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Mazzoccoli G.,Scientific Institute and Regional General Hospital
World Journal of Hepatology | Year: 2012

Aim: To assess whether Most Care is able to detect the cardiovascular alterations in response to physiological stress (posture). Methods: Non invasive hemodynamic was assessed in 26 cirrhotic patients compared to healthy subjects, both in the supine and standing positions. Results: In baseline conditions, when compared to healthy subjects, cirrhotic patients showed significantly lower values of dicrotic and diastolic pressures and systemic vascular resistance. While in the standing position, cirrhotic patients showed higher values of cardiac index, stroke volume index and cardiac cycle efficiency. When returning to the supine position, cirrhotic patients exhibited lower values of dicrotic and diastolic pressures and systemic vascular resistance in the presence of higher values of cardiac index, stroke volume index and cardiac cycle efficiency. Conclusion: Most Care proved to be able to detect cardiovascular abnormalities bedside in the resting state and after postural challenge in cirrhotic patients. © 2012 Baishideng.


Mazzoccoli G.,Scientific Institute and Regional General Hospital | Dagostino M.P.,Scientific Institute and Regional General Hospital | Greco A.,Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza
Biomedicine and Preventive Nutrition | Year: 2012

Background: Epicardial adipose tissue is correlated to the amount of visceral fat and is a marker of metabolic and cardiovascular risk. Aging alters body fat mass and its function. Epicardial fat (EF) thickness, as measured by ultrasonography, reflects intra-abdominal visceral fat and is related to features of the metabolic syndrome and to cardiovascular risk. The aim of our study was to evaluate differences in the EF thickness between young-middle aged and old aged subjects. Methods: We evaluated EF thickness in 26 young-middle aged subjects (age. ±. SD 45.9. ±. 10.3 years) compared to 50 old aged subjects (age. ±. SD 76.1. ±. 7.3 years) with the common cardiovascular risk factors. Each subject underwent transthoracic M-mode echocardiogram to measure EF thickness. Results: Old aged subjects had thicker EF (11.3. ±. 1.9. mm versus 9.3. ±. 2.8. mm, p<. 0.001). A statistically significant positive trend was evidenced between age and epicardial fat thickness (R=0.437, p<. 0.001). Univariate linear regression analyses evidenced that EF correlated positively with age (p<. 0.001), obesity (p=0.003), dyslipidemia (p=0.01), arterial hypertension (p=. 0.047) and multivariate linear regression models showed that EF correlated positively with age (p<. 0.001), male gender (p=. 0.025) and obesity (p<. 0.001). Conclusion: epicardial adipose tissue is more abundant in the elderly and is correlated to visceral adipose tissue depots, indicating a higher cardiometabolic risk especially in male subjects. © 2011 Elsevier Masson SAS.


Piepoli A.,Scientific Institute and Regional General Hospital | Mazzoccoli G.,Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza | Panza A.,Scientific Institute and Regional General Hospital | Tirino V.,National Tumor Institute | And 8 more authors.
Digestive and Liver Disease | Year: 2012

Background: Juvenile polyposis syndrome with gastric involvement may mimic Ménétrier's disease, which is correlated to transforming growth factor (TGF)α overproduction and PDX1 upregulation in the gastric fundus. Aim: We report a family with juvenile polyposis syndrome where one member showed typical features of Ménétrier's disease and concomitant Helicobacter pylori infection. Methods: We studied a 31-year-old woman belonging to a family with juvenile polyposis syndrome, who exhibited a particular form of hyperplastic gastropathy diagnosed as Ménétrier's disease with Helicobacter pylori infection. Results: TGFα overexpression and undetectable PDX1 expression were demonstrated in the fundic gastric biopsy specimens. In all affected members of the family we identified a 4-bp deletion in exon 9 of SMAD4 gene, a mutation usually associated with a more virulent form of juvenile polyposis syndrome with a higher incidence of gastric and colonic polyposis. Conclusion: To explain the association of juvenile polyposis syndrome with Ménétrier's disease we hypothesized a new mechanism that involves TGFβ-SMAD4 pathway inactivation and TGFα overexpression related to Helicobacter pylori infection. © 2012 Editrice Gastroenterologica Italiana S.r.l.


Mazzoccoli G.,Scientific Institute and Regional General Hospital | Inglese M.,Scientific Institute and Regional General Hospital | De Cata A.,Scientific Institute and Regional General Hospital | Carughi S.,Scientific Institute and Regional General Hospital | And 6 more authors.
Geriatrics and Gerontology International | Year: 2011

Aim: The nervous, endocrine and immune systems are connected by shared neurotransmitters, hormones and cytokines. The function of these systems shows patterns of circadian rhythmicity and a number of age-related changes in the 24-h hormonal and non-hormonal rhythms have been found in older human beings. The aim of this study was to evaluate integration among the nervous, endocrine and immune systems in the elderly.Methods: Cortisol and melatonin serum levels were measured and lymphocyte subpopulation analyses were performed on blood samples collected every 4 h for 24 h from 15 healthy young-middle-aged subjects (range 36-55 years, mean age ± standard error [SE] 44.08 ± 1.76) and 15 healthy old-aged subjects (range 67-79 years, mean age ± SE 68.52 ± 1.27).Results: There was a statistically significant difference between the groups in the observed values of CD20 (total B cells higher in young-middle-aged subjects, P = 0.02), CD25 (activated T cells with expression of the α-chain of interleukin-2 receptor, higher in elderly subjects, P = 0.04) and DR+ T cells (activated T cells higher in elderly subjects, P = 0.01). There were different correlations among lymphocyte subpopulations and hormone serum levels in young and middle-aged subjects in compared to old-aged subjects. In the group of young-middle-aged subjects, a clear circadian rhythm was validated for the time-qualified changes of all the factors studied. In the group of elderly subjects, a clear circadian rhythm was validated for the nyctohemeral changes of CD3 (with a phase delay of 3 h), CD8, CD4/CD8 ratio, CD16, CD25 (in opposite phase), cortisol (with a phase delay of 1 h) and melatonin.Conclusion: The results of the current study show that aging is associated with enhanced responsiveness of the T-cell compartment, impairment of B-cell compartment and alterations in temporal architecture and correlations of neuroendocrine-immune parameters. © 2010 Japan Geriatrics Society.


Mazzoccoli G.,Scientific Institute and Regional General Hospital | Pazienza V.,Scientific Institute and Regional General Hospital | Piepoli A.,Scientific Institute and Regional General Hospital | Muscarella L.A.,Scientific Institute and Regional General Hospital | And 2 more authors.
Integrative Cancer Therapies | Year: 2012

The aim of this study was to evaluate the hypothalamic-pituitary-thyroid (HPT) axis function in patients suffering from lung cancer. Thyrotropin- releasing hormone (TRH), thyroid-stimulating hormone (TSH), free thyroxine (FT4), interleukin (IL)-2, and melatonin serum levels were measured in blood samples collected every 4 hours for 24 hours from 11 healthy participants (H; ages 35-53 years) and 9 patients suffering from non-small-cell lung cancer (C; ages 43-63 years). Relationships between hormone levels overall and over time of day were evaluated within and among groups. A prominent circadian rhythm with peaks near midnight was present for TSH and melatonin serum levels in both H and C, indicating similar synchronization of the main body clock to the 24-hour environmental light-dark cycle. As regards 24-hour means in H and C, TSH was lower in C, whereas TRH, FT4, and IL-2 were higher in C, with no difference in melatonin levels. Simple linear regression, FT4 versus TRH, showed a positive correlation in H and a negative correlation in C, whereas FT4 versus TSH showed a negative correlation in both groups. For FT4 versus IL-2, a negative correlation was found in C but not for H, whereas TSH versus TRH showed no correlation for either group. Both groups were found to be similarly synchronized to the 24-hour sleep-wake schedule, but HPT axis function was altered in patients suffering from lung cancer. When compared with healthy controls, cancer patients showed modifications of hormone serum levels overall and a negative correlation between individual TRH and FT4 levels. © The Author(s) 2012.

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