17 results on '"Chiodini, Paolo"'
Search Results
2. Epidemiology of low-proteinuric chronic kidney disease in renal clinics
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De Nicola, Luca, primary, Provenzano, Michele, additional, Chiodini, Paolo, additional, Borrelli, Silvio, additional, Russo, Luigi, additional, Bellasi, Antonio, additional, Santoro, Domenico, additional, Conte, Giuseppe, additional, and Minutolo, Roberto, additional
- Published
- 2017
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3. The Association between Educational Level and Cardiovascular and Cerebrovascular Diseases within the EPICOR Study: New Evidence for an Old Inequality Problem
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Ricceri, Fulvio, primary, Sacerdote, Carlotta, additional, Giraudo, Maria Teresa, additional, Fasanelli, Francesca, additional, Lenzo, Giulia, additional, Galli, Matteo, additional, Sieri, Sabina, additional, Pala, Valeria, additional, Masala, Giovanna, additional, Bendinelli, Benedetta, additional, Tumino, Rosario, additional, Frasca, Graziella, additional, Chiodini, Paolo, additional, Mattiello, Amalia, additional, and Panico, Salvatore, additional
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- 2016
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4. Epidemiology of CKD Regression in Patients under Nephrology Care
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Borrelli, Silvio, primary, Leonardis, Daniela, additional, Minutolo, Roberto, additional, Chiodini, Paolo, additional, De Nicola, Luca, additional, Esposito, Ciro, additional, Mallamaci, Francesca, additional, Zoccali, Carmine, additional, and Conte, Giuseppe, additional
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- 2015
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5. Metabolic Syndrome and Breast Cancer Risk: A Case-Cohort Study Nested in a Multicentre Italian Cohort
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Agnoli, Claudia, primary, Grioni, Sara, additional, Sieri, Sabina, additional, Sacerdote, Carlotta, additional, Ricceri, Fulvio, additional, Tumino, Rosario, additional, Frasca, Graziella, additional, Pala, Valeria, additional, Mattiello, Amalia, additional, Chiodini, Paolo, additional, Iacoviello, Licia, additional, De Curtis, Amalia, additional, Panico, Salvatore, additional, and Krogh, Vittorio, additional
- Published
- 2015
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6. Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care
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De Nicola, Luca, primary, Provenzano, Michele, additional, Chiodini, Paolo, additional, Borrelli, Silvio, additional, Garofalo, Carlo, additional, Pacilio, Mario, additional, Liberti, Maria Elena, additional, Sagliocca, Adelia, additional, Conte, Giuseppe, additional, and Minutolo, Roberto, additional
- Published
- 2015
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7. Espresso Coffee Consumption and Risk of Coronary Heart Disease in a Large Italian Cohort
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Grioni, Sara, primary, Agnoli, Claudia, additional, Sieri, Sabina, additional, Pala, Valeria, additional, Ricceri, Fulvio, additional, Masala, Giovanna, additional, Saieva, Calogero, additional, Panico, Salvatore, additional, Mattiello, Amalia, additional, Chiodini, Paolo, additional, Tumino, Rosario, additional, Frasca, Graziella, additional, Iacoviello, Licia, additional, de Curtis, Amalia, additional, Vineis, Paolo, additional, and Krogh, Vittorio, additional
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- 2015
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- View/download PDF
8. Dietary Glycemic Load and Glycemic Index and Risk of Cerebrovascular Disease in the EPICOR Cohort
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Sieri, Sabina, primary, Brighenti, Furio, additional, Agnoli, Claudia, additional, Grioni, Sara, additional, Masala, Giovanna, additional, Bendinelli, Benedetta, additional, Sacerdote, Carlotta, additional, Ricceri, Fulvio, additional, Tumino, Rosario, additional, Giurdanella, Maria Concetta, additional, Pala, Valeria, additional, Berrino, Franco, additional, Mattiello, Amalia, additional, Chiodini, Paolo, additional, Panico, Salvatore, additional, and Krogh, Vittorio, additional
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- 2013
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9. Prognosis and determinants of serum PTH changes over time in 1-5 CKD stage patients followed in tertiary care
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Mario Cozzolino, Roberto Minutolo, Michele Provenzano, Anna Maria Costanzo, Claudio Ronco, Giuseppe Conte, Paolo Chiodini, Carlo Garofalo, Giuliana Gualberti, Luca De Nicola, Carlo Manno, Silvio Borrelli, Giuseppe Remuzzi, Borrelli, Silvio, Chiodini, Paolo, De Nicola, Luca, Minutolo, Roberto, Provenzano, Michele, Garofalo, Carlo, Remuzzi, Giuseppe, Ronco, Claudio, Cozzolino, Mario Gennaro, Manno, Carlo, Costanzo, Anna Maria, Gualberti, Giuliana, and Conte, Giuseppe
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Nephrology ,Male ,European People ,030232 urology & nephrology ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,Biochemistry ,Tertiary Care Centers ,0302 clinical medicine ,Endocrinology ,Chronic Kidney Disease ,Medicine and Health Sciences ,Ethnicities ,Prospective Studies ,Prospective cohort study ,lcsh:Science ,Aged, 80 and over ,Multidisciplinary ,Middle Aged ,Prognosis ,Italian People ,Survival Rate ,Chemistry ,Proteinuria ,Bioassays and Physiological Analysis ,Quartile ,Italy ,Parathyroid Hormone ,Cohort ,Physical Sciences ,Female ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,Endocrine Disorders ,Urology ,Research and Analysis Methods ,Disease-Free Survival ,Phosphates ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Internal medicine ,medicine ,Diabetes Mellitus ,Humans ,Survival rate ,Aged ,Renal Analysis ,Proportional hazards model ,business.industry ,lcsh:R ,Chemical Compounds ,Biology and Life Sciences ,medicine.disease ,Hormones ,Bone Diseases, Metabolic ,Metabolic Disorders ,People and Places ,Kidney Failure, Chronic ,Population Groupings ,lcsh:Q ,business ,Kidney disease ,Follow-Up Studies - Abstract
International Guidelines for mineral bone disorders recommend that in Non Dialytic-Chronic Kidney Disease (ND-CKD) clinical decisions should be based on the trend of serum PTH changes over time rather than on a single value. However, the prognostic impact of these changes in ND-CKD patients remains unknown. We performed a multicenter cohort study in ND-CKD patients (stage 1-5) followed for 36 months in 24 Italian Nephrology Units. PTH changes (ΔPTH) were defined as the absolute differences between all available PTH measurements following the first control and basal value. Primary endpoint in this subanalysis was renal death (End-Stage Renal Disease (ESRD) or all-causes death before ESRD). Association between renal death and ΔPTH was assessed by time-dependent Cox model for repeated measurements. Out of the original cohort (N = 884), we selected 543 patients (66.3±15.4 ys, 58.4% males) with at least two serum PTH measurements. At baseline, eGFR was 36 (IQR: 22.4-56.8) mL/min/1.73m2 and serum PTH 46 (IQR: 28-81) pg/mL. ΔPTH was in median 0 (IQR:-18/18) pg/mL. Basal predictors of longitudinal PTH increments were higher serum phosphate, more advanced CKD stages and lower serum PTH. Fully adjusted Cox model with ΔPTH quartiles as discrete time-dependent covariate showed a significant risk of renal death in the highest quartile (HR: 1.91; 95%CI:1.08-3.38; P = 0.026). Considering ΔPTH, as continuous time-dependent variable, (HR:1.02; 95%C.I.: 1.01-1.04; P = 0.004), risk of renal death progressively rose as ΔPTH increased. An increment in serum PTH over time is associated with a worse prognosis in ND-CKD patients, independently from baseline or any absolute concentration of serum PTH and phosphate.
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- 2018
10. Epidemiology of CKD Regression in Patients under Nephrology Care
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Luca De Nicola, Francesca Mallamaci, Giuseppe Conte, Paolo Chiodini, Roberto Minutolo, Silvio Borrelli, Daniela Leonardis, Carmine Zoccali, Ciro Esposito, Borrelli, Silvio, Leonardis, Daniela, Minutolo, Roberto, Chiodini, Paolo, DE NICOLA, Luca, Esposito, Ciro, Mallamaci, Francesca, Zoccali, Carmine, and Conte, Giuseppe
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Nephrology ,Male ,medicine.medical_specialty ,lcsh:Medicine ,urologic and male genital diseases ,End stage renal disease ,Risk Factors ,Internal medicine ,medicine ,Confidence Intervals ,Odds Ratio ,Outpatient clinic ,Humans ,Renal Insufficiency, Chronic ,lcsh:Science ,Prospective cohort study ,Intensive care medicine ,Demography ,Proportional Hazards Models ,Multidisciplinary ,Proportional hazards model ,business.industry ,lcsh:R ,Absolute risk reduction ,Odds ratio ,Middle Aged ,medicine.disease ,Survival Analysis ,female genital diseases and pregnancy complications ,Logistic Models ,Kidney Failure, Chronic ,lcsh:Q ,Female ,Patient Care ,business ,Kidney disease ,Research Article ,Follow-Up Studies - Abstract
Chronic Kidney Disease (CKD) regression is considered as an infrequent renal outcome, limited to early stages, and associated with higher mortality. However, prevalence, prognosis and the clinical correlates of CKD regression remain undefined in the setting of nephrology care. This is a multicenter prospective study in 1418 patients with established CKD (eGFR: 60-15 ml/min/1.73m²) under nephrology care in 47 outpatient clinics in Italy from a least one year. We defined CKD regressors as a ΔGFR ≥0 ml/min/1.73 m2/year. ΔGFR was estimated as the absolute difference between eGFR measured at baseline and at follow up visit after 18-24 months, respectively. Outcomes were End Stage Renal Disease (ESRD) and overall-causes Mortality.391 patients (27.6%) were identified as regressors as they showed an eGFR increase between the baseline visit in the renal clinic and the follow up visit. In multivariate regression analyses the regressor status was not associated with CKD stage. Low proteinuria was the main factor associated with CKD regression, accounting per se for 48% of the likelihood of this outcome. Lower systolic blood pressure, higher BMI and absence of autosomal polycystic disease (PKD) were additional predictors of CKD regression. In regressors, ESRD risk was 72% lower (HR: 0.28; 95% CI 0.14-0.57; p
- Published
- 2015
11. Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care
- Author
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Michele Provenzano, Adelia Sagliocca, Roberto Minutolo, Giuseppe Conte, Paolo Chiodini, Luca De Nicola, Carlo Garofalo, Silvio Borrelli, Mario Pacilio, Maria Elena Liberti, DE NICOLA, Luca, Provenzano, M, Chiodini, Paolo, Borrelli, S, Garofalo, C, Pacilio, M, Liberti, Me, Sagliocca, A, Conte, Giuseppe, and Minutolo, Roberto
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,Endpoint Determination ,Renal function ,lcsh:Medicine ,urologic and male genital diseases ,Nephropathy ,Cohort Studies ,Diabetic nephropathy ,Internal medicine ,Diabetes mellitus ,Hypertensive Nephropathy ,medicine ,Polycystic kidney disease ,Humans ,Renal Insufficiency, Chronic ,Intensive care medicine ,lcsh:Science ,Referral and Consultation ,Aged ,Proportional Hazards Models ,Multidisciplinary ,business.industry ,lcsh:R ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Multivariate Analysis ,Disease Progression ,Female ,lcsh:Q ,business ,Research Article ,Follow-Up Studies ,Glomerular Filtration Rate ,Kidney disease - Abstract
Primary kidney disease is suggested to affect renal prognosis of CKD patients; however, whether nephrology care modifies this association is unknown. We studied patients with CKD stage I-IV treated in a renal clinic and with established diagnosis of CKD cause to evaluate whether the risk of renal event (composite of end-stage renal disease and eGFR decline ≥ 40%) linked to the specific diagnosis is modified by the achievement or maintenance in the first year of nephrology care of therapeutic goals for hypertension (BP ≤ 130/80 mmHg in patients with proteinuria ≥ 1 50 mg/24h and/or diabetes and ≤ 140/90 in those with proteinuria
- Published
- 2015
12. Metabolic syndrome and breast cancer risk: a case-cohort study nested in a multicentre italian cohort
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Sara Grioni, Fulvio Ricceri, Sabina Sieri, Valeria Pala, Carlotta Sacerdote, Vittorio Krogh, Claudia Agnoli, Licia Iacoviello, Paolo Chiodini, Amalia Mattiello, Rosario Tumino, Amalia De Curtis, Graziella Frasca, Salvatore Panico, Agnoli, Claudia, Grioni, Sara, Sieri, Sabina, Sacerdote, Carlotta, Ricceri, Fulvio, Tumino, Rosario, Frasca, Graziella, Pala, Valeria, Mattiello, Amalia, Chiodini, Paolo, Iacoviello, Licia, De Curtis, Amalia, Panico, Salvatore, and Krogh, Vittorio
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Oncology ,Blood Glucose ,medicine.medical_specialty ,European Continental Ancestry Group ,lcsh:Medicine ,Breast Neoplasms ,White People ,Breast cancer ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective cohort study ,lcsh:Science ,Life Style ,Abdominal obesity ,Gynecology ,Metabolic Syndrome ,Biochemistry, Genetics and Molecular Biology (all) ,Multidisciplinary ,business.industry ,Medicine (all) ,Metabolic Syndrome X ,lcsh:R ,Case-control study ,medicine.disease ,European Prospective Investigation into Cancer and Nutrition ,Postmenopause ,Prospective Studie ,Agricultural and Biological Sciences (all) ,Italy ,Premenopause ,Case-Control Studies ,Female ,Hypertension ,lcsh:Q ,Metabolic syndrome ,medicine.symptom ,Case-Control Studie ,business ,Breast Neoplasm ,Human ,Cohort study ,Research Article - Abstract
Background Metabolic syndrome (defined as at least three among abdominal obesity, high blood triglycerides, low high-density lipoprotein cholesterol, high blood glucose, and high blood pressure) is emerging as a risk factor for breast cancer; however few studies – most confined to postmenopausal women – have investigated associations between breast cancer risk and metabolic syndrome. The purpose of this study was to examine the association between metabolic syndrome and its components, and risk of breast cancer in postmenopausal and premenopausal women. Methods We performed a case-cohort study on 22,494 women recruited in 1993-1998 to four Italian centres (Turin, Varese, Naples, Ragusa) of the European Prospective Investigation into Cancer and Nutrition (EPIC) and followed-up for up to 15 years. A random subcohort of 565 women was obtained and 593 breast cancer cases were diagnosed. Hazard ratios (HR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Prentice-weighted Cox proportional hazards models. Results Presence of metabolic syndrome was associated with significantly increased breast cancer risk in all women (HR 1.52, 95%CI 1.14-2.02). When the analyses were repeated separately for menopausal status, the association was limited to postmenopausal women (HR 1.80, 95%CI 1.22-2.65) and absent in premenopausal women (HR 0.71, 95%CI 0.43-1.16); P for interaction between metabolic syndrome and menopausal status was 0.001. Of metabolic syndrome components, only high blood glucose was significantly associated with increased breast cancer risk in all women (HR 1.47, 95%CI 1.13-1.91) and postmenopausal women (HR 1.89, 95%CI 1.29-2.77), but not premenopausal women (HR 0.80, 95%CI 0.52-1.22; P interaction=0.004). Conclusions These findings support previous data indicating that metabolic syndrome is an important risk factor for breast cancer in postmenopausal women, but not in premenopausal women, and suggest that prevention of metabolic syndrome through lifestyle changes could confer protection against breast cancer.
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- 2015
13. The Association between Educational Level and Cardiovascular and Cerebrovascular Diseases within the EPICOR Study: New Evidence for an Old Inequality Problem
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Sabina Sieri, Maria Teresa Giraudo, Valeria Pala, Matteo Galli, Paolo Chiodini, Fulvio Ricceri, Francesca Fasanelli, Graziella Frasca, Giovanna Masala, Salvatore Panico, Benedetta Bendinelli, Giulia Lenzo, Carlotta Sacerdote, Amalia Mattiello, Rosario Tumino, Ricceri, Fulvio, Sacerdote, Carlotta, Giraudo, Maria Teresa, Fasanelli, Francesca, Lenzo, Giulia, Galli, Matteo, Sieri, Sabina, Pala, Valeria, Masala, Giovanna, Bendinelli, Benedetta, Tumino, Rosario, Frasca, Graziella, Chiodini, Paolo, Mattiello, Amalia, and Panico, Salvatore
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Male ,Genetics and Molecular Biology (all) ,Gerontology ,lcsh:Medicine ,Social Sciences ,Blood Pressure ,030204 cardiovascular system & hematology ,Pathology and Laboratory Medicine ,Vascular Medicine ,Biochemistry ,Cohort Studies ,Endocrinology ,0302 clinical medicine ,Sociology ,Risk Factors ,Medicine and Health Sciences ,Medicine ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,Alcohol Consumption ,Multidisciplinary ,Medicine (all) ,Incidence (epidemiology) ,Relative index of inequality ,Hazard ratio ,Middle Aged ,Socioeconomic Aspects of Health ,Hyperlipidemia ,Italy ,Cardiovascular Diseases ,Hypertension ,Cohort ,Educational Status ,Female ,Research Article ,Cohort study ,Endocrine Disorders ,Hypercholesterolemia ,Education ,Cerebrovascular Disorders ,Humans ,Life Style ,Socioeconomic Factors ,Biochemistry, Genetics and Molecular Biology (all) ,Agricultural and Biological Sciences (all) ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Diabetes Mellitus ,Social Stratification ,Socioeconomic status ,Educational Attainment ,Nutrition ,business.industry ,Proportional hazards model ,lcsh:R ,Biology and Life Sciences ,Physical Activity ,Confidence interval ,Diet ,Health Care ,Metabolic Disorders ,lcsh:Q ,business ,Demography - Abstract
Background A consistent association has been reported between low socioeconomic status (SES) and cardiovascular events (CE), whereas the association between SES and cerebrovascular events (CBVD) is less clear. The aim of this study was to investigate the association between SES (measured using education) and CE/CBVD in a cohort study, as well as to investigate lifestyle and clinical risk factors, to help to clarify the mechanisms by which SES influences CE/CBVD. Material and Methods We searched for diagnoses of CE and CBVD in the clinical records of 47,749 members of the EPICOR cohort (average follow-up time: 11 years). SES was determined by the relative index of inequality (RII). Results A total of 1,156 CE and 468 CBVD were found in the clinical records. An increased risk of CE was observed in the crude Cox model for the third tertile of RII compared to the first tertile (hazard ratio [HR] = 1.39; 95% confidence interval [CI] 1.21–1.61). The increased risk persisted after adjustment for lifestyle risk factors (HR = 1.19; 95%CI 1.02–1.38), clinical risk factors (HR = 1.35; 95%CI 1.17–1.56), and after full adjustment (HR = 1.17; 95%CI 1.01–1.37). Structural equation model showed that lifestyle rather than clinical risk factors are involved in the mechanisms by which education influences CE. No significant association was found between education and CBVD. A strong relationship was observed between education and diabetes at baseline. Conclusion The most important burden of inequality in CE incidence in Italy is due to lifestyle risk factors.
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- 2016
14. Dietary glycemic load and glycemic index and risk of cerebrovascular disease in the EPICOR cohort
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Carlotta Sacerdote, Claudia Agnoli, Salvatore Panico, Franco Berrino, Vittorio Krogh, Paolo Chiodini, Amalia Mattiello, Benedetta Bendinelli, Rosario Tumino, Furio Brighenti, Maria Concetta Giurdanella, Fulvio Ricceri, Valeria Pala, Giovanna Masala, Sabina Sieri, Sara Grioni, Sieri, S, Brighenti, F, Agnoli, C, Grioni, S, Masala, G, Bendinelli, B, Sacerdote, C, Ricceri, F, Tumino, R, Giurdanella, Mc, Pala, V, Berrino, F, Mattiello, A, Chiodini, Paolo, Panico, S, Krogh, V., Chiodini, P, and Panico, Salvatore
- Subjects
Male ,Gerontology ,Critical Care and Emergency Medicine ,Epidemiology ,Glycobiology ,Cardiovascular ,Biochemistry ,Brain Ischemia ,Cohort Studies ,Risk Factors ,Surveys and Questionnaires ,Stroke ,Multidisciplinary ,Incidence ,Incidence (epidemiology) ,Middle Aged ,Hemorrhagic Stroke ,Glycemic index ,Neurology ,Cohort ,population characteristics ,Medicine ,Female ,Intracranial Hemorrhages ,Research Article ,Cohort study ,Adult ,medicine.medical_specialty ,Clinical Research Design ,Cerebrovascular Diseases ,Science ,Carbohydrates ,Stroke risk ,Internal medicine ,parasitic diseases ,Glycemic load ,Dietary Carbohydrates ,medicine ,Humans ,Biology ,Cardiovascular Disease Epidemiology ,Aged ,Proportional Hazards Models ,Ischemic Stroke ,Nutrition ,business.industry ,Proportional hazards model ,Acute Cardiovascular Problems ,medicine.disease ,Diet ,Glycemic Index ,Multivariate Analysis ,business ,human activities - Abstract
BackgroundStudies on the association of stroke risk to dietary glycemic index (GI) and glycemic load (GL) have produced contrasting results.ObjectiveTo investigate the relation of dietary GI and GL to stroke risk in the large EPIC-Italy cohort (EPICOR) recruited from widely dispersed geographic areas of Italy.DesignWe studied 44099 participants (13,646 men and 30,453 women) who completed a dietary questionnaire. Multivariable Cox modeling estimated adjusted hazard ratios (HRs) of stroke with 95% confidence intervals (95%CI). Over 11 years of follow-up, 355 stroke cases (195 ischemic and 83 hemorrhagic) were identified.ResultsIncreasing carbohydrate intake was associated with increasing stroke risk (HR = 2.01, 95%CI = 1.04-3.86 highest vs. lowest quintile; p for trend 0.025). Increasing carbohydrate intake from high-GI foods was also significantly associated with increasing stroke risk (HR 1.87, 95%CI = 1.16-3.02 highest vs. lowest, p trend 0.008), while increasing carbohydrate intake from low-GI foods was not. Increasing GL was associated with significantly increasing stroke risk (HR 2.21, 95%CI = 1.16-4.20, highest vs. lowest; p trend 0.015). Dietary carbohydrate from high GI foods was associated with increased both ischemic stroke risk (highest vs. lowest HR 1.92, 95%CI = 1.01-3.66) and hemorrhagic stroke risk (highest vs. lowest HR 3.14, 95%CI = 1.09-9.04). GL was associated with increased both ischemic and hemorrhagic stroke risk (HR 1.44, 95%CI = 1.09-1.92 and HR 1.56, 95%CI = 1.01-2.41 respectively, continuous variable).ConclusionsIn this Italian cohort, high dietary GL and carbohydrate from high GI foods consumption increase overall risk of stroke.
- Published
- 2013
15. Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy.
- Author
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Galiero R, Loffredo G, Simeon V, Caturano A, Vetrano E, Medicamento G, Alfano M, Beccia D, Brin C, Colantuoni S, Di Salvo J, Epifani R, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, Calabrese C, De Lucia Sposito P, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Numis F, Bologna C, Nunziata M, Esposito V, Coppola N, Maturo N, Nasti R, Di Micco P, Perrella A, Adinolfi LE, Chiodini P, Di Domenico M, Rinaldi L, and Sasso FC
- Subjects
- Humans, Italy epidemiology, Female, Male, Middle Aged, Retrospective Studies, Aged, Severity of Illness Index, Aged, 80 and over, Hospitalization statistics & numerical data, Adult, COVID-19 mortality, COVID-19 epidemiology, COVID-19 pathology, Liver Cirrhosis mortality, Liver Cirrhosis pathology, Liver Cirrhosis virology, Hospital Mortality, SARS-CoV-2 isolation & purification
- Abstract
Background & Aims: SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects., Methods: This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.45
3.25), respectively group 1,2,3., Results: At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.45 3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.45 3.25 (42.3%, group 3)., Conclusions: FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Galiero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) - Published
- 2024
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16. Lack of effect on in-hospital mortality of drugs used during COVID-19 pandemic: Findings of the retrospective multicenter COVOCA study.
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Pafundi PC, Galiero R, Simeon V, Rinaldi L, Perrella A, Vetrano E, Caturano A, Alfano M, Beccia D, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, De Lucia Sposito P, Vocciante L, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Bologna C, Amitrano M, Esposito V, Coppola N, Maturo N, Adinolfi LE, Chiodini P, and Sasso FC
- Subjects
- Aged, COVID-19 epidemiology, Female, Hospital Mortality, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Respiratory Therapy, Retrospective Studies, Antiviral Agents therapeutic use, COVID-19 mortality, COVID-19 Drug Treatment
- Abstract
Introduction: During COVID-19 pandemic, the use of several drugs has represented the worldwide clinical practice. However, though the current increase of knowledge about the disease, there is still no effective treatment for the usage of drugs. Thus, we retrospectively assessed use and effects of therapeutic regimens in hospitalized patients on in-hospital mortality., Methods: COVOCA is a retrospective observational cohort study on 18 COVID centres throughout Campania Region Hospitals. We included adult patients with confirmed SARS-CoV-2 infection, discharged/dead between March/June 2020., Results: 618 patients were included, with an overall in-hospital cumulative mortality incidence of 23.1%. Most prescribed early treatments were antivirals (72%), antibiotics (65%) and hydroxychloroquine/anticoagulants (≈50%). Tocilizumab, indeed, was largely prescribed late during hospitalization. Multivariable models, with a cut-off at day 2 for early COVID-19 therapy administration, did not disclose any significant association of a single drug administration on the clinical outcome., Discussion: COVOCA represents the first multicenter database in Campania region. None drug class used during the pandemic significantly modified the outcome, regardless of therapy beginning, both overall and net of those already in non-invasive ventilation (NIV)/ orotracheal intubation (OTI) at hospitalization. Our cumulative incidence of mortality seems lower than other described during the same period, particularly in Northern Italy., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2021
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17. Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study.
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Galiero R, Pafundi PC, Simeon V, Rinaldi L, Perrella A, Vetrano E, Caturano A, Alfano M, Beccia D, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, De Lucia Sposito P, Vocciante L, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Bologna C, Amitrano M, Esposito V, Coppola N, Maturo N, Adinolfi LE, Chiodini P, and Sasso FC
- Subjects
- Aged, Aged, 80 and over, COVID-19 diagnosis, COVID-19 mortality, Chronic Disease, Comorbidity, Female, Hospital Mortality, Hospitalization, Humans, Italy epidemiology, Liver Diseases diagnosis, Liver Diseases mortality, Male, Middle Aged, Prognosis, Retrospective Studies, SARS-CoV-2 isolation & purification, COVID-19 epidemiology, Liver Diseases epidemiology
- Abstract
Background: Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory., Objectives: Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy)., Methods: COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission., Results: Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings., Conclusion: Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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