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1. Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study

Author

Marasco, G., Cremon, C., Barbaro, M. R., Salvi, D., Cacciari, G., Kagramanova, A., Bordin, D., Drug, V., Miftode, E., Fusaroli, P., Mohamed, S. Y., Ricci, C., Bellini, M., Rahman, M. M., Melcarne, L., Santos, J., Lobo, B., Bor, S., Yapali, S., Akyol, D., Sapmaz, F. P., Urun, Y. Y., Eskazan, T., Celebi, A., Kacmaz, H., Ebik, B., Binicier, H. C., Bugdayci, M. S., Yagci, M. B., Pullukcu, H., Kaya, B. Y., Tureyen, A., Hatemi, I., Koc, E. S., Sirin, G., Caliskan, A. R., Bengi, G., Alis, E. E., Lukic, S., Trajkovska, M., Hod, K., Dumitrascu, D., Pietrangelo, A., Corradini, E., Simren, M., Sjolund, J., Tornkvist, N., Ghoshal, U. C., Kolokolnikova, O., Colecchia, A., Serra, J., Maconi, G., De Giorgio, R., Danese, S., Portincasa, P., Di Stefano, M., Maggio, M., Philippou, E., Lee, Y. Y., Venturi, A., Borghi, C., Zoli, M., Gionchetti, P., Viale, P., Stanghellini, V., Barbara, G., Piacentini, A., Shengelia, M., Vechorko, V., Cardamone, C., Rosei, C. A., Pancetti, A., Rettura, F., Pedrosa, M., Campoli, C., Mijac, D., Korac, M., Karic, U., Markovic, A., Najdeski, A., Nikolova, D., Dimzova, M., Lior, O., Shinhar, N., Perelmutter, O., Ringel, Y., Sabo, C. M., Chis, A., Bonucchi, G., Caio, G. P. I., Ghirardi, C., Marziani, B., Rizzello, B., Aguilar, A., Capogreco, A., Aghemo, A., Di Paolo, D. M., Marconi, G., Di Sabatino, A., Tagliaferri, S., Naves, J. E., Galli, A., Dragoni, G., Nedelcu, L., Mauloni, P. A., Del Vecchio, S., Rotondo, L., Capuani, F., Montanari, D., Palombo, F., Paone, C., Mastel, G., Fontana, C., Bellacosa, L., Cogliandro, R. F., Marasco, Giovanni, Cremon, Cesare, Barbaro, Maria Raffaella, Salvi, Daniele, Cacciari, Giulia, Kagramanova, Anna, Bordin, Dmitry, Drug, Vasile, Miftode, Edgidia, Fusaroli, Pietro, Mohamed, Salem Youssef, Ricci, Chiara, Bellini, Massimo, Rahman, M Masudur, Melcarne, Luigi, Santos, Javier, Lobo, Beatriz, Bor, Serhat, Yapali, Suna, Akyol, Deniz, Sapmaz, Ferdane Pirincci, Urun, Yonca Yilmaz, Eskazan, Tugce, Celebi, Altay, Kacmaz, Huseyin, Ebik, Berat, Binicier, Hatice Cilem, Bugdayci, Mehmet Sait, Yağcı, Munkhtsetseg Banzragch, Pullukcu, Husnu, Kaya, Berrin Yalınba, Tureyen, Ali, Hatemi, İbrahim, Koc, Elif Sitre, Sirin, Goktug, Calıskan, Ali Riza, Bengi, Goksel, Alıs, Esra Ergun, Lukic, Snezana, Trajkovska, Meri, Hod, Keren, Dumitrascu, Dan, Pietrangelo, Antonello, Corradini, Elena, Simren, Magnu, Sjolund, Jessica, Tornkvist, Navkiran, Ghoshal, Uday C, Kolokolnikova, Olga, Colecchia, Antonio, Serra, Jordi, Maconi, Giovanni, De Giorgio, Roberto, Danese, Silvio, Portincasa, Pietro, Di Stefano, Michele, Maggio, Marcello, Philippou, Elena, Lee, Yeong Yeh, Venturi, Alessandro, Borghi, Claudio, Zoli, Marco, Gionchetti, Paolo, Viale, Pierluigi, Stanghellini, Vincenzo, and Barbara, Giovanni

Subjects
Male, medicine.medical_specialty, Settore MED/17 - Malattie Infettive, Coronavirus disease 2019 (COVID-19), Nausea, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), diarrhea, Disease, Gastrointestinal Symptoms, COVID-19, Acute Respiratory Syndrome, GI-COVID-19, NO, Russia, Manifestations, Interviews as Topic, Rating scale, Internal medicine, Surveys and Questionnaires, parasitic diseases, medicine, Prevalence, Humans, In patient, Prospective Studies, Respiratory system, Settore MED/12 - Gastroenterologia, Hepatology, business.industry, SARS-CoV-2, pandemic, Gastroenterology, COVID-19, Middle Aged, gastrointestinal, Gastroenteritis, Europe, Hospital admission, Egypt, Female, medicine.symptom, business, human activities
Abstract

INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection., Fondazione Cassa di Risparmio in Bologna; Italian Ministry of Education, University and Research; Fondazione del Monte di Bologna e Ravenna [SC1-BHC-01-2019]; European Grant H2020, DISCOvERIE [SC1-BHC-01-2019]; Italian Ministry of Health [Ricerca Finalizzata GR-2018-12367062], G.B. contribution to this research was permitted in part by funding from Fondazione Cassa di Risparmio in Bologna; the ItalianMinistry of Education, University and Research; and Fondazione del Monte di Bologna e Ravenna and European Grant H2020, DISCOvERIE, SC1-BHC-01-2019. M.R.B. is a recipient of a grant from the Italian Ministry of Health (Ricerca Finalizzata GR-2018-12367062). None of the funding organizations have had any role in the design and conduct of the study; in the collection, management, and analysis of the data; or in the preparation, review, and approval of the article.

Published
2022

2. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

Author

Jyvakorpi S. K., Ramel A., Strandberg T. E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H. M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V. S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P. V., Marzetti E., Pitkala K. H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A. M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D. L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A. R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A. R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C. A., Gonzales Turin J., Zafra O. L. L., Picazo A. L., Sepulveda L. P., SanchezSanchez J. L., Puelles C. S., Aragones M. V., CruzJentoft A. J., Santos J. A., Alvarez-Nebreda L., JimenezJimenez N. F., Nozal J. M. -D., Montero-Errasquin B., Moreno B. P. B. P., Roldan-Plaza C., Vicente A. R. -D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M. N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J. J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P. P., Sieber C. C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S. D., Ebner N., Grutz R., von Haehling S., Schols A. M. W. J., Gosker H., Huysmans S., Quaaden S., Schols J. M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A. -M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G. A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P. -J., Teguo M. T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T. B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R. L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A. C., Yuan J., Roubenoff R., Kortebein P., Miller R. R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I. M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S. D., Feletti L., Marchioro E., Mocci F., Varesio M. G., Cesario A., Cabin B., de Boer W. P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A. -M., Mokhtari H., Rodon N., RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Clinicum, Department of General Practice and Primary Health Care, University of Helsinki, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Helsinki University Hospital Area, Teachers' Academy, Jyvakorpi S.K., Ramel A., Strandberg T.E., Piotrowicz K., Blaszczyk-Bebenek E., Urtamo A., Rempe H.M., Geirsdottir O., Vagnerova T., Billot M., Larreur A., Savera G., Soriano G., Picauron C., Tagliaferri S., Sanchez-Puelles C., Cadenas V.S., Perl A., Tirrel L., Ohman H., Weling-Scheepers C., Ambrosi S., Costantini A., Pavelkova K., Klimkova M., Freiberger E., Jonsson P.V., Marzetti E., Pitkala K.H., Landi F., Calvani R., Bernabei R., Boni C., Brandi V., Broccatelli M., Celesti C., Cicchetti A., Collamati A., Coretti S., D'Angelo E., D'Elia M., Landi G., Lorenzi M., Mariotti L., Martone A.M., Ortolani E., Pafundi T., Picca A., Ruggeri M., Salini S., Tosato M., Vetrano D.L., Lattanzio F., Baldoni R., Bernabei S., Bonfigli A.R., Bustacchini S., Carrieri B., Cassetta L., Cherubini A., Cucchi M., Cucchieri G., Costantini A.R., Dell'Aquila G., Espinosa E., Fedecostante M., Fraternali R., Galeazzi R., Mengarelli A., Piomboni S., Posacki E., Severini E., Tregambe T., Trotta F., Maggio M., Lauretani F., Butto V., Fisichella A., Guareschi C., Longobucco Y., Di Bari M., Rodriguez-Manas L., Alamo S., Bouzon C.A., Gonzales Turin J., Zafra O.L.L., Picazo A.L., Sepulveda L.P., SanchezSanchez J.L., Puelles C.S., Aragones M.V., CruzJentoft A.J., Santos J.A., Alvarez-Nebreda L., JimenezJimenez N.F., Nozal J.M.-D., Montero-Errasquin B., Moreno B.P.B.P., Roldan-Plaza C., Vicente A.R.-D., Sanchez-Cadenas V., Sanchez-Castellano C., Sanchez-Garcia E., Vaquero-Pinto M.N., Topinkova E., Bautzka L., Blechova K., Gueye T., Juklickova I., Klbikova T., Krenkova J.J., Madlova P., Mejstrikova H., Melcova R., Michalkova H., Ryznarova I., Drastichova I., Hasalikova E., Hucko R., Jakub S., Janacova M., Kilmkova M., Parizkova M., Redrova M., Ruskova P.P., Sieber C.C., Auerswald T., Engel C., Franke A., Freibergen E., Freiheit U., Gotthardt S., Kampe K., Kob R., Kokott C., Kraska C., Meyer C., Reith V., Rempe H., Schoene D., Sieber G., Zielinski K., Anker S.D., Ebner N., Grutz R., von Haehling S., Schols A.M.W.J., Gosker H., Huysmans S., Quaaden S., Schols J.M., Smeets N., Stevens P., van de Bool C., Weling C., Strandberg T., Jyvakorpi S., Hallikas K., Herranen M., Huusko T., Hytonen L., Ikonen K., Karppi-Sjoblom A., Karvinen K., Kayhty M., Kindsted T., Landstrom E., Leirimaa S., Pitkala K., Punkka A., Saavalainen A.-M., Salo T., Sepa M., Sohlberg K., Vaatamoinen E., Venalainen S., Vanhanen H., Vellas B., Van Kan G.A., Biville V., Brigitte L., Cervera C., Cesari M., Champarnaud M., Cluzan C., Croizet M., Dardenne S., Dorard M., Dupuy C., Durand E., Faisant C., Fougere B., Girard P., Guyonnet S., Hoogendijk E., Mauroux R., Milhet A., Montel S., Ousset P.-J., Teguo M.T., Teysseyre B., Andrieu S., Blasimme A., Dray C., Rial-Sebbag E., Valet P., Dantoine T., Cardinaud N., Castelli M., Charenton-Blavignac M., Ciccolari-Micaldi C., Gayot C., Laubarie-Mouriet C., Marchesseau D., Mergans T., Nguyen T.B., Papon A., Ribet J., Saulinier I., Tchalla A., Rapp T., Sirven N., Skalska A., Blaszcyk E., Cwynar M., Czesak J., Fatyga P., Fedyk-Lukasik M., Grodzicki T., Jamrozik P., Janusz Z., Klimek E., Komoniewska S., Kret M., Ozog M., Parnicka A., Petitjean K., Pietrzyk A., Skalska-Dulinska B., Starzyk D., Szczerbinska K., Witkiewicz B., Wlodarczyk A., Sinclair A., Harris S., Ogborne A., Ritchie S., Sinclair C., Sinclair H., Bellary S., Worthington H., Derejczyk J., Roller-Wirnsberger R., Jonsson P., Bordes P., Arnaud S., Asbrand C., Bejuit R., Durand S., Flechsenhar K., Joly F., Lain R.L., Moncharmont M., Msihid J., Ndja A., Riche B., Weber A.C., Yuan J., Roubenoff R., Kortebein P., Miller R.R., Gorostiaga C., Belissa-Mathiot P., Hu H., Laigle L., Melchor I.M., Russel A., Bennecky M., Haws T., Joshi A., Philpott K., Walker A., Zia G., Giorgi S.D., Feletti L., Marchioro E., Mocci F., Varesio M.G., Cesario A., Cabin B., de Boer W.P., Ignaszewski C., Klingmann I., Vollenbroek-Hutten M., Hermens T., Jansen-Kosterink S., Tabak M., Blandin P., Coutard L., Lenzotti A.-M., Mokhtari H., Rodon N., Epidemiology and Data Science, APH - Aging & Later Life, and APH - Quality of Care

Subjects
0301 basic medicine, Gerontology, Sarcopenia, [SDV]Life Sciences [q-bio], Population, PROTEIN, RECOMMENDATIONS, law.invention, SUPPLEMENTATION, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), Cultural diversity, medicine, Nutrition counselling, Nutrition intervention, Humans, 030212 general & internal medicine, Medical prescription, education, Exercise, Aged, 2. Zero hunger, education.field_of_study, 030109 nutrition & dietetics, Frailty, business.industry, Settore MED/09 - MEDICINA INTERNA, ADULTS, medicine.disease, mobility, 3. Good health, Feasibility Studie, Malnutrition, SPRINTT, resistance exercise, muscle mass, Protein intake, 3121 General medicine, internal medicine and other clinical medicine, Feasibility Studies, Energy intake, Independent Living, business, Nutrition counseling, Research Paper, Human
Abstract

Aim To describe the methods and feasibility of the nutritional intervention carried out within the SPRINTT Randomized cotrolled trial. We also illustrate how nutrition interventionists identified participants at risk of malnutrition and the lessons learnt from the nutrition intervention. Findings SPRINTT nutrition intervention was well-received by the majority of the participants. It was mainly carried out using tailored nutrition counselling, but also other means of delivering the intervention were successfully used. Compared with a standard nutrition prescription, an individualized protocol to diagnose malnutrition and follow-up by tailored nutrition counselling helped achieve nutritional targets more effectively in spite of diversity of population in nutritional habits and in some cases reluctance to accept changes. Message The SPRINTT nutrition intervention was feasible and allowed flexibility to the varying needs and cultural differences of this heterogeneous population of frail, older Europeans. It may serve as a model to educate and improve nutrition among community-dwelling older people at risk of mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4., Background The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3–9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0–1.2 g/kg body weight, energy intake of 25–30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-020-00438-4.

Published
2021
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3. Placental dysfunction in uncomplicated and complicated intrauterine growth restriction by preeclampsia and neonatal outcome

Author

Alessandra Ammendola, Marta Campanile, Antonio Raffone, Fulvio Zullo, Salvatore Tagliaferri, Nicolò Pini, Gabriele Saccone, Maurizio Guida, Antonio Travaglino, Maria D'Armiento, Maria Raffaela Campanino, Giuseppe Zara, Maria G. Signorini, Giuseppe Maria Maruotti, Giovanni Magenes, Tagliaferri, S., Travaglino, A., Raffone, A., Saccone, G., Campanino, M. R., Zara, G., Ammendola, A., Pini, N., Maruotti, G. M., Magenes, G., Signorini, M. G., Guida, M., Zullo, F., D'Armiento, M., and Campanile, M.

Subjects
medicine.medical_specialty, intrauterine growth restriction, Cardiotocography, Placenta, Birth weight, placental histological abnormalities, Intrauterine growth restriction, neonatal outcome, Preeclampsia, Pre-Eclampsia, Pregnancy, Placental dysfunction, Internal medicine, Clinical endpoint, Humans, Medicine, Pathological, Retrospective Studies, Fetal Growth Retardation, business.industry, Infant, Newborn, Obstetrics and Gynecology, Heart Rate, Fetal, medicine.disease, placental histological abnormalitie, Fetal heart monitoring, Case-Control Studies, embryonic structures, Pediatrics, Perinatology and Child Health, Cardiology, Female, Base excess, business, Complication
Abstract

To investigate the use of computerized cardiotocography (cCTG) parameters in Intrauterine Growth Restriction (IUGR) pregnancies for the prediction of 1) complication with preeclampsia; 2) placental histological abnormalities, and 3) neonatal outcomes. A single-center observational retrospective case-control study was performed by reviewing medical records, cCTG databases and pathological reports of women with singleton pregnancy and IUGR uncomplicated (controls) and complicated by preeclampsia (cases). Primary endpoint was the association between cCTG parameters and preeclampsia in IUGR. Secondary endpoints were the association between cCTG parameters and 1) placental abnormalities, and 2) neonatal outcomes. The one-way ANOVA test was used to compare cCTG parameters in cases and controls. t-test was applied to compare neonatal outcomes and placental abnormalities in both groups. The Spearman Test value Correlation coefficients between the cCTG parameters and neonatal outcome in the two groups. A p value < .05 was considered significant for all analyses. Among all cCTG parameters, a significant association with preeclampsia in IUGR was found for Fetal Heart Rate (FHR, p = .008), Delta (p = .018), Short Term Variability (STV, p = .021), Long Term Variability (LTV, p = .028), Acceleration Phase Rectified Slope (APRS, p = .018) and Deceleration Phase Rectified Slope (DPRS, p = .038). Of all placental histologic abnormalities, only vascular alterations at least moderate were significantly associated with increased FHR (p = .02). About neonatal outcomes, all cCTG parameters were significantly associated with birth weight, Apgar index at 1 and 5 min, pH and pCO2. FHR, LTI, Delta, Approximate Entropy (ApEn) and LF were significantly associated with pO2; LTI, Interval Index (II) and ApEn with base excess. Among controls, Delta, ApEn, Low Frequency (LF) and High Frequency (HF) were significantly associated with pCO2, while among cases, STV and Delta were significantly associated with pH; STV, LTI, Delta, ApEn, LF and HF with pCO2; STV, LTI, Delta and ApEn with pO2; HF with base excess; FHR and LF with lactates. cCTG parameters may be useful to detect complication with preeclampsia in IUGR pregnancies. Regarding placental status, cCTG parameters may detect overall circulation alterations, but not specific histological abnormalities. Lastly, all cCTG parameters may predict neonatal outcomes, helping to tailor the patients’ management.

Published
2021
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4. Maternal haemodynamic profile in pregnancy after assisted reproductive technology: A pilot study

Author

Marta Campanile, Farid Talhami, Salvatore Tagliaferri, Laura Sarno, Maurizio Guida, Sonia Migliorini, Annunziata Carlea, Giuseppe Maria Maruotti, Sarno, L., Tagliaferri, S., Carlea, A., Talhami, F., Migliorini, S., Maruotti, G. M., Campanile, M., and Guida, M.

Subjects
Cardiac output, Adult, medicine.medical_specialty, Reproductive Techniques, Assisted, Systemic vascular resistance, medicine.medical_treatment, Hemodynamics, Pilot Projects, Pregnancy outcome, Pregnancy, Internal Medicine, medicine, Humans, Pilot Project, Prospective Studies, Hemodynamic, Assisted reproductive technology, Obstetrics, Singleton, Obstetric examination, business.industry, Maternal haemodynamic, Obstetrics and Gynecology, medicine.disease, Prospective Studie, medicine.anatomical_structure, Increased risk, Case-Control Studies, Vascular resistance, Female, Case-Control Studie, business, Human
Abstract

Singleton pregnancies obtained by assisted reproductive technology (ART) are at increased risk of adverse pregnancy outcome. Aim of this pilot study was to compare maternal hemodynamic profile in ART and spontaneous singleton pregnancies. Patients were enrollered during a third trimester routine obstetric examination. Maternal haemodynamic assessment was carried out by a single trained operator using an UltraSonic Cardiac Output Monitor in standardized conditions. Our pilot data suggests that women conceived after ART may have significantly lower Cardiac Output and significantly higher Systemic Vascular Resistance when compared to those conceiving spontaneously. These differences, if confirmed in larger studies, might explain the increased prevalence of adverse outcome, especially hypertensive disorders of pregnancy, in singleton ART pregnancies.

Published
2021
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5. miR-16-5p, miR-103-3p, and miR-27b-3p as Early Peripheral Biomarkers of Fetal Growth Restriction

Author

Salvatore Tagliaferri, Pasquale Cepparulo, Antonio Vinciguerra, Marta Campanile, Giuseppina Esposito, Giuseppe Maria Maruotti, Fulvio Zullo, Lucio Annunziato, Giuseppe Pignataro, Tagliaferri, S., Cepparulo, P., Vinciguerra, A., Campanile, M., Esposito, G., Maruotti, G. M., Zullo, F., Annunziato, L., and Pignataro, G.

Subjects
Disease, Pediatrics, Andrology, fetal growth restriction, 03 medical and health sciences, 0302 clinical medicine, Placenta, medicine, Pregnancy, Fetus, 030219 obstetrics & reproductive medicine, microRNA, business.industry, hypoxia, lcsh:RJ1-570, biomarkers, Gestational age, lcsh:Pediatrics, Brief Research Report, Hypoxia (medical), medicine.disease, FGR, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Gestation, Population study, biomarker, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Current tests available to diagnose fetal hypoxia in-utero lack sensitivity thus failing to identify many fetuses at risk. Emerging evidence suggests that microRNAs derived from the placenta circulate in the maternal blood during pregnancy and may be used as non-invasive biomarkers for pregnancy complications. With the intent to identify putative markers of fetal growth restriction (FGR) and new therapeutic druggable targets, we examined, in maternal blood samples, the expression of a group of microRNAs, known to be regulated by hypoxia. The expression of microRNAs was evaluated in maternal plasma samples collected from (1) women carrying a preterm FGR fetus (FGR group) or (2) women with an appropriately grown fetus matched at the same gestational age (Control group). To discriminate between early- and late-onset FGR, the study population was divided into two subgroups according to the gestational age at delivery. Four microRNAs were identified as possible candidates for the diagnosis of FGR: miR-16-5p, miR-103-3p, miR-107-3p, and miR-27b-3p. All four selected miRNAs, measured by RT-PCR, resulted upregulated in FGR blood samples before the 32nd week of gestation. By contrast, miRNA103-3p and miRNA107-3p, analyzed between the 32nd and 37th week of gestation, showed lower expression in the FGR group compared to aged matched controls. Our results showed that measurement of miRNAs in maternal blood may form the basis for a future diagnostic test to determine the degree of fetal hypoxia in FGR, thus allowing the start of appropriate therapeutic interventions to alleviate the burden of this disease.

Published
2021

6. Treatment of Delirium in Older Persons: What We Should Not Do!

Author

Giovanna Pelà, Sara Tagliaferri, Giuseppe Bellelli, Marcello Maggio, Fulvio Lauretani, S. Morganti, Lauretani, F, Bellelli, G, Pela, G, Morganti, S, Tagliaferri, S, and Maggio, M

Subjects
medicine.medical_specialty, media_common.quotation_subject, Review, Catalysis, Pharmacological treatment, Inorganic Chemistry, lcsh:Chemistry, 03 medical and health sciences, 0302 clinical medicine, delirium, pharmacological treatment, Orientation (mental), Perception, Cerebral function, Medicine, Humans, Cognitive Dysfunction, 030212 general & internal medicine, Physical and Theoretical Chemistry, Intensive care medicine, Molecular Biology, lcsh:QH301-705.5, Spectroscopy, Brain function, media_common, Balance (ability), older person, Psychotropic Drugs, business.industry, Organic Chemistry, Stressor, General Medicine, Computer Science Applications, Hospitalization, neurogeriatric disorders, lcsh:Biology (General), lcsh:QD1-999, Acute Disease, older persons, Delirium, neurogeriatric disorder, medicine.symptom, business, Cognition Disorders, 030217 neurology & neurosurgery
Abstract

The presentation of common acute diseases in older age is often referred to as “atypical”. Frequently, the symptoms are neither single nor tissue related. In most cases, the onset of symptoms and diseases is the expression of a diminished reserve with a failure of the body system and imbalance of brain function. Delirium is one of the main devastating and prevalent atypical symptoms and could be considered as a geriatric syndrome. It encompasses an array of neuropsychiatric symptoms and represents a disarrangement of the cerebral function in response to one or more stressors. The most recent definition, reported in the DSM-V, depicts delirium as a clear disturbance in attention and awareness. The deficit is to be developed in a relatively short time period (usually hours or days). The attention disorder must be associated with another cognitive impairment in memory, orientation, language, visual-spatial or perception abilities. For the treatment, it is imperative to remove the potential causes of delirium before prescribing drugs. Even a non-pharmacological approach to reducing the precipitating causes should be identified and planned. When we are forced to approach the pharmacological treatment of hyperactive delirium in older persons, we should select highly cost-effective drugs. High attention should be devoted to the correct balance between improvement of psychiatric symptoms and occurrence of side effects. Clinicians should be guided in the correct choice of drugs following cluster symptoms presentation, excluding drugs that could potentially produce complications rather than advantages. In this brief point-of-view, we propose a novel pharmacological flow-chart of treatment in relation to the basic clusters of diseases of an older patient acutely admitted to the hospital and, in particular, we emphasize “What We Should Not Do!”, with the intention of avoiding possible side effects of drugs used.

Published
2020

7. Impact of nuchal cord on antenatal and intrapartum foetal heart rate surveillance and perinatal outcome

Author

Maurizio Guida, Giovanni Magenes, Gabriele Saccone, Giuseppina Esposito, Francesca Giovanna Esposito, Marta Campanile, Fulvio Zullo, Salvatore Tagliaferri, Maria G. Signorini, Tagliaferri, S., Esposito, F. G., Esposito, G., Saccone, G., Signorini, M. G., Magenes, G., Campanile, M., Guida, M., and Zullo, F.

Subjects
medicine.medical_specialty, Cardiotocography, Term Birth, Birth weight, Perinatal outcome, Foetal heart rate, labour, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, obstetric, Birth Weight, Humans, signal interpretation, reproductive and urinary physiology, Retrospective Studies, Foetal monitoring, Observer Variation, Labor, Obstetric, 030219 obstetrics & reproductive medicine, pregnancy outcome, medicine.diagnostic_test, business.industry, Vaginal delivery, Obstetrics, Infant, Newborn, Reproducibility of Results, Obstetrics and Gynecology, nuchal cord, Heart Rate, Fetal, Delivery, Obstetric, medicine.disease, female genital diseases and pregnancy complications, 030220 oncology & carcinogenesis, computer-assisted, Foetal monitoring, labour, obstetric, nuchal cord, pregnancy outcome, signal interpretation, computer-assisted, Gestation, Female, Apgar score, Nuchal cord, business
Abstract

Analysing antepartum and intrapartum computerised cardiotocographic (cCTG) parameters in physiological term pregnancies with nuchal (NC) or body cord (BC), in order to correlate them with labour events and neonatal outcome. We enrolled 808 pregnant women, composed of 264 with ‘one NC’, 121 with ‘multiple NCs’, 39 with BC and 384 with ‘no NC’, were monitored from the 37th week of gestation before labour, while 49 pregnant women with ‘one or more NCs’ and 47 with ‘no NCs’ were analysed during labour. No differences in maternal characteristics, foetal pH at birth and 5-min Apgar score were observed. The birth weight was significantly lower in the ‘multiple NCs’ group, while 1-minute Apgar score was lower in the BC group than the other groups, respectively. No relevant differences in cCTG parameters were observed, except for LTI, Delta and number of variable decelerations in antepartum period and only variable deceleration in intrapartum period.Impact statementWhat is already known on this subject? Ultrasound cannot predict which foetuses with NCs are likely to have problem during labour. The question arose if single or multiple NC could affects FHR monitoring prior and during labour. What do the results of this study add? Computerised cardiotocography (cCTG) is a standardised method developed to reduce inter- and intra-observer variability and the poor reproducibility of visual analysis. Few studies have investigated the influence of NCs on FHR variability and, to our knowledge, no one has evaluated its linear and nonlinear characteristics in antepartum and intrapartum period using a computerised analysis system. No differences in maternal characteristics, foetal pH at birth and 5-min Apgar score were observed. Birth weight was significantly lower in the ‘multiple NCs’ group, while 1-min Apgar score was lower in the BC group than the other groups, respectively. Foetuses with ‘one or more NCs’ evidenced a larger number of prolonged second stage and meconium-stained liquor cases, while the operative vaginal delivery and emergency caesarean section rates were unchanged. No relevant differences in cCTG parameters were observed, except for LTI, Delta and number of variable decelerations in antepartum period and only variable deceleration in intrapartum period. What are the implications of these findings for clinical practice and/or further research? cCTG monitoring results confirmed their usefulness for assessing the state of good oxygenation for all foetuses investigated.

Published
2019

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