anguissola B, Buzzetti R, Moretti C C, Leto G, Pozzilli P, Manfrini S, Maurizi A, Leotta S, Altomare M, Abbruzzese S, Carletti S, Suraci C, Filetti S, Manca Bitti M, Arcano S, Cavallo M, De Bernardinis M, Pitocco D, Caputo S, Rizzi A, Manto A, Schiaffini R, Cappa M, Benevento D, Frontoni S, Malandrucco I, Morano S, Filardi T, Lauro D, Marini M, Castaldo E, Sabato D, Tuccinardi F, Forte E, Viterbori P, Arnaldi C, Minuto N, d'Annunzio G, Corsi A, Rota R, Scaranna C, Trevisan R, Valentini U, Girelli A, Bonfadini S, Zarra E, Plebani A, Prandi E, Felappi B, Rocca A, Meneghini E, Galli P, Ruggeri P, Carrai E, Fugazza L, Baggi V, Conti D, Bosi E, Laurenzi A, Caretto A, Molinari C, Orsi E, Grancini V, Resi V, Bonfanti R, Favalli V, Bonura C, Rigamonti A, Bonomo M, Bertuzzi F, Pintaudi B, Disoteo O, Perseghin G, Perra S, Chiovato L, De Cata P, Zerbini F, Lovati E, Laneri M, Guerraggio L, Bossi A, De Mori V, Galetta M, Meloncelli I, Aiello A A, Di Vincenzo S, Nuzzi A, Fraticelli E, Ansaldi E, Battezzati M, Lombardi M, Balbo M, Lera R, Secco A, De Donno V, Cadario F, Savastio S, Ponzani C, Aimaretti G, Rabbone I, Ignaccolo G, Tinti D, Cerutti F, Bari F, Giorgino F, Piccinno E, Zecchino O, Cignarelli M, Lamacchia O, Picca G, De Cosmo S, Rauseo A, Tomaselli L, Tumminia A, Egiziano C, Scarpitta A, Maggio F, Cardella F, Roppolo R, Provenzano V, Fleres M, Scorsone A, Scatena A, Gregori G, Lucchesi S, Gadducci F, Di Cianni S, Pancani S, Del Prato S, Aragona M, Crisci I, Calianno A, Fattor B, Crazzolara D, Reinstadler P, Longhi S, Incelli G, Rauch S, Romanelli T, Orrasch M, Cauvin V, Franceschi R, Lalli C, Pianta A, Marangoni A, Aricò C, Marin N, Nogara N, Simioni N, Filippi A, Gidoni Guarneri G, Contin M.L M, Decata A, Bondesan L, Confortin L, Coracina A, Lombardi S, Costa Padova S, Cipponeri E, Scotton R, Galasso S, Boscari F, Zanon M, Vinci C, Lisato G, Gottardo L, Bonora E, Trombetta M, Negri C, Brangani C, Maffeis C, Sabbion A, Marigliano M. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion. Nutr Metab Cardiovasc Dis 2018; 28:335-342. [PMID: 29428572 DOI: 10.1016/j.numecd.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/31/2017] [Accepted: 12/02/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). METHODS AND RESULTS Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. <58 mmol/mol for age <18 years and <53 mmol/mol for age >18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. CONCLUSIONS Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. CLINICAL TRIAL REGISTRATION NUMBER NCT 02620917 (ClinicalTrials.gov).
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25
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Gentile S, Strollo F, Corte TD, Marino G, Guarino G. Skin complications of insulin injections: A case presentation and a possible explanation of hypoglycaemia. Diabetes Res Clin Pract 2018; 138:284-287. [PMID: 29427696 DOI: 10.1016/j.diabres.2018.02.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 11/23/2022]
Abstract
We are willing to report the case of a woman with type 2 diabetes treated with insulin, 4 shots a day, referring to us for 2 very large pigmented abdominal lipo-hypertrophy (LH) areas due to incorrect injection technique. The ultrasound examination showed the presence offluidwithin both LH lesions. Fluid examination showed insulin concentrations 13 times higher thancirculating ones. A12-month longstructured training on correct injection techniques normalized metabolic control and took rid of all sudden severe hypoglycemic episodes and the wide glycemic variability. In fact, both LH areas disappeared became softer and slightly smaller and got fluid-free. This is the first case documenting the presence of sort of an insulin reservoir within LH lesions and fluid reabsorption can explain the disappearance of hypoglycemic episodes and the improvement of glycemic control.
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Affiliation(s)
- S Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy; Study Group on Injection Technique of AMD (Medical Association of Diabetology), Italy.
| | - F Strollo
- Endocrinology and Diabetes, San Raffaele Termini Institute, Rome, Italy
| | - T Della Corte
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - G Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - G Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
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26
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Gentile S, Fusco A, Colarusso S, Piscopo M, Improta MR, Corigliano M, Martedi E, Oliva D, Santorelli A, Simonetti R, Giammarco A, Colella C, Miretto L, D'Alessandro A, Russo V, Guarino G, Marino G, Corigliano G, Strollo F. A randomized, open-label, comparative, crossover trial on preference, efficacy, and safety profiles of lispro insulin u-100 versus concentrated lispro insulin u-200 in patients with type 2 diabetes mellitus: a possible contribution to greater treatment adherence. Expert Opin Drug Saf 2018; 17:445-450. [PMID: 29564932 DOI: 10.1080/14740338.2018.1453495] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Several outstanding pharmacological advances making innovative drugs sophisticateddevices available during the last few years. Nevertheless too many patients still disappointingly fail to meetthe metabolic targets suggested by current guidelines. Incorrect insulin administration techniques may greatly affect metabolic control in T2DM people. The aim of our study was to compare glycemic control associated with a concentrated insulin analog preparation (U-200 lispro) in people with T2DM to the one observed with standard U-100 lispro. The secondary endpoint of our study was patients' preference and performance ratings of U-200 lispro. METHODS 126 patients with T2DM were enrolled. They were also assessed for limited joint mobility syndrome (LJMS),defined as limitation in at least two anatomical areas of the dominant upper extremity. After a 4-weekstructured insulin injection education period. Half of them were randomized to U-100 lispro, half to U-200 and after 12 weeks they were switched to the other preparation for 12 weeks. At the end a questionnaire was also administered to investigate patient preference. RESULTS No significant variation in fasting blood glucose, HbA1c, severe or mild hypoglycemic rate and daily fast-acting insulin analog dose was observed with U-100 lispro while U-200 lispro treatment was associated with a significant improvement of all the above mentioned parameters and with around 20% decrease in insulin requirement. Moreover patients' answers to the questionnaire pointed out a higher preference for U-200 lispro for continuing treatment due to fewer difficulties completing injection. DISCUSSION The explanation of better metabolic results with the U-200 device might be the lower inner piston inertia and volume and shorter duration of a complete injection. CONCLUSIONS Checking for LJIMS before insulin prescription could be adopted as a standard practiceaimed at choosing the most suitable device for patient's specific characteristics and abilities. The use of U-200 lispro might improve treatment adherence and metabolic control. This would also result intocost reduction by saving about half the amount of pens per year and of time spent to both fill prescriptionand dump the pharmacy.
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Affiliation(s)
- Sandro Gentile
- a Department of Clinical and Experimental Medicine , Università della Campania "Luigi Vanvitelli" , Napoli , Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Viviana Russo
- a Department of Clinical and Experimental Medicine , Università della Campania "Luigi Vanvitelli" , Napoli , Italy
| | - Giuseppina Guarino
- a Department of Clinical and Experimental Medicine , Università della Campania "Luigi Vanvitelli" , Napoli , Italy
| | - Giampiero Marino
- a Department of Clinical and Experimental Medicine , Università della Campania "Luigi Vanvitelli" , Napoli , Italy
| | | | - Felice Strollo
- j Istituto San Raffaele Termini, Endocrinology Unit , Roma , Italy
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27
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Gentile S, Guarino G, Marino G, Strollo F. Comment to: Assessment of insulin injection techniques among diabetes patients in a tertiary care centre. Diabetes Metab Syndr 2017; 11 Suppl 2:S1045-S1046. [PMID: 28778428 DOI: 10.1016/j.dsx.2017.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 07/24/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Sandro Gentile
- Department of Internal Medicine, Campania University, Naples, Italy; Endocrinology and Metabolism, Elle-di, Rome, Italy
| | - Giuseppina Guarino
- Department of Internal Medicine, Campania University, Naples, Italy; Endocrinology and Metabolism, Elle-di, Rome, Italy
| | - Giampiero Marino
- Department of Internal Medicine, Campania University, Naples, Italy; Endocrinology and Metabolism, Elle-di, Rome, Italy
| | - Felice Strollo
- Department of Internal Medicine, Campania University, Naples, Italy; Endocrinology and Metabolism, Elle-di, Rome, Italy.
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Rodríguez-Sanz L, Bernasconi SM, Marino G, Heslop D, Müller IA, Fernandez A, Grant KM, Rohling EJ. Penultimate deglacial warming across the Mediterranean Sea revealed by clumped isotopes in foraminifera. Sci Rep 2017; 7:16572. [PMID: 29185446 PMCID: PMC5707372 DOI: 10.1038/s41598-017-16528-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 11/13/2017] [Indexed: 11/22/2022] Open
Abstract
The variability of seawater temperature through time is a critical measure of climate change, yet its reconstruction remains problematic in many regions. Mg/Ca and oxygen isotope (δ18OC) measurements in foraminiferal carbonate shells can be combined to reconstruct seawater temperature and δ18O (δ18OSW). The latter is a measure of changes in local hydrology (e.g., precipitation/evaporation, freshwater inputs) and global ice volume. But diagenetic processes may affect foraminiferal Mg/Ca. This restricts its potential in many places, including the Mediterranean Sea, a strategic region for deciphering global climate and sea-level changes. High alkalinity/salinity conditions especially bias Mg/Ca temperatures in the eastern Mediterranean (eMed). Here we advance the understanding of both western Mediterranean (wMed) and eMed hydrographic variability through the penultimate glacial termination (TII) and last interglacial, by applying the clumped isotope (Δ47) paleothermometer to planktic foraminifera with a novel data-processing approach. Results suggest that North Atlantic cooling during Heinrich stadial 11 (HS11) affected surface-water temperatures much more in the wMed (during winter/spring) than in the eMed (during summer). The method’s paired Δ47 and δ18OC data also portray δ18OSW. These records reveal a clear HS11 freshwater signal, which attenuated toward the eMed, and also that last interglacial surface warming in the eMed was strongly amplified by water-column stratification during the deposition of the organic-rich (sapropel) interval known as S5.
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Affiliation(s)
- L Rodríguez-Sanz
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia.
| | - S M Bernasconi
- Geological Institute, ETH Zurich, Sonneggstr. 5, 8092, Zurich, Switzerland
| | - G Marino
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia.,University of Vigo, Campus Universitario, 36310, Vigo, Spain
| | - D Heslop
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - I A Müller
- Geological Institute, ETH Zurich, Sonneggstr. 5, 8092, Zurich, Switzerland
| | - A Fernandez
- Geological Institute, ETH Zurich, Sonneggstr. 5, 8092, Zurich, Switzerland
| | - K M Grant
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - E J Rohling
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia.,Ocean and Earth Science, University of Southampton, National Oceanography Centre, Southampton, S014 3ZH, UK
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Abbey SR, Eckhard U, Solis N, Marino G, Matthew I, Overall CM. The Human Odontoblast Cell Layer and Dental Pulp Proteomes and N-Terminomes. J Dent Res 2017; 97:338-346. [PMID: 29035686 DOI: 10.1177/0022034517736054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/16/2022] Open
Abstract
The proteome and N-terminome of the human odontoblast cell layer were identified for the first time by shotgun proteomic and terminal amine isotopic labeling of substrates (TAILS) N-terminomic analyses, respectively, and compared with that of human dental pulp stroma from 26 third molar teeth. After reverse-phase liquid chromatography-tandem mass spectrometry, >170,000 spectra from the shotgun and TAILS analyses were matched by 4 search engines to 4,888 and 12,063 peptides in the odontoblast cell layer and pulp stroma, respectively. Within these peptide groups, 1,543 and 5,841 protein N-termini, as well as 895 and 2,423 unique proteins, were identified with a false discovery rate of ≤1%. Thus, the human dental pulp proteome was expanded by 974 proteins not previously identified among the 4,123 proteins in our 2015 dental pulp study. Further, 222 proteins of the odontoblast cell layer were not found in the pulp stroma, suggesting many of these proteins are synthesized only by odontoblasts. When comparing the proteomes of older and younger donors, differences were more apparent in the odontoblast cell layer than in the dental pulp stroma. In the odontoblast cell layer proteome, we found proteomic evidence for dentin sialophosphoprotein, which is cleaved into dentin sialoprotein and dentin phosphoprotein. By exploring the proteome of the odontoblast cell layer and expanding the known dental pulp proteome, we found distinct proteome differences compared with each other and with dentin. Moreover, between 61% and 66% of proteins also occurred as proteoforms commencing with a neo-N-terminus not annotated in UniProt. Hence, TAILS increased proteome coverage and revealed considerable proteolytic processing, by identifying stable proteoforms in these dynamic dental tissues. All mass spectrometry raw data have been deposited to ProteomeXchange with the identifier <PXD006557>, with the accompanying metadata at Mendeley Data ( https://data.mendeley.com/datasets/b57zfh6wmy/1 ).
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Affiliation(s)
- S R Abbey
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - U Eckhard
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,2 Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - N Solis
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,2 Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - G Marino
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,2 Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - I Matthew
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - C M Overall
- 1 Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,2 Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada.,3 Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
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30
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Lorenzon L, Parini D, Rega D, Mellano A, Vigorita V, Biondi A, Jaminez-Rosellon R, Scheiterle M, Giannini I, Gallo G, Marino G, Turati L, Marsanic P, De Franco L, Marano L, De Luca R. Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO). Eur J Surg Oncol 2017; 43:1472-1480. [PMID: 28571778 DOI: 10.1016/j.ejso.2017.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/12/2017] [Accepted: 04/30/2017] [Indexed: 12/26/2022] Open
Abstract
AIM To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. METHODS Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. RESULTS Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. CONCLUSION Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
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Affiliation(s)
- L Lorenzon
- Surgical and Medical Department of Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
| | - D Parini
- General Surgery Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - D Rega
- Colorectal Surgical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione Giovanni Pascale IRCCS, Naples, Italy
| | - A Mellano
- Surgical Oncology Unit, Candiolo Cancer Institute - IRCCS - Candiolo Cancer Institute - IRCCS, Turin, Italy
| | - V Vigorita
- Unit of Coloproctology, Department of General and Digestive Surgery, University Hospital Complex of Vigo Alvaro Conquieiro Hospital, Vigo, Spain
| | - A Biondi
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | | | - M Scheiterle
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Italy
| | - I Giannini
- General Surgery Unit, Policlinico Bari, Italy
| | - G Gallo
- Coloproctology Unit, Santa Rita Clinic, Vercelli, Italy; Department of Medical and Surgical Sciences, University of Catanzaro, Italy
| | - G Marino
- Surgery Unit, IRCCS CROB Regional Oncologic Center, Rionero in Vulture, Potenza, Italy
| | - L Turati
- Surgical Oncology Unit, Treviglio Hospital, ASST Bergamo Ovest, Italy
| | - P Marsanic
- Surgical Oncology Unit, Candiolo Cancer Institute - IRCCS - Candiolo Cancer Institute - IRCCS, Turin, Italy
| | - L De Franco
- Department of Medicine, Surgery and Neurosciences - Unit of General Surgery and Surgical Oncology, University of Siena, Italy
| | - L Marano
- Multidisciplinary Robotic Surgery Unit, "San Matteo degli Infermi Hospital" - ASL Umbria 2, Spoleto, Perugia, Italy
| | - R De Luca
- Department of Surgical Oncology, National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy
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31
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Gentile S, Guarino G, Marino G, Strollo F. Risk factors for severe hypoglycemia in people with insulin-treated diabetes: Are we sure we took into account all variables involved? Nutr Metab Cardiovasc Dis 2017; 27:415-416. [PMID: 28428024 DOI: 10.1016/j.numecd.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 11/20/2022]
Affiliation(s)
- S Gentile
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - G Guarino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - G Marino
- Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples, Italy
| | - F Strollo
- Endocrinology and Diabetes, FBF St. Peter's Hospital, Rome, Italy.
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32
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Guarino G, Strollo F, Carbone L, Della Corte T, Letizia M, Marino G, Gentile S. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. J BIOL REG HOMEOS AG 2017; 31:495-502. [PMID: 28685558] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Berberine, a quaternary isoquinoline alkaloid present in Berberis aristata, is well known in terms of cholesterol-lowering, hypoglycemic, and insulin sensitizing effects. Because of its low oral bioavailability, to improve intestinal absorption it has been recently combined with silymarin (Silybum marianum). The aim of our placebo controlled study was to evaluate the effects of its association with silymarin on abdominal fat in overweight/obese patients with type 2 diabetes mellitus (T2DM). To do so, 136 obese subjects with T2DM and metabolic syndrome were analyzed for fasting blood glucose and insulin, Insulin Resistance index according to the Homeostatic Model Assessment (HOMA-R), total, HDL and LDL cholesterol, triglycerides, uric acid, BMI, waist circumference, waist to hip ratio and underwent bioelectrical impedance to assess % of abdominal fat. All the above-mentioned parameters, as recorded at enrollment, after 6 months and at the end of the study, had significantly improved in the BBR-treated group in respect to baseline and to the control group. A validated national cardiovascular risk score also improved significantly after BBR treatment in respect to placebo. Our results point to a clinically significant effect in obese people with T2DM and metabolic syndrome. Moreover, for the first time, they provide evidence of a significant uric acid lowering activity as an additive beneficial effect of the association BBR + silymarin.
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Affiliation(s)
- G Guarino
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Strollo
- Endocrinology and Metabolism, Elle-di, Rome, Italy
| | - L Carbone
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - T Della Corte
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - M Letizia
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Marino
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - S Gentile
- Department of Clinical and Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
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Carletti L, Rocco D, Locatelli A, De Angelis C, Gili VF, Ravaro M, Favero I, Leo G, Finazzi M, Ghirardini L, Celebrano M, Marino G, Zayats AV. Controlling second-harmonic generation at the nanoscale with monolithic AlGaAs-on-AlOx antennas. Nanotechnology 2017; 28:114005. [PMID: 28205510 DOI: 10.1088/1361-6528/aa5645] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We review recent achievements in the field of nanoscale nonlinear AlGaAs photonics based on all-dielectric optical antennas. After discussing the motivation and main technological challenges for the development of an AlGaAs monolithic platform for χ (2) nonlinear nanophotonics, we present numerical and experimental investigations of the second-order nonlinear response and physical reasons for high efficiency of second-order nonlinear interactions in the AlGaAs nano-antennas. In particular, we emphasize the role of the dipolar resonances at the fundamental frequency and the multipolar resonances at the second harmonic wavelength. We also discuss second-harmonic generation directionality and show possible strategies to engineer the radiation pattern of nonlinear antennas.
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Affiliation(s)
- L Carletti
- Department of Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
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Abstract
Endometriosis is a benign condition described as the presence of endometrial- like tissue found outside the uterine cavity. Hepatic endometriosis is one of the rarest localization of extrapelvic endometriosis, only 22 cases have been reported in the literature. The preoperative diagnosis of hepatic endometriosis is rather difficult because in about the half of the patient affected they had no history of endometriosis. Moreover radiological images reveal no characteristic findings for hepatic endometriosis. It is often described as cystic mass with or without solid component, difficult to distinguish from hepatic abscess, hematoma, cystoadenoma or malignant neoplasia. We report a case of a 27-year-old female with a large cystic mass involving the left lobe of the liver. The patient underwent laparoscopic exploration and converted to laparotomy for resection of giant hepatic endometriosis.
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35
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Sannino F, Giuliani M, Salvatore U, Apuzzo GA, de Pascale D, Fani R, Fondi M, Marino G, Tutino ML, Parrilli E. A novel synthetic medium and expression system for subzero growth and recombinant protein production in Pseudoalteromonas haloplanktis TAC125. Appl Microbiol Biotechnol 2016; 101:725-734. [DOI: 10.1007/s00253-016-7942-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/20/2016] [Accepted: 10/13/2016] [Indexed: 02/05/2023]
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36
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Cona G, Marino G, Semenza C. TMS of supplementary motor area (SMA) facilitates mental rotation performance: Evidence for sequence processing in SMA. Neuroimage 2016; 146:770-777. [PMID: 27989840 DOI: 10.1016/j.neuroimage.2016.10.032] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/02/2016] [Accepted: 10/18/2016] [Indexed: 11/16/2022] Open
Abstract
In the present study we applied online transcranial magnetic stimulation (TMS) bursts at 10Hz to the supplementary motor area (SMA) and primary motor cortex to test whether these regions are causally involved in mental rotation. Furthermore, in order to investigate what is the specific role played by SMA and primary motor cortex, two mental rotation tasks were used, which included pictures of hands and abstract objects, respectively. While primary motor cortex stimulation did not affect mental rotation performance, SMA stimulation improved the performance in the task with object stimuli, and only for the pairs of stimuli that had higher angular disparity between each other (i.e., 100° and 150°). The finding that the effect of SMA stimulation was modulated by the amount of spatial orientation information indicates that SMA is causally involved in the very act of mental rotation. More specifically, we propose that SMA mediates domain-general sequence processes, likely required to accumulate and integrate information that are, in this context, spatial. The possible physiological mechanisms underlying the facilitation of performance due to SMA stimulation are discussed.
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Affiliation(s)
- G Cona
- Department of Neuroscience, University of Padua, Italy.
| | - G Marino
- Department of General Psychology, University of Padua, Italy
| | - C Semenza
- Department of Neuroscience, University of Padua, Italy; Center of Cognitive Neuroscience, University of Padua, Italy; IRCCS San Camillo Hospital Foundation, Neuropsychology Unit, 30126 Lido-Venice, Italy
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37
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Di Mario C, Petricca L, Gigante M, Marino G, Varriano V, Barini A, Canestri S, Barini A, Tolusso B, Ferraccioli G, Gremese E. FRI0306 Serum Anti-Müllerian Hormone Levels in SLE Patients: Influence of Disease Severity and Therapy on The Ovarian Reserve. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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38
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Patel E, Cicatiello P, Deininger L, Clench MR, Marino G, Giardina P, Langenburg G, West A, Marshall P, Sears V, Francese S. A proteomic approach for the rapid, multi-informative and reliable identification of blood. Analyst 2016; 141:191-8. [DOI: 10.1039/c5an02016f] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Blood evidence is frequently encountered at the scene of violent crimes and can provide valuable intelligence in the forensic investigation of serious offences.
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Affiliation(s)
- E. Patel
- Biomolecular Research Centre
- Sheffield Hallam University
- Sheffield
- UK
| | - P. Cicatiello
- Dipartimento di Scienze Chimiche
- Universita’ di Napoli Federico II
- via Cinthia I-80126 Naples
- Italy
| | - L. Deininger
- Biomolecular Research Centre
- Sheffield Hallam University
- Sheffield
- UK
| | - M. R. Clench
- Biomolecular Research Centre
- Sheffield Hallam University
- Sheffield
- UK
| | - G. Marino
- Dipartimento di Scienze Chimiche
- Universita’ di Napoli Federico II
- via Cinthia I-80126 Naples
- Italy
| | - P. Giardina
- Dipartimento di Scienze Chimiche
- Universita’ di Napoli Federico II
- via Cinthia I-80126 Naples
- Italy
| | | | | | | | - V. Sears
- Centre for Applied Science and Technology
- St Albans
- UK
| | - S. Francese
- Biomolecular Research Centre
- Sheffield Hallam University
- Sheffield
- UK
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39
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Palmer SC, Ruospo M, Wong G, Craig JC, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Tonelli M, Natale P, Saglimbene V, Pellegrini F, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Ferrari JN, del Castillo D, Bernat AG, Hegbrant J, Wollheim C, Gargano L, Bots CP, Strippoli GF, Raña S, Serrano M, Claros S, Arias M, Petracci L, Arana M, De Rosa P, Gutierrez A, Simon M, Vergara V, Tosi M, Cernadas M, Vilamajó I, Gravac D, Paulón M, Penayo L, Carrizo G, Ghiani M, Perez G, Da Cruz O, Galarce D, Gravielle M, Vescovo E, Paparone R, Mato Mira C, Mojico E, Hermida O, Florio D, Yucoswky M, Labonia W, Rubio D, Di Napoli G, Fernandez A, Altman H, Rodriguez J, Serrano S, Valle G, Lobos M, Acosta V, Corpacci G, Jofre M, Gianoni L, Chiesura G, Capdevila M, Montenegro J, Bequi J, Dayer J, Gómez A, Calderón C, Abrego E, Cechín C, García J, Corral J, Natiello M, Coronel A, Muñiz M, Muñiz V, Bonelli A, Sanchez F, Maestre S, Olivera S, Camargo M, Avalos V, Geandet E, Canteli M, Escobar A, Sena E, Tirado S, Peñalba A, Neme G, Cisneros M, Oliszewski R, Nascar V, Daud M, Mansilla S, Paredes Álvarez A, Gamín L, Arijón M, Coombes M, Zapata M, Boriceanu C, Frantzen-Trendel S, Albert K, Csaszar I, Kiss E, Kosa D, Orosz A, Redl J, Kovacs L, Varga E, Szabo M, Magyar K, Kriza G, Zajko E, Bereczki A, Csikos J, Kuti A, Mike A, Steiner K, Nemeth E, Tolnai K, Toth A, Vinczene J, Szummer S, Tanyi E, Toth R, Szilvia M, Dambrosio N, Paparella G, Sambati M, Donatelli C, Pedone F, Cagnazzo V, Antinoro R, Torsello F, Saturno C, Giannoccaro G, Maldera S, Boccia E, Mantuano M, Di Toro Mammarella R, Meconizzi M, Steri P, Riccardi C, Flammini A, Moscardelli L, Murgo M, San Filippo N, Pagano S, Marino G, Montalto G, Cantarella S, Salamone B, Randazzo G, Rallo D, Maniscalco A, Fici M, Lupo A, Pellegrino P, Fichera R, D’Angelo A, Falsitta N, Bochenska-Nowacka E, Jaroszynski A, Drabik J, Birecka M, Daniewska D, Drobisz M, Doskocz K, Wyrwicz G, Inchaustegui L, Outerelo C, Sousa Mendes D, Mendes A, Lopes J, Barbas J, Madeira C, Fortes A, Vizinho R, Cortesão A, Almeida E, Bernat A, De la Torre B, Lopez A, Martín J, Cuesta G, Rodriguez R, Ros F, Garcia M, Orero E, Ros E, Caetano A, MacGregor K, Santos M, Silva Pinheiro S, Martins L, Leitão D, Izidoro C, Bava G, Bora A, Gorena H, Calderón T, Dupuy R, Alonso N, Siciliano V, Frantzen-Trendel S, Nagy K, Bajusz Ö, Pinke I, Decsi G, Gyergyoi L, Jobba Z, Zalai Z, Zsedenyi Á, Kiss G, Pinter M, Kereszturi M, Petruzzi M, De Benedittis M, Szkutnik J, Sieczkarek J, Capelo A, Garcia Gallart M, Mendieta C. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study. Am J Kidney Dis 2015; 66:666-76. [DOI: 10.1053/j.ajkd.2015.04.051] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/29/2015] [Indexed: 01/28/2023]
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Marino G, Rohling EJ, Rodríguez-Sanz L, Grant KM, Heslop D, Roberts AP, Stanford JD, Yu J. Correction: Corrigendum: Bipolar seesaw control on last interglacial sea level. Nature 2015; 526:144. [DOI: 10.1038/nature14960] [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: 11/09/2022]
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41
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Marino G, Rohling EJ, Rodríguez-Sanz L, Grant KM, Heslop D, Roberts AP, Stanford JD, Yu J. Bipolar seesaw control on last interglacial sea level. Nature 2015. [PMID: 26062511 DOI: 10.1038/nature14499.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Our current understanding of ocean-atmosphere-cryosphere interactions at ice-age terminations relies largely on assessments of the most recent (last) glacial-interglacial transition, Termination I (T-I). But the extent to which T-I is representative of previous terminations remains unclear. Testing the consistency of termination processes requires comparison of time series of critical climate parameters with detailed absolute and relative age control. However, such age control has been lacking for even the penultimate glacial termination (T-II), which culminated in a sea-level highstand during the last interglacial period that was several metres above present. Here we show that Heinrich Stadial 11 (HS11), a prominent North Atlantic cold episode, occurred between 135 ± 1 and 130 ± 2 thousand years ago and was linked with rapid sea-level rise during T-II. Our conclusions are based on new and existing data for T-II and the last interglacial that we collate onto a single, radiometrically constrained chronology. The HS11 cold episode punctuated T-II and coincided directly with a major deglacial meltwater pulse, which predominantly entered the North Atlantic Ocean and accounted for about 70 per cent of the glacial-interglacial sea-level rise. We conclude that, possibly in response to stronger insolation and CO2 forcing earlier in T-II, the relationship between climate and ice-volume changes differed fundamentally from that of T-I. In T-I, the major sea-level rise clearly post-dates Heinrich Stadial 1. We also find that HS11 coincided with sustained Antarctic warming, probably through a bipolar seesaw temperature response, and propose that this heat gain at high southern latitudes promoted Antarctic ice-sheet melting that fuelled the last interglacial sea-level peak.
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Affiliation(s)
- G Marino
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - E J Rohling
- 1] Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia [2] Ocean and Earth Science, University of Southampton, National Oceanography Centre, Southampton SO14 3ZH, UK
| | - L Rodríguez-Sanz
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - K M Grant
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - D Heslop
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - A P Roberts
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - J D Stanford
- Department of Geography, Wallace Building, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - J Yu
- Research School of Earth Sciences, The Australian National University, Canberra, Australian Capital Territory 2601, Australia
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Marino G, Rohling EJ, Rodríguez-Sanz L, Grant KM, Heslop D, Roberts AP, Stanford JD, Yu J. Bipolar seesaw control on last interglacial sea level. Nature 2015; 522:197-201. [DOI: 10.1038/nature14499] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 04/15/2015] [Indexed: 11/09/2022]
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Messuti L, Zoli A, Marino G, Petricca L, Nowik M, Gigante M, Varriano V, Gremese E, Tolusso B, Ferraccioli G. SAT0406 Lupus Arthropathy: the Different forms of Deforming Arthropathy. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quartuccio M, Marino G, Mannarino C, Cristarella S. Permanent Lateral Deviation and Stenosis of the Cervix in an Infertile Jennet. Anat Histol Embryol 2015; 45:145-7. [PMID: 26031440 DOI: 10.1111/ahe.12185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 04/04/2015] [Indexed: 11/30/2022]
Abstract
Congenital abnormalities of the uterus and the cervix are rare in horses, often associated with infertility, despite normal ovarian activity and sexual behaviour. An abnormality of the cervix in a 5-year-old jennet with a history of infertility was described. Clinical and ultrasound examination of the genital tract showed a normal development of the uterus with regular cyclic activity in both the ovaries. Vaginoscopy revealed a normal development of the vagina and a cervix deviated on the left side of the vagina by a thick dorsoventral fold. The lateral deviation was permanent in any stage of oestrus cycle. Furthermore, the cervical os was narrow and digital penetration was not realizable. Using a 5-mm catheter, the full penetration was not possible even during oestrus; moreover, the inoculation of fluid could be revealed in uterus by ultrasound (fluid was not present before inoculation), demonstrating a minimal patency. An abnormal and permanent lateral displacement of a stenotic cervix was suspected as the primary cause of infertility in the jennet.
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Affiliation(s)
- M Quartuccio
- Department of Veterinary Science, University of Messina, Messina, Italy
| | - G Marino
- Department of Veterinary Science, University of Messina, Messina, Italy
| | - C Mannarino
- Department of Veterinary Science, University of Messina, Messina, Italy
| | - S Cristarella
- Department of Veterinary Science, University of Messina, Messina, Italy
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45
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Landoulsi Z, Miceli F, Palmese A, Amoresano A, Marino G, El Ayeb M, Taglialatela M, Benkhalifa R. 23. A novel toxin variant from the Androctonus australis hector scorpion venom selectively activates Kv7.4 channel. Toxicon 2014. [DOI: 10.1016/j.toxicon.2014.08.031] [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: 10/24/2022]
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46
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Rohling EJ, Foster GL, Grant KM, Marino G, Roberts AP, Tamisiea ME, Williams F. Sea-level and deep-sea-temperature variability over the past 5.3 million years. Nature 2014; 508:477-82. [PMID: 24739960 DOI: 10.1038/nature13230] [Citation(s) in RCA: 394] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 03/04/2014] [Indexed: 11/09/2022]
Abstract
Ice volume (and hence sea level) and deep-sea temperature are key measures of global climate change. Sea level has been documented using several independent methods over the past 0.5 million years (Myr). Older periods, however, lack such independent validation; all existing records are related to deep-sea oxygen isotope (δ(18)O) data that are influenced by processes unrelated to sea level. For deep-sea temperature, only one continuous high-resolution (Mg/Ca-based) record exists, with related sea-level estimates, spanning the past 1.5 Myr. Here we present a novel sea-level reconstruction, with associated estimates of deep-sea temperature, which independently validates the previous 0-1.5 Myr reconstruction and extends it back to 5.3 Myr ago. We find that deep-sea temperature and sea level generally decreased through time, but distinctly out of synchrony, which is remarkable given the importance of ice-albedo feedbacks on the radiative forcing of climate. In particular, we observe a large temporal offset during the onset of Plio-Pleistocene ice ages, between a marked cooling step at 2.73 Myr ago and the first major glaciation at 2.15 Myr ago. Last, we tentatively infer that ice sheets may have grown largest during glacials with more modest reductions in deep-sea temperature.
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Affiliation(s)
- E J Rohling
- 1] Research School of Earth Sciences, The Australian National University, Canberra 0200, Australia [2] Ocean and Earth Science, University of Southampton, National Oceanography Centre, Southampton SO14 3ZH, UK
| | - G L Foster
- Ocean and Earth Science, University of Southampton, National Oceanography Centre, Southampton SO14 3ZH, UK
| | - K M Grant
- Research School of Earth Sciences, The Australian National University, Canberra 0200, Australia
| | - G Marino
- Research School of Earth Sciences, The Australian National University, Canberra 0200, Australia
| | - A P Roberts
- Research School of Earth Sciences, The Australian National University, Canberra 0200, Australia
| | - M E Tamisiea
- National Oceanography Centre, Joseph Proudman Building, Liverpool L3 5DA, UK
| | - F Williams
- Ocean and Earth Science, University of Southampton, National Oceanography Centre, Southampton SO14 3ZH, UK
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Marino G, Rizzo S, Quartuccio M, Macrì F, Pagano G, Taormina A, Cristarella S, Zanghì A. Deslorelin Implants in Pre-pubertal Female Dogs: Short- and Long-Term Effects on the Genital Tract. Reprod Domest Anim 2014; 49:297-301. [DOI: 10.1111/rda.12272] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- G Marino
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - S Rizzo
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - M Quartuccio
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - F Macrì
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - G Pagano
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - A Taormina
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - S Cristarella
- Department of Veterinary Sciences; University of Messina; Messina Italy
| | - A Zanghì
- Department of Veterinary Sciences; University of Messina; Messina Italy
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Strollo F, Guarino G, Marino G, Paolisso G, Gentile S. Different prevalence of metabolic control and chronic complication rate according to the time of referral to a diabetes care unit in the elderly. Acta Diabetol 2014; 51:447-53. [PMID: 24366424 DOI: 10.1007/s00592-013-0537-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/22/2013] [Indexed: 12/12/2022]
Abstract
The time of diagnosis is crucial for type 2 diabetes mellitus (T2DM) in terms of disease severity and chronic complications, as initial glycated haemoglobin (HbA1c) predicts 5-year cardiovascular mortality. The Italian health-care system relies on about 650 diabetes care units (DCU) interfacing with a large number of general practitioners (GPs). It may thus reach the goal of preventing complications easier than others by adopting a more comprehensive multifactorial approach. To assess whether the interval between diagnosis and referral to the DCU might influence the course of the disease in terms of HbA1c, associated cardiovascular risk factors, drug utilisation, and chronic complications in the elderly, the electronic records of 313 elderly T2DM patients (74.6 ± 4.9 years) followed by their GPs until referral to our DCU were retrospectively analysed for the above-mentioned parameters and divided into an early referral (ER) group (diagnosed within 12 months, n = 111) and a late referral (LR) group (diagnosed >12 months before, n = 202). A further set of 200 patients routinely taken care by our DCU, matched with the LR group for age, gender, and disease duration, was classified as "long-standing follow-up" (LSF) and compared to the others to rule out any confounding effects of long-standing disease per se on the clinical outcomes investigated in our study. About 35 % of T2DM patients referred to our DCU within 12 months of diagnosis; the rest did so some 5 years after diagnosis. LR patients displayed worse HbA1c levels (10.8 vs. 7.7 %, p < 0.01), used more drugs, and had more than twice as high complication rates as their ER counterparts. Almost all risk factors and complications were lower in the LSF (0.001 < p < 0.05) and ER groups than in the LR group. In both the ER and the LSF groups, we observed a lower burden of diabetes than in the LR group. This rules out the possibility that disease duration might play a major role per se in the burden of the disease in the elderly as opposed to the thoughtful patient care attitude exhibited by the DCU. A better and more efficient organisation has to be developed, including a strong interaction among GPs, diabetes specialists, and elderly people with T2DM allowing the latter to take charge of their own disease management through a sustained empowerment policy.
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Messuti L, Gremese E, Petricca L, Gigante MR, Marino G, Nowik M, Ferraccioli G. THU0313 Antineutrophil Cytoplasmic Autoantibodies (ANCA) Positivity as a Red Flag of Severe Disease in Lupus Nephritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Marino G, Barna A, Rizzo S, Zanghì A, Catone G. Endometrial polyps in the bitch: a retrospective study of 21 cases. J Comp Pathol 2013; 149:410-6. [PMID: 23651692 DOI: 10.1016/j.jcpa.2013.03.004] [Citation(s) in RCA: 7] [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] [Received: 12/10/2012] [Revised: 01/28/2013] [Accepted: 03/12/2013] [Indexed: 10/26/2022]
Abstract
Endometrial polyps (EPs) are tumour-like lesions reported frequently in domestic carnivores. The present report describes the clinical and pathological features of EPs in 21 bitches. Most affected bitches had a regular reproductive history. Five bitches had no clinical signs and eleven showed clinical signs of pyometra. Four bitches had a large EP which resulted in compression of the abdominal viscera. One bitch had an acute uterine torsion. A clinical diagnosis of EPs was only made when the lesions were large and identified by abdominal palpation or ultrasound. Grossly, the EPs were 5-25 cm in diameter and were single, sessile or pedunculated. They were often associated with cystic endometrial hyperplasia. Microscopically, the EPs were fibroglandular with the stroma sometimes being haemorrhagic and infiltrated by inflammatory cells. In one case, there were areas of stromal smooth muscle and epithelial squamous metaplasia, which may have been consistent with preneoplastic change.
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Affiliation(s)
- G Marino
- Department of Veterinary Sciences, University of Messina, Italy.
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