Antonio Vuolo - Academia.edu (original) (raw)
Papers by Antonio Vuolo
Nutrition, 1997
Percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding, but ... more Percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding, but only a few studies describe a long-term follow-up. The purpose of this study is to analyze the follow-up of PEG enteral feeding patients in the long term, and to report on the complication and survival rates. Between January 1991 and June 1995, we studied 136 patients (49% cancer and 51% non-cancer patients; male = 68%, female = 32%) after PEG insertion. One hundred twenty-eight patients had a long-term follow-up of over 31 d. The mean duration of PEG feeding was 277 ? 358 d (range 3 1-1590) : 17% of patients returned to oral feeding, 34% continued enteral nutrition, and 49% died. Major complications occurred in 3% of the patients: 1 aspiration pneumonia, 1 subcutaneous abscess, 2 buried bumper syndrome. Minor complications arose in 14% of our cases: 8 tube blockages, 4 tube dislodgements, 6 site infections. For the whole group of 136 patients, survival probabilities after PEG insertion at 1, 6, 12, and 24 mo were 90.5%, 52%, 42%, and 35%, respectively. After 180 d, the difference in survival probabilities between cancer and non-cancer patients became significant (P < 0.02). Median survival probability was 64% for non-cancer and 39% for cancer patients, and this trend did not change over 2 y.
Diabetic Medicine, 1994
In a large population-based survey, 1947 Type 2 diabetic subjects aged 40 yr and over were identi... more In a large population-based survey, 1947 Type 2 diabetic subjects aged 40 yr and over were identified, with high ascertainment (91%). Age-specific prevalence increased from 2.48% in the age group 40-64 to 5.62% in the age group > or = 65 yr; 35% of subjects were 65 yr and over at the onset of the disease. Elderly diabetic subjects showed a significantly (p < 0.001) lower frequency of family history of diabetes (26% vs 42%), obesity at diagnosis (62% vs 70.6%) and fasting plasma glucose (FPG) (8.3 +/- 2.4 vs 8.1 +/- 2.8 mmol l-1). Elderly diabetic subjects were more commonly managed by general practitioners (GPs) (29.7% vs 21.5%). Elderly patients attending only the GPs differed in FPG, which was significantly lower (7.9 +/- 2.1 nmol l-1 vs 8.5 +/- 2.6 mmol l-1). Good metabolic control (FPG < 6.6 mmol l-1) was found in 17.5% of subjects in the age group 40-64 and in 22.9% in the age group > or = 65 yr. Poor metabolic control was more commonly seen in those attending the diabetic clinic. HBA1c measurement was available in 32.0% of the elderly attending the diabetic clinic and in only 10.7% of those in the care of GPs. Fundal examination was available in 48.2% and in 36.5%, respectively, of diabetic subjects in the age groups 40-64 > or = 65 yr, without differences between those attending and those not attending the diabetic clinic.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care, 1993
Objective— To report the incidence of IDDM in the age-group 0–29 yr in the Province of Turin, Ita... more Objective— To report the incidence of IDDM in the age-group 0–29 yr in the Province of Turin, Italy (951, 445 inhabitants 0–29 yr of age), over a 5-yr period (1984–1988) according to age, sex, and geographical region within the area and to identify any temporal trend. Research Design and Methods— The survey used as the primary data source the list of all patients attending diabetic clinics, and as secondary data source, used the list of hospital discharges for diabetes. Results— We identified 298 incident cases of IDDM in people 0–29 yr of age. Estimated completeness of ascertainment of the registry was 97%. Age-adjusted (world-standard) incidence rates were 7.40/100,000 (95% CI 6.28–8.71), 5.83 (4.95–6.86), and 6.70 (5.97–7.51), respectively, in the age-groups 0–14, 15–29, and 0–29 yr. Incidence was significantly higher in males than in females in the age-group 15–29 yr (7.36, 6.02–8.98, vs. 4.21, 3.12–5.56). An increasing incidence from rural areas to the greater Turin area (city ...
Diabetes, 1994
Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-... more Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-dependent diabetes mellitus (IDDM) patients, but the pathophysiological basis of this association is not clear. To see whether or not hemostatic dysfunctions might contribute to explain this association, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), factor VII activity, plasma fibrinogen, and plasma endothelin-1 (ET-1) in 13 microalbuminuric (albumin excretion rate [AER], 20–200 μg/min) and in 13 comparable normoalbuminuric (< 20 μg/min) IDDM patients. t-PA and ET-1 were similar in the two groups, whereas PAI-1 activity (5.65 ± 1.92 vs. 0.85 ± 0.58 IU/ml, P < 0.05), factor VII (87.85 ± 4.94 vs. 76.54 ± 2.31%, P < 0.05), and plasma fibrinogen (3.38 ± 0.21 vs. 2.65 ± 0.13 g/l, P < 0.05) were significantly higher in microalbuminuric than in normoalbuminuric patients. Plasma fibrinogen was related to AER (r2 = 0.23, P < 0.05), wher...
Nutrition, 1997
Percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding, but ... more Percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding, but only a few studies describe a long-term follow-up. The purpose of this study is to analyze the follow-up of PEG enteral feeding patients in the long term, and to report on the complication and survival rates. Between January 1991 and June 1995, we studied 136 patients (49% cancer and 51% non-cancer patients; male = 68%, female = 32%) after PEG insertion. One hundred twenty-eight patients had a long-term follow-up of over 31 d. The mean duration of PEG feeding was 277 ? 358 d (range 3 1-1590) : 17% of patients returned to oral feeding, 34% continued enteral nutrition, and 49% died. Major complications occurred in 3% of the patients: 1 aspiration pneumonia, 1 subcutaneous abscess, 2 buried bumper syndrome. Minor complications arose in 14% of our cases: 8 tube blockages, 4 tube dislodgements, 6 site infections. For the whole group of 136 patients, survival probabilities after PEG insertion at 1, 6, 12, and 24 mo were 90.5%, 52%, 42%, and 35%, respectively. After 180 d, the difference in survival probabilities between cancer and non-cancer patients became significant (P < 0.02). Median survival probability was 64% for non-cancer and 39% for cancer patients, and this trend did not change over 2 y.
Diabetic Medicine, 1994
In a large population-based survey, 1947 Type 2 diabetic subjects aged 40 yr and over were identi... more In a large population-based survey, 1947 Type 2 diabetic subjects aged 40 yr and over were identified, with high ascertainment (91%). Age-specific prevalence increased from 2.48% in the age group 40-64 to 5.62% in the age group > or = 65 yr; 35% of subjects were 65 yr and over at the onset of the disease. Elderly diabetic subjects showed a significantly (p < 0.001) lower frequency of family history of diabetes (26% vs 42%), obesity at diagnosis (62% vs 70.6%) and fasting plasma glucose (FPG) (8.3 +/- 2.4 vs 8.1 +/- 2.8 mmol l-1). Elderly diabetic subjects were more commonly managed by general practitioners (GPs) (29.7% vs 21.5%). Elderly patients attending only the GPs differed in FPG, which was significantly lower (7.9 +/- 2.1 nmol l-1 vs 8.5 +/- 2.6 mmol l-1). Good metabolic control (FPG < 6.6 mmol l-1) was found in 17.5% of subjects in the age group 40-64 and in 22.9% in the age group > or = 65 yr. Poor metabolic control was more commonly seen in those attending the diabetic clinic. HBA1c measurement was available in 32.0% of the elderly attending the diabetic clinic and in only 10.7% of those in the care of GPs. Fundal examination was available in 48.2% and in 36.5%, respectively, of diabetic subjects in the age groups 40-64 > or = 65 yr, without differences between those attending and those not attending the diabetic clinic.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care, 1993
Objective— To report the incidence of IDDM in the age-group 0–29 yr in the Province of Turin, Ita... more Objective— To report the incidence of IDDM in the age-group 0–29 yr in the Province of Turin, Italy (951, 445 inhabitants 0–29 yr of age), over a 5-yr period (1984–1988) according to age, sex, and geographical region within the area and to identify any temporal trend. Research Design and Methods— The survey used as the primary data source the list of all patients attending diabetic clinics, and as secondary data source, used the list of hospital discharges for diabetes. Results— We identified 298 incident cases of IDDM in people 0–29 yr of age. Estimated completeness of ascertainment of the registry was 97%. Age-adjusted (world-standard) incidence rates were 7.40/100,000 (95% CI 6.28–8.71), 5.83 (4.95–6.86), and 6.70 (5.97–7.51), respectively, in the age-groups 0–14, 15–29, and 0–29 yr. Incidence was significantly higher in males than in females in the age-group 15–29 yr (7.36, 6.02–8.98, vs. 4.21, 3.12–5.56). An increasing incidence from rural areas to the greater Turin area (city ...
Diabetes, 1994
Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-... more Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-dependent diabetes mellitus (IDDM) patients, but the pathophysiological basis of this association is not clear. To see whether or not hemostatic dysfunctions might contribute to explain this association, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), factor VII activity, plasma fibrinogen, and plasma endothelin-1 (ET-1) in 13 microalbuminuric (albumin excretion rate [AER], 20–200 μg/min) and in 13 comparable normoalbuminuric (< 20 μg/min) IDDM patients. t-PA and ET-1 were similar in the two groups, whereas PAI-1 activity (5.65 ± 1.92 vs. 0.85 ± 0.58 IU/ml, P < 0.05), factor VII (87.85 ± 4.94 vs. 76.54 ± 2.31%, P < 0.05), and plasma fibrinogen (3.38 ± 0.21 vs. 2.65 ± 0.13 g/l, P < 0.05) were significantly higher in microalbuminuric than in normoalbuminuric patients. Plasma fibrinogen was related to AER (r2 = 0.23, P < 0.05), wher...