bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrotherapy in Advanced Heart Failure: the Cardio-HKT Pilot Study
Authors: MunicinÃ³ Annamaria , Nicolino Annamaria , Milanese Manlio , Gronda Edoardo , Andreuzzi Bruno , Oliva Fabrizio , Chiarella Francesco
Published: July 2016

Background: In-water exercise, hydrotherapy, may offer an attractive alternative to conventional training in markedly compromised patients with advanced HF. This Pilot Study evaluates the safety and efficacy of Cardio-Hydrokinesitherapy (Cardio-HKT) in patients with advanced HF on optimal medical therapy. Cardio-HKT is a novel rehabilitation program that includes training sessions in warm water (31Â°C), integrated by educational and psycho-behavioural sessions to promote healthy life style modifications. Methods: We studied 18 adult patients with advanced HF, LVEFII and peak oxygen uptake (peak VO2) <18 ml/kg/min. Cardio-HKT consisted of a 3 weeks daily in-water training, combined to educational and psycho-behavioural sessions. Patients underwent a six-minute-walking-test (6mWT), a cardiopulmonary exercise test at baseline and after 3 weeks of Cardio- HKT. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHF). Results: All patients completed the Cardio-HKT rehabilitation program without complications. The 6mWT improved from 453Â±172 m to 571Â±120 m (p<0.01), peak VO2 from 13.0Â±3.1 to 14.5Â±2.9 ml/kg/min (p=0.03), whereas VE/ CO2 slope declined from 37Â±10 to 33Â±9 (p=0.01). MLHF markedly improved from 56 (68-27) to 18 (40-7) (p<0.01). Conclusions: Our results support the safety and efficacy of the innovative Cardio-HKT rehabilitation program in patients with advanced HF.
Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic ecocardiography study in 5.631 patients
Authors: Serafini O. , Misuraca G. , Siniscalchi A. , Manes M.T. , Meringolo G. , Tomaselli C. , Chiatto M. , Buffon A.
Published: July 2016

Cerebral ischemia is among the principal causes of mortality and morbidity in industrialized countries being responsible of 10-12% of all deaths and of an elevated number of permanent disability. The cardioembolic forms may be responsible of the 30-35% of cerebrovascular acute syndrome, nevertheless in a significant percentage of cases, especially among young people, cerebral ischemic episodes are not induced by these cardiembolic forms: these cases are defined as cryptogenetic stroke/TIA. In these patients cardiac abnormalities represented by an aneurysm of the interatrial septum (ASA) and by a patent foramen ovale (PFO) have been frequently observed. The purpose of our prospective study was to evaluate, through transthoracic ecocardiography and tissue harmonic imaging (ETT-THI), the prevalence of ASA in the general population (group A) and the prevalence of ASA-FOP in a subgroup of patients with recent episode of cryptogenetic ischemic stroke/TIA (group B). We studied in a prospective manner from January 1 2003 to October 31t 2004 n. 5.631 patients. The presence of ASA was found in 3,2% of patients of group A, while in patients of group B we identifyed an ASA in 32% and a POF in 42% of the cases. Using a ETT-THI, our study shows in a wide range of a non selected population a prevalence of ASA greater than in previous studies. Such high prevalence in the general population of patients submitted to echocardiography and the higher frequency in subjects with recent cryptogenetic stroke, suggests to search carefully these abnormalities at the level of the interatrial septum using the harmonic imaging method.
Hyperhomocysteinemia in developing age and nutritional aspects of folates: an early cardiovascular risk factor
Authors: Caramia Giuseppe , Belardinelli Romualdo
Published: July 2016

elevated plasma levels of homocysteine are associated with an increased risk of atherosclerosis and cardiovascular ischemic events. Despite this evidence, however, there are still concerns about the mechanisms(s) by which homocysteine exerts its pro-atherogenic effect, and it is unclear whether the decreased plasma levels of homocysteine through diet or drugs may be paralleled by a reduction in cardiovascular risk. Experimental studies have shown that many possible mechanisms are implicated in the pro-atherogenic effect of homocysteine. Endothelial function is altered in subjects with hyperhomocysteinemia, and endothelial dysfunction is correlated with plasma levels of homocysteine. Exercise training reduces plasma levels of homocysteine and improves endothelial function, however without evidence of a better outcome. Larger studies are needed in order to demonstrate that the reduction of plasma levels of homocysteine by oral supplementation with folates and vitamins B6 and B12 translates into a decreased incidence of ischemic events, in particular in patients with documented coronary artery disease and ischemic encephalopathy.
CONVEGNO SPORT E SALUTE 2006 Napoli, Clinic Center Relazioni ed Abstract selezionati
Authors: VV AA
Published: July 2016

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La riabilitazione cardiologica: le Linee Guida e la realtÃ italiana
Authors: Giannuzzi Pantaleo
Published: July 2016

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Come ottimizzare il trattamento dopo la fase acuta: quali programmi per quali pazienti?
Authors: Sinagra G.
Published: July 2016

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La necessitÃ di competenze multidisciplinari e il valore aggiunto della Cardiologia Riabilitativa nel paziente cardioperato
Authors: Temporelli Pier Luigi
Published: July 2016

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Il ruolo della Cardiologia Riabilitativa nei programmi di disease management dello scompenso cardiaco
Authors: Urbinati Stefano
Published: July 2016

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Efficacy of Telecardiology in improving the results of Cardiac Rehabilitation after acute myocardial infarction
Authors: Giallauria Francesco , Lucci Rosa , Pilerci Francesco , De Lorenzo Anna , Manakos Athanasio , Psaroudaki Marianna , Dâ€™Agostino Mariantonietta , Vitelli Alessandra , Maresca Luigi , Del Forno Domenico , Vigorito Carlo
Published: July 2016

Background: This study was addressed to verify if Telecardiology (TC) improves the results of Cardiac Rehabilitation in patients following a home-based Cardiac Rehabilitation Program (CRP) after acute myocardial infarction (AMI). Materials and Methods: We studied three groups of patients after AMI: Group A (control group): 15 patients, who followed a standard in-hospital CRP of 3 weekly sessions of 2 months duration; Group B (study group): 15 patients, who were enrolled in a home-based CRP of similar duration and were monitored by TC with the aid of an ecg-device (Sorin Life Watch CG 6106); Group C (second control group): 15 patients, who followed a home-based CRP without ecgmonitoring by TC. All patients performed a symptom-limited exercise testing at the beginning of the CRP. Psychometric data (STAI-Y1, STAI-Y2, BDI) were also evaluated. At the end of the CRP all patients underwent repeated exercise testing and psychometric evaluation. Results: TC applied to the home-based CRP was associated with a good compliance to the program. Compared to Group C, in Group B we observed an increase of maximal heart rate, exercise duration, maximal work-load, and an improvement of anxiety, a trend to reduction of depression, and an improvement of quality of life. These results were very similar to Group A patients following a hospital-based CRP. Conclusions: TC improves compliance, functional capacity and psychological profile of patients undergoing a home-based CRP, compared to patients enrolled in a homebased CRP without ecg-monitoring by Telecardiology.
Acute myocardial infarction in the elderly. A case-control study with a younger population and review of literature
Authors: Corsini Fabrizio , Scaglione Anna , Iacomino Maria , Mascia Giuseppe , Melorio Saverio , Riccio Carmine , Romano Salvatore , Vetrano Alfredo , Celardo Silvana , Corsini Giancarlo , Chieffo Carmelo
Published: July 2016

Background: ST elevation myocardial infarction (STEMI) in old and old-old patients presents several peculiarities in natural history, delay of hospitalization and response to treatment. Aim of this retrospective case control study was to determine presentation, complications and management of elderly patients with STEMI compared to a younger population. Methods: 462 patients (205 M and 257 F) aged â‰¥75 years, hospitalized in CCU between 1999 and 2003 for STEMI, were valuated. The control group consisted of 490 consecutive patients (268 M and 222 F) aged 50-70 years. Attention was focused on clinical presentation, complications, management and outcome in elderly compared with younger patients. Results: The mean interval between the onset of symptoms and the arrive in CCU was of 9 hour in the elderly compared to 4,5 hour in the control. Chest pain was less frequent (50% vs 90%) in the elderly; the prevalence of dyspnoea and neurological symptoms was higher in patients >75 years (30% vs 15% and 25% vs 10%). In the elderly, previous angina and AMI, cerebral and peripheral vascular diseases, peripheral and renal failure were frequent. Early severe complications prevailed in the elderly. Thrombolysis was performed only in 39% of the elderly compared to 65% of the control. Significantly higher was cerebral haemorrhage after thrombolysis (4,9% vs 1,8%). Comparable were the mayor extra cranial bleedings. Primary or facilitated PTCA was performed in few patients in the last year. Two weeks mortality was 20%, compared to 6,5% in the control group. Conclusion: The patientes >75 years with STEMI were hospitalized later, had atypical presentation with less chest pain and more cardiac failure, were less likely to receive thrombolysis, had more complications and more cerebral bleedings. Elderly had more associated diseases and in-hospital mortality was higher.
1a Conferenza Nazionale della Cardiologia Riabilitativa e Preventiva
Authors: Pirelli Salvatore
Published: July 2016

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Gender similarity in low agreement between written and video ISAAC asthma questionnaires
Authors: Gharagozlou M. , Khalili S. , Hallajmofrad M. , Mohammadzadeh R. , Mousavi G. , Golkari H.
Published: July 2016

Background and Aim. The prevalence of childhood asthma varies among different nations and appears to have increased in recent years. It has been difficult to determine this prevalence precisely and compare the communities due to the lack of a standardized method. The International Studies of Asthma and Allergies in Childhood (ISAAC) has developed a written and video questionnaire to measure asthma prevalence and overcome these difficulties. This study was carried out to determine the prevalence of childhood asthma in Kashan, the central area of Iran, and to assess the agreement between the ISAAC written and video questionnaires and its gender relationship. Methods. Between December 2002 and June 2003, 2533 school children, aged 13-14 years, in Kashan secondary schools completed sequentially the ISAAC written and video questionnaires. The agreement between responses to the two questionnaires for reported â€œever wheezeâ€, â€œexercise wheezeâ€, â€œnight wheezeâ€ and â€œnight coughâ€ was determined, using kappa coefficient and concordance. Results. The prevalence of asthma symptoms were significantly lower in the responses to the video questionnaire compared with the written questionnaire. Kappa coefficient showed only poor to fair agreement (Îº = 0.13- 0.24) between video and written questionnaires, although the concordance between them always exceeded 60%. Conclusions. This study showed that reported asthma symptoms based on video questionnaires were significantly lower than the written questionnaire, and that there is low agreement between the two questionnaires which requires further investigation to explain the findings. In addition, this investigation revealed no significant difference between the genders for this low agreement.
APAP titration in patients with mild to moderate OSAS and periodic limb movement syndrome
Authors: Drigo R. , Fontana M. , Coin A. , Ferraresso A. , Enzo E. , Zambotto F.M.
Published: July 2016

(APAP) titration in a partially attended setting; 2) to verify whether APAP performance depends on the apneahypopnea and periodic limb movement indexes (PLMI). Methods. 65 CPAP naÃ¯ve subjects with a sleep disorder of breathing and daytime sleepiness underwent a standard polysomnography (first night), APAP titration (second night, partially attended), and a standard polysomnography using continuous positive airway pressure (CPAP) at the effective pressure (Peff) established from the APAP titration (third night) in a sleep disorder laboratory in a 400-bed community hospital. We examined the apnea-hypopnea index (AHI), sleep stages, arousals induced by respiratory events (RESPa) and PLM (PLMa), and oxygen saturation during the first and third nights on CPAP at the Peff. Patients were divided into three groups according to their AHI and PLMI. Results. At the Peff defined using APAP on the third night, the mean AHI dropped from 29.6 Â± 21.8 to 3.1 Â± 3.4, and the RESPa index from 16.5 Â± 16.2 to 1.7 Â± 2.6. No differences emerged in sleep stages or spontaneous arousals (first vs third night). Overall, 92% of the patients met the standard for an acceptable outcome of positive pressure titration. Baseline AHI and PLMI did not affect the outcome of titration. Conclusions. In patients with mild to moderate OSAS and PLMS, APAP titration enables the optimal fixed pressure for CPAP home therapy to be determined in at least 90% of patients.
Non-occupational malignant pleural mesothelioma due to asbestos and non-asbestos fibres
Authors: Proietti L. , Spicuzza L. , Di Maria A. , Polosa R. , Sebastian Torres E. , Asero V. , Di Maria G.U.
Published: July 2016

Background and aim. The occurrence of malignant pleural mesothelioma (MPM) has been reported among population groups with no documented professional exposure to asbestos fibres living in different geographic areas. This paper reviews existing data related to non occupational MPM including its occurrence in the province of Catania (Sicily, Italy). Methods. An electronic search of literature related to non occupational MPM was performed including the year 2005. Results. Non occupational MPM in subjects living in areas contaminated by a variety of asbestos and non asbestos fibres has been well documented through a number of epidemiologic studies including cases series, case-control studies, and a cohort study. In addition, the observation of familial clustering of MPM, suggests that genetic factors may play a role in the pathogenesis of this malignancy. The epidemiological evidence also suggests that MPM may occur as a result of the interaction between environmental carcinogens, genetic factors, and virus infection. Conclusion. It is likely that genetic predisposition and non-occupational exposure to low doses of asbestos and asbestos- like fibres may concur to the development of malignant mesothelioma. However, additional epidemiological and laboratory studies are needed to further understand the relationship between environmental exposure and individual susceptibility to this malignancy.
Smoking characteristics and cessation in patients with thromboangiitis obliterans
Authors: JimÃ©nez-Ruiz C.A. , Dale L.C. , Astray Mochales J. , VelÃ¡zquez BuendÃ­a L. , De Granda Orive I. , Guirao GarcÃ­a A.
Published: July 2016

Aim. Describe the smoking characteristics and the results of a smoking intervention programme involving 27 cigarette smokers with Thromboangiitis Obliterans (TAO). Methods. Clinical records of all cigarette smokers with TAO that attended our smoking treatment clinic from 1990 to 2004 were reviewed. Demographic and smoking characteristics, the type of smoking treatment received and its efficacy and safety up to 12 months was abstracted. Treatment consisted of the combination of behavioural and pharmacological treatment. The behavioural treatment was delivered in eight individual visits: one baseline visit and seven follow-up visits. Pharmacological treatment consisted of combinations of nicotine patches and nicotine gum (NRT) and/or bupropion. This is anâ€˜intent to treatâ€™ analysis. A descriptive analysis of the variables was performed. Qualitative variable relationships were tested using the Ï‡-square test for independence, or Fisherâ€™s Exact Test when expected values were less than five. Statistical significance was accepted at a level of p<0.05. Results. 27 cigarette smokers (23 male and 4 female), mean (SD) age 36.07 (7.23), mean FTND-score 8.4 (1.4), smoked a mean of 29.6 (7.71) cigarettes daily. They attended our clinic a mean of 45.48 (8.63) months after onset of TAO. Their mean number of attempts to stop was 3.22 (2.75). The continuous abstinence rate decreased from 29% at the end of treatment to 18.5% at 12-month follow up. The seven day point prevalence abstinence rate at the 12th month of follow up was 40.7%. We found that continuous abstinence at 6 and 12 months was more frequent among those with multiple previous stop attempts (p=0.003 and p=0.001, respectively). There were no significant differences in abstinence outcomes between groups. Incidence of adverse effects was similar to other smokers seeking treatment. All the smokers who achieved continuous tobacco abstinence had improvement in their disease and none of them underwent amputation, compared to 50% of those who resumed smoking and later required an amputation. Conclusions. Continuous abstinence rates among treated cigarette smokers with TAO are relatively low, but abstinence does improve symptoms and reduce the likelihood of amputation. More aggressive treatment programmes need to be developed for this high risk, highly tobacco dependent population.
Isolated interrupted inferior vena cava with azygos continuation mimicking paraesophageal lymph node enlargement
Authors: YÄ±lmaz U. , Halilcolar H. , Unsal I. , YapÄ±cÄ±oglu S. , YÄ±ldÄ±rÄ±m Y. , ApaydÄ±n M.
Published: July 2016

We report a case of interrupted inferior vena cava with azygos continuation diagnosed as a isolated finding in a patient with lung carcinoma. Findings of the unopacified CT scan initially simulated a paraesophageal lymphadenopathy. The contrast - enhanced spiral CT scan showed a dilated azygos vein in the absence of definable inferior vena cava.
Staff training influence on non-invasive ventilation outcome for acute hypercapnic respiratory failure
Authors: Lopez-Campos J.L. , Garcia Polo C. , Leon Jimenez A. , Arnedillo A. , Gonzalez-Moya E. , Fenandez Berni J.J.
Published: July 2016

Background. Although non-invasive ventilation (NIV) efficacy in the treatment of acute hypercapnic respiratory failure (AHRF) have been previously demonstrated, not all the studies reveal this fact in the same degree, with some variability in the results. This study aimed to analyse variables related to NIV outcome for AHRF. Methods. A group of consecutive patients requiring NIV due to AHRF were included in a prospective observational cohort study performed in conventional wards. Variables considered included those reported in the literature, as well as staff problems during the management of the ventilators. The study aimed to include all patients during one year, but after the initial results, it had to be suspended. Results. Fifteen patients were included in the study: 10 males, mean age 68 Â± 12. APACHE-II score was 17.6 Â± 6.5. pH and pCO2 before NIV were 7.22 Â± 0.11 and 110 Â± 72 mmHg respectively. pH, corticosteroids use, APACHE score, and EPAP were found to influence outcome. Besides, an inadequate use of NIV due to lack of personnel training was detected in all patients with NIV failure (RR 3.5; 95% CI: 1.08-11.2; p = 0.007). In the light of these results, the study had to be suspended and patients were transferred to the respiratory ward. Conclusions. NIV is a life-saving respiratory treatment influenced by several factors, of which staff training is a key one. Centres attending acute respiratory patients should have an area in which this requirement is fulfilled.
Hemomediastinum and bilateral hemothorax with extensive angiomatosis of anterior mediastinum
Authors: Karimi Sh. , Mohammadi F. , Pejhan S. , Bakhshayeshkaram M. , Akhavan-Azari P. , Bahadori M.
Published: July 2016

Angiomatosis is a rare, benign but clinically extensive and serious vascular lesion of soft tissue. Hereby, we report a case of diffuse angiomatosis of mediastinum, presenting with hemomediastinum and bilateral massive hemothorax in a 19-year old boy. On medical imaging, mediastinal widening along with enhanced small vessels and capillaries were detected. On operation, hemorrhagic sponge-like vascular tissue patches were seen extensively in pericardium, pleura, lymph node and thymus as well. The lesion was debulked. The pathologic evaluation revealed characteristic features of soft tissue angiomatosis involving thymus, lymph node, pleura, pericardium and its fibrofatty tissue. Diffuse angiomatosis should be considered for differential diagnosis of vascular lesions of anterior mediastinum.
Weekly chemotherapy with cisplatin and paclitaxel in advanced NSCLC: a phase II study
Authors: Buccheri G. , Ferrigno D. , Giordano M.C.
Published: July 2016

Background. This phase II study was designed to assess the activity and toxicity of administration of the cisplatin/ paclitaxel combination in advanced non-small cell lung cancer (NSCLC). Methods. Eligibility criteria included: age up to 70 years, pathological diagnosis of NSCLC, inoperable disease or post-operative tumour recurrence, performance status </=2, no severe co-morbidity, no previous chemotherapy, and informed consent. Treatment consisted of intravenous infusion of cisplatin, 25 mg/m2, and paclitaxel, 80 mg/m2, every week. Chemotherapy was continued until completion of a 22-week treatment plan, disease progression, persistent toxicity, or patient refusal. Results. Forty-nine patients entered the study. They received a median of 14 cycles (range 0-22). For both drugs, the median dose-intensity was 75% of projected. Toxicity was generally acceptable, and never life threatening. Alopecia was the most common side effect, followed by anemia, leukopenia, and nausea/vomiting. Twenty patients responded (40.8% response rate), with three complete, pathologically documented responses. The estimated median time to progression was 35 weeks (95% CI: 29-41); the median survival time was 56 weeks (95% CI: not calculable), with a 2-year survival rate of 46.1%. Conclusions. When given on a weekly basis, the cisplatin/ paclitaxel combination is well tolerated, active, and associated to remarkably long survivals.
Diagnosis of Respiratory Bronchiolitis associated interstitial lung disease
Authors: Robalo Cordeiro C. , Freitas S. , Rodrigues B. , Catarino A. , Matos M.J. , Ferreira I. , Carvalho L.
Published: July 2016

Background. Respiratory Bronchiolitis (RB), described by Niewoehner et al in 1974, is a common finding in heavy smokers and is characterised by the presence of pigmented macrophages within respiratory bronchioles and adjacent alveoli. In the 1980s, Myers et al described RB associated with interstitial lung disease (RBILD), which is a rare entity expressed as an amplified respiratory bronchiolitis in response to cigarette smoke. Methods. The authors studied a group of 8 patients with biopsy-proven RBILD diagnosed within the last five years, and assessed epidemiological data, clinical and imaging features, lung function tests, bronchoalveolar lavage findings, therapeutic approaches and clinical evolution. Results and Conclusions. The most difficult differential diagnosis is between RBILD and Desquamative Interstitial Pneumonia (DIP), which seems to suggest that these disorders are either end of the same spectrum, although the authors claim that there are some clinical, morphological and prognostic distinctions. The diagnosis of RBILD requires an appropriate clinical setting (including smoking habits), characteristic image findings (like ground glass shadowing and centrilobular nodules), and Bronchoalveolar Lavage (BAL) data to exclude other diagnosis. Pathological confirmation may also be important, not only to exclude more adverse interstitial lung disease, such as idiopathic pulmonary fibrosis, but also, as in the eight cases presented, to illustrate some specific features such as the prevalence of lymphocytosis in BAL.
Arthropathy and cutaneous manifestations in a 28-year-old patient with cystic fibrosis
Authors: Lampert S. , Pour Schahin S. , Wiest G.H. , Hahn E.G. , Ficker J.H.
Published: July 2016

We report on a 28-year-old man with known cystic fibrosis who presented with pain and cutaneous nodules in the elbow joints. His symptoms had appeared episodically in the previous months, they were always self-limiting, and independent of pulmonary exacerbations. A radiograph of the joints was unremarkable. These findings fit well with a special form of CF-related arthritis. As in the case of classical CF arthritis, the treatment to be considered is, in particular, symptomatic administration of non-steroidal anti-inflammatory drugs and possibly glucocorticoids. Also under discussion as a further possibility is the use of antibiotics. Our patient has always refused medication. The condition again proved to be self-limiting. In contrast to the classical form of CF arthritis, the special form is not associated with either joint swelling or local warmth. In the presence of arthritic symptoms in CF patients, consideration must always be given to a hypertrophic pulmonary osteoarthropathy. The latter, however, shows typical radiological changes and is exacerbated by lung infections. The presence of arthritic pathologies in a patient with CF further underscores the fact that CF is a multiorgan morbid condition.
Sunflower seed mimicking complicated hydatid cyst
Authors: FÄ±ndÄ±kcÄ±oglu A. , Kilic D. , Hatipoglu A.
Published: July 2016

We present a case of a foreign body in lung parenchyma, found incidentally during surgery in an adult woman. The clinical and radiological findings were consistent with a pulmonary hydatid cyst. Owing to the similar clinical and radiological appearances, a thoracotomy was required for the correct diagnosis of a sunflower seed mimicking hydatid disease.
Pneumonia: how important are local epidemiology and smoking habits?
Authors: Blasi F. , Aliberti S.
Published: July 2016

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Demographics and microbiological profile of Pneumonia in United Arab Emirates
Authors: Al-Muhairi S. , Zoubeidi T. , Ellis M. , Gary Nicholls M. , Safa W. , Joseph J.
Published: July 2016

Background. Pneumonia is a common respiratory disease, which has a mortality rate of approximately 14% worldwide. The management of pneumonia is based on the patient and microbiological profile existing in the community. There is a paucity of data regarding patient demographics and the microbiological profile for pneumonia in the United Arab Emirates (UAE). Methods. We conducted a retrospective analysis of inpatients with pneumonia in the UAE. Epidemiological, clinical and microbiological data was collected from patients over the age of 16 years admitted to a single university hospital with a diagnosis of pneumonia between the years 1997 and 2002. Patients were categorised as having community acquired (CAP) or hospital acquired pneumonia (HAP). Results. Among the 361 patients, 186 were females and 175 males. The mean age (Â±SEM) of the males was 59Â±1.6 years and of the females, 56.9Â±1.5 years. The annual hospital admission rate for pneumonia increased from 410 per million population in 1997 to 760 in 2002. The pneumonia was community acquired in 289 (80%) and hospital acquired in 72 (20%). Hospitalisation for CAP showed a significant seasonal variation with peak admission rates in March and April and the nadir in August and September. The overall mortality rate was 13%, and was significantly higher for HAP (24%) than for CAP (10%, p<0.01). The common microorganisms isolated from sputum culture in CAP were Haemophilus.influenzae (18.6%) and Streptococcus.pneumoniae (10%). The common pathogen in HAP was Pseudomonas.aeruginosa in (50%). 4 out of 17 (23%) H. influenzae isolates were resistant to amoxicillin and 2 of 9 S. pneumoniae isolates (22%) were resistant to penicillin. Conclusions. The hospitalisation rate for CAP has increased over the years and showed a clear seasonal trend in the UAE. H. influenzae was the most common organism among patients with CAP and P. aeruginosa in HAP. The mortality rate for HAP was significantly higher than for CAP. The drug resistance pattern was similar to reports from centres elsewhere in South East Asia.
Dose dependence of efficacy but not of safety in sublingual immunotherapy
Authors: Frati F. , Incorvaia C. , Marcucci F. , Sensi L. , Di Cara G. , Puccinelli P. , Dal Bo S.
Published: July 2016

Sublingual immunotherapy (SLIT) currently represents, as indicated by meta-analysis of its efficacy and safety, a valid option to the generally used traditional subcutaneous immunotherapy (SCIT) for treating respiratory allergy. Regarding efficacy, recent studies demonstrated that, similar to what has already been observed in SCIT as well as in experimental and clinical studies about the magnitudo of allergen exposure, the effectiveness on both clinical symptoms and immunologic changes depends on the amount of allergen administered during treatment. In addition, in vitro studies addressed with the role of dendritic cells, currently considered to be of pivotal importance in orienting toward tolerance the immune response to allergens, showed that the internalisation of allergen molecules, which is followed by tolerogenic presentation to T cells, depends on the amount of allergen. However, such dose dependence is not apparent concerning the safety. In fact, the comparison of studies respectively conducted with high and low allergen doses did not show differences in the rate of systemic reactions, which in any case never had the presentation of anaphylaxis, and instead a significant difference in the rate of local reactions, following the oral and gastrointestinal contact with the allergen extract, in favour of high dose studies.
Dose dependence of efficacy and safety of subcutaneous immunotherapy
Authors: Incorvaia C. , Frati F. , Puccinelli P. , Riario-Sforza G.G. , Dal Bo S.
Published: July 2016

A number of experimental and clinical evidence has shown that exposure to high amounts of allergen molecules favours the development of tolerance. This is true also for subcutaneous immunotherapy (SCIT), for which a dose dependence of clinical efficacy was clearly demonstrated. The effective doses, measured as Î¼g of major allergens, to be administered during maintenance treatment were established for the main allergens. Regarding pollens, the range of effectiveness corresponds to 25-41 and 13-20 Î¼g of major allergens Phl p 5 and Phl p 6 for grasses, to 10-47 Î¼g of Amb a 1 for ragweed, to 12 Î¼g of Bet v 1 for birch, and to 6.2 Î¼g of Par j 1 for Parietaria. With house dust mites, a maintenance dose of 5-11.5 Î¼g of the major allergen from Dermatophagoides pteronyssinus Der p 1 is associated to clinically relevant effects, and with cat epithelium the clinical success is observed using a dose of 13-15 Î¼g of Fel d 1. Nevertheless, there are adverse reactions facing SCIT, which are related to the amount of injected allergen. In fact, the safety decreases when the administered doses increase. This has led to â€œoptimal dosesâ€ being defined which show a good balance between efficacy and safety (corresponding for example to a dose of 7 Î¼g for Der p 1 and of 13 Î¼g for Fel d 1). The dose dependency with respect to both efficacy and safety makes essential to accurately consider the risk/benefit ratio in each patient eligible for SCIT.
Lung Stem Cell Update: Promise and Controversy
Authors: Neuringer I.P. , Randell S.H.
Published: July 2016

Currently, there is great enthusiasm about potential stem cell therapies for intractable diseases. We previously reviewed the topic of stem cells in lung injury and repair, including the role of endogenous, tissue (somatic) stem cells and the contribution of circulating cells to the lung parenchyma. Our purpose here is to provide a concise update in this fast-moving field. New information and ongoing debate focus attention on basic issues in lung stem cell biology and highlight the need for additional studies to establish the feasibility of cell therapies to prevent or treat lung diseases.
Euthyroid goitre and sleep apnea
Authors: De Felice A. , Fuschillo S. , Martucci M. , De Angelis E. , Balzano G.
Published: July 2016

A number of predisposing factors (obesity, nasal obstruction, adenoidal hypertrophy, macroglossia, etc) have been related to obstructive sleep apnea syndrome (OSAS). In addition hypothyroidism and large goitres have been reported to be associated to OSAS, but this association has not been adequately studied. We describe an obese patient with euthyroid goitre associated with OSAS. The patient showed a body mass index (BMI) of 47 and a large neck with a circumference of 60 cm. The flow-volume curve demonstrated an expiratory plateau suggesting an intrathoracic upper airway obstruction. Arterial blood gas analysis results were: pH 7.39; PCO2 54.2 mmHg; P O2 47 mmHg. Nocturnal polisomnography showed an apnea/hypopnea index (AHI) of 31 episodes/hour. Upper airway collapse was overcome by a nasal continuous positive airway pressure (nCPAP) of 14 cmH2O. Weight loss obtained by a hypocaloric diet was not accompanied by any OSAS improvement. After thyroidectomy, a nCPAP of 4 cmH2O was sufficient to prevent upper airway closure. Discontinuation of nCPAP treatment for 4 consecutive nights did not determine worsening of sleep apnea symptoms, nor a worsening of overnight oxymetry. A new polysomnography carried out after 4 nights off nCPAP showed an AHI of 33 episodes/hour. OSAS should be suspected in patients with large goitres. Decisions regarding discontinuation of nCPAP treatment after thyroidectomy should be based on polisomnographic results.
Chronic productive cough in young adults is very often due to chronic rhino-sinusitis
Authors: Corsico A.G. , Villani S. , Zoia M.C. , Niniano R. , Ansaldo E. , Cervio G. , Quaresima P.M. , Gatto E. , Crippa E. , Marinoni A. , Foresi A. , Pozzi E. , Cerveri I.
Published: July 2016

Background. Chronic productive cough is a common clinical problem; often potential causes outside the lower respiratory tract are forgotten or ignored. The aim of this study was to make a precise etiopathogenetic diagnosis of chronic productive cough in young adults. Methods. In a clinical setting, 212 subjects (mean age 41Â±5 years) who had reported chronic productive cough in a previous postal survey of a young adult population underwent within two years clinical and functional investigations following a rational diagnostic approach. Two pulmonologists independently established the diagnosis using a clinically structured interview on nasal and respiratory symptoms, spirometry and other tests when appropriate (bronchodilator test or methacholine bronchial challenge, chest radiography); if rhino-sinusitis was suspected, subjects underwent an ENT examination with nasal endoscopy and/or sinus computed tomography. Results. At the end of the diagnostic procedure, 87 subjects (41%) no longer had chronic productive cough and had normal function. Fifty-eight subjects (27%) had chronic rhino-sinusitis; seventeen subjects (8%) had asthma, and of these fourteen also had chronic rhino-sinusitis; 50 subjects (24%) had COPD stage 0+, of these seven also had chronic rhino-sinusitis. Chronic rhino-sinusitis was more frequent in females than in males (p<0.05). Conclusions. Both in clinical practice and in epidemiological studies, it is important to consider that the origin of chronic productive cough could be frequently outside the lower respiratory tract; a consistent percentage of young adults with persistent productive cough has indeed chronic rhino-sinusitis.
Secondary bronchial botryomycosis due to foreign body aspiration
Authors: MÃ¼ller-Quernheim J. , Vollmer E. , Galle J.
Published: July 2016

Botryomycosis is recognised mainly as a visceral disorder with rare cases of pulmonary manifestation. The most frequent cause of pulmonary Botryomycosis is aspiration of a foreign body which induces bacteria to group together instead of spreading out forming conglomerates resembling the granules of Actinomyces. Here we report on the clinical and pathologic findings of a 38-year-old patient without any further predisposing factors. It should be mentioned that the disease was cured following the extraction of a foreign body without the need for any surgery or antibiotic therapy. Factors influencing the course of the disease are discussed below.
Degree of control of physiciandiagnosed asthma and COPD in Italy
Authors: Caramori G. , Bettoncelli G. , Carone M. , Tosatto R. , Di Blasi P. , Pieretto A. , Invernizzi G. , Franco Novelletto B. , Ciaccia A. , Adcock I.M. , Papi A.
Published: July 2016

Background. It is important for the Italian National Health Service to obtain data on the degree of control of asthma and chronic obstructive pulmonary disease (COPD) in the general population in Italy in order for balanced planning of future investments in these diseases to be made. Currently, precise estimates of these parameters are not available in literature. Objectives. In collaboration with the Italian Academy of General Practitioners (SIMG; www.simg.it) we have investigated the degree of control of physician-diagnosed asthma and COPD in Italy. Methods. A standardised questionnaire on asthma and COPD has been self-administered to a sample of 1937 Italian family physicians (representing around 5% of all the Italian doctors involved in general practice) chosen to cover all the Italian counties. Results. We have collected questionnaire data from 19,917 patients with asthma and COPD followed in their practice and 12,438 (62.4%) were correctly filled in enabling evaluation. We selected the number of emergency room visits, hospitalisations and intensive care unit admissions for asthma and COPD in the last 12 months as objective measures of the degree of asthma and COPD morbidity in these patients. The figures were respectively 12.4% (emergency room visits), 17.3% (hospitalisations) and 1.2% (intensive care unit admissions) of all patients with physician-diagnosed asthma and COPD. Conclusions. This data suggests that in Italy the morbidity of asthma and COPD remains high; representing a significant burden for the Italian National Health Service. There is a clear necessity for further studies to investigate the causes of this incomplete control.
The usefulness of transesophageal echocardiography in the staging of locally advanced lung cancer
Authors: Caterino U. , Dialetto G. , Covino F.E. , Mazzarella G. , Grella E. , Massimo M.
Published: July 2016

Background. The pre-operative staging of locally advanced non-small cell lung cancer (NSCLC) is an important clinical and radiological issue. Computed tomography (CT) scan cannot always provide sufficient information about resectability and some patients may undergo unnecessary thoracotomy. The purpose of this study was to evaluate the utility of transesophageal echocardiography (TEE) in distinguishing T3 from T4 lesions in patients with lung cancer possibly involving cardiovascular structures and to compare its findings with those of computed tomography and, whenever possible, of surgical samples. Methods. Between January 1998 and December 2001, sixteen patients were referred to our pulmonology unit for evaluation of locally advanced NSCLC possibly involving the heart or great vessels. All patients underwent mediastinal staging with both contrast enhancement CT scan and TEE. Results. The mediastinal staging by CT scan classified eleven patients as T4N0M0 and five patients as T3N0M0. TEE suggested mediastinal extension of the tumour in nine out of sixteen patients, who were eventually classified as T4; the remaining seven patients had no mediastinal involvement according to TEE and were therefore classified as T3. The pathologic staging confirmed clinical TEE staging in all of the ten patients who subsequently underwent surgery. The remaining six patients were excluded from surgery either because of major coexistent illnesses or because refused to be operated on. Conclusion. TEE is a useful diagnostic tool in the staging of patients with locally advanced NSCLC which suspect involvement of heart and/or great vessels.
Progress in treatment of viral infections in children with acute lymphoblastic leukemia
Authors: Moschovi Maria , Adamaki Maria , Vlahopoulos Spiros A.
Published: July 2016

In children, the most commonly encountered type of leukemia is acute lymphoblastic leukemia (ALL). An important source of morbidity and mortality in ALL are viral infections. Even though allogeneic transplantations, which are often applied also in ALL, carry a recognized risk for viral infections, there are multiple factors that make ALL patients susceptible to viral infections. The presence of those factors has an influence in the type and severity of infections. Currently available treatment options do not guarantee a positive outcome for every case of viral infection in ALL, without significant side effects. Side effects can have very serious consequences for the ALL patients, which include nephrotoxicity. For this reason a number of strategies for personalized intervention have been already clinically tested, and experimental approaches are being developed. Adoptive immunotherapy, which entails administration of ex vivo grown immune cells to a patient, is a promising approach in general, and for transplant recipients in particular. The ex vivo grown cells are aimed to strengthen the immune response to the virus that has been identified in the patients’ blood and tissue samples. Even though many patients with weakened immune system can benefit from progress in novel approaches, a viral infection still poses a very significant risk for many patients. Therefore, preventive measures and supportive care are very important for ALL patients.
Association between Vascular Endothelial Growth Factor Gene Polymorphisms with Breast Cancer Risk in an Iranian Population
Authors: Rezaei Maryam , Hashemi Mohammad , Sanaei Sara , Mashhadi Mohammad Ali , Taheri Mohsen
Published: July 2016

Breast cancer (BC) is one of the most causes of death in women worldwide. It affects Iranian female population approximately a decade earlier than those in other parts of the world. Previous studies have shown that vascular endothelial growth factor (VEGF) gene variants were associated with BC risk. The current study aimed to evaluate the impact of VEGF rs3025039 (+936C>T), rs2010963 (+405C>G), rs833061 (–460T>C), rs699947 (–2578C>A), and rs35569394 (18-bp I/D) polymorphisms on BC risk in an Iranian population in southeast of Iran. This case-control study was done on 250 BC patients and 215 healthy women. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or PCR was used to genotype the polymorphisms. Our findings showed that VEGF rs 699947 variant increased the risk of BC (OR = 1.71, 95% CI = 1.15–2.54, P = 0.009, CA vs CC; OR = 2.12, 95% CI = 1.14–3.93, P = 0.021, AA vs CC; OR = 1.78, 95% CI = 1.22–2.60, P = 0.004, CA+AA vs CC; OR = 1.47, 95% CI = 1.12–1.92, P = 0.005, A vs C). The VEGF rs 3025039, rs2010963, rs833061, and rs35569394 variants were not associated with risk/protection of BC. In conclusion, our results proposed that VEGF rs 699947 polymorphism may increase the risk of BC development. Furthers studies with larger sample sizes and different ethnicities are necessary to confirm our findings.
Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications
Authors: Edwards Elizabeth Skidmore , Sackett Sarah Carson
Published: July 2016

This article reviews psychosocial influences on women's participation in physical activity as they differ from men and how associated activity differences impact women's risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women's health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male counterparts. These lower rates of physical activity are directly related to both incidence of and outcomes from cardiovascular disease, type 2 diabetes, and breast and gynecological cancers. The relationship between psychosocial factors that are understood to affect physical activity differs between men and women. Specifically, self-efficacy, social support, and motivation are empirically substantiated factors that found to impact physical activity participation among women differently than men. Understanding these relationships is integral to designing effective interventions to target physical activity participation in women so that the related health risks are adequately addressed.
Классификация сложности задачи о рeберной раскраске для некоторого семейства классов графов
Authors: Malyshev Dmitriy Sergeevich
Published: July 2016

Класс графов называется монотонным, если он замкнут относительно удалений вершин и рeбер. Любой такой класс может быть задан запрещeнными подграфами. Хроматическим индексом графа называется наименьшее количество цветов, необходимое для такого раскрашивания его рeбер, что любые два соседних ребра имеют разные цвета. В статье получена полная классификация сложности задачи о хроматическом индексе для всех монотонных классов, определяемых запрещeнными подграфами, каждый из которых имеет не более 6 рeбер или не более 7 вершин.
Работа выполнена при поддержке Российского Фонда Фундаментальных Исследований, проект № 16-31-60008-мол_а_дк, гранта Президента РФ МК-4819.2016.1, лаборатории алгоритмов и технологий анализа сетевых структур НИУ ВШЭ.
О FE-предполных классах счетнозначной логики
Authors: Marchenkov Sergey Seraphimovich
Published: July 2016

На множестве функций счетнозначной логики рассматривается оператор замыкания относительно систем функциональных уравнений (оператор FE-замыкания). Доказывается, что мощность семейства всех FE-предполных классов гиперконтинуальна.
Работа выполнена при поддержке Российского фонда фундаментальных исследований, проект 13-01-00958.
О предельном поведении максимальной степени вершины условного конфигурационного графа вблизи критических точек
Authors: Pavlov Yurii Leonidovich , Feklistova E V
Published: July 2016

Рассматриваются конфигурационные графы с $N$ вершинами. Степени вершин являются независимыми одинаково распределенными случайными величинами, имеющими дискретное степенное распределение с параметром $\tau>0$. Этот параметр имеет две критические точки: $\tau=1$ и $\tau=2$. Свойства графа резко изменяются, когда $\tau=\tau(N)$ при $N\to\infty$ проходит через эти точки. Пусть $G_{N, n}$ - случайный конфигурационный граф, рассматриваемый при условии, что сумма степеней его вершин равна $n$. Доказана предельная теорема для максимальной степени вершины графа $G_{N, n}$ при $N, n\to\infty$ и $\tau\to 1$ или $\tau\to 2$.
Работа выполнена при поддержке Российского Фонда Фундаментальных Исследований, проект №13-01-00009а.
Оценки числа $(k,l)$-сумм в конечной абелевой группе
Authors: Sargsyan Vahe Gnelovich
Published: July 2016

Подмножество $A$ группы $G$ называется $(k,l)$-суммой, если существует такое подмножество $B\subseteq G$, что $A=kB-lB$, где $kB-lB=\{x_1 +…+x_k-x_{k+1}…- x_{k+l}\mid x_1,…, x_{k+l} \in B\}$. Получены верхняя и нижняя оценки числа $(k,l)$-сумм в абелевой группе.
Работа выполнена при поддержке Российского фонда фундаментальных исследований (проект 13-01-00958a)