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Scheggi V, Merilli I, Ceschia N, Vanni F, Alterini B, Stefano PL, Marchionni N. Infective endocarditis in octogenarians: a retrospective study in a single surgical center. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Infective endocarditis (IE) is a severe disease associated with high morbidity and mortality. The EURO-ENDO registry reported a mean age of 59.25 ± 18.03 years; 46.3% of patients were over 65 and 12.0% over 80 years. Little is known about the best management of elderly patients with IE. In these patients, surgery may be challenging.
Purpose
We aimed to determine the clinical and echographic characteristics, the therapeutic strategy, and the outcome of IE in octogenarians.
Method
We retrospectively included in the analysis 457 consecutive patients with definite active IE in a single surgical centre. Descriptive statistics are reported as mean ± standard deviation (SD) or median ± interquartile range (IQR) for continuous variables with normal and non-normal distribution and as frequencies and percentages for categorical variables. Between-groups comparisons were assessed by Student’s t-test, Mann-Whitney U test, Kruskal-Wallis, or chi-square test, as appropriate. Univariate long-term survival was analysed by the Kaplan-Meier method.
Results
In our cohort, octogenarians were 17% of the whole population (N = 77). In patients under the age of eighty, males were mostly involved with a sex ratio exceeding 2:1. This ratio was inverted in older people, where the female gender represented 57% of the total (0.001). Staphylococcus aureus (10.4 vs 20.5%, p =0.038) and Enterococci (29.9 vs 16.3%, p =0.008) were significantly less and more frequent than in younger people, respectively. Comorbidities were more frequent in elderly patients, such as hypertension (80.5 vs 53.2%, p = 0.001), dyslipidaemia (42.7 vs 27.3%, p = 0.008), and history of cancer (29.9 vs 19.2%, p = 0.036). Consequently, EUROSCORE II was higher (median ± IQR 19.18 ± 19.0 vs 11.9 ± 5.7, p = 0.001). In octogenarians, IE was more frequently left-sided (98.7 vs 89.2, p = 0.009) and complicated less often with peripheral embolism (31.2 vs 43.9%, p = 0.038). We found no differences between the two groups for the type of infected valve (native or prosthetic), the severity of valve dysfunction, paravalvular extension, and vegetation length. Octogenarians were more often excluded from surgery despite indication (19.5 vs 7.7%, p = 0.016) and had higher thirty-day (11.7 vs 7.9%, p = 0.001) and three-year (45 vs 30%, p = 0.001) mortality than younger patients.
Conclusions
Octogenarians represent a considerable proportion of overall cases of IE, with specific clinical and microbiological characteristics. Older patients are more often excluded from surgery, and the overall prognosis is poor. Abstract Figure.
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Affiliation(s)
- V Scheggi
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - I Merilli
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - N Ceschia
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - F Vanni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - B Alterini
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - PL Stefano
- Careggi University Hospital, Cardiac surgery, Florence, Italy
| | - N Marchionni
- Careggi University Hospital, Cardiac surgery, Florence, Italy
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Scheggi V, Vanni F, Filardo C, Rinaldi A, D"anna G, Giammetti S, Castellini G, Alterini B, Marchionni N, Ricca V. The starving heart. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Anorexia Nervosa (AN) is a psychiatric disorder that can lead to cardiac complications, especially in severely malnourished patients. Cardiovascular involvement includes autonomic dysfunction (increased vagal tone, bradycardia, orthostatic hypotension, syncope), arrhythmias, pericardial effusion, heart failure and sudden death. A few studies have examined the echocardiographic abnormalities secondary to AN, reporting mainly a decreased cardiac mass and an increased incidence of pericardial effusion. No previous studies examined the changes of Global Longitudinal Strain (GLS), which has been shown to be an early marker of myocardial damage in other subsets.
Purpose
This study aimed to characterize echocardiographic abnormalities in AN, and to assess impairment of global and regional longitudinal strain (LS) and its clinical value in this context.
Methods
We prospectively enrolled 42 consecutive patients (1 male) admitted to a highly specialized AN unit between November 2020 and July 2021 with AN (Mental Disorders, 4th Edition-DSM IVr). We also selected 34 healthy controls, matched for age and sex. In all subjects, we reported the cardiac frequency, systolic and diastolic blood pressure, blood examinations, and we performed an echocardiography, including GLS measurement. Eighteen patients were treated with enteral or parenteral feeding. A subset of 26 AN patients performed a second echocardiography after one month of follow up; 14 of them received forced feeding.
Results
Compared with healthy subjects, AN patients had significantly lower albumin levels (45.1 ± 10.3 vs 66.0 ± 4.8 mg/dl, p = 0.031), lower FT3 levels (3.7 ± 1.0 vs 7.9 ± 6.4 pg/mL, p = 0.001), higher FT4 levels (13.8 ± 1.8 vs 9.6 ± 8.1 pg/mL, p = 0.008), a lower cardiac frequency (63 ± 18 vs 73 ± 12 bpm, p = 0.004), a higher incidence of pericardial effusion (9/42 vs 0/34, p = 0.008), a lower myocardial mass (62.3 ± 15.0 vs 98.5 ± 28.5 g, p < 0.001), a lower absolute value of GLS (-18.8 ± 2.8 vs -20.3 ± 2.0 %, p = 0.014) and basal LS (-15.4 ± 6.1 vs -19.6 ± 2.8 %, p < 0.001). The bull’s eye mapping showed a plot pattern with blue basal areas in 17/42 AN patients vs 1/34 healthy subjects (p < 0.001). The 17 anorexic patients with a blue basal pattern needed forced feeding in a higher proportion (11/17 vs 7/25, p = 0.018) and presented more frequently amenorrhea (14/17 vs 11/25, p = 0.046). During the follow up (26 AN patients performed a second echocardiography), of 13 patients with blue areas in the first bull’s eye mapping, 11 recovered a completely red pattern, and of 13 patients with a red bull’s eye in the first examination, no one presented blue areas on the second one.
Conclusions
GLS is significantly altered in AN patients and a basal blue pattern on bull’s eye mapping individuates more severe cases. These changes seem to be reversible (Figure 1), although further studies are necessary to understand which factors influence this pattern besides BMI. Abstract Figure 1
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Affiliation(s)
- V Scheggi
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - F Vanni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - C Filardo
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - A Rinaldi
- Careggi University Hospital, Psychiatry, Florence, Italy
| | - G D"anna
- Careggi University Hospital, Psychiatry, Florence, Italy
| | - S Giammetti
- Careggi University Hospital, Psychiatry, Florence, Italy
| | - G Castellini
- Careggi University Hospital, Psychiatry, Florence, Italy
| | - B Alterini
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - N Marchionni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - V Ricca
- Careggi University Hospital, Psychiatry, Florence, Italy
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Scheggi V, Ceschia N, Vanni F, Merilli I, Sottili E, Alterini B, Marchionni N, Stefano PL. Injection drug use infective endocarditis: clinical features and therapeutic challanges. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Injection drug use (IDU) is a known risk factor for infective endocarditis (IE) and is associated with frequent recurrences, but its prognostic impact is still debated. Moreover, the potential futility of surgery in this population is an unsolved matter.
Purpose
We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of injection drug use IE (IDUIE).
Method
We retrospectively included in the analysis 454 consecutive episodes of definite active IE admitted in a single surgical centre from January 2012 to December 2020; 14 out of them where a subsequent infective episode of the same patient.
Results
IDUIE cases were 63 (13.8%), without significant proportional differences over time. IDUIE patients were significantly younger (43.95±10.12 vs 67.84±13.33, p 0.00) and presented fewer comorbidities (p<0.001). They were admitted with a first episode of IE only in 60.3% of cases vs 92.8% of non-IDU (p<0.001). Embolism was present at admission in a higher percentage (60.3 vs 38.4%, p<0.001). IDUIE was more frequently associated with spondylodiscitis (15.9 vs 7.4%, p=0.026). The infection was less frequently left-sided than in non-IDU patients (57.1 vs 97.2%, p<0.001) and was more often polimicrobic (12.7 vs 4.9%, p=0.015). Most patients were positive for Staphylococcus aureus (54.0 vs 12.8%, p<0.001), while Streptococci were significantly less frequent in patients with IDUIE (11 vs 25%, p=0.015). The proportion of patients undergoing surgery was similar among the two groups (85.5 vs 78.8%, NS). IDUIE patients treated medically for absence of surgical indication had a better survival than patients undergoing surgery for complicated IE (p<0.001). IDUIE was associated with a higher proportion of relapse during follow-up (28.3 vs 3.3%, p<0.001). It was not associated with higher mortality (Figure 1) but was an independent predictor of mortality in multivariable analysis including age (HR per unit 1.048, 95% CI 1.038–1.063, p=0.00) and drug abuse (HR 3.2, 95% CI 1.8–5.6, p=0.00; Figure 2). Among IDUIE patients, we did not find predictors of futility of surgery, not even multiple relapses.
Conclusions
IDUIE represents a considerable proportion of overall cases of IE, mainly affecting young people. Staphylococcus aureus is the most common microbiologic agent. IDUIE is not associated with higher mortality but drug abuse is an independent predictor of mortality. Considering that patient with uncomplicated IE treated medically have a better prognosis, we should reserve surgery to patients with a strict indication for it. On the other hand, since there are no predictors of futility of surgery, all patients with a complicated IE should undergo surgery without delay. The main determinant of prognosis in these patients is not IE but drug abuse itself. For this reason, increased focus on addiction treatment following hospital discharge is mandatory to improve long term prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Scheggi
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - N Ceschia
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - F Vanni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - I Merilli
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - E Sottili
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - B Alterini
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - N Marchionni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - P L Stefano
- Careggi University Hospital, Cardiac surgery, Florence, Italy
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Scheggi V, Vanni F, Ceschia N, Merilli I, Sottili E, Alterini B, Stefano PL, Marchionni N. Double-valve infective endocarditis: clinical features and prognostic impact; a retrospective study in a surgical centre. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging.
Purpose
We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of double-valve IE (DVIE).
Method
We retrospectively included in the analysis 380 consecutive patients with definite active IE in a single surgical centre. The univariate and multivariate long-term survival was analysed by the Kaplan-Meier method and by stepwise Cox proportional hazards models, respectively. We repeated the mortality analysis using the propensity score matching technique, to adjust for baseline differences between SVIE and DVIE groups.
Results
DVIE occurred in 60 of the total enrolled 380 patients (15.8%) and involved mostly the combination of mitral and aortic valves (N=52, 87%). Most patients had double-native IE (N=38, 63%). Staphylococci were significantly less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (p<0.001). Valve repair of at least one valve was associated with non-significant better survival than double replacement. DVIE was associated with higher all-cause mortality than SVIE (p<0.001). DVIE was not associated with a higher risk of relapse or non-fatal adverse events.
Conclusions
DVIE represents a considerable proportion of overall cases of IE, mainly involving aortic and mitral valves, with a jet lesion on the mitral valve; Staphylococcus is significantly less frequent than in SVIE; DVIE is independently associated with higher mortality; finally, mitral valve repair is feasible in a considerable proportion of surgical cases.
Funding Acknowledgement
Type of funding sources: None. Propensity score matchingKaplan-Meier analysis: survival of DVIE
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Affiliation(s)
- V Scheggi
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - F Vanni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - N Ceschia
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - I Merilli
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - E Sottili
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - B Alterini
- Careggi University Hospital, Department of Cardiology, Florence, Italy
| | - P L Stefano
- Careggi University Hospital, Cardiac surgery, Florence, Italy
| | - N Marchionni
- Careggi University Hospital, Department of Cardiology, Florence, Italy
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Martino EC, Misso G, Pastina P, Costantini S, Vanni F, Gandolfo C, Botta C, Capone F, Lombardi A, Pirtoli L, Tassone P, Ulivieri C, Tagliaferri P, Cusi MG, Caraglia M, Correale P. Immune-modulating effects of bevacizumab in metastatic non-small-cell lung cancer patients. Cell Death Discov 2016; 2:16025. [PMID: 27752361 PMCID: PMC5045963 DOI: 10.1038/cddiscovery.2016.25] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/02/2016] [Indexed: 01/24/2023] Open
Abstract
The mPEBev is an anticancer regimen which combines a chemotherapy doublet, based on cisplatin and oral etoposide (mPE), with bevacizumab (mPEBev), a mAb targeting the vasculo-endothelial growth factor (VEGF). In previous studies, this regimen showed powerful anti-angiogenetic effects and significant antitumor activity in metastatic non-small-cell lung cancer (mNSCLC) patients. We also recorded the best benefit in patients exhibiting low-systemic inflammatory profile at baseline. On these bases, we hypothesized that mPEBev antitumor activity could be partially related to bevacizumab-associated immunological effects. For this reason, we performed an immunological monitoring in 59 out of 120 stage IIIb-IV NSCLC patients enrolled in the BEVA2007 phase II trial, who received fractioned cisplatin (30 mg/sqm days 1-3q21) and oral etoposide (50 mg, days 1-15q21) (mPE doublet) ±bevacizumab. In this group of patients, 12 received the mPE doublet alone and 47 the doublet in combination with bevacizumab (5 mg/kg on the day 3q21; mPEBev regimen). Blood cell counts, serum analysis, multiplex cytokine assay and immunocytofluorimetric analysis, performed on baseline and post-treatment on blood samples from these patients, revealed that bevacizumab addition to the doublet decreased levels of pro-angiogenic (VEGF, Angiostatin-1 and Follistatin) and inflammatory cytokines (interferon (IFN)γ, IL4 and IL17), improved in vivo and in vitro cytotoxic T-lymphocytes (CTL) response and promoted dendritic cell activation. These results suggest that the mPEBev regimen improve the micro-environmental conditions for an efficient antigen-specific CTL response, making it a feasible candidate regimen to be assessed in combination with immune-checkpoint inhibitors in NSCLC patients.
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Affiliation(s)
- E C Martino
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - G Misso
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - P Pastina
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | | | - F Vanni
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - C Gandolfo
- Microbiology and Virology Unit, Department of Medical Biotechnology , Siena, Italy
| | - C Botta
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | | | - A Lombardi
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - L Pirtoli
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
| | - P Tassone
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | - C Ulivieri
- Department of Science of Life; University of Siena , Siena, Italy
| | - P Tagliaferri
- Medical Oncology Unit, 'Magna Graecia' University and AUO 'Materdomini' , Catanzaro, Italy
| | - M G Cusi
- Microbiology and Virology Unit, Department of Medical Biotechnology , Siena, Italy
| | - M Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second Naples University , Naples, Italy
| | - P Correale
- Radiotherapy Unit, Department of Oncology, Siena University Hospital , Siena, Italy
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Vanni F, Conversano C, Del Debbio A, Landi P, Carlini M, Fanciullacci C, Bergamasco M, Di Fiorino A, Dell'Osso L. A survey on virtual environment applications to fear of public speaking. Eur Rev Med Pharmacol Sci 2013; 17:1561-1568. [PMID: 23832719] [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: 06/02/2023]
Abstract
BACKGROUND Social Anxiety Disorder (SAD) is one of the most prevalent anxiety disorders in Europe and comprises the fear of public speaking as its typical sub-type. Cognitive-Behavioural Therapy (CBT) is the intervention of choice for SAD, and it includes exposure to anxiety-provoking stimuli to induce systematic desensitization and reduce anxiety. Similarly, exposure therapy per se has been used and found effective, although it is not as specific as CBT for the treatment of SAD. Interestingly, exposure to anxiety-provoking situations can be achieved in Virtual Environments (VEs) through the simulation of social situations allowing individuals with public speaking anxiety to live and develop real exposure-like reactions. The Virtual Reality Exposure Therapy (VRET) is the treatment of anxiety disorders based on such VEs. AIM This article aims to provide an overview of the scientific literature related to the applications of Virtual Reality to the treatment of fear of public speaking. MATERIALS AND METHODS We conducted the literature review on PubMed and Google Scholar for studies including the fear-of-public-speaking VEs. RESULTS AND CONCLUSIONS Reviewed studies addressed two main aspects: the design parameters of the VEs for adequate reactions to synthetic social stimuli, and the efficacy of VEs for fear of public speaking treatment. VEs resulted effective for triggering as-if-real reactions in relation to public speaking. VE-based exposures reduced public speaking anxiety measurements, decreased scores and maintained them at 3 month follow-up. Studies comparing VRET to pharmacological therapy are lacking, and there are few randomized controlled trials that compare VRET to CBT, especially on fear of public speaking treatment.
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Affiliation(s)
- F Vanni
- Perceptual Robotics Laboratory, Scuola Superiore Sant'Anna, Pisa, Italy.
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Aguiar AP, Almeida J, Bayat M, Cardeira B, Cunha R, Häusler A, Maurya P, Oliveira A, Pascoal A, Pereira A, Rufino M, SebastiÃo L, Silvestre C, Vanni F. Cooperative Control of Multiple Marine Vehicles Theoretical Challenges and Practical Issues. ACTA ACUST UNITED AC 2009. [DOI: 10.3182/20090916-3-br-3001.0072] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Barbini DA, Vanni F, Pelosi P, Generali T, Amendola G, Stefanelli P, Girolimetti S, Di Muccio A, Mantovani A, Spera G, Silvestroni L. Low levels of organochlorine pesticides in subjects with metabolic disturbances: a survey taken in Rome in 2001-2002. Bull Environ Contam Toxicol 2004; 73:219-226. [PMID: 15386032 DOI: 10.1007/s00128-004-0416-y] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- D A Barbini
- Department Environment and Primary Prevention, ISS-National Institute of Health, Viale Regina Elena, 299-00161 Rome, Italy
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Di Muccio A, Stefanelli P, Funari E, Barbini DA, Generali T, Pelosi P, Girolimetti S, Amendola G, Vanni F, Di Muccio S. Organochlorine pesticides and polychlorinated biphenyls in 12 edible marine organisms from the Adriatic Sea, Italy, Spring 1997. Food Addit Contam 2002; 19:1148-61. [PMID: 12623675 DOI: 10.1080/0265203021000012394] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Edible portions of 12 marine organisms from several areas of the Adriatic Sea, Italy, were collected during Spring 1997 and analysed for 32 organochlorine pesticides residues and 27 polychlorobiphenyl congeners. Only eight organochlorine pesticides - hexachlorobenzene (HCB), hexachlorocyclohexane (HCH) isomers, diphenyl-dichloro-trichloroethane (DDT) group, dieldrin - were determined at levels in the range <0.01-19.88 ng g(-1) wet weight, with 1,1'-dichloro-2,2'-bis(4-chlorophenyl)ethylene (DDE) being the more relevant single organochlorine. The contamination by organochlorine pesticides was comparable in organisms from the North, Centre and South Adriatic. Polychlorinated biphenyls (PCBs) were determined at levels in the range <0.05-14.46 ng g(-1), with CB 101, 118, 138, 153, 180 and 187 being more relevant (penta-, hexa- and hepta-chlorinated congeners). The sum of PCBs congeners determined were in the range 1.18-69.05 ng g(-1). The contamination by PCBs is more relevant in organisms from the North Adriatic Sea owing to the antropic discharge from major rivers such as Po and Adige that flow through highly industrialized and densely populated areas.
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Affiliation(s)
- A Di Muccio
- Laboratory of Applied Toxicology, ISS (Istituto Superiore di Sanità), Viale Regina Elena 299, I-00161 Rome, Italy.
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