Asti Hospital

Asti, Italy

Asti Hospital

Asti, Italy
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D'Andrea G.,Research and Innovation R&I s.r.l. | Bussone G.,C Besta Neurological Institute Irccs Foundation | Di Fiore P.,C Besta Neurological Institute Irccs Foundation | Perini F.,Vicenza Hospital | And 7 more authors.
Neurological Sciences | Year: 2017

The aim of this study was to explore the possible role of tryptamine in the pathogenesis of chronic cluster headache along with that of adrenaline and noradrenaline (α-agonists) together with arginine metabolism in the origin of cluster bouts. Plasma levels of tyramine, tryptamine, serotonin, 5-hydroxyindolacetic acid, noradrenalin, adrenalin and the markers of arginine metabolism such as arginine, homoarginine, citrulline, ADMA and NMMA, were measured in 23 chronic cluster headache patients (10 chronic cluster ab initio and 13 transformed from episodic cluster) and 28 control subjects. The plasma levels of tyramine, tryptamine, noradrenalin and adrenalin were found several times higher in chronic cluster headache patients compared to controls, whereas the plasma levels of arginine, homoarginine and citrulline were significantly lower. No differences were found in the plasma levels of serotonin, 5-hydroxyindolacetic, ADMA and NMMA between chronic cluster headache patients and control subjects. These results provide support for a role of tryptamine in the pathogenesis of chronic cluster headache and, in particular, in the duration of the cluster bouts. In addition, the low levels of the nitric oxide substrates together with the high levels of noradrenalin and adrenalin suggest an activation of endothelial TAAR1 receptors followed by the release of nitric oxide in the circulation that may constitute the final step of the physiopathology of cluster crisis. © 2017, Springer-Verlag Italia.


D'Andrea G.,Research and Innovation RandI S.r.l. | Leone M.,C Besta Neurological Institute Irccs Foundation | Bussone G.,C Besta Neurological Institute Irccs Foundation | Fiore P.D.,C Besta Neurological Institute Irccs Foundation | And 8 more authors.
Cephalalgia | Year: 2017

Objective Episodic cluster headache is characterized by abnormalities in tyrosine metabolism (i.e. elevated levels of dopamine, tyramine, octopamine and synephrine and low levels of noradrenalin in plasma and platelets.) It is unknown, however, if such biochemical anomalies are present and/or constitute a predisposing factor in chronic cluster headache. To test this hypothesis, we measured the levels of dopamine and noradrenaline together with those of elusive amines, such as tyramine, octopamine and synephrine, in plasma of chronic cluster patients and control individuals. Methods Plasma levels of dopamine, noradrenaline and trace amines, including tyramine, octopamine and synephrine, were measured in a group of 23 chronic cluster headache patients (10 chronic cluster ab initio and 13 transformed from episodic cluster), and 16 control participants. Results The plasma levels of dopamine, noradrenaline and tyramine were several times higher in chronic cluster headache patients compared with controls. The levels of octopamine and synephrine were significantly lower in plasma of these patients with respect to control individuals. Conclusions These results suggest that anomalies in tyrosine metabolism play a role in the pathogenesis of chronic cluster headache and constitute a predisposing factor for the transformation of the episodic into a chronic form of this primary headache. © International Headache Society.


Tassorelli C.,National Neurological Institute C Mondino | Tassorelli C.,University of Pavia | Aguggia M.,Asti Hospital | De Tommaso M.,University of Bari | And 8 more authors.
Journal of Headache and Pain | Year: 2017

Background: Chronic migraine is a complex clinical condition often undertreated. Onabotulinumtoxin A (OBT-A) was approved in Italy in 2013 for symptom relief in patients with chronic migraine who have failed, or do not tolerate, oral prophylactic treatments. However, the impact of OBT-A in clinical practice remains to be defined. Methods: To investigate the current management of chronic migraine with OBT-A in clinical practice, a web-based survey was conducted among clinicians working in third-level headache centers across Italy. A 26-item questionnaire was designed and developed by a group of 10 Italian headache specialists to address the following issues: treatment paradigm and OBT-A injection intervals, frequency of treatment and retreatment, definition of responders/non-responders, satisfaction with treatment potential impact of early treatment with OBT-A. Ninety-six headache centers were selected and contacted via e-mail. The online survey was anonymous and carried out using a secure website. Results: Overall, 64 of the 96 centers (66.7%) completed the questionnaire. Most centers (98.4%) had been using OBT-A for >1 year. OBT-A was administered according to the PREEMPT paradigm in most centers (88.9%). While during the first year of prophylaxis with OBT-A most clinicians (93.6%) repeated OBT-A treatment every 3 months, as recommended, in the following years interval duration was variable. Response to OBT-A was defined as a ≥ 50% reduction in the headache days by 58.7% of the clinicians, and as a ≥ 30% reduction by 25.4% of them. Almost 60% of the clinicians considered OBT-A as a long-lasting therapy, while for one-third of them treatment could be discontinued in patients showing a benefit for ≥6 months. According to 80% of the clinicians, early administration of OBT-A after the onset of chronic migraine was associated with better outcomes, and 47.6% felt that OBT-A should be recommended as a first-line option. Conclusions: This survey indicates that in third-level headache centers in Italy OBT-A is used in good compliance with current recommendations. There is agreement about the definition of response as a reduction in headache days by 30% to 50%. Additional effort is required to define response to OBT-A and to establish optimal treatment duration. © 2017, The Author(s).


D'Andrea G.,Research and Innovation RandI S.r.l. | D'Amico D.,C Besta Neurological Institute Irccs Foundation | Bussone G.,C Besta Neurological Institute Irccs Foundation | Bolner A.,Research and Innovation RandI S.r.l. | And 8 more authors.
Cephalalgia | Year: 2013

Objective: The pathogenesis of chronic migraine (CM) remains largely unknown. We hypothesized that anomalies of tyrosine metabolism, found in migraine without aura (MwwA) patients, play an important role in the transformation of MwwA into CM, since the increase in the number of MwwA attacks is the most predisposing factor for the occurrence of CM. Methods: To test our hypothesis we measured the plasma levels of dopamine (DA), noradrenaline (NE) and trace amines, including tyramine (TYR) and octopamine (OCT), in a group of 73 patients with CM, 13 patients with chronic tensiontype headache (CTTH) and 37 controls followed in the Headache Centers of the Neurology Departments of Asti, Milan and Vicenza hospitals in Italy. Results: The plasma levels of DA and NE were several-fold higher in CM patients compared with control subjects (p>0.001). The plasma levels of TYR were also extremely elevated (p>0.001); furthermore, these levels progressively increased with the duration of the CM. Conclusions: Our data support the hypothesis that altered tyrosine metabolism plays an important role in the pathogenesis of CM. The high plasma levels of TYR, a potent agonist of the trace amine associated receptors type 1 (TAAR1), may ultimately down-regulate this receptor because of loss of inhibitory presynaptic regulation, therein resulting in uncontrolled neurotransmitter release. This may produce functional metabolic consequences in the synaptic clefts of the pain matrix implicated in CM. © 2013 International Headache Society.


D'Amico D.,Neurological Institute IRCCS Foundation | Bussone G.,Neurological Institute IRCCS Foundation | Aguggia M.,Asti Hospital | Saracco M.G.,Asti Hospital | And 3 more authors.
Neurological Sciences | Year: 2014

The primary aim of this study (TA-CH, Tryptophan Amine in Chronic Headache) was to investigate a possible role of tryptophan (TRP) metabolism in chronic migraine (CM) and chronic tension-type headache (CTTH). It is not known if TRP metabolism plays any role in CM and/or CTTH. Plasma levels of serotonin (5-HT), 5-hydroxyindolacetic acid (5-HIAA), metabolite of 5-HT, and tryptamine (TRY) were tested in 73 patients with CM, 15 patients with CTTH and 37 control subjects. Of these, plasmatic TRY was significantly lower in CM (p < 0.001) and in CTTH (p < 0.002) patients with respect to control subjects, while 5-HIAA levels in plasma were within the same range in all groups. 5-HT was undetectable in the plasma of almost all subjects. Our results support the hypothesis that TRP metabolism is altered in CM and CTTH patients, leading to a reduction in plasma TRY. As TRY modulates the function of pain matrix serotonergic system, this may affect modulation of incoming nociceptive inputs from the trigeminal endings and posterior horns of the spinal cord. We suggest that these biochemical abnormalities play a role in the chronicity of CM and CTTH. © 2014, Springer-Verlag Italia.


Tonini M.C.,G Salvini Hospital | Tonini M.C.,G Salvini Hospital Garbagnate Mse Mi | Giordano L.,Mario Negri Institute for Pharmacological Research | Atzeni L.,San Gerardo Hospital | And 28 more authors.
Epilepsy and Behavior | Year: 2012

The prevalence and characteristics of interictal headache, epilepsy and headache/epilepsy comorbidity were assessed in 858 women and 309 men aged 18-81. years from headache and epilepsy centers in Italy. The research hypothesis was that comorbidity among patients with either disorder would be expected to be higher than in the general population.Interictal headache was diagnosed in 675 cases (migraine 482; tension-type headache 168; other types 25), epilepsy in 336 (partial 171; generalized 165) and comorbidity in 156 (1.6% from headache centers; 30.0% from epilepsy centers). Patients with epilepsy, headache and comorbidity differed in a number of demographic and clinical aspects. However, for both headache and epilepsy, a family history of the same clinical condition was equally prevalent in patients with and without comorbidity. These findings do not support the purported association between headache and epilepsy. © 2012 Elsevier Inc.


Zicari G.,Chieri Hospital | Marro S.,Chieri Hospital | Panata M.,Chieri Hospital | Soardo V.,Asti Hospital | And 5 more authors.
Progress in Nutrition | Year: 2014

Background: The Italian national regulations, to verify the suitability of water intended for human consumption, require the monitoring of a concentration of about 70 chemical, physical and microbiological parameters. In Piedmont, where 4,357,663 residents are divided into 1,207 municipalities (2012), analytical monitoring is implemented by 12 local health authorities in collaboration with the laboratories of the Regional Agency for Environmental Protection. Objectives: We present the results of monitoring the quality of water intended for human consumption implemented by the Health Service and other information provided by the Managers of the water service. Methods: The official results of the analytical control of water intended for human consumption are recorded in Regional Health Service databases. These databases also collect information on the managers of the water service and the characteristics of the distribution network. Results: Most of the 2,222 water networks in Piedmont can serve up to 500 people and less than 40 networks could provide a sufficient quantity of water to meet all regional households demands. The Local Health Authorities make at least 21,000 samples of water per year, by some of the 8,478 sites selected for sampling, mainly in the terminal part of the distribution network. In the years 2008-2012, it have been implemented 790,306 analytical determinations about 74 different parameters, including 23 residues of plant protection products. The highest fraction of non-compliant parameters, taken over by some local health authorities, was equal to 2% of the researches which were carried out. Among the parameters that do not comply, it should be noted: coliform bacteria at 37°C, Clostridium perfringens, Escherichia coli, aluminum, arsenic, iron, manganese, nitrates and sulfates; atrazine, bentazone, desethylatrazine, metolachlor and terbuthylazine. Conclusions and recommendations: The management of the analytical control officer provides annual regional planning that could be improved by making it more flexible and adaptable to different local contexts. © Mattioli 1885


PubMed | Health service consultant and corresponding author., Asti Hospital and Chieri Hospital
Type: Journal Article | Journal: Igiene e sanita pubblica | Year: 2014

Italian legislation (Article 13 of Legislative Decree 31/2001) provides for the possibility of establishing derogations from chemical parametric values for drinking water set by EU legislation (Council Directive 98/83/EC), if the supply of drinking water cannot be maintained by any other reasonable means. A derogation is possible only after obtaining a specific authorization and must be limited to the shortest time possible. This paper presents the history of derogations granted in Italy and the case of arsenic and nickel in Piedmont. From 2003 to 2009, 13 regions requested a derogation (Campania, Emilia Romagna, Latium, Lombardy, Marche, Piedmont, Apulia, Sardinia, Sicily, Tuscany, Trentino Alto Adige, Umbria, Venetia) at different times and for a total of 13 parameters. In 2012, tap water provided to almost one million Italians in 112 municipalities of three regions (Latium, Tuscany and Campania), did not comply with the legal limits for the following parameters: arsenic, boron and fluorides. Currently, in the Piedmont region there are no derogations from the maximum permitted concentrations of contaminants in drinking water. In the past derogations have been applied for the nickel parameter (years 2006-2007) and from the arsenic parameter (years 2006-2008).


Soardo V.,Asti Hospital | Rivetti D.,Asti Hospital
Progress in Nutrition | Year: 2013

The agronomic spreading of livestock manure is almost exclusively carried out considering the nitrogen and a few other crop nutrients such as phosphorus and potassium. The contaminants that can be found in manure are different: pathogens, drug residues, heavy metals such as copper and zinc. These could lead to contamination of water, soil and food. In some areas, due to the presence of farms, the probability of increasing the risks to health and the environment increase.The contribution of manure, such as to distribute the maximum amount of nitrogen fixed by the regulations, may result in increased concentrations of unwanted substances at levels higher than those naturally present in soil and water. It is estimated that in Piedmont, for every 10,000 square meters of agricultural land, we have the availability of manure derived from 2 cows, 3 pigs, 22 chickens and 700 kg of compost from municipal solid waste and up to 200 kg of sludge from wastewater treatment. Still to be added chemical fertilizers and digested by anaerobic fermentation also using the dedicated crops such as corn. In this paper we examine some risks of chemical and preventive measures are proposed.


The term "Fare" indicates the payment rate that users must implement to use the service water supply. The Price for drinking water supply distinguishes between a domestic use and other types of use, such as the agricultural or the industrial one, and it is given by the sum of a fixed quota and another proportional to consumption. Method: We compared the fares of different categories of users applied by the Managers of the Water Service operating in the Province of Asti area (Piedmont, Italy), where 222,500 inhabitants live. Results: In the Province of Asti, over 13 Managers of Water Service are active to supply more than 100 water networks and in various municipalities very different prices have been applied: they can vary up to 3-4 times. Generally, the prices applied to households are more than the double of those applied to agricultural and livestock utilities, but at least 80-90 times lower than bottled water prices. In this paper, we examine the prices applied by the different municipalities in the Province of Asti and we propose strategies to modulate the costs on the basis of "efficiency and sustainability" in order to encourage savings and a better use of water resources.

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