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1.
J Cardiovasc Med (Hagerstown) ; 24(5): 297-301, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36938818

RESUMEN

BACKGROUND: Preparticipation screenings have been conceived for the potential to prevent sudden cardiac death in young athletes by early identification of hidden cardiac diseases. Commonly used protocols include family history collection, physical examination, and resting electrocardiogram. Transthoracic echocardiography has been hypothesized to have a primary role in the preparticipation screening. AIMS: The present study aimed to evaluate the additional role of echocardiogram in identifying cardiovascular abnormalities that might be undetected by commonly used preparticipation screening. METHODS: We retrospectively reviewed Ferrari Formula Benessere, a corporate wellness program database, and analyzed data recorded from 2017 to 2022 to compare two medical models: a 'standard' preparticipation screening including medical history, physical examination, electrocardiogram and exercise stress testing versus an 'advanced' preparticipation screening comprising history, physical examination, electrocardiogram, exercise stress testing and echocardiography. RESULTS: From an initial sample size of 7500 patients, we included 500 patients (420 male, 33.69 ±â€Š7.9 mean age) enrolled for the first time in the corporate wellness program between 2017 and 2022. Three hundred and thirty-nine (67.8%) patients had no abnormal findings at 'standard' preparticipation screening and, even if they would have not required further evaluation, we performed echocardiography anyway ('advanced' preparticipation screening): 31 (9.1%) showed some abnormal cardiovascular findings at echocardiography, such as patent foramen ovalis, bicuspid aortic valve, aortic root ectasia or mitral valve prolapse. CONCLUSIONS: Screening echocardiogram showed an additional value (about 10% more) in detecting patients with cardiovascular abnormalities, otherwise undiagnosed with the 'standard' preparticipation screening protocol.


Asunto(s)
Anomalías Cardiovasculares , Tamizaje Masivo , Humanos , Masculino , Estudios Retrospectivos , Tamizaje Masivo/métodos , Ecocardiografía/métodos , Electrocardiografía , Muerte Súbita Cardíaca/etiología , Muerte Súbita Cardíaca/prevención & control , Anomalías Cardiovasculares/diagnóstico , Atletas , Examen Físico
2.
G Ital Cardiol (Rome) ; 24(1): 62-65, 2023 Jan.
Artículo en Italiano | MEDLINE | ID: mdl-36573512

RESUMEN

The irrefutable benefits of physical activity as a tool for the prevention and treatment of several clinical conditions, including cardiovascular diseases, are nowadays widely recognized. However, physical exercise may trigger adverse events in subjects with underlying heart disease, often undiagnosed and asymptomatic. It is fundamental to consider that various sports disciplines have peculiar and specific physiological and metabolic adaptations, and it is essential to consider the individual profile of the subject, including gender. We report the case of an agonistic female swimmer with a history of tachycardia heartbeat when resurfacing from dynamic apnea, in whom a diagnosis of atrioventricular nodal reentrant tachycardia was made. This case report provides practical evidence of the importance of a personalized approach, in both individual sex- and sport-specific terms, to optimize the diagnostic and therapeutic pathways.


Asunto(s)
Ablación por Catéter , Taquicardia por Reentrada en el Nodo Atrioventricular , Humanos , Femenino , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Apnea/complicaciones , Electrocardiografía
3.
Int J Cancer ; 147(2): 565-574, 2020 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-32096871

RESUMEN

High-grade serous ovarian cancer (HGS-EOCs) is generally sensitive to front-line platinum (Pt)-based chemotherapy although most patients at an advanced stage relapse with progressive resistant disease. Clinical or molecular data to identify primary resistant cases at diagnosis are not yet available. HGS-EOC biopsies from 105 Pt-sensitive (Pt-s) and 89 Pt-resistant (Pt-r) patients were retrospectively selected from two independent tumor tissue collections. Pathway analysis was done integrating miRNA and mRNA expression profiles. Signatures were further validated in silico on a cohort of 838 HGS-EOC cases from a published dataset. In all, 131 mRNAs and 5 miRNAs belonging to different functionally related molecular pathways distinguish Pt-s from Pt-r cases. Then, 17 out of 23 selected elements were validated by orthogonal approaches (SI signature). As resistance to Pt is associated with a short progression-free survival (PFS) and overall survival (OS), the prognostic role of the SI signature was assessed, and 14 genes associated with PFS and OS, in multivariate analyses (SII signature). The prognostic value of the SII signature was validated in a third extensive cohort. The expression profiles of SDF2L1, PPP1R12A and PRKG1 genes (SIII signature) served as independent prognostic biomarkers of Pt-response and survival. The study identified a prognostic molecular signature based on the combined expression profile of three genes which had never been associated with the clinical outcome of HGS-EOC. This may lead to early identification, at the time of diagnosis, of patients who would not greatly benefit from standard chemotherapy and are thus eligible for novel investigational approaches.


Asunto(s)
Proteína Quinasa Dependiente de GMP Cíclico Tipo I/genética , Cistadenocarcinoma Seroso/tratamiento farmacológico , Perfilación de la Expresión Génica/métodos , Proteínas de la Membrana/genética , Fosfatasa de Miosina de Cadena Ligera/genética , Neoplasias Ováricas/tratamiento farmacológico , Platino (Metal)/uso terapéutico , Adulto , Anciano , Cistadenocarcinoma Seroso/genética , Cistadenocarcinoma Seroso/patología , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Persona de Mediana Edad , Clasificación del Tumor , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento
4.
Environ Res ; 150: 144-153, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27288912

RESUMEN

BACKGROUND: Several studies proposed a relationship between environmental factors and semen quality, as well as the negative effect of air pollution on spermatogenesis and gonadal function. No specific studies evaluated the environmental influence on semen quality in a specific geographical area. AIM: to evaluate the environmental influence on male sperm parameters in a Northern Italian population referred for semen analysis in the National Health System. The objective of the study is the assessment of the relationship of both air pollution and environmental parameters with quality-related sperm variables, during the coldest months of the year when air is usually most polluted, due to low ventilation and poor rainfall. STUDY DESIGN: A retrospective, observational, cohort study was carried out in the province of Modena, located in the Emilia-Romagna region of Northern Italy. METHODS: Semen analyses (n=406), environmental temperature, air humidity and air particulate matter (PM) measurements from the 1st of November 2014 to the 19th of February 2015 were acquired to the first database. Since spermatogenesis lasts over two months, a second, wider database was arranged, evaluating environmental exposure in the 3 months before semen collection (from August 1st 2014). All data included in the database were registered by geo-coding the residential address of the patients and the site of registration of environmental factors. The geo-codification of parameters was performed using Fusion Tables of Google available at https://www.google.com/fusiontables/data? dsrcid=implicit, considering the exact time of measurement. RESULTS: Average air temperature was inversely related to sperm concentration and to total sperm number (p<0.001). Semen volume was inversely related only to the minimum (p<0.001) and not to maximum recorded temperature (p=0.110). Air humidity was not related to sperm quantity and quality. PM2.5 was directly related to total sperm number (p<0.001). PM10 was directly related to both semen volume (0<0.001), and typical forms (p<0.001), inversely related to atypical forms (p<0.001), but related neither to sperm concentration (p=0.430) nor to sperm motility. The extended analyses considering environmental parameters in the 3 months before semen collection, confirmed the relationship between air temperature and sperm quantity, whereas no influence was found between PM and sperm quality. CONCLUSION: An influence of environmental temperature on semen quantity is suggested, without a clear effect of air pollution, as assessed through PM10 levels, on sperm parameter variations.


Asunto(s)
Contaminantes Atmosféricos/toxicidad , Frío , Exposición a Riesgos Ambientales , Material Particulado/toxicidad , Espermatozoides/fisiología , Adulto , Humanos , Italia , Masculino , Estudios Retrospectivos , Estaciones del Año , Análisis de Semen
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