6 research outputs found
Piastrine, farmaci antiaggreganti e metodiche di laboratorio.
No full textMonografia sull'utilità del monitoraggio terapia antiaggregante
Smoking cessation and body weight
No full textA great attention is presently paid to smoking cessation and pharmacotherapy combined with counselling has been found to achieve the highest rate of smoking cessation. Smoking cessation is associated with weight gain and this may reduce compliance in a subset of smokers. In a previous research we evaluated the efficacy of a combined Group Counselling therapy and Bupropion therapy and we identified some outcome predictors.The aim of the present study is to evaluate the effects of smoking cessation on body weight during a one-year follow-up period. From January 2001 to December 2005, 587 volunteers (263 males and 324 females) who wanted to quit smoking were recruited by our unit. After an individual motivational interview subjects started a Six-week Group Counselling Program (SGCP) for smoking cessation and ten days before the “quitting day” were asked to begin a seven-week pharmacotherapy consisting of 300 mg Bupropion SR/daily (BT). Prior to admission to the program subjects were submitted to a physical examination by the medical staff and underwent a structured interview about their smoking history. The amount of exhaled CO was taken as a further measure of the smoking habit. Some psychometric instruments were administered: the Fagerström Tolerance Questionnaire (FTQ), the Severity of Dependence Scale (SDS) and the Three Factor Eating Questionnaire (TFEQ). Subjects were called in by counsellors after 3, 6 and 12 months to check their current smoking habit and body weight. Of the 229 subjects who accepted BT only 115 subjects completed the seven-week cycle of therapy (BT-COMP group) whereas the remaining 114 subjects discontinued medication (BT-NONCOMP group) but continued to attend SGCP. According to a previous report (3) both BT groups achieved a higher abstinence rate if compared to the sole SGCP. At the one-year follow-up abstinence rates were 65.4% and 47.4% in BT-COMP and BT-NONCOMP groups, respectively, whereas 39.7% was the quit rate of the SGCP sole group. We evaluated the increasing body weight in the three groups of subjects (SGCP only, BT-COMP e BT NONCOMP) according to gender and to the results of the one-year abstinence. Subjects who did not smoke after 12 months (nonS) are compared with those who were still smokers (S). Females and males non-smokers revealed - at five-week abstinence and at one-year follow-up - a weight gain significantly higher if compared with S of the same sex. Several different studies have shown that a great many people believe that smoking helps control weight and ex-smokers risk weight gain. Unfortunately, this widespread opinion is an accurate one and contributes to making difficult to quit this dangerous habit. Eating more food, particularly more sweet food, and a decrease in metabolic rate are the main causes. Our data suggest that seven-week BT is not a protective factor in increasing body weight. Regular aerobic exercise and nutritional counselling may be helpful to minimize weight gain after quitting smoking. Psychometric measures seem to be weak predictors of weight gain
The Effect of Obesity Management on Body Image in Patients Seeking Treatment at Medical Centers
No full texttreatment-
seeking patients with obesity. We aimed to investigate
the effects of obesity management on body image in patients
with obesity attending Italian medical centers for
weight loss programs.
Research Methods and Procedures: A total of 473 obese
patients seeking treatment in 13 Italian medical centers
(80% females; age, 45.9 standard deviation 11.0 years;
BMI, 36.8 5.7 kg/m2) were evaluated at baseline and after
a 6-month weight loss treatment. Body uneasiness, psychiatric
distress, and binge eating were tested by Body Uneasiness
Test (BUT, Part A), Symptom CheckList-90 (SCL-
90), and Binge Eating Scale (BES), respectively.
Results: At 6-month follow-up, the percentage weight loss
was significantly higher in men (9.0 6.3%) than in
women (6.8 7.3%; p 0.010). Both men and women had
a significant improvement in BUT Global Severity Index
and in all of the BUT subscales with the exception of the
Compulsive Self-Monitoring subscale. Linear regression
analysis selected baseline psychological and behavioral
measures (global score of BUT and SCL-90) and improved
psychiatric distress and binge eating as independent predictors
of changes in basal body dissatisfaction in females,
whereas in males, changes were associated only with baseline
BUT-Global Severity Index score, binge eating, and its
treatment-associated improvement. Pre-treatment BMI and
BMI changes did not enter the regression.
Discussion: Obesity treatment, even with a modest degree
of weight loss, is associated with a significant improvement
of body image, in both females and males. This effect
depends mainly on psychological factors, not on the amount
of weight loss
MRP4 Expression and Platelet Activation in Children and Adolescents with Different Subtypes of Primary Thrombocythemia
No full textBackground and aims. Essential thrombocythemia (ET) rarely occurs in children and adolescents. In our experience, 40% of pediatric patients with primary thrombocythemia (PT) have JAK2 V617F or CALR mutations, 24% have a diagnosis of ET without any known molecular markers while 36% have hereditary thrombocytosis (HT) with a MPLS505A mutation. Thrombotic events, frequent in adult ET presenting high-risk factors and rare in pediatric PT, have been observed in pediatric HT patients with MPLS505A mutation in treatment with aspirin (ASA). The multidrug resistance protein-4 (MRP4) is an ATP-binding cassette transporter involved in the efflux of several pharmacological and physiological compounds. MRP4 has been identified as a modulator of ASA action in platelets; in addition, it also influences platelet activation. Recent studies have shown that MRP4 over-expression has a role in reducing the effect of ASA in patients who have undergone a bypass surgical procedure and that ASA induces platelet MRP4 upregulation. Aims of this study were to evaluate and correlate MRP4 expression and platelet function in children and adolescents aged <20 years at diagnosis with different subtypes of PT.
Methods. MRP4 protein and mRNA expressions were evaluated in platelets obtained from healthy volunteers (HV) and from 41 PT patients: M/F ratio: 0.78; median age at diagnosis: 14.5 years; median platelet count at study: 671x109/L. Ten patients had MPLS505A mutation (HT), 10 were JAK2V617F-mutated (ET) and 6 harbored CALR mutations (ET) while 15 cases were JAK2, CALR and MPL wilde-type (ET). Expression of MRP4 protein and mRNA were analyzed by Western blot and RT-PCR, respectively, and the results were reported as ET/HV or HT/HV expression values. Platelet aggregation, using ADP at different concentration (0.8 to 2 μM) and collagen (1 μg/ml) as agonists, and platelet secretion, expressed as ATP release after U46619 + epinephrine (1 + 20 μM), using the luciferin-luciferase assay, were utilized as platelet function tests. This study was conducted in accordance with the Declaration of Helsinki.
Results. Protein MRP4 expression was higher both in HT (4.23+/-1.88) and in ET patients with CALR mutations (4.27+/-2.60) compared to the values found in wild-type ET patients (3.55+/-1.52). In JAK2V617F-mutated ET patients, the MRP4 protein expression (2.03+/-1.46) was significantly lower compared to the values observed in all other ET and HT patients (p .05), whereas the MRP4 mRNA expression was significantly higher (ΔΔCt 0.021+0.003) compared both to HT patients (0.009+/-0.0039 ΔΔCt) (p .01) and CALR-mutated patients (ΔΔCt 0.014+/- 0.006). Patients with HT showed a significantly higher response to ADP 0.8 μM (83+/-29 Mx%) compared to all subgroups of ET patients who showed a similar response (60+/-34 Mx%; p .01). A significantly shorter lag-phase in response to collagen (1 μg/ml) was observed in HT compared to ET patients (33+/-3 sec vs 51+/-4 sec, p .005). Among the ET population, JAK2-mutated patients showed a significantly shorter lag-phase in response to collagen compared to wild-type patients (39+/-12.5 sec vs 50+/-15 sec), p .011. Platelet secretion was significantly higher in HT compared to ET patients, p .001.
Conclusions. This study for the first time provides evidence that children and adolescents with MPLS505A-mutated HT show a higher platelet reactivity compared to age-matched patients with ET. Moreover, platelet reactivity correlates with MRP4 protein overexpression. These findings help to shed light into the thrombotic events observed in HT MPLS505A patients despite treatment with ASA
Validating the Body Uneasiness Test (BUT) in obese patients
No full textOBJECTIVE: To investigate the psychometric properties of the Body
Uneasiness Test (BUT) in a large sample of subjects with obesity seeking treatment. BUT is a
71-item self-report questionnaire in two parts: BUT-A which measures weight phobia, body
image concerns, avoidance, compulsive self-monitoring, detachment and estrangement feelings
towards one’s own body (depersonalization); and BUT-B, which looks at specific worries
about particular body parts or functions. METHODS: We recruited a clinical sample of
1,812 adult subjects (age range 18-65 years, females 1,411, males 401) with obesity (Body
Mass Index, BMI ≥30 kg/m2) and a normal weight (BMI value between 18.5 and 25 kg/m2)
non-clinical sample of 457 adult subjects (females 248, males 209) with an Eating Attitudes
Test-26 (EAT-26) score under the cut-off point 20 (scores ≥20 indicate possible cases of eating
disorders). RESULTS: The exploratory and confirmatory analyses confirmed a structural
five-factor model for BUT-A and an eight-factor model for BUT-B. Internal consistency was
satisfactory. Concurrent validity with Binge Eating Scale (BES) and Three-Factor Eating
Questionnaire (TFEQ) was evaluated. The authors calculated mean values for BUT scores in
adult (18-65 years) patients with obesity, and evaluated the influence of gender, age and BMI.
Females obtained statistically significant higher scores than males in all age groups and in all
classes of obesity; patients with obesity, compared with normal weight subjects, generally
obtained statistically significant higher scores, but few differences could be attributed to the
influence of BMI. CONCLUSION: The BUT can be a valuable multidimensional tool for the
clinical assessment of body uneasiness in obesity; the scores of its sub-scales do not show a
linear correlation with BMI values
A double-blind randomized study comparing intramuscular (i.m.) granisetron with i.m. granisetron plus dexamethasone in the prevention of delayed emesis induced by cisplatin
No full textGranisetron has been shown to exert a beneficial therapeutic effect in the prophylaxis and treatment of acute nausea and vomiting due to chemotherapy. However, limited data regarding its efficacy in the prevention and treatment of delayed emesis are available. A total of 532 patients entered this multicenter double-blind study, aimed at comparing the efficacy and safety of intramuscular (i.m.) granisetron with that of i.m. granisetron plus dexamethasone. Complete response and total control were evaluated for 3 days following the first 24 h after cisplatin administration in two groups of patients: 262 treated with granisetron 3 mg i.m. daily (plus placebo), and 265 with granisetron at the same dose plus dexamethasone 8 and 4 mg twice daily. The rate of complete response was 58.0% in the granisetron group and 78.9% in the granisetron plus dexamethasone group over days 1-3 (p < 0.01). Similarly, over the same period total control was 44.7% with granisetron alone and 65.3% with granisetron plus dexamethasone (p < 0.01). Local and systemic tolerability of the i.m. therapy with granisetron were satisfactory. In conclusion, granisetron plus dexamethasone showed good protection against delayed emesis due to emetogenic chemotherapy
