E. Altobelli - Academia.edu (original) (raw)
Papers by E. Altobelli
resistance in migraineurs:
Objectives: Several studies have suggested an association between migraine and insulin resistance... more Objectives: Several studies have suggested an association between migraine and insulin resistance (IR) without adequately addressing the issue according to migraine type. We assessed IR in subjects with migraine with aura (MwA) and migraine without aura (MwoA) to estimate the consistency of the possible association. Methods: In a case-control study we included case subjects with MwA and MwoA, who were consecutively selected from those referred to our Regional Headache Center from September 2011 to February 2013, and age-matched control subjects selected using general practitioners ’ databases. IR was calculated by means of the homeostatic model assessment of IR (HOMA-IR), b-cell function (HOMA-B), and the quantitative insulin sensitivity check index (QUICKI) measuring glucose and insulin values in a blood sample collected in the morning after overnight fasting. Data regarding anthropo-metric measures, comorbidity risk factors, and migraine characteristics were also recorded. Results...
European review for medical and pharmacological sciences, 2021
The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk f... more The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk factors: elevated blood pressure, dyslipidemia and glycemic alterations, causing metabolic syndrome. A subgroup of obese, Metabolically Healthy Obese (MHO), appears to be less prone to the development of metabolic disturbances. Carotid intima-media thickness (cIMT) is a non-invasive marker of subclinical atherosclerosis and it is associated with increased risk of CVD events. To investigate the cardiovascular risk, demonstrated through the increase of cIMT in obese subjects without Metabolic Syndrome (MetS), we have studied cIMT in MHO, metabolically unhealthy obese (MUO) and obese with MetS diagnosed with the IDEFICS criteria and compared to a control group. 224 obese children aged 6 to 21 years (13,50 ± 4.01 years) and 103 normal weight subjects aged 7 to 19 years (13.2 ± 4.1 years) were studied. The body mass index (BMI) of the obese children was ≥ the 95th percentile. Based on the IDEF...
Hepato-gastroenterology
The value of pre-operative angiographic evaluation in patients undergoing gastric cancer surgery ... more The value of pre-operative angiographic evaluation in patients undergoing gastric cancer surgery with extended lymphadenectomy was assessed in a prospective study comparing exposed and unexposed groups of patients. During the period from July 1991 to October 1997, 76 patients (Group A--exposed) were pre-operatively submitted to a digital subtraction angiography (DSA) after informed consent. Concurrently, 94 patients (Group B--unexposed) were included as an unexposed reference group. All patients underwent total or subtotal gastrectomy with D2 lymphadenectomy according to the guidelines proposed by the Japanese Research Society for Gastric Cancer (JRSGC). In 34 (45%) exposed patients (Group A), DSA detected an atypical vascular anatomy. Major anatomical variations of the celiac axis, its branches and the superior mesenteric artery were discovered in 4 subjects (5%). Vascular anomalies affecting the surgical tactics of lymphadenectomy were detected in less than 8% of patients. Five po...
European Journal of Epidemiology, 2001
The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. ... more The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. In Italy, anti-HCV positivity values are extremely variable, depending on the age and geographic location of the population being analysed. The aims of the study were: (1) evaluating positivity for anti-HCV antibodies in various age groups and determining the HBsAg in a mountainous and
Journal of the European Academy of Dermatology and Venereology, 2011
Background Patient adherence is a key element for therapeutic success and represents a major conc... more Background Patient adherence is a key element for therapeutic success and represents a major concern for all healthcare professionals. Objective Aim of our study was to assess the frequency of use of treatments currently available for psoriasis and its association with specific socio-demographical and clinical variables. Methods The study population consisted of 1689 patients, aged 12-85 years. Information concerning sociodemographical variables, clinical features and the type of current treatment was collected. Items on patients' satisfaction of current treatments and of dermatologist-patient relationship were also included. The chi-squared test was used to estimate the association between the categorical variables, whereas Wilcoxon and Kruskal-Wallis tests were applied to the interval and ordinal variables. The Cochran-Mantel-Haenszel chi-squared trend test was used to evaluate the degree of satisfaction related to dermatologist-patient relationship. Results Of the 1689 psoriatic patients, 54.1% did not use any treatments and 45.9% used at least one treatment. The use of drugs was significantly associated exclusively to severity of disease and affected body surface area. Systemic therapies, both traditional treatments and biological agents, were mainly used in patients with disease duration >10 years and disease severity. Treatment adherence was significantly associated to the degree of patient's satisfaction of his ⁄ her relationship with the dermatologist. Alternative treatment such as over the counter medications and acupuncture were used by 33% of patients. Conclusion The majority of psoriatic patients do not use any treatments. However, treatment adherence significantly increases when dermatologists clarify the treatment schedule, inform patients and meet the patients' needs.
Journal of Pediatric Endocrinology and Metabolism, 1998
In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital h... more In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital hypothyroid children, we studied 23 (10 girls and 13 boys) consecutive patients. Their age ranged from 3 to 8 weeks. One of these patients had familiar dyshormonogenesis, 21 had ectopic glands and one hemiagenesis. As a control group, we studied 46 sex-and agematched healthy newborns. Before the beginning of therapy, the hypothyroid patients showed higher values of calcium (2.78 ± 0.04 vs 2.65 ± 0.07 mmol/1; ρ < 0.05) and of 1,25-dihydroxyvitamin D (159.7 ± 31.6 vs 90.5 ± 33.1 ng/1; ρ < 0.01), while they showed lower values of osteocalcin (1.9 ± 0.8 vs 2.9 ± 0.9 ng/ml; ρ < 0.01) than controls. After 3 months of therapy, we found a complete normalization of all these parameters and a progressive increase of osteocalcin. Our data show that in congenital hypothyroid children there are abnormalities in calcium metabolism which seem to be transient and reversible after L-thyroxine replacement therapy.
Journal of Pediatric Endocrinology and Metabolism, 1997
The incidence rates of IDDM in Italy show remarkable variability. Sardinia, a region with the sec... more The incidence rates of IDDM in Italy show remarkable variability. Sardinia, a region with the second highest incidence rate in the world, co-exists with other regions with lower rates. We review and compare epidemiologic data on the incidence of childhood-onset IDDM in Italy. papers published from 1980 to 1996 reporting incidence data in Italian areas were found by search of Medline and non-indexed Italian journals. The incidence data found cover only 57% of the Italian population. The analysis of our results shows how difficult it is to make a careful study of epidemiology of IDDM in Italy. The RIDI (the Registry for Insulin-dependent Diabetes mellitus in Italy) project started in 1996 according to international guidelines. The aims is to coordinate local IDDM registries, to promote the start of new registries in uncovered areas, and to standardize registration and data collection.
Journal of Clinical Ultrasound, 1998
The aim of this study was to evaluate the influence of insulin-dependent diabetes mellitus (IDDM)... more The aim of this study was to evaluate the influence of insulin-dependent diabetes mellitus (IDDM) on the size of the pancreas in children. Pancreas size was evaluated sonographically in a group of 60 diabetic children and adolescents, aged 3-15 years, and 60 sex- and age-matched healthy controls. A significant reduction in pancreatic area and other parameters was found in diabetic patients particularly in children aged 8-12 and 13-15 years. The pancreas was larger in children 3-7 years old who had had IDDM for 2 years of less (mean size, 8.61 cm2) than in children 8-12 and 13-15 years old who had had IDDM for more than 5 years (mean size, 8.06 and 8.40 cm2, respectively). An inverse correlation between area of the pancreas and duration of IDDM was seen in all age groups (p &amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Diabetes affects the growth of the pancreas in children with IDDM. Sonography can be used to noninvasively evaluate the influence of the disease on pancreas size.
Brain Injury, 2011
To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R). Two observers applied... more To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R). Two observers applied the Italian version of the CRS-R to selected patients. On day 1, observer A and B independently scored each patient; the comparison of their observations was used to evaluate inter-observer agreement. On day 2, observer A completed a second evaluation and the comparison of this observation with that obtained on day 1 by the same observer was used to evaluate test-re-test agreement. For each evaluation, also diagnostic impression (vegetative state/minimally conscious state) was reported. Thirty-eight patients were evaluated (mean age ± SD, 58.9 ± 13.8 years). Inter-observer (ρ = 0.81; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) as well as test-re-test agreement (ρ = 0.97; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) for the total score was high. Inter-observer agreement was excellent for the communication sub-scale, good for the auditory, visual and motor sub-scales and moderate for the oromotor/verbal and arousal sub-scales. Test-re-test agreement was excellent for the visual, motor, oromotor/verbal and communication sub-scales, good for the auditory sub-scale and moderate for the arousal sub-scale. When considering the diagnostic impression, inter-observer agreement was good (κ = 0.75; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and test-re-test agreement was excellent (κ = 0.92; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The Italian version of the CRS-R can be administered reliably and can be also employed to discriminate patients in vegetative and in minimally conscious state.
Acta Paediatrica, 1999
ABSTRACT An attempt was made by the Jordanian National Center for Diabetes, Endocrine and Genetic... more ABSTRACT An attempt was made by the Jordanian National Center for Diabetes, Endocrine and Genetic Diseases (NCDEGD) to identify all cases of type 1 diabetes among Jordanian children aged 0-14 y. Data were obtained retrospectively for the years 1992-1994 and prospectively for the years 1995 and 1996, including full name, national identifying number, date of birth, date of diagnosis and family history. The incidence was calculated as the number of cases per 100000 population, according to the national census of 1994. The incidence rate for these years (1992 through 1996) was 2.8, 2.9, 3.2, 3.6 and 3.6 per 100000 population, respectively. The ma1e:female ratio was (1: 1.03). Seasonal variation at clinical onset was noticed, with maximum incidence in the winter months and minimum incidence in the summer months. In conclusion, the incidence of type 1 diabetes mellitus in Jordanian children aged 0-14y is among the lowest in the region, but is rising. □Children, incidence, insulin-dependent diabetes mellitus, Jordan, type 1 diabetes
Acta Ophthalmologica, 2009
Purpose To compare the retinal nerve fiber layer (RNFL) measurements and macular thickness measur... more Purpose To compare the retinal nerve fiber layer (RNFL) measurements and macular thickness measurements in healthy eyes using two different Fourier‐domain optical coherence tomographies (OCT) devices: Cirrus HD OCT (Carl Zeiss Meditec, Dublin, Ca) and Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). Methods Fifty healthy eyes (33 women and 17 men, aged from 23 to 59 years) were prospectively analysed using 3 optic disc protocols and 3 volume cube scans with each device. Descriptive statistics, analysis of variance and coefficients of variation (COV) were calculated for RNFL average thickness and for the 9 areas corresponding to the Early Treatment Diabetic Retinopathy Study (ETDRS) in macular protocol. Differences between the acquisitions of RNFL quadrants with both devices made them unable to compare. Results RNFL thickness measurements showed significant differences between Cirrus HD OCT and Spectralis OCT (mean: 98.91 ± 7.39 microns and 102.20 ± 7.93 microns respecti...
Clinical and Experimental Medicine, 2005
The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the ... more The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the Abruzzo region (central Italy). Sixty incident cases from the Abruzzo region were studied together with 120 unrelated control subjects living in the same administrative areas. The relative risk of diabetes associated with the alleles under study was calculated by deriving the odds ratio (OR) maximum likelihood estimates and their 95% confidence intervals (CI) by the exponentiation of the logistic regression beta-parameter. The combination DRB1*03/DQA1*0501/DQB1*0201 was found in 20.0% of patients and 7.1% of the control subjects, conferring an OR of 4.04 and a CI of 1.97-8.49. The combination DRB1*04/DQA1*0301/DQB1*0302 was found in 23.3% of diabetic patients and 6.7% of controls, giving an OR of 5.69 and a CI of 2.77-12.05. DRB1*11/DQA1*0505/DQB1*0301 and DQA1*0505/DQB1*0301 were negatively associated with type 1 diabetes (OR=0.27, CI 0.11-0.57; OR=0.07, CI 0.02-0.19). The DQA1 genotype at risk was found to be DQA1*0301/DQA1*0501: OR=23.80, CI 2.97-190.89, as it occurred with the highest frequency in the patient group. The DQB1 genotype at risk was found to be DQB1*0201/DQB1*0302, which occurred in 13.3% of patients but in only 1.1% of the control group (OR=29.75, CI 5.36-549.25). Our results shed further light on the risk of development of this disease during a specific time period in an area where the overall incidence of type 1 diabetes is known.
International Journal of Immunopathology and Pharmacology, 2007
CD1 is a small family comprising 5 MHC-like genes located on chromosome 1 and encoding glycoprote... more CD1 is a small family comprising 5 MHC-like genes located on chromosome 1 and encoding glycoproteins termed CD1a, CD1b, CD1c, CD1d and CD1e. They are expressed mainly on the surface of dendritic cells, monocytes and some thymocytes and are specialized in presenting lipid antigens to T lymphocytes. The structure is similar to that of MHC class I molecules with 3 globular domains and the β2-microglobulin. It has been shown that all five human CD1 genes exhibit a limited number of polymorphisms in the alpha1 domain whose effects are still unknown. CD1e results to be the most polymorphic isoform with six CD1e alleles (01, 02 in exon 2 and 03, 04, 05, 06 in ex3) described to date. At this moment, few investigations on the allele frequencies of the CD1 genes have been reported and all additional information improves our knowledge on this new class of antigen-presenting molecules. In order to study possible allelic variations of exon 2 of human CD1a and CD1e genes, we analyzed, by a sensit...
European Journal of Histochemistry, 2015
Increasing evidence supports the hypothesis that TGFb1 signalling may be mediated by high tempera... more Increasing evidence supports the hypothesis that TGFb1 signalling may be mediated by high temperature requirement A1 (HtrA1) serine protease, acting on important regulatory mechanisms such as cell proliferation and mobility. Evidence is now accumulating to suggest that HtrA1 is involved in the development and progression of several pathologies. The aim of this study was to evaluate: i) if HtrA1 and TGFb1 expressions differ in eutopic and ectopic endometrium in women with endometriosis; ii) if HtrA1 correlates to TGFb1, pSmad and Ki67. This study was carried out including 10 women with ovarian endometriosis (cases) and 10 women with non endometriotic diseases (controls). Endometrial tissue underwent immunohistochemical H-score analysis for HtrA1, TGFb1, pSmad and Ki67 molecules. Data evaluation was performed by a nonparametric Kruskal-Wallis test and Spearman correlation was applied to evaluate the relationship among the molecules investigated in the epithelial and in the stromal com...
Panminerva medica, 2003
The "Naiade" Project was carried out in execution of the Decree of December 1994 by the... more The "Naiade" Project was carried out in execution of the Decree of December 1994 by the Italian Ministry of Health, with the objective of defining the therapeutic role of spa therapy in the various sectors of medicine. In this study the authors refer to the results obtained in osteoarthritis (OA). The OA study included the observation of patients for 2 consecutive years, with the compilation of a series of clinical and socio-economic data. The initial sample was of 11437 patients suffering from primary and secondary OA, and in the 2(nd) year the total number of assessable patients was 6111 (53.4%). All patients underwent 1 annual cycle of balneotherapy and mud packs therapy for 2 consecutive years. The thermal treatments were carried out in 98 Italian spas with sulphurous water, sodium chloride-bromide-iodide water, sulphate water, and bicarbonate water. Analysis of the data collected confirmed the clinical efficacy of spa treatments for OA, particularly for localisations ...
Annali di igiene : medicina preventiva e di comunità
Recent epidemiological studies have demonstrated that coeliac disease (CD) prevalence is still un... more Recent epidemiological studies have demonstrated that coeliac disease (CD) prevalence is still underestimated both in Europe and in Mediterranean regions. Here we review the latest data on CD prevalence and incidence in the European Union (EU) as of September 2014. The current epidemiological scenario of CD prevalence and incidence was investigated by searching PubMed for papers in English using the following key words: "celiac disease", "celiac disease plus prevalence" (limits: 1990-2014), "incidence" (limits: 1970-2014), and "frequency", plus "in Europe". Another search was performed with the same key words plus the name of each European country. Only prevalence data obtained by serology using anti-gliadin antibodies (AGA), EMA test, tTG test, and/or duodenal biopsy were included. The study designs considered were retrospective and prospective studies: population-based (PB), cross-sectional, case-control and cohort studies. Extensi...
Annali di igiene : medicina preventiva e di comunità
Substance abuse is the result of interaction between constitutional, environmental and socio-demo... more Substance abuse is the result of interaction between constitutional, environmental and socio-demographic factors. Several studies have been demonstrated that the adolescent substance abuse is a serious and growing problem. The aim of our study is to investigate the association between substance, alcohol and tobacco abuse and socio-familiar factors, to evaluate a substance abuse prevention program which decreases substance use in adolescents. A cross-sectional survey was developed and carried out by involving a group of adolescents, randomly selected from the secondary school of Teramo province. Data were collected by a self-administered questionnaire. The associations between substance use and the determinants taken into account was evaluated by the chi-square test of Fisher exact test or trend test when appropriated. Our data show that the alcohol abuse is more frequent in males (41.1%, p = 0.000), while the nicotine abuse is more frequent in females (46.1%, p = 0.005). However, ou...
International angiology : a journal of the International Union of Angiology, 2002
Chronic venous disorders carry lifelong medical and social burdens. Within conservative approache... more Chronic venous disorders carry lifelong medical and social burdens. Within conservative approaches, spa hydrotherapy is popular among patients with venous disorders in Europe, but whether the practice is associated with health or social benefits remains controversial. The present work is a substudy of the nation-wide Italian Naiade Project, a large multicenter observational exercise on spa treatments in different disease groups. The "Chronic Phlebopathies" substudy included 2504 patients with primary or secondary varicosis or non-varicose venous insufficiency. After a first visit and administration of a detailed questionnaire, patients underwent a "thermal cycle" of 15-20 days consisting of underwater active and passive physical therapy with mineral waters. The same procedures were repeated after 1 year on the 1352 patients (54%) who spontaneously returned to the same spa. Primary endpoints of the study were some indicators of the use of health resources related ...
British Journal of Cancer, 2015
Background: We performed a multicentre randomised controlled trial to evaluate the effect on part... more Background: We performed a multicentre randomised controlled trial to evaluate the effect on participation in organised screening programmes of a self-sampling device mailed home or picked up at a pharmacy compared with the standard recall letter. Methods: Women aged 30-64 non-responding to screening invitation were eligible. Response rate to first invitation ranged from 30% to 60% between centres. The control was the standard reminder letter to undergo the test used by the programme (Pap test in three centres and HPV DNA test in three other centres). Home mailing of the self-sampler was preceded by a letter with a leaflet about HPV. The analysis was intention-to-treat. Results: In all, 14 041 women were randomised and recruited: 5012 in the control arm, 4516 to receive the self-sampler at home, and 4513 to pick up the self-sampler at a pharmacy. Participation was 11.9% in the control, 21.6% (relative participation: 1.75; 95% CI 1.60-1.93) in home, and 12.0% (relative participation: 0.96; 95% CI 0.86-1.07) in the pharmacy arms, respectively. The heterogeneity between centres was high (excess heterogeneity of that expected due to chance, i.e., I 2 , 94.9% and 94.1% for home and pharmacy arm, respectively). The estimated impact on the overall coverage was þ 4.3% for home mail self-sampling compared with þ 2.2% for standard reminder. Conclusions: Home mailing of self-sampler proved to be an effective way to increase participation in screening programmes, even in those with HPV as primary testing. Picking up at pharmacies showed effects varying from centre to centre.
resistance in migraineurs:
Objectives: Several studies have suggested an association between migraine and insulin resistance... more Objectives: Several studies have suggested an association between migraine and insulin resistance (IR) without adequately addressing the issue according to migraine type. We assessed IR in subjects with migraine with aura (MwA) and migraine without aura (MwoA) to estimate the consistency of the possible association. Methods: In a case-control study we included case subjects with MwA and MwoA, who were consecutively selected from those referred to our Regional Headache Center from September 2011 to February 2013, and age-matched control subjects selected using general practitioners ’ databases. IR was calculated by means of the homeostatic model assessment of IR (HOMA-IR), b-cell function (HOMA-B), and the quantitative insulin sensitivity check index (QUICKI) measuring glucose and insulin values in a blood sample collected in the morning after overnight fasting. Data regarding anthropo-metric measures, comorbidity risk factors, and migraine characteristics were also recorded. Results...
European review for medical and pharmacological sciences, 2021
The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk f... more The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk factors: elevated blood pressure, dyslipidemia and glycemic alterations, causing metabolic syndrome. A subgroup of obese, Metabolically Healthy Obese (MHO), appears to be less prone to the development of metabolic disturbances. Carotid intima-media thickness (cIMT) is a non-invasive marker of subclinical atherosclerosis and it is associated with increased risk of CVD events. To investigate the cardiovascular risk, demonstrated through the increase of cIMT in obese subjects without Metabolic Syndrome (MetS), we have studied cIMT in MHO, metabolically unhealthy obese (MUO) and obese with MetS diagnosed with the IDEFICS criteria and compared to a control group. 224 obese children aged 6 to 21 years (13,50 ± 4.01 years) and 103 normal weight subjects aged 7 to 19 years (13.2 ± 4.1 years) were studied. The body mass index (BMI) of the obese children was ≥ the 95th percentile. Based on the IDEF...
Hepato-gastroenterology
The value of pre-operative angiographic evaluation in patients undergoing gastric cancer surgery ... more The value of pre-operative angiographic evaluation in patients undergoing gastric cancer surgery with extended lymphadenectomy was assessed in a prospective study comparing exposed and unexposed groups of patients. During the period from July 1991 to October 1997, 76 patients (Group A--exposed) were pre-operatively submitted to a digital subtraction angiography (DSA) after informed consent. Concurrently, 94 patients (Group B--unexposed) were included as an unexposed reference group. All patients underwent total or subtotal gastrectomy with D2 lymphadenectomy according to the guidelines proposed by the Japanese Research Society for Gastric Cancer (JRSGC). In 34 (45%) exposed patients (Group A), DSA detected an atypical vascular anatomy. Major anatomical variations of the celiac axis, its branches and the superior mesenteric artery were discovered in 4 subjects (5%). Vascular anomalies affecting the surgical tactics of lymphadenectomy were detected in less than 8% of patients. Five po...
European Journal of Epidemiology, 2001
The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. ... more The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. In Italy, anti-HCV positivity values are extremely variable, depending on the age and geographic location of the population being analysed. The aims of the study were: (1) evaluating positivity for anti-HCV antibodies in various age groups and determining the HBsAg in a mountainous and
Journal of the European Academy of Dermatology and Venereology, 2011
Background Patient adherence is a key element for therapeutic success and represents a major conc... more Background Patient adherence is a key element for therapeutic success and represents a major concern for all healthcare professionals. Objective Aim of our study was to assess the frequency of use of treatments currently available for psoriasis and its association with specific socio-demographical and clinical variables. Methods The study population consisted of 1689 patients, aged 12-85 years. Information concerning sociodemographical variables, clinical features and the type of current treatment was collected. Items on patients' satisfaction of current treatments and of dermatologist-patient relationship were also included. The chi-squared test was used to estimate the association between the categorical variables, whereas Wilcoxon and Kruskal-Wallis tests were applied to the interval and ordinal variables. The Cochran-Mantel-Haenszel chi-squared trend test was used to evaluate the degree of satisfaction related to dermatologist-patient relationship. Results Of the 1689 psoriatic patients, 54.1% did not use any treatments and 45.9% used at least one treatment. The use of drugs was significantly associated exclusively to severity of disease and affected body surface area. Systemic therapies, both traditional treatments and biological agents, were mainly used in patients with disease duration >10 years and disease severity. Treatment adherence was significantly associated to the degree of patient's satisfaction of his ⁄ her relationship with the dermatologist. Alternative treatment such as over the counter medications and acupuncture were used by 33% of patients. Conclusion The majority of psoriatic patients do not use any treatments. However, treatment adherence significantly increases when dermatologists clarify the treatment schedule, inform patients and meet the patients' needs.
Journal of Pediatric Endocrinology and Metabolism, 1998
In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital h... more In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital hypothyroid children, we studied 23 (10 girls and 13 boys) consecutive patients. Their age ranged from 3 to 8 weeks. One of these patients had familiar dyshormonogenesis, 21 had ectopic glands and one hemiagenesis. As a control group, we studied 46 sex-and agematched healthy newborns. Before the beginning of therapy, the hypothyroid patients showed higher values of calcium (2.78 ± 0.04 vs 2.65 ± 0.07 mmol/1; ρ < 0.05) and of 1,25-dihydroxyvitamin D (159.7 ± 31.6 vs 90.5 ± 33.1 ng/1; ρ < 0.01), while they showed lower values of osteocalcin (1.9 ± 0.8 vs 2.9 ± 0.9 ng/ml; ρ < 0.01) than controls. After 3 months of therapy, we found a complete normalization of all these parameters and a progressive increase of osteocalcin. Our data show that in congenital hypothyroid children there are abnormalities in calcium metabolism which seem to be transient and reversible after L-thyroxine replacement therapy.
Journal of Pediatric Endocrinology and Metabolism, 1997
The incidence rates of IDDM in Italy show remarkable variability. Sardinia, a region with the sec... more The incidence rates of IDDM in Italy show remarkable variability. Sardinia, a region with the second highest incidence rate in the world, co-exists with other regions with lower rates. We review and compare epidemiologic data on the incidence of childhood-onset IDDM in Italy. papers published from 1980 to 1996 reporting incidence data in Italian areas were found by search of Medline and non-indexed Italian journals. The incidence data found cover only 57% of the Italian population. The analysis of our results shows how difficult it is to make a careful study of epidemiology of IDDM in Italy. The RIDI (the Registry for Insulin-dependent Diabetes mellitus in Italy) project started in 1996 according to international guidelines. The aims is to coordinate local IDDM registries, to promote the start of new registries in uncovered areas, and to standardize registration and data collection.
Journal of Clinical Ultrasound, 1998
The aim of this study was to evaluate the influence of insulin-dependent diabetes mellitus (IDDM)... more The aim of this study was to evaluate the influence of insulin-dependent diabetes mellitus (IDDM) on the size of the pancreas in children. Pancreas size was evaluated sonographically in a group of 60 diabetic children and adolescents, aged 3-15 years, and 60 sex- and age-matched healthy controls. A significant reduction in pancreatic area and other parameters was found in diabetic patients particularly in children aged 8-12 and 13-15 years. The pancreas was larger in children 3-7 years old who had had IDDM for 2 years of less (mean size, 8.61 cm2) than in children 8-12 and 13-15 years old who had had IDDM for more than 5 years (mean size, 8.06 and 8.40 cm2, respectively). An inverse correlation between area of the pancreas and duration of IDDM was seen in all age groups (p &amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Diabetes affects the growth of the pancreas in children with IDDM. Sonography can be used to noninvasively evaluate the influence of the disease on pancreas size.
Brain Injury, 2011
To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R). Two observers applied... more To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R). Two observers applied the Italian version of the CRS-R to selected patients. On day 1, observer A and B independently scored each patient; the comparison of their observations was used to evaluate inter-observer agreement. On day 2, observer A completed a second evaluation and the comparison of this observation with that obtained on day 1 by the same observer was used to evaluate test-re-test agreement. For each evaluation, also diagnostic impression (vegetative state/minimally conscious state) was reported. Thirty-eight patients were evaluated (mean age ± SD, 58.9 ± 13.8 years). Inter-observer (ρ = 0.81; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) as well as test-re-test agreement (ρ = 0.97; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) for the total score was high. Inter-observer agreement was excellent for the communication sub-scale, good for the auditory, visual and motor sub-scales and moderate for the oromotor/verbal and arousal sub-scales. Test-re-test agreement was excellent for the visual, motor, oromotor/verbal and communication sub-scales, good for the auditory sub-scale and moderate for the arousal sub-scale. When considering the diagnostic impression, inter-observer agreement was good (κ = 0.75; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and test-re-test agreement was excellent (κ = 0.92; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The Italian version of the CRS-R can be administered reliably and can be also employed to discriminate patients in vegetative and in minimally conscious state.
Acta Paediatrica, 1999
ABSTRACT An attempt was made by the Jordanian National Center for Diabetes, Endocrine and Genetic... more ABSTRACT An attempt was made by the Jordanian National Center for Diabetes, Endocrine and Genetic Diseases (NCDEGD) to identify all cases of type 1 diabetes among Jordanian children aged 0-14 y. Data were obtained retrospectively for the years 1992-1994 and prospectively for the years 1995 and 1996, including full name, national identifying number, date of birth, date of diagnosis and family history. The incidence was calculated as the number of cases per 100000 population, according to the national census of 1994. The incidence rate for these years (1992 through 1996) was 2.8, 2.9, 3.2, 3.6 and 3.6 per 100000 population, respectively. The ma1e:female ratio was (1: 1.03). Seasonal variation at clinical onset was noticed, with maximum incidence in the winter months and minimum incidence in the summer months. In conclusion, the incidence of type 1 diabetes mellitus in Jordanian children aged 0-14y is among the lowest in the region, but is rising. □Children, incidence, insulin-dependent diabetes mellitus, Jordan, type 1 diabetes
Acta Ophthalmologica, 2009
Purpose To compare the retinal nerve fiber layer (RNFL) measurements and macular thickness measur... more Purpose To compare the retinal nerve fiber layer (RNFL) measurements and macular thickness measurements in healthy eyes using two different Fourier‐domain optical coherence tomographies (OCT) devices: Cirrus HD OCT (Carl Zeiss Meditec, Dublin, Ca) and Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). Methods Fifty healthy eyes (33 women and 17 men, aged from 23 to 59 years) were prospectively analysed using 3 optic disc protocols and 3 volume cube scans with each device. Descriptive statistics, analysis of variance and coefficients of variation (COV) were calculated for RNFL average thickness and for the 9 areas corresponding to the Early Treatment Diabetic Retinopathy Study (ETDRS) in macular protocol. Differences between the acquisitions of RNFL quadrants with both devices made them unable to compare. Results RNFL thickness measurements showed significant differences between Cirrus HD OCT and Spectralis OCT (mean: 98.91 ± 7.39 microns and 102.20 ± 7.93 microns respecti...
Clinical and Experimental Medicine, 2005
The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the ... more The objective was to evaluate HLA DR/DQ alleles and their risk factor for type 1 diabetes in the Abruzzo region (central Italy). Sixty incident cases from the Abruzzo region were studied together with 120 unrelated control subjects living in the same administrative areas. The relative risk of diabetes associated with the alleles under study was calculated by deriving the odds ratio (OR) maximum likelihood estimates and their 95% confidence intervals (CI) by the exponentiation of the logistic regression beta-parameter. The combination DRB1*03/DQA1*0501/DQB1*0201 was found in 20.0% of patients and 7.1% of the control subjects, conferring an OR of 4.04 and a CI of 1.97-8.49. The combination DRB1*04/DQA1*0301/DQB1*0302 was found in 23.3% of diabetic patients and 6.7% of controls, giving an OR of 5.69 and a CI of 2.77-12.05. DRB1*11/DQA1*0505/DQB1*0301 and DQA1*0505/DQB1*0301 were negatively associated with type 1 diabetes (OR=0.27, CI 0.11-0.57; OR=0.07, CI 0.02-0.19). The DQA1 genotype at risk was found to be DQA1*0301/DQA1*0501: OR=23.80, CI 2.97-190.89, as it occurred with the highest frequency in the patient group. The DQB1 genotype at risk was found to be DQB1*0201/DQB1*0302, which occurred in 13.3% of patients but in only 1.1% of the control group (OR=29.75, CI 5.36-549.25). Our results shed further light on the risk of development of this disease during a specific time period in an area where the overall incidence of type 1 diabetes is known.
International Journal of Immunopathology and Pharmacology, 2007
CD1 is a small family comprising 5 MHC-like genes located on chromosome 1 and encoding glycoprote... more CD1 is a small family comprising 5 MHC-like genes located on chromosome 1 and encoding glycoproteins termed CD1a, CD1b, CD1c, CD1d and CD1e. They are expressed mainly on the surface of dendritic cells, monocytes and some thymocytes and are specialized in presenting lipid antigens to T lymphocytes. The structure is similar to that of MHC class I molecules with 3 globular domains and the β2-microglobulin. It has been shown that all five human CD1 genes exhibit a limited number of polymorphisms in the alpha1 domain whose effects are still unknown. CD1e results to be the most polymorphic isoform with six CD1e alleles (01, 02 in exon 2 and 03, 04, 05, 06 in ex3) described to date. At this moment, few investigations on the allele frequencies of the CD1 genes have been reported and all additional information improves our knowledge on this new class of antigen-presenting molecules. In order to study possible allelic variations of exon 2 of human CD1a and CD1e genes, we analyzed, by a sensit...
European Journal of Histochemistry, 2015
Increasing evidence supports the hypothesis that TGFb1 signalling may be mediated by high tempera... more Increasing evidence supports the hypothesis that TGFb1 signalling may be mediated by high temperature requirement A1 (HtrA1) serine protease, acting on important regulatory mechanisms such as cell proliferation and mobility. Evidence is now accumulating to suggest that HtrA1 is involved in the development and progression of several pathologies. The aim of this study was to evaluate: i) if HtrA1 and TGFb1 expressions differ in eutopic and ectopic endometrium in women with endometriosis; ii) if HtrA1 correlates to TGFb1, pSmad and Ki67. This study was carried out including 10 women with ovarian endometriosis (cases) and 10 women with non endometriotic diseases (controls). Endometrial tissue underwent immunohistochemical H-score analysis for HtrA1, TGFb1, pSmad and Ki67 molecules. Data evaluation was performed by a nonparametric Kruskal-Wallis test and Spearman correlation was applied to evaluate the relationship among the molecules investigated in the epithelial and in the stromal com...
Panminerva medica, 2003
The "Naiade" Project was carried out in execution of the Decree of December 1994 by the... more The "Naiade" Project was carried out in execution of the Decree of December 1994 by the Italian Ministry of Health, with the objective of defining the therapeutic role of spa therapy in the various sectors of medicine. In this study the authors refer to the results obtained in osteoarthritis (OA). The OA study included the observation of patients for 2 consecutive years, with the compilation of a series of clinical and socio-economic data. The initial sample was of 11437 patients suffering from primary and secondary OA, and in the 2(nd) year the total number of assessable patients was 6111 (53.4%). All patients underwent 1 annual cycle of balneotherapy and mud packs therapy for 2 consecutive years. The thermal treatments were carried out in 98 Italian spas with sulphurous water, sodium chloride-bromide-iodide water, sulphate water, and bicarbonate water. Analysis of the data collected confirmed the clinical efficacy of spa treatments for OA, particularly for localisations ...
Annali di igiene : medicina preventiva e di comunità
Recent epidemiological studies have demonstrated that coeliac disease (CD) prevalence is still un... more Recent epidemiological studies have demonstrated that coeliac disease (CD) prevalence is still underestimated both in Europe and in Mediterranean regions. Here we review the latest data on CD prevalence and incidence in the European Union (EU) as of September 2014. The current epidemiological scenario of CD prevalence and incidence was investigated by searching PubMed for papers in English using the following key words: "celiac disease", "celiac disease plus prevalence" (limits: 1990-2014), "incidence" (limits: 1970-2014), and "frequency", plus "in Europe". Another search was performed with the same key words plus the name of each European country. Only prevalence data obtained by serology using anti-gliadin antibodies (AGA), EMA test, tTG test, and/or duodenal biopsy were included. The study designs considered were retrospective and prospective studies: population-based (PB), cross-sectional, case-control and cohort studies. Extensi...
Annali di igiene : medicina preventiva e di comunità
Substance abuse is the result of interaction between constitutional, environmental and socio-demo... more Substance abuse is the result of interaction between constitutional, environmental and socio-demographic factors. Several studies have been demonstrated that the adolescent substance abuse is a serious and growing problem. The aim of our study is to investigate the association between substance, alcohol and tobacco abuse and socio-familiar factors, to evaluate a substance abuse prevention program which decreases substance use in adolescents. A cross-sectional survey was developed and carried out by involving a group of adolescents, randomly selected from the secondary school of Teramo province. Data were collected by a self-administered questionnaire. The associations between substance use and the determinants taken into account was evaluated by the chi-square test of Fisher exact test or trend test when appropriated. Our data show that the alcohol abuse is more frequent in males (41.1%, p = 0.000), while the nicotine abuse is more frequent in females (46.1%, p = 0.005). However, ou...
International angiology : a journal of the International Union of Angiology, 2002
Chronic venous disorders carry lifelong medical and social burdens. Within conservative approache... more Chronic venous disorders carry lifelong medical and social burdens. Within conservative approaches, spa hydrotherapy is popular among patients with venous disorders in Europe, but whether the practice is associated with health or social benefits remains controversial. The present work is a substudy of the nation-wide Italian Naiade Project, a large multicenter observational exercise on spa treatments in different disease groups. The "Chronic Phlebopathies" substudy included 2504 patients with primary or secondary varicosis or non-varicose venous insufficiency. After a first visit and administration of a detailed questionnaire, patients underwent a "thermal cycle" of 15-20 days consisting of underwater active and passive physical therapy with mineral waters. The same procedures were repeated after 1 year on the 1352 patients (54%) who spontaneously returned to the same spa. Primary endpoints of the study were some indicators of the use of health resources related ...
British Journal of Cancer, 2015
Background: We performed a multicentre randomised controlled trial to evaluate the effect on part... more Background: We performed a multicentre randomised controlled trial to evaluate the effect on participation in organised screening programmes of a self-sampling device mailed home or picked up at a pharmacy compared with the standard recall letter. Methods: Women aged 30-64 non-responding to screening invitation were eligible. Response rate to first invitation ranged from 30% to 60% between centres. The control was the standard reminder letter to undergo the test used by the programme (Pap test in three centres and HPV DNA test in three other centres). Home mailing of the self-sampler was preceded by a letter with a leaflet about HPV. The analysis was intention-to-treat. Results: In all, 14 041 women were randomised and recruited: 5012 in the control arm, 4516 to receive the self-sampler at home, and 4513 to pick up the self-sampler at a pharmacy. Participation was 11.9% in the control, 21.6% (relative participation: 1.75; 95% CI 1.60-1.93) in home, and 12.0% (relative participation: 0.96; 95% CI 0.86-1.07) in the pharmacy arms, respectively. The heterogeneity between centres was high (excess heterogeneity of that expected due to chance, i.e., I 2 , 94.9% and 94.1% for home and pharmacy arm, respectively). The estimated impact on the overall coverage was þ 4.3% for home mail self-sampling compared with þ 2.2% for standard reminder. Conclusions: Home mailing of self-sampler proved to be an effective way to increase participation in screening programmes, even in those with HPV as primary testing. Picking up at pharmacies showed effects varying from centre to centre.