Maria Maiello, Annagrazia Cecere, Marco Matteo Ciccone, Pasquale Palmiero
Objective. We studied the prevalence and major predisposing factors of permanent atrial fibrillation (PAF) in a population of hypertensive post-menopausal (HPMW) women. Materials and Methods. We enrolled 125 consecutive HPMW with PAF, 125 HPMW in sinus rhythm were the control group (CG). Women with valvular heart disease, coronary artery disease, WPW syndrome, left ventricular (LV) ejection fraction <45% and thyroid disorders were excluded. The mean age was similar: 53±3 years for women on PAF and 51±6 for women with sinus rhythm (P<0.45). All women who underwent M-B mode echocardiography, LV mass, function, and left atrial (LA) volume were assessed according to American Society of Echocardiography guidelines. Diabetes was assessed according to American Diabetes Association guidelines. Results. In a population of 8945 consecutive women, 4497 were hypertensive (50.2%) and 125 were on PAF (0.3%). We observed a highly significant difference between the two groups in relation to obesity: 31 (24.8%) in the AF-group and 15 (12%) in CG, Chi-squared 10, P<0.0016, OR 2.8, 95%; to increased LA volume: 37 (29.6%) in AF-group and 13 (10.4%) in CG, Chi-squared 14.4, P<0.0001, OR 3.62, 95%. No difference in diabetes: 30 (24%) in AFgroup and 28 (22.4%) in CG, Chi-squared 0.09, P<0.76, OR 1.09, 95%, and LV diastolic dysfunction (LVDD): 24 (19.2%) in AF-group and 20 (16%) in CG, Chi-squared 0.44, P<0.5, OR 1.25, 95%. In contrast to what was expected LV hypertrophy had a lower incidence of 59 (47.2%) in AF-group than in CG 84 (67.2%), Chi-squared 10.21, P<0.0014, OR 0.44, 95%. Conclusions. The prevalence of PAF in HPMW is not elevated, obesity and increased LA volume are strong determinants of PAF, not depending on age. LVDD, LV hypertrophy, and diabetes status seem not to play a relevant role as PAF determinants.
目标。我们研究了高血压绝经后妇女(HPMW)人群中永久性心房颤动(PAF)的患病率和主要易感因素。材料与方法。我们连续入组125例伴有PAF的HPMW，其中125例有窦性心律的HPMW为对照组(CG)。排除瓣膜性心脏病、冠状动脉疾病、WPW综合征、左心室射血分数≥45%和甲状腺疾病的妇女。平均年龄相似:患有PAF的女性为53±3岁，患有窦性心律的女性为51±6岁(P<0.45)。所有接受M-B型超声心动图检查的女性，左室质量、功能和左房(LA)容积均按照美国超声心动图学会指南进行评估。糖尿病是根据美国糖尿病协会的指南进行评估的。结果。在8945名连续的女性人群中，4497名患有高血压(50.2%)，125名服用PAF(0.3%)。我们观察到两组之间与肥胖相关的极显著差异:af组有31例(24.8%)，CG组有15例(12%)，卡方10,P<0.0016, OR 2.8, 95%;到LA体积增加:af组37例(29.6%)，CG组13例(10.4%)，卡方14.4,P<0.0001, OR 3.62, 95%。糖尿病无差异:af组30例(24%)，CG 28例(22.4%)，卡方0.09,P<0.76, OR 1.09, 95%;左室舒张功能障碍(LVDD): af组24例(19.2%)，CG 20例(16%)，卡方0.44,P<0.5, OR 1.25, 95%。与预期相反，af组左室肥厚的发生率为59(47.2%)低于CG组84(67.2%)，卡方10.21,P<0.0014, OR 0.44, 95%。结论。HPMW中PAF的患病率没有升高，肥胖和LA体积增加是PAF的重要决定因素，与年龄无关。左室dd、左室肥厚和糖尿病状态似乎不是PAF的决定因素。
{"title":"Prevalence and determinants of permanent atrial fibrillation in post-menopausal hypertensive women","authors":"Maria Maiello, Annagrazia Cecere, Marco Matteo Ciccone, Pasquale Palmiero","doi":"10.4081/itjm.2023.1652","DOIUrl":"https://doi.org/10.4081/itjm.2023.1652","url":null,"abstract":"Objective. We studied the prevalence and major predisposing factors of permanent atrial fibrillation (PAF) in a population of hypertensive post-menopausal (HPMW) women. Materials and Methods. We enrolled 125 consecutive HPMW with PAF, 125 HPMW in sinus rhythm were the control group (CG). Women with valvular heart disease, coronary artery disease, WPW syndrome, left ventricular (LV) ejection fraction <45% and thyroid disorders were excluded. The mean age was similar: 53±3 years for women on PAF and 51±6 for women with sinus rhythm (P<0.45). All women who underwent M-B mode echocardiography, LV mass, function, and left atrial (LA) volume were assessed according to American Society of Echocardiography guidelines. Diabetes was assessed according to American Diabetes Association guidelines. Results. In a population of 8945 consecutive women, 4497 were hypertensive (50.2%) and 125 were on PAF (0.3%). We observed a highly significant difference between the two groups in relation to obesity: 31 (24.8%) in the AF-group and 15 (12%) in CG, Chi-squared 10, P<0.0016, OR 2.8, 95%; to increased LA volume: 37 (29.6%) in AF-group and 13 (10.4%) in CG, Chi-squared 14.4, P<0.0001, OR 3.62, 95%. No difference in diabetes: 30 (24%) in AFgroup and 28 (22.4%) in CG, Chi-squared 0.09, P<0.76, OR 1.09, 95%, and LV diastolic dysfunction (LVDD): 24 (19.2%) in AF-group and 20 (16%) in CG, Chi-squared 0.44, P<0.5, OR 1.25, 95%. In contrast to what was expected LV hypertrophy had a lower incidence of 59 (47.2%) in AF-group than in CG 84 (67.2%), Chi-squared 10.21, P<0.0014, OR 0.44, 95%. Conclusions. The prevalence of PAF in HPMW is not elevated, obesity and increased LA volume are strong determinants of PAF, not depending on age. LVDD, LV hypertrophy, and diabetes status seem not to play a relevant role as PAF determinants.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135830024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To control diabetes in a society, risk assessment tools are used to predict disease risk. We aimed to assess the value of different risk factors for diabetes mellitus in a remarkable community in the city of Kerman, one of the vast areas in the southeast of Iran, with the final goal of designing a predictive model for diabetes in this region. This study was a cross-sectional study with the aim of investigating the predictive value of risk factors indicating the presence of diabetes in the population of Kerman City based on the guidelines of the American Diabetes Association (ADA) risk assessment tool. The information of 4000 people participating in the comprehensive screening plan for cardiovascular risk factors in Kerman City was extracted by reviewing the relevant data registry. According to the ADA guideline, 32.5% of participants were at risk for diabetes mellitus. The hazard ratio of diabetes mellitus in the subgroup with the ADA final score ≥5 as compared to those with a lower final score was 1.9. Advanced age, history of gestational diabetes, family history of diabetes mellitus, history of hypertension, low physical activity, and higher body mass index were the main determinants of diabetes mellitus. According to ADA guidelines and the diabetes mellitus risk assessment tool, 32.5% of the population residents in Kerman City are potentially at risk for diabetes mellitus that can be successfully predicted aide by the ADA risk assessment tool.
{"title":"Predictive model for diabetes mellitus occurrence in Iran’s southeastern region: a study based on American diabetes association guidelines","authors":"Seyedeh Mahdieh Khoshnazar, Hamid Najafipour, Lida SoltaniNejad, Sara Pezeshki, Gholamreza Yousefzadeh","doi":"10.4081/itjm.2023.1642","DOIUrl":"https://doi.org/10.4081/itjm.2023.1642","url":null,"abstract":"To control diabetes in a society, risk assessment tools are used to predict disease risk. We aimed to assess the value of different risk factors for diabetes mellitus in a remarkable community in the city of Kerman, one of the vast areas in the southeast of Iran, with the final goal of designing a predictive model for diabetes in this region. This study was a cross-sectional study with the aim of investigating the predictive value of risk factors indicating the presence of diabetes in the population of Kerman City based on the guidelines of the American Diabetes Association (ADA) risk assessment tool. The information of 4000 people participating in the comprehensive screening plan for cardiovascular risk factors in Kerman City was extracted by reviewing the relevant data registry. According to the ADA guideline, 32.5% of participants were at risk for diabetes mellitus. The hazard ratio of diabetes mellitus in the subgroup with the ADA final score ≥5 as compared to those with a lower final score was 1.9. Advanced age, history of gestational diabetes, family history of diabetes mellitus, history of hypertension, low physical activity, and higher body mass index were the main determinants of diabetes mellitus. According to ADA guidelines and the diabetes mellitus risk assessment tool, 32.5% of the population residents in Kerman City are potentially at risk for diabetes mellitus that can be successfully predicted aide by the ADA risk assessment tool.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134886360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Delle Monache, Marco Carli, Annarita Vestri, Lorenzo Nosotti, Teresa Morgillo, Michele Delle Monache
Background. Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. As an infrequent disease, a Facebook group was created for patients to share experiences and problems. In fact, during the COVID-19 pandemic, patient analysis could only be done through remote connection systems. Therefore, to analyze patients' quality of life (QoL), we exploited social networks and online data collection platforms. Objectives. A survey was carried out to evaluate the QoL of patients with PBC during the COVID-19 pandemic. Materials and Methods. A Facebook group was used for patient enrolment. Age, sex, diagnosis, years since diagnosis, associated diseases, histological stage of the disease, value of elastography, and current therapy were collected. PBC 40 online questionnaire was submitted to patients to assess their QoL. Results. 78 patients participated in the study: 75 females, and 3 males, the mean (±SD) age was 46.4±11.5. The main diagnoses were PBC in 66 patients and overlapping syndrome PBC + autoimmune hepatitis in 10. Histology was available in 45 patients, of whom 34 were stages 1-2 and 11 stages 3-4. The main therapy was ursodeoxycholic acid in 56 pts. The questionnaire is divided into 6 domains, covering fatigue, emotional, social, and cognitive functions, general symptoms, and itching. The mean and standard deviation of the scores were computed. Interpretation of the results obtained by applying a quantitative scale showed no impairment for social, mild impairment for general symptoms, itching, cognitive and emotional function, and moderate impairment for fatigue. No correlation was found between scores and disease duration. Conclusions. This study demonstrates that online questionnaires are a viable substitute for paper questionnaires and that data collected from online surveys on Facebook can have scientific relevance; PBC had the greatest impact on QoL on fatigue and the least on social aspects.
{"title":"Collecting clinical data during an emergency: quality of life in primary biliary cholangitis during the COVID-19 pandemic","authors":"Marco Delle Monache, Marco Carli, Annarita Vestri, Lorenzo Nosotti, Teresa Morgillo, Michele Delle Monache","doi":"10.4081/itjm.2023.1609","DOIUrl":"https://doi.org/10.4081/itjm.2023.1609","url":null,"abstract":"Background. Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. As an infrequent disease, a Facebook group was created for patients to share experiences and problems. In fact, during the COVID-19 pandemic, patient analysis could only be done through remote connection systems. Therefore, to analyze patients' quality of life (QoL), we exploited social networks and online data collection platforms. Objectives. A survey was carried out to evaluate the QoL of patients with PBC during the COVID-19 pandemic. Materials and Methods. A Facebook group was used for patient enrolment. Age, sex, diagnosis, years since diagnosis, associated diseases, histological stage of the disease, value of elastography, and current therapy were collected. PBC 40 online questionnaire was submitted to patients to assess their QoL. Results. 78 patients participated in the study: 75 females, and 3 males, the mean (±SD) age was 46.4±11.5. The main diagnoses were PBC in 66 patients and overlapping syndrome PBC + autoimmune hepatitis in 10. Histology was available in 45 patients, of whom 34 were stages 1-2 and 11 stages 3-4. The main therapy was ursodeoxycholic acid in 56 pts. The questionnaire is divided into 6 domains, covering fatigue, emotional, social, and cognitive functions, general symptoms, and itching. The mean and standard deviation of the scores were computed. Interpretation of the results obtained by applying a quantitative scale showed no impairment for social, mild impairment for general symptoms, itching, cognitive and emotional function, and moderate impairment for fatigue. No correlation was found between scores and disease duration. Conclusions. This study demonstrates that online questionnaires are a viable substitute for paper questionnaires and that data collected from online surveys on Facebook can have scientific relevance; PBC had the greatest impact on QoL on fatigue and the least on social aspects.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134960305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Monkeypox has been announced recently as a global public health emergency by the World Health Organization. The recent outbreak of monkeypox has brought back concerns about how this viral infection can spread easily between individuals and cause a major health concern. Objectives. The objective of this study was to assess healthcare workers’ (HCWs) knowledge about monkeypox illness, its transmission, prevention, and attitudes toward this re-emerging disease. Materials and Methods. A descriptive correlational cross-sectional survey was conducted in Saudi Arabia from June to August 2022 and targeted HCWs including medical technologists and technicians, physicians, nurses, pharmacists, and others. Results. A total of 385 participants were included where 53.5% of respondents were male compared to 46.5% female. The average score for knowledge was 9.90, and the majority of respondents had an inadequate understanding of monkeypox. In addition, the average score of attitude toward monkeypox infection was 50.19, which indicate that HCWs have a positive view of efforts to prevent monkeypox. Conclusions. In Saudi Arabia, HCWs were found to have an inadequate understanding of the virus that causes monkeypox. This study shows how important it is for HCWs to learn more, since managing contagious infections requires a lot of help from trained and knowledgeable medical professionals.
{"title":"Assessment of knowledge and attitude among healthcare workers towards monkeypox disease: a cross-sectional study from Saudi Arabia","authors":"Talal Qadah","doi":"10.4081/itjm.2023.1645","DOIUrl":"https://doi.org/10.4081/itjm.2023.1645","url":null,"abstract":"Background. Monkeypox has been announced recently as a global public health emergency by the World Health Organization. The recent outbreak of monkeypox has brought back concerns about how this viral infection can spread easily between individuals and cause a major health concern. Objectives. The objective of this study was to assess healthcare workers’ (HCWs) knowledge about monkeypox illness, its transmission, prevention, and attitudes toward this re-emerging disease. Materials and Methods. A descriptive correlational cross-sectional survey was conducted in Saudi Arabia from June to August 2022 and targeted HCWs including medical technologists and technicians, physicians, nurses, pharmacists, and others. Results. A total of 385 participants were included where 53.5% of respondents were male compared to 46.5% female. The average score for knowledge was 9.90, and the majority of respondents had an inadequate understanding of monkeypox. In addition, the average score of attitude toward monkeypox infection was 50.19, which indicate that HCWs have a positive view of efforts to prevent monkeypox. Conclusions. In Saudi Arabia, HCWs were found to have an inadequate understanding of the virus that causes monkeypox. This study shows how important it is for HCWs to learn more, since managing contagious infections requires a lot of help from trained and knowledgeable medical professionals.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134958284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed A. El-Sakhawy, Mohammad Zahidul Iqbal, Gamal A. Gabr, Abdullah A. Alqasem, Abeer Ali El-Sherbiny Ateya, Fatma A. Ahmed, Samah A. El-Hashash, Heba S. Ibrahim, Usama M. Abu El-Ghiet
Spirulina happens to be a special type of blue-green algae that originally emerged 3.5 billion years ago and was used as a source of nutrition. Spirulina gets its name from the filaments’ spiral or helical structure, but its true name is taxonomically Genus Arthrospira which encompasses several species. The most common species are S. fusiformis, S. maxima, and S. platensis. It is rich in various nutrients and chemical components including protein, carbohydrates, lipids, vitamins, minerals, pigments, chlorophyll, and enzymes. Spirulina’s active molecules and rich nutrients make it have several pharmacological activities and uses including antioxidant, anti-inflammatory, immunomodulatory, immune system booster, anticancer, antiviral activity, and neuroprotective properties. It is also utilized as a nutritional supplement and for weight loss. Moreover, several studies confirm that Spirulina improves insulin sensitivity and reduces blood glucose levels in rat models as well as diabetic patients. The reason behind this unique behavior could be credited to the presence of several active components in it, but the action’s fundamental mechanism is still a matter of debate. Several studies have suggested different mechanisms including anti-inflammatory activity, increased insulin sensitivity, inhibition of gluconeogenesis, antioxidant activity, modulating gut microbiota composition, improved glucose homeostasis, and insulin receptor activation. Therefore, it became clear that Spirulina is a mine of active substances used as a nutritional supplement and reduces blood glucose levels or used in conjunction with other treatments to tackle type 2 diabetes. Further exploration is required to fully explain its effects on human physiology and determine optimal dosages for treatment.
螺旋藻恰好是一种特殊类型的蓝绿藻，最初出现在35亿年前，被用作营养来源。螺旋藻得名于其细丝呈螺旋状或螺旋状的结构，但它真正的名字在分类学上是节螺旋藻属，包括几个物种。最常见的种类是S. fususiformis, S. maxima和S. platensis。它富含各种营养和化学成分，包括蛋白质、碳水化合物、脂类、维生素、矿物质、色素、叶绿素和酶。螺旋藻的活性分子和丰富的营养使其具有多种药理活性和用途，包括抗氧化、抗炎、免疫调节、免疫系统增强、抗癌、抗病毒活性和神经保护特性。它也被用作营养补充剂和减肥。此外，几项研究证实，螺旋藻可以改善大鼠模型和糖尿病患者的胰岛素敏感性，降低血糖水平。这种独特行为背后的原因可以归功于其中存在几种有效成分，但这种行为的基本机制仍然是一个有争议的问题。一些研究提出了不同的机制，包括抗炎活性、增加胰岛素敏感性、抑制糖异生、抗氧化活性、调节肠道微生物群组成、改善葡萄糖稳态和胰岛素受体激活。因此，很明显，螺旋藻含有丰富的活性物质，可作为营养补充剂，降低血糖水平，或与其他治疗方法一起用于治疗2型糖尿病。需要进一步探索，以充分解释其对人体生理的影响，并确定最佳的治疗剂量。
{"title":"The mechanism of action of Spirulina as antidiabetic: a narrative review","authors":"Mohamed A. El-Sakhawy, Mohammad Zahidul Iqbal, Gamal A. Gabr, Abdullah A. Alqasem, Abeer Ali El-Sherbiny Ateya, Fatma A. Ahmed, Samah A. El-Hashash, Heba S. Ibrahim, Usama M. Abu El-Ghiet","doi":"10.4081/itjm.2023.1639","DOIUrl":"https://doi.org/10.4081/itjm.2023.1639","url":null,"abstract":"Spirulina happens to be a special type of blue-green algae that originally emerged 3.5 billion years ago and was used as a source of nutrition. Spirulina gets its name from the filaments’ spiral or helical structure, but its true name is taxonomically Genus Arthrospira which encompasses several species. The most common species are S. fusiformis, S. maxima, and S. platensis. It is rich in various nutrients and chemical components including protein, carbohydrates, lipids, vitamins, minerals, pigments, chlorophyll, and enzymes. Spirulina’s active molecules and rich nutrients make it have several pharmacological activities and uses including antioxidant, anti-inflammatory, immunomodulatory, immune system booster, anticancer, antiviral activity, and neuroprotective properties. It is also utilized as a nutritional supplement and for weight loss. Moreover, several studies confirm that Spirulina improves insulin sensitivity and reduces blood glucose levels in rat models as well as diabetic patients. The reason behind this unique behavior could be credited to the presence of several active components in it, but the action’s fundamental mechanism is still a matter of debate. Several studies have suggested different mechanisms including anti-inflammatory activity, increased insulin sensitivity, inhibition of gluconeogenesis, antioxidant activity, modulating gut microbiota composition, improved glucose homeostasis, and insulin receptor activation. Therefore, it became clear that Spirulina is a mine of active substances used as a nutritional supplement and reduces blood glucose levels or used in conjunction with other treatments to tackle type 2 diabetes. Further exploration is required to fully explain its effects on human physiology and determine optimal dosages for treatment.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136308171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carmine Siniscalchi, Pietro Rossetti, Gaetano Carolla, Pierpaolo Di Micco, Adriano Stella, Michele Riva
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic or obstetric events occurring in patients with persistent antiphospholipid antibodies. Thrombotic APS is characterized by venous, arterial, or microvascular thrombosis. The diagnosis is accepted when both one clinical and one laboratory criteria according to the updated Sapporo classification are established. APS may occur in combination with other autoimmune diseases, mainly systemic lupus erythematosus, or in its primary form. Long-term anticoagulation with a vitamin K antagonist is the standard of care for patients who develop thrombosis, considering the high rate of recurrent thrombosis. The current international guidelines are not in favor of recommending direct oral anticoagulants for secondary prevention of thrombotic antiphospholipid syndrome, especially in the context of arterial thrombosis and triple-positive antiphospholipid patients. The most common approach, endorsed by the American College of Chest Physicians guidelines is the combination of heparin and low-dose aspirin (75-100 mg) daily for women who fulfill the clinical and serologic criteria for obstetric APS. New potential therapeutic approaches are under evaluation but actually the anticoagulation remains the cornerstone of treatment.
抗磷脂综合征(APS)是一种系统性自身免疫性疾病，其特征是持续性抗磷脂抗体患者发生血栓形成或产科事件。血栓性APS以静脉、动脉或微血管血栓形成为特征。当根据更新的Sapporo分类建立了一个临床和一个实验室标准时，诊断被接受。APS可合并其他自身免疫性疾病，主要是系统性红斑狼疮，或以其原发性形式发生。考虑到血栓复发率高，长期使用维生素K拮抗剂抗凝治疗是血栓形成患者的标准护理。目前的国际指南不赞成推荐直接口服抗凝剂用于血栓性抗磷脂综合征的二级预防，特别是在动脉血栓形成和抗磷脂三阳性患者的情况下。美国胸科医师学会(American College of Chest Physicians)指南认可的最常见的方法是，对于符合产科APS临床和血清学标准的女性，每日联合使用肝素和低剂量阿司匹林(75-100毫克)。新的潜在治疗方法正在评估中，但实际上抗凝仍然是治疗的基石。
{"title":"A review on management of antiphospholipid syndrome in clinical practice","authors":"Carmine Siniscalchi, Pietro Rossetti, Gaetano Carolla, Pierpaolo Di Micco, Adriano Stella, Michele Riva","doi":"10.4081/itjm.2023.1649","DOIUrl":"https://doi.org/10.4081/itjm.2023.1649","url":null,"abstract":"Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic or obstetric events occurring in patients with persistent antiphospholipid antibodies. Thrombotic APS is characterized by venous, arterial, or microvascular thrombosis. The diagnosis is accepted when both one clinical and one laboratory criteria according to the updated Sapporo classification are established. APS may occur in combination with other autoimmune diseases, mainly systemic lupus erythematosus, or in its primary form. Long-term anticoagulation with a vitamin K antagonist is the standard of care for patients who develop thrombosis, considering the high rate of recurrent thrombosis. The current international guidelines are not in favor of recommending direct oral anticoagulants for secondary prevention of thrombotic antiphospholipid syndrome, especially in the context of arterial thrombosis and triple-positive antiphospholipid patients. The most common approach, endorsed by the American College of Chest Physicians guidelines is the combination of heparin and low-dose aspirin (75-100 mg) daily for women who fulfill the clinical and serologic criteria for obstetric APS. New potential therapeutic approaches are under evaluation but actually the anticoagulation remains the cornerstone of treatment.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135741945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mashaer Taha Edris, Maye Mohammad Merghani, Shaza Salih Gafar, Ahmed Mohamed Asmali, Elrashed B. Yasin, Raed Alserihi, Heba Alkhatabi, Haitham MH. Qutob, Rowaid Qahwaji, Elshazali Widaa Ali
Background and Objectives. The enzyme methionine synthase reductase is involved in cellular methylation reactions, DNA synthesis, and epigenetic processes. It is encoded by the MTRR gene, which garnered a lot of attention in current medical genetics research. This study was conducted to study the association between MTRR (A66G) polymorphism and the risk of developing acute lymphoblastic leukemia among Sudanese patients. Materials and Methods. This is a case-control study in which 150 patients with acute lymphoblastic leukemia (ALL) and 150 healthy participants as a control group were enrolled. DNA was extracted and analyzed for the MTRR (A66G) polymorphism using the real-time polymerase chain reaction. Results. Based on flow cytometry results, B-ALL was more common (79%) than T-ALL (21%). The comparison of hematological parameters in acute lymphoblastic leukemia subtypes showed a statistically significant high mean total white blood count (P=0.000) and mean blast percentage (P=0.050) in patients with T-ALL. The molecular analysis showed that the incidence of the MTRR homozygous genotypes AA and GG were higher in the patients (44% and 9.3%, respectively) compared to the control group (40% and 6.7%, respectively). In comparison, the heterozygous genotype AG was lower in the patients (46.7%) than in the control group (53.3%). However, the association between the polymorphism and acute lymphoblastic leukemia risk was not statistically significant (OR: 1.179, 95% CI 0.7459-1.865, P=0.445). Conclusions. This study concluded that MTRR A66G polymorphism was not associated with the risk of acute lymphoblastic leukemia among the Sudanese population.
背景和目标。蛋氨酸合成酶还原酶参与细胞甲基化反应、DNA合成和表观遗传过程。它由MTRR基因编码，在当前医学遗传学研究中备受关注。本研究旨在研究苏丹患者MTRR (A66G)多态性与急性淋巴细胞白血病发病风险之间的关系。材料与方法。这是一项病例对照研究，其中150名急性淋巴细胞白血病(ALL)患者和150名健康参与者作为对照组。提取DNA，采用实时聚合酶链反应分析MTRR (A66G)多态性。结果。根据流式细胞术结果，B-ALL(79%)比T-ALL(21%)更常见。急性淋巴细胞白血病各亚型的血液学参数比较显示，T-ALL患者的平均总白细胞计数(P=0.000)和平均细胞百分率(P=0.050)较高，具有统计学意义。分子分析显示，MTRR纯合基因型AA和GG在患者中的发生率(分别为44%和9.3%)高于对照组(分别为40%和6.7%)。相比之下，患者的杂合基因型AG(46.7%)低于对照组(53.3%)。然而，多态性与急性淋巴细胞白血病风险之间的相关性无统计学意义(OR: 1.179, 95% CI 0.7459-1.865, P=0.445)。结论。本研究得出结论，MTRR A66G多态性与苏丹人群急性淋巴细胞白血病的风险无关。
{"title":"Association of methionine synthase reductase (MTRR A66G) polymorphism with susceptibility to acute lymphoblastic leukemia","authors":"Mashaer Taha Edris, Maye Mohammad Merghani, Shaza Salih Gafar, Ahmed Mohamed Asmali, Elrashed B. Yasin, Raed Alserihi, Heba Alkhatabi, Haitham MH. Qutob, Rowaid Qahwaji, Elshazali Widaa Ali","doi":"10.4081/itjm.2023.1644","DOIUrl":"https://doi.org/10.4081/itjm.2023.1644","url":null,"abstract":"Background and Objectives. The enzyme methionine synthase reductase is involved in cellular methylation reactions, DNA synthesis, and epigenetic processes. It is encoded by the MTRR gene, which garnered a lot of attention in current medical genetics research. This study was conducted to study the association between MTRR (A66G) polymorphism and the risk of developing acute lymphoblastic leukemia among Sudanese patients. Materials and Methods. This is a case-control study in which 150 patients with acute lymphoblastic leukemia (ALL) and 150 healthy participants as a control group were enrolled. DNA was extracted and analyzed for the MTRR (A66G) polymorphism using the real-time polymerase chain reaction. Results. Based on flow cytometry results, B-ALL was more common (79%) than T-ALL (21%). The comparison of hematological parameters in acute lymphoblastic leukemia subtypes showed a statistically significant high mean total white blood count (P=0.000) and mean blast percentage (P=0.050) in patients with T-ALL. The molecular analysis showed that the incidence of the MTRR homozygous genotypes AA and GG were higher in the patients (44% and 9.3%, respectively) compared to the control group (40% and 6.7%, respectively). In comparison, the heterozygous genotype AG was lower in the patients (46.7%) than in the control group (53.3%). However, the association between the polymorphism and acute lymphoblastic leukemia risk was not statistically significant (OR: 1.179, 95% CI 0.7459-1.865, P=0.445). Conclusions. This study concluded that MTRR A66G polymorphism was not associated with the risk of acute lymphoblastic leukemia among the Sudanese population.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135742010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Chronic hepatitis B virus (HBV) infection is the main pathogen of hepatocellular carcinoma. However, the mechanisms of HBV-related hepatocellular carcinoma (HCC) progression are practically unknown. Materials and Methods. The results of RNA-sequence and clinical data for GSE121248 and GSE17548 were accessed from the Gene Expression Omnibus data library. We screened Sangerbox 3.0 for differentially expressed genes (DEGs). The weighted gene co-expression network analysis (WGCNA) was employed to select core modules and hub genes, and protein-protein interaction network module analysis also played a significant part in it. Validation was performed using RNA-sequence data of cancer and normal tissues of HBV-related HCC patients in the cancer genome atlas-liver hepatocellular cancer database (TCGA-LIHC). Results. 787 DEGs were identified from GSE121248 and 772 DEGs were identified from GSE17548. WGCNA analysis indicated that black modules (99 genes) and grey modules (105 genes) were significantly associated with HBV-related HCC. Gene ontology analysis found that there is a direct correlation between DEGs and the regulation of cell movement and adhesion; the internal components and external packaging structure of plasma membrane; signaling receptor binding, calcium ion binding, etc. Kyoto Encyclopedia of Genes and Genomes pathway analysis found out the association between cytokine receptors, cytokine-cytokine receptor interactions, and viral protein interactions with cytokines were important and HBV-related HCC. Finally, we further validated 6 key genes including C7, EGR1, EGR3, FOS, FOSB, and prostaglandin-endoperoxide synthase 2 by using the TCGALIHC. Conclusions. We identified 6 hub genes as candidate biomarkers for HBV-related HCC. These hub genes may act as an essential part of HBV-related HCC progression.
{"title":"Identification of hub genes associated with hepatitis B virus-related hepatocellular cancer using weighted gene co-expression network analysis and protein-protein interaction network analysis","authors":"Wenze Wu, Fang Lin, Zifan Chen, Kejia Wu, Changhuan Ma, Zhuang Jing, Donglin Sun, Qiang Zhu, Longqing Shi","doi":"10.4081/itjm.2023.1626","DOIUrl":"https://doi.org/10.4081/itjm.2023.1626","url":null,"abstract":"Background. Chronic hepatitis B virus (HBV) infection is the main pathogen of hepatocellular carcinoma. However, the mechanisms of HBV-related hepatocellular carcinoma (HCC) progression are practically unknown. Materials and Methods. The results of RNA-sequence and clinical data for GSE121248 and GSE17548 were accessed from the Gene Expression Omnibus data library. We screened Sangerbox 3.0 for differentially expressed genes (DEGs). The weighted gene co-expression network analysis (WGCNA) was employed to select core modules and hub genes, and protein-protein interaction network module analysis also played a significant part in it. Validation was performed using RNA-sequence data of cancer and normal tissues of HBV-related HCC patients in the cancer genome atlas-liver hepatocellular cancer database (TCGA-LIHC). Results. 787 DEGs were identified from GSE121248 and 772 DEGs were identified from GSE17548. WGCNA analysis indicated that black modules (99 genes) and grey modules (105 genes) were significantly associated with HBV-related HCC. Gene ontology analysis found that there is a direct correlation between DEGs and the regulation of cell movement and adhesion; the internal components and external packaging structure of plasma membrane; signaling receptor binding, calcium ion binding, etc. Kyoto Encyclopedia of Genes and Genomes pathway analysis found out the association between cytokine receptors, cytokine-cytokine receptor interactions, and viral protein interactions with cytokines were important and HBV-related HCC. Finally, we further validated 6 key genes including C7, EGR1, EGR3, FOS, FOSB, and prostaglandin-endoperoxide synthase 2 by using the TCGALIHC. Conclusions. We identified 6 hub genes as candidate biomarkers for HBV-related HCC. These hub genes may act as an essential part of HBV-related HCC progression.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47230261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
La progressione della malattia renale cronicaG. Pinna Basso peso alla nascita, numero di nefroni e malattia renale cronicaD. Manfellotto, M. Cortinovis, N. Perico, G. Remuzzi Malattia renale in corso di diabete mellito: vecchi e nuovi paradigmiE. Gatti, I. Pellicelli, A. Bovino, D. Fasano, E. Gnappi, L. Zerbini, A. Magnano, S. Pioli, L. Bianchi, A. Caiazza, T.M. Attardo, M. Meschi Il ruolo dell’ipertensione arteriosa nella malattia renale cronica: vittima e colpevoleA. De Pascalis, D. Vetrano, A. Tomassetti, S. Bianchi, G. Cianciolo Il ruolo dell’autoimmunità nelle malattie renaliM. Giliberti, V. Di Leo, E.D. Stea, A. Mitrotti, L. Gesualdo Transizione dal danno renale acuto alla malattia renale cronicaF. Di Mario, M.C. Pacchiarini, E. Fiaccadori Le frontiere del trattamento dell’iperpotassiemiaA. Montagnani, M. Caselli, S. Cappelli
{"title":"La progressione della malattia renale cronica","authors":"D. Manfellotto, G. Pinna","doi":"10.4081/itjm.q.2023.3","DOIUrl":"https://doi.org/10.4081/itjm.q.2023.3","url":null,"abstract":"\u0000La progressione della malattia renale cronicaG. Pinna \u0000Basso peso alla nascita, numero di nefroni e malattia renale cronicaD. Manfellotto, M. Cortinovis, N. Perico, G. Remuzzi \u0000Malattia renale in corso di diabete mellito: vecchi e nuovi paradigmiE. Gatti, I. Pellicelli, A. Bovino, D. Fasano, E. Gnappi, L. Zerbini, A. Magnano, S. Pioli, L. Bianchi, A. Caiazza, T.M. Attardo, M. Meschi \u0000Il ruolo dell’ipertensione arteriosa nella malattia renale cronica: vittima e colpevoleA. De Pascalis, D. Vetrano, A. Tomassetti, S. Bianchi, G. Cianciolo \u0000Il ruolo dell’autoimmunità nelle malattie renaliM. Giliberti, V. Di Leo, E.D. Stea, A. Mitrotti, L. Gesualdo \u0000Transizione dal danno renale acuto alla malattia renale cronicaF. Di Mario, M.C. Pacchiarini, E. Fiaccadori \u0000Le frontiere del trattamento dell’iperpotassiemiaA. Montagnani, M. Caselli, S. Cappelli","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47760551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weizhao Lin, Xu Yang, F. Zheng, Jian-Fei Yang, Yonggang Zhang
Objective. To investigate whether Smad2/3 signaling is involved in urotensin II (UII) induced activation of aortic adventitial fibroblasts. Materials and Methods. Growth-arrested adventitial fibroblasts were stimulated with UII in the presence or absence of urotensin II receptor (UT) antagonist SB710411 or transfected with Smad2/3 small inhibitory RNA (siRNA). UII stimulated Smad2/3 phosphorylation, α-smooth muscle actin (α-SMA), and collagen I expression and migration of adventitial fibroblasts were evaluated by western blot analysis, real-time reverse transcription polymerase chain reaction, immunofluorescence, ELISA, and transwell migration assay, respectively. Results. In cultured adventitial fibroblasts, UII time- and dose-dependently stimulated Smad2/3 protein phosphorylation, with maximal effect at 10-8 mol/l (increased by 147.2%, P<0.001). UII stimulated Smad2/3 upregulation and nuclear translocation. SB710411 significantly inhibited these effects. In addition, UII potently induced α-SMA and procollagen 1 protein or mRNA expression (P<0.01), which were completely blocked by Smad2 (decreased by 75.1%, 54.2% in protein, and by 73.3% and 38.2% in mRNA, respectively, P<0.01) or Smad3 siRNA (decreased by 80.3% and 47.0% in protein, and by 72.3% and 47.7% in mRNA, respectively, P<0.01). Meanwhile, Smad2 or smad3 siRNA significantly inhibited the UII-induced collagen 1 secretion and cell migration. Conclusions. UII may stimulate adventitial-fibroblast phenotype conversion, migration, and collagen I synthesis via phosphorylated-Smad2/3 signal transduction pathways.
{"title":"Smad2/3 signaling involved in urotensin II-induced phenotypic differentiation, collagen synthesis and migration of rat aortic adventitial fibroblasts","authors":"Weizhao Lin, Xu Yang, F. Zheng, Jian-Fei Yang, Yonggang Zhang","doi":"10.4081/itjm.2023.1637","DOIUrl":"https://doi.org/10.4081/itjm.2023.1637","url":null,"abstract":"Objective. To investigate whether Smad2/3 signaling is involved in urotensin II (UII) induced activation of aortic adventitial fibroblasts. Materials and Methods. Growth-arrested adventitial fibroblasts were stimulated with UII in the presence or absence of urotensin II receptor (UT) antagonist SB710411 or transfected with Smad2/3 small inhibitory RNA (siRNA). UII stimulated Smad2/3 phosphorylation, α-smooth muscle actin (α-SMA), and collagen I expression and migration of adventitial fibroblasts were evaluated by western blot analysis, real-time reverse transcription polymerase chain reaction, immunofluorescence, ELISA, and transwell migration assay, respectively. Results. In cultured adventitial fibroblasts, UII time- and dose-dependently stimulated Smad2/3 protein phosphorylation, with maximal effect at 10-8 mol/l (increased by 147.2%, P<0.001). UII stimulated Smad2/3 upregulation and nuclear translocation. SB710411 significantly inhibited these effects. In addition, UII potently induced α-SMA and procollagen 1 protein or mRNA expression (P<0.01), which were completely blocked by Smad2 (decreased by 75.1%, 54.2% in protein, and by 73.3% and 38.2% in mRNA, respectively, P<0.01) or Smad3 siRNA (decreased by 80.3% and 47.0% in protein, and by 72.3% and 47.7% in mRNA, respectively, P<0.01). Meanwhile, Smad2 or smad3 siRNA significantly inhibited the UII-induced collagen 1 secretion and cell migration. Conclusions. UII may stimulate adventitial-fibroblast phenotype conversion, migration, and collagen I synthesis via phosphorylated-Smad2/3 signal transduction pathways.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45220701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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