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Conti D, Girone N, Benatti B, Gambini O, Albert U, Maina G, Amore M, Porta M, Dell’Osso B. Assessing response, remission and treatment resistance in patients with Obsessive-Compulsive Disorder with and without Tic Disorders: results from a multicenter study. Eur Psychiatry 2022. [PMCID: PMC9567475 DOI: 10.1192/j.eurpsy.2022.1648] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Obsessive Compulsive Disorder (OCD) and Tic Disorder (TD) are two highly disabling, comorbid and difficult-to-treat conditions. DSM-5 acknowledged a new “tic-related” specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD), which may show poor treatment response. Objectives The aim of the present study was to evaluate rates and clinical correlates of response, remission and resistance to treatment in a large multicentre sample of OCD patients with versus without tics. Methods 398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten psychiatric departments across Italy. Treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to highlight possible treatment response related factors. Results Later ages of onset of TD and OCD were found in the remission group. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts were associated to the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement. Conclusions While remission was related to later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response, with a significant impairment in quality of life for both patients and their caregivers. These findings suggest a worse profile of treatment response for patients with OCTD. Disclosure No significant relationships.
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Porta M, Moreno J, Werner M, Chirife Ó, López-Rueda A. Anomalous location of intracranial vessels in adults. Radiologia (Engl Ed) 2022; 64:41-53. [PMID: 35180986 DOI: 10.1016/j.rxeng.2021.11.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
Anomalous intracranial vessels are not uncommon, and this finding is not always associated with arteriovenous malformations. Other conditions such as anomalous connections between arteries or phlebitc patterns can also present as vessels with abnormal intracranial locations. Noninvasive diagnosis is important to determine whether to do more invasive tests such as cerebral digital subtraction angiography or to estimate the risk of bleeding in arteriovenous malformations and therefore to evaluate the need for endovascular/surgical treatment. In this paper, we present an algorithm for the differential diagnosis of anomalous intracranial vessels according to their location (intra/extra-axial) and function (whether the vessels are arterialized). Moreover, we analyze the important points of the angioarchitecture of the principal arteriovenous malformations with risk of intracranial bleeding, such as pial arteriovenous malformations and dural fistulas.
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Affiliation(s)
- M Porta
- Departamento de Radiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Spain
| | - J Moreno
- Departamento de Radiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Spain
| | - M Werner
- Departamento de Radiología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Ó Chirife
- Departamento de Radiología, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A López-Rueda
- Departamento de Radiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Spain.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Porta M, Moreno J, Werner M, Chirife Ó, López-Rueda A. Vasos intracraneales en localización anómala en adultos. Radiología 2022. [DOI: 10.1016/j.rx.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leban B, Fabbri D, Lecca LI, Uras M, Monticone M, Porta M, Pau M, Campagna M. Characterization of hand forces exerted during non-powered hospital bed pushing and pulling tasks. Int J Occup Saf Ergon 2021; 28:991-999. [PMID: 33249998 DOI: 10.1080/10803548.2020.1857081] [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] [Indexed: 10/22/2022]
Abstract
Accurate assessment of biomechanical risk associated with pushing/pulling tasks represents a challenging issue, especially in the health system where personnel are often required to maneuver beds and carts. Most studies in this field have been carried out in the laboratory, while few data have been collected under actual working conditions. This study aims to characterize the forces exerted during non-powered hospital bed maneuvering. Twenty participants were required to move a bed (equipped with a customized handlebar to measure exerted forces) along an actual hospital path including straight, turn and maneuver phases. The results show that higher forces are associated with the initial phase (peak and mean values 222 and 68 N) while the straight, turn and maneuvering phases required similar (lower) efforts. The combined effect of left, right and transversal forces suggests that the trunk of the operator might experience axial rotation, thus calling for further investigations of this aspect.
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Affiliation(s)
- Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - D Fabbri
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - L I Lecca
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - M Uras
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - M Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - M Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - M Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - M Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
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Matejcic M, Lesueur F, Biessy C, Renault AL, Mebirouk N, Yammine S, Keski-Rahkonen P, Li K, Hémon B, Weiderpass E, Rebours V, Boutron-Ruault MC, Carbonnel F, Kaaks R, Katzke V, Kuhn T, Boeing H, Trichopoulou A, Palli D, Agnoli C, Panico S, Tumino R, Sacerdote C, Quirós JR, Duell EJ, Porta M, Sánchez MJ, Chirlaque MD, Barricarte A, Amiano P, Ye W, Peeters PH, Khaw KT, Perez-Cornago A, Key TJ, Bueno-de-Mesquita HB, Riboli E, Vineis P, Romieu I, Gunter MJ, Chajès V. Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort. Int J Cancer 2018; 143:2437-2448. [PMID: 30110135 DOI: 10.1002/ijc.31797] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 02/11/2024]
Abstract
There are both limited and conflicting data on the role of dietary fat and specific fatty acids in the development of pancreatic cancer. In this study, we investigated the association between plasma phospholipid fatty acids and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The fatty acid composition was measured by gas chromatography in plasma samples collected at recruitment from375 incident pancreatic cancer cases and375 matched controls. Associations of specific fatty acids with pancreatic cancer risk were evaluated using multivariable conditional logistic regression models with adjustment for established pancreatic cancer risk factors. Statistically significant inverse associations were found between pancreatic cancer incidence and levels of heptadecanoic acid (ORT3-T1 [odds ratio for highest versus lowest tertile] =0.63; 95%CI[confidence interval] = 0.41-0.98; ptrend = 0.036), n-3 polyunsaturated α-linolenic acid (ORT3-T1 = 0.60; 95%CI = 0.39-0.92; ptrend = 0.02) and docosapentaenoic acid (ORT3-T1 = 0.52; 95%CI = 0.32-0.85; ptrend = 0.008). Industrial trans-fatty acids were positively associated with pancreatic cancer risk among men (ORT3-T1 = 3.00; 95%CI = 1.13-7.99; ptrend = 0.029), while conjugated linoleic acids were inversely related to pancreatic cancer among women only (ORT3-T1 = 0.37; 95%CI = 0.17-0.81; ptrend = 0.008). Among current smokers, the long-chain n-6/n-3 polyunsaturated fatty acids ratio was positively associated with pancreatic cancer risk (ORT3-T1 = 3.40; 95%CI = 1.39-8.34; ptrend = 0.007). Results were robust to a range of sensitivity analyses. Our findings suggest that higher circulating levels of saturated fatty acids with an odd number of carbon atoms and n-3 polyunsaturated fatty acids may be related to lower risk of pancreatic cancer. The influence of some fatty acids on the development of pancreatic cancer may be sex-specific and modulated by smoking.
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Affiliation(s)
- M Matejcic
- International Agency for Research on Cancer, Lyon, France
| | - F Lesueur
- Genetic Epidemiology of Cancer team, Inserm, U900, Paris, France
- Institut Curie, Paris, France
- PSL University, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - C Biessy
- International Agency for Research on Cancer, Lyon, France
| | - A L Renault
- Genetic Epidemiology of Cancer team, Inserm, U900, Paris, France
- Institut Curie, Paris, France
- PSL University, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - N Mebirouk
- Genetic Epidemiology of Cancer team, Inserm, U900, Paris, France
- Institut Curie, Paris, France
- PSL University, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - S Yammine
- International Agency for Research on Cancer, Lyon, France
| | | | - K Li
- International Agency for Research on Cancer, Lyon, France
| | - B Hémon
- International Agency for Research on Cancer, Lyon, France
| | - E Weiderpass
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Public Health Division of Gipuzkoa, BioDonostia Research institute, San Sebastian, Spain
| | - V Rebours
- Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France
| | - M C Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Health across Generations Team, Institut Gustave Roussy, Villejuif, France
- Université Paris Sud, UMRS, Villejuif, France
| | - F Carbonnel
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, Health across Generations Team, Institut Gustave Roussy, Villejuif, France
- Université Paris Sud, UMRS, Villejuif, France
- Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - V Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Kuhn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Boeing
- Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - A Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - C Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Panico
- Clinical Medicine and Surgery Department, Università degli Studi di Napoli Federico II, Naples, Italy
| | - R Tumino
- Cancer Registry and Histopathology Department, ASP, "Civic - M.P. Arezzo" Hospital, Ragusa, Italy
| | - C Sacerdote
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Centre for Cancer Prevention (CPO), Turin, Italy
| | - J R Quirós
- EPIC Asturias, Public Health Directorate, Asturias, Spain
| | - E J Duell
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - M Porta
- Hospital del Mar Research Institute - IMIM, CIBER Epidemiología y Salud Pública (CIBERESP) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M J Sánchez
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M D Chirlaque
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - A Barricarte
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarra Public Health Institute, Pamplona, Spain
| | - P Amiano
- Public Health Division of Gipuzkoa, BioDonostia Research institute, San Sebastian, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - W Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- The Medical Biobank at Umeå University, Umeå, Sweden
| | - P H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - K T Khaw
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - A Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - T J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - H B Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - P Vineis
- MRC-PHE Center for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
| | - I Romieu
- International Agency for Research on Cancer, Lyon, France
| | - M J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - V Chajès
- International Agency for Research on Cancer, Lyon, France
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8
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Abstract
Diabetes eye complications, and particularly diabetic retinopathy, are the major cause of blindness in the working age groups of industrialised countries. Laser photocoagulation has been proven to reduce blindness due to retinopathy by at least 60% but even more patients would benefit if treatment were delivered at an early enough stage. High risk retinopathy, though, does not cause visual symptoms and when the latter occur it is often too late to reverse them. Hence, a screening programme for diabetic retinopathy should aim at detecting patients at risk when they can still be effectively treated. This can be obtained by regularly checking the patients' eyes. Its target, as defined by the joint World Health Organisation/International Diabetes Federation Saint Vincent Declaration Working Group, is to reduce diabetes-related blindness by one third or more in the next 5 years. The number of persons to be screened is high, 30,000/million total population/year, but available data indicate that this is feasible and that the initial investments in professional and material resources are more than justified by the reduction of preventable blindness and of the financial burdens that go with it. Indeed, prevention of the major cause of blindness in the working age should rate the same priority as other widely deployed programmes, such as those to screen for cancer, neonatal hypothyroidism and phenylketonuria. The concerted action of government health departments, patients' and professional associations will be vital for the successful implementation of this programme. The texts of this document (a protocol for the screening of diabetic retinopathy and cataract), Appendix 1 (data collection card) and Appendix 2 (informative leaflet for the patients) were approved by 57 specialists, representing 30 diabetic and ophthalmic societies from 21 European countries, and endorsed for translation into all European languages and distribution at the appropriate levels.
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Affiliation(s)
- E M Kohner
- Diabetic Retinopathy Unit, Hammersmith Hospital, London, U.K
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9
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Porta M, Dosso AA, Williams FM, Kanse S, Kohner EM. A study of the Effects of Angiotensins 1, 2, 3 and Bradykinin on the Replication of Bovine Retinal Capillary Endothelial Cells and Pericytes. Eur J Ophthalmol 2018; 2:21-6. [PMID: 1638161 DOI: 10.1177/112067219200200105] [Citation(s) in RCA: 3] [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: 11/17/2022]
Abstract
The renin-angiotensin system of the human eye may play a role in the regulation of retinal blood flow and the development of new vessels. We have investigated whether angiotensins 1, 2 and 3 or bradykinin, in concentrations ranging between 1 × 10–12 and 1 × 10–6, have any mitogenic activity on cultured bovine retinal endothelial cells (BREC) and pericytes (BRP). Cell replication was assessed by 3H-thymidine incorporation and, in the case of BREC and A T-2, also by cell counts. A T-2 was also tested on bovine aortic EC (BAEC). None of the substances elicited any response on BREC, BRP or BAEC. Whether angiotensin(s) induce angiogenesis in retinal vessels in vivo remains to be established but this does not appear to occur through direct stimulation of cell replication.
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Affiliation(s)
- M Porta
- Department of Medicine, Hammersmith Hospital, London, U.K
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10
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Abstract
Retinopathy is probably the first long-term complication of diabetes mellitus to become clinically evident, possibly because the retina is the only microvascular bed that can be observed directly and repeatedly. This makes it a good model for studying the pathogenesis and natural history of diabetic microangiopathy. Most of the proposals to account for its pathogenesis invoke mechanisms that depend directly on the circulating and tissue levels of glucose: protein glycosylation, activation of the “polyol pathway”, abnormalities of vascular endothelium, altered capillary blood flow. Several population studies and clinical trials suggest that the degree of metabolic control maintained over the years influences the rates of appearance and progression of retinopathy. However, on an individual basis, factors independent of control may intervene, making some patients more or less prone to this complication. Animal models also suggest that the progression of retinopathy may become irreversible from its very early stages. From a clinical point of view, it is difficult to establish a satisfactory definition of “good” control and approaching it may increase the risk of dangerous hypoglycemia and weight gain. Diabetes and eye specialists are thus left to strive for the best possible, sensible, metabolic control but must also rely on early diagnosis and treatment for the sight-threatening complications of diabetes.
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Affiliation(s)
- M Porta
- Institute of Internal Medicine, University of Torino, Italy
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11
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Brücke T, Jain R, Van Dyck N, Chen L, Thun P, Seijo F, Suarez San Martin E, Visser-Vandewalle V, Barbe M, Gill S, Whone A, Porta M, Servello D, Timmermann L, Alesch F. Long term results of the VANTAGE study: A prospective multicenter trial evaluating deep brain stimulation with a multiple source, constant current system in Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.082] [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: 11/26/2022]
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12
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Lorefice L, Coghe G, Fenu G, Porta M, Pilloni G, Frau J, Corona F, Sechi V, Barracciu MA, Marrosu MG, Pau M, Cocco E. 'Timed up and go' and brain atrophy: a preliminary MRI study to assess functional mobility performance in multiple sclerosis. J Neurol 2017; 264:2201-2204. [PMID: 28894919 DOI: 10.1007/s00415-017-8612-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 12/12/2022]
Abstract
Motor and cognitive disabilities are related to brain atrophy in multiple sclerosis (MS). 'Timed up and go' (TUG) has been recently tested in MS as functional mobility test, as it is able to evaluate ambulation/coordination-related tasks, as well as cognitive function related to mobility. The objective of this study is to evaluate the relationship between brain volumes and TUG performances. Inclusion criteria were a diagnosis of MS and the ability to walk at least 20 m. TUG was performed using a wearable inertial sensor. Times and velocities of TUG sub-phases were calculated by processing trunk acceleration data. Patients underwent to a brain MRI, and volumes of whole brain, white matter (WM), grey matter (GM), and cortical GM (C) were estimated with SIENAX. Sixty patients were enrolled. Mean age was 41.5 ± 11.6 years and mean EDSS 2.3 ± 1.2. Total TUG duration was correlated to lower WM (ρ = 0.358, p = 0.005) and GM (ρ = 0.309, p = 0.017) volumes. A stronger association with lower GM volume was observed for intermediate (ρ = 0.427, p = 0.001) and final turning (ρ = 0.390, p = 0.002). TUG is a useful tool in a clinical setting as it can not only evaluate patients' disability in terms of impaired functional mobility, but also estimate pathological features, such as grey atrophy.
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Affiliation(s)
- Lorena Lorefice
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy.
| | - G Coghe
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - G Fenu
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - M Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - G Pilloni
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - J Frau
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - F Corona
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - V Sechi
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M A Barracciu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, Cagliari, Italy
| | - M G Marrosu
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
| | - M Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - E Cocco
- Multiple Sclerosis Center, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, Via Is Guadazzonis 2, 09126, Cagliari, Italy
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13
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Briguglio M, Dell'Osso B, Galentino R, Zanaboni Dina C, Banfi G, Porta M. Tics and obsessive-compulsive disorder in relation to diet: Two case reports. Encephale 2017; 44:479-481. [PMID: 28870689 DOI: 10.1016/j.encep.2017.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 11/26/2022]
Affiliation(s)
- M Briguglio
- Tourette's Syndrome and Movement Disorders Centre, I.R.C.C.S. Galeazzi Hospital, Via Riccardo Galeazzi, 4, 20161 Milan, MI, Italy.
| | - B Dell'Osso
- University of Milan, Department of Pathophysiology and Transplantation, I.R.C.C.S. Ca' Granda Foundation, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, 291 campus drive, 94305 Stanford, CA, USA.
| | - R Galentino
- Tourette's Syndrome and Movement Disorders Centre, I.R.C.C.S. Galeazzi Hospital, Via Riccardo Galeazzi, 4, 20161 Milan, MI, Italy.
| | - C Zanaboni Dina
- Tourette's Syndrome and Movement Disorders Centre, I.R.C.C.S. Galeazzi Hospital, Via Riccardo Galeazzi, 4, 20161 Milan, MI, Italy.
| | - G Banfi
- Scientific Direction, I.R.C.C.S. Galeazzi Hospital, Milan, Italy.
| | - M Porta
- Tourette's Syndrome and Movement Disorders Centre, I.R.C.C.S. Galeazzi Hospital, Via Riccardo Galeazzi, 4, 20161 Milan, MI, Italy.
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14
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Lasagni A, Giordano P, Lacilla M, Raviolo A, Trento M, Camussi E, Grassi G, Charrier L, Cavallo F, Albera R, Porta M, Zanone MM. Cochlear, auditory brainstem responses in Type 1 diabetes: relationship with metabolic variables and diabetic complications. Diabet Med 2016; 33:1260-7. [PMID: 26605750 DOI: 10.1111/dme.13039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Accepted: 11/18/2015] [Indexed: 01/29/2023]
Abstract
AIMS Few studies have analysed the presence of hearing abnormalities in diabetes. We assessed the presence of subclinical auditory alterations and their possible association with early vascular and neurological dysfunction in young adults with Type 1 diabetes of long duration. METHODS Thirty-one patients with Type 1 diabetes (mean age 33 ± 2.3 years, disease duration 25.7 ± 4.2 years) and 10 healthy controls underwent pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) analyses. Associations with metabolic variables and chronic complications were explored. RESULTS Compared with healthy controls, patients with diabetes had significantly higher mean hearing thresholds, although still within the normoacusic range. DPOAE intensities at medium frequencies (2.8-4 kHz) were significantly lower in patients with diabetes. In ABR, in addition to waves I, III and V, we observed the appearance of a visible wave IV in patients with diabetes compared with controls (prevalence 61% vs. 10%, P < 0.05), and its appearance was related to a prolonged I-V interval (4.40 ± 0.62 ms vs. 4.19 ± 0.58 ms, P < 0.05). Diastolic blood pressure was higher in people with abnormal DPOAE (P < 0.05), whereas systolic blood pressure correlated with wave V and interpeak I-V interval latencies. A trend towards an association between evidence of wave IV and the presence of somatic neuropathy or abnormal cardiovascular autonomic tests was observed. CONCLUSIONS Young adults with long-term Type 1 diabetes have subclinical abnormalities in qualitative auditory perception, despite normal hearing thresholds, which might reflect neuropathic and/or vascular alterations.
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Affiliation(s)
- A Lasagni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Giordano
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Lacilla
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - A Raviolo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Trento
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Camussi
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - G Grassi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - L Charrier
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - F Cavallo
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - R Albera
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Porta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M M Zanone
- Department of Medical Sciences, University of Turin, Turin, Italy
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15
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Abstract
Gli Autori riferiscono come il back pain tuttora presenti difficoltà sia diagnostiche che terapeutiche non risolte, verosimilmente per la complessità anatomo-funzionale delle strutture osteomio-legamentose che compongono la colonna vertebrale. Fra le cause di lombalgia l'aumento della pressione intradiscale può rivestire un ruolo anche importante in considerazione delle diverse terminazioni sensitive situate sulla porzione esterna del disco. La nucleo-aspirazione secondo la tecnica di Onik rappresenta, in casi selezionati, un valido rimedio terapeutico.
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Affiliation(s)
| | | | | | - M. Porta
- Divisione Neurologia - Policlinico S. Marco - Zingonia (BG)
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16
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Abstract
Clinical benefit from treatment of symptomatic severe carotid stenoses has been demonstrated recently. The safety profile of endarterectomy, however, justifies the development of alternative techniques as percutaneous transluminal angioplasty (PTA), at least in mild to moderate stenoses. Early results and follow-up data from our series of 44 carotid stenoses treated by PTA are reviewed in this paper, in comparison with other reports from literature. PTA may be beneficial as a therapy of symptomatic internal carotid stenoses, provided its cost/effectiveness has been evaluated by a valid method.
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Affiliation(s)
- L M Munari
- Dept. of Neurology-Stroke Unit, Policlinico San Marco, Zingonia Bergamo, Italy
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17
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Macerollo A, Martino D, Cavanna AE, Gulisano M, Hartmann A, Hoekstra PJ, Hedderly T, Debes NM, Muller-Vahl K, Neuner I, Porta M, Rickards H, Rizzo R, Cardona F, Roessner V. Refractoriness to pharmacological treatment for tics: A multicentre European audit. J Neurol Sci 2016; 366:136-138. [PMID: 27288792 DOI: 10.1016/j.jns.2016.05.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 04/05/2016] [Accepted: 05/02/2016] [Indexed: 11/17/2022]
Affiliation(s)
- A Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, The National Hospital of Neurology and Neurosurgery, Institute of Neurology, University College London, London, United Kingdom
| | - D Martino
- International Parkinson's Centre of Excellence, King's College and King's College Hospital, Denmark Hill Campus, London, United Kingdom; Queen Elizabeth Hospital, Woolwich, Lewisham & Greenwich NHS Trust, London, United Kingdom.
| | - A E Cavanna
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, United Kingdom
| | - M Gulisano
- Section of Child Neuropsichiatry, Dipartimento di Scienze Mediche e Pediatriche, Catania University, Catania, Italy
| | - A Hartmann
- Centre de Référence National Maladie Rare: Syndrome Gilles de la Tourette, Département de Neurologie, Pôle des Maladies du Système Nerveux, France
| | - P J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - T Hedderly
- TANDeM Clinic-Evelina London Children's Hospital at Guys and St. Thomas', Kings Health Partners AHSC, London, United Kingdom
| | - N M Debes
- Pediatric Department, Glostrup University Hospital, Glostrup, Denmark
| | - K Muller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Street 1, D-30625 Hannover, Germany
| | - I Neuner
- Institute of Neuroscience and Medicine 4, (INM 4), Forschungszentrum, Jülich, Jülich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, JARA-BRAIN - Translational Medicine, Germany
| | - M Porta
- Departments of Neurosurgery and Neurology, IRCCS Galeazzi, Milan, Italy
| | - H Rickards
- Department of Neuropsychiatry, BSMHFT and University of Birmingham, United Kingdom
| | - R Rizzo
- Section of Child Neuropsichiatry, Dipartimento di Scienze Mediche e Pediatriche, Catania University, Catania, Italy
| | - F Cardona
- Department of Psychology, University of Rome, La Sapienza, Rome, Italy
| | - V Roessner
- Klinik und Poliklinikfür Kinder- und Jugendpsychiatrie und -psychotherapie, TechnischeUniversität Dresden, Germany
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18
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Porta M, Saleh C, Zekaj E, Zanaboni Dina C, Bona AR, Servello D. Why so many deep brain stimulation targets in Tourette’s syndrome? Toward a broadening of the definition of the syndrome. J Neural Transm (Vienna) 2016; 123:785-790. [DOI: 10.1007/s00702-015-1494-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/30/2015] [Indexed: 12/01/2022]
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19
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Porta M, Pumarega J, Gasull M, López T, Lee DH. Number of Persistent Organic Pollutants (POPs) Detected at High Concentrations in the U.S. Population (NHANES 2003–04). Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Porta M. The New Edition of A Dictionary of Epidemiology: What's so New in the Ongoing Methodological ‘Revolution'? Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.254] [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: 11/12/2022] Open
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21
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Alesch F, Jain R, Chen L, Brücke T, Seijo F, Martin ESS, Haegelen C, Verin M, Maarouf M, Barbe M, Gill S, Whone A, Porta M, Servello D, Timmermann L. Essai VANTAGE : suivi de douze (12) mois d’une étude prospective multicentrique évaluant la stimulation cérébrale profonde avec un nouveau système rechargeable à sources de courant multiples indépendantes (Vercise™) dans la maladie de Parkinson. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich et al. Horm Res Paediatr 2014; 80:305-8. [PMID: 24107550 DOI: 10.1159/000355668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- A C Gore
- Division of Pharmacology and Toxicology, The University of Texas, Austin, Tex., USA
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Reprint of: policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich et al. Horm Behav 2014; 65:190-3. [PMID: 24289987 DOI: 10.1016/j.yhbeh.2013.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- A C Gore
- Division of Pharmacology and Toxicology, The University of Texas, Austin, TX 78712, USA.
| | - J Balthazart
- University of Liège, GIGA Neurosciences, B-4000 Liège, Belgium
| | - D Bikle
- VA Medical Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - D O Carpenter
- Institute for Health and the Environment, University at Albany, State University of New York, Albany, NY 12222, USA
| | - D Crews
- Section of Integrative Biology, The University of Texas, Austin, TX 78712, USA
| | | | | | - R M Dores
- Department of Biological Sciences, University of Denver, Denver, CO 80208, USA
| | - D Grattan
- Department of Anatomy, University of Otago, North Dunedin 9016, New Zealand
| | - P R Hof
- Icahn School of Medicine at Mt Sinai, New York, NY 10029, USA
| | - A N Hollenberg
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - C Lange
- University of Minnesota Masonic Cancer Center, Minneapolis, MN 55455, USA
| | - A V Lee
- University of Pittsburgh Cancer Institute, Magee Women's Research Institute, Pittsburgh, PA 15213, USA
| | - J E Levine
- Wisconsin National Primate Research Center, Madison, WI 53715, USA
| | - R P Millar
- UCT/MRC Receptor Biology Unit, University of Cape Town, Cape Town, South Africa
| | - R J Nelson
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - M Porta
- Hospital del Mar Institute of Medical Research, School of Medicine, Universitat Autònoma de Barcelona, 080041 Barcelona, Spain
| | - M Poth
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - D M Power
- Department of Biosciences, Universidade do Algarve, 8005-139 Faro, Portugal
| | - G S Prins
- Department of Physiology and Biophysics, University of Illinois, Chicago, IL 60612, USA
| | - E C Ridgway
- Department of Medicine, University of Colorado School of Medicine, Denver, CO 80208, USA
| | - E F Rissman
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - J A Romijn
- Division of Medicine, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, The Netherlands
| | - P E Sawchenko
- Laboratory of Neuronal Structure and Function, The Salk Institute, La Jolla, CA 92037, USA
| | - P D Sly
- Queensland Children's Medical Institute, University of Queensland, Royal Children's Hospital, Brisbane, Queensland 4000, Australia
| | - O Söder
- Karolinska Institutet at Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - H S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
| | - M Tena-Sempere
- Department of Cell Biology and Physiology, University of Córdoba, 14071 Córdoba, Spain
| | - H Vaudry
- Institut National de la Santé et de la Recherche Médicale U982, University of Rouen, 76821 Rouen, France
| | - K Wallen
- Department of Psychology, Yerkes National Primate Research Center, Emory University, Atlanta, GA 30322, USA
| | - Z Wang
- Department of Psychology and Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - L Wartofsky
- Department of Medicine, Washington Hospital Center, Washington, DC 20010, USA
| | - C S Watson
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Reprint of: policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich, et al. Front Neuroendocrinol 2014; 35:2-5. [PMID: 24268499 DOI: 10.1016/j.yfrne.2013.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 11/24/2022]
Affiliation(s)
- A C Gore
- Pharmacology and Toxicology, The University of Texas at Austin, Austin, TX 78712, United States.
| | - J Balthazart
- University of Liège, GIGA Neurosciences, B-4000 Liège, Belgium
| | - D Bikle
- VA Medical Center and University of California, San Francisco, San Francisco, CA 94143, United States
| | - D O Carpenter
- Institute for Health and the Environment, University at Albany, State University of New York, Albany, NY 12222, United States
| | - D Crews
- Section of Integrative Biology, The University of Texas, Austin, TX 78712, United States
| | - P Czernichow
- Professor Emeritus of Pediatrics, University of Paris, 75006 Paris, France
| | | | - R M Dores
- Department of Biological Sciences, University of Denver, Denver, CO 80208, United States
| | - D Grattan
- Department of Anatomy, University of Otago, North Dunedin 9016, New Zealand
| | - P R Hof
- Icahn School of Medicine at Mt Sinai, New York, NY 10029, United States
| | | | - C Lange
- University of Minnesota Masonic Cancer Center, Minneapolis, MN 55455, United States
| | - A V Lee
- University of Pittsburgh Cancer Institute and Magee Women's Research Institute, Pittsburgh, PA 15213, United States
| | - J E Levine
- Wisconsin National Primate Research Center, Madison, WI 53715, United States
| | - R P Millar
- UCT/MRC Receptor Biology Unit, University of Cape Town, Cape Town, South Africa
| | - R J Nelson
- Department of Neuroscience, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
| | - M Porta
- Hospital del Mar Institute of Medical Research and School of Medicine, Universitat Autònoma de Barcelona, 080041 Barcelona, Spain
| | - M Poth
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
| | - D M Power
- Department of Biosciences, Universidade do Algarve, 8005-139 Faro, Portugal
| | - G S Prins
- Department of Physiology and Biophysics, University of Illinois, Chicago, IL 60612, United States
| | - E C Ridgway
- Department of Medicine, University of Colorado School of Medicine, Denver, CO 80208, United States
| | - E F Rissman
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, VA 22908, United States
| | - J A Romijn
- Division of Medicine, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, The Netherlands
| | - P E Sawchenko
- Laboratory of Neuronal Structure and Function, The Salk Institute, La Jolla, CA 92037, United States
| | - P D Sly
- Queensland Children's Medical Institute, University of Queensland, Royal Children's Hospital, Brisbane, Queensland 4000, Australia
| | - O Söder
- Karolinska Institutet at Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
| | - H S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, United States
| | - M Tena-Sempere
- Department of Cell Biology and Physiology, University of Córdoba, 14071 Córdoba, Spain
| | - H Vaudry
- Institut National de la Santé et de la Recherche Médicale U982, University of Rouen, 76821 Rouen, France
| | - K Wallen
- Department of Psychology and Yerkes National Primate Research Center, Emory University, Atlanta, GA 30322, United States
| | - Z Wang
- Department of Psychology and Neuroscience, Florida State University, Tallahassee, FL 32306, United States
| | - L Wartofsky
- Department of Medicine, Washington Hospital Center, Washington, DC 20010, United States
| | - C S Watson
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX 77555, United States
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Trento M, Trevisan M, Coppo E, Raviolo A, Zanone MM, Cavallo F, Porta M. Diagnosis of type 1 diabetes within the first five years of life influences quality of life and risk of severe hypoglycemia in adulthood. Acta Diabetol 2014; 51:509-11. [PMID: 24241339 DOI: 10.1007/s00592-013-0530-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 09/06/2013] [Accepted: 10/31/2013] [Indexed: 11/29/2022]
Abstract
Progressive adaptation to disease is paramount to improve quality of life (QoL) and other psychological dimensions in type 1 diabetes (T1DM). This study aimed at identifying possible correlations between QoL, locus of control (LoC) and clinical variables in patients with T1DM followed up for 16 years. Fifty-nine patients (27 women) with T1DM, part of a cohort of 112 followed since 1996, accepted to participate. Patients were divided into those in whom onset of T1DM had been during the first 5 years of life (n = 16) or later. They were also stratified into worsened, stable and improved, based on whether their HbA1c had increased/decreased by 1 percentage point between baseline and last follow-up visit. QoL was measured by the Diabetes Quality of Life questionnaire (DQOL), translated into Italian and re-validated. The LoC was measured by the Peyrot- and Rubin-specific questionnaire. Patients who developed T1DM before age 5 had a better total DQOL score than those who developed it later in life, mainly due to the satisfaction dimension and a tendency to decreased fatalism in adult age. All subjects whose HbA1c had worsened from baseline had had their diagnosis after age 5 and reported more frequent episodes of hypoglycemia. Onset of diabetes after age 5 and more frequent hypoglycemia was more likely in subjects with worsened HbA1c (ORs 7.6, p < 0.10 and 20.3, p < 0.01, respectively, from a multivariate logistic model with HbA1c, dichotomized in 'worsened' vs all others, as dependent variable). Onset of T1DM during the first 5 years of life may result in better QoL and less fatalism in the long term. Presumably, these patients have no memory of disease onset, which may reduce trauma and facilitate adaptation to managing life with diabetes.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Corso AM Dogliotti 14, 10126, Turin, Italy,
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Trento M, Trevisan M, Raballo M, Passera P, Charrier L, Cavallo F, Porta M. Depression, anxiety, cognitive impairment and their association with clinical and demographic variables in people with type 2 diabetes: a 4-year prospective study. J Endocrinol Invest 2014; 37:79-85. [PMID: 24464454 DOI: 10.1007/s40618-013-0028-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 08/05/2013] [Accepted: 11/16/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate depression, anxiety and cognitive impairment and their associations with clinical and socio-demographic variables in type 2 diabetes. METHODS The Zung Self-Rating Depression-Anxiety Scale and Mini-Mental State Examination (MMSE) were administered at baseline and after 4 years to 498 consecutive patients, 249 non-insulin treated (NIT) and 249 insulin treated (IT), aged 40-80 years. RESULTS At baseline, IT patients were older, had longer disease duration, higher HbA1c and did more glucose monitoring (p < 0.001, all) but their depression scores were lower than among NIT (p = 0.006), with no differences for anxiety or MMSE. After 4 years, 72 patients were lost to the follow-up, of whom 18 had died. 41 NIT had switched to insulin and increased BMI (p = 0.004), blood pressure (p < 0.001), retinopathy severity (p = 0.03) and microalbuminuria (p = 0.0045), but did not change their scores for depression, anxiety or MMSE. The remaining 171 NIT improved fasting glucose (p = 0.006), total cholesterol (p < 0.0001), triglyceride (p = 0.0026) and HbA1c (p = 0.0006). Despite increased prevalence of microalbuminuria and retinopathy (p < 0.0001, both), depression (p = 0.04) and MMSE (p = 0.0007) improved. Foot ulcers (p = 0.03), retinopathy (p < 0001), microalbuminuria (p = 0.0047) and hypertension (p < 0.0001) increased in the remaining 214 IT patients, in whom depression (p = 0.0005) and anxiety (p < 0.0001) worsened while MMSE improved slightly (p = 0.0002). On multivariate analysis, depression was associated with being a woman and anxiety with diabetes duration and lower schooling, which also affected MMSE scores. CONCLUSIONS Depression was associated with female gender and worsening complications but not modified by diabetes duration or switching to insulin therapy. Diabetes duration and lower schooling may affect anxiety and cognitive impairment.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Corso AM Dogliotti 14, 10126, Turin, Italy,
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich et al. Eur J Endocrinol 2013; 169:E1-4. [PMID: 24057478 DOI: 10.1530/eje-13-0763] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A C Gore
- Division of Pharmacology and Toxicology, The University of Texas, Austin, Texas 78712, USA
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrich et al. Endocrinology 2013; 154:3957-60. [PMID: 24048095 PMCID: PMC5398595 DOI: 10.1210/en.2013-1854] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- A C Gore
- PhD, Editor-in-Chief, Endocrinology, Gustavus, Louise Pfeiffer Professor of Pharmacology, Toxicology, The University of Texas at Austin, Austin, Texas 78712.
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Gore AC, Balthazart J, Bikle D, Carpenter DO, Crews D, Czernichow P, Diamanti-Kandarakis E, Dores RM, Grattan D, Hof PR, Hollenberg AN, Lange C, Lee AV, Levine JE, Millar RP, Nelson RJ, Porta M, Poth M, Power DM, Prins GS, Ridgway EC, Rissman EF, Romijn JA, Sawchenko PE, Sly PD, Söder O, Taylor HS, Tena-Sempere M, Vaudry H, Wallen K, Wang Z, Wartofsky L, Watson CS. Policy decisions on endocrine disruptors should be based on science across disciplines: a response to Dietrichet al. Andrology 2013; 1:802-5. [DOI: 10.1111/j.2047-2927.2013.00151.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A. C. Gore
- Division of Pharmacology and Toxicology; The University of Texas; Austin TX USA
| | - J. Balthazart
- University of Liège; GIGA Neurosciences; Liège Belgium
| | - D. Bikle
- VA Medical Center and University of California, San Francisco; San Francisco CA USA
| | - D. O. Carpenter
- Institute for Health and the Environment; University at Albany; State University of New York; Albany NY USA
| | - D. Crews
- Section of Integrative Biology; The University of Texas; Austin TX USA
| | | | | | - R. M. Dores
- Department of Biological Sciences; University of Denver; Denver CO USA
| | - D. Grattan
- Department of Anatomy; University of Otago; North Dunedin New Zealand
| | - P. R. Hof
- Icahn School of Medicine at Mt Sinai; New York NY USA
| | - A. N. Hollenberg
- Beth Israel Deaconess Medical Center; Harvard Medical School; Boston MA USA
| | - C. Lange
- University of Minnesota Masonic Cancer Center; Minneapolis MN USA
| | - A. V. Lee
- University of Pittsburgh Cancer Institute and Magee Women's Research Institute; Pittsburgh PA USA
| | - J. E. Levine
- Wisconsin National Primate Research Center; Madison WI USA
| | - R. P. Millar
- UCT/MRC Receptor Biology Unit; University of Cape Town; Cape Town South Africa
| | - R. J. Nelson
- Department of Neuroscience; The Ohio State University Wexner Medical Center; Columbus OH USA
| | - M. Porta
- Hospital del Mar Institute of Medical Research and School of Medicine; Universitat Autònoma de Barcelona; Barcelona Spain
| | - M. Poth
- Uniformed Services University of the Health Sciences; Bethesda MD USA
| | - D. M. Power
- Department of Biosciences; Universidade do Algarve; Faro Portugal
| | - G. S. Prins
- Department of Physiology and Biophysics; University of Illinois; Chicago IL USA
| | - E. C. Ridgway
- Department of Medicine; University of Colorado School of Medicine; Denver CO USA
| | - E. F. Rissman
- Department of Biochemistry and Molecular Genetics; School of Medicine; University of Virginia; Charlottesville VA USA
| | - J. A. Romijn
- Division of Medicine; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - P. E. Sawchenko
- Laboratory of Neuronal Structure and Function; The Salk Institute; La Jolla CA USA
| | - P. D. Sly
- Queensland Children's Medical Institute; University of Queensland; Royal Children's Hospital; Brisbane Qld Australia
| | - O. Söder
- Karolinska Institutet at Karolinska University Hospital Solna; Stockholm Sweden
| | - H. S. Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences; Yale School of Medicine; New Haven CT USA
| | - M. Tena-Sempere
- Department of Cell Biology and Physiology; University of Córdoba; Córdoba Spain
| | - H. Vaudry
- Institut National de la Santé et de la Recherche Médicale U982; University of Rouen; Rouen France
| | - K. Wallen
- Department of Psychology and Yerkes National Primate Research Center; Emory University; Atlanta GA USA
| | - Z. Wang
- Department of Psychology and Neuroscience; Florida State University; Tallahassee FL USA
| | - L. Wartofsky
- Department of Medicine; Washington Hospital Center; Washington DC USA
| | - C. S. Watson
- Department of Biochemistry and Molecular Biology; University of Texas Medical Branch; Galveston TX USA
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Trento M, Panero F, Porta M, Gruden G, Barutta F, Cerutti F, Gambino R, Perotto M, Cavallo Perin P, Bruno G. Diabetes-specific variables associated with quality of life changes in young diabetic people: the type 1 diabetes Registry of Turin (Italy). Nutr Metab Cardiovasc Dis 2013; 23:1031-1036. [PMID: 23466181 DOI: 10.1016/j.numecd.2013.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 01/07/2013] [Accepted: 01/07/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Type 1 diabetes (T1DM) affects young people during the most active years of their life. Our aim was to assess quality of life (QoL) and associated variables in a large cohort of adults with childhood-onset and adult-onset T1DM. METHODS A cohort of adult patients (18 years and older) from the T1DM Registry of Turin, Italy, was recruited. Clinical characteristics and Diabetes QoL (DQOL) questionnaire were assessed by standardized procedures. RESULTS 310 adults completed the questionnaire. Age and diabetes duration at assessment (mean ± SD) were 32.8 ± 7.3 years and 17.3 ± 6.3 years, respectively. DQOL and its subscores were in the lower quartiles of their distributions, indicating a good level of QoL. However, scores were significantly higher in females than in males, particularly for the subscale of diabetes-related worries. In multivariate analysis, lower QoL was independently associated with female sex (β = 1.07, 95% CI 1.03-1.11, p = 0.003), higher age at onset (β = 1.03, 1.00-1.05, p = 0.009), lower schooling (β = 1.05, 1.00-1.09, p = 0.02), higher fasting plasma glucose (β = 1.03, 1.01-1.05, p = 0.008), daily SMBG >4 (β = 1.06, 1.01-1.10, p = 0.01), severe hypoglycemia over the last year (β = 1.06, 1.01-1.11, p = 0.02), lower numbers of diabetologic visits (β = 1.07, 1.01-1.13, p = 0.02) and hypertension (β = 1.06, 1.02-1.10, p = 0.005). Autonomic neuropathy was associated with diabetes impact. Female sex (β = 4.36, 2.43-7.83) and daily SMBG >4 (β = 3.77, 1.72-8.30) were independently associated with worst level and CSII with better level (β = 0.22, 0.07-0.68) of diabetes-related worries. CONCLUSIONS The impact of T1DM on QoL may depend on demographic, metabolic control-related variables, presence of complications and insulin delivery modality.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Dept of Medical Sciences, University of Turin, Italy
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31
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Sicuro J, Bondonio P, Charrier L, Berchialla P, Cavallo F, Porta M, Trento M. Cost analysis of group versus usual care in patients with type 2 diabetes in the ROMEO clinical trial. Nutr Metab Cardiovasc Dis 2013; 23:e13-e14. [PMID: 23220076 DOI: 10.1016/j.numecd.2012.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
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Pasquero P, Albani S, Sitia E, Castagno F, D’Antico S, Porta M. Inferior vena cava diameters and collapsibility index changes reveal early volume depletion in a healthy donor model. Crit Ultrasound J 2012. [PMCID: PMC3524494 DOI: 10.1186/2036-7902-4-s1-a29] [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: 12/05/2022] Open
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Porta M, Servello D, Zanaboni C, Anasetti F, Menghetti C, Sassi M, Robertson MM. Deep brain stimulation for treatment of refractory Tourette syndrome: long-term follow-up. Acta Neurochir (Wien) 2012; 154:2029-41. [PMID: 22961243 DOI: 10.1007/s00701-012-1497-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 08/23/2012] [Indexed: 12/19/2022]
Abstract
BACKGROUND Eighteen patients with severe and refractory Tourette Syndrome underwent bilateral thalamic deep brain stimulation. The surgical procedures and stimulation processes of the cohort were reported in 2008; the 2 year follow-up was reported in 2009. The aim of the research is the assessment of long-term outcome (5-6 years) on tics, obsessional behaviours, anxiety, mood, and on the overall general health of the patients and their general satisfaction. METHOD In this study, all 18 of the original patients will be discussed, pre- and post-DBS, according to our protocol using standardized objective schedules, as well as the clinical impressions of both clinicians and patients. As there were no substantial nor statistical differences on measures of cognitive functioning between pre-DBS and 2 year follow-up, we decided not to continue this aspect of the formal assessment, particularly as there were also no clinical indications. RESULTS At 5-6 year follow-up, there was a significant reduction in tic severity (p < 0.001), and significant improvements in obsessive compulsive behaviours (p = 0.003), anxiety (p < 0.001) and depressive (p < 0.001) symptoms. Patients, in general, required less medication for tics, co-morbid conditions and/or co-existent psychopathologies. The long-term outcome/satisfaction were not unanimous between patients and the medical team. CONCLUSIONS At long-term follow-up, DBS was very successful in terms of a significant improvement in tics and also a significant reduction in the potentially disabling symptoms of obsessionality, anxiety and depression. However, compared with our more positive overall results at 2 years, these later results demonstrate long-term difficulties as follows: non-compliance, long-term complications , and the differences in the opinions between the (a) medical, (b) the surgical teams and (c) the post-DBS patients as to their outcome/satisfaction with the procedures. Our experience highlights the need for controlled studies, for long-term follow up, and the need to improve the selection of patients for DBS.
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Affiliation(s)
- M Porta
- Tourette Center- IRCCS Galeazzi Hospital, via R. Galeazzi 4, 20161, Milano, Italy.
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Porta M, Gallen M, Belloc J, Malats N. Predictors of the interval between onset of symptoms and first medical visit in patients with digestive tract cancer. Int J Oncol 2012; 8:941-9. [PMID: 21544449 DOI: 10.3892/ijo.8.5.941] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Lack of effective population screening programmes for digestive tract cancer makes a prompt diagnosis of symptomatic patients the primary option for early detection. The objective of the study was to analyze the characteristics and determinants of the interval between the first medical symptom and the first medical visit (ISV) in a sample of symptomatic patients of mid-low socioeconomic level admitted to hospital for a digestive tract cancer. During two years, 183 patients were personally interviewed with a structured questionnaire designed to elicit initial symptoms of digestive cancer. Fifty-seven percent consulted a physician during the first month after onset of symptoms, and over two-thirds did so within the first 2 months, but it took more than 3 months for 22.4% of the patients. In univariate analyses, the ISV was longer among patients illiterate, unemployed and in the lower social classes. The interval was also significantly longer when the physician-interviewer judged that the patient did not correctly identify the first symptom (p<0.05). In multivariate analyses, the chance of a longer ISV was 2.8 times higher in men; 16 times higher in unemployed patients; 9 times higher in patients with a first symptom of the lower digestive tract; and it increased 8-fold in subjects who attributed no importance to the first manifestation (all p<0.05). In spite of virtually universal health coverage, social factors seemed to act as barriers to seeking medical help in a subgroup of patients. Their procrastination was also related to the nature of the initial symptoms. Achieving an early clinical detection of digestive cancers may be difficult in some segments of the population, and may require substantial improvements in access to and the efficiency of the health system.
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Affiliation(s)
- M Porta
- HOSP MARE DEU ESPERANCA,DEPT ONCOL,BARCELONA,SPAIN. HOSP MARE DEU ESPERANCA,DEPT GASTROENTEROL,BARCELONA,SPAIN
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Trento M, Raballo M, Trevisan M, Sicuro J, Passera P, Cirio L, Charrier L, Cavallo F, Porta M. A cross-sectional survey of depression, anxiety, and cognitive function in patients with type 2 diabetes. Acta Diabetol 2012; 49:199-203. [PMID: 21442429 DOI: 10.1007/s00592-011-0275-z] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 03/04/2011] [Indexed: 01/21/2023]
Abstract
To evaluate the prevalence of depression in outpatients with type 2 diabetes and its possible correlation with anxiety, cognitive function, and clinical variables. The Zung Self-Rating Depression and Anxiety Scales and the Mini-Mental-State Examination were administered to 249 non-insulin-treated (NIT) and 249 insulin-treated (IT) outpatients with type 2 diabetes, aged 40-80, in a cross-sectional survey. Compared with a reported prevalence of 6-13% in the general population, 104 (20.9%) patients had either a score indicative of depression or were on anti-depressant medication. Assuming that medication might modify the responses to questionnaires, the latter patients were excluded from further analysis. IT patients had higher age, known duration of diabetes, HbA1c, more foot ulcers, retinopathy, microalbuminuria and practised more self-monitoring of blood glucose (P < 0.01 all) but a slightly lower mean depression score (P = 0.004) and similar anxiety or cognitive function. At multivariate analysis, depression was associated with anxiety (P < 0.001), age (P < 0.001), gender (men having lower scores than women, P = 0.042), and insulin treatment, IT patients being less depressed than NIT (P < 0.001), but none of the clinical variables. Anxiety correlated with age (P < 0.001). The association between depression and anxiety became progressively weaker with increasing age. These data confirm increased prevalence of depression in a population of patients with type 2 diabetes who did not show impaired cognitive function. The lack of correlation with disease duration, metabolic control, and complications suggests that depression may not appear/worsen with diabetes and/or its complications but rather supports suggestions that it might predate both.
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Affiliation(s)
- M Trento
- Dipartimento di Medicina Interna, Laboratorio di Pedagogia Clinica, Università di Torino, Corso AM Dogliotti 14, 10126, Turin, Italy.
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Bandello F, Cunha-Vaz J, Chong NV, Lang GE, Massin P, Mitchell P, Porta M, Prünte C, Schlingemann R, Schmidt-Erfurth U. New approaches for the treatment of diabetic macular oedema: recommendations by an expert panel. Eye (Lond) 2012; 26:485-93. [PMID: 22241014 PMCID: PMC3325561 DOI: 10.1038/eye.2011.337] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [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: 08/22/2011] [Accepted: 11/10/2011] [Indexed: 02/08/2023] Open
Abstract
The current standard therapy for patients with diabetic macular oedema (DME)--focal/grid laser photocoagulation--usually does not improve impaired vision, and many patients lose vision despite laser therapy. Recent approval of ranibizumab by the European Medicines Agency to treat visual impairment due to DME fulfils the previously unmet medical need for a treatment that can improve visual acuity (VA) in these patients. We reviewed 1- and 2-year clinical trial findings for ranibizumab used as treatment for DME to formulate evidence-based treatment recommendations in the context of this new therapy. DME with or without visual impairment should be considered for treatment when it fulfils the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria for clinically significant oedema. For DME with centre involvement and associated vision loss due to DME, monthly ranibizumab monotherapy with treatment interruption and re-initiation based on VA stability is recommended. Laser therapy based on ETDRS guidelines is recommended for other forms of clinically significant DME without centre involvement or when no vision loss has occurred, despite centre involvement. Because these recommendations are based on randomised controlled trials of 1-2 years duration, guidance may need updating as long-term ranibizumab data become available and as additional therapeutic agents are assessed in clinical trials.
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Affiliation(s)
- F Bandello
- Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy
| | - J Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - N V Chong
- Oxford Eye Hospital, University of Oxford, Oxford, UK
| | - G E Lang
- Department of Ophthalmology, University Eye Hospital, Ulm, Germany
| | - P Massin
- Assistance Publique des Hôpitaux de Paris, Ophthalmology Department, Hôpital Lariboisière, Paris, France
| | - P Mitchell
- Discipline of Ophthalmology, University of Sydney, Sydney, Australia
| | - M Porta
- Department of Internal Medicine, University of Turin, Turin, Italy
| | - C Prünte
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Vista Klinik, Binningen, Switzerland
| | - R Schlingemann
- Medical Retina Unit and Ocular Angiogenesis Group, Department of Ophthalmology, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands
- Department of Clinical and Molecular Ophthalmogenetics, The Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, The Netherlands
| | - U Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
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Giannicola G, Rosa M, Servello D, Menghetti C, Marceglia S, Rossi L, Pacchetti C, Porta M, Scelzo E, Barbieri S, Priori A. 2.306 WHAT THE SUBTHALAMIC LOCAL FIELD POTENTIALS SAY AFTER YEARS OF CHRONIC STIMULATION IN PARKINSON'S DISEASE? Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70629-0] [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: 11/17/2022]
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Gallo V, Egger M, McCormack V, Farmer PB, Ioannidis JPA, Kirsch-Volders M, Matullo G, Phillips DH, Schoket B, Stromberg U, Vermeulen R, Wild C, Porta M, Vineis P. STrengthening the Reporting of OBservational studies in Epidemiology - Molecular Epidemiology (STROBE-ME): An extension of the STROBE statement. Mutagenesis 2012; 27:17-29. [DOI: 10.1093/mutage/ger039] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Howard SG, Heindel JJ, Thayer KA, Porta M. Environmental pollutants and beta cell function: relevance for type 1 and gestational diabetes. Diabetologia 2011; 54:3168-9. [PMID: 21947423 DOI: 10.1007/s00125-011-2318-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 08/11/2011] [Indexed: 02/06/2023]
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Abstract
Diabetic retinopathy (DR) is a leading cause of visual impairment in working age in industrialized countries. It is classified as non-proliferative (mild, moderate or severe) and proliferative, with diabetic macular oedema potentially developing at any of these stages. The prevalence and incidence of DR increase with diabetes duration and worsening of metabolic and blood pressure control. Current approaches to prevent and/or treat DR include optimized control of blood glucose and blood pressure and screening for early identification of high-risk, although still asymptomatic, retinal lesions. Results from recent clinical trials suggest a role for blockers of the renin-angiotensin system (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers) and for fenofibrate in reducing progression and/or inducing regression of mild-to-moderate non-proliferative DR. Intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents was shown to reduce visual loss in more advanced stages of DR, especially in macular oedema.
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Affiliation(s)
- M Porta
- Diabetic Retinopathy Centre, Department of Internal Medicine, University of Turin, Corso A M Dogliotti 14, Turin, Italy.
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Porta M, Hainer JW, Jansson SO, Malm A, Bilous R, Chaturvedi N, Fuller JH, Klein R, Orchard T, Parving HH, Sjølie AK. Exposure to candesartan during the first trimester of pregnancy in type 1 diabetes: experience from the placebo-controlled DIabetic REtinopathy Candesartan Trials. Diabetologia 2011; 54:1298-303. [PMID: 21225239 DOI: 10.1007/s00125-010-2040-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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: 10/05/2010] [Accepted: 12/06/2010] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS The teratogenic consequences of angiotensin-converting enzyme inhibitors angiotensin receptor blockers (ARBs) during the second and third trimesters of pregnancy are well described. However, the consequences of exposure during the first trimester are unclear, especially in diabetes. We report the experience from DIRECT (DIabetic REtinopathy and Candesartan Trials), three placebo-controlled studies designed to examine the effects of an ARB, candesartan, on diabetic retinopathy. METHODS Over 4 years or longer, 178 normotensive women with type 1 diabetes (86 randomised to candesartan, 32 mg once daily, and 92 assigned to placebo) became pregnant (total of 208 pregnancies). RESULTS More than half of patients were exposed to candesartan or placebo prior to or in early pregnancy, but all discontinued it at an estimated 8 weeks from the last menstrual period. Full-term pregnancies (51 vs 50), premature deliveries (21 vs 27), spontaneous miscarriages (12 vs 15), elective terminations (15 vs 14) and other outcomes (1 vs 2) were similar in the candesartan and placebo groups. There were two stillbirths and two 'sick babies' in the candesartan group, and one stillbirth, eight 'sick babies' and one cardiac malformation in the placebo group. CONCLUSIONS/INTERPRETATION The risk for fetal consequences of ARBs in type 1 diabetes may not be high if exposure is clearly limited to the first trimester. Long-term studies in fertile women can be conducted with ARBs during pregnancy, provided investigators diligently stop their administration upon planning or detection of pregnancy. TRIAL REGISTRATION ClinicalTrials.gov DIRECT-Prevent 1 NCT00252733; DIRECT-Protect 1 NCT00252720; DIRECT-Protect 2 NCT00252694. FUNDING The study was funded jointly by AstraZeneca and Takeda.
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Affiliation(s)
- M Porta
- Department of Internal Medicine, University of Turin, Corso AM Dogliotti 14, 10126 Torino, Italy.
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Sjølie AK, Klein R, Porta M, Orchard T, Fuller J, Parving HH, Bilous R, Aldington S, Chaturvedi N. Retinal microaneurysm count predicts progression and regression of diabetic retinopathy. Post-hoc results from the DIRECT Programme. Diabet Med 2011; 28:345-51. [PMID: 21309844 DOI: 10.1111/j.1464-5491.2010.03210.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the association between baseline retinal microaneurysm score and progression and regression of diabetic retinopathy, and response to treatment with candesartan in people with diabetes. METHODS This was a multicenter randomized clinical trial. The progression analysis included 893 patients with Type 1 diabetes and 526 patients with Type 2 diabetes with retinal microaneurysms only at baseline. For regression, 438 with Type 1 and 216 with Type 2 diabetes qualified. Microaneurysms were scored from yearly retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Retinopathy progression and regression was defined as two or more step change on the ETDRS scale from baseline. Patients were normoalbuminuric, and normotensive with Type 1 and Type 2 diabetes or treated hypertensive with Type 2 diabetes. They were randomized to treatment with candesartan 32 mg daily or placebo and followed for 4.6 years. RESULTS A higher microaneurysm score at baseline predicted an increased risk of retinopathy progression (HR per microaneurysm score 1.08, P < 0.0001 in Type 1 diabetes; HR 1.07, P = 0.0174 in Type 2 diabetes) and reduced the likelihood of regression (HR 0.79, P < 0.0001 in Type 1 diabetes; HR 0.85, P = 0.0009 in Type 2 diabetes), all adjusted for baseline variables and treatment. Candesartan reduced the risk of microaneurysm score progression. CONCLUSIONS Microaneurysm counts are important prognostic indicators for worsening of retinopathy, thus microaneurysms are not benign. Treatment with renin-angiotensin system inhibitors is effective in the early stages and may improve mild diabetic retinopathy. Microaneurysm scores may be useful surrogate endpoints in clinical trials.
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Affiliation(s)
- A K Sjølie
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
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Trento M, Trinetta A, Kucich C, Grassi G, Passera P, Gennari S, Paganin V, Tedesco S, Charrier L, Cavallo F, Porta M. Carbohydrate counting improves coping ability and metabolic control in patients with Type 1 diabetes managed by Group Care. J Endocrinol Invest 2011; 34:101-5. [PMID: 20440106 DOI: 10.1007/bf03347038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS To assess, in patients with Type 1 diabetes (T1DM), the effects of adding a carbohydrate counting programme (CCP) to continuing education by Group Care on coping ability, quality of life (QoL), knowledge of diabetes, and metabolic control. MATERIALS AND METHODS Out of 56 patients with T1DM followed by Group Care, 27 were randomized to receive an 8-session CCP and 29 controls continued Group Care without a CCP. QoL, knowledge, and coping ability were assessed at baseline and after 30 months. Glycated hemoglobin (HbA1c), body weight, blood glucose, hypoglycemic episodes, and insulin dosages were checked every 3 months. RESULTS QoL improved (p<0.0001) in both CCP (88.7 ± 9.2 vs 78.0 ± 9.9) and control patients (88.7 ± 12.5 vs 80.4 ± 11.7). At the end of study, patients on CCP had better scores in knowledge [difference 0.72 (95% CI 0.44; 0.99), p<0.0001] and the 3 coping areas [problem solving: 1.75 (1.2; 2.3), p<0.0001; social support seeking: -1.4 (-2.3; -0.48) p<0.005; avoidance: -1.59 (-2.6; -0.56), p<0.005] than controls. All variables showed a greater, although not statistically significant, improvement in patients with poor schooling. At 30 months, HbA1c was lower in the CCP patients than controls (7.2 ± 0.9 vs 7.9 ± 1.4), p<0.05. There were no changes in insulin dosage, hypoglycemic episodes or blood lipids. CONCLUSIONS This study confirms that Group Care improves QoL in people with T1DM, but suggests that specific educational and psychological supports are needed to modify adaptation to the disease. The CCP we developed appears effective in promoting change, also in patients with poor schooling.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Department of Internal Medicine, University of Turin, Corso AM Dogliotti 14, I-10126 Turin, Italy.
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Trento M, Kucich C, Tibaldi P, Gennari S, Tedesco S, Balbo M, Arvat E, Cavallo F, Ghigo E, Porta M. A study of central serotoninergic activity in healthy subjects and patients with Type 2 diabetes treated by traditional one-to-one care or Group Care. J Endocrinol Invest 2010; 33:624-8. [PMID: 20142635 DOI: 10.1007/bf03346660] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIM Central serotoninergic activity may modulate glucose metabolism via neuroendocrine effectors. Group Care is a clinico-pedagogic intervention that improves metabolic control and quality of life in Type 2 diabetes through lifestyle modification and, possibly, central mechanisms. The hypothesis that central serotoninergic activity is modified in patients followed by Group Care was tested by measuring their hypothalamic- pituitary-adrenal response to citalopram, a selective serotonin reuptake inhibitor. METHODS AND SUBJECTS Ten healthy controls and 17 non-obese, non-insulin-treated patients with Type 2 diabetes received, in random order, iv infusions of either 20 mg citalopram or saline. Nine patients had been longterm on Group Care and 8 had always been on traditional one-to-one care. Circulating glucose, insulin, ACTH, cortisol, DHEA, GH and PRL were measured every 15 min for 240 min. Differences between areas under the curves after citalopram and saline (Δ-AUC) were calculated. RESULTS Citalopram stimulated ACTH and cortisol secretion in healthy subjects (p=0.026 and p=0.011, respectively) and patients on Group Care (p=0.056 and p=0.038) but not in patients on traditional care. In healthy subjects, basal glucose correlated with growth hormone Δ- AUC (r=0.820; p=0.004) and inversely with insulin Δ-AUC (r=-0.822; p=0.003). The former correlation was preserved in the patients (r=0.637; p=0.026). CONCLUSIONS Diabetes may blunt the response of the hypothalamic-pituitary-adrenal axis to citalopram, but this is preserved in patients followed by a long-term intervention model that improves clinical as well as cognitive and emotional variables.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Department of Internal Medicine, University of Turin, Corso A.M. Dogliotti 14, Turin, Italy.
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Rosales M, Fernandez M, Muñoz O, Roca G, Skodova M, Garcia P, Porta M. P14.20 Direct observation of hand hygiene in a teaching hospital. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60169-7] [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: 10/19/2022]
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Estevez P, Khan S, Lambert P, Porta M, Polat I, Scherer C, Tichem M, Staufer U, Langen HH, Schmidt RM. A Haptic Tele-operated System for Microassembly. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/978-3-642-11598-1_2] [Citation(s) in RCA: 2] [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: 02/21/2023]
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Porta M, Brambilla A, Cavanna AE, Servello D, Sassi M, Rickards H, Robertson MM. Thalamic deep brain stimulation for treatment-refractory Tourette syndrome: two-year outcome. Neurology 2009; 73:1375-80. [PMID: 19858459 DOI: 10.1212/wnl.0b013e3181bd809b] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Eighteen patients with severe and refractory Tourette syndrome (TS) underwent bilateral thalamic deep brain stimulation (DBS). OBJECTIVE To assess the long-term outcome on tics, behavioral symptoms, and cognitive functions in the largest case series of thalamic DBS for TS to date. METHODS In this prospective cohort study, 15 of the original 18 patients were evaluated before and after surgery according to a standardized protocol that included both neuropsychiatric and neuropsychological assessments. RESULTS In addition to marked reduction in tic severity (p = 0.001), 24-month follow-up ratings showed improvement in obsessive-compulsive symptoms (p = 0.009), anxiety symptoms (p = 0.001), depressive symptoms (p = 0.001), and subjective perception of social functioning/quality of life (p = 0.002) in 15 of 18 patients. There were no substantial differences on measures of cognitive functions before and after DBS. CONCLUSIONS At 24-month follow-up, tic severity was improved in patients with intractable Tourette syndrome (TS) who underwent bilateral thalamic deep brain stimulation. Available data from 15 of 18 patients also showed that neuropsychiatric symptoms were improved and cognitive performances were not disadvantaged. Controlled studies on larger cohorts with blinded protocols are needed to verify that this procedure is effective and safe for selected patients with TS. LEVEL OF EVIDENCE This study provides class IV evidence that bilateral thalamic deep brain stimulation reduces global tic severity measured 24 months after implantation in patients with severe intractable Tourette syndrome.
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Affiliation(s)
- M Porta
- Movement Disorders and Tourette Centre, IRCCS Galeazzi, Milan, Italy
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Trento M, Porta M. Abstract: 997 ROMEO (RETHINK ORGANIZATION TO IMPROVE EDUCATION AND OUTCOMES). A 4-YEAR MULTICENTRE RANDOMISED CONTROLLED TRIAL OF GROUP CARE FOR THE MANAGEMENT OF TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70368-x] [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: 10/20/2022]
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Fernández CA, Puig-Domingo M, Lomeña F, Estorch M, Camacho Martí V, Bittini AL, Marazuela M, Santamaría J, Castro J, Martínez de Icaya P, Moraga I, Martín T, Megía A, Porta M, Mauricio D, Halperin I. Effectiveness of retinoic acid treatment for redifferentiation of thyroid cancer in relation to recovery of radioiodine uptake. J Endocrinol Invest 2009; 32:228-33. [PMID: 19542739 DOI: 10.1007/bf03346457] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Retinoic acid (RA) treatment has been used for redifferentiation of metastatic thyroid neoplasia that have lost radioiodine (131I) uptake with heterogeneous results. AIM Retrospective analysis of the recovery rate of 131I uptake after RA treatment in patients from 11 Spanish hospitals. METHODS Twenty-seven patients (14 men, 13 women) with papillary [21], follicular [4], and oncocytic [2] thyroid cancer initially treated with total thyroidectomy plus 131I, and with 131I negative metastatic disease, were given 13-cis RA (0.66-1.5 mg/kg for 5-12 weeks) followed by a therapeutic 131I dose (3700-7400 MBq); 3 months later thyroglobulin levels and computed tomography imaging were performed. RESULTS In 9 out 27 cases (33%) (8 papillary, 1 follicular) optimal positive 131I scan was observed after RA treatment; in the remaining 18, 10 had a suboptimal uptake (7 papillary, 2 follicular, 1 oncocytic) and in the rest there was no 131I uptake recovery (6 papillary, 1 follicular, 1 oncocytic). In 17 positive responses to RA (either optimal or suboptimal) in which image follow-up was available, decrease or stabilization of metastatic growth was observed in 7, while tumor mass increased at short term in the remaining 10. No major side effects were detected. CONCLUSION Quite a high rate of 131I uptake recovery after RA treatment may be obtained in advanced differentiated thyroid cancer, but the potential modification of the natural course of the disease is uncertain. A better biological characterization of these tumors allowing the identification of potential responders to RA may improve the outcome of RA coadjuvant therapy.
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Affiliation(s)
- C A Fernández
- Endocrinology Service, Barcelona Clinical Hospital, Barcelona, Spain
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