213 research outputs found
INTERNATIONAL AGENCY FOR RESEARCH ON CANCER MONOGRAPHS (IARC)
Author reply pp. 86-7. In taliano
Use of pharmacological treatments by a sample of Italian patients affected by alcohol use disorders
Title: USE OF PHARMACOLOGICAL TREATMENTS BY A SAMPLE OF ITALIAN PATIENTS AFFECTED BY ALCOHOL USE DISORDERS
Author name(s): R. Agabio; E.M. Diana; D. Grazzini; R. Pirastu; G.L. Gessa
Institution: Department of Biochemical Sciences, Section of Neuroscience, Preclinical and Clinical Pharmacology, University of Cagliari, Italy
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Background: It has often been reported that the majority of patients affected by Alcohol Use Disorders (AUDs) do not receive any pharmacological treatment. This study was aimed at investigating the use of the medications available in Italy (disulfiram, naltrexone, acamprosate, and γ-hydroxybutyric acid) by a sample of outpatients affected by AUDs.
Methods: Four trained psychologists interviewed outpatients affected by AUDs in an area of Sardinia, Italy, of approximately 550.000 adult inhabitants.
Results: A total sample of 208 outpatients affected by AUDs was interviewed (~1/3 of total outpatients affected by AUDs of that area). Their main features were: 166 males (79.5%); mean age=48.6±0.6 year; duration of AUDs=15.8±0.7 years; number of drinks per drinking days=19.4±1.3; number of criteria of DSM-IV-Tr=5.8±0.1. Before the admission into specific services, 13 patients (6.2%) had already received medication for AUDs; 7 patients (3.4%) had received disulfiram and 6 patients (2.9%) γ-hydroxybutyric acid. Over the same period, 22 patients (10.6%) had already attended self-help groups and 4 patients (1.9%) had received thiamine (Vitamine B1). After the admission into specific medical settings for the treatment of AUDs, 113 patients (54.3%) received medication for AUDs: 58 patients (27.9%) received disulfiram, 65 patients (31.2%) γ-hydroxybutyric acid, 2 patients (1.0%) naltrexone, and 6 patients (2.9%) acamprosate. In the same period, 54 patients (26.0%) frequented self-help associations, and 21 patients (10.1%) received thiamine.
Conclusions: The results of this study confirm that the number of patients who receive a treatment for AUDs continues to be surprisingly low. Despite the long duration and the high level of severity of the AUDs, the majority of patients affected by AUDs did not receive any treatment before their admission in specific medical settings for the treatment of AUDs (10% of patients frequented self-help groups, 6% received a medication for AUDs, and 2% thiamine). After the admission into specific medical settings, the number of patients who received a treatment increased: 26% frequented self-help associations, 54% received a specific medication, and 10% received thiamine. However, approximately half of the patients did not receive any pharmacological treatment even if they frequented medical settings for the treatment of AUDs. Additional work is needed to understand the reasons of such a scarce use of treatments.
Acknowledgements: This study was supported by a grant from Regione Autonoma della Sardegna
The complete mitochondrial DNA sequence of the Montecristo goat
The remote island of Montecristo is renowned for a resident goat population, whose origins are unclear. We describe the complete mtDNA sequence of a male specimen captured on the island. The sequence turned out to belong to haplogroup (Hg) A. Our results exclude that the sequence belongs to a lineage more closely related to bezoars than domestic goats. The lineages most similar to the Montecristo sequence are currently found in Western Europe, favouring partial feralization for the Montecristo isolate. Positioning of the Montecristo mitogenome in the emerging phylogenetic tree for domestic goats reveals a new lineage with multiple derived nucleotide states shared with lineages so far described in Europe as well as in North Asian breeds. This reveals the presence, within Hg A, of lineages with a palearctic distribution, whose descendants are now grown from Eastern Asia to Western Europe
Environmental and genetic contribution to hypertension prevalence: data from an epidemiological survey on Sardinian genetic isolates.
Background and objectivesHypertension represents a major cause of cardiovascular morbidity and mortality worldwide but its prevalence has been shown to vary in different countries. The reasons for such differences are still matter of debate, the relative contributions given by environmental and genetic factors being still poorly defined. We estimated the current prevalence, distribution and determinants of hypertension in isolated Sardinian populations and also investigated the environmental and genetic contribution to hypertension prevalence taking advantage of the characteristics of such populations.Methods and resultsAn epidemiological survey with cross-sectional design was carried out measuring blood pressure in 9845 inhabitants of 10 villages of Ogliastra region between 2002 and 2008. Regression analysis for assessing blood pressure determinants and variance component models for estimating heritability were performed. Overall 38.8% of this population had hypertension, its prevalence varying significantly by age, sex and among villages taking into account age and sex structure of their population. About 50% of hypertensives had prior cardiovascular disease. High blood pressure was independently associated with age, obesity related factors, heart rate, total cholesterol, alcohol consumption, low education and smoking status, all these factors contributing more in women than in men. Heritability was 27% for diastolic and 36% for systolic blood pressure, its contribution being significantly higher in men (57%) than in women (46%). Finally, the genetic correlation between systolic and diastolic blood pressure was 0.74, indicating incomplete pleiotropy.ConclusionGenetic factors involved in the expression of blood pressure traits account for about 30% of the phenotypic variance, but seem to play a larger role in men; comorbidities and environmental factors remain of predominant importance, but seem to contribute much more in women
A population-based study of an Italian genetic isolate reveals that mean platelet volume is not a risk factor for thrombosis.
INTRODUCTION: Several studies revealed that mean platelet volume (MPV) was larger in the acute phase of arterial and venous thrombosis and predicted a poor clinical outcome. It has been suggested that MPV is a risk factor for thrombosis. However, it is unclear whether increased platelet size is a cause or a consequence of thrombosis. It was the objective of this study to verify whether MPV is a risk factor for arterial and venous thrombosis.
METHODS: We search for associations between platelet parameters and thrombosis by a population-based study in 11,084 inhabitants of an Italian genetic isolate characterized by wide variability of platelet parameters. To validate this methodology of investigation, we also evaluated whether it was able to identify several well known thrombotic risk factors in the study population.
RESULTS: Statistical analysis confirmed that male gender, ageing, hypertension, high total cholesterol, low HDL cholesterol, diabetes, obesity and smoking were risk factors for arterial thrombosis, while alcohol consumption had a protective effect. Female gender, ageing, pregnancy, estroprogestinic treatment, obesity, varicose veins were associated with venous thrombosis. At variance, MPV and platelet count were unrelated to previous thrombotic events. However, MPV was negatively correlated with the time since the last thrombotic event.
CONCLUSIONS: This study indicated that an epidemiologic study of a population isolate is appropriate for the identification of thrombotic risk factors, but it failed to identify such a role for MPV. Thus, we suggest that the increased MPV previously described in subjects with acute thrombosis was a consequence instead of a cause of thrombosis
A Strategy analysis for genetic association studies with known inbreeding
Background: Association studies consist in identifying the genetic variants which are related to a specific disease through the use of statistical multiple hypothesis testing or segregation analysis in pedigrees. This type of studies has been very successful in the case of Mendelian monogenic disorders while it has been less successful in identifying genetic variants related to complex diseases where the insurgence depends on the interactions between different genes and the environment. The current technology allows to genotype more than a million of markers and this number has been rapidly increasing in the last years with the imputation based on templates sets and whole genome sequencing. This type of data introduces a great amount of noise in the statistical analysis and usually requires a great number of samples. Current methods seldom take into account gene-gene and gene-environment interactions which are fundamental especially in complex diseases. In this paper we propose to use a non-parametric additive model to detect the genetic variants related to diseases which accounts for interactions of unknown order. Although this is not new to
the current literature, we show that in an isolated population, where the most related subjects share also most of their genetic code, the use of additive models may be improved if the available genealogical tree is taken into account. Specifically, we form a sample of cases and controls with the highest inbreeding by means of the Hungarian method, and estimate the set of genes/environmental variables, associated with the disease, by means of Random Forest.
Results: We have evidence, from statistical theory, simulations and two applications, that we build a suitable
procedure to eliminate stratification between cases and controls and that it also has enough precision in
identifying genetic variants responsible for a disease. This procedure has been successfully used for the betathalassemia, which is a well known Mendelian disease, and also to the common asthma where we have identified
candidate genes that underlie to the susceptibility of the asthma. Some of such candidate genes have been also found related to common asthma in the current literature.
Conclusions: The data analysis approach, based on selecting the most related cases and controls along with the Random Forest model, is a powerful tool for detecting genetic variants associated to a disease in isolated
populations. Moreover, this method provides also a prediction model that has accuracy in estimating the unknown disease status and that can be generally used to build kit tests for a wide class of Mendelian diseases
Dissecting metabolic syndrome components: data from an epidemiologic survey in a genetic isolate
The metabolic syndrome (MetS) is a large-scale and expanding public-health and clinical threat worldwide. We investigated the determinants of MetS, assessed its prevalence and components and, estimated their genetic contribution, taking advantage of the special characteristics of Sardinian isolated populations. Inhabitants of 10 villages in Ogliastra region participated in a cross-sectional survey in 2002-2008 (n = 9,647). Blood samples, blood pressure (BP), anthropometry and, data from a standardized interview were collected. Prevalence of MetS was estimated by the direct method of standardization. Variables associated with the MetS were identified using multilevel logistic regression. Heritability was determined using variance component models. MetS Prevalence was 19.6% (95% CI 18.9-20.4%) according to NCEP-ATPIII, 24.8% (95% CI 24.0-25.6%) according to IDF and, 29% (95% CI 28.1-29.8%) according to AHA/NHLBI harmonized criteria, ranging from 9 to 26% among villages. The most prevalent combination was BP + HDL-cholesterol (HDL) + triglycerides (TRIG) (19%), followed by BP + HDL + waist circumference (WAIST) (17%) and, BP + HDL + TRIG + WAIST (13.6%). Heritability of MetS was 48% (p = 1.62 × 10(-25)), as the two most common combinations (BP + HDL + TRIG and BP + HDL + WAIST) showed heritability of 53 and 52%, respectively. The larger genetic components of the two most frequent combinations determining MetS deserve greater investigation in order to understand the underlying mechanisms. Besides, further studies are warranted to confirm these findings both in isolated and outbred populations
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