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Arpaia P.,University of Sannio | Manna C.,University of Naples Federico II | Montenero G.,University of Sannio | D'Addio G.,Rehabilitation Institute of Telese
IEEE Sensors Journal | Year: 2012

A swarm intelligence-based procedure to detect critical conditions of a patient, affected by a specific disease, at an early stage in absence of clinician, is proposed. The procedure is to be integrated inside a remote health care system for patients at home, where some physiological parameters related to a specific disease are being monitored. A significant variation in the monitored parameters can lead the patient to a critical state, thus the proposed method is aimed at predicting a possible future bad condition of the patient on the basis of past measurements. Moreover, different physiological parameters contribute to diverse degrees in dissimilar diseases; consequently, a swarm intelligence-based method is proposed for optimizing the weight of each parameter for a more accurate diagnosis. The proposed approach has been validated experimentally under the framework of the industrial research project Patient Diagnosis and Monitoring at Domicile (PADIAMOND: co-funded by EU and the company Filia srl, Caserta, Italy). © 2011 IEEE.

Fuschillo S.,Rehabilitation Institute of Telese | Martucci M.,Rehabilitation Institute of Telese | Donner C.F.,Mondo Medico | Balzano G.,Rehabilitation Institute of Telese
Respiratory Medicine | Year: 2012

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and, according to the World Health Organization, its prevalence will double by 2020. COPD is a chronic inflammatory disease of the lung characterized by poorly reversible airflow limitation and, frequently, by extrapulmonary manifestations. In particular, the cardiovascular manifestations are responsible for high morbidity and mortality. Methods and results: A systematic literature search was performed of studies published in Medline until December 2010, using the key-words: COPD, bacterial colonization, COPD exacerbation, atherosclerosis, systemic inflammation, cardiovascular event and risk factors. In addition to the studies identified in the primary search, reference lists of included articles were analyzed for additional papers related to the topic. The pathogenetic mechanisms underlying atherosclerosis - namely inflammation, oxidative stress and endothelial dysfunction - are in common with COPD. Moreover, they are increased in the presence of COPD, especially in patients who present airway bacterial colonization, increased rate of exacerbations and elevated levels of both airway and systemic inflammation. Conclusion: COPD is associated with an increased burden of atherosclerotic disease. Systemic inflammation and oxidative stress play key roles in this association. COPD patients with airway bacterial colonization, as compared to patients without airway colonization, generally present more frequent exacerbations and higher levels of both airway and systemic inflammation. This COPD subgroup should be considered at particularly increased risk of developing cardiovascular complications and receive more attention concerning diagnosis, treatment, prevention and research. © 2012 Elsevier Ltd. All rights reserved.

Grossi D.,The Second University of Naples | De Lucia N.,The Second University of Naples | Milan G.,Geriatric Center Frullone | Trojano L.,The Second University of Naples | Trojano L.,Rehabilitation Institute of Telese
Journal of the International Neuropsychological Society | Year: 2015

Environmental dependency (ED) phenomena, including utilization behavior and imitation behavior, are clinical manifestations typically observed in patients with the behavioral variant of fronto-temporal dementia (bvFTD), who may also show the closing-in (CI) phenomenon. Here, we explored the neuropsychological correlates of ED and CI in bvFTD, and the association of ED with CI to clarify the mechanisms underlying these clinical manifestations. Thirty-one bvFTD patients underwent a wide cognitive assessment in addition to special tasks to detect occurrence of CI and ED phenomena. Both ED and CI phenomena were present in more than half of the sample. Logistic regression analyses revealed that both ED and CI phenomena were significantly associated with poor scores on frontal neuropsychological tests. Although ED and CI often co-occurred, 3/12 patients with CI did not show ED, and 5/18 patients with ED did not show CI. A logistic regression model showed that the presence of ED was not significantly associated to CI. CI and ED are associated to progressive derangement of frontal functions in bvFTD. However, specific frontal dysfunctions might explain the occurrence of either phenomenon in isolation. (JINS, 2015, 21, 1-7) © INS. 2014 The International Neuropsychological Society.

Di Minno M.N.D.,University of Naples Federico II | Peluso R.,University of Naples Federico II | Iervolino S.,Rehabilitation Institute of Telese | Russolillo A.,University of Naples Federico II | And 2 more authors.
Annals of the Rheumatic Diseases | Year: 2014

Objectives: To evaluate prospectively the effect of weight loss on the achievement of minimal disease activity (MDA) in overweight/obese patients with psoriatic arthritis (PsA) starting treatment with tumour necrosis factor α (TNFα) blockers. Methods: Among subjects with PsA starting treatment with TNFα blockers, 138 overweight/obese patients received a concomitant dietary intervention (69 a hypocaloric diet (HD) and 69 a free-managed diet (FD)). Changes in metabolic variables were measured and a complete clinical rheumatological evaluation was made in all patients at baseline and after a 6-month follow-up to define the achievement of MDA. Results: 126 subjects completed the study. MDA was more often achieved by HD than by FD subjects (HR=1.85, 95% CI 1.019 to 3.345, p=0.043). A diet was successful (≥5% weight loss) in 74 (58.7%) patients. Regardless of the type of diet, after 6 months of treatment with TNFα blockers, ≥5% of weight loss was a predictor of the achievement of MDA (OR=4.20, 95% CI 1.82 to 9.66, p<0.001). For increasing weightloss categories (<5%, 5-10%, >10%), MDA was achieved by 23.1%, 44.8% and 59.5%, respectively. A higher rate of MDA achievement was found in subjects with 5-10% (OR=3.75, 95% CI 1.36 to 10.36, p=0.011) and in those with >10% (OR=6.67, 95% CI 2.41 to 18.41, p<0.001) weight loss in comparison with those with <5% weight loss. Conclusions: Regardless of the type of diet, a successful weight loss (≥5% from baseline values) is associated with a higher rate of achievement of MDA in overweight/obese patients with PsA who start treatment with TNFα blockers.

Peluso R.,University of Naples Federico II | Cafaro G.,University of Naples Federico II | Di Minno A.,University of Naples Federico II | Iervolino S.,Rehabilitation Institute of Telese | And 3 more authors.
Clinical Rheumatology | Year: 2013

Psoriatic arthritis is an inflammatory rheumatic disorder, which occurs in patients with skin and/or nail psoriasis. In psoriatic arthritis, the importance of biologic mediators modulating inflammatory reaction, such as tumor necrosis factor, and the knowledge on their role in the pathogenesis of psoriatic arthritis influence the therapeutic choices. In the last years, the introduction of biologic drugs has greatly changed the treatment of psoriasis and psoriatic arthritis. In fact, tumor necrosis factor-α blockers demonstrated an effective action in the treatment of both skin and joint manifestations of psoriatic arthritis, but they have some adverse effects. The aim of this review is to revisit the literature data on adverse effects of tumor necrosis factor-α blockers in patients with psoriatic arthritis. © 2013 Clinical Rheumatology.

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