Riccardo Pistelli | Università Cattolica del Sacro Cuore (Catholic University of the Sacred Heart) (original) (raw)

Papers by Riccardo Pistelli

Research paper thumbnail of Quality Control of Spirometry in the Elderly

Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multice... more Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly (⩾ 65 yr). The factors determining this quality were also evaluated. ...

Research paper thumbnail of Quality Control of Spirometry in the Elderly

Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multice... more Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly (⩾ 65 yr). The factors determining this quality were also evaluated. ...

Research paper thumbnail of Accuracy of a pulse oximeter in the measurement of the oxyhaemoglobin saturation

The European respiratory journal, 1998

The aim of the present study was to evaluate the accuracy, in comparison with a reference method,... more The aim of the present study was to evaluate the accuracy, in comparison with a reference method, of the Nellcor N-20P pulse oximeter in the assessment of oxyhaemoglobin saturation (Sa,O2). Sa,O2 was monitored at rest by the Nellcor N-20P pulse oximeter in 100 subjects (82 males, mean age 68+/-12 yrs) consecutively enroled. At the same time, an arterial blood sample was collected for the measurement of Sa,O2, carboxyhaemoglobin, and methaemoglobin by an IL-282 Co-oximeter. A significant difference was found between Sa,O2 values measured with the two methods (t=11.78, p<0.05), but the two series of measurements were significantly correlated (r=0.97). Both the level and the limits of agreement between the two methods were satisfactory when the more appropriate Bland and Altman method was applied. Nevertheless, a lack of accuracy of the pulse oximeter was found, but only for Sa,O2 values <82% and >94%, as demonstrated by the Youden index. In conclusion, these data show that Ne...

Research paper thumbnail of Accuracy of a pulse oximeter in the measurement of the oxyhaemoglobin saturation

The European respiratory journal, 1998

The aim of the present study was to evaluate the accuracy, in comparison with a reference method,... more The aim of the present study was to evaluate the accuracy, in comparison with a reference method, of the Nellcor N-20P pulse oximeter in the assessment of oxyhaemoglobin saturation (Sa,O2). Sa,O2 was monitored at rest by the Nellcor N-20P pulse oximeter in 100 subjects (82 males, mean age 68+/-12 yrs) consecutively enroled. At the same time, an arterial blood sample was collected for the measurement of Sa,O2, carboxyhaemoglobin, and methaemoglobin by an IL-282 Co-oximeter. A significant difference was found between Sa,O2 values measured with the two methods (t=11.78, p<0.05), but the two series of measurements were significantly correlated (r=0.97). Both the level and the limits of agreement between the two methods were satisfactory when the more appropriate Bland and Altman method was applied. Nevertheless, a lack of accuracy of the pulse oximeter was found, but only for Sa,O2 values <82% and >94%, as demonstrated by the Youden index. In conclusion, these data show that Ne...

Research paper thumbnail of Parental smoking and lung function: Misclassification due to background exposure to passive smoking

We evaluated the role played by background exposure (i.e. exposure to Environmental Tobacco Smoke... more We evaluated the role played by background exposure (i.e. exposure to Environmental Tobacco Smoke, ETS, from sources other than parental smoking) when evaluating the effect of parental smoking on lung function of adolescents. We performed a cross-sectional survey (937 adolescents) in the Lazio Region. Data were collected by a questionnaire, lung function tests and urinary cotinine to creatinine ratios (CCR) were measured. We found that 62.1% of subjects were exposed to current parental smoke. Among the 355 adolescents not exposed to parental smoke, a total of 92 (25.9%) had CCR levels greater than the median value of the distribution (17.3 ng/mg). Subjects with smoking parents had higher FVC and significant lower FEV(1)/FVC ratios than subjects without smoking parents. When &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Background&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ETS exposure was removed from the unexposed group by separately studying those without parental exposure but with CCR&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;17.3, results showed a reduction in lung function due to parental smoking which is greater compared to the previous model. Our study adds further evidence regarding the detrimental effect of ETS on lung function of adolescents. Negative results on the effect of parental smoking on lung function should be revisited if background exposure has not been considered in the analysis.

Research paper thumbnail of The MASTER registry on venous thromboembolism: Description of the study cohort

Thrombosis Research, 2008

Research paper thumbnail of The MASTER registry on venous thromboembolism: Description of the study cohort

Thrombosis Research, 2008

Research paper thumbnail of Questionnaire Data as Predictors of Urinary Cotinine Levels among Nonsmoking Adolescents

Archives of Environmental Health: An International Journal, 1993

The strength of association between urinary cotinine and questionnaire data on passive smoking am... more The strength of association between urinary cotinine and questionnaire data on passive smoking among 542 adolescents was evaluated. There were 103 individuals with urinary cotinine higher than 30 ng/ml; they were compared with all other subjects. The single variable that best predicted the urinary cotinine level was maternal smoking. A strong effect was made by house size and, consequently, house crowding. Maternal smoking and house crowding had a synergic effect. The subject&#39;s perception of passive smoking at home also was an independent indication of a high cotinine level. The final model had a fairly good sensitivity, whereas the specificity was somewhat lower. The results suggest that maternal smoking, house crowding, and subject&#39;s perception of a smoky environment could be surrogate indices of high passive smoking exposure in this age group and could be useful for epidemiologic studies.

Research paper thumbnail of Questionnaire Data as Predictors of Urinary Cotinine Levels among Nonsmoking Adolescents

Archives of Environmental Health: An International Journal, 1993

The strength of association between urinary cotinine and questionnaire data on passive smoking am... more The strength of association between urinary cotinine and questionnaire data on passive smoking among 542 adolescents was evaluated. There were 103 individuals with urinary cotinine higher than 30 ng/ml; they were compared with all other subjects. The single variable that best predicted the urinary cotinine level was maternal smoking. A strong effect was made by house size and, consequently, house crowding. Maternal smoking and house crowding had a synergic effect. The subject&#39;s perception of passive smoking at home also was an independent indication of a high cotinine level. The final model had a fairly good sensitivity, whereas the specificity was somewhat lower. The results suggest that maternal smoking, house crowding, and subject&#39;s perception of a smoky environment could be surrogate indices of high passive smoking exposure in this age group and could be useful for epidemiologic studies.

Research paper thumbnail of Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis

Background: A progressive lung disease and a worse survival have been observed in patients with s... more Background: A progressive lung disease and a worse survival have been observed in patients with systemic sclerosis and alveolitis. The objective of this study was to define the functional, radiological and biological markers of alveolitis in SSc patients.

Research paper thumbnail of Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis

Background: A progressive lung disease and a worse survival have been observed in patients with s... more Background: A progressive lung disease and a worse survival have been observed in patients with systemic sclerosis and alveolitis. The objective of this study was to define the functional, radiological and biological markers of alveolitis in SSc patients.

Research paper thumbnail of Repeatability of the ISAAC video questionnaire and its accuracy against a clinical diagnosis of asthma

Respiratory Medicine, 2000

The objective of the study was to evaluate the performance of the International Study of Asthma a... more The objective of the study was to evaluate the performance of the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire in terms of repeatability and accuracy against a clinical diagnosis of asthma achieved according to the National Heart, Lung and Blood Institute (NHLBI) algorithm.

Research paper thumbnail of Repeatability of the ISAAC video questionnaire and its accuracy against a clinical diagnosis of asthma

Respiratory Medicine, 2000

The objective of the study was to evaluate the performance of the International Study of Asthma a... more The objective of the study was to evaluate the performance of the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire in terms of repeatability and accuracy against a clinical diagnosis of asthma achieved according to the National Heart, Lung and Blood Institute (NHLBI) algorithm.

Research paper thumbnail of Correlates of osteoporosis in chronic obstructive pulmonary disease

Respiratory Medicine, 2000

The aim of this study was to analyse the correlates of reduced bone mineral density in patients w... more The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.

Research paper thumbnail of Correlates of osteoporosis in chronic obstructive pulmonary disease

Respiratory Medicine, 2000

The aim of this study was to analyse the correlates of reduced bone mineral density in patients w... more The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.

Research paper thumbnail of Practical management problems of stable chronic obstructive pulmonary disease in the elderly

Current Opinion in Pulmonary Medicine, 2011

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent and increasing health p... more Chronic obstructive pulmonary disease (COPD) is one of the most prevalent and increasing health problems in the elderly on a worldwide scale. The management of COPD in older patients presents practical diagnostic and treatment issues, which are reviewed with reference to the stable stage of the disease. In the diagnostic approach of COPD in the elderly the use of spirometry is recommended, but both patient conditions (such as inability to correctly perform it due to fatigue, lack of coordination, and cognitive impairment) and metrics characteristics should be taken into account for the test performance. It has been demonstrated in population studies that the use of the fixed ratio determines a substantial overdiagnosis of COPD in the oldest patients. Other parameters have been suggested [such as the evaluation of Lower Limit of Normality (LLN) for the FEV1/FVC ratio], which may be useful to guide the diagnosis. Several nonpharmacologic - such as smoking cessation, vaccination, physical activity, and pulmonary rehabilitation, nutrition, and eventually invasive ventilation - and pharmacologic interventions have been shown to improve outcomes and have been reviewed. Effective management of COPD in older adults should always consider the ability of patients to properly use inhalers and the involvement of caregivers or family members as a useful support to care, especially when treating cognitively impaired patients. Especially in the older population, timely identification and treatment of comorbidities are also crucial, but evidence in this area is still lacking and clinical practice guidelines do not take comorbidities into account in their recommendations. The Global Initiative for Obstructive Lung Disease has recommended criteria for diagnosis and management of COPD in the general population. On the contrary, available evidence suggests practical limitations in diagnostic approach and intervention strategies in older patients with stable COPD that need to be further studied for a translation into clinical practice guidelines.

Research paper thumbnail of Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children

Thorax, 2000

Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in se... more Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in several studies. The epidemiological evidence of the eVect on respiratory symptoms and asthma is limited. The consumption of fruit rich in vitamin C was examined in relation to wheezing and other respiratory symptoms in cross sectional and follow up studies of Italian children. Methods-Standardised respiratory questionnaires were filled in by parents of 18 737 children aged 6-7 years living in eight areas of Northern and Central Italy. The winter intake of citrus fruit and kiwi fruit by the children was categorised as less than once per week, 1-2 per week, 3-4 per week, and 5-7 per week. A subset of 4104 children from two areas was reinvestigated after one year using a second parental questionnaire to record the occurrence of wheezing symptoms over the intervening period. Results-In the cross sectional analysis, after controlling for several confounders (sex, study area, paternal education, household density, maternal smoking, paternal smoking, dampness or mould in the child's bedroom, parental asthma), intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months (odds ratio (OR) = 0.66, 95% confidence intervals (CI) 0.55 to 0.78, for those eating fruit 5-7 times per week compared with less than once per week), shortness of breath with wheeze (OR = 0.68, 95% CI 0.56 to 0.84), severe wheeze (OR = 0.59, 95% CI 0.40 to 0.85), nocturnal cough (OR = 0.73, 95% CI 0.65 to 0.83), chronic cough (OR = 0.75, 95% CI 0.65 to 0.88), and non-coryzal rhinitis (OR = 0.72, 95% CI 0.63 to 0.83). In the follow up study fruit intake recorded at baseline was a strong and independent predictor of all symptoms investigated except noncoryzal rhinitis. In most cases the protective eVect was evident even among children whose intake of fruit was only 1-2 times per week and no clear dose-response relationship was found. The eVect was stronger (although not significantly so (p = 0.13)) in subjects with a history of asthma; those eating fresh fruit at least once a week experienced a lower one year occurrence of wheeze (29.3%) than those eating fruit less than once per week (47.1%) (OR = 0.46, 95% CI 0.27 to 0.81). Conclusions-Although the eVect of other dietary components cannot be excluded, it is concluded that the consumption of fruit rich in vitamin C, even at a low level of intake, may reduce wheezing symptoms in childhood, especially among already susceptible individuals.

Research paper thumbnail of Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children

Thorax, 2000

Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in se... more Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in several studies. The epidemiological evidence of the eVect on respiratory symptoms and asthma is limited. The consumption of fruit rich in vitamin C was examined in relation to wheezing and other respiratory symptoms in cross sectional and follow up studies of Italian children. Methods-Standardised respiratory questionnaires were filled in by parents of 18 737 children aged 6-7 years living in eight areas of Northern and Central Italy. The winter intake of citrus fruit and kiwi fruit by the children was categorised as less than once per week, 1-2 per week, 3-4 per week, and 5-7 per week. A subset of 4104 children from two areas was reinvestigated after one year using a second parental questionnaire to record the occurrence of wheezing symptoms over the intervening period. Results-In the cross sectional analysis, after controlling for several confounders (sex, study area, paternal education, household density, maternal smoking, paternal smoking, dampness or mould in the child's bedroom, parental asthma), intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months (odds ratio (OR) = 0.66, 95% confidence intervals (CI) 0.55 to 0.78, for those eating fruit 5-7 times per week compared with less than once per week), shortness of breath with wheeze (OR = 0.68, 95% CI 0.56 to 0.84), severe wheeze (OR = 0.59, 95% CI 0.40 to 0.85), nocturnal cough (OR = 0.73, 95% CI 0.65 to 0.83), chronic cough (OR = 0.75, 95% CI 0.65 to 0.88), and non-coryzal rhinitis (OR = 0.72, 95% CI 0.63 to 0.83). In the follow up study fruit intake recorded at baseline was a strong and independent predictor of all symptoms investigated except noncoryzal rhinitis. In most cases the protective eVect was evident even among children whose intake of fruit was only 1-2 times per week and no clear dose-response relationship was found. The eVect was stronger (although not significantly so (p = 0.13)) in subjects with a history of asthma; those eating fresh fruit at least once a week experienced a lower one year occurrence of wheeze (29.3%) than those eating fruit less than once per week (47.1%) (OR = 0.46, 95% CI 0.27 to 0.81). Conclusions-Although the eVect of other dietary components cannot be excluded, it is concluded that the consumption of fruit rich in vitamin C, even at a low level of intake, may reduce wheezing symptoms in childhood, especially among already susceptible individuals.

Research paper thumbnail of Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2)

Environmental Health, 2009

Background: Epidemiological studies have provided evidence that exposure to vehicular traffic inc... more Background: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure.

Research paper thumbnail of Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2)

Environmental Health, 2009

Background: Epidemiological studies have provided evidence that exposure to vehicular traffic inc... more Background: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure.

Research paper thumbnail of Quality Control of Spirometry in the Elderly

Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multice... more Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly (⩾ 65 yr). The factors determining this quality were also evaluated. ...

Research paper thumbnail of Quality Control of Spirometry in the Elderly

Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multice... more Abstract We evaluated the outcome of the spirometry quality control program of the SA. RA multicenter project, the aim of which is the multidimensional assessment of asthma and COPD in the elderly (⩾ 65 yr). The factors determining this quality were also evaluated. ...

Research paper thumbnail of Accuracy of a pulse oximeter in the measurement of the oxyhaemoglobin saturation

The European respiratory journal, 1998

The aim of the present study was to evaluate the accuracy, in comparison with a reference method,... more The aim of the present study was to evaluate the accuracy, in comparison with a reference method, of the Nellcor N-20P pulse oximeter in the assessment of oxyhaemoglobin saturation (Sa,O2). Sa,O2 was monitored at rest by the Nellcor N-20P pulse oximeter in 100 subjects (82 males, mean age 68+/-12 yrs) consecutively enroled. At the same time, an arterial blood sample was collected for the measurement of Sa,O2, carboxyhaemoglobin, and methaemoglobin by an IL-282 Co-oximeter. A significant difference was found between Sa,O2 values measured with the two methods (t=11.78, p<0.05), but the two series of measurements were significantly correlated (r=0.97). Both the level and the limits of agreement between the two methods were satisfactory when the more appropriate Bland and Altman method was applied. Nevertheless, a lack of accuracy of the pulse oximeter was found, but only for Sa,O2 values <82% and >94%, as demonstrated by the Youden index. In conclusion, these data show that Ne...

Research paper thumbnail of Accuracy of a pulse oximeter in the measurement of the oxyhaemoglobin saturation

The European respiratory journal, 1998

The aim of the present study was to evaluate the accuracy, in comparison with a reference method,... more The aim of the present study was to evaluate the accuracy, in comparison with a reference method, of the Nellcor N-20P pulse oximeter in the assessment of oxyhaemoglobin saturation (Sa,O2). Sa,O2 was monitored at rest by the Nellcor N-20P pulse oximeter in 100 subjects (82 males, mean age 68+/-12 yrs) consecutively enroled. At the same time, an arterial blood sample was collected for the measurement of Sa,O2, carboxyhaemoglobin, and methaemoglobin by an IL-282 Co-oximeter. A significant difference was found between Sa,O2 values measured with the two methods (t=11.78, p<0.05), but the two series of measurements were significantly correlated (r=0.97). Both the level and the limits of agreement between the two methods were satisfactory when the more appropriate Bland and Altman method was applied. Nevertheless, a lack of accuracy of the pulse oximeter was found, but only for Sa,O2 values <82% and >94%, as demonstrated by the Youden index. In conclusion, these data show that Ne...

Research paper thumbnail of Parental smoking and lung function: Misclassification due to background exposure to passive smoking

We evaluated the role played by background exposure (i.e. exposure to Environmental Tobacco Smoke... more We evaluated the role played by background exposure (i.e. exposure to Environmental Tobacco Smoke, ETS, from sources other than parental smoking) when evaluating the effect of parental smoking on lung function of adolescents. We performed a cross-sectional survey (937 adolescents) in the Lazio Region. Data were collected by a questionnaire, lung function tests and urinary cotinine to creatinine ratios (CCR) were measured. We found that 62.1% of subjects were exposed to current parental smoke. Among the 355 adolescents not exposed to parental smoke, a total of 92 (25.9%) had CCR levels greater than the median value of the distribution (17.3 ng/mg). Subjects with smoking parents had higher FVC and significant lower FEV(1)/FVC ratios than subjects without smoking parents. When &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Background&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; ETS exposure was removed from the unexposed group by separately studying those without parental exposure but with CCR&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;17.3, results showed a reduction in lung function due to parental smoking which is greater compared to the previous model. Our study adds further evidence regarding the detrimental effect of ETS on lung function of adolescents. Negative results on the effect of parental smoking on lung function should be revisited if background exposure has not been considered in the analysis.

Research paper thumbnail of The MASTER registry on venous thromboembolism: Description of the study cohort

Thrombosis Research, 2008

Research paper thumbnail of The MASTER registry on venous thromboembolism: Description of the study cohort

Thrombosis Research, 2008

Research paper thumbnail of Questionnaire Data as Predictors of Urinary Cotinine Levels among Nonsmoking Adolescents

Archives of Environmental Health: An International Journal, 1993

The strength of association between urinary cotinine and questionnaire data on passive smoking am... more The strength of association between urinary cotinine and questionnaire data on passive smoking among 542 adolescents was evaluated. There were 103 individuals with urinary cotinine higher than 30 ng/ml; they were compared with all other subjects. The single variable that best predicted the urinary cotinine level was maternal smoking. A strong effect was made by house size and, consequently, house crowding. Maternal smoking and house crowding had a synergic effect. The subject&#39;s perception of passive smoking at home also was an independent indication of a high cotinine level. The final model had a fairly good sensitivity, whereas the specificity was somewhat lower. The results suggest that maternal smoking, house crowding, and subject&#39;s perception of a smoky environment could be surrogate indices of high passive smoking exposure in this age group and could be useful for epidemiologic studies.

Research paper thumbnail of Questionnaire Data as Predictors of Urinary Cotinine Levels among Nonsmoking Adolescents

Archives of Environmental Health: An International Journal, 1993

The strength of association between urinary cotinine and questionnaire data on passive smoking am... more The strength of association between urinary cotinine and questionnaire data on passive smoking among 542 adolescents was evaluated. There were 103 individuals with urinary cotinine higher than 30 ng/ml; they were compared with all other subjects. The single variable that best predicted the urinary cotinine level was maternal smoking. A strong effect was made by house size and, consequently, house crowding. Maternal smoking and house crowding had a synergic effect. The subject&#39;s perception of passive smoking at home also was an independent indication of a high cotinine level. The final model had a fairly good sensitivity, whereas the specificity was somewhat lower. The results suggest that maternal smoking, house crowding, and subject&#39;s perception of a smoky environment could be surrogate indices of high passive smoking exposure in this age group and could be useful for epidemiologic studies.

Research paper thumbnail of Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis

Background: A progressive lung disease and a worse survival have been observed in patients with s... more Background: A progressive lung disease and a worse survival have been observed in patients with systemic sclerosis and alveolitis. The objective of this study was to define the functional, radiological and biological markers of alveolitis in SSc patients.

Research paper thumbnail of Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis

Background: A progressive lung disease and a worse survival have been observed in patients with s... more Background: A progressive lung disease and a worse survival have been observed in patients with systemic sclerosis and alveolitis. The objective of this study was to define the functional, radiological and biological markers of alveolitis in SSc patients.

Research paper thumbnail of Repeatability of the ISAAC video questionnaire and its accuracy against a clinical diagnosis of asthma

Respiratory Medicine, 2000

The objective of the study was to evaluate the performance of the International Study of Asthma a... more The objective of the study was to evaluate the performance of the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire in terms of repeatability and accuracy against a clinical diagnosis of asthma achieved according to the National Heart, Lung and Blood Institute (NHLBI) algorithm.

Research paper thumbnail of Repeatability of the ISAAC video questionnaire and its accuracy against a clinical diagnosis of asthma

Respiratory Medicine, 2000

The objective of the study was to evaluate the performance of the International Study of Asthma a... more The objective of the study was to evaluate the performance of the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire in terms of repeatability and accuracy against a clinical diagnosis of asthma achieved according to the National Heart, Lung and Blood Institute (NHLBI) algorithm.

Research paper thumbnail of Correlates of osteoporosis in chronic obstructive pulmonary disease

Respiratory Medicine, 2000

The aim of this study was to analyse the correlates of reduced bone mineral density in patients w... more The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.

Research paper thumbnail of Correlates of osteoporosis in chronic obstructive pulmonary disease

Respiratory Medicine, 2000

The aim of this study was to analyse the correlates of reduced bone mineral density in patients w... more The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.

Research paper thumbnail of Practical management problems of stable chronic obstructive pulmonary disease in the elderly

Current Opinion in Pulmonary Medicine, 2011

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent and increasing health p... more Chronic obstructive pulmonary disease (COPD) is one of the most prevalent and increasing health problems in the elderly on a worldwide scale. The management of COPD in older patients presents practical diagnostic and treatment issues, which are reviewed with reference to the stable stage of the disease. In the diagnostic approach of COPD in the elderly the use of spirometry is recommended, but both patient conditions (such as inability to correctly perform it due to fatigue, lack of coordination, and cognitive impairment) and metrics characteristics should be taken into account for the test performance. It has been demonstrated in population studies that the use of the fixed ratio determines a substantial overdiagnosis of COPD in the oldest patients. Other parameters have been suggested [such as the evaluation of Lower Limit of Normality (LLN) for the FEV1/FVC ratio], which may be useful to guide the diagnosis. Several nonpharmacologic - such as smoking cessation, vaccination, physical activity, and pulmonary rehabilitation, nutrition, and eventually invasive ventilation - and pharmacologic interventions have been shown to improve outcomes and have been reviewed. Effective management of COPD in older adults should always consider the ability of patients to properly use inhalers and the involvement of caregivers or family members as a useful support to care, especially when treating cognitively impaired patients. Especially in the older population, timely identification and treatment of comorbidities are also crucial, but evidence in this area is still lacking and clinical practice guidelines do not take comorbidities into account in their recommendations. The Global Initiative for Obstructive Lung Disease has recommended criteria for diagnosis and management of COPD in the general population. On the contrary, available evidence suggests practical limitations in diagnostic approach and intervention strategies in older patients with stable COPD that need to be further studied for a translation into clinical practice guidelines.

Research paper thumbnail of Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children

Thorax, 2000

Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in se... more Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in several studies. The epidemiological evidence of the eVect on respiratory symptoms and asthma is limited. The consumption of fruit rich in vitamin C was examined in relation to wheezing and other respiratory symptoms in cross sectional and follow up studies of Italian children. Methods-Standardised respiratory questionnaires were filled in by parents of 18 737 children aged 6-7 years living in eight areas of Northern and Central Italy. The winter intake of citrus fruit and kiwi fruit by the children was categorised as less than once per week, 1-2 per week, 3-4 per week, and 5-7 per week. A subset of 4104 children from two areas was reinvestigated after one year using a second parental questionnaire to record the occurrence of wheezing symptoms over the intervening period. Results-In the cross sectional analysis, after controlling for several confounders (sex, study area, paternal education, household density, maternal smoking, paternal smoking, dampness or mould in the child's bedroom, parental asthma), intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months (odds ratio (OR) = 0.66, 95% confidence intervals (CI) 0.55 to 0.78, for those eating fruit 5-7 times per week compared with less than once per week), shortness of breath with wheeze (OR = 0.68, 95% CI 0.56 to 0.84), severe wheeze (OR = 0.59, 95% CI 0.40 to 0.85), nocturnal cough (OR = 0.73, 95% CI 0.65 to 0.83), chronic cough (OR = 0.75, 95% CI 0.65 to 0.88), and non-coryzal rhinitis (OR = 0.72, 95% CI 0.63 to 0.83). In the follow up study fruit intake recorded at baseline was a strong and independent predictor of all symptoms investigated except noncoryzal rhinitis. In most cases the protective eVect was evident even among children whose intake of fruit was only 1-2 times per week and no clear dose-response relationship was found. The eVect was stronger (although not significantly so (p = 0.13)) in subjects with a history of asthma; those eating fresh fruit at least once a week experienced a lower one year occurrence of wheeze (29.3%) than those eating fruit less than once per week (47.1%) (OR = 0.46, 95% CI 0.27 to 0.81). Conclusions-Although the eVect of other dietary components cannot be excluded, it is concluded that the consumption of fruit rich in vitamin C, even at a low level of intake, may reduce wheezing symptoms in childhood, especially among already susceptible individuals.

Research paper thumbnail of Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children

Thorax, 2000

Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in se... more Background-A beneficial eVect of fresh fruit consumption on lung function has been observed in several studies. The epidemiological evidence of the eVect on respiratory symptoms and asthma is limited. The consumption of fruit rich in vitamin C was examined in relation to wheezing and other respiratory symptoms in cross sectional and follow up studies of Italian children. Methods-Standardised respiratory questionnaires were filled in by parents of 18 737 children aged 6-7 years living in eight areas of Northern and Central Italy. The winter intake of citrus fruit and kiwi fruit by the children was categorised as less than once per week, 1-2 per week, 3-4 per week, and 5-7 per week. A subset of 4104 children from two areas was reinvestigated after one year using a second parental questionnaire to record the occurrence of wheezing symptoms over the intervening period. Results-In the cross sectional analysis, after controlling for several confounders (sex, study area, paternal education, household density, maternal smoking, paternal smoking, dampness or mould in the child's bedroom, parental asthma), intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months (odds ratio (OR) = 0.66, 95% confidence intervals (CI) 0.55 to 0.78, for those eating fruit 5-7 times per week compared with less than once per week), shortness of breath with wheeze (OR = 0.68, 95% CI 0.56 to 0.84), severe wheeze (OR = 0.59, 95% CI 0.40 to 0.85), nocturnal cough (OR = 0.73, 95% CI 0.65 to 0.83), chronic cough (OR = 0.75, 95% CI 0.65 to 0.88), and non-coryzal rhinitis (OR = 0.72, 95% CI 0.63 to 0.83). In the follow up study fruit intake recorded at baseline was a strong and independent predictor of all symptoms investigated except noncoryzal rhinitis. In most cases the protective eVect was evident even among children whose intake of fruit was only 1-2 times per week and no clear dose-response relationship was found. The eVect was stronger (although not significantly so (p = 0.13)) in subjects with a history of asthma; those eating fresh fruit at least once a week experienced a lower one year occurrence of wheeze (29.3%) than those eating fruit less than once per week (47.1%) (OR = 0.46, 95% CI 0.27 to 0.81). Conclusions-Although the eVect of other dietary components cannot be excluded, it is concluded that the consumption of fruit rich in vitamin C, even at a low level of intake, may reduce wheezing symptoms in childhood, especially among already susceptible individuals.

Research paper thumbnail of Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2)

Environmental Health, 2009

Background: Epidemiological studies have provided evidence that exposure to vehicular traffic inc... more Background: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure.

Research paper thumbnail of Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2)

Environmental Health, 2009

Background: Epidemiological studies have provided evidence that exposure to vehicular traffic inc... more Background: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure.