Cristina Cinti - Academia.edu (original) (raw)
Papers by Cristina Cinti
Respiratory Medicine, 2006
Background: The adherence to the prescribed oxygen therapy is difficult to obtain for patients on... more Background: The adherence to the prescribed oxygen therapy is difficult to obtain for patients on long-term oxygen therapy (LTOT). There is little information on the modalities of oxygen utilisation for patients on LTOT who are using liquid oxygen in real life. Study objective: Evaluation of the behaviour and the knowledge regarding LTOT in a large group of patients mainly using liquid oxygen. Design and setting: Questionnaire administered to consecutive outpatients on domiciliary LTOT for at least 6 months referring to one of 20 clinics throughout Italy. Blinded to this result, the physician who cared for the patient completed another questionnaire. Results: We evaluated 1504 patients (mean age 71.6 years; males 64%; 74% suffering from COPD). Most respondents (93%) used liquid oxygen with mobile device. Fifteen per cent of patients had a prescribed length of oxygen therapy less than 15 h/day; 21% reported to practice oxygen for less than 15 h/day. Patients reported using
Respiratory Medicine, 2011
Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre... more Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre, cross-sectional, observational study investigates the prevalence of inhaler mishandling in a large population of experienced patients referring to chest clinics; to analyze the variables associated with misuse and the relationship between inhaler handling and health-care resources use and disease control.
![Research paper thumbnail of Erratum to “Inhaler mishandling remains common in real life and is associated with reduced disease control” [Respir Med 105 (6) 2011 930–938]](https://attachments.academia-assets.com/40335605/thumbnails/1.jpg)
](Respiratory Medicine, 2012
Respiratory Medicine, 2010
We investigated the readiness to quit and the smoking cessation rates of smokers requiring bronch... more We investigated the readiness to quit and the smoking cessation rates of smokers requiring bronchoscopy and receiving advice quitting. This randomized controlled trial evaluated the effectiveness of two smoking cessation interventions, either a brief advice (control group), or a longer support, delivered at the time of bronchoscopy. We consecutively enrolled 233 adult smokers, regardless of the initial level of motivation to quit. Their mean (SD) age was 57 (12) years; males were 192. They had smoked a median of 44.5 pack-years. Their mean (SD) Fagerstrom score was 8 (2). There was no difference between groups. Surprisingly, 45% of participants were in the action stage at baseline; these 105 subjects had quit in the week immediately prior to the bronchoscopy. At 6- and 12-months follow-up visits, respectively 41% and 29% of participants in the intervention group and 27% and 13% in the control group objectively showed a 1-week point prevalence abstinence. The difference was significant at 6 months (p<0.05) but not at 1-year visit (p=0.052), even if there was a trend towards greater cessation rate in the intervention group. In multivariable logistic models, at the final visit being a quitter was positively associated with having been in the action stage at baseline and negatively with the Fagerstrom score and the presence of smokers in household. We conclude that the time of bronchoscopy may possibly predispose smokers to quit. Further efforts are needed to clear whether more protracted support might achieve higher long-term smoking cessation rates.
Journal of Fish Biology, 2002
ABSTRACT
Journal of Clinical Pathology, 1995
Aims-To evaluate whether endothelin-1 is involved in the pathology of idiopathic pulmonary fibros... more Aims-To evaluate whether endothelin-1 is involved in the pathology of idiopathic pulmonary fibrosis (IPF). Methods-Plasma endothelin-1 concentrations were evaluated in 37 patients with IPF and 27 normal controls by radioimmunoassay. In addition, expression of endothelin-1 in lung tissue was evaluated in biopsy specimens obtained from four patients with IPF. Three biopsy specimens of normal lung were used as controls. Endothelin-1 immunoreactivity was detected using immunohistochemistry. Results-Elevated endothelin-l plasma concentrations were found in patients with IPF compared with controls and a positive correlation was found with duration ofdisease. No significant difference was observed between treated and untreated patients with IPF. Increased endothelin-1 immunoreactivity was found in lungs of three of four patients with IPF. Endothelin-l positive cells consisted mainly of small vessel endothelial cells. Some scattered macrophages were also positive. Conclusions-Elevated plasma concentrations and expression of endothelin-1 in lung tissue are suggestive of increased production of endothelin-1 in at least a proportion of patients with IPF. Consequently, endothelin-l activity could play a role in the fibrogenic process of the disease. (J7 Clin Pathol 1995;48:330-334)
European Respiratory Journal, 1999
Henoch-Schönlein purpura (HSP) is a widespread necrotizing vasculitis affecting small vessels cha... more Henoch-Schönlein purpura (HSP) is a widespread necrotizing vasculitis affecting small vessels characterized by nonthrombocytopenic purpura. Pulmonary involvement is a rare fatal complication with diffuse alveolar haemorrhage. The objective of this study was to evaluate possible early lung function abnormalities and to establish any relationship with the clinical activity of the disease. Fifteen children with HSP and without clinical or radiological evidence of lung involvement underwent pulmonary function study at the onset of the disease. A sample of 28 subjects matched by age, height, and weight was chosen as a control group. After a mean of 21 months (range 12-43) lung function tests were repeated in 10 of the previously studied children. During the acute phase of the disease the transfer factor for carbon monoxide, measured by steady-state (TL,COss) and single-breath (TL,COsb) methods, was found to be significantly lower in children with HSP than control subjects. There was no significant relationship between pulmonary function tests with symptoms and signs at onset, nor was there any correlation between variables and serum immunoglobulin A (IgA) concentration. In all but two patients, clinical recovery was observed within 6 weeks from the onset of the disease. In one case relapses of purpuric skin lesions were observed during the first 3 months of follow-up. The second case had relapses of purpuric skin lesions and microscopical haematuria during the 12 months following the onset of the disease with characteristic IgA mesangial deposition on renal biopsy. Although the overall mean value of TL,COsb improved from baseline to the second investigation, in both patients the recurrences of clinical signs were associated with a slight impairment of TL,COsb at the second evaluation. These data suggest an early subclinical lung impairment in children with Henoch-Schönlein purpura during the active phase of the disease. The presence of isolated pulmonary function abnormalities was not associated with the subsequent development of lung disease.
European Respiratory Journal, 2001
Due to the lack of information on this topic, the Educational Group of the Italian Association of... more Due to the lack of information on this topic, the Educational Group of the Italian Association of Hospital Pneumologists performed an open, multicentre, observational survey to evaluate home nebulizer practices in Italy. From May-December 1999, all patients attending one of the 27 participating chest clinics throughout Italy and who were or had been using a home nebulizer in the previous 6 months were consecutively enrolled. All patients completed a self-administered questionnaire on their current practices of home nebulization. Of the 1,721 questionnaires delivered, 1,257 were returned with an overall response rate of 73%. Most patients (82.8%) reported using their nebulizer for bronchopulmonary symptoms and the remaining patients only used theirs for upper respiratory tract diseases. Subjects using their nebulizer for lower respiratory symptoms were older (p<0.001), predominantly female (p<0.001) and used their nebulizer more frequently (p<0.001). Forty per cent of patients >60 yrs old used their nebulizer regularly, at least once a day. More than 60% of respondents never received any information from healthcare workers on the correct usage of their nebulizer, and >75% received no information on nebulizer hygiene and care. Patients who received information on the use and maintenance of their nebulizer from caregivers more commonly attended to these practices (p<0.01). The present survey suggests that home nebulizer use and maintenance in Italy are heterogeneous, and there is the need to implement better nebulizer practice.
Annals of Allergy, Asthma & Immunology, 2004
Pressurized metered-dose inhalers (pMDIs) are often poorly used, but little information is availa... more Pressurized metered-dose inhalers (pMDIs) are often poorly used, but little information is available concerning use of the newer dry powder inhalers (DPIs). To estimate the inhalation technique and variables associated with the misuse of pMDIs and newer DPIs in clinical practice. A multicenter, observational survey was used to evaluate the inhalation technique in 1,404 experienced outpatients aged 15 to 88 years affected mostly by asthma (47%) and chronic obstructive pulmonary disease (39%). A total of 1,056 patients were using pMDIs, 190 in conjunction with a large volume spacer (LVS); regarding DPIs, 230 patients were using the Aerolizer Inhaler, 524 were using the Turbuhaler, and 475 were using the Diskus. In each center, a trained observer recorded patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; inhalation techniques for each inhaler used against a standardized step-by-step checklist. Twenty-four percent and 3% of patients used pMDIs poorly, alone or with an add-on LVS, respectively. Failure to correctly perform essential steps for reliable lung delivery with the Aerolizer Inhaler, Turbuhaler, and Diskus was found in 17%, 23%, and 24% of patients, respectively. There was no difference in most variables correlated with poor inhalation between patients using pMDIs and those using DPIs. The use of DPIs is associated with a similar percentage of inadequate inhalation technique as the use of pMDIs in clinical practice. The addition of an LVS to a pMDI and education from health care personnel, rather than simply changing inhalers, represent the best strategies for minimizing poor inhalation technique.
Aerobiologia, 1992
Summary A new non-instrumental method, disposable for T determination (Immunograph-Acculevel, Sy... more Summary A new non-instrumental method, disposable for T determination (Immunograph-Acculevel, Syva, Palo Alto, USA) in out-patients related to the EMIT method in laboratory is described. 24 patients were studied with the two methods by a little blood arterial sample used also for the gasanalysis (15 M, 9 F: average age 63 (±2.3), range 32–74; 6 with asthma, 8 with chronic bronchitis
Aerobiologia, 1992
Bronchial responsiveness to methacoline (PD20 FEVI mcg) was measured in 64 non smoker asthmatic p... more Bronchial responsiveness to methacoline (PD20 FEVI mcg) was measured in 64 non smoker asthmatic patients with baseline FEV1 >90% predicted. Patients underwent skin prick tests (SPT) and RAST. Allergic patients had." SPT>_ 3+ and RAST-score > II class to the same antigen and con'elation with asthmatic symptoms; non allergic patients had negative SPT and RAST. We divided patients in four groups: lst) allergic seasonal asthmatics before pollen season; 2nd) allergic seasonal asthmatics during pollen season; 3rd) allergic perennial asthmatics; 4th) non-allergic perennial asthmatics. A significant difference in log PD20 was observed between Ist and 2nd group (p< 0.0005); between 1st and 3rd group (p< 0.0005); between 1st and 4th group (p< 0.0005). In allergic seasonal asthmatics before pollen season 10/20 subjects were non-responsive to methacholine (PD20>__1600 mcg), while in 2nd, 3rd and 4th group no subjects were non-responsive. The attthors conchtde that non-specific bronchial hyperresponsiveness to methacoline is not constant in seasonal allergic asthmatics out of pollen season.
Rassegna di Patologia dell'Apparato Respiratorio
con particolare riguardo alle cattive notizie Communicating in Pulmonology, bad news in particula... more con particolare riguardo alle cattive notizie Communicating in Pulmonology, bad news in particular Articolo di revisione / Review article 185 Luigi Portalone (foto) Parole chiave Comunicazione • Pneumolo-gia • Cattive notizie Key words Communication • Pulmono-logy • Bad news Ricevuto il 17-2-2014. Accettato il 16-4-2014. Riassunto La comunicazione è diventata fondamentale nel rapporto medico paziente. Gli AA esaminano le difficoltà nell'atto di comunicare in campo pneumologico con particolare riguardo alla comunicazione delle cattive notizie. Propongono una linea di comportamento sulla scorta dell'esperienza personale e della letteratura. Dall'analisi emerge come sia necessario preparare il medico anche a questo non facile compito, unendo alla tecnica una maggiore sensibilità umana. Summary Communication has become more and more important in the doctor-patient relationship. AA examine the dif-ficulties in the act of communicating in the field of chest disease particularl...
Respiratory Medicine, 2006
Background: The adherence to the prescribed oxygen therapy is difficult to obtain for patients on... more Background: The adherence to the prescribed oxygen therapy is difficult to obtain for patients on long-term oxygen therapy (LTOT). There is little information on the modalities of oxygen utilisation for patients on LTOT who are using liquid oxygen in real life. Study objective: Evaluation of the behaviour and the knowledge regarding LTOT in a large group of patients mainly using liquid oxygen. Design and setting: Questionnaire administered to consecutive outpatients on domiciliary LTOT for at least 6 months referring to one of 20 clinics throughout Italy. Blinded to this result, the physician who cared for the patient completed another questionnaire. Results: We evaluated 1504 patients (mean age 71.6 years; males 64%; 74% suffering from COPD). Most respondents (93%) used liquid oxygen with mobile device. Fifteen per cent of patients had a prescribed length of oxygen therapy less than 15 h/day; 21% reported to practice oxygen for less than 15 h/day. Patients reported using
Respiratory Medicine, 2011
Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre... more Proper inhaler technique is crucial for effective management of asthma and COPD. This multicentre, cross-sectional, observational study investigates the prevalence of inhaler mishandling in a large population of experienced patients referring to chest clinics; to analyze the variables associated with misuse and the relationship between inhaler handling and health-care resources use and disease control.
Respiratory Medicine, 2012
Respiratory Medicine, 2010
We investigated the readiness to quit and the smoking cessation rates of smokers requiring bronch... more We investigated the readiness to quit and the smoking cessation rates of smokers requiring bronchoscopy and receiving advice quitting. This randomized controlled trial evaluated the effectiveness of two smoking cessation interventions, either a brief advice (control group), or a longer support, delivered at the time of bronchoscopy. We consecutively enrolled 233 adult smokers, regardless of the initial level of motivation to quit. Their mean (SD) age was 57 (12) years; males were 192. They had smoked a median of 44.5 pack-years. Their mean (SD) Fagerstrom score was 8 (2). There was no difference between groups. Surprisingly, 45% of participants were in the action stage at baseline; these 105 subjects had quit in the week immediately prior to the bronchoscopy. At 6- and 12-months follow-up visits, respectively 41% and 29% of participants in the intervention group and 27% and 13% in the control group objectively showed a 1-week point prevalence abstinence. The difference was significant at 6 months (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) but not at 1-year visit (p=0.052), even if there was a trend towards greater cessation rate in the intervention group. In multivariable logistic models, at the final visit being a quitter was positively associated with having been in the action stage at baseline and negatively with the Fagerstrom score and the presence of smokers in household. We conclude that the time of bronchoscopy may possibly predispose smokers to quit. Further efforts are needed to clear whether more protracted support might achieve higher long-term smoking cessation rates.
Journal of Fish Biology, 2002
ABSTRACT
Journal of Clinical Pathology, 1995
Aims-To evaluate whether endothelin-1 is involved in the pathology of idiopathic pulmonary fibros... more Aims-To evaluate whether endothelin-1 is involved in the pathology of idiopathic pulmonary fibrosis (IPF). Methods-Plasma endothelin-1 concentrations were evaluated in 37 patients with IPF and 27 normal controls by radioimmunoassay. In addition, expression of endothelin-1 in lung tissue was evaluated in biopsy specimens obtained from four patients with IPF. Three biopsy specimens of normal lung were used as controls. Endothelin-1 immunoreactivity was detected using immunohistochemistry. Results-Elevated endothelin-l plasma concentrations were found in patients with IPF compared with controls and a positive correlation was found with duration ofdisease. No significant difference was observed between treated and untreated patients with IPF. Increased endothelin-1 immunoreactivity was found in lungs of three of four patients with IPF. Endothelin-l positive cells consisted mainly of small vessel endothelial cells. Some scattered macrophages were also positive. Conclusions-Elevated plasma concentrations and expression of endothelin-1 in lung tissue are suggestive of increased production of endothelin-1 in at least a proportion of patients with IPF. Consequently, endothelin-l activity could play a role in the fibrogenic process of the disease. (J7 Clin Pathol 1995;48:330-334)
European Respiratory Journal, 1999
Henoch-Schönlein purpura (HSP) is a widespread necrotizing vasculitis affecting small vessels cha... more Henoch-Schönlein purpura (HSP) is a widespread necrotizing vasculitis affecting small vessels characterized by nonthrombocytopenic purpura. Pulmonary involvement is a rare fatal complication with diffuse alveolar haemorrhage. The objective of this study was to evaluate possible early lung function abnormalities and to establish any relationship with the clinical activity of the disease. Fifteen children with HSP and without clinical or radiological evidence of lung involvement underwent pulmonary function study at the onset of the disease. A sample of 28 subjects matched by age, height, and weight was chosen as a control group. After a mean of 21 months (range 12-43) lung function tests were repeated in 10 of the previously studied children. During the acute phase of the disease the transfer factor for carbon monoxide, measured by steady-state (TL,COss) and single-breath (TL,COsb) methods, was found to be significantly lower in children with HSP than control subjects. There was no significant relationship between pulmonary function tests with symptoms and signs at onset, nor was there any correlation between variables and serum immunoglobulin A (IgA) concentration. In all but two patients, clinical recovery was observed within 6 weeks from the onset of the disease. In one case relapses of purpuric skin lesions were observed during the first 3 months of follow-up. The second case had relapses of purpuric skin lesions and microscopical haematuria during the 12 months following the onset of the disease with characteristic IgA mesangial deposition on renal biopsy. Although the overall mean value of TL,COsb improved from baseline to the second investigation, in both patients the recurrences of clinical signs were associated with a slight impairment of TL,COsb at the second evaluation. These data suggest an early subclinical lung impairment in children with Henoch-Schönlein purpura during the active phase of the disease. The presence of isolated pulmonary function abnormalities was not associated with the subsequent development of lung disease.
European Respiratory Journal, 2001
Due to the lack of information on this topic, the Educational Group of the Italian Association of... more Due to the lack of information on this topic, the Educational Group of the Italian Association of Hospital Pneumologists performed an open, multicentre, observational survey to evaluate home nebulizer practices in Italy. From May-December 1999, all patients attending one of the 27 participating chest clinics throughout Italy and who were or had been using a home nebulizer in the previous 6 months were consecutively enrolled. All patients completed a self-administered questionnaire on their current practices of home nebulization. Of the 1,721 questionnaires delivered, 1,257 were returned with an overall response rate of 73%. Most patients (82.8%) reported using their nebulizer for bronchopulmonary symptoms and the remaining patients only used theirs for upper respiratory tract diseases. Subjects using their nebulizer for lower respiratory symptoms were older (p<0.001), predominantly female (p<0.001) and used their nebulizer more frequently (p<0.001). Forty per cent of patients >60 yrs old used their nebulizer regularly, at least once a day. More than 60% of respondents never received any information from healthcare workers on the correct usage of their nebulizer, and >75% received no information on nebulizer hygiene and care. Patients who received information on the use and maintenance of their nebulizer from caregivers more commonly attended to these practices (p<0.01). The present survey suggests that home nebulizer use and maintenance in Italy are heterogeneous, and there is the need to implement better nebulizer practice.
Annals of Allergy, Asthma & Immunology, 2004
Pressurized metered-dose inhalers (pMDIs) are often poorly used, but little information is availa... more Pressurized metered-dose inhalers (pMDIs) are often poorly used, but little information is available concerning use of the newer dry powder inhalers (DPIs). To estimate the inhalation technique and variables associated with the misuse of pMDIs and newer DPIs in clinical practice. A multicenter, observational survey was used to evaluate the inhalation technique in 1,404 experienced outpatients aged 15 to 88 years affected mostly by asthma (47%) and chronic obstructive pulmonary disease (39%). A total of 1,056 patients were using pMDIs, 190 in conjunction with a large volume spacer (LVS); regarding DPIs, 230 patients were using the Aerolizer Inhaler, 524 were using the Turbuhaler, and 475 were using the Diskus. In each center, a trained observer recorded patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; inhalation techniques for each inhaler used against a standardized step-by-step checklist. Twenty-four percent and 3% of patients used pMDIs poorly, alone or with an add-on LVS, respectively. Failure to correctly perform essential steps for reliable lung delivery with the Aerolizer Inhaler, Turbuhaler, and Diskus was found in 17%, 23%, and 24% of patients, respectively. There was no difference in most variables correlated with poor inhalation between patients using pMDIs and those using DPIs. The use of DPIs is associated with a similar percentage of inadequate inhalation technique as the use of pMDIs in clinical practice. The addition of an LVS to a pMDI and education from health care personnel, rather than simply changing inhalers, represent the best strategies for minimizing poor inhalation technique.
Aerobiologia, 1992
Summary A new non-instrumental method, disposable for T determination (Immunograph-Acculevel, Sy... more Summary A new non-instrumental method, disposable for T determination (Immunograph-Acculevel, Syva, Palo Alto, USA) in out-patients related to the EMIT method in laboratory is described. 24 patients were studied with the two methods by a little blood arterial sample used also for the gasanalysis (15 M, 9 F: average age 63 (±2.3), range 32–74; 6 with asthma, 8 with chronic bronchitis
Aerobiologia, 1992
Bronchial responsiveness to methacoline (PD20 FEVI mcg) was measured in 64 non smoker asthmatic p... more Bronchial responsiveness to methacoline (PD20 FEVI mcg) was measured in 64 non smoker asthmatic patients with baseline FEV1 >90% predicted. Patients underwent skin prick tests (SPT) and RAST. Allergic patients had." SPT>_ 3+ and RAST-score > II class to the same antigen and con'elation with asthmatic symptoms; non allergic patients had negative SPT and RAST. We divided patients in four groups: lst) allergic seasonal asthmatics before pollen season; 2nd) allergic seasonal asthmatics during pollen season; 3rd) allergic perennial asthmatics; 4th) non-allergic perennial asthmatics. A significant difference in log PD20 was observed between Ist and 2nd group (p< 0.0005); between 1st and 3rd group (p< 0.0005); between 1st and 4th group (p< 0.0005). In allergic seasonal asthmatics before pollen season 10/20 subjects were non-responsive to methacholine (PD20>__1600 mcg), while in 2nd, 3rd and 4th group no subjects were non-responsive. The attthors conchtde that non-specific bronchial hyperresponsiveness to methacoline is not constant in seasonal allergic asthmatics out of pollen season.
Rassegna di Patologia dell'Apparato Respiratorio
con particolare riguardo alle cattive notizie Communicating in Pulmonology, bad news in particula... more con particolare riguardo alle cattive notizie Communicating in Pulmonology, bad news in particular Articolo di revisione / Review article 185 Luigi Portalone (foto) Parole chiave Comunicazione • Pneumolo-gia • Cattive notizie Key words Communication • Pulmono-logy • Bad news Ricevuto il 17-2-2014. Accettato il 16-4-2014. Riassunto La comunicazione è diventata fondamentale nel rapporto medico paziente. Gli AA esaminano le difficoltà nell'atto di comunicare in campo pneumologico con particolare riguardo alla comunicazione delle cattive notizie. Propongono una linea di comportamento sulla scorta dell'esperienza personale e della letteratura. Dall'analisi emerge come sia necessario preparare il medico anche a questo non facile compito, unendo alla tecnica una maggiore sensibilità umana. Summary Communication has become more and more important in the doctor-patient relationship. AA examine the dif-ficulties in the act of communicating in the field of chest disease particularl...