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2. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Author

Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, A. Tarasconi, M. Sella, S. Auriemma, G. Paternò, G. Faggian, C. Lucarelli, N. De Grazia, C. Alberto, A. Margola, L. Porcella, I. Nardiello, E. Chimenti, M. Zeni, A. Giani, S. Famularo, E. Romairone, C. Minaglia, C. Ceccotti, G. Guerra, G. Mantovani, F. Monacelli, T. Candiani, A. Ballestrero, F. Santolini, M. Rosso, V. Bono, S. Sibilla, P. Dal Santo, M. Ceci, P. Barone, T. Schirinzi, A. Formenti, G. Nastasi, G. Isaia, D. Gonella, A. Battuello, S. Casson, D. Calvani, F. Boni, A. Ciaccio, R. Rosa, G. Sanna, S. Manfredini, L. Cortese, M. Rizzo, R. Prestano, A. Greco, M. Lauriola, G. Gelosa, V. Piras, M. Arena, D. Cosenza, A. Bellomo, M. LaMontagna, L. Gabbani, L. Lambertucci, S. Perego, G. Parati, G. Basile, V. Gallina, G. Pilone, C. Giudice, F. De, L. Pietrogrande, B. De, M. Mosca, I. Corazzin, P. Rossi, V. Nunziata, F. D'Amico, A. Grippa, S. Giardini, R. Barucci, A. Cossu, L. Fiorin, M. Distefano, M. Lunardelli, M. Brunori, I. Ruffini, E. Abraham, A. Varutti, E. Fabbro, A. Catalano, G. Martino, D. Leotta, A. Marchet, G. Dell'Aquila, A. Scrimieri, M. Davoli, M. Casella, A. Cartei, G. Polidori, D. Brischetto, S. Motta, R. Saponara, P. Perrone, G. Russo, D. Del, C. Car, T. Pirina, S. Franzoni, A. Cotroneo, F. Ghiggia, G. Volpi, C. Menichetti, M. Bo, A. Panico, P. Calogero, G. Corvalli, M. Mauri, E. Lupia, R. Manfredini, F. Fabbian, A. March, M. Pedrotti, M. Veronesi, E. Strocchi, C. Borghi, A. Bianchetti, A. Crucitti, V. DiFrancesco, G. Fontana, L. Bonanni, F. Barbone, C. Serrati, G. Ballardini, M. Simoncelli, G. Ceschia, C. Scarpa, R. Brugiolo, S. Fusco, T. Ciarambino, C. Biagini, E. Tonon, M. Porta, D. Venuti, M. DelSette, M. Poeta, G. Barbagallo, G. Trovato, A. Delitala, P. Arosio, F. Reggiani, G. Zuliani, B. Ortolani, E. Mussio, A. Girardi, A. Coin, G. Ruotolo, A. Castagna, M. Masina, R. Cimino, A. Pinciaroli, G. Tripodi, U. Cannistrà, F. Cassadonte, M. Vatrano, L. Scaglione, P. Fogliacco, C. Muzzuilini, F. Romano, A. Padovani, L. Rozzini, A. Cagnin, F. Fragiacomo, G. Desideri, E. Liberatore, A. Bruni, G. Orsitto, M. Franco, L. Bonfrate, M. Bonetto, N. Pizio, G. Magnani, G. Cecchetti, A. Longo, V. Bubba, L. Marinan, M. Cotelli, M. Turla, M. Sessa, L. Abruzzi, G. Castoldi, D. LoVetere, C. Musacchio, M. Novello, A. Cavarape, A. Bini, A. Leonardi, F. Seneci, W. Grimaldi, F. Fimognari, V. Bambara, A. Saitta, F. Corica, M. Braga, E. Ettorre, C. Camellini, G. Bellelli, G. Annoni, A. Marengoni, A. Crescenzo, G. Noro, R. Turco, M. Ponzetto, L. Giuseppe, B. Mazzei, G. Maiuri, D. Costaggiu, R. Damato, M. Formilan, G. Patrizia, M. Gallucci, M. Paragona, P. Bini, D. Modica, C. Abati, M. Clerici, I. Barbera, F. NigroImperiale, A. Manni, C. Votino, C. Castiglioni, M. Di, M. Degl'Innocenti, G. Moscatelli, S. Guerini, C. Casini, D. Dini, E. D'Imporzano, S. DeNotariis, F. Bonometti, C. Paolillo, A. Riccardi, A. Tiozzo, M. DiBari, S. Vanni, A. Scarpa, D. Zara, P. Ranieri, M. Alessandro, F. Di, D. Pezzoni, C. Platto, V. D'Ambrosio, C. Ivaldi, P. Milia, F. DeSalvo, C. Solaro, M. Strazzacappa, M. Cazzadori, S. Confente, M. Grasso, E. Troisi, V. Guerini, B. Bernardini, C. Corsini, S. Boffelli, A. Filippi, K. Delpin, B. Faraci, E. Bertoletti, M. Vannucci, F. Tesi, P. Crippa, A. Malighetti, D. Bettini, F. Maltese, G. Abruzzese, D. Cosimo, M. Azzini, M. Colombo, G. Procino, S. Fascendini, F. Barocco, P. Del, A. Mazzone, E. Riva, D. Dell'Acqua, M. Cottino, G. Vezzadini, S. Avanzi, C. Brambilla, S. Orini, F. Sgrilli, A. Mello, L. Lombardi, E. Muti, B. Dijk, S. Fenu, C. Pes, P. Gareri, M. Passamonte, R. Rigo, L. Locusta, L. Caser, G. Rosso, S. Cesarini, R. Cozzi, C. Santini, P. Carbone, I. Cazzaniga, R. Lovati, A. Cantoni, P. Ranzani, D. Barra, G. Pompilio, S. Dimori, S. Cernesi, C. Riccò, F. Piazzolla, E. Capittini, C. Rota, F. Gottardi, L. Merla, A. Barelli, A. Millul, G. De, G. Morrone, M. Bigolari, M. Macchi, F. Zambon, C. Pizzorni, G. DiCasaleto, G. Menculini, M. Marcacci, G. Catanese, D. Sprini, T. DiCasalet, M. Bocci, S. Borga, P. Caironi, C. Cat, E. Cingolani, L. Avalli, G. Greco, G. Citerio, L. Gandini, G. Cornara, R. Lerda, L. Brazzi, F. Simeone, M. Caciorgna, D. Alampi, S. Francesconi, E. Beck, B. Antonini, K. Vettoretto, M. Meggiolaro, E. Garofalo, S. Notaro, R. Varutti, F. Bassi, G. Mistraletti, A. Marino, R. Rona, E. Rondelli, I. Riva, A. Scapigliati, A. Cortegiani, F. Vitale, L. Pistidda, R. D'Andrea, L. Querci, P. Gnesin, M. Todeschini, M. Lugano, G. Castelli, M. Ortolani, A. Cotoia, S. Maggiore, L. DiTizio, R. Graziani, I. Testa, E. Ferretti, C. Castioni, F. Lombardi, R. Caserta, M. Pasqua, S. Simoncini, F. Baccarini, M. Rispoli, F. Grossi, L. Cancelliere, M. Carnelli, F. Puccini, G. Biancofiore, A. Siniscalchi, C. Laici, E. Mossello, M. Torrini, G. Pasetti, S. Palmese, R. Oggioni, V. Mangani, S. Pini, M. Martelli, E. Rigo, F. Zuccalà, A. Cherri, R. Spina, I. Calamai, N. Petrucci, A. Caicedo, F. Ferri, P. Gritti, N. Brienza, R. Fonnesu, M. Dessena, G. Fullin, D. Saggioro, Morandi, A, Inzitari, M, Udina, C, Gual, N, Mota, M, Tassistro, E, Andreano, A, Cherubini, A, Gentile, S, Mossello, E, Marengoni, A, Olivé, A, Riba, F, Ruiz, D, de Jaime, E, Bellelli, G, Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, Italian Study Group of Delirium, Claudio Borghi, Morandi, Alessandro, Inzitari, Marco, Udina, Cristina, Gual, Neu, Mota, Miriam, Tassistro, Elena, Andreano, Anita, Cherubini, Antonio, Gentile, Simona, Mossello, Enrico, Marengoni, Alessandra, Olivé, Anna, Riba, Francesc, Ruiz, Domingo, de Jaime, Elisabet, Bellelli, Giuseppe, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, G Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, E D'Imporzano, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D'Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
medicine.medical_specialty, Activities of daily living, Cross-sectional study, Hearing loss, medicine.medical_treatment, Visual impairment, Psychological intervention, visual impairment, Socio-culturale, behavioral disciplines and activities, Hearing impairment, delirium, older, sensory deficits, visual impairment, sensory deficit, Hearing impairment, 03 medical and health sciences, delirium, older, sensory deficits, 0302 clinical medicine, Risk Factors, Activities of Daily Living, mental disorders, medicine, Humans, Dementia, 030212 general & internal medicine, LS4_4, Hearing Loss, General Nursing, Rehabilitation, business.industry, Health Policy, General Medicine, medicine.disease, nervous system diseases, Cross-Sectional Studies, Italy, Emergency medicine, Delirium, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

Published
2021

3. 5-Year Control and Treatment of Edema and Increased Capillary Filtration in Venous Hypertension and Diabetic Microangiopathy Using O-(β-Hydroxyethyl)-Rutosides: A Prospective Comparative Clinical Registry

Author

Maria Rosaria Cesarone, I. Ruffini, Marcello Corsi, Gianni Belcaro, Andrea Di Renzo, Andrea Ledda, Edmondo Ippolito, M G Grossi, Mark Dugall, Marisa Cacchio, Anna Rita Marino Santarelli, and Andrea Ricci

Subjects
Adult, medicine.medical_specialty, Time Factors, Chronic venous insufficiency, Administration, Oral, Capillary filtration, Severity of Illness Index, Drug Administration Schedule, Group B, law.invention, Capillary Permeability, Randomized controlled trial, law, Edema, Diabetes mellitus, Varicose veins, Laser-Doppler Flowmetry, Humans, Medicine, Prospective Studies, Registries, Skin, Dose-Response Relationship, Drug, business.industry, Microangiopathy, Cardiovascular Agents, Middle Aged, medicine.disease, Surgery, Hydroxyethylrutoside, Treatment Outcome, Venous Insufficiency, Anesthesia, Chronic Disease, Patient Compliance, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Blood Gas Monitoring, Transcutaneous, Venous Pressure, Blood Flow Velocity, Diabetic Angiopathies, Stockings, Compression
Abstract

This independent prospective controlled trial evaluates the efficacy of O-(β-hydroxyethyl)-rutosides (HR) during 5 years of administration against signs and symptoms and further degeneration of microcirculatory disturbances. The protective effect of HR in preventing end-point complications such as venous ulceration is evaluated. This study is based on evaluation of edema and the capillary filtration rate (CFR) in association with a clinical score scale. Patients having a severe degree of chronic venous insufficiency (CVI) and venous microangiopathy and completing at least 5 years of treatment are included. The following 4 groups are considered: group A (patients with CVI but without diabetes mellitus, receiving 1500 mg/d of HR), group B (patients with CVI and diabetes mellitus, receiving 2 g/d of HR), group C (control subjects receiving no pharmacologic or compression treatment), and group D (patients using elastic compression stockings only). All patients received the “best” available treatment. No adverse effects or intolerance is noted, with good compliance (>85%). In group A, there is a statistically significant decrease in the CFR during 5 years of follow-up. In group B, the decrease in the CFR is greater than that in group A. Reductions in edema, swelling, and the CFR during 5 years are notable, and values approach normal levels. During 5 years, HR is effective in treating venous edema and hypertension and in preventing deterioration of the distal venous system. The prevention of ulcerations with HR is another important observation. The effects of HR seem to be partially dose related, and tolerability and compliance are good.

Published
2008
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4. Prevention of Edema in Long Flights with Pycnogenol®

Author

Andrea Ricci, Luciano Pellegrini, E. Ippolito, Marisa Cacchio, Mark Dugall, A. Di Renzo, M. Scoccianti, B.M. Errichi, M. G. Vinciguerra, F. Mucci, F. Fano, P. Bavera, G. Acerbi, I. Ruffini, P. Rohdewald, M. R. Cesarone, and G Belcaro

Subjects
Adult, Antithrombotic Agent, Objective data, 030204 cardiovascular system & hematology, Research management, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Edema, medicine, Humans, 030212 general & internal medicine, Exercise, Flavonoids, Travel, Plant Extracts, business.industry, Hematology, General Medicine, Middle Aged, medicine.disease, Venous thrombosis, medicine.anatomical_structure, Anesthesia, Ankle, medicine.symptom, Aviation, business, Body mass index, Platelet Aggregation Inhibitors
Abstract

The aim of this study was to evaluate the prevention of edema during long-haul flights with an oral, anti-edema and antithrombotic agent (Pycnogenol®, Horphag, Research Management SA, Geneva, Switzerland) in asymptomatic subjects. The assessment of edema was performed by evaluating an analogue scale, the rate of ankle swelling by strain-gauge derived rate of ankle swelling (RAS), and by assessing the ankle circumference variation. The study included 211 subjects; 169 completed the study (88 in the control group and 81 in the Pycnogenol® group). There were no important differences between the two groups (comparable for age, gender, weight, body mass index, and pattern distribution). The edema score, the RAS, and the circumference at inclusion were also comparable. After the flight in those treated with Pycnogenol®, the edema score was increased only by 17.9% (vs. an increase of 58.3% in the control group) (p® group (age 44.5; SD 8) and in 23 in the control group (age 45; SD 9) was increased on average by 91% in the control group and 36% in the Pycnogenol® group (p® group (11% in the control group; p® on edema during long flights when considering subjective and objective data. No unwanted effects were observed.

Published
2005
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5. Variations in Plasma Free Radicals with Topical Aescin + Essential Phospholipids Gel in Venous Hypertension: New Clinical Data

Author

Umberto Cornelli, Marcello Corsi, E. Ippolito, M. R. Cesarone, Mark Dugall, G Belcaro, I. Ruffini, and Andrea Ricci

Subjects
Adult, Male, medicine.medical_specialty, Free Radicals, Administration, Topical, Urology, Microcirculation, chemistry.chemical_compound, Essential phospholipids, Varicose veins, Humans, Medicine, Tibia, Venous hypertension, Aged, Aescin, Escin, Massage, business.industry, Microangiopathy, Middle Aged, medicine.disease, Surgery, Drug Combinations, Venous Insufficiency, chemistry, Phosphatidylcholines, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Gels, Venous Pressure
Abstract

The aim of this study was the evaluation of the effects of Aescin + essential phospholipids (AEPL) gel on plasma free radicals (PFRs). In this study, ten patients with venous hypertension, no ulcerations or infections, venous microangiopathy, and varicose veins were treated with topical AEPL applied in a standard protocol. AEPL was applied for 2 weeks, three times daily at the same skin region (perimalleolar internal region at defined distance from the medial malleolus and from the anterior edge of the tibia). In subjects with venous hypertension, PFR values were higher than 420 Carr units. After treatment, the values of PRF decreased to almost normal as an effect of the massage with AEPL gel. The decrease in value was observed in all treatment subjects. A ranking system indicates that the AEPL preparation is active in all subjects who have venous microangiopathy. The decrease in PFR value was greater than 30% in all treatment subjects (p

Published
2004
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6. Prevention of Venous Thrombosis in Long-Haul Flights with Flite Tabs: The LONFLIT-FLITE Randomized, Controlled Trial

Author

M. R. Cesarone, G Belcaro, Neil H. Riordan, A. Di Renzo, P Bavera, Andrea Ricci, G. Vinciguerra, Mark Dugall, G. Acerbi, George Geroulakos, I. Ruffini, J. Kenyon, R. Brandolini, Marcello Corsi, Maura Griffin, E. Ippolito, Andrew Nicolaides, Stefano Stuard, and B.M. Errichi

Subjects
Adult, Male, medicine.medical_specialty, Deep vein, Capsules, 030204 cardiovascular system & hematology, Placebo, Asymptomatic, Veins, law.invention, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Risk Factors, law, medicine, Edema, Humans, Subtilisins, 030212 general & internal medicine, Vein, Exercise, Aged, Ultrasonography, Flavonoids, Venous Thrombosis, Leg, Travel, Plant Extracts, business.industry, Fibrinogen, Middle Aged, medicine.disease, Thrombosis, Surgery, Drug Combinations, Venous thrombosis, medicine.anatomical_structure, Anesthesia, Concomitant, Aerospace Medicine, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors
Abstract

The aim of this study was to evaluate the development of edema, and superficial and deep vein thrombosis (DVT) prophylaxis with an oral profibrinolytic agent (Flite Tabs, 150 mg pinokinase, Aidan, Tempe, AZ, USA) in long-haul flights (7-8 hours), in high-risk subjects. A group of 300 subjects was included; 76 were excluded for several problems including concomitant treat ments ; 204 were randomized into 2 groups (active treatment or placebo) to evaluate the effects of prophylaxis with Flite Tabs. An exercise program was used in both groups. The femoral, popliteal, tibial, and superficial veins were scanned with ultrasound before and within 90 minutes after flights. Of the included subjects, 92 of 103 controls and 94 of 101 treated subjects completed the study. Dropouts were due to connection problems. Age, gender, and risk distribution were comparable in the groups. In the treatment group, no DVT was observed. In the control group, 5 subjects (5.4%) had a DVT and there were 2 superficial thromboses (7 events in 92 subjects; 7.6%). At inclusion, edema was comparable in the 2 groups. After flights there was an increase in score in controls (+12%) in comparison with a decrease (-15%) in the Flite Tabs group (the difference in variation was statistically significant). Intention-to-treat analysis for thrombotic events shows 18 failures in controls (11 lost to follow-up + 7 throm botic events) of 92 subjects (19.6%) in comparison with 7 failures (of 94 subjects, equivalent to 7.4%) in the treatment group (p

Published
2003
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7. Foam-Sclerotherapy, Surgery, Sclerotherapy, and Combined Treatment for Varicose Veins: A 10-Year, Prospective, Randomized, Controlled, Trial (VEDICO Trial)

Author

G. Belcaro, M.R. Cesarone, A. di Renzo, R. Brandolini, L. Coen, G. Acerbi, C. Marelli, B.M. Errichi, M. Malouf, K. Myers, D. Christopoulos, A. Nicolaides, G. Geroulakos, S. Vasdekis, E. Simeone, A. Ricci, I. Ruffini, S. Stuard, E. Ippolito, P. Bavera, M. Georgiev, M. Corsi, M. Scoccianti, U. Cornelli, N. Caizzi, M. Dugall, M. Veller, R. Venniker, M. Cazaubon, and M. Griffin

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Statistics, Nonparametric, law.invention, Varicose Veins, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Recurrence, law, Sclerotherapy, Varicose veins, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Vein, Prospective cohort study, Ultrasonography, Doppler, Duplex, Chi-Square Distribution, Varix, Vascular disease, business.industry, Middle Aged, medicine.disease, Combined Modality Therapy, Surgery, Treatment Outcome, medicine.anatomical_structure, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Varices, business
Abstract

The study compared, by a prospective, randomized method, 6 treatment options: A: Sclero therapy ; B: High-dose sclerotherapy; C: Multiple ligations; D: Stab avulsion; E: Foam-sclero therapy ; F: Surgery (ligation) followed by sclerotherapy. Results were analyzed 10 years after inclusion and initial treatment. Endpoints of the study were variations in ambulatory venous pressure (AVP), refilling time (RT), presence of duplex-reflux, and number of recurrent or new incompetent venous sites. The number of patients, limbs, and treated venous segments were comparable in the 6 treatment groups, also comparable for age and sex distribution. The occur rence of new varicose veins at 5 years varied from 34% for group F (surgery + sclero) and ligation (C) to 44% for the foam + sclero group (E) and 48% for group A (dose 1 sclero). At 10 years the occurrence of new veins varied from 37% in F to 56% in A. At inclusion AVP was comparable in the different groups. At 10 years the decrease in AVP and the increase in RT (indicating decrease in reflux), was generally comparable in the different groups. Also at 10 years the number of new points of major incompetence was comparable in all treatment groups. These results indicate that, when correctly performed, all treatments may be similarly effective. "Standard," low-dose sclerotherapy appears to be less effective than high-dose sclero and foam-sclerotherapy which may obtain, in selected subjects, results comparable to surgery.

Published
2003
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8. Improvement of Microcirculation and Healing of Venous Hypertension and Ulcers with Crystacide. Evaluation of Free Radicals, Laser Doppler Flux and PO2. A Prospective- Randomized-Controlled Study

Author

Andrea Ricci, Mark Dugall, I. Ruffini, Andrew N. Nicolaides, Massimo Milani, R. Brandolini, G Belcaro, A. Di Renzo, George Geroulakos, U. Cornelli, Maura Griffin, and Maria Rosaria Cesarone

Subjects
Male, medicine.medical_specialty, Free Radicals, Chronic venous insufficiency, 030204 cardiovascular system & hematology, Statistics, Nonparametric, Varicose Ulcer, Microcirculation, Ointments, Duplex scanning, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Laser-Doppler Flowmetry, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, Ultrasonography, Doppler, Duplex, Wound Healing, business.industry, Vascular disease, Microangiopathy, Hydrogen Peroxide, Middle Aged, Laser Doppler velocimetry, medicine.disease, Venous Obstruction, Surgery, Oxygen, Treatment Outcome, Venous Insufficiency, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

In 20 patients with chronic venous insufficiency and venous hypertension associated with ulcerations, the effects of a new compound, applied onto the skin (Crystacide) were assessed in a randomized, controlled study. Duplex scanning was used to assess the presence of venous obstruction and incompetence, and microcirculatory methods were used to assess and quantify venous microangiopathy and to follow up subjects after local treatment with Crystacide. Laser Doppler flowmetry (LDF) was used to assess skin perfusion in association with transcutaneous (tc) partial pressure of oxygen (PO2) measurements. Local plasma free radicals (PFR) were evaluated in the area surrounding the venous ulcer, with the D-Rom test. Crystacide was applied around and on the ulcer for 10 days. Crystacide was more effective than the control treatment: PO2 was increased, PFR and LDF were decreased (flux increase is associated with venous hypertension), and the ulcer area was significantly smaller at 10 days in the Crystacide group in comparison with the placebo group (p < 0.05). In conclusion, in venous ulcerations, local treatment with Crystacide (10 days) improves the microcirculation and decreases skin free radicals improving healing.

Published
2003
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9. Efficacy of Topical Treatment with Aescin + Essential Phospholipids Gel in Venous Insufficiency and Hypertension

Author

M. R. Cesarone, G Belcaro, Mark Dugall, and I. Ruffini

Subjects
Adult, Male, inorganic chemicals, medicine.medical_specialty, Chronic venous insufficiency, Administration, Topical, 030204 cardiovascular system & hematology, Microcirculation, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, TCPO, Skin, Aescin, Escin, Varix, integumentary system, Vascular disease, business.industry, Microangiopathy, Carbon Dioxide, Middle Aged, respiratory system, medicine.disease, respiratory tract diseases, Surgery, Oxygen, Drug Combinations, Venous Insufficiency, chemistry, Anesthesia, Chronic Disease, Phosphatidylcholines, Female, Cardiology and Cardiovascular Medicine, Varices, business, Gels, Venous Pressure, circulatory and respiratory physiology
Abstract

Aescin and essential phospholipids (AEPL) in a gel was used in a microcirculatory model to assess the effects on skin perfusion in chronic venous insufficiency and severe venous hypertension. The aim of this efficacy study was to evaluate the efficacy of an AEPL gel on the microcirculation measuring transcutaneous skin PO2 and PCO2 in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Transcutaneous PO2 and PCO2 were measured at the internal perimalleolar region. After 2 weeks of treatment with AEPL, all TcPO2 individual values were increased and all PCO2 values were decreased (p

Published
2004
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10. Lady Prelox® improves sexual function in post-menopausal women

Author

A, Bottari, G, Belcaro, A, Ledda, M R, Cesarone, G, Vinciguerra, A, Di Renzo, S, Stuard, M, Dugall, L, Pellegrini, S, Errichi, G, Gizzi, E, Ippolito, A, Ricci, M, Cacchio, I, Ruffini, F, Fano, and M, Hosoi

Subjects
Aspartic Acid, Time Factors, Plant Extracts, Pilot Projects, Middle Aged, Arginine, Postmenopause, Drug Combinations, Sexual Dysfunction, Physiological, Patient Satisfaction, Dietary Supplements, Humans, Women's Health, Female, Single-Blind Method, Sexual Dysfunctions, Psychological
Abstract

AIM:he aim of this pilot, single-blinded study was to evaluate the efficacy of a proprietary, dietary supplement Lady Prelox® for supporting and improving sexual function in generally healthy, post-menopausal women. METHODS: The Lady Prelox® and placebo control groups were comparable at inclusion with regard to the total Female Sexual Function Index (FSFI) score, as well as for the six individual FSFI domains, with 40 women (50.1±3.1 years) and 43 women (51.2±2.3 years), respectively. RESULTS:At baseline the women in the verum group presented with a mean total FSFI score of 44.6±24.1 which increased significantly already after four weeks treatment with Lady Prelox® to 70.9±18.5 and further increased to 71.7±23.9 after completion of the eight-week trial period. In the control group the mean total FSFI was 44.1±22.8 at inclusion and non-significantly increased to 45±21.4 after four weeks and 47.4±21.8 after eight weeks, respectively. The treatment with Lady Prelox® was comparatively significantly more effective than placebo after both four and eight weeks of treatment (P0.05). The individual six FSFI domains related to desire, arousal, lubrication, orgasm, satisfaction and pain did all respond favourably to treatment with Lady Prelox®; however, with only marginable higher scores in the placebo group. Four women in each group dropped out because of inabilities to attend scheduled check-ups. No adverse effects were reported. CONCLUSION: This study opens an interesting perspective for women experiencing moderate sexual function impairment and suggests a promising new treatment option. Further studies with larger numbers of women, including also premenopausal and perimenopausal women are warranted.

Published
2012

11. Prevention of flu episodes with colostrum and Bifivir compared with vaccination: an epidemiological, registry study

Author

G, Belcaro, M R, Cesarone, U, Cornelli, L, Pellegini, A, Ledda, M G, Grossi, M, Dugall, I, Ruffini, F, Fano, A, Ricci, S, Stuard, R, Luzzi, and M, Hosoi

Subjects
Male, Analysis of Variance, Time Factors, Colostrum, Cost-Benefit Analysis, Probiotics, Middle Aged, Drug Costs, Prebiotics, Treatment Outcome, Italy, Influenza Vaccines, Pregnancy, Influenza, Human, Humans, Immunologic Factors, Female, Registries, Hospital Costs, Aged
Abstract

The aim of this study was to evaluate the efficacy of colostrum (ARD Colostrum) in association with the immunomodulator Bifivir in the prevention of flu episodes compared with anti-flu vaccination. The registry groups included no prevention, vaccination, vaccination+immunomodulators, and immunomodulators only. Groups were comparable for age and sex distribution. In the group without prevention there were 8 major episodes and 12 minor episodes out of 34 subjects (8-12/34); in the vaccination group the respective figures were 8-13/38; in the group treated with a combination of vaccination and immunomodulators (ARD Colostrum + Bifivir) the figures were 4-9/33; and in the group treated with immunomodulators only there were 11 viral episodes (3-8) in 36 subjects. The episodes in the vaccination+immunomodulators and immunomodulators only groups were significantly lower compared with the other two groups (P0.05). The number of episodes registered with the immunnomodulators was significantly lower than those observed in patients using vaccination or no prevention (P0.05). The number of days of disease was higher in untreated controls compared to the groups treated with immunomodulators (P0.05) and 2 times higher in the vaccination group compared to the same groups (P0.05). The average relative costs were significantly lower (2.3 times) in the immunomodulators groups in comparison with the other groups (P0.05). No problems concerning tolerability or side effects were observed during the study. Compliance was very good. In conclusion, the administration of immunomodulators is very cost effective and appears to be more effective than vaccination to prevent flu.

Published
2010

12. Action of an antioxidant complex on the antioxidant power of saliva

Author

U, Cornelli, G, Belcaro, G M, Nardi, M R, Cesarone, M, Dugall, M, Hosoi, M G, Grossi, E, Ippolito, A, Ledda, and I, Ruffini

Subjects
Adult, Male, Placebos, Time Factors, Nutritional Sciences, Dietary Supplements, Humans, Female, Saliva, Models, Biological, Antioxidants
Abstract

Based on the results of the soluble antioxidants test (SAT), we have produced a combination of oral antioxidants aimed at increasing the antioxidant power of saliva. Several antioxidants are included in this product (Vit E, beta-carotene, Vit A, Vit C, polyphenols, cathechins, ellagic acid, anthocyanins, coenzyme Q10 and pyridoxine in association with Se, Zn, L-cysteine). The aim of this registry study was to evaluate the efficacy of these antioxidants in saliva, plasma and urines.MF Odontovis, an antioxidant complex, was administered to healthy subjects in the evening for one week with a final administration in the morning.Plasma, urine and saliva showed an increase in antioxidant power following both the evening administration and the final morning administration. The antioxidant action appeared to be present even at night when salival secretion is lower. Plasma SAT levels (SATs) in the morning following evening treatment were increased by 21% in comparison with controls. Morning administration increased levels up to 34% when measured 4 hours after treatment. Comparable increases were observed in saliva (SATs and morning values were +44 %; +58% two hours after morning administration and +28 % after 4 hours). In urine the evening administration caused an increase in antioxidant power (+6%).This study indicated that antioxidant levels can be increased with specific nutritional supplement. The clinical value of an increased antioxidant power in biological fluids, particularly in saliva, may be relevant for future trials of prevention and treatment.

Published
2010

13. Management of uncomplicated ankle sprains with topical or oral ketoprofen treatment. A registry study

Author

G, Vinciguerra, G, Belcaro, M R, Cesarone, B M, Errichi, A, Di Renzo, S, Errichi, A, Ricci, G, Gizzi, M, Dugall, M, Cacchio, E, Ippolito, I, Ruffini, F, Fano, S, Stuard, and M G, Grossi

Subjects
Adult, Male, Pain Threshold, Anti-Inflammatory Agents, Non-Steroidal, Administration, Oral, Pain, Middle Aged, Administration, Cutaneous, Treatment Outcome, Ketoprofen, Sprains and Strains, Humans, Female, Ankle Injuries, Prospective Studies, Range of Motion, Articular, Pain Measurement
Abstract

Ankle sprains mainly caused by accidents or strenuous sport activities can often be quite painful and impair motility. If not treated immediately and correctly, sprains may lead to severe complications. The aim of the present study was to compare the efficacy and safety of topically applied ketoprofen versus orally administered ketoprofen in 20 patients with grade I ankle sprain and 34 patients with grade II sprain. The patients were divide into in two treatment groups and received either topically applied ketoprofen treatment (ketoprofen 10% spray-gel; Prontoflex; 360 mg/die) or orally administered ketoprofen treatment (ketoprofen tablets; 3x50 mg/die). Treatment duration was one week. After 3 and 7 days of treatment, reduction of spontaneous pain and pain on active movement in the Prontoflex group was significantly bigger greater in the oral treatment group, irrespective of sprain severity. Regarding secondary parameters as mobility impairment and ankle swelling topically applied ketoprofen treatment turned out to be significantly superior to orally administered ketoprofen treatment. Additionally, Prontoflex was well tolerated, whereas ketoprofen tablets caused gastrointestinal side effects in some patients. The good efficacy in pain reduction and absence of side effects in the present study distinguished the topically applied ketoprofen as a favorable treatment for patients with accidental or sport soft tissue injuries.

Published
2009

14. O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study

Author

Marcello Corsi, Anna Rita Marino Santarelli, Gianni Belcaro, Andrea Di Renzo, Andrea Ledda, Maria Rosaria Cesarone, Marisa Cacchio, I. Ruffini, M G Grossi, Edmondo Ippolito, Mark Dugall, and Andrea Ricci

Subjects
Adult, medicine.medical_specialty, Time Factors, Chronic venous insufficiency, Administration, Oral, Administration, Cutaneous, Severity of Illness Index, Capillary Permeability, Edema, Varicose veins, medicine, Laser-Doppler Flowmetry, Humans, Prospective Studies, Registries, Prospective cohort study, Skin, business.industry, Vascular disease, Microangiopathy, Cardiovascular Agents, Middle Aged, medicine.disease, Surgery, Hydroxyethylrutoside, Treatment Outcome, Tolerability, Venous Insufficiency, Anesthesia, Ambulatory, Chronic Disease, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Blood Gas Monitoring, Transcutaneous, Gels, Venous Pressure, Blood Flow Velocity, Diabetic Angiopathies, Stockings, Compression
Abstract

O-(β-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, >56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1-g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO 2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.

Published
2008

15. Treatment of osteoarthritis with Pycnogenol®. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects

Author

G. Belcaro, M. R. Cesarone, S. Errichi, C. Zulli, B. M. Errichi, G. Vinciguerra, A. Ledda, A. Di Renzo, S. Stuard, M. Dugall, L. Pellegrini, G. Gizzi, E. Ippolito, A. Ricci, M. Cacchio, G. Cipollone, I. Ruffini, F. Fano, M. Hosoi, and P. Rohdewald

Subjects
Osteoarthrosis, Adult, Male, medicine.medical_specialty, WOMAC, Anti-Inflammatory Agents, Pain, Osteoarthritis, Placebo, law.invention, Muscular performance, Noninvasive investigations, Age Distribution, Randomized controlled trial, Adjuvants, Immunologic, Double-Blind Method, law, Immunologic, Edema, Arthropathy, medicine, Antiinflammatory agents, Humans, Sign/symptom, Adjuvants, Treadmill, Sex Distribution, Flavonoids, Pharmacology, business.industry, Plant Extracts, Foot, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Joints, Pycnogenol®, Ankle, Female, Anesthesia, medicine.symptom, business
Abstract

The aim of this double-blind, placebo-controlled study was to evaluate the efficacy of 100 mg Pycnogenol daily (oral capsules) in a 3 month study in patients with osteoarthritis (OA). OA symptoms were evaluated by WOMAC scores, mobility by recording their walking performance (treadmill). Treatment (77 patients) and placebo group (79) were comparable for age, sex distribution, WOMAC scores, walking distances and use of antiinflammatory drugs. The global WOMAC score decreased by 56% (p < 0.05) in the treatment group versus 9.6% in the placebo group. Walking distance in the treadmill test was prolonged from 68 m at the start to 198 m after 3 months treatment (p < 0.05), under placebo, from 65 m to 88 m (NS). The use of drugs decreased by 58% in the treatment group (p < 0.05) versus 1% under placebo. Gastrointestinal complications decreased by 63% in the treatment group, but only 3% under placebo. Overall, treatment costs were reduced significantly compared with placebo. Foot edema was present in 76% of the patients of the treatment group at inclusion and in 79% of the controls. After 3 months edema decreased in 79% of Pycnogenol patients (p < 0.05) vs 1% in controls. In conclusion, Pycnogenol offers an option for reduction of treatment costs and side effects by sparing antiinflammatory drugs.

Published
2008

16. Variations in C-reactive protein, plasma free radicals and fibrinogen values in patients with osteoarthritis treated with Pycnogenol®

Author

G. Belcaro, S. Errichi, Marisa Cacchio, G. Vinciguerra, Peter Rohdewald, Giuseppe Cipollone, B. M. Errichi, M. Hosoi, F. Fano, L. Pellegrini, I. Ruffini, G Gizzi, Stefano Stuard, M. Dugall, A. Ricci, C. Zulli, M. R. Cesarone, E. Ippolito, A. Di Renzo, and A. Ledda

Subjects
Male, medicine.medical_specialty, Antioxidant, WOMAC, Free Radicals, Physiology, medicine.medical_treatment, Clinical Biochemistry, Inflammation, Osteoarthritis, Fibrinogen, Gastroenterology, Biochemistry, Adjuvants, Immunologic, Immunologic, Internal medicine, Medicine, Humans, Adjuvants, Treadmill, Flavonoids, biology, Plant Extracts, business.industry, C-reactive protein, Biochemistry (medical), CRP, Pycnogenol, C-Reactive Protein, Female, Middle Aged, Treatment Outcome, Cell Biology, medicine.disease, Surgery, Joint pain, biology.protein, medicine.symptom, business, medicine.drug
Abstract

In a previous, double-blind, placebo-controlled study we evaluated the efficacy of a 3-month treatment with Pycnogenol for 156 patients with osteoarthritis of the knee. Pycnogenol significantly decreased joint pain and improved joint function as evaluated using the WOMAC score and walking performance of patients on a treadmill. In this study, we further investigated the anti-inflammatory and antioxidant activity of Pycnogenol in a subset of the osteoarthritis patients presenting with elevated C-reactive protein (CRP) and plasma-free radicals. Elevated CRP levels have been suggested to be associated with disease progression in osteoarthritis. In our study, 29 subjects of the Pycnogenol group and 26 patients in the placebo group showed CRP levels higher than 3 mg/l at baseline. Comparison of blood specimens drawn at baseline and after 3-month treatment showed that Pycnogenol significantly decreased plasma free radicals to 70.1% of baseline values. Plasma CRP levels decreased from baseline 3.9 mg/l to 1.1 mg/l in the Pycnogenol group whereas the control group had initial values of 3.9 mg/l which decreased to 3.6 mg/l. The CRP decrease in the Pycnogenol was statistical significant as compared to the control group (P < 0.05). Fibrinogen levels were found to be lowered to 62.8% of initial values (P < 0.05) in response to Pycnogenol. No significant changes for plasma free radicals, CRP and fibrinogen were found in the placebo-treated group. The decrease of systemic inflammatory markers suggests that Pycnogenol may exert anti-inflammatory activity in osteoarthritic joints and patients did not present with other ailments or infections. The nature of the anti-inflammatory effects of Pycnogenol with regard to CRP warrants further investigation.

Published
2008

18. Prevention of influenza episodes with colostrum compared with vaccination in healthy and high-risk cardiovascular subjects: the epidemiologic STUDY IN SAN VALENTINO

Author

Luciano Pellegrini, Andrea Di Renzo, Angelica Bottari, Gianni Belcaro, Andrea Ricci, G. Vinciguerra, F. Fano, Stefano Stuard, Mark Dugall, Marisa Cacchio, I. Ruffini, Andrea Ledda, Gilberto Del Boccio, and Maria Rosaria Cesarone

Subjects
Adult, Male, medicine.medical_specialty, Epidemiologic study, animal diseases, 030204 cardiovascular system & hematology, 03 medical and health sciences, fluids and secretions, 0302 clinical medicine, Risk Factors, Internal medicine, Influenza prevention, Influenza, Human, medicine, Immune Tolerance, Humans, 030212 general & internal medicine, reproductive and urinary physiology, Aged, Aged, 80 and over, business.industry, Incidence (epidemiology), Colostrum, Vaccination, Healthy subjects, food and beverages, General Medicine, Hematology, Middle Aged, Clinical trial, Italy, Cardiovascular Diseases, Health, Influenza Vaccines, Hospital admission, Immunology, Female, business
Abstract

The efficacy of a 2-month treatment with oral colostrum in the prevention of flu episodes compared with antiinfluenza vaccination was evaluated. Groups included healthy subjects without prophylaxis and those receiving both vaccination and colostrum. After 3 months of follow-up, the number of days with flu was 3 times higher in the non-colostrum subjects. The colostrum group had 13 episodes versus 14 in the colostrum + vaccination group, 41 in the group without prophylaxis, and 57 in nontreated subjects. Part 2 of the study had a similar protocol with 65 very high-risk cardiovascular subjects, all of whom had prophylaxis. The incidence of complications and hospital admission was higher in the group that received only a vaccination compared with the colostrum groups. Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective.

Published
2007

19. Improvement of microcirculation and healing of venous hypertension and ulcers with Crystacide®: Evaluation with a microcirculatory model, including free radicals, laser doppler flux, and PO2/PCO2 measurements

Author

G. Vinciguerra, F. Fano, Mark Dugall, I. Ruffini, Marisa Cacchio, G. Gizzi, Maria Rosaria Cesarone, S Errichi, M G Grossi, Gianni Belcaro, Bruno M. Errichi, Andrea Ricci, and Andrea Di Renzo

Subjects
Male, Crystacide, 030204 cardiovascular system & hematology, Cardiovascular, Ointments, Laser doppler flux, 0302 clinical medicine, Models, Laser-Doppler Flowmetry, 030212 general & internal medicine, Venous hypertension, Skin, Models, Cardiovascular, Laser Doppler velocimetry, Middle Aged, Statistical, Treatment Outcome, Administration, Cardiology, Blood Gas Monitoring, Female, Cardiology and Cardiovascular Medicine, Blood Flow Velocity, Adult, medicine.medical_specialty, Transcutaneous, Free Radicals, Chronic venous insufficiency, Administration, Cutaneous, Cardiovascular Agents, Chronic Disease, Humans, Hydrogen Peroxide, Microcirculation, Models, Statistical, Varicose Ulcer, Venous Insufficiency, Venous Pressure, Wound Healing, Blood Gas Monitoring, Transcutaneous, pCO2, 03 medical and health sciences, Internal medicine, medicine, business.industry, Microangiopathy, medicine.disease, Surgery, Cutaneous, business
Abstract

In 32 patients with chronic venous insufficiency and venous hypertension associated with ulcerations, the effects of the local application of a hydrogen peroxide cream (Crystacide) applied onto the skin was evaluated using a complex, proportional, microcirculatory model to assess and quantify venous microangiopathy after local treatment. A comparative group treated without Crystacide was included. Laser Doppler flowmetry was used to assess skin perfusion (flux and venoarteriolar response) in association with transcutaneous PO2 and PCO2 measurements. Local plasma free radicals were evaluated in the area surrounding the venous ulcer using the D-Roms test. Crystacide was applied around and on the ulcer for 10 days. Crystacide was more effective than the control treatments. PO2 was increased (improved, P < .05), and plasma free radicals, PCO2, and laser Doppler flowmetry were decreased (improving toward normal values, P < .05). Also, the ulcerated area was significantly smaller at 10 days in the Crystacide group in comparison with controls (P < .05). In the proportional microcirculatory model, all parameters indicated an important level of improvement significantly larger than in controls. In conclusion, in chronic venous insufficiency and venous ulcerations, local treatment with Crystacide (10 days) improves the microcirculation and decreases skin free radicals, thus improving healing.

Published
2007

20. Topical heparin: New observations

Author

A. Di Renzo, M G Grossi, E. Ippolito, S Errichi, Andrea Ledda, F. Fano, Morio Hosoi, Stefano Stuard, Mark Dugall, G. Vinciguerra, Umberto Cornelli, I. Ruffini, G. Gizzi, Marcello Corsi, M. R. Cesarone, Luciano Pellegrini, G Belcaro, Andrea Ricci, Marisa Cacchio, and B.M. Errichi

Subjects
medicine.medical_specialty, Superficial vein thrombosis, medicine.drug_class, Administration, Topical, Skin permeability, 030204 cardiovascular system & hematology, Bioinformatics, Anticoagulants, Heparin, Humans, Liposomes, Thrombosis, Cardiology and Cardiovascular Medicine, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, business.industry, Anticoagulant, medicine.disease, Surgery, Topical, Skin penetration, Administration, medicine.symptom, business, Vasoconstriction, medicine.drug
Abstract

Topical effects of heparins on the skin need deeper investigations. The lack of evidence is mainly due to the lack of large investments in this field. Three main local actions of heparin on the skin can be defined: (a) the anticoagulant action, (b) the microcirculatory-modulatory action determining important control of the microcirculation in case of excessive vasoconstriction or vasodilatation, and (c) the `facilitatory action' on skin permeability allowing other drugs to diffuse better and faster into the skin (producing a therapeutic effect). These aspects have to be evaluated more extensively in both experimental and clinical conditions. Recent experimental studies demonstrate these effects of locally applied heparin. Therefore, key questions on local heparin administration such as skin penetration and the action on the local thrombi have promising answers. These observations suggest important clinical applications for local liposomal heparin. Both the potentials of local applications of heparin, particularly with new formulations, and some new aspects in the management of superficial vein thrombosis (SVT) can focus on locally applied heparin. SVT is an important clinical condition considering its frequency and the potentially heavy use of local heparin in this clinical problem. Results from new studies and observations presented in this issue of Angiology could be a window for suggesting new significant clinical applications and therapeutic solutions.

Published
2007

21. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol

Author

G Gizzi, Andrea Ledda, M. Hosoi, G. Belcaro, Andrea Ricci, Luciano Pellegrini, A. Di Renzo, Stefano Stuard, I. Ruffini, E. Ippolito, F. Fano, Giuseppe Cipollone, Marisa Cacchio, Mark Dugall, Peter Rohdewald, M. R. Cesarone, and B.M. Errichi

Subjects
Ulcer healing, Diabetic microangiopathy, Male, medicine.medical_specialty, Oral treatment, Treatment outcome, 030204 cardiovascular system & hematology, Diabetic ulcers, Gastroenterology, Lower limb, law.invention, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Combined treatment, Randomized controlled trial, law, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Ulcer, Flavonoids, business.industry, Plant Extracts, Drug Administration Routes, Microcirculation, Hematology, General Medicine, Middle Aged, Diabetic Foot, Surgery, Treatment Outcome, Female, business, Diabetic Angiopathies
Abstract

Diabetic microangiopathy leads to lower limb ulcers that are very slow to heal. Pycnogenol was evaluated on diabetic ulcers in a controlled trial. Ulcer medications were used in 4 groups (30 patients): (1) systemic Pycnogenol and local application; (2) local Pycnogenol only; (3) oral Pycnogenol; and (4) medications only (control group). Ulcerated areas and symptom scores were more reduced with the combined oral and local treatment ( P < .05). Oral and local treatment were less effective, but still improved compared with the controls. Combined treatment produced 89% complete healing at 6 weeks versus 84% with local treatment and 85% with oral treatment; healing in controls was 61%. The combined treatment group and oral only group had better microcirculation after the combined treatment. Combined local and systemic application of Pycnogenol may offer a new treatment of diabetic ulcers. Local treatment also speeds ulcer healing.

Published
2006

22. Venoruton vs Daflon: evaluation of effects on quality of life in chronic venous insufficiency

Author

G. Gizzi, Andrea Ricci, G Belcaro, Luciano Pellegrini, Cesarone Mr, G. Vinciguerra, Andrea Ledda, Marisa Cacchio, A. Di Renzo, I. Ruffini, M Dugall, F. Fano, Umberto Cornelli, E. Ippolito, Morio Hosoi, and G. Acerbi

Subjects
Adult, Male, medicine.medical_specialty, Popliteal Vein, Chronic venous insufficiency, Population, Administration, Oral, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Quality of life, law, Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Ultrasonography, Doppler, Color, education, Prospective cohort study, Aged, education.field_of_study, Vascular disease, business.industry, Microangiopathy, Anticoagulants, Middle Aged, medicine.disease, Surgery, Hydroxyethylrutoside, Treatment Outcome, Venous Insufficiency, Chronic Disease, Quality of Life, Diosmin, Female, Cardiology and Cardiovascular Medicine, Varices, business, Blood Flow Velocity, Follow-Up Studies
Abstract

The aim of this independent study was to investigate differences in efficacy between oxerutins (Venoruton) and 500 mg micronized diosmin + hesperidin (D+H) (Daflon) in patients with chronic venous insufficiency (CVI), evaluating venous-related quality of life (Ve-QOL). A first group of 90 patients with severe venous hypertension (CVI, ankle swelling) was randomized to treatment with oxerutins or D+H. The oxerutins group received oral oxerutins (2 g/day); the D+H group received 3 (500 mg) tablets daily every 8 hours for 8 weeks. A second group of 122 comparable patients was included in a registry following the same study format. The 2 treatments were administered with the same methods and procedures. Clinical conditions were comparable. All patients completing 8 weeks of treatment were included in a registry. Specialists or general practitioners included patients when they considered that clinical conditions were compatible with treatment indications using 1 of the 2 treatments on the basis of their evaluation and experience. When cases were compatible with the registry, the prescribing physician communicated the case to our monitoring center. Patients were evaluated without interfering with their treatment. The main target of evaluation for this study was the change in Ve-QOL (range, 0-100) induced by treatment. A specific Ve-QOL questionnaire was used for this study. Ve-QOL score is a specific expression of the changes in QOL induced by CVI in patients between 35 and 75 years old (defined in our population studies) in which no other significant clinical disease is present (as a confounding factor affecting QOL). Two hundred twelve patients completed the 2 parts of the study. The 2 treatment groups were comparable for age and gender distribution. The mean age was 42 years (SD ±5.5) in the oxerutins group and 41.5 (SD ±6) in the D+H group. There were no differences in the severity of CVI between the treatment groups at inclusion. A significant decrease (46.8%, p

Published
2006

23. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol

Author

Stefano Stuard, Peter Rohdewald, Luciano Pellegrini, G Belcaro, Morio Hosoi, A. Di Renzo, E. Ippolito, Andrea Ricci, M. R. Cesarone, Andrea Ledda, I. Ruffini, Mark Dugall, F. Fano, Marisa Cacchio, and B.M. Errichi

Subjects
Male, Oral treatment, medicine.medical_specialty, Time Factors, Chronic venous insufficiency, Administration, Oral, 030204 cardiovascular system & hematology, Administration, Cutaneous, Varicose Ulcer, 03 medical and health sciences, 0302 clinical medicine, Combined treatment, Edema, Medicine, Humans, 030212 general & internal medicine, Venous hypertension, Flavonoids, Wound Healing, business.industry, Plant Extracts, Microcirculation, Microangiopathy, Middle Aged, medicine.disease, Surgery, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Venous disease, Perfusion, Platelet Aggregation Inhibitors
Abstract

Chronic venous insufficiency (CVI) causes a well-defined microangiopathy described as venous hypertensive microangiopathy (VHM) leading to venous ulcerations. VHM is mainly observed in the distal part of the leg, in the perimalleolar region. In VHM edema is the consequence of increased capillary pressure and reduced local clearance, and this affects local perfusion. The healing of venous ulcers is usually very slow. Many treatments are available, but there is still no standard. Oral Pycnogenol® is effective in venous disease and particularly in controlling edema. The aim of this study was the evaluation of the local effects of Pycnogenol on ulcers healing associated with venous hypertension. The study lasted 6 weeks including 18 patients (16 completed the study) with venous ulcerations. The oral treatment with Pycnogenol was compared with a combination treatment including oral and local treatment. In subjects treated with the combination treatment (oral and local), venous ulcers healed better (there was a faster reduction in ulcerated area) in comparison with oral treatment only. According to this pilot study Pycnogenol appears to have an important role in local treatment of venous ulcers improving healing and signs/symptoms.

Published
2005

24. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol

Author

P. Bavera, G Belcaro, Mark Dugall, Francesco Cerritelli, A. Di Renzo, I. Ruffini, Andrea Ricci, M. Griffin, M. G. Vinciguerra, P. Rohdewald, M. R. Cesarone, G. Acerbi, E. Ippolito, and B.M. Errichi

Subjects
medicine.medical_specialty, Superficial vein thrombosis, Antithrombotic Agent, Popliteal Vein, Premedication, 030204 cardiovascular system & hematology, Research management, Thrombophlebitis, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030216 legal & forensic medicine, Exercise, Ultrasonography, Flavonoids, Venous Thrombosis, Travel, Tibia, business.industry, Plant Extracts, Incidence, Hematology, General Medicine, Femoral Vein, medicine.disease, Surgery, Venous thrombosis, Treatment Outcome, Anesthesia, business, Aviation, Platelet Aggregation Inhibitors
Abstract

The aim of this study was to evaluate the occurrence of deep venous thrombosis (DVT) and superficial vein thrombosis (SVT) and its prophylaxis with an oral anti-edema and antithrombotic agent (Pycnogenol®, Horphag, Research Management SA, Geneva, Switzerland) in long-haul flights, in subjects at moderate to high-risk of DVT and SVT. The study pre-included 244 pre-selected subjects; 211 were included (33 were excluded for several reasons due to logistic problems) and 198 completed the study; 13 subjects were lost for follow-up at the end of the flight, all for non-medical problems (i.e., for difficult connections). All subjects were scanned within 90 minutes before the flight and within 2 hours after disembarking. Subjects were supplemented with 100 mg Pycnogenol® per capsule. Treatment subjects received two capsules between 2 and 3 hours before flights with 250 mL of water; two capsules were taken 6 hours later with 250 mL of water and one capsule the next day. The control group received comparable placebo at the same intervals. The flight duration was on average 8 hours and 15 minutes (SD 55 min) (range, 7.45-12.33). In the control group there were five thrombotic events (one DVT and four superficial thromboses) while only nonthrombotic, localized phlebitis was observed in the Pycnogenol®group (5.15% vs. no events; p® treatment was effective in decreasing the number of thrombotic events (DVT and SVT) in moderate-to-high risk subjects, during long-haul flights.

Published
2004

25. Prevention of venous thrombosis with elastic stockings during long-haul flights: the LONFLIT 5 JAP study

Author

G. Belcaro, M. R. Cesarone, A. N. Nicolaides, A. Ricci, G. Geroulakos, S. S. G. Shah, E. Ippolito, K. A. Myers, P. Bavera, M. Dugall, M. Moia, A. Di Renzo, B. M. Errichi, R. Brandolini, M. Griffin, I. Ruffini, and G. Acerbi

Subjects
Adult, Male, medicine.medical_specialty, Knee Joint, 030204 cardiovascular system & hematology, Asymptomatic, law.invention, Veins, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Medicine, Edema, Humans, 030212 general & internal medicine, Exercise, Elastic stockings, Aged, Venous Thrombosis, business.industry, Incidence (epidemiology), Hematology, General Medicine, Middle Aged, medicine.disease, Bandages, Surgery, Venous thrombosis, medicine.anatomical_structure, Tolerability, Concomitant, Female, medicine.symptom, Ankle, business, Aviation
Abstract

The aim of this study was to evaluate deep venous thrombosis (DVT) prophylaxis with specific elastic stockings in longhaul flights (11-13 hours), in high-risk subjects. A group of 300 subjects was included; 76 were excluded for several problems including concomitant treatments; 224 were randomized into two groups (stockings vs. controls) to evaluate prophylaxis with below-knee stockings. An exercise program was used in both groups. Scholl (UK) Flight Socks (14-17 mmHg of pressure at the ankle) were used. DVT was diagnosed with ultrasound scanning. The femoral, popliteal, and tibial veins were scanned before and within 90 minutes after the flights. Of the 205 included subjects, 102 controls and 103 treated subjects completed the study. Drop-outs were due to flight connection problems. Age, gender, and risk distributions were comparable in the two groups. In the treatment group (103 subjects; mean age, 42; SD 9; M:F, 55:48), one limited, distal DVT was observed (0.97%). In the control group (102 subjects; mean age, 42.1; SD 10.3; M:F, 56:46), six subjects (5.8%) had a DVT. There were no superficial thromboses. The difference in DVT incidence is significant (p

Published
2003

26. Hypoxanthine and xanthine as markers in early diagnosis of foetal diseases

Author

F, Gizzi, M, Papponetti, G D, Palka, I, Ruffini, C, Di Ilio, M, Odorisio, and G, Spoto

Subjects
Adult, Hypoxanthine, Pregnancy, High-Risk, Amniotic Fluid, Xanthine, Fetal Diseases, Predictive Value of Tests, Pregnancy, Prenatal Diagnosis, Humans, False Positive Reactions, Female, Biomarkers, Chromatography, High Pressure Liquid, Maternal Age
Published
1998

27. Hypoxanthine and Xanthine as Markers in Early Diagnosis of Foetal Diseases

Author

M. Odorisio, M. Papponetti, I. Ruffini, C Di Ilio, G. Spoto, F. Gizzi, and Giandomenico Palka

Subjects
Down syndrome, Amniotic fluid, Neural tube defect, business.industry, Neural tube, Physiology, Retinitis, Gene mutation, Macular degeneration, medicine.disease, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, medicine, business, reproductive and urinary physiology, Hypoxanthine
Abstract

Human chorionic gonadotrophin (hCG), alpha-feto protein (αFP), unconjugated 3-oestriol (uE3) are the markers currently used in prenatal serum screening programs for neural tube defects and chromosomal disorders (1). However the use of triple markers, when screening for foetal Down syndrome, still fails to detect 40% of Down syndrome in women less than 35 years of age. Other screening methods are currently under investigation (2). In Down syndrome, abnormalities of purine metabolism have been detected (3–5); gene mutation of PDEa and PDEb have been identified in cases of retinitis pigmen-tosa and of macular degeneration (6–8).

Published
1998
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28. Imp-Dehydrogenase (IMPDH), Hypoxanthine-Guanine Phosphoribosyltransferase (HGPRT), and Phosphodiesterases (PDEs) Expression During Mycophenolic Acid (MPA)-Induced Differentiation in Human Neuroblastoma Cell Lines

Author

G. Spoto, Alessandro Giacomello, F. Gizzi, A. Arduini, G. Angelini, C. P. Quaratino, Elisa Messina, I. Ruffini, and M. Odorisio

Subjects
chemistry.chemical_classification, Phosphodiesterase, Metabolism, Biology, Mycophenolic acid, Neuroblastoma cell, chemistry, Biochemistry, IMP dehydrogenase, Hypoxanthine-guanine phosphoribosyltransferase, medicine, Nucleotide, Neuroblastoma cell line, medicine.drug
Abstract

The IMP dehydrogenase (IMPDH) inhibitor mycophenolic acid (MPA), at concentrations ranging from 5 to 50 nM, induces differentiation in various human neuroblastoma cell lines.1 Purpose of the present study was to investigate guanylate synthesis and cyclic nucleotides metabolism during mycophenolic acid-induced differentiation in the human neuroblastoma cell line LA-N-5.

Published
1998
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29. IMP-dehydrogenase (IMPDH), hypoxanthine-guanine phosphoribosyltransferase (HGPRT), and phosphodiesterases (PDEs) expression during mycophenolic acid (MPA)-induced differentiation in human neuroblastoma cell lines

Author

C P, Quaratino, E, Messina, A, Arduini, G, Angelini, G, Spoto, F, Gizzi, I, Ruffini, M, Odorisio, and A, Giacomello

Subjects
Gene Expression Regulation, Neoplastic, Hypoxanthine Phosphoribosyltransferase, Kinetics, Neuroblastoma, IMP Dehydrogenase, Nucleotides, Phosphoric Diester Hydrolases, Tumor Cells, Cultured, Humans, Cell Differentiation, Mycophenolic Acid, Gene Expression Regulation, Enzymologic
Published
1998

31. IMP-dehydrogenase (IMPDH), hypoxanthine-guanine phosphoribosyltransferase (HGPRT) and phosphodiesterases (PDES) expression during mycophenolic acid (MPA)-induced differentiation in human neuroblastoma cell lines

Author

G. Spoto, C.P. Quaratino, M. Odorisio, I. Ruffini, Elisa Messina, F. Gizzi, and Alessandro Giacomello

Subjects
Neuroblastoma cell, Chemistry, Hypoxanthine-guanine phosphoribosyltransferase, IMP dehydrogenase, Clinical Biochemistry, medicine, Phosphodiesterase, General Medicine, Molecular biology, Mycophenolic acid, medicine.drug
Published
1997
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32. Evaluation of the local effects of vitamin E (E-Mousse) on free radicals in diabetic microangiopathy: a randomized, controlled trial

Author

Umberto Cornelli, Mark Dugall, Andrea Ricci, R. Brandolini, Marcello Corsi, E. Ippolito, Maura Griffin, G Belcaro, P. Pomante, M. R. Cesarone, P Bavera, G. Acerbi, George Geroulakos, L. Coen, Massimo Milani, A. Di Renzo, and I. Ruffini

Subjects
Male, medicine.medical_specialty, Free Radicals, Administration, Topical, medicine.medical_treatment, Blood sugar, 030204 cardiovascular system & hematology, Gastroenterology, law.invention, Microcirculation, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Diabetes mellitus, Laser-Doppler Flowmetry, medicine, Humans, Vitamin E, 030212 general & internal medicine, Aged, Skin, Leg, Vascular disease, business.industry, Middle Aged, medicine.disease, Surgery, Diabetes Mellitus, Type 2, Tolerability, Metabolic control analysis, Female, Skin Temperature, Cardiology and Cardiovascular Medicine, business, Diabetic Angiopathies
Abstract

The aims of the study were to evaluate the short-term effects of a new thermosensitive, vitamin E (V-E) mousse on local free radicals (FR) and skin flux in diabetic microangiopathy. A group of 40 patients with diabetic microangiopathy was included. The variation in measure ments of skin FR was evaluated by the D-Rom test. Subjects were between 45 and 65 years with type II diabetes and good metabolic control. E-mousse®, a thermoactive preparation of acetate vitamin E (20%), was applied twice daily on the whole surface of the leg (below knee) and foot for 3 weeks. The contralateral leg was untreated acting as control. Subjects with age between 45 and 65 years with type II diabetes (diagnosed at least 5 years before) and good metabolic control (blood sugar < 180 mg/dL) were included after informed consent. Patients with uncontrolled diabetes, peripheral vascular disease, and severe lower limbs infec tions were excluded. Local free radicals (FR) and laser Doppler flux including the venoarteriolar response (VAR) were evaluated. The tolerability was evaluated by a semiquantitative score. Of the 40 included patients 34 completed the study. The 2 groups were comparable. At 3 weeks there was no decrease in FR in controls; the decrease in the treatment group was 45.3% (p < 0.05). Also in the treatment group RF decreased (p < 0.05) and the VARveno improved from an average of 21% to an average of 38% (p < 0.05). No significant variations were observed in the control group. The variation in symptomatic score was from a total value of 8 to 5 in the control group and from 8 to 1 in the treatment group (p < 0.02). Their tolerability was good. In conclusion local treatment with E-mousse for 3 weeks in diabetic microangiopathy improves skin microcirculation and the metabolic condition as shown by the decrease in FR.

33. Prevalence and features of delirium in older patients admitted to rehabilitation facilities

Author

Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, Tarasconi, A, Sella, M, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D’Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell’Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Null, Ettorre, E, Camellini Bellelli, C G, Annoni, G, Marengoni, A, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl’Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D’Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D’Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, A Tarasconi, M Sella, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, L Porcella, I Nardiello, E Chimenti, M Zeni, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, L Pietrogrande, M Mosca, I Corazzin, P Rossi, V Nunziata, F D’Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena , M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell’Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, A Geriatria, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta , D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambar, A Saitta, F Corica, M Braga, Servi, E Ettorre , C G Camellini Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, L Santuar , M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl’Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D’Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D’Amico, A Grippa , A Mazzone, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L E Lombardi Muti, B Dijk , S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul , G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D’Amico, F D’Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Cortegiani, L Pistidda, R D’Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà , A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin & D Saggioro, VU University medical center, Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, and Saggioro, D

Subjects
Aging, Disability, Rehabilitation, Delirium, Dementia, Physical restraint, Cross-Sectional Studies, Activities of Daily Living, mental disorders, Prevalence, Humans, Geriatrics and Gerontology, Aged
Abstract

Background: Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. Aim: We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”. Methods: We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. Results: Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36, p value < 0.0001). Conclusion: This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.

Published
2022
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34. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017

Author

Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Margola, A, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, De, F, Pietrogrande, L, De, B, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Bianchetti, A, Crucitti, A, Di Francesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Pezzoni, D, Gentile, S, Platto, C, D'Ambrosio, V, Faraci, B, Brambilla, C, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, C Boffelli S, Corsini, Filippi, A, Delpin, K, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, A Millul A, Barelli, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Scapigliati, A, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, M, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Citerio, G, Zucchelli, Alberto, Valsecchi, M G, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, A Bianchetti, A Crucitti, V Di Francesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, F Cassandonte, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, G Patrizia, L Santuari, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, P Calogero, G Corvalli, D Pezzoni, S Gentile, A Morandi, C Platto, V D'Ambrosio, B Faraci, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
Male, Aging, medicine.medical_specialty, Sarcopenia, medicine.medical_treatment, Socio-culturale, Older person, Logistic regression, Delirium, Older persons, Sarcopenia, Internal medicine, mental disorders, Delirium, Older persons, medicine, Dementia, Humans, LS4_4, Muscle, Skeletal, Pathological, Aged, Rehabilitation, business.industry, Area under the curve, Settore MED/23 - Chirurgia Cardiaca, Skeletal, medicine.disease, Skeletal muscle mass, Cross-Sectional Studies, Italy, Muscle, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium.

Published
2022

35. Optimization of cognitive assessment in Parkinsonisms by applying artificial intelligence to a comprehensive screening test.

Author

Ortelli P, Ferrazzoli D, Versace V, Cian V, Zarucchi M, Gusmeroli A, Canesi M, Frazzitta G, Volpe D, Ricciardi L, Nardone R, Ruffini I, Saltuari L, Sebastianelli L, Baranzini D, and Maestri R

Abstract

The assessment of cognitive deficits is pivotal for diagnosis and management in patients with parkinsonisms. Low levels of correspondence are observed between evaluations assessed with screening cognitive tests in comparison with those assessed with in-depth neuropsychological batteries. A new tool, we named CoMDA (Cognition in Movement Disorders Assessment), was composed by merging Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Frontal Assessment Battery (FAB). In total, 500 patients (400 with Parkinson's disease, 41 with vascular parkinsonism, 31 with progressive supranuclear palsy, and 28 with multiple system atrophy) underwent CoMDA (level 1-L1) and in-depth neuropsychological battery (level 2-L2). Machine learning was developed to classify the CoMDA score and obtain an accurate prediction of the cognitive profile along three different classes: normal cognition (NC), mild cognitive impairment (MCI), and impaired cognition (IC). The classification accuracy of CoMDA, assessed by ROC analysis, was compared with MMSE, MoCA, and FAB. The area under the curve (AUC) of CoMDA was significantly higher than that of MMSE, MoCA and FAB (p < 0.0001, p = 0.028 and p = 0.0007, respectively). Among 15 different algorithmic methods, the Quadratic Discriminant Analysis algorithm (CoMDA-ML) showed higher overall-metrics performance levels in predictive performance. Considering L2 as a 3-level continuous feature, CoMDA-ML produces accurate and generalizable classifications: micro-average ROC curve, AUC = 0.81; and AUC = 0.85 for NC, 0.67 for MCI, and 0.83 for IC. CoMDA and COMDA-ML are reliable and time-sparing tools, accurate in classifying cognitive profile in parkinsonisms.This study has been registered on ClinicalTrials.gov (NCT04858893)., (© 2022. The Author(s).)

Published
2022
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36. Lady Prelox® improves sexual function in post-menopausal women.

Author

Bottari A, Belcaro G, Ledda A, Cesarone MR, Vinciguerra G, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Errichi S, Gizzi G, Ippolito E, Ricci A, Cacchio M, Ruffini I, Fano F, and Hosoi M

Subjects
Dietary Supplements, Drug Combinations, Female, Humans, Middle Aged, Patient Satisfaction, Pilot Projects, Postmenopause, Sexual Dysfunction, Physiological physiopathology, Sexual Dysfunctions, Psychological physiopathology, Single-Blind Method, Time Factors, Women's Health, Arginine therapeutic use, Aspartic Acid therapeutic use, Plant Extracts therapeutic use, Sexual Dysfunction, Physiological drug therapy, Sexual Dysfunctions, Psychological drug therapy
Abstract

Aim: The aim of this pilot, single-blinded study was to evaluate the efficacy of a proprietary, dietary supplement Lady Prelox® for supporting and improving sexual function in generally healthy, post-menopausal women., Methods: The Lady Prelox® and placebo control groups were comparable at inclusion with regard to the total Female Sexual Function Index (FSFI) score, as well as for the six individual FSFI domains, with 40 women (50.1 ± 3.1 years) and 43 women (51.2 ± 2.3 years), respectively., Results: At baseline the women in the verum group presented with a mean total FSFI score of 44.6 ± 24.1 which increased significantly already after four weeks treatment with Lady Prelox® to 70.9 ± 18.5 and further increased to 71.7 ± 23.9 after completion of the eight-week trial period. In the control group the mean total FSFI was 44.1 ± 22.8 at inclusion and non-significantly increased to 45 ± 21.4 after four weeks and 47.4 ± 21.8 after eight weeks, respectively. The treatment with Lady Prelox® was comparatively significantly more effective than placebo after both four and eight weeks of treatment (P<0.05). The individual six FSFI domains related to desire, arousal, lubrication, orgasm, satisfaction and pain did all respond favourably to treatment with Lady Prelox®; however, with only marginable higher scores in the placebo group. Four women in each group dropped out because of inabilities to attend scheduled check-ups. No adverse effects were reported., Conclusion: This study opens an interesting perspective for women experiencing moderate sexual function impairment and suggests a promising new treatment option. Further studies with larger numbers of women, including also premenopausal and perimenopausal women are warranted.

Published
2012

37. Prevention of flu episodes with colostrum and Bifivir compared with vaccination: an epidemiological, registry study.

Author

Belcaro G, Cesarone MR, Cornelli U, Pellegini L, Ledda A, Grossi MG, Dugall M, Ruffini I, Fano F, Ricci A, Stuard S, Luzzi R, Grossi MG, and Hosoi M

Subjects
Aged, Analysis of Variance, Cost-Benefit Analysis, Drug Costs, Female, Hospital Costs, Humans, Immunologic Factors adverse effects, Immunologic Factors economics, Influenza, Human economics, Influenza, Human epidemiology, Influenza, Human virology, Italy epidemiology, Male, Middle Aged, Pregnancy, Probiotics adverse effects, Probiotics economics, Registries, Time Factors, Treatment Outcome, Colostrum immunology, Immunologic Factors therapeutic use, Influenza Vaccines economics, Influenza, Human prevention & control, Prebiotics adverse effects, Prebiotics economics, Probiotics therapeutic use
Abstract

The aim of this study was to evaluate the efficacy of colostrum (ARD Colostrum) in association with the immunomodulator Bifivir in the prevention of flu episodes compared with anti-flu vaccination. The registry groups included no prevention, vaccination, vaccination+immunomodulators, and immunomodulators only. Groups were comparable for age and sex distribution. In the group without prevention there were 8 major episodes and 12 minor episodes out of 34 subjects (8-12/34); in the vaccination group the respective figures were 8-13/38; in the group treated with a combination of vaccination and immunomodulators (ARD Colostrum + Bifivir) the figures were 4-9/33; and in the group treated with immunomodulators only there were 11 viral episodes (3-8) in 36 subjects. The episodes in the vaccination+immunomodulators and immunomodulators only groups were significantly lower compared with the other two groups (P<0.05). The number of episodes registered with the immunnomodulators was significantly lower than those observed in patients using vaccination or no prevention (P<0.05). The number of days of disease was higher in untreated controls compared to the groups treated with immunomodulators (P<0.05) and 2 times higher in the vaccination group compared to the same groups (P<0.05). The average relative costs were significantly lower (2.3 times) in the immunomodulators groups in comparison with the other groups (P<0.05). No problems concerning tolerability or side effects were observed during the study. Compliance was very good. In conclusion, the administration of immunomodulators is very cost effective and appears to be more effective than vaccination to prevent flu.

Published
2010

38. Action of an antioxidant complex on the antioxidant power of saliva.

Author

Cornelli U, Belcaro G, Nardi GM, Cesarone MR, Dugall M, Hosoi M, Grossi MG, Ippolito E, Ledda A, and Ruffini I

Subjects
Adult, Antioxidants metabolism, Dietary Supplements, Female, Humans, Male, Models, Biological, Nutritional Sciences, Placebos, Time Factors, Antioxidants therapeutic use, Saliva drug effects
Abstract

Aim: Based on the results of the soluble antioxidants test (SAT), we have produced a combination of oral antioxidants aimed at increasing the antioxidant power of saliva. Several antioxidants are included in this product (Vit E, beta-carotene, Vit A, Vit C, polyphenols, cathechins, ellagic acid, anthocyanins, coenzyme Q10 and pyridoxine in association with Se, Zn, L-cysteine). The aim of this registry study was to evaluate the efficacy of these antioxidants in saliva, plasma and urines., Methods: MF Odontovis, an antioxidant complex, was administered to healthy subjects in the evening for one week with a final administration in the morning., Results: Plasma, urine and saliva showed an increase in antioxidant power following both the evening administration and the final morning administration. The antioxidant action appeared to be present even at night when salival secretion is lower. Plasma SAT levels (SATs) in the morning following evening treatment were increased by 21% in comparison with controls. Morning administration increased levels up to 34% when measured 4 hours after treatment. Comparable increases were observed in saliva (SATs and morning values were +44 %; +58% two hours after morning administration and +28 % after 4 hours). In urine the evening administration caused an increase in antioxidant power (+6%)., Conclusion: This study indicated that antioxidant levels can be increased with specific nutritional supplement. The clinical value of an increased antioxidant power in biological fluids, particularly in saliva, may be relevant for future trials of prevention and treatment.

Published
2010

39. Management of uncomplicated ankle sprains with topical or oral ketoprofen treatment. A registry study.

Author

Vinciguerra G, Belcaro G, Cesarone MR, Errichi BM, Di Renzo A, Errichi S, Ricci A, Gizzi G, Dugall M, Cacchio M, Ippolito E, Ruffini I, Fano F, Stuard S, and Grossi MG

Subjects
Administration, Cutaneous, Administration, Oral, Adult, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Female, Humans, Ketoprofen administration & dosage, Male, Middle Aged, Pain drug therapy, Pain Measurement, Pain Threshold, Prospective Studies, Range of Motion, Articular, Treatment Outcome, Ankle Injuries drug therapy, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Ketoprofen therapeutic use, Sprains and Strains drug therapy
Abstract

Ankle sprains mainly caused by accidents or strenuous sport activities can often be quite painful and impair motility. If not treated immediately and correctly, sprains may lead to severe complications. The aim of the present study was to compare the efficacy and safety of topically applied ketoprofen versus orally administered ketoprofen in 20 patients with grade I ankle sprain and 34 patients with grade II sprain. The patients were divide into in two treatment groups and received either topically applied ketoprofen treatment (ketoprofen 10% spray-gel; Prontoflex; 360 mg/die) or orally administered ketoprofen treatment (ketoprofen tablets; 3x50 mg/die). Treatment duration was one week. After 3 and 7 days of treatment, reduction of spontaneous pain and pain on active movement in the Prontoflex group was significantly bigger greater in the oral treatment group, irrespective of sprain severity. Regarding secondary parameters as mobility impairment and ankle swelling topically applied ketoprofen treatment turned out to be significantly superior to orally administered ketoprofen treatment. Additionally, Prontoflex was well tolerated, whereas ketoprofen tablets caused gastrointestinal side effects in some patients. The good efficacy in pain reduction and absence of side effects in the present study distinguished the topically applied ketoprofen as a favorable treatment for patients with accidental or sport soft tissue injuries.

Published
2008

40. Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects.

Author

Belcaro G, Cesarone MR, Errichi S, Zulli C, Errichi BM, Vinciguerra G, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Errichi S, Gizzi G, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M, and Rohdewald P

Subjects
Adjuvants, Immunologic adverse effects, Adjuvants, Immunologic therapeutic use, Adult, Age Distribution, Ankle pathology, Anti-Inflammatory Agents adverse effects, Anti-Inflammatory Agents therapeutic use, Double-Blind Method, Edema drug therapy, Edema pathology, Female, Flavonoids adverse effects, Foot pathology, Humans, Male, Middle Aged, Osteoarthritis pathology, Osteoarthritis physiopathology, Pain drug therapy, Pain pathology, Plant Extracts, Sex Distribution, Treatment Outcome, Flavonoids therapeutic use, Osteoarthritis drug therapy
Abstract

The aim of this double-blind, placebo-controlled study was to evaluate the efficacy of 100 mg Pycnogenol daily (oral capsules) in a 3 month study in patients with osteoarthritis (OA). OA symptoms were evaluated by WOMAC scores, mobility by recording their walking performance (treadmill). Treatment (77 patients) and placebo group (79) were comparable for age, sex distribution, WOMAC scores, walking distances and use of antiinflammatory drugs. The global WOMAC score decreased by 56% (p < 0.05) in the treatment group versus 9.6% in the placebo group. Walking distance in the treadmill test was prolonged from 68 m at the start to 198 m after 3 months treatment (p < 0.05), under placebo, from 65 m to 88 m (NS). The use of drugs decreased by 58% in the treatment group (p < 0.05) versus 1% under placebo. Gastrointestinal complications decreased by 63% in the treatment group, but only 3% under placebo. Overall, treatment costs were reduced significantly compared with placebo. Foot edema was present in 76% of the patients of the treatment group at inclusion and in 79% of the controls. After 3 months edema decreased in 79% of Pycnogenol patients (p < 0.05) vs 1% in controls. In conclusion, Pycnogenol offers an option for reduction of treatment costs and side effects by sparing antiinflammatory drugs., ((c) 2008 John Wiley & Sons, Ltd.)

Published
2008
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41. O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study.

Author

Belcaro G, Rosaria Cesarone M, Ledda A, Cacchio M, Ruffini I, Ricci A, Ippolito E, Di Renzo A, Dugall M, Corsi M, Marino Santarelli AR, and Grossi MG

Subjects
Administration, Cutaneous, Administration, Oral, Adult, Blood Flow Velocity, Blood Gas Monitoring, Transcutaneous, Capillary Permeability drug effects, Cardiovascular Agents administration & dosage, Chronic Disease, Diabetic Angiopathies complications, Diabetic Angiopathies physiopathology, Edema drug therapy, Edema etiology, Gels, Humans, Hydroxyethylrutoside administration & dosage, Hydroxyethylrutoside therapeutic use, Laser-Doppler Flowmetry, Middle Aged, Prospective Studies, Registries, Severity of Illness Index, Skin blood supply, Stockings, Compression, Time Factors, Treatment Outcome, Venous Insufficiency complications, Venous Insufficiency physiopathology, Venous Pressure drug effects, Cardiovascular Agents therapeutic use, Diabetic Angiopathies drug therapy, Hydroxyethylrutoside analogs & derivatives, Venous Insufficiency drug therapy
Abstract

O-(beta-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, > 56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1 g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.

Published
2008
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42. Variations in C-reactive protein, plasma free radicals and fibrinogen values in patients with osteoarthritis treated with Pycnogenol.

Author

Belcaro G, Cesarone MR, Errichi S, Zulli C, Errichi BM, Vinciguerra G, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Gizzi G, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M, and Rohdewald P

Subjects
Adjuvants, Immunologic therapeutic use, Female, Humans, Male, Middle Aged, Osteoarthritis blood, Plant Extracts, Treatment Outcome, C-Reactive Protein metabolism, Fibrinogen metabolism, Flavonoids therapeutic use, Free Radicals blood, Osteoarthritis drug therapy
Abstract

In a previous, double-blind, placebo-controlled study we evaluated the efficacy of a 3-month treatment with Pycnogenol for 156 patients with osteoarthritis of the knee. Pycnogenol significantly decreased joint pain and improved joint function as evaluated using the WOMAC score and walking performance of patients on a treadmill. In this study, we further investigated the anti-inflammatory and antioxidant activity of Pycnogenol in a subset of the osteoarthritis patients presenting with elevated C-reactive protein (CRP) and plasma-free radicals. Elevated CRP levels have been suggested to be associated with disease progression in osteoarthritis. In our study, 29 subjects of the Pycnogenol group and 26 patients in the placebo group showed CRP levels higher than 3 mg/l at baseline. Comparison of blood specimens drawn at baseline and after 3-month treatment showed that Pycnogenol significantly decreased plasma free radicals to 70.1% of baseline values. Plasma CRP levels decreased from baseline 3.9 mg/l to 1.1 mg/l in the Pycnogenol group whereas the control group had initial values of 3.9 mg/l which decreased to 3.6 mg/l. The CRP decrease in the Pycnogenol was statistical significant as compared to the control group (P < 0.05). Fibrinogen levels were found to be lowered to 62.8% of initial values (P < 0.05) in response to Pycnogenol. No significant changes for plasma free radicals, CRP and fibrinogen were found in the placebo-treated group. The decrease of systemic inflammatory markers suggests that Pycnogenol may exert anti-inflammatory activity in osteoarthritic joints and patients did not present with other ailments or infections. The nature of the anti-inflammatory effects of Pycnogenol with regard to CRP warrants further investigation.

Published
2008
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43. Improvement of microcirculation and healing of venous hypertension and ulcers with Crystacide: evaluation with a microcirculatory model, including free radicals, laser doppler flux, and PO2/PCO2 measurements.

Author

Belcaro G, Cesarone MR, Errichi BM, Di Renzo A, Errichi S, Ricci A, Gizzi G, Dugall M, Cacchio M, Ruffini I, Fano F, Vinciguerra G, and Grossi MG

Subjects
Administration, Cutaneous, Adult, Blood Flow Velocity drug effects, Cardiovascular Agents administration & dosage, Chronic Disease, Female, Humans, Hydrogen Peroxide administration & dosage, Male, Microcirculation drug effects, Middle Aged, Models, Cardiovascular, Models, Statistical, Ointments, Skin blood supply, Treatment Outcome, Varicose Ulcer blood, Varicose Ulcer etiology, Varicose Ulcer pathology, Varicose Ulcer physiopathology, Venous Insufficiency blood, Venous Insufficiency drug therapy, Venous Insufficiency pathology, Venous Insufficiency physiopathology, Wound Healing drug effects, Blood Gas Monitoring, Transcutaneous, Cardiovascular Agents therapeutic use, Free Radicals blood, Hydrogen Peroxide therapeutic use, Laser-Doppler Flowmetry, Varicose Ulcer drug therapy, Venous Insufficiency complications, Venous Pressure drug effects
Abstract

In 32 patients with chronic venous insufficiency and venous hypertension associated with ulcerations, the effects of the local application of a hydrogen peroxide cream (Crystacide) applied onto the skin was evaluated using a complex, proportional, microcirculatory model to assess and quantify venous microangiopathy after local treatment. A comparative group treated without Crystacide was included. Laser Doppler flowmetry was used to assess skin perfusion (flux and venoarteriolar response) in association with transcutaneous PO2 and PCO2 measurements. Local plasma free radicals were evaluated in the area surrounding the venous ulcer using the D-Roms test. Crystacide was applied around and on the ulcer for 10 days. Crystacide was more effective than the control treatments. PO2 was increased (improved, P < .05), and plasma free radicals, PCO2, and laser Doppler flowmetry were decreased (improving toward normal values, P < .05). Also, the ulcerated area was significantly smaller at 10 days in the Crystacide group in comparison with controls (P < .05). In the proportional microcirculatory model, all parameters indicated an important level of improvement significantly larger than in controls. In conclusion, in chronic venous insufficiency and venous ulcerations, local treatment with Crystacide (10 days) improves the microcirculation and decreases skin free radicals, thus improving healing.

Published
2007
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44. Topical heparin: new observations.

Author

Cesarone MR, Belcaro G, Errichi S, Cornelli U, Pellegrini L, Ruffini I, Errichi BM, Ledda A, Vinciguerra G, Ricci A, Gizzi G, Ippolito E, Fano F, Dugall M, Cacchio M, Di Renzo A, Hosoi M, Grossi MG, Stuard S, and Corsi M

Subjects
Administration, Topical, Anticoagulants pharmacokinetics, Anticoagulants pharmacology, Heparin pharmacokinetics, Heparin pharmacology, Humans, Liposomes, Thrombosis drug therapy, Anticoagulants administration & dosage, Heparin administration & dosage
Abstract

Topical effects of heparins on the skin need deeper investigations. The lack of evidence is mainly due to the lack of large investments in this field. Three main local actions of heparin on the skin can be defined: (a) the anticoagulant action, (b) the microcirculatory-modulatory action determining important control of the microcirculation in case of excessive vasoconstriction or vasodilatation, and (c) the 'facilitatory action' on skin permeability allowing other drugs to diffuse better and faster into the skin (producing a therapeutic effect). These aspects have to be evaluated more extensively in both experimental and clinical conditions. Recent experimental studies demonstrate these effects of locally applied heparin. Therefore, key questions on local heparin administration such as skin penetration and the action on the local thrombi have promising answers. These observations suggest important clinical applications for local liposomal heparin. Both the potentials of local applications of heparin, particularly with new formulations, and some new aspects in the management of superficial vein thrombosis (SVT) can focus on locally applied heparin. SVT is an important clinical condition considering its frequency and the potentially heavy use of local heparin in this clinical problem. Results from new studies and observations presented in this issue of Angiology could be a window for suggesting new significant clinical applications and therapeutic solutions.

Published
2007
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45. Prevention of influenza episodes with colostrum compared with vaccination in healthy and high-risk cardiovascular subjects: the epidemiologic study in San Valentino.

Author

Cesarone MR, Belcaro G, Di Renzo A, Dugall M, Cacchio M, Ruffini I, Pellegrini L, Del Boccio G, Fano F, Ledda A, Bottari A, Ricci A, Stuard S, and Vinciguerra G

Subjects
Adult, Aged, Aged, 80 and over, Cardiovascular Diseases pathology, Female, Humans, Immune Tolerance immunology, Influenza Vaccines economics, Influenza, Human epidemiology, Influenza, Human pathology, Italy epidemiology, Male, Middle Aged, Risk Factors, Cardiovascular Diseases epidemiology, Cardiovascular Diseases immunology, Colostrum immunology, Health, Influenza Vaccines immunology, Influenza, Human immunology, Influenza, Human prevention & control
Abstract

The efficacy of a 2-month treatment with oral colostrum in the prevention of flu episodes compared with antiinfluenza vaccination was evaluated. Groups included healthy subjects without prophylaxis and those receiving both vaccination and colostrum. After 3 months of follow-up, the number of days with flu was 3 times higher in the non-colostrum subjects. The colostrum group had 13 episodes versus 14 in the colostrum + vaccination group, 41 in the group without prophylaxis, and 57 in nontreated subjects. Part 2 of the study had a similar protocol with 65 very high-risk cardiovascular subjects, all of whom had prophylaxis. The incidence of complications and hospital admission was higher in the group that received only a vaccination compared with the colostrum groups. Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective.

Published
2007
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46. Mercury distribution in medium-size rivers and reservoirs of the Sao Paulo state (southeast Brazil).

Author

Tomazelli AC, Martinelli LA, Krug FJ, Santos D Jr, Ruffini I, de Camargo PB, and Horvat M

Subjects
Animals, Brazil, Environmental Monitoring, Food Contamination, Geologic Sediments analysis, Mercury metabolism, Methylmercury Compounds metabolism, Rivers chemistry, Water Pollutants, Chemical metabolism, Water Supply analysis, Bivalvia metabolism, Fishes metabolism, Mercury analysis, Methylmercury Compounds analysis, Water Pollutants, Chemical analysis
Abstract

The aim of this work was to investigate mercury (Hg) levels in six meso-scale watersheds (Upper Paranapanema, Aguapeí, Peixe, São José dos Dourados, Mogi-Guaçu, and Piracicaba) of the São Paulo state to contribute to a more comprehensive understanding of Hg contamination in Brazil. Water, sediment, bivalves, and fish samples were collected during 2001 at 11 sites. Fish were also collected in the Jurumirim and Salto Grande Reservoirs which are 39 and 52 yr old since impoundment, respectively. Results showed that Hg concentrations were low in almost all samples, except fish from Jurumirim Reservoir (total mercury [T-Hg] = 1.14 +/- 0.55 mg kg(-1) wet wt.). In spite of industrialization and high population, the results showed that there was no important source of Hg contamination in the investigated areas. The higher concentrations found in fish from Jurumirim seem to be the result of processes that favor Hg mobilization and methylation as a consequence of the impoundment of the reservoir area. The same levels were not observed in the Salto Grande Reservoir, probably because these are no longer significant due to the long time since the impoundment. To understand the dynamics of methylmercury (MeHg) production and its accumulation in fish, further studies are needed in the Jurumirim Reservoir. The results show that even at low T-Hg concentrations in sediment and water, concentrations in fish can reach values that pose concerns for consumption. This emphasizes the importance of designing an optimized biomonitoring program that can provide warning of biogeochemical conditions that promote formation of MeHg.

Published
2007
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47. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol.

Author

Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Gizzi G, Rohdewald P, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, and Hosoi M

Subjects
Diabetic Angiopathies complications, Diabetic Foot drug therapy, Drug Administration Routes, Female, Humans, Male, Microcirculation, Middle Aged, Plant Extracts, Treatment Outcome, Diabetes Complications drug therapy, Flavonoids administration & dosage, Ulcer drug therapy
Abstract

Diabetic microangiopathy leads to lower limb ulcers that are very slow to heal. Pycnogenol was evaluated on diabetic ulcers in a controlled trial. Ulcer medications were used in 4 groups (30 patients): (1) systemic Pycnogenol and local application; (2) local Pycnogenol only; (3) oral Pycnogenol; and (4) medications only (control group). Ulcerated areas and symptom scores were more reduced with the combined oral and local treatment (P < .05). Oral and local treatment were less effective, but still improved compared with the controls. Combined treatment produced 89% complete healing at 6 weeks versus 84% with local treatment and 85% with oral treatment; healing in controls was 61%. The combined treatment group and oral only group had better microcirculation after the combined treatment. Combined local and systemic application of Pycnogenol may offer a new treatment of diabetic ulcers. Local treatment also speeds ulcer healing.

Published
2006
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48. Venoruton vs Daflon: evaluation of effects on quality of life in chronic venous insufficiency.

Author

Cesarone MR, Belcaro G, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Di Renzo A, Ruffini I, Gizzi G, Ippolito E, Fano F, Dugall M, Acerbi G, Cornelli U, Hosoi M, and Cacchio M

Subjects
Administration, Oral, Adult, Aged, Anticoagulants administration & dosage, Blood Flow Velocity drug effects, Chronic Disease, Diosmin administration & dosage, Female, Follow-Up Studies, Humans, Hydroxyethylrutoside administration & dosage, Hydroxyethylrutoside therapeutic use, Male, Middle Aged, Prospective Studies, Treatment Outcome, Ultrasonography, Doppler, Color, Venous Insufficiency physiopathology, Venous Insufficiency psychology, Anticoagulants therapeutic use, Diosmin therapeutic use, Hydroxyethylrutoside analogs & derivatives, Popliteal Vein, Quality of Life, Venous Insufficiency drug therapy
Abstract

The aim of this independent study was to investigate differences in efficacy between oxerutins (Venoruton) and 500 mg micronized diosmin + hesperidin (D+H) (Daflon) in patients with chronic venous insufficiency (CVI), evaluating venous-related quality of life (Ve-QOL). A first group of 90 patients with severe venous hypertension (CVI, ankle swelling) was randomized to treatment with oxerutins or D+H. The oxerutins group received oral oxerutins (2 g/day); the D+H group received 3 (500 mg) tablets daily every 8 hours for 8 weeks. A second group of 122 comparable patients was included in a registry following the same study format. The 2 treatments were administered with the same methods and procedures. Clinical conditions were comparable. All patients completing 8 weeks of treatment were included in a registry. Specialists or general practitioners included patients when they considered that clinical conditions were compatible with treatment indications using 1 of the 2 treatments on the basis of their evaluation and experience. When cases were compatible with the registry, the prescribing physician communicated the case to our monitoring center. Patients were evaluated without interfering with their treatment. The main target of evaluation for this study was the change in Ve-QOL (range, 0-100) induced by treatment. A specific Ve-QOL questionnaire was used for this study. Ve-QOL score is a specific expression of the changes in QOL induced by CVI in patients between 35 and 75 years old (defined in our population studies) in which no other significant clinical disease is present (as a confounding factor affecting QOL). Two hundred twelve patients completed the 2 parts of the study. The 2 treatment groups were comparable for age and gender distribution. The mean age was 42 years (SD +/-5.5) in the oxerutins group and 41.5 (SD +/-6) in the D+H group. There were no differences in the severity of CVI between the treatment groups at inclusion. A significant decrease (46.8%, p <0.05) in Ve-QOL score; that is, improvement, was observed in the oxerutins group. The change in Ve-QOL was significantly less in the D+H group (15.5%). In conclusion, CVI, venous microangiopathy, and edema were significantly improved by the treatment with oxerutins; the improvement in QOL was significantly greater in the oxerutins group. The comparison with D+H indicates that oxerutins is comparatively more effective on Ve-QOL and on signs/symptoms of CVI.

Published
2006
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49. Venous ulcers: microcirculatory improvement and faster healing with local use of Pycnogenol.

Author

Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Rohdewald P, Ippolito E, Ricci A, Cacchio M, Ruffini I, Fano F, and Hosoi M

Subjects
Administration, Cutaneous, Administration, Oral, Female, Humans, Male, Microcirculation physiopathology, Middle Aged, Plant Extracts, Time Factors, Wound Healing physiology, Flavonoids administration & dosage, Platelet Aggregation Inhibitors administration & dosage, Varicose Ulcer drug therapy, Varicose Ulcer physiopathology
Abstract

Chronic venous insufficiency (CVI) causes a well-defined microangiopathy described as venous hypertensive microangiopathy (VHM) leading to venous ulcerations. VHM is mainly observed in the distal part of the leg, in the perimalleolar region. In VHM edema is the consequence of increased capillary pressure and reduced local clearance, and this affects local perfusion. The healing of venous ulcers is usually very slow. Many treatments are available, but there is still no standard. Oral Pycnogenol is effective in venous disease and particularly in controlling edema. The aim of this study was the evaluation of the local effects of Pycnogenol on ulcers healing associated with venous hypertension. The study lasted 6 weeks including 18 patients (16 completed the study) with venous ulcerations. The oral treatment with Pycnogenol was compared with a combination treatment including oral and local treatment. In subjects treated with the combination treatment (oral and local), venous ulcers healed better (there was a faster reduction in ulcerated area) in comparison with oral treatment only. According to this pilot study Pycnogenol appears to have an important role in local treatment of venous ulcers improving healing and signs/symptoms.

Published
2005
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50. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol.

Author

Belcaro G, Cesarone MR, Rohdewald P, Ricci A, Ippolito E, Dugall M, Griffin M, Ruffini I, Acerbi G, Vinciguerra MG, Bavera P, Di Renzo A, Errichi BM, and Cerritelli F

Subjects
Aviation, Exercise, Femoral Vein diagnostic imaging, Humans, Incidence, Plant Extracts, Popliteal Vein diagnostic imaging, Premedication, Thrombophlebitis drug therapy, Thrombophlebitis etiology, Tibia blood supply, Tibia diagnostic imaging, Treatment Outcome, Ultrasonography, Venous Thrombosis drug therapy, Venous Thrombosis etiology, Flavonoids administration & dosage, Platelet Aggregation Inhibitors administration & dosage, Thrombophlebitis prevention & control, Travel, Venous Thrombosis prevention & control
Abstract

The aim of this study was to evaluate the occurrence of deep venous thrombosis (DVT) and superficial vein thrombosis (SVT) and its prophylaxis with an oral anti-edema and antithrombotic agent (Pycnogenol, Horphag, Research Management SA, Geneva, Switzerland) in long-haul flights, in subjects at moderate to high-risk of DVT and SVT. The study pre-included 244 pre-selected subjects; 211 were included (33 were excluded for several reasons due to logistic problems) and 198 completed the study; 13 subjects were lost for follow-up at the end of the flight, all for non-medical problems (i.e., for difficult connections). All subjects were scanned within 90 minutes before the flight and within 2 hours after disembarking. Subjects were supplemented with 100 mg Pycnogenol per capsule. Treatment subjects received two capsules between 2 and 3 hours before flights with 250 mL of water; two capsules were taken 6 hours later with 250 mL of water and one capsule the next day. The control group received comparable placebo at the same intervals. The flight duration was on average 8 hours and 15 minutes (SD 55 min) (range, 7.45-12.33). In the control group there were five thrombotic events (one DVT and four superficial thromboses) while only nonthrombotic, localized phlebitis was observed in the Pycnogenol group (5.15% vs. no events; p<0.025). The ITT (intention to treat) analysis detects 13 failures in the control group (eight lost to follow up + five thrombotic events) of 105 subjects (12.4%) vs. five failures (4.7%; all lost, no thrombotic events) in the treatment group (p<0.025). No unwanted effects were observed. In conclusion, this study indicates that Pycnogenol treatment was effective in decreasing the number of thrombotic events (DVT and SVT) in moderate-to-high risk subjects, during long-haul flights.

Published
2004
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