Campobasso, Italy
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Bonaccio M.,IRCCS Instituto Neurologico Mediterraneo NEUROMED | Di Castelnuovo A.,IRCCS Instituto Neurologico Mediterraneo NEUROMED | Rago L.,EPICOMED Research Srl | De Curtis A.,IRCCS Instituto Neurologico Mediterraneo NEUROMED | And 9 more authors.
Thrombosis and Haemostasis | Year: 2015

T-wave axis deviation (TDev) may help identifying subjects at risk for major cardiac events and mortality, but the pathogenesis of TDev is not well established; in particular, the possible association between TDev and inflammation is unexplored and unknown. We aimed at investigating the association between low-grade inflammation and TDev abnormalities by conducting a cross-sectional analysis on 17,507 subjects apparently free from coronary heart and haematological diseases enrolled in the MOLI-SANI study. TDev was measured from a standard 12-lead resting electrocardiogram. High sensitivity (Hs) C-reactive protein (CRP), leukocyte (WBC) and platelet counts, neutrophil or granulocyte to lymphocyte ratios were used as markers of inflammation. In multivariable model subjects reporting high CRP levels had higher odds of having borderline and abnormal TDev (OR=1.70; 95 %CI: 1.53-1.90 and OR=1.72; 95 %CI: 1.23-2.41, respectively); the association was still significant, although reduced, after controlling for body mass index (OR=1.17; 95 %CI: 1.05-1.32, for borderline and OR=1.46; 95 %CI: 1.03-2.08, for abnormal). Similarly, higher neutrophil or granulocyte to lymphocyte ratios were associated with increased odds of having abnormal TDev. Neither platelet nor leukocyte counts were associated with abnormal TDev. The relationship between CRP with TDev abnormalities was significantly stronger in men, in non-obese or normotensive individuals, and in those without metabolic syndrome. In conclusion, C-reactive protein and some cellular biomarkers of inflammation such as granulocyte or neutrophil to lymphocyte ratios were independently associated with abnormal TDev, especially in subjects at low CVD risk. These results suggest that a low-grade inflammation likely contributes to the pathogenesis of T-wave axis deviation. © Schattauer 2015.


Bonanni A.E.,Epicomed Research Srl | Bonaccio M.,IRCCS Instituto Neurologico Medieterraneo Neuromed | di Castelnuovo A.,IRCCS Instituto Neurologico Medieterraneo Neuromed | de Lucia F.,Cuoresano Onlus | And 6 more authors.
Nutrients | Year: 2013

Mediterranean diet (MD) has been associated with lower risk of ischemic cerebro- and cardio-vascular disease, neurological degenerative disease, and breast and colonrectal cancers. Nevertheless, adherence to this pattern has decreased. Food labels are a potentially valid means to encourage towards healthier dietary behavior. This study, conducted on a subsample of 883 subjects enrolled in the Moli-sani Project, evaluated whether food labels reading (LR) is associated with MD adherence. Participants completed a questionnaire on nutrition knowledge, information, and attitudes, with a specific question on food labels reading. Biometric measurements, socio-economic status, education, physical activity, and smoking habits were collected. The European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire was used to collect dietary habits, and subsequently evaluated by both the Mediterranean diet score (MDS) and Italian Mediterranean index (IMI), a priori dietary patterns. Food consumption patterns were generated by Principal Components Analysis (PCA), an a posteriori approach. Multivariable odds ratios were calculated to quantify the association of LR categories with dietary habits. LR was significantly associated with greater adherence to both MDS (p = 0.0004) and IMI (p = 0.0019) in a multivariable model. LR participants had 74% (MDS) or 68% (IMI) higher probability to be in the highest level of adherence to Mediterranean diet-like patterns. Moreover, they showed greater adherence to Mediterranean-like food consumption patterns (0.1 vs. -0.2, p < 0.0001) and lower adherence to two Western-like patterns (0.01 vs. 0.2, p = 0.009 and 0.1 vs. 0.2, p = 0.02). These findings support an association between food label use and consuming a Mediterranean-type diet. © 2013 by the authors; licensee MDPI, Basel, Switzerland.


Bonaccio M.,IRCCS Instituto Neurologico Mediterraneo Neuromed | Di Castelnuovo A.,IRCCS Instituto Neurologico Mediterraneo Neuromed | Bonanni A.,Epicomed Research Srl | Costanzo S.,IRCCS Instituto Neurologico Mediterraneo Neuromed | And 6 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2014

Background and aims: Adherence to Mediterranean diet (MD) is reportedly declining in the last decades. We aimed to investigate the adherence to MD over the period 2005-2010 and exploring the possible role of the global economic crisis in accounting for the changing in the dietary habits in Italy. Methods and results: Cross-sectional analysis in a population-based cohort study which randomly recruited 21,001 southern Italian citizens enrolled within the Moli-sani study. Food intake was determined by the Italian EPIC food frequency questionnaire. Adherence to MD was appraised by the Italian Mediterranean Index (IMI). A wealth score was derived to evaluate the economic position and used together with other socioeconomic indicators. Highest prevalence of adherence to MD was observed during the years 2005-2006 (31.3%) while the prevalence dramatically fell down in the years 2007-2010 (18.3%; P<. 0.0001). The decrease was stronger in the elderly, less affluent groups, and among those living in urban areas. Accordingly, we observed that in 2007-2010 socioeconomic indicators were strongly associated with higher adherence to MD, whereas no association was detected in the years before the economic crisis began; both wealth score and education were major determinants of high adherence to MD with 31% (95%CI: 18-46%) higher adherence to this pattern within the wealthier group compared to the less affluent category. Conclusion: Adherence to MD has considerably decreased over the last few years. In 2007-2010 socioeconomic indicators have become major determinants of adherence to MD, a fact likely linked to the economic downturn. © 2014 Elsevier B.V.


Bonaccio M.,Catholic University of the Sacred Heart | Bonaccio M.,IRCCS Instituto Neurologico Mediterraneo Neuromed | Di Castelnuovo A.,Catholic University of the Sacred Heart | Bonanni A.,Catholic University of the Sacred Heart | And 9 more authors.
BMJ Open | Year: 2013

Objectives: Mediterranean diet (MD) is associated with a reduced risk of major chronic disease. Healthrelated quality of life (HRQL) is a valid predictor of mortality. The aim of this study is to investigate the association between MD and HRQL and to examine the possible role of dietary antioxidants, fibre content and/or fatty acid components. Design: Cross-sectional study on a sample of Italian participants enrolled in the Moli-sani Project, a population-based cohort study. Food intake was recorded by the Italian European prospective investigation into cancer and nutrition study food frequency questionnaire. Adherence to MD was appraised by a Greek Mediterranean diet score (MDS), an Italian Mediterranean diet index (IMI) and by principal component analysis (PCA). HRQL was assessed by the 36-Item Short Form Health Survey. Setting: Molise region, Italy. Participants: 16 937 participants of 24 325 Italian citizens (age=35). Main outcomes: Dietary patterns and HRQL. Results: Mental health was associated consistently and positively with MDS, IMI and an 'Olive oil and vegetable' pattern (PCA1), but negatively with an 'Eggs and sweets' pattern (PCA3). Physical health was associated positively with MDS and PCA1, but negatively with a 'Meat and pasta' pattern. Subjects with the highest MD adherence had 42% (MDS), 34% (IMI) or 59% (PCA1) statistically significant multivariable odds of being in the uppermost level of mental health, as compared with subjects in the lowest category. The associations disappeared after further adjustment for either total food antioxidant content or dietary fibre, while they were not modified by the inclusion of either monounsaturated or polyunsaturated fatty acids. Individuals in the highest PCA1 or PCA3 had significantly higher odds of being in the top level of physical health. Conclusions: Adherence to an MD pattern is associated with better HRQL. The association is stronger with mental health than with physical health. Dietary total antioxidant and fibre content independently explain this relationship.


Costanzo S.,IRCCS Instituto Neurologico Mediterraneo Neuromed | De Curtis A.,IRCCS Instituto Neurologico Mediterraneo Neuromed | Di Niro V.,Nuovo Ospedale Civile di Sassuolo | Olivieri M.,EPICOMED Research Srl | And 9 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2015

Objective Postoperative atrial fibrillation is a major cause of morbidity and mortality for stroke after cardiac surgery. Both systemic inflammation and oxidative stress play a role in the initiation of postoperative atrial fibrillation after cardiac surgery. The possible association between long-term intake of antioxidant-rich foods and postoperative atrial fibrillation incidence was examined in patients undergoing cardiac surgery. Methods A total of 217 consecutive patients (74% were men; median age, 68.4 years) undergoing cardiac surgery, mainly coronary artery bypass grafting and valve replacement or repair, were recruited from January 2010 to September 2012. Total antioxidant capacity was measured in foods by the Trolox equivalent antioxidant capacity assay. The European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary total antioxidant capacity assessment. The association among tertiles of dietary total antioxidant capacity and postoperative atrial fibrillation incidence was assessed using multivariable logistic analysis. Results The overall incidence of total arrhythmias and postoperative atrial fibrillation was 42.4% and 38.2%, respectively. In multivariable analysis, after adjustment for age, gender, use of hypoglycemic drugs, physical activity, education, previous diagnosis of atrial fibrillation, and total energy intake, patients in the highest tertile of dietary total antioxidant capacity had a lower risk of postoperative atrial fibrillation than patients in the 2 lowest tertiles (odds ratio, 0.46; 95% confidence interval, 0.22-0.95; P =.048). A restricted cubic spline transformation confirmed the nonlinear relationship between total antioxidant capacity (in continuous scale) and postoperative atrial fibrillation (P =.023). When considering only coronary artery bypass grafting, valve replacement/repair, and combined surgeries, the protective effect on postoperative atrial fibrillation of a diet rich in antioxidants was confirmed. Conclusions Long-term consumption of antioxidant-rich foods is associated with a reduced incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery. © 2015 The American Association for Thoracic Surgery.


Bonaccio M.,Research Laboratories | Di Castelnuovo A.,Research Laboratories | Costanzo S.,Research Laboratories | De Lucia F.,Research Laboratories | And 7 more authors.
Appetite | Year: 2013

A Mediterranean dietary pattern has been associated with reducing the risk of cardiovascular and chronic disease. The aim of this study was to evaluate the role of nutrition knowledge in determining possible differences among dietary patterns in a general population from a Mediterranean region. We conducted a cross-sectional study on a subsample of 744 subjects enrolled in the population-based cohort of the Moli-sani Project. A 92-item questionnaire on nutrition knowledge was elaborated, validated and administered. Dietary information were obtained from the EPIC food frequency questionnaire and adherence to a Mediterranean dietary pattern was evaluated both by the a priori Greek Mediterranean diet score and the a posteriori approach obtained by principal component analysis. Nutrition knowledge was significantly associated with higher adherence to a Mediterranean dietary pattern. The odds of having higher adherence to a Mediterranean dietary pattern increased with greater nutrition knowledge. The odds ratio of being obese significantly decreased with increasing nutrition knowledge levels. The results showed that nutrition knowledge was significantly associated with higher adherence to a Mediterranean dietary pattern and with lower prevalence of obesity in a Southern Italian region with Mediterranean diet tradition independently from education and other socioeconomic factors. © 2013 Elsevier Ltd.


Simona C.,IRCCS Instituto Neurologico Mediterraneo Neuromed | de Katleen G.D.,Catholic University | Lara C.,Catholic University | Olivieri M.,EPICOMED Research srl | And 4 more authors.
Epidemiology Biostatistics and Public Health | Year: 2014

Background: Influenza vaccination protects high-risk populations from severe outcomes.Methods: During the 2011-2012 flu season at "Gemelli Hospital" in Rome, all hospitalised patients who developed suspected influenza-like illness within 14 days were recruited to assess the feasibility of testing the influenza vaccine effectiveness against laboratory-confirmed influenza requiring hospitalisation.Conclusions: No difference in vaccine status between patients with positive and negative laboratory tests was found due to the small sample size. Larger numbers are required to explore influenza vaccine effectiveness.Results: Sixty-two patients were recruited; among them, 18 were laboratory confirmed for influenza A or B. In the target group for vaccination (N=47), the prevalence of vaccinated subjects was less than expected (38%). © 2014 Prex S.p.A. All right reserved.


Iacoviello L.,IRCCS Instituto Neurologico Mediterraneo | Di Castelnuovo A.,IRCCS Instituto Neurologico Mediterraneo | Rago L.,Epicomed Research S.r.l. | Vaglio M.,AMPS LLC | And 4 more authors.
2014 8th Conference of the European Study Group on Cardiovascular Oscillations, ESGCO 2014 | Year: 2014

Computerized electrocardiogram (ECG) may be extremely useful to develop new tools for the definition of the risk and the prevention of cardiovascular disease. The Moli-sani project (http://www.moli-sani.org) is a population-based cohort study that recruited over 24.000 men and women, aged >35 year, from the general population. The aim was the evaluation of risk factors linked to chronic-degenerative disease with particular regard to cardiovascular disease and cancer and intermediate metabolic phenotypes such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome. Standard 12-lead resting ECG was performed by a Cardiette ar2100-view electrocardiograph and tracings stored in digital standard communication protocol format for subsequent analysis. The digital ECG database of the Moli-sani project is currently being used to assess the association between physiologic variables, pathophysiologic conditions such as hypertension, diabetes and obesity and parameters derived from the ECG signal. This is a comprehensive review of the database and of the results until now obtained with its analysis. © 2014 IEEE.


PubMed | Epicomed Research Srl
Type: Journal Article | Journal: Nutrients | Year: 2013

Mediterranean diet (MD) has been associated with lower risk of ischemic cerebro- and cardio-vascular disease, neurological degenerative disease, and breast and colonrectal cancers. Nevertheless, adherence to this pattern has decreased. Food labels are a potentially valid means to encourage towards healthier dietary behavior. This study, conducted on a subsample of 883 subjects enrolled in the Moli-sani Project, evaluated whether food labels reading (LR) is associated with MD adherence. Participants completed a questionnaire on nutrition knowledge, information, and attitudes, with a specific question on food labels reading. Biometric measurements, socio-economic status, education, physical activity, and smoking habits were collected. The European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire was used to collect dietary habits, and subsequently evaluated by both the Mediterranean diet score (MDS) and Italian Mediterranean index (IMI), a priori dietary patterns. Food consumption patterns were generated by Principal Components Analysis (PCA), an a posteriori approach. Multivariable odds ratios were calculated to quantify the association of LR categories with dietary habits. LR was significantly associated with greater adherence to both MDS (p = 0.0004) and IMI (p = 0.0019) in a multivariable model. LR participants had 74% (MDS) or 68% (IMI) higher probability to be in the highest level of adherence to Mediterranean diet-like patterns. Moreover, they showed greater adherence to Mediterranean-like food consumption patterns (0.1 vs. -0.2, p < 0.0001) and lower adherence to two Western-like patterns (0.01 vs. 0.2, p = 0.009 and 0.1 vs. 0.2, p = 0.02). These findings support an association between food label use and consuming a Mediterranean-type diet.


Rondy M.,EpiConcept | Launay O.,Cochin hospital | Launay O.,French Institute of Health and Medical Research | Puig-Barbera J.,Vaccines Research | And 87 more authors.
Eurosurveillance | Year: 2015

While influenza vaccines aim to decrease the incidence of severe influenza among high-risk groups, evidence of influenza vaccine effectiveness (IVE) among the influenza vaccine target population is sparse. We conducted a multicentre test-negative case–control study to estimate IVE against hospitalised laboratoryconfirmed influenza in the target population in 18 hospitals in France, Italy, Lithuania and the Navarre and Valencia regions in Spain. All hospitalised patients aged ≥18 years, belonging to the target population presenting with influenza-like illness symptom onset within seven days were swabbed. Patients positive by reverse transcription polymerase chain reaction for influenza virus were cases and those negative were controls. Using logistic regression, we calculated IVE for each influenza virus subtype and adjusted it for month of symptom onset, study site, age and chronic conditions. Of the 1,972 patients included, 116 were positive for influenza A(H1N1)pdm09, 58 for A(H3N2) and 232 for influenza B. Adjusted IVE was 21.3% (95% confidence interval (CI): -25.2 to 50.6; n=1,628), 61.8% (95% CI: 26.8 to 80.0; n=557) and 43.1% (95% CI: 21.2 to 58.9; n=1,526) against influenza A(H1N1) pdm09, A(H3N2) and B respectively. Our results suggest that the 2012/13 IVE was moderate against influenza A(H3N2) and B and low against influenza A(H1N1) pdm09. © 2015, European Centre for Disease Prevention and Control (ECDC). All rights reserved.

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