Giampaolo Greco - Academia.edu (original) (raw)

Papers by Giampaolo Greco

PurposeTo evaluate the association of subjective social status (SSS) with metabolic syndrome (Met... more PurposeTo evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer. Methods Multi-center cross-sectional study (10 US hospitals) in women (n=1206) with primary diagnosis of invasive breast cancer received during Mar/2013- Feb/2020. Participants, self-identified as non-Hispanic white or black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history and behavioral risks. SSS was measured with the 10-rung McArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation. ResultsAverage age was 58 years. On average, the SSS of black women, given equivalent level of income and education, was lower than the SSS of white women: 6.6 (6.1 to 7.0) vs 7.7 (7.54 to 7.79) among co...

Endocrine-Related Cancer

The survival for breast cancer (BC) is improving but remains lower in Black women than White wome... more The survival for breast cancer (BC) is improving but remains lower in Black women than White women. A number of factors potentially drive the racial differences in BC outcomes. The aim of our study was to determine if insulin resistance (defined as homeostatic model assessment for insulin resistance (HOMA-IR)), mediated part of the relationship between race and BC prognosis (defined by the improved Nottingham prognostic index (iNPI)). We performed a cross-sectional study, recruiting self-identified Black and White women with newly diagnosed primary invasive BC from 10 US hospitals between March 2013 and February 2020. Survey, anthropometric, laboratory, and tumor pathology data were gathered, and we compared the results between Black and White women. We calculated HOMA-IR as well as iNPI scores and examined the associations between HOMA-IR and iNPI. After exclusions, the final cohort was 1206: 911 (76%) White and 295 (24%) Black women. Metabolic syndrome and insulin resistance were ...

This article cites 36 articles, 24 of which can be accessed free

Diabetes, 2019

Hyperglycemia is associated with adverse outcomes in critically ill surgical patients with increa... more Hyperglycemia is associated with adverse outcomes in critically ill surgical patients with increasing recognition that those without preexisting DM (NODM) are more affected. As the brain acts as a major regulator of glucose and exclusively depends on it for its high energy needs, we examined the association between hyperglycemia and outcomes in ICU patients undergoing elective or emergent neurosurgery (NSGY) with and without DM. Patients (N 864) were grouped as NODM, pre-existing DM on (DMTR) and not on medications (DMNT) (NODM 637 DMNT 80 DMTR 147). Postop glucose (BG) and time weighted average BG (TWAg) 24 hours postop, postop length of stay (pLOS), hospitalization cost and adverse outcomes (death, respiratory failure, infection, stroke, MI) were obtained retrospectively from admissions between May 2011 - January 2015. Those in DMTR had higher TWAg than in DMNT and NODM (188 vs. 166, 145 mg/dL p<0.005). After adjustment for demographics, comorbidities and surgical characteristi...

Journal of Diabetes and its Complications, 2018

Diabetes Care, 2016

OBJECTIVE The management of postoperative hyperglycemia is controversial and generally does not t... more OBJECTIVE The management of postoperative hyperglycemia is controversial and generally does not take into account pre-existing diabetes. We analyzed clinical and economic outcomes associated with postoperative hyperglycemia in cardiac surgery patients, stratifying by diabetes status. RESEARCH DESIGN AND METHODS Multicenter cohort study in 4,316 cardiac surgery patients operated on in 2010. Glucose was measured at 6-h intervals for 48 h postoperatively. Outcomes included cost, hospital length of stay (LOS), cardiac and respiratory complications, major infections, and death. Associations between maximum glucose levels and outcomes were assessed with multivariable regression and recycled prediction analyses. RESULTS In patients without diabetes, increasing glucose levels were associated with a gradual worsening of outcomes. In these patients, hyperglycemia (≥180 mg/dL) was associated with an additional cost of $3,192 (95% CI 1,972 to 4,456), an additional hospital LOS of 0.8 days (0.4 ...

Journal of Vascular Surgery, 2006

Differential effects of human immunodeficiency virus isolates on beta-chemokine and gamma interfe... more Differential effects of human immunodeficiency virus isolates on beta-chemokine and gamma interferon production and on cell proliferation

This article cites 35 articles, 18 of which can be accessed free

Examination of a large panel of chemokines indi-cates that in addition to RANTES, MIP-1a and MIP-... more Examination of a large panel of chemokines indi-cates that in addition to RANTES, MIP-1a and MIP-1b, the b-chemokine MCP-2 and, to a lesser extent, the c-chemokine lymphotactin also show anti-human immunodeficiency virus (HIV) activity in cell culture. The amount of chemokine needed to sup-press HIV replication by Z50 % was generally greater (Z250 ng/ml) than that required for in-hibition of virus infection by RANTES, MIP-1a and MIP-1b. The b-chemokine MCP-3 was found to enhance the replication of both non-syncytium-inducing (NSI) and syncytium-inducing (SI) viruses at high concentrations (0–5–5 lg/ml). In contrast to a previous report, macrophage-derived chemokine was not found to inhibit HIV replication of either NSI

Journal of Clinical Oncology, 2021

560 Background: Metabolic syndrome (MS) is associated with worse breast cancer prognosis. Black w... more 560 Background: Metabolic syndrome (MS) is associated with worse breast cancer prognosis. Black women have higher rates of advanced breast cancer, as well as MS, diabetes and obesity. As socioeconomic status is associated with MS, we asked whether the subjective perception of social status (SSS), might influence this association in black and white women with a new breast cancer (BC) diagnosis. Methods: We surveyed, obtained serum and conducted anthropometric measures of 1206 women with a new BC diagnosis. Triglycerides, systolic blood pressure (SBP), waist circumference (cm), HDL and glucose were used to calculate a severity index of MS (MS-Zscore: mean=0; sd=1). Women reported their SSS on the 10 rung McArthur US social status ladder, their household income, education attained, diet quality (5 point scale), and exercise measured with metabolic equivalents (METS). Data were analyzed with multivariable generalized linear models. Missing data were imputed with multiple imputation. Res...

Annals of Surgical Oncology

The Annals of thoracic surgery, 2018

Mediastinal infections are a potentially devastating complication of cardiac operations. This stu... more Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis. There were 43 mediastinal infections in 41 patients (cumulative incidence, 0.79%; 95% confidence interval [CI] 0.60% to 1.06%). Median time to infection was 20.0 days, with 65% of infections occurring after the index hospitalization discharge. Higher body mass index (hazard ratio [HR] 1.06; 95% CI, 1.01 to 1.10), higher creatinine (HR, 1...

Diabetes care, Mar 20, 2017

Hyperglycemia and hyperlactatemia are associated with increased morbidity and mortality in critic... more Hyperglycemia and hyperlactatemia are associated with increased morbidity and mortality in critical illness. We evaluated the relationship among hyperlactatemia, glycemic control, and diabetes mellitus (DM) after cardiac surgery. This was a retrospective cohort study of 4,098 cardiac surgery patients treated between 2011 and 2015. Patients were stratified by DM and glucose-lowering medication history. Hyperglycemia (glucose >180 mg/dL), hypoglycemia (<70 mg/dL), and the hyperglycemic index (HGI) were assessed postoperatively (48 h). The relationship between lactate and glucose levels was modeled using generalized linear regression. Mortality was analyzed using an extended Cox regression model. Hyperglycemia occurred in 26.0% of patients without DM (NODM), 46.5% with DM without prior drug treatment (DMNT), 62.8% on oral medication (DMOM), and 73.8% on insulin therapy (DMIT) (P < 0.0001). Hypoglycemia occurred in 6.3%, 9.1%, 8.8%, and 10.8% of NODM, DMNT, DMOM, and DMIT, resp...

Aids Research and Human Retroviruses, Nov 1, 1998

CD4+ T lymphocytes from different donors vary in their ability to replicate different isolates of... more CD4+ T lymphocytes from different donors vary in their ability to replicate different isolates of HIV. Beta-chemokines have been shown to reduce the rate of HIV replication in cultured cells. We now demonstrate, using CD4+ cells from 19 different donors, that the variations in viral replication observed in CD4+ lymphocytes are not due to endogenous production of beta-chemokines by the cells. Instead of finding a correlation of high-level beta-chemokine production with low-level replication of virus, we found either no consistent relationship between these two parameters or a correlation between high-level beta-chemokine production and high-level virus replication. This observation was made with both chemokine-sensitive and chemokine-resistant HIV isolates. Thus, other mechanisms appear to be involved in the variability in HIV replication in cultured CD4+ cells.

Cancer Research, Feb 1, 1993