-
F Cesari,
R Marcucci,
A M Gori,
R Caporale,
A Fanelli,
G Casola,
D Balzi,
A Barchielli,
S Valente,
C Giglioli, G F Gensini,
R Abbate
[show abstract]
[hide abstract]
ABSTRACT: Reticulated platelets (RP) are newly-formed platelets with a greater mass, a residual amount of RNA and an increased prothrombotic potential. No studies investigating the association between RP and the risk of cardiovascular death in acute coronary syndrome (ACS) patients are available. In the frame of the AMI-Florence 2 study, we investigated RP in 229 (154 M/ 75 F) ACS patients (125 ST-elevation myocardial infarction [STEMI]; 104 Non-STEMI/Unstable Angina). RP were measured by using the Sysmex XE-2100 haematology analyzer and were expressed as the percentage of RP out of the total optical platelet count (immature platelet fraction; IPF) and as the percentage of RP highly fluorescent (H-IPF). At one-year follow-up, 22 out of 229 patients (9.6%) died from cardiovascular causes. Higher values of IPF (p=0.05) and H-IPF (p=0.006) were detected in dead compared to alive patients. A receiver operating characteristics curve analysis identified IPF ≥3.3% and H-IPF ≥0.9% as optimal cut-off values to predict cardiovascular death. At the multivariate model adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score, the association between RP and cardiovascular death remained significant for both IPF [OR (95%CI) : 4.15 (1.24-13.91) p=0.02] and H-IPF [OR (95%CI): H-IPF 5.03 (1.38-18.38) p=0.01]. In conclusion, RP are independent predictors of cardiovascular death and may be useful in improving risk stratification for ACS patients. Future prospective studies to evaluate the role of RP in determining cardiovascular events are warranted.
Thrombosis and Haemostasis 03/2013; 109(5). · 5.04 Impact Factor
-
A Grippo,
R Carrai,
S Fossi,
C Cossu,
E Mazzeschi,
A Peris,
M Bonizzoli,
M Ciapetti, G F Gensini,
F Pinto,
A Amantini
[show abstract]
[hide abstract]
ABSTRACT: Introduction: Early prediction of neurological outcome for patients resuscitated from cardiac arrest (CA) is a challenging task. Therapeutic hypothermia (TH) has been shown to improve neurological outcome after CA. Two recent studies indicated that Somatosensory Evoked Potentials (SEP) recorded during TH retains high prediction value for poor neurological outcome. It remains unclear whether TH can influence the recovery of bilaterally absent (BA) N20 after re-warming. The primary endpoint of the present study was to evaluate if patients with BA SEPs during TH can recover cortical responses after re-warming. The secondary endpoint was to evaluate whether BA SEPs recorded during TH retains its prediction value for poor neurological outcome as in normothermic patients. Methods: A single centre prospective cohort study including comatose adults resuscitated from in/out-ofhospital CA treated with TH. SEPs were recorded during TH (6-24 hrs after CA) and after re-warming in those patients who remained comatose. Neurological outcome was assessed 6 months after CA using the Glasgow Outcome Scale. Results: Sixty patients were included. In patients with preserved SEP, no significant differences were found between N20 mean amplitude during TH and after re-warming. During TH, 24 patients showed bilaterally absent N20 but none of these recovered cortical responses after re-warming. All patients with absent SEPs during TH did not recover consciousness. Conclusions: In a single centre cohort of comatose CA patients, our results showed that all patients with absent SEPs during early recording (6-24 hs) during TH showed bilaterally absent SEPs after re-warming. As a secondary result we confirmed previous data that BA SEPs during TH retains its prognostic value for poor neurological outcome, as in normothermic patients.
Minerva anestesiologica 02/2013; · 2.66 Impact Factor
-
F Sofi,
A Whittaker,
F Cesari,
A M Gori,
C Fiorillo,
M Becatti,
I Marotti,
G Dinelli,
A Casini,
R Abbate, G F Gensini,
S Benedettelli
[show abstract]
[hide abstract]
ABSTRACT: Background/Objectives:Khorasan wheat (Kamut) is an ancient grain with widely acclaimed beneficial effects on human health. The objective was to characterise Kamut and to examine the effect of a replacement diet with their products on cardiovascular risk parameters.Subjects/Methods:We conducted a randomized, single-blinded cross-over trial with two intervention phases on 22 healthy subjects (14 females; 8 males). The participants were assigned to consume products (bread, pasta and crackers) made either from Kamut or control semi-whole-grain wheat for 8 weeks in a random order. An 8-week washout period was implemented between the interventions. Laboratory analyses were performed both at the beginning and at the end of each intervention phase.Results:At a general linear model for repeated measurements adjusted for several confounders, consumption of Kamut products showed a significant reduction of metabolic risk factors such as total cholesterol (mean reduction: -8.46 mg/dl; -4%), low-density lipoprotein cholesterol (-9.82 mg/dl; -7.8%) and blood glucose. Similarly, redox status was significantly improved only after the Kamut intervention phase, as measured by a reduction in both thiobarbituric acid reactive substances (-0.17 nmol/ml; -21.5%;) and carbonyl levels (-0.16 nmol/ml; -17.6%). The replacement diet with Kamut products also resulted in a significant increase of serum potassium and magnesium. Circulating levels of key pro-inflammatory cytokines (interleukin (IL)-6, IL-12, tumour necrosis factor-α and vascular endothelial growth factor) were significantly reduced after the consumption of Kamut products.Conclusions:The present results suggest that a replacement diet with Kamut products could be effective in reducing metabolic risk factors, markers of both oxidative stress and inflammatory status.European Journal of Clinical Nutrition advance online publication, 9 January 2013; doi:10.1038/ejcn.2012.206.
European journal of clinical nutrition 01/2013; · 3.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND AND AIM: No data are so far available on the impact of age and obesity in ST-elevation myocardial infarction (STEMI) submitted to percutaneous coronary intervention (PCI). METHODS AND RESULTS: We assessed the impact of age on the prognostic value of body mass index (BMI) in 1268 consecutive STEMI patients admitted to our Intensive Cardiac Care Unit (ICCU). BMI categories were as follows: 37 "lean" patients (37/1268, 2.9%), 403 "normal" patients (403/1268, 31.8%), 656 "overweight" patients (656/1268, 51.7%), 172 "obese" patients (172/1268, 13.6%). Among patients aged <75 years, as BMI increased, the number of males and diabetic patients significantly increased (p < 0.001 and p = 0.004, respectively). Among STEMI patients aged ≥75 years, lean patients showed a higher in-ICCU mortality in respect to the other BMI categories but this did not reach statistical significance. BMI was an independent predictor of In-ICCU mortality in the whole population (lean vs. "normal": OR 3.47, 95%CI 1.08-11.14, p = 0.036) and it was associated with long term mortality only in patients <75 years since lean and overweight patients showed lower survival rate (lean vs. "normal": HR 9.25, 95%CI 3.09-27.63, p < 0.001; overweight vs. "normal": OR 2.10; 95%CI 1.04-4.23, p = 0.039). CONCLUSIONS: In our series, underweight is associated with the highest mortality across all age subgroups, while only in patients <75 years, overweight patients showed increased in-hospital mortality rate and a poorer long term survival rate. According to our data, the "so called obesity paradox" should be probably age-contextualized.
Nutrition, metabolism, and cardiovascular diseases: NMCD 08/2012; · 3.52 Impact Factor
-
Irish Journal of Medical Science 05/2011; 180(4):923-4. · 0.58 Impact Factor
-
F Sofi,
R Molino Lova,
V Nucida,
A Taviani,
F Benvenuti,
M Stuart,
M Weinrich,
F Cecchi,
R Abbate, G F Gensini,
C Macchi
[show abstract]
[hide abstract]
ABSTRACT: Back pain is a significant problem due to the high healthcare utilization, rising costs of care and low effectiveness of many current treatments.
Aim of this study was to determine the effects of a community-based Adapted Physical Activity (APA) program focused on chronic, non-specific back pain.
Open-label intervention study.
Community.
All patients admitted to Empoli Rehabilitation Department for non-specific back pain for at least three months, were considered for APA. Exclusion criteria were: "red flags", difficulty/disability in basic daily living activities, severe/acute medical conditions, acute pain, psychiatric disease or cognitive impairment, severe visuoauditory deficit. Overall, 650 persons were enrolled.
The APA program, including strength and flexibility training and exercises for improving posture was delivered for 12 months, with 1-hour group classes three times per week.
Overall 261 (40.2%) subjects completed the 12-month APA program and were compared to the 310 (47.7%) who were screened but failed to initiate or complete the study. There were no significant differences in baseline demographic and clinical characteristics between groups. Patients who followed the APA program reported significantly improved health status and significant back pain improvement, compared with those who did not adhere to the program. In the logistic regression analysis adjusted for age and gender, a distance from home to gymnasium greater than the median for the study population (2.6 km) was the only baseline characteristic significantly associated with an increased risk of non-adherence (OR 1.44, 95%CI 1.01-2.13; P=0.04).
This study suggests that a community-based APA program can improve back pain and health status in persons with chronic, non-specific low back pain. CLINICA REHABILITATION IMPACT: These findings highlight the potential for new approaches to manage chronic disease and disability by facilitating a healthy lifestyle and promoting physical activity through implementation of community-based exercise programs.
European journal of physical and rehabilitation medicine 04/2011; 47(4):543-9. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The relationship between physical activity and cognitive function is intriguing but controversial. We performed a systematic meta-analysis of all the available prospective studies that investigated the association between physical activity and risk of cognitive decline in nondemented subjects.
We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, The Cochrane Library and bibliographies of retrieved articles up to January 2010. Studies were included if they analysed prospectively the association between physical activity and cognitive decline in nondemented subjects.
After the review process, 15 prospective studies (12 cohorts) were included in the final analysis. These studies included 33,816 nondemented subjects followed for 1-12 years. A total of 3210 patients showed cognitive decline during the follow-up. The cumulative analysis for all the studies under a random-effects model showed that subjects who performed a high level of physical activity were significantly protected (-38%) against cognitive decline during the follow-up (hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.54-0.70; P < 0.00001). Furthermore, even analysis of low-to-moderate level exercise also showed a significant protection (-35%) against cognitive impairment (HR 0.65, 95% CI 0.57-0.75; P < 0.00001).
This is the first meta-analysis to evaluate the role of physical activity on cognitive decline amongst nondemented subjects. The present results suggest a significant and consistent protection for all levels of physical activity against the occurrence of cognitive decline.
Journal of Internal Medicine 01/2011; 269(1):107-17. · 5.48 Impact Factor
-
C Fiorillo,
M Becatti,
M Attanasio,
L Lucarini,
N Nassi,
L Evangelisti,
M C Porciani,
P Nassi, G F Gensini,
R Abbate,
G Pepe
International journal of cardiology 12/2010; 145(3):544-6. · 7.08 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Several polymorphisms in genes that encode platelet components (receptors or enzymes), or cytochrome P450 enzyme isoforms, involved in clopidogrel metabolism, have been proposed as possible mechanisms for nonresponsiveness to clopidogrel. Among them, a great deal of attention has been focused on the loss-of-function CYP2C19(*)2 (or 681 G > A) polymorphism. We performed a meta-analysis of all the prospective studies that have been published, which analyze the role of such a polymorphism in recurrent cardiovascular events in patients with coronary artery disease (CAD) being treated with clopidogrel. Studies were searched in MedLine, Embase, Web of Science, The Cochrane Systematic Review Database, Google Scholar and bibliographies of retrieved articles up to January 2010. The principal underlying hypothesis was that the presence of the (*)2 variant allele of the polymorphism would be associated with an increased risk of clinical recurrence. Data were available for a total of 8043 patients from seven cohort prospective studies, who were followed for a period of time ranging from 6 months to 8.3 years. The summary risk ratios (RRs) for the prospective cohort studies included showed a significant association between the CYP2C19(*)2 polymorphism and an increased risk of major adverse cardiovascular events in the follow-up (RR: 1.96 (1.14-3.37); P = 0.02). When studies evaluating stent thrombosis (n = 4) for a total of 4975 patients were considered, the presence of the variant allele was associated with an increased risk of stent thrombosis (RR: 3.82 (2.23-6.54); P = 0.0001). The current meta-analysis, carried out on nearly 8000 patients with CAD undergoing clopidogrel treatment, shows that the CYP2C19(*)2 polymorphism is associated with an increased risk of major adverse cardiovascular events and stent thrombosis.
The Pharmacogenomics Journal 03/2010; 11(3):199-206. · 4.54 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The present review is aimed at going over the pharmacological profile (and the clinical impact) of the emerging drugs involved in the management of patients with ST-elevation myocardial infarction (STEMI) in order to provide the cardiologists who deal with these patients in the early phase with the most recent evidence on this topic.
Anticoagulant and antiplatelet drugs are the main cornerstones of therapy in the treatment of STEMI patients undergoing primary percutaneous coronary intervention (PCI). The main issues that clinicians have to deal with are represented by balancing thrombotic and bleeding risks. In tailoring therapy, variables such as age, sex and previous disease should be taken into account, as well as ongoing complications (such as acute renal failure) that could affect hemostasis. Despite the well-established clinical benefits of antiplatelet agents, questions remain, mainly surrounding potential for variable platelet response, which are strictly related to non-genetic (i.e., diet, drug-drug interaction, clinical factors such as obesity, diabetes mellitus, and inflammation) and genetic determinants.
In their daily practice, cardiologists cannot abstract from the knowledge and updating on the ongoing research fields as well as the newly developed drugs, which they should frame in the very patient in the attempt to the develop a personalized medical strategy. These include also the pharmacological option(s) in the treatment of the reperfusion injury, the metabolic aspects and the stem cell therapy. TAKE HOME MASSAGE: In our opinion, the goal of ongoing research on the pharmacological approach to STEMI patients is a personalized medical strategy that relies on critical clinicians who merge newly developed acquisitions on this topic and a more complete, systemic and critical approach to the patient.
Expert Opinion on Emerging Drugs 03/2010; 15(1):87-105. · 3.21 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The concept of risk in medicine varies according to different health settings and different times. At present, risk is considered, in the cardiovascular area, the probability of developing a clinical event through time computed on the basis of the quantification of the presence and of the interaction of different diseases and/or risk factors. The definition of risk factors in the biomedical field is here documented through time to show how recent clinical-epidemiological elements have been achieved. In the twentieth century many epistemological and methodological objectives have been attained with regard to the theoretical idea of risk and to the practical tools useful to modify it, and the example of the management of diabetes is furnished as documentation of this progress. Nonetheless, correct risk evaluation continues to remain a formidable challenge in the health scenario.
Minerva medica 02/2010; 101(1):59-62. · 0.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We performed this meta-analysis to update the clinical evidences on the relation between clopidogrel non-responsiveness and clinical outcomes in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention. An electronic literature search through MEDLINE, EMBASE, Web of Science, and the Cochrane Library and bibliographies of retrieved articles up to January, 2009 was conducted. Studies were included if they had a cohort prospective design, if they analysed clopidogrel responsiveness in CAD patients in relation to death and/or occurrence of adverse coronary events during follow-up, and if they reported an adequate statistical analysis. Fourteen studies, totalling 4,564 CAD patients followed for a time ranging from 14 days to one year, were included. The cumulative analysis reported that residual platelet reactivity despite clopidogrel treatment was significantly associated with an increased risk of death and/or thrombotic recurrences (odds ratio [OR] 5.67, 95% confidence interval [CI] 2.97 to 10.84; p<0.00001). However, four studies contributed to a consistent heterogeneity of the model and evidenced a significant risk of publication bias, so were excluded from the analysis. This exclusion, however, did not influence the overall result, by confirming the increased risk of cardiovascular recurrences for patients with a poor response to clopidogrel treatment (OR 3.58, 95%CI 2.54 to 5.05; p<0.00001). The present updated meta-analysis documents a significant association between residual platelet reactivity under clopidogrel treatment and recurrent cardiovascular events, so suggesting the relevance of ongoing interventional studies aimed at tailoring the antithrombotic therapy in CAD patients.
Thrombosis and Haemostasis 02/2010; 103(4):841-8. · 5.04 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: During the past few years, it has become evident that metabolic control is a major determinant of postoperative outcomes, not only for diabetic patients but for all patients undergoing surgery.In cardiac and vascular surgery, myocardial ischemia is a common challenge and the management of hyperglycemia should be part of the strategy aimed at optimizing cardiac protection during these types of surgery, since performed in high risk patients. Little informations are available on the relation between glucose substrate and the type of anesthesia and few studies have been performed on glucose metabolism in the perioperative risk assessment as well as on intraoperative and post surgical management of hyperglycemia in patients submitted to cardiac and vascular surgery. Evidence exists that even slight increased in glycemia are detrimental for patients (diabetic and non) elective for cardiac and vascular surgery, though the precise details of the timing of insulin therapy, the desired target serum glucose level, and the duration of therapy are so far to be completely elucidated. Anesthestiologists can therefore affect outcome by simply preserving a normal blood glucose concentration initiating in the operating room. The challenge to optimize glucose control should begin during preoperative evaluation.
HSR proceedings in intensive care & cardiovascular anesthesia. 01/2010; 2(1):19-26.
-
[show abstract]
[hide abstract]
ABSTRACT: Procalcitonin concentrations are considered as a component of the inflammatory response and as an acute-phase marker, after shock or tissue injury (i.e. burn, trauma, surgery) or infections and sepsis. No data are so far available on the dynamics of procalcitonin levels in patients with cardiogenic shock following ST-elevation myocardial infarction, with no clinical or laboratory sign of infection.
We evaluated procalcitonin values every day during intensive cardiac care staying in ten cardiogenic shock patients admitted to our intensive cardiac care unit. NT-pro Brain Natriuretic Peptide, C Reactive Protein and APACHE II score were also assessed.
Six patients survived, whereas 4 patients died. A progressive reduction in procalcitonin values was observed in cardiogenic shock patients who survived, whereas the lack of changes in procalcitonin concentrations was documented in cardiogenic shock patients who died (survivors: slope = -3.76; dead: slope = -0.81, p=0.004). Furthermore, higher values of glycemia, NT-pro Brain Natriuretic Peptide and C Reactive Protein (as well as higher APACHE II scores) were detectable in dead patients in respect to survivors.
In our preliminary study we observed that in patients with cardiogenic shock and no sign of infections a reduction of procalcitonin levels was detectable only in survivors. Moreover, higher values of NT- Brain Natriuretic Peptide, a marked systemic inflammation (higher values of C Reactive Protein) and higher severity score (as depicted by APACHE II) are associated with an ominous prognosis in cardiogenic shock patients.
HSR proceedings in intensive care & cardiovascular anesthesia. 01/2010; 2(3):201-7.
-
S Saint,
A Conti,
A Bartoloni,
G Virgili,
F Mannelli,
S Fumagalli,
P di Martino,
A A Conti,
S R Kaufman,
M A M Rogers, G F Gensini
[show abstract]
[hide abstract]
ABSTRACT: Despite the importance of hand hygiene in reducing infection, healthcare worker compliance with hand hygiene recommendations remains low. In a previous study, we found a generally low level of compliance at baseline, with substantial differences between doctors and nurses and between hospital units. We describe here the results of our multimodal intervention intended to improve levels of healthcare worker hand hygiene.
A 6-month, before-and-after, multimodal interventional study in five hospital units in Florence, Italy. We used direct observation to assess hand hygiene rates for doctors and nurses, focusing on hygiene before touching the patient. We explored reasons for unit variability via interviews of doctor and nurse leaders on the units.
Overall healthcare worker hand hygiene increased from 31.5% to 47.4% (p<0.001). Hand hygiene adherence among nurses increased from 33.7% to 47.9% (p<0.001); adherence among doctors increased from 27.5% to 46.6% (p<0.001). Improvement was statistically significant in three out of five units, and units differed in the magnitude of their improvement. Based on the interviews, variability appeared related to the "champion" on each unit, as well as the level of motivation each physician leader exhibited when the preintervention results were provided.
Although overall healthcare worker adherence with hand hygiene procedures before patient contact substantially increased after the multimodal intervention, considerable variability-for both nurses and doctors and across the 5 units-was seen. Although adherence substantially increased, overall hand hygiene in these units could still be greatly improved.
Quality and Safety in Health Care 12/2009; 18(6):429-33. · 1.68 Impact Factor
-
A Peris,
G Zagli,
F Barbani,
L Tutino,
S Biondi,
S di Valvasone,
S Batacchi,
M Bonizzoli,
R Spina,
M Miniati,
S Pappagallo,
V Giovannini, G F Gensini
[show abstract]
[hide abstract]
ABSTRACT: We present the case of a healthy young male who developed acute respiratory failure as a result of infection with influenza A/H1N1 of swine-origin and in whom ventilatory support was optimised and recovery of lung function was monitored by the use of sequential chest ultrasound examinations. The potential pivotal role of bedside lung ultrasonography in H1N1-induced respiratory failure is discussed.
Anaesthesia 12/2009; 65(3):294-7. · 2.96 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Deep vein thrombosis (DVT) is a major complication in intensive care units (ICU) but dedicated guidelines on its management are still lacking.
This study investigated the effect of a 1-year educational program for the implementation of DVT prophylaxis on the incidence of inferior limb DVT in a mixed-bed ICU that admits high-risk surgical and trauma patients, investigated during a first retrospective phase [126 patients, SAPS II score 42 (28-54)] and a following prospective phase [264 patients, SAPS II score II 41 (27-55)]. The role of baseline and time-dependent DVT risk factors in DVT occurrence was also investigated during the prospective phase.
The educational program on implementation of DVT prophylaxis was associated with a significant decrease in DVT incidence from 11.9% to 4.5% (P < 0.01) and in the mean length of ICU stay (P < 0.01). Combined with pharmacological prophylaxis, the use of elastic compressive stockings significantly also increased in the prospective phase (P < 0.01). The duration of mechanical ventilation, vasopressor administration and neuromuscular block were significantly different between DVT-positive and DVT-negative patients (P < 0.01). Multivariate analysis identified neuromuscular block as the strongest independent predictor for DVT incidence.
One-year ICU-based educational programs on implementation of DVT prophylaxis were associated with a significant decrease in the incidence of DVT and also in the length of stay in ICU.
Journal of Thrombosis and Haemostasis 10/2009; 8(1):121-8. · 5.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Platelet nitric oxide (NO) synthesis is compromised in patients with acute coronary syndrome (ACS), and platelet NO availability may be critically relevant in determining the extent of thrombosis in ACS patients. It has been demonstrated that an impaired responsiveness to the antiaggregatory effects of NO may affect platelet dysfunction in diabetic patients with ACS. Since NO availability may be genetically determined, we have investigated the role of endothelial nitric oxide synthase (eNOS) gene in influencing platelet aggregability in relation to the presence (n=247) or absence (n=883) of type 2 diabetes in ACS patients.
We have genotyped 1130 consecutive high risk ACS patients on dual antiplatelet therapy, previously investigated in relation to platelet function. eNOS 4a allele frequency was significantly higher in diabetic vs. non-diabetic patients (p=0.02). In non-diabetic patients the eNOS 4a allele significantly modulated platelet aggregability in response to arachidonic acid (AA), but not to collagen and adenosine diphosphate (ADP) stimulus, after Bonferroni correction for multiple testing. After adjustment for age, gender, smoking habit, hypertension and ejection fraction ≤40%, the eNOS 4a allele remained significantly and independently associated with platelet aggregability in response to AA stimulus [β (SE)=0.17 (0.07), p=0.01]. When platelet aggregation values were considered according to the presence or absence of high residual platelet reactivity (RPR) eNOS 4a, but not -786C and 894T, allele was significantly associated with RPR by AA stimulus. The haplotype reconstruction analysis for eNOS gene showed that the -786C/894G/4a and -786C/894G/4b haplotypes significantly influenced platelet aggregation after AA stimulus.
Our study indicates that eNOS 4a allele, may be a determinant of higher platelet aggregability and residual platelet reactivity in non-diabetic ACS patients.
Nutrition, metabolism, and cardiovascular diseases: NMCD 10/2009; 21(1):11-7. · 3.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Some studies recently reported a favourable effect for cis-9, trans-11 conjugated linoleic acid (CLA) on plasma lipoprotein profile of healthy subjects. Aim of this crossover intervention study was to evaluate the influence of a short-term dietary intake of a cheese derived from sheep's milk naturally rich in CLA on several atherosclerotic biomarkers, in comparison with a commercially available cheese.
Ten subjects (6 F; 4 M) with a median age of 51.5 followed for 10 weeks a diet containing 200 g/week of cheese naturally rich in CLA (intervention period) and for the same period a diet containing a commercially available cheese of the same quantity (placebo period). Consumption of the dairy product naturally rich in cis-9, trans-11 CLA determined a significant (p<0.05) reduction in inflammatory parameters such as interleukin-6 (pre: 8.08+/-1.57 vs. post: 4.58+/-0.94 pg/mL), interleukin-8 (pre: 45.02+/-5.82 vs. post: 28.59+/-2.64 pg/mL), and tumour necrosis factor-alpha (pre: 53.58+/-25.67 vs. post: 32.09+/-17.42 pg/mL) whereas no significant differences in the placebo period were observed. With regard to haemorheological parameters, the test period significantly ameliorated erythrocytes' filtration rate (pre: 7.61+/-0.71% vs. post: 9.12+/-0.97%; p=0.03) with respect to the placebo period. Moreover, a reduction in the extent of platelet aggregation, induced by arachidonic acid [pre: 87.8+/-1.76% vs. post: 77.7+/-3.56%; p=0.04] was observed during the test period in comparison with the placebo period.
Dietary short-term intake of the tested dairy product naturally rich in cis-9, trans-11 CLA appeared to cause favourable biochemical changes of atherosclerotic markers.
Nutrition, metabolism, and cardiovascular diseases: NMCD 06/2009; 20(2):117-24. · 3.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Already more than two thousands years ago the Greek physician Hippocrates (V-IV century B.C.) used the extracts of the willow bark to fight fever. At the end of the eighteen hundreds the German chemist Felix Hoffmann obtained acetylsalicylic acid in stable and pure form, and from then on Aspirin (where A is the abbreviation of acetyl and Spir stands for Spirsaure, the German name of salicylic acid) has had enormous diffusion. In 1953 Lawrence Craven reported that he had successfully prescribed aspirin to hundreds of adult male patients for the non-specific prophylaxis of coronary thrombosis. Aspirin is now one of the most well-known drugs in the world, and in the last decades a large body of scientific evidence has appeared with regard to the preventive and therapeutic effects of aspirin and those of other antiplatelet agents. In fact, antiplatelet agents constitute a cornerstone in current pharmacological treatment and prophylaxis. Among the most interesting recent and beneficial areas of impact of aspirin and of other antiplatelet drugs, there are those of stroke and of coronary artery disease, and today targeted pharmacological and non-pharmacological interventions should be carefully combined to deal, preventively and therapeutically, with the cardiovascular epidemic.
Minerva medica 05/2009; 100(2):133-6. · 0.90 Impact Factor
