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Article ; Online: GLP-1 Receptor Agonists in Non-Alcoholic Fatty Liver Disease: Current Evidence and Future Perspectives.

Nevola, Riccardo / Epifani, Raffaella / Imbriani, Simona / Tortorella, Giovanni / Aprea, Concetta / Galiero, Raffaele / Rinaldi, Luca / Marfella, Raffaele / Sasso, Ferdinando Carlo

International journal of molecular sciences

2023 Volume 24, Issue 2

Abstract: To date, non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease, affecting up to 70% of patients with diabetes. Currently, there are no specific drugs available for its treatment. Beyond their anti-hyperglycemic effect and the ... ...

Abstract	To date, non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease, affecting up to 70% of patients with diabetes. Currently, there are no specific drugs available for its treatment. Beyond their anti-hyperglycemic effect and the surprising role of cardio- and nephroprotection, GLP-1 receptor agonists (GLP-1 RAs) have shown a significant impact on body weight and clinical, biochemical and histological markers of fatty liver and fibrosis in patients with NAFLD. Therefore, GLP-1 RAs could be a weapon for the treatment of both diabetes mellitus and NAFLD. The aim of this review is to summarize the evidence currently available on the role of GLP-1 RAs in the treatment of NAFLD and to hypothesize potential future scenarios.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/pathology ; Glucagon-Like Peptide 1/pharmacology ; Glucagon-Like Peptide-1 Receptor/agonists ; Glucagon-Like Peptide-1 Receptor/genetics ; Glucagon-Like Peptide-1 Receptor/metabolism ; Liver/metabolism ; Liver/pathology ; Non-alcoholic Fatty Liver Disease/drug therapy ; Non-alcoholic Fatty Liver Disease/genetics ; Non-alcoholic Fatty Liver Disease/metabolism ; Non-alcoholic Fatty Liver Disease/pathology
Chemical Substances	Glucagon-Like Peptide 1 (89750-14-1) ; Glucagon-Like Peptide-1 Receptor
Language	English
Publishing date	2023-01-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24021703
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Article ; Online: The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples.

Corrado, Bruno / Giardulli, Benedetto / Polito, Francesco / Aprea, Salvatore / Lanzano, Mariangela / Dodaro, Concetta

Geriatrics (Basel, Switzerland)

2020 Volume 5, Issue 4

Abstract: Urinary incontinence is a hygienic and psychosocial problem that often brings people to restrict their social life and to experience depression. The main aim of this study was to evaluate the impact of urinary incontinence on quality of life among ... ...

Abstract	Urinary incontinence is a hygienic and psychosocial problem that often brings people to restrict their social life and to experience depression. The main aim of this study was to evaluate the impact of urinary incontinence on quality of life among residents of the Metropolitan City of Naples, Italy, using a newly designed multidimensional questionnaire. The secondary objective was to find which variables affect the quality of life and symptom severity in these patients. To do so, a sample composed of twenty-eight patients was recruited in a multicentre cross-sectional study. Most of the participants had a mild impairment (60%) concerning social life and self-perception, especially those whose education was above the primary level (
Language	English
Publishing date	2020-11-20
Publishing country	Switzerland
Document type	Journal Article
ISSN	2308-3417
ISSN (online)	2308-3417
DOI	10.3390/geriatrics5040096
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Article ; Online: Platypnea-orthodeoxia syndrome in SARS-CoV-2 related ARDS: a case report.

Aprea, Concetta / Imbriani, Simona / Cirigliano, Giovanna / Gjeloshi, Klodian / Meo, Luciana Agnese / Padula, Andrea / Ranieri, Roberta / Ricozzi, Carmen / Ruosi, Carolina / Cozzolino, Domenico / Adinolfi, Luigi Elio / Nevola, Riccardo

Acta bio-medica : Atenei Parmensis

2022 Volume 93, Issue S1, Page(s) e2022102

Abstract: Platypnea-Orthodeoxia Syndrome (POS) is an often misdiagnosed clinical condition characterized by dyspnea and hypoxia in sitting or semi-sitting position, reversible in supine position. Although POS is typically associated with intracardiac shunts, it ... ...

Abstract	Platypnea-Orthodeoxia Syndrome (POS) is an often misdiagnosed clinical condition characterized by dyspnea and hypoxia in sitting or semi-sitting position, reversible in supine position. Although POS is typically associated with intracardiac shunts, it seems frequent also in SARS-CoV-2 related Acute Respiratory Distress Syndrome (ARDS). In fact, the prevalent involvement of the lung bases due to interstitial pneumonia can determine refractory positional hypoxemia, with marked desaturation in the sitting position and regression or improvement in the supine position, configuring the clinical picture of the POS. We present a clinical case of POS associated with acute respiratory distress from SARS-CoV-2 pneumonia in which refractory hypoxia would have required support by invasive mechanical ventilation if the syndrome had not been identified.
MeSH term(s)	COVID-19/complications ; Dyspnea/diagnosis ; Dyspnea/etiology ; Humans ; Hypoxia/diagnosis ; Hypoxia/etiology ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; SARS-CoV-2
Language	English
Publishing date	2022-06-07
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v93iS1.12824
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Article ; Online: Can Metformin Exert as an Active Drug on Endothelial Dysfunction in Diabetic Subjects?

Teresa Salvatore / Pia Clara Pafundi / Raffaele Galiero / Luca Rinaldi / Alfredo Caturano / Erica Vetrano / Concetta Aprea / Gaetana Albanese / Anna Di Martino / Carmen Ricozzi / Simona Imbriani / Ferdinando Carlo Sasso

Biomedicines, Vol 9, Iss 3, p

2021 Volume 3

Abstract: Cardiovascular mortality is a major cause of death among in type 2 diabetes (T2DM). Endothelial dysfunction (ED) is a well-known important risk factor for the development of diabetes cardiovascular complications. Therefore, the prevention of diabetic ... ...

Abstract	Cardiovascular mortality is a major cause of death among in type 2 diabetes (T2DM). Endothelial dysfunction (ED) is a well-known important risk factor for the development of diabetes cardiovascular complications. Therefore, the prevention of diabetic macroangiopathies by preserving endothelial function represents a major therapeutic concern for all National Health Systems. Several complex mechanisms support ED in diabetic patients, frequently cross-talking each other: uncoupling of eNOS with impaired endothelium-dependent vascular response, increased ROS production, mitochondrial dysfunction, activation of polyol pathway, generation of advanced glycation end-products (AGEs), activation of protein kinase C (PKC), endothelial inflammation, endothelial apoptosis and senescence, and dysregulation of microRNAs (miRNAs). Metformin is a milestone in T2DM treatment. To date, according to most recent EASD/ADA guidelines, it still represents the first-choice drug in these patients. Intriguingly, several extraglycemic effects of metformin have been recently observed, among which large preclinical and clinical evidence support metformin’s efficacy against ED in T2DM. Metformin seems effective thanks to its favorable action on all the aforementioned pathophysiological ED mechanisms. AMPK pharmacological activation plays a key role, with metformin inhibiting inflammation and improving ED. Therefore, aim of this review is to assess metformin’s beneficial effects on endothelial dysfunction in T2DM, which could preempt development of atherosclerosis.
Keywords	metformin ; endothelial dysfunction ; diabetes ; CV risk ; Biology (General) ; QH301-705.5
Subject code	616
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article: Can Metformin Exert as an Active Drug on Endothelial Dysfunction in Diabetic Subjects?

Salvatore, Teresa / Pafundi, Pia Clara / Galiero, Raffaele / Rinaldi, Luca / Caturano, Alfredo / Vetrano, Erica / Aprea, Concetta / Albanese, Gaetana / Di Martino, Anna / Ricozzi, Carmen / Imbriani, Simona / Sasso, Ferdinando Carlo

Biomedicines

2020 Volume 9, Issue 1

Abstract	Cardiovascular mortality is a major cause of death among in type 2 diabetes (T2DM). Endothelial dysfunction (ED) is a well-known important risk factor for the development of diabetes cardiovascular complications. Therefore, the prevention of diabetic macroangiopathies by preserving endothelial function represents a major therapeutic concern for all National Health Systems. Several complex mechanisms support ED in diabetic patients, frequently cross-talking each other: uncoupling of eNOS with impaired endothelium-dependent vascular response, increased ROS production, mitochondrial dysfunction, activation of polyol pathway, generation of advanced glycation end-products (AGEs), activation of protein kinase C (PKC), endothelial inflammation, endothelial apoptosis and senescence, and dysregulation of microRNAs (miRNAs). Metformin is a milestone in T2DM treatment. To date, according to most recent EASD/ADA guidelines, it still represents the first-choice drug in these patients. Intriguingly, several extraglycemic effects of metformin have been recently observed, among which large preclinical and clinical evidence support metformin's efficacy against ED in T2DM. Metformin seems effective thanks to its favorable action on all the aforementioned pathophysiological ED mechanisms. AMPK pharmacological activation plays a key role, with metformin inhibiting inflammation and improving ED. Therefore, aim of this review is to assess metformin's beneficial effects on endothelial dysfunction in T2DM, which could preempt development of atherosclerosis.
Language	English
Publishing date	2020-12-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines9010003
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Article ; Online: Remdesivir Plus Dexamethasone Versus Dexamethasone Alone for the Treatment of Coronavirus Disease 2019 (COVID-19) Patients Requiring Supplemental O2 Therapy: A Prospective Controlled Nonrandomized Study.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2022 Volume 75, Issue 1, Page(s) e403–e409

Abstract: Background: Remdesivir is an antiviral used to treat coronavirus disease 2019 (COVID-19), which improves some clinical outcomes. Dexamethasone has been shown to be effective in reducing mortality. It has been hypothesized that combination of these two ... ...

Abstract	Background: Remdesivir is an antiviral used to treat coronavirus disease 2019 (COVID-19), which improves some clinical outcomes. Dexamethasone has been shown to be effective in reducing mortality. It has been hypothesized that combination of these two drugs can improve mortality. We evaluated the effect of combination on mortality of COVID-19 patients requiring O2 therapy. Methods: A prospective quasi-experimental study, including two independent, sequential controlled cohorts, one received remdesivir-dexamethasone and the other dexamethasone alone, was designed. All COVID-19 patients requiring supplemental O2 therapy were enrolled consecutively. The sample size to power mortality was a priori calculated. The primary endpoints were 30-day mortality and viral clearance differences. Secondary endpoints were differences in hospitalization times, improvement in respiratory failure (PO2/FiO2) and inflammatory indices (fibrinogen, CRP, neutrophil/lymphocyte ratio, D-Dimer). Kaplan-Meier curves and the log-rank test were used to evaluate significant differences in mortality between groups. Results: In total, 151 COVID-19 patients were enrolled (remdesivir/dexamethasone group, 76, and dexamethasone alone, 75). No differences in demographic, clinical, and laboratory characteristics were observed between the 2 groups at baseline. Faster viral clearance occurred in the remdesivir/dexamethasone group compared to dexamethasone alone (median 6 vs 16 days; P < .001). The 30-day mortality in the remdesivir/dexamethasone group was 1.3%, whereas in dexamethasone alone was 16% (P < .005). In the remdesivir/dexamethasone group compared to dexamethasone alone there was a reduction in hospitalization days (P < .0001) and a faster improvement in both respiratory function and inflammatory markers. Conclusions: Remdesivir/dexamethasone treatment is associated with significant reduction in mortality, length of hospitalization, and faster SARS-CoV-2 clearance, compared to dexamethasone alone.
MeSH term(s)	Adenosine Monophosphate/analogs & derivatives ; Alanine/analogs & derivatives ; Antiviral Agents ; COVID-19/drug therapy ; Dexamethasone/therapeutic use ; Humans ; Prospective Studies ; SARS-CoV-2
Chemical Substances	Antiviral Agents ; remdesivir (3QKI37EEHE) ; Adenosine Monophosphate (415SHH325A) ; Dexamethasone (7S5I7G3JQL) ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Controlled Clinical Trial ; Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciac014
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Article ; Online: Non-invasive respiratory support in SARS-CoV-2 related acute respiratory distress syndrome: when is it most appropriate to start treatment?

Nevola, Riccardo / Russo, Antonio / Scuotto, Samuel / Imbriani, Simona / Aprea, Concetta / Abitabile, Marianna / Beccia, Domenico / Brin, Chiara / Carusone, Caterina / Cinone, Francesca / Cirigliano, Giovanna / Colantuoni, Sara / Cozzolino, Domenico / Cuomo, Giovanna / Del Core, Micol / Gjeloshi, Klodian / Marrone, Aldo / Medicamento, Giulia / Meo, Luciana Agnese /

Nappo, Francesco / Padula, Andrea / Pafundi, Pia Clara / Ranieri, Roberta / Ricozzi, Carmen / Rinaldi, Luca / Romano, Ciro Pasquale / Ruocco, Rachele / Ruosi, Carolina / Salvati, Annabella / Sasso, Ferdinando Carlo / Sellitto, Ausilia / Sommese, Pino / Villani, Angela / Coppola, Nicola / Adinolfi, Luigi Elio

Respiratory research

2022 Volume 23, Issue 1, Page(s) 327

Abstract: Background: Acute respiratory distress syndrome (ARDS) is one of the most severe complications of SARS-CoV-2 infection. Non-Invasive Respiratory Support (NRS) as Continuous Positive Airway Pressure (CPAP) and/or Non-Invasive Ventilation (NIV) has been ... ...

Abstract	Background: Acute respiratory distress syndrome (ARDS) is one of the most severe complications of SARS-CoV-2 infection. Non-Invasive Respiratory Support (NRS) as Continuous Positive Airway Pressure (CPAP) and/or Non-Invasive Ventilation (NIV) has been proven as effective in the management of SARS-CoV-2-related ARDS. However, the most appropriate timing for start NRS is unknown. Methods: We conducted a prospective pilot study including all consecutive patients who developed moderate SARS-CoV-2-related ARDS during hospitalization. Patients were randomly divided into two intervention groups according to ARDS severity (assessed by PaO Results: Among 146 eligible patients, 29 underwent CPAP/NIV when P/F was ≤ 200 (Group A), 68 when P/F was ≤ 150 (Group B) and 31 patients agreed to non-invasive treatment only when P/F was ≤ 100 (Group C). Starting NRS at P/F level between 151 and 200 did not results in significant differences in the outcomes as compared to treatment starting with P/F ranging 101-150. Conversely, patients undergone CPAP/NIV in a moderate stage (P/F 101-200) had a significantly lower in-hospital mortality rate (13.4 vs. 29.0%, p = 0.044) and hospitalization length (14 vs. 15 days, p = 0.038) than those in the severe stage (P/F ≤ 100). Age and need for continuous ventilation were independent predictors of CPAP/NIV failure. Conclusions: Starting CPAP/NIV in patients with SARS-CoV-2-related ARDS in moderate stage (100 > P/F ≤ 200) is associated to a reduction of both in-hospital mortality and hospitalization length compared to the severe stage (P/F ≤ 100). Starting CPAP/NIV with a P/F > 150 does not appear to be of clinical utility.
MeSH term(s)	Humans ; SARS-CoV-2 ; Pilot Projects ; Prospective Studies ; COVID-19/therapy ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/therapy
Language	English
Publishing date	2022-12-03
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-022-02258-5
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Article ; Online: Proton pump inhibitor use in a university teaching hospital

Maria Meli / Renato Malta / Luigi Aprea / Andrea Pasquale / Concetta La Seta / Salvatore Di Rosa / Natale D’Alessandro

Italian Journal of Medicine, Vol 6, Iss

2012 Volume 3

Abstract: Introduction Proton pump inhibitors (PPIs) are highly prescribed drugs in Italy and in particular in the Sicilian region but little is known about their use in the hospital setting. Materials and methods PPI utilization and related costs were reviewed ... ...

Abstract	Introduction Proton pump inhibitors (PPIs) are highly prescribed drugs in Italy and in particular in the Sicilian region but little is known about their use in the hospital setting. Materials and methods PPI utilization and related costs were reviewed retrospectively by examining the pharmaceutical records of drug dispensation to the various wards of the Policlinico Universitario P. Giaccone of Palermo in 2010. Differences in the prescribing rates and drug preferences among the different clinical wards were analyzed. Results A total of 20,420 patients were hospitalized at the Policlinico of Palermo in 2010. Overall, the consumption of PPIs was 120 DDD/100 bed-days for the year 2010 with a total cost of 42,780 euros. Omeprazole and esomeprazole were the most commonly prescribed molecules accounting for over 70% of all prescriptions: nevertheless, wide differences in drug choices were noted even within the same ward. As expected, greater utilization rates were registered in the Internal Medicine and General Surgery departments. In particular, the highest consumption was observed in the Oncology, Geriatry and Obesity Surgery wards, with about 250 DDD/100 bed-days. All wards reported intravenous PPI administration suggesting some inappropriate use. Discussion From our data, PPIs appear to be moderately over-used at the Policlinico of Palermo. This practice may lead to the inappropriate continuation of therapy in primary care, further increasing costs and risks of adverse events. A survey evaluating in more detail the appropriateness of prescriptions is advisable.
Keywords	Proton pump inhibitors ; Drug utilization ; Prescribing appropriateness ; Hospital ; DDD ; Medicine ; R
Language	English
Publishing date	2012-10-01T00:00:00Z
Publisher	PAGEPress Publications
Document type	Article ; Online
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Article: Twenty-four-hour urinary excretion of ten pesticide metabolites in healthy adults in two different areas of Italy (Florence and Ragusa).

Saieva, Calogero / Aprea, Cristina / Tumino, Rosario / Masala, Giovanna / Salvini, Simonetta / Frasca, Graziella / Giurdanella, Maria Concetta / Zanna, Ines / Decarli, Adriano / Sciarra, Gianfranco / Palli, Domenico

The Science of the total environment

2004 Volume 332, Issue 1-3, Page(s) 71–80

Abstract: The determination of pesticide metabolites in human biological fluids represents an important biomarker of exposure in the general population and exposed workers. In the frame of a prospective study, we measured the 24-h urinary excretion of 10 pesticide ...

Abstract	The determination of pesticide metabolites in human biological fluids represents an important biomarker of exposure in the general population and exposed workers. In the frame of a prospective study, we measured the 24-h urinary excretion of 10 pesticide metabolites to evaluate non-occupational exposure to pesticides in the general population in two different areas in Italy. We collected 24-h urine samples from 69 healthy adults residing in Florence (Central Italy, n = 51) and Ragusa (Southern Italy, n = 18). The volunteers (25 males, 44 females; mean age 56 years) did not report any occupational exposure. We measured: six alkylphosphates, aspecific metabolites of organophosphorus pesticides [dimethylphosfate (DMP), dimethylthiophosfate (DMTP), dimethyldithiophosfate (DMDTP), diethylphosfate (DEP), diethylthiophosfate (DEDP), and diethyldithiophosfate (DEDTP)]; 3,5,6-trichloro-2-pyridinol (TCP), the main metabolite of chlorpyrifos; 3-phenoxybenzoic acid (3-PBA), a metabolite of pyrethroid insecticides; ethylenethiourea (ETU) a metabolite of ethylenebisdithiocarbamates; methamidophos (METH), an organophosphorus insecticide. We also measured PABA excretion as compliance marker (mean recovery 95%). Dimethylphosphates were found in detectable concentrations in the majority of samples (89.9%, 82.6% and 60.9% for DMP, DMTP and DMDTP, respectively). Urinary diethylphosphates (DEP, DETP, DEDTP) concentrations were above the detection limit in 80.9%, 61.8% and 27.5% of samples, respectively. TCP, 3-PBA and ETU were detected in 78.3%, 53.6% and 21.7% of samples, respectively. Methamidophos was detected in two samples (2.8%). The median number of metabolites detected in the same urine sample was 6 (range 0-9). Excretion levels were highest for alkylphosphates, particularly for DMTP (median: 142.6 nmol/day). Multivariate analysis showed statistically significant differences between these two groups of adults, with higher mean values of urinary excretion of alkylphosphates, TCP and ETU in Florence in comparison to Ragusa. Overall, a very high percentage of 24-h urine samples positive for several pesticide metabolites emerged, with higher levels of urinary daily excretion in subjects residing in the more urbanised area. Our results suggest that food monitoring programs should be supported by general campaigns aimed to reduce the use of pesticides in agriculture.
MeSH term(s)	Adult ; Chlorpyrifos/metabolism ; Chlorpyrifos/urine ; Diet ; Diet Records ; Environmental Monitoring ; Female ; Food Contamination ; Humans ; Insecticides/metabolism ; Insecticides/urine ; Italy ; Male ; Middle Aged ; Pesticide Residues/urine ; Pyrethrins/metabolism ; Pyrethrins/urine
Chemical Substances	Insecticides ; Pesticide Residues ; Pyrethrins ; Chlorpyrifos (JCS58I644W)
Language	English
Publishing date	2004-10-01
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2004.02.026
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