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1.
Biostatistics ; 2023 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-37811675

RESUMO

We propose a nonparametric compound Poisson model for underreported count data that introduces a latent clustering structure for the reporting probabilities. The latter are estimated with the model's parameters based on experts' opinion and exploiting a proxy for the reporting process. The proposed model is used to estimate the prevalence of chronic kidney disease in Apulia, Italy, based on a unique statistical database covering information on m = 258 municipalities obtained by integrating multisource register information. Accurate prevalence estimates are needed for monitoring, surveillance, and management purposes; yet, counts are deemed to be considerably underreported, especially in some areas of Apulia, one of the most deprived and heterogeneous regions in Italy. Our results agree with previous findings and highlight interesting geographical patterns of the disease. We compare our model to existing approaches in the literature using simulated as well as real data on early neonatal mortality risk in Brazil, described in previous research: the proposed approach proves to be accurate and particularly suitable when partial information about data quality is available.

2.
J Cell Mol Med ; 26(13): 3608-3615, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35715961

RESUMO

The phosphorylated neurofilament heavy chain (pNfH) is a promising biomarker in amyotrophic lateral sclerosis (ALS). We examined plasma pNfH concentrations in order to corroborate its role as a diagnostic and prognostic biomarker in ALS. Incident ALS cases enrolled in a population-based registry were retrospectively selected and matched by sex and age with a cohort of healthy volunteers. Plasma pNfH levels were measured by an ELISA kit and correlated with clinical parameters. Discrimination ability of pNfH was tested using receiving operating characteristic (ROC) curves. Kaplan-Meier (KM) analysis and Cox proportional hazard models were used for survival analysis. Plasma pNfH was significantly higher in patients compared to controls. An optimal cut-off of 39.74 pg/ml discriminated cases from controls with an elevated sensitivity and specificity. Bulbar-onset cases had higher plasma pNfH compared to spinal onset (p = 0.0033). Furthermore, plasma pNfH positively correlated with disease progression rate (r = 0.19, p = 0.031). Baseline plasma pNfH did not influence survival in our cohort. Our findings confirmed the potential utility of plasma pNfH as a diagnostic biomarker in ALS. However, further studies with longitudinal data are needed to corroborate its prognostic value.


Assuntos
Esclerose Lateral Amiotrófica , Esclerose Lateral Amiotrófica/diagnóstico , Biomarcadores , Humanos , Filamentos Intermediários , Proteínas de Neurofilamentos , Estudos Retrospectivos
3.
J Med Virol ; 94(8): 3890-3899, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35355293

RESUMO

Rapid start of antiretroviral therapy (ART) pending genotypic resistance test (GRT) has been recently proposed, but the effectiveness of this strategy is still debated. The rate of virological success (VS), defined as HIV-RNA < 50 copies/ml, with and without GRT was compared in drug-naïve individuals enrolled in the Italian ARCA cohort who started ART between 2015 and 2018. 521 individuals started ART: 397 without GRT (pre-GRT group) and 124 following GRT (post-GRT group). Overall, 398 (76%) were males and 30 (6%) were diagnosed with AIDS. In the pre-GRT group, baseline CD4+ cell counts were lower (p < 0.001), and viral load was higher (p < 0.001) than in the post-GRT group. The estimated probability of VS in pre-GRT versus post-GRT group was 72.54% (CI95 : 67.78-76.60) versus 66.94% (CI95 : 57.53-74.26) at Week 24 and 92.40% (CI95 : 89.26-94.62) versus 92.92% (CI95 : 86.35-96.33) at Week 48, respectively (p = 0.434). At Week 48, VS was less frequent among individuals with baseline CD4+ cell counts <200 versus >500 (90.33% vs. 97.33%), log viral load <5.00 versus >5.70 log10 cps/ml (97.17% vs 78.16%; p < 0.001), and those treated with protease inhibitors or non-nucleoside reverse transcriptase inhibitors versus those treated with integrase strand transfer inhibitors (p < 0.001). The rate of VS does not seem to be affected by an early ART initiation pending GRT results, but it could be influenced by the composition of the ART regimen, as well as immuno-virological parameters.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/farmacologia , Antirretrovirais/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Farmacorresistência Viral/genética , Feminino , Infecções por HIV/tratamento farmacológico , HIV-1/genética , Humanos , Masculino , Estudos Retrospectivos , Carga Viral
4.
Biom J ; 63(6): 1309-1324, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33963597

RESUMO

In the last few years, diabetes mellitus and obesity revealed to be one of the fastest-growing chronic diseases in youth in the United States. The number of new diabetes cases is dramatically increasing, and, for the moment, effective therapy does not exist. Experts believe that one of the causes of this increase is the decline in exercise behavior. The California Education Code requires local educational agencies (LEAs) to administer the FITNESSGRAM, the Physical Fitness Test (PFT), to Californian students of public schools. This test evaluates six fitness areas, and experts defined that a passing result on all six areas of the test represents a fitness level that offers some protection against the diseases associated with physical inactivity. We consider 2015-2016 data provided by the California Department of Education (CDE): for each Californian county ( m=57 ), we aim at estimating the county-level proportion of students with a score equal to six. To account for the heterogeneity of the phenomenon and the presence of outlying counties, we extend the standard area-level model by specifying the random effects as a symmetric α -stable (S α S) distribution that can accommodate different types of outlying observations. The model can accurately estimate the county-level proportion of students with a score equal to six. Results highlight some interesting relationships with social and economic situations in each county. The performance of the proposed model is also investigated through an extensive simulation study.


Assuntos
Obesidade , Aptidão Física , Adolescente , Teorema de Bayes , Humanos , Instituições Acadêmicas , Estudantes , Estados Unidos
5.
J Infect Dis ; 222(1): 102-110, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32031626

RESUMO

BACKGROUND: A study of respiratory syncytial virus-A (RSV A) genotype ON1 genetic variability and clinical severity in infants hospitalized with bronchiolitis over 6 epidemic seasons (2012-2013 to 2017-2018) was carried out. METHODS: From prospectively enrolled term infants hospitalized for bronchiolitis, samples positive for RSV A ON1 (N = 139) were sequenced in the second half of the G gene. Patients' clinical data were obtained from medical files and each infant was assigned a clinical severity score. ANOVA comparison and adjusted multinomial logistic regression were used to evaluate clinical severity score and clinical parameters. RESULTS: The phylogenetic analysis of 54 strains showed 3 distinct clades; sequences in the last 2 seasons differed from previous seasons. The most divergent and numerous cluster of 2017-2018 strains was characterized by a novel pattern of amino acid changes, some in antigenic sites. Several amino acid changes altered predicted glycosylation sites, with acquisition of around 10 new O-glycosylation sites. Clinical severity of bronchiolitis increased in 2016-2017 and 2017-2018 and changed according to the epidemic seasons only. CONCLUSIONS: Amino acid changes in the hypervariable part of G protein may have altered functions and/or changed its immunogenicity, leading to an impact on disease severity.


Assuntos
Bronquiolite/fisiopatologia , Bronquiolite/virologia , Variação Genética , Infecções por Vírus Respiratório Sincicial/genética , Infecções por Vírus Respiratório Sincicial/fisiopatologia , Vírus Sincicial Respiratório Humano/genética , Índice de Gravidade de Doença , Bronquiolite/epidemiologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Filogenia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Cidade de Roma/epidemiologia
6.
J Infect Dis ; 219(4): 526-534, 2019 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-30204889

RESUMO

Background: We aimed to study respiratory syncytial virus (RSV) genotype distribution, clinical presentation, and disease severity in infants with bronchiolitis from RSV subtypes and new RSV genotypes. Methods: We prospectively enrolled previously healthy term infants less than 1 year old hospitalized for bronchiolitis in an Italian university hospital over 12 epidemic seasons. In 312 nasopharyngeal washings positive for RSV, we sequenced the viral genotype and analyzed this according to patient data. Strain-specific RSV loads were quantified for 273 specimens. Results: From 2005-2006 to 2011-2012, the RSV-A genotype NA1 predominated, and was replaced in 2012 by the novel ON1. All infants infected with RSV subtype B were genotype BA. Stratifying data according to genotypes NA1, ON1, and BA showed that NA1-infected infants were the youngest and had the most severe clinical course. Conversely, BA-infected infants had less severe symptoms and more frequently had eosinophilia and a family history of asthma. Infants with the ON1 genotype had a milder clinical course than those with NA1 and more risk factors for asthma, despite having the highest viral loads. Conclusion: The disease course in infants hospitalized for acute RSV bronchiolitis may depend on the RSV genotype.


Assuntos
Bronquiolite/patologia , Bronquiolite/virologia , Genótipo , Infecções por Vírus Respiratório Sincicial/patologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/classificação , Feminino , Hospitalização , Hospitais Universitários , Humanos , Lactente , Itália , Masculino , Estudos Prospectivos , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Fatores de Risco , Análise de Sequência de DNA , Carga Viral
7.
Environ Res ; 158: 188-193, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28647513

RESUMO

BACKGROUND: In this study we sought to evaluate the association between viral bronchiolitis, weather conditions, and air pollution in an urban area in Italy. METHODS: We included infants hospitalized for acute bronchiolitis from 2004 to 2014. All infants underwent a nasal washing for virus detection. A regional agency network collected meteorological data (mean temperature, relative humidity and wind velocity) and the following air pollutants: sulfur dioxide, nitrogen oxide, carbon monoxide, ozone, benzene and suspended particulate matter measuring less than 10µm (PM10) and less than 2.5µm (PM2.5) in aerodynamic diameter. We obtained mean weekly concentration data for the day of admission, from the urban background monitoring sites nearest to each child's home address. Overdispersed Poisson regression model was fitted and adjusted for seasonality of the respiratory syncytial virus (RSV) infection, to evaluate the impact of individual characteristics and environmental factors on the probability of a being positive RSV. RESULTS: Of the 723 nasal washings from the infants enrolled, 266 (68%) contained RSV, 63 (16.1%) rhinovirus, 26 (6.6%) human bocavirus, 20 (5.1%) human metapneumovirus, and 16 (2.2%) other viruses. The number of RSV-positive infants correlated negatively with temperature (p < 0.001), and positively with relative humidity (p < 0.001). Air pollutant concentrations differed significantly during the peak RSV months and the other months. Benzene concentration was independently associated with RSV incidence (p = 0.0124). CONCLUSIONS: Seasonal weather conditions and concentration of air pollutants seem to influence RSV-related bronchiolitis epidemics in an Italian urban area.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Bronquiolite/epidemiologia , Monitoramento Ambiental , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/fisiologia , Tempo (Meteorologia) , Bronquiolite/virologia , Cidades/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Itália/epidemiologia , Masculino , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/virologia , Estações do Ano
8.
Stat Med ; 34(3): 487-503, 2015 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-25327293

RESUMO

With reference to a questionnaire that aimed to assess the quality of life for dysarthric speakers, we investigate the usefulness of a model-based procedure for reducing the number of items. We propose a mixed cumulative logit model, which is known in the psychometrics literature as the graded response model: responses to different items are modelled as a function of individual latent traits and as a function of item characteristics, such as their difficulty and their discrimination power. We jointly model the discrimination and the difficulty parameters by using a k-component mixture of normal distributions. Mixture components correspond to disjoint groups of items. Items that belong to the same groups can be considered equivalent in terms of both difficulty and discrimination power. According to decision criteria, we select a subset of items such that the reduced questionnaire is able to provide the same information that the complete questionnaire provides. The model is estimated by using a Bayesian approach, and the choice of the number of mixture components is justified according to information criteria. We illustrate the proposed approach on the basis of data that are collected for 104 dysarthric patients by local health authorities in Lecce and in Milan.


Assuntos
Teorema de Bayes , Psicometria/métodos , Qualidade de Vida , Inquéritos e Questionários , Simulação por Computador , Disartria/psicologia , Humanos , Itália , Modelos Logísticos , Análise de Componente Principal , Perfil de Impacto da Doença
9.
Radiol Med ; 120(11): 1031-42, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25851081

RESUMO

Patello-femoral malalignment (PFM) is a common cause of disability often related to patello-femoral syndrome (PFS). Several causes have been taken into account; a proper diagnosis requires instrumental imaging and a methodical evaluation of different parameters. The aim of the present study was to identify the most reliable parameters for measuring patello-femoral and inferior limb alignment by CT. Twenty randomly selected patients suffering from PFS for a total of 40 knees were studied by static CT scans in order to assess patellar tilt, patellar displacement, patellar and trochlear morphology and inferior limb alignment. All known parameters were measured; the variability of the measurements between observers was evaluated by boxplots, Pearson's correlation coefficients, and infraclass correlation coefficient [ICC(2,1)] based on a two-way random effect model. Bland-Altman mean differences and 95 % limits of agreement were computed for each pair of measurements. Patellar tilt parameters appeared equally reliable; patellar displacement is best measured with BoTot that showed an ICC of 0.889; morphology is best measured with WibergTot, with an ICC of 0.862; lastly, for the inferior limb alignment parameters' analysis, FTV outperformed the others in terms of reliability. The present study allowed us to select a limited number of reliable parameters in the evaluation of patello-femoral and inferior limb alignment. The use of these parameters may also result in a more reliable comparison of studies on PFM and in a better evaluation of the treatment outcomes.


Assuntos
Artropatias/diagnóstico por imagem , Articulação Patelofemoral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Reprodutibilidade dos Testes
10.
Data Brief ; 55: 110579, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38948411

RESUMO

This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to the Russian invasion of Ukraine in February 2022 and monitoring this reaction for the first six months of the attack through a six-round survey. Each round involved a representative sample of approximately 1010 (1007-1015) Italian adult citizens. Participants were asked questions about emotional reactions to the Russian invasion, coping strategies used, solidarity behaviour toward Ukrainian refugees, perceptions of refugees as a threat to the country, trust in national and international authorities to manage the international situation, and prospects for the future. Demographic data on the respondents were also collected. The survey design was developed by a research group from two universities (the University of Salento and the University of Foggia) and a European research centre, EICAP (European Institute of Cultural Analysis for Policy). The data provided in this article is a resource for researchers, public authorities, and other parties interested in surveying and studying public opinion. This dataset can be used to explore a wide range of topics, including prosocial behaviour and attitudes towards refugees in humanitarian emergencies.

11.
J Clin Med ; 13(10)2024 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-38792527

RESUMO

Background: The inhibition of PCSK9 lowered LDL cholesterol levels, reducing the risk of cardiovascular events. However, the effect on patients who have undergone surgical myocardial revascularization has not yet been evaluated. Methods: From January 2017 to December 2022, 180 dyslipidemic patients who underwent coronary artery bypass were included in the study. Until December 2019, 100 patients optimized therapy with statin ± ezetimibe (SG). Since January 2020, 80 matched patients added treatment with Evolocumab every 2 weeks (EG). All 180 patients were followed-up at 3 and 12 months, comparing outcomes. Results: The two groups are homogenous. At 3 months and 1 year, a significant decrease in the parameter mean levels of LDL cholesterol and total cholesterol is detected in the Evolocumab group compared to the standard group. No mortality was detected in either group. No complications or drug discontinuation were recorded. In the SG group, five patients (5%) suffered a myocardial infarction during the 1-year follow-up. In the EG group, two patients (2.5%) underwent PTCA due to myocardial infarction. There is no significant difference in overall survival according to the new treatment (p-value = 0.9), and the hazard ratio is equal to 0.94 (95% C.I.: [0.16-5.43]; p-value = 0.9397). Conclusions: The use of Evolocumab, which was started immediately after coronary artery bypass graft surgery, significantly reduced LDL cholesterol and total cholesterol levels compared to statin treatment alone and is completely safe. However, at one year of follow-up, this result did not have impact on the reduction in major clinical events.

12.
Biostatistics ; 13(1): 101-12, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21856651

RESUMO

Peptide Microarray Immunoassay (PMI for brevity) is a novel technology that enables researchers to map a large number of proteomic measurements at a peptide level, providing information regarding the relationship between antibody response and clinical sensitivity. PMI studies aim at recognizing antigen-specific antibodies from serum samples and at detecting epitope regions of the protein antigen. PMI data present new challenges for statistical analysis mainly due to the structural dependence among peptides. A PMI is made of a complete library of consecutive peptides. They are synthesized by systematically shifting a window of a fixed number of amino acids through the finite sequence of amino acids of the antigen protein as ordered in the primary structure of the protein. This implies that consecutive peptides have a certain number of amino acids in common and hence are structurally dependent. We propose a new flexible Bayesian hierarchical model framework, which allows one to detect recognized peptides and bound epitope regions in a single framework, taking into account the structural dependence between peptides through a suitable latent Markov structure. The proposed model is illustrated using PMI data from a recent study about egg allergy. A simulation study shows that the proposed model is more powerful and robust in terms of epitope detection than simpler models overlooking some of the dependence structure.


Assuntos
Epitopos , Modelos Estatísticos , Análise Serial de Proteínas/estatística & dados numéricos , Teorema de Bayes , Bioestatística , Dessensibilização Imunológica , Hipersensibilidade a Ovo/imunologia , Hipersensibilidade a Ovo/terapia , Proteínas Dietéticas do Ovo/imunologia , Epitopos/genética , Humanos , Cadeias de Markov , Ovalbumina/imunologia , Peptídeos/genética , Peptídeos/imunologia , Proteômica/estatística & dados numéricos , Razão Sinal-Ruído
13.
Stat Appl Genet Mol Biol ; 11(4): Article 3, 2012 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-22745023

RESUMO

When modeling time course microarray data special interest may reside in identifying time frames in which gene expression levels follow a monotonic (increasing or decreasing) trend. A trajectory may change its regime because of the reaction to treatment or of a natural developmental phase, as in our motivating example about identification of genes involved in embryo development of mice with the 22q11 deletion. To this aim we propose a new flexible Bayesian autoregressive hidden Markov model based on three latent states, corresponding to stationarity, to an increasing and to a decreasing trend. In order to select a list of genes, we propose decision criteria based on the posterior distribution of the parameters of interest, taking into account the uncertainty in parameter estimates. We also compare the proposed model with two simpler models based on constrained formulations of the probability transition matrix.


Assuntos
Algoritmos , Teorema de Bayes , Cadeias de Markov , Análise em Microsséries/métodos , Modelos Genéticos , Animais , Síndrome de DiGeorge/embriologia , Síndrome de DiGeorge/genética , Desenvolvimento Embrionário/genética , Humanos , Camundongos , Modelos Estatísticos
14.
Calcif Tissue Int ; 91(5): 335-42, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22965625

RESUMO

The purpose of this study was to evaluate the diagnostic performance of vertebral fracture assessment (VFA) using the Lunar iDXA scanner. Conventional spinal radiographs and images acquired by dual-energy X-ray absorptiometry (DXA) of 350 subjects (269 females, 81 males) were evaluated by two different readers. We visualized 4,476/4,550 (98.4 %) vertebrae from T4 to L4 on VFA images compared to 4,535/4,550 (99.7 %) on radiographs. Among the visualized vertebrae, 205/4,535 (4.5 %) and 190/4,476 (4.2 %) were identified as nonfracture deformities by reading of radiographs and VFA, respectively. Vertebral fractures (VFs) were 231 in 126 patients and 228 in 125 patients by semiquantitative assessment of radiographs (SQ-Rx) and by VFA, respectively. There was excellent agreement between the two techniques and high diagnostic performance of VFA both on a per-vertebra basis (k score = 0.984, 95 % CI 0.972-0.996, sensitivity 98.68 %, specificity 99.91 %, PPV 98.25 %, NPV 99.93 %) and on a per-patient basis (k score = 0.957, 95 % CI 0.925-0.988, sensitivity 96.83 %, specificity 98.66 %, PPV 97.60 %, NPV 98.22 %). In older patients (≥65 years) affected by moderate or severe osteoarthritis, SQ-Rx and VFA identified 96 VFs and 95 versus 90 vertebral deformities, respectively. This study demonstrates that most vertebrae are evaluable using the iDXA scanner, with improved VFA diagnostic performance even in discriminating mild VFs from vertebral deformities. Therefore, VFA may be appropriate as an alternative to conventional radiography in patients at high risk of VF who are undergoing DXA bone densitometry and in the follow-up of osteoporotic patients on treatment.


Assuntos
Fraturas da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Absorciometria de Fóton/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Pediatr Pulmonol ; 57(3): 640-647, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34918490

RESUMO

INTRODUCTION: Viral bronchiolitis is a common lower respiratory tract infection in infants. Environmental and genetic factors can favor respiratory tract infections. AIM: The aim of this study is to analyze risk factors for bronchiolitis and to investigate the predisposing factors for developing transient wheezing and asthma through a 6-year follow-up after hospitalization for bronchiolitis compared with a group of healthy controls that belonged to Piccolipiù cohort, who never had bronchiolitis. METHODS: We enrolled 645 infants hospitalized with bronchiolitis. A structured questionnaire was used to obtain demographic and clinical data. At 6 years of age, 370 cases and 183 controls were investigated for the presence of asthma by the structured questionnaire, for prick test and for spirometry, and were classified to asthmatic, transient wheezing, and no wheezing/no asthma. RESULTS: Breastfeeding was an independent protective factor (odds ratio [OR]: 0.3, 95% confidence interval [95% CI]: 0.2-0.4, p < 0.001) and tobacco smoke was a risk factor for the development of bronchiolitis (OR: 2.1, 95% CI: 1.4-3.1, p < 0.001). Analyzing follow-up, bronchiolitis increased the risk of developing transient wheezing by 12.9 (95% CI: 6.3-26.1, p < 0.001) and of developing asthma by 4.6 (95% CI: 1.9-10.7, p < 0.001). A positive family history of atopy increased the risk of developing asthma by 3.1 (95% CI: 1.4-6.7, p = 0.005). Asthmatic patients had a lower % FEV1, a lower % flow-volume curve (FVC), and a lower FEV1/FVC value, and they had more frequently positive skin prick test. CONCLUSION: Bronchiolitis is influenced by environmental factors: tobacco smoke increases its risk and breastfeeding is a protective factor. At the end of 6 years of follow-up, bronchiolitis is a significant risk factor to have pre-school wheezing and asthma.


Assuntos
Asma , Bronquiolite , Poluição por Fumaça de Tabaco , Asma/complicações , Asma/etiologia , Bronquiolite/complicações , Bronquiolite/etiologia , Pré-Escolar , Progressão da Doença , Seguimentos , Humanos , Lactente , Estudos Prospectivos , Sons Respiratórios/etiologia , Fatores de Risco , Poluição por Fumaça de Tabaco/efeitos adversos
16.
Pediatr Pulmonol ; 57(3): 616-622, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34931488

RESUMO

BACKGROUND: The heterogeneity of bronchiolitis may imply or reflect a different predisposition to respiratory sequelae. OBJECTIVE: Our aim was to investigate whether, among infants hospitalized with bronchiolitis, different clinical profiles extracted by latent class analysis (LCA) are associated with different risks of wheezing. METHODS: Over 15 consecutive epidemic seasons (2004-2019), we prospectively enrolled infants <1 year hospitalized for the first episode of bronchiolitis in a single tertiary hospital. A detailed clinical questionnaire was filled for each infant. LCA was applied to differentiate bronchiolitis phenotypes, and after hospital discharge, a phone interview was performed annually to record the presence of wheezing episodes. Adjusted multivariate regression analyses were run to investigate the risk of wheezing during 7 years follow-up according to clinical phenotypes. RESULTS: LCA performed on 1312 infants resulted in a three-class model. Profile 1 (65.5%): moderate bronchiolitis; Profile 2 (6.1%): severe bronchiolitis; and Profile 3(28.4%): bronchiolitis infants with high eosinophils blood count. At 1 year of follow up, about 50% of children presented wheezing in each profile. Compared to Profile 1, the adjusted odds ratio (OR) of having wheezing episodes was significantly higher in Profile 2 at 2, 3, and 4 years of follow-up. At 7 years, Profile 3 had an adjusted OR = 2.58, higher than Profile 2 (adjusted OR = 2.29). CONCLUSIONS: LCA clearly identified a "moderate", "severe," and "high eosinophils blood count" bronchiolitis. During the first 4 years after bronchiolitis, the "severe" profile showed the higher risk of wheezing, but after 7 years this risk seems higher in the "high eosinophils blood count" group.


Assuntos
Bronquiolite , Eosinofilia , Infecções por Vírus Respiratório Sincicial , Progressão da Doença , Eosinofilia/complicações , Humanos , Lactente , Análise de Classes Latentes , Fenótipo , Sons Respiratórios/etiologia , Infecções por Vírus Respiratório Sincicial/complicações , Sistema Respiratório
17.
Calcif Tissue Int ; 89(3): 252-7, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21701937

RESUMO

This study was performed to investigate the effect of monthly oral administration of 500 µg of calcidiol (25-hydroxyvitamin D(3)) for 4 months on both serum vitamin D levels and sequential changes of parameters of calcium metabolism; 18 normal women aged 24-72 years were investigated. There was a significant increase of serum 25(OH)D after the first administration; thereafter all values persisted significantly higher compared to the basal value (P < 0.001). Mean 1,25(OH)(2)D serum levels peaked at day 3 and then tended to stabilize following day 30. During the first month, all mean values observed following the initial administration were significantly higher than basal values. The first calcidiol dose produced a significant reduction of serum PTH levels (P < 0.001), which then remained constant over time. Concerning serum calcium and phosphorus, we were not able to demonstrate any significant change during the entire observation period. Considering the single values for both serum ionized and total calcium, the values of Ca(2+) exceeded upper limits of normal on only two occasions. Regarding biochemical markers of bone remodeling, mean changes of serum bone isoenzyme of alkaline phosphatase activity showed a significant trend to decrease, starting at day 30. No significant changes of serum CTX values were noted. Overall, 24-h urinary excretion of calcium did not change, seven values exceeding the threshold of 4 mg/kg body weight. Monthly administration of 500 µg of 25-hydroxyvitamin D(3) may be considered an alternative for vitamin D repletion, without any detrimental effect.


Assuntos
Calcifediol/administração & dosagem , Metabolismo/efeitos dos fármacos , Adulto , Idoso , Calcitriol/análise , Calcitriol/sangue , Cálcio/sangue , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Metabolismo/fisiologia , Pessoa de Meia-Idade , Fósforo/sangue , Fatores Sexuais , Fatores de Tempo , Vitamina D/análogos & derivados , Vitamina D/análise , Vitamina D/sangue , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-33672569

RESUMO

To analyze the middle latency auditory evoked potential index (MLAEPi), compared to the standard bispectral index (BIS), as a method for evaluating the sedation level in drug-induced sleep endoscopy (DISE). In this controlled clinical study on a sample of 99 obstructive sleep apnea (OSA) or snoring patients, we compared the MLAEPi with the BIS after propofol infusion during the standard DISE technique in order to define the MLAEPi values within the observational window of the procedure. The DISE procedure was divided into eight steps, and we collected both MLAEPi and BIS data values from the same patient in every step. The MLAEPi showed a faster response than the BIS after propofol infusion during DISE. Therefore, the clinical use of the MLAEPi in evaluating the sedation level seems to be a good alternative to the current technological standards.


Assuntos
Preparações Farmacêuticas , Propofol , Endoscopia , Potenciais Evocados Auditivos , Humanos , Sono
19.
Front Aging Neurosci ; 13: 698571, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34531734

RESUMO

Beta-amyloid (Aß) plaques have been observed in the brain of healthy elderlies with frequencies strongly influenced by age. The aim of the study is to evaluate the role of age and other biochemical and hematological parameters on Aß1-42 plasma levels in cognitively and neurologically normal individuals. Two-hundred and seventy-five normal subjects stratified by age groups (<35 years, 35-65 years, and >65 years) were included in the study. Aß1-42 plasma levels significantly correlated with age (rs = 0.27; p < 0.0001) in the whole sample, inversely correlated with age in the first age group (rs = -0.25, p = 0.01), positively correlated in the second group (rs = 0.22, p = 0.03), while there was no significant correlation in the older group (rs = 0.02, p = 0.86). Both age (ß-estimate = 0.08; p < 0.001) and cholesterol (ß-estimate = 0.03; p = 0.009) were significantly associated with Aß1-42 plasma level in multivariable analysis. However, only the association with age survived post hoc adjustment for multiple comparisons. The different effects of age on the Aß level across age groups should be explored in further studies to better understand the age-dependent variability. This could better define the value of plasma Aß as a biomarker of the Alzheimer neuropathology.

20.
J Exp Bot ; 60(12): 3379-86, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19516072

RESUMO

The long-term objective of tomato breeders is to identify metabolites that contribute to defining the target flavour and to design strategies to enhance it. This paper reports the results of network analysis, based on metabolic phenotypic and sensory data, to highlight important relationships among such traits. This tool allowed a reduction in data set complexity, building a network consisting of 35 nodes and 74 links corresponding to the 74 significant (positive or negative) correlations among the variables studied. A number of links among traits contributing to fruit organoleptic quality and to the perception of sensory attributes were identified. Modular partitioning of the characteristics involved in fruit organoleptic perception captured the essential fruit parameters that regulate interactions among different class traits. The main feature of the network was the presence of three nodes interconnected among themselves (dry matter, pH, and degrees Brix) and with other traits, and nodes with widely different linkage degrees. Identification of strong associations between some metabolic and sensory traits, such as citric acid with tomato smell, glycine with tomato smell, and granulosity with dry matter, suggests a basis for more targeted investigations in the future.


Assuntos
Redes Reguladoras de Genes , Característica Quantitativa Herdável , Solanum lycopersicum/genética , Aminoácidos/análise , Frutas/química , Frutas/genética , Frutas/metabolismo , Solanum lycopersicum/química , Solanum lycopersicum/metabolismo , Compostos Orgânicos/análise
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