PubMed Health⌕ Search

Biomedical subjects

Paola Morelli

Publications and source records attributed to Paola Morelli.

8 recordsLinked to original sources
PubMed2005

Increased CD36 expression on circulating monocytes during HIV infection.

BACKGROUND: Metabolic alterations and abnormalities of fat distribution are common findings in antiretroviral-treated HIV-1-infected patients. CD36 is a multifunctional receptor with a wide tissue distribution that plays a crucial role in the cellular uptake and metabolism of lipids. OBJECTIVES: To define the level of CD36 expression on circulating monocytes from HIV-1-infected patients and healthy controls (HCs) and to correlate CD36 expression levels with metabolic and immunovirologic parameters. METHODS: CD36 expression on peripheral blood monocytes was measured by means of flow cytometry in 165 HIV-1-infected patients and in 35 HCs. Statistical analysis was performed by means of univariate and multivariate analysis of variance models. RESULTS: CD36 expression was significantly higher in HIV-1-infected patients compared with HCs (P < 0.0001). HIV-1 infection was the only variable associated with CD36 expression on multivariate analysis, whereas no correlation was found between CD36 level and age, sex, body mass index, lipid serum levels, HIV RNA levels, time on antiretroviral therapy, or kind of antiretroviral regimen. CONCLUSIONS: HIV-1 infection is associated with increased expression of CD36 on circulating monocytes, and antiretroviral drugs play only a minor role in the complex homeostasis of this receptor. Given its role in the cellular uptake and accumulation of lipids, CD36 increased levels on monocytes could represent a proatherogenic condition in HIV-infected patients.

Adult↗
PubMed2004

Long-term efficacy of the surgical treatment of buffalo hump in patients continuing antiretroviral therapy.

Fat redistribution disorders are common complications of antiretroviral therapy. Corrective surgery is increasingly used to treat localized fat accumulations that are difficult to treat medically or by changes in drug regimens, but is limited by relapses caused by the continuation of antiretroviral therapy. The surgical treatment of buffalo hump has a long-term favourable effect in the majority of patients continuing antiretroviral therapy, and can therefore be considered in patients experiencing considerable physical or psychological discomfort.

Adult↗
PubMed2003

Correlates of risk of adipose tissue alterations and their modifications over time in HIV-1-infected women treated with antiretroviral therapy.

OBJECTIVE: To assess the correlates of risk of the different types of lipodystrophy and their modifications over time in a cohort of HIV-positive women receiving antiretroviral therapy (ART). METHODS: A consecutive series of HIV-infected women receiving ART was prospectively enrolled between 1 and 31 March 1998, and followed up for 2 years. Adipose tissue alterations (ATAs) and their variations over time were assessed by means of clinical observation and anthropometric measurements, and logistic regression analysis was used to describe the associated risk factors identified by univariate and multivariate analyses. RESULTS: One-hundred-and-seventeen of the 212 women (55.2%) developed ATAs during the 24 months of follow-up. Central adiposity was observed in 95 patients and peripheral lipoatrophy in 91, with 21 patients (9.9%) showing pure lipoatrophy, 26 (12.3%) pure fat accumulation and 70 (33%) combined forms. Only six of the 223 regional adipose tissue alterations identified in 74 patients during the first 12 months of the study had disappeared by month 24. Of the 43 patients who developed breast enlargement during the first 12 months, 11 (25.6%) showed a decrease in breast size during the second year of follow-up that was unrelated to changes in therapy or therapeutic success. The development of ATAs during the first 12 months of follow-up independently correlated with protease inhibitor (PI) use (OR 2.81, P=0.002) but, by the end of the second year of follow-up, the only factor significantly related to the development of ATAs was the overall duration of ART (OR 1.85, P=0.041). The use of PI significantly increased the risk of developing central adiposity during the first 12 months of the study (OR 2.27, P=0.002), whereas the only variable significantly influencing the risk at month 24 was HIV-infection due to intravenous drug use, which proved to be protective (OR 0.53, P=0.043). During the first 12 months of follow-up, the development of peripheral lipoatrophy was significantly associated with stavudine (OR 2.19, P=0.037) and PI use at enrolment (OR 2.27, P=0.023). At the end of the study, the variables associated with peripheral lipoatrophy were stavudine use at enrolment (OR 2.82, P=0.002), ART exposure for >1000 days at enrolment (OR 2.32, P=0.007), a CD4 cell count of >200/microl at enrolment (OR 2.89, P=0.002) and an age of >28 years (OR 1.91, P=0.036). The only factor significantly associated with an increased risk of breast enlargement during the first 12 months of follow-up was PI use (adjusted OR 2.51; 95% CI: 1.16-5.46, P=0.02); however, at month 24, none of the tested variables was associated with a significantly increased risk of this ATA. CONCLUSIONS: ATAs (particularly central adiposity) are frequent in women treated with ART, and the different forms have different correlates of risk. Once they have become clinically evident, they generally tend to remain or worsen, and improve in only a small minority of cases. The considerable variations in adipomasty over time are apparently unrelated to changes in ART.

Adipose Tissue↗
PubMedDate not supplied

Prospective observational study of fever in hospitalized returning travelers and migrants from tropical areas, 1997-2001.

BACKGROUND: An estimated 50 million people each year from industrialized countries visit tropical areas: 3% to 11% of these travelers report a febrile illness on their return. We conducted a 5-year prospective observational study on the causes of fever in patients admitted to a university teaching hospital after returning from the tropics. METHODS: We enrolled in this study all consecutive patients admitted to the Division of Infectious Diseases of the University of Milan, Italy, between January 1997 and December 2001 presenting with fever (oral temperature > or =37.5 degrees C) and a history of travel to a tropical country in the previous 6 months. RESULTS: Seven percent (147/2,074) of all hospital admissions in the study period were due to fever in travelers and migrants returning from the tropics. Malaria accounted for 47.6 % of all admissions (70/147), followed by presumed self-limiting viral infections (12%). Pretravel screening and vaccination strategies could have prevented a considerable number of hospitalizations (e.g., hepatitis A and typhoid fever). The most useful investigations were blood examination and PCR for malaria, which gave positive results in 65% of cases in which they were performed. CONCLUSIONS: During a 5-year period, the number of patients returning from tropical areas who were admitted with fever to a university hospital in northern Italy remained stable; malaria was the most frequent diagnosis, and should be considered in any febrile patient returning from the tropics. With the exception of hepatitis A and dengue fever infections, in a real-world setting serology is of modest utility and is probably overused.

Adult↗