Prevalence of Metabolic Syndrome and Insulin Resistance in a Sample of Adult ADHD Outpatients

BACKGROUND: High prevalence of Metabolic Syndrome (MS) was found in patients with schizophrenia and bipolar disorders. Insulin Resistance (IR) seems to mediate MS role in developing cardiometabolic consequences. AIMS: To investigate the prevalence of MS, and the role of MS components and IR surrogate indexes in determining MS in adult ADHD outpatients. METHODS: In the present cross-sectional study, MS, defined according to the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III), and IR surrogate indexes were assessed on a consecutive sample of adult ADHD outpatients. Logistic regression analysis was performed to evaluate the effect of each ATP III component and IR surrogate index in determining MS. RESULTS: Seventeen out of 158 patients (10.8%, 95%CI = 0.064/0.167) fulfilled the ATP-III criteria for MS. A comprehensive comparison with prevalence in the reference population was hindered by the lack of patients over 60 in the study sample, however under this age no significant differences were found. Among MS components, blood triglycerides level (OR = 1.02, 95%CI=1.01/1.03, p = 0.001) was the main predictor for MS, followed by diastolic blood pressure (OR = 1.08, 95%CI=1.01/1.16, p = 0.024) and waist circumference (OR = 1.06, 95%CI=1.01/1.13, p = 0.029). Lipid Accumulation Product (LAP, OR = 1.0006, 95%CI=1.0003/1.0009, p < 0.001) outperformed Triglyceride-Waist Circumference (TG-WC, OR=1.03, 95%CI=1.01/1.04, p < 0.001) in predicting MS. CONCLUSIONS: More attention should be paid not only to MS but also to each ATP III component of MS and LAP in ADHD patients both at first assessment and during follow-up process

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P &lt; 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P &lt; 0.001), sNox2-dp (r(s), -0.57; P &lt; 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P &lt; 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

Highly luminescent hetero-ligand MOF nanocrystals with engineered massive Stokes shift for photonic applications.

A high efficiency emission with a massive Stokes shift is obtained by fluorescent conjugated acene building blocks arranged in nanocrystals. The two ligands of equal molecular length and connectivity, yet complementary electronic properties, are co-assembled by zirconium oxy-hydroxy clusters, generating highly crystalline hetero-MOF nanoparticles The fast diffusion of singlet molecular excitons in the framework, coupled with the fine matching of ligands absorption and emission properties, enables to achieve an ultrafast activation of the low energy emission by diffusion-mediated non-radiative energy transfer in the 100 ps time scale, by using a low amount of co-ligands. This allow to obtain MOF nanocrystals with a fluorescence quantum efficiency of ̴ 70% and an actual Stokes shift as large as 750 meV. This large Stokes shift suppresses the reabsorption of fast emission issues in bulk devices, pivotal for a plethora of applications in photonics and photon managing spacing from solar technologies, imaging, and detection of high energy radiation. These features allowed to realize a prototypal fast nanocomposite scintillator that shows an enhanced performance with respect to the homo-ligand nanocrystals, achieving benchmark. values which compete with those of some inorganic and organic commercial systems

Misure critiche. N.s. A.2, n.1-2(2003)

N.S. A.2, n.1-2(2003) : Chirico I., La traduzione di Alfano per la tradizione manoscritta di Nemesio: Note, P. 5 ; Grimaldi E., Lettura di “Inferno”, XXXII, P. 16 ; Cardillo A., Demetrio, “Della locuzione” (Note sulla fortuna del testo tra Medioevo e Rinascimento), P. 30 ; Sapienza A., Parodia e metateatro. “Francesca da Rimini” di Antonio Petito, P. 45 ; Corvi F., Ceccardo maestro rinnegato: da Montale a Quasimodo, P. 60 ; Villani P., Per una nuova lettura della critica crociana: Francesco Bruno, P. 76 ; Di Biasio R., Una rilettura dell’opera narrativa di Salvatore Mignano, P. 94 ; Pascale V., Rea e la radice del raccontare, P. 104 ; Tuscano P., I due tempi della poesia di Giuseppe Capitanucci, P. 119 ; Di Pasqua S., L’utopia skinneriana tra scienza del comportamento e letteratura, P. 129 ; Lezza A., Premessa, P. 139 ; Aymone R., Temi e motivi nella lirica di Francesco Gaeta, P. 141 ; Di Lieto C., L’ “imago” materna e l’identificazione proiettiva nella poesia di Francesco Gaeta, P. 178 ; Acanfora N., Francesco Gaeta attraverso il suo epistolario. Ritratto di uno scrittore “borghese e malinconico”, P. 220 ; Acanfora N., Bibliografia, P. 238 ; Di Lorenzo E., Giorgio Brugnoli dantista, P. 243 ; Giusti G., Medicina e Filologia: le intuizioni scientifiche dei vocabolaristi, P. 250 ; Ricco R., Musica e istituzioni musicali nel ventennio fascista: “L’orchestra del duce” di Stefano Biguzzi, P. 257 ; Di Lieto C., Teatro, poesia e musica: il punto su Viviani, P. 265 ; Di Lieto C., Giuseppe Bonaviri e le emozioni dell’oltre, P. 272 ; Napoli A., Geografia del probabile. Per una rilettura de “Lo stadio di Wimbledon” di Daniele Del Giudice, P. 279 ; Salsano R., Navigazioni di critica e narrativa: un libro recente su Antonio Tabucchi, P. 286 ; Acanfora N., recensione a, ll viaggio e la scrittura, a cura di Patrizia Nerozzi Bellman e Vincenzo Matera, Napoli, l’Ancora del Mediterraneo 2001, P. 295 ; Bracco V., recensione a, Andrea Sessa, Il melodramma italiano, 1861-1900, Firenze, Olschki 2003, P. 297 ; Camarda D., recensione a, Italian Grotesque Theater, a cura di Michael Vena, London,Fairleigh Dickiusou University Press 2001, P. 300 ; Dainotti F., recensione a, Giorgio Cadoni, Appunti di viaggio e destini di scrittori, Roma, Edizioni Scettro del Re 2002, P. 304 ; Di Lieto C., recensione a, Pietro Milone, L’udienza. Sciascia scrittore e critico pirandelliano, Roma Vecchiarelli 2002, P. 308 ; Di Lieto C., recensione a, Carlo Felice Colucci, Il viaggio inutile, Venezia, Edizioni del Leone 2003, P. 312 ; Di Lieto C., recensione a, La “Fiera Letteraria” per Marino Moretti A cura di Manuela Ricci, Bologna, Clueb 2002, P. 316 ; Di Lieto C., recensione a, Concetta D’Angeli, Leggere Elsa Morante. Aracoeli, La Storia e Il mondo salvato dai ragazzini, Roma, Carocci 2003, P. 319 ; Di Lorenzo E., recensione a, Le Lingue dello Straniero a cura di Giovanna Calabrò, Napoli, Liguori 2003, P. 322 ; Di Lorenzo E., recensione a, Teoria, didattica e prassi della traduzione, a cura di Giovanna Calabrò, Napoli, Liguori 2001, P. 324 ; Giannantonio V., recensione a, Lina Jannuzzi, Una “storia” del Novecento, Napoli, ESI 2002, P. 328 ; Pelosi P., recensione a, Massimo Oldoni, Calle del Fumo. Poesie 1991-2000, Salerno, Edizioni Ripostes 2003, P. 330 ; D’Amato G., recensione a, Pompeo Onesti, Il fascista, Napoli, Controcorrente 2002, P. 332 ; Montella L., recensione a, Niccolò Forteguerri, Capitoli, a cura di Carmen Di Donna Prencipe, Bologna Commissione per i testi di Lingua 2003, P. 335 ; Montella L., recensione a, Agostino Rizzo, Niente Proprio…, Salerno, Provincia Di Salerno 2003, P. 336 ; Fimiani G., recensione a, Marco Santagata, Il maestro dei santi pallidi, Parma, Guanda 2003, P. 338 ; D’Amato G., recensione a, Epifanio Ajello, Carlo Goldoni. L’esattezza e lo sguardo, Salerno, Edisud 2001, P. 341 ; Giordano E., recensione a, Roberto Dianese, Eloisa a cura di Lia Bronzi, Arezzo, Helicon 2001, P. 345 ; Di Biase C., recensione a, Luciano Nicastri, Classici nel tempo. Sondaggi sulla ricezione di Properzio, Orazio, Ovidio, Salerno, Edisud 2003, P. 347 ; Spila C., recensione a, Francesco De Cristoforo, Zoo di romanzi. Balzac, Manzoni, Dickens e altri bestiari, Napoli, Liguori 2002, P. 350 ; Scognamiglio A., recensione a, I linguaggi e la storia, a cura di Antonio Trampus e Ulrike Kindl, Bologna, Il Mulino 2003, P. 353 ; De Rosa M., recensione a, Enrico Ruta, Il segreto di Partenope, a cura di Nicola D’Antuono, Bologna, Millennium 2003, P. 358 ; D’Amaro S., recensione a, Pietro Di Donato, Madre Cabrini, la santa degli emigranti, traduzione di Ada Prisco, Piazza del Galdo (SA), Il Grappolo 2003, P. 362 ; D’Amaro S., recensione a, Luigi Fontanella, La parola trasfuga. Scrittori italiani in America, Fiesole (FI), Cadmo 2003, P. 363 ; D’Amaro S., recensione a, Fernanda Pivano, Mostri degli anni Venti, Milano, La Tartaruga 2002, P. 364 ; D’Amaro, S., recensione a, Michael Fiaschetti, Gioco duro, a cura di Martino Marazzi, Cava de’ Tirreni (SA), Avagliano 2002, P. 365 ; D’Amaro S., recensione a, John Fante, Romanzi e racconti, a cura di Francesco Durante, Milano, Meridiani Mondadori 2003, P. 366; D’Amaro S., recensione a, Silvana Ghiazza, Carlo Levi e Umberto Saba. Storia di un’amicizia, Bari, Dedalo 2002, P. 367 ; Vaglio M., recensione a, Francesco De Nicola, Manuale di letteratura italiana contemporanea. Dall’Unità nazionale all’era televisiva, Genova, De Ferrari 2004, P. 368 ; Corvi F., recensione a, Lorenzo Viani, Parigi, a cura di Marcello Ciccuto, Genova, De Ferrari 2004, P. 369 ; Cardillo A., recensione a, “Nel mondo mutabile e leggiero”. Torquato Tasso e la cultura del suo tempo, a cura di Dante Della Terza, Pasquale Sabbatino e Giuseppina Scognamiglio, Napoli, ESI 2003, P. 373 ; Cardillo A., recensione a, Claudio Gigante, Esperienze di Filologia cinquecentesca. Salviati, Mazzoni, Trissino, Costo, Il Bargeo, Tasso, Roma, Salerno Editrice 2003, P. 373 ; Cardillo A., recensione a, Pasquale Guaragnella, Tra antichi e moderni. Morale e retorica nel Seicento italiano, Lecce, Argo 2003, P. 374 ; Cardillo A., recensione a, Sul Tasso. Studi di Filologia e Letteratura italiana offerti a Luigi Poma, a cura di Franco Gavazzeni, Roma-Padova, Antenore 2003, P. 374

Incidence and Recurrence of Portal Vein Thrombosis in Cirrhotic Patients

Cirrhosis has been long considered a risk factor for bleeding due to the co-existence of the so-called \u2018coagulopathy\u2019. More recently, however, compelling evidences have been provided on the occurrence of thrombotic events in the portal and systemic circulation.3\u20135 Portal vein thrombosis (PVT) is predominantly observed in patients with moderate to severe liver failure with a variable prevalence ranging from 0.6 to 25%. Only fewstudies have provided a longitudinal assessment of the PVT incidence and its sequelae, including recurrence and survival.9\u201314 Due to the variability of PVT incidence and the paucity of data regarding recurrence and survival,15\u201320 we prospectively analysed the incidence and the recurrence of PVT in the population of Portal vein thrombosis Relevance On Liver cirrhosis: ItalianVenous thromboticEventsRegistry (PROLIVER), a multi-centre study,8 which involved 43 enrolling centres in Italy (ClinicalTrials.gov Identifier: NCT01470547)

Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study.

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child-Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800-1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50 × 103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11-3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16-3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients

Frequency of Left Ventricular Hypertrophy in Non-Valvular Atrial Fibrillation

Left ventricular hypertrophy (LVH) is significantly related to adverse clinical outcomes in patients at high risk of cardiovascular events. In patients with atrial fibrillation (AF), data on LVH, that is, prevalence and determinants, are inconsistent mainly because of different definitions and heterogeneity of study populations. We determined echocardiographic-based LVH prevalence and clinical factors independently associated with its development in a prospective cohort of patients with non-valvular (NV) AF. From the "Atrial Fibrillation Registry for Ankle-brachial Index Prevalence Assessment: Collaborative Italian Study" (ARAPACIS) population, 1,184 patients with NVAF (mean age 72 \ub1 11 years; 56% men) with complete data to define LVH were selected. ARAPACIS is a multicenter, observational, prospective, longitudinal on-going study designed to estimate prevalence of peripheral artery disease in patients with NVAF. We found a high prevalence of LVH (52%) in patients with NVAF. Compared to those without LVH, patients with AF with LVH were older and had a higher prevalence of hypertension, diabetes, and previous myocardial infarction (MI). A higher prevalence of ankle-brachial index 640.90 was seen in patients with LVH (22 vs 17%, p = 0.0392). Patients with LVH were at significantly higher thromboembolic risk, with CHA2DS2-VASc 652 seen in 93% of LVH and in 73% of patients without LVH (p <0.05). Women with LVH had a higher prevalence of concentric hypertrophy than men (46% vs 29%, p = 0.0003). Logistic regression analysis demonstrated that female gender (odds ratio [OR] 2.80, p <0.0001), age (OR 1.03 per year, p <0.001), hypertension (OR 2.30, p <0.001), diabetes (OR 1.62, p = 0.004), and previous MI (OR 1.96, p = 0.001) were independently associated with LVH. In conclusion, patients with NVAF have a high prevalence of LVH, which is related to female gender, older age, hypertension, and previous MI. These patients are at high thromboembolic risk and deserve a holistic approach to cardiovascular prevention

Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of \ue2\u88\ubc4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64\uc2\ub137 years; 47% Child\ue2\u80\u93Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800\ue2\u80\u931,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count \ue2\u89\ua450\uc3\u97103/\uce\ubcl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11\ue2\u80\u933.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16\ue2\u80\u933.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients

Drug–drug interactions involving CYP3A4 and p-glycoprotein in hospitalized elderly patients

Polypharmacy is very common in older patients and may be associated with drug-drug interactions. Hepatic cytochrome P450 (notably 3A4 subtype, CYP3A4) is a key enzyme which metabolizes most drugs; P-glycoprotein (P-gp) is a transporter which significantly influences distribution and bioavailability of many drugs. In this study, we assess the prevalence and patterns of potential interactions observed in an hospitalized older cohort (Registro Politerapia Societa Italiana di Medicina Interna) exposed to at least two interacting drugs involving CYP3A4 and P-gp at admission, during hospitalization and at discharge. Individuals aged 65 and older (N-4039; mean age 79.2; male 48.1%), hospitalized between 2010 and 2016, were selected. The most common combinations of interacting drugs (relative frequency &gt; 5%) and socio-demographic and clinical factors associated with the interactions were reported. The prevalence of interactions for CYP3A4 was 7.9% on admission, 10.3% during the stay and 10.7% at discharge; the corresponding figures for P-gp interactions were 2.2%, 3.8% and 3.8%. The most frequent interactions were amiodarone-statin for CYP3A4 and atorvastatin-verapamil-diltiazem for P-gp. The prevalence of some interactions, mainly those involving cardiovascular drugs, decreased at discharge, whereas that of others, e.g. those involving neuropsychiatric drugs, increased. The strongest factor associated with interactions was polypharmacy (OR 6.7, 95% CI 5.0-9.2). In conclusion, hospital admission is associated with an increased prevalence, but also a changing pattern of interactions concerning CYP3A4 and P-gp in elderly. Educational strategies and appropriate use of dedicated software seem desirable to limit drug interactions and the inherent risk of adverse events in older patients

Patterns of infections in older patients acutely admitted to medical wards: data from the REPOSI register

No abstract availabl