Plasma lycopene concentration is low in subjects with stable asthma.
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Adult↗
Biomedical subjects
G Riccioni
Publications and source records attributed to G Riccioni.
Cysteinyl-leukotriene receptor antagonists: present situation and future opportunities.
Cysteinlyl-leukotriene receptor antagonists (LTRAs) were introduced as oral preventative anti-asthma medications in the late 1990s and, very recently, montelukast has been approved also for the relief of symptoms of perennial and seasonal allergic rhinitis. Although clinical trials and clinical practice showed LTRAs to be effective in the treatment of asthma patients with a wide range of disease severity, their exact role in the therapy of asthma is not well defined and possibly under-appreciated. As for other anti-asthma drugs, clinical trials with LTRAs uncovered a range of patient responses, so that an understanding of the variability mechanisms (e.g. acquired or genetic factors, etc.) is needed to maximize the probability of a beneficial response. Since the molecular cloning of CysLT receptors (CysLTRs) has been achieved, new roles for cysteinyl-LTs in pathophysiological conditions have been suggested or established from the observed distribution in cells and tissues other than the lung. Cysteinyl-LTs and CysLTRs have been implicated in the pathophysiology of other inflammatory conditions including cancer, atopic dermatitis, idiopathic chronic urticaria, and cardiovascular diseases. As a result, LTRAs might be worth assessing for a therapeutic role in some of these pathologies. This review summarizes and attempts to integrate recent data on the therapeutic efficacy, effectiveness and safety of LTRAs in asthma and allergic rhinitis, and speculates on other therapeutic opportunities.
Acetates↗
Prevalence and severity of airway obstruction in an Italian adult population.
BACKGROUND: This study sets out to estimate the prevalence and the degree of severity of bronchial obstruction in an adult population with three different diagnostic criteria: the European Respiratory Society (ERS), the American Thoracic Society (ATS), and the World Health Organization (WHO) defined as Global Obstructive Lung Disease (GOLD). METHODS: 1514 subjects underwent complete medical evaluation and spirometry. RESULTS: The prevalence of bronchial obstruction was respectively 27.5 % (ERS), 33% (GOLD), and 47.3 % (ATS). The prevalence of bronchial obstruction in the smoker group was 33.4% (ERS), 38.1% (GOLD), and 52.3% (ATS). The prevalence of obstruction in the ex-smoker group was 33% (ERS), 41.4% (GOLD), and 57.1% (ATS). The prevalence of obstruction in the non-smoker group was 21.1% (ERS), 24.9% (GOLD), and 38.6% (ATS). CONCLUSIONS: The results show that the prevalence of airway obstruction increases proportionally with age; the cigarette smoking represents an important conditioning factor. These observations warrant the necessity of a more complete and multi-parametric analysis in the evaluation of patients with airway obstruction using methodologies that explore the functional state and the risk factors that cause the airway obstruction.
Adult↗
Irritable bowel syndrome and bronchial hyperresponsiveness: is there a link?
BACKGROUND/AIM: Many studies have demonstrated a high prevalence of bronchial hyperresponsiveness in patients with irritable bowel syndrome (IBS). The aim of this 24-month prospective study was to evaluate the prevalence of IBS in asthmatic patients. METHODS: We analyzed 623 asthmatic patients that were evaluated for body mass index, sex, and age before undergoing both a methacholine challenge test (MCHt) and skin prick tests. RESULTS: We found that 276 asthmatic patients (44.3%) were positive on the MCHt, while 347 (55.7%) were negative. We also found that 27 (9.7%) of the 276 patients with a positive MCHt and 44 (12.7%) of the 347 patients with a negative MCHt were affected by IBS. Therefore, there was no statistically significant difference between positive MCHt tests and IBS. The PC(20) (mean provocation concentration of methacholine producing a 20% reduction in forced expiratory volume in 1 s < or =16 mg/ml) in all patients tested was 8.64 +/- 2.58 mg/ml, being 8.75 +/- 2.52 and 8.55 +/- 2.32 mg/ml for males and females, respectively. CONCLUSIONS: These results do not demonstrate a relationship between MCHt and IBS. However, a relationship might still exist in a subpopulation of patients whose symptoms worsen by stress.
Adolescent↗
Quality of Life and clinical symptoms in asthmatic subjects.
OBJECTIVE: Quality of Life (QoL) measurements are more responsive to clinically significant changes than conventional clinical measures. The aim of the study was to evaluate the relationship between asthma symptoms and QoL in asthmatic patients. METHODS: A total of 277 asthmatics subjects, divided into three groups showing different symptoms, underwent complete clinical evaluation, baseline respiratory function, and methacholine challenge test and completed an Asthma Quality of Life Questionnaire (AQLQ). RESULTS: One hundred and forty-five subjects with asthmatic crisis, chest tightness, and dyspnea (group 3) reported a significantly lower median value in single domains and all items compared to the values scored by the 97 subjects with wheezing, rhinitis, and conjunctivitis (group 2) (p < 0.01). No statistical significance was found between the 35 patients of group 1 (with only cough) and group 3. CONCLUSIONS: The main advantage for the clinician is to evaluate important areas in which QoL could be improved and the possibility to correct and optimize compliance to chronic therapy.
Adolescent↗
Prevalence of bronchial asthma in patients with endoscopically-documented esophagitis.
The association of gastroesophageal reflux, esophagitis, and asthma has been studied for a long time, but the results are often conflicting. The aim of this study is to evaluate the prevalence of bronchial asthma and the presence of extra-esophageal symptoms in subjects with endoscopically-documented reflux esophagitis. Forty patients were divided into 2 groups: group A (22 patients) affected by endoscopically-documented esophagitis, and group B (18 patients) with positive endoscopic examination for other pathologies of the gastroenteric tract. All of the patients underwent complete medical examination, skin-prick tests, esophageal-gastric-endoscopy, and pulmonary function tests (basal and after methacholine). The prevalence of asthma was 30% in group A vs 10% in group B (odds ratio = 2.57; confidence interval = 0.75-10.25). Relationships between chronic cough and esophagitis (p<0.01) and between chronic cough and asthma (p<0.05) were found. No significant relationships were observed between esophagitis and the other respiratory symptoms considered (wheezing, chest tightness, hoarseness, bronchospasm, and dysphagia). The results confirm the increased prevalence of asthma in patients with esophagitis and they emphasize the role of gastroesophageal reflux as a trigger factor for asthma. Chronic cough represents an important symptom of asthma in subjects with esophagitis.
Adult↗
[Leptin and hypothalamus-hypophysis-thyroid axis].
The leptin system is a major regulator of food intake and metabolic rate. The leptin, an adipose tissue hormone whose plasma levels reflect energy stores, plays an important rule in the pathogenesis of such eating disorders like bulimia and anorexia. Thyroid hormones are major regulators of energy homeostasis. It is possible that leptin and thyroid hormone exert their actions on thermogenesis and energy metabolism via the same common effector patways. Leptin influences feedback regulation of the hypotalamic TRH-secreting neurons by thyroid hormone. Low serum levels of thyroid hormones reflect a dysfunction of the hypotalamic-pituitary-thyroid (HPT) and hypotalamic-pituitary-adrenal (HPA) axis in patients with nervosa anorexia. Neuroendocrine effects of leptin include effects on the HPT and HPA axis. The aim of this work is to evaluated the interactions between leptina and HPT axis on the basis of recent published works and reviews in literature.
Humans↗
[Identification of macronutrients and some oligoelements in "molisano" Tuber aestivum truffles].
Many scientifical published works have documented the presence of macro and micronourished of truffle coming from Umbria, Toscana, and Piemonte, while are few the studies that documented the analysis of these nourishes of the truffle coming from Molise. In our study has been evaluated the concentrations of macro-nourishes and oligoelements in Molisano Tuber aestivum truffle. The contents of macro-nourishes (proteins, carbohydrates, lipids, and water) and oligoelements (lead, cadmium, chromium, manganese, zinc, nickel, and copper) have been determined. The results have demonstrated an adequate concentration of macronutrients, in particularly water and oligoelements, the latest important in many metabolic reaction of the body. A pathological concentration of heavy metals has not been found.
Ascomycota↗
Comparison of montelukast and budesonide on bronchial reactivity in subjects with mild-moderate persistent asthma.
We studied 51 atopic non-smoking subjects who were divided to four treatments groups: (A) montelukast 10mg daily, (B) budesonide 400 microg twice a day (bid), (C) montelukast 10 mg daily plus budesonide 400 microg bid and (D) budesonide 800 microg bid. Bronchial responsiveness was assessed before and after 12 weeks of treatment. The bronchial responsiveness, evaluated by means of PC(20) values, showed a strong significant increase in groups B, C and D, and a weak but significant rise in group A, when compared to basal data. Regarding other pulmonary parameters (FEV(1), PEF) there were no significant differences among the groups after 12 weeks of therapy. A statistical significance was founded after therapy between group A and C (p < 0.05), but not between the group B and D treated with only budesonide at different doses. No significant differences was observed in the side effect pattern among the various treatments. The study data demonstrated that administration of montelukast provided an important and additional effect on bronchial hyperresponsiveness. Oral administration represents a significant advantage over the majority of other anti-asthmatic drugs. Our results confirm the anti-inflammatory properties of both the inhaled corticosteroid (ICS) and montelukast and the possible role of these drugs can have on airway remodelling. While currently low dose ICS remains the reference drug as a controller in mild-moderate persistent asthma, montelukast may be viewed as a possible option, either in monotherapy or in association.
Acetates↗
Asthma of the gut: dream or reality?
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Asthma↗
Effect of natural allergen exposure on non-specific bronchial reactivity in asthmatic farmers.
The aim of the study was to assess the seasonal variability of non-specific bronchial reactivity (NSBR) evaluated with methacholine in asthmatic farmers allergic to pollens. Twenty farmers (16 male and four female) with allergy to pollens, e.g. 'Graminae' and 'Parietaria', entered the study. None of the patients had been previously treated with specific immunotherapy. Patients underwent a methacholine challenge at the first visit and then in the subsequent seasons. Four groups of tests were obtained according to the period when the challenge was performed. Group 1: challenges performed in December, January and February; group 2 in March, April and May; group 3 in June, July and August; group 4 in September, October and November. PD20 values were expressed as the natural logarithm of the cumulative dose of methacholine causing at least a 20% fall in FEV1. Bronchial hyperreactivity was highest in summer, followed by spring and autumn; in winter it was much lower. Multiple group analysis (ANOVA) showed statistically significant differences between the groups (P < 0.01). When the groups were compared individually, statistically significant differences existed only between group 1 (winter) and each of the other groups, respectively 2 (spring) (P = 0.02), 3 (summer) (P = 0.004) and 4 (autumn) (P = 0.02). The results underlined the importance of allergic inflammation in determining changes in NSBR. In the region where the study was carried out (central Italy), the grass and Paretaria pollination lasts from March to November. Therefore, farmers had a progressive increase in NSBR from spring to summer and a decrease in fall as a consequence of the varying pollen concentration in different seasons. The level of allergen exposure is, in fact, the main factor that determines the severity of bronchial inflammation, thus affecting NSBR.
Agriculture↗
Large waist circumference and risk of hypertension.
OBJECTIVE: To examine the relationship between 24 h ambulatory blood pressure monitoring and three commonest anthropometric measurements for obesity--body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (W). DESIGN: Cross-sectional survey among outpatients at the Obesity Research Center. SUBJECTS AND METHODS: Four-hundred and sixty-one overweight or obese subjects, non-diabetic, otherwise healthy, aged 20-70 y, of either sex, were consecutively recruited. All subjects underwent 24 h ambulatory blood pressure monitoring. The population study was separated in normotensive and hypertensive males and females and the possible risk factors for hypertension (W, WHR, BMI and age) were subdivided into different classes of values. RESULTS: Logistic regression shows that W is the most important anthropometric factor associated with the hypertensive risk. Among males with W> or =102 cm the odds ratio (OR) for hypertension is three times that of males with W<94 cm using casual BP measure (OR 3.04), nearly four times higher using 24 h BP mean (OR 3.97), and even five times higher using day-time BP mean (OR 5.19). Females with W> or =88 cm have a risk for hypertension twice that of females with W<80 cm, whatever BP measurement was take (casual, 24 h or day-time). Males with WHR> or =0.96 and females with WHR> or =0.86 show significant OR for hypertension only by 24 h BP measurement and by day-time BP measurement. BMI seems to have no significant relationship to hypertensive risk. Age shows a significant relationship to hypertensive risk only considering males aged > or =55 y and females aged > or =50 y. CONCLUSION: The waist circumference seems to have a strong association with the risk of hypertension, principally by the ambulatory BP monitoring, when compared with casual BP measurement.
Adipose Tissue↗
Influence of total IgE and seasonal increase of eosinophil cationic protein on bronchial hyperreactivity in asthmatic grass-sensitized farmers.
BACKGROUND: This study correlates biomarkers of atopy (serum total and specific IgE) and inflammation (serum eosinophil cationic protein) with bronchial hyperreactivity assessed after the complete end of pollination, in a group of farmers suffering from grass-allergic asthma. METHODS: A total of 28 asthmatic farmers, with allergy to grass pollen, reporting persistent asthma symptoms after grass pollination, were enrolled. An accurate allergologic screening excluded other sensitizations. Analysis of total and grass-specific IgE and eosinophil cationic protein was carried out before (March) and during (May) the following spring. After the complete end of pollination, bronchial hyperreactivity was assessed. RESULTS: Symptoms (cough, wheezing) persisted during the autumn for a mean period of 41 days (range 13-69). Total IgE was moderately high and grass-specific IgE ranged from 9.25 to 41.12 kU/l without significant differences before and during spring. On the contrary, serum ECP levels significantly increased during the pollination period. PD20 methacholine evaluated after the end of grass pollination was negatively significantly correlated with levels of total IgE (r=-0.73; P<0.01) and the increase (from March to May) of serum ECP (r=-0.75; P<0.01). However, PD20 methacholine did not correlate with grass-specific IgE and serum ECP absolute values of both March and May. A positive correlation was found between number of postseasonal days with symptoms and both spring increase of serum ECP (r=0.75; P=0.04) and levels of total IgE (r=0.76; P<0.01). The number of postseasonal days with symptoms inversely correlated with postseason PD20 methacholine (r=-0.76; P<0.01). CONCLUSIONS: The study demonstrates that in grass-sensitized farmers with asthmatic symptoms persisting for several weeks after grass pollination has ceased, the degree of airways hyperreactivity and the duration of postseasonal symptoms are directly related to the spring increase of ECP levels, as well as to the level of total IgE in serum. This allows us to identify two candidate biomarkers for the risk of developing prolonged asthma symptoms, and for the effective monitoring of anti-inflammatory treatment and allergen-specific immunotherapy.
Adult↗
Prevalence of Isospora belli in AIDS and immunocompetent patients in Uganda.
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AIDS-Related Opportunistic Infections↗
Clinical aspects and imaging patterns with ultrasonography and endoscopy in hepatosplenic schistosomiasis in Uganda.
In patients with hepato-splenic schistosomiasis, a close relationship between the grade of periportal fibrosis and portal vein diameter, spleen size and presence of oesophageal varices and their grade was found.
Adolescent↗
Clinical and endoscopic aspects of hepatosplenic schistosomiasis in Uganda.
INTRODUCTION: Hepatosplenic schistosomiasis is characterized by hepatic periportal fibrosis (Symmers' fibrosis), portal venous obstruction that leads to portal hypertension and its complications, and splenomegaly. Demonstration of pathological lesions due to Schistosoma mansoni can be achieved by using different techniques but because of its sensitivity, specificity and simplicity, ultrasound has replaced wedge biopsy of the liver as the gold standard for detecting schistosomal periportal fibrosis. The aims of the study were to evaluate clinical aspects of schistosomiasis in a well defined area and to assess whether there was a relationship between the grade of periportal fibrosis and the presence of oesophageal varices and their features. MATERIALS AND METHODS: A total of 122 patients with proven schistosome infection were enrolled in the study. Each underwent ultrasound examination to assess hepatosplenic involvement and staging, and upper digestive endoscopy to assess the presence of oesophageal varices and their features. For all the patients, the main characteristics and symptoms, possibly related to schistosomiasis, were also recorded. RESULTS: A close relationship was found between the grade of periportal fibrosis and the presence of oesophageal varices, their grade and localization in the oesophagus. There was also was a relationship between haematemesis and size of varix, localization of varix and presence of cherry-red spots, but no correlation was found with other endoscopic features of varices. CONCLUSION: Clinical aspects of schistosomiasis in Hoima District are similar to what is known from the literature and there are no specific features. The study shows that ultrasonography is an important tool for accurate staging of hepatosplenic schistosomiasis. Although it cannot replace endoscopy, it can direct the need for performing it. In fact, the higher the grade of periportal fibrosis the greater the possibility of having oesophageal varices. Endoscopy is of value in detecting oesophageal varices especially in advanced stages of liver schistosomiasis, in describing their endoscopic features so as to detect those more at risk of bleeding, and for emergency sclerotherapy.
Adult↗
Bronchoalveolar lavage fluid level of carcinoembryonic antigen in the diagnosis of peripheral lung cancer.
The objective of this study was to verify whether the assay of carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) can increase the sensitivity and specificity of serum CEA for the diagnosis of lung cancer. We examined 72 subjects, 53 males and 19 females, 18 affected with peripheral lung cancer (10 adenocarcinoma, 6 squamous cell carcinoma, 1 small cell lung cancer, 1 adenosquamous carcinoma), 19 with acute pneumonia, 14 with chronic obstructive pulmonary disease (COPD), 6 with interstitial lung disease (ILD), and 15 healthy subjects. CEA was assayed in blood and in BALF using microparticle enzyme immunoassay (MEIA) (IMX Abbott). The mean serum CEA value in the lung cancer group did not differ from that in each group of non-neoplastic subjects, neither was it different from that in healthy subjects. The mean BALF CEA in patients with lung cancer, pneumonia, and COPD was significantly increased compared with that in healthy subjects, whereas there was no difference between the three groups of patients. The ratio of BALF CEA was not significantly different in the three groups of patients. There were no differences according to the histological type of the tumour (adenocarcinoma or squamous cell carcinoma). Based on the results in healthy subjects, the upper limits of normal were defined for serum CEA, BALF CEA, and CEA/albumin ratio. Thus, the sensitivity of BALF CEA in detecting lung cancer (50%) was higher than that of serum CEA (33%), although clinically not useful. In addition, BALF CEA had only 59% specificity compared to 100% of serum CEA. The diagnostic accuracy was 79% for serum CEA and 56% for BALF CEA.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
A study of breastfeeding and the return of menses in Hoima District, Uganda.
The effect of breastfeeding on reestablishment of ovulation and fertility and on birth spacing are now well known. A study was conducted on lactational amenorrhoea (LAM) at 180 days in Hoima District, Uganda in order to understand whether and how LAM could be applied in fertility control and birth spacing. Since the introduction of supplementary food by Ugandan women does not replace or substitute for breastfeeding, a study was designed to determine if LAM was effective irrespective of supplementation of infant's diet. One hundred and fifty four mother/child pairs were entered into the study and 134 women completed the sixth month of the study. At the end of the period, eighty four women (62.7%) were amenorrhoeic of whom only 33 (39.3%) were exclusively breastfeeding and no woman had dropped out of the study because of pregnancy or the use of other family planning methods other than LAM. The study confirmed that LAM could be applicable in Uganda to the majority of the breastfeeding women (62.7%). It is expected that if health workers increase the intensity of breastfeeding support as well as the women's knowledge and motivation to use LAM for family planning, this would contribute to children's health as well as to birth spacing that is one of the major factors related to infant deaths. According to data from this study, the return of menses is irrespective of whether supplements have been introduced and their frequency.
Adolescent↗