Hospital San Giovanni Battista

San Giovanni al Natisone, Italy

Hospital San Giovanni Battista

San Giovanni al Natisone, Italy

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Angeli F.,Hospital Sm Della Misericordia | Angeli E.,Hospital San Giovanni Battista | Verdecchia P.,Hospital of Assisi
International Journal of Molecular Sciences | Year: 2015

Hypertensive disorders of pregnancy are a major cause of poor outcome, including placental abruption, organ failure, cerebrovascular accident and disseminated intravascular coagulation. These disorders are associated with increased fetal risk of intrauterine growth restriction, intrauterine death and prematurity. Electrocardiography (ECG) recently emerged as a useful tool to evaluate cardiovascular complications during pregnancy. Specifically, left atrial abnormalities detected by standard ECG are associated with a fourfold increased risk of developing hypertensive disorders during pregnancy. The mechanisms linking left atrial abnormality on ECG with hypertensive disorders are still elusive. Several mechanisms, possibly reflected by abnormal left atrial activation on ECG, has been suggested. These include increased reactivity to angiotensin II and up-regulation of angiotensin type 1 receptors, with activation of autoantibodies targeting these receptors. © 2015 by the authors; licensee MDPI, Basel, Switzerland.


PubMed | Ford Motor Company, University of Duisburg - Essen, Ramon and Cajal Hospital, Hospital San Giovanni Battista and 22 more.
Type: Journal Article | Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society | Year: 2016

Daclatasvir (DCV) is a potent, pangenotypic nonstructural protein 5A inhibitor with demonstrated antiviral efficacy when combined with sofosbuvir (SOF) or simeprevir (SMV) with or without ribavirin (RBV) in patients with chronic hepatitis C virus (HCV) infection. Herein, we report efficacy and safety data for DCV-based all-oral antiviral therapy in liver transplantation (LT) recipients with severe recurrent HCV. DCV at 60mg/day was administered for up to 24 weeks as part of a compassionate use protocol. The study included 97 LT recipients with a mean age of 59.38.2 years; 93% had genotype 1 HCV and 31% had biopsy-proven cirrhosis between the time of LT and the initiation of DCV. The mean Model for End-Stage Liver Disease (MELD) score was 13.06.0, and the proportion with Child-Turcotte-Pugh (CTP) A/B/C was 51%/31%/12%, respectively. Mean HCV RNA at DCV initiation was 14.36 log10 IU/mL, and 37% had severe cholestatic HCV infection. Antiviral regimens were selected by the local investigator and included DCV+SOF (n=77), DCV+SMV (n=18), and DCV+SMV+SOF (n=2); 35% overall received RBV. At the end of treatment (EOT) and 12 weeks after EOT, 88 (91%) and 84 (87%) patients, respectively, were HCV RNA negative or had levels <43 IU/mL. CTP and MELD scores significantly improved between DCV-based treatment initiation and last contact. Three virological breakthroughs and 2 relapses occurred in patients treated with DCV+SMV with or without RBV. None of the 8 patient deaths (6 during and 2 after therapy) were attributed to therapy. In conclusion, DCV-based all-oral antiviral therapy was well tolerated and resulted in a high sustained virological response in LT recipients with severe recurrent HCV infection. Most treated patients experienced stabilization or improvement in their clinical status.


PubMed | Hospital Sm Della Misericordia, Hospital San Giovanni Battista and Hospital of Assisi
Type: Journal Article | Journal: International journal of molecular sciences | Year: 2015

Hypertensive disorders of pregnancy are a major cause of poor outcome, including placental abruption, organ failure, cerebrovascular accident and disseminated intravascular coagulation. These disorders are associated with increased fetal risk of intrauterine growth restriction, intrauterine death and prematurity. Electrocardiography (ECG) recently emerged as a useful tool to evaluate cardiovascular complications during pregnancy. Specifically, left atrial abnormalities detected by standard ECG are associated with a fourfold increased risk of developing hypertensive disorders during pregnancy. The mechanisms linking left atrial abnormality on ECG with hypertensive disorders are still elusive. Several mechanisms, possibly reflected by abnormal left atrial activation on ECG, has been suggested. These include increased reactivity to angiotensin II and up-regulation of angiotensin type 1 receptors, with activation of autoantibodies targeting these receptors.


Banche G.,University of Turin | Mandras N.,University of Turin | Giacchino F.,Civil Hospital | Scalas D.,University of Turin | And 7 more authors.
Future Microbiology | Year: 2013

Aim: We evaluated the potential impact of caspofungin (CAS) on the functional activities of polymorphonuclear leukocytes (PMNs) from hemodialyzed patients (HDs) and renal transplant recipients (RTRs) against a multidrug-resistant clinical strain of Candida glabrata compared with those of PMNs from healthy subjects (HSs). Materials & methods: Effects of CAS on PMN phagocytosis and intracellular killing towards multidrug-resistant C. glabrata were evaluated in 66 HDs, 54 RTRs and 30 HSs in the absence and presence of CAS at MIC and sub-MICs. Results: When HD PMNs and RTR PMNs were exposed to both MICs and sub-MICs of CAS, their fungicidal activity against the multidrug-resistant C. glabrata strain was significantly higher than that of drug-free controls, with survival index values that overlapped with those achieved by HS PMNs. Conclusion: The obtained results underline the role of CAS in the restoration of the impaired PMN functions in HDs and RTRs. CAS might still constitute an effective therapeutic option for the treatment of invasive fungal infections caused by multidrug-resistant C. glabrata in patients with altered phagocyte-dependent innate immunity. © 2013 Future Medicine Ltd.


D'Amelio P.,University of Turin | Grimaldi A.,University of Turin | Cristofaro M.A.,University of Turin | Ravazzoli M.,University of Turin | And 4 more authors.
Osteoporosis International | Year: 2010

This study evaluates the effect of alendronate on osteoclastogenesis, cytokine production, and bone resorption in postmenopausal women. We suggest that it acts on mature bone resorbing osteoclasts after 3 months of treatment, whereas, after 1 year, it diminishes their formation by reducing their precursors and serum RANKL. Introduction: Osteoclasts are the target cells of bisphosphonates, though the most drug-sensitive steps of their formation and activity have not been determined. The present study evaluates the effect of alendronate on osteoclastogenesis, cytokine production, and bone resorption in postmenopausal women. Methods: The study was conducted on 35 osteoporotic women; 15 were pretreated with alendronate 70 mg/week, whereas, 20 were treated with calcium 1 g/day and vitamin D 800 IU/day. After 3 months, 30 received alendonate 70/mg, vitamin D 2800 IU/week, and calcium 1 g/day for 12 months (combined therapy), whereas, the other five patients remained on calcium 1 g/day and vitamin D 800 IU/day. The following parameters were assessed before and after therapy: changes in bone resorption markers, circulating osteoclast precursors, formation of osteoclasts in peripheral blood mononuclear cell cultures, their viability, and variations in cytokines production. Results: After 3 months of alendronate, there was no significant reduction in the number of osteoclast precursors, osteoclast formation and viability, and cytokine levels, whereas, there was a significant reduction of bone resorption markers. One year of the combined therapy, on the other hand, reduced osteoclast precursors, osteoclast formation, and serum RANKL, whereas, calcium plus vitamin D alone had no effect. Conclusions: We suggest that alendronate mainly acts on mature bone resorbing osteoclasts in the short term, whereas, its long-term administration diminishes their formation by reducing their precursors and serum RANKL. © 2009 International Osteoporosis Foundation and National Osteoporosis Foundation.


Degiuli M.,University of Turin | Sasako M.,National Cancer Center Hospital | Ponti A.,Hospital San Giovanni Battista
British Journal of Surgery | Year: 2010

Background; A randomized clinical trial was performed to compare Dl and D2 gastrectomy in specialized Western centres. This paper reports short-term results. Methods A total of 267 patients with gastric cancer were randomly assigned to either a Dl or a D2 procedure in five specialized centres. Based on the findings of the phase II trial and published phase III trials, a prespecified non-inferiority boundary at 12 per cent difference between groups was set regarding total morbidity. Results: In the intention-to-treat analysis, the overall morbidity rate after D2 and Dl dissections was 17-9 and 12-0 per cent respectively (P = 0-178), with a 95 per cent confidence interval of the difference of 0 to 13-0 per cent, slightly exceeding the prespecified non-inferiority limit. There was a single duodenal stump leak in the D2 arm (0-7 per cent). The postoperative 30-day mortality rate was 3-0 per cent after Dl and 2-2 per cent after D2 gastrectomy (P = 0-722). Conohnlon. In specialized centres the rate of complications following D2 dissection is much lower than in published randomized Western trials. D2 dissection, in an appropriate setting, can therefore be considered a safe option for the radical management of gastric cancer in Western patients. Registration number: ISRCTN11154654 (http://www.controlled-trials.com). Copyright © 2010 British Journal of Surgery Society Ltd.


PubMed | University of Rome La Sapienza, University of Social Sciences and Humanities of Warsaw, Hospital San Giovanni Battista and University Niccolo Cusano
Type: | Journal: Stress and health : journal of the International Society for the Investigation of Stress | Year: 2016

This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients.


Angeli F.,Hospital S Maria Della Misericordia | Angeli E.,Hospital San Giovanni Battista | Ambrosio G.,University of Perugia | Mazzotta G.,University of Perugia | And 3 more authors.
American Journal of Hypertension | Year: 2011

BackgroundElevated neutrophil count, a marker of systemic inflammation, has been suggested as a prognostic marker of cardiovascular disease in postmenopausal women with hypertension. We tested the hypothesis that an association exists between elevated neutrophil count and increased arterial stiffness, as reflected by a wide pulse pressure (PP), in this population of women. We also tested PP as predictor of cardiovascular adverse events in this population.MethodsWe analyzed data relating to 886 postmenopausal women with hypertension, consecutively enrolled in a prospective registry. Ambulatory blood pressure monitoring was carried out at entry in all the subjects. The median duration of follow-up was 7.4 years (range: 1-21 years).ResultsThere was a direct relationship between neutrophil count and 24-h ambulatory PP (P <0.0001) and this association remained significant after adjusting for age, serum glucose, and left ventricular (LV) hypertrophy at electrocardiogram (ECG) (all P <0.01). During follow-up there were 121 first-time major cardiovascular (CV) events. The rate (× 100 patient-years) of CV events was 1.02, 1.36, and 3.75, respectively in the three tertiles of the distribution of 24-h PP (P <0.0001). In a multivariate analysis, 24-h ambulatory PP and neutrophil count were independent predictors of total CV events after adjusting for the influence of other risk markers. In particular, for each 10mmHg increase in 24-h PP, there was a 73% higher risk for total CV events (P = 0.015). Office-recorded PP did not achieve significance when forced in the same model.ConclusionsIncreased arterial stiffness, as reflected in high values of 24-h ambulatory PP, is an adverse prognostic marker in postmenopausal women with hypertension, possibly as an additional correlate of systemic inflammation. © 2011 American Journal of Hypertension, Ltd.


Angeli E.,Hospital San Giovanni Battista | Verdecchia P.,Hospital of Assisi | Narducci P.,Hospital San Giovanni Battista | Angeli F.,Hospital S Maria Della Misericordia
Hypertension Research | Year: 2011

Prediction of hypertensive complications during pregnancy remains limited, especially in healthy and initially normotensive women. We conducted a prospective screening study for hypertensive complications in pregnant women. We studied 221 nulliparous healthy and normotensive women with singleton pregnancies whose first routine visit was carried out before the twelfth week of gestation. We tested several demographic, clinical and laboratory variables as predictors of a composite pool of prespecified events, including gestational hypertension, preeclampsia or eclampsia. We analyzed the potential additive role of ECG in the identification of women at increased risk of hypertensive disorders. Mean age at entry was 30 years. During pregnancy, there were 28 prespecified events (22 women with gestational hypertension, 5 with preeclampsia and 1 with eclampsia). In univariate analyses, blood pressure (BP), weight, body mass index (BMI) and left atrial (LA) abnormality detected by ECG in lead V 1 showed an association with the risk of hypertensive disorders (all P0.05). In a multivariable analysis, only mean BP (OR: 3.08, 95% confidence interval (CI): 1.61-5.92; P0.001 for each 10 mm Hg increase) and LA abnormality in lead V 1 (OR: 4.35, 95% CI: 1.84-10.31; P0.001) were independent predictors of hypertensive disorders. The final model discriminated well between women who developed hypertensive disorders and women who remained normotensive (AUC0.75; 95% CI: 0.67-0.84; P0.0001). This study suggests that standard ECG is valuable to refine risk stratification for hypertensive disorders in initially normotensive pregnant women. LA abnormality, easily detected by simple visual inspection of the traditional ECG, and mean arterial pressure (MAP), allows a rapid and effective risk stratification for hypertensive disorders. © 2011 The Japanese Society of Hypertension All rights reserved.


Fabbriciani G.,University of Perugia | Pirro M.,University of Perugia | Manfredelli M.R.,University of Perugia | Bianchi M.,Hospital Santa Maria della Misericordia | And 3 more authors.
Rheumatology International | Year: 2012

A 62-year-old man presented with a 2-month history of increasing pain in the left hip. Magnetic resonance imaging (MRI) showed bone marrow edema (BME) of the left femur, dual energy X-ray absorptiometry (DXA) showed osteopenia at the same level, whereas pelvis X-rays failed to show any objective findings. After ruling out other possible causes of BME such as aseptic osteonecrosis, infectious arthritis, primary or metastatic malignancy, tuberculosis, osteomyelitis, rheumatoid arthritis, and seronegative spondyloarthropathies, a diagnosis of transient osteoporosis of the hip (TOH) was made, and treatment with teriparatide at a daily dose of 20 lg was started and continued for 4 weeks. Disappearance of the symptoms and normalization of MRI were obtained. © 2011 Springer-Verlag.

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