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Calcaterra V, Farolfi A, D'Auria E, De Silvestri A, Baldassarre P, Ferrara F, Tiranini L, Ghezzi M, Garancini N, Bernardo L, Nappi RE, Zuccotti G. Perimenstrual Asthma and Premenstrual Disorders in Adolescents with Asthma. J Pediatr Adolesc Gynecol 2024; 37:132-136. [PMID: 37977436 DOI: 10.1016/j.jpag.2023.11.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Asthma is a common chronic disease in pediatric patients, and perimenstrual asthma (PMA), refers to the worsening of asthma symptoms during the perimenstrual period, mainly reported in adult women. However, there is limited information regarding the exacerbation of symptoms in the presence of premenstrual disorders (PMDs) in adolescents. The aim of this pilot observational study was to investigate the frequency and potential association of PMA and PMDs in a clinical sample of adolescents with asthma. PATIENTS AND METHODS The study included 50 adolescents (aged 12-18 years, mean 16.08 ± 2.35) with asthma and at least 2 years of gynecological age. The participants completed the Asthma Control Test (ACT) to assess asthma control (considered pathological if ACT score < 20) and the modified Premenstrual Symptoms Screening Tool for Adolescents (PSST-A) to evaluate PMDs. RESULTS A total of 75.5% of adolescents reported PMA. The prevalence of premenstrual symptoms did not significantly differ between the PMA and no-PMA group. Among the study sample, 38.7% experienced symptoms indicative of moderate/severe premenstrual syndrome, and 8.1% exhibited symptoms of premenstrual dysphoric disorder. Compared with the no-PMA group, patients with PMA showed a significant impairment in daily and home activities (P = .03 and P = .02, respectively) and exhibited a difference in the frequency of asthma symptoms (P < .001) and medication use (P ≤ .01). CONCLUSION Perimenstrual worsening of asthma symptoms may be common in adolescents with a severe form of asthma. Prospective data collection through menstrual diaries is necessary to further explore the association between PMA and PMDs. Identifying early risk factors for PMA could facilitate the development of preventive strategies and early interventions for adolescents with asthma.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Andrea Farolfi
- Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Enza D'Auria
- Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy.
| | - Annalisa De Silvestri
- Scientific Direction, Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Francesca Ferrara
- Department of Childhood and Adolescent Medicine and Gender Medicine, The Fatebenefratelli-Melloni Hospital, Milan, Italy
| | - Lara Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, School of Medicine, University of Pavia, Italy
| | - Michele Ghezzi
- Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Nicolò Garancini
- Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Luca Bernardo
- Department of Childhood and Adolescent Medicine and Gender Medicine, The Fatebenefratelli-Melloni Hospital, Milan, Italy
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, School of Medicine, University of Pavia, Italy; Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy; Department of Biomedical and Clinical Science, University of Milano, Milano, Italy
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Ghezzi M, Abbattista L, Dighera A, Silvestri AD, Farolfi A, Pelizzo G, Riccipetitoni G, Costanzo S, Calcaterra V, Zuccotti GV. Lung Function Evaluated By Structured Light Plethysmography in Children After Lung Surgery: A Preliminary Analysis. Pediatr Allergy Immunol Pulmonol 2024; 37:7-12. [PMID: 38484265 DOI: 10.1089/ped.2023.0069] [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] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background: Structured light plethysmography (SLP) is a novel light-based method that captures chest wall movements to evaluate tidal breathing. Methods: Thirty-two children who underwent lung surgery were enrolled. Their clinical history was collected along with spirometry and SLP. Results: Median age of surgery was 9 months (interquartile range 4-30). Most frequent diagnosis was congenital pulmonary airway malformation (14/32), then pulmonary sequestration (9/32), tumor (5/32), and bronchogenic cyst (4/32). The most frequent surgical approach was lobectomy (59%), segmentectomy (38%), and complete resection (3%). More than 80% had surgery when younger than 3 years of age. Eight patients had short-term complications (pleural effusion was the most frequent), while long-term effects were reported in 15 patients (19% recurrent cough, 13% thoracic deformities, 13% airway infections, 9% wheezing, 6% reduced exercise tolerance, and 3% columnar deformities). Spirometry was normal in 9/22 patients. Nine patients had a restrictive pattern, while 4 showed a mild bronco-reactivity. Ten patients did not perform spirometry because of young age. SLP revealed the presence of obstructive pattern in 10% of patients (IE50 > 1.88) and showed a significant difference between the two hemithorax in 29% of patients. Discussion: SLP may be a new method to evaluate lung function, without collaboration and radiation exposure, in children who underwent lung resection, also in preschool age.
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Affiliation(s)
- Michele Ghezzi
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Luisa Abbattista
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Anna Dighera
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Annalisa De Silvestri
- Department of Biometry and Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Farolfi
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, "Vittore Buzzi" Children's Hospital, Milano, Italy
- Department of Biomedical and Clinical Science "L. Sacco," University of Milano, Milano, Italy
| | - Giovanna Riccipetitoni
- Department of Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia
| | - Sara Costanzo
- Department of Pediatric Surgery, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
- Pediatric and Adolescent Unit, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, Milano, Italy
- Department of Biomedical and Clinical Science "L. Sacco," University of Milano, Milano, Italy
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Ghezzi M, Garancini N, De Santis R, Gianolio L, Zirpoli S, Mandelli A, Farolfi A, D’Auria E, Zuccotti GV. Recurrent Respiratory Infections in Children with Down Syndrome: A Review. Children (Basel) 2024; 11:246. [PMID: 38397357 PMCID: PMC10888118 DOI: 10.3390/children11020246] [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] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Down Syndrome (DS) is the most common chromosomal abnormality compatible with life. The life of patients suffering from DS can be strongly impacted by Recurrent Respiratory tract Infections (RRIs), leading to an increased rate of hospitalisation, a higher need for intensive care and fatality. With a literature review, we summarise here the main etiological factors for RRI in this category of patients, particularly focusing on airway malformations such as tracheomalacia, tracheal bronchus and bronchomalacia, comorbidities associated with the syndrome, like congenital heart diseases, dysphagia, gastroesophageal reflux, musculoskeletal involvement and obesity, and immunologic impairments, involving both innate and adaptive immunity. For these patients, a multidisciplinary approach is imperative as well as some preventive strategies, in particular vaccinations in accordance with their national schedule for immunization.
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Affiliation(s)
- Michele Ghezzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Nicolò Garancini
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Raffaella De Santis
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Laura Gianolio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Salvatore Zirpoli
- Pediatric Radiology Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy;
| | - Anna Mandelli
- Division of Pediatric Anesthesia and Intensive Care Unit, Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy;
| | - Andrea Farolfi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Enza D’Auria
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (N.G.); (R.D.S.); (L.G.); (A.F.); (E.D.); (G.V.Z.)
- Department of Biomedical and Clinical Science, Università Degli Studi di Milano, 20157 Milan, Italy
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Ghirardo S, Ullmann N, Zago A, Ghezzi M, Minute M, Madini B, D'Auria E, Basile C, Castelletti F, Chironi F, Capodiferro A, Andrenacci B, Risso FM, Aversa S, Dotta L, Coretti A, Vittucci AC, Badolato R, Amaddeo A, Barbi E, Cutrera R. Increased bronchiolitis burden and severity after the pandemic: a national multicentric study. Ital J Pediatr 2024; 50:25. [PMID: 38350986 PMCID: PMC10865582 DOI: 10.1186/s13052-024-01602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The coronavirus 2019 (COVID-19) related containment measures led to the disruption of all virus distribution. Bronchiolitis-related hospitalizations shrank during 2020-2021, rebounding to pre-pandemic numbers the following year. This study aims to describe the trend in bronchiolitis-related hospitalization this year, focusing on severity and viral epidemiology. METHODS We conducted a retrospective investigation collecting clinical records data from all infants hospitalized for bronchiolitis during winter (1st September-31th March) from September 2018 to March 2023 in six Italian hospitals. No trial registration was necessary according to authorization no.9/2014 of the Italian law. RESULTS Nine hundred fifty-three infants were hospitalized for bronchiolitis this last winter, 563 in 2021-2022, 34 in 2020-2021, 395 in 2019-2020 and 483 in 2018-2019. The mean length of stay was significantly longer this year compared to all previous years (mean 7.2 ± 6 days in 2022-2023), compared to 5.7 ± 4 in 2021-2022, 5.3 ± 4 in 2020-2021, 6.4 ± 5 in 2019-2020 and 5.5 ± 4 in 2018-2019 (p < 0.001), respectively. More patients required mechanical ventilation this winter 38 (4%), compared to 6 (1%) in 2021-2022, 0 in 2020-2021, 11 (2%) in 2019-2020 and 6 (1%) in 2018-2019 (p < 0.05), respectively. High-flow nasal cannula and non-invasive respiratory supports were statistically more common last winter (p = 0.001 or less). RSV prevalence and distribution did not differ this winter, but coinfections were more prevalent 307 (42%), 138 (31%) in 2021-2022, 1 (33%) in 2020-2021, 68 (23%) in 2019-2020, 61 (28%) in 2018-2019 (p = 0.001). CONCLUSIONS This study shows a growth of nearly 70% in hospitalisations for bronchiolitis, and an increase in invasive respiratory support and coinfections, suggesting a more severe disease course this winter compared to the last five years.
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Affiliation(s)
- Sergio Ghirardo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, via dell'Istria 65/1, Trieste, Italy.
| | - Nicola Ullmann
- Pediatric Pulmonology and Cystic Fibrosis Unit, Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Zago
- Department of Medicine, Surgery and Health Sciences, University of Trieste, via dell'Istria 65/1, Trieste, Italy
| | - Michele Ghezzi
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy
| | - Marta Minute
- Ospedale Regionale Ca Foncello Treviso, Treviso, Italy
| | - Barbara Madini
- S.C. Pediatria Pneumoinfettivologia Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enza D'Auria
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy
| | - Cecilia Basile
- Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy
| | | | - Federica Chironi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, 20122, Italy
| | - Agata Capodiferro
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, 20122, Italy
| | - Beatrice Andrenacci
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Francesco Maria Risso
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Salvatore Aversa
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Laura Dotta
- Department of Pediatrics and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Antonella Coretti
- Pediatric Pulmonology and Cystic Fibrosis Unit, Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anna Chiara Vittucci
- Pediatric Pulmonology and Cystic Fibrosis Unit, Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Raffaele Badolato
- Department of Pediatrics and "A. Nocivelli" Institute for Molecular Medicine, Department of Clinical and Experimental Sciences, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, 34137, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, via dell'Istria 65/1, Trieste, Italy
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, 34137, Italy
| | - Renato Cutrera
- Pediatric Pulmonology and Cystic Fibrosis Unit, Respiratory Intermediate Care Unit, Sleep and Long-Term Ventilation Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Garancini N, Ricci G, Ghezzi M, Tommasi P, Zunica F, Mandelli A, Zoia E, D'Auria E, Zuccotti GV. Invasive Group A streptococcal infections: are we facing a new outbreak? A case series with the experience of a single tertiary center. Ital J Pediatr 2023; 49:88. [PMID: 37468965 DOI: 10.1186/s13052-023-01494-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND In pediatric age, Group A Streptococcus (GAS) is responsible for a wide spectrum of clinical manifestations, from mild localized infections to life-threatening invasive diseases. In December 2022, the World Health Organization reported an increased incidence of scarlet fever and invasive GAS infections (iGAS) cases in Europe and the United States. In line with these observations, surveillance has been strengthened in our Region, allowing the identification of certified or highly suspected forms of iGAS. CASE PRESENTATION We report here 4 emblematic cases of iGAS admitted to our Intensive Care Unit (ICU) in the short time span from mid-February to mid-March 2023. Particularly, we describe a case of pleuropneumonia (4 year old boy) and a case of respiratory failure (2 year old boy), who necessitated Non-Invasive Ventilation support, a case of Streptococcal Toxic Shock Syndrome (6 year old girl), presenting with multi-organ failure, who needed Invasive Ventilation, and a case of meningitis (5 year old girl). All these patients needed intensive care support. CONCLUSIONS Accurate differential diagnosis and early treatment both could help to reduce the transmission of GAS and consequently the risk of severe iGAS. These cases confirmed the need for close monitoring and appropriate notification, in order to verify their actual increased incidence.
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Affiliation(s)
- Nicolò Garancini
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Giulia Ricci
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Michele Ghezzi
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Paola Tommasi
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Fiammetta Zunica
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Anna Mandelli
- Division of Pediatric Anesthesia and Intensive Care Unit, Department of Pediatrics, Children's Hospital Vittore Buzzi, 20154, Milan, Italy
| | - Elena Zoia
- Division of Pediatric Anesthesia and Intensive Care Unit, Department of Pediatrics, Children's Hospital Vittore Buzzi, 20154, Milan, Italy
| | - Enza D'Auria
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy.
| | - Gian Vincenzo Zuccotti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154, Milan, Italy
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157, Milan, Italy
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Ghezzi M, Kantar A. Lung Function in Childhood: Designing the Future Trajectories. Children (Basel) 2023; 10:1036. [PMID: 37371267 DOI: 10.3390/children10061036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Lung development is a highly regulated process that may be disrupted by both genetic and environmental factors beginning at an early age [...].
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Affiliation(s)
- Michele Ghezzi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Ahmad Kantar
- Pediatric Asthma and Cough Centre, Gruppo Ospedaliero San Donato, 24036 Bergamo, Italy
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Ghezzi M, Longoni E, Munari A, Raso I, Biganzoli G, Zuccotti G, D'Auria E. Lung involvement in children with COVID-19 multisystem inflammatory syndrome. Pediatr Pulmonol 2023; 58:615-618. [PMID: 36345237 PMCID: PMC9877654 DOI: 10.1002/ppul.26224] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/30/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
Since the beginning of the COVID-19 pandemic, multisystem inflammatory syndrome in children (MIS-C) has been reported in increasing numbers, mostly focusing on cardiac dysfunction. Very few studies have evaluated lung involvement in terms of imaging findings, while data regarding pulmonary function in children with MIS-C are not available. The purpose of our study was to evaluate lung involvement in MIS-C by imaging and lung function by structured light plethysmography (SLP) at hospital admission and 6 months afterwards. Spirometry is the gold standard technique to evaluate lung function in children. However, SLP has the advantage of not requiring contact with the patient, offering an effective solution for the evaluation of lung function during the pandemic. To our knowledge this is the first study that aims to investigate pulmonary function by SLP in children with MIS-C.
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Affiliation(s)
- Michele Ghezzi
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
| | - Emma Longoni
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Alice Munari
- Department of Radiology, V. Buzzi Children's Hospital, Milano, Italy
| | - Irene Raso
- Pediatric Cardiology Unit, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Giacomo Biganzoli
- Medical Statistics Unit, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
| | - Enza D'Auria
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
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D'Auria E, Calcaterra V, Gasparini C, De Silvestri A, Lamberti R, Ghezzi M, Zuccotti G. The impact of adiposity indices on lung function in children with respiratory allergic diseases. Obes Res Clin Pract 2022; 16:314-318. [PMID: 35850917 DOI: 10.1016/j.orcp.2022.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 06/07/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The effect of obesity on lung function in children stratified by asthma status is not fully elucidated. We evaluated the impact of adiposity indices, including Body Mass Index (BMI) and estimated fat mass (eFT), on lung changes in asthmatic and non-asthmatic children with rhinitis. PATIENTS AND METHODS We performed a retrospective review of 400 pediatric patients, classified into an asthma group (n = 200) and a no-asthma group (n = 200). According to the BMI z-score all subjects were classified into normal-weight patients (NW; -2 ≤ BMI z-score <1) and overweight patients/patients with obesity (OW/OB; BMI z-score ≥1). Lung function parameters were measured by spirometry. BMI and eFM were considered as adiposity indices. RESULTS Excess weight/obesity was present in 37 % of patients. The OW/OB group showed higher basal forced expiratory vital capacity (FVC) and lower forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio compared to the NW group (p ≤ 0.01). FVC and FEV1 were correlated with the BMI z-score, and FEV1/FVC with eFT (p ≤ 0.01). No differences were noted between the NW and the OW/OB groups in terms of respiratory parameters except for FVC (p < 0.01). In the OW/OB group, asthma patients were significantly different based on FEV1, FEV1/FVC, and forced expiratory flow at 25-75 % of FVC (FEF25/75) (p < 0.01). The BMI z-score was correlated with FVC and FEV1 in both the no-asthma and asthma groups (p ≤ 0.01 and p ≤ 0.05, respectively), while eFM was correlated with FEV1/FVC (p = 0.007) in the asthma group only. CONCLUSION Obesity seems to have a significant impact on lung function in children with respiratory allergic diseases. BMI and eFM may be used to evaluate the impact of adiposity on lung function.
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Affiliation(s)
- Enza D'Auria
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20157 Milan, Italy.
| | - Valeria Calcaterra
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Chiara Gasparini
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Annalisa De Silvestri
- Biometry and Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Rossella Lamberti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Michele Ghezzi
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - GianVincenzo Zuccotti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20157 Milan, Italy
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D’Auria E, Calcaterra V, Verduci E, Ghezzi M, Lamberti R, Vizzuso S, Baldassarre P, Pendezza E, Perico V, Bosetti A, Zuccotti GV. Immunonutrition and SARS-CoV-2 Infection in Children with Obesity. Nutrients 2022; 14:nu14091701. [PMID: 35565668 PMCID: PMC9101404 DOI: 10.3390/nu14091701] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Since the beginning of the SARS-CoV-2 pandemic, there has been much discussion about the role of diet and antiviral immunity in the context of SARS-CoV-2 infection. Intake levels of vitamins D, C, B12, and iron have been demonstrated to be correlated with lower COVID-19 incidence and mortality. Obesity has been demonstrated to be an independent risk for the severity of COVID-19 infection in adults and also in children. This may be due to different mechanisms, mainly including the gut dysbiosis status observed in obese children. Moreover, the existence of a gut-lung axis added new knowledge to on the potential mechanisms by which diet and dietary substances may affect immune function. The aim of this narrative review is to address the intricate inter-relationship between COVID-19, immune function, and obesity-related inflammation and to describe the role of nutrients and dietary patterns in enhancing the immune system. Two ways to fight against COVID-19 disease exist: one with an antiviral response through immune system boosting and another with antioxidants with an anti-inflammatory effect. In the current pandemic situation, the intake of a varied and balanced diet, rich in micronutrients and bioactive compounds including fibers, should be recommended. However, clinical studies conducted on children affected by SARS-CoV-2 infection and comorbidity are warranted.
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Affiliation(s)
- Enza D’Auria
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
- Correspondence:
| | - Michele Ghezzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Rossella Lamberti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Sara Vizzuso
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Erica Pendezza
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Veronica Perico
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Piazza M, Di Cicco M, Pecoraro L, Ghezzi M, Peroni D, Comberiati P. Long COVID-19 in Children: From the Pathogenesis to the Biologically Plausible Roots of the Syndrome. Biomolecules 2022; 12:556. [PMID: 35454144 PMCID: PMC9024951 DOI: 10.3390/biom12040556] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Long Coronavirus disease-19 (COVID-19) refers to the persistence of symptoms related to the infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). This condition is described as persistent and can manifest in various combinations of signs and symptoms, such as fatigue, headache, dyspnea, depression, cognitive impairment, and altered perception of smells and tastes. Long COVID-19 may be due to long-term damage to different organs-such as lung, brain, kidney, and heart-caused by persisting viral-induced inflammation, immune dysregulation, autoimmunity, diffuse endothelial damage, and micro thrombosis. In this review, we discuss the potential and biologically plausible role of some vitamins, essential elements, and functional foods based on the hypothesis that an individual's dietary status may play an important adjunctive role in protective immunity against COVID-19 and possibly against its long-term consequences.
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Affiliation(s)
- Michele Piazza
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (M.P.); (L.P.)
| | - Maria Di Cicco
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy; (M.D.C.); (P.C.)
| | - Luca Pecoraro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (M.P.); (L.P.)
| | - Michele Ghezzi
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy;
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy; (M.D.C.); (P.C.)
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy; (M.D.C.); (P.C.)
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11
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Ghezzi M, D’Auria E, Farolfi A, Calcaterra V, Zenga A, De Silvestri A, Pelizzo G, Zuccotti GV. Airway Malacia: Clinical Features and Surgical Related Issues, a Ten-Year Experience from a Tertiary Pediatric Hospital. Children (Basel) 2021; 8:children8070613. [PMID: 34356592 PMCID: PMC8307910 DOI: 10.3390/children8070613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Abstract
Background: Few studies have been carried out with the aim of describing the clinical course and follow-up of patients with tracheomalacia. We aim to describe the symptoms at diagnosis and the post-treatment clinical course of patients affected by airway malacia. Methods: We retrospectively analyzed characteristics of pediatric patients with a diagnosis of airway malacia. Patients were classified into three groups: bronchomalacia (BM), tracheomalacia (TM) and tracheo-bronchomalacia (TBM). Demographic and clinical data, diagnostic work-up and surgical treatment were recorded. Results: 13/42 patients were affected by congenital syndromes (30.9%). Esophageal atresia with or without tracheal-esophageal fistula (EA/TEF) was detected in 7/42 patients (16.7%). Cardiovascular anomalies were found in 9/42 (21.4%) and idiopathic forms in 13/42 (30.9%). BM occurred in 7/42 (16.6%), TM in 23/42 (54.7%) and TBM in 12/42 (28.6%). At the diagnosis stage, a chronic cough was reported in 50% of cases with a higher prevalence in EA/TEF (p = 0.005). Surgery was performed in 16/42 (40%) of children. A chronic cough and acute respiratory failure were correlated to the need for surgery. During follow-up, there was no difference in persistence of symptoms between conservative vs surgical treatment (p = 0.47). Conclusion: the management of tracheomalacia remains a challenge for pediatricians. Clinical manifestations, such as a barking cough and acute respiratory failure may suggest the need for surgery. Follow-up is crucial, especially in those patients affected by comorbidities, so as to be able to manage effectively the possible persistence of symptoms, including those that may continue after surgical treatment.
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Affiliation(s)
- Michele Ghezzi
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.); (A.F.); (A.Z.)
- Correspondence: ; Tel.: +039-02-6363-5797
| | - Enza D’Auria
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.); (A.F.); (A.Z.)
| | - Andrea Farolfi
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.); (A.F.); (A.Z.)
| | - Valeria Calcaterra
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (V.C.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Alessandra Zenga
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.); (A.F.); (A.Z.)
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Gloria Pelizzo
- Department of Pediatric Surgery, V. Buzzi Children’s Hospital, 20154 Milan, Italy;
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (V.C.); (G.V.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Goker F, Donati G, Grecchi F, Sparaco A, Ghezzi M, Rania V, Rossi CA, Del Fabbro M. Treatment of BRONJ with ozone/oxygen therapy and debridement with piezoelectric surgery. Eur Rev Med Pharmacol Sci 2021; 24:9094-9103. [PMID: 32964999 DOI: 10.26355/eurrev_202009_22855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Bisphosphonate related osteonecrosis of the jaw (BRONJ) is progressive bone destruction in the maxillofacial region of patients under current or previous treatment with Bisphosphonates. The present case series study aimed to evaluate if ozone/oxygen therapy and debridement with piezoelectric surgery may improve the treatment of BRONJ. PATIENTS AND METHODS The treatment modality of the patients included ozone/oxygen mixture from medical oxygen. The protocol for ozone/oxygen mixture therapy appointments was set as twice a week for 10 weeks, for a total of 20 applications for each patient. The evaluation of the lesions was based on the clinical and radiologic parameters. The primary outcome was the necrotic lesion reduction during ozone/oxygen therapy sessions and up to the end of follow up periods. The healing of the lesion was taken as a positive result. The level of significance was taken as p <0.05. RESULTS A total of 14 patients affected by osteonecrosis were included. The mean follow-up of the patients was 14.3 months. The overall success rate after treatment was 64.2%. CONCLUSIONS According to the results, ozone/oxygen therapy and debridement with Piezoelectric surgery for BRONJ treatment is a safe procedure with successful outcomes.
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Affiliation(s)
- F Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.
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13
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Ghezzi M, Pescina S, Padula C, Santi P, Del Favero E, Cantù L, Nicoli S. Polymeric micelles in drug delivery: An insight of the techniques for their characterization and assessment in biorelevant conditions. J Control Release 2021; 332:312-336. [PMID: 33652113 DOI: 10.1016/j.jconrel.2021.02.031] [Citation(s) in RCA: 305] [Impact Index Per Article: 101.7] [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: 01/07/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022]
Abstract
Polymeric micelles, i.e. aggregation colloids formed in solution by self-assembling of amphiphilic polymers, represent an innovative tool to overcome several issues related to drug administration, from the low water-solubility to the poor drug permeability across biological barriers. With respect to other nanocarriers, polymeric micelles generally display smaller size, easier preparation and sterilization processes, and good solubilization properties, unfortunately associated with a lower stability in biological fluids and a more complicated characterization. Particularly challenging is the study of their interaction with the biological environment, essential to predict the real in vivo behavior after administration. In this review, after a general presentation on micelles features and properties, different characterization techniques are discussed, from the ones used for the determination of micelles basic characteristics (critical micellar concentration, size, surface charge, morphology) to the more complex approaches used to figure out micelles kinetic stability, drug release and behavior in the presence of biological substrates (fluids, cells and tissues). The techniques presented (such as dynamic light scattering, AFM, cryo-TEM, X-ray scattering, FRET, symmetrical flow field-flow fractionation (AF4) and density ultracentrifugation), each one with their own advantages and limitations, can be combined to achieve a deeper comprehension of polymeric micelles in vivo behavior. The set-up and validation of adequate methods for micelles description represent the essential starting point for their development and clinical success.
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Affiliation(s)
- M Ghezzi
- ADDRes Lab, Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - S Pescina
- ADDRes Lab, Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - C Padula
- ADDRes Lab, Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - P Santi
- ADDRes Lab, Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - E Del Favero
- Department of Medical Biotechnologies and Translational Medicine, LITA, University of Milan, Segrate, Italy
| | - L Cantù
- Department of Medical Biotechnologies and Translational Medicine, LITA, University of Milan, Segrate, Italy
| | - S Nicoli
- ADDRes Lab, Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy.
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14
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Mameli C, Ghezzi M, Mari A, Cammi G, Macedoni M, Redaelli FC, Calcaterra V, Zuccotti G, D’Auria E. The Diabetic Lung: Insights into Pulmonary Changes in Children and Adolescents with Type 1 Diabetes. Metabolites 2021; 11:metabo11020069. [PMID: 33530418 PMCID: PMC7912250 DOI: 10.3390/metabo11020069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022] Open
Abstract
Historically, the lung was not listed and recognized as a major target organ of diabetic injury. The first evidence of diabetic lung involvement was published fifty years ago, with a study conducted in a population of young adults affected by type 1 diabetes (T1D). In recent years, there has been mounting evidence showing that the lung is a target organ of diabetic injury since the beginning of the disease—at the pediatric age. The deeply branched vascularization of the lungs and the abundance of connective tissue, indeed, make them vulnerable to the effects of hyperglycemia, in a way similar to other organs affected by microvascular complications. In this review, we focus on pulmonary function impairment in children and adolescents affected by T1D. We also cover controversial aspects regarding available studies and future perspectives in this field.
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Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Department of Biomedical and Clinical Science “L. Sacco”, Università di Milano, 20157 Milan, Italy
- Correspondence: ; Tel.: +39-0263635324
| | - Michele Ghezzi
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Alessandra Mari
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Giulia Cammi
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Maddalena Macedoni
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Francesca Chiara Redaelli
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
| | - Valeria Calcaterra
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Department of Biomedical and Clinical Science “L. Sacco”, Università di Milano, 20157 Milan, Italy
| | - Enza D’Auria
- Department of Pediatrics, V. Buzzi Children’s Hospital, 20154 Milan, Italy; (M.G.); (A.M.); (G.C.); (M.M.); (F.C.R.); (V.C.); (G.Z.); (E.D.)
- Allergology and Pneumology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy
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Montalbano L, Ferrante G, Montella S, Cilluffo G, Di Marco A, Bozzetto S, Di Palmo E, Licari A, Leonardi L, Caldarelli V, Ghezzi M, La Grutta S, Rusconi F. Relationship between quality of life and behavioural disorders in children with persistent asthma: a Multiple Indicators Multiple Causes (MIMIC) model. Sci Rep 2020; 10:6957. [PMID: 32332757 PMCID: PMC7181655 DOI: 10.1038/s41598-020-62264-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/11/2020] [Indexed: 12/04/2022] Open
Abstract
Knowledge on multiple interdependences between quality of life (QoL) and behavioural problems in relation to asthma severity and control is undetermined. The aims of the study were: (i) to assess the relationship of QoL and behavioural problems with asthma severity and control (ii) to predict children’s “abnormal/borderline” status with variation in QoL. For these purposes a multicenter case-control study on 47 Severe Asthma (SA) and 94 Moderate Asthma (MA) children was performed. The MIMIC approach was applied to investigate the effect of SA and non-controlled asthma (NC) on QoL and behavioural disorders. Logistic regression was used to estimate probabilities of having an “abnormal/borderline” status with variation in QoL. The MIMIC model showed that the magnitude of the effect of SA and NC was larger on QoL (β = −0.37 and β = −0.30, respectively) than on behavioural problems (β = 0.27). With regards to the probability of having a borderline status, in MA a QoL of 1 returned a probability of 0.81, whereas in SA a QoL of 1 returned a probability of 0.89. In conclusion, SA children are highly affected by impaired QoL and behavioural problems. The MIMIC model allowed us to obtain a comprehensive assessment of QoL and behavioural problems with asthma severity and control.
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Affiliation(s)
- Laura Montalbano
- National Research Council of Italy, Institute for Research and Biomedical Innovation, IRIB, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Silvia Montella
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanna Cilluffo
- National Research Council of Italy, Institute for Research and Biomedical Innovation, IRIB, Via Ugo La Malfa 153, 90146, Palermo, Italy.
| | - Antonio Di Marco
- Pediatric Pulmonology and Sleep & Long Term Ventilation Unit, Academic Department Pediatric Hospital "Bambino Gesù", Piazza S. Onofrio 4, Rome, Italy, 00165, Roma, Italy
| | - Sara Bozzetto
- Division of Emergency Medicine, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Emanuela Di Palmo
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Amelia Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, piazzale Golgi 19, 27100, Pavia, Italy
| | - Lucia Leonardi
- Department of Paediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Valeria Caldarelli
- Pediatric Unit, Department of Obstetrics, Gynecology and Pediatrics, Azienda USL - IRCCS, Azienda USL-IRCCS, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Michele Ghezzi
- Department of Pediatrics, Ospedale dei Bambini, University of Milan, Milan, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute for Research and Biomedical Innovation, IRIB, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Franca Rusconi
- Unit of Epidemiology, 'Anna Meyer' Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
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Rocca MS, Di Nisio A, Sabovic I, Ghezzi M, Foresta C, Ferlin A. E2F1 copy number variations contribute to spermatogenic impairment and cryptorchidism by increasing susceptibility to heat stress. Andrology 2019; 7:251-256. [PMID: 30659775 DOI: 10.1111/andr.12583] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Copy number variations (CNVs) play an important role in the onset of several diseases, and recently research focused on the relationship between these structural variants and diseases of the reproductive tract, including male infertility and cryptorchidism. OBJECTIVES To evaluate the contribution of copy number variations of E2F1 gene to idiopathic male infertility and the factors influencing expression of this gene. MATERIALS AND METHODS We performed a retrospective study on 540 subjects recruited from September 2014 to February 2015. TaqMan CNV assay was used to analyze E2F1 CNV. Real-time PCR was used to assess E2F1 and HSP70 expression level in heat stressed and transfected cells with three E2F1 copies. RESULTS We found a significant difference in the frequency of altered E2F1 copies in patients (12/343, 3.5%) compared with controls (0/197) (p = 0.005). Six patients with E2F1 CNV had history of cryptorchidism, but the prevalence between men with idiopathic infertility (6/243, 2.5%) and infertile men with history of cryptorchidism (6/100, 6.0%) was not statistically different (p = 0.1). E2F1 expression increased under heat stress conditions, especially in cells carrying more copies of gene and this was associated with increased expression of HSP70. DISCUSSION Our data suggest that an abnormal E2F1 expression caused by multiple copies of E2F1 gene predisposes to the onset of infertility and that the risk further increases if subjects with altered E2F1 copies have stressful conditions, such as heat stress or history of cryptorchidism. CONCLUSION This study shows a link between E2F1 CNV and male infertility, suggesting that the increased risk of spermatogenic impairment associated with higher E2F1 copies might be due to higher susceptibility to stressful conditions.
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Affiliation(s)
- M S Rocca
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - A Di Nisio
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - I Sabovic
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - M Ghezzi
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - C Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - A Ferlin
- Department of Clinical and Experimental Sciences, Unit of Endocrinology, University of Brescia, Brescia, Italy
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Sacco O, Silvestri M, Ghezzi M, Capizzi A, Rossi GA. Airway inflammation and injury in children with prevalent weakly acidic gastroesophageal refluxes. Respir Med 2018; 143:42-47. [DOI: 10.1016/j.rmed.2018.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022]
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Ghezzi M, Tenero L, Piazza M, Zaffanello M, Paiola G, Piacentini GL. Feasibility of structured light plethysmography for the evaluation of lung function in preschool children with asthma. Allergy Asthma Proc 2018; 39:e38-e42. [PMID: 30095401 DOI: 10.2500/aap.2018.39.4143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Structured light plethysmography (SLP) is a new noninvasive technology to capture the movement of the thoracic and abdominal wall, and to assess some parameters indicative for lung function. OBJECTIVE The purpose of the study was to evaluate the feasibility of SLP in children with asthma. METHODS A total of 52 patients were enrolled: 25 with asthma exacerbation (group 1), 13 with well-controlled asthma (group 2), and 14 healthy controls (group 3). Every patient underwent SLP evaluation and a lung function test. RESULTS SLP evaluations showed that the ratio of inspiratory flow at 50% of tidal volume (Vt) to expiratory flow at 50% of Vt, in which Vt is taken to be the exhaled chest wall movement, and flow is taken to be the time derivative of the chest wall movement (IE50) value increased in group 1 compared with groups 2 and 3, with statistical significance (p = 0.018); the data were consistent with the spirometry parameter. A correlation between the IE50 and forced expiratory volume in the first second of expiration was highlighted (r = -0.35, p = 0.019). CONCLUSION SLP assessed airway obstruction, and its use in clinical practice could be applied in preschool children in future studies.
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Milardi D, Luca G, Grande G, Ghezzi M, Caretta N, Brusco G, De Filpo G, Marana R, Pontecorvi A, Calafiore R, Foresta C, Garolla A. Prednisone treatment in infertile patients with oligozoospermia and accessory gland inflammatory alterations. Andrology 2017; 5:268-273. [DOI: 10.1111/andr.12300] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/02/2016] [Accepted: 09/26/2016] [Indexed: 02/02/2023]
Affiliation(s)
- D. Milardi
- International Scientific Institute ‘Paul VI’; Catholic University; Rome Italy
| | - G. Luca
- Department of Experimental Medicine; University of Perugia; Perugia Italy
| | - G. Grande
- International Scientific Institute ‘Paul VI’; Catholic University; Rome Italy
| | - M. Ghezzi
- Department of Medicine, Andrology and Reproductive Unit; University of Padova; Padova Italy
| | - N. Caretta
- Department of Medicine, Andrology and Reproductive Unit; University of Padova; Padova Italy
| | - G. Brusco
- Unit of Diagnosis and Treatment of Human Reproduction University of Perugia; Perugia Italy
| | - G. De Filpo
- Department of Experimental Medicine; University of Perugia; Perugia Italy
| | - R. Marana
- International Scientific Institute ‘Paul VI’; Catholic University; Rome Italy
| | - A. Pontecorvi
- Division of Endocrinology; Catholic University; Rome Italy
| | - R. Calafiore
- Department of Medicine; University of Perugia; Perugia Italy
| | - C. Foresta
- Department of Medicine, Andrology and Reproductive Unit; University of Padova; Padova Italy
| | - A. Garolla
- Department of Medicine, Andrology and Reproductive Unit; University of Padova; Padova Italy
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Ghezzi M, Silvestri M, Sacco O, Panigada S, Girosi D, Magnano GM, Rossi GA. Mild tracheal compression by aberrant innominate artery and chronic dry cough in children. Pediatr Pulmonol 2016; 51:286-94. [PMID: 26099051 DOI: 10.1002/ppul.23231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 04/28/2015] [Accepted: 04/28/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND In children with aberrant innominate artery (AIA) one of the most prevalent respiratory symptom is dry cough. How frequently this mediastinal vessels anomaly, that can induce tracheal compression (TC) of different degree, may be detected in children with chronic dry cough is not known. METHODS In a 3-year retrospective study, the occurrence of mediastinal vessels abnormalities and the presence and degree of TC was evaluated in children with recurrent/chronic dry cough. RESULTS Vascular anomalies were detected in 68 out of the 209 children evaluated. A significant TC was detected in 54 children with AIA, in eight with right aortic arch, in four with double aortic arch but not in two with aberrant right subclavian artery. In AIA patients, TC evaluated on computed tomography scans, was mild in 47, moderate in six and severe in one. During bronchoscopy TC increased in expiration or during cough, but this finding was more pronounced in children with right aortic arch and double aortic arch in which a concomitant tracheomalacia was more evident. Comorbidities were detected in 21 AIA patients, including atopy, reversible bronchial obstruction and gastroesophageal reflux. Aortopexy was performed in eight AIA patients, while the remaining AIA patients were managed medically and showed progressive improvement with time. CONCLUSION Mild TC induced by AIA can be detected in a sizeable proportion of children with recurrent/chronic dry cough. The identification of this anomaly, that may at least partially explain the origin of their symptom, may avoid further unnecessary diagnostic examinations and ineffective chronic treatments.
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Affiliation(s)
- Michele Ghezzi
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | - Michela Silvestri
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | - Oliviero Sacco
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | - Serena Panigada
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | - Donata Girosi
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Giovanni A Rossi
- Pediatric Pulmonology and Allergy Unit and Cystic Fibrosis Center, Istituto Giannina Gaslini, Genoa, Italy
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21
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Ferlin A, Selice R, Di Mambro A, Ghezzi M, Di Nisio A, Caretta N, Foresta C. Role of vitamin D levels and vitamin D supplementation on bone mineral density in Klinefelter syndrome. Osteoporos Int 2015; 26:2193-202. [PMID: 25963234 DOI: 10.1007/s00198-015-3136-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 01/09/2015] [Accepted: 04/07/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED This manuscript describes the role of low vitamin D in bone metabolism of Klinefelter subjects. Low vitamin D is frequent in this condition and seems to be more important than testosterone in inducing low bone mineral density (BMD) and osteoporosis. Supplementation with vitamin D restores BMD after 2 years of treatment, whereas testosterone alone seems to be ineffective. INTRODUCTION Decreased bone mineral density (BMD) in Klinefelter syndrome (KS) is frequent, and it has been traditionally related to low testosterone (T) levels. However, low BMD can be observed also in patients with normal T levels and T replacement therapy does not necessarily increase bone mass in these patients. Nothing is known about vitamin D levels and supplementation in KS. In this study, we determine vitamin D status and bone mass in KS subjects and compare the efficacy of T therapy and vitamin D supplementation on BMD. METHODS A total of 127 non-mosaic KS patients and 60 age-matched male controls were evaluated with reproductive hormones, 25-hydroxyvitamin D, PTH, and bone densitometry by dual-energy X-ray absorptiometry (DEXA). Patients with hypogonadism and/or 25-hydroxyvitamin D deficiency were treated with T-gel 2% and/or calcifediol and re-evaluated after 24 months of treatment. RESULTS 25-hydroxyvitamin D levels were significantly lower in KS patients with respect to controls, and they had significantly lower lumbar and femoral BMD. The percentage of osteopenia/osteoporosis in subjects with 25-hydroxyvitamin D deficiency was higher with respect to subjects with normal 25-hydroxyvitamin D and was not related to the presence/absence of low T levels. Subjects treated with calcifediol or T + calcifediol had a significant increase in lumbar BMD after treatment. No difference was found in T-treated group. CONCLUSIONS These data highlight that low 25-hydroxyvitamin D levels seem to have a more critical role than low T levels in inducing low BMD in KS subjects. Furthermore, vitamin D supplementation seems to be more effective than T replacement therapy alone in increasing BMD.
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Affiliation(s)
- A Ferlin
- Department of Medicine and Centre for Human Reproduction Pathology, University of Padova, Via Giustiniani 2, 35100, Padova, Italy
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22
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Napoli F, Di Iorgi N, Bagnasco F, Cangemi G, D'Amico B, Boschetti M, Allegri AEM, Bruzzone Ichim IA, Traggiai C, Allodi A, Polo Perucchin P, Ghezzi M, Noli S, Giaccardi M, Roviglione B, De Miglio L, Calcagno A, Lorini R, Maghnie M. Growth factors and metabolic markers in cord blood: relationship to birth weight and length. J BIOL REG HOMEOS AG 2014; 28:237-249. [PMID: 25001656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Low birth weight and length for gestational age are associated with a high risk of short stature and metabolic syndrome in adulthood. The mechanisms that link prenatal growth to adult stature and metabolic syndrome have not yet been entirely clarified. The aim of our study was to evaluate the relationship between standardized anthropometric measures at birth and insulin-like growth factor (IGF)-I, IGF-II, insulin, adiponectin, and non-esterified fatty acid (NEFA) cord blood levels in the general population. One hundred fifty-eight random newborn subjects (77F, 81M) from Genoa, Italy, were analyzed. Anthropometric parameters were measured and standardized according to standard Italian tables. Insulin values were treated as categorical, since in several cases the results fell below detection cut-off. Mean birth weight was 3,214.23∓488.99 gr and mean length was 49.82∓2.17 cm. Females had higher mean IGF-I (p=0.04), and were more likely to have insulin values either <2 μU/ml or >4.5μU/ml (p= 0.04) compared to males. Weight and length SD scores (SDS) were higher in subjects with elevated insulin levels (p=0.002). A moderate correlation was found between weight and IGF-II (r=0.354). Multivariable analysis demonstrated that standardized birth weight was associated with IGFII and insulin values. Our data highlight the importance of IGF-II in fetal growth and suggest that gender differences should be taken into consideration when evaluating prenatal growth.
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Affiliation(s)
- F Napoli
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - N Di Iorgi
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - F Bagnasco
- Epidemiology, Biostatistics and Committee Unit, Istituto G. Gaslini, Genova, Italy
| | - G Cangemi
- Clinical Pathology Laboratory Unit, Istituto G. Gaslini, Genova, Italy
| | - B D'Amico
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - M Boschetti
- Department of Endocrinology and Medical Sciences, University of Genova, Genova, Italy
| | - A E M Allegri
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | | | - C Traggiai
- Neonatal Intensive Care Unit, Istituto G.Gaslini, Genova, Italy
| | - A Allodi
- Neonatology, S. Martino Hospital, Genova, Italy
| | - P Polo Perucchin
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - M Ghezzi
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - S Noli
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - M Giaccardi
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - B Roviglione
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - L De Miglio
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - A Calcagno
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - R Lorini
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
| | - M Maghnie
- Pediatric Clinic, IRCCS G. Gaslini, University of Genova, Genova, Italy
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Pedros DCC, Oliveira JBA, Petersen CG, Mauri AL, Nascimento AM, Vagnini LD, Nicoletti A, Massaro FC, Cavagna M, Martins AMVC, Baruffi RLR, Franco JG, Hart R, Doherty DA, Handelsman DJ, McLachlan R, Skakkebaek NE, Keelan JA, Norman RJ, Dokuzeylul N, Onal M, Acet M, Basar M, Kahraman S, Garolla A, Pizzol D, Ghezzi M, Selice R, Bertoldo A, Menegazzo M, Foresta C, Jordan C, Broderick P. Session 18: Lifestyle dangers for men's fertility. Hum Reprod 2013. [DOI: 10.1093/humrep/det145] [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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24
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Maccagnano C, Freschi M, Ghezzi M, Rocchini L, Pellucchi F, Rigatti P, Montorsi F, Colombo R. Kidney endometriosis. MINERVA UROL NEFROL 2013; 65:157-159. [PMID: 23703102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Ghezzi M, Guida E, Ullmann N, Sacco O, Mattioli G, Jasonni V, Rossi GA, Silvestri M. Weakly acidic gastroesophageal refluxes are frequently triggers in young children with chronic cough. Pediatr Pulmonol 2013; 48:295-302. [PMID: 22553136 DOI: 10.1002/ppul.22581] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 04/05/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate whether the proportion of acid and weakly acidic refluxes preceding cough bursts could be different in infants, preschool- and school-aged children with chronic, unexplained cough. PATIENTS AND METHODS One hundred six children with unexplained chronic cough, not receiving acid suppressive therapy, underwent impedance-pH monitoring. They were divided into Group A: <2 years (21 pts), Group B: ≥2 to ≤6 years (41 pts), and Group C: >6 years (44 pts). Reflux was defined as acid (pH <4), weakly acidic (WA; pH 4-7), and weakly alkaline (pH >7).Cough episodes were considered temporally associated with gastroesophageal reflux (GER) when occurring within 2 min after a GER episode. RESULTS Impedance-pH detected 55.50 (39.00-76.00) reflux episodes/patient with an acid-to-WA reflux event ratio of 3.31 (1.55-8.33). This parameter was significantly lower in Group A (1.33 [0.41-3.40]) than in Group B (3.06 [2.00-6.50]; P < 0.05] and Group C (5.09 [2.34-12.43; P < 0.001]). No cough episode was preceded by weakly alkaline refluxes in any patient. During impedance-pH recording, 93 patients (87.7%) had at least one cough episode that had been preceded by impedance refluxes in 83 patients. In this latter group (83 pts), the median number of cough episodes was 12.0 (5.0-25.5), of which 48.15% (30.15-71.43%) were preceded by refluxes; GER-preceded cough episodes were similar in the three groups. The majority of children had cough episodes preceded by acid refluxes in the total population (78.3%), in Group B (80.5%) and in Group C (93.7%), but not in Group A (40.0%; P < 0.001). CONCLUSIONS In addition to acid, also a significant proportion of WA GER may precede cough episodes in young children with persistent cough, possibly explaining the inconstant effects of anti-acid treatment on respiratory symptoms.
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Affiliation(s)
- Michele Ghezzi
- Pediatric Pulmonology and Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy
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26
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Sparaco A, Ghezzi M, Donati G, Andriella K, Montebello A, Luraghi C, Romanoni G, Rania V. Surgical dental implants in people living with HIV-AIDS. Retrovirology 2012. [PMCID: PMC3360299 DOI: 10.1186/1742-4690-9-s1-p85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Ghezzi M, Silvestri M, Guida E, Pistorio A, Sacco O, Mattioli G, Jasonni V, Rossi GA. Acid and weakly acid gastroesophageal refluxes and type of respiratory symptoms in children. Respir Med 2011; 105:972-8. [PMID: 21334184 DOI: 10.1016/j.rmed.2011.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 01/25/2011] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To evaluate the association between the frequency of acid reflux (AR) and weakly acid reflux (WAR) and specific respiratory symptoms (RS) in childhood. STUDY DESIGN We retrospectively reviewed medical records of children with difficult-to-treat RS, not under acid suppressive therapy, and with a positive multiple intraluminal esophageal impedance (pH/MII) monitoring. To discriminate children with prevalent AR and WAR events, a ROC curve was designed and the distribution of the different RS in children with prevalent AR or WAR events was analyzed. RESULTS A higher number of AR over WAR events was detected (p < 0.0001) but the WAR-to-AR events ratio progressively decreased with the age of the subjects (p < 0.01). Similar total number of reflux events was found in the three age group and in children with a more prevalent WAR or AR. The most prevalent RS, equally distributed among the three age groups, were persistent and/or nocturnal cough, wheezy bronchitis/asthma, and recurrent lower respiratory tract infections (RLRTI). Apnoea was most frequent in infants (p = 0.036). A higher frequency of RLRTI, but not of nocturnal cough or wheezy bronchitis/asthma, was shown in WAR as compared with AR patients (p = 0.040), and specifically those in the school-aged group (p = 0.013). Age and WAR were respectively identified as independent predictors of apnoea and RLRTI (p < 0.05). CONCLUSION WAR events are common in children with gastroesophageal reflux and difficult-to-treat RS and often associated with RLRTI. These findings support the role of pH/MII monitoring in the evaluation of these patients and may explain the disappointing clinical results often observed with anti-acid treatments.
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Affiliation(s)
- Michele Ghezzi
- Pediatric Pulmonology and Allergy Unit, G Gaslini Institute, Largo G Gaslini 5, 16147 Genoa, Italy
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Sparaco A, Donati G, Ghezzi M, Ranìa V, Luraghi C, Liverani A, Quattrone G, Alivia M. Clinical patterns in odontoiatric surgery patients: Comparison between antibiotics plus antalgics versus Arnica planta tota D3 plus Silicea compositum. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.09.088] [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: 11/16/2022]
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29
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Di Iorgi N, Calandra E, Secco A, Napoli F, Calcagno A, Ghezzi M, Frassinetti C, De Terlizzi F, Giorgiani G, Locatelli F, Maghnie M. Quantitative ultrasound detects bone changes following bone marrow transplantation in pediatric subjects with hematological diseases: a longitudinal study. J Endocrinol Invest 2010; 33:478-82. [PMID: 20101099 DOI: 10.1007/bf03346628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/26/2022]
Abstract
BACKGROUND Bone marrow transplantation (BMT) is associated with bone morbidity. We investigated bone status with quantitative ultrasound (QUS) in pediatric patients with hematological diseases prior to and up to 3 yr following BMT. METHODS Phalangeal QUS measures for amplitude- dependent speed of sound (Ad-SoS) and bone transmission time (BTT) were obtained in 40 hematological patients (25 with malignant, 15 with non-malignant disease; 9.7+/-4.9 yr) before BMT and 6, 12, 24, and 36 months after BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls. RESULTS Mean Ad-SoS and BTT Z-scores were normal before BMT and reduced at 36 months (analysis of variance: p=0.0542 and p=0.0233). Ad-SoS and BTT Z-scores remained relatively stable in the first 6 months after BMT and then progressively decreased reaching a plateau at 12-36 months. In non-malignant patients, BTT Z-score decreased at 6-12 months (p=0.029) and subsequently increased, while in malignant patients BTT Z-score showed a decrease at 12-24 months. Pre-pubertal subjects displayed a drop of BTT Z-Score values at both 12 (p=0.023) and 36 months after BMT (p=0.049), while BTT Z-score remained relatively unchanged in pubertal subjects. Early impairment of BTT Z-score was found in patients who suffered acute graft versus host disease (GVHD) compared to patients without this clinical condition; BTT Z-score was lower at 36 months (p=0.045). CONCLUSIONS Longitudinal assessment by QUS of pediatric BMT survivors evidenced that bone status is mildly affected up to 36 months after BMT, mainly in malignant patients, in pre-pubertal subjects at BMT and in patients who suffered acute GVHD.
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Affiliation(s)
- N Di Iorgi
- Department of Pediatrics, IRCCS G. Gaslini, University of Genoa, Largo G. Gaslini 5, 16147 Genoa, Italy.
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30
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di Iorgi N, Napoli F, Allegri A, Secco A, Calandra E, Calcagno A, Frassinetti C, Ghezzi M, Ambrosini L, Parodi S, Gastaldi R, Loche S, Maghnie M. The accuracy of the glucagon test compared to the insulin tolerance test in the diagnosis of adrenal insufficiency in young children with growth hormone deficiency. J Clin Endocrinol Metab 2010; 95:2132-9. [PMID: 20350939 DOI: 10.1210/jc.2009-2697] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT The accuracy of the glucagon test in the diagnosis of central adrenal insufficiency in young children has not yet been definitively established. OBJECTIVE The aim of this study was to investigate the diagnostic accuracy of the glucagon test as an alternative to the insulin tolerance test (ITT) in children with GH deficiency under 6 yr of age. DESIGN AND SETTING This was a prospective study conducted in two Pediatric Endocrinology Centers. PATIENTS AND METHODS Forty-eight children (median age, 4.2 yr) with GH deficiency confirmed by a peak GH to ITT and arginine less than 10 microg/liter were enrolled: 24 with normal hypothalamic-pituitary anatomy, seven with isolated anterior pituitary hypoplasia, and 17 with structural hypothalamic-pituitary abnormalities at magnetic resonance imaging. Twelve subjects had central adrenal insufficiency defined by a peak cortisol response of less than 20 microg/dl to ITT. All children underwent a glucagon stimulation test with blood sampling for cortisol and glucose (time 0 to 180 min) after the im administration of 30 microg/kg of glucagon. RESULTS The mean peak cortisol after glucagon was not significantly different from that obtained after ITT in the whole cohort (25.9 vs. 26.0 microg/dl; P = 0.908), and it was significantly reduced in patients with structural hypothalamic-pituitary abnormalities (P < 0.001). Receiver operating characteristic curve analysis showed that the best diagnostic accuracy was obtained with a peak cortisol cutoff to glucagon of 14.6 microg/dl (sensitivity, 66.67%; specificity, 100%; area under the curve = 0.91; 95% confidence interval, 0.82-0.99). Using this cutoff, 91.67% of the patients were correctly classified. CONCLUSIONS This study shows that glucagon is an accurate and safe diagnostic test for adrenal function in young children who are at risk for adrenal insufficiency.
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Affiliation(s)
- Natascia di Iorgi
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy
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31
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Secco A, di Iorgi N, Napoli F, Calandra E, Ghezzi M, Frassinetti C, Parodi S, Casini MR, Lorini R, Loche S, Maghnie M. The glucagon test in the diagnosis of growth hormone deficiency in children with short stature younger than 6 years. J Clin Endocrinol Metab 2009; 94:4251-7. [PMID: 19837934 DOI: 10.1210/jc.2009-0779] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [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: 11/19/2022]
Abstract
CONTEXT Few studies have addressed the diagnostic role of the glucagon test in children with suspected GH deficiency (GHD). OBJECTIVE The objective of the study was to investigate the diagnostic value of the glucagon test as an alternative test to insulin tolerance test (ITT) and arginine in GHD children younger than 6 yr. DESIGN AND SETTING This study was conducted in two pediatric endocrinology centers. PATIENTS AND METHODS Forty-eight children (median age 4.2 yr, median height -3.0 sd score) with GHD confirmed by a peak GH to ITT and arginine less than 10 microg/liter (median 4.7 and 3.4 microg/liter, respectively) underwent a glucagon stimulation test. Magnetic resonance imaging showed normal hypothalamic-pituitary anatomy in 24 children, isolated anterior pituitary hypoplasia in seven, and structural hypothalamic-pituitary abnormalities in 17. RESULTS Median GH peak response to glucagon (13.5 microg/liter) was significantly higher than that observed after ITT and arginine (P < 0.0001). GH peak after glucagon was less than 10 microg/liter in 20 subjects (group 1) and greater than 10 microg/liter in 28 subjects (group 2) without significant clinical or biochemical differences between the two groups. Median GH peak after glucagon was similar between patients with multiple pituitary hormone deficiency and those with isolated GHD and between subjects with and without structural hypothalamic-pituitary abnormalities. The magnitude of the GH peak after glucagon was negatively correlated to age at diagnosis (rho = -0.636, P < 0.0001). CONCLUSIONS This study shows that glucagon has an effective GH-releasing activity and can be used to evaluate somatotroph function in young children with short stature. Normative data for this test in young children need to be established before its use in clinical practice.
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Affiliation(s)
- Andrea Secco
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico G Gaslini Institute, University of Genova, 16147 Genova, Italy
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Secco A, di Iorgi N, Napoli F, Calandra E, Calcagno A, Ghezzi M, Frassinetti C, Fratangeli N, Parodi S, Benassai M, Leitner Y, Gastaldi R, Lorini R, Maghnie M, Radetti G. Reassessment of the growth hormone status in young adults with childhood-onset growth hormone deficiency: reappraisal of insulin tolerance testing. J Clin Endocrinol Metab 2009; 94:4195-204. [PMID: 19837937 DOI: 10.1210/jc.2009-0602] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT The 2007 Consensus Statement suggested a peak GH cutoff to insulin tolerance test (ITT) of less than 6 microg/liter in the diagnosis of permanent GH deficiency (GHD) in young adults with childhood-onset GHD (COGHD), although further validation was recommended. OBJECTIVE The aim of the study was to evaluate the accuracy of ITT, mean 12-h spontaneous nocturnal GH (SNGH), and IGF-I in the definition of permanent GHD. DESIGN AND SETTING The study was conducted in two Pediatric Endocrinology Centers. PATIENTS AND METHODS ITT, 12-h SNGH, and IGF-I were evaluated as single or combined tests in 79 subjects with COGHD (median age, 18.0 yr). The cohort consisted of 48 subjects with isolated GHD or one additional pituitary defect and normal MRI or anterior pituitary hypoplasia (group LLGHD, low likelihood GHD), and 31 subjects with structural hypothalamic-pituitary abnormalities or multiple pituitary hormone deficiencies (group HLGHD, high likelihood GHD). RESULTS Receiver operating characteristic analysis showed the best diagnostic accuracy for peak GH cutoffs to ITT of 5.62 microg/liter or less [sensitivity, 77.4%; specificity, 93.8%; area under the curve (AUC) = 0.92], mean 12-h SNGH of 1.20 microg/liter or less (sensitivity, 90.3%; specificity, 89.6%; AUC = 0.93), and IGF-I of -2.83 sd score or less (sensitivity, 80.7%; specificity, 95.7%; AUC = 0.93). Seven patients in group HLGHD showed a peak GH to ITT above 5.62 microg/liter, but a median IGF-I that was significantly lower than that of group LLGHD (-3.30 vs. -0.73 sd score; P = 0.0001). Peak GH to ITT of 3.6 microg/liter or less and arginine of 3.1 microg/liter or less at childhood diagnosis can predict a future permanent GHD condition. CONCLUSIONS The adopted peak GH to ITT below 5.62 microg/liter is an accurate diagnostic cutoff point for HLGHD in young adults with COGHD. In addition, IGF-I is a reliable marker providing information about the severity of GHD. Careful follow-up is required for subjects with discordant ITT and IGF-I results.
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Affiliation(s)
- Andrea Secco
- Department of Pediatrics, Instituto di Ricovero e Cura aCarattere Scientifico, Giannina Gaslini Institute, University of Genova, 16147 Genova, Italy
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Ghezzi M, Parenti G, de Franchis R, Farina V, de Leva F, Guarino A, Canani RB, Strisciuglio P. Clinical variability of cardio-facio-cutaneous syndrome: report of two additional cases. Clin Genet 2008; 42:206-9. [PMID: 1358488 DOI: 10.1111/j.1399-0004.1992.tb03239.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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: 11/28/2022]
Abstract
We describe two new cases of cardio-facio-cutaneous (CFC) syndrome, and underline the clinical variability of the CFC phenotype in our two patients presenting with border-line psychomotor development. The first patient showed some additional clinical manifestations, such as cryptorchidism and scoliosis, and the second one had atypical skin lesions.
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Affiliation(s)
- M Ghezzi
- Department of Pediatrics, University of Naples, Italy
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Roscigno M, Scattoni V, Freschi M, Raber M, Colombo R, Bertini R, Ghezzi M, Montorsi F, Rigatti P. Follow-up of patients with isolated mono and plurifocal High Grade Prostatic Intraepithelial Neoplasia (HGPIN) on initial prostate needle biopsy. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s1569-9056(02)80645-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Abal M, Ghezzi M, Quiroga M, Solana H, Auza N. Concentrations of progesterone during storage of whole blood from llama (Lama glama): effects of anticoagulants, storage time and temperature. Acta Vet Scand 1996. [PMID: 8659341 DOI: 10.1186/bf03548125] [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: 11/10/2022] Open
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Abal MA, Ghezzi M, Quiroga M, Solana H, Auza N. Concentrations of progesterone during storage of whole blood from llama (Lama glama): effects of anticoagulants, storage time and temperature. Acta Vet Scand 1996; 37:123-5. [PMID: 8659341 PMCID: PMC8063986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Reproductive studies usually utilizes measurement of progesterone in various fluids such as plasma, serum or milk. It has been shown that progesterone concentrations in bovine whole blood decrease proportionally to: i) the time elapsed between the collection of the sample and the separation of plasma or serum from the erythrocytes and ii) the temperature of storage during this period (Breuel et al, 1988, Pulido et al. 1991). The addition of anticoagulants cause a more rapid decline in progesterone concentrations (Wiseman et al. 1982). In equine, porcine and canine blood samples storage time and temperature has a negligible effect on progesterone concentrations (Wiseman et al. 1982; Oltner & Edqvist 1982). Cordero et al. (1991) working with llama and alpaca whole blood, treated with EDTA as anticoagulant, reported a slight progesterone metabolization in alpaca plasma, but not in llama plasma.
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Affiliation(s)
- M A Abal
- Department of Clinical Chemistry, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Parenti G, Rizzolo MG, Ghezzi M, Di Maio S, Sperandeo MP, Incerti B, Franco B, Ballabio A, Andria G. Variable penetrance of hypogonadism in a sibship with Kallmann syndrome due to a deletion of the KAL gene. Am J Med Genet 1995; 57:476-8. [PMID: 7677154 DOI: 10.1002/ajmg.1320570323] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report on the clinical and molecular characterization of 3 sibs with X-linked ichthyosis and variable expression of Kallmann syndrome. One of the affected brothers had mild hyposmia and showed normal pubertal progression. However, we demonstrated the same partial deletion of the X-linked Kallmann gene, sparing the first exon in the mildly affected patient as well as in one of his severely affected brothers.
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Affiliation(s)
- G Parenti
- Department of Pediatrics, Federico II University, Naples, Italy
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Abstract
Antiphospholipid antibodies are acquired circulating immunoglobulins that interact with phospholipids. These factors may manifest anticoagulant properties in vitro, interfering with phospholipid-dependent coagulation tests. They are not, however, associated with a hemorrhagic diathesis. Indeed, far from exerting the anticoagulant properties they possess in vitro, they are associated with episodes of thromboembolism, systemic and cerebral. We report the clinical and instrumental findings in 7 patients with ischemic stroke and circulating antiphospholipid antibodies classifiable as antiphospholipid antibodies syndrome.
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Affiliation(s)
- S Severi
- U.O. Neurologia/Neurofisiopatologia, Ospedale USL 23, Arezzo
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39
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Abstract
We investigated the diagnostic value of a new in vitro test, Pharmacia CAP System (Pharmacia Diagnostics AB, Uppsala, Sweden), for the quantitative measurement of allergen-specific IgE antibodies by comparison with RAST in 2 groups of patients, 71 atopic and 48 non-atopic. In the last 20 years RAST has supplied a good diagnostic tool, but this test presents some problems, the main one being sensitivity. The new test has a solid phase able to bind even very small amounts of specific IgE and an anti-IgE tracer with very low cross-reactivity with other immunoglobulins, thus presenting more favourable conditions. From the analysis of our results, Pharmacia CAP System gave higher sensitivity (94% compared to 88% of RAST) with no loss of specificity (96% for both tests). The reliability of these results is ensured by the proper selection of patients who were all suffering from pollinosis and were clinically diagnosed as certainly hypersensitive to a single pollen. A positive trend was found between severity of asthma and levels of specific IgE for timothy. Pharmacia CAP System appears to identify a larger number of atopic patients than RAST.
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Affiliation(s)
- E A Pastorello
- 1st Department of Internal Medicine, University of Milan, Italy
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40
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Severi S, Ghezzi M, Felici M. The primary antiphospholipid syndrome: case report. Ital J Neurol Sci 1992; 13:599-601. [PMID: 1428795 DOI: 10.1007/bf02233404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Lupus anticoagulant antibodies and anticardiolipin antibodies are acquired circulating immunoglobulins that interact with phospholipids. These factors may exert anticoagulant properties in vitro and so interfere with coagulation tests that use phospholipids. These antibodies are not, however, associated with a hemorrhagic diathesis. Indeed, despite their name and their in vitro anticoagulant properties, they have been associated right from the earliest reports with systemic and cerebral thromboembolic episodes. We report the clinical and instrumental findings in a patient with ischemic stroke and anticoagulant antibodies in the serum.
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Affiliation(s)
- S Severi
- U.O. di Neurologia e Neurofisiopatologia, Ospedale USL 23, Arezzo
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Abstract
C3 was detected bound in vivo to the opaque cornea of horses inoculated with killed Leptospira interrogans. Employing epithelial corneal cells isolated from a monolayer in tissue culture, we proved that C3 is fixed in vitro to the intact cell surface after incubation with a fresh equine anti-Leptospira serum. These findings, in addition to the infiltration of cornea with neutrophils and lymphocytes, may explain the mechanisms of tissue damage in recurrent uveitis of horses with leptospirosis.
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Affiliation(s)
- A E Parma
- Lab. Inmunoquimica y Biotecnologia, Facultad Cs. Veterinarias, Univ. Nac. del Centro PBA, Tandil, Argentina
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42
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Severi S, Ghezzi M, Zolo P, Bianchi A. [Antiphospholipid antibodies and cerebral ischemia]. Riv Neurol 1991; 61:203-9. [PMID: 1813971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Lupus anticoagulants (LAs) and anticardiolipin antibodies (ACAs) are acquired circulating immunoglobulins that cross-react with anionic and neural phospholipids. These factors may display anticoagulant properties in vitro by interfering with phospholipid-dependent coagulation tests. These antibodies are usually not associated with a bleeding tendency. In fact, paradoxically to their name, since the initial recognition they have been related to systemic and cerebral thromboembolisms, despite their in vitro "anticoagulant" properties. We report the clinical and laboratory findings in 4 LAs and ACAs positive patients with brain ischemia.
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Affiliation(s)
- S Severi
- U.O. Neurologia-Neurofisiopatologia, Ospedale USL 23, Arezzo
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Linoli G, Tomelleri G, Ghezzi M. [Oculopharyngeal muscular dystrophy. Description of a case with involvement of the central nervous system]. Pathologica 1991; 83:325-34. [PMID: 1923632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A sporadic case of oculopharyngeal muscular dystrophy occurred in a 74-year-old woman is described. High levels of IgA and IgG in the serum, and esophageal smooth muscle involvement are shown. Electromyography of several limb muscles displayed myopathic pattern with giant polyphasic motor unit potentials, suggesting superimposed denervation. The histological examination of peroneus brevis muscle biopsy specimen showed myopathic changes with dystrophic features, associated with neurogenic changes, including atrophic angulated fibers, small-group atrophy and type-grouping: concomitant involvement of spinal motor neuron pathway is hypotized, normal values of motor and sensory nerve conduction velocities excluding associated polineuropathy. Furthermore, Somatosensory Evoked Potentials recording revealed bilaterally increased Central Conduction Time. Referring to other similar cases previously reported in the literature, the significance of neurogenic involvement in oculopharyngeal muscular dystrophy is discussed.
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Affiliation(s)
- G Linoli
- Unità Operativa di Neurologia, USL 23 di Arezzo
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Forni E, Ghezzi M, Polesello A. HPLC separation and fluorimetric estimation of chlorophylls and pheophytins in fresh and frozen peas. Chromatographia 1988. [DOI: 10.1007/bf02268135] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [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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Mensi M, Ghezzi M, Ravasi S, Scoppetta FP. Il Liposarcoma Del Funicolo Spermatico: Considerazioni Su Di Un Caso Clinico. Urologia 1988. [DOI: 10.1177/039156038805500423] [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: 11/17/2022]
Affiliation(s)
| | | | | | - F. P. Scoppetta
- I.R.C.C.S. S. Matteo di Pavia, Divisione di Urologia - Primario inc.:
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Ghezzi M, Gallini G. [The most used square knot done with instruments]. Attual Dent 1988; 4:48-9, 52-4. [PMID: 3077256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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47
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Ghezzi M, Giansanti M, Malentacchi GM, Barontini F. Neuromyelitis optica in the old age: a clinico-pathological contribution. Ital J Neurol Sci 1987; 8:613-6. [PMID: 3429221 DOI: 10.1007/bf02333670] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We present a case of neuromyelitis optica (NMO) in a previously healthy 64-year-old woman. While CT scan and MRI investigations of the brain as well as myelography were normal, CSF revealed a pathological increase of IgG. Notwithstanding an intensive steroid therapy the patient died after 4 1/2 months. Microscopic examination showed, besides extensive demyelination of the optic nerves and spinal cord (especially in its cervico-dorsal tract), several small demyelinating plaques in the white matter of the pons and near the right lateral ventricle. These findings confirm once again that NMO is a clinical variant of multiple sclerosis and that this disease may make it first appearance at an old age.
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Affiliation(s)
- M Ghezzi
- Servizio di Neurologia, U.S.L.23, Arezzo
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48
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Gallini G, Ghezzi M. [The subepithelial connective free flap]. Attual Dent 1987; 3:12-3, 15, 17 passim. [PMID: 3483619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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49
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Ravasi S, Mensi M, Montefiore F, Ghezzi M. La Cistectomia Parziale Nel Trattamento Del Carcinoma Vescicale Infiltrante: Studio Retrospettivo Di 55 Casi Con « Follow up » Superiore a 5 Anni (). Urologia 1983. [DOI: 10.1177/039156038305000423] [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: 11/15/2022]
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Abstract
A 72-year-old woman, previously in good health, suffered for 2 years from attacks of a complex neuropsychiatric syndrome lasting from 2 days to 4 weeks. These episodes, which were followed by intervals of nearly complete recovery, were usually marked by fever, headache, mental confusion, vomiting ataxia, anisocoria, epileptic seizures and stiffness of the neck. Neuroradiological investigation revealed only slight ventricular dilatation. In 13 CSF examinations, there was reduced glucose, increased protein, considerable rise of the IgG index and constant oligoclonal bands. There was also an increase of polymorphonuclear leucocytes, lymphocytes or epithelial-like cells. As all microbial, viral or mycotic tests were negative and the patient recovered, the case was considered to be benign recurrent meningitis of Mollaret. The nosological position of this rare disease, as well as its probable pathogenetic mechanisms, are discussed.
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