G Caimi

Università degli Studi di Palermo, Palermo, Sicily, Italy

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Publications (208)481.44 Total impact

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    ABSTRACT: Venous leg ulcers are common in subjects with chronic venous insufficiency. The increased intraluminal pressure causes alteration of the skin microcirculation, leukocyte activation and release of proteolytic enzymes leading to ulceration. An impaired expression and activity of matrix metalloproteases (MMPs) and their tissue inhibitors (TIMPs) might influence extracellular matrix degradation and deposition in chronic venous ulcers with the failure of the healing process. Our aim was to evaluate plasma concentration of gelatinases (MMP-2 and MMP-9) and their inhibitors (TIMP-1 and TIMP-2) in subjects with venous leg ulcers before and after the compression therapy. We enrolled 36 subjects (12 men and 24 women, mean age 67.38 ± 12.7 yrs) with non-infected venous leg ulcers (CEAP C6), which underwent a color Duplex scan examination of the veins and arteries of the inferior limbs and were treated with a multi-layer bandaging system. The ulcer healing was obtained in 23 subjects only (9 men and 14 women). We evaluated, on fasting venous blood, the plasma levels of MMP-2, MMP-9, TIMP-1 and TIMP-2 using ELISA kit, before and after the treatment. We observed a significant increase in plasma concentration of gelatinases and their inhibitors and in MMP-2/TIMP-2 ratio in subjects with leg ulcers in comparison with normal controls. In subjects with healed ulcers we found a decrease in MMP-9 and TIMP-1 levels and in MMP-2/TIMP-2 ratio compared to the baseline values, although higher levels of all the examined parameters in comparison with normal controls. In conclusion, plasma MMPs profile is impaired in subjects with venous leg ulcers and it improves after the healing, persisting anyway altered in respect to healthy controls.
    Clinical hemorheology and microcirculation 08/2014; · 3.40 Impact Factor
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    ABSTRACT: Aims Our purpose was to examine the total antioxidant status (TAS) in subjects with metabolic syndrome (MS) subdivided according to the presence or not of diabetes mellitus. Methods We enrolled 106 subjects (45 women, 61 men) with MS subsequently subdivided in diabetics (14 women, 29 men) and nondiabetics (31 women, 29 men). TAS was obtained using an Assay kit which relies on the ability of plasma antioxidant substances to inhibit the oxidation of 2,2′-azino-bis(3-ethylbenzthiazoline sulfonic acid) to the radical ABTS Results In the group of MS subjects a significant decrease in TAS (p < 0.05) in comparison with normal controls was evident. This difference was present between normal subjects and nondiabetic subjects with MS (p < 0.001) but not between normal and diabetic subjects with MS. Examining the linear regression among TAS, age, anthropometric profile, blood pressure values and glycometabolic pattern, conflicting data were found. Conclusions Although we know that TAS includes several enzymatic and non enzymatic antioxidants, we retain that the difference observed in the two subgroups of subjects with MS must be looked in particular into two pathophysiological aspects regarding bilirubin and uric acid.
    Diabetes and Metabolic Syndrome Clinical Research and Reviews 07/2014;
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    ABSTRACT: Our aim was to evaluate nitric oxide metabolites (nitrite and nitrate), expressed as NOx, and erythrocyte deformability, expressed as elongation index, in a group of subjects with obstructive sleep apnea syndrome (OSAS). We enrolled 48 subjects (36 men and 12 women; mean age 50.3 ± 14.68 yrs) with OSAS diagnosed after a 1-night cardiorespiratory sleep study. OSAS severity was assessed evaluating the apnea/hypopnea index (AHI) and subjects were subdivided in two subgroups: Low (L = AHI <30) and High (H = AHI >30). NOx was examined converting nitrate into nitrite with a nitrate reductase and then assessing nitrite with spectrophotometry after the addition of Griess reagent. The elongation index was obtained using the diffractometer Rheodyn SSD of Myrenne at shear stresses of 30 and 60 Pa and it was expressed as elongation index (EI). We found no difference in NOx among the entire group of OSAS subjects and normal controls, while we observed a NOx decrease in the H subgroup in comparison with L subgroup, but not in comparison with normal controls. We noted a significant decrease in EI at each shear stress in the entire group and also in the two subgroups in comparison with controls. The decrease in NO bioavailability and in erythrocyte deformability might contribute to explain the increased cardiovascular risk in OSAS subjects.
    Clinical hemorheology and microcirculation 02/2014; · 3.40 Impact Factor
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    ABSTRACT: Our aim was to evaluate lipid peroxidation, expressed as thiobarbituric acid-reactive substances (TBARS), nitric oxide metabolites (nitrite + nitrate) expressed as NO x , and TBARS/NO x ratio in a group of subjects with metabolic syndrome (MS). In this regard we enrolled 106 subjects with MS defined according to the IDF criteria, subsequently subdivided into diabetic (DMS) and nondiabetic (NDMS) and also into subjects with a low triglycerides/HDL-cholesterol (TG/HDL-C) index or with a high TG/HDL-C index. In the entire group and in the four subgroups of MS subjects we found an increase in TBARS and NO x levels and a decrease in TBARS/NO x ratio in comparison with normal controls. Regarding all these parameters no statistical difference between DMS and NDMS was evident, but a significant increase in NO x was present in subjects with a high TG/HDL-C index in comparison with those with a low index. In MS subjects we also found a negative correlation between TBARS/NO x ratio and TG/HDL-C index. Considering the hyperactivity of the inducible NO synthase in MS, these data confirm the altered redox and inflammatory status that characterizes the MS and suggest a link between lipid peroxidation, inflammation, and insulin resistance, evaluated as TG/HDL-C index.
    Oxidative medicine and cellular longevity. 01/2014; 2014:824756.
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    ABSTRACT: Our aim was to examine some parameters of oxidative status, gelatinases, and their inhibitors and to evaluate their interrelationships in subjects with metabolic syndrome (MS). We enrolled 65 MS subjects, subdivided according to the presence or not of diabetes mellitus. We examined lipid peroxidation (expressed as thiobarbituric acid reacting substances, TBARS), protein oxidation (expressed as carbonyl groups), nitric oxide metabolites (NO x ), total antioxidant status (TAS), MMP-2, MMP-9, TIMP-1, and TIMP-2. We found that MS subjects, diabetics and nondiabetics, showed an increase in TBARS, PC, and NO x . A significant decrease in TAS was observed only in nondiabetic MS subjects in comparison with diabetic MS subjects. We observed increased concentrations of MMP-2, MMP-9, TIMP-1, and TIMP-2, higher in diabetic subjects. Our data showed a positive correlation between TAS and MMP-2, TAS and MMP-9, and TAS and MMP-9/TIMP-1 and a negative correlation between TBARS and MMP-2 in diabetic MS subjects in the entire group. In MS subjects a prooxidant status and increased levels of gelatinases and their inhibitors are evident although the correlations between oxidative stress and MMPs or TIMPs are controversial and need further investigation.
    Mediators of Inflammation 01/2014; 2014:510619. · 3.88 Impact Factor
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    ABSTRACT: We determined the concentration of nitric oxide metabolites (NO2-+NO3-), expressed as NOx, in several clinical conditions. Regarding this, we have examined 25 subjects with arterial hypertension, 41 subjects with chronic kidney disease in conservative treatment, 106 subjects with metabolic syndrome subdivided according to the presence (n = 43) or not (n = 63) of diabetes mellitus, 48 subjects with obstructive sleep apnea syndrome (OSAS), 14 women with systemic sclerosis complicated with Raynaud's phenomenon, 42 dialyzed subjects and 105 young subjects with acute myocardial infarction (AMI). In subjects with arterial hypertension, chronic kidney disease, metabolic syndrome, systemic sclerosis, as well as, in dialyzed and AMI subjects, we found at baseline a NOx increase. In dyalized subjects after a standard dialysis session, we observed a decrease in NOx. The increase in NOx in juvenile AMI was significantly influenced by cigarette smoking and less by cardiovascular risk factors and the extent of coronary lesions; at 3 and 12 months later than the initial event, we observed a decrease of NOx that remains significantly higher than the control group. In subjects with OSAS no difference in NOx was noted in comparison with normal controls, although their subdivision according to the apnea/hypopnea index operates a clear distinction regarding NOx concentration.
    Clinical hemorheology and microcirculation 09/2013; · 3.40 Impact Factor
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    ABSTRACT: Atherosclerosis (AS) is a chronic, progressive, multifactorial disease mostly affecting large and medium-sized elastic and muscular arteries. It has formerly been considered a bland lipid storage disease. Currently, multiple independent pathways of evidence suggest this pathological condition is a peculiar form of inflammation, triggered by cholesterol-rich lipoproteins and influenced both by environmental and genetic factors. The Human Genome Project opened up the opportunity to dissect complex human traits and to understand basic pathways of multifactorial diseases such as AS. Population-based association studies have emerged as powerful tools for examining genes with a role in common multifactorial diseases that have a strong environmental component. These association studies often estimate the risk of developing a certain disease in carriers and non-carriers of a particular genetic polymorphism. Dissecting out the influence of pro-inflammatory genes within the complex pathophysiology of AS and its complications will help to provide a more complete risk assessment and complement known classical cardiovascular risk factors. The detection of a risk profile will potentially allow both the early identification of individuals susceptible to disease and the possible discovery of potential targets for drug or lifestyle modification; i.e. it will open the door to personalized medicine.
    Current Atherosclerosis Reports 06/2013; 15(6):329. · 2.92 Impact Factor
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    Clinical hemorheology and microcirculation 05/2013; · 3.40 Impact Factor
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    ABSTRACT: AIM: To evaluate matrix metalloproteases (MMP)-2 and MMP-9 and tissue inhibitor of metalloproteases (TIMP)-1 and TIMP-2 in a group of subjects with metabolic syndrome (MS) subdivided according to the presence or absence of diabetes mellitus. METHODS: We examined in 90 subjects (51 men and 39 women) with MS, defined following the International Diabetes Federation criteria, and subsequently subdivided into diabetic subjects (22 men and 11 women) and nondiabetic subjects s (29 men and 28 women), the plasma concentrations of MMP-2 and MMP-9 and of TIMP-1 and TIMP-2 using specific enzyme-linked immunosorbent assay kits. RESULTS: We found a significant increase in plasma concentrations of MMP-2, MMP-9, TIMP-1, and TIMP-2 in the whole group of MS subjects (P < 0.001) and in both subgroups of MS subjects with diabetes mellitus (P < 0.001) and without diabetes mellitus (P < 0.001) in comparison with healthy controls. We also noted higher concentrations of all the examined parameters in the MS subjects with diabetes mellitus in comparison with the MS subjects without diabetes mellitus. Matrix metalloproteases and TIMPs showed some significant correlations with body mass index and waist circumference and with metabolic parameters in the whole group of MS subjects. CONCLUSION: An altered pattern of MMPs and their inhibitors is demonstrated in MS; the presence of diabetes mellitus strongly influences the concentration of MMP and TIMP, contributing probably to the increased cardiovascular risk of MS subjects.
    Journal of Investigative Medicine 05/2013; · 1.75 Impact Factor
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    ABSTRACT: Physical exercise influences the body's oxidative status. The modifications can involve lipids, proteins and nucleic acids, and different effects seem to be induced by regular and acute exercise respectively. We examined protein oxidation, expressed as concentration of protein carbonyl groups (PC), in trained subjects before (time 0), 10 min (time 1) and 24 hours (time 2) after a cardiopulmonary test performed on a cycloergometer. We enrolled 38 trained subjects (26 men and 12 women), subdivided in two groups (A1 and B1) of 19 subjects each, according to the median value of VO2max, and in two groups (A2 and B2) of 19 subjects each, according to the median value of PC at baseline. PC concentration was measured by an enzyme-linked immunosorbent assay (ELISA). The groups A1 and B1 did not differ from each other as regards the basal PC level and groups A2 and B2 were not different as regards the VO2max. At time 1 PC showed a significant increase in comparison with baseline in trained subjects as a whole group, as well as in each subgroup. At time 2, PC were decreased in comparison with both times 0 and 1 in the whole group and in subgroups A1 and B2, whereas in subgroups A2 and B1 the PC value at time 2 was not different compared to time 0. The percentage increase of PC at time 1 vs time 0, as well as the percentage decrease at time 2 vs time 1 and time 0 respectively, were not different between subgroups A1 and B1. On the contrary, the percentage variations observed at each interval were significantly different between subgroups A2 and B2. The results suggest a reaction of antioxidant systems to acute exercise in trained subjects, influenced by basal PC levels more than by aerobic fitness.
    Clinical hemorheology and microcirculation 04/2013; · 3.40 Impact Factor
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    Nutrition, metabolism, and cardiovascular diseases: NMCD 03/2013; · 3.52 Impact Factor
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    ABSTRACT: Aim: In chronic kidney disease (CKD) cardiovascular risk is increased. Oxidative stress is strictly involved in the pathophysiology of this enhanced risk as well as leukocytes' activation. To better elucidate these phaenomena we evaluated some parameters of leukocyte activation and oxidative state on fasting blood samples obtained from CKD patients on conservative or hemodialysis (HD) treatment, compared to those obtained from control subjects. Methods:We enrolled 41 patients (25 men and 16 women, mean age 64.7±11.1 years) with CKD and 42 patients (21 men and 21 women, mean age 66.83±14.8 years) with CKD on hemodialysis (HD) treatment. Hemodialyzed patients were evaluated before and after a standard HD session. Leukocyte activation was evaluated by determining plasma elastase and myeloperoxidase level employing ELISA methods. Lipid peroxidation was evaluated as thiobarbituric acid-reactive substances (TBARS), total antioxidant status using spectrophotometry. Results: Elastase was higher in CKD on conservative and on HD treatment and its value increased after the HD session. Myeloperoxidase did not show any variation in CKD on conservative and HD treatment while after HD its value was increased. Lipid peroxidation was increased in CKD on conservative and on HD therapy and its value after dialysis showed no significant variation. Total antioxidant status was increased in CKD on HD treatment and significantly decreased after the HD session; no variation between normal controls and CKD subjects on conservative therapy was observed. Conclusion: Several aspects derive from these data considering the role of oxidative stress in the cardiovascular events that accompany CKD.
    Minerva urologica e nefrologica = The Italian journal of urology and nephrology 03/2013; 65(1):69-76. · 0.63 Impact Factor
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    Eugenia Hopps, Gregorio Caimi
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    ABSTRACT: Purpose: Oxidative stress plays a pivotal role in the pathogenesis of the metabolic syndrome and in the progression of its complications. Carbonylated proteins are a stable marker of severe oxidative stress because damage to the protein structure is irreversible and may cause an inhibition of their enzymatic activity or an increased susceptibility to proteolysis. There are few data regarding protein oxidation in metabolic syndrome, although elevated levels of carbonyl groups are often detected in subjects with obesity, diabetes mellitus, hypertension or dyslipidemia, well-known components of the metaboic syndrome. In particular, obesity, insulin resistance and diabetes mellitus are frequently associated with increased protein carbonylation. A relationship between insulin resistance, protein oxidative stress and inflammation has also been suggested as well as protein oxidation products are correlated with overexpression of resistin, TNF-α and IL-6. Conclusion: Therapeutic interventions based on lifestyle modifications and pharmacological agents in order to correct all the main risk factors influence oxidative stress and protein carbonylation.
    Clinical and investigative medicine. Medecine clinique et experimentale 01/2013; 36(1):E1. · 1.15 Impact Factor
  • C Urso, S Brucculeri, G Caimi
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    ABSTRACT: Exercise Associated Hyponatremia (EAH) is an occurrence of endurance sports that can cause severe clinical manifestations such as cerebral edema or respiratory failure. EAH is a dilutional hyponatremia, variant of SIADH, characterized by a plasma concentration of sodium lower than 135 mEq/l. Female gender and the duration of the competitions are associated with higher risk of hyponatremia. The incidence of hyponatremia, in fact, increases with duration, especially 4-8 hours after the start of the race. Women seem to be at greater risk than men. The pathophysiological mechanisms include increased loss of sodium through sweating and excessive intake of hypotonic fluids during and after the sporting event. In the genesis of EAH seems to have a decisive role the inadequate secretion of AVP by non osmotic stimuli, including IL-6. Indications for the prevention of hyponatremia include education of athletes for adequate consumption of fluids and monitoring of changes in body weight. Following the identification of electrolyte imbalance, the treatment requires a water restriction and infusion of hypertonic solutions 3%, especially in cases of severe hyponatremia. The effectiveness of the V2 receptor antagonists needs further investigation. Clin Ter 2012; 163(5):e349-356.
    La Clinica terapeutica 09/2012; 163(5):e349-e356. · 0.33 Impact Factor
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    ABSTRACT: To evaluate the concentration of metabolites (NO(2)(-), NO(3)(-)) of nitric oxide (NO) in metabolic syndrome (MS). We enrolled 106 subjects (45 women and 61 men) with MS of which 43 (14 women and 27 men) with diabetes mellitus and 63 (31 women and 32 men) without diabetes mellitus, and 54 subjects (19 women and 35 men) as control group. The nitric oxide metabolites (nitrite+nitrate=NOx) were evaluated employing the Griess reagent. In the whole group of MS subjects was evident, in comparison with control group, a significant increase in NOx. The same finding was also present between control group and diabetic subjects with MS and between control group and nondiabetic subjects with MS. No difference was observed between the two subgroups (diabetic and nondiabetic subjects with MS) about NOx. Contrasting information were obtained examining the linear regression among NOx, age, anthropometric profile, blood pressure values and glycometabolic pattern of subjects with MS. In MS subjects we found a significant increase in NOx not influenced by diabetes mellitus. The NOx is a parameter that must be considered in MS keeping in mind that its behavior is related to chronic inflammation that accompanies this clinical condition.
    Diabetes & metabolic syndrome. 07/2012; 6(3):132-5.
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    ABSTRACT: Our aim was to investigate the effects of an exercise test on some indices of oxidative status and endothelial function, in trained and untrained subjects. We examined lipid peroxidation, nitric oxide metabolites (NOx) and their ratio before and after a cardiopulmonary test, using a cycloergometer. We enrolled 60 male subjects who practiced sport unprofessionally, subdivided in two groups (A and B) according to the values of VO2max. Group A included sportsmen with poor or fair aerobic fitness (VO2max <39 ml/Kg/min), group B sportsmen with average to excellent aerobic fitness (VO2max >39 ml/Kg/min). The control group included 19 male sedentary subjects. Lipid peroxidation was evaluated by detection of the thiobarbituric acid-reactive substances (TBARS); the NOx were evaluated employing the Griess reagent. At rest, in comparison with sedentary controls, an increase in TBARS, NOx and TBARS/NOx ratio was found in all sportsmen and partially in the two groups. After the cardiopulmonary test, the increase of TBARS and TBARS/NOx ratio was significantly more evident in sedentary controls than in sportsmen. No variation was observed for NOx in any group. These data suggest that sportsmen are protected against the acute oxidative stress induced by an exercise test, and that protection is not strictly dependent on the aerobic fitness.
    Clinical hemorheology and microcirculation 06/2012; · 3.40 Impact Factor
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    E Hopps, G Caimi
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    ABSTRACT: Metabolic syndrome is commonly accompanied by an elevated cardiovascular risk with high morbidity and mortality. The alterations of the arterial vasculature begin with endothelial dysfunction and lead to micro- and macrovascular complications. The remodeling of the endothelial basal membrane, that promotes erosion and thrombosis, has a multifactorial pathogenesis that includes leukocyte activation, increased oxidative stress and also an altered matrix metalloproteinases (MMPs) expression. MMPs are endopeptidases which degrade extracellular matrix proteins, such as collagen, gelatins, fibronectin and laminin. They can be secreted by several cells within the vascular wall, but macrophages are determinant in the atherosclerotic plaques. Their activity is regulated by tissue inhibitors of MMP (TIMPs) and also by other molecules, such as plasmin. MMPs could be implicated in plaque instability predisposing to vascular complications. It has been demonstrated that an impaired MMP or TIMP expression is associated with higher risk of all-cause mortality. A large number of studies evaluated MMPs pattern in obesity, diabetes mellitus, arterial hypertension and dyslipidemia, all of which define metabolic syndrome according to several Consensus Statement (i.e. IDF, ATP III, AHA). However, few research have been carried out on subjects with metabolic syndrome. The evidences of an improvement in MMP/TIMP ratio with diet, exercise and medical therapy should encourage further investigations with the intent to contrast the atherosclerotic process and to reduce morbidity and mortality of this kind of patients.
    European Journal of Internal Medicine 03/2012; 23(2):99-104. · 2.30 Impact Factor
  • C Urso, G Caimi
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    ABSTRACT: Sodium, the most important extracellular fluid electrolyte, is the focus of several homeostatic mechanisms that regulate fluid and electrolyte balance. Hyponatremia is a common electrolyte abnormality caused by an actual sodium deficiency or extracellular compartment fluid excess. Clinical symptoms are related with acuity and speed with which this abnormality is established. The symptoms are mainly neurological and neuromuscular disorders (headache, confusion, stupor, seizures, coma) due to brain cells edema. Hyponatremia due to sodium deficiency is caused by sodium loss from kidney (nephritis, diuretics, mineralocorticoid deficiency) and / or extrarenal (vomiting, diarrhea, burns). Hyponatremia due to water excess seems to be the most common and it is attributable to cirrhosis, nephrotic syndrome, heart failure, infusion 5% glucose solutions and drugs that stimulate ADH secretion. It was recently highlighted the role of inflammation and IL-6 in the non-osmotic ADH release. Hyponatremia is considered also marker of phlogosis. Acute (<48 h) and severe (<125 mEq/ L) hyponatremia is a medical emergency that requires prompt correction. Patients with chronic hyponatremia have a high risk of osmotic demyelination syndrome if rapid correction of the plasmatic sodium occurs. In combination with conventional therapy, a new class of drugs, vasopressin receptors antagonists (AVP-R antagonists) would be able to increase the excretion of electrolyte-free water and the serum sodium concentration.
    La Clinica terapeutica 02/2012; 163(1):e29-39. · 0.33 Impact Factor
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    ABSTRACT: The purpose of this research was to evaluate the plasma protein carbonyl groups (PC) in 81 trained subjects (TS) who practiced regular, non professional physical activity. They were divided into three groups according to the type of sport they practiced (endurance, mixed or power). On fasting venous blood we examined the PC groups employing an enzyme-linked immunosorbent assay (ELISA) kit, in which 2,4-dinitrophenyl-hydrazine reacts with the PC forming a stable hydrazone product. In the whole group of TS a significant decrease in PC was present, in comparison with sedentary controls (SC). Dividing TS into groups, we observed a decreased PC concentration in those practicing endurance and mixed sports, but not in those practicing power sports. There was no difference between men and women for PC either in SC or in TS; male TS had a PC concentration significantly lower than male SC. Our data show that body proteins are more protected against oxidative stress in subjects who practice endurance and mixed sports. These results give further support to the promotion of regular physical activity including aerobic exercise.
    Clinical hemorheology and microcirculation 01/2012; 51(2):111-6. · 3.40 Impact Factor
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    ABSTRACT: We evaluated the erythrocyte deformability in a group of subjects with polycythemia vera (PV) using a Rheodyn-SSD Laser Diffractometer, at the shear stresses of 6, 12, 30 and 60 Pa. Our data showed a significant decrease of red cell deformability, expressed as elongation index (EI), in PV subjects compared with normal controls. These results suggest that the hyperviscosity syndrome accompanying this myeloproliferative disease may be considered a mixed form, resulting from the association of a polycythemic condition with a sclerocythemic disorder.
    Clinical hemorheology and microcirculation 01/2012; 50(3):189-92. · 3.40 Impact Factor

Publication Stats

854 Citations
481.44 Total Impact Points


  • 1986–2014
    • Università degli Studi di Palermo
      • • Department of internal medicine and medical specialties (DIMIS)
      • • Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.)
      Palermo, Sicily, Italy
  • 2005
    • Istituzione Leonardo Da Vinci
      Santa Rosalía de Guagua, Huila, Colombia
  • 1998–1999
    • Università degli Studi del Sannio
      Benevento, Campania, Italy