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Paoli D, Pallotti F, Anzuini A, Bianchini S, Caponecchia L, Carraro A, Ciardi MR, Faja F, Fiori C, Gianfrilli D, Lenzi A, Lichtner M, Marcucci I, Mastroianni CM, Nigro G, Pasculli P, Pozza C, Rizzo F, Salacone P, Sebastianelli A, Lombardo F. Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study. J Endocrinol Invest 2023; 46:89-101. [PMID: 35943723 PMCID: PMC9362397 DOI: 10.1007/s40618-022-01887-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE While SARS-CoV-2 infection appears not to be clinically evident in the testes, indirect inflammatory effects and fever may impair testicular function. To date, few long-term data of semen parameters impairment after recovery and comprehensive andrological evaluation of recovered patients has been published. The purpose of this study was to investigate whether SARS-CoV-2 infection affect male reproductive health. METHODS Eighty patients were recruited three months after COVID-19 recovery. They performed physical examination, testicular ultrasound, semen analysis, sperm DNA integrity evaluation (TUNEL), anti-sperm antibodies (ASA) testing, sex hormone profile evaluation (Total testosterone, LH, FSH). In addition, all patients were administered International Index of Erectile Function questionnaire (IIEF-15). Sperm parameters were compared with two age-matched healthy pre-COVID-19 control groups of normozoospermic (CTR1) and primary infertile (CTR2) subjects. RESULTS Median values of semen parameters from recovered SARS-CoV-2 subjects were within WHO 2010 fifth percentile. Mean percentage of sperm DNA fragmentation (%SDF) was 14.1 ± 7.0%. Gelatin Agglutination Test (GAT) was positive in 3.9% of blood serum samples, but no positive semen plasma sample was found. Only five subjects (6.2%) had total testosterone levels below the laboratory reference range. Mean bilateral testicular volume was 31.5 ± 9.6 ml. Erectile dysfunction was detected in 30% of subjects. CONCLUSION Our data remark that COVID-19 does not seem to cause direct damage to the testicular function, while indirect damage appears to be transient. It is possible to counsel infertile couples to postpone the research of parenthood or ART procedures around three months after recovery from the infection.
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Affiliation(s)
- D Paoli
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - F Pallotti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Anzuini
- Hormone Laboratory, Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - S Bianchini
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - L Caponecchia
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - A Carraro
- Infectious Diseases Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - M R Ciardi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - F Faja
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Fiori
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Lichtner
- Infectious Diseases Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - I Marcucci
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - G Nigro
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - P Pasculli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - C Pozza
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - F Rizzo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - P Salacone
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - A Sebastianelli
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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2
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Guarisco G, Fasolo M, Capoccia D, Morsello G, Carraro A, Zuccalà P, Marocco R, Del Borgo C, Pelle G, Iannarelli A, Orlando E, Spagnoli A, Carbone I, Lichtner M, Iacobellis G, Leonetti F. Blood glucose and epicardial adipose tissue at the hospital admission as possible predictors for COVID-19 severity. Endocrine 2022; 75:10-18. [PMID: 34729688 PMCID: PMC8563297 DOI: 10.1007/s12020-021-02925-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/20/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE To study the possible association of CT-derived quantitative epicardial adipose tissue (EAT) and glycemia at the admission, with severe outcomes in patients with COVID-19. METHODS Two hundred and twenty-nine patients consecutively hospitalized for COVID-19 from March 1st to June 30th 2020 were studied. Non contrast chest CT scans, to confirm diagnosis of pneumonia, were performed. EAT volume (cm3) and attenuation (Hounsfield units) were measured using a CT post-processing software. The primary outcome was acute respiratory distress syndrome (ARDS) or in-hospital death. RESULTS The primary outcome occurred in 56.8% patients. Fasting blood glucose was significantly higher in the group ARDS/death than in the group with better prognosis [114 (98-144) vs. 101 (91-118) mg/dl, p = 0.001]. EAT volume was higher in patients with vs without the primary outcome [103 (69.25; 129.75) vs. 78.95 (50.7; 100.25) cm3, p < 0.001] and it was positively correlated with glycemia, PCR, fibrinogen, P/F ratio. In the multivariable logistic regression analysis, age and EAT volume were independently associated with ARDS/death. Glycemia and EAT attenuation would appear to be factors involved in ARDS/death with a trend of statistical significance. CONCLUSIONS Our findings suggest that both blood glucose and EAT, easily measurable and modifiable targets, could be important predisposing factors for severe Covid-19 complications.
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Affiliation(s)
- G Guarisco
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy.
| | - M Fasolo
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - D Capoccia
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - G Morsello
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - A Carraro
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - P Zuccalà
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - R Marocco
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - C Del Borgo
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - G Pelle
- Department of Diagnostic and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - A Iannarelli
- Department of Diagnostic and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - E Orlando
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, I.C.O.T. Hospital, Latina, Italy
| | - A Spagnoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - I Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, I.C.O.T. Hospital, Latina, Italy
| | - M Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Infectious Diseases Unit, SM Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - G Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL, USA
| | - F Leonetti
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
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3
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Rosenbaum S, Morell R, Abdel-Baki A, Ahmadpanah M, Anilkumar TV, Baie L, Bauman A, Bender S, Boyan Han J, Brand S, Bratland-Sanda S, Bueno-Antequera J, Camaz Deslandes A, Carneiro L, Carraro A, Castañeda CP, Castro Monteiro F, Chapman J, Chau JY, Chen LJ, Chvatalova B, Chwastiak L, Corretti G, Dillon M, Douglas C, Egger ST, Gaughran F, Gerber M, Gobbi E, Gould K, Hatzinger M, Holsboer-Trachsler E, Hoodbhoy Z, Imboden C, Indu PS, Iqbal R, Jesus-Moraleida FR, Kondo S, Ku PW, Lederman O, Lee EHM, Malchow B, Matthews E, Mazur P, Meneghelli A, Mian A, Morseth B, Munguia-Izquierdo D, Nyboe L, O’Donoghue B, Perram A, Richards J, Romain AJ, Romaniuk M, Sadeghi Bahmani D, Sarno M, Schuch F, Schweinfurth N, Stubbs B, Uwakwe R, Van Damme T, Van Der Stouwe E, Vancampfort D, Vetter S, Waterreus A, Ward PB. Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ). BMC Psychiatry 2020; 20:108. [PMID: 32143714 PMCID: PMC7060599 DOI: 10.1186/s12888-020-2473-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/30/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.
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Affiliation(s)
- S. Rosenbaum
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - R. Morell
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - A. Abdel-Baki
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Ahmadpanah
- grid.411950.80000 0004 0611 9280Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - T. V. Anilkumar
- grid.413226.00000 0004 1799 9930Department of Psychiatry, Government Medical College, Trivandrum, India
| | - L. Baie
- grid.16149.3b0000 0004 0551 4246Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - A. Bauman
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia
| | - S. Bender
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - J. Boyan Han
- grid.253561.60000 0001 0806 2909California State University, Los Angeles, USA
| | - S. Brand
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - S. Bratland-Sanda
- Department of Sport, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Notodden, Norway
| | - J. Bueno-Antequera
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - A. Camaz Deslandes
- grid.8536.80000 0001 2294 473XPsychiatry Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L. Carneiro
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, GERON Research Community, Vila Real, Portugal
| | - A. Carraro
- grid.34988.3e0000 0001 1482 2038Faculty of Education, Free University of Bolzano, Bolzano, Italy
| | - C. P. Castañeda
- Early Intervention Program, JHorwitz Psychiatric Institute, Santiago, Chile
| | - F. Castro Monteiro
- grid.8532.c0000 0001 2200 7498Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J. Chapman
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J. Y. Chau
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,grid.1004.50000 0001 2158 5405Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - L. J. Chen
- grid.445057.7Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - B. Chvatalova
- grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic
| | - L. Chwastiak
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - G. Corretti
- Department of Mental Health, North-West Tuscany, Italy
| | - M. Dillon
- HSE Louth Meath Mental Health Services, Louth, Ireland
| | - C. Douglas
- South Coast Private Hospital, Wollongong, Australia
| | - S. T. Egger
- grid.10863.3c0000 0001 2164 6351Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain ,grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - F. Gaughran
- grid.451052.70000 0004 0581 2008South London and Maudesley NHS Foundation Trust, London, UK
| | - M. Gerber
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
| | - E. Gobbi
- grid.6612.30000 0004 1937 0642Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland
| | - K. Gould
- grid.460013.0St John of God Hospital, North Richmond, Australia
| | - M. Hatzinger
- Psychiatric Services Solothurn, Solothurn, Switzerland
| | - E. Holsboer-Trachsler
- grid.6612.30000 0004 1937 0642Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Z. Hoodbhoy
- grid.7147.50000 0001 0633 6224Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - C. Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland ,Private Clinic Wyss, Muenchenbuchsee, Switzerland
| | - P. S. Indu
- grid.413226.00000 0004 1799 9930Department of Community Medicine, Government Medical College, Trivandrum, India
| | - R. Iqbal
- grid.7147.50000 0001 0633 6224Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - F. R. Jesus-Moraleida
- grid.8395.70000 0001 2160 0329Department of Physical Therapy, Universidade Federal do Ceará, Fortaleza, Brazil
| | - S. Kondo
- grid.412708.80000 0004 1764 7572Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - P. W. Ku
- grid.412038.c0000 0000 9193 1222Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan
| | - O. Lederman
- grid.477714.60000 0004 0587 919XKeeping the Body In Mind, South Eastern Sydney Local Health District, Sydney, Australia
| | - E. H. M. Lee
- grid.194645.b0000000121742757Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - B. Malchow
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - E. Matthews
- grid.24349.380000000106807997School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - P. Mazur
- LWL-Klinik Marsberg, Hospital for Psychiatry, Psychotherapy and Psychosomatics, Marsberg, Germany
| | - A. Meneghelli
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - A. Mian
- grid.7147.50000 0001 0633 6224Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | - B. Morseth
- grid.10919.300000000122595234School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - D. Munguia-Izquierdo
- grid.15449.3d0000 0001 2200 2355Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - L. Nyboe
- grid.154185.c0000 0004 0512 597XDepartment of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - B. O’Donoghue
- grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - A. Perram
- grid.267827.e0000 0001 2292 3111Faculty of Health, Victoria University Wellington, Wellington, New Zealand
| | - J. Richards
- grid.1013.30000 0004 1936 834XSchool of Public Health, University of Sydney, Sydney, Australia ,Gallipoli Medical Research Institute, Brisbane, Australia
| | - A. J. Romain
- grid.410559.c0000 0001 0743 2111Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Canada
| | - M. Romaniuk
- grid.412112.50000 0001 2012 5829Kermanshah University of Medical Sciences, Sleep Disorders and Substance Abuse Prevention Research Center, Kermanshah, Iran
| | - D. Sadeghi Bahmani
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland ,grid.477714.60000 0004 0587 919XThe Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, Australia
| | - M. Sarno
- Association of early intervention in mental disorders-Cambiare la Rotta-Onlus, Milano, Italy
| | - F. Schuch
- grid.411239.c0000 0001 2284 6531Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - N. Schweinfurth
- grid.6612.30000 0004 1937 0642University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - B. Stubbs
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, King’s College London, London, England
| | - R. Uwakwe
- grid.412207.20000 0001 0117 5863Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - T. Van Damme
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - E. Van Der Stouwe
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Groningen, Netherlands
| | - D. Vancampfort
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - S. Vetter
- grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - A. Waterreus
- grid.1012.20000 0004 1936 7910Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Australia
| | - P. B. Ward
- grid.1005.40000 0004 4902 0432School of Psychiatry, UNSW Sydney, Sydney, Australia ,grid.429098.eSchizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
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Tolomeo AM, Carraro A, Bakiu R, Toppo S, Garofalo F, Pellegrino D, Gerdol M, Ferro D, Place SP, Santovito G. Molecular characterization of novel mitochondrial peroxiredoxins from the Antarctic emerald rockcod and their gene expression in response to environmental warming. Comp Biochem Physiol C Toxicol Pharmacol 2019; 225:108580. [PMID: 31374295 DOI: 10.1016/j.cbpc.2019.108580] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/25/2019] [Revised: 07/17/2019] [Accepted: 07/26/2019] [Indexed: 02/07/2023]
Abstract
In the present study we describe the molecular characterization of the two paralogous mitochondrial peroxiredoxins from Trematomus bernacchii, a teleost that plays a pivotal role in the Antarctic food chain. The two putative amino acid sequences were compared with orthologs from other fish, highlighting a high percentage of identity and similarity with the respective variant, in particular for the residues that are essential for the characteristic peroxidase activity of these enzymes. The temporal expression of Prdx3 and Prdx5 mRNAs in response to short-term thermal stress showed a general upregulation of prdx3, suggesting that this isoform is the most affected by temperature increase. These data, together with the peculiar differences between the molecular structures of the two mitochondrial Prdxs in T. bernacchii as well as in the tropical species Stegastes partitus, suggest an adaptation that allowed these poikilothermic aquatic vertebrates to colonize very different environments, characterized by different temperature ranges.
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Affiliation(s)
- A M Tolomeo
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - A Carraro
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - R Bakiu
- Department of Aquaculture and Fisheries, Agricultural University of Tirana, Tirana, Albania
| | - S Toppo
- Department of Molecular Medicine, University of Padova, Italy
| | - F Garofalo
- Departmentof of Biology, Ecology and Earth Sciences (B.E.S.T.), University of Calabria, Arcavacata di Rende, Italy
| | - D Pellegrino
- Departmentof of Biology, Ecology and Earth Sciences (B.E.S.T.), University of Calabria, Arcavacata di Rende, Italy
| | - M Gerdol
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - D Ferro
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - S P Place
- Department of Biology, Sonoma State University, Rohnert Park, CA, USA
| | - G Santovito
- Department of Biology, University of Padova, Padova, Italy.
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5
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Tognetti L, Rubegni P, Vitiello G, Bormioli S, Carraro A, Cinotti E, Fimiani M, Maggi E. Persistent unilateral ulcer of the ear as the first manifestation of relapsing polychondritis. Clin Exp Dermatol 2018; 43:823-824. [PMID: 29770469 DOI: 10.1111/ced.13615] [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] [Accepted: 01/02/2018] [Indexed: 11/28/2022]
Affiliation(s)
- L Tognetti
- Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - P Rubegni
- Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - G Vitiello
- Experimental and Clinical Medicine Department, University of Florence, Florence, Italy
| | - S Bormioli
- Experimental and Clinical Medicine Department, University of Florence, Florence, Italy
| | - A Carraro
- Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - E Cinotti
- Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - M Fimiani
- Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - E Maggi
- Experimental and Clinical Medicine Department, University of Florence, Florence, Italy
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Cima L, Riva G, D'Errico A, Casartelli-Liviero M, Capelli P, Tomezzoli A, Montin U, Carraro A, Scarpa A, Ghimenton C, Colombari R, Brunelli M, Eccher A. Fast Chromotrope Aniline Blue Special Stain Is a Useful Tool to Assess Fibrosis on Liver Biopsy During Transplantation. Transplant Proc 2017; 49:667-670. [PMID: 28457367 DOI: 10.1016/j.transproceed.2017.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Assessment of potential liver allograft donors with frozen sections has clinical relevant consequences for the transplant recipient. Several clinical risk factors have been identified that increase the risk of transplantation failure and it is critical for the pathologist to become familiar with the histologic criteria for donor liver suitability. In this setting an accurate and reliable assessment of fibrosis is crucial. We sought to report the value of the rapid chromotrope aniline blue stain (CAB) in a transplantation clinical work-flow for scoring liver fibrosis. MATERIALS AND METHODS Twenty consecutive intraoperative donor liver biopsy specimens were evaluated by a pathologist at the Transplant Pathology Board Room, AOUI Verona, during 24-hour on-call service. The stage of fibrosis was evaluated according to Ishak score ranging from 0 to 6 (absent to cirrhosis) using hematoxylin and eosin stain (H&E) plus rapid CAB special stain. After a 3-week washout period, only the slides stained with H&E were re-assessed for fibrosis stage by the same pathologist blinded to donor patient data. RESULTS Combination H&E-CAB staging fibrosis score was higher in 20%, lower in 10%, and the same in 70% of biopsy specimens as determined using only H&E stain alone. Rapid CAB stain takes 20 minutes longer than H&E stain alone. CONCLUSIONS CAB staining may be performed on frozen tissue from liver biopsy during a transplantation process without a significant delay in diagnosis. Combination H&E-CAB staining improves sensibility of interpretation of fibrosis.
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Affiliation(s)
- L Cima
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - G Riva
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - A D'Errico
- Department of Specialized, Experimental and Diagnostic Medicine, S. Orsola-Malpighi University Hospital of Bologna, Bologna, Italy
| | - M Casartelli-Liviero
- Department of Surgical Science, Neurosurgery and Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - P Capelli
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - A Tomezzoli
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - U Montin
- Department of Surgical Science, Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy
| | - A Carraro
- Department of Surgical Science, Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy
| | - A Scarpa
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - C Ghimenton
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - R Colombari
- Anatomic Pathology, Fra Castoro Hospital of San Bonifacio, Verona, Italy
| | - M Brunelli
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - A Eccher
- Department of Diagnostics and Public Health, Anatomic Pathology, University and Hospital Trust of Verona, Verona, Italy.
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Guillaud M, Keyes M, Ye Q, Carraro A, Harrison A, Hayes M, Nichol A, Leung S. Large-scale DNA organization is a prognostic marker of breast cancer survival. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.013] [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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Carraro A, Fabbri P, Giaretta A, Peruzzo L, Tateo F, Tellini F. Effects of redox conditions on the control of arsenic mobility in shallow alluvial aquifers on the Venetian Plain (Italy). Sci Total Environ 2015; 532:581-594. [PMID: 26115337 DOI: 10.1016/j.scitotenv.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 06/04/2023]
Abstract
The Venetian Plain is known for the occurrence of areas with high concentrations of arsenic in groundwater (greater than 400 μg/L). The study area represents the typical residential, industrial and agricultural features of most Western countries and is devoid of hydrothermal, volcanic or anthropogenic sources of arsenic. The aim of the study is to model the arsenic mobilization and the water-rock interaction by a complete hydrogeochemical investigation (analyses of filtered and unfiltered groundwater sediment mineralogy and geochemistry). The groundwater arsenic contamination and redox conditions are highly variable. Groundwaters with oxidizing and strongly reducing potentials have much lower arsenic concentrations than do mildly reducing waters. The grain size of the aquifer sediments includes gravels, sands and silty-clays. A continuous range of organic material concentrations is observed (from zero to 40%). The amount of sedimentary organic matter is highly correlated with the arsenic content of the sediments (up to 300 mg/kg), whereas no relationships are detectable between arsenic and other chemical parameters. The occurrence of arsenic minerals was observed as a peculiar feature under the scanning electron microscope. Arsenic and sulfur are the sole constituents of small tufts or thin crystals concentrated in small masses. These arsenic minerals were clearly observed in the peat sediments, in agreement with the geochemical modeling that requires very reducing conditions for their precipitation from the groundwater. The modeling suggests that, under oxidizing conditions, arsenic is adsorbed; moreover, a continuous decrease in the redox potential causes increasing desorption of arsenic. If the reducing conditions become more intense, the formation of As-S minerals would explain the lower concentration of arsenic measured in the strongly reducing groundwater. Even if As-sulfides are rare under low-temperature conditions, the anomalous abundance of reductants (organic matter) can locally stabilize As-S minerals, which can scavenge large quantities of groundwater arsenic.
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Affiliation(s)
- A Carraro
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy
| | - P Fabbri
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy; Department of Geosciences, University of Padova, 35131 Padova, Italy
| | - A Giaretta
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy
| | - L Peruzzo
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy
| | - F Tateo
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy
| | - F Tellini
- Institute of Geosciences and Earth Resources, National Research Council (CNR) of Italy, Padova, Italy c/o Department of Geosciences, University of Padova, 35131 Padova, Italy
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9
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Tolomeo AM, Carraro A, Bakiu R, Toppo S, Place SP, Ferro D, Santovito G. Peroxiredoxin 6 from the Antarctic emerald rockcod: molecular characterization of its response to warming. J Comp Physiol B 2015; 186:59-71. [PMID: 26433650 DOI: 10.1007/s00360-015-0935-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/09/2015] [Accepted: 09/22/2015] [Indexed: 12/22/2022]
Abstract
In the present study, we describe the purification and molecular characterization of two peroxiredoxins (Prdxs), referred to as Prdx6A and Prdx6B, from Trematomus bernacchii, a teleost widely distributed in many areas of Antarctica, that plays a pivotal role in the Antarctic food chain. The two putative amino acid sequences were compared with Prdx6 orthologs from other fish, highlighting a high percentage of identity and similarity with the respective variant, in particular for the residues that are essential for the characteristic peroxidase and phospholipase activities of these enzymes. Phylogenetic analyses suggest the appearance of the two prdx6 genes through a duplication event before the speciation that led to the differentiation of fish families and that the evolution of the two gene variants seems to proceed together with the evolution of fish orders and families. The temporal expression of Prdx6 mRNA in response to short-term thermal stress showed a general upregulation of prdx6b and inhibition of prdx6a, suggesting that the latter is the variant most affected by temperature increase. The variations of mRNA accumulation are more conspicuous in heart than the liver, probably related to behavioral changes of the specimens in response to elevated temperature. These data, together with the peculiar differences between the molecular structures of the two Prdx6s in T. bernacchii as well as in the tropical species Stegastes partitus, suggest an adaptation that allowed these poikilothermic aquatic vertebrates to colonize very different environments, characterized by different temperature ranges.
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Affiliation(s)
- A M Tolomeo
- Department of Biology, University of Padova, via U. Bassi 58/B, 35100, Padua, Italy
| | - A Carraro
- Department of Biology, University of Padova, via U. Bassi 58/B, 35100, Padua, Italy
| | - R Bakiu
- Department of Aquaculture and Fisheries, Agricultural University of Tirana, Tirana, Albania
| | - S Toppo
- Department of Molecular Medicine, University of Padova, Padua, Italy
| | - S P Place
- Department of Biology, Sonoma State University, Rohnert Park, CA, USA
| | - D Ferro
- Institute for Evolution and Biodiversity, Westfälische Wilhelms-Universität, Münster, Germany
| | - G Santovito
- Department of Biology, University of Padova, via U. Bassi 58/B, 35100, Padua, Italy.
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Zanus G, Carraro A, Vitale A, Gringeri E, D'Amico F, Valmasoni M, D'Amico FE, Brolese A, Boccagni P, Neri D, Srsen N, Burra P, Feltracco P, Bonsignore P, Scopelliti M, Cillo U. Alcohol abuse and de novo tumors in liver transplantation. Transplant Proc 2014; 41:1310-2. [PMID: 19460548 DOI: 10.1016/j.transproceed.2009.03.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 12/14/2022]
Abstract
INTRODUCTION Organ transplant recipients show an increased incidence of cancer ranging from 4% to 16% owing to several causes: immunosuppression, viral infection, individual predisposition, and so on. MATERIALS AND METHODS We retrospectively reviewed the records of 43/683 (6.3%) recipients of 734 liver transplants performed from November 1991 to November 2008 who experienced a de novo neoplasm. CONCLUSION Alcohol abuse significantly increased the rate of all de novo neoplasms and particularly pharyngogastroesophageal cancers among population of liver transplant recipients. Minimization of immunosuppressive therapy is necessary to reduce the risk of a de novo neoplasm. Strict posttransplant follow-up is required to identify early gastroenteric tumors.
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Affiliation(s)
- G Zanus
- Hepatobiliary and Liver Transplant Unit, Department of General Surgery and Organ Transplant, University of Padua, Padua, Italy.
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11
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Gringeri E, Bonsignore P, Bassi D, D'Amico F, Mescoli C, Polacco M, Buggio M, Luisetto R, Boetto R, Noaro G, Ferrigno A, Boncompagni E, Freitas I, Vairetti M, Carraro A, Neri D, Cillo U. Subnormothermic Machine Perfusion for Non–Heart-Beating Donor Liver Grafts Preservation in a Swine Model: A New Strategy to Increase the Donor Pool? Transplant Proc 2012; 44:2026-8. [DOI: 10.1016/j.transproceed.2012.06.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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12
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Rinonapoli G, Carraro A, Delcogliano A. The clinical diagnosis of meniscal tear is not easy. Reliability of two clinical meniscal tests and magnetic resonance imaging. Int J Immunopathol Pharmacol 2011; 24:39-44. [PMID: 21669136 DOI: 10.1177/03946320110241s208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIM to clarify the reliability of two clinical meniscal tests, McMurray's and Apley's and the MRI imaging, in order to establish how to reduce unjustified arthroscopies. METHODS 102 patients were selected out of 160. All patients were submitted to a triple clinical examination (by a young surgeon and two skilled surgeons), MRI and an arthroscopic procedure. The investigated clinical tests were McMurray's and Apley's test. The positivity or negativity of the tests and MRI were compared to arthroscopic findings. Arthroscopy is considered the gold standard for the diagnosis of meniscal lesions. We measured the length of the meniscal lesions in order to correlate it to the clinical findings. RESULTS From the clinical examination, we got the following data: McMurray's test: sensitivity 79.7%, specificity 78.5%, accuracy 79.4%, positive likelihood ratio 3.7, negative likelihood ratio 0.2. Apley's test: sensitivity 83.7%, specificity 71.4%, accuracy 80.3%, positive likelihood ratio 2.9, negative likelihood ratio 0.2. The composite assessment is strictly dependent on how the discordance of the two tests is evaluated. The assessment of the clinical tests was done even in relation to medial or lateral meniscal lesion. No statistical difference was found about the length of the meniscal tear. MRI gave the following results: sensitivity 78.3%, specificity 85.7%, accuracy 80.3%. CONCLUSIONS If we use, as diagnostic means, McMurray's and Apley's clinical tests and MRI as imaging procedure, we have an accuracy of about 80%. It is important to keep in mind that it is not possible to have the absolute certainty of make a correct diagnosis in case of meniscal lesions. Patients, too, have to be informed about the risk of a negative arthroscopy.
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Affiliation(s)
- G Rinonapoli
- Orthopaedic Dept., University of Perugia, Italy.
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13
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Zanus G, Boetto R, Gringeri E, Vitale A, D'Amico F, Carraro A, Bassi D, Bonsignore P, Noaro G, Mescoli C, Rugge M, Angeli P, Senzolo M, Burra P, Feltracco P, Cillo U. Microwave thermal ablation for hepatocarcinoma: six liver transplantation cases. Transplant Proc 2011; 43:1091-4. [PMID: 21620060 DOI: 10.1016/j.transproceed.2011.02.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Surgical resection for malignant hepatic tumors, especially hepatocarcinoma (HCC), has been demonstrated to increase overall survival; however, the majority of patients are not suitable for resection. Radiofrequency ablation (RFA) is the most widely used modality for radical treatment of small HCC (<3 cm). It improves 5-year survival compared with standard chemotherapy and chemical ablation, allowing down-staging of unresectable hepatic masses. Microwave ablation (MWA) has been extensively applied in Asia and was recently introduced in the United States of America and Europe with excellent results, especially with regard to large unresectable HCC. Our single-center experience between May 2009 and October 2010 included application of MWA to 154 patients of median age ± standard deviation of 63.5 ± 8.5 years, 6 males, and 1 female, of mean Model for End-Stage Liver Disease (MELD) score (10.1 ± 3.8). The HCC included, hepatitis C virus (HCV)-related (n=70; 45.5%); alcool (ETOH)-related (n=42; 27%), hepatitis B virus (HBV)-related (n=16; 10.5%); and cryptogenic cases (n=26; 17%). The cases were performed for radical treatment down-staging for multifocal pathology or bridging liver transplantation to orthotopic (OLT) in selected patients with single nodules. A computed tomography (CT) scan was performed at 1 month after the surgical procedure to evalue responses to treatment. Among 6 selected patients who underwent OLT; 5 (83.3%) showed disease-free survival at one-year follow-up. The radical treatment achieved no intraoperative evidence of tumor spread or of pathological signs of active HCC among the explanted liver specimens. In conclusion, a MWA seemed to be a safe novel approach to treat HCC and could serve as a "bridge" to OLT and down-staging for patients with HCC.
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Affiliation(s)
- G Zanus
- General Surgery and Organ Transplantation, Hepatobiliary Surgery and Liver Transplant Unit, Azienda Università di Padova, Padova, Italy.
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14
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Vitale A, Volk ML, Gambato M, Zanus G, D'Amico F, Carraro A, Pauletto A, Bonsignore P, Scopelliti M, Polacco M, Russo F, Senzolo M, Burra P, Romano A, Angeli P, Cillo U. Estimation of the harm to the waiting list as a crucial factor in the selection of patients with hepatocellular carcinoma for liver transplantation. Transplant Proc 2010; 42:1194-6. [PMID: 20534259 DOI: 10.1016/j.transproceed.2010.03.089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Long-term survival rates after orthotopic liver transplantation (OLT) for patients with hepatocellular carcinoma (HCC) of any size and number may now be predicted using the Metroticket calculator. The aim of this study was to evaluate the minimum post-OLT survival threshold that would justify the selection of a patient with HCC for OLT. METHODS We used a Markov model, recently developed at the University of Michigan, which assumes that a patient with HCC should undergo OLT if his or her transplant benefit is greater than the cumulative harm to the rest of the waiting list (WL). In the base case, we considered a patient with a low survival perspective without OLT (5-year survival rate, 10%). The data sources to construct and validate the model were as follows: the Organ Procurement and Transplantation Network report, and our prospective database. RESULTS Our center was generally characterized by lower WL mortalities, although there were lower transplant probabilities for both HCC and non-HCC patients than the average US center. The proportion of HCC patients on the WL was higher in Padua (25%) than in the United States (10%). The calculated harm to the WL was 434 quality-adjusted days of life in Padua, and 957 in the United States (P < .01). The OLT benefit outweighed the harm to the WL when the 5-year post-OLT survival rate was higher than 30% in Padua, and 61% in the United States. CONCLUSIONS In a decision model including the concepts of transplantation benefit and harm to the WL, the minimum 5-year post-OLT survival threshold justifying the selection of a patient with HCC for OLT in Padua was 30%.
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Affiliation(s)
- A Vitale
- Unità di Chirurgia Epatobiliare e Trapianto Epatico, Azienda - Università di Padova, Padova, Italy
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Polacco M, Vitale A, Valmasoni M, D'Amico F, Gringeri E, Brolese A, Zanus G, Neri D, Carraro A, Pauletto A, Romanelli E, Lo Bello S, Cillo U. Liver resection associated with mini porto-caval shunt as salvage treatment in patients with progression of hepatocellular carcinoma before liver transplantation: a case report. Transplant Proc 2010; 42:1378-80. [PMID: 20534307 DOI: 10.1016/j.transproceed.2010.03.090] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Tumor progression before orthotopic liver transplantation (OLT) is the main cause of dropouts from waiting lists among patients with hepatocellular carcinoma (HCC). Performing a porto-caval shunt (PCS) before parenchymal liver transection has the potential to allow an extended hepatectomy in patients with decompensated liver cirrhosis, reducing portal hyperflow and therefore the sinusoidal shear-stress on the remnant liver. We report the case of a 59-year-old man affected by hepatitis C virus (HCV)-related decompensated liver cirrhosis (Child Pugh score presentation, C-10; Model for End Stage Liver Disease score, 18) and HCC (2 lesions of 2 and 2.8 cm). The patient began the evaluation to join the OLT waiting list, but, in the 3 months required to complete the evaluation, he developed tumor progression: 3 HCC lesions, the largest 1 with a diameter of about 4.4 cm. These findings excluded transplantation criteria and the patient was referred to our center. After appropriate preoperative studies, the patient underwent a major liver resection (trisegmentectomy) after side-to-side PCS by interposition of an iliac vein graft from a cadaveric donor. The patient overcame the worsened severity of cirrhosis. After 6 months of follow-up, he developed 2 other HCC nodules. He was then included on the waiting list at our center, undergoing OLT from a cadaveric donor at 8 months after salvage treatment. At 36 months after OLT, he is alive and free from HCC recurrence. Associating a partial side-to-side PCS with hepatic resection may represent a potential salvage therapy for patients with decompensated cirrhosis and HCC progression beyond listing criteria for OLT.
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Affiliation(s)
- M Polacco
- Unità di Chirurgia Epatobiliare e Trapianto Epatico, Dipartimento assistenziale di Chirurgia Generale e Trapianti d'Organo, Università degli Studi di Padova, Padova, Italy.
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Vitale A, Saracino E, D'Amico F, Grigoletto F, Burra P, Angeli P, Boccagni P, Brolese A, Zanus G, Neri D, Gringeri E, D'Amico F, Valmasoni M, Carraro A, Gambato M, Feltracco P, Romano A, Buggio M, D'Amico D, Cillo U. Prospective Validation of a New Priority Allocation Model for Liver Transplant Candidates: An Interim Analysis. Transplant Proc 2009; 41:1092-5. [DOI: 10.1016/j.transproceed.2009.03.053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Vitale A, Saracino E, Boccagni P, Brolese A, D'Amico F, Gringeri E, Neri D, Srsen N, Valmasoni M, Zanus G, Carraro A, Violi P, Pauletto A, Bassi D, Polacco M, Burra P, Farinati F, Feltracco P, Romano A, D'Amico D, Cillo U. Validation of the BCLC Prognostic System in Surgical Hepatocellular Cancer Patients. Transplant Proc 2009; 41:1260-3. [DOI: 10.1016/j.transproceed.2009.03.054] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nosadini R, Carboni A, Manconi A, Angius F, Caria S, Cherchi S, Satta A, Faedda R, Obinu D, Nieddu M, Carraro A, Tonolo GC. WITHDRAWN: The decline of glomerular function is not always associated with the development of micro- and macroalbuminuria in hypertensive patients with type 2 diabetes. Diabetologia 2008. [PMID: 18607559 DOI: 10.1007/s00125-008-1079-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 05/21/2008] [Indexed: 11/25/2022]
Affiliation(s)
- R Nosadini
- Department of Endocrinology and Metabolic Diseases, Internal Medicine Department, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy,
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Vitale A, Gringeri E, Valmasoni M, D'Amico F, Carraro A, Pauletto A, D'Amico FJ, Polacco M, D'Amico DF, Cillo U. Long-term results of liver transplantation for hepatocellular carcinoma: an update of the University of Padova experience. Transplant Proc 2007; 39:1892-4. [PMID: 17692645 DOI: 10.1016/j.transproceed.2007.05.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) competes with benign liver disease as indication for liver transplantation (OLT). The aim of this study was to determine long-term results of OLT for HCC. METHODS We retrospectively analyzed the prognostic role of HCC diagnosis at pathological exam in adult OLT. In the HCC group, we evaluated the prognostic role of the time of diagnosis (incidental versus nonincidental) and of pathological tumor TNM staging. The primary endpoint was 1-, 3-, and 10-year patient survivals. RESULTS From 1991 to 2006, among 550 adults who underwent first OLT, HCC was found in 120 patients at pathological exam. In 26 cases (22%), the diagnosis of HCC was incidental. There were 59 cases (49%) of pathological T1 to T2 tumor (one nodule < 5 cm, or two to three nodules < 3 cm, without metastases and/or vascular invasion), and 61 cases (51%) of pathologic T3-T4a tumor. HCC diagnosis did not show a significant prognostic impact by Cox survival analysis. After a median follow-up of 31 months, 1-, 5-, and 10-year survivals were 91%, 81%, and 73% in the HCC group, and 84%, 76%, and 67% in the non-HCC group. Time of HCC diagnosis (incidental versus nonincidental) and pathological TNM staging (T1 to T2 vs T3 to T4a) did not result significant survival predictors upon Cox analysis. CONCLUSION In our experience, the long-term results of OLT for HCC overlapped those of OLT for benign disease, although 51% of tumors were T3 to T4a at pathological exam.
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Affiliation(s)
- A Vitale
- Unità di Chirurgia Oncologica, Istituto Oncologico Veneto, IOV-IRCCS, Padova, Italy.
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Gringeri E, Vitale A, Brolese A, Zanus G, Boccagni P, Neri D, Valmasoni M, D'Amico F, Ciarleglio FA, Carraro A, Pauletto A, Violi P, Bassi D, D'Amico F, D'Amico DF, Cillo U. Hepatitis C virus-related cirrhosis as a significant mortality factor in intention-to-treat analysis in liver transplantation. Transplant Proc 2007; 39:1901-3. [PMID: 17692648 DOI: 10.1016/j.transproceed.2007.05.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Liver transplantation represents the gold standard for the treatment of chronic liver disease. The whole transplantation process was assessed using an intention-to-treat analysis and considering patients from the time of their inclusion on the list and throughout lengthy follow-up. MATERIALS AND METHODS From January 1, 1999 to June 1, 2004, 373 adults joined the waiting list for liver transplantation at our institution. The main variables analyzed were: age, gender, etiology, Model for End-stage Liver Disease score, Child-Pugh class, United Network for Organ Sharing (UNOS) status. Global survival was evaluated using intention-to-treat analysis from the time of patient inclusion in the list to the end of their late follow-up. RESULTS The median waiting time was 20 months (range 0.1 to 70.2). By univariate analysis, the variables significantly influencing survival when patients joined the waiting list were: encephalopathy; ascites, poor nutritional status, Child-Pugh class C, UNOS 2, hepatitis C virus (HCV) and bilirubin > 2 mg/dL. By multivariate analysis, only HCV-related cirrhosis emerged as having an independent prognostic value. By intention-to-treat analysis, the 5-year survival rate was 67% and 79% for HCV-positive and HCV-negative patients, respectively (P = .0003). CONCLUSIONS HCV-related cirrhosis is an independent prognostic factor for survival according to an intention-to-treat analysis. Different inclusion criteria or treatments while on the waiting list and after transplantation need to be considered in the future for HCV-positive patients.
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Affiliation(s)
- E Gringeri
- Unità di Chirurgia Epatobiliare e Trapianto Epatico, Dipartimento assistenziale di Chirugia Generale e Trapianti d'Organo, Università, Azienda Ospedaliera di Padova, Padova, Italy.
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Zanus G, Carraro A, Vitale A, Boccagni P, Brolese A, Neri D, Srsen N, Gringeri E, Valmasoni M, D'Amico F, Ciarleglio FA, Violi P, Bonsignore P, Pauletto A, Bassi D, D'Amico F, Burra P, Masier A, Rigotti P, Furian L, Polacco M, D'Amico DF, Cillo U. Combined liver and kidney transplantation: analysis of Padova experience. Transplant Proc 2007; 39:1933-5. [PMID: 17692657 DOI: 10.1016/j.transproceed.2007.05.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM The main indications for combined liver and kidney transplantation (CLKT) are as follows: (1) cirrhosis with renal damage dependent or not upon liver disease, (2) renal failure with dialysis and concomitant liver end-stage disease, (3) congenital diseases, and (4) enzymatic liver deficiency with concomitant renal failure. The aim of this study was to evaluate our results with CLKT both in adult and pediatric patients. METHODS From September 1995 to September 2006, 15 CLKT (2.8%) among 541 liver transplantations included 4 pediatric patients (27%). The main indications for CLKT were hepatitis C virus (HCV) and polycystic diseases in adult patients, and primary hyperoxaluria in pediatric patients. RESULTS The double transplantation was performed from the same donor in all cases. All adult patients received whole liver grafts, whereas 3 split transplants and 1 whole liver graft were transplanted in the pediatric patients. Median liver and kidney cold ischemia times were 468 and 675 minutes, respectively. After a median follow-up of 36 months (range, 1-125), the overall survival rate was 80%. Five-year patient and graft survival rates were 100% for adult CLKT, whereas they were 50% for pediatric patients. We observed only 2 cases (18%) of delayed renal function, requiring temporary hemodialysis with progressive graft improvement. There was only 1 case of kidney retransplantation due to early graft nonfunction in a pediatric patient. CONCLUSION Although CLKT is related to major surgical risks, results after transplantation are satisfactory with an evident immunological advantage.
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Affiliation(s)
- G Zanus
- Department of Surgical and Gastroenterological Science, University of Padova, Padova, Italy.
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22
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Carraro A, Gringeri E, Calabrese F, Violi P, Brolese A, Zanus G, Boccagni P, Valente ML, Bassi D, D'Amico F, D'Amico DF, Cillo U. A new experimental model of isolated perfused pig liver to support acute hepatic failure. Transplant Proc 2007; 39:2028-30. [PMID: 17692683 DOI: 10.1016/j.transproceed.2007.05.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Liver transplantation still represents the only effective treatment for patients with liver failure, but many patients die while awaiting transplantation, even though many attempts have been made to increase the organ procurement rates and to partially support hepatic function in recent years. Our aim was to design an "open" ex vivo perfused liver model to simplify liver support using an isolated porcine liver perfused with arterial and portal blood from the recipient pig, while monitoring the metabolic capacity of the supporting graft. It was possible to perfuse the isolated liver for 6 hours as a bridging procedure with satisfactory hemodynamic homeostasis controlled by software biofeedbacks.
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Affiliation(s)
- A Carraro
- 1st Surgical Clinic, Hepatobiliary and Transplant Unit, University of Padova, Padova, Italy.
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Vitale A, D'Amico F, Brolese A, Zanus G, Boccagni P, Neri D, Gringeri E, Valmasoni M, Ciarleglio FA, Carraro A, Pauletto A, Bonsignore P, Bassi D, Polacco M, D'Amico DF, Cillo U. Prognostic Impact of Model for End-Stage Liver Disease Score in Patients Undergoing Liver Transplantation With Suboptimal Livers. Transplant Proc 2007; 39:1907-9. [PMID: 17692650 DOI: 10.1016/j.transproceed.2007.05.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND/AIMS The aim of this retrospective study is to analyze the prognostic impact of Model for End-Stage Liver Disease (MELD) score in patients undergoing liver transplantation (OLT) with suboptimal livers. METHODS Between January 2002 and January 2006, 160 adult patients with liver cirrhosis received a whole liver for primary OLT at our institution including 81 with a suboptimal liver (SOL group) versus 79 with an optimal liver (group OL). The definition of suboptimal liver was: one major criterion (age >60 years, steatosis >20%) or at least two minor criteria: sodium >155 mEq/L, Intensive Care Unit stay >7 days, dopamine >10 microg/kg/min, abnormal liver tests, and relevant hemodynamic instability. RESULTS Baseline recipients characteristics were comparable in the two study groups. The SOL group had a significantly greater number of early graft deaths (<30 days) than the OL group, while the 3-year Kaplan-Meier patient survivals were similar. Using logistic regression, MELD score was significantly related to patient death only in the SOL group (P = .01), and the receiver operator characteristics curve method identified 17 as the best MELD cutoff with the 3-year survival of 93% versus 85% for MELD < or =7 versus >17, respectively (P > 05). In comparison, it was 94% and 72% in the SOL group (P < .05). Similarly, MELD >17 was significantly associated with early graft death rates only in the SOL group. CONCLUSION This study advised surgeons to not use suboptimal livers for patients with advanced MELD scores, thus supporting a donor-recipient matching policy.
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Affiliation(s)
- A Vitale
- Unità di Chirurgia Oncologica, Istituto Oncologico Veneto, IOV-IRCCS, Padova, Italy.
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Brolese A, Vitale A, Zanus G, Boccagni P, Neri D, Gringeri E, D'Amico F, Valmasoni M, Ciarleglio FA, Carraro A, Zancan L, Guariso G, D'Antiga L, D'Amico DF, Cillo U. Pediatric Liver Transplantation: The University of Padua Experience. Transplant Proc 2007; 39:1939-41. [PMID: 17692659 DOI: 10.1016/j.transproceed.2007.05.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/23/2022]
Abstract
OBJECTIVE The objective of this study was to analyze experience on pediatric liver transplantation (LT) between June 1993 and September 2006, including split liver transplantation (SLT), living donor liver transplantation (LDLT), and auxiliary partial orthotopic liver transplantation (APOLT). Furthermore, hepatocyte transplantation (HT) had a role in one patient with metabolic disease. METHODS From November 1990 to September 2006, 657 LTs were performed including 63 pediatric LTs (9.6%) in 57 patients (32 boys and 25 girls). Six were retransplantations (9.5%). Thirty-two patients (57%) were younger than 5 years. The types of graft included the following: 26 whole organs (41%), 32 in situ split organs (51%), 4 reduced-size organs (6%), and 1 graft from a living donor (2%). Two patients received an APOLT, 4 patients received a combined kidney-liver transplantation (CKLT), and 1 patient received HT. Of the 63 pediatric LTs, 16 were behaved to be highly urgent (25%). RESULTS Overall 1-, 3-, 5-, and 10-year patient survival rates were 82%, 82%, 78%, and 78%, respectively. Overall 1-, 3-, 5-, and 10-year graft survival rates were 76%, 76%, 72%, and 72%, respectively. In patients younger than 1 year, the 5-year survival rate was 100%. Perioperative mortality was 8.8%. Vascular complications occurred in 4 patients (6.3%). Six children required retransplantation due to primary nonfunction (PNF) in 4 cases (7%) and vascular thrombosis in 2 cases (3.5%). CONCLUSIONS Cholestatic liver disease and age younger than 1 year were the best prognostic factors for excellent survival.
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Affiliation(s)
- A Brolese
- Hepato-Biliary and Liver Transplantation Unit, University of Padua, Padua, Italy.
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Cillo U, Vitale A, Grigoletto F, Gringeri E, D'Amico F, Valmasoni M, Brolese A, Zanus G, Srsen N, Carraro A, Burra P, Farinati F, Angeli P, D'Amico DF. Intention-to-treat analysis of liver transplantation in selected, aggressively treated HCC patients exceeding the Milan criteria. Am J Transplant 2007; 7:972-81. [PMID: 17391137 DOI: 10.1111/j.1600-6143.2006.01719.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [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: 01/25/2023]
Abstract
This prospective study analyzed the dropout probability and intention-to-treat survival rates of patients with hepatocellular carcinoma (HCC) selected and treated according to our policy before liver transplantation (LT), with particular attention to those exceeding the Milan criteria. Exclusion criteria for LT were macroscopic vascular invasion, metastases, and poorly differentiated disease at percutaneous biopsy. A specific multi-modal adjuvant algorithm was used to treat HCC before LT. A total of 100 HCC patients were listed for LT: 40 exceeded the Milan criteria in terms of nodule size and number (MILAN OUT) either at listing or in list, while 60 patients continued to meet the criteria (MILAN IN). The Milan criteria did not prove to be a significant predictor of dropout probability or survival rates using Cox's analysis. Cumulative dropout probability at 6 and 12 months was 0% and 4% for MILAN OUT, and 6% and 11% for MILAN IN. The intention-to-treat survival rates at 1 and 3 years were 95% and 85% in MILAN OUT, and 84% and 69% in MILAN IN. None of the 68 transplanted patients had recurrent HCC after a median 16-month follow-up (0-69 months). In conclusion, LT may be effective for selected, aggressively-treated HCC patients exceeding the Milan criteria.
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Affiliation(s)
- U Cillo
- Unità di Chirurgia Epatobiliare e Trapianto Epatico, Dipartimento di Chirurgia Generale e Trapianti d'Organo, Azienda Ospedaliera di Padova, Italy
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Tonolo G, Velussi M, Brocco E, Abaterusso C, Carraro A, Morgia G, Satta A, Faedda R, Abhyankar A, Luthman H, Nosadini R. Simvastatin maintains steady patterns of GFR and improves AER and expression of slit diaphragm proteins in type II diabetes. Kidney Int 2006; 70:177-86. [PMID: 16710349 DOI: 10.1038/sj.ki.5001515] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The factors determining the course of glomerular filtration rate (GFR) and albumin excretion rate (AER) and the expression of mRNA of slit diaphragm (SD) and podocyte proteins in microalbuminuric, hypertensive type II diabetic patients are not fully understood. GFR, AER, and SD protein mRNA were studied in 86 microalbuminuric, hypertensive, type II diabetics at baseline and after 4-year random double-blind treatment either with 40 mg simvastatin (Group 1) or with 30 g cholestyramine (Group 2) per day. Both groups had at baseline a GFR decay per year in the previous 2-4 years of 3 ml/min/1.73 m(2). Both Groups 1 and 2 showed a significant decrease of low-density lipoprotein cholesterol levels after simvastatin and cholestyramine treatment (P<0.01). No change from base line values was observed as for hs-C-reactive protein and interleukin-6. A significant decrease of 8-hydroxydeoxyguanosine urinary excretion was observed after simvastatin treatment. GFR did not change from baseline with simvstatin, whereas a decrease was observed with cholestyramine treatment (simvastatin vs cholestyramine: -0.21 vs -2.75 ml/min/1.73 m(2), P<0.01). AER decreased in Group 1 (P<0.01), but not in Group 2 patients. Real-time polymerase chain reaction measurement of mRNA SD proteins (CD2AP, FAT, Actn 4, NPHS1, and NPHS2) significantly increased in kidney biopsy specimens after simvastatin, but not cholestyramine treatment. Simvastatin, but not cholestyramine, 4-year treatment maintains steady patterns of GFR, and improves AER and expression of SD proteins in type II diabetes, despite similar hypocholesterolemic effects in circulation.
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Affiliation(s)
- G Tonolo
- U.O. Diabetologia, Asl, Olbia, Italy
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Galioto A, Angeli P, Guarda S, Burra P, Zanus G, Fasolato S, Fagiuoli S, Sticca A, Semplicini A, Sartori M, Carraro A, Boccagni P, Cillo U, Gatta A. Comparison Between Nifedipine and Carvedilol in the Treatment of de novo Arterial Hypertension After Liver Transplantation: Preliminary Results of a Controlled Clinical Trial. Transplant Proc 2005; 37:1245-7. [PMID: 15848684 DOI: 10.1016/j.transproceed.2005.01.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
There is no controlled clinical trial on the treatment of de novo arterial hypertension after liver transplantation (LT) a common complication using calcineurin inhibitors (CNI) for immunosuppressive therapy. The aim of this study was to compare the efficacy and safety of nifedipine, a calcium channel blocker, and carvedilol, an alpha1- and beta-blocker. The study included 50 patients who developed arterial hypertension after LT. The data on the first 30 patients who have completed 12-month follow-up are reported herein. Eighteen patients received nifedipine, and 12 patients received carvedilol. Patients were evaluated monthly at the outpatient clinic for 1 year. If patients developed severe adverse effects to nifedipine, they were switched to carvedilol and vice versa (therapy failure). The two groups were similar for clinical features, indications for LT, immunosuppressive therapy, and baseline blood pressures. A failure of treatment was observed in 9 of 18 patients treated with nifedipine (50.0%) and one of 12 patients treated with carvedilol (8%, P < .025). Nifedipine was effective in 4 of 18 patients, carvedilol, in 4 of 12 patients (22.21% vs 33.3%, P = NS). Two of the nine nonresponders to nifedipine responded to carvedilol. The efficacy of monotherapy was observed in 11 of 40 randomized patients (27.5%). Carvedilol monotherapy is as effective as nifedipine but far better tolerated.
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Affiliation(s)
- A Galioto
- Department of Clinical and Experimental Medicine, University of Padua, Padova, Italy.
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Bassanello M, Vitale A, Ciarleglio FA, Brolese A, Zanus G, D'Amico F, Carraro A, Cappuzzo G, Bridda A, Senzolo M, Burra P, Pevere S, D'Amico D, Cillo U. Adjuvant chemotherapy for transplanted hepatocellular carcinoma patients: impact on survival or HCV recurrence timing. Transplant Proc 2004; 35:2991-4. [PMID: 14697958 DOI: 10.1016/j.transproceed.2003.10.075] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 02/07/2023]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide. In the Western world the current epidemic of cirrhosis due to the hepatitis C virus (HCV) is increasing the number of new cases. Liver transplantation (OLTx) represents a radical treatment for HCC and the underlying cirrhosis. Whether adjuvant chemotherapy is indicated in the postoperative period to prevent recurrence is controversial. MATERIAL AND PATIENTS Forty-eight HCC patients underwent liver transplantation during 11 years, including 21 who were chemo-treated (CT) patients. Thirty-one patients (65%) had post-necrotic virus-C cirrhosis (PNC-C). Twenty-one cases (44%) were p-TNM stages III-IV, and 15 cases (31%) incidental HCC detected in the explanted liver. Seven HCV patients (15%) received chemotherapy (before 1998). RESULTS One-, 3-, and 5-year overall survival rates were 100%, 85%, 79% (CT group), and 89%, 71%, 71% (no CT group), respectively. The HCV recurrence-free survival rates at 3, 6, and 12 months were 29%, 14%, 0% for the CT group, versus 76%, 38%, 25% for the no CT group (P =.005). CONCLUSIONS Discontinuation of HCV-HCC patients by chemotherapeutic adjuvant protocols after transplantation appears rational due to the early hepatitis C recurrence confirmed in our series. Moreover, few studies have demonstrated that CT prolongs survival of HCC transplanted patients. New pharmacological approaches are necessary to solve these questions.
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Affiliation(s)
- M Bassanello
- Clinica Chirurgica 1 and Liver Transplantation Unit, Department of Surgical and Gastroenterological Sciences, Padua University, P.G. Cevese University Hospital, Via Giustiniani 2, Padua 35128, Italy.
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Cillo U, Ciarleglio FA, Bassanello M, Brolese A, Vitale A, Boccagni P, Zanus G, Zancan L, D'Antiga L, Dall'igna P, Montin U, Gringeri E, Carraro A, Cappuzzo G, Violi P, Baldessin M, Bridda A, D'Amico DF, Perilongo G. Liver transplantation for the management of hepatoblastoma. Transplant Proc 2003; 35:2983-5. [PMID: 14697956 DOI: 10.1016/j.transproceed.2003.10.072] [Citation(s) in RCA: 14] [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: 10/26/2022]
Abstract
INTRODUCTION Hepatoblastoma (HEP) is the most frequent liver malignancy occurring in childhood. Surgical resection currently represents the gold standard for treatment. In patients with initially unresectable tumors, chemotherapy may induce remarkable reductions in size. In nonresponder patients, liver transplantation (OLTx) may offer a chance of cure. MATERIALS AND METHODS From 1990 to 2003, a total of 400 OLTx (31 pediatric transplants) have been performed at Padua University. Seven patients (4 males and 3 females) underwent OLTx for hepatoblastoma. All patients presented with bilobar liver involvement and had received chemotherapy according to the SIOPEL-1. In all patients preoperative staging was negative for extrahepatic involvement. RESULTS The mean age of the pts was 8.2 years (range 6.4 months to 34 years). Mean follow-up after OLTx was 41.4 months (median 36, range 3 to 108 months). Actuarial patient survival rates after OLTx for hepatoblastoma are 83.3%, 83.3%, and 56% at 1, 3, and 5 years, respectively. Five of seven subjects with HEP are alive after transplant at 3, 12, 36, 65, and 108 months. Two patients died owing to recurrent disease after 6 and 60 months, respectively, from transplantation. Another subject, primarily treated with surgical resection, shows HEP recurrence at 40 months after OLTx. The remaining 4 patients are alive and well at a mean follow-up of 28 months (median 24, range 3 to 65 months). CONCLUSIONS Liver transplantation may represent a valid therapeutic option for patients with unresectable HEP, but it is contraindicated in cases of recurrence following previous resection surgery. Neo-adjuvant chemotherapy is of paramount importance to obtain good long-term results.
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Affiliation(s)
- U Cillo
- Clinica Chirurgica 1 and Liver Transplantation Unit, P.G. Cevese Department of Surgical and Gastroenterological Sciences, Padua University, Via Giustiniani 2, Padua 35128, Italy
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Poulin N, Frost A, Carraro A, Mommers E, Guillaud M, Van Diest PJ, Grizzle W, Beenken S. Risk biomarker assessment for breast cancer progression: replication precision of nuclear morphometry. Anal Cell Pathol 2003; 25:129-38. [PMID: 12775917 PMCID: PMC4618986 DOI: 10.1155/2003/262918] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Nuclear morphometry is a method for quantitative measurement of histopathologic changes in the appearance of stained cell nuclei. Numerous studies have indicated that these assessments may provide clinically relevant information related to the degree of progression and malignant potential of breast neoplasia. Nuclear features are derived from computerized analysis of digitized microscope images, and a quantitative Feulgen stain for DNA was used. Features analyzed included: (1) DNA content; (2) nuclear size and shape; and (3) texture features, describing spatial features of chromatin distribution. In this study replicated measurements are described on a series of 54 breast carcinoma specimens of differing pathologic grades. Duplicate measurements were performed using two serial sections, which were processed and analyzed separately. The value of a single feature measurement, the nuclear area profile, was shown to be the strongest indicator of progression. A quantitative nuclear grade was derived and shown to be strongly correlated with not only the pathologic nuclear grade, but also with tubule formation, mitotic grade, and with the overall histopathologic grade. Analysis of replication precision showed that the standard methods of the histopathology laboratory, if practiced in a uniform manner, are sufficient to ensure reproducibility of these assessments. We argue that nuclear morphometry provides a standardized and reproducible framework for quantitative pathologic assessments.
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Affiliation(s)
- N Poulin
- Cancer Imaging, BC Cancer Research Center, Vancouver, Canada.
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Brocco E, Velussi M, Cernigoi AM, Abaterusso C, Bruseghin M, Carraro A, Sambataro M, Piarulli F, Sfriso A, Nosadini R. Evidence of a threshold value of glycated hemoglobin to improve the course of renal function in type 2 diabetes with typical diabetic glomerulopathy. J Nephrol 2001; 14:461-71. [PMID: 11783602] [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: 02/23/2023]
Abstract
We recently observed that the course of glomerular filtration rate (GFR) rapidly declines in a subgroup of Type 2 diabetic patients (D) with abnormalities of albumin excretion rate (AER) and typical diabetic nephropathy, despite tight blood pressure control. The aim of this study was to evaluate whether amelioration of blood glucose control, using insulin, improves the course of GFR. GFR decay was measured by spline modeling analysis of the plasma clearance rate of 51CR-EDTA, assessed every 6 months. We identified two groups of D using morphometric analysis of renal biopsy, who had values of glomerular basement membrane (GBM) and fractional mesangial volume (Vv mes/glom) respectively below (Group A: 38) or above (Group B: 50) the mean+2SD of values found in 27 kidney donors (GBM: 389 nm; Vv mes/glom: 0.25), as previously described in detail. Median AER was similar at base line in the 2 groups (109 microg/min, 29-1950, in Group A, 113 microg/min, 37-1845, in Group B; n.s.). Conventional metabolic therapy (sulphonylureas and/or biguanides) was used both in Group A and B during a 3 year follow-up period (Period 1). Group B was further divided in two subgroups with body mass index below (Group B, a) and above (Group B, b) the value of 30 kg/m2. Mean +/- SD HbA1c was 8.2 +/- 1.6% in Group A, 8.3 +/- 1.7% in Group B (a) (n.s.) and 9.1 +/- 1.7% in Group B (b) (n.s.). Tight blood pressure control was achieved and maintained using angiotensin converting enzyme inhibitors and/or beta blockers and/or calcium antagonists and/or thiazides. The mean arterial blood pressure (MAP) was 92 +/- 3 mmHg in Group A and 91 +/- 4 mmHg in Group B (n.s.). GFR decay was significantly greater in Group B than in Group A (Group A vs B: +1.21 +/- 0.71 vs -5.86 +/- 1.61 ml/min/1.73 m2/year). Median AER significantly rose in Group B (177 microg/min, p<0.05 vs base line) but not in Group A (134 microg/min, n.s.) during the third year of follow-up. Groups A and B were then followed over 4.1 years (range 3.1-4.4) (Period 2) maintaining the above described antihypertensive regimen, resulting in MAP values similar to those described during Period 1. Group A patients were treated with the same conventional glycemic control during Period 2. Group B (a) was conversely treated with intensive insulin therapy to achieve a HbA1c value below 7.5% (3 daily injections of regular and 1 or 2 daily injections of intermediate acting insulin associated with metformin 500 mg twice daily in 64% of the patients). Group B (b) patients were only treated by metformin (850 mg thrice daily) to achieve a HbA1c value below 7.5%. HbA1c decreased below the 7.5% target value in Group B (a) (7.0 +/- 1.6%, p<0.01 vs Period 1), but not in Group B (b) (8.0 +/- 1.6%, p<0.05 vs Period 1) and in Group A (8.3 +/- 1.7%, n.s. vs Period 1). The GFR decay of Group B, a during Period 2 was lower than that during Period 1 (Period 1 vs Period 2: -5.9 +/- 1.8 vs -1.8 +/- 0.7 ml/min/1.73 m2/year, p<0.01). GFR decay during Period 2 was similar to that observed during Period 1 in Group A (Period 1 vs Period 2: +1.21 +/- 0.71 vs +0.7 +/- 0.6 ml/min/1.73 ml/year, n.s.) and in Group B (b) (Period 1 vs Period 2: -4.4 +/- 0.71 vs -4.2 +/- 0.6 ml/min/1.73 m2/year, n.s.). Median AER did not significantly change in the fourth year of Period 2 , either in Group A or B (Group A vs B: 141 vs 152 microg/min, n.s.). In conclusion, our findings seem to suggest that amelioration of blood glucose control is attained both by insulin and metformin intensive treatment, but only insulin decreases and maintains HbA1c levels below 7.5%. These pattens of HbA1c appear to be a threshold value in order to significantly blunt GFR decay in a subgroup of Type 2 diabetic patients with typical diabetic glomerular lesions, who are less responsive to tight blood pressure control alone. Conversely, the cohort of patients with less severe diabetic glomerulopathy steadily show constant GFR patterns, despite similar abnormalities of albumin excretion rate, and HbA1c average values above 7.5%.
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Affiliation(s)
- E Brocco
- Department of Medical and Surgical Sciences and Center for the Study of Ageing of the National Research Council, University of Padua, Italy
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Nosadini R, Velussi M, Brocco E, Bruseghin M, Abaterusso C, Saller A, Dalla Vestra M, Carraro A, Bortoloso E, Sambataro M, Barzon I, Frigato F, Muollo B, Chiesura-Corona M, Pacini G, Baggio B, Piarulli F, Sfriso A, Fioretto P. Course of renal function in type 2 diabetic patients with abnormalities of albumin excretion rate. Diabetes 2000; 49:476-84. [PMID: 10868971 DOI: 10.2337/diabetes.49.3.476] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.9] [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: 12/22/2022]
Abstract
Heterogeneity in renal structure has been described in type 2 diabetic patients with both microalbuminuria and proteinuria; in fact, only a subset of type 2 diabetic patients have the typical diabetic glomerulopathy. However, it is currently unknown whether abnormalities in albumin excretion rate (AER) have a different renal prognostic value depending on the underlying renal structure. Aims of this study were: 1) to study the course of renal function in type 2 diabetic patients with altered AER; 2) to evaluate the relationship between the course of glomerular filtration rate (GFR) and renal structure; and 3) to evaluate the relationship between the course of GFR and baseline AER levels, metabolic control, and blood pressure levels during a follow-up period of 4 years. A total of 108 type 2 diabetic patients, 74 with microalbuminuria (MA) and 34 with proteinuria (P), were recruited into a prospective study that encompassed: 1) a baseline kidney biopsy with morphometric measurements of glomerular parameters; 2) intensified antihypertensive treatment for an average 4-year period (blood pressure target <140/90 mmHg); and 3) determinations of GFR at baseline and every 6 months. Mean (+/- SD) GFR significantly decreased from baseline in both MA (-1.3+/-9.4 [95% CI -3.51 to +0.86], P < 0.05) and P (-3.0+/-13.0 ml x min(-1) x 1.73 m(-2) per year [-7.71 to +1.61], P < 0.01). However, the changes in GFR were quite heterogeneous. Thus, on the basis of percent GFR change per year from baseline (delta%GFR), both MA and P patients were defined as progressors or nonprogressors when they were below or above the median, respectively. Baseline parameters of glomerular structure had a strong influence on the course of GFR. Indeed, the odds ratios of being progressors significantly increased across the quartiles of baseline glomerular basement membrane (GBM) width and mesangial fractional volume [Vv(mes/glom)], being 2.71 and 2.85 higher, respectively, in the fourth quartile than in the first quartile (P < 0.01 for both). Conversely, nonprogressors outnumbered progressors in the first quartile of GBM width (odds ratio: 2.14, P < 0.05) and in the first quartile of Vv(mes/glom) (odds ratio: 2.28, P < 0.01). Baseline albumin excretion rate (AER) did not influence delta%GFR; in fact, the number of progressors did not increase across quartiles of baseline AER among either MA or P. Similarly, mean blood pressure levels during follow-up (and intensified antihypertensive therapy) did not affect the course of GFR: the number of progressors and nonprogressors did not change across quartiles of mean blood pressure. In contrast, HbA1c during follow-up had an impact on delta%GFR: the odds ratio for being a progressor increased across quartiles of HbA1c, particularly for the highest quartile (HbA1c >9.0%). In conclusion, the course of renal function is heterogeneous in type 2 diabetic patients with microalbuminuria or proteinuria. In fact, a subset of patients has a rapid decline in GFR over a 4-year follow-up period; these patients have more advanced diabetic glomerulopathy and worse metabolic control than the remaining patients, whose GFR remains stable. These two cohorts are otherwise undistinguishable as regards the degree of AER at baseline and tight blood pressure control. Kidney biopsy has an important prognostic role in these patients. Thus, tight blood pressure control, when not associated with satisfactory glycemic control, is unable to prevent rapid GFR decline in type 2 diabetic patients with typical diabetic glomerulopathy.
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Affiliation(s)
- R Nosadini
- Department of Endocrinology and Metabolic Diseases, University of Sassari, Italy
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Abstract
The importance of work focused on body experience in the therapy of Eating Disorders is widely acknowledged. Even so, few researches have been devoted to this aspect. This paper describes the employment of adapted physical activity as part of a residential cure programme for 96 eating disorder patients. The chief aims of this programme relate to individual identity, relations with others, the body, and getting patients to build themselves a correct image of physical activity. The wide variety of working tools includes both individual and group activities: movement exercise, adapted sports, dancing, expressive activities, relaxation. The following are used to evaluate results: individual and group talks, specific observation scales, and video recordings of some meetings. As shown by other authors, the observations indicate that controlled physical activities can be usefully integrated into an eating disorders cure project.
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Affiliation(s)
- A Carraro
- Casa di Cura Parco dei Tigli, Villa di Teolo, PD, Italy
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34
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Fioretto P, Stehouwer CD, Mauer M, Chiesura-Corona M, Brocco E, Carraro A, Bortoloso E, van Hinsbergh VW, Crepaldi G, Nosadini R. Heterogeneous nature of microalbuminuria in NIDDM: studies of endothelial function and renal structure. Diabetologia 1998; 41:233-6. [PMID: 9498659 DOI: 10.1007/s001250050895] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Microalbuminuria (MA) is associated with microangiopathy (renal and retinal lesions) in insulin-dependent diabetic (IDDM) patients. In contrast MA does not reflect microvascular damage in a substantial number of non-insulin-dependent diabetic (NIDDM) patients. MA predicts cardiovascular disease in NIDDM patients with increased von Willebrand factor (vWF) plasma levels which are hypothesized to reflect endothelial dysfunction. However, it is not known whether MA is consequent to generalised endothelial dysfunction or to renal injury. Thus, this study evaluated vWF plasma levels in relation to renal and retinal structural abnormalities in NIDDM patients with MA. Kidney biopsies, fundoscopy and measures of vWF plasma levels were performed in 32 NIDDM patients with MA. These patients were allocated to two renal structural categories: A) Without renal structural abnormalities (C I, n = 10): normal or near-normal renal structure, and B) With renal structural abnormalities (n = 22), further divided into: C II (n = 12) with typical diabetic nephropathology, predominantly glomerulopathy, and C III (n = 10) with atypical patterns of renal injury (more advanced tubulo-interstitial and arteriolar than glomerular changes). vWF plasma levels were significantly higher in category B (C II: 195+/-49% and C III: 161+/-46%) than in category A (C I: 119+/-42%), (chi-square, p < 0.05). Diabetic retinopathy was also related to vWF plasma levels (ANOVA, p < 0.05). These data suggest that there are two types of MA in NIDDM: one associated with increased vWF levels, established renal injury and frequently retinopathy, and the other characterized by normal vWF levels, normal renal structure and absent or mild diabetic retinopathy. We propose that vWF plasma levels in NIDDM patients with MA may help to identify patients with important renal structural changes, increased retinopathy risk and, perhaps, generalised endothelial dysfunction. Whether vWF plasma levels predict end-stage renal disease and cardiovascular events deserves longitudinal studies.
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Affiliation(s)
- P Fioretto
- Department of Internal Medicine and Center for the Study of Aging, National Research Council, University of Padova, Italy
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35
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Brocco E, Fioretto P, Mauer M, Saller A, Carraro A, Frigato F, Chiesura-Corona M, Bianchi L, Baggio B, Maioli M, Abaterusso C, Velussi M, Sambataro M, Virgili F, Ossi E, Nosadini R. Renal structure and function in non-insulin dependent diabetic patients with microalbuminuria. Kidney Int Suppl 1997; 63:S40-4. [PMID: 9407419] [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
We have recently described heterogeneity in renal structure in non-insulin-dependent diabetic patients (NIDDM) with microalbuminuria (MA; defined as albumin excretion rate from 20 to 200 micrograms/min). Thus, at variance with IDDM patients, "typical" diabetic glomerulopathy by light microscopy is observed only in a third of NIDDM with MA (Category II, CII). Further, despite persistent MA, 30% of NIDDM have normal or near normal renal structure (Category I, CI). Another one-third shows "atypical" patterns of renal injury with absent or mild diabetic glomerular changes, associated with disproportionately severe tubulointerstitial lesions and/or arteriolar hyalinosis and global glomerular sclerosis (Category III, CIII). The aims of this study were to evaluate whether similar patterns of renal lesions could be confirmed in a larger group of NIDDM with MA and to investigate tubular function in order to understand the mechanisms underlying MA in NIDDM patients. Renal biopsies were performed in 53 NIDDM with MA. Categories I, II and III were found in 41%, 26% and 33% of NIDDM with MA, respectively. All 8 patients with proliferative diabetic retinopathy were in CII. We also studied the urinary daily excretion rate of alpha 1-microglobulin (alpha 1 m), a low molecular weight protein, which is a useful indicator of tubular function. alpha 1 m was markedly increased only in CII patients (CI vs. CII vs. CIII: 6.2 +/- 1.2 vs. 13.7 +/- 2.1 vs. 7.3 +/- 0.9 mg/day, ANOVA, P < 0.01). In conclusion, we confirm that there is heterogeneity in renal structure in NIDDM patients with MA. This heterogeneity is not due to renal diseases other than diabetes. Increased alpha 1 m and proliferative retinopathy are useful indicators of the subgroup of MA NIDDM patients with typical diabetic glomerulopathy. It is suggested that diabetic microangiopathy explains the simultaneous occurrence of typical diabetic glomerulopathy, proliferative retinopathy and tubular dysfunction in a subgroup of NIDDM patients with MA.
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Affiliation(s)
- E Brocco
- Institute of Internal Medicine, University of Padova, Italy
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36
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Fioretto P, Mauer M, Carraro A, Bruseghin M, Brocco E, Crepaldi G, Nosadini R. Renal structural changes in non-insulin-dependent diabetes mellitus. Am J Hypertens 1997; 10:184S-188S. [PMID: 9324120 DOI: 10.1016/s0895-7061(97)00151-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- P Fioretto
- Department of Internal Medicine and Center for the Study of Aging of the National Research Council, University of Padova Medical School, Italy
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37
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Scognamiglio R, Nosadini R, Marin M, Nisti S, Fasoli G, Palisi M, Frigato F, Virgili F, Carraro A, Crepaldi G. Evaluation of the efficacy and tolerability of nitrendipine in reducing both pressure and left ventricular mass in hypertensive type 2 diabetic patients. Diabetes Care 1997; 20:1290-2. [PMID: 9250456 DOI: 10.2337/diacare.20.8.1290] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the efficacy and tolerability of nitrendipine in comparison with captopril in hypertensive diabetic patients with left ventricular hypertrophy (LVH). RESEARCH DESIGN AND METHODS A total of 75 patients enrolled in this study presented stable type 2 diabetes (not treated with insulin) and mild-to-moderate hypertension with a left ventricular mass > or = 75 g/m2 by two-dimensional echocardiography. After a 4-week washout period, 38 patients were assigned to treatment with captopril, and 37 patients to nitrendipine (random allocation). The duration of follow-up was 36 weeks. RESULTS Patients of both groups were similar with regard to the duration of diabetes and hypertension, systolic and diastolic blood pressure at rest, degree of LVH, metabolic control, and albumin excretion rate (AER). Both drugs were equally effective in reducing systolic and diastolic blood pressure (captopril: from 165 +/- 13/100 +/- 4 to 147 +/- 11/87 +/- 4 mmHg; nitrendipine: from 167 +/- 17/100 +/- 5 to 143 +/- 9/86 +/- 4 mmHg; P < 0.05) and in reversing LVH (nitrendipine: from 87 +/- 2 to 81 +/- 1 g/m2; captopril: from 89 +/- 2 to 85 +/- 2 g/m2; P = 0.0001). Neither the left ventricular end-diastolic volume index nor the left ventricular ejection fraction changed significantly during the treatment period. CONCLUSION Nitrendipine is as effective as captopril in reducing both systolic and diastolic blood pressure and in reversing LVH. Neither drug showed any negative side effects on fasting plasma glucose and glycated hemoglobin (HbA1c) levels, and both maintain constant AERs.
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Affiliation(s)
- R Scognamiglio
- Division of Cardiology, Padua University Medical School, Italy
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38
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Abstract
Only rarely is a mature complex odontoma seen in a periapical location and in association with a primary tooth. Complex odontomas usually present as a radiopacity with a radiolucent rim. The differential diagnosis must include mature fibro-osseous lesions (e.g. cementoblastoma). Complex odontomas can be differentiated from fibro-osseous lesions because they usually present a nonhomogeneous radiopacity and almost always will present as solitary lesions. For complex odontomas located in the periapical region, the differential diagnosis must include idiopathic periapical osteosclerosis. In this case, the presence of the radiolucent rim and the presence of denser, sharper radiopacities produced by enamel distinguish the odontoma.
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Affiliation(s)
- A Piattelli
- Department of Oral Medicine and Pathology, Dental School, University of Chieti, Italy
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39
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Bellioni P, Catalano B, Cervellera G, Filiaci F, Mira E, Carraro A. Comparison of mizolastine with loratadine in the treatment of perennial allergic rhinitis. Rhinology 1996; 34:101-4. [PMID: 8876072] [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: 02/02/2023]
Abstract
Mizolastine is a new, non-sedating antihistamine providing satisfactory symptomatic relief in seasonal allergic rhinitis. The purpose of this study has been to compare mizolastine to loratadine in perennial allergic rhinitis. This multicentre, double-blind study has involved 68 patients, randomly allocated, after a one-week placebo run-in, to 10 mg mizolastine or 10 mg loratadine, both given on a once-daily basis, for four weeks. Comparable symptom relief occurs in both groups resulting, respectively for mizolastine and loratadine, in a 66.6% and a 61.3% decrease in total nasal score, to a 74.8% and a 76.4% decrease in total ocular score, and to a 69.0% and a 64.8% decrease in global total score. Safety is satisfactory in both groups. Mizolastine is at least as effective as loratadine in relieving perennial allergic rhinitis symptoms and its safety profile allows its use in the treatment of this disease.
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Affiliation(s)
- P Bellioni
- Department of Otorhinolaryngology, Università Cattolica, Sacro Cuore, Rome, Italy
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40
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Velussi M, Brocco E, Frigato F, Zolli M, Muollo B, Maioli M, Carraro A, Tonolo G, Fresu P, Cernigoi AM, Fioretto P, Nosadini R. Effects of cilazapril and amlodipine on kidney function in hypertensive NIDDM patients. Diabetes 1996; 45:216-22. [PMID: 8549868 DOI: 10.2337/diab.45.2.216] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Contrasting information has been reported concerning the course of renal function in NIDDM with hypertension alone or in association with renal damage. The aim of the present study was to elucidate the course of the glomerular filtration rate (GFR) in hypertensive NIDDM patients during antihypertensive therapy. Furthermore, we compared the effects of ACE inhibitors (cilazapril, Inibace, Roche, Milan, Italy) and Ca(2+)-channel blockers (amlodipine, Norvasc, Pfizer, Rome, Italy). Of the hypertensive NIDDM patients attending the outpatient's clinic of the internal medicine departments of the University of Padova and Sassari, 44 participated in the present study. Of these patients, 26 were normoalbuminuric and 18 microalbuminuric. They were randomly treated with either cilazapril or amlodipine. The target of antihypertensive treatment was a value < 140 mmHg for systolic and 85 mmHg for diastolic blood pressure (BP). Microalbuminuria was defined as an albumin excretion rate (AER) between 20 and 200 micrograms/min. GFR was measured by plasma clearance of 51Cr-labeled EDTA at baseline and every 6-12 months during a 3-year follow-up interval. A significant decrease was observed in the values of GFR, AER, and systolic and diastolic BP in normoalbuminuric and microalbuminuric patients during antihypertensive therapy. The GFR fall in the overall population of NIDDM patients was significantly and inversely related to the decrease of mean BP (diastolic + 1/3 pulse pressure) (r = -0.80, P < 0.0001) but not to that of HbA1c, triglycerides, and BMI. The GFR decline (mean +/- SE) per year in the normoalbuminuric patient was 2.03 +/- 0.66 ml.min-1 x 1.73 m-2 (95% CI 0.92-3.17) during cilazapril and 2.01 +/- 0.71 ml.min-1 x 1.73 m-2 (95% CI 0.82-3.11) during amlodipine therapy. The GFR decline per year in the microalbuminuric patient was 2.15 +/- 0.69 ml.min-1 x 1.73 m-2 (95% CI 0.86-3.89) during cilazapril and 2.33 +/- 0.83 ml.min-1 x 1.73 m-2 per year (95% CI 1.03-3.67) during amlodipine therapy. Cilazapril and amlodipine lowered AER to a similar extent in normoalbuminuric and microalbuminuric patients. No significant changes were observed concerning other clinical and biochemical features between the two antihypertensive therapies and particularly HbA1c, BMI, triglycerides, and cholesterol plasma values. These results support the tenet that arterial hypertension plays a pivotal role in contributing to renal damage in NIDDM, even when AER is normal. However, the degree of BP control, with both cilazapril and amlodipine, can successfully delay the slope of GFR decline in hypertensive NIDDM patients with or without incipient nephropathy.
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Affiliation(s)
- M Velussi
- Centro Antidiabetico di Monfalcone, Gorizia, Italy
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41
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Sambataro M, Thomaseth K, Pacini G, Robaudo C, Carraro A, Bruseghin M, Brocco E, Abaterusso C, DeFerrari G, Fioretto P, Maioli M, Tonolo GC, Crepaldi G, Nosadini R. Plasma clearance rate of 51Cr-EDTA provides a precise and convenient technique for measurement of glomerular filtration rate in diabetic humans. J Am Soc Nephrol 1996; 7:118-27. [PMID: 8808118 DOI: 10.1681/asn.v71118] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
It has not yet been fully clarified whether the plasma or renal clearance approach is the most reliable to investigate GFR in humans. The study presented here aimed to compare plasma decay with renal clearance of 51Cr-EDTA in 27 diabetic patients with patterns of renal function broadly dispersed in a wide range of values. Moreover, the comparison was also performed with renal clearance of nonlabeled iothalamate in a subgroup of 17 patients. A biexponential function was found to fulfill statistical and heuristic criteria for the modeling analysis of plasma 51Cr-EDTA decay with 19 samples after bolus intravenous 51Cr-EDTA injection. Individual GFR values from 51Cr-EDTA plasma clearance highly correlated with those from renal clearance (r2 = 0.977, P < 0.0001), but resulted on average about 2.5 mL.min-1.1.73 m-2 higher (66.8 +/- 6.5 mL.min-1.1.73 m-2 (mean +/- SE) versus 64.3 +/- 6.4, P < 0.02). This difference remained relatively constant from patients with normal renal function to those with impaired renal function, suggesting that the plasma clearance is slightly less accurate than renal clearance approach because of a constant extrarenal clearance rate. In the subgroup studied, a similar difference was found between GFR values from 51Cr-EDTA plasma clearance (84.7 +/- 7.3) and renal clearance of iothalamate (82.8 +/- 7.3), although not statistically significant (P = 0.4). Individual GFR values well correlated (r2 = 0.913, P < 0.0001). The precision and reproducibility of the experimental approaches were assessed by comparing three coefficients of variation: (1) CVb of the bolus injection, because of measurement errors; (2) CVc of the continuous infusion, which additionally includes errors of urine volume measurement and physiological variability in the same day; and (3) CVr of repeated measurements by using bolus injection, which also accounts for physiological variability in different days. CVc of iothalamate and 51Cr-EDTA infusions were 7.5 +/- 1.9% and 7.4 +/- 1.2% respectively. CVb and CVr of bolus injection of 51Cr-EDTA were 2.6 +/- 0.3% and 3.5 +/- 0.8% respectively. CVb and CVr of bolus injection of 51Cr-EDTA, but not CVc of iothalamate and 51Cr-EDTA infusions were twofold to tenfold lower than the percent yearly change reported in IDDM and NIDDM patients. More particularly, CVr was significantly less than CVc. In order to make the test less cumbersome, a reduced sampling schedule with seven samples was designed and validated. GFR measured with seven samples was 66.1 +/- 6.4 (P = 0.1 when compared with the full 19-sample schedule) with a CVb of 3.5 +/- 0.5%. This seven-sample protocol was not different from that obtained with the previously described simplified method of Brøchner-Mortensen (63.9 +/- 6.8, P = 0.16), yet yielding a statistically more accurate estimate (coefficient of variation for Brøchner-Mortensen method = 12.1 +/- 2.9, P = 0.004). Moreover, only bolus injection, along with modeling analysis of plasma clearance rate, allows the accurate measurement of the extracellular fluid volume, an important parameter in diabetic patients. It was concluded that the reduced seven-plasma sample protocol is able to detect as small as 4 to 5% changes per year in a single patient. Moreover, it provides precise and accurate estimate of GFR in diabetic patients with hyperfiltration, who are postulated to be at higher risk to develop renal damage.
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Affiliation(s)
- M Sambataro
- Institute of Internal Medicine, University of Padova, Italy
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42
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Crepaldi G, Carraro A, Brocco E, Adezati L, Andreani D, Bompiani G, Brunetti P, Fedele D, Giorgino R, Giustina G. Hypertension and non-insulin-dependent diabetes. A comparison between an angiotensin-converting enzyme inhibitor and a calcium antagonist. Acta Diabetol 1995; 32:203-8. [PMID: 8590792 DOI: 10.1007/bf00838494] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The effects of the angiotensin-converting enzyme lisinopril were compared with those of the calcium antagonist nifedipine in 162 non-insulin-dependent diabetic hypertensive patients for a 24-week period. In 83 and 79 patients, respectively, lisinopril and slow-release nifedipine produced similar reductions in blood pressure (systolic/diastolic: -16/-13 mmHg supine and -14/-11 mmHg standing after lisinopril; -15/-12 mmHg supine and -14/-11 mmHg standing nifedipine). Fasting and post-prandial plasma glucose, glycosylated haemoglobin and plasma lipids appeared to be unaffected by either agent. Also, 28% of the patients on lisinopril and 30% of those on nifedipine presented microalbuminuria. Both drugs induced a reduction in the albumin excretion rate (AER). The geometric mean x:tolerance factor of the reduction in AER among the 23 microalbuminuric patients on lisinopril (-10.0 x:1.3 micrograms/min) was greater, though not significantly so, than that observed in the 26 on nifedipine (-0.9 x 1.2 micrograms/min). Moreover, lisinopril appeared to be better tolerated than nifedipine in our study population. Microalbuminuria is an important risk factor for cardiovascular mortality in non-insulin-dependent diabetic patients as well as in the general population. To what extent a reduction in the AER could ameliorate diabetic patients is, at present, unknown. Finally, both lisinopril and nifedipine showed a similar antihypertensive effect in these patients which was not associated with significant differences in plasma glucose, insulin or lipid concentrations. The clinical consequences of the insignificant differences in AER remain unclear.
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Affiliation(s)
- G Crepaldi
- Department of Internal Medicine, University Hospital, Padua, Italy
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43
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Giusti M, Giovale M, Sessarego P, Carraro A, Pompei A, Giordano G. Cholinergic modulation of growth hormone, prolactin and thyroid stimulating hormone responses to thyrotropin-releasing hormone in normal aging. Recenti Prog Med 1995; 86:341-4. [PMID: 7569294] [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: 01/26/2023]
Abstract
Endocrine changes occur during the normal aging process. These include alterations in GH, TSH and, to a lesser extent, PRL secretion. Pyrodistigmine (PD) increases basal GH secretion in a widely variable manner and partially reverses the blunted GH response to GHRH found in elderly subjects. The aims of this study were to verify the finding of a paradoxical GH response to TRH (200 micrograms iv) and to evaluate the effect of priming with PD (120 mg orally) on basal and TRH-stimulated GH, TSH and PRL secretion in 7 euthyroid subjects (aged 75-96 years). Hormonal responses after control saline and PD were also evaluated. PD did not modify TSH or PRL responses to TRH. A slight increase in GH secretion was observed after PD. A clear-cut increase in GH levels after TRH was found in 4 out of 7 subjects. TRH-induced GH secretion was significantly increased by pretreatment with PD. Functional abnormalities in the neuroendocrine control of GH secretion in aging could explain, at least in part, the appearance of GH release after TRH. Cholinergic neurotransmission, which is thought to be stimulated by PD administration, seems to be involved in the non-specific GH release after TRH administration in elderly subjects.
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Affiliation(s)
- M Giusti
- DISEM, Cattedra di Endocrinologia, Università, Genova
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44
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Giusti M, Falivene MR, Carraro A, Cuttica CM, Valenti S, Giordano G. The effect of non-steroidal antiandrogen flutamide on luteinizing hormone pulsatile secretion in male-to-female transsexual subjects. J Endocrinol Invest 1995; 18:420-6. [PMID: 7594235 DOI: 10.1007/bf03349739] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We evaluated LH pulsatile patterns before and 4 weeks after the oral administration of flutamide (750 mg/day) in 9 male-to-female transsexuals (age range 17-28 yr) requesting gender reassignment. Flutamide was given to explore the feedback role of androgens on the LHRH-LH unit in LH pulsatility in transsexuals. Seven normal age-matched men served as a control group, without receiving flutamide, due to ethical considerations. LH pulsatility was evaluated on samples collected every 15 min for 360 min. FSH, PRL, cortisol, SHBG and sex steroids were evaluated on pooled samples. LH pulses were analyzed by the Santen and Bardin algorithm, slightly modified. No differences in FSH, PRL, total- or free-testosterone, estradiol and SHBG levels were noted between transsexuals and controls. Normal circadian cortisol decline was observed in all subjects. Mean LH levels (p < 0.05) and LH pulses (p < 0.01) were significantly lower in transsexuals. Flutamide induced an increase in mean LH and testosterone levels (p < 0.01). After flutamide administration there was an increase in LH pulse frequency (P < 0.01) and the frequency and amplitude of LH pulses in transsexuals were restored to levels observed in controls. No differences in FSH, PRL or estradiol levels were found after flutamide. These data suggest that a decrease in LH pulse frequency could be an endocrine marker in male-to-female transsexuals. An increase in endogenous androgen negative feed-back could be speculated in these subjects. However, normal testosterone levels indirectly suggest that a normal that a normal qualitative LH secretion is maintained.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Giusti
- Cattedra di Endocrinologia, University of Genova, Italy
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45
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Abstract
Arginine vasopressin (AVP) exerts a potentiating effect on the responses of cortisol and ACTH to ovine CRF (oCRF). A stimulation test using AVP plus oCRF to assess ACTH reserve has been proposed. In central diabetes insipidus, long-term substitution therapy is commonly undertaken with desmopressin (DDAVP), an analogue of the natural hormone which has a greater antidiuretic action but whose effects on the ACTH-cortisol axis are still controversial. The aim of our study was to evaluate the variations in the responses of ACTH and cortisol to oCRF in various phases of the treatment of central diabetes insipidus: no treatment, endonasal treatment with DDAVP solution and oral treatment with DDAVP in tablet form. Seven patients suffering from central diabetes insipidus underwent testing with oCRF during the various phases of treatment. In the absence of DDAVP treatment, normal responses were registered for cortisol (basal 164.1 +/- 29.4 ng ml-1, peak 396.1 +/- 37.9 ng ml-1; P < 0.05) and ACTH (basal 20.4 +/- 3.9 pg ml-1, peak 86.3 +/- 20.9 pg ml-1; P < 0.05) in all patients. During oral treatment with DDAVP, no variation in cortisol response to oCRF was seen. By contrast, when DDAVP was administered endonasally, a significant reduction in cortisol responsiveness to oCRF (secretory area: 2429 +/- 548 ng ml-1 120 min) was noted in comparison with that found during the other two tests (no treatment: 3070 +/- 704 ng ml-1 120 min; oral DDAVP: 3419 +/- 650 ng ml-1 120 min; P < 0.05) performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Carraro
- Cattedra di Endrocinologia, University of Genova, Genoa, Italy
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46
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Cuttica CM, Fazzuoli L, Cariola G, Carraro A, Porcella E, Giusti M, Giordano G. [Behavior of the pituitary-thyroid axis in acromegalic subjects during prolonged intermittent and pulsatile treatment with octreotide]. Recenti Prog Med 1994; 85:7-12. [PMID: 8184183] [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: 01/29/2023]
Abstract
Octreotide, as well as endogenous somatostatin, inhibits GH and TSH secretion. The drug is employed in the medical therapy of acromegaly. We studied the effects of a long-term (1-120 months; median 12 months) therapy with octreotide (300 micrograms/day) given in 3-times intermittent s.c. administration or in pulsatile s.c. (25 micrograms/120 min) way, upon the pituitary-thyroid axis. Thirteen patients (11 with normal thyroid function, 1 with secondary hypothyroidism, 1 with toxic goiter) with active acromegaly were studied. In the euthyroid patients no significative variations in both TSH levels and thyroid hormones were found during octreotide therapy. In the non-euthyroid patients octreotide did not induce changes in the dosages of drugs acting to thyroid function. The 24-hour IC-TSH levels did not show any variation during octreotide. TSH response to TRH was reduced (P < 0.05) during octreotide therapy. No correlation among TSH, IGF-I and GH levels was observed. Long-term treatment of acromegaly with octreotide reduces TSH response to TRH but do not interfere with both 24-hour IC-TSH levels and thyroid function.
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Affiliation(s)
- C M Cuttica
- DISEM, Cattedra di Endocrinologia, Università, Genova
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47
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Giusti M, Porcella E, Carraro A, Cuttica M, Valenti S, Giordano G. A cross-over study with the two novel dopaminergic drugs cabergoline and quinagolide in hyperprolactinemic patients. J Endocrinol Invest 1994; 17:51-7. [PMID: 7911813 DOI: 10.1007/bf03344963] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cabergoline and quinagolide, two new dopamine agonist drugs with long-lasting activity, are currently under investigation for the treatment of hyperprolactinemia. At present, studies comparing these drugs for tolerability and efficacy in the same patients are lacking. It was our aim to make such a comparison in an open randomized cross-over trial. Cabergoline (0.5 mg twice weekly) and quinagolide (75 micrograms once daily) were given orally. Each drug was administered for 12 weeks. Treatment with the second drug was started after the recurrence of hyperprolactinemia. Twelve women with hyperprolactinemia due to idiopathic disease (n = 6), microprolactinoma (n = 5) or postsurgical empty sella (n = 1) were evaluated. Six women were amenorrheic and 6 were oligomenorrheic. Ten had spontaneous or provoked galactorrhea. Baseline characteristics (age, clinical signs and PRL levels) of patients initially allocated to the two treatment groups were similar. Nine patients completed both treatment cycles and PRL levels were lower under cabergoline (10.7 +/- 3.7 micrograms/L) than under quinagolide (25.0 +/- 7.7 micrograms/L; p < 0.05). One patient discontinued cabergoline because of dryness of the eyes after having completed the quinagolide cycle and 2 patients initially treated with cabergoline discontinued quinagolide because of gastrointestinal symptoms. After completion of the first treatment cycle, the time of recurrence of hyperprolactinemia was significantly longer after cabergoline (14 +/- 7 weeks) than after quinagolide (5 +/- 1 weeks; p < 0.05). At week 12, normal PRL levels (< 20 micrograms/L) were observed in 10 and 6 women during cabergoline and quinagolide, respectively. Only one case was resistant to both drugs. The clinical effects of the two treatments were similar.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Giusti
- DISEM, Cattedra di Endocrinologia, Università di Genova, Italy
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48
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Carraro A, Giusti M. [Oral desmopressin in the treatment of central diabetes insipidus]. Minerva Med 1993; 84:563. [PMID: 8247312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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49
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Nosadini R, Sambataro M, Thomaseth K, Pacini G, Cipollina MR, Brocco E, Solini A, Carraro A, Velussi M, Frigato F. Role of hyperglycemia and insulin resistance in determining sodium retention in non-insulin-dependent diabetes. Kidney Int 1993; 44:139-46. [PMID: 8355455 DOI: 10.1038/ki.1993.224] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sodium retention has been advocated to give rise to hypertension in humans. Increases in blood glucose and insulin concentrations ensue in the stimulation of sodium reabsorption by the kidney. Although the combined occurrence of hyperglycemia and hyperinsulinemia, frequently secondary to insulin resistance with regard to carbohydrate metabolism, is a hallmark of non-insulin dependent diabetes (NIDDM), the role of these abnormalities in determining an impaired natriuresis in NIDDM is not yet fully understood. We studied sodium homeostasis in 14 control subjects and 59 NIDDM normotensive, normoalbuminuric patients who were divided into two groups with markedly impaired (Group 2 NIDDM: 30) and less severely impaired (Group 1 NIDDM: 29) insulin sensitivity during euglycemic-hyperinsulinemic (80 to 90 microU/ml plasma insulin) clamp. A hyperglycemic (9 mmol/liter plasma glucose)--nearly euinsulinemic (20 to 40 microU/ml plasma insulin) clamp was also performed in the same 14 controls and in two cohorts of 22 Group 2 and 17 Group 1 NIDDM patients. The two groups of patients had similar overnight fasting glucose levels (Group 1 NIDDM vs. Group 2 NIDDM: 176 +/- 13 vs. 185 +/- 15 mg/dl, mean +/- SE). Conversely, overnight fasting plasma insulin was significantly higher in Group 2 NIDDM than in Group 1 NIDDM patients (Group 1 NIDDM vs. Group 2 NIDDM: 12 +/- 3 vs. 18 +/- 3 microU/ml, P < 0.05). Both NIDDM Groups had higher plasma glucose and insulin than controls (75 +/- 4 mg/dl and 6 +/- 3 microU/ml). Blood pressure levels and albumin excretion rates were slightly but significantly higher in Group 2 NIDDM, but not in Group 1 NIDDM patients, than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Nosadini
- Department of Internal Medicine, University of Padova, Italy
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50
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Nosadini R, Fioretto P, Carraro A, Brocco E, Sambataro M, Cipollina MR, Trevisan M, Abaterusso C, Vaccaro L, Mollo F. Effects of cilazapril on Na+ retention and ANP resistance in IDDM hypertensives. Am J Med 1993; 94:66S-69S. [PMID: 8488864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- R Nosadini
- Istituto di Medicina Interna, Policlinico Universitario, Padova, Italy
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