F Cibella

Università degli studi di Palermo, Palermo, Sicily, Italy

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Publications (58)155.41 Total impact

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    ABSTRACT: Respiratory allergic symptoms impact on social life and school activities, influencing the patient's mood states. We evaluated the relationships between allergic respiratory diseases and depressive/anxious mood in a large sample of Italian middle school students, using the partial directed acyclic graph (P-DAG). We studied 1283 subjects aged 10-13. A health respiratory questionnaire including questions relevant to socioeconomic status (HCI) and a test for depression and anxiety were administered. All subjects performed spirometry and skin prick tests. A causal role of rhinitis on depression was found: the likelihood of being depressed increased from 11.2 to 17.7%, when rhinitis was present. Moreover, a direct effect of low HCI on depressive mood was shown (p < 0.0001) as well as the correlation between anxiety and depression (p < 0.0001). Gender was not a direct causal factor for depressive mood, but their relation was mediated through anxious mood. Anxiety appeared to have a stronger association with depression than gender. Allergic sensitization was significantly related to both asthma and rhinitis (p < 0.0001, respectively). Asthma and rhinitis were also directly associated (p < 0.0001). Conversely, asthma was not directly associated with depressive mood, but their relation was mediated through rhinitis. Body mass index (BMI) and impaired lung function (IPF) were not associated with the other variables. The use of this novel approach to analyzing the dynamic relationships allowed us to find a causal role of rhinitis on depressive state. Moreover, anxious condition and low socioeconomic status contributed to induce depressive mood.
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    ABSTRACT: Respiratory allergic symptoms impact on social life and school activities, influencing the patient's mood states. We evaluated the relationships between allergic respiratory diseases and depressive/anxious mood in a large sample of Italian middle school students, using the partial directed acyclic graph (P-DAG). We studied 1283 subjects aged 10-13. A health respiratory questionnaire including questions relevant to socioeconomic status (HCI) and a test for depression and anxiety were administered. All subjects performed spirometry and skin prick tests. A causal role of rhinitis on depression was found: the likelihood of being depressed increased from 11.2 to 17.7%, when rhinitis was present. Moreover, a direct effect of low HCI on depressive mood was shown (p < 0.0001) as well as the correlation between anxiety and depression (p < 0.0001). Gender was not a direct causal factor for depressive mood, but their relation was mediated through anxious mood. Anxiety appeared to have a stronger association with depression than gender. Allergic sensitization was significantly related to both asthma and rhinitis (p < 0.0001, respectively). Asthma and rhinitis were also directly associated (p < 0.0001). Conversely, asthma was not directly associated with depressive mood, but their relation was mediated through rhinitis. Body mass index (BMI) and impaired lung function (IPF) were not associated with the other variables. The use of this novel approach to analyzing the dynamic relationships allowed us to find a causal role of rhinitis on depressive state. Moreover, anxious condition and low socioeconomic status contributed to induce depressive mood.
    Pediatric Allergy and Immunology 03/2014; · 3.38 Impact Factor
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    ABSTRACT: COPD often coexists with other comorbidities and has an impact on Quality of Life (QoL). We evaluated QoL in COPD patients and the possible role of comorbidities in their relationship. We studied 60 stable COPD outpatients (39 M, aged 53-91) and 30 subjects without respiratory disease (controls, 14 M, aged 50-86). Spirometry and a clinical evaluation of comorbidities were performed. COPD patients were classified on the basis of COPD guidelines. We evaluated dyspnea perception by modified Medical Research Council questionnaire (mMRC). QoL was assessed by SF-36 through Physical Health (PCS) and Mental Health (MCS) components. PCS was significant lower in COPD with respect to controls (p=0.005); no significant difference was found in MCS. mMRC was significant higher in COPD patients (p= 0.022). Among comorbidities (disorders of lipid metabolism -DLM-, hypertension, diabetes, obesity, arrhythmia) only DLM prevalence was significant higher in COPD patients (p=0.012). A significant negative correlation was found between PCS and mMRC (p=0.0001); mMRC was directly related to DLM (p=0.02), only in COPD patients. PCS was not related to comorbidities neither in COPD nor in controls. In COPD PCS was inversely correlated to disease severity according to 2012 guidelines (p=0.001). In conclusion, COPD patients have a poorer QoL with respect to controls in its physical component but not in mental component. Dyspnea perception, in COPD patients is a strong indirect determinant for PCS, regardless of comorbidities. Moreover, among comorbidities DDL seems to determine a higher dyspnea in COPD patients. Detecting and monitoring dyspnea perception may be a useful element in management of COPD patient in order to increase QoL.
    ERS-Annual Congress 2013 –The latest insights in pulmonary rehabilitation, Barcellona; 11/2013
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    ABSTRACT: We evaluated the mood states disorders in COPD patients and their relationship with COPD severity parameters. We studied 60 consecutive stable COPD outpatients (39 M; aged 53-91) and 30 subjects without respiratory disease (control group) (14 M; aged 50-86). All subjects performed a spirometry and a six minutes walking test (6’WT). Dyspnea perception was evaluated by modified Medical Research Council questionnaire (mMRC). Depressive and anxious symptoms were investigated by Beck Depression Inventory-II and Stay Y, respectively. The COPD patients were classified on the basis of guidelines: 30 in group A, 8 in B, 13 in C, and 9 in D. The prevalence of depressive symptoms in COPD patients and in controls was 28% and 23%, respectively (NS). No significant difference was found between groups for depression severity. Among COPD patients, depressive symptoms distribution was: 5 in categorie A, 4 in B, 2 in C and 6 in D (p=.034). A higher prevalence of depressive symptoms and higher severity levels were found in B+D when compared to A+C subjects (p<0.0001). No difference was found between A+B vs C+D subjects. 6’WT and mMRC were inversely related only in COPD patients (p<0.0001). The mMRC was significant different between groups (p=.022). mMRC and depression were directly correlated (p<0.001). No association was found between depression and GOLD stages, exacerbation in the last year. Anxiety prevalence was not different between groups. Anxiety was not associated with mMRC, GOLD stages, exacerbation in the last year. We conclude that, among individual parameters of COPD severity, only mMRC score is a good, strong and direct predictor of depression in COPD patients. Depressive symptoms should be investigated in COPD when mMRC score is high.
    Annual Congress 2013 –The best posters in chronic care, Barcellona; 09/2013
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    ABSTRACT: Smoking still represents a huge public health problem. Millions of children suffer the detrimental effects of passive smoking. An increasing number of countries have recently issued laws to regulate smoking in public places. Instead, homes remain a site where children are dangerously exposed to environmental tobacco smoke (ETS). The combination of tobacco smoke pollutants which remain in an indoor environment, the so-called 'third-hand smoke' (THS), represent a new concept in the field of tobacco control. THS consists of pollutants that remain on surfaces and in dust after tobacco has been smoked, are re-emitted into the gas-phase, or react with other compounds in the environment to form secondary pollutants. Indoor surfaces can represent a hidden reservoir of THS constituents that could be re-emitted long after the cessation of active smoking. Human exposure to THS pollutants has not yet been thoroughly studied. Infants and children are more prone to the risks related to THS exposure than adults because they typically spend more time indoors and have age-specific behaviours that may expose them to potential health hazards from THS. Further investigations are warranted to study the health effects of THS relevant to different exposure pathways and profiles. It would also be very important to evaluate how THS may affect the lung development through the in utero exposure during the pre-natal life. We aimed at reviewing recent findings published about THS, with special reference to the effects on children's health.
    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo 03/2013; 79(1):38-43.
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    Epidemiologia e prevenzione 01/2013; 37(4-5):252-262. · 0.92 Impact Factor
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    Epidemiologia e prevenzione 01/2013; 37(4-5):220-229. · 0.92 Impact Factor
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    Epidemiologia e prevenzione 01/2013; 37(4-5):230-241. · 0.92 Impact Factor
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    Epidemiologia e prevenzione 01/2013; 37(4-5):209-219. · 0.92 Impact Factor
  • XIII Congresso Nazionale della Pneumologia UIP Catania 3-6 ottobre 2012., Catania; 10/2012
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a disorder leading to physical and mental impairment. Aim of the present study was to evaluate the effect of BODE index and its components on depressive symptoms and Quality of Life (QoL). We studied 37 consecutive COPD outpatients (26 M, aged 53-86 years). COPD diagnosis was confirmed by clinical and functional assessment. The patients were classified on the basis of GOLD and BODE stages. QoL was assessed by SF-36 questionnaire through its two components: Physical Health (PCS) and Mental Health (MCS). Depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II). 14 patients were allocated in GOLD stage I, 18 in II, and 5 in III. No patient was in GOLD stage IV. BODE index ranged 0-6. Median depression value (IQ range) was 7 (4-11). 23 subjects did not present depressive symptoms, 8 showed mild depression, and 6 moderate depression. None showed severe depression. Mean PCS and MCS were 46.4 (±10.4) and 47.5 (±9.6) respectively. PCS and MCS values lower respect to mean value of Italian general population were found in 22 and 17 subjects, respectively. A negative relationship was found between BDI-II and PCS (p=0.02). BDI-II was linearly correlated to BODE (p<0.0001) but not to GOLD stage. PCS was inversely correlated to BODE (p=0.02), but not to GOLD Stage. MCS was not correlatet to BODE and to GOLD Stage. Among individual components of BODE, only MRC was a good and direct predictor for depression (p=.007), and an inverse predictor for both MCS (p=.007) and PCS (p=.0002). In conclusion, a greater dyspnea perception, regardless of disease severity, is associated with higher depression score and poorer QoL.
    Poster discussion presented to ERS (Europan Respiratory Society) annual congress Austria 1-5 september 2012., Vienna; 09/2012
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    ABSTRACT: Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma and respiratory allergy. Environmental factors, especially indoor and outdoor air quality, may play an important role in triggering acute exacerbations of respiratory symptoms. The authors have reviewed the literature reporting effects of outdoor and indoor pollutants on FeNO in children. Although the findings are not consistent, urban and industrial pollution-mainly particles (PM(2.5) and PM(10)), nitrogen dioxide (NO(2)), and sulfur dioxide (SO(2))-as well as formaldehyde and electric baseboard heating have been shown to increase FeNO, whilst ozone (O(3)) tends to decrease it. Among children exposed to Environmental Tobacco Smoke (ETS) with a genetic polymorphisms in nitric oxide synthase genes (NOS), a higher nicotine exposure was associated with lower FeNO levels. Finally, although more studies are needed in order to better investigate the effect of gene and environment interactions which may affect the interpretation of FeNO values in the management of children with asthma, clinicians are recommended to consider environmental exposures when taking medical histories for asthma and respiratory allergy. Further research is also needed to assess the effects of remedial interventions aimed at reducing/abating environmental exposures in asthmatic/allergic patients.
    Journal of Allergy 01/2012; 2012:916926.
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    ABSTRACT: Increased body weight may influence airway inflammatory mechanisms. To assess whether overweight-obesity (OW-O), evaluated as increased body mass index, is associated either with exhaled nitric oxide (eNO), a marker of airway inflammation, or with allergic sensitization in a large sample of children and adolescents. A cross-sectional, epidemiological study was performed on a population sample of schoolchildren evaluating 708 subjects (age 10-16 years; BMI 13-39 kg/m(2)) by respiratory health questionnaire, skin prick tests, spirometry, and eNO measure. Prevalence rates were: OW-O 16.4%, asthma ever (A) 11.9%, and rhinoconjunctivitis (RC) 14.8%. Asthma ever and allergic sensitization were significantly more frequent among OW-O (21.0 and 51.6%) than in non-OW-O (10.2 and 37.0%, respectively). The forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) ratio was not significantly different between OW-O and non-OW-O. Exhaled NO (median and interquartile range) was 15.3 (11.2-23.1) ppb in the overall sample, 20.3 (12.9-35.8) ppb among allergic subjects, and 13.9 (10.6-18.3) ppb among nonallergic subjects (P<.0001). No significant difference between OW-O and non OW-O subjects was found in eNO levels. Similarly, OW-O subjects with A or RC did not show significantly higher eNO levels than non-OW-O. In a logistic regression model, presence of allergic sensitization, A, and RC, and not OW-O, were significant predictors of increased eNO. In children, OW-O was not associated with increased eNO levels, but it was an independent risk factor for asthma and allergic sensitization.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 10/2011; 107(4):330-6. · 3.45 Impact Factor
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    ABSTRACT: Trace element contents in specimens of hair collected from 137 children aged 11-13 years old, living in Palermo (Sicily, Italy) were determined by ICP-MS. This work reports analytical data for the following 19 elements: Al, As, Ba, Cd, Co, Cr, Cu, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sr, U, V and Zn. The most abundant chemical elements were zinc and copper (Zn > Cu), with concentrations exceeding 10 μg/g (Zn = 189.2 μg/g; Cu = 22.9 μg/g). Other elements with concentrations greater than 1 μg/g were, in order of abundance, Al>Sr>Ba>Pb. The remaining elements were all below 1 μg/g. The average elemental concentrations in hair were statistically compared by Kolmogorov-Smirnov's test taking children's gender into account. Al, Ba, Cr, Li, Rb, Sb, Sr, V and Zn were statistically different according to gender, with significance p < 0.001. This study thus confirms the need for hair analysis to differentiate female data from those of males. IUPAC coverage intervals and coverage uncertainties for trace elements in the analysed hair samples are also reported.
    Environmental toxicology and pharmacology. 07/2011; 32(1):27-34.
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    ABSTRACT: Large variations in prevalence of atopy and allergic diseases are reported worldwide in children, but in epidemiological studies the use of skin prick tests (SPT) and spirometry along with questionnaires is not common in the Mediterranean Area. The present work was aimed at evaluating the prevalence of current asthma (CA), rhinoconjunctivitis (RC), and eczema (E), with atopy and respiratory function, and the role of risk factors for allergic respiratory diseases. A total of 2150 Italian schoolchildren were cross-sectionally investigated through respiratory questionnaire, SPT, and spirometry. A proportional Venn diagram quantified the distribution of CA, RC, and E, stratifying for allergic sensitization to show differences in prevalence of allergic diseases among subjects with and without positive SPT. CA prevalence was 4.2%, RC 17.9%, and E 5.3%. CA and RC increased, while E decreased, with respect to previous local studies. Allergic sensitization prevalence (evaluated as positive response to at least one SPT) was 39.2%. A double Venn diagram identified 15 categories. Atopic CA was threefold more frequent than non-atopic CA. Atopic vs non-atopic RC and E were 9.6% vs 10.3% and 2.0% vs 3.3%, respectively. Atopic vs non-atopic RC associated with CA were 1.6% vs 0.5%; the same figures for RC associated with E were 0.8% vs 1.3%. Asymptomatic atopic subjects were 27.0%. Atopy, RC, parental asthma, and environmental risk factors were associated with CA. Atopy and environmental factors were risk factors also for RC. Asthma and traffic exposure were linked to reduced lung function. Respiratory allergic diseases are still increasing and largely concomitant in Italian adolescents. Atopy is more important for CA than RC. Avoiding exposures to measured environmental risk factors would prevent 41% of current asthma and 34% of rhinoconjunctivitis.
    Pediatric Allergy and Immunology 02/2011; 22(1 Pt 1):60-8. · 3.38 Impact Factor
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    ABSTRACT: The extent to which the sensitization to the German cockroach Blattella germanica (BG) affects onset/presence of rhinoconjunctivitis (RC) in children is unknown. The present work was aimed to assess the prevalence of BG sensitization in an outpatient pediatric population from an allergy clinic, the association with allergic diseases, and the effect of age in children with allergic sensitization. Five hundred and four consecutive children with at least one positive skin test to a panel of 17 food and inhalant allergens, including BG, and with personal history of atopic diseases, were enrolled in an Allergy Unit of Palermo, Mediterranean area of Southern Italy. A questionnaire was administered to obtain data on epidemiologic and clinical characteristics. Atopy index was computed as the number of the individual positive skin prick tests. Logistic regression was used to estimate the associations between age classes and BG sensitization and RC, as well as the population-attributable risk (PAR) for RC. Prevalence of BG sensitization was 10.5% (5.2% and 15.8% in lower and upper age classes respectively, p=0.0001). Atopy index significantly increased from the lower to the higher age class (p<0.0001). The older age class (OR 3.12; 95% CI 1.57-6.19) and a higher atopy index (OR 37.16; 95% CI 5.04-274.13) were recognized as main risks factors for BG sensitization. In the upper age class, the PAR of BG sensitization for RC was 20.6%. BG sensitization increases in the higher ages, along with atopic index, and BG sensitization is associated with rhinoconjunctivis in older allergic children.
    Pediatric Allergy and Immunology 01/2011; 22(5):521-7. · 3.38 Impact Factor
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    ABSTRACT: The most frequent cause of death in patients with Amyotrophic Lateral Sclerosis (ALS) is respiratory failure. Recently, it has been shown that non-invasive ventilation improves survival and quality of life in ALS patients with respiratory failure, but little is known about predictors of non-invasive ventilation adaptation and tolerance. In this study we evaluated the effect of a comprehensive information about non-invasive ventilation use and a prolonged and intensive monitoring on tolerance to this palliative care. We prospectively monitored all consecutive ALS patients with chronic respiratory failure and indication to non-invasive ventilation between January 2005 and December 2007. Non-invasive ventilation adaptation was always performed in a hospital setting. Forty-four patients were considered eligible: six declined the non-invasive ventilation proposal and one was excluded due to severe fronto-temporal dementia. Non-invasive ventilation was offered to thirty-seven inpatients in our ALS Centre, thirty-two of whom presented with severe (n=9) or mild-moderate (n=23) bulbar impairment at non-invasive ventilation initiation. The mean time interval for adaptation to ventilation was 5±2 days, but patients remained in hospital for an average extended period of one week. Thirty-five of the 37 patients who started non-invasive ventilation, including those with severe bulbar impairment, remained tolerant at twelve months follow-up. Our study shows that an intensive educational training and adaptation on non-invasive ventilation, when performed in a hospital multidisciplinary setting, increases compliance and tolerance over time, even in those patients with severe bulbar impairment. However, the design of our study, mainly based on a continuous monitoring and educational training of the patients, might not make it fully applicable to an outpatients setting.
    Journal of the neurological sciences 01/2011; 303(1-2):114-8. · 2.32 Impact Factor
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    ABSTRACT: To cite this article: La Grutta S, Cibella F, Passalacqua G, Cuttitta G, Liotta G, Ferlisi A, Viegi G. Association of Blattella germanica sensitization with atopic diseases in pediatric allergic patients. Pediatr Allergy Immunol 2011; 22: 521–527. AbstractBackground: The extent to which the sensitization to the German cockroach Blattella germanica (BG) affects onset/presence of rhinoconjunctivitis (RC) in children is unknown.Objectives: The present work was aimed to assess the prevalence of BG sensitization in an outpatient pediatric population from an allergy clinic, the association with allergic diseases, and the effect of age in children with allergic sensitization.Methods: Five hundred and four consecutive children with at least one positive skin test to a panel of 17 food and inhalant allergens, including BG, and with personal history of atopic diseases, were enrolled in an Allergy Unit of Palermo, Mediterranean area of Southern Italy. A questionnaire was administered to obtain data on epidemiologic and clinical characteristics. Atopy index was computed as the number of the individual positive skin prick tests. Logistic regression was used to estimate the associations between age classes and BG sensitization and RC, as well as the population‐attributable risk (PAR) for RC.Results: Prevalence of BG sensitization was 10.5% (5.2% and 15.8% in lower and upper age classes respectively, p = 0.0001). Atopy index significantly increased from the lower to the higher age class (p BG sensitization.Conclusion: In the upper age class, the PAR of BG sensitization for RC was 20.6%. BG sensitization increases in the higher ages, along with atopic index, and BG sensitization is associated with rhinoconjunctivis in older allergic children.
    Pediatric Allergy and Immunology 01/2011; 22(5). · 3.38 Impact Factor
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    ABSTRACT: We investigated acute and chronic exposure to environmental tobacco smoke (ETS) in a cohort of young adolescents using urinary cotinine and hair nicotine testing after recent implementation of Italian smoke free legislation. Study subjects were 372 Italian young adolescents, between 10 and 16 years of age from the principal city of Sicily, Palermo. Urine and hair samples were collected between November 2005 and May 2006, when the legislation to ban smoking in all the enclosed places of employment (including bars, restaurants, pubs) was completely enforced. An exhaustive questionnaire including sociodemographic characteristics and active and passive exposure to cigarette smoking was completed. Urinary cotinine was analyzed by radioimmunoassay and hair nicotine by a validated GC/MS method. Based on urinary cotinine results, 2.1% and 89% of the study participants, respectively, showed non-exposure and low acute exposure to ETS, whereas only 1.6% presented very high exposure or a hidden active smoking habit in the recent past. Hair nicotine disclosed non-exposure and low exposure to ETS in 11.8% and 65.6% of the young adolescents, respectively, taking into consideration a larger time-window. High repeated exposure, suggesting active smoking in some cases was observed in 8.6% of the study subjects. Hair nicotine was inversely related to educational level of the adolescents' parents. Overall, due to the implementation of smoke-free legislation and information campaign against smoking, a significant trend toward low exposure to ETS was observed in this study cohort with no association between exposure to ETS and respiratory illnesses.
    Forensic science international 03/2010; 196(1-3):97-100. · 2.10 Impact Factor
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    ABSTRACT: To evaluate the relationship between pro-inflammatory and pro-remodeling mediators and severity and control of asthma in children, the levels of IL-8, MMP-9, TIMP-1 in induced sputum supernatants, the number of sputum eosinophils, as well as FeNO, were investigated in 35 asthmatic children, 12 with intermittent (IA) and 23 with moderate asthma (MA), and 9 controls (C). The patients with asthma were followed for 1 yr and sputum was obtained twice during the follow-up. Biomarker levels were correlated with the number of exacerbations. We found that IL-8, MMP-9, TIMP-1 and the numbers of eosinophils in induced sputum, as well as FeNO, were increased in children with IA and MA in comparison to C. The ongoing inflammation was confirmed by increased nuclear p65 NF-kappaB subunit localization in sputum cells. In MA, FeNO measurements, sputum eosinophils and IL-8 levels, positively correlated with the occurrence of disease exacerbations during a 1-yr follow-up. According to FeNO, sputum eosinophils and IL-8 sputum concentrations, and the number of exacerbations, two distinct phenotypes of MA were identified. This study shows that the presence of bronchial inflammation is detectable in the airways of some IA, as well as in the airways of MA, despite the regular ICS treatment. This study also proposes the need to perform large prospective studies to confirm the importance of measuring specific biomarkers in induced sputum, concomitantly to FeNO analyses, to assess sub-clinical airway inflammation and disease control in children with asthma.
    Pediatric Allergy and Immunology 09/2009; 20(8):780-90. · 3.38 Impact Factor

Publication Stats

396 Citations
155.41 Total Impact Points

Institutions

  • 2009–2011
    • Università degli studi di Palermo
      • • Department of earth and marine science (DiSTeM)
      • • Department of internal medicine and medical specialties (DIMIS)
      Palermo, Sicily, Italy
  • 1993–2011
    • National Research Council
      • Institute of Biomedicine and Molecular Immunology "Alberto Monroy" IBIM
      Roma, Latium, Italy