San Severo, Italy
San Severo, Italy

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D'Alessandro A.,T Masselli Mascia Hospital | D'Alessandro A.,University of Foggia | Carolil A.,National Epidemiological Observatory on Chronic Venous Insufficiency | Mandolesi D.,University of Rome La Sapienza | And 6 more authors.
Acta Phlebologica | Year: 2015

Aim: Chronic venous disease (CVD) can be classified in seven clinical categories using the CHEAP system. Aim of this pilot study was to evaluate Ginkgo biloba's (Agheron phytosome) therapeutic effects in patients affected by chronic venous disorders of the legs (CHEAP CI, C2, C3). Methods: We recruited 53 subjects with IVC at stage CI, C2 or C3. Oral anticoagulations, antiplatelet therapy and pregnancy have been exclusion criterion for that study. Dosage of Ginkgoselect® Phytosome® was 120 mg once daily. Clinical evaluation was performed 1 month and 3 months after starting therapy with Ginkgo biloba. Results: From the anamnestic questionnaires resulted that the more common symptoms in our sample were represented by heavy legs (96%), aching legs (91%) and swelling (81.8%). Heavy legs (16.3%) and swelling (13.6%) were the commonest daily discomfort together with heat or burning sensation (21.8%).50 of 53 patients (95%) believed that their leg problem interfered with their normal social activities, in the most part of cases moderately. The best results were obtained about the sense of heavy legs: there are significant statistical differences between day 0 and 90th day of treatment (P<0.01 X2=18.0798 and 6 degrees of freedom). At the end of the treatment, more than 60% of the sample rated the leg problem as mild (1, 2, 3 points), while at the beginning of the therapy only the 23% of the patient used this score. The differences (as improvement) about evening edema between day 0 and 90th day from the beginning of the therapy are not statistical significant, but there is a trend of significativity. Conclusion: In conclusion Ginkgoselect® Phytosome® can significantly decrease the sense of "heavy legs" and, despite not reaching statistical significance, it shows potentiality in treatment of evening edema. Further study are necessary to evaluate all the potentiality of Ginkgo biloba's extracts in CVD.


Mandolesi S.,University of Rome La Sapienza | D'alessandro A.,T Masselli Mascia Hospital | Manconi E.,University of Cagliari | Niglio T.,Instituto Superiore Of Sanita Rome | And 5 more authors.
Acta Phlebologica | Year: 2014

Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by reflux, stenoses or flow block of the internal jugular, vertebral and/or azygos veins with disturbed flow and formation of collateral venous channels. The EchoColorDoppler (ECD) to assess the CCSVI is a very difficult and long examination, it needs about an hour of work for an expert sonographer. It is: venous ECD assessment of the main veins draining the brain in supine position, venous ECD assessment in upright position, Manconi breathing test, neck rotation test, Valsalva maneuver, transcranial deep veins assessment and 3rd ventricle measure. The real problem of the assessment is to remember the CCSVI five criteria that may cause frequently many mistakes. To collect by the same standard procedure the ECD assessment on map report we propose the use of a shared terminology and specific symbols that are shown here. The National Epidemiological Observatory on CCSVI (www. osservatorioccsvi.org) uses, for ECD data collection in its computerized platform, the program MEM-net, that works on internet, and with its algorithm makes a blind control of ECD report and avoids the figure of the audit so eliminate another possible human error and subjective interpretation of the assessment.


Guglielmi G.,University of Foggia | Guglielmi G.,Scientific Institute Hospital Casa Sollievo della Sofferenza | Di Chio F.,University of Foggia | Vergini M.R.D.,University of Foggia | And 3 more authors.
Clinical Cases in Mineral and Bone Metabolism | Year: 2013

Vertebral fractures are a common clinical entity, caused by trauma or related to osteoporosis (benign). Their recognition is especially important in the post-menopausal female population but also important is their differentiation from pathological (malignant) fractures (1). A vertebral fracture is evidenced by vertebral body deformity or reduction in vertebral body height beyond a certain threshold value in the absence of bone discontinuity. For prognosis and treatment it is extremely important to recognize the cause of the fracture. In contrast to fractures that occur in other locations, vertebral fractures often go unrecognized in the acute phase as the pain may be transient and radiographic and evaluation of the spine may be difficult (2). Objective measurement of the vertebral deformity provides invaluable information to the interpreting physician and helps grade fracture severity. The recognition and diagnosis of vertebral fractures can be performed using additional diagnostic tools.


Carella A.M.,T Masselli Mascia Hospital | Antonucci G.,T Masselli Mascia Hospital | Conte M.,T Masselli Mascia Hospital | Di Pumpo M.,T Masselli Mascia Hospital | And 2 more authors.
Current Diabetes Reviews | Year: 2010

Metabolic syndrome, a "cluster" of metabolic disorders including hypertension, increases the cardiovascular risk, and insulin resistance plays a key role in its pathogenesis. In this syndrome antihypertensive treatment with beta- blockers is underused because of their adverse metabolic effects. The aim was to review the evidences supporting the reasons for under-using beta-blockers in hypertensive patients with metabolic syndrome. A review of Literature has been carried out via PubMed from 1998 to 2008: most of beta-blockers have adverse effects on insulin sensitivity, carbohydrate and lipid metabolism, and are not recommended in metabolic syndrome. However, some recent large studies have shown a better metabolic profile with newer third generation vasodilating beta-blockers, such as Carvedilol and Nebivolol. Vasodilating action of Carvedilol and Nebivolol, due respectively to alpha1-blocking effect and release of nitric oxide, explains the lack of adverse metabolic effects of these beta-blockers that could also be used in hypertensive patients with metabolic syndrome. © 2010 Bentham Science Publishers Ltd.

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