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1,065 results on '"Gensini, GF"'

1. Marfan syndrome: current perspectives

Author

Pepe G, Giusti B, Sticchi E, Abbate R, Gensini GF, and Nistri S

Subjects
Marfan syndrome, thoracic aortic aneurysm, fibrillin 1, cardiovascular manifestations, diagnosis, therapy, Medicine (General), R5-920, Genetics, QH426-470
Abstract

Guglielmina Pepe,1,2 Betti Giusti,1,2 Elena Sticchi,1,2 Rosanna Abbate,1,2 Gian Franco Gensini,1–3 Stefano Nistri2,4 1Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, DENOTHE Center, University of Florence, 2Cardiothoracovascular Department, Marfan Syndrome and Related Disorders Regional Referral Center, Careggi Hospital, 3Santa Maria agli Ulivi, Fondazione Don Carlo Gnocchi, Onlus, Institute for Cancer Research and Treatment, Florence, 4Cardiology Service, CMSR Veneto Medica, Altavilla Vicentina, Italy Abstract: Marfan syndrome (MFS) is a pleiotropic connective tissue disease inherited as an autosomal dominant trait, due to mutations in the FBN1 gene encoding fibrillin 1. It is an important protein of the extracellular matrix that contributes to the final structure of a microfibril. Few cases displaying an autosomal recessive transmission are reported in the world. The FBN1 gene, which is made of 66 exons, is located on chromosome 15q21.1. This review, after an introduction on the clinical manifestations that leads to the diagnosis of MFS, focuses on cardiovascular manifestations, pharmacological and surgical therapies of thoracic aortic aneurysm and/or dissection (TAAD), mechanisms underlying the progression of aneurysm or of acute dissection, and biomarkers associated with progression of TAADs. A Dutch group compared treatment with losartan, an angiotensin II receptor-1 blocker, vs no other additional treatment (COMPARE clinical trial). They observed that losartan reduces the aortic dilatation rate in patients with Marfan syndrome. Later on, they also reported that losartan exerts a beneficial effect on patients with Marfan syndrome carrying an FBN1 mutation that causes haploinsufficiency (quantitative mutation), while it has no significant effect on patients displaying dominant negative (qualitative) mutations. Moreover, a French group in a 3-year trial compared the administration of losartan vs placebo in patients with Marfan syndrome under treatment with beta-receptor blockers. They observed that losartan decreases blood pressure but has no effect on aortic diameter progression. Thus, beta-receptor blockers remain the gold standard therapy in patients with Marfan syndrome. Three potential biochemical markers are mentioned in this review: total homocysteine, serum transforming growth factor beta, and lysyl oxidase. Moreover, markers of oxidative stress measured in plasma, previously correlated with clinical features of Marfan syndrome, may be explored as potential biomarkers of clinical severity. Keywords: Marfan syndrome, thoracic aortic aneurysm, fibrillin 1, cardiovascular manifestations, diagnosis, therapy

Published
2016

2. Exercise as a prescription therapy for breast and colon cancer survivors

Author

Galanti G, Stefani L, and Gensini GF

Subjects
Medicine (General), R5-920
Abstract

Giorgio Galanti,1 Laura Stefani,1 Gianfranco Gensini2 1Sports Medicine Center, 2Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy Background: Breast and colon tumors are the most common types of cancer in the general population. As a result of improved diagnosis and treatment, more people are now surviving cancer. Lifestyle has been identified as one of the potential risk factors for cancer, and it has been demonstrated recently that physical activity reduces the physiological and psychological symptoms and side effects of chemotherapy. Muscular atrophy, weight changes, decreased aerobic capacity, fatigue, and depression are the most common symptoms in cancer patients. The exact amount of moderate to vigorous physical activity needed to overcome these effects has not yet been established, but an individualized and variable exercise program as prescription therapy could be considered a helpful tool for improving quality of life. This paper proposes a model of lifestyle analysis and dedicated individualized exercise programs for the treatment of cancer patients. The program starts with a preliminary evaluation of the patient’s lifestyle using a questionnaire and accelerometer, which provides information on the amount of daily physical activity and number of steps taken, as well as an assessment of aerobic capacity, cardiovascular response, muscle strength, and resistance. Two different levels of aerobic exercise, ie, low-to-moderate (40% of maximal heart rate) to moderate (60% of maximal heart rate) can be prescribed. This model of exercise prescription in patients with cancer offers a flexible program for assisting in the management of this complex disease. It is projected to ensure easier management of medical problems related to cancer, and to attract a greater number of participants over time. Keywords: physical exercise, therapy, breast cancer, colon cancer, lifestyle

Published
2013

8. In reply

Author

Cabitza, F, Rasoini, R, Gensini, G, Gensini, GF, Cabitza, F, Rasoini, R, Gensini, G, and Gensini, GF

Published
2017

10. “Handle with care”: About the potential unintended consequences of oracular artificial intelligence systems in medicine

Author

Cabitza, F, Alderighi, C, Rasoini, R, Gensini, G, Gensini, GF, Cabitza, F, Alderighi, C, Rasoini, R, Gensini, G, and Gensini, GF

Abstract

Decisional support systems based on machine learning (ML) in medicine are gaining a growing interest as some recent articles have highlighted the high diagnostic accuracy exhibited by these systems in specific medical contexts. However, it is implausible that any potential advantage can be obtained without some potential drawbacks. In light of the current gaps in medical research about the side effects of the application of these new AI systems in medical practice, in this article we summarize the main unexpected consequences that may result from the widespread application of "oracular" systems, that is highly accurate systems that cannot give reasonable explanations of their advice as those endowed with predictive models developed with ML techniques usually are. These consequences range from the intrinsic uncertainty in the data that are used to train and feed these systems, to the inadequate explainability of their output; through the risk of overreliance, deskilling and context desensitization of their end-users. Although some of these issues may be currently hard to evaluate due to the still scarce adoption of these decisional systems in medical practice, we advocate the study of these potential consequences also for a more informed policy of approval beyond hype and disenchantment., Decisional support systems based on machine learning (ML) in medicine are gaining a growing interest as some recent articles have highlighted the high diagnostic accuracy exhibited by these systems in specific medical contexts. However, it is implausible that any potential advantage can be obtained without some potential drawbacks. In light of the current gaps in medical research about the side effects of the application of these new AI systems in medical practice, in this article we summarize the main unexpected consequences that may result from the widespread application of "oracular" systems, that is highly accurate systems that cannot give reasonable explanations of their advice as those endowed with predictive models developed with ML techniques usually are. These consequences range from the intrinsic uncertainty in the data that are used to train and feed these systems, to the inadequate explainability of their output; through the risk of overreliance, deskilling and context desensitization of their end-users. Although some of these issues may be currently hard to evaluate due to the still scarce adoption of these decisional systems in medical practice, we advocate the study of these potential consequences also for a more informed policy of approval beyond hype and disenchantment

Published
2017

11. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report

Author

Malfertheiner, P, Megraud, F, O'Morain, Ca, Atherton, J, Axon, At, Bazzoli, F, Gensini, Gf, Gisbert, Jp, Graham, Dy, Rokkas, T, El Omar EM, Kuipers, Ej, The European Helicobacter Study Group, Rugge, Massimo, Gastroenterology & Hepatology, Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, El-Omar EM, Kuipers EJ, and European Helicobacter Study Group

Subjects
medicine.medical_specialty, Helicobacter pylori infection, MEDLINE, Disease, Helicobacter Infections, Pharmacotherapy, SDG 3 - Good Health and Well-being, Stomach Neoplasms, Clarithromycin, h.pylori, Gastroscopy, medicine, Humans, Aspirin, biology, Helicobacter pylori, business.industry, Probiotics, Anti-Inflammatory Agents, Non-Steroidal, Gastroenterology, Consensus conference, Diagnostic test, Proton Pump Inhibitors, biology.organism_classification, Surgery, Anti-Bacterial Agents, Prebiotics, Family medicine, Gastroesophageal Reflux, Drug Therapy, Combination, business, management, medicine.drug
Abstract

Management of Helicobacter pylori infection is evolving and in this 4th edition of the Maastricht consensus report aspects related to the clinical role of H pylori were looked at again in 2010. In the 4th Maastricht/Florence Consensus Conference 44 experts from 24 countries took active part and examined key clinical aspects in three subdivided workshops: (1) Indications and contraindications for diagnosis and treatment, focusing on dyspepsia, non-steroidal anti-inflammatory drugs or aspirin use, gastro-oesophageal reflux disease and extraintestinal manifestations of the infection. (2) Diagnostic tests and treatment of infection. (3) Prevention of gastric cancer and other complications. The results of the individual workshops were submitted to a final consensus voting to all participants. Recommendations are provided on the basis of the best current evidence and plausibility to guide doctors involved in the management of this infection associated with various clinical conditions.

Published
2012

12. Eplerenone in patients with systolic heart failure and mild symptoms

Author

Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, Vincent J, Pocock SJ, Pitt B, Drexler H, McMurray J, Remme WJ, Cornel JH, Hildebrandt P, Hradec J, Mareev V, Reddy KS, Sindone A, Martinez F, Alonso Garcia A, Wilhelmsen L, Dargie HJ, Tavazzi L, Pocock S, Leizorovic A, Collier T, Nul DR, Serra JL, Thierer JM, Cross DB, Sindone AP, Singh BB, Boreux JL, Charlier FP, Dendale P, De Keulenaer G, Marchandise B, Marechal P, Marenne F, Mieghem WV, Van Dorpe AC, Vanhaecke J, Arnold JM, Dion D, Huynh T, Kouz SM, Lepage S, McKelvie RS, O'Meara E, Proulx G, Sauve C, Aschermann M, Brecka D, Filipovsky J, Groch L, Jerabek O, Jokl I, Linkova H, Motovska Z, Munz J, Penicka M, Rucka D, Mid JS, Spacek R, Spinar J, Stipal R, Vojacek J, Attali P, Bonneau A, Bousser JP, Dutoit L, Funck F, Galinier MP, Gibelin P, Hautefeuille BD, Hittinger L, Jobic Y, Jourdain P, Komajda M, Maupas E, Olive T, Philias A, Roul G, Rouleau F, Trochu JN, Boehm M, Bruch L, Engelhardt H, Erbs S, Foerster A, Franz N, Hambrecht R, Heuer H, Krueger U, Landmesser U, Leischik R, Mitrovic V, Moehlenkamp S, Monti J, Mueller Ehmsen J, Oezcelik C, Philipp S, Pieske B, Roehnisch JU, Schunkert H, Schwinger R, Wachter R, Willenbrock R, Winkelmann BR, Winkler R, Wollert KC, Adamopoulos S, Kalikazaros I, Karavidas A, Karvounis H, Kremastinos D, Manolis AJ, Nanas I, Sotirellos K, Vasiliadis K, Zaboulis C, Lee S, Yu CM, Czibok C, Édes I, Forster T, Preda I, Simon K, Takacs J, Zámolyi K, Bhagavatula KS, Chockalingam K, Desai N, Iyengar SS, Jayadev SM, Mullasari AS, Sathe SP, Sinha N, Vadagenalli PS, Wander GS, McDonald KM, Nash P, Vaughan CJ, Agostoni P, Ambrosio GB, Bittolo Bon G, Boffa G, Cacciavillani L, Capucci A, Chiariello M, Cirrincione V, Gensini GF, Masini F, Modena MG, Monte I, Rosano GM, Senni M, Sinagra G, Tamburino C, Terrosu P, Villani GQ, Volterrani M, Chae SC, Ha CW, Ha JW, Shin JH, Bayram Llamas E, Calvillo JC, Cruz Diaz A, Delgado Leal L, Estrada Gomez MM, Kosturakis D, Petersen Aranguren F, Velasco Sanchez RG, Daniëls MC, Dirkali A, Dunselman PH, de Kluiver EP, Kragten JA, Lok DJ, Maas AH, Michels HR, Nicastia DM, Stoel I, de Swart JB, Thijssen HJ, Van Kempen LH, Voors AA, Willems FF, Dluzniewski M, Gaciong Z, Kawecka Jaszcz K, Jozwa R, Korewicki J, Krzeminska Pakula M, Kurowski M, Ogorek M, Pempera M, Rynkiewicz A, Ujda M, Wierzchowiecki M, Abreu Á, Andrade A, Carrageta M, Fonseca C, Franco F, Gil VM, Lousada N, Mendonca C, Moreira I, Padua FP, Providência L, Cardoso JC, Trabulo M, Aroutyunov GP, Gindin K, Karpov YB, Kostenko VA, Nikitin YP, Obraztsova GI, Shilkina NP, Shlyakhto EV, Skvortsov A, Ding ZP, Yeo DP, Ambrovicova V, Gaspar L, Goncalvesova E, Kycina P, Litvinova J, Mikes Z, Murin J, Poliacik P, Uhliar R, Lloyd EA, Marx D, Naidoo DP, Prozesky HW, Sliwa Hahnle K, Theron H, Anguita M, De Teresa E, Galve E, Juanatey JR, Orbe PM, Vida M, Ahremark U, Andersson B, Axelsson U, Berglund S, Boman K, Dahlstrom U, Fu M, Holm Orndahl L, Johansson A, Lindgren M, Nemeczek C, Prantare H, Roussine V, Stehn G, Stenberg A, Vasko P, Bazylevych A, Dyadyk OI, Dzyak GV, Girina OM, Ignatenko GA, Kononenko LG, Kubyshkin VF, Kuryata OV, Parkhomenko AN, Perepelytsya MV, Pertseva TO, Popik GS, Rishko MV, Sakharchuk II, Tseluyko VI, Tykhonova SA, Vizir V, Voronkov LG, Al Khaja N, Almahmeed WA, Bazargani N, Adgey AA, Al Mohammad A, Banerjee P, Barlow M, Bridges AB, Brooks N, Connolly EC, Denvir MA, Egdell RM, Kardos A, Keeling PJ, Khokhar AA, Senior R, Williams SG, Anand IS, Anderson JL, Berk MR, Bertolet BD, Bisognano JD, Blonder RD, Breburda CS, Canaday DB, Capodilupo RC, Choiunard MD, Colucci WS, Dahiya RJ, Dunlap SH, Essandoh LK, Flores AR, Henderson DA, Herzog WR Jr, Katz RJ, Kosinski EJ, Labin IN, Lally FL, Lash JA, McGrew FA 3rd, Mohiuddin SM, Moraes D, Murali SC, Nallasivan M, Philbin E, Prabhu S, Primack DS, Ramani R, Rawitscher D, Sangrigoli R, Schamalfuss CM, Stoletniy L, Strong MH, Thadani U, Treasure CB 2nd, Vicari RM, Vogel CD, Wlsh MN, Wencker D, Wilson SA, Winkel E, Wiseman AH, Zoiopoulos LY, Mancebo JR, Mendoza I, Waich S.T., PERRONE FILARDI, PASQUALE, Zannad, F, Mcmurray, Jj, Krum, H, van Veldhuisen, Dj, Swedberg, K, Shi, H, Vincent, J, Pocock, Sj, Pitt, B, Drexler, H, Mcmurray, J, Remme, Wj, Cornel, Jh, Hildebrandt, P, Hradec, J, Mareev, V, Reddy, K, Sindone, A, Martinez, F, Alonso Garcia, A, Wilhelmsen, L, Dargie, Hj, Tavazzi, L, Pocock, S, Leizorovic, A, Collier, T, Nul, Dr, Serra, Jl, Thierer, Jm, Cross, Db, Sindone, Ap, Singh, Bb, Boreux, Jl, Charlier, Fp, Dendale, P, De Keulenaer, G, Marchandise, B, Marechal, P, Marenne, F, Mieghem, Wv, Van Dorpe, Ac, Vanhaecke, J, Arnold, Jm, Dion, D, Huynh, T, Kouz, Sm, Lepage, S, Mckelvie, R, O'Meara, E, Proulx, G, Sauve, C, Aschermann, M, Brecka, D, Filipovsky, J, Groch, L, Jerabek, O, Jokl, I, Linkova, H, Motovska, Z, Munz, J, Penicka, M, Rucka, D, Mid, J, Spacek, R, Spinar, J, Stipal, R, Vojacek, J, Attali, P, Bonneau, A, Bousser, Jp, Dutoit, L, Funck, F, Galinier, Mp, Gibelin, P, Hautefeuille, Bd, Hittinger, L, Jobic, Y, Jourdain, P, Komajda, M, Maupas, E, Olive, T, Philias, A, Roul, G, Rouleau, F, Trochu, Jn, Boehm, M, Bruch, L, Engelhardt, H, Erbs, S, Foerster, A, Franz, N, Hambrecht, R, Heuer, H, Krueger, U, Landmesser, U, Leischik, R, Mitrovic, V, Moehlenkamp, S, Monti, J, Mueller Ehmsen, J, Oezcelik, C, Philipp, S, Pieske, B, Roehnisch, Ju, Schunkert, H, Schwinger, R, Wachter, R, Willenbrock, R, Winkelmann, Br, Winkler, R, Wollert, Kc, Adamopoulos, S, Kalikazaros, I, Karavidas, A, Karvounis, H, Kremastinos, D, Manolis, Aj, Nanas, I, Sotirellos, K, Vasiliadis, K, Zaboulis, C, Lee, S, Yu, Cm, Czibok, C, Édes, I, Forster, T, Preda, I, Simon, K, Takacs, J, Zámolyi, K, Bhagavatula, K, Chockalingam, K, Desai, N, Iyengar, S, Jayadev, Sm, Mullasari, A, Sathe, Sp, Sinha, N, Vadagenalli, P, Wander, G, Mcdonald, Km, Nash, P, Vaughan, Cj, Agostoni, P, Ambrosio, Gb, Bittolo Bon, G, Boffa, G, Cacciavillani, L, Capucci, A, Chiariello, M, Cirrincione, V, Gensini, Gf, Masini, F, Modena, Mg, Monte, I, PERRONE FILARDI, Pasquale, Rosano, Gm, Senni, M, Sinagra, G, Tamburino, C, Terrosu, P, Villani, Gq, Volterrani, M, Chae, Sc, Ha, Cw, Ha, Jw, Shin, Jh, Bayram Llamas, E, Calvillo, Jc, Cruz Diaz, A, Delgado Leal, L, Estrada Gomez, Mm, Kosturakis, D, Petersen Aranguren, F, Velasco Sanchez, Rg, Daniëls, Mc, Dirkali, A, Dunselman, Ph, de Kluiver, Ep, Kragten, Ja, Lok, Dj, Maas, Ah, Michels, Hr, Nicastia, Dm, Stoel, I, de Swart, Jb, Thijssen, Hj, Van Kempen, Lh, Voors, Aa, Willems, Ff, Dluzniewski, M, Gaciong, Z, Kawecka Jaszcz, K, Jozwa, R, Korewicki, J, Krzeminska Pakula, M, Kurowski, M, Ogorek, M, Pempera, M, Rynkiewicz, A, Ujda, M, Wierzchowiecki, M, Abreu, Á, Andrade, A, Carrageta, M, Fonseca, C, Franco, F, Gil, Vm, Lousada, N, Mendonca, C, Moreira, I, Padua, Fp, Providência, L, Cardoso, Jc, Trabulo, M, Aroutyunov, Gp, Gindin, K, Karpov, Yb, Kostenko, Va, Nikitin, Yp, Obraztsova, Gi, Shilkina, Np, Shlyakhto, Ev, Skvortsov, A, Ding, Zp, Yeo, Dp, Ambrovicova, V, Gaspar, L, Goncalvesova, E, Kycina, P, Litvinova, J, Mikes, Z, Murin, J, Poliacik, P, Uhliar, R, Lloyd, Ea, Marx, D, Naidoo, Dp, Prozesky, Hw, Sliwa Hahnle, K, Theron, H, Anguita, M, De Teresa, E, Galve, E, Juanatey, Jr, Orbe, Pm, Vida, M, Ahremark, U, Andersson, B, Axelsson, U, Berglund, S, Boman, K, Dahlstrom, U, Fu, M, Holm Orndahl, L, Johansson, A, Lindgren, M, Nemeczek, C, Prantare, H, Roussine, V, Stehn, G, Stenberg, A, Vasko, P, Bazylevych, A, Dyadyk, Oi, Dzyak, Gv, Girina, Om, Ignatenko, Ga, Kononenko, Lg, Kubyshkin, Vf, Kuryata, Ov, Parkhomenko, An, Perepelytsya, Mv, Pertseva, To, Popik, G, Rishko, Mv, Sakharchuk, Ii, Tseluyko, Vi, Tykhonova, Sa, Vizir, V, Voronkov, Lg, Al Khaja, N, Almahmeed, Wa, Bazargani, N, Adgey, Aa, Al Mohammad, A, Banerjee, P, Barlow, M, Bridges, Ab, Brooks, N, Connolly, Ec, Denvir, Ma, Egdell, Rm, Kardos, A, Keeling, Pj, Khokhar, Aa, Senior, R, Williams, Sg, Anand, I, Anderson, Jl, Berk, Mr, Bertolet, Bd, Bisognano, Jd, Blonder, Rd, Breburda, C, Canaday, Db, Capodilupo, Rc, Choiunard, Md, Colucci, W, Dahiya, Rj, Dunlap, Sh, Essandoh, Lk, Flores, Ar, Henderson, Da, Herzog WR, Jr, Katz, Rj, Kosinski, Ej, Labin, In, Lally, Fl, Lash, Ja, McGrew FA, 3rd, Mohiuddin, Sm, Moraes, D, Murali, Sc, Nallasivan, M, Philbin, E, Prabhu, S, Primack, D, Ramani, R, Rawitscher, D, Sangrigoli, R, Schamalfuss, Cm, Stoletniy, L, Strong, Mh, Thadani, U, Treasure CB, 2nd, Vicari, Rm, Vogel, Cd, Wlsh, Mn, Wencker, D, Wilson, Sa, Winkel, E, Wiseman, Ah, Zoiopoulos, Ly, Mancebo, Jr, Mendoza, I, and Waich, S. T.

Published
2011

13. Agenzia sanitaria e sociale regionale. Servizio Sanitario Regionale Emilia-Romagna. G-PAC. Guida formativa per la PREVENZIONE SECONDARIA degli accidenti cerebrovascolari

Author

Ferro S, Petetti F, Terri F, Biocca M, Polizzi BM, Basaglia N, Cerrato P, CAvazzuti M, D'Argenio P, Di Pasquale G, Fontana S, Gensini GF, Guidetti D, Lanza G, Liberati A, Malferrari G, MArcello N, Pedrini N, Provinciali L, Rasi S, Ricci S, Sacchetti ML, Sacquegna T, Sterzi R, Tola MR, Tortorici G, Zampolini M, Zaninelli A., BORGHI, CLAUDIO, Ferro S, Petetti F, Terri F, Biocca M, Polizzi BM, Basaglia N, Borghi C, Cerrato P, CAvazzuti M, D'Argenio P, Di Pasquale G, Fontana S, Gensini GF, Guidetti D, Lanza G, Liberati A, Malferrari G, MArcello N, Pedrini N, Provinciali L, Rasi S, Ricci S, Sacchetti ML, Sacquegna T, Sterzi R, Tola MR, Tortorici G, Zampolini M, and Zaninelli A.

Abstract

progettare e valutare la fattibilità di un piano di formazione per la prevenzione secondaria degli accidenti cerebrovascolari.

Published
2009

14. Trattamento riabilitativo e continuità dell'assistenza

Author

Gensini, GF, Zaninelli, A, Provinciali, L, Bottini, G, Cappa, S, Ceravolo, M, Cerri, C, Coccia, M, Consolmagno, P, Corea, F, Di Bari, M, Flosi, C, Frediani, R, Gandolfi, M, Masotti, G, Mezzarobba, S, Paolucci, S, Pasotti, F, Salina, M, Smania, N, Stramba-Badiale, M, Zampolini, M, Ceravolo, MG, Cerri, CG, Zaninelli, A., Gensini, GF, Zaninelli, A, Provinciali, L, Bottini, G, Cappa, S, Ceravolo, M, Cerri, C, Coccia, M, Consolmagno, P, Corea, F, Di Bari, M, Flosi, C, Frediani, R, Gandolfi, M, Masotti, G, Mezzarobba, S, Paolucci, S, Pasotti, F, Salina, M, Smania, N, Stramba-Badiale, M, Zampolini, M, Ceravolo, MG, Cerri, CG, and Zaninelli, A.

Published
2016

16. Nutritional recommendations for the prevention of ischemic stroke

Author

Rotilio G, Berni Canani R, Barba G, Branca F, Cairella G, Dilaghi B, Fieschi C, Garbagnati F, Gentile MG, Gensini GF, Gualtieri A, Inzitari D, La Massa M, Luisi ML, Mancia G, Marcelli M, Masini ML, Mastrilli F, Paolucci S, Pratesi L, Sacchetti ML, Salvia A, Scalfi L, Scognamiglio U, Siani A, Strazzullo P, Italian Working Group on Nutrition, Stroke P.r.e.v.e.n.t.i.o.n., RUBBA, PAOLO OSVALDO FEDERICO, Rotilio, G, Berni Canani, R, Barba, G, Branca, F, Cairella, G, Dilaghi, B, Fieschi, C, Garbagnati, F, Gentile, Mg, Gensini, Gf, Gualtieri, A, Inzitari, D, La Massa, M, Luisi, Ml, Mancia, G, Marcelli, M, Masini, Ml, Mastrilli, F, Paolucci, S, Pratesi, L, Rubba, PAOLO OSVALDO FEDERICO, Sacchetti, Ml, Salvia, A, Scalfi, L, Scognamiglio, U, Siani, A, Strazzullo, P, Italian Working Group on, Nutrition, and Stroke, P. r. e. v. e. n. t. i. o. n.

Subjects
Surgical critical care, medicine.medical_specialty, Nutrition and Dietetics, food, ischemic stroke, nutrients, nutrition, prevention, recommendations, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Brain Ischemia, Nutrition Policy, Stroke, Italy, Risk Factors, Stroke prevention, Family medicine, Ischemic stroke, Practice Guidelines as Topic, medicine, Physical therapy, Humans, Nutritional Physiological Phenomena, Cardiology and Cardiovascular Medicine, Nutrition
Abstract

The Italian Working Group on Nutrition and Stroke Prevention G. Rotilio 1,2, R. Berni Canani 2, G. Barba 3, E Branca 4,17, G. Cairella 5,17, B. Dilaghi 6, C. Fieschi 7, E Garbagnati 2, M.G. Gentile 8,17, G.E Gensini 6, A. Gualtieri 7, D. Inzitari 9, M. La Massa 9, M.L.E. Luisi 1°, 17, G. Mancia n, M. Marcelli 12,17, M.L. Masini 13, E Mastrilli 14, S. Paolucci 14 , L. Pratesi 14, P. Rubba 15 , M.L. Sacchetti 7 , A. Salvia 14 , L. Scalfi 16,17, U. Scognamiglio 2, A. Siani 3,17, p. Strazzul1015 1Department of Biology, Tor Vergata University of Rome, 2Centre of Research on Nutrition and Rehabilitation (CeSAR), IRCCS Fondazione S. Lucia, Rome, 3Institute of Food Sciences, CNR, Avellino, 4National Institute for Research on Food and Nutrition (1NRAN), Rome, 5Department of Prevention Nutrition Unit ASL RMB, Rome, 6Department of Medical and Surgical Critical Care, Section of Clinical Medicine and Cardiology, A.O.U. Careggi, Florence, 7Department of Neurology, University "La Sapienza", Rome, 8Clincal Nutrition Unit, Niguarda Hospital, Milan, 9Department of Neurological and Psychiatric Sciences, University of Florence, 1°Don Carlo Gnocchi Foundation, IRCCS Florence, 11Department of Clinical Medicine, Prevention and Applied Biotechnologies, University of Milano-Bicocca, Monza, 12Clinical Nutrition Unit A.O.S. Giovanni Addolorata, Rome, 13Dietetic Unit A.O.U. Careggi, Florence, 14IRCCS Fondazione S. Lucia, Rome, 15Department of Clinical and Experimental Medicine, Federico 1I University of Naples, 16Department of Food Science, Federico II University of Naples, and 17Italian Society of Human Nutrition (SINU)

Published
2004
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17. EFFECTS OF DEFIBROTIDE IN PATIENTS WITH CHRONIC DEEP INSUFFICIENCY. THE PROVEDIS STUDY

Author

COCCHERI S, ANDREOZZI G. M, DADDATO M, GENSINI GF, NOVO, Salvatore, COCCHERI S, ANDREOZZI G M, DADDATO M, GENSINI GF, and NOVO S

Subjects
Male, fibrinolytic agent, Ultrasonography, Doppler, Middle Aged, Bandages, venous insufficiency, therapy, Polydeoxyribonucleotides, Double-Blind Method, Fibrinolytic Agents, Chronic Disease, Humans, Female, Vascular Diseases, venous thrombosis, Ankle, Aged
Abstract

Aim. In the ­present study the ­effect of defi­bro­tide, an anti­throm­bot­ic and prof­i­brin­o­lyt­ic agent, was inves­ti­gat­ed in ­patients with chron­ic ­venous insuf­fi­cien­cy (CVI) due to deep vein obstruc­tion and/or ­reflux (chron­ic deep vein insuf­fi­cien­cy, CDVI). Meth­ods. The study was a mul­ti­cen­ter, ran­dom­ized, dou­ble blind pla­ce­bo con­trolled trial in which only ­patients with CDVI con­firmed by ultra­sound were ­enrolled. All ­patients were treat­ed with ade­quate elas­tic com­pres­sion and ran­dom­ized to ­receive ­either oral defi­bro­tide (800 mg/die) or match­ing pla­ce­bo for 1 year. ­Patients with ­active or pre­vi­ous leg ulcer were exclud­ed. ­Results. A total of 288 ­patients were ran­dom­ized and 159 com­plet­ed the study. At base­line ultra­sound inves­ti­ga­tion, obstruc­tive chang­es were found in 2/3 of all ­patients thus ascer­tain­ing a post-throm­bot­ic syn­drome (PTS). The pri­mary end­point, ankle cir­cum­pher­ence, was sig­nif­i­cant­ly ­reduced under defi­bro­tide from day 120 through­out 360. ­Scores for pain and edema were ­improved. The num­ber of epi­sodes of super­fi­cial throm­boph­le­bitis and deep vein throm­bo­sis was sig­nif­i­cant­ly lower under defi­bro­tide (n=2) than under pla­ce­bo (n=10). The major­ity of these ­events ­occurred in the sub­set of ­patients with doc­u­ment­ed PTS. Con­clu­sion. Treat­ment with defibro­tide in addi­tion to elas­tic com­pres­sion in ­patients with objec­tive­ly ­assessed CDVI, most­ly due to PTS, result­ed in clin­i­cal ben­e­fits and pre­vent­ed throm­bot­ic com­pli­ca­tions harm­ful to the limb conditions

Published
2004

19. Open Educational Resources in Medicina

Author

Masoni, M, Guelfi, Mr, and Gensini, Gf

Subjects
Open Educational Resources, Open CourseWare, Massive Online Open Course, Creative Commons License, ComputingMilieux_COMPUTERSANDEDUCATION
Published
2014

20. Nutrizione e Ictus

Author

ROTILIO G, BERNI CANANI, ROBERTO, BRANCA F, CAIRELLA G, FIESCHI C, GARBAGNATI F, GENTILE MG, GENSINI GF, GUALTIERI A, LUISI MLE, MARCELLI M, MASINI ML, MASTRILLI F, PAOLUCCI S, PRATESI L, SACCHETTI ML, SALVIA A, SCALFI, LUCA, SCOGNAMIGLIO U, STRAZZULLO, PASQUALE, GENSINI F CCORDINATORE, Rotilio, G, BERNI CANANI, Roberto, Branca, F, Cairella, G, Fieschi, C, Garbagnati, F, Gentile, Mg, Gensini, Gf, Gualtieri, A, Luisi, Mle, Marcelli, M, Masini, Ml, Mastrilli, F, Paolucci, S, Pratesi, L, Sacchetti, Ml, Salvia, A, Scalfi, Luca, Scognamiglio, U, and Strazzullo, Pasquale

Published
2003

22. SonoVue renal wash-in/wash-out curve analysis detects cortical perfusion defects in patients with significant renal artery stenosis and renin activation

Author

Scastellani, S.Castellani, Fd'Abate, F.D'Abate, Gla, G.La Cava, Colianti, C.Olianti, Acquafresca, M., Aungar, A.Ungar, Imenchi, I.Menchi, and Gensini, Gf

Subjects
Contrast agent-other, urogenital system, Contrast agent-oral, Contrast Media - Without Subtopic, kidney perfusion, renal artery stenosis, urologic and male genital diseases, Contrast agent-intravenous, Contrast agents
Abstract

Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: Doppler testing is a well standardized method for an accurate diagnosis of significant Renal Artery Stenoses (RAS); little experimental data is available on the ability of US techniques inevaluating side differences in the renal kinetics ofa...

Published
2010
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35. Effects of defibrotide in patients with chronic deep insufficiency - The PROVEDIS study

Author

Coccheri, S, Andreozzi, Gm, D'Addato, M, Gensini, Gf, Garibaldi, O, Signorelli, S, Di Pino, L, Belardi, P, Grana, A, Belcaro, G, Incandela, G, Laurora, G, Biasi, Gm, Bellucci, M, Careggi, P, Innocenti, Aa, Frosini, P, Borromeo, Osc, Bonfardeci, G, Cimminiello, C, Arpaia, G, Bracale, Cg, Selvetella, L, De Rosa, V, Martini, L, Coppi, G, Marra, F, Stella, A, Mirelli, M, Donini, I, Viaggi, R, Cataldi, A, Ferrero, S, Dorigo, B, Cameli, A, Licata, G, Pinto, A, Mannarino, Elmo, Pasqualini, Leonella, Vaudo, Gaetano, Marchitelli, E, Pepe, R, Novo, S, Tantillo, R, Nuzzaci, G, Righi, D, Pitzus, F, Manconi, E, Ponzio, F, Rizzon, P, Ciccone, M, Campagna, Mg, Scondotto, G, Aloisi, D, Valitutti, P, and Fornino, G.

Published
2004

37. Virtual Coronary Angioscopy - EBCT vs MDCT

Author

van Ooijen, P, Dorgelo, J, Oudkerk, M, Lewis, BS, Halon, DA, Flugelman, MY, and Gensini, GF

Subjects
BEAM COMPUTED-TOMOGRAPHY, genetic structures, eye diseases
Abstract

Introduction of new acquisition techniques like Electron Beam Computed Tomography (EBCT) and Multi Detector Computed Tomography (MDCT) have enabled the visualization of the coronary artery tree using non-invasive methods. Because of the use of these new techniques, new possibilities have emerged in the visualization of the coronary artery tree. Three-dimensional visualization techniques used to visualize the three-dimensional data space acquired cannot only be used to display the heart and coronary arteries from the outside, but also from the inside. In this article we demonstrate the feasibility of this inter-arterial visualization, also known as Virtual Coronary Angioscopy (VCA).

Published
2003

38. Multi-dimensional visualization of coronary aberrancies using multi detector computed tomography

Author

van Ooijen, P, Dorgelo, J, Tukker, W, Willemsen, H, Oudkerk, M, Lewis, BS, Halon, DA, Flugelman, MY, and Gensini, GF

Abstract

The purpose of this study was to evaluate the usefulness of three and four dimensional visualization of multi detector computed tomography datasets for the evaluation of coronary aberrancies. Multi detector computed tomography (MDCT) datasets were obtained in thirteen patients following a standard protocol on a Sensation16 Cardiac (Siemens Medical Systems, Erlangen, Germany). The aberrant coronary arteries were clearly visualized in in three- and four dimensional volume rendering with a high average diagnostic image quality. Results of MDCT combined with four dimensional visualization using volume rendering techniques are very promising. All aberrancies were clearly visualized and the four dimensional aspect could give insight in possible dangerous routes of the aberrant coronary arteries between the aorta and the pulmonary artery.

Published
2003

40. Seasonal blood pressure changes: an independent relationship with temperature and daylight hours

Author

Modesti, P, Morabito, M, Massetti, L, Rapi, S, Orlandini, S, Mancia, G, Gensini, G, Parati, G, Modesti, PA, Gensini, GF, MANCIA, GIUSEPPE, PARATI, GIANFRANCO, Modesti, P, Morabito, M, Massetti, L, Rapi, S, Orlandini, S, Mancia, G, Gensini, G, Parati, G, Modesti, PA, Gensini, GF, MANCIA, GIUSEPPE, and PARATI, GIANFRANCO

Abstract

Seasonal blood pressure (BP) changes have been found to be related to either outdoor or indoor temperature. No information regarding the independent effects of temperature measured proximally to the patient, the personal-level environmental temperature (PET), is available. Inclusion of daylight hours in multivariate analysis might allow exploring the independent interaction of BP with seasonality. To investigate whether ambulatory BP monitoring is affected by PET or by seasonality, 1897 patients referred to our hypertension units underwent ambulatory BP monitoring with a battery-powered temperature data logger fitted to the carrying pouch of the monitor. Predictors of 24-hour daytime and nighttime BP and of morning BP surge were investigated with a multivariate stepwise regression model, including age, sex, body mass index, antihypertensive treatment, office BP, ambulatory heart rate, PET, relative humidity, atmospheric pressure, and daylight hours as independent variables. At adjusted regression analysis, daytime systolic BP was negatively related to PET (−0.14; 95% confidence interval, −0.25 to −0.02); nighttime BP was positively related to daylight hours (0.63; 0.37–0.90); and morning BP surge was negatively related to daylight hours (−0.54; −0.87 to −0.21). These results provide new evidence that PET and seasonality (daylight hours) are 2 independent predictors of ambulatory BP monitoring.

Published
2013

41. Fibrillin-1 (FBN1) gene frameshift mutations in Marfan patients: genotype-phenotype correlation

Author

Pepe, G, Giusti, B, Evangelisti, L, Porciani, Mc, Brunelli, T, Giurlani, L, Attanasio, M, Fattori, R, Bagni, C, Comeglio, P, Abbate, R, and Gensini, Gf

Subjects
mechanisms, disease, Aortic aneurysm, Settore BIO/13, microfibrils, chain, Fibrilin-1 gene, Frameshift mutations, Marfan syndrome, MASS, gel-electrophoresis, dna, sequence, mass, fibrillin-1 gene, marfan syndrome, aortic aneurysm, frameshift mutations, mutagenesis, domains
Abstract

Marfan syndrome (MFS) is a multisystemic disease associated with mutations in the fibrillin-1 gene. Most of the reported mutations are missense substitutions mainly affecting the epidermal growth factor (EGF)-like protein domain structure and the calcium-binding (cb) site. The aim of our study was to investigate the correlation between fibrillin-1 frameshift mutations and the clinical phenotype in patients affected by MFS. In 48 out of 66 Marfan patients a pathogenetic mutation was found. We detected novel mutations causing premature termination codon in exons 19, 37, 40 and 41 of four Italian patients. The first mutation in exon 19 (cbEGF #8 domain) results in a clinical phenotype involving mainly the skeletal and cardiovascular systems. Interestingly, we noticed that, while mutations in exons 37 and 41 (eight cysteine domains #4 and #5) are milder, the mutation in exon 40 (cbEGF #24 domain) is more severe and causes major cardiovascular involvement with thoracic and abdominal aortic aneurysms. It is noteworthy that the degree of the severity in the phenotype of one of our patients and another from the literature carrying a mutation in exon 41 could be explained with alterations in mRNA expression. ispartof: Clinical genetics vol:59 issue:6 pages:444-450 ispartof: location:Denmark status: published

Published
2001
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42. Type 2 diabetes mellitus is associated with faster degeneration of bioprosthetic valve: results from a propensity score-matched Italian multicenter study.

Author

Lorusso, R, Gelsomino, S, Lucà, F, De Cicco, G, Billè, G, Carella, R, Villa, E, Troise, G, Viganò, M, Banfi, C, Gazzaruso, C, Gagliardotto, P, Menicanti, L, Formica, F, Paolini, G, Benussi, S, Alfieri, O, Pastore, M, Ferrarese, S, Mariscalco, G, Di Credico, G, Leva, C, Russo, C, Cannata, A, Trevisan, R, Livi, U, Scrofani, R, Antona, C, Sala, A, Gensini, G, Maessen, J, Giustina, A, FERRARESE, SAMUELE, Gensini, GF, Giustina, A., FORMICA, FRANCESCO, PAOLINI, GIOVANNI, Lorusso, R, Gelsomino, S, Lucà, F, De Cicco, G, Billè, G, Carella, R, Villa, E, Troise, G, Viganò, M, Banfi, C, Gazzaruso, C, Gagliardotto, P, Menicanti, L, Formica, F, Paolini, G, Benussi, S, Alfieri, O, Pastore, M, Ferrarese, S, Mariscalco, G, Di Credico, G, Leva, C, Russo, C, Cannata, A, Trevisan, R, Livi, U, Scrofani, R, Antona, C, Sala, A, Gensini, G, Maessen, J, Giustina, A, FERRARESE, SAMUELE, Gensini, GF, Giustina, A., FORMICA, FRANCESCO, and PAOLINI, GIOVANNI

Abstract

The present study was aimed at determining the impact of type 2 diabetes mellitus (DM) on postoperative bioprosthetic structural valve degeneration. Twelve Italian centers participated in the study. Patient data refer to bioprosthetic implantations performed from November 1988 to December 2009, which resulted in 6184 patients (mean age 71.3±5.4 years, 60.1% male) being enrolled. Of these patients, 1731 (27.9%) had type 2 DM. The propensity score-matching algorithm successfully matched 1113 patients with type 2 DM with the same number of no-DM patients. The postmatching standard differences were less than 0.1 for each of the covariates, and 64.2% of DM patients were matched. The early (30 days) mortality rate was 7.8% (n=87) versus 2.9% (n=33) in patients with or without type 2 DM (P<0.001), respectively. Seven-year freedom from valve deterioration was significantly lower in patients with DM (73.2% [95% confidence interval, 61.6-85.5] versus 95.4% [95% confidence interval, 83.9-100], P<0.001). In Cox regression models with robust SEs that accounted for the clustering of matched pairs, DM was the strongest predictor of structural valve degeneration (hazard ratio 2.39 [95% confidence interval 2.28-3.52]). When we allowed for interaction between type 2 DM and other key risk factors, DM remained a significant predictor beyond any potentially associated variable. Patients with type 2 DM undergoing bioprosthetic valve implantation are at high risk of early and long-term mortality, as well as of structural valve degeneration

Published
2012

43. VIHTA 2: valore in Health Technology Assessment. Un progetto di formazione e condivisione

Author

Gensini, Gf, Terzi, A, Zamparelli, B, Palombella, O, Ricciardi, Walter, Kheiraoui, F, Tarricone, R, Agostinelli, A, Tringali, M, Patarnello, F, Cadeddu, Chiara, De Belvis, Ag, De Waure, Chiara, Pitrelli, A, Sabetta, T, Specchia, Maria Lucia, Ricciardi, Gualtiero (ORCID:0000-0002-5655-688X), Cadeddu, Chiara (ORCID:0000-0003-0149-1078), De Waure, Chiara (ORCID:0000-0002-4346-1494), Specchia, Maria Lucia (ORCID:0000-0002-3859-4591), Gensini, Gf, Terzi, A, Zamparelli, B, Palombella, O, Ricciardi, Walter, Kheiraoui, F, Tarricone, R, Agostinelli, A, Tringali, M, Patarnello, F, Cadeddu, Chiara, De Belvis, Ag, De Waure, Chiara, Pitrelli, A, Sabetta, T, Specchia, Maria Lucia, Ricciardi, Gualtiero (ORCID:0000-0002-5655-688X), Cadeddu, Chiara (ORCID:0000-0003-0149-1078), De Waure, Chiara (ORCID:0000-0002-4346-1494), and Specchia, Maria Lucia (ORCID:0000-0002-3859-4591)

Published
2012

45. The Italian Guidelines for stroke prevention : The Stroke Prevention and Educational Awareness Diffusion (SPREAD) Collaboration

Author

Coordinator: GF Gensini Methodology, Introduction, Definitions: AA Bignamini, Cesana, Gc, Sega Epidemiology, R., Inzitari, Diagnostic work up: D., Ciccone, A., Carlucci, G., Gandolfo, C., Grezzana, L., Menegolli, G., Ottonello, G., Salvolini, U., Carlucci, Review group: G., Consoli, D., Spairani, C., Picicci, Am, Mantovani Primary prevention, F., Sterzi, Risk factors: R., Abbate, R., Ceriello, A., Leonetti, G., Neri, G., Passamonti, M., Proto, C., Rostagno, C., Abbate, Review group: R., De Falco, F., Gullo, A., Ratti, E., Toso, F. Negri Secondary prevention: V., Coccheri, S., Di Pasquale, G., Filippi, A., Gensini, Gf, Mariani, M., Mariotti, R., Odero, A., Pirrelli, S., Simone, I., Simone, Review group: I., Grasso, E., Amatori, B., Bussotti, A., Lanza, O. Voyat Surgical therapy: G., Bonalumi, F., Costantini, A., Pratesi, C., Ricci, S., Ciccone, Review group: A., Bella, Rita, Zappella, Eg, MG Spagnolo Care maintenance, Rehabilitation, Zaninelli, Prevention of complications: A., Cerri, C., Messina, E., Masotti, G., Provinciali, L., Cerri, Review group: C., Pari, B., Borra, E., Lbm, Anelli, Montis, Pf, Rossi New perspectives for prevention, G., Prisco, multidisciplinary research: D., Arbustini, E., Mugelli Bioethics: CA Defanti, A., Bignamini, Aa, D’Alessandro, G., Rota Vender Economy, L., Toso, Resource allocation: S. Capri Task force: V., Bignamini, A., Sterzi, R., Carlucci, A. Zaninelli Editorial board: G., Inzitari, D., and Prisco, D.

Published
2000

46. Index measured at an intermediate altitude to predict impending acute mountain sickness

Author

Modesti, P, Rapi, S, Paniccia, R, Bilo, G, Revera, M, Agostoni, P, Piperno, A, Cambi, G, Rogolino, A, Biggeri, A, Mancia, G, Gensini, G, Abbate, R, Parati, G, BILO, GRZEGORZ, Cambi, GE, Gensini, GF, PIPERNO, ALBERTO, MANCIA, GIUSEPPE, PARATI, GIANFRANCO, Modesti, P, Rapi, S, Paniccia, R, Bilo, G, Revera, M, Agostoni, P, Piperno, A, Cambi, G, Rogolino, A, Biggeri, A, Mancia, G, Gensini, G, Abbate, R, Parati, G, BILO, GRZEGORZ, Cambi, GE, Gensini, GF, PIPERNO, ALBERTO, MANCIA, GIUSEPPE, and PARATI, GIANFRANCO

Abstract

Purpose: Acute mountain sickness (AMS) is a neurological disorder that may be unpredictably experienced by subjects ascending at a high altitude. The aim of the present study was to develop a predictive index, measured at an intermediate altitude, to predict the onset of AMS at a higher altitude. Methods: In the first part, 47 subjects were investigated and blood withdrawals were performed before ascent, at an intermediate altitude (3440 m), and after acute and chronic exposition to high altitude (Mount Everest Base Camp, 5400 m (MEBC1 and MEBC2)). Parameters independently associated to the Lake Louise scoring (LLS) system, including the self-reported and the clinical sections, and coefficients estimated from the model obtained through stepwise regression analysis were used to create a predictive index. The possibility of the index, measured after an overnight stay at intermediate altitude (Gnifetti hut, 3647 m), to predict AMS (defined as headache and LLS≥ 4) at final altitude (Capanna Margherita, 4559 m), was then investigated in a prospective study performed on 44 subjects in the Italian Alps. Results: During the expedition to MEBC, oxygen saturation, hematocrit, day of expedition, and maximum velocity of clot formation were selected as independently associated with LLS and were included in the predictive index. In the Italian Alps, subjects with a predictive index value≥ 5.92 at an intermediate altitude had an odds ratio of 8.1 (95% confidence limits = 1.7-38.6, sensitivity = 85%, specificity = 59%) for developing AMS within 48 h of reaching high altitude. Conclusion: In conclusion, a predictive index combining clinical and hematological parameters measured at an intermediate step on the way to the top may provide information on impending AMS. © 2011 by the American College of Sports Medicine.

Published
2011

47. Complicanze psico-cognitive dell'ictus

Author

Gensini, GF, Zaninelli, A, Micieli, G, Bottini, G, Cerri, C, Consoli, D, Cavallini, M, Del Sette, M, Di Bari, M, Di Piero, V, Gandolfo, C, Guidetti, D, Pantoni, L, Paolucci, S, Racagni, G, Sgoifo, A, Torta, R, Toso, V, Zarcone, D, Cavallini, MC, Zarcone, D., CERRI, CESARE GIUSEPPE, Gensini, GF, Zaninelli, A, Micieli, G, Bottini, G, Cerri, C, Consoli, D, Cavallini, M, Del Sette, M, Di Bari, M, Di Piero, V, Gandolfo, C, Guidetti, D, Pantoni, L, Paolucci, S, Racagni, G, Sgoifo, A, Torta, R, Toso, V, Zarcone, D, Cavallini, MC, Zarcone, D., and CERRI, CESARE GIUSEPPE

Published
2010

48. Psychological predictors of the antihypertensive effects of music-guided slow breathing

Author

Modesti, P, Ferrari, A, Bazzini, C, Costanzo, G, Simonetti, I, Taddei, S, Biggeri, A, Parati, G, Gensini, G, Sirigatti, S, Modesti, PA, PARATI, GIANFRANCO, Gensini, GF, Sirigatti, S., Modesti, P, Ferrari, A, Bazzini, C, Costanzo, G, Simonetti, I, Taddei, S, Biggeri, A, Parati, G, Gensini, G, Sirigatti, S, Modesti, PA, PARATI, GIANFRANCO, Gensini, GF, and Sirigatti, S.

Abstract

Background: The possibility that daily sessions of music-guided slow breathing may reduce 24-h ambulatory blood pressure (ABP), and predictors of efficacy were explored in a randomized, placebo-controlled trial with parallel design. Methods: Age-matched and sex-matched hypertensive patients were randomized to music-guided slow breathing exercises (4-6 breaths/min; 1: 2 ratio of inspiration: expiration duration) (Intervention; n = 29) or to control groups who were thought to relax while either listening to slow music (Control-M; n = 26) or reading a book (Control-R; n = 31). At baseline and at follow-up visits (1 week and 1, 3 and 6 months), ABP monitoring was performed. Results: At mixed model analysis, intervention was associated with a significant reduction of 24-h (P = 0.001) and night-time (0100-0600 h) (P < 0.0001) systolic ABP. The average reduction of systolic 24-h ABP at 6 months was 4.6 mmHg [confidence limits at 95% 1.93-7.35] and 4.1 mmHg (95% confidence limits 1.59-6.67) vs. Control-M and Control-R groups, respectively, (P < 0.001 for both). Antihypertensive treatment was selected as negative predictor of BP reduction at multivariate stepwise analysis. When antihypertensive treatment was inserted as covariate in a generalized linear model, psychological subscales assessed at baseline by the Mental Health Inventory questionnaire were found to affect systolic blood pressure reduction at 6-month follow-up (general positive affect P < 0.001; emotional ties, P < 0.001; loss of behavioral control, P = 0.035). In particular, a level of general positive affect higher than the 75th percentiles was found to be significantly associated with low treatment efficacy (odds ratio 0.09; 95% confidence limits 0.01-0.93). Conclusion: Daily sessions of voluntary music-guided slow breathing significantly reduce 24-h systolic ABP, and psychological predictors of efficacy can be identified. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Published
2010

49. Office and 24-h ambulatory blood pressure control by treatment in general practice: The 'Monitoraggio della pressione ARteriosa nella medicina TErritoriale' study

Author

Zaninelli, A, Parati, G, Cricelli, C, Bignamini, A, Modesti, P, Pamparana, F, Bilo, G, Mancia, G, Gensini, G, Bignamini, AA, Modesti, PA, Gensini, GF, Zaninelli, A, Parati, G, Cricelli, C, Bignamini, A, Modesti, P, Pamparana, F, Bilo, G, Mancia, G, Gensini, G, Bignamini, AA, Modesti, PA, and Gensini, GF

Abstract

Background Guidelines recommend that blood pressure (BP) should be lowered in hypertensive patients to prevent cardiovascular accidents. Management of antihypertensive treatment by general practitioners is usually based on office measurements, which may not allow an assessment of BP control over 24 h, which requires ambulatory BP monitoring (ABPM) to be implemented. This is rarely done in general practice, and limited information is available on the consistency between the evaluations of the response to treatment provided by office measurement and by ABPM in this setting.Aim To assess concordance between office BP measurements and ABPM-based estimates of hypertension control in a general practice setting.Design of study Prospective, comparative between techniques.Setting General practice.Methods Seventy-eight general practices, representative of all Italian regions, participated in this study by recruiting sequential hypertensive adults on stabilized treatment, who were subdivided into even groups with office BP, respectively, controlled or noncontrolled by treatment. In each individual, ABPM was applied by the general practitioner after appropriate training, and 24-h ABP values were defined as controlled or not according to current guidelines. Concordance between office and ABPM evaluation of BP control was assessed with kappa statistics. Positive and negative predictive values of office measurement versus ABPM were estimated.Results Between July 2005 and November 2006, 190 general practitioners recruited 2059 hypertensive patients based on office BP measurements; in 1728 patients, a 24-h ABPM was performed, yielding 1524 recordings considered as valid for further analysis. The agreement between the assessment of BP control by office measurement and by ABPM was poor (kappa=0.120), with office measurements showing a satisfactory positive predictive value (0.842) and a poor negative predictive value (0.278); the situation was worse in patients with three or more amon

Published
2010

50. Il ragionamento probabilistico nella diagnosi medica: sensibilità e insensibilità alle informazioni.

Author

Giaretta, P, Moretto, A, Gensini, GF, Trabucchi, M, Cherubini, P, Russo, S, Rusconi, P, D'Addario, M, Boccuti, I, CHERUBINI, PAOLO, RUSCONI, PATRICE PIERCARLO, D'ADDARIO, MARCO, Boccuti, I., Giaretta, P, Moretto, A, Gensini, GF, Trabucchi, M, Cherubini, P, Russo, S, Rusconi, P, D'Addario, M, Boccuti, I, CHERUBINI, PAOLO, RUSCONI, PATRICE PIERCARLO, D'ADDARIO, MARCO, and Boccuti, I.

Abstract

Il giudizio diagnostico umano su problemi astratti sembra ricalcare, in parte, quanto previsto dai modelli formali della revisione delle conoscenze probabilistiche: alcuni esperimenti mostrano come anche individui non esperti siano in grado di accorgersi che un determinato insieme di indizi aumenta la probabilità di una determinata ipotesi e questa capacità appare tanto più evidente quanto più grande è il contenuto d’informazione di tali indizi. Tuttavia, l’analisi di alcuni risultati sperimentali evidenzia come i giudizi spontanei siano anche afflitti da tendenze psicologiche prive di validità formale. Ad esempio, alcune caratteristiche dei dati o delle ipotesi possono costituire dei veri e propri “indizi euristici”, cioè appigli psicologicamente salienti ma formalmente privi di alcun valore diagnostico. In compiti astratti, inoltre, gli individui non esperti tendono ad una sistematica sottostima dell’informazione disponibile, sottostimando o addirittura ignorando l’informazione veicolata dagli indizi assenti. I medici impegnati in compiti realistici si mostrano, al contrario, maggiormente sensibili all’informazione veicolata dai sintomi e sono più abili nel considerare l’importanza degli indizi assenti (come l’assenza di sintomi). Emerge, inoltre, sia per i medici sia per gli individui non esperti, la tendenza a sottostimare la forza di indizi fortemente contrari ad una diagnosi, evidenziando una tendenza alla conferma, che dovrebbe, quindi, essere tenuta in considerazione nella formazione metodologica del medico.

Published
2009

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