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Gil-Lespinard M, Almanza-Aguilera E, Castañeda J, Guiñón-Fort D, Eriksen AK, Tjønneland A, Rothwell JA, Shah S, Cadeau C, Katzke V, Johnson T, Schulze MB, Oliverio A, Pasanisi F, Tumino R, Manfredi L, Masala G, Skeie G, Lundblad MW, Brustad M, Lasheras C, Crous-Bou M, Molina-Montes E, Colorado-Yohar S, Guevara M, Amiano P, Johansson I, Hultdin J, Forouhi NG, Freisling H, Merdas M, Debras C, Heath AK, Aglago EK, Aune D, Zamora-Ros R. Plasma Concentration of 36 (Poly)phenols and Prospective Body Weight Change in Participants from the EPIC Cohort. Ann Nutr Metab 2024; 80:87-100. [PMID: 38272006 PMCID: PMC10997261 DOI: 10.1159/000535803] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/25/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Dietary intake of (poly)phenols has been linked to reduced adiposity and body weight (BW) in several epidemiological studies. However, epidemiological evidence on (poly)phenol biomarkers, particularly plasma concentrations, is scarce. We aimed to investigate the associations between plasma (poly)phenols and prospective BW change in participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS This study included 761 participants with data on BW at baseline and after 5 years of follow-up. Plasma concentrations of 36 (poly)phenols were measured at baseline using liquid chromatography-tandem mass spectrometry. Associations were assessed through general linear mixed models and multinomial logistic regression models, using change in BW as a continuous or as a categorical variable (BW loss, maintenance, gain), respectively. Plasma (poly)phenols were assessed as log2-transformed continuous variables. The false discovery rate (FDR) was used to control for multiple comparisons. RESULTS Doubling plasma (poly)phenol concentrations showed a borderline trend towards a positive association with BW loss. Plasma vanillic acid showed the strongest association (-0.53 kg/5 years; 95% confidence interval [CI]: -0.99, -0.07). Similar results were observed for plasma naringenin comparing BW loss versus BW maintenance (odds ratio: 1.1; 95% CI: 1.0, 1.2). These results did not remain significant after FDR correction. CONCLUSION Higher concentrations of plasma (poly)phenols suggested a tendency towards 5-year BW maintenance or loss. While certain associations seemed promising, they did not withstand FDR correction, indicating the need for caution in interpreting these results. Further studies using (poly)phenol biomarkers are needed to confirm these suggestive protective trends.
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Affiliation(s)
- Mercedes Gil-Lespinard
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Enrique Almanza-Aguilera
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jazmín Castañeda
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Daniel Guiñón-Fort
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Joseph A. Rothwell
- Centre for Epidemiology and Population Health (CESP) U1018, French National Institute of Health and Medical Research (Inserm) “Exposome, Heredity, Cancer and Health” Team, University of Paris-Saclay, Versailles Saint-Quentin-en-Yvelines University (UVSQ), Villejuif, France
| | - Sanam Shah
- Centre for Epidemiology and Population Health (CESP) U1018, French National Institute of Health and Medical Research (Inserm) “Exposome, Heredity, Cancer and Health” Team, University of Paris-Saclay, Versailles Saint-Quentin-en-Yvelines University (UVSQ), Villejuif, France
| | - Claire Cadeau
- Centre for Epidemiology and Population Health (CESP) U1018, French National Institute of Health and Medical Research (Inserm) “Exposome, Heredity, Cancer and Health” Team, University of Paris-Saclay, Versailles Saint-Quentin-en-Yvelines University (UVSQ), Villejuif, France
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Theron Johnson
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Andreina Oliverio
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Fabrizio Pasanisi
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research (AIRE-ONLUS), Ragusa, Italy
| | - Luca Manfredi
- Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Giovana Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Guri Skeie
- Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway
| | | | - Magritt Brustad
- Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | | | - Marta Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Esther Molina-Montes
- Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Biomedical Research Centre, Institute of Nutrition and Food Technology (INYTA) “José Mataix”, University of Granada, Granada, Spain
| | - Sandra Colorado-Yohar
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Biomedical Research Centre, Institute of Nutrition and Food Technology (INYTA) “José Mataix”, University of Granada, Granada, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
| | - Marcela Guevara
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Pilar Amiano
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | | | - Johan Hultdin
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Nita G. Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Heinz Freisling
- Nutrition and Epidemiology Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Mira Merdas
- Nutrition and Epidemiology Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Charlotte Debras
- Nutrition and Epidemiology Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elom K. Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ulleval, Oslo, Norway
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Nutrition, Food Sciences and Gastronomy, Nutrition and Food Safety Research Institute (INSA), Food Innovation Network (XIA), Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
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Almanza-Aguilera E, Guiñón-Fort D, Perez-Cornago A, Martínez-Huélamo M, Andrés-Lacueva C, Tjønneland A, Eriksen AK, Katzke V, Bajracharya R, Schulze MB, Masala G, Oliverio A, Tumino R, Manfredi L, Lasheras C, Crous-Bou M, Sánchez MJ, Amiano P, Colorado-Yohar SM, Guevara M, Sonestedt E, Bjartell A, Thysell E, Weiderpass E, Aune D, Aglago EK, Travis RC, Zamora-Ros R. Intake of the Total, Classes, and Subclasses of (Poly)Phenols and Risk of Prostate Cancer: A Prospective Analysis of the EPIC Study. Cancers (Basel) 2023; 15:4067. [PMID: 37627095 PMCID: PMC10452452 DOI: 10.3390/cancers15164067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Existing epidemiological evidence regarding the potential role of (poly)phenol intake in prostate cancer (PCa) risk is scarce and, in the case of flavonoids, it has been suggested that their intake may increase PCa risk. We investigated the associations between the intake of the total and individual classes and subclasses of (poly)phenols and the risk of PCa, including clinically relevant subtypes. The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort included 131,425 adult men from seven European countries. (Poly)phenol intake at baseline was assessed by combining validated center/country-specific dietary questionnaires and the Phenol-Explorer database. Multivariable-adjusted Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). In total, 6939 incident PCa cases (including 3501 low-grade and 710 high-grade, 2446 localized and 1268 advanced, and 914 fatal Pca cases) were identified during a mean follow-up of 14 years. No associations were observed between the total intake of (poly)phenols and the risk of PCa, either overall (HRlog2 = 0.99, 95% CI 0.94-1.04) or according to PCa subtype. Null associations were also found between all classes (phenolic acids, flavonoids, lignans, and stilbenes) and subclasses of (poly)phenol intake and the risk of PCa, overall and according to PCa subtype. The results of the current large prospective cohort study do not support any association between (poly)phenol intake and PCa incidence.
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Affiliation(s)
- Enrique Almanza-Aguilera
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (E.A.-A.); (D.G.-F.); (M.C.-B.)
| | - Daniel Guiñón-Fort
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (E.A.-A.); (D.G.-F.); (M.C.-B.)
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.P.-C.); (R.C.T.)
| | - Miriam Martínez-Huélamo
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Nutrition and Food Safety Research Institute (INSA), Food Innovation Network (XIA), Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (M.M.-H.); (C.A.-L.)
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Andrés-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Nutrition and Food Safety Research Institute (INSA), Food Innovation Network (XIA), Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain; (M.M.-H.); (C.A.-L.)
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Danish Cancer Society, 2100 Copenhagen, Denmark; (A.T.); (A.K.E.)
- Department of Public Health, University of Copenhagen, 2177 Copenhagen, Denmark
| | - Anne Kirstine Eriksen
- Danish Cancer Society Research Center, Danish Cancer Society, 2100 Copenhagen, Denmark; (A.T.); (A.K.E.)
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (V.K.); (R.B.)
| | - Rashmita Bajracharya
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (V.K.); (R.B.)
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany;
- Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, 50139 Florence, Italy;
| | - Andreina Oliverio
- Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy;
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research (AIRE-ONLUS), 97100 Ragusa, Italy;
| | - Luca Manfredi
- Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy;
| | - Cristina Lasheras
- Functional Biology Department, University of Oviedo, 33003 Oviedo, Spain;
| | - Marta Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (E.A.-A.); (D.G.-F.); (M.C.-B.)
| | - Maria-José Sánchez
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Instituto de Investigación Biosanitaria Ibs. GRANADA, University of Granada, 18011 Granada, Spain;
- Instituto de Investigación Biosanitaria Ibs. GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (S.M.C.-Y.); (M.G.)
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (S.M.C.-Y.); (M.G.)
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain
- Epidemiology of Chronic and Communicable Diseases Group, BioGipuzkoa Health Research Institute, 20014 San Sebastian, Spain
| | - Sandra M. Colorado-Yohar
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (S.M.C.-Y.); (M.G.)
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia University, 30003 Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín 050010, Colombia
| | - Marcela Guevara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (P.A.); (S.M.C.-Y.); (M.G.)
- Navarra Public Health Institute, 31003 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, 214 28 Malmö, Sweden;
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, 205 02 Malmö, Sweden;
| | - Elin Thysell
- Department of Medical Biosciences, Umeå University, 901 87 Umeå, Sweden;
| | | | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK; (D.A.); (E.K.A.)
- Department of Nutrition, Oslo New University College, 0456 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Elom K. Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK; (D.A.); (E.K.A.)
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (A.P.-C.); (R.C.T.)
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (E.A.-A.); (D.G.-F.); (M.C.-B.)
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Sanchez T, Mavragani A, Gilcrease W, Macciotta A, Saugo C, Manfredi L, Gnavi R, Strippoli E, Zengarini N, Caramello V, Costa G, Sacerdote C, Ricceri F. Multimorbidity and SARS-CoV-2-Related Outcomes: Analysis of a Cohort of Italian Patients. JMIR Public Health Surveill 2023; 9:e41404. [PMID: 36626821 PMCID: PMC9951075 DOI: 10.2196/41404] [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: 07/25/2022] [Revised: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to gender and age, multimorbidity seems to be 1 of the predisposing factors coming out of many studies investigating the possible causes of increased susceptibility to SARS-CoV-2 infection and adverse outcomes. However, only a few studies conducted have used large samples. OBJECTIVE The objective is to evaluate the association between multimorbidity, the probability to be tested, susceptibility, and the severity of SARS-CoV-2 infection in the Piedmont population (Northern Italy, about 4 million inhabitants). For this purpose, we considered 5 main outcomes: access to the swab, positivity to SARS-CoV-2, hospitalization, intensive care unit (ICU) admission, and death within 30 days from the first positive swab. METHODS Data were obtained from different Piedmont health administrative databases. Subjects aged from 45 to 74 years and infections diagnosed from February to May 2020 were considered. Multimorbidity was defined both with the Charlson Comorbidity Index (CCI) and by identifying patients with previous comorbidities, such as diabetes and oncological, cardiovascular, and respiratory diseases. Multivariable logistic regression models (adjusted for age and month of infection and stratified by gender) were performed for each outcome. Analyses were also conducted by separating 2 age groups (45-59 and 60-74 years). RESULTS Of 1,918,549 subjects, 85,348 (4.4%) performed at least 1 swab, of whom 12,793 (14.9%) tested positive for SARS-CoV-2. Of these 12,793 subjects, 4644 (36.3%) were hospitalized, 1508 (11.8%) were admitted to the ICU, and 749 (5.9%) died within 30 days from the first positive swab. Individuals with a higher CCI had a higher probability of being swabbed but a lower probability of testing positive. We observed the same results when analyzing subjects with previous oncological and cardiovascular diseases. Moreover, especially in the youngest group, we identified a greater risk of being hospitalized and dying. Among comorbidities considered in the study, respiratory diseases seemed to be the most likely to increase the risk of having a positive swab and worse disease outcomes. CONCLUSIONS Our study shows that patients with multimorbidity, although swabbed more frequently, are less likely to get infected with SARS-CoV-2, probably due to greater attention on protective methods. Moreover, a history of respiratory diseases is a risk factor for a worse prognosis of COVID-19. Nonetheless, whatever comorbidities affect the patients, a strong dose-response effect was observed between an increased CCI score and COVID-19 hospitalization, ICU admission, and death. These results are important in terms of public health because they help in identifying a group of subjects who are more prone to worse SARS-CoV-2 outcomes. This information is important for promoting targeted prevention and developing policies for the prioritization of public health interventions.
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Affiliation(s)
| | | | - Winston Gilcrease
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,UNESCO Chair in Sustainable Development and Territory Management, University of Turin, Turin, Italy
| | - Alessandra Macciotta
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Carlo Saugo
- Klinik für Innere Medizin - Gastroenterologie, Hepatologie & Infektiologie, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Luca Manfredi
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Elena Strippoli
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Nicolás Zengarini
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Valeria Caramello
- Emergency Department and High Dependency Unit, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy
| | - Giuseppe Costa
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
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Manfredi L, Sciannameo V, Destefanis C, Prisecaru M, Cossu G, Gnavi R, Macciotta A, Catalano A, Pepe RR, Sacerdote C, Ricceri F. Health status assessment of a population of asylum seekers in Northern Italy. Global Health 2022; 18:57. [PMID: 35659014 PMCID: PMC9164173 DOI: 10.1186/s12992-022-00846-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/02/2022] [Indexed: 11/11/2022] Open
Abstract
Background Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world’s most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy). Methods A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival. Results Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0–27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September–November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma). Conclusions This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00846-0.
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Affiliation(s)
- Luca Manfredi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.
| | - Veronica Sciannameo
- Department of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Marta Prisecaru
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Giorgia Cossu
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute E Della Scienza University-Hospital, Turin, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Santangeli R, Salvucci S, Gamba L, Montozzi G, Manfredi L, Moroncini G. AB0427 RENAL INVOLVEMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS: A DIFFICULT-TO-TREAT CLINICAL CASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundLupus nephritis (LN) is one of the major organ involvement of Systemic Lupus Erythematosus (SLE), causing significant increase of morbidity, mortality and healthcare impact.1 According to international guidelines, immunosuppressive therapy is indicated for LN class III and IV, while class V usually do not require this treatment, less than there is a proteinuria in the nephrotic range, and so for class II, also with a risk of evolution in a more aggressive form.2 Immunosuppressive drugs commonly used are mycophenolate mofetil/mycophenolate acid (MMF/MPA) and cyclophosphamide for the initial treatment and MMF/MPA or azathioprine for the maintenance of remission. LN treatment is often difficult because of the drug adverse events and the comorbidities that make therapeutic choices very challenging.ObjectivesWe describe the case of a young woman with SLE and other major systemic comorbidities who developed severe LN. This case emphasizes the importance of considering patients in their complexity and the delicate role of the physician in tailoring the treatment strategy on the individual patient.MethodsA 36-year-old woman presented to our Department for lymphadenopathy, headache, epistaxis, fever and weight loss. In her past medical history, she had a cerebral abscess caused by Streptococcus Constellatus with residual left hemiplegia and cervical HPV-related high-grade dysplasia, treated by ring biopsy. Upon admission, blood tests revealed severe neutropenia and lymphocytopenia, thrombocytopenia and low complement; blood cultures were negative. A total body CT scan showed multiple lymphadenopathies. Lymph node and bone marrow biopsies were performed and histological examination was negative for hematological disease. The autoimmune panel was positive for antinuclear, anti-DNAn, anti-Sm, anti-U1RNP, anti-cardiolipin and anti-beta2glycoprotein antibodies. According to clinical and laboratory results, a diagnosis of SLE was made.ResultsHigh-dose corticosteroid therapy was started with good clinical response and improvement of blood tests. Because of the gynecological history, immunosuppressive therapy was not started, and a wait-and-see strategy with steroid tapering and careful follow-up was started. A few months later, the patient developed an increase of serum creatinine with proteinuria at nephrotic range. Thus, a kidney biopsy was performed with evidence of class III LN. Following this result, we started high-dose corticosteroid therapy, with only partial response. After executing colposcopy with biopsy, that was negative for HPV-related lesions, we decided to start MMF, continuing with a careful follow-up. After six months, proteinuria reduced but maintained on levels around 1 gr per day. Bearing in mind the growing number of studies reporting the efficacy of belimumab in LN 3,4, we added this drug to achieve a better disease control, continuing to closely monitor the patients and potential adverse events.ConclusionIn patients with LN the choice of the immunosuppressive therapy can be very challenging. A tailored approach to the individual patient may be the best option to improve the management of this complex disease.References[1]Gasparotto M. et al. Lupus nephritis: clinical presentations and outcomes in the 21st century. Rheumatology (Oxford). 2020 Dec 5;59(Suppl5):v39-v51[2]Fanouriakis A. et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020 Jun;79(6):713-723.[3]Furie R. et al. Two-Year, Randomized, Controlled Trial of Belimumab in Lupus Nephritis. N Engl J Med. 2020 Sep 17;383(12):1117-1128.[4]Ward M. et al. Belimumab as Add-on Therapy in Lupus Nephritis. N Engl J Med. 2020 Sep 17;383(12):1184-1185.Disclosure of InterestsNone declared
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Santangeli R, Montozzi G, Gamba L, Salvucci S, Manfredi L, Moroncini G. AB1514 AN UNUSUAL ASSOCIATION BETWEEN THROMBOTIC THROMBOCYTOPENIC PURPURA AND PRIMARY ANTIPHOSPHOLIPID SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy characterized by microangiopathic haemolytic anemia, consumption thrombocytopenia and organ injury, particularly kidney failure and neurological manifestation1.Two forms are distinguished: the hereditary one, caused by a deficit of the metalloprotease ADAMTS13, and the idiopathic one characterized by the presence of antibodies directed against ADAMTS13. The second one is the most common. There are various subgroups of acquired TTP associated with HIV infection, sepsis, pregnancy, autoimmune disease, disseminated malignancies and drugs. Antiphospholipid syndrome (APS) is a clinical immunological condition characterized by thromboembolic events, repetead miscarriages or stillbirth and thrombocytopenia; it can be a primary disorder or due to connective tissue disease, in particular systemic lupus erythematosus2.ObjectivesWe describe a case of TTP associated with a primary APS. The real clinical challenge lies in the differential diagnosis between TTP and anti-phospholipid antibody syndrome.MethodsA 37-year-old man presented to the emergency department for short-term episodes of anesthesia of the right upper limb and face with spontaneous resolution. In his past medical history, he suffered of antiphospholipid syndrome treated with warfarin. Upon admission, blood tests revealed severe thrombocytopenia, haemolytic anemia with schistocytes on peripheral blood smear, low thrombin time and prolongation in the prothrombin time. Neurological symptoms were assessed by electroencephalogram and CT brain, resulted negative, while a brain MRI revealed acute-subacute ischemic stroke. Based on these findings we suspected a diagnosis of TTP, subsequently confirmed by reduced activity of ADAMTS-13 with borderline ADAMTS-13 inhibitory antibodies. Immunological testing confirmed positivity of antiphospholipid antibodies and antinuclear antibodies.ResultsAccording to the last guidelines3 about management of acute episode of TTP, immediate therapy with high-dose corticosteroids (prednisone 1 mg/kg) and plasmapheresis was started and then we added infusion of rituximab (375 mg/m2/week for 4 times). Efficacy of treatment was evaluated by weekly dosage of ADAMTS13 activity, with a gradual rise in values (3 → 78%) and improvement in symptoms and laboratory examination. After persistent remission, we gradually reduced steroid therapy. Few months later, in February 2021, patient developed a bilateral comunitary pneumonia, that required hospitalization, oxygen - therapy (also with C-PAP) and endovenous antibiotics. After two weeks patient was discharged from hospital in good clinical health and he was subjected to periodic outpatients visits. Disease activity was in remission, so steroid therapy was reduced and recently we added hydroxychloroquine for APS. Some days ago patient developed covid – 19 infection, despite vaccination, and he was treated with monoclonal antibodies, with good clinical response.ConclusionWe have described a rare clinical case of TTP, despite concomitant warfarin treatment for primary anti-phospholipid syndrome. A careful follow-up of these medical conditions is recommended for patient’s fragility and for the risk of related serious clinical complications.References[1]Saha M. et al. Thrombotic thrombocytopenic purpura: pathogenesis, diagnosis and potential novel therapeutics. J Thromb Haemost. 2017 Oct;15(10):1889-1900.[2]De Carvalho JF et al. Primary antiphospholipid syndrome with thrombotic thrombocytopenic purpura: a very unusual association. Lupus. 2009 Aug;18(9):841-4.[3]Zheng XL et al. ISTH guidelines for treatment of thrombotic thrombocytopenic purpura. J Thromb Haemost. 2020 Oct;18(10):2496-2502.Disclosure of InterestsNone declared
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Stronati G, Manfredi L, Dichiara C, Dello Russo A, Gabrielli A, Guerra F. Incidence and predictors of arrhythmias in patients with systemic sclerosis and no overt cardiac disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac involvement in SSc is frequent, mostly subclinical and represents a negative prognostic factor. Speckle tracking derived measurement global longitudinal strain (GLS) has been able to identify primary heart involvement in patients with SSc and no overt cardiac disease. SSc-related cardiomyopathy, defined as a condition affecting the heart primarily and globally, has been proven to progress over time and seems to be correlated to cardiac arrhythmias. Nonetheless, cardiac arrhythmias represent 6% of the overall causes of death in SSc patients.
Purpose
The aim of our study was to assess the incidence of cardiac arrhythmias in SSc patients with no overt cardiac disease and to identify potential predictors.
Methods
Prospective longitudinal study enrolling all consecutive patients with a diagnosis of SSc and no overt cardiac disease or pulmonary hypertension. Echocardiographic parameters and GLS were obtained at baseline and at each follow up. Presence of atrial fibrillation (AF), atrial tachycardia (AT), ventricular ectopic beats >1000/24 h (VEB), supraventricular ectopic beats (SVEB), bundle branch block (BBB) and atrioventricular block (AVB) was assessed through clinical history, ECG and 24-Holter monitoring over time.
Results
Among 67 consecutive patients with SSc, 11 (16.7%) had at least one episode of AF or AT. Moreover, respectively 12 (17.9%) and 16 (23.9%) had a significant amount of SVEB and VEB at Holter monitoring. Conduction defects were common, with 4 (4.6%) of all patients with grade I AVB, 1 (1.5%) with grade II AVB and 1 (1.5%) with complete heart block. Complete right BBB was seen in 6 (6.9%) of patients. Four patients (4.6%) experienced a sudden cardiac death during follow-up (median 20 months, 1st-3rd quartile 12–24 months).
Years from SSc diagnosis (RR 1.10; 95% CI 1.02–1.23; p=0.047) and indexed right atrial volume (iRAV; RR 1.22; 95% CI 1.07–1.39; p=0.004), but not indexed left atrial volume were independently correlated with the diagnosis of AF/AT. The same two variables were independently correlated with any degree of AV block (years from SSc diagnosis: RR 1.11; 95% CI 1.01–1.23; p=0.004; iRAV: RR 1.14; 95% CI 1.02–1.27; p=0.019). Due to the low sample size, we were unable to detect any clinical predictors of sudden cardiac death in our population, however those who died experienced a larger worsening in left ventricle GLS values (4.0±1.6 vs. 0.9±0.4, p=0.056).
Conclusions
Supraventricular arrhythmias and conduction defects are common in patients with SSc. Time from diagnosis and right atrial volumes are able to predict the incidence of such conditions, supporting the hypothesis that a long-lasting disease and the anatomical remodelling of the right atrium could contribute to the developing of tachy- and bradyarrhythmias in this population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Stronati
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - L Manfredi
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - C Dichiara
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - A Dello Russo
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - A Gabrielli
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - F Guerra
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
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Benfaremo D, Manfredi L, Paterno I, Dichiara C, Risa AM, Silvi G, Gabrielli A. AB0551 CLINICAL SIGNIFICANCE OF COGNITIVE IMPAIRMENT AND MALNUTRITION IN PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Previous studies reported a high prevalence of cognitive dysfunction in systemic sclerosis (SSc). Cognitive impairment was estimated to involve 60% to 80% of SSC patients and to be correlated with older age, disease severity, diffuse cutaneous subset and poor quality of life.Objectives:The aim of our study was to evaluate the association between cognitive impairment, nutritional status and the quality of life of SSc patients.Methods:Sixty-eight consecutive SSc patients followed at our Institution were evaluated for cognitive impairment using the validated Italian version of the Montreal Cognitive Assessment (MoCA). Scores <26 were considered abnormal. We also assessed other domains and quality of life measures such as UCLA SCTC GIT 2.0 for gastrointestinal involvement, BDI-II and PHQ-9 for anxiety and depression, EAT-10 for dysphagia symptoms, SHAQ and SF-36 for function and quality of life (QoL). The risk and the presence of overt malnutrition were assessed using the MUST questionnaire and the GLIM criteria, respectively. Clinical and demographic parameters such as age, sex, BMI, disease subset, organ involvement, autoantibody profile and modified Rodnan Skin Score were also recorded for each patient. Data were analysed by Student t-test or chi-square test and regression analyses were used to assess the association between variables.Results:A total of 68 SSc patients [47 (69.1%) limited SSc (lSSc) and 21 (30.9%) with diffuse SSc (dSSc), 59 female; mean age 60.2 (±13.4) years; mean disease duration 9 (±8.2) years; mean mRSS 8.1 (±7.6)] were included in the study.Cognitive impairment was identified in 30 (44.1%) SSc patients; the mean MoCA score was 24.7 (±4.3). According to GLIM criteria, 16 (23.5%) patients were malnourished. Compared to patients with a MoCA≥26, patients with cognitive impairment were older (p<0.001), had more comorbidities (p<0.0001) and a worse QoL as assessed by the physical and general health domains of the Sf-36 (p<0.05). Malnourished patients were significantly more dysphagic (p<0.01) and had a worse HAQ (p<0.01) compared to well-fed patients. On regression analyses, cognitive impairment was related to increasing age (OR 1.08, 95%CI 1.03 to 1.14, p=0.001), but not to malnutrition, disease subset or symptoms. Malnutrition was associated with dysphagia (OR 1.10, 95%CI 1.01 to 1.20, p=0.01) and HAQ score (OR 2.69, 95%CI 1.24 to 5.82, p=0.01), but was not predicted by cognitive impairment.Conclusion:Cognitive dysfunction is frequently observed in SSc patients and mostly associated with increasing age and number of comorbidities. Malnutrition and cognitive impairment are both associated to QoL but seem to be unrelated.Disclosure of Interests:None declared
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Benfaremo D, Stronati G, Manfredi L, Zuliani L, Ferrarini A, Fischetti C, Dichiara C, Guerra F, Dello Russo A, Gabrielli A. SAT0307 PROGRESSION OF SUBCLINICAL MYOCARDIAL INVOLVEMENT IN PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic sclerosis (SSc) is a progressive autoimmune disease affecting the skin as well as internal organs, including the heart. A few studies have identified a subclinical heart involvement in patients with no pulmonary hypertension. Changes in myocardial deformation are consistent with the idea of SSc-related cardiomyopathy as a primary condition affecting the heart globally through microvascular dysfunction and subsequent myocardial fibrosis.Objectives:The aim of the present study is to describe the progression of myocardial deformation in patients with SSc and no overt cardiac disease.Methods:Prospective longitudinal study enrolling consecutive SSc patients referred to the Clinica Medica, University Hospital ‘Ospedali Riuniti’, Ancona, Italy, from February 2016 to December 2018. All patients fulfilled the 2013 ACR/EULAR classification criteria for SSc. Patients with structural heart disease, heart failure, atrial fibrillation or pulmonary hypertension were excluded. Disease subset, antibodies pattern, cardiovascular risk factors and involvement of other organ systems were recorded for each patient. An echocardiographic exam was performed for all patients at baseline and during their follow-up evaluation. Standard and speckle-tracking derived variables for the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV) were acquired. Speckle tracking analysis software (EchoPAC 13.0; GE Medical Systems, Milwaukee, USA) was used to assess the GLS of the left and right ventricle, excluding the ventricular septum from right ventricular GLS calculations.Results:Seventy-two patients (68 females, age 56.6±15.4 years) were enrolled. Common echocardiographic parameters of left and right systolic function were within normal range at baseline and did not change during follow-up. Mean GLS, however, worsened for both left (from -19.8±3.5% to -18.7±3.5%, p=.034) and right ventricle (from -20.9±6.1% to -18.7±5.4%, p=.013) during a median follow-up of 20 months (1st-3rd quartile 12-24 months). The increased impairment registered in SSc patients was homogenous across endocardial layers (LV from -22.5±-3.9 to -21.4±3.9, p=.041; RV from -24.2±6.2 to -20.6±5.9, p=.001), mesocardial layers (LV -19.7±3.6 to -18.7±3.5, p=.043; RV from -21.3±5.9 to -18.8±5.7, p=.012) and epicardial layers (LV from -17.1±3.0 to -16.4±3.1, p=.112, RV -18.8±6.3 to -16.0±8.4, p=.035), as well as myocardial segments. No difference in progression rate was observed stratifying patients according to disease subset or other clinical parameters.Conclusion:GLS impairment progressed over a 20-month follow-up period in a cohort of SSc patients without clinically overt cardiac involvement. Further studies are needed to assess the significance of subclinical heart involvement and its progression in patients with SSc.Disclosure of Interests:None declared
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Stronati G, Guerra F, Zuliani L, Manfredi L, Ferrarini A, Fischetti C, Danieli MG, Gabrielli A, Capucci A. 3079Subclinical progression of biventricular cardiomyopathy in patients with systemic sclerosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Systemic sclerosis (SSc) is a progressive autoimmune disease which has been proven to affect the heart. While it is widely known that the disease can cause pulmonary artery hypertension and therefore secondary right heart impairment, new studies have detected a subclinical heart involvement of both the left and right ventricles. The similar changes in myocardial deformation of both chambers assessed by speckle tracking imaging are consistent with the definition of SSc-related cardiomyopathy as a standalone entity with peculiar characteristics.
Purpose
The aim of the present study is to describe the progression of myocardial deformation as assessed through speckle tracking in patients with SSc and no pulmonary hypertension.
Methods
Prospective, longitudinal study on 48 patients affected by SSc. Patients with a history of heart failure, known structural heart disease, atrial fibrillation, and pulmonary hypertension were excluded. For every patient, standard echocardiographical and speckle-tracking derived variables for the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV) were acquired at baseline and after 15±6 months.
Results
While common parameters of systolic function (Simpons's left ventricular ejection fraction, right ventricular fractional area change, TAPSE, tricuspidal S') did not change during follow-up, mean global longitudinal strain (GLS) significantly worsened for both left (from −19.1%±4.2% to −17.2%±5.0%) and right ventricle (from −17.9%±5.2% to −15.9%±4.8%) over 15 months. The increased impairment seen in SSc patients was homogeneous across endocardial layers (LV: from −21.8%±4.8% to −18.8%±5.2%; RV: from −20.6%±4.5% to −19.4%±4.9%), midventricular layers (LV: from −19.2%±4.5% to −17.7%±4.9%; RV: from −17.7%±4.7% to −16.7%±4.6%) and epicardial layers (LV: from −16.3%±4.7% to −16.0%±4.3%; RV: from −15.4%±5.0% to −14.6%±4.1%), as well as across myocardial segments (Figure 1). No difference in progression rate was seen between the diffuse and limited version of SSc, nor between different serotypes.
Figure 1
Conclusions
While traditional echocardiographical parameters are useless in order to follow the natural history of SSc-related cardiomyopathy during its early stages, GLS impairment progresses during a 15-month follow-up and involves similarly both the left and right ventricle. Whether, how, and how much the altered myocardial deformation contributes to the incidence of pulmonary arterial hypertension in these patients is still to be assessed.
Acknowledgement/Funding
Marche Polytechnic University
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Affiliation(s)
- G Stronati
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Guerra
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - L Zuliani
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - L Manfredi
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - A Ferrarini
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - C Fischetti
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - M G Danieli
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - A Gabrielli
- Marche Polytechnic University of Ancona, Clinica Medica, Ancona, Italy
| | - A Capucci
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
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Bianchi T, Wolcott R, Peghetti A, Leaper D, Cutting K, Polignano R, Rosa Rita Z, Moscatelli A, Greco A, Romanelli M, Pancani S, Bellingeri A, Ruggeri V, Postacchini L, Tedesco S, Manfredi L, Camerlingo M, Rowan S, Gabrielli A, Pomponio G. Recommendations for the management of biofilm: a consensus document. J Wound Care 2016; 25:305-17. [DOI: 10.12968/jowc.2016.25.6.305] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- T. Bianchi
- UO Dermatologia AUSL Bologna – Istituto delle scienze neurologiche Bellaria, Bologna, Italy
| | - R.D. Wolcott
- Southwest Regional Wound Care Center, Lubbock, Texas, USA
| | - A. Peghetti
- Casa Di Cura Solatrix Rovereto, AISLeC Membership, Italy
| | - D. Leaper
- University of Newcastle upon Tyne, Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - K. Cutting
- Wound Care 4 Heroes and Perfectus Biomed, UK
| | - R. Polignano
- IOT Hospital Cardiovascular Rehabilitation, Florence, Italy
| | - Z. Rosa Rita
- Ambulatorio Infermieristico ASS 1 Trieste, AISLeC Membership, Italy
| | - A. Moscatelli
- Lesioni Cutanee e Ambulatori Infermieristici Lesioni Cutanee SITRA, A.O. Legnano e Abbiategrasso, AISLeC Membership, Italy
| | - A. Greco
- Outpatient Wound Care Centre, Local Health Care System Frosinone, Italy
| | - M. Romanelli
- Division of Dermatology, Dept. of Clinical and Experimental Medicine, University of Pisa, Pisa Italy
| | - S. Pancani
- Burns Unit, Department of Neonatal and Emergency Surgery, “Meyer” Children's Hospital, Florence (Italy)
| | - A. Bellingeri
- Ambulatory vascular and wound care centre, Policlinic San Matteo, Pavia, Italy
| | - V. Ruggeri
- Wound Care Centre - AOU Careggi, Firenze, AISLeC Membership, Italy
| | - L. Postacchini
- Università Politecnica delle Marche, Istituto di Clinica Medica, AOU Ospedali Riuniti di Ancona, Italy
| | - S. Tedesco
- UO Dermatologia AUSL Bologna – Istituto delle scienze neurologiche Bellaria, Bologna, Italy
| | - L. Manfredi
- Università Politecnica delle Marche, Istituto di Clinica Medica, AOU Ospedali Riuniti di Ancona, Italy
| | | | - S. Rowan
- University of Modena, C3S – Lecturer - Clinical Scientific Support Services, Italy
| | - A. Gabrielli
- Università Politecnica delle Marche, Istituto di Clinica Medica, AOU Ospedali Riuniti di Ancona, Italy
| | - G. Pomponio
- Istituto di Clinica Medica, AOU Ospedali Riuniti di Ancona, Italy
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Manfredi L, Benfaremo D, Tedesco S, Danieli M, Luchetti M, Gabrielli A, Pomponio G. AB0358 Efficacy and Safety of Intravenous and Subcutaneous Tocilizumab in A Cohort of Patients Affected by Rheumatoid Arthritis in Real-Life. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3219] [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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Manfredi L, Marlin S, Fauroux B, Garabedian N, Couloigner V, Leboulanger N. Pycnodysostosis presenting as atypical stridor. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:87-90. [PMID: 26856677 DOI: 10.1016/j.anorl.2015.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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]
Abstract
OBJECTIVES Pycnodysostosis is a rare genetic disorder caused by a mutation of the cathepsin K gene involved in bone turnover. It is responsible, in particular, for a combination of dwarfism and bone fragility. Upper airway obstruction may be observed, but associated stridor has never been previously described. MATERIALS AND METHODS Single-centre retrospective study over a period of 15 years with review of the literature. RESULTS Three children (aged 2-18 months) were managed for stridor and obstructive sleep apnoea syndrome confirmed by polysomnography. Physical examination of these children revealed stridor with laryngomalacia, characteristic dysmorphic features and failure to thrive. Patient 1 presented typical laryngomalacia treated by surgical section of the aryepiglottic folds. Patient 2 presented upper airway obstruction with a narrow nasopharynx and long soft palate, treated by surgery and noninvasive ventilation. Patient 3 presented moderate laryngomalacia and nasal obstruction, treated by surgery and noninvasive ventilation. CONCLUSION The diagnosis of pycnodysostosis must be considered in the presence of atypical laryngomalacia associated with multifactorial upper airway obstruction, failure to thrive and dysmorphic syndrome. A genetics consultation is essential in these patients.
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Affiliation(s)
- L Manfredi
- Service d'ORL et chirurgie cervico-faciale, CHU de Bicêtre, 78, rue du Général-Leclerc, 94276 Le Kremlin Bicêtre, France.
| | - S Marlin
- Service de génétique, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - B Fauroux
- Service de pneumopédiatrie, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Garabedian
- Service d'ORL et chirurgie cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - V Couloigner
- Service d'ORL et chirurgie cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Leboulanger
- Service d'ORL et chirurgie cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
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Luchetti M, Balloni A, Benfaremo D, Bolognini L, Farinelli A, Cedraro S, Rossini M, Capeci W, Manfredi L, Postacchini L, Tedesco S, Fava G, Lorenzini I, Pomponio G, Gabrielli A. SAT0259 Patient Reported Outcomes and Quality of Life in a Cohort of Patients Affected by Entheropathic Spondyloarthritis: Preliminary Results from a Monocentric Prospective Observational Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2633] [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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Fraticelli P, Fischetti C, Manfredi L, Albani L, Mattioli M, Gabrielli A. FRI0485 Preliminary Analysis of a Cohort of Patients with Systemic Sclerosis Treated with Rituximab and Mycophenolate Mofetil. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Luchetti M, Benfaremo D, Balloni A, Bolognini L, Farinelli A, Cedraro S, Rossini M, Capeci W, Manfredi L, Postacchini L, Tedesco S, Fava G, Lorenzini I, Pomponio G, Gabrielli A. THU0219 Effect of Adalimumab Therapy on Both Gastrointestinal and Articular Inflammation at 6 Months in Patients Affected by Enteropathic Spondyloarthritis: Preliminary Results from a Monocentric Prospective Observational Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3054] [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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17
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Menditto VG, Tedesco S, Manfredi L, Postacchini L, Pomponio G. Abstract-to-publication ratio and predictors for publication success for papers presented at the Italian Emergency Medicine Meeting: a cross-sectional study. Eur J Intern Med 2015; 26:141-2. [PMID: 25550148 DOI: 10.1016/j.ejim.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 11/21/2022]
Affiliation(s)
- V G Menditto
- Department of Internal Medicine, Ospedali Riuniti di Ancona, Ancona, Italy.
| | - S Tedesco
- Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
| | - L Manfredi
- Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
| | - L Postacchini
- Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
| | - G Pomponio
- Clinica Medica, Università Politecnica delle Marche, Ancona, Italy
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18
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Manfredi L, Assaf T, Mintchev S, Marrazza S, Capantini L, Orofino S, Ascari L, Grillner S, Wallén P, Ekeberg O, Stefanini C, Dario P. A bioinspired autonomous swimming robot as a tool for studying goal-directed locomotion. Biol Cybern 2013; 107:513-527. [PMID: 24030051 DOI: 10.1007/s00422-013-0566-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 08/13/2013] [Indexed: 06/02/2023]
Abstract
The bioinspired approach has been key in combining the disciplines of robotics with neuroscience in an effective and promising fashion. Indeed, certain aspects in the field of neuroscience, such as goal-directed locomotion and behaviour selection, can be validated through robotic artefacts. In particular, swimming is a functionally important behaviour where neuromuscular structures, neural control architecture and operation can be replicated artificially following models from biology and neuroscience. In this article, we present a biomimetic system inspired by the lamprey, an early vertebrate that locomotes using anguilliform swimming. The artefact possesses extra- and proprioceptive sensory receptors, muscle-like actuation, distributed embedded control and a vision system. Experiments on optimised swimming and on goal-directed locomotion are reported, as well as the assessment of the performance of the system, which shows high energy efficiency and adaptive behaviour. While the focus is on providing a robotic platform for testing biological models, the reported system can also be of major relevance for the development of engineering system applications.
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Affiliation(s)
- L Manfredi
- Institute for Medical Science and Technology (IMSaT), University of Dundee, Wilson House, 1 Wurzburg Loan, Dundee Medipark, Dundee, DD2 1FD, UK,
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19
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Stefanini C, Orofino S, Manfredi L, Mintchev S, Marrazza S, Assaf T, Capantini L, Sinibaldi E, Grillner S, Wallén P, Dario P. A novel autonomous, bioinspired swimming robot developed by neuroscientists and bioengineers. Bioinspir Biomim 2012; 7:025001. [PMID: 22619181 DOI: 10.1088/1748-3182/7/2/025001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper describes the development of a new biorobotic platform inspired by the lamprey. Design, fabrication and implemented control are all based on biomechanical and neuroscientific findings on this eel-like fish. The lamprey model has been extensively studied and characterized in recent years because it possesses all basic functions and control mechanisms of higher vertebrates, while at the same time having fewer neurons and simplified neural structures. The untethered robot has a flexible body driven by compliant actuators with proprioceptive feedback. It also has binocular vision for vision-based navigation. The platform has been successfully and extensively experimentally tested in aquatic environments, has high energy efficiency and is ready to be used as investigation tool for high level motor tasks.
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Affiliation(s)
- C Stefanini
- The BioRobotics Institute, Scuola Superiore Sant’Anna (SSSA), Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
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20
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Mancini F, Calandrella D, Del Fante M, Riboldazzi G, Zangaglia R, Pacchetti C, Manfredi L, Antonini A. 2.256 SYMPTOMATIC NEUROPATHY IN PARKINSON'S DISEASE PATIENTS DURING DUODENAL LEVODOPA INFUSION TREATMENT. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70580-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Manfredi L, Hill RJ, van de Ven TG. Bridging flocculation of PEI-functionalized latex particles using nanocrystalline cellulose. J Colloid Interface Sci 2011; 360:117-23. [DOI: 10.1016/j.jcis.2011.04.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/14/2011] [Accepted: 04/19/2011] [Indexed: 11/16/2022]
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22
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Antonini A, Mancini F, Canesi M, Zangaglia R, Isaias I, Manfredi L, Pacchetti C, Zibetti M, Natuzzi F, Lopiano L, Nappi G, Pezzoli G. Duodenal Levodopa Infusion Improves Quality of Life in Advanced Parkinson’s Disease. NEURODEGENER DIS 2008; 5:244-6. [DOI: 10.1159/000113714] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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23
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Pisani S, Leoni O, Manfredi L, Bonarrigo D, Gambino M, Oria C, Prandini B, Soma R, Banfi F. [Use of healthcare services by elderly people in a local health authority in Varese (Italy)]. Ig Sanita Pubbl 2007; 63:629-640. [PMID: 18216879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Older people use more healthcare than younger people and aging of the population is considered to be one of the main factors leading to consumption of healthcare resources. The aim of this study was to evaluate rates of hospitalization, use of out-patient services and medicine confections among the elderly population (>65 years) in the local health authority of Varese (Italy), in the three-year period from 2003-2005, and to calculate the trend for the years 2006 and 2007. Rates of hospitalization and drug use remained stable while use of out-patient services showed an increasing trend. In spite of the influence of aging on consumption of healthcare resources, the use of medical services is determined mainly by the health state of the population: monitoring of the burden of morbidity in the population should therefore be improved.
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Affiliation(s)
- Salvatore Pisani
- Dipartimento Programmazione, Acquisto e Controllo, ASL della Provincia di Varese.
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24
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Abstract
The electromyographic silent period following the motor potential evoked by cortical magnetic stimulation is decreased in parkinsonian patients. In this study we investigated whether the decrease in the silent period is connected only with parkinsonian symptoms. We evaluated the effect of apomorphine (a potent and rapid dopamine-agonist) on the changes in the peripheral and central silent period in 29 patients with Parkinson's disease and in two patients affected by multisystem atrophy (MSA). Apomorphine injection was found to induce a significant improvement in the central silent period in parkinsonian patients but not in the MSA patients, suggesting a relation between the clinical parkinsonian symptoms (akinesia and rigidity) and the silent period duration. The central silent period changes after apomorphine injection could be used as an adjunctive, safe and effective diagnostic tool to assess dopamine responsiveness of parkinsonian syndromes.
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Affiliation(s)
- L Manfredi
- Department of Neurology, Ospedale Valduce, Como, Italy
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25
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Tagliabue A, Bertoli S, Trentani C, Lanzola E, Manfredi L, Veggiotti PA, Lanzi G. [Drug-resistant epilepsy treated with ketogenic diet]. Recenti Prog Med 1997; 88:77-9. [PMID: 9148371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 4-year old girl affected by intractable seizures was treated with ketogenic diet. The diet was calculated to provide appropriate protein intake for growth (1.4 g/kg body weight) and adequate calories (1600 kcal) derived from 4 parts fat and 1 part protein + carbohydrates. The child remained on the diet for 8 months and had a decrease in seizure frequency of 90%. No serious side effects were reported and it was possible to discontinue or decrease antiepileptic drugs. Our results confirm the efficacy of ketogenic diet in the treatment of epilepsy. Since it is known that 20 to 30% of all patients with epilepsy do not have their seizures completely controlled with established antiepileptic drugs, it would be useful to increase the application of this dietetic treatment in selected patients in Italy as it already happens in other countries.
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Affiliation(s)
- A Tagliabue
- Centro Ricerche di Nutrizione Umana e Dietetica, Università, Pavia
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26
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Abstract
This preliminary study examined differences between cocaine-dependent pregnant women who received "baseline" drug treatment (N = 13) and those requiring additional "intensive" treatment (N = 9). Baseline drug treatment consisted of weekly individual counseling sessions. Intensive treatment, in the form of contingency management procedures, was added for patients who showed no reduction in cocaine use during the first 4 weeks of treatment. There were no differences between the two groups in terms of demographic and pregnancy characteristics or history of cocaine use. Significantly more patients in the baseline treatment group were cocaine-free at intake and had a higher rate of compliance with scheduled prenatal clinical visits. These findings may indicate a decision to cease cocaine use prior to entering treatment, and a high degree of motivation to remain drug-free. Despite the small sample size, the finding that a substantial proportion of cocaine-dependent pregnant women remain cocaine-free during treatment is encouraging.
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Affiliation(s)
- R Elk
- University of Texas-Houston, Health Science Center
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27
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Molica S, Tucci L, Levato D, Levato L, Manfredi L. Combined Use of Interferon Alpha-2, Chlorambucil and Prednisone in Previously Treated Patients with Low-Grade Non-Hodgkin's Lymphomas. Results of a Phase II Study. Tumori 1993; 79:195-7. [PMID: 8236503 DOI: 10.1177/030089169307900307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background To investigate therapeutic activity and safety of alpha-interferon (alpha-IFN) in combination with chlorambucil (CLB) and prednisone (PDN), we treated 9 low-grade non-Hodgkin lymphoma patients with clinical evidence of relapsed (5 cases) or resistant (4 cases) disease with such an association. Methods In all instances, treatment consisted of alpha-2a IFN administered by subcutaneous route thrice weekly for 3 weeks, CLB, 5 mg/day for 21 days, and PDN, 30 mg three times a week for 3 weeks. Cycles were repeated every 28 days. Results A well-documented clinical response was observed in 6 (4 CRs+2 PRs) of 9 patients. Interestingly, 3 of 4 CRs were achieved in patients with histologically proven bone marrow involvement. Median duration of response was 18.5 months (range, 4-29 months). Myelosuppression was a common side effect. Two patients experienced grade 3 hematologic toxicity which did not preclude continuation of therapy. Conclusions As new purine analogues are not currently available, the combination of alpha-IFN, CLB, and PDN may represent, in our opinion, a valid therapy for patients not eligible for aggressive therapy such as autologous bone marrow transplantation.
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Affiliation(s)
- S Molica
- Divisione di Ematologia, Ospedale Regionale A. Pugliese, Catanzaro, Italy
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28
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Mongini T, Doriguzzi C, Palmucci L, De Francesco A, Bet L, Manfredi L, Ponzetto C, Bresolin N. Lipid storage myopathy in multiple acyl-CoA dehydrogenase deficiency: an adult case. Eur Neurol 1992; 32:170-6. [PMID: 1592075 DOI: 10.1159/000116817] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 25-year-old woman had been complaining of episodes of muscle weakness, nausea and vomiting since the age of 10. Muscle biopsy showed free fatty acid accumulation and mitochondrial abnormalities. Mitochondrial DNA appeared to be normal at Southern analysis. Biochemical investigations demonstrated: glutaric aciduria type II, decreased levels of carnitine in liver and values at the lower level of normal in muscle, increased muscle carnitine palmitoyl transferase activity, partial cytochrome c oxidase and succinate cytochrome reductase deficiency in muscle homogenate. In isolated muscle mitochondria, cytochromes aa3, b and c were partially decreased, butyryl-CoA dehydrogenase and palmitoyl-CoA dehydrogenase activities were 10 and 54% of the normal, respectively. Muscle cell cultures did not show lipid storage. Low-lipid diet reduced critical episodes and lipid storage in muscle biopsy.
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Affiliation(s)
- T Mongini
- Centro per le Malattie Neuromuscolari Paolo Peirolo, Università di Torino, Italia
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29
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Abstract
The authors evaluated magnetic resonance imaging (MRI) of deep white matter hyperintensity (DWMH) in 90 adult psychiatric inpatients in whom MRIs were clinically indicated and 25 age-matched, medically healthy controls. Forty-two percent of the psychiatric patients and 12% of the controls had evidence of DWMH on MRI. Both incidence and severity of DWMH were significantly correlated with age in both groups. Even after controlling for age in the psychiatric population, DWMH was significantly associated with hypertension, history of myocardial infarction or angina, abnormal electrocardiogram, and abnormal neurological examinations.
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Affiliation(s)
- R F Deicken
- University of California School of Medicine, Department of Psychiatry, San Francisco 94143
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30
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Dalla Libera L, Scarpini E, Manfredi L, Marini A. Urinary 3-methylhistidine output in newborn human infants. Muscle Nerve 1984; 7:494-5. [PMID: 6543904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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31
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Meola G, Manfredi L, Scarpini E, Moggio M, Pellegrini G, Scarlato G. Cytochemical and ultrastructural studies of human foetal muscle in culture. Acta Neurol (Napoli) 1983; 5:85-95. [PMID: 6880889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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32
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Meola G, Scarpini E, Manfredi L, Mariani C, Scarlato G. Pentazocine-blocked myogenesis in human foetal muscle cultures. Acta Neuropathol Suppl 1981; 7:310-2. [PMID: 6939260 DOI: 10.1007/978-3-642-81553-9_89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A critical review of the published cases reports suggests that the muscle changes could be induced by Pentazocine by mechanisms other than local myotoxicity. The mechanism of myotoxicity in Pentazocine-myopathy remains uncertain and for this reason a tissue culture study was performed in order to investigate the close relationship between myopathy and Pentazocine. The effects of Pentazocine on the extent of myogenesis in human foetal muscle cultures were investigated. The phase contrast study, the light microscopy the quantitative assessment of myogenesis (the number of nuclei incorporated into myotubes were counted and expressed as a percentage of the total number of nuclei) showed a complete block of myogenesis in Pentazocine treated culture and a delayed fusion process was present in D-arabinofuranosylcytosine (Ara-C)-Pentazocine-treated cultures. The present preliminary data, however, suggest that muscle stem cells could participate in the replacement of skeletal muscle by fibrous tissue in neuromuscular syndrome induced by Pentazocine.
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33
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Romanini C, Liverani A, Arduini D, Lafuenti G, Manfredi L. [Further observations on the treatment of premenstrual syndromes associated with dysmenorrhea, using 6-dehydro-retro-progesterone]. Ann Ostet Ginecol Med Perinat 1979; 100:250-65. [PMID: 576028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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34
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Scarlato G, Meola G, Silani V, Manfredi L, Bottiroli G, Zanella A. Erythrocyte spectrofluorometric abnormalities in Duchenne patients and carriers. A new approach to carrier detection. Acta Neurol Scand 1979; 59:262-9. [PMID: 474067 DOI: 10.1111/j.1600-0404.1979.tb02936.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Duchenne muscular dystrophy (DMD) is a disorder whose pathogenesis is attributed, according to the most recent theories, to generalized membrane abnormalities, including red cell membrane. The study of erythrocyte ghosts in patients affected by DMD showed alterations in ion transport and in various enzymatic activities. Employing a spectrofluorometric method using 1-anilino-8-naphthalene sufonate (1.8-ANS) we have tried to characterize the erythrocyte ghosts of DMD patients, definite DMD carriers and normal controls, matched for age and sex. We found an increase of membrane polarity in DMD and definite DMD-carrier erythrocyte ghosts. Using this new method we were able to: - confirm by means of a different technique the previous observations of many authors on erythrocyte ghost alterations in DMD - find a new technique useful in detecting the DMD carriers. It is noteworthy that in such a way the detection rate of definite DMD carriers was higher than with the CPK test.
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35
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Marsili E, Manfredi L, Borreani B, Bresadola F. Lymphography in the study of cancer of the rectum. Panminerva Med 1967; 9:62-9. [PMID: 6045263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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36
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Bresadola F, Marsili E, Borreani B, Manfredi L, Vallebona D. [Behavior of the lymphatic system of the lower extremities after lumbar sympathectomy operations. (Lymphographic study)]. MINERVA CHIR 1966; 21:388-90. [PMID: 5914403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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37
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Donini I, Manfredi L, Bresadola F, Berretti C. [On the chemico-physical composition of human lymph. Comparative study of lymph and blood]. MINERVA CHIR 1966; 21:251-5. [PMID: 5939736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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38
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Marsili E, Borreani B, Manfredi L, Bresadola F. [Lymphographic observations in carcinoma of the rectum]. MINERVA CHIR 1966; 21:265-71. [PMID: 5939739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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39
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Mondini P, Manfredi L. [Clinico-statistical contribution to the therapy of perforated gastroduodenal ulcer]. Acta Chir Ital 1965; 21:601-18. [PMID: 5879731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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40
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Donini I, Manfredi L. [Comparative measurements of blood flow changes in the femoral artery after plastic surgery with heterologous and autologous materials]. Chir Patol Sper 1965; 13:220-7. [PMID: 5870177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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41
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Mondini P, Palazzoli A, Manfredi L. [The surgical treatment of cranial-injured patients. (Clinical contribution)]. Boll Soc Med Chir Cremona 1964; 18:473-90. [PMID: 5881386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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