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Marchetti D, Di Lenarda F, Novembre ML, Paolisso P, Schillaci M, Melotti E, Doldi M, Terzi R, Gallazzi M, Conte E, Volpato V, Bartorelli A, Andreini D. Contemporary Echocardiographic Evaluation of Mitral Regurgitation and Guidance for Percutaneous Mitral Valve Repair. J Clin Med 2023; 12:7121. [PMID: 38002733 PMCID: PMC10672624 DOI: 10.3390/jcm12227121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/16/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Mitral valve regurgitation (MR) is a multifaceted valvular heart disease. Echocardiography plays a central role in etiology assessment, severity quantification, treatment candidacy, outcome evaluation, and patient follow-up. In this review, we describe the comprehensive echocardiographic assessment of MR, including transthoracic (TTE) and transesophageal (TEE) approaches, 2D and 3D modalities, strain imaging, stress echocardiography, and artificial intelligence (AI) applications. Transcatheter edge-to-edge mitral valve repair (TEER) has been established as a key therapy for patients with severe, symptomatic MR and high surgical risk. TEER is performed under TEE guidance. We outline a practical overview of echocardiographic guidance on TEER.
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Affiliation(s)
- Davide Marchetti
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Francesca Di Lenarda
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Maria Laura Novembre
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Pasquale Paolisso
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Matteo Schillaci
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Eleonora Melotti
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Marco Doldi
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Riccardo Terzi
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Michele Gallazzi
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Edoardo Conte
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Valentina Volpato
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Antonio Bartorelli
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
| | - Daniele Andreini
- Division of University Cardiology, IRCCS Ospedale Galeazzi Sant’Ambrogio, 20100 Milan, Italy; (D.M.); (E.M.); (R.T.); (A.B.)
- Department of Clinical and Biomedical Sciences, University of Milan, 20100 Milan, Italy
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Chiarito M, Oliva A, Novelli L, Terzi R, Sturla M, Lacevic E, Carnabuci AG, Regazzoli D, Mangieri A, Sticchi A, Ferrante G, Gasparini G, Pagnotta P, Colombo A, Mehran R, Torracca L, Condorelli G, Reimers B, Stefanini GG. 760 IMPACT OF COMORBIDITIES AND PATIENTS PREFERENCE ON THE CHOICE BETWEEN PERCUTANEOUS OR SURGICAL REVASCULARIZATION FOR LEFT MAIN CORONARY ARTERY DISEASE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Recent evidence has rendered percutaneous coronary intervention (PCI) a valuable alternative to coronary artery bypass grafting (CABG) in patients with left main coronary artery disease (LMCAD). Nevertheless, the optimal management and patients selection is still subject to discussion
Methods
We retrospectively included 431 patients treated with PCI and 324 patients treated with CABG with the primary objective of comparing procedural failure according to revascularization strategy. Secondary endpoints were post procedural and clinically relevant myocardial infarction, in-hospital stroke, major bleeding defined according to the Bleeding Academic Research Consortium (BARC) criteria, death, and 1-year major adverse cardiac events (MACE).
Results
There was no observed difference in the rates of procedure failure in patients who received PCI compared to patients who received CABG (4.6% vs 3.7%, respectively) odds ratio [OR] 1.26; (95% confidence intervals [CI] 0.58-2.9, p= 0.52.) There was no significant difference in the defined ischemic outcome for PCI vs CABG (0.9% vs 2.4%, respectively) OR 0.37; (95% CI 0.08-1.4), P = 0.09. There was a mild increase in periprocedural myocardial infarction (MI) after PCI (4.2% vs 1.5%) compared to CABG; (OR = 2.8; 95% CI 0.99-9.8, P = 0.034). On the contrary there was a higher risk of major bleeding and transfusions in the patients who had been treated with CABG who has a clinical profile suited for PCI.
Conclusions
PCI did not significantly increase the risk for procedural failure or ischemic events compared to CABG in patients with LM CAD. The higher risk for post-procedural MI after PCI was offset by a higher risk for major bleeding events and transfusion requirements in those undergoing CABG, especially for those who were clinically suited for PCI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Roxana Mehran
- The Zena And Michael A. Wiener Cardiovascular Insitute Mount Sinai Hospital
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Fazzari F, Cannata F, Chiarito M, Gitto M, Terzi R, Didedda E, Lisi C, Condorelli G, Stefanini G, Chiti A, Bragato R, Francone M. 1129 IMAGING STRESS TEST OR CORONARY COMPUTED TOMOGRAPHY PRIOR TO NON-CARDIAC SURGERY? A SEVEN YEARS SINGLE CENTRE EXPERIENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Recent published ESC guidelines on non-cardiac surgery suggest the use of imaging stress test in patients with poor functional capacity and high likelihood of coronary artery disease or high clinical risk (class I, level B), while the use of coronary computed tomography has lower evidence (class IIa, level B). Witch test has the best performance in the clinical contest of pre-operative risk assessment is a matter of debate.
Aim
The aim of our single centre, retrospective study was to compare the prognostic role of the three main cardiac imaging modalities (CCT: Cardiac computed tomography, sCMR: stress cardiac magnetic resonance, SPECT MPI:single photon emission computed tomography myocardial perfusion imaging) in relation to 30 days post-surgery cardiac events (composite endpoint of myocardial infarction, unstable angina, cardiac death, cardiogenic shock, pulmonary oedema, life threatening cardiac arrythmias).
Method
Clinical data of patients from January 2015 to December 2021 were retrospectively collected from review of electronical medical records. Recorded data included demographic characteristics, clinical risk factors, results from laboratory tests, results from cardiac imaging tests, pharmacological therapy, type of intervention, cardiac complication within 30 days after surgery.
Results
Eight-hundred eighty-three patients were included (287 sCMR, 382 SPECT-MPI, 214 CCT). Rate of 30-days myocardial infarction was not significantly different between different modalities (CMR 1.1%, SPECT 1.3%; CT 0.5%; CMR vs SPECT p 0.998; sCMR vs CT p 0.639; SPECT vs CT 0.427); while planned invasive coronary angiography (ICA) was more common in CT group (CT 34%, CMR 16%, SPECT 10%, p<0,001). Absence of ischemia on stress test and absence of relevant coronary artery disease on CT are associate to lower cardiac events at follow-up (0.67%).
Conclusions
The use of imaging stress test and coronary CT are both associated to low incidence of cardiac events and should be recommended in risk assessment before non-cardiac surgery, in the appropriate clinical context.
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Affiliation(s)
- Fabio Fazzari
- Humanitas Research Hospital , Rozzano, Milano, Italia
| | | | | | - Mauro Gitto
- Humanitas Research Hospital , Rozzano, Milano, Italia
| | | | | | - Costanza Lisi
- Humanitas Research Hospital , Rozzano, Milano, Italia
| | | | | | - Arturo Chiti
- Humanitas Research Hospital , Rozzano, Milano, Italia
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Terzi R, Chiarito M, Oliva A, Iaccarino A, Novelli L, Carnabuci AG, Regazzoli D, Mangieri A, Sticchi A, Ferrante G, Sturla M, Gasparini G, Pagnotta P, Colombo A, Condorelli G, Barbone A, Torracca L, Reimers B, Mehran R, Stefanini GG. 759 LEFT MAIN PERCUTANEOUS OR SURGICAL REVASCULARIZATION AND SUBSEQUENT RISK OF ACUTE KIDNEY INJURY: INSIGHTS FROM THE LUCKY REGISTRY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Recent evidence has rendered percutaneous coronary intervention (PCI) a valuable alternative to coronary artery bypass grafting (CABG) in patients with left main coronary artery disease (LMCAD). Nevertheless, the optimal management and patients selection is still subject to discussion
Methods
We retrospectively included 431 patients treated with PCI and 324 patients treated with CABG with the primary objective of comparing procedural failure according to revascularization strategy. Secondary endpoints were post procedural and clinically relevant myocardial infarction, in-hospital stroke, major bleeding defined according to the Bleeding Academic Research Consortium (BARC) criteria, death, and 1-year major adverse cardiac events (MACE).
Results
There was no observed difference in the rates of procedure failure in patients who received PCI compared to patients who received CABG (4.6% vs 3.7%, respectively) odds ratio [OR] 1.26; (95% confidence intervals [CI] 0.58-2.9, p= 0.52.) There was no significant difference in the defined ischemic outcome for PCI vs CABG (0.9% vs 2.4%, respectively) OR 0.37; (95% CI 0.08-1.4), P = 0.09. There was a mild increase in periprocedural myocardial infarction (MI) after PCI (4.2% vs 1.5%) compared to CABG; (OR = 2.8; 95% CI 0.99-9.8, P = 0.034). On the contrary there was a higher risk of major bleeding and transfusions in the patients who had been treated with CABG who has a clinical profile suited for PCI.
Conclusions
PCI did not significantly increase the risk for procedural failure or ischemic events compared to CABG in patients with LM CAD. The higher risk for post-procedural MI after PCI was offset by a higher risk for major bleeding events and transfusion requirements in those undergoing CABG, especially for those who were clinically suited for PCI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Roxana Mehran
- The Zena And Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital
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Condello F, Maurina M, Chiarito M, Sturla M, Terzi R, Fazzari F, Sanz-Sanchez J, Cannata F, Condorelli G, Stefanini GG. Direct oral anticoagulants versus vitamin K antagonists in the treatment of left ventricular thrombosis: a systematic review and meta-analysis. Minerva Cardiol Angiol 2022; 70:666-676. [PMID: 35080357 DOI: 10.23736/s2724-5683.21.05893-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Evidence about the use of direct oral anticoagulants (DOACs) in patients with left ventricular thrombosis (LVT) are emerging. The aim of our study was to provide a comprehensive synthesis of the available evidence concerning the clinical effects of DOACs versus vitamin K antagonists (VKAs) in LVT treatment. EVIDENCE ACQUISITION Systematic search of studies evaluating DOACs versus VKAs use in patients with LVT was performed on May 11th, 2021. Data were pooled by meta-analysis using a random-effects model. Odds ratios (OR) with relative 95% confidence intervals (CI) were used as measures of effect estimates. The primary efficacy and safety endpoint were ischemic stroke and any bleeding, respectively. Secondary endpoints were LVT resolution, systemic embolism, major bleeding, hemorrhagic stroke, and all cause death. EVIDENCE SYNTHESIS Twenty studies were included in the meta-analysis: 1,391 patients were treated with DOACs and 1,534 with VKAs. A significant reduction in the risk of ischemic stroke (OR 0.67, 95% CI, 0.45-0.98, P=0.048, number needed to treat to benefit [NNTB] 22 [95% CI 15-43]) and any bleeding (OR 0.64, 95% CI 0.46-0.89, P=0.009, NNTB 26 [95% CI 16-80]) was observed with DOACs compared to VKAs. No statistically significant difference was observed among the two treatment arms for the secondary endpoints. CONCLUSIONS Compared to VKAs, DOACs are associated with a reduced risk of ischemic stroke and bleeding. In light of these findings, and the practical advantages of DOACs, additional large scale randomized controlled trials are needed to confirm the benefits of DOACs in patients with LVT.
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Affiliation(s)
- Francesco Condello
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Maurina
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Sturla
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Riccardo Terzi
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Fabio Fazzari
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Jorge Sanz-Sanchez
- La Fe Polytechnic University Hospital, Valencia, Spain.,Centro de Investigacion Biomedica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Francesco Cannata
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giulio G Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy - .,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Gitto M, Kotinas AS, Terzi R, Oliva A, Zagoreo J, Reimers B, Stefanini GG, Mirani M, Favacchio G, Condorelli G, Panico C. Biochemical Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors by Cardiovascular Risk Profile and Volume Status in a Real-World Diabetic Population. J Cardiovasc Pharmacol 2022; 80:140-147. [PMID: 35436244 PMCID: PMC9249071 DOI: 10.1097/fjc.0000000000001280] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Despite large-scale randomized clinical trials (RCTs) highlighting a consistent prognostic benefit of sodium-glucose cotransporter 2 inhibitors (SGLT2is) both in diabetic patients at high cardiovascular risk and in those with heart failure, there is relative paucity of data on their biochemical effects in a real-world setting. We performed a retrospective analysis on consecutive diabetic patients who were prescribed a SGLT2i in a tertiary referral center and completed at least 1 year of treatment. Changes in glycated hemoglobin, weight, and hematocrit were compared across 2 cardiovascular risk categories, defined through the inclusion criteria of 3 large RCTs. Of the 459 patients screened, 312 completed 1 year of treatment (68.0%), 92 interrupted the treatment prematurely (20.0%), and 55 were lost to follow-up (12.0%). The most common cause of drug discontinuation was genital or urinary tract infections (9.4%). At 1 year, reduction in glycated hemoglobin concentration (-0.7 ± 1.5%, P < 0.001) and body weight (2.4 ± 4.6 kg, P < 0.001) was comparable between patients at high versus low cardiovascular risk, while hematocrit increase (2.3 ± 3.3%, P < 0.001) was more marked in patients with high cardiovascular risk and low baseline hematocrit. In a real-world population of diabetic patients, SGLT2is were well-tolerated at 1 year and led to improved glycemic control and weight loss. Hematocrit increase was more consistent in patients with high cardiovascular risk and signs of fluid overload, indicating euvolemic restoration as a potential cardioprotective mechanism mediated by these compounds.
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Affiliation(s)
- Mauro Gitto
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Alexios S. Kotinas
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
| | - Riccardo Terzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
| | - Angelo Oliva
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Jorgele Zagoreo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
| | - Bernhard Reimers
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Giulio G. Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Marco Mirani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Giuseppe Favacchio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Cristina Panico
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; and
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
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Kotinas AS, Gitto M, Terzi R, Oliva A, Zagoreo J, Reimers B, Stefanini GG, Mirani M, Favacchio G, Condorelli G, Panico C. 617 Effects of SGLT2 inhibitors on left and right ventricular function in a real-world diabetic population. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab139.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Heart failure (HF) is a pandemic and despite improvements in therapy, the mortality rate has remained unacceptably high. Sodium glucose cotransporter-2 inhibitors (SGLT2i) have emerged as a promising new class of glucose-lowering drugs, reducing HF-related outcomes across all ejection fraction ranges in clinical trials. However, few studies have assessed their efficacy using echocardiography imaging in a real-world setting.
Methods and results
Type 2 diabetes mellitus (T2DM) patients treated with SGLT2i from 2015 to 2020 were enrolled in a retrospective observational study. Clinical, biochemical, and echocardiographic data at baseline and 6 and 12 months after treatment initiation were collected. Of the 459 patients screened, 312 (68%) patients completed 1 year of SGLT2i therapy. Side effects were developed in 92 (20%) patients leading them to stop treatment pre-maturely, while 55 (12%) were lost to follow-up. From the 312 patients who completed 1 year of treatment, 83 patients had echocardiography data before initiation and after either 6 or 12 months of treatment and were included in the data analysis. Sample’s average age was 65.78 ± 8.53 years, 23 (27.7%) were females, and the mean BMI was 32.10 ± 6.29 kg/m2. At baseline patients had Hb1Ac 7.94 ± 1.80% and the mean duration of diabetes was 11.19 ± 8.54 years. 59 (71.1%) patients were asymptomatic (NYHA I) at baseline. The mean left ventricular ejection fraction (LVEF) at baseline was 48.40 ± 10.89%, while mean left ventricular end-diastolic volume (LVEDV) was 127.96 ± 41.84 ml. Mean pulmonary artery systolic pressure (PASP) was 33.63 ± 7.89 mmHg and mean tricuspid annular plane systolic excursion (TAPSE) was 20.18 ± 4.17 mm before treatment started. Mean E/e′ ratio at baseline was 9.75 ± 3.50. Mean septal wall thickness before therapy was initiated was 12.05 ± 1.80 mm while mean anterior wall thickness was 11.22 ± 1.52 mm. Almost all of the patients had at least one cardiovascular risk factor, hypertension being the most common (77, 92.8%), while 53 (63.9%) patients had a history of coronary artery disease (CAD), of which 42 (50.6%) had suffered a myocardial infarction. All-cause HF was present in 31 (37.3%) patients (19 HFrEF, 7 HFmrEF, 5 HFpEF). After a mean of 12.94 ± 7.91 months of SGLT2i treatment, left ventricular function was improved as LVEF was increased to 50.62 ± 10.04% (+2.22%, P = 0.018), while LVEDV was reduced to 123.24 ± 41.41 ml (−4.72 ml, P = 0.052). A trend towards improvement of the right ventricular function was also observed as TAPSE increased to 21.45 ± 3.92 mm (+1.27 mm, P = 0.076). PASP remained rather stable (−0.83 mm, P = 0.620), as well as the E/e′ ratio (−0.11, P = 0.857). Septal wall thickness was found unchanged (−0.16 mm, P = 0.449), as well as the anterior wall thickness (−0.63 mm, P = 0.143). After 1 year of treatment the number of asymptomatic patients remained stable (60, P = 0.863).
Conclusions
SGLT2i improved left ventricular systolic function in a sample of real-world diabetic patients, as shown by the changes in LVEF and LVEDV. A trend towards right ventricular function improvement was also recorded, demonstrated by the TAPSE increase. These findings highlight SGLT2i action on ventricular function and might be hypothesis generating to further elucidate their cardiovascular mechanism of action, beyond their already noted diuretic effect.
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Condello F, Sturla M, Terzi R, Polimeni A, Stefanini G. 745 Meta-analysis comparing the safety and efficacy of ticagrelor monotherapy after a short course of ticagrelor-based dual antiplatelet therapy versus standard therapy in complex percutaneous coronary interventions. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab129.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Current guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor for 6–12 months after percutaneous coronary intervention (PCI). A shorter duration ticagrelor-based DAPT followed by ticagrelor monotherapy can significantly reduce bleeding events while preserving anti-ischaemic effects in patients undergoing conventional PCI. Whether this strategy can be safely and effectively applied to those patient that undergo ‘complex’ PCI is uncertain.
Methods
We performed a systematic search of randomized controlled trials comparing a short course of ticagrelor-based DAPT vs. standard DAPT in patients undergoing complex PCI. A mixed-effects Poisson regression model with random intervention effects was used to estimate the pooled incidence rate ratios (IRR) with 95% confidence intervals (CI).
Results
Out of 10 689 studies screened, three were identified for a total of 4176 participants on ticagrelor monotherapy after a short course of ticagrelor based DAPT, and 4209 on standard DAPT. Overall, the pooled analysis showed a strong evidence that compared to standard treatment, ticagrelor monotherapy after a short course of ticagrelor-based DAPT (1–3 months) reduced the risk of cardiovascular death [IRR 0.52; CI (0.28–0.96); P = 0.04; I2 = 0%], all-cause death [IRR 0.65; CI (0.49–0.86); P = 0.003; I2 = 0%], and any bleeding events [IRR 0.62; CI (0.47–0.81); P < 0.001; I2 = 44%]. Weak evidence was found of an association between the experimental strategy and a lower risk of myocardial infarction [IRR 0.79; CI (0.61–1.01); P = 0.06; I2 = 0%]. Instead, no significant difference in the risk of major bleeding [IRR 0.72; CI (0.48–1.08); P = 0.11; I2 = 61%], definite or probable stent thrombosis [IRR 0.77; CI (0.34–1.75); P = 0.53; I2 = 0%] and ischaemic stroke [IRR 0.83; CI (0.25–2.73); P = 0.76; I2 = 0%] was observed. We speculate that the observed mortality benefits might be related to the reduction of any bleeding events, mainly dictated by minor bleeding reduction, since major bleeding did not seem to be decreased in the shorter regimen group.
Conclusion
Among patients undergoing complex PCI, ticagrelor monotherapy after a short course of ticagrelor-based DAPT significantly reduced bleeding risk without increasing ischaemic risk. As complex PCI procedures are being increasingly performed nowadays, and more comorbid patients are being treated, more studies are required to confirm and explain these findings. This could lead to optimization of antiplatelet therapy across a broad spectrum of patients.
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Affiliation(s)
- Francesco Condello
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Matteo Sturla
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Riccardo Terzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Alberto Polimeni
- Division of Cardiology and Research, Center for Cardiovascular Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, Viale, Europa, Catanzaro, Italy
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
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Condello F, Maurina M, Chiarito M, Sturla M, Terzi R, Fazzari F, Sanz-Sanchez J, Cannata F, Condorelli G, Stefanini G. 21 Direct oral anticoagulants vs. vitamin K antagonists in the treatment of left ventricular thrombosis: a systematic review and meta-analysis. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab131.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Evidence about the use of direct oral anticoagulants (DOACs) in patients with left ventricular thrombosis (LVT) are emerging. The aim of our study was to provide a comprehensive synthesis of the available evidence concerning the clinical effects of DOACs vs. vitamin K antagonists (VKAs) in LVT treatment.
Methods
Systematic search of studies evaluating DOACs vs. VKAs use in patients with LVT was performed on 11 May 2021. Data were pooled by meta-analysis using a random-effects model. Odds ratios (OR) with relative 95% confidence intervals (CI) were used as measures of effect estimates. The primary efficacy and safety endpoint were ischaemic stroke and any bleeding, respectively. Secondary endpoints were LVT resolution, systemic embolism, major bleeding, haemorrhagic stroke, and all cause death.
Results
Twenty studies were included in the meta-analysis: 1391 patients were treated with DOACs and 1534 with VKAs. A significant reduction in the risk of ischaemic stroke [OR 0.67, 95% CI 0.45–0.98, P = 0.048, number needed to treat to benefit (NNTB) 22 (95% CI 15–43)] and any bleeding [OR 0.64, 95% CI 0.46–0.89, P = 0.009, NNTB 26 (95% CI 16–80)] was observed with DOACs compared to VKAs. No statistically significant difference was observed among the two treatment arms for the secondary endpoints.
Conclusion
Compared to VKAs, DOACs are associated with a reduced risk of ischaemic stroke and bleeding. In light of these findings, and the practical advantages of DOACs, additional large scale randomized controlled trials are needed to confirm the benefits of DOACs in patients with LVT.
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Affiliation(s)
- Francesco Condello
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Matteo Maurina
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Mauro Chiarito
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Matteo Sturla
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Riccardo Terzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Fabio Fazzari
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Jorge Sanz-Sanchez
- Hospital Universitario Y Politecnico De La Fe, Valencia, Spain
- Centro De Investigacion Biomedica En Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Francesco Cannata
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Gianluigi Condorelli
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giulio Stefanini
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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10
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Gitto M, Kotinas A, Terzi R, Oliva A, Zagoreo J, Reimers B, Stefanini GG, Mirani M, Favacchio G, Condorelli G, Panico C. 112 Safety and biochemical efficacy of sodium–glucose cotransporter 2 inhibitors based on cardiovascular risk profile and volume status in a real-world diabetic population. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab136.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Sodium–glucose cotransporter 2 inhibitors (SGLT2i) have become a first-line cardiovascular medication. However, their potential side effects still limit a widespread use in real-world clinical practice. Further, there is uncertainty about the mechanisms mediating SGLT2i-associated cardiovascular benefit.
Methods
We performed a retrospective analysis on consecutive diabetic patients who were prescribed a SGLT2i in a tertiary referral centre. Patients who completed at least 1 year of treatment were included in the data analysis. Changes in glycated haemoglobin, weight and haematocrit were evaluated and compared across two cardiovascular risk categories, defined through the inclusion criteria of three large randomized clinical trials. Additionally, a modified clinical score (mH2FPEF) was applied to detect the probability of heart failure with preserved ejection fraction (HFpEF).
Results
Of the 459 patients screened from 2015 to 2020, 312 completed 1 year of treatment (68.0%), 92 interrupted the treatment prematurely (20.0%) and 55 were lost to follow-up (12.0%). The most common causes of drug discontinuation were genital or urinary tract infections (9.4%) and poor glycaemic control (5%). At 1 year, a significant reduction in glycated haemoglobin concentration (−0.6 ± 1.4%, P < 0.001) and body weight (2.4 ± 4.6 Kg, P < 0.001) was observed and was comparable between patients at high vs. low cardiovascular risk. Haematocrit increase at 1 year (2.3 ± 3.3%, P < 0.001) was more marked in patients with high cardiovascular risk and low baseline haematocrit. Among patients with no established heart failure (N = 295), 156 (52.9%) had >50% probability of HFpEF (mH2FPEF ≥3).
Conclusions
In a real-world population of diabetic patients, SGLT2i were well-tolerated at 1 year and led to improved glycaemic control and weight loss. Haematocrit increase was more consistent in patients with high cardiovascular risk and signs of fluid overload, indicating the potentially beneficial role of euvolemic restoration. More than half of these diabetic patients had a high likelihood of unrecognized HFpEF.
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Affiliation(s)
- Mauro Gitto
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Alexios Kotinas
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Riccardo Terzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Angelo Oliva
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Jorgele Zagoreo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Bernhard Reimers
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Giulio G Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Marco Mirani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Giuseppe Favacchio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
| | - Cristina Panico
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy
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11
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Condello F, Sturla M, Terzi R. Subclinical leaflet thrombosis after transcatheter aortic valve replacement and anticoagulant treatment: lights and shadows. J Thromb Thrombolysis 2021; 53:561-563. [PMID: 34557974 DOI: 10.1007/s11239-021-02572-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Francesco Condello
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milano, Italy. .,IRCCS Humanitas Research Hospital, via Alessandro Manzoni 56, Rozzano, 20089, Milano, Italy.
| | - Matteo Sturla
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milano, Italy
| | - Riccardo Terzi
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milano, Italy
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12
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Terzi R, Özer T. A tuber calcanei avulsion fracture developed on the basis of idiopathic osteoporosis in a young male: a case report. Osteoporos Int 2015; 26:2381-4. [PMID: 25851698 DOI: 10.1007/s00198-015-3111-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
Calcaneus fractures constitute 1.2 % of all fractures. Tuber calcanei avulsion fractures constitute 1.3-2.7 % of calcaneus fractures. Osteoporosis, osteomalacia, and diabetes mellitus have been reported to increase the risk of development of these fractures. It has been reported that tuber calcanei avulsion fractures in elderly females might develop due to osteoporosis. As far as we know, no tuber calcanei avulsion fracture developing on the basis of osteoporosis without presence of a trauma has been reported in young males in the literature. In the current case report, a 41-year-old male patient who was admitted with complaints of pain in the left heel and diagnosed with calcaneal avulsion fracture that developed on the basis of idiopathic osteoporosis and who was treated with conservative methods was presented.
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Affiliation(s)
- R Terzi
- Department of Physical Medicine and Rehabilitation, Kocaeli Derince Education and Research Hospital, Derince, Kocaeli, Turkey,
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13
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Saglam A, Terzi R, Demiralay M. Effect of polyethylene glycol induced drought stress on photosynthesis in two chickpea genotypes with different drought tolerance. Acta Biol Hung 2014; 65:178-88. [PMID: 24873911 DOI: 10.1556/abiol.65.2014.2.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Responses of parameters related with photosynthesis and the involvement of various factors in photosynthetic damage in two chickpea genotypes, Gokce (tolerant) and Kusmen (sensitive) under drought stress were assessed. Photosynthetic pigment content decreased under drought stress in two genotypes. Significant decreases in gs, Pn and E were determined in Kusmen. No significant change in these parameters was measured in Gokce under drought stress. Fv/Fm, ΦPS2 and ETR decreased in drought stressed plants of Kusmen as compared to control plants however Fv/Fm, ΦPS2 and ETR did not change in Gokce under drought stress. Increases in NPQ were determined under stress in both genotypes. Drought stress did not affect rubisco activity and rubisco concentration in Gokce while, the activity and the content declined in Kusmen. The drought tolerance of the Gokce genotype is a consequence of a balance among leaf water potential, stomatal conductance, photosynthesis, and transpiration. On the other hand, photosynthesis in Kusmen may be not only restricted by stomatal limitations but also by non-stomatal limitations under drought stress.
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Affiliation(s)
- A Saglam
- Karadeniz Technical University Department of Molecular Biology and Genetics, Faculty of Sciences 61080 Trabzon Turkey
| | - R Terzi
- Karadeniz Technical University Department of Biology, Faculty of Sciences 61080 Trabzon Turkey
| | - M Demiralay
- Karadeniz Technical University Department of Biology, Faculty of Sciences 61080 Trabzon Turkey
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14
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Calò E, Massaro C, Terzi R, Cancellara A, Pesce E, Re M, Greco A, Maffezzoli A, Gonzalez-Chi PI, Salomi A. Rotational Molding of Polyamide-6 Nanocomposites with Improved Flame Retardancy. INT POLYM PROC 2013. [DOI: 10.3139/217.2552] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The aim of this work was to develop polyamide-6/ organic-modified montmorillonite (omMMT) nanocomposites for the production of hollow parts by rotational molding. Particular emphasis was placed on the mechanical and flame retardancy properties needed for the fabrication of vessels for flammable liquids. The morphology of the melt compounded nanocomposites, produced by melt compounding, was investigated by X-ray diffraction measurements (WAXD), and Transmission Electron Microscopy (TEM) showed an exfoliated structure. Rheological measurements were used in order to verify whether the viscosity of materials was adequate for rotational molding. While thermomechanical analysis has revealed that neat PA6 and its nanocomposites were not suitable for rotational molding, due to the very low thermal stability of the polymer, the addition of a thermal stabilizer, shifted the onset of degradation to higher temperatures, thus widening the processing window of both PA6 and PA6 nanocomposites. Large-scale vessel prototypes were obtained by rotational molding of thermo-stabilized PA6 and its nanocomposites, and samples extracted from the rotomolded parts were characterized with respect to physical and mechanical properties. It was found that the PA6 nanocomposites exhibited significant improvements at cone calorimeter tests in comparison with neat PA6.
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Affiliation(s)
- E. Calò
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - C. Massaro
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - R. Terzi
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - A. Cancellara
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - E. Pesce
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - M. Re
- ENEA – Department of Advanced Physical Technologies and New Materials, Brindisi Research Centre, Brindisi, Italy
| | - A. Greco
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - A. Maffezzoli
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - P. I. Gonzalez-Chi
- Centro de Investigacionn Cientifica de Yucatan, Unidad de Materiales, Merida, Yucatan, Mexico
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15
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Maserati R, Clerici M, Lauriola M, Pacei M, De Gennaro M, Chiesa E, Coen M, Terzi R, Bray DH, Lo Caputo S. Immune and virologic responses to Truvada or Combivir as a first-line therapy of HIV-infected, treatment-naïve patients. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p206] [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: 11/10/2022] Open
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16
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Colli G, Terzi R, Terzi M, Catenacci G. Application of mathematical modelling for assessing the urinary half-times of nickel in stainless steel welders. G Ital Med Lav Ergon 2005; 27:427-30. [PMID: 16512340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The study regards workers employed in manual metal are welding of stainless steel (MMA/SS). For two weeks they collected their urine during the work shift and the 16 hours following in order to evaluate the kinetics of nickel. Using one-compartment mathematical modelling we calculated the values of the toxicant's urinary half life during the two phases of exposure and postexposure and also during non working weekends. The aim of the study was to find correlations between inhaled doses and excreted quantities and to acquire practical data for use in biological monitoring. In the welders the mean urinary half life in the exposure period was 59.5 hours, in the post exposure it was 95.6 hours, while in weekend it was 95.5 hours. The study showed that exposure to fumes containing nickel could determine the accumulation of the metal in slow elimination speed compartment. As a consequence of the accumulation of nickel in compartments with different elimination speeds, the collection of single urinary portions in biological monitoring seems to give little information about the actual exposure. In our opinion this indicates collecting urine samples throughout the entire work shift and the 16 hours following exposure.
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Affiliation(s)
- G Colli
- Scuola di Specializzazione in Medicina del lavoro, Università degli Studi di Pavia, Italy.
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17
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Pelosi P, Severgnini P, Bianchi E, Terzi R, Lanza C, Minoja G, Chiumello D, Storelli E, Chiaranda M. Crit Care 2003; 7:P155. [DOI: 10.1186/cc2044] [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: 11/10/2022] Open
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18
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Micelli F, Maffezzoli A, Terzi R, Luprano VA. Characterization of the kinetic behavior of resin modified glass-ionomer cements by DSC, TMA and ultrasonic wave propagation. J Mater Sci Mater Med 2001; 12:151-156. [PMID: 15348322 DOI: 10.1023/a:1008974128215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In this study the isothermal kinetic behavior of two resin modified glass ionomer cements (RMGIC) and a dental composite have been compared by differential scanning calorimetry (DSC) and thermo-mechanical analysis (TMA). The simultaneous evolution of the multiple reactions occurring in RMGIC has been analyzed not only by DSC and TMA but also by ultrasonic wave propagation using the pulse-echo technique. The propagation of ultrasonic waves, acting as a dynamic mechanical deformation at high frequencies, is proportional to the longitudinal bulk moduli of the material and may be used to measure the changes of mechanical properties induced by a chemical reaction as occurs in RMGIC. TMA and ultrasonic analysis have been used to monitor the acid-base reaction of RMGIC in dark conditions. Moreover an RMGIC presenting a double reactive mechanism in dark conditions, a thermally activated radical polymerization and an acid-base reaction are studied using these experimental techniques. Finally DSC and TMA results obtained during photopolymerization of an RMGIC and of a dental composite have been compared.
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Affiliation(s)
- F Micelli
- Department of Innovation Engineering, Materials Section, University of Lecce, Via Monteroni, 73100 Lecce, Italy
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19
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Colli G, Terzi M, Vinci L, Terzi R, Candura SM. [A case of pleural mesothelioma caused by unusual occupational exposure to asbestos in the wool industry]. G Ital Med Lav Ergon 2001; 23:18-20. [PMID: 11386181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We report the case of a 73-year-old worker who died of pleural mesothelioma, after being employed for 35 years in a wool textile plant of Biella (Italy). Close investigations revealed that he provided for the maintenance of materials and machines. In particular, he used to replace asbestos parts such as rings, joints and insulations of pipelines (dyeing unit), as well as brake linings of warping, looming and combing machines. Beside confirming the importance of an accurate occupational anamnesis to recognize work-induced cancers, the case draws the attention on the risk of mesothelioma in the wool industry, an occupational setting that is not usually considered as a potential source of exposure to asbestos fibres. Such pollution might explain the increased mortality due to pleural mesothelioma in the Biella area (characterized by a prosperous textile industry), reported in previous epidemiological studies.
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Affiliation(s)
- G Colli
- Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Pavia
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20
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Abstract
Adequate assessment of circulatory and gas-exchange interactions may involve the quantification of the Haldane effect (HE) and of the changes in blood PCO(2) mediated by changes in Hb-O(2) saturation and O(2)-linked CO(2) binding. This is commonly prevented by the complexity of the involved calculations. To simplify the task, a large series of patient measurements has been processed by regression analysis, thus developing an accurate fit for this quantification (v-a) PCO(2)HE + 0.460 [(a-v) HbO(2)]0.999e0.015(PvCO(2))-0.852(Hct) (n = 247, r(2) = 0. 99, P << 0.001), where (v-a)PCO(2 HE) is the reduction in venous PCO(2) (Pv(CO(2)), Torr) allowed by the chemical binding of CO(2) in blood due to the HE (Torr), (a-v)HbO(2) is the arteriovenous difference in Hb-bound O(2) (ml/dl), and Hct is hematocrit fraction. Values of (v-a)PCO(2 HE) estimated by this expression compared well with the results of previously published experiments. This formula is useful in assessing the impact of HE on Pv(CO(2)) and venoarterial PCO(2) gradient and the survival advantage offered by HE in extreme conditions. Use may be extended to all investigative and clinical settings in which changes in blood O(2) saturation and O(2)-linked CO(2) binding must be converted into the corresponding changes in dissolved CO(2) and PCO(2).
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Affiliation(s)
- I Giovannini
- Department of Surgery (Geriatric Surgery), Catholic University School of Medicine, I-00168 Rome, Italy
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21
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Catenacci G, Tringali S, Terzi R. [Retrospective study of morbidity in a group professionally exposed to chlorotriazine herbicides]. G Ital Med Lav Ergon 1997; 19:23-5. [PMID: 9377737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Two different groups of workers involved, during the last 10 years, in the production or formulation of chlorotriazine herbicides have been retrospectively studied in order to verify the occurrence of diseases possibly related to Atrazine, Simazine, Propazine and Terbuthylazine exposure. A control group has been selected between clerical workers of the same plants. Exposure data have been collected during the last five years and some extrapolations have been performed to hypothesize the level of exposure in the preceeding years. Clinical findings and laboratory data obtained from ten year medical surveillance records have been evaluated to highlight possible differences between the investigated groups. A first close examination of the data concerning the anamnesis and clinical, hematochemical and functional reports of the three groups of investigated subjects does not show any pathological situation or symptoms specifically connected to chlorotriazine compounds exposure and/or significant differences between exposed and non exposed. A next series of statistical surveys involving some of the hematochemical indicators (RBC, WBC, Hb%, SGOT, SGPT, gamma GT) has been performed either on internal values of each group or on the average-values of the three groups differently exposed (production, formulation, control). The first survey was a longitudinal study, the second one was a cross sectional one. Both the investigations have excluded significant differences attributable to the occupational exposure.
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Affiliation(s)
- G Catenacci
- Dipartimento di Medicina Preventiva Occupazionale e di Comunità, Università degli Studi di Pavia
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22
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Sosa EA, Terzi R, Gruppi C, Brito FS, de Paola AA, Pimenta J, Lorga AM, Maia IG, Gizzi JC, Solimene MC. [Consensus SOCESP-SBC on electrocardiography by Holter system]. Arq Bras Cardiol 1995; 65:447-50. [PMID: 8729865] [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: 02/01/2023] Open
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23
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Catenacci G, Pezzagno G, Tringali S, Terzi R, Fidanza L. [The biological monitoring of those exposed to 1,1,1-trichloroethane: a longitudinal study]. G Ital Med Lav 1991; 13:61-4. [PMID: 1845460] [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: 12/29/2022]
Abstract
Data on long-term biological monitoring in two groups of workers engaged in cleaning operations in a wool factory and exposed to methylchloroform are presented. The longitudinal survey lasted one year and brought about 19 random systematic sampling (once or twice a month for everyone of the 13 subjects monitored). The biological marker adopted was the urinary concentration of the solvent as such, according to a previously studied method. The collected data allowed to measure: the annual average level of exposure (estimated by the long term geometric mean); the day to day variation of the true daily exposure averages (estimated by the geometric standard deviation); the probability of overexposure (daily exposures exceeding the biological exposure limit) and the yearly number of work shifts of overexposure. The usefulness of performing long-term surveys of occupational exposure to the chemical substances by mean of longitudinal biological monitoring is discussed.
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Affiliation(s)
- G Catenacci
- Dipartimento di Medicina Preventiva, Occupazionale e di Comunità, Università di Pavia
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24
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Finazzi G, Mannucci PM, Lazzarin A, Gringeri A, Arici C, Ciaci D, Terzi R, Barbui T. Low incidence of bleeding from HIV-related thrombocytopenia in drug addicts and hemophiliacs: implications for therapeutic strategies. Eur J Haematol Suppl 1990; 45:82-5. [PMID: 2209823 DOI: 10.1111/j.1600-0609.1990.tb00422.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The records of 608 intravenous drug addicts and 124 hemophiliacs diagnosed in 1985 to be seropositive for HIV were reviewed to identify patients with thrombocytopenia. The records of 54 drug addicts (8.9%) and 14 hemophiliacs (11.2%) who had chronic thrombocytopenia were then followed through June 1989 to estimate the incidence of bleeding episodes. The records of 55 HIV-seronegative patients with idiopathic thrombocytopenic purpura (ITP), comparable for age, platelet count at diagnosis and duration of follow-up, were used for comparison. Patients with ITP were significantly different from those with HIV-associated thrombocytopenia in having a higher proportion of females (M/F ratio 13/42 v 53/15, p less than 0.001) and more intensive treatment (treated: 62% v 21%, p less than 0.001; splenectomized 37% v 1.5%, p less than 0.001). The incidence of major bleeding was not significantly different in drug addicts, hemophiliacs and ITP patients (0.98, 1.82 and 1.17/100 patients/year). Among drug addicts, bleeding was significantly more frequent in women than in men (3.4 v 0/100 patients/year, p less than 0.05). Our results indicate that the incidence of major bleeding in patients with HIV-associated thrombocytopenia is low and similar to that observed in more intensively treated ITP patients.
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Affiliation(s)
- G Finazzi
- Division of Hematology, Bergamo Hospitals, Italy
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25
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Terzi R, Marcaletti G, Tringali S, Catenacci G. [The evaluation of the individual thermal load in work activity with uneven energy expenditure]. G Ital Med Lav 1989; 11:283-7. [PMID: 2562750] [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: 01/01/2023]
Abstract
It is often very difficult to quantify the potential thermal stress in jobs characterized by sudden variations of energy expenditure and thermal overload for time periods of short duration. Heart rate varies rapidly with the changes of energy expenditure and thermal load and the application of the mathematical model, proposed by Givoni and Goldmann for prediction of heart rate response to work in hot environments, to values of the physiological parameter, continuously measured during the periods of work and rest, allows the calculation of the two components of the HSI stress index (Er, Emax) from which to derive safe times of exposure. In this study practical applications of the theoretical method are verified in the control of the potential thermal stress of workers engaged in the carbon coke production. In that job the variability of thermal conditions make unfeasible a complete and whole evaluation of thermal overload only based on the measure of the microclimatic environmental parameters.
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Affiliation(s)
- R Terzi
- Fondazione Clinica del lavoro, Pavia
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Catenacci G, Terzi R, Marcaletti G, Tringali S. [Evaluation of thermal comfort in a student population: predictive value of an integrated index (Fanger's predicted mean value]. Med Lav 1989; 80:405-11. [PMID: 2622412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Practical applications and predictive values of a thermal comfort index (Fanger's PRV) were verified on a sample school population (1236 subjects) by studying the relationships between thermal sensations (subjective analysis), determined by means of an individual questionnaire, and the values of thermal comfort index (objective analysis) obtained by calculating the PMV index individually in the subjects under study. In homogeneous conditions of metabolic expenditure rate and thermal impedence from clothing, significant differences were found between the two kinds of analyses. At 22 degrees C mean radiant and operative temperature, the PMV values averaged 0 and the percentage of subjects who experienced thermal comfort did not exceed 60%. The high level of subjects who were dissatisfied with their environmental thermal conditions confirms the doubts regarding the use of the PMV index as a predictive indicator of thermal comfort, especially considering that the negative answers were not homogeneous nor attributable to the small thermal fluctuations (less than 0.5 degree C) measured in the classrooms.
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Terzi R, Marcaletti G, Catenacci G. [Evaluation of individual thermal load in working environments with non-homogeneous microclimatic conditions]. Med Lav 1989; 80:211-7. [PMID: 2796830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
It is often very difficult to quantify the potential thermal stress of jobs requiring high worker mobility in unevenly hot environments. The determination of integrated indexes such as HSI can be a cause of error in risk evaluation. However, monitoring of physiological parameters of exposed workers, such as internal body temperature, provides a direct expression of man-environment interaction. On the basis of measurement of micro-climatic parameters and internal body temperature of subjects employed in a glass production plant, an attempt was made to calculate an integrated index of thermal stress risk which reflected the job requirements. The mathematical model used was the one proposed by Givoni and Goldman for prediction of rectal temperature and heart rate response to work in hot environments.
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Terzi R, Marcaletti G, Tringali S, Catenacci G. [Assessment of risk in occupational tasks with exposure to environmental noise of variable duration and intensity]. G Ital Med Lav 1988; 10:239-42. [PMID: 3154905] [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: 01/04/2023]
Abstract
The discontinuous exposure to environmental working noise often brings about risk situations hardly assessable by means of phonometric measurements and studying the exposure time, even if accurate. The use of the personal dosimetry can simplify the measurements and give a time-weighted value (Leq) comparable to a fixed limit value. Such a measurement is effective only for the considered time (usually a work shift); nevertheless it is assumed to be representative of the usual exposure to the job even though the variability of the working conditions constitute a limiting factor. In this work we tried to verify the possible use of the measurements of environmental sound pressure levels given by the dosimeter every 0.25 sec. The first aim being the study of the type of distribution of these values (during 5 consecutive shifts) and the estimate of mean and standard deviation values. The mean and the standard deviation values were used to get a OTL (one sided tolerance limits) usually employed for assessing the working chemical pollution. The second aim being the compliance control and the possible need of more measurements.
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Affiliation(s)
- R Terzi
- Fondazione Clinica del Lavoro Centro Medico di Pavia
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Terzi R, Marcaletti G, Catenacci G. [Predictive values of biological monitoring indicators in the control of environmental lead exposure. Study using a pharmacokinetic model]. Boll Soc Ital Biol Sper 1988; 64:621-6. [PMID: 3228506] [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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30
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Terzi R, Marcaletti G, Catenacci G, Minoia C. [Application of a mathematical model to the study of occupational exposure to hexavalent chromium]. Boll Soc Ital Biol Sper 1986; 62:923-8. [PMID: 3790334] [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: 01/07/2023]
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31
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Catenacci G, Marcaletti G, Terzi R, Casati C. [Verification of a thermal comfort index in a sample student population]. Boll Soc Ital Biol Sper 1986; 62:877-82. [PMID: 3790327] [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: 01/07/2023]
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32
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Terzi R, Marcaletti G, Catenacci G, Battaglia A. [Importance of the relative humidity values in determining thermohygrometric comfort]. G Ital Med Lav 1986; 8:149-52. [PMID: 3452558] [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: 01/05/2023]
Abstract
A condition of discomfort with specific symptoms, such as throat dryness, eye irritation, in a group of workers of a small, air conditioned, working department, is described. Neither the measurements of the possible environmental pollutants concentrations, nor the assessment of the usually adopted comfort indexes (PMV-PPD) justified the worker's symptoms. They completely disappeared by means of appropriate environmental improvements aiming to increase the relative humidity values from 29% to 50-55% (drop of the amount of the hygroscopic material stored, setting up of an humidifier). The effects of the low humidity values on the hygrometric and thermal comfort are finally discussed.
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Affiliation(s)
- R Terzi
- Fondazione Clinica del Lavoro, Pavia
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33
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Terzi R, Catenacci G, Marcaletti G. [Monitoring of occupational activities under the risk of heat stress: use of mathematical models in the prediction of physiological parameters]. G Ital Med Lav 1985; 7:187-91. [PMID: 3842816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Some authors proposed mathematical models that, starting from standardized conditions of environmental microclimate parameters, thermal impedance of the clothing, and energetic expenditure allowed the forecast of the body temperature and heart rate variations in respect to the basal values in subjects standing in the same environment. In the present work we verify the usefulness of these models applied to the working tasks characterized by standardized job made under unfavourable thermal conditions. In subject working in an electric power station the values of the body temperature and heart rate are registered and compared with the values obtained by the application of the studied models. The results are discussed in view of the practical use.
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34
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Terzi R, Marcaletti G, Catenacci G. [Evaluation of thermal comfort parameters in the operating rooms of a hospital surgical department]. Boll Soc Ital Biol Sper 1985; 61:1009-14. [PMID: 4074523] [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: 01/08/2023]
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35
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Terzi R, Marcaletti G, Catenacci G. [Prospects for environment intervention following biological monitoring of exposure to chromium]. Boll Soc Ital Biol Sper 1984; 60:2333-7. [PMID: 6529510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The authors study the statistical distribution and the graphical representation of the urinary chromium values investigated during three consecutive years in three work environments of a same plant: polishing 1 degree, electrotyping, polishing 2 degrees, to evaluate the environmental situations of exposure and their variations. The adopted method, based on the graphical representation of the values in logarithmic coordinate paper, allows to quickly and carefully calculate the percent of the workers having urinary chromium values above the prefixed limits.
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36
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Terzi R, Marcaletti G, Catenacci G. [Validity of a biophysical model for predicting heart rate values during activities operating under a risk of thermal stress]. Boll Soc Ital Biol Sper 1984; 60:2083-9. [PMID: 6525263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
After measuring the heart rate values of workers unfolding a standardized job made under unfavourable microclimatic conditions, the Authors calculate them by application of a proposed biophysical model starting from ambient climatic conditions, energetic expenditure and thermal resistance of the clothing. The results, compared by means of statistical methods, do not show any significant difference between the two methods. Therefore is also possible the proposal of the use of the biophysical model for the prevision of heart rate under standardized working conditions.
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Minoia C, Biscaldi GP, Terzi R, Colli M, Marcaletti G, Tempini G. [Reference values of chromium urine in the population residing in Lombardy]. G Ital Med Lav 1984; 6:169-76. [PMID: 6545205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
The accurate determination of Cr in normal human urine still presents a considerable challenge, connected to its very low content, supposedly about 1 ppb. The analytical data obtaining from many Authors varying between 0.3 microgram/day and 150 micrograms/day. The question now arises which data picture the true Cr content of normal human urine. To this purpose we have determined the content of total urinary chromium in 310 healthy individuals (170 male, 140 female) resident in Lombardy (Italy). A mean urinary Cr concentration of 0.59 +/- 0.26 ppb was obtained. The levels of urinary chromium tended to be higher in males than in females and to decrease with age.
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Catenacci G, Terzi R, Marcaletti G, Maugeri U. [Control of duration limits of work activity at risk in thermal stress by prediction of values for internal body temperature]. Boll Soc Ital Biol Sper 1984; 60:1401-1407. [PMID: 6477754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A biophysical model for studying the response of the rectal temperature to changes in metabolic rate and environmental conditions has been utilized to establish the safe exposure times for works at risk of thermal stress. The prediction of the rectal temperature allows to evaluate for how long the heat load due to metabolic rate is lasting after the work stopping in the period of recovery.
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39
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Terzi R, Catenacci G, Marcaletti G, Maugeri U. [Use of a biophysical model to verify various methods for limiting the time of work activity at risk in thermal stress]. Boll Soc Ital Biol Sper 1984; 60:1393-9. [PMID: 6477753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The Authors measure the environmental microclimatic parameters (dry bulb temperature, wet bulb temperature, globe temperature, natural wet bulb, air speed, vapor pressure) in twenty working sites. Starting from the values obtained, they calculate the safe exposure times for works under unfavourable thermal conditions by means of three different methods (time weighted average WBGT, allowable exposure time-AET, required sweat rate index). Finally they verify the results obtained by application of a biophisical model proper to calculate the response of rectal temperature to changes in metabolic rate and environmental conditions.
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Terzi R, Catenacci G, Marcaletti G, Maugeri U. [Decrease in environmental pollution and changes in biological indicators in occupational exposure to lead]. Boll Soc Ital Biol Sper 1984; 60:1211-6. [PMID: 6477735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The Authors examine the variations of the levels of PbB and EPP in 39 workers at known lead exposure and evaluate the capacity of these parameters to follow the measured decreases of the environmental pollution. They conclude that the variations of the mean PbB values are well related to environmental pollution and that the diagram on the probability paper of median values and their corresponding standard deviations allows to calculate the number of exposed workers with biological values above a fixed limit.
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Catenacci G, Grampella D, Terzi R, Sala A, Pollini G. Hepatic function in subjects exposed to environmental concentrations of DMF lower than the actually proposed TLV. G Ital Med Lav 1984; 6:157-8. [PMID: 6534780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hepatic function investigation in 54 workers, exposed to an airborne concentration of DMF lower than TLV in an acrylic fiber plant, has been carried out. The results suggest the probable absence of hepatic cytolysis phenomena for this degree of exposure.
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Taccola A, Gotti GB, Zelaschi GP, Pisati P, Terzi R. [Changes in spontaneous platelet aggregation induced by the ambient temperature]. Minerva Med 1984; 75:975-80. [PMID: 6233503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The diagnostic meaning of the functional platelets modifications (particularly those of spontaneous platelet aggregation = P.A.) in cardiovascular pathology has been recalled. It is emphasized that, in order to have significantly predictable data on eventual pathological alterations in case of deviations of values considered normal, one has to use methods that do not differ from the real haemorheological conditions. A research has therefore been made with the purpose to evaluate the influence that variations of temperature may have on the samples collected and left to sediment (for the separation of the PRP) and the subsequent modifications of P.A. The research has been made in double on plasma sedimented at 37 degrees C and at room-temperature on 731 subjects, 289 of which were the casuistic groups for the subsequent statistic elaboration. With similar modalities in other 8 patients the eventual variations in excretion of beta-TG were looked for. The results have shown that there are important variations of the spontaneous P.A. rates, that the difference is always statistically very significant and that lowering the temperature of the samples favors an increase in beta-TG excretion . The Authors think therefore that only the sedimentation at 37 degrees C issues a plasma usefull for the further performing of platelets tests, while in the plasma obtained with sedimentation at room-temperature the platelets are perhaps already stimulated to an activation (and subsequently an aggregation) higher than the real one. Data obtained from a homogeneous group of subjects, healthy from a clinical point of view, allowed to fix the new range of normal values within 3% of aggregability . The mechanisms that lead to such different results are discussed. Emphasis is put on the fact that the spontaneous P.A. determined by the means mentioned seems satisfactorily near to the real clinical conditions. That's why the hypothesis arises that also other tests concerning platelet functions could be negatively influenced if they have room-temperature as a condition for plasma separation.
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Terzi R, Catenacci G, Marcaletti G. [Control of cardiac frequency in work activity at risk of thermal stress]. Boll Soc Ital Biol Sper 1984; 60:569-74. [PMID: 6712823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The working time in work places termically uncomfortable must be limited in order to prevent the risk of thermal stress; the safe exposure times are based on the microclimatic parameters and the energetic expenditure required for the job. Hearth rate measure is proposed by various Authors as index connected with the energetic expenditure level and with the microclimatic conditions. In the present work the Authors realise the monitoring of a job uncomfortable for thermal conditions by means of the hearth rate measure of the workers. The results show the better accuracy of the purposed method in comparison with the application of the safe exposure times.
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Marcaletti G, Terzi R, Catenacci G. [Microclimatic indexes and limits of safe exposure in work activity at risk of thermal stress]. Boll Soc Ital Biol Sper 1984; 60:561-7. [PMID: 6712822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The working time in work places thermically uncomfortable must be limited in order to prevent the risk of thermal stress. In a previous study we have demonstrated that the best method for calculation of the safe exposure times is based on the required sweat rate index. In the present work we verified in different work places termically uncomfortable, grouped for equivalent values of WBGT index, the variability of the safe exposure times calculated by means of a method just now mentioned for various levels of energetic expenditure. The results point out the possibility of a mathematical relation between energetic expenditure, WBGT index and mean of safe exposure times.
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Catenacci G, Terzi R, Marcaletti G. [Thermal balance in workers of in greenhouses for the cultivation of tropical plants]. Boll Soc Ital Biol Sper 1984; 60:575-80. [PMID: 6712824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The Authors starting from the microclimatic parameters globe temperature (tg), dry bulb temperature (ts) forced wet bulb temperature (tu), natural wet bulb temperature (tun), speed of the air (v) observed every half an hour in greenhouses for tropical plants, evaluate the required sweating rate per hour during a specimen working shift for a known energetic expenditure. The sweating rate values calculated exceed by far the highest limits accepted for the workers perfectly acclimatized and impose the application of the working safe exposure times.
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Catenacci G, Terzi R, Marcaletti G, Ragni F. [Relation between thermal comfort indices and various values of thermal impedence for clothes]. Boll Soc Ital Biol Sper 1983; 59:1966-72. [PMID: 6671055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The Authors show that there is some relationship between WBGT microclimatic index and PMV thermic comfort index. This relationship can be noticed at various levels of energetic expenditure and for three values of thermic impedance from clothes used in working places in the four seasons.
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Terzi R, Marcaletti G, Catenacci G, Maugeri U. [Microclimate and duration of work tolerance in hothouse for cultivation of tropical plants]. G Ital Med Lav 1983; 5:255-8. [PMID: 6544227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
The AA. starting from the environmental values carried out in a greenhouse for tropical plants investigate the possibility of prevent the risk of thermal stress at standardized energetic expenditures by means of the measurement of a few microclimatic parameters; they elaborate also a nomogram proper to calculate the safe exposure times for works under unfavourable thermal conditions.
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48
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Terzi R, Catenacci G. [Duration limit of moderately heavy work activity in technically unfavorable environments]. Boll Soc Ital Biol Sper 1983; 59:1486-1491. [PMID: 6661308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The working time in work places thermically uncomfortable must be limited in order to prevent the risk of thermal stress. The Authors measure the environmental microclimatic parameters (dry bulb temperature, wet bulb temperature, globe temperature, natural wet bulb temperature, air speed, vapor pressure) in twenty working sites of a thermal power plant. Starting from the values obtained, they calculate the safe exposure times under unfavourable thermal conditions by means of four different methods (WBGT, time weighted average WBGT, allowable exposure time-AET, required sweat rate index). The results are critically analysed.
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49
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Terzi R, Catenacci G. [Threshold of energy expenditure for maintenance of thermal comfort in working areas]. Boll Soc Ital Biol Sper 1983; 59:78-82. [PMID: 6849696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The Authors test the possibility of improving the microclimatic conditions of some working areas by assessing the threshold energetic expenditure (KCal/hour and KCal/min) in order to maintain the thermic well-being by means of a "thermic comfort" parameter, PMV. For this purpose, we measured PMV on the basis of tg, ts, V, tun, Pa and Clo in 15 working areas. Then, by an iterative mathematical process, we calculated the threshold value of energetic expenditure in accordance with the values of PMV which show conditions of thermic comfort, that is between + 0.5 and - 0.5. In all the working areas observed it is possible to perform works requiring energetic expenditures lower than 200 KCal/h in conditions of thermic comfort; in 50% of the situations we examined even works requiring higher energetic expenditures.
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Terzi R, Marcaletti G, Prestinoni A, Catenacci G. [Simplification of periodic audiometric tests in persons exposed to industrial noise. An operative proposal]. G Ital Med Lav 1982; 4:193-6. [PMID: 7185633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Today the pure tonal audiometric test is the most used in periodical screening of the "hypoacusis" hazard in exposed patients because of its easy performance. The high number of patients to be tested and the screening frequency suggested to simplify the annual checks by testing only some of the frequency to be tested is made on the basis of the first complete audiogram performed according to a scheduled scheme. Available screening data and testing on the field show that a consistent reduction in testing time is possible and that the complete exam is reliable.
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