F Cibella

Institute of Immunology, Santiago de Cali, Valle del Cauca, Colombia

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Publications (82)225.29 Total impact

  • G Cuttitta · F Cibella · P Alfano · P Audino · M Melis · G Viegi · S Bucchieri
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    ABSTRACT: RATIONALE Spirometry is the objective measurement to detect airway obstruction. In some patients respiratory symptoms related to airway obstruction are not present, when airway obstruction is detected by spirometry. Aim of the present study was to detect early airway obstruction in an adult population sample in a primary care setting. METHODS Seventeen general practitioners were involved and 912 patients were asked to participate in the study, between January and June 2014: of them, 583 (323M), aged 40-92 yrs, accepted and were investigated through a respiratory questionnaire, the mMRC dyspnoea scale, and spirometry through the Quark PFT (Cosmed, Italy) spirometer. Smoking habits, BMI, respiratory symptoms, doctor respiratory diagnoses, dyspnoea score, and forced expirograms were obtained. Based on answers on doctor diagnosis, we identified 4 subgroups: doctor COPD diagnosis (COPD); doctor Asthma diagnosis (A); Asthma COPD Overlap Syndrome (ACOS); no respiratory diagnosis (NRD). For screening purposes, a FEV1/FVC<70% was considered a marker of airway obstruction. Severity was determined by FEV1 level: I mild (FEV1≥80% of predicted); II moderate (50-79%), III severe (30-49%); IV more severe (<30%). RESULTS One hundred and ninety subjects were current smokers, 235 ex smokers and 155 non smokers. Prevalence rates of cough, sputum, wheezing and dyspnoea were 27%, 26%, 32%, 44%, respectively. Prevalence rates of COPD, A, and ACOS were 12.5%, 7.8%, and 3.6%, respectively. In the overall sample 16.3% (95) showed airway obstruction: of them, 26% mild, 56% moderate, 17% severe, 1% very severe. Among obstructed subjects 12% did not report any respiratory symptom and were distributed among FEV1 levels I-III. Those reporting neither respiratory symptoms nor respiratory doctor diagnosis were 60% in level I; 43% in level II; 44% in level III; none in level IV. In obstructed vs not obstructed individuals, a higher frequency of smokers (χ2=.002) and a higher mMRC score (χ2<.05) were found. A significant association among cough, sputum, wheezing, dyspnoea and obstruction was found (χ2<.001). In a logistic model, wheezing (p=.001), sputum (p=.036), smoking habits (p=.028), and older age (p=.0001) were the best predictors of airway obstruction. CONCLUSIONS We found an elevated prevalence of airway obstruction in our sample of primary care adults associated with elevated respiratory symptoms prevalence and smoking. However, a high prevalence of subjects without symptoms or medical diagnoses was found among obstructed patients, indicating the need of implementing spirometry in family practice as early diagnosis tool.
    Am J Respir Crit Care Med; 05/2015
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    ABSTRACT: Asthma and obesity are important and growing health issues worldwide. Obesity is considered a risk factor for asthma, due to the induction of changes in airway mechanics and altered airway inflammation. We cross-sectionally investigated the effect of increased weight on pulmonary function in a large population sample of healthy children, aged 10-17 yrs living in Palermo, Italy. Explanatory effect of weight on lung function variables were evaluated by multiple linear regression models, taking into account height, gender, and age-class. Among the 2,393 subjects, FVC and FEV1 were positively correlated to weight. Multiple regression models showed that the weight beta coefficient for FEV1 was significantly lower with respect to that for FVC (0.005 and 0.009 l/kg, respectively), indicating a different magnitude in explanatory effect of weight on FVC and FEV1. Both FEV1/FVC and FEF25-75%/FVC ratios were negatively correlated to weight, while FEF25-75% was not significantly correlated. Similar results were obtained also when 807 symptomatic subjects were introduced in the model through a sensitivity analysis. In healthy children, the disproportionate increase of FEV1 and FVC with weight produces airflow decrease and consequently apparent poorer lung function independently from respiratory disease status.
    PLoS ONE 05/2015; 10(5):e0127154. DOI:10.1371/journal.pone.0127154 · 3.23 Impact Factor
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    ABSTRACT: AIMS: Here, we present results from a prospective pilot study that was aimed at surveying changes in daily cigarette consumption in smokers making their first purchase at vape shops. Modifications in products purchase were also noted. DESIGN: Participants were instructed how to charge, fill, activate and use their e-cigarettes (e-cigs). Participants were encouraged to use these products in the anticipation of reducing the number of cig/day smoked. SETTINGS: Staff from LIAF contacted 10 vape shops in the province of the city of Catania (Italy) that acted as sponsors to the 2013 No Tobacco Day. PARTICIPANTS: 71 adult smokers (≥18 years old) making their first purchase at local participating vape shops were asked by professional retail staff to complete a form. MEASUREMENTS: Their cigarette consumption was followed-up prospectively at 6 and 12 months. Details of products purchase (i.e., e-cigs hardware, e-liquid nicotine strengths and flavours) were also noted. FINDINGS: Retention rate was elevated, with 69% of participants attending their final follow-up visit. At 12 month, 40.8% subjects could be classified as quitters, 25.4% as reducers and 33.8% as failures. Switching from standard refillables (initial choice) to more advanced devices (MODs) was observed in this study (from 8.5% at baseline to 18.4% at 12 month) as well as a trend in decreasing thee-liquid nicotine strength, with more participants adopting low nicotine strength (from 49.3% at baseline to 57.1% at 12 month). CONCLUSIONS: We have found that smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates.
    International Journal of Environmental Research and Public Health 04/2015; 12(4):3428-3438. DOI:10.3390/ijerph120403428 · 2.06 Impact Factor
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    ABSTRACT: High levels of indoor NO2 are associated with increased asthma symptoms and decreased expiratory peak flows in children. We investigated the association of exposure to domestic indoor NO2, objectively measured in winter and spring, with respiratory symptoms and lung function in a sample of adolescents from a southern Mediterranean area. From a large school population sample (n=2150) participating in an epidemiological survey in the urban area of the City of Palermo (southern Italy), a sub-sample of 303 adolescents was selected which furnished an enriched sample for cases of current asthma. All subjects were evaluated by a health questionnaire, skin prick tests and spirometry. One-week indoor NO2 monitoring of their homes was performed by diffusive sampling during spring and again during winter. We found that about 25% of subjects were exposed to indoor NO2 levels higher than the 40µg/m(3) World Health Organization limit, during both spring and winter. Moreover, subjects exposed to the highest indoor NO2 concentrations had increased frequency of current asthma (p=0.005), wheeze episodes in the last 12 months (p<0.001), chronic phlegm (p=0.013), and rhinoconjunctivitis (p=0.008). Finally, subjects with a personal history of wheeze ever had poorer respiratory function (FEF25-75%, p=0.01) when exposed to higher indoor NO2 concentrations. Home exposure to high indoor NO2 levels frequently occurs in adolescents living in a southern Mediterranean urban area and is significantly associated with the risks for increased frequency of both respiratory symptoms and reduced lung function. Copyright © 2015 Elsevier Inc. All rights reserved.
    Environmental Research 02/2015; 138C:8-16. DOI:10.1016/j.envres.2015.01.023 · 3.95 Impact Factor
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    ABSTRACT: Rhinitis and conjunctivitis are common diseases worldwide that are frequently associated. Nevertheless, the risk factors for rhinoconjunctivitis are not well-described and the impact of conjunctivitis on rhinitis and asthma in children remains unknown. This study explored the different risk factors and evaluated the burden of rhinoconjunctivitis among adolescents. This was a cross-sectional study conducted on a random sample of schoolchildren, aged 10-17 years, using skin prick tests and a self-administered questionnaire on respiratory health investigating the impact of rhinitis and rhinoconjunctivitis on daily activities. A complete evaluation was obtained for 2,150 children. The prevalence of rhinitis alone was 18.2% and rhinitis associated with conjunctivitis was 20.5%. Rhinoconjunctivitis was more frequently associated with females, a parental history of atopy, domestic exposure to mold/dampness, passive smoke exposure, and reported truck traffic in residential streets. Moreover, rhinoconjunctivitis was associated with a higher level of allergic sensitization. The prevalence of current asthma was 1.7% in subjects without rhinitis or rhinoconjunctivitis, 5.1% in rhinitis and 10.7% in rhinoconjunctivitis. In a logistic model, rhinoconjunctivitis yielded a 2-fold risk for current asthma with respect to rhinitis. Subjects with rhinoconjunctivitis had poorer quality of life (QoL); there was an impact on daily activities in 4.6% of rhinitis and 10.7% of rhinoconjunctivitis. Ocular symptoms increase the role of rhinitis as a risk factor for asthma and its impact on daily activities in children.
    Allergy, asthma & immunology research 01/2015; 7(1):44-50. DOI:10.4168/aair.2015.7.1.44 · 3.08 Impact Factor
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    ABSTRACT: The interaction between IgE antibodies and allergens is a key event in triggering an allergic reaction. The characterization of this region provides information of paramount importance for diagnosis and therapy. Par j 2 Lipid Transfer Protein is one of the most important allergens in southern Europe and a wellestablished marker of sensitization in Parietaria pollen allergy. The main aim of this study was to map the IgE binding regions of this allergen and to study the pattern of reactivity of individual Parietaria-allergic patients. By means of gene fragmentation, six overlapping peptides were expressed in Escherichia coli, and their IgE binding activity was evaluated by immunoblotting in a cohort of 79 Parietaria-allergic patients. Our results showed that Pj-allergic patients display a heterogeneous pattern of IgE binding to the different recombinant fragments, and that patients reacted simultaneously against several protein domains spread all the over the molecule, even in fragments which do not contain structural features resembling the native allergen. Our results reveal the presence of a large number of linear and conformational epitopes on the Par j 2 sequence, which probably explains the high allergenic activity of this allergen.
    Molecular Immunology 10/2014; 63(2). DOI:10.1016/j.molimm.2014.09.012 · 3.00 Impact Factor
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    ABSTRACT: Indoor air pollution is estimated to be greater in indoor than in outdoor environment. Tobacco smoke may significantly contribute to indoor air pollution and domestic smoking is correlated to indoor airborne particulates with aerodynamic diameter<2.5µg (PM2.5). Heavy metals, such as Cd and Tl, are present in tobacco and dispersed in the environment by tobacco combustion. In the context of RESPIRA Project, we performed outdoor/indoor measurements of PM2.5 by gravimetric sampling in 73 houses in the Mediterranean Area of South Italy. Gravimetric Teflon filters were analyzed for PM metal content by inductively coupled plasma (ICP) optical emission spectrometry and ICP mass spectrometry for obtaining Cd and Tl concentration. The presence/absence of smokers in each dwelling was investigated by a questionnaire fulfilled by householders. The relationships of indoor/outdoor concentrations were not significant for both Cd and Tl. Conversely, the indoor Cd/Tl correlation was highly significant (R2=.812, p<.0001) showing that both metals in indoor PM2.5 have a common indoor source. Higher concentration of PM2.5 such as of Cd and Tl was associated to the presence of smokers at home: PM2.5 was (median and interquartile range) 24.2 µg/m3 (16.9-41.5) for smoker and 15.7 (10.9-22.5) for non-smoker houses (p<.0001); Cd was 0.148 ng/m3 (0.081-0.449) and 0.032 (0.028-0.080) respectively (p=.0002); Tl 0.069 ng/m3 (0.042-0.146) and 0.020 (0.008-0.042, p<.0001) (Mann-Whitney U-test for nonparametric data). These results suggest that the levels of cadmium and thallium in PM2.5 are markers of third-hand smoking RESPIRA Project was funded by Operational Cross-border Program Italy-Malta 2007-13 code A1.2.3-72.
    European Respiratory Society Annual congress 2014, Munich; 09/2014
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    ABSTRACT: Aim of the study was to evaluate the influence of living in highly polluted areas in Malta and in Sicily on reported allergic respiratory diseases in children. Malta has a very high population density while the petrochemical industry located close to Gela is one of the main sources of industrial air pollution in Sicily. In the context of RESPIRA Project, we evaluated 2,047 schoolchildren (972 M), aged 10-15 yrs, selected from 12 junior high schools of Southern Sicily (n=1,189 evaluated subjects) and 6 of Malta (n=858). Children′s parents fulfilled an ISAAC respiratory questionnaire. Rhinitis in the last 12 months was reported by 6.6% in Italy and 7.9% in Malta (p=.05); wheeze in the last 12 months (W12m) by 7.4% in Italy and 12.7% in Malta (p<.0001); doctor diagnosed asthma (DDA) by 7.9% in Italy and 18.1% in Malta (p<.0001). Current asthma (CA), defined as DDA + W12m, was reported by 3.0% in Italy and 7.8.% in Malta (p<.0001). Use of drugs for asthma in the last 12 months was reported by 4.9% in Italy and 12.1% in Malta (p<.0001). In a logistic model, when correcting for asthmatic bronchitis in the first two years of life, parental atopy, early and current passive smoke exposure, mould/dampness at home, personal history for rhinitis, socioeconomic status and presence of pets at home, children living in Malta showed a higher risk factor for CA with respect to those living in Southern Sicily (OR 2.48, IC 1.32-4.70, p=.005). In conclusion, children living in Malta are at higher risk for developing allergic respiratory diseases with respect to those living in Southern Sicily Funded by Cross-border Program Italy-Malta 2007-2013 code A1.2.3-72.
    European Respiratory Society Annual Congress 2014, Munich; 09/2014
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    ABSTRACT: Introduction: The RESPIRA study was performed in the Health District of Gela (Southern Sicily) and Malta in 2012/3 in 11-14 years old schoolchildren (n=2,047) by means of standard respiratory questionnaires (ISAAC),and clinical exam of case and control subjects. Aims and Objectives: To measure total serum IgE levels in cases (n=127, Male=45) and controls (n=142, Male=64), and specific IgEs in cases (n=90, male=53), and controls (n=82, males=38). Materials and Methods: Cases reported wheeze and/or use of asthma medications in the last 12 months, while controls answered negatively to both and also to rhinitis in the last 12 months. The method used for Specific IgE's (sIgE) was that supplied by R-Biopharm (R-Biopharm AG, Landwehrstr. 54, D-64293 Darmstadt, Germany). The method was Enzyme Sorbent Test (EAST). The method used for Total IgE (tIgE) was by ELISA supplied by Genetic Diagnostics (Genesis Diagnostics Ltd, Eden Research Park, Henry Crabb Road, Littleport, Cambridgeshire, United Kingdom). Results: Total Serum IgE (n=269) was raised(>144 IU/l) in 45/127 cases versus 25/142 controls (p=0.0001). In Males 30/76 of cases vs 11/64 controls (p=0.005), while in Females cases 15/51 vs 14/78, (p=0.14). Positive specific IgE (>0.34 U/ml) was noted in at least one allergen in 54/90 cases vs 30/82 controls (p=0.002). HDM was positive in 27/90 cases vs 12/82 controls (p=0.0001), Parietaria positive 12/90 cases vs 2/82 controls (p=0.011), cat 22/90 vs 13/82 controls (p=0.19) in whole sample, while in male subgroup 14/53 of cases were positive vs 4/38 controls (p=0.06). Dog 9/90 cases vs 8/82 controls (p=0.86). Olive positive in 13/90 cases vs 8/82 controls (p=0.48). Alternaria positive in 6/90 cases vs 2/82 controls (p=0.28). Goldenrod Solidago Virgaurea positive in 2/90 cases vs 1/82 controls, and Cladosporium 0/90 cases, 1/82 controls. Conclusion: Positive Total serum IgE, and specific IGE to HDM and Parietaria in all patients were significantly higher in Cases than in control subjects. IGE to moulds and dog allergen was not significantly different. Positive cat IgE was close to statistical significance in males only. RESPIRA Study was funded by Operational Cross-border Program Italy
    European Respiratory Society Annual congress - 2014, Munich; 09/2014
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    ABSTRACT: Introduction: The RESPIRA study was performed in the Health District of Gela (Southern Sicily) and Malta in 2012/3 in 11-14 years old schoolchildren (n=2,047) by means of standard respiratory questionnaires (ISAAC) and clinical exam of case and control subjects. Aims and Objectives: To assess sensitivity to common allergens in cases and controls in these southern Mediterranean islands. Materials and Methods: Cases (n=137, M=84) reported wheeze and/or use of asthma medications in the last 12 months, while controls (n=159, M=70) answered negatively to both and also to rhinitis in the last 12 months. Results: A positive skin test (>=3mm) for at least one allergen tested was found in 80/137 cases and 51/159 controls (p=0.0001). House Dust Mite (cases 62/137, controls 28/159, p=0.001), Parietaria (22/137, 10/159, p=0.008), Alternaria (19/137, 9/159, p=0.018), and Blattella (12/137, 5/159, p=0.046) were more frequently positive in cases than in controls. Olive (25/137, 19/159, p=0.142), cat (17/137, 11/159, P=0.116), and dog (9/137, 5/159, p=0.182) did not show a significant difference between cases and controls. Grass pollen sensitization was slightly higher in controls (10/137, 13/159). There was a significant difference by gender in a 2x4 chi 2 comparing positives amongst cases and controls. HDM; Males (cases 41/84 Controls 15/70), females (Cases 21/53, Con 13/89) p=0.011, Olive; in Males (CAS 19/84, Con 10/70) Females (Cas6/53, con 9/89) p=0.007, Cat; Males (Cas.12/84, Con 6/70) Females (Cas.5/53 and 5/89) p=0.019 and for Dog; Males (CAS 7/84 and 2/70) and Females (Cases 2 /53 and 4/89 p=0.017. Conclusion: Skin prick sensitivity to common Mediterranean aero-allergens in asthma patients vs controls was significantly higher in 11-14 year old Males when compared to females. RESPIRA Study was funded by Operational Cross-border Program Italy
    European Respiratory Society - annual congress 2014, Munich; 09/2014
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    ABSTRACT: The Respira project: Difference in levels of indoor biological pollutants in schools and homes in Southern Sicily and Malta Valeria Longo1, David Bilocca2, Chris Zammit2, Martin Balzan2, Fabio Cibella1, Steve Montefort2, Giovanni Viegi1 and Paolo Colombo1 + Author Affiliations 1Istituto di Biomedicina ed Immunologia Molecolare, Consiglio Nazionale delle Ricerche, Palermo, Italy 2Department of Medicine, Mater Dei Hospital, Msida, Malta Abstract Guidelines in asthma and allergic disease highlighted the importance of indoor levels of allergens and LPS evaluation, to identify the “threshold value” in sensitization and symptom onset. The RESPIRA Project has provided a monitoring study of LPS and four allergens (Derp1, Feld1, Alta1 and Phlp5) in Sicily and Malta. Methods: Dust samples were collected by vacuum sampling from schools (12 in Sicily and 6 in Malta – 3 classrooms per each school). From a population sample of 2,047 schoolchildren (11-14 years) a subsample of subjects with and without symptoms of allergic diseases was selected and their houses evaluated (74 in Sicily and 81 in Malta). LPS evaluation was determined by chromogenic LAL assay and allergen quantization was performed by Elisa assays. Results: In Sicily (Health District of Gela), data show a higher level of LPS in schools than in houses (p<0.0001); 70% of houses have a concentration of Der p 1 above the threshold value of sensitization (≥1 µg allergen/g dust) and, in any case, higher in dwellings than in schools (p<0.0001). In Malta no statistical difference in LPS concentration was recorded between houses and schools; on the other hand Der p 1 and Fel d 1 allergens are present in higher amount in Maltese dwelling. No differences were reported for Alt a 1 and Phl p 5. Finally, the comparison between LPS and allergens distribution between Sicily and Malta shows i) a significant higher LPS concentration in Italian schools (p<0.0001); ii) higher Fel d 1 concentration in Maltese schools; iii) higher Der p 1 concentration in Italian houses. Funded by Operational Programme Italia-Malta 2007-2013, RESPIRA Project #A.1.2.3-72.
    European Respiratory Society Annual congress 2014, Munich; 09/2014
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    ABSTRACT: Pollutants in particulate matter (PM) are associated with respiratory disorders. Data on indoor concentration of elemental chemical pollutants in highly polluted areas is scanty. In the context of RESPIRA Project, we evaluated both outdoor and indoor concentrations of air pollutants in the Mediterranean area. Gravimetric samples of PM with aerodynamic diameter<2.5 µm were collected on Teflon filters. Concentration of ICP-MS extracted component was measured in 84 sites of South of Sicily (41 in Gela, close to a petrochemical complex, 43 in rural area) and 54 in Malta. Similarly. Indoor measures were performed in 73 houses in Sicily (35 in Gela, 38 in rural area) and in 46 of Malta. Outdoor Vanadium (V) concentrations (median and interquartile range, ng/m3) were: 1.77 (0.60-4.30) in Malta, 1.51 (0.72-2.89) in Gela, and 0.29 (0.11-0.69) in Rural Area (p<.0001); Nickel (Ni): 1.37 (0.65-2.74), 0.82 (0.45-1.37), and 0.29 (0.17-0.55, p<.0001); Sulphur (S) 210 (73-683), 705 (334-1,078), 203 (148-384, p=.0004). Home Indoor V concentrations were 1.34 (0.38-6.70) in Malta, 1.03 (0.44-2.04) in Gela, and 0.16 (0.10-0.44) in Rural Area (p<.0001); Ni: 1.10 (0.52-3.35), 0.61 (0.40-1.16), and 0.28 (0.19-0.35, p<.0001); S: 324 (71-728), 662 (379-1,090), and 257 (187-437, p=.0007). Outdoor/indoor relationships for the investigated elements were tested. V: R2=.665, p<.0001. Ni: R2=.750, p<.0001. S: R2=.587, p<.0001. In conclusion, significantly higher indoor concentration of atmospheric pollutants exist in highly polluted areas. These, in absence of indoor sources, depend on outdoor concentrations RESPIRA Project was funded by Operational Cross-border Program Italy-Malta 2007-2013 code A1.2.3-72.
    European Respiratory society annual congress 2014, Munich; 09/2014
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    ABSTRACT: Low vitamin D is involved in allergic asthma and rhinitis. IL-31 and IL-33 correlate with Th2-associated cytokines in allergic disease. We investigated whether low vitamin D is linked with circulating IL-31 and IL-33 in children with allergic disease of the airways. 25-Hydroxyvitamin D [25(OH) Vit D], IL-31, and IL-33 plasma levels were measured in 28 controls (HC), 11 allergic rhinitis (AR) patients, and 35 allergic asthma with rhinitis (AAR) patients. We found significant lower levels of 25(OH) Vit D in AR and in AAR than in HC. IL-31 and IL-33 plasma levels significantly increased in AAR than HC. IL-31 and IL-33 positively correlated in AR and AAR. 25(OH) Vit D deficient AAR had higher levels of blood eosinophils, exacerbations, disease duration, and total IgE than patients with insufficient or sufficient 25(OH) Vit D. In AAR 25(OH) Vit D levels inversely correlated with total allergen sIgE score and total atopy index. IL-31 and IL-33 did not correlate with 25(OH) Vit D in AR and AAR. In conclusion, low levels of 25(OH) Vit D might represent a risk factor for the development of concomitant asthma and rhinitis in children with allergic disease of the airways independently of IL-31/IL-33 Th2 activity.
    Mediators of Inflammation 06/2014; 2014:520241. DOI:10.1155/2014/520241 · 3.24 Impact Factor
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    ABSTRACT: Both severe asthma and obesity are growing health problems. Severe asthma leads to a poor quality of life. The relationship among BMI, comorbidities, and severe asthma control in adults is still unclear. The aim of the study is to better understand the effect of the comorbidities as atopy, type II diabetes, OSAS, gastroesophageal reflux, hypertension, cardiovascular diseases, osteoporosis, infections, and psychological factors with BMI on asthma control in a cohort of adult severe asthmatics. One hundred and two patients were enrolled in a cross-sectional study assessing asthma control, treatments, pulmonary function, inflammatory markers, and comorbidities. Patients were divided into 3 classes according to BMI: normal weight, overweight, and obese. We found that the optimal state of asthma control is lower. whereas the score of Asthma Control Questionnaire, the number of asthma exacerbations during last year, the oral corticosteroids requirement during the previous year, and the LABA treatments are higher in obese than in overweight and normal weight severe asthmatics. The number of subjects with type II diabetes and OSAS are higher among obese and overweight patients than in normal weight asthmatics. In conclusion, BMI represents per se a factor for the deterioration in disease control in severe asthma.
    BioMed Research International 05/2014; 2014:607192. DOI:10.1155/2014/607192 · 2.71 Impact Factor
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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; DOI:10.1111/pai.12215 · 3.86 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: OBJECTIVES: this study aims at presenting the results from the Italian EpiaAir2 Project on the short-term effects of air pollution on adult population (35+ years old) in 25 Italian cities. DESIGN: the short-term effects of air pollution on resident people died in their city were analysed adopting the time series approach. The association between increases in 10 μg/m3 in PM10, PM2.5, NO2 and O3 air concentration and natural, cardiac, cerebrovascular and respiratory mortality was studied. City-specific Poisson models were fitted to estimate the association of daily concentrations of pollutants with daily counts of deaths. The analysis took into account temporal and meteorological factors to control for potential confounding effect. Pooled estimates have been derived from random-effects meta-analysis, evaluating the presence of heterogeneity in the city-specific results. SETTING AND PARTICIPANTS: it was analysed 422,723 deaths in the 25 cities of the project among people aged 35 years or more, resident in each city during the period 2006-2010. MAIN OUTCOMES: daily counts of natural, cardiac, cerebrovascular, and respiratory mortality, obtained from the registries of each city. Demographic information were obtained by record linkage procedure with the civil registry of each city. RESULTS: mean numberofdeaths for natural causes ranged from 513 in Rovigo to 20,959 in Rome. About 25% of deaths are duetocardiac diseases, 10%tocerebrovascular diseases, and 7% to respiratory diseases. It was found an immediate effect of PM10 on natural mortality (0.51%; 95%CI 0.16-0.86; lag 0-1). More relevant and prolonged effects (lag 0-5) have been found for PM2.5 (0.78%; 95%CI 0.12-1.46) and NO2 (1.10%; 95%CI 0.63-1.58). Increases in cardiac mortality are associated with PM10 (0.93%; 95%CI 0.16-1.70) and PM2.5 (1.25%; 95%CI 0.17-2.34), while for respiratory mortality exposure to NO 2 has an important role (1.67%; 95%CI 0.23-3.13; lag 2-5), as well as PM10 (1.41%; 95%CI-0.23;+3.08). Results are strongly homogeneous among cities, except for respiratory mortality. No effect has been found for cerebrovascular mortality and weak evidence of association has been observed between ozone and mortality. CONCLUSIONS: a clear increase in mortality associated to air pollutants was observed. More important are the effects of NO2 (on natural mortality), mostly associated with traffic emissions, and of PM2.5 (on cardiac and respiratory mortality). Nitrogen dioxide shows an independent effect from the particulate matter, as observed in the bi-pollutant models.
    Epidemiologia e prevenzione 07/2013; 37(4-5):220-229. · 1.46 Impact Factor
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    ABSTRACT: Electronic cigarettes (e-cigarettes) are becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms, and to continue having a 'smoking' experience, but with reduced health risks. Research on e-cigarettes is urgently needed in order to ensure that the decisions of regulators, healthcare providers and consumers are based on science. Methods ECLAT is a prospective 12-month randomized, controlled trial that evaluates smoking reduction/abstinence in 300 smokers not intending to quit experimenting two different nicotine strengths of a popular e-cigarette model ('Categoria'; Arbi Group Srl, Italy) compared to its non-nicotine choice. GroupA (n = 100) received 7.2 mg nicotine cartridges for 12 weeks; GroupB (n = 100), a 6-week 7.2 mg nicotine cartridges followed by a further 6-week 5.4 mg nicotine cartridges; GroupC (n = 100) received no-nicotine cartridges for 12 weeks. The study consisted of nine visits during which cig/day use and exhaled carbon monoxide (eCO) levels were measured. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed. Declines in cig/day use and eCO levels were observed at each study visits in all three study groups (p<0.001 vs baseline), with no consistent differences among study groups. Smoking reduction was documented in 22.3% and 10.3% at week-12 and week-52 respectively. Complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and week-52 respectively. A substantial decrease in adverse events from baseline was observed and withdrawal symptoms were infrequently reported during the study. Participants' perception and acceptance of the product under investigation was satisfactory. In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects. ClinicalTrials.gov NCT01164072 NCT01164072.
    PLoS ONE 06/2013; 8(6):e66317. DOI:10.1371/journal.pone.0066317 · 3.23 Impact Factor

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716 Citations
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Institutions

  • 2011–2015
    • Institute of Immunology
      Santiago de Cali, Valle del Cauca, Colombia
    • INO - Istituto Nazionale di Ottica
      Florens, Tuscany, Italy
  • 1993–2015
    • Italian National Research Council
      • Institute of Biomedicine and Molecular Immunology "Alberto Monroy" IBIM
      Roma, Latium, Italy
  • 2004
    • Istituto di Bioimmagini e Fisiologia Molecolare
      Segrate, Lombardy, Italy